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Santoro A, Armocida D, Paglia F, Iacobucci M, Berra LV, D'Angelo L, Cirelli C, Guidetti G, Biraschi F, Cantore G. Treatment of giant intracranial aneurysms: long-term outcomes in surgical versus endovascular management. Neurosurg Rev 2022; 45:3759-3770. [PMID: 36269463 PMCID: PMC9663390 DOI: 10.1007/s10143-022-01884-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/22/2022] [Accepted: 10/11/2022] [Indexed: 10/24/2022]
Abstract
Aneurysms with a major diameter > 25 mm are defined as giant intracranial aneurysms (GIAs). Different clinical, pathological, and radiological factors were revealed as playing a role in choosing the best strategy between surgical and endovascular approaches. Despite the improvement of both techniques, the efficacy and safety of these different management are still debated. We evaluated the differences in clinical and radiological outcomes of GIAs treated with surgical and endovascular techniques in a large retrospective mono-centric study. We compared aneurysm location, clinical, morphological features, treatment outcome, and complications on the ground of treatment technique. The final cohort consisted of 162 patients. All the patients were assigned on the ground of the type of eligible treatment: surgical (118 patients) and endovascular procedure (44 patients). The different treatment strategies were made through a multidisciplinary selection whereas clinical parameters, location, and morphologic features of the aneurysm were considered. The surgical group manifested a greater reduction in performance levels and neurological status in the post-operative phases than the endovascular group (p < 0.01) with a higher incidence of complications (p = 0.012) in contrast to a lower recurrence rate (p > 0.01). There is no significant difference in post-operative mortality and survival between surgical and endovascular groups. The surgical group manifested a higher incidence of complications after treatment. The endovascular group has a better post-operative outcome, but a higher risk of recurrence and the necessity of further treatment.
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Affiliation(s)
- Antonio Santoro
- Rome Human Neurosciences Departmen, AUO "Policlinico Umberto I", Neurosurgery Division, Sapienza University, Via del Policlinico, 155, 00161, Rome, Italy
| | - Daniele Armocida
- Rome Human Neurosciences Departmen, AUO "Policlinico Umberto I", Neurosurgery Division, Sapienza University, Via del Policlinico, 155, 00161, Rome, Italy.
| | - Francesco Paglia
- Rome Human Neurosciences Departmen, AUO "Policlinico Umberto I", Neurosurgery Division, Sapienza University, Via del Policlinico, 155, 00161, Rome, Italy
| | - Marta Iacobucci
- Department of Radiological, Oncological and Anatomopathological Sciences, Unit of Interventional Neuroradiology, Sapienza" University of Rome, Umberto I University Hospital, Rome, Italy
| | - Luigi Valentino Berra
- Rome Human Neurosciences Departmen, AUO "Policlinico Umberto I", Neurosurgery Division, Sapienza University, Via del Policlinico, 155, 00161, Rome, Italy
| | - Luca D'Angelo
- Rome Human Neurosciences Departmen, AUO "Policlinico Umberto I", Neurosurgery Division, Sapienza University, Via del Policlinico, 155, 00161, Rome, Italy
| | - Carlo Cirelli
- Department of Radiological, Oncological and Anatomopathological Sciences, Unit of Interventional Neuroradiology, Sapienza" University of Rome, Umberto I University Hospital, Rome, Italy
| | - Giulio Guidetti
- Department of Radiological, Oncological and Anatomopathological Sciences, Unit of Interventional Neuroradiology, Sapienza" University of Rome, Umberto I University Hospital, Rome, Italy
| | - Francesco Biraschi
- Department of Radiological, Oncological and Anatomopathological Sciences, Unit of Interventional Neuroradiology, Sapienza" University of Rome, Umberto I University Hospital, Rome, Italy
| | - Giampaolo Cantore
- Rome Human Neurosciences Departmen, AUO "Policlinico Umberto I", Neurosurgery Division, Sapienza University, Via del Policlinico, 155, 00161, Rome, Italy
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Paglia F, Caporlingua A, Armocida D, Rizzo F, Santoro A, D'angelo L. Preoperative 3D volume reconstruction of the posterior wall of the sphenoid sinus with Horos: A free, simple and reliable tool in endoscopic endonasal trans-sphenoidal surgery. Neurocirugia (Astur : Engl Ed) 2022; 33:219-226. [PMID: 36084958 DOI: 10.1016/j.neucie.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/18/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND The purpose of the study was to create computer-aided design models of the sphenoid sinus with a free-source software in order to perform a preoperative planning during trans-sphenoidal endoscopic surgery (TES) and clarify the three-dimensional anatomical features of the sphenoid sinus and its surrounding structures. METHODS For each patient a 3D volume rendering of the sphenoid sinus was obtained from a thin slice head and maxilla-facial CT scan using a free-source DICOM viewer. The 3D models obtained preoperatively were examined preoperatively by six neurosurgeons in order to identify the boundaries of the sella. RESULTS For the main anatomical landmark, all of the observers were able to recognize the anatomical structure at a rate ranging from 80 to 98%, 28 to 60% and 25 to 58% for expert (n=3), inexpert (n=3) and the entire group of observers (n=6), respectively. The analysis of the data shows that both observation groups presented a lower recognition rate of the following parameters: right and left medial and lateral optocarotid recesses and tumor prominence, however, the sellar prominence, clival recess, planum sphenoidalis, right and left ICA prominence, right and left optic prominences represent the main anatomical landmarks to be recognized during TES immediately before the opening of the sellar floor. CONCLUSIONS The use of a preoperative 3D imaging is not in itself a novelty in the literature, however the fact that a simple tool obtained with a free-source software like Horos can represent a considerable help in surgical practice without resorting to the use of more complex software and expensive represents the real utility of this work.
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Affiliation(s)
- Francesco Paglia
- Human Neurosciences Department, Neurosurgery Division, "Sapienza" University, Italy
| | | | - Daniele Armocida
- Human Neurosciences Department, Neurosurgery Division, "Sapienza" University, Italy.
| | - Francesca Rizzo
- Human Neurosciences Department, Neurosurgery Division, "Sapienza" University, Italy
| | - Antonio Santoro
- Human Neurosciences Department, Neurosurgery Division, "Sapienza" University, Italy
| | - Luca D'angelo
- Human Neurosciences Department, Neurosurgery Division, "Sapienza" University, Italy
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Mercuri V, Armocida D, Paglia F, Patrizia G, Santoro A, D'Angelo L. Giant Prolactinoma Embedded by Pseudoaneurysm of the Cavernous Carotid Artery Treated with a Tailored Therapeutic Scheme. J Neurosci Rural Pract 2022; 13:358-369. [PMID: 35945997 PMCID: PMC9357472 DOI: 10.1055/s-0042-1749662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
AbstractThe coexistence of intracranial aneurysm (IA) is generally thought to be highest in patients with pituitary adenomas (PAs). Different mechanisms may play a role in aneurysm formation, but whether the PA contributes to aneurysm formation is still unclear. In the literature, there are numerous reported cases of this association; however, the analyses of the characteristics of PAs, aneurysms, and treatment management are rare and limited to a restricted number of case reports. We report a rare case of an embedded aneurysm in a macroprolactinoma treated with therapeutic management tailored to the clinical, neurological, and radiological characteristics of the patient. To select the best treatment, we reviewed the literature and reported the only cases in which the radiological characteristics of aneurysms, PAs, therapeutic management, and patient outcome are described. We aimed to understand what are the variables that determine the best therapeutic management with the best possible outcome. The presence of a large pseudoaneurysm of the internal carotid artery completely embedded in a giant macroprolactinoma is rare and needs a tailored treatment strategy. The importance of the preoperative knowledge of asymptomatic IA coexisting with PA can avoid accidental rupture of the aneurysm during surgical resection and may lead to planning the best treatment. A high degree of suspicion for an associated aneurysm is needed, and if magnetic resonance imaging shows some atypical features, digital subtraction angiography must be performed prior to contemplating any intervention to avoid iatrogenic aneurysmal rupture. Our multimodal approach with the first-line therapy of low-dose cabergoline to obtain prolactin normalization with minimum risks of aneurysms rupture and subsequent endovascular treatment with flow diverter has not been described elsewhere to our knowledge. In the cases, we suggest adopting a tailored low-dose cabergoline therapy scheme to avoid rupture during cytoreduction and initiate a close neuroradiological follow-up program.
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Affiliation(s)
- Valeria Mercuri
- Endocrinology Unit, Department of Experimental Medicine, 'Sapienza' University of Rome, Rome, Italy
| | - Daniele Armocida
- Department of Human Neurosciences, Neurosurgery, 'Sapienza' University of Rome, Rome, Italy
| | - Francesco Paglia
- Department of Human Neurosciences, Neurosurgery, 'Sapienza' University of Rome, Rome, Italy
| | - Gargiulo Patrizia
- Endocrinology Unit, Department of Experimental Medicine, 'Sapienza' University of Rome, Rome, Italy
| | - Antonio Santoro
- Department of Human Neurosciences, Neurosurgery, 'Sapienza' University of Rome, Rome, Italy
| | - Luca D'Angelo
- Department of Human Neurosciences, Neurosurgery, 'Sapienza' University of Rome, Rome, Italy
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Paglia F, Giammattei L, di Russo P, Froelich S. Combined petrosal approach for resection of a large left petroclival meningioma. Neurosurgical Focus: Video 2022; 6:V6. [PMID: 36284995 PMCID: PMC9558915 DOI: 10.3171/2022.1.focvid21226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/21/2022] [Indexed: 11/06/2022]
Abstract
Petroclival meningiomas represent the most complex lesions in skull base surgery, being closely related to critical neurovascular structures. The combined petrosal approach allows a wide exposure of the petroclival region and provides multiple angles of attack, limiting brain retraction.
The authors present the case of a 54-year-old man with a large left petroclival meningioma responsible for headaches, dysphagia, and trigeminal neuralgia. The lesion was resected using a combined petrosal approach. A progressive improvement of the preoperative symptoms was observed. Postoperative MRI showed a near-total resection of the tumor, along with reexpansion of the brainstem.
The video can be found here: https://stream.cadmore.media/r10.3171/2022.1.FOCVID21226
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Affiliation(s)
- Francesco Paglia
- Department of Neurosurgery, Lariboisiere Hospital, Paris Diderot University, Paris, France
| | - Lorenzo Giammattei
- Department of Neurosurgery, Lariboisiere Hospital, Paris Diderot University, Paris, France
| | - Paolo di Russo
- Department of Neurosurgery, Lariboisiere Hospital, Paris Diderot University, Paris, France
| | - Sebastien Froelich
- Department of Neurosurgery, Lariboisiere Hospital, Paris Diderot University, Paris, France
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Pesce A, Armocida D, Paglia F, Palmieri M, Frati A, D'Andrea G, Salvati M, Santoro A. IDH Wild-type Glioblastoma Presenting with Seizure: Clinical Specificity, and Oncologic and Surgical Outcomes. J Neurol Surg A Cent Eur Neurosurg 2021; 83:351-360. [PMID: 34794192 DOI: 10.1055/s-0041-1735515] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Glioblastoma (GBM) is the most common and aggressive primary brain neoplasia in adults. Seizure is a common manifestation in GBM. Up to 25 to 60% of patients with GBM have seizures. We aim to summarize all the relevant clinical, surgical, radiologic, and molecular features of a cohort of patients suffering from GBM-related epilepsy and measure the outcome, to understand the possible existence of a clinical/phenotypical specificity of this subgroup of patients. METHODS We retrospectively analyzed a cohort of 177 patients affected by isocitrate dehydrogenase wild-type (IDH-WT) GBM; 49 patients presented seizure at onset (SaO) and 128 were seizure free (SF). We investigated the relationship between seizures and other prognostic factors of GBMs. RESULTS A statistically significant association between the location of the lesions in the parietal lobe and seizures was observed. The left side was more commonly affected. Interestingly, there was a statistical relationship between tumors involving the subventricular zone (SVZ) and SaO patients. The tumors were also smaller on average at diagnosis, and generalized SaOs were associated with longer overall survival. CONCLUSIONS The typical patient with IDH-WT GBM with SaO is a young (<55 year) male without a history of headache. The lesion is typically small to medium in size and located in the temporoparietal dominant lobe, with a high tendency to involve the SVZ.
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Affiliation(s)
| | - Daniele Armocida
- Division of Neurosurgery, Department of Human Neurosciences, "Sapienza" University, Rome, Italy
| | - Francesco Paglia
- Division of Neurosurgery, Department of Human Neurosciences, "Sapienza" University, Rome, Italy
| | - Mauro Palmieri
- Division of Neurosurgery, Department of Human Neurosciences, "Sapienza" University, Rome, Italy
| | - Alessandro Frati
- Division of Neurosurgery, Department of Human Neurosciences, "Sapienza" University, Rome, Italy.,IRCCS "Neuromed" Pozzilli (IS), Italy
| | | | - Maurizio Salvati
- IRCCS "Neuromed" Pozzilli (IS), Italy.,Department of Mental and Neurological, Dental and Sensory Organs Health, Tor Vergata University, Rome Italy
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Paglia F, di Norcia V, D'Angelo L, Berra LV, Santoro A. A rare case of Meckel's cave primary lymphoma: a case report and elaboration of the diagnostic algorithm. Acta Neurol Belg 2021; 121:907-914. [PMID: 31983037 DOI: 10.1007/s13760-020-01281-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/11/2020] [Indexed: 11/26/2022]
Abstract
Management of lesions involving Meckel's cave can represent a challenge for neurosurgeons, because of the deep-seated location and the surrounding complex neurovascular structures. Very small lesions arising from MC are generally asymptomatic and radiological follow-up with head MRI and PET-CT is sufficient to control these lesions. In rare cases, the rapid increase in the size of lesions and the alteration of the neurologic status make early histological characterization mandatory in the plethora of lesions arising from Meckel's cave; a very small percentage is represented by central nervous system lymphomas. Primary diffuse large B-cell lymphoma is the most commonly found. Aggressive surgery, in case of suspicious Meckel's cave lesions, is strongly discouraged, because this procedure may increase the risk of postoperative deficit and provides no survival benefit compared with biopsy alone. The aim of the present paper is to report a very rare case of primary Meckel's cave diffuse large B-cell lymphoma (only seven cases were described in literature) and standardize an operative algorithm to avoid the risks of an incorrect surgical conduct.
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Affiliation(s)
- Francesco Paglia
- Department of Neurology and Psychiatry, Neurosurgery, 'Sapienza' University of Rome, Rome, Italy.
| | - Valerio di Norcia
- Department of Neurology and Psychiatry, Neurosurgery, 'Sapienza' University of Rome, Rome, Italy
| | - Luca D'Angelo
- Department of Neurology and Psychiatry, Neurosurgery, 'Sapienza' University of Rome, Rome, Italy
| | - Luigi Valentino Berra
- Department of Neurology and Psychiatry, Neurosurgery, 'Sapienza' University of Rome, Rome, Italy
| | - Antonio Santoro
- Department of Neurology and Psychiatry, Neurosurgery, 'Sapienza' University of Rome, Rome, Italy
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Paglia F, C.F A, L D, Paglia F, F M, L S, A S. Management of Spontaneous Cerebrospinal Fluid Leaks in the Middle Cranial Fossa and Bone Tegmen Tympani Defect in Patients with Meningitis and Rhinorrhea. Surg Case Rep 2020. [DOI: 10.31487/j.scr.2020.02.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The pathogenetic process of spontaneous CerebroSpinal Fluid (CSF) leaks in the middle cranial fossa has not been clearly identified yet. It is related to a tegmen defect associated to the presence of a simultaneous encephalocele or meningoencephalocele. The main complication of a CSF leak is meningitis, whose occurrence rate ranges from 4% to 50% according to different causes and conditions of the leak [1]. Surgical approaches to temporal bone reconstruction include middle cranial fossa (MCF) craniotomy, transmastoid (TM), or a combined (MCF/TM) approach. In our experience, we describe 2 cases of patients who presented with CSF rhinorrhea and meningoencephaloceles correlated with conductive hearing loss and meningitis. The MCF approach is a considerable way to successful repair CSF leaks and encephaloceles due to tegmen tympani and dural defects.
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Bufalieri F, Caimano M, Lospinoso Severini L, Basili I, Paglia F, Sampirisi L, Loricchio E, Petroni M, Canettieri G, Santoro A, D’Angelo L, Infante P, Di Marcotullio L. The RNA-Binding Ubiquitin Ligase MEX3A Affects Glioblastoma Tumorigenesis by Inducing Ubiquitylation and Degradation of RIG-I. Cancers (Basel) 2020; 12:cancers12020321. [PMID: 32019099 PMCID: PMC7072305 DOI: 10.3390/cancers12020321] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/24/2020] [Accepted: 01/28/2020] [Indexed: 12/14/2022] Open
Abstract
Glioblastoma multiforme (GB) is the most malignant primary brain tumor in humans, with an overall survival of approximatively 15 months. The molecular heterogeneity of GB, as well as its rapid progression, invasiveness and the occurrence of drug-resistant cancer stem cells, limits the efficacy of the current treatments. In order to develop an innovative therapeutic strategy, it is mandatory to identify and characterize new molecular players responsible for the GB malignant phenotype. In this study, the RNA-binding ubiquitin ligase MEX3A was selected from a gene expression analysis performed on publicly available datasets, to assess its biological and still-unknown activity in GB tumorigenesis. We find that MEX3A is strongly up-regulated in GB specimens, and this correlates with very low protein levels of RIG-I, a tumor suppressor involved in differentiation, apoptosis and innate immune response. We demonstrate that MEX3A binds RIG-I and induces its ubiquitylation and proteasome-dependent degradation. Further, the genetic depletion of MEX3A leads to an increase of RIG-I protein levels and results in the suppression of GB cell growth. Our findings unveil a novel molecular mechanism involved in GB tumorigenesis and suggest MEX3A and RIG-I as promising therapeutic targets in GB.
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Affiliation(s)
- Francesca Bufalieri
- Department of Molecular Medicine, Sapienza University, Viale Regina Elena 291, 00161 Rome, Italy; (F.B.); (M.C.); (L.L.S.); (I.B.); (M.P.); (G.C.)
| | - Miriam Caimano
- Department of Molecular Medicine, Sapienza University, Viale Regina Elena 291, 00161 Rome, Italy; (F.B.); (M.C.); (L.L.S.); (I.B.); (M.P.); (G.C.)
| | - Ludovica Lospinoso Severini
- Department of Molecular Medicine, Sapienza University, Viale Regina Elena 291, 00161 Rome, Italy; (F.B.); (M.C.); (L.L.S.); (I.B.); (M.P.); (G.C.)
| | - Irene Basili
- Department of Molecular Medicine, Sapienza University, Viale Regina Elena 291, 00161 Rome, Italy; (F.B.); (M.C.); (L.L.S.); (I.B.); (M.P.); (G.C.)
| | - Francesco Paglia
- Dipartimento di Neurologia e Psichiatria, Neurochirurgia, Sapienza University, Viale dell’Università 30, 00185 Rome, Italy; (F.P.); (L.S.); (A.S.); (L.D.)
| | - Luigi Sampirisi
- Dipartimento di Neurologia e Psichiatria, Neurochirurgia, Sapienza University, Viale dell’Università 30, 00185 Rome, Italy; (F.P.); (L.S.); (A.S.); (L.D.)
| | - Elena Loricchio
- Center for Life Nano Science (CLNS@Sapienza), Istituto Italiano di Tecnologia, Viale Regina Elena 291, 00161 Rome, Italy
| | - Marialaura Petroni
- Department of Molecular Medicine, Sapienza University, Viale Regina Elena 291, 00161 Rome, Italy; (F.B.); (M.C.); (L.L.S.); (I.B.); (M.P.); (G.C.)
| | - Gianluca Canettieri
- Department of Molecular Medicine, Sapienza University, Viale Regina Elena 291, 00161 Rome, Italy; (F.B.); (M.C.); (L.L.S.); (I.B.); (M.P.); (G.C.)
- Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti-Department of Molecular Medicine, Sapienza University, Viale Regina Elena 291, 00161 Rome, Italy
| | - Antonio Santoro
- Dipartimento di Neurologia e Psichiatria, Neurochirurgia, Sapienza University, Viale dell’Università 30, 00185 Rome, Italy; (F.P.); (L.S.); (A.S.); (L.D.)
| | - Luca D’Angelo
- Dipartimento di Neurologia e Psichiatria, Neurochirurgia, Sapienza University, Viale dell’Università 30, 00185 Rome, Italy; (F.P.); (L.S.); (A.S.); (L.D.)
| | - Paola Infante
- Center for Life Nano Science (CLNS@Sapienza), Istituto Italiano di Tecnologia, Viale Regina Elena 291, 00161 Rome, Italy
- Correspondence: (P.I.); (L.D.M.); Tel.: +39-06-49255132 (P.I.); +39-06-49255657 (L.D.M.); Fax: +39-06-49255660 (L.D.M.)
| | - Lucia Di Marcotullio
- Department of Molecular Medicine, Sapienza University, Viale Regina Elena 291, 00161 Rome, Italy; (F.B.); (M.C.); (L.L.S.); (I.B.); (M.P.); (G.C.)
- Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti-Department of Molecular Medicine, Sapienza University, Viale Regina Elena 291, 00161 Rome, Italy
- Correspondence: (P.I.); (L.D.M.); Tel.: +39-06-49255132 (P.I.); +39-06-49255657 (L.D.M.); Fax: +39-06-49255660 (L.D.M.)
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D'Angelo L, Paglia F, Caporlingua A, Sampirisi L, Guidetti G, Santoro A. Atypical Manifestation of Direct Low-Flow Carotid-Cavernous Fistula: Case Report and Review of the Literature. World Neurosurg 2019; 125:456-460. [DOI: 10.1016/j.wneu.2019.02.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 02/02/2019] [Indexed: 10/27/2022]
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Armocida D, Pesce A, Frati A, Miscusi M, Paglia F, Raco A. Pneumoventricle of Unknown Origin: A Personal Experience and Literature Review of a Clinical Enigma. World Neurosurg 2019; 122:661-664. [DOI: 10.1016/j.wneu.2018.11.050] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/04/2018] [Accepted: 11/07/2018] [Indexed: 12/15/2022]
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Tonna M, Ottoni R, Paglia F, De Panfilis C, marchesi C. “Pseudoneurotic Schizophrenia” Revisited: The role of obsessive-compulsive symptoms in low-level disorganization psychosishosiser. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
ObjectiveRecent research has suggested a dual impact of obsessive-compulsive dimension on functioning in schizophrenia with a gradual transition from an improving to a worsening effect depending on obsessive-compulsive symptom (OCS) severity (from mild to moderate-severe). Aim of the present study was to investigate whether this varying effect of OCS on functioning might be mediated or moderated by schizophrenia symptom dimensions or occur independently.MethodSeventy-five patients affected by schizophrenia were administered the SCID-IV, the PANSS, the YBOCS and the SOFAS.The sample was divided into two groups according to the severity of OCS (absent/mild and moderate/high).ResultsIn both groups, a significant interaction between OCS and disorganization dimension was found: the dual effect of OCS on functioning occurred only among patients with low disorganization symptoms while it was no more apparent at higher levels of disorganization (Figure 1).ConclusionData suggest that in patients with schizophrenia, functioning at least in part depends on the interaction between disorganization and OCS. Particularly, mild OCS contributes to higher levels of functioning in patients with psychosis at low levels of disorganization. In keeping with the historical concept of “pseudoneurotic schizophrenia”, we speculate that obsessive dimension might have a pathoplastic influence in milder forms of schizophrenia spectrum disorders, balancing the effect of underlying low disorganization symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Paglia F, Vak D, van Embden J, Chesman ASR, Martucci A, Jasieniak JJ, Della Gaspera E. Photonic Sintering of Copper through the Controlled Reduction of Printed CuO Nanocrystals. ACS Appl Mater Interfaces 2015; 7:25473-8. [PMID: 26503740 DOI: 10.1021/acsami.5b08430] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The ability to control chemical reactions using ultrafast light exposure has the potential to dramatically advance materials and their processing toward device integration. In this study, we show how intense pulsed light (IPL) can be used to trigger and modulate the chemical transformations of printed copper oxide features into metallic copper. By varying the energy of the IPL, CuO films deposited from nanocrystal inks can be reduced to metallic Cu via a Cu2O intermediate using single light flashes of 2 ms duration. Moreover, the morphological transformation from isolated Cu nanoparticles to fully sintered Cu films can also be controlled by selecting the appropriate light intensity. The control over such transformations enables for the fabrication of sintered Cu electrodes that show excellent electrical and mechanical properties, good environmental stability, and applications in a variety of flexible devices.
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Affiliation(s)
- Francesco Paglia
- CSIRO Manufacturing , Bayview Avenue, Clayton, Victoria 3168, Australia
- Dipartimento di Ingegneria Industriale Via Marzolo 9, Universita' di Padova , 35131 Padova, Italy
| | - Doojin Vak
- CSIRO Manufacturing , Bayview Avenue, Clayton, Victoria 3168, Australia
| | - Joel van Embden
- School of Applied Science, RMIT University , Melbourne, Victoria 3000, Australia
| | | | - Alessandro Martucci
- Dipartimento di Ingegneria Industriale Via Marzolo 9, Universita' di Padova , 35131 Padova, Italy
| | - Jacek J Jasieniak
- Department of Materials Science and Engineering, Monash University , Clayton, Victoria 3800, Australia
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Carnevale V, Scillitani A, Vecci E, D'Erasmo E, Romagnoli E, Paglia F, Pepe J, Baldini V, Santori C, De Geronimo S, Minisola S. Dehydroepiandrosterone sulfate and bone resorption rates as reflected by serum levels of C-terminal telopeptide of type I collagen: a study in healthy men. J Endocrinol Invest 2005; 28:102-5. [PMID: 15887853 DOI: 10.1007/bf03345350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Sex steroid hormones contribute to the physiological regulation of bone turnover in males. To address this issue, we investigated serum estradiol (E2), total testosterone (T), and DHEAS concentrations, along with serum levels of carboxy-terminal telopeptide of type I collagen (sCTx), in a sample of 76 healthy men aged 23 to 87. The concentration of sCTx declined with age. Both T and DHEAS, at variance with E2, showed a significant age-related decline. T, DHEAS and sCTx significantly (p<0.01) correlated with each other. DHEAS and T were significantly associated after correcting for age (r=0.35, p=0.002) or body mass index (r=0.65, p<0.0001). DHEAS, but not T, significantly correlated with sCTx after correcting for age (r=0.26, p=0.026, and r=0.20, p=0.08, respectively). Stepwise multiple regression analysis showed that only DHEAS (but not T or E2) was a significant independent predictor of sCTx (p=0.0001). Our results show that adrenal androgens play a crucial role in regulating bone resorption in aging men.
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Affiliation(s)
- V Carnevale
- Department of Internal Medicine, Casa Sollievo della Sofferenza Hospital IRCCS, San Giovanni Rotondo (FG), Italy.
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Romagnoli E, Paglia F, Dionisi S, De Geronimo S, Pepe J, Di Virgilio R, Minisola S. [Male osteoporosis: current treatments and future options]. Clin Ter 2003; 154:49-53. [PMID: 12854284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
PURPOSE To provide indications for currently approved treatments and future options for male osteoporosis, based on the pathogenetic mechanisms of bone loss in the male sex. DESIGN Review of the most significant data reported in the literature. RESULTS Unhealthy lifestyle habits should be modified. Testosterone replacement is indicated only in patients with diagnosis of hypogonadism. Based on the demonstrated pathogenetic role of estrogen lack in bone loss in men, either low doses of this hormone or selective androgen receptor modulators have been proposed for the treatment of male osteoporosis. Bisphosphonates are the only medications approved by Food and Drug Administration for idiopathic and glucocorticoid-induced osteoporosis in men. As far as anabolic treatments are concerned, there is not agreement on clinical utility of sodium fluoride. Short-term treatment with parathyroid hormone (PTH) seems to be safe and effective in patients with idiopathic osteoporosis, due to its anabolic action. Therapeutic use of growth hormone (GH) and insulin-like growth factor type I (IGF-I), both considered as potential anabolic agents, is still limited because of the high incidence of side effects and relatively transient efficacy, particularly of IGF-I. CONCLUSIONS Treatments should be selected on the basis of anti-fracture efficacy of various medications, which has been demonstrated so far only for alendronate and risedronate. Although anabolic agents produce noticeable increase of bone mineral density, is still debated if they also reduce fracture incidence in males with osteoporosis.
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Affiliation(s)
- E Romagnoli
- Ospedale San Giovanni Battista, Università La Sapienza, Roma, Italia
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15
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Minisola S, Rosso R, Romagnoli E, Pepe J, De Geronimo S, Dionisi S, Paglia F, Raejntroph N, Aliberti G, Mazzuoli GF. Uneven deficits in vertebral bone density in postmenopausal patients with primary hyperparathyroidism as evaluated by posterior-anterior and lateral dual-energy absorptiometry. Osteoporos Int 2002; 13:618-23. [PMID: 12181619 DOI: 10.1007/s001980200083] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This investigation was undertaken to determine whether the preservation of bone mass in patients with mild primary hyperparathyroidism (PHPT) could be detected when measuring spine density in the lateral projection. We compared the bone mineral density (BMD) of L2-L4 utilizing the posterior-anterior (PA) and lateral projections in postmenopausal patients with PHPT and in a group of 27 postmenopausal normal women. Thirty-three consecutive postmenopausal patients with PHPT were studied; 25 were asymptomatic whereas the remaining 8 suffered complications related to the disease. Based upon the criteria established by the Consensus Conference on the Management of Asymptomatic PHPT, only 10 of the 25 asymptomatic patients could be considered affected by mild disease; the remaining patients were classified as having moderate disease. Patients with mild disease had mean lateral total BMD values (0.682 +/- 0.113 g/cm(2)) significantly higher than normal women (0.588 +/- 0.076, p<0.02) and patients with moderate disease (0.599 +/- 0.077, p<0.05). There were significant differences among the three groups in both PA L2-L4 and L1-L4 levels: patients with mild disease had significantly higher mean BMD values than patients with moderate disease and normal women, when either three or four vertebrae were considered. Interestingly, at this latter site, patients with moderate disease had significantly ( p<0.05) lower values than normal women. Our results indicate that patients with mild PHPT have a preservation of vertebral mass when compared with the other hyperparathyroid patients and normal women, when taking into account both the mainly trabecular portion and the whole vertebra. The finding that when the PA projection was assessed, BMD values of patients with moderate disease were significantly lower than those of normal women, might be attributed to the detrimental effect of raised parathyroid hormone levels on the cortical component of the vertebral body.
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Affiliation(s)
- S Minisola
- Dipartimento di Scienze Cliniche, Università La Sapienza, Rome.
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Minisola S, Dionisi S, Pacitti MT, Paglia F, Carnevale V, Scillitani A, Mazzaferro S, De GS, Pepe J, Derasmo E, Romagnoli E. Gender differences in serum markers of bone resorption in healthy subjects and patients with disorders affecting bone. Osteoporos Int 2002; 13:171-5. [PMID: 11905526 DOI: 10.1007/s001980200009] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
To assess how two different serum markers of bone resorption may reflect changes in bone turnover, we compared age- and sex-related changes in serum C-terminal telopeptide of type I collagen (betaCTx) and tartrate-resistant acid phosphatase activity (TRAP) in 136 healthy men and 184 normal women. Serum levels of the two markers were also assessed in several groups of patients of both sexes presenting with the most common metabolic and endocrine bone diseases: established osteoporosis (n = 77), primary hyperparathyroidism (n = 44), glucocorticoid excess (n = 17), chronic renal failure (n = 39), active Paget's disease of bone (n = 5), humoral hypercalcemia of malignancy (n = 3), osteomalacia (n = 3), hyperthyroidism (n = 10), post-surgical hypoparathyroidism (n = 10), acromegaly (active disease, n = 8) and Cushing's syndrome (n = 10). In men the regression of betaCTx with age showed an initial decrease in bone resorption followed by an increase thereafter, starting from the sixth decade of life. No age-related change in serum TRAP activity was observed. In women, by contrast, a slight but significant linear correlation of both serum betaCTx and TRAP with age (r = 0.223, p<0.003 and r = 0.333, p<0.0001, respectively) was found, the two markers being positively correlated (r = 0.238, p<0.002). In each class of patients the mean Z-scores of betaCTx were significantly higher than those of TRAP activity. Moreover, compared with normal subjects, serum betaCTx seems to be characterized by a superior sensitivity relative to TRAP measurement, at least in the disorders studied.
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Affiliation(s)
- S Minisola
- Department of Clinical Sciences, University of Rome La Sapienza, Italy.
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Carnevale V, Pacitti MT, Pileri M, Paglia F, Scillitani A, Dionisi S, Caravella P, Romagnoli E, Minisola S. Short-term effects of surgery in post-menopausal patients with primary hyperparathyroidism and normal bone turnover. J Endocrinol Invest 2001; 24:575-9. [PMID: 11686539 DOI: 10.1007/bf03343897] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The most common clinical presentation of primary hyperparathyroidism (PHPT) is nowadays characterized by a slight skeletal involvement. We studied 5 consecutive female patients with PHPT presenting with bone turnover marker levels within the reference range of our Center and whose bone mineral density values were above the usual fracture risk threshold. In each patient we measured, both in basal conditions and daily, for the first 5 days after surgery, the following indexes: serum total (T-ALP) and bone-specific (B-ALP) alkaline phosphatase activity, osteocalcin (BGP, by two different assays), together with the 24-hour urinary excretions of total pyridinoline (Pyr/Cr) and deoxypyridinoline (DPyr/Cr), free deoxypyridinoline (FD-Pyr/Cr), cross-linked N-telopeptide of type I collagen (NTx/Cr), and type I C-telopeptide (CTx/Cr). The markers of both bone formation and resorption significantly decreased after surgery (p<0.001 by multiple ANOVA). Individual post-surgical markers changes were all significant but T-ALP and FD-Pyr, the most pronounced percent reductions being shown by NTx and CTx. The time-course of such variations substantially differed among the various indexes. These results show that bone formation and resorption markers are up-regulated also in PHPT patients with mild skeletal involvement; acute removal of parathyroid hormone excess differently affected the markers of bone turnover in terms of both entity and time-course.
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Affiliation(s)
- V Carnevale
- Department of Internal Medicine, Ospedale Casa Sollievo della Sofferenza, IRCCS, San Giovanni Rotondo, FG, Italy
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Paglia F, Dionisi S, De Geronimo S, Rosso R, Romagnoli E, Raejntroph N, Ragno A, Celi M, Pepe J, D'Erasmo E, Minisola S, Raejentroph N. Biomarkers of bone turnover after a short period of steroid therapy in elderly men. Clin Chem 2001; 47:1314-6. [PMID: 11427468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- F Paglia
- Dipartimento di Scienze Cliniche, Università di Roma La Sapienza, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy
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Romagnoli E, Minisola G, Pacitti MT, Rosso R, Paglia F, Dionisi S, Aliberti G, Minisola S. Exogenous glucocorticoids affect in different way the various phases of bone formation in postmenopausal patients. MINERVA ENDOCRINOL 2000; 25:69-73. [PMID: 11338398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND To determine the effect of glucocorticoid excess on the most important circulating markers of bone formation in postmenopausal treated patients. METHODS The study included 15 postmenopausal women taking glucocorticoids for various medical conditions and two groups of 30 healthy premenopausal and 28 age-matched postmenopausal women as controls. Osteoblastic activity was assessed by measuring both serum levels of osteocalcin (BGP) (N-tact Osteo SP, Incstar Co.) and the bone-specific isoenzyme of alkaline phosphatase (BAP) (Alkphase-B, Metra Biosystems). RESULTS The mean values of serum BGP found in patients taking steroids were significantly reduced as compared to those found in both fertile and postmenopausal women (p < 0.0001). The mean serum levels of BAP were significantly increased in treated patients as compared to premenopausal women (p < 0.0001), while no significant difference was found between patients and age-matched postmenopausal women. Similar results were also obtained when individual values of both serum BAP and BGP were expressed as standard units in comparison to values obtained in fertile subjects (T-score) or postmenopausal subjects (Z-score). CONCLUSIONS Steroid therapy in postmenopausal patients differentially affects the various phases of bone formation. Measurement of serum BGP may represent a reliable parameter for monitoring bone formation in postmenopausal treated patients.
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Affiliation(s)
- E Romagnoli
- Presidio Ospedaliero Villa Betania, Ospedale San Giovanni Battista (ACISMOM), Italy
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Paglia F, Hivet M, Poilleux J. [Atheromatous occlusion of the celiac trunk]. Ateneo Parmense 1 1971; 41:41-7. [PMID: 5154089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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