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Johnson R, Shaffer A, Tang A, Tsai K, Guglielmi G, Arnold PM. Posterior-only 2-level vertebrectomy and fusion in a medically complex patient with lumbar metastasis: illustrative case. J Neurosurg Case Lessons 2024; 7:CASE23646. [PMID: 38560936 PMCID: PMC10988232 DOI: 10.3171/case23646] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/28/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Spinal metastases are commonly seen in patients with cancer and often indicate a poor prognosis. Treatment can include curative or palliative surgery, chemotherapy, and radiation therapy. The surgical approach varies widely on the basis of the affected region of the spine, the location of the tumor (anterior versus posterior), the goal of surgery, the health of the patient, and surgeon preference. OBSERVATIONS The authors present a case of a 68-year-old male with intractable lower-back pain and substantially diminished ambulation. Diagnostic imaging revealed a lumbar metastasis from a cholangiocarcinoma primary at L2-3 (4.5 cm anteroposterior × 5.7 cm transverse × 7.0 cm craniocaudal). The patient underwent a 2-level vertebrectomy with expandable cage placement and T10 to S2 fusion via a posterior-only approach. The patient regained much of his mobility and quality of life after the surgery. LESSONS Although this was a high-risk surgery, the authors show that a posterior-only approach can be used for lumbar vertebrectomies and fusion when necessary. Palliative surgeries carrying a high risk, especially in the setting of a limited prognosis, should include multidisciplinary deliberations and a thorough discussion of the risks and outcome expectations with the patient.
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Affiliation(s)
- Ryan Johnson
- 1Department of Neurosurgery, Carle Foundation Hospital, Urbana, Illinois; and
| | - Annabelle Shaffer
- 2Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois
| | - Ashley Tang
- 2Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois
| | - Kathryn Tsai
- 2Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois
| | - Gina Guglielmi
- 1Department of Neurosurgery, Carle Foundation Hospital, Urbana, Illinois; and
| | - Paul M Arnold
- 1Department of Neurosurgery, Carle Foundation Hospital, Urbana, Illinois; and
- 2Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois
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2
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Finneran MM, Johnson R, Guglielmi G, Nardone E. Minimally Invasive Bilateral Decompressive Lumbar Laminectomy with Unilateral Approach Among Obese versus Nonobese Patients. World Neurosurg 2023; 179:e81-e89. [PMID: 37572832 DOI: 10.1016/j.wneu.2023.08.015] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVE Decompressive lumbar laminectomy (DLL) is a common procedure for lumbar stenosis. A unilateral approach, unlike the traditional open approach, spares the posterior elements to mitigate the risk of iatrogenic instability associated with a DLL. Various minimally invasive techniques have been described but little attention has been aimed toward this specific microsurgical approach, particularly regarding obese patients. We aimed to compare operative details, perioperative outcomes, and complication profiles between obese and nonobese patients. METHODS One hundred and ninety-four patients who underwent bilateral laminectomy with a unilateral approach by the study surgeon from July 2013 to June 2018 were included. Of these patients, 105 were classified as obese, with body mass index (BMI) ≥30.0 kg/m2, and 89 were nonobese, with BMI <30.0 kg/m2. The obese and nonobese groups were compared; operative time, blood loss, and complications were assessed. RESULTS Operative time was nonsignificantly increased in the obese group (177 vs. 166 minutes; P = 0.21) and estimated blood loss was nonsignificantly lower (91 mL vs. 97 mL; P = 1.00) in the obese group. Durotomy rates (3 [2.9%] obese vs. 2 [2.2%] nonobese; P = 0.789) and postoperative wound drainage rates (4 [3.8%] obese vs. 2 [3.8%] nonobese; P = 0.92) did not significantly differ between the 2 groups. Length of stay was significantly longer in the obese group (1.5 vs. 1.0 days; P = 0.0005). CONCLUSIONS Compared with the nonobese group, the obese group had significantly longer length of hospitalization, as well as nonsignificantly increased length of operation and decreased blood loss. The 2 groups had similar perioperative complication rates.
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Affiliation(s)
- Megan M Finneran
- Department of Neurosurgery, Carle BroMenn Medical Center, Normal, Illinois, USA.
| | - Ryan Johnson
- Department of Neurosurgery, Carle BroMenn Medical Center, Normal, Illinois, USA
| | - Gina Guglielmi
- Department of Neurosurgery, Carle BroMenn Medical Center, Normal, Illinois, USA
| | - Emilio Nardone
- Department of Neurosurgery, Carle BroMenn Medical Center, Normal, Illinois, USA
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3
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Zhou Y, Guglielmi G, Garg S, Hankinson TC. Delayed Diagnosis of Cervical Epidural Hematoma in a 3-Year-Old Boy: A Case Report. JBJS Case Connect 2023; 13:01709767-202309000-00070. [PMID: 37651573 DOI: 10.2106/jbjs.cc.23.00170] [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] [Indexed: 09/02/2023]
Abstract
CASE A 3-year-old boy presented to the emergency department with torticollis after a fall. With normal cervical radiographs and neurologic exam, he was diagnosed with cervical strain and discharged. After 2-week progressive symptoms, he was referred to a pediatric spine surgeon. Magnetic resonance imaging (MRI) revealed a cervical epidural hematoma, which was then surgically evacuated. He recovered fully and remains symptom-free 2 years later. CONCLUSION Pediatric spinal epidural hematoma is a rare condition with potentially serious outcomes yet often nonspecific symptoms. Timely management based on a comprehensive evaluation of symptoms and imaging findings is crucial in improving patient outcomes.
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Affiliation(s)
- Yan Zhou
- University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado
| | - Gina Guglielmi
- Graduate Medical Education, Neurological Surgery Residency, Carle BroMenn Medical Center, Normal, Illinois
| | - Sumeet Garg
- Department of Orthopedics, Children's Hospital Colorado, Aurora, Colorado
- Department of Orthopedics, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado
| | - Todd C Hankinson
- Department of Neurosurgery, Children's Hospital Colorado, Aurora, Colorado
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado
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4
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Shaffer A, Johnson R, Guglielmi G, Naik A, Najafali D, Khan AA, Bellafiore FJ, Arnold PM, Hassaneen W. Disseminated blastomycosis with an intracranial fungoma in an immunocompetent patient: illustrative case. J Neurosurg Case Lessons 2023; 5:CASE22406. [PMID: 36647253 PMCID: PMC9844530 DOI: 10.3171/case22406] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/02/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Blastomyces dermatitidis is a fungus endemic to central and southern North America. While infection most commonly results in pneumonia, a small number of infections progress to systemic disease, which may include intracranial lesions. Progression to systemic disease is most common in immunocompromised patients, such as those with human immunodeficiency virus. OBSERVATIONS The authors present a 44-year-old immunocompetent male who presented following a tonic-clonic seizure. Initial workup revealed a 19-mm enhancing intracranial mass. There was avid uptake of fluorescein sodium, and an en bloc resection of the mass was performed. Histopathology revealed B. dermatitidis. Medical management included amphotericin B and azole therapy. Postoperative recovery was uneventful, and no focal neurological deficits were appreciated. LESSONS This case highlights the neurosurgical management of a rare intracranial fungal manifestation in an immunocompetent patient. A literature review was also performed to better understand the role of neurosurgery in fungal infections. There were limited cases of intracranial Blastomyces reported in immunocompetent patients, and neurosurgical management varied (no intervention, biopsy, resection) and was underreported. Too few cases are reported to suggest neurosurgical intervention for blastomycosis improves outcomes. Medical management was relatively standard with azole and amphotericin therapy.
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Affiliation(s)
- Annabelle Shaffer
- Carle Illinois College of Medicine, University of Illinois Urbana Champaign, Urbana, Illinois; and
| | | | | | - Anant Naik
- Carle Illinois College of Medicine, University of Illinois Urbana Champaign, Urbana, Illinois; and
| | - Daniel Najafali
- Carle Illinois College of Medicine, University of Illinois Urbana Champaign, Urbana, Illinois; and
| | - Amir A. Khan
- Carle Illinois College of Medicine, University of Illinois Urbana Champaign, Urbana, Illinois; and ,Infectious Diseases, and
| | | | - Paul M. Arnold
- Carle Illinois College of Medicine, University of Illinois Urbana Champaign, Urbana, Illinois; and ,Departments of Neurosurgery,
| | - Wael Hassaneen
- Carle Illinois College of Medicine, University of Illinois Urbana Champaign, Urbana, Illinois; and ,Departments of Neurosurgery,
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Carpagnano FA, Eusebi L, Giannubilo W, Fenu F, Safi M, Bartelli F, Guglielmi G. Prostate Multiparametric MRI: Evaluation of Recurrence and Post-treatment Changes. Curr Radiol Rep 2022. [DOI: 10.1007/s40134-022-00404-x] [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: 11/25/2022]
Abstract
Abstract
Purpose of Review
This article reviews all the most common therapeutic strategies of prostate cancer, systemic or local, and all the following morpho-structural alterations, with the aim of helping the radiologist to recognize the signs of recurrence by using mp-MRI.
Recent Findings
According to the most recent evidences, prostate mp-MRI has now become a strong, non-invasive, and valid tool to evaluate all patient treated for prostatic carcinoma across the time, especially in the suspicion of biochemical recurrence.
Summary
The minimal signs of focal recurrence can put a strain on radiologists, especially if they are novice with multi-parametric prostate MRI. Familiarizing themselves with the outcomes of treatment, local or systemic, and its characteristics to MR imaging is indispensable to avoid diagnostic pitfalls and, subsequently, unnecessary reinterventions.
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Putty M, Guglielmi G, Farhat H. An Alternative Operative Approach to Lumbar Spondylolisthesis. Cureus 2022; 14:e25276. [PMID: 35755524 PMCID: PMC9224977 DOI: 10.7759/cureus.25276] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 11/05/2022] Open
Abstract
Lumbosacral spondylolisthesis is a frequently encountered pathology with high-grade spondylolisthesis being the least common. A circumferential construct is usually the preferred treatment as these can resist the shearing forces present at L5-S1. However, the severity of the slip, sacral inclination, and the slip angle may make a traditional anterior approach difficult to achieve. In this case series, we present three patients with axial back pain that were treated with an anterior L5-S1 transvertebral cage. This technique is intended for both grade II spondylolisthesis and high sacral slope. The L5-S1 transvertebral cage may be sufficient to prevent further listhesis, fuse the patient, and alleviate axial back pain.
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De Marzo V, Barbara C, Maragliano P, Lotti R, Guglielmi G, Porcile A, Russo C, Griffo R, Makikallio T, Hautala A, Porto I, Clavario P. P366 EFFECTS OF EXERCISE REHABILITATION IN PATIENTS WITH LONG COVID–19. Eur Heart J Suppl 2022. [PMCID: PMC9384063 DOI: 10.1093/eurheartj/suac012.352] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Moving from the first COVID–19 pandemic to the chronic phase of COVID–19, more than 50 long–term detrimental effects have been recognized in the so–called long COVID–19 syndrome. The exact mechanisms underlying the exercise capacity reduction and functional limitations are unknown, however, rehabilitation could play a pivotal role. The aim of this study was to evaluate whether a combination of aerobic and resistance training performed in the same session for 8 weeks could be well–tolerated and effective in long COVID–19 patients with reduced exercise capacity [(<85% of predicted peak aerobic capacity (VO2peak)] at 3–month from hospital discharge after COVID–19. The exercise training program included 3 exercise sessions per week. Each session included: a) aerobic exercise (starting at 30 min and increasing to 60 min) with 5 min warm–up and 5–min cool down; b) nine major muscle group resistance exercises (for the lower extremity: leg extension/flexion, abduction/adduction, and leg press; for the upper extremity: push–up/pull–down; for the core muscles: abdomen, back). The intensity of aerobic exercise was defined according to VO2peaktest results targeting the 80% level of lactate threshold in Watts. Resistance training load was determined for each muscle groups according to the results of the maximal dynamic strength testing (1RM; one repetition maximum) and was confirmed and updated after 4 weeks by defining new 1RM values. Resistance training prescription loading was defined as 40% of 1RM, 2 sets (3 sets for last two weeks) and 12 repetitions for each muscle group. The duration of a single training session was approximately 90 min. Out of 220 patients screened, 50 patients (aged 55.8±9.7 years, 15 women, body mass index 26.6±5.2 kg/m2) were enrolled. Mean exercise training sessions was 66.1±34.0; none of the patients dropped out from the study. VO2peak increased 15% and peak ventilation 9% (p < 0.001 for both). After the training program, mean percentage of VO2peak significantly increased (+14.2%, p < 0.001). Muscle strength increased markedly for all major muscle groups ranging from 16% to 33% increase (p < 0.010). An exercise rehabilitation with combined aerobic and resistance exercises for 8 weeks increases markedly both cardiorespiratory and musculoskeletal fitness in long COVID–19 patients. These results may highlight the importance of regular exercise rehabilitation aiming to promote daily activities, independent living, and better quality of life.
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Affiliation(s)
- V De Marzo
- UNIVERSITÀ DEGLI STUDI DI GENOVA – IRCCS OSPEDALE POLICLINICO SAN MARTINO, GENOVA; AZIENDA SANITARIA LOCALE, ASL 3 GENOVESE, GENOVA; FACULTY OF SPORTS AND HEALTH SCIENCES, UNIVERSITY OF JYVÄSKYLÄ, FINLAND, OULU
| | - C Barbara
- UNIVERSITÀ DEGLI STUDI DI GENOVA – IRCCS OSPEDALE POLICLINICO SAN MARTINO, GENOVA; AZIENDA SANITARIA LOCALE, ASL 3 GENOVESE, GENOVA; FACULTY OF SPORTS AND HEALTH SCIENCES, UNIVERSITY OF JYVÄSKYLÄ, FINLAND, OULU
| | - P Maragliano
- UNIVERSITÀ DEGLI STUDI DI GENOVA – IRCCS OSPEDALE POLICLINICO SAN MARTINO, GENOVA; AZIENDA SANITARIA LOCALE, ASL 3 GENOVESE, GENOVA; FACULTY OF SPORTS AND HEALTH SCIENCES, UNIVERSITY OF JYVÄSKYLÄ, FINLAND, OULU
| | - R Lotti
- UNIVERSITÀ DEGLI STUDI DI GENOVA – IRCCS OSPEDALE POLICLINICO SAN MARTINO, GENOVA; AZIENDA SANITARIA LOCALE, ASL 3 GENOVESE, GENOVA; FACULTY OF SPORTS AND HEALTH SCIENCES, UNIVERSITY OF JYVÄSKYLÄ, FINLAND, OULU
| | - G Guglielmi
- UNIVERSITÀ DEGLI STUDI DI GENOVA – IRCCS OSPEDALE POLICLINICO SAN MARTINO, GENOVA; AZIENDA SANITARIA LOCALE, ASL 3 GENOVESE, GENOVA; FACULTY OF SPORTS AND HEALTH SCIENCES, UNIVERSITY OF JYVÄSKYLÄ, FINLAND, OULU
| | - A Porcile
- UNIVERSITÀ DEGLI STUDI DI GENOVA – IRCCS OSPEDALE POLICLINICO SAN MARTINO, GENOVA; AZIENDA SANITARIA LOCALE, ASL 3 GENOVESE, GENOVA; FACULTY OF SPORTS AND HEALTH SCIENCES, UNIVERSITY OF JYVÄSKYLÄ, FINLAND, OULU
| | - C Russo
- UNIVERSITÀ DEGLI STUDI DI GENOVA – IRCCS OSPEDALE POLICLINICO SAN MARTINO, GENOVA; AZIENDA SANITARIA LOCALE, ASL 3 GENOVESE, GENOVA; FACULTY OF SPORTS AND HEALTH SCIENCES, UNIVERSITY OF JYVÄSKYLÄ, FINLAND, OULU
| | - R Griffo
- UNIVERSITÀ DEGLI STUDI DI GENOVA – IRCCS OSPEDALE POLICLINICO SAN MARTINO, GENOVA; AZIENDA SANITARIA LOCALE, ASL 3 GENOVESE, GENOVA; FACULTY OF SPORTS AND HEALTH SCIENCES, UNIVERSITY OF JYVÄSKYLÄ, FINLAND, OULU
| | - T Makikallio
- UNIVERSITÀ DEGLI STUDI DI GENOVA – IRCCS OSPEDALE POLICLINICO SAN MARTINO, GENOVA; AZIENDA SANITARIA LOCALE, ASL 3 GENOVESE, GENOVA; FACULTY OF SPORTS AND HEALTH SCIENCES, UNIVERSITY OF JYVÄSKYLÄ, FINLAND, OULU
| | - A Hautala
- UNIVERSITÀ DEGLI STUDI DI GENOVA – IRCCS OSPEDALE POLICLINICO SAN MARTINO, GENOVA; AZIENDA SANITARIA LOCALE, ASL 3 GENOVESE, GENOVA; FACULTY OF SPORTS AND HEALTH SCIENCES, UNIVERSITY OF JYVÄSKYLÄ, FINLAND, OULU
| | - I Porto
- UNIVERSITÀ DEGLI STUDI DI GENOVA – IRCCS OSPEDALE POLICLINICO SAN MARTINO, GENOVA; AZIENDA SANITARIA LOCALE, ASL 3 GENOVESE, GENOVA; FACULTY OF SPORTS AND HEALTH SCIENCES, UNIVERSITY OF JYVÄSKYLÄ, FINLAND, OULU
| | - P Clavario
- UNIVERSITÀ DEGLI STUDI DI GENOVA – IRCCS OSPEDALE POLICLINICO SAN MARTINO, GENOVA; AZIENDA SANITARIA LOCALE, ASL 3 GENOVESE, GENOVA; FACULTY OF SPORTS AND HEALTH SCIENCES, UNIVERSITY OF JYVÄSKYLÄ, FINLAND, OULU
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Buselli R, Corsi M, Veltri A, Baldanzi S, Chiumiento M, Del Lupo E, Marino R, Necciari G, Caldi F, Perretta S, Foddis R, Guglielmi G, Cristaudo A. Quarantine and Mental Health Challenges for Occupational Medicine: The Case Report of a Nurse Infected With SARS-CoV-2. Workplace Health Saf 2022; 70:43-49. [PMID: 35037513 DOI: 10.1177/21650799211045715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This case study draws attention to the psychosocial difficulties that emerged in the context of the coronavirus disease 2019 (COVID-19) outbreak in relation to the remote management of subjects with psychiatric vulnerabilities following exposure to prolonged quarantine. The case involves a 56-year-old hospital nurse, followed by the Occupational Health Department of a major university hospital in central Italy for mood instability in the context of a cyclothymic temperament. She was quarantined for occupationally acquired COVID-19 and remained positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via swab test for more than 2 months between March and May 2020. In this case study, we discuss the challenges presented by the risk of a prolonged quarantine in a psychologically vulnerable employee, the need for occupational medicine to provide adequate health surveillance of all health care workers during the COVID-19 pandemic, the effectiveness of telepsychiatry, and the difficulties in formulating a proper treatment strategy.
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Affiliation(s)
- R Buselli
- Azienda Ospedaliero-Universitaria Pisana
| | - M Corsi
- Azienda Ospedaliero-Universitaria Pisana
| | - A Veltri
- Azienda Ospedaliero-Universitaria Pisana
| | - S Baldanzi
- Azienda Ospedaliero-Universitaria Pisana
| | | | - E Del Lupo
- Azienda Ospedaliero-Universitaria Pisana
| | - R Marino
- Azienda Ospedaliero-Universitaria Pisana
| | - G Necciari
- Azienda Ospedaliero-Universitaria Pisana
| | - F Caldi
- Azienda Ospedaliero-Universitaria Pisana
| | - S Perretta
- Azienda Ospedaliero-Universitaria Pisana
| | - R Foddis
- Azienda Ospedaliero-Universitaria Pisana
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9
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Raimondo A, Guglielmi G, Marino C, Ligrone L, Lembo S. An acute spondyloarthritis during successful treatment with dupilumab for severe atopic dermatitis. Clin Exp Dermatol 2021; 47:592-593. [PMID: 34655234 DOI: 10.1111/ced.14984] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 10/13/2021] [Indexed: 11/29/2022]
Abstract
we report the case of a 44-year-old male affected by life-long, severe and recalcitrant form of atopic dermatitis (AD), with various atopic comorbidities. Multiple systemic therapies had been performed before our first observation, all interrupted for ineffectiveness. On May 2018, the patient recorded an Eczema Area and Severity Index (EASI) of 52, Peak Pruritus Numerical Rating Scale (NRS) of 8, and Dermatology Life Quality Index (DLQI) of 20. Blood exams showed a significant increased of total immunoglobulin E (IgE) plasma levels (5321 kUa/L; 0,00-100,00 kUa/L reference range).
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Affiliation(s)
- A Raimondo
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana", University of Salerno, Italy
| | - G Guglielmi
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana", University of Salerno, Italy
| | - C Marino
- S. Giovanni di Dio e Ruggi D', Aragona University Hospital, P.O. "Santa Maria Incoronata Dell'Olmo", Cava dè Tirreni, Salerno, Italy
| | - L Ligrone
- S. Giovanni di Dio e Ruggi D', Aragona University Hospital, P.O. "Santa Maria Incoronata Dell'Olmo", Cava dè Tirreni, Salerno, Italy
| | - S Lembo
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana", University of Salerno, Italy
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10
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Guglielmi G, Mollo A, Bandera F, Camporeale A, Frigelli M, Alfonzetti E, Lombardi M, Pieroni M, Pieruzzi F, Guazzi M. Functional capacity and gender-related differences in Fabry disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1818] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Fabry disease (FD) is a rare x-linked lysosomal storage disease characterized by accumulation of glicosphingolipids in several organs, including the heart. Cardiac involvement manifests as left ventricular (LV) hypertrophy, often complicated by myocardial fibrosis. The impact of disease on functional capacity is not well defined, as well as the potential gender-related differences.
Aim
To evaluate the functional capacity in a cohort of FD patients with different degree of cardiac involvement.
Methods
Seventy-two patients were prospectively enrolled from March 2015 to December 2019. Patients underwent cardiac magnetic resonance (CMR) and cardiopulmonary exercise test (CPET) with cycle ergometer. In addition to standard CPET parameters, Chronotropic Index (CI) was calculated as (HR max − HR rest) / (HR max predicted − HR rest), adjusting with HR max predicted calculated as 119 + (HR rest/2) − (age/2) in case of beta-blockers treatment.
Results
CMR showed left ventricle (LV) hypertrophy (LV mass greater than normal reference value) in 36.1% of patients, LGE and reduced T1 values were detected in 30.6% and 59.7% of subjects respectively. Twenty-eight patients were males (39%), the median age was 40 (28–54) [median (25th–75th)] years and only 11 (15%) subjects were on beta-blockers. All subjects performed a maximal test [RQ max = 1.21 (1.14–1.26)] using a ramp protocol of 15 (15–20) Watt. The absolute peakVO2 was 18.2 (15.75–24.08) mL/min/kg, whilst the percentage of predicted peakVO2 was 67.7 (57.3–76.6)%. The chronotropic response of the overall population was characterized by reduced peak heart rate (HRmax) [80.3 (73.8–87.6)% of predicted], and diminished chronotropic index (CI) [0.67 (0.55–0.77) normal value: 0.80], but preserved heart rate reserve (HRR) [21 (12–28) bpm]. Ventilatory efficiency was preserved [VE/VCO2 = 25.70 (23.18–28.00)]. At gender analysis, men showed higher absolute peakVO2 [men vs females: 19.95 (17.20–28.28) vs 17.80 (15.50–21.28) mL/min/kg, p=0.02] but lower percentage of predicted [64.24 (52.58–70.61) vs 70.75 (59.05–78.02)%, p<0.001] than females. No differences between genders were observed in chronotropic response [HRmax = 138 (108–154) vs 142 (135–153) bpm, p=0.38; HRR = 22 (13–36) vs 20 (11–26), p=0.097; CI: 0.67 (0.51–0.76) vs 0.67 (0.58–0.79), p=0.33], whilst females showed a lower peak O2 pulse (VO2/HR) than males [men vs females: 12.08 (10.04–13.64) vs 7.76 (6.88–9.22), p<0.001], possibly related to gender differences in LV dimensions and stroke volume.
Conclusions
This large cohort of FD patients with different degree of cardiac involvement showed a significantly impaired functional capacity, mainly characterized by relevant chronotropic incompetence (independent from the use of beta-blockers), consistent with systemic autonomic dysfunction. The degree of chronotropic incompetence was similar between the genders, but females showed higher predicted peakVO2 despite a lower peak O2 pulse.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- G Guglielmi
- IRCCS Policlinico San Donato, Cardiology University Department, San Donato Milanese, Italy
| | - A Mollo
- IRCCS Policlinico San Donato, Cardiology University Department, San Donato Milanese, Italy
| | - F Bandera
- IRCCS Policlinico San Donato, Cardiology University Department, San Donato Milanese, Italy
| | - A Camporeale
- IRCCS Policlinico San Donato, Multimodality Cardiac Imaging Section, San Donato Milanese, Italy
| | - M Frigelli
- IRCCS Policlinico San Donato, Cardiology University Department, San Donato Milanese, Italy
| | - E Alfonzetti
- IRCCS Policlinico San Donato, Cardiology University Department, San Donato Milanese, Italy
| | - M Lombardi
- IRCCS Policlinico San Donato, Multimodality Cardiac Imaging Section, San Donato Milanese, Italy
| | - M Pieroni
- San Donato Hospital of Arezzo, Department of Cardiology, Arezzo, Italy
| | - F Pieruzzi
- San Gerardo Hospital, Nephrology and Dialysis Unit, Monza, Italy
| | - M Guazzi
- San Paolo Hospital, Cardiology University Department, Milan, Italy
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De Marzo V, Clavario P, Lotti R, Barbara C, Porcile A, Guglielmi G, Russo C, Autala AJ, Griffo R, Parati G, Corra' U, Porto I. Cardiopulmonary exercise testing in COVID-19 patients at 3 months follow-up. Eur Heart J 2021. [PMCID: PMC8767621 DOI: 10.1093/eurheartj/ehab724.2669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Long-term effects of Coronavirus Disease of 2019 (COVID-19) and their sustainability are of the utmost relevance. For the chronic phase, the main concerns are the development of pulmonary interstitial disease and/or lingering cardiovascular involvement. How to intercept, assess, and treat these patients with long-term consequences of COVID-19 remains uncertain. Purpose We aimed to determine: 1) functional capacity of COVID-19 survivors by cardiopulmonary exercise testing (CPET); 2) those characteristics associated with CPET performance; 3) safety and tolerability of CPET. Methods We prospectively enrolled consecutive patients with laboratory-confirmed COVID-19 discharged alive at a single hospital in northern Italy. At 3-month from hospital discharge, complete clinical evaluation, trans-thoracic echocardiography, cardiopulmonary exercise testing (CPET), pulmonary function test (PFT), and dominant leg extension (DLE) maximal strength evaluation were performed. Results From 225 patients discharged from March to November 2020 we excluded 12 incomplete/missing cases, and 13 unable to perform CPET leading to a final population of 200 patients. At PFT all median parameters were within normality range. Median percent-predicted peak oxygen uptake (%pVO2) was 88% (78.3–103.1). Ninety-nine (49.5%) patients had %pVO2 below, whereas 101 (50.5%) above the 85% predicted value (indicating normality). Sixteen (16.2%) patients had respiratory, 28 (28.9%) cardiac, 21 (21.2%) mixed-cardiopulmonary, and 34 (34.3%) non-cardiopulmonary limitation of exercise. One-hundred sixty (80.0%) patients complain at least one symptom, without relationship with peakVO2. Multivariate linear regression analysis showed percent-predicted forced expiratory volume in one-second (β=5.29, p=0.023), percent-predicted diffusing capacity of lungs for carbon monoxide (β=6.31, p=0.001), and DLE maximal strength (β=14.09, p=0.008) independently associated with peakVO2. At sensitivity analysis, the results of previous multivariate linear regression analysis were also similar among sub-groups of patients with no previous significant disease in anamnesis (cardiovascular disease except for arterial hypertension, respiratory disease, kidney disease, or cancer) and of those with a length of hospital stay ≤7 days. None major event was reported during/after CPET, whereas only two cases (1.0%) had a mild symptomatic hypotension post exercise. None of the involved health professionals developed COVID-19. Conclusions CPET after COVID-19 is safe and about 1/3rd of COVID-19 survivors show functional capacity limitation mainly explained by muscular impairment, calling for future research to identify patients at higher risk of long-term effects that may benefit from careful surveillance and targeted rehabilitation. Funding Acknowledgement Type of funding sources: None.
Types of mainly CPET limitation ![]() Peak VO2 per leg extension strength ![]()
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Affiliation(s)
- V De Marzo
- Ospedale Policlinico San Martino IRCCS, Cardiology Unit, Cardiothoracic and Vascular Department, Genoa, Italy
| | - P Clavario
- Asl 3, Cardiac Rehabilitation Center of Genoa, Genoa, Italy
| | - R Lotti
- Ospedale Policlinico San Martino IRCCS, Cardiology Unit, Cardiothoracic and Vascular Department, Genoa, Italy
| | - C Barbara
- Asl 3, Cardiac Rehabilitation Center of Genoa, Genoa, Italy
| | - A Porcile
- Asl 3, Cardiac Rehabilitation Center of Genoa, Genoa, Italy
| | - G Guglielmi
- Ospedale Policlinico San Martino IRCCS, Cardiology Unit, Cardiothoracic and Vascular Department, Genoa, Italy
| | - C Russo
- Asl 3, Cardiac Rehabilitation Center of Genoa, Genoa, Italy
| | - A J Autala
- University of Jyvaskyla, Faculty of Sports and Health Sciences, Jyvaskyla, Finland
| | - R Griffo
- Asl 3, Cardiac Rehabilitation Center of Genoa, Genoa, Italy
| | - G Parati
- University of Milan-Bicocca, Department of Medicine and Surgery, Milan, Italy
| | - U Corra'
- Istituti Clinici Scientifici Maugeri, Department of Cardiac Rehabilitation, Veruno, Italy
| | - I Porto
- Ospedale Policlinico San Martino IRCCS, Cardiology Unit, Cardiothoracic and Vascular Department, Genoa, Italy
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12
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Guglielmi G, Eschbach KL, Alexander AL. Smaller Knife, Fewer Seizures? Recent Advances in Minimally Invasive Techniques in Pediatric Epilepsy Surgery. Semin Pediatr Neurol 2021; 39:100913. [PMID: 34620456 DOI: 10.1016/j.spen.2021.100913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 02/02/2023]
Abstract
Children with drug-resistant epilepsy are at high risk for developmental delay, increased mortality, psychiatric comorbidities, and requiring assistance with activities of daily living. Despite the advent of new and effective pharmacologic therapies, about one in 5 children will develop drug-resistant epilepsy, and most of these children continue to have seizures despite trials of other medication. Epilepsy surgery is often a safe and effective option which may offer seizure freedom or at least a significant reduction in seizure burden in many children. However, despite published evidence of safety and efficacy, epilepsy surgery remains underutilized in the pediatric population. Patient and family fears about the risks of surgery may contribute to this gap. Less invasive surgical techniques may be more palatable to children with epilepsy and their caregivers. In this review, we present recent advances in minimally invasive techniques for the surgical treatment of epilepsy as well as intriguing possibilities for the future. We describe the indications for, benefits of, and limits to minimally-invasive techniques including Stereo-encephalography, laser interstitial thermal ablation, deep brain stimulation, focused ultrasound, stereo-encephalography-guided radiofrequency ablation, endoscopic disconnections, and responsive neurostimulation.
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Affiliation(s)
- Gina Guglielmi
- Graduate Medical Education, Neurological Surgery Residency, Carle BroMenn Medical Center, Normal IL; Section of Pediatric Neurology, Children's Hospital Colorado, Aurora CO; Department of Pediatrics, University of Colorado Anschutz School of Medicine, Aurora CO; Division of Pediatric Neurosurgery, Children's Hospital Colorado, Aurora CO; Department of Neurosurgery, University of Colorado Anschutz School of Medicine, Aurora CO
| | - Krista L Eschbach
- Graduate Medical Education, Neurological Surgery Residency, Carle BroMenn Medical Center, Normal IL; Section of Pediatric Neurology, Children's Hospital Colorado, Aurora CO; Department of Pediatrics, University of Colorado Anschutz School of Medicine, Aurora CO; Division of Pediatric Neurosurgery, Children's Hospital Colorado, Aurora CO; Department of Neurosurgery, University of Colorado Anschutz School of Medicine, Aurora CO
| | - Allyson L Alexander
- Graduate Medical Education, Neurological Surgery Residency, Carle BroMenn Medical Center, Normal IL; Section of Pediatric Neurology, Children's Hospital Colorado, Aurora CO; Department of Pediatrics, University of Colorado Anschutz School of Medicine, Aurora CO; Division of Pediatric Neurosurgery, Children's Hospital Colorado, Aurora CO; Department of Neurosurgery, University of Colorado Anschutz School of Medicine, Aurora CO.
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13
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Pugliese F, Salcuni AS, Battista C, Carnevale V, Guglielmi G, Columbu C, Velluzzi F, Giovanelli L, Eller-Vainicher C, Scillitani A, Chiodini I. Prevalence of less severe hypercortisolism in fractured patients admitted in an outpatient clinic for metabolic bone diseases. Endocrine 2021; 73:203-208. [PMID: 33484412 DOI: 10.1007/s12020-021-02616-1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the prevalence of less severe hypercortisolism (LSH) in fractured patients, and its association with hypertension, hyperglicemia, dyslipidemia, and obesity. METHOD From July 2015 to October 2018 we enrolled all fractured patients admitted in our outpatient center for metabolic bone diseases, after exclusion of patients with secondary osteoporosis apart from diabetes and taking drugs known to affect bone metabolism. In all enrolled patients we collected data regarding gonadal status, history of diabetes, high blood pressure, dyslipidemia, and measured blood pressure, lipid profile, fasting glycaemia. Bone mass was measured with DXA at lumbar spine and femoral neck and the presence of fractures was evaluated with X-ray of thoracic and lumbar spine. All patients performed twice, 1 mg overnight dexametasone suppression test (DST) and, as confirmatory, 2day low-dose DST for diagnosing hypercortisolism. RESULTS We enrolled 101 fractured patients (75 females, 26 males), aged 65 ± 10.3 years. Five out of 101 (5.0%) patients were diagnosed as LSH. Fifty-five (54.5%) out of 101 were hypertensive, 57 (56.4%) dyslipidemic, 17 (16.8%) hyperglicaemic, 28(27.7%) obese patients. LSH tended to be associated to blood hypertension [5/5 vs 50/96 (Fisher exact test, p = 0.06) hypertensive patients]. Four out five LSH patients were hypogonadic. CONCLUSIONS Our study confirms that a nonnegligible percentage of fractured subjects actually presents an unrecognized hypercortisolism. Accordingly, regardless of age, we suggest to screen for hypercortisolism all patients with established osteoporosis and in particular hypertensive subjects.
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Affiliation(s)
- F Pugliese
- Units of Endocrinology, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy
| | - A S Salcuni
- Units of Endocrinology, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy
| | - C Battista
- Units of Endocrinology, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy
| | - V Carnevale
- Unit of Internal Medicine, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy
| | - G Guglielmi
- Unit of Radiology, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy
| | - C Columbu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - F Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - L Giovanelli
- Department of Endocrine and Metabolic Diseases, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | - C Eller-Vainicher
- Unit of Endocrinology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A Scillitani
- Units of Endocrinology, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy.
| | - I Chiodini
- Department of Endocrine and Metabolic Diseases, IRCCS, Istituto Auxologico Italiano, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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14
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Testini V, Mattera M, De Michele F, Guglielmi G, La Tegola L. Body Composition by DXA as a Tool to Detect Sarcopenia in Dialyzed Patients. Semin Musculoskelet Radiol 2021. [DOI: 10.1055/s-0041-1731529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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Pengo M, Albini F, Guglielmi G, Mollica C, Soranna D, Zambra G, Zambon A, Bilo G, Parati G. Home blood pressure during COVID-19 related lockdown in patients with hypertension. Eur J Prev Cardiol 2021. [PMCID: PMC8227353 DOI: 10.1093/eurjpc/zwab061.142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Funding Acknowledgements Type of funding sources: None. Abstract COVID-19 pandemic has induced governments to promote strict containment measures which
inevitably altered patients’ lifestyle with potential effects on blood pressure (BP)
control. We aimed to evaluate the changes in home BP (HBP) during the COVID-19 related
lockdown in a cohort of hypertensive patients. Consecutive adult patients with arterial hypertension and stable medical treatment were
recruited. HBP values were recorded before and after lockdown in March 2020. An
additional set of HBP measurements, recorded one year before the pre-lockdown period,
were also considered as reference because of similar environmental temperature. A total of 126 patients were included: 47% males, mean age 66 [58-72], reference HBP
124.78 (9.90)/76.19 (8.10) mmHg. In the whole group, patients during lockdown exhibited
lower systolic and diastolic HBP values compared to the pre-lockdown period [123.23 vs
125.05 mmHg, p = 0.008 and 74.45 vs 75.28 mmHg, p = 0.023, respectively]. Patients with
uncontrolled HBP showed the most consistent drop of systolic HBP [136.06 (8.36) and
138.0 (2.08) vs 130 (9.35) p = 0.001 and p < 0.001] and diastolic [81.30 (6.75) and
84.9 (1.85) vs 78.78 (9.25), p = 0.018 and p = 0.002] from pre-lockdown to lockdown and
when considering reference values taken one year before, respectively. (Figure 1: Mean
values at baseline, pre-lockdown and during lockdown in the 3 groups for systolic (A)
and diastolic (B) blood pressure (dotted line = uncontrolled BP group, solid
line = unstable BP control, dashed line = controlled BP group). *p<.001 (one year
before lockdown vs lockdown SBP), #p = 0.001 (pre-lockdown vs lockdown SBP), $p = 0.002
(one year before lockdown vs lockdown DBP), §p = 0.018 (pre-lockdown vs lockdown DBP).
Grey box refers to the lockdown period. SBP = systolic blood pressure, DBP = diastolic
blood pressure.) In conclusion, this study reports for the first time the occurrence of no changes or
even a reduction in home BP of treated hypertensive patients during lockdown due to
COVID-19. These results may have implications for the management of patients with high
blood pressure not only during the current pandemic but also in case of future lockdown
conditions. Abstract Figure 1 ![]()
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Affiliation(s)
- M Pengo
- Ospedale St. Luca - Istituto Auxologico Italiano, Milan, Italy
| | - F Albini
- Ospedale St. Luca - Istituto Auxologico Italiano, Milan, Italy
| | - G Guglielmi
- Ospedale St. Luca - Istituto Auxologico Italiano, Milan, Italy
| | - C Mollica
- Ospedale St. Luca - Istituto Auxologico Italiano, Milan, Italy
| | - D Soranna
- Ospedale St. Luca - Istituto Auxologico Italiano, Milan, Italy
| | - G Zambra
- Ospedale St. Luca - Istituto Auxologico Italiano, Milan, Italy
| | - A Zambon
- University of Milan-Bicocca, Milan, Italy
| | - G Bilo
- University of Milan-Bicocca, Milan, Italy
| | - G Parati
- University of Milan-Bicocca, Milan, Italy
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16
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Kendler DL, Body JJ, Brandi ML, Broady R, Cannata-Andia J, Cannata-Ortiz MJ, El Maghraoui A, Guglielmi G, Hadji P, Pierroz DD, de Villiers TJ, Ebeling PR, Rizzoli R. Osteoporosis management in hematologic stem cell transplant recipients: Executive summary. J Bone Oncol 2021; 28:100361. [PMID: 33996429 PMCID: PMC8095179 DOI: 10.1016/j.jbo.2021.100361] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 01/14/2021] [Revised: 03/26/2021] [Accepted: 03/28/2021] [Indexed: 01/09/2023] Open
Abstract
Hematopoietic stem cell transplant (HSCT) patients are living longer. Bone health is an important long-term comorbidity post-HSCT. HSCT patients are at high risk of bone loss and fragility fracture. HSCT patients are at high risk of bone loss and fragility fracture. Recommendations are provided for better monitoring of bone health. Recommendations include bone assessment, dietary advice and osteoporosis medication.
Background Treatment advances have reduced the adverse events associated with hematopoietic stem cell transplant (HSCT) and led to an increased number of transplants performed. HSCT patients are living longer with concerns on long-term outcomes. Bone fragility and fracture are at the forefront for long-term morbidities post-HSCT. Results In HSCT recipients, evidence has accumulated to support recommendations for more extensive monitoring of bone fragility and more appropriate administration of osteoporosis pharmacotherapies for patients at high risk of bone loss and/or fracture. Conclusion This executive summary reports and summarizes the main recommendations published previously, including bone assessment, dietary and lifestyle recommendations and osteoporosis medication.
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Affiliation(s)
- D L Kendler
- Department of Medicine, Division of Endocrinology, University of British Columbia, Vancouver, Canada
| | - J J Body
- CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - M L Brandi
- Mineral and Bone Metabolic Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - R Broady
- Department of Medicine, Division of Hematology, University of British Columbia, Vancouver, Canada
| | - J Cannata-Andia
- Servicio de Metabolismo Óseo y Mineral, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain
| | - M J Cannata-Ortiz
- Haematology Department, Hospital de la Princesa, IIS Princesa, Madrid, Spain
| | - A El Maghraoui
- Rheumatology Department, Military Hospital Mohammed V, Mohammed V-Souissi University, Rabat, Morocco
| | - G Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy
| | - P Hadji
- Frankfurt Center of Bone Health, Frankfurt/Main, Germany
| | - D D Pierroz
- International Osteoporosis Foundation (IOF), Nyon, Switzerland
| | - T J de Villiers
- Department of Gynaecology, Faculty of Health Sciences, Stellenbosch University and Mediclinic Panorama, Cape Town, South Africa
| | - P R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia
| | - R Rizzoli
- Division of Bone Diseases, Geneva University Hospitals & Faculty of Medicine, Geneva, Switzerland
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17
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Eusebi L, Carpagnano FA, Sortino G, Bartelli F, Guglielmi G. Prostate Multiparametric MRI: Common Pitfalls in Primary Diagnosis and How to Avoid Them. Curr Radiol Rep 2021. [DOI: 10.1007/s40134-021-00378-2] [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: 11/25/2022]
Abstract
Abstract
Purpose of Review
To provide the radiologist with basic knowledge about normal and abnormal findings in the prostatic mp-MRI, taking a look at the possible diagnostic pitfalls commonly seen in daily clinical practice, allowing him to recognize and consequently avoid them.
Recent Findings
Prostate mp-MRI has now become commonly used in most diagnostic imaging centers, as a precise, accurate and above all non-invasive tool, useful in the diagnosis, staging and follow-up of prostate diseases, first of all prostatic carcinoma. For this reason, it is important to take into account the existence of numerous possible anatomic and pathologic processes which can mimick or masquerade as prostate cancer.
Summary
Through the combination of anatomical (T2WI) and functional sequences (DWI/ADC and DCE), the mp-MRI of the prostate provides all the information necessary for a correct classification of patients with prostate disease, cancer in particular. It is not uncommon, however, for the radiologist to make errors in the interpretation of imaging due to conditions, pathological or otherwise, that mimic prostate cancer and that, consequently, affect the diagnostic/therapeutic process of patients. The strategy, and what this pictorial review aims at, is to learn to recognize the potential pitfalls of the prostatic mp-MRI and avoid them.
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18
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Carpagnano FA, Eusebi L, Tupputi U, Testini V, Giannubilo W, Bartelli F, Guglielmi G. Multiparametric MRI: Local Staging of Prostate Cancer. Curr Radiol Rep 2020. [DOI: 10.1007/s40134-020-00374-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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19
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Mazziotti G, Tupputi U, Ferrante G, Guglielmi G. Abdominal Aortic Calcification as a Marker of Relationship Between Atherosclerosis and Skeletal Fragility. J Clin Densitom 2020; 23:539-542. [PMID: 32536435 DOI: 10.1016/j.jocd.2020.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/22/2020] [Accepted: 05/05/2020] [Indexed: 11/21/2022]
Abstract
There is a pathophysiological and clinical link between atherosclerosis and skeletal fragility. Abdominal aortic calcifications (AACs) can be considered as a marker of coexistent atherosclerotic disease and osteoporosis. Indeed, AACs have been associated with alterations in bone strength and severe AACs predicted vertebral fractures in post-menopausal women and older men, independent of densitometric diagnosis of osteoporosis. Although quantitative computed tomography is the gold standard for evaluation of AACs, dual-energy x-ray absorptiometry can be considered as a cost-effective tool to identify and quantify AACs in clinical practice. This article provides an update on diagnostic aspects and clinical relevance of AACs as predictor of fractures in patients at high cardiovascular risk.
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Affiliation(s)
- G Mazziotti
- Endocrinology, Diabetology and Andrology Unit, Osteoporosis and Metabolic Bone Diseases Section, Humanitas Clinical and Research Center, IRCCS, Rozzano (Milan), Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - U Tupputi
- Department of Radiology, University of Foggia, Foggia, Italy
| | - G Ferrante
- Department of Cardiovascular Medicine, Humanitas Clinical and Research Center, IRCCS, Rozzano (Milan), Italy
| | - G Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy; Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Foggia, Italy.
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20
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Yao WJ, Guo Z, Wang L, Li K, Saba L, Guglielmi G, Cheng XG, Brown JK, Blake GM, Liu B. Pancreas fat quantification with quantitative CT: an MRI correlation analysis. Clin Radiol 2020; 75:397.e1-397.e6. [PMID: 31992455 DOI: 10.1016/j.crad.2019.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 12/23/2019] [Indexed: 12/13/2022]
Abstract
AIM To assess the fat content of the pancreas using quantitative computed tomography (QCT) and to correlate the results with chemical-shift-encoded magnetic resonance imaging (CSE-MRI) measurements of proton density fat fraction (PDFF). MATERIAL AND METHODS Institutional review board approval for this research was obtained and 52 participants (25 men, 27 women; mean age 35.1 years; age range 22-50 years), who were enrolled in the Prospective Urban Rural Epidemiology (PURE) Study, underwent QCT and CSE-MRI for quantification of fat content in the pancreas. Two observers placed regions of interest (area of 100-130 mm2) in the head, body, and tail of the pancreas as closely matched as possible on the two scans. Pearson correlation and Bland-Altman analysis were performed to evaluate the correlation between the QCT and CSE-MRI measurements and the systematic difference between the two techniques. RESULTS The QCT and CSE-MRI measurements of pancreatic fat content were well correlated (r=0.805, p<0.0001), although Bland-Altman analysis showed that the QCT measurements were systematically lower by 6.3% compared to CSE-MRI PDFF. CONCLUSION In conclusion, the results of this study suggest good correlation between QCT and CSE-MRI measurements of pancreatic fat content. Further studies are required to improve the numerical agreement of QCT measurements with PDFF.
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Affiliation(s)
- W J Yao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China; Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Z Guo
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - L Wang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - K Li
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - L Saba
- Department of Radiology, Policlinico Universitario, Cagliari, Italy
| | - G Guglielmi
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Foggia, Italy
| | - X G Cheng
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - J K Brown
- Mindways Software Inc., Austin, TX, USA
| | - G M Blake
- Biomedical Engineering Department, King's College London, Strand, London, WC2R 2LS, UK
| | - B Liu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
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Abstract
The aim of this narrative review is to highlight the role of CXCL9 in Ulcerative Colitis (UC), in order to understand the mechanism underlying the inflammation in UC and to investigate also if Th1-chemokines could be useful as a marker of disease. It was shown that chemokine (C-X-C motif) receptor (CXCR)3 and its ligand chemokine, monokine induced by interferon (IFN)-γ(MIG)/ chemokine (C-X-C motif) ligand 9 (CXCL)9, are highly overexpressed both in the intestinal mucosa of mice with experimental colitis and in patients with UC (specifically, in lymphocytes, macrophages and epithelial cells). In epithelial colonic cells CXCL9 expression is increased by IFN-γ. MIG has an important role in the recruitment of mononuclear cells and granulocytes, so in maintaining the inflammation in UC. Since serum CXCL9 levels are related with UC disease activity, it could be a marker for the responsiveness of patients to treatments. It has been recently suggested that blocking CXCL9 may be a potentially effective therapy for moderately-to-severely active UC.
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Affiliation(s)
- G Elia
- Department of Clinical and Experimental Medicine, University of Pisa
| | - G Guglielmi
- Operative Unit of Preventive and Occupational Medicine, University Hospital of Pisa, Pisa, Italy
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22
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Kendler DL, Body JJ, Brandi ML, Broady R, Cannata-Andia J, Cannata-Ortiz MJ, El Maghraoui A, Guglielmi G, Hadji P, Pierroz DD, de Villiers TJ, Rizzoli R, Ebeling PR. Bone management in hematologic stem cell transplant recipients. Osteoporos Int 2018; 29:2597-2610. [PMID: 30178158 DOI: 10.1007/s00198-018-4669-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 08/13/2018] [Indexed: 12/13/2022]
Abstract
Autologous and allogeneic hematopoietic stem cell transplantation (HSCT) is the treatment of choice for patients with some malignant and non-malignant hematological diseases. Advances in transplantation techniques and supportive care measures have substantially increased the number of long-term HSCT survivors. This has led to an increasing patient population suffering from the late effects of HSCT, of which, bone loss and its consequent fragility fractures lead to substantial morbidity. Altered bone health, with consequent fragility fractures, and chronic graft-versus-host disease (GVHD) are factors affecting long-term quality of life after HSCT. Hypogonadism, HSCT preparative regimens, nutritional factors, and glucocorticoids all contribute to accelerated bone loss and increased fracture risk. Management strategies should include bone mineral density examination, evaluation of clinical risk factors, and general dietary and physical activity measures. Evidence has accumulated permitting recommendations for more attentiveness to evaluation and monitoring of bone health, with appropriate application of osteoporosis pharmacotherapies to patients at increased risk of bone loss and fracture.
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Affiliation(s)
- D L Kendler
- Department of Medicine, Division of Endocrinology, University of British Columbia, 150 - 943 W. Broadway, Vancouver, V5Z 4E1, Canada.
| | - J J Body
- CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - M L Brandi
- Mineral and Bone Metabolic Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - R Broady
- Department of Medicine, Division of Hematology, University of British Columbia, Vancouver, Canada
| | - J Cannata-Andia
- Servicio de Metabolismo Óseo y Mineral, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain
| | - M J Cannata-Ortiz
- Haematology Department, IIS Princesa, Hospital de la Princesa, Madrid, Spain
| | - A El Maghraoui
- Rheumatology Department, Military Hospital Mohammed V, Mohammed V-Souissi University, Rabat, Morocco
| | - G Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy
| | - P Hadji
- Department of Bone Oncology, Endocrinology and Reproductive Medicine, Nord West Hospital, Frankfurt, Germany
| | - D D Pierroz
- International Osteoporosis Foundation (IOF), Nyon, Switzerland
| | - T J de Villiers
- Department of Gynaecology, Faculty of Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- Mediclinic Panorama, Cape Town, South Africa
| | - R Rizzoli
- Division of Bone Diseases, Faculty of Medicine, Geneva University Hospital, Geneva, Switzerland
| | - P R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia
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Krueger EM, Trombly R, Guglielmi G, Farhat H. Delayed Rupture of a Cortical Traumatic Intracranial Aneurysm. Cureus 2018; 10:e3643. [PMID: 30723642 PMCID: PMC6351004 DOI: 10.7759/cureus.3643] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 11/26/2018] [Indexed: 12/03/2022] Open
Abstract
Traumatic intracranial aneurysms are rare lesions that occur after blunt or primarily penetrating mechanisms. These are extremely fragile vessel injuries associated with significant morbidity and mortality, especially after rupture. Disease natural history, surveillance strategies, and management are based on small case series. Here we present a case of a 29-year-old male with a large epidural hematoma after blunt trauma, who underwent emergent surgical intervention. Three months postoperatively, he presented with unusual cerebral bleeding. Clinical suspicion prompted a conventional angiogram, which diagnosed a ruptured cortical traumatic intracranial aneurysm. The patient was urgently treated by surgical clipping with a good outcome.
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Affiliation(s)
| | - Ryan Trombly
- Neurosurgery, Advocate Health Care, Downers Grove, USA
| | - Gina Guglielmi
- Neurosurgery, Advocate Bromenn Medical Center, Chicago, USA
| | - Hamad Farhat
- Neurosurgery, Advocate Christ Medical Center, Oak Lawn, USA
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Cornacchia S, Errico A, Errico R, Pierpaoli E, Guglielmi G. EP-2366: A new IMRT template for early stage Hodgkin’s Lymphoma: the 5 fields Sectorial Sliding Window IMRT. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32675-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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25
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Fallahi P, Foddis R, Elia G, Ragusa F, Patrizio A, Guglielmi G, Frenzilli G, Benvenga S, Cristaudo A, Antonelli A, Ferrari SM. Induction of Th1 chemokine secretion in dermal fibroblasts by vanadium pentoxide. Mol Med Rep 2018. [PMID: 29532885 DOI: 10.3892/mmr.2018.8712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Vanadium is a soft, silvery‑grey metal with a number of different oxidation states. The most common commercial form of vanadium is vanadium pentoxide (V2O5). All vanadium compounds are considered toxic. An increase in skin rashes has been observed in certain vanadium workers, including the development of atopic dermatitis. However, to the best of our knowledge, no prior in vivo or in vitro studies have evaluated the effect of vanadium exposure in human dermal fibroblasts. The present study evaluated the effect of V2O5 on proliferation and chemokine secretion in dermal fibroblasts. The results revealed that V2O5 had no significant effect on the viability or proliferation of fibroblasts, however it was able to induce the secretion of T‑helper (Th)1 chemokines from dermal fibroblasts, synergistically increasing the effect of important Th1 cytokines, including interferon‑γ and tumor necrosis factor‑α. Through these processes, V2O5 may lead to the induction and perpetuation of an inflammatory reaction in dermal tissue. The induction and perpetuation of inflammation in the dermis and the variety of involved candidate genes may be at the base of V2O5‑induced effects following occupational and environmental exposures. Further studies are necessary to evaluate dermal integrity and manifestations in subjects who are occupationally exposed, or living in polluted areas.
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Affiliation(s)
- P Fallahi
- Department of Clinical and Experimental Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - R Foddis
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, I‑56126 Pisa, Italy
| | - G Elia
- Department of Clinical and Experimental Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - F Ragusa
- Department of Clinical and Experimental Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - A Patrizio
- Department of Clinical and Experimental Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - G Guglielmi
- U.O. Medicina Preventiva del Lavoro, Azienda Ospedaliero‑Universitaria Pisana, I‑56124 Pisa, Italy
| | - G Frenzilli
- Department of Clinical and Experimental Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - S Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, I‑98125 Messina, Italy
| | - A Cristaudo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, I‑56126 Pisa, Italy
| | - A Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - S M Ferrari
- Department of Clinical and Experimental Medicine, University of Pisa, I‑56126 Pisa, Italy
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26
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Veronese N, Stubbs B, Koyanagi A, Hébert JR, Cooper C, Caruso MG, Guglielmi G, Reginster JY, Rizzoli R, Maggi S, Shivappa N. Pro-inflammatory dietary pattern is associated with fractures in women: an eight-year longitudinal cohort study. Osteoporos Int 2018; 29:143-151. [PMID: 29018920 PMCID: PMC5760322 DOI: 10.1007/s00198-017-4251-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 09/27/2017] [Indexed: 01/17/2023]
Abstract
In this study, during 8 years of follow-up, we reported that higher dietary inflammatory index values were associated with a higher risk of incident fractures in women, but not in men, after adjusting for potential confounders. INTRODUCTION Inflammation is a key risk factor for many adverse outcomes in older people. While diet is a potential source of inflammation, little is known about the impact of inflammatory diet on fractures. Thus, we investigated whether higher Dietary Inflammatory Index (DII)™ ® scores are associated with fractures in a cohort of North American people. METHODS This longitudinal study with a follow-up of 8 years included 3648 participants (1577 males and 2071 females; mean age = 60.6 years) with/at risk of knee osteoarthritis participating with in the Osteoarthritis Initiative. DII scores were calculated using the validated Block Brief 2000 Food Frequency Questionnaire, categorized into sex-specific quintiles. Information on fractures was obtained through self-reported history of fractures at hip, spine, and forearm. The relationship between baseline DII score and incident fracture was assessed through a Cox's regression analysis, adjusted for potential baseline confounders, and reported as hazard ratios (HRs). RESULTS During 8 years of follow-up, 560 individuals developed fractures (15.4%). Adjusting for 10 potential confounders, women in the highest DII score quintile (i.e., most pro-inflammatory diet) had a significantly higher risk for fractures (HR = 1.46; 95% CI = 1.02-2.11) compared to women in the lowest quintile. An increase in one standard deviation of DII scores significantly predicted fracture onset in women (adjusted HR = 1.14; 95% CI = 1.02-1.27). The association between DII score and fractures was not significant among men or in the sample as whole. CONCLUSION Pro-inflammatory diet is associated with a higher incidence of fractures in women but not men.
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Affiliation(s)
- N Veronese
- National Research Council,, Neuroscience Institute, Aging Branch, Via Giustiniani, 2, 35128, Padova, Italy.
- Ambulatory of Nutrition, IRCCS "S. de Bellis", National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy.
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Box SE5 8AF, London, UK
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, CM1 1SQ, UK
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - J R Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Connecting Health Innovations LLC, Columbia, SC, USA
| | - C Cooper
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
- National Institute for Health Research Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - M G Caruso
- Ambulatory of Nutrition, IRCCS "S. de Bellis", National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy
| | - G Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy
- Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia, Italy
| | - J Y Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liege, CHU Sart Tilman B23, 4000, Liège, Belgium
| | - R Rizzoli
- Division of Bone Diseases, Department of Internal Medicine Specialties, and Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - S Maggi
- National Research Council,, Neuroscience Institute, Aging Branch, Via Giustiniani, 2, 35128, Padova, Italy
| | - N Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Connecting Health Innovations LLC, Columbia, SC, USA
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27
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Du X, Jiao J, Cheng X, Wang L, Li K, Liu H, Wang C, Arena C, Zhurakivska K, Guglielmi G, Lo Muzio L. Age-related changes of bone mineral density in mandible by quantitative computed tomography. J BIOL REG HOMEOS AG 2017; 31:997-1003. [PMID: 29254305] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Quantitative Computed Tomography (QCT) was used to investigate age-related changes in trabecular bones of the mandible. The volumetric Bone Mineral Density (vBMD) of mandibles was found to be increasing with aging in the 20-29, 30-39, 40-49 age groups, while resulted decreasing in the 50~ years age group in a Chinese population. The aim of this study was to validate QCT as a reliable method to measure the vBMD of the mandible and to assess vBMD of the mandible in a Chinese population. A total of seven hundred and eighteen volunteers (299 males, 419 females), ranging from 20 to 63 years of age, previously enrolled in another study, were included for vBMD measurements by QCT. A total of 50 subjects were enrolled for the validation of QCT measurement. Basic information (age, height and weight), and vBMD of the mandible (middle, body and angle) were recorded. Comparisons among age and sex groups were analyzed using the Mann-Whitney test. Linear correlation analysis between vBMD and age was performed. The mandibular vBMD was twice measured with QCT by one operator and resulted highly repeatable (ICC 0. 97, P 0. 05). The vBMD in the middle of the mandible was the highest, followed by that in the body and at the angle of mandible. In each age group, the mean vBMD increased with aging except for the 50~ years age group (P less than 0.05) in which it decreased. The mean mandibular vBMD was higher in females than males in each age group (P less than 0.05). Correlation between vBMD and age was statistically significant (r=0.15, P less than 0.01). QCT shows high precision for the measurement of BMD in the mandible. The present study provides normative data of the mandible in an age- and sex-stratified manner, which can be helpful in clinical practice.
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Affiliation(s)
- X Du
- Department of Radiology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - J Jiao
- Department of Radiology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - X Cheng
- Department of Radiology, Beijing Jishuitan Hospital, Xicheng District, Beijing, China
| | - L Wang
- Department of Radiology, Beijing Jishuitan Hospital, Xicheng District, Beijing, China
| | - K Li
- Department of Radiology, Beijing Jishuitan Hospital, Xicheng District, Beijing, China
| | - H Liu
- Department of Radiology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - C Wang
- Department of Radiology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - C Arena
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - K Zhurakivska
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - G Guglielmi
- Department of Radiology, University of Foggia, Italy
| | - L Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Crowe L, Guglielmi G, Hachulla AL, Noble S, Soccal P, Beghetti M, Lador F, Vallée JP. P218 Assessment of mean pulmonary artery pressure with 4D flow MRI. Chest 2017. [DOI: 10.1016/j.chest.2017.04.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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29
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Hachulla AL, Lador F, Muller H, Guglielmi G, Noble S, Crowe L, Soccal P, Beghetti M, Vallée JP. P212 MRI derived global right ventricle diastolic strains correlate with mPAP in CTEPH patients. Chest 2017. [DOI: 10.1016/j.chest.2017.04.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
Morphogenesis of multicellular organisms is driven by changes in cell behavior, which happen at precise locations and defined developmental stages. Therefore, the studying of morphogenetic events would greatly benefit from tools that allow the perturbation of cell activity with spatial and temporal precision. We recently developed an optogenetic approach to modulate cell contractility with cellular precision and on fast (seconds) timescales during Drosophila embryogenesis. We present here a protocol to handle genetically engineered photosensitive Drosophila embryos and achieve light-mediated inhibition of apical constriction during tissue invagination. The possibility to modulate the levels of optogenetic activation at different laser powers makes this method suited also for studying how mechanical stresses are sensed and interpreted in vivo. Given the conserved function of cell contractility during animal development, the application of this method to other morphogenetic processes will facilitate our understanding of tissue mechanics and cell-cell interaction during morphogenesis.
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Affiliation(s)
- G Guglielmi
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - S De Renzis
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
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31
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Gonzalez-Esquer CR, Smarda J, Rippka R, Axen SD, Guglielmi G, Gugger M, Kerfeld CA. Cyanobacterial ultrastructure in light of genomic sequence data. Photosynth Res 2016; 129:147-157. [PMID: 27344651 DOI: 10.1007/s11120-016-0286-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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: 12/18/2015] [Accepted: 06/14/2016] [Indexed: 06/06/2023]
Abstract
Cyanobacteria are physiologically and morphologically diverse photosynthetic microbes that play major roles in the carbon and nitrogen cycles of the biosphere. Recently, they have gained attention as potential platforms for the production of biofuels and other renewable chemicals. Many cyanobacteria were characterized morphologically prior to the advent of genome sequencing. Here, we catalog cyanobacterial ultrastructure within the context of genomic sequence information, including high-magnification transmission electron micrographs that represent the diversity in cyanobacterial morphology. We place the image data in the context of tabulated protein domains-which are the structural, functional, and evolutionary units of proteins-from the 126 cyanobacterial genomes comprising the CyanoGEBA dataset. In particular, we identify the correspondence between ultrastructure and the occurrence of genes encoding protein domains related to the formation of cyanobacterial inclusions. This compilation of images and genome-level domain occurrence will prove useful for a variety of analyses of cyanobacterial sequence data and provides a guidebook to morphological features.
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Affiliation(s)
- C R Gonzalez-Esquer
- MSU-DOE Plant Research Laboratory, Michigan State University, East Lansing, MI, USA
| | - J Smarda
- Department of Biology, Faculty of Medicine, Masaryk University, University Campus, Building A6, Kamenice 5, 625 00, Brno, Czech Republic
| | - R Rippka
- Unité des Cyanobactéries, Institut Pasteur, Centre National de la Recherche Scientifique (CNRS) Unité de Recherche Associée (URA) 2172, 75724, Paris Cedex 15, France
| | - S D Axen
- Bioinformatics Graduate Group, University of California, San Francisco, CA, 94158, USA
| | - G Guglielmi
- Institut de Biologie de l'ENS, IBENS, Inserm, U1024, CNRS, UMR 8197, Ecole Normale Supérieure, 75005, Paris, France
| | - M Gugger
- Unité des Cyanobactéries, Institut Pasteur, Centre National de la Recherche Scientifique (CNRS) Unité de Recherche Associée (URA) 2172, 75724, Paris Cedex 15, France
| | - C A Kerfeld
- MSU-DOE Plant Research Laboratory, Michigan State University, East Lansing, MI, USA.
- Physical Biosciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
- Department of Plant and Microbial Biology, UC Berkeley, Berkeley, CA, USA.
- Berkeley Synthetic Biology Institute, UC Berkeley, Berkeley, CA, USA.
- Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing, MI, USA.
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32
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Magarelli N, Savastano MA, Palmieri D, Zappacosta R, Lattanzio G, Salini V, Orso CA, Guglielmi G, Colosimo C. Poly-L-Lactic Acid β-Tricalcium Phosphate Screws: A Preliminary In Vivo Biocompatibility Study. Int J Immunopathol Pharmacol 2016; 20:207-11. [PMID: 17346447 DOI: 10.1177/039463200702000126] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of this study is to assess the biocompatibility of two types of Poly-L-lactic acid (PLLA) screws (with either hydroxiapatite (HA) or β-tricalcium phosphate (β-TCP)) implanted in the left femur of four sheep euthanized at 42, 50, 57 and 84 days after surgery. Titanium screws were also implanted for comparison purposes. No signs of inflammation were seen in the 240 specimens. A rating of “+/-”for macrophages and “-”for neutrophils was assigned to all specimens. All specimens were assigned a rating which ranged from “+/-” to “+++” for fibroblasts and osteoblasts. The presence of macrophages, neutrophils and fibroblasts/osteoblasts was not statistically different for the four implantation periods. PLLA implants with β-TCP have a biocompatibility comparable to PLLA implants with HA.
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Murayama Y, Viñuela F, Duckwiler G, Gobin Y, Guglielmi G. Endovascular Treatment of Incidental Cerebral Aneurysms. Interv Neuroradiol 2016; 5 Suppl 1:79-81. [DOI: 10.1177/15910199990050s114] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/1999] [Accepted: 09/30/1999] [Indexed: 11/16/2022] Open
Abstract
One hundred and fifteen patients with 120 intracranial incidental aneurysms were embodied using the GDC endovascular technique at UCLA Medical Center. Angiographic results showed complete or near complete aneurysm occlusion in 109 aneurysms (91%) and an incomplete occlusion in five aneurysms (4%). An unsuccessful GDC embolization was attempted in six aneurysms (5%). One hundred and nine patients (94.8%) remained neurologically intact or unchanged from initial clinical status. Five patients (43%) deteriorated due to immediate procedural complications. All these complications occurred in the first 50 patients. No clinical complications were observed in the last 65 patients. In Groups 1 and 3, the average length of hospitalization was 3.3 days. The technical evolution of the GDC technology has proved to be safe for the treatment of incidental aneurysms (0% morbidity in the last 65 patients). The topography of the aneurysm/s and the clinical condition of the patient did not influence final anatomical or clinical outcomes. GDC technology also brings a positive economical impact by decreasing hospitalization time and eliminating postembolization ICU care.
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Affiliation(s)
- Y. Murayama
- Division of Interventional Neuroradiology, University of California; School of Medicine; Los Angeles, California
| | - F. Viñuela
- Division of Interventional Neuroradiology, University of California; School of Medicine; Los Angeles, California
| | - G.R. Duckwiler
- Division of Interventional Neuroradiology, University of California; School of Medicine; Los Angeles, California
| | - Y.P. Gobin
- Division of Interventional Neuroradiology, University of California; School of Medicine; Los Angeles, California
| | - G. Guglielmi
- Division of Interventional Neuroradiology, University of California; School of Medicine; Los Angeles, California
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Abstract
OBJECTIVE The main aim of this work was to report on trabecular bone score (TBS) by dual-energy X-ray absorptiometry (DXA) of healthy Italian subjects to be used as a reference standard for future study in clinical and research settings. The secondary aim was to investigate the link between TBS and conventional parameters of bone and body composition by DXA. METHODS 250 individuals of 5 age bands (spanning from 18 to 70 years of age, equally distributed for both age and sex) were prospectively recruited. A lumbar spine (LS) DXA scan (Lunar iDXA™; GE Healthcare, Madison, WI) was acquired for each subject and then analysed with the latest version of TBS iNsight v. 2.1 (Med-Imaps, Pessac, France) software. LS bone mineral density (LS BMD), Z-score, T-score and TBS values were collected. Pearson's test was used to investigate the correlations between TBS and LS BMD and the influence of age, body mass index (BMI) and body composition on these parameters. RESULTS A significant decrease of TBS and LS BMD was observed with ageing in both males (TBS mean values from 1.486 to 1.374; LS BMD mean values from 1.219 to 1.187) and females (TBS mean values from 1.464 to 1.306; LS BMD mean values from 1.154 to 1.116). No statistically significant difference was achieved among males and females of the same age group for both TBS and LS BMD, with the exception of the fifth age group. A significant correlation was found between LS BMD and TBS values in both sexes (r = 0.555-0.655, p < 0.0001). BMI influenced LS BMD but not TBS. TBS values were inversely correlated with some fat mass parameters, in particular with visceral adipose tissue (in males: r = -0.332, p < 0.001; in females: r = -0.348, p < 0.0001). No significant correlation was found between TBS and total lean mass, opposite to LS BMD (in males: r = 0.418; p < 0.0001; in females: r = -0.235; p < 0.001). CONCLUSION This report is an attempt to start building a database for healthy Italian people providing age- and sex-specific reference curves for TBS. This could help clinicians to improve patient management in the detection of impaired bone mineral status and to monitor bone changes. ADVANCES IN KNOWLEDGE The study reports TBS values of a selectively enrolled Italian healthy population, ranging from younger to older ages and including males as a reference standard. Moreover, links between body composition and TBS are explored.
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Affiliation(s)
- A Bazzocchi
- 1 Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy
| | - F Ponti
- 2 Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - D Diano
- 2 Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - M Amadori
- 2 Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - U Albisinni
- 1 Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy
| | - G Battista
- 2 Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - G Guglielmi
- 3 Department of Radiology, University of Foggia, Foggia, Italy.,4 Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, Foggia, Italy
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Guglielmi G. Welcome to the first issue of BJR|case reports! BJR Case Rep 2015; 1:20150193. [PMID: 30363201 PMCID: PMC6159158 DOI: 10.1259/bjrcr.20150193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 05/06/2015] [Indexed: 11/05/2022] Open
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36
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Bianchi ML, Duca P, Vai S, Guglielmi G, Viti R, Battista C, Scillitani A, Muscarella S, Luisetto G, Camozzi V, Nuti R, Caffarelli C, Gonnelli S, Albanese C, De Tullio V, Isaia G, D'Amelio P, Broggi F, Croci M. Improving adherence to and persistence with oral therapy of osteoporosis. Osteoporos Int 2015; 26:1629-38. [PMID: 25619634 DOI: 10.1007/s00198-015-3038-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [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] [Received: 08/28/2014] [Accepted: 01/12/2015] [Indexed: 11/29/2022]
Abstract
UNLABELLED Osteoporosis treatment has low adherence and persistence. This study evaluated if greater patient involvement could improve them. At 12 months, only 114 out of 344 participants were "fully adherent and persistent" (all drug doses taken throughout the study). Only frequency of drug administration had a significant influence on adherence. INTRODUCTION Osteoporosis affects millions of individuals worldwide. There are now several effective drugs, but adherence to and persistence with treatment are low. This 12-month multicenter, prospective, randomized study evaluated the efficacy of two different methods aimed at improving adherence and persistence through greater patient involvement, compared with standard clinical practice. METHODS Three hundred thirty-four post-menopausal women, receiving an oral prescription for osteoporosis for the first time, were recruited and randomized into three groups: group 1 (controls, managed according to standard clinical practice) and groups 2 and 3 (managed with greater patient and caregiver involvement and special reinforcements: group 2, instructed to use several different "reminders"; group 3, same "reminders" as group 2, plus regular phone calls from and meetings at the referring Center). All enrolled women had two visits (baseline and 12 months). RESULTS Of 334 enrolled women, 247 (74%) started the prescribed therapy. Of those who started, 219 (88.7%) persisted in therapy for at least 10 months. At final evaluation, only 114 women were considered as "fully adherent and persistent" (all doses taken throughout the 12 months). There were no significant differences regarding "full adherence" among the three randomized groups. The frequency of drug administration had a significant influence: weekly administration had a >5-fold higher adherence and monthly administration an 8-fold higher adherence (p < 0.0001) than daily administration. CONCLUSIONS The special effort of devising and providing additional reminders did not prove effective. Additional interventions during the follow-up, including costly interventions such as phone calls and educational meetings, did not provide significant advantages.
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Affiliation(s)
- M L Bianchi
- Bone Metabolism Unit, Istituto Auxologico Italiano IRCCS, Via L. Ariosto 13, 20145, Milano, Italy,
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Bazzocchi A, Diano D, Albisinni U, Marchesini G, Battista G, Guglielmi G. Liver in the analysis of body composition by dual-energy X-ray absorptiometry. Br J Radiol 2014; 87:20140232. [PMID: 24919499 DOI: 10.1259/bjr.20140232] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To investigate the predictive value for hepatic steatosis of a new software for the quantification of visceral fat by dual-energy X-ray absorptiometry (DXA) and to design new regions of interest (ROIs). METHODS Adult volunteers were prospectively screened for hepatic steatosis by ultrasonography to obtain a well-balanced population according to the presence/absence of the disease. 90 adult patients without steatosis and 90 with steatosis (mild, 53.3%; moderate, 37.7%; and severe, 10.0%) were recruited. On the same day, all subjects were submitted to blood testing and to anthropometric and whole-body DXA for body composition evaluation. A new software for android visceral fat assessment was employed, and six new "liver-suited" ROIs as well as two modified android ROIs were designed. Their association with steatosis grade was tested by correlation analysis. RESULTS Fat mass (FM) of the new ROIs showed the highest correlation coefficients with steatosis grade (ρ = 0.610-0.619; p < 0.001), which was also confirmed by multivariate analysis. On the whole population, the new ROIs maintained the highest predictive role for liver steatosis, with areas under the receiver operating characteristic curve up to 0.820 ± 0.032. Inter- and intra-operator agreement for the new ROIs was excellent (k = 0.915-1.000 and k = 0.927-1.000). CONCLUSION New ROIs could be designed, standardized and implemented in DXA whole-body scan to provide more specific and predictive values of hepatic lipid content. ADVANCES IN KNOWLEDGE This is the first study to investigate the predictive value for hepatic steatosis of visceral and regional FM assessed on the hepatic site by DXA in comparison with ultrasonography, anthropometry and surrogate markers derived by previously validated algorithms (fatty liver index).
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Affiliation(s)
- A Bazzocchi
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola Malpighi Hospital, Bologna, Italy
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Shofty B, Bokstein F, Ram Z, Ben-Sira L, Freedman S, Kesler A, Constantini S, Shofty B, Mauda-Havakuk M, Ben-Bashat D, Dvir R, Pratt LT, Weizman L, Joskowicz L, Tal M, Ravid L, Ben-Sira L, Constantini S, Dodgshun A, Maixner W, Sullivan M, Hansford J, Ma J, Wang B, Toledano H, Muhsinoglu O, Luckman J, Michowiz S, Goldenberg-Cohen N, Schroeder K, Rosenfeld A, Grant G, McLendon R, Cummings T, Becher O, Gururangan S, Aguilera D, Mazewski C, Janss A, Castellino RC, Schniederjan M, Hayes L, Brahma B, MacDonald T, Osugi Y, Kiyotani C, Sakamoto H, Yanagisawa T, Kanno M, Kamimura S, Kosaka Y, Hirado J, Takimoto T, Nakazawa A, Hara J, Hwang E, Mun A, Kilburn L, Chi S, Knipstein J, Oren M, Dvir R, Hardy K, Rood B, Packer R, Kandels D, Schmidt R, Geh M, Breitmoser-Greiner S, Gnekow AK, Bergthold G, Bandopadhayay P, Rich B, Chan J, Santagata S, Hoshida Y, Ramkissoon S, Ramkissoon L, Golub T, Tabak B, Ferrer-Luna R, Weng PY, Stiles C, Grill J, Kieran MW, Ligon KL, Beroukhim R, Fisher MJ, Levin MH, Armstrong GT, Broad JH, Zimmerman R, Bilaniuk LT, Feygin T, Liu GT, Gan HW, Phipps K, Spoudeas HA, Kohorst M, Warad D, Keating G, Childs S, Giannini C, Wetjen N, Rao; AN, Nakamura H, Makino K, Hide T, Kuroda JI, Shinojima N, Yano S, Kuratsu JI, Rush S, Madden J, Hemenway M, Foreman N, Sie M, den Dunnen WFA, Lourens HJ, Meeuwsen-de Boer TGJ, Scherpen FJG, Kampen KR, Hoving EW, de Bont ESJM, Gnekow AK, Kandels D, Walker DA, Perilongo G, Grill J, Stokland T, Sehested AM, van Schouten AYN, de Paoli A, de Salvo GL, Pache-Leschhorn S, Geh M, Schmidt R, Gnekow AK, Gass D, Rupani K, Tsankova N, Stark E, Anderson R, Feldstein N, Garvin J, Deel M, McLendon R, Becher O, Karajannis M, Wisoff J, Muh C, Schroeder K, Gururangan S, del Bufalo F, Carai A, Macchiaiolo M, Messina R, Cacchione A, Palmiero M, Cambiaso P, Mastronuzzi A, Anderson M, Leary S, Sun Y, Buhrlage S, Pilarz C, Alberta J, Stiles C, Gray N, Mason G, Packer R, Hwang E, Biassoni V, Schiavello E, Bergamaschi L, Chiaravalli S, Spreafico F, Massimino M, Krishnatry R, Kroupnik T, Zhukova N, Mistry M, Zhang C, Bartels U, Huang A, Adamski J, Dirks P, Laperriere N, Silber J, Hawkins C, Bouffet E, Tabori U, Riccardi R, Rizzo D, Chiaretti A, Piccardi M, Dickmann A, Lazzareschi I, Ruggiero A, Guglielmi G, Salerni A, Manni L, Colosimo C, Falsini B, Rosenfeld A, Etzl M, Miller J, Carpenteri D, Kaplan A, Sieow N, Hoe R, Tan AM, Chan MY, Soh SY, Orphanidou-Vlachou E, MacPherson L, English M, Auer D, Jaspan T, Arvanitis T, Grundy R, Peet A, Bandopadhayay P, Bergthold G, Sauer N, Green A, Malkin H, Dabscheck G, Marcus K, Ullrich N, Goumnerova L, Chi S, Beroukhim R, Kieran M, Manley P, Donson A, Kleinschmidt-DeMasters B, Aisner D, Bemis L, Birks D, Mulcahy-Levy J, Smith A, Handler M, Rush S, Foreman N, Davidson A, Figaji A, Pillay K, Kilborn T, Padayachy L, Hendricks M, van Eyssen A, Parkes J, Gass D, Dewire M, Chow L, Rose SR, Lawson S, Stevenson C, Jones B, Pai A, Sutton M, Pruitt D, Fouladi M, Hummel T, Cruz O, de Torres C, Sunol M, Morales A, Santiago C, Alamar M, Rebollo M, Mora J, Sauer N, Dodgshun A, Malkin H, Bergthold G, Manley P, Chi S, Ramkissoon S, MacGregor D, Beroukhim R, Kieran M, Sullivan M, Ligon K, Bandopadhayay P, Hansford J, Messina R, De Benedictis A, Carai A, Mastronuzzi A, Rebessi E, Palma P, Procaccini E, Marras CE, Aguilera D, Castellino RC, Janss A, Schniederjan M, McNall R, Kim S, MacDOnald T, Mazewski C, Zhukova N, Pole J, Mistry M, Fried I, Krishnatry R, Stucklin AG, Bartels U, Huang A, Laperriere N, Dirks P, Zelcer S, Sylva M, Johnston D, Scheinemann K, An J, Hawkins C, Nathan P, Greenberg M, Bouffet E, Malkin D, Tabori U, Kiehna E, Da Silva S, Margol A, Robison N, Finlay J, McComb JG, Krieger M, Wong K, Bluml S, Dhall G, Ayyanar K, Moriarty T, Moeller K, Farber D. LOW GRADE GLIOMAS. Neuro Oncol 2014; 16:i60-i70. [PMCID: PMC4046289 DOI: 10.1093/neuonc/nou073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
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Bazzocchi A, Garzillo G, Fuzzi F, Diano D, Albisinni U, Salizzoni E, Battista G, Guglielmi G. Localizer sequences of magnetic resonance imaging accurately identify osteoporotic vertebral fractures. Bone 2014; 61:158-63. [PMID: 24473374 DOI: 10.1016/j.bone.2014.01.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 01/02/2014] [Accepted: 01/19/2014] [Indexed: 01/23/2023]
Abstract
The aim of the present study was to evaluate the performance of sagittal MR localizer (MR-loc), in terms of diagnostic accuracy and intra- and inter-observer agreement in the detection of vertebral fractures (VFs). Three-hundred MR examinations of the thoracic and/or lumbar spine were randomly collected. A semi-quantitative approach was used and morphometric analysis was performed when a VF was suspected. MR-loc images were evaluated blindly by three radiologists in two different sessions. A full diagnostic sagittal T1-weighted fast spin echo MR sequence was used as standard of reference (RS). Degenerative arthritis was also scored on RS. Only vertebral bodies which were assessable by both MR-loc and RS were considered for the analysis. Area under the receiver operating characteristic curve (AUROC), Cohen kappa statistic, and linear-by-linear association were used for statistical analysis. Kappa values were compared by means of the z distribution. A total of 2186 vertebrae were analysed in 300 MRI exams (147 males, 153 females, 59.4±16.4y.o.). Sixty-seven out of 2136 (3.1%) VFs were identified in 23/300 (7.7%) patients submitted to MRI. In the detection of VFs, sensitivity and specificity of MR-loc were both 100% (accuracy AUROC=1.000). Inter-observer agreement was excellent (k=0.938±0.013), while intra-observer agreement was perfect (k=1.000). The diagnostic performance was independent from degenerative arthritis, vertebral level, type and grade of VFs. MR-loc is a simple but accurate tool in the detection of VFs. It should be introduced for systematic evaluation in the detection of VFs in MR examinations performed in daily clinical practice.
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Affiliation(s)
- A Bazzocchi
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Via G. Massarenti 9, 40138 Bologna, Italy; Diagnostic and Interventional Radiology, "Rizzoli" Orthopaedic Institute, Via G. C. Pupilli 1, 40136 Bologna, Italy
| | - G Garzillo
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Via G. Massarenti 9, 40138 Bologna, Italy
| | - F Fuzzi
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Via G. Massarenti 9, 40138 Bologna, Italy
| | - D Diano
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Via G. Massarenti 9, 40138 Bologna, Italy
| | - U Albisinni
- Diagnostic and Interventional Radiology, "Rizzoli" Orthopaedic Institute, Via G. C. Pupilli 1, 40136 Bologna, Italy
| | - E Salizzoni
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Via G. Massarenti 9, 40138 Bologna, Italy
| | - G Battista
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Via G. Massarenti 9, 40138 Bologna, Italy
| | - G Guglielmi
- Department of Radiology, University of Foggia, Viale Luigi Pinto 1, 71100 Foggia, Italy; Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, Viale Cappuccini 1, 71013 San Giovanni Rotondo, Foggia, Italy.
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Caivano R, Rabasco P, Lotumolo A, D' Antuono F, Zandolino A, Villonio A, Macarini L, Guglielmi G, Salvatore M, Cammarota A. Gastric cancer: The role of diffusion weighted imaging in the preoperative staging. Cancer Invest 2014; 32:184-90. [PMID: 24654696 DOI: 10.3109/07357907.2014.896014] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE Evaluate the role of diffusion-weighted-imaging (DWI) in the diagnosis and staging of gastric carcinoma. MATERIALS AND METHODS A total of 31 patients with gastric adenocarcinoma, which underwent preoperative staging with 3Tesla Magnetic Resonance Imaging (MRI), were enrolled. Two radiologists evaluated the tumor staging in DWI. Results were compared to postsurgical pathologic findings. RESULTS The T factor accuracy of conventional MRI and DWI was 73% and 80% respectively; while the N staging accuracy of conventional MRI and DWI was 80% and 93%, respectively. CONCLUSION DWI and apparent diffusion coefficient (ADC) values showed to be useful in preoperative staging of gastric cancer.
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Affiliation(s)
- R Caivano
- I.R.C.C.S. -C.R.O.B. , Rionero in Vulture (Pz) , Italy ,1
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Affiliation(s)
- G Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy
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Gonnelli S, Caffarelli C, Tanzilli L, Cadirni A, Guglielmi G, Rossi S, Nuti R. Relationship between quantitative ultrasound parameters at the calcaneus and health-related quality of life in postmenopausal Italian women: the FEDRO study. Calcif Tissue Int 2013; 93:487-94. [PMID: 23912952 DOI: 10.1007/s00223-013-9769-8] [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] [Received: 03/06/2013] [Accepted: 07/09/2013] [Indexed: 10/26/2022]
Abstract
Reduced bone mineral density has been reported to adversely affect health-related quality of life (HRQoL) in postmenopausal women without vertebral fracture. To date, no data exist in the literature about any possible influences of quantitative ultrasonographic (QUS) parameters on HRQoL. This study aimed to assess whether QUS parameters at the calcaneus may be associated with HRQoL. In 1,812 ambulatory postmenopausal women aged 60 years or over, we measured HRQoL by the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) and stiffness index using QUS at the calcaneus. By grouping the 1,812 women on the basis of stiffness index, a highly significant (p < 0.001) difference was found for both total QUALEFFO and five domains of the QUALEFFO, whereas for the Pain and Mental Function domains the significance was modest. Stiffness was inversely associated (p < 0.01) with total QUALEFFO and with all QUALEFFO domains. In stepwise multiple logistic regression analysis stiffness values were negatively associated with both QUALEFFO total score and all domains of the QUALEFFO-41. The presence of concomitant diseases was associated with a worsening of HRQoL in all domains of the QUALEFFO, whereas age was associated with the three domains of physical function but not with the Pain and Mental Function domains. Our study suggests that in postmenopausal women there is a close relationship between bone status measured by QUS at the calcaneus and quality of life assessed by the QUALEFFO. Therefore, QUS at the calcaneus may have a role in early strategies to prevent HRQoL impairment and osteoporosis exacerbation.
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Affiliation(s)
- Stefano Gonnelli
- Department of Internal Medicine, Endocrine-Metabolic Science and Biochemistry, University of Siena, Policlinico Le Scotte, Viale Bracci 2, 53100, Siena, Italy,
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Guglielmi G, Viñuela F. Est modus in rebus. AJNR Am J Neuroradiol 2013; 35:E1. [PMID: 24287096 DOI: 10.3174/ajnr.a3823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Bazzocchi A, Fuzzi F, Garzillo G, Diano D, Rimondi E, Merlino B, Moio A, Albisinni U, Battista G, Guglielmi G. Reliability and accuracy of scout CT in the detection of vertebral fractures. Br J Radiol 2013; 86:20130373. [PMID: 24100019 DOI: 10.1259/bjr.20130373] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate the reliability of scout CT (sCT) lateral radiograph, in terms of diagnostic accuracy and intra- and interobserver agreement in the detection of vertebral fractures (VFs). METHODS 300 CT examinations of the thoracic and/or lumbar spine were collected and independently analysed by 3 musculoskeletal radiologists in 2 different sessions. A semi-quantitative approach was used for VF assessment on sCT, and morphometric analysis was performed when a VF was suspected. Results of multiplanar sagittal CT reconstructions interpreted by the most expert radiologist were considered as gold standard. Arthrosis was also scored. Only vertebral bodies assessable by both sCT and gold standard were considered for the analysis. Area under the receiver operating characteristic curve (AUROC), Cohen's kappa statistic and linear-by-linear association were used for statistical analysis. RESULTS 1522 vertebrae were considered (130 males and 170 females; ages, 73.0±2.8 years). 73 of 1522 (4.8%) VFs were identified in 34/300 patients (11.3%). In the detection of VFs, the sensitivity and specificity of sCT were 98.7% and 99.7%, respectively. Accuracy (AUROC=0.992±0.008), as well as interobserver agreement (k=0.968±0.008), was excellent. Intra-observer agreement was perfect (k=1.000). Performance of this method was independent of arthrosis, vertebral level and type and grade of VFs. CONCLUSION sCT is a simple but very accurate method for the detection of VFs. It should be introduced as a spine evaluation tool for the detection of VFs in examinations that are performed for other diagnostic purposes. ADVANCES IN KNOWLEDGE sCT lateral radiograph is an accurate tool for the detection of VFs. This technique may be used with several advantages in clinical practice.
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Affiliation(s)
- A Bazzocchi
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
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Guglielmi G, Pantani E, Pistelli A, Bonotti A, Foddis R, Cristaudo A. [Report of medical surveillance of workers exposed to asbestos at the Operative Unit of Occupational Medicine in Pisa]. G Ital Med Lav Ergon 2012; 34:574-576. [PMID: 23405720] [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: 06/01/2023]
Abstract
We report our experience about the medical surveillance of 739 workers previously exposed to asbestos. They were observed during the period between January 2009 and May 2012. The diagnosis of 594 patients, that were observed for the first time, were analyzed in order to assess the presence of benign or malignant pulmonary diseases that is so found: 16.33% of benign pulmonary diseases related to asbestos, 17.84% benign pulmonary diseases not related to asbestos and 1% of malignant pulmonary diseases probably related to asbestos. The diagnosis of 221 patients, that were followed over time, were analyzed in order to assess the evolution in time: a new onset of pulmonary disease was found in the 2.26%, a worsening of the pulmonary disease was found in the 6.79%.
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Affiliation(s)
- G Guglielmi
- U.O Medicina Preventiva del Lavoro, Azienda Ospedaliero-Universitaria Pisana, Via S. Maria 110, 50126 Pisa
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Pistelli A, Foddis R, Guglielmi G, Bonotti A, Cristaudo A. [Prevalence of thyroid disease in healthcare workers occupationally exposed to ionizing radiation at the University Hospital of Pisa]. G Ital Med Lav Ergon 2012; 34:280-282. [PMID: 23405642] [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: 06/01/2023]
Abstract
The study analyzes the prevalence of thyroid disease in 1960 healthcare workers, classified as occupationally exposed to ionizing radiation, who have worked at the University Hospital of Pisa. They underwent a medical surveillance protocol from January 2005 until Mars 2012 at the Operative Unit of Occupational Medicine. A positive history of thyroid disease was found in 221 persons, but only 110 (the 5.61% of the population) developed the disease during or after the occupational exposure. Benign thyroid diseases, found in 93 workers, were in order of frequency: Hashimoto's thyroiditis, nodular disease, Basedow's disease, multinodular goiter, subacute thyroiditis and hypothyroidism. Malignant thyroid diseases were found in 17 workers (the 0.87% of the total population), 15 workers suffered from the papillary histotype and 2 from the medullary histotype.
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Affiliation(s)
- A Pistelli
- Dipartimento di Endocrinologia e Metabolismo, Ortopedia, Traumatologia e Medicina del Lavoro - Università di Pisa, Italy.
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Pattamapaspong N, Srisuwan T, Sivasomboon C, Nasuto M, Suwannahoy P, Settakorn J, Kraisarin J, Guglielmi G. Accuracy of radiography, computed tomography and magnetic resonance imaging in diagnosing foreign bodies in the foot. Radiol Med 2012; 118:303-10. [DOI: 10.1007/s11547-012-0844-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Accepted: 11/18/2011] [Indexed: 11/28/2022]
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Diacinti D, Guglielmi G, Pisani D, Diacinti D, Argirò R, Serafini C, Romagnoli E, Minisola S, Catalano C, David V. Vertebral morphometry by dual-energy X-ray absorptiometry (DXA) for osteoporotic vertebral fractures assessment (VFA). Radiol Med 2012; 117:1374-85. [PMID: 22744340 DOI: 10.1007/s11547-012-0835-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [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: 01/20/2012] [Accepted: 03/26/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE This study was done to evaluate the diagnostic accuracy of dual-energy X-ray absorptiometry (DXA) compared with conventional radiography for identifying vertebral fractures. MATERIALS AND METHODS A total of 930 postmenopausal women underwent conventional radiography and DXA imaging of the spine. The images were evaluated by two expert skeletal radiologists using the semiquantitative (SQ) method for conventional radiography and the morphometric vertebral fracture assessment (VFA) for DXA. RESULTS The SQ method for radiography (SQ-Rx) analysed 99.1% of vertebrae, identifying 442 vertebral fractures; VFA analysed 97.5% vertebrae, detecting 420 vertebral fractures. Agreement between SQ-Rx and VFA reached 98.76%, and the κ-score was 0.96 [95% confidence interval (CI), 0.95-0.98]. Assessing the grading of vertebral fractures, agreement reached 97.5% and the κ-score was 0.841 (95% CI, 0.821-0.891). Considering SQ-Rx method as "gold standard", VFA had a sensitivity of 97.85 % and a specificity of 99.81%. The negative (NPV) and positive (PPV) predictive value for VFA were 99.83 % and 98.15%, respectively. Fractures were identified in 251 (27 %) and 242 (26 %) of patients on SQ-Rx and VFA, respectively. On a per-patient basis, the agreement between the two methods was 97% and the κ-score was 0.95 (95% CI, 0.920-0.968). The diagnostic parameters for VFA were 97.23% sensitivity, 98.86% specificity, 97.60% PPV and 98.84% NPV. CONCLUSIONS This study demonstrated that VFA with DXA may reach a high level of accuracy for diagnosing vertebral fractures, suggesting that VFA should be introduced in the screening of individuals with a risk of osteoporosis and in the follow-up of osteoporotic patients receiving treatment.
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Affiliation(s)
- D Diacinti
- Department of Radiology, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
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Casiglia E, Tikhonoff V, Boschetti G, Bascelli A, Saugo M, Guglielmi G, Caffi S, Rigoni G, Giordano N, Grasselli C, Martini B, Mazza A, Lazzari FD, Palatini P. The C825T GNB3 polymorphism, independent of blood pressure, predicts cerebrovascular risk at a population level. Am J Hypertens 2012; 25:451-7. [PMID: 22258330 DOI: 10.1038/ajh.2011.257] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The role of C825T polymorphism of the candidate GNB3 gene in predicting cerebrovascular outcome has been poorly explored in longitudinal setting at a population level. METHODS In an epidemiological setting, 1,678 men and women from general population were genotyped for C825T polymorphism of GNB3 gene and follow-up for 10 years to detect nonfatal and fatal cerebrovascular events (CE). Established cerebrovascular risk factors were used to adjust the multivariate Cox analysis for confounders. RESULTS Seventy-three nonfatal and 30 fatal CE were recorded. Incidence of CE was higher in TT than in C-carriers (fatal: 2.6 vs. 1.7%, P < 0.03; nonfatal: 7.8 vs. 3.9%, P < 0.03; fatal recurrences: 1.6 vs. 0.6%, P < 0.03). In Cox analysis, the TT genotype predicted nonfatal (hazard ratio 1.99, 95% confidence interval 1.05-3.79, P = 0.03), fatal (2.91, 1.05-8.12, P = 0.04), and fatal recurrent CE (6.82, 1.50-31.1, P = 0.02) also after adjustment for age, gender, systolic and diastolic blood pressure, body adiposity, atherogenetic blood lipids, serum uric acid, diabetes, calories, caffeine and ethanol intake, and coronary events at baseline. Further adjustment for historical CE made the association between TT genotype and incident fatal CE nonsignificant (hazard ratio 2.72, 95% confidence interval 0.96-7.22, P = 0.06). CONCLUSIONS The TT genotype of GNB3 gene predicts incident CE independent of blood pressure and other established risk factors at a population level. Further studies are needed to clarify the nature and pathways of this association.
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Tartaglione T, Filograna L, Roiati S, Guglielmi G, Colosimo C, Bonomo L. Importance of 3D-CT imaging in single-bullet cranioencephalic gunshot wounds. Radiol Med 2012; 117:461-70. [PMID: 22271006 DOI: 10.1007/s11547-011-0784-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Accepted: 11/19/2010] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this paper is to demonstrate that computed tomography (CT) and three-dimensional (3D) CT imaging techniques can be useful tools for evaluating gunshot wounds of the skull in forensic medicine. Three purposes can be achieved: (1) identifying and recognising the bullet entrance wound - and exit wound, if present; (2) recognising the bullet's intracranial course by studying damage to bone and brain tissue; (3) suggesting hypotheses as to the dynamics of the event. MATERIALS AND METHODS Ten cadavers of people who died of a fatal head injury caused by a single gunshot were imaged with total-body CT prior to conventional autoptic examination. Three-dimensional-CT reconstructions were obtained with the volume-rendering technique, and data were analysed by two independent observers and compared with autopsy results. RESULTS In our experience, CT analysis and volumetric reconstruction techniques allowed the identification of the bullet entrance and exit wounds and intracranial trajectory, as well as helping to formulate a hypothesis on the extracranial trajectory to corroborate circumstantial evidence. CONCLUSIONS CT imaging techniques are excellent tools for addressing the most important questions of forensic medicine in the case of gunshot wounds of the skull, with results as good as (or sometimes better than) traditional autoptic methods.
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Affiliation(s)
- T Tartaglione
- Dipartimento di Bioimmagini e Scienze Radiologiche, Istituto di Radiologia, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Roma, Italy.
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