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Suglia V, Palazzo L, Bevilacqua V, Passantino A, Pagano G, D’Addio G. A Novel Framework Based on Deep Learning Architecture for Continuous Human Activity Recognition with Inertial Sensors. Sensors (Basel) 2024; 24:2199. [PMID: 38610410 PMCID: PMC11014138 DOI: 10.3390/s24072199] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 02/26/2024] [Accepted: 03/08/2024] [Indexed: 04/14/2024]
Abstract
Frameworks for human activity recognition (HAR) can be applied in the clinical environment for monitoring patients' motor and functional abilities either remotely or within a rehabilitation program. Deep Learning (DL) models can be exploited to perform HAR by means of raw data, thus avoiding time-demanding feature engineering operations. Most works targeting HAR with DL-based architectures have tested the workflow performance on data related to a separate execution of the tasks. Hence, a paucity in the literature has been found with regard to frameworks aimed at recognizing continuously executed motor actions. In this article, the authors present the design, development, and testing of a DL-based workflow targeting continuous human activity recognition (CHAR). The model was trained on the data recorded from ten healthy subjects and tested on eight different subjects. Despite the limited sample size, the authors claim the capability of the proposed framework to accurately classify motor actions within a feasible time, thus making it potentially useful in a clinical scenario.
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Affiliation(s)
- Vladimiro Suglia
- Department of Electrical and Information Engineering (DEI), Polytechnic University of Bari, 70126 Bari, Italy; (V.S.); (L.P.); (V.B.)
| | - Lucia Palazzo
- Department of Electrical and Information Engineering (DEI), Polytechnic University of Bari, 70126 Bari, Italy; (V.S.); (L.P.); (V.B.)
- Scientific Clinical Institutes Maugeri SPA SB IRCCS, 70124 Bari, Italy; (A.P.); (G.D.)
| | - Vitoantonio Bevilacqua
- Department of Electrical and Information Engineering (DEI), Polytechnic University of Bari, 70126 Bari, Italy; (V.S.); (L.P.); (V.B.)
- Apulian Bioengineering S.R.L.,Via delle Violette 14, 70026 Modugno, Italy
| | - Andrea Passantino
- Scientific Clinical Institutes Maugeri SPA SB IRCCS, 70124 Bari, Italy; (A.P.); (G.D.)
| | - Gaetano Pagano
- Scientific Clinical Institutes Maugeri SPA SB IRCCS, 70124 Bari, Italy; (A.P.); (G.D.)
| | - Giovanni D’Addio
- Scientific Clinical Institutes Maugeri SPA SB IRCCS, 70124 Bari, Italy; (A.P.); (G.D.)
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La Bella G, Basanisi MG, Nobili G, Coppola R, Damato AM, Donatiello A, Occhiochiuso G, Romano AC, Toce M, Palazzo L, Pellegrini F, Fanelli A, Di Martino B, Suffredini E, Lanave G, Martella V, La Salandra G. Evidence of Circulation and Phylogenetic Analysis of Hepatitis E Virus (HEV) in Wild Boar in South-East Italy. Viruses 2023; 15:2021. [PMID: 37896798 PMCID: PMC10611066 DOI: 10.3390/v15102021] [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: 09/01/2023] [Revised: 09/21/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
Hepatitis E virus (HEV) is an important cause of acute viral hepatitis in humans worldwide. The food-borne transmission of HEV appears to be a major route in Europe through the consumption of pork and wild boar meat. HEV epidemiology in wild boars has been investigated mainly in Northern and Central Italian regions, whilst information from Southern Italy is limited. We investigated the occurrence of HEV in wild boar in the Apulia and Basilicata regions (Southern Italy). Thirteen (10.4%) out of one hundred and twenty-five wild boar samples tested positive for HEV using a quantitative reverse transcription PCR. HEV prevalence was 12% in Apulia and 9.3% in Basilicata. Seven samples were genotyped, and different subtypes (c, f, m) of genotype 3 were identified. The complete genome of a 3m strain was determined, and the virus showed the highest nucleotide identity to a human HEV strain identified in France in 2017. These findings demonstrate the substantial circulation of HEV in the wild boar population in Italian Southern regions. Gathering information on the HEV strains circulating in different geographical areas is useful for tracking the origin of HEV outbreaks and assessing the epidemiological role of wild boar as a potential virus reservoir for domestic pigs.
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Affiliation(s)
- Gianfranco La Bella
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Maria Grazia Basanisi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Gaia Nobili
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Rosa Coppola
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Annita Maria Damato
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Adelia Donatiello
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Gilda Occhiochiuso
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | | | - Mariateresa Toce
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Lucia Palazzo
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Francesco Pellegrini
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Bari, Italy
| | - Angela Fanelli
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Bari, Italy
| | - Barbara Di Martino
- Department of Veterinary Medicine, Università degli Studi di Teramo, 64100 Teramo, Italy
| | - Elisabetta Suffredini
- Department of Food Safety Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Gianvito Lanave
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Bari, Italy
| | - Vito Martella
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Bari, Italy
| | - Giovanna La Salandra
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
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Fraccalvieri R, Bianco A, Difato LM, Capozzi L, Del Sambro L, Simone D, Catanzariti R, Caruso M, Galante D, Normanno G, Palazzo L, Tempesta M, Parisi A. Toxigenic Genes, Pathogenic Potential and Antimicrobial Resistance of Bacillus cereus Group Isolated from Ice Cream and Characterized by Whole Genome Sequencing. Foods 2022; 11:foods11162480. [PMID: 36010481 PMCID: PMC9407285 DOI: 10.3390/foods11162480] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 11/22/2022] Open
Abstract
Bacillus cereus is isolated from a variety of foods where it may cause food spoilage and/or food poisoning due to its toxigenic and pathogenic nature. In this study, we identified members of B. cereus groups in 65% of the ice cream samples analyzed, which were characterized based on multi locus variable number tandem repeats analysis (MLVA) and whole genome sequencing (WGS). The MLVA revealed that 36 strains showed different allelic profiles. Analyses of WGS data enabled the identification of three members of the B. cereus group: B. cereus sensu stricto, B. mosaicus and B. thuringiensis. Based on the multi locus sequence typing (MLST) scheme, the strains were classified in 27 sequence types (STs), including ST26 that causes food poisoning. Toxin genes’ detection revealed the presence of the genes encoding nonhemolytic enterotoxin (NHE), hemolysin BL (HBL), cytotoxin K (cytK) and cereulide (ces) in 100%, 44%, 42% and 8% of the strains, respectively. The identification of eleven antimicrobial resistance (AMR) genes predicted the resistance to five different antimicrobials, and the resistance to beta-lactam antibiotics was confirmed with a phenotypic antimicrobial test. Taken together, the results showed that the B. cereus strains isolated from ice cream were a potential hazard for consumer safety.
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Affiliation(s)
- Rosa Fraccalvieri
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZS PB), Via Manfredonia 20, 71121 Foggia, Italy
| | - Angelica Bianco
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZS PB), Via Manfredonia 20, 71121 Foggia, Italy
- Experimental Zooprophylactic Institute of Apulia and Basilicata, 71121 Foggia, Italy
- Correspondence: ; Tel.: +39-080-4057858; Fax: +39-080-4057753
| | - Laura Maria Difato
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZS PB), Via Manfredonia 20, 71121 Foggia, Italy
| | - Loredana Capozzi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZS PB), Via Manfredonia 20, 71121 Foggia, Italy
| | - Laura Del Sambro
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZS PB), Via Manfredonia 20, 71121 Foggia, Italy
| | - Domenico Simone
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZS PB), Via Manfredonia 20, 71121 Foggia, Italy
| | - Roberta Catanzariti
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZS PB), Via Manfredonia 20, 71121 Foggia, Italy
| | - Marta Caruso
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZS PB), Via Manfredonia 20, 71121 Foggia, Italy
| | - Domenico Galante
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZS PB), Via Manfredonia 20, 71121 Foggia, Italy
| | - Giovanni Normanno
- Department of Science of Agriculture, Food and the Environment (SAFE), University of Foggia, 71121 Foggia, Italy
| | - Lucia Palazzo
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZS PB), Via Manfredonia 20, 71121 Foggia, Italy
| | - Maria Tempesta
- Department of Veterinary Medicine, University Aldo Moro of Bari, Strada per Casamassima Km 3, 70010 Valenzano, Italy
| | - Antonio Parisi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZS PB), Via Manfredonia 20, 71121 Foggia, Italy
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Palazzo L, Rossi C, Frezzato I, Frezzato A, Guerra D, Russo N. La stampa 3D nella preparazione chirurgica dei casi complessi: risoluzione di lesioni periapicali granulomatose e cistiche. Dental Cadmos 2022. [DOI: 10.19256/d.cadmos.2021.47] [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: 11/20/2022]
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Marucci G, Romano AC, Interisano M, Toce M, Pietragalla I, Collazzo GP, Palazzo L. Trichinella pseudospiralis in a red kite (Milvus milvus) from Italy. Parasitol Res 2021; 120:2287-2290. [PMID: 33932154 DOI: 10.1007/s00436-021-07165-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/15/2021] [Indexed: 12/18/2022]
Abstract
Trichinella pseudospiralis is a non-encapsulated species infecting both mammals and birds. In Italy, this species has been reported so far only in central regions (two nocturnal birds of prey, one red fox, and one wild boar) and in northeast regions (four wild boars). In November 2020, Trichinella sp. larvae were isolated by enzymatic digestion from muscle tissues of a red kite (Milvus milvus) specimen belonging to a population residing in the Basilicata region (Southern Italy). The parasite was identified as T. pseudospiralis by multiplex PCR, and the sequencing of the expansion segment V (ESV) region of the nuclear large subunit ribosomal DNA showed, in the microsatellite region, the polymorphism characteristic of the Palearctic population. This represents the first record of T. pseudospiralis in a red kite and the first report of this parasite in Southern Italy. The isolation of the parasite in a resident bird confirms that T. pseudospiralis is present, even if at low prevalence, in the Italian avifauna.
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Affiliation(s)
- Gianluca Marucci
- Department of Infectious Diseases, Unit of Foodborne and Neglected Parasitic Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Antonella Cristina Romano
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Zona industriale Tito Scalo, 85050, Tito (PZ), Italy
| | - Maria Interisano
- Department of Infectious Diseases, Unit of Foodborne and Neglected Parasitic Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Mariateresa Toce
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Zona industriale Tito Scalo, 85050, Tito (PZ), Italy
| | - Ileana Pietragalla
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Zona industriale Tito Scalo, 85050, Tito (PZ), Italy
| | - Giuseppina Patrizia Collazzo
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Zona industriale Tito Scalo, 85050, Tito (PZ), Italy
| | - Lucia Palazzo
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Zona industriale Tito Scalo, 85050, Tito (PZ), Italy
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Padalino I, Di Guardo G, Carbone A, Troiano P, Parisi A, Galante D, Cafiero MA, Caruso M, Palazzo L, Guarino L, De Riso L, Centelleghe C, Mazzariol S, Petrella A. Dolphin Morbillivirus in Eurasian Otters, Italy. Emerg Infect Dis 2019; 25:372-374. [PMID: 30666943 PMCID: PMC6346476 DOI: 10.3201/eid2502.180256] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We report biomolecular evidence of dolphin morbillivirus in 4 wild Eurasian otters (Lutra lutra) from southern Italy; 2 animals showed simultaneous immunohistochemical reactivity against morbilliviral antigen. These cases add further concern and support to the progressively expanding host range of dolphin morbillivirus in the western Mediterranean Sea.
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Morera J, Guillaume A, Courtheoux P, Palazzo L, Rod A, Joubert M, Reznik Y. Preoperative localization of an insulinoma: selective arterial calcium stimulation test performance. J Endocrinol Invest 2016; 39:455-63. [PMID: 26577133 DOI: 10.1007/s40618-015-0406-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 06/28/2015] [Accepted: 10/29/2015] [Indexed: 12/24/2022]
Abstract
PURPOSE Preoperative localization of an insulinoma is recommended to improve the cure rate, but non-invasive procedures can fail to detect the tumour. The objective of the study was to assess the performance of a selective arterial calcium stimulation test in the preoperative localization of insulinomas that were not detected by conventional imaging procedures. METHODS We conducted a monocenter retrospective case review of 13 patients who had endogenous hyperinsulinism and were treated between 1994 and 2013. Patients were selected on the basis of negative or doubtful non-invasive preoperative imaging. A selective arterial calcium stimulation test was performed by pancreatic and hepatic arteriography with selective intra-arterial calcium stimulation and hepatic venous sampling in order to obtain the plasma insulin measurement. We evaluated the efficacy of the test by comparing the results with an endoscopic ultrasound. RESULTS Twelve of the 13 patients underwent surgery, and the presence of an insulinoma was proven in 11 patients by pathological analysis of the tumour. An endoscopic ultrasound was consistent with surgery in 71.4 % of cases, while selective arterial calcium stimulation was consistent with surgery in 90.9 % and allowed detection of an insulinoma in two additional patients with a negative endoscopic ultrasound. One false-negative and one false-positive arterial calcium test were observed. No adverse events were recorded except transient skin flush following calcium injection in one patient. CONCLUSION The selective arterial calcium stimulation test is a sensitive diagnostic procedure for localizing insulinomas and may be considered when non-invasive radiological imaging does not allow the detection of an occult insulinoma.
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Affiliation(s)
- J Morera
- Endocrinology Unit, Centre Hospitalo-Universitaire de Caen, Avenue de la côte de Nacre, CS 30001, 14033, Caen Cedex 9, France
| | - A Guillaume
- Endocrinology Unit, Centre Hospitalo-Universitaire de Caen, Avenue de la côte de Nacre, CS 30001, 14033, Caen Cedex 9, France
| | - P Courtheoux
- Diagnostic Radiology Unit, Centre Hospitalo-Universitaire de Caen, Avenue de la côte de nacre, CS 30001, 14033, Caen Cedex 9, France
| | - L Palazzo
- Endoscopic Ultrasound Unit, Trocadero Clinic, 75016, Paris, France
| | - A Rod
- Endocrinology Unit, Centre Hospitalo-Universitaire de Caen, Avenue de la côte de Nacre, CS 30001, 14033, Caen Cedex 9, France
| | - M Joubert
- Endocrinology Unit, Centre Hospitalo-Universitaire de Caen, Avenue de la côte de Nacre, CS 30001, 14033, Caen Cedex 9, France
| | - Y Reznik
- Endocrinology Unit, Centre Hospitalo-Universitaire de Caen, Avenue de la côte de Nacre, CS 30001, 14033, Caen Cedex 9, France.
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Caruso M, Latorre L, Santagada G, Fraccalvieri R, Miccolupo A, Sottili R, Palazzo L, Parisi A. Methicillin-resistant Staphylococcus aureus (MRSA) in sheep and goat bulk tank milk from Southern Italy. Small Rumin Res 2016. [DOI: 10.1016/j.smallrumres.2015.12.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Palazzo L. How to perform EUS in the pancreaticobiliary area. Minerva Med 2014; 105:371-389. [PMID: 25325566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
EUS remains mandatory in the management of the majority of pancreaticobiliary diseases. This article fully describes with details how to examine the pancreatico-biliary region using radial and linear EUS. Pancreaticobiliary examination with a radial instrument: 1) place the patient on left lateral decubitus position, tilted towards the examination table at an angle of 30° to 40°; 2) use a moderately inflated balloon; 3) begin the examination in the stomach 45 to 50 cm from the incisors, to examine the body and tail region; 4) after advancing through the pylorus under endoscopic control, proceed from the bulb to the second part of the duodenum by pushing the echoendoscope which is in opened position of the handle gently under ultrasound control, turning the handle clockwise if the superior duodenal angle is open, then push the echoendoscope in the long position towards the ampulla of Vater, adding up angulation. Use the ERCP withdrawal manoeuvre under endoscopic control, from the apex of the bulb if the superior duodenal angle is closed (thin patient), and allow the head of the echoendoscope to fall into the second duodenum, then push the tip over the ampulla of Vater, in the long position, and start the examination at this point. Pancreaticobiliary examination with a linear instrument: place the patient in the same position as with a radial instrument. 1) balloon slightly inflated or uninflated; 2) use the neutral position of the handle as a starting point in the stomach. Move from this position to the open position by turning the handle anti-clockwise and to the closed position by turning the handle clockwise while advancing or withdrawing the echoendoscope, adding clockwise torquing to the endoscope shaft when necessary (to examine the pancreatic tail); 3) almost the whole of the pancreatic gland, apart from the juxtaduodenal segment of the head and uncinate process and in particular the ampulla of Vater, can be examined through the stomach; 4) the examination is conducted exclusively by following the vascular structures and ducts, hence the importance of anatomical knowledge; 5) use constant up angulation.
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Affiliation(s)
- L Palazzo
- Department of Gastroenterology and Endoscopy Trocadero Clinic, Paris, France. -
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Rossi L, Palazzo L, Yazbeck C, Walker F, Chis C, Luton D, Koskas M. Can rectal endoscopic sonography be used to predict infiltration depth in patients with deep infiltrating endometriosis of the rectum? Ultrasound Obstet Gynecol 2014; 43:322-327. [PMID: 23754206 DOI: 10.1002/uog.12535] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [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: 03/03/2013] [Revised: 05/29/2013] [Accepted: 05/31/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To evaluate the diagnostic accuracy of rectal endoscopic sonography (RES) in the prediction of the infiltration depth of rectal endometriosis and to ascertain whether RES could be used to choose between segmental bowel resection and a more conservative approach, such as shaving or discoid resection. METHODS In this retrospective study, 38 consecutive patients with symptomatic deep infiltrating endometriosis of the rectum who underwent laparoscopic colorectal resection were included. RES results for infiltration depth of rectal endometriosis were compared with results of pathological examination. The sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively), positive and negative likelihood ratios (LRs) and test accuracy were calculated for the presence of infiltration of the muscularis layers and submucosal/mucosal layers, as demonstrated by RES and confirmed by histopathological analysis. RESULTS For the detection of muscularis layer infiltration by endometriosis, the PPV of RES was 100%, whereas for the detection of submucosal/mucosal layer involvement, the sensitivity was 89%, specificity was 26%, PPV was 55%, NPV was 71%, test accuracy was 58% and positive and negative LRs were 1.21 and 0.40, respectively. CONCLUSIONS RES is a valuable tool for detecting rectal endometriosis as endometriotic infiltration of the muscularis layer can be predicted accurately. However, RES is less accurate in detecting submucosal/mucosal layer involvement and cannot, therefore, be used to choose between bowel resection and a more conservative approach.
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Affiliation(s)
- L Rossi
- Department of Obstetrics and Gynecology, Bichat Hospital, Paris, France
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Conio M, Fisher DA, Palazzo L. Radiofrequency ablation and endoscopic mucosal resection in Barrett's esophagus with early neoplasia. Can we avoid complications? Endoscopy 2013; 45:506. [PMID: 23733732 DOI: 10.1055/s-0032-1326486] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Sebbag-Sfez D, Berrod JL, Palazzo L, Zins M. Pedunculated insulinoma on the anterior border of the head of the pancreas: an unusual location to be aware of. Diagn Interv Imaging 2013; 94:327-9. [PMID: 23352878 DOI: 10.1016/j.diii.2012.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Gauche Cazalis C, Koskas M, Martin B, Palazzo L, Madelenat P, Yazbeck C. [Preoperative imaging of deeply infiltrating endometriosis in: Transvaginal sonography, rectal endoscopic sonography and magnetic resonance imaging]. ACTA ACUST UNITED AC 2012; 40:634-41. [PMID: 23123282 DOI: 10.1016/j.gyobfe.2012.09.014] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Accepted: 09/13/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Compare the accuracy of transvaginal ultrasonography (TVUS), rectal endoscopic sonography (RES), and magnetic resonance imaging (MRI) before deeply infiltrating endometriosis surgery. PATIENTS AND METHODS A retrospective study with 25 deeply endometriosis patients underwent the three imaging examinations before surgery. Calculation of sensitivity, specificity, positive predictive value, negative predictive value and accuracy for the different locations: ovaries, uterosacral ligaments and torus, rectovaginal septum, rectosigmoid junction, bladder. RESULTS Ovarian and deep pelvic endometriosis was found in surgery and confirmed by histology in all patients. Sensitivity and specificity are respectively: for ovaries: 88.2% and 71% of TVUS; 80% and 81.2% of RES; 87.5% and 71% of MRI. For uterosacral ligaments: 63% and 82,6% of TVUS; 37% and 100% of RES; 69% and 82.6% of MRI. For torus: 57.1% and 100% of TVUS; 76.2% and 100% of RES; 76.2% and 100% of MRI. For rectovaginal septum: 63.2% and 100% for TVUS; 89.5% and 66.7% of EER; 47.4% and 100% of MRI. For rectosigmoid junction: 73.7% and 66.7% of TVUS; 94.7% and 66.7% of RES; 89.5% and 50% of MRI. For bladder: 16.7% and 100% of TVUS; 16.7% and 100% of RES; 33.3% and 89.5% of MRI. DISCUSSION AND CONCLUSION We found that TVUS is the more performant for endometriomas, it is MRI for torus, uterosacral ligaments and little bladder lesions, RES for rectovaginal septum and rectosigmoid junction. So in the clinical practice, the three imaging examinations are complementary for the preoperative assessment of deeply endometriosis.
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Affiliation(s)
- C Gauche Cazalis
- Service de gynécologie obstétrique, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France.
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Palazzo L, Carlo ED, Santagada G, Serrecchia L, Aceti A, Guarino A, Adone R, Fasanella A. Recent Epidemic-Like Anthrax Outbreaks in Italy: What Are the Probable Causes? ACTA ACUST UNITED AC 2012. [DOI: 10.4236/ojvm.2012.22012] [Citation(s) in RCA: 6] [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: 11/20/2022]
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Palazzo L, O'Toole D. Endoscopic ultrasound in cystic pancreatic lesions: operator training needs to be improved, EUS-guided sampling should be standardized, and decision-making should be multidisciplinary and evidence-based. Endoscopy 2011; 43:557-9. [PMID: 21717377 DOI: 10.1055/s-0030-1256614] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Fasanella A, Garofolo G, Galante D, Quaranta V, Palazzo L, Lista F, Adone R, Jones MH. Severe anthrax outbreaks in Italy in 2004: considerations on factors involved in the spread of infection. New Microbiol 2010; 33:83-86. [PMID: 20402418] [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: 05/29/2023]
Abstract
Anthrax is a disease of humans and animals caused by the encapsulated, spore-forming Bacillus anthracis. In Italy, anthrax is normally a sporadic disease. During the summer 2004, anthrax broke out in the Basilicata, in southern Italy, a region with a low prevalence of anthrax in which vaccination had been suspended since 1998. The disease involved several animals in few weeks and in a large area. Over 41 days, 81 cattle died, as well as 15 sheep, 9 goats, 11 horses and 8 deer. The Multiple-locus Variable-Number Tandem Repeats Analysis (MLVA) showed that all the 53 isolates belonged to the Cluster Ala, genotype 1. The results of the Single Nucleotide Repeats (SNRs) Analysis showed that 48/53 B. anthacis strains belonged to a single clonal lineage, the sub-genotype sgt - eB. Two sporadic mutants, sgt - eB,m1 and sgt - eB,m2, were isolated, only one managing to infect other herds. Factors that could have contributed to the spread of infection, such as the transmission of spores by insect vectors and the favourable weather conditions were evaluated.
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Affiliation(s)
- Antonio Fasanella
- Anthrax Reference Institute of Italy, Istituto Zooprofilattico Sperimentale of Puglia and Basilicata, Foggia, Italy.
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Ghigna MR, Drak Alsibai K, Porras J, Palazzo L, Godchaux JM, Fabre M. Deep-seated rectal/anal basaloid carcinoma: useful immunocytochemistry in rare squamous cell carcinoma variants. Cytopathology 2009; 20:315-20. [DOI: 10.1111/j.1365-2303.2008.00560.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Benbara A, Fortin A, Martin B, Palazzo L, Le Tohic A, Madelenat P, Yazbeck C. [Surgical and functional results of rectosigmoidal resection for severe endometriosis]. ACTA ACUST UNITED AC 2008; 36:1191-201. [PMID: 19019719 DOI: 10.1016/j.gyobfe.2008.09.016] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2008] [Accepted: 09/24/2008] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Indications of colorectal resection for endometriosis are controversial because of the risk of major complications. This study aims to evaluate the value of different diagnostic tests in decision-making, and to evaluate the surgical results and complications, as well as long-term functional results after surgery. PATIENTS AND METHODS In the set of a retrospective case series, 50 patients who have been admitted for a colorectal resection because of deep endometriosis were included. Most of them have had an MRI and an endorectal ultrasonography. Specific questionnaires have been proposed in order to evaluate symptoms, sexuality (BISF-W) and quality of life (EHP-30). RESULTS For the diagnosis of rectal involvement, the sensitivity of MRI and endorectal ultrasonography were 55 and 100%, respectively. Forty-one colorectal amputations and nine partial colorectal resections have been done by 24 laparotomies, two laparoscopies and 24 laparoconversions. Major complications included six (12.5%) digestive fistulas, three (6%) anastomotic strictures, one ureterovaginal fistula and one ureteral stricture. Risk factors associated with digestive fistulas were the association of a vaginal opening (p=0.002) and an additional ileocaecal resection (p=0.007). The mean follow-up period was of 42 months. A significant improvement of dysmenorrhea (p<10(-4)), dyschesia (p<10(-4)), chronic pelvic pain (p<10(-4)), and of some digestive symptoms such as catamenial epreintes (p=0.002) and catamenial diarrheas (p=0.006), was noted. We noted postoperative 14 dysurias, six constipations and 12 rectal polykynesias. Four patients have had deep recurrent lesions. Twenty patients had a desire of pregnancy after the operation, 17 pregnancies were obtained (eight spontaneous and nine by ART) giving birth to 14 living children. Sexuality evaluation was below normal range. The quality of life was improved for most of the items. The global satisfaction was good (91%). DISCUSSION AND CONCLUSION Colorectal resection for deep endometriosis improve significantly most of the pain symptoms, but the women should have detailed counselling about the risks of major complications and recurrence.
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Affiliation(s)
- A Benbara
- Service de gynécologie-obstétrique, hôpital Bichat Claude-Bernard, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
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Palazzo L. [Non-glandular rectal tumors: where's the limit for treatment?]. Gastroenterol Clin Biol 2008; 32:S133-S139. [PMID: 18472239 DOI: 10.1016/j.gcb.2008.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- L Palazzo
- Cabinet médicale, 30, rue d'Astorg, 75008, Paris, France.
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Affiliation(s)
- Antonio Fasanella
- Istituto Zooprofilattico Sperimentale of Puglia and Basilicata, Foggia, Italy
| | - Lucia Palazzo
- Istituto Zooprofilattico Sperimentale of Puglia and Basilicata, Foggia, Italy
| | - Antonio Petrella
- Istituto Zooprofilattico Sperimentale of Puglia and Basilicata, Foggia, Italy
| | - Vincenzo Quaranta
- Istituto Zooprofilattico Sperimentale of Puglia and Basilicata, Foggia, Italy
| | - Bruno Romanelli
- Istituto Zooprofilattico Sperimentale of Puglia and Basilicata, Foggia, Italy
| | - Giuliano Garofolo
- Istituto Zooprofilattico Sperimentale of Puglia and Basilicata, Foggia, Italy
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Barthet M, Napoléon B, Palazzo L, Chemali M, Letard JC, Laugier R, Arpurt JP, Boyer J, Boustière C, Canard JM, Cassigneul J, Dalbiès PA, Escourrou J, Gay G, Ponchon T, Richard-Molard B, Sautereau D, Tucat G, Vedrenne B. Management of cystic pancreatic lesions found incidentally. Endoscopy 2007; 39:926-8. [PMID: 17968813 DOI: 10.1055/s-2007-966786] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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22
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Boyer J, Laugier R, Chemali M, Arpurt JP, Boustière C, Canard JM, Dalbies PA, Gay G, Escourrou J, Napoléon B, Palazzo L, Ponchon T, Richard-Mollard B, Sautereau D, Tucat G, Vedrenne B. French Society of Digestive Endoscopy SFED guideline: monitoring of patients with Barrett's esophagus. Endoscopy 2007; 39:840-2. [PMID: 17703397 DOI: 10.1055/s-2007-966653] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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23
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Dagher C, Palazzo L, Guillermand-Gérard H, Lalloue C, Fabre M. Endoscopic ultrasonography-guided fine needle aspiration of a nodule in the rectovaginal septum. Cytopathology 2007; 18:255-9, 210. [PMID: 17559568 DOI: 10.1111/j.1365-2303.2007.00415.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C Dagher
- Department of Pathology, Bicêtre University Hospital, AP-HP, Paris, France
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24
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Latorre L, Parisi A, Fraccalvieri R, Normanno G, La Porta MCN, Goffredo E, Palazzo L, Ciccarese G, Addante N, Santagada G. Low prevalence of Listeria monocytogenes in foods from Italy. J Food Prot 2007; 70:1507-12. [PMID: 17612085 DOI: 10.4315/0362-028x-70.6.1507] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [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: 11/11/2022]
Abstract
Listeria monocytogenes is an important foodborne pathogen that causes gastrointestinal disorders, and, especially in immunocompromised people, serious extraintestinal diseases, such as septicemia and meningitis, as well as abortion in pregnant women. Many foods, from both plant and animal origin, have been involved in listeriosis outbreaks. This article reports the results of a 12-year survey (1993 through 2004) on the presence of L. monocytogenes in several kinds of food marketed in Italy. Of 5,788 analyzed samples, 121 (2.1%) were contaminated with L. monocytogenes. The highest prevalence was found in smoked salmon (10.6%) and in poultry meat samples (8.5%) and the lowest in red meat (0.3%). L. monocytogenes was not found in 154 samples of fresh seafood products. Fifty-two isolates were also serotyped by the agglutination method. The most common serotypes detected in the 52 strains tested were 1/2a (36.5%), followed by 1/2c (32.8%), 1/2b (13.5%), 4b (11.5%), 3a (3.8%), and 3b (1.9%). The results of the present study showed low levels of L. monocytogenes in the analyzed samples. A total of 61.5% of the 52 L. monocytogenes strains analyzed belonged to serotypes 1/2a, 1/2b, and 4b, namely the serovars that are most commonly involved in extraintestinal human listeriosis outbreaks. In the ready-to-eat samples, these three serotypes were 40.0% (1/2a), 17.1% (1/2b), and 14.3% (4b). This finding highlights the need to implement strict hygienic measures during the production, distribution, and sale of foods to reduce the risk of foodborne listeriosis in humans to an acceptable level.
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Affiliation(s)
- L Latorre
- Experimental Zooprophylactic Institute of Apulia and Basilicata, V. della Tecnica 23, 75100 Matera.
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25
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Cataldi TRI, Bianco G, Palazzo L, Quaranta V. Occurrence of N-acyl-L-homoserine lactones in extracts of some Gram-negative bacteria evaluated by gas chromatography-mass spectrometry. Anal Biochem 2006; 361:226-35. [PMID: 17207763 DOI: 10.1016/j.ab.2006.11.037] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [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: 09/22/2006] [Revised: 11/10/2006] [Accepted: 11/21/2006] [Indexed: 11/18/2022]
Abstract
Acylated homoserine lactones (AHLs) are self-generated signal molecules that mediate population density-dependent gene expression (quorum sensing) in a variety of Gram-negative bacteria. These signal molecules diffuse from bacterial cells and accumulate in the medium as a function of cell growth. In selected foods AHLs contribute to product spoilage. As different bacterial species produce AHL analogs that differ in length of the N-acyl chain, ranging from 4 to 14 carbons and in the substitution at the C-3 position of the side chain (i.e., oxo or hydroxyl group), the suitability and applicability of a gas chromatography-mass spectrometry direct method for characterizing trace amounts of AHLs was evaluated using N-heptanoyl-homoserine lactone as internal standard. Crude cell-free supernatants of bacterial cultures of Aeromonas hydrophila, Aeromonas salmonicida, Pseudomonas aeruginosa, Pseudomonas fluorescens, Yersinia enterocolitica, and Serratia liquefaciens were screened for AHL production in selected ion monitoring mode, using the prominent fragment at m/z 143. The observed profiles of distinguishable N-acyl-homoserine lactones occurring in bacterial extracts were compared and discussed. The presence of a labile 3-oxo-hexanoylhomoserine lactone was evidenced but serious difficulties arose in estimating its concentration as thermal degradation occurs during the gas chromatographic separation. Its electron impact mass spectra was, however, given and interpreted.
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Affiliation(s)
- Tommaso R I Cataldi
- Dipartimento di Chimica, Università degli Studi della Basilicata, Via N. Sauro, 85, 85100 Potenza, Italy.
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27
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Affiliation(s)
- D O'Toole
- Service de Gatroentérologie, Hôpital Beaujon, Clichy 92118, Beaujon Hospital, University of Paris VII, Clichy, France
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28
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Dimet S, Lazure T, Palazzo L, Coindre JM, Fabre M. Fine needle aspiration of a mediastinal spindle cell tumour: cytological, immunocytochemical and molecular diagnosis. Cytopathology 2006; 17:97-9. [PMID: 16548995 DOI: 10.1111/j.1365-2303.2006.00321.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S Dimet
- Department of Pathology, Bicêtre University Hospital, AP-HP, Paris, France
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29
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Barthet M, Gay G, Sautereau D, Ponchon T, Napoleo B, Boyer J, Canard JM, Dalbies P, Escourrou J, Greff M, Lapuelle J, Letard JC, Marchetti B, Palazzo L, Rey JF. Endoscopic surveillance of chronic inflammatory bowel disease. Endoscopy 2005; 37:597-9. [PMID: 15933939 DOI: 10.1055/s-2005-861421] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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30
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Saurin JC, Napoleon B, Gay G, Ponchon T, Arpurt JP, Boustiere C, Boyer J, Canard JM, Dalbies PA, Escourrou J, Greff M, Lapuelle J, Laugier R, Letard JC, Marchetti B, Palazzo L, Sautereau D, Vedrenne B. Endoscopic management of patients with familial adenomatous polyposis (FAP) following a colectomy. Endoscopy 2005; 37:499-501. [PMID: 15844037 DOI: 10.1055/s-2005-861295] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- J-C Saurin
- Hépatologie Gastroenterologie, Centre Hospitalier Lyon Sud, France.
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31
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Beaugerie L, Napoleon B, Ponchon T, Boyer J, Canard JM, Dalbies P, Escourrou J, Greff M, Lapuelle J, Letard JC, Marchetti B, Palazzo L, Rey JF, Sautereau D. Guidelines of the French Society for Digestive Endoscopy (SFED). Role of endoscopy in microscopic colitis. Endoscopy 2005; 37:97-8. [PMID: 15657871 DOI: 10.1055/s-2004-826117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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32
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Barthet M, Napoleon B, Gay G, Ponchon T, Sautereau D, Arpurt JP, Boustiere C, Boyer J, Canard JM, Dalbies PA, Escourrou J, Greff M, Lapuelle J, Laugier R, Letard JC, Marchetti B, Palazzo L, Vedrenne B. Antibiotic prophylaxis for digestive endoscopy. Endoscopy 2004; 36:1123-5. [PMID: 15578308 DOI: 10.1055/s-2004-826118] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- M Barthet
- Société Française d'Endoscopie Digestive (SFED)
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Camagna O, Dhainaut C, Dupuis O, Soncini E, Martin B, Palazzo L, Chosidow D, Madelenat P. [Surgical management of rectovaginal septum endometriosis from a continuous series of 50 cases]. ACTA ACUST UNITED AC 2004; 32:199-209. [PMID: 15123117 DOI: 10.1016/j.gyobfe.2003.12.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2003] [Accepted: 12/09/2003] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To assess the value of MRI and ano-rectal endosonography (ARES) for the diagnosis and surgical prognosis of rectovaginal septum endometriosis and to analyse the surgical management in order to evaluate its functional results and complications. PATIENTS AND METHODS Retrospective study of 50 consecutive patients operated for a clinical presumption of endometriosis nodule of the recto vaginal septum. Thirty-nine patients had a MRI, 31 an ARES and 28 both exams. All the patients had a complete dissection of the rectovaginal septum and all lesions were excised. RESULTS For the diagnosis of rectovaginal septum endometriosis nodule, MRI results are: sensitivity 73%, specificity 50%, positive predictive value (PPV) 89%, negative predictive value (NPV) 25%; for uterosacral ligaments involvement: sensitivity 84%, specificity 95%, PPV 94%, NPV 86% and for rectal wall infiltration: sensitivity 53%, specificity 82%, PPV 69%, NPV 69%. The ARES results for diagnosis of rectovaginal septum endometriosis nodule are: sensitivity 93%, specificity 100%, PPV 100%, NPV 50% and for rectal wall infiltration: sensitivity 100%, specificity 71%, PPV 81%, NPV 100%. ARES appeared more sensitive than MRI for the detection of rectal wall infiltration (P = 0.002) and for rectovaginal septum endometriosis nodule diagnosis (P = 0.03). Eighty-nine percent of the patients had a coelioscopy in first intention and 15 laparoconversions were performed, 11 in order to perform a digestive resection: 45 nodules were found. In 43cases the nodule was excised, associated to 19 digestive resections, 30 colpectomys, and 22 uterosacral ligaments resections. Three patients required an additional surgical treatment by Hartman's procedure with Mickulicz's drainage for peritonitis. Forty-one nodules were endometriosis nodules: the two other cases were fibrosis nodules. Thirty-three patients were interviewed about the evolution of their pains over a mean history of 20 months: 90% of the patients were satisfied with the management results. DISCUSSION AND CONCLUSIONS Our data support the efficiency of MRI for rectovaginal septum endometriosis nodule and uterosacral ligaments involvement diagnosis; accord ARES to rectovaginal septum endometriosis nodule diagnosis and its reliability in establishing a diagnosis of rectal wall involvement. The surgical cure of rectovaginal septum nodules without digestive infiltration is performed by coelioscopic or coelio-vaginal procedure, but in case of associated digestive affliction, laparotomy is actually the standard procedure in order to achieve a complete cure of the lesions. Complications, in particular peritonitis, are not frequent. Our data support the efficiency of radical surgical treatment for the improvement of pain symptoms. Results on fertility seem to be satisfactory, but complication risks suggest being careful in this indication. Clinical examination during a catamenial period is essential in order to evoke the diagnosis. MRI yields a complete map of the sub-peritoneal and peritoneal lesions and ARES allows for the diagnosis of an infiltration of the rectal wall. Pre-operative association of those two exams is actually indispensable for the surgical management of those patients, which consists of complete excision of endometriosical lesions and is efficient at treating pain symptoms and fertility. Complications are rare but severe, therefore, justifying a cure in specialised centres.
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Affiliation(s)
- O Camagna
- Service de gynécologie-obstétrique, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France.
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Béchade D, Palazzo L, Desramé J, Duvic C, Hérody M, Didelot F, Coutant G, Algayres JP. [Pancreatic metastasis of renal cell carcinoma: report of three cases]. Rev Med Interne 2002; 23:862-6. [PMID: 12428491 DOI: 10.1016/s0248-8663(02)00693-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [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: 11/28/2022]
Abstract
INTRODUCTION The pancreas is an uncommon site of metastasis from renal cell carcinoma. EXEGESIS Three observations are described in this review which is aimed at reporting recent data on diagnosis, prognosis and therapeutic features of this kind of metastasis 0: The average space of time between nephrectomy and the diagnosis of the metastasis was 16 years. They have been fortuitously discovered in 2 cases, in patients who did not complain of any pancreatic symptom, during abdominal ultrasonography done for another reason. In the third case, pancreatic symptoms led to the diagnosis. Endoscopic ultrasonography (EUS) was useful to diagnose multiple lesions misdiagnosed on CT-scan or MRI imaging. EUS patterns are characteristic, but histological and cytological examinations of EUS-guided needle biopsies are difficult to study according to the hypervascularized character of these metastasis. CONCLUSION The diagnosis of pancreatic metastasis must be suggested for patients suffering from a pancreatic mass with a previous medical history of late renal cell carcinoma. According to their hypervascularized character, the negativity of EUS-guided needle biopsies could strongly direct the diagnosis. When surgery is possible, the survival rate is better than in primary pancreatic adenocarcinoma and is even better than in pancreatic metastasis from other sites.
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Affiliation(s)
- D Béchade
- Service de clinique médicale, hôpital du Val-de-Grâce, 74, boulevard de Port-Royal, 75230 Paris, France.
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Maire F, Hammel P, Terris B, Olschwang S, O'Toole D, Sauvanet A, Palazzo L, Ponsot P, Laplane B, Lévy P, Ruszniewski P. Intraductal papillary and mucinous pancreatic tumour: a new extracolonic tumour in familial adenomatous polyposis. Gut 2002; 51:446-9. [PMID: 12171972 PMCID: PMC1773367 DOI: 10.1136/gut.51.3.446] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.5] [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] [Indexed: 12/11/2022]
Abstract
Familial adenomatous polyposis (FAP) is characterised by the development of numerous colorectal adenomatous polyps. Other extracolonic benign or malignant lesions have been reported previously in association with FAP but precancerous lesions in the pancreas have never been described. We report the first case of intraductal papillary and mucinous pancreatic tumour (IPMT) in a patient with FAP. A 48 year old man with a well documented past history of FAP was admitted for epigastric pain, weight loss, and new onset diabetes mellitus. Spiral computed tomography scan revealed a large tumour in the pancreatic head with upstream main pancreatic duct dilatation. Endoscopic ultrasonography confirmed these data. Mucous secretion was seen at duodenoscopy and a lesion in the main pancreatic duct was confirmed by retrograde pancreatography. The patient underwent a pancreaticoduodenectomy for suspected IPMT. Histological examination of the resected specimen confirmed an IPMT with in situ carcinoma. Twelve months after resection, the patient remained free of tumour relapse. Genetic analysis showed loss of the wild allele of the adenomatous polyposis coli gene in IPMT, causing inactivation of both alleles and demonstrating that IPMT was not incidental in this patient. IPMT should be included in the extracolonic localisation of FAP.
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Affiliation(s)
- F Maire
- Fédération Médico-Chirurgicale d'Hépato-Gastroentérologie, Hôpital Beaujon, Clichy, France.
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Campinos C, Palazzo L, Ruszniewski P, Pradalier A. Gastroentérite à éosinophiles. Rev Med Interne 2002. [DOI: 10.1016/s0248-8663(02)80279-x] [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: 11/25/2022]
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Rey JF, Dumas R, Canard JM, Ponchon T, Sautereau D, Helbert T, Escourrou J, Gay G, Giovannini M, Greff M, Grimaud JC, Lapuelle J, Marchetti B, Napoleon B, Palazzo L. Guidelines of the French Society of Digestive Endoscopy: biliary stenting. Endoscopy 2002; 34:169-73, 181-5. [PMID: 11822014 DOI: 10.1055/s-2002-19846] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- J F Rey
- French Society of Digestive Endoscopy, Saint Laurent du Var, France
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Camagna O, Dupuis O, Soncini E, Martin B, Palazzo L, Madelenat P. Prise en charge chirurgicale des nodules endométriosiques de la cloison recto-vaginale. A propos d'une série continue de 40 cas. ACTA ACUST UNITED AC 2002. [DOI: 10.1007/bf03018029] [Citation(s) in RCA: 9] [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: 11/28/2022]
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Affiliation(s)
- L Palazzo
- Departement de Gastro-entérologie et des maladies du pancréas, Hopital Beaujon, Université de Paris VII, Clichy, France.
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Lazure T, Essamet W, Palazzo L, Epardeau B, Fabre M. Cytological findings of a primary mediastino-pulmonary leiomyosarcoma. Report of a case diagnosed by endoscopic ultrasonography-guided fine needle aspiration. Cytopathology 2001; 12:410-3. [PMID: 11843945 DOI: 10.1046/j.1365-2303.2001.0373b.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sautereau D, Palazzo L. [Single-use biopsy forceps for digestive endoscopy: a wise decision or a caricature of precaution principles?]. Gastroenterol Clin Biol 2001; 25:653-5. [PMID: 11673730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Abstract
BACKGROUND EUS-guided fine-needle aspiration (EUS-FNA) permits both morphologic and cytologic analysis of lesions within or adjacent to the GI tract. Despite increasing use of this technique, the safety and overall complication rates remain poorly defined. METHODS During a period of 20 months, 322 consecutive patients underwent EUS-FNA in 2 centers. All procedures were performed with the patients under general anesthesia. All complications (including local complications resulting from endoscopy/aspiration or clinical complications after the procedure) were evaluated. Potential risk factors for the development of complications were also analyzed including site and nature of the lesion, presence of portal hypertension, and number of needle passes. RESULTS A total of 345 lesions were aspirated in 322 patients. EUS-FNA involved the pancreas in 248 cases. Pancreatic lesions included solid (134) and cystic (114) types, which required a mean of 2.5 and 1.4 needle passes, respectively. Complications were observed in 4 (1.2%) patients after aspiration of pancreatic cystic lesions (acute pancreatitis, n = 3; aspiration pneumonia, n = 1) and all cases of pancreatitis resulted from FNA of lesions in the head/uncinate process. No complications resulted from FNA of solid pancreatic lesions. Complications were not observed after FNA of lymph nodes (n = 62) and one case of aspiration pneumonia was observed after FNA of a stromal tumor. EUS-FNA was performed without complication in 16 patients (5%) with portal hypertension. The number of needle passes was not predictive of complications. CONCLUSIONS Because the overall risk of complications from EUS-FNA was relatively low (1.6%) with no severe or fatal incidents and although the risk appears slightly higher than that for standard EUS alone, the safety of EUS-FNA appears acceptable based on this analysis from an experienced center.
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Affiliation(s)
- D O'Toole
- Fédération Medico-Chirurgicule d' Héputo-Yastroentérologic, Hôpital Beaujon, Clichy, France
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Giovannini M, Bardou VJ, Barclay R, Palazzo L, Roseau G, Helbert T, Burtin P, Bouché O, Pujol B, Favre O. Anal carcinoma: prognostic value of endorectal ultrasound (ERUS). Results of a prospective multicenter study. Endoscopy 2001; 33:231-6. [PMID: 11293755 DOI: 10.1055/s-2001-12860] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND STUDY AIMS The classification of anal carcinoma is based on the clinical examination and the estimation of the tumor height (Union Internationale Contre le Cancer (UICC) 1987 Classification). This classification has a direct therapeutic application since tumors which are designated T1 and T2 are generally treated by radiotherapy whereas T3, T4 or N+ lesions are treated by concomitant radiation and chemotherapy. The aim of this prospective multicenter study was to evaluate endorectal ultrasound (ERUS) and to define an ERUS-based classification. PATIENTS AND METHODS Between January 1994 and May 1997, 146 patients (42 men and 104 women; mean age, 63) from eight different centers were studied prospectively. The ERUS classification incorporates disease of the anal canal and the perirectal lymph nodes, thus: usT1 describes involvement of the mucosa and submucosa with sparing of the internal sphincter; usT2, involvement of the internal sphincter with sparing of the external sphincter; usT3, involvement of the external sphincter; usT4, involvement of a pelvic organ; N0 describes no suspicious perirectal lymph nodes, and N+, perirectal lymph nodes fulfilling endosonographic criteria for malignancy (e.g. round, hypoechoic). Tumors classified as UICC T1-T2 (<4cm) N0 were treated by radiotherapy alone, whereas lesions with a UICC classification of T2 (> 4 cm), T3-T4, N0-N1-2-3 received combined radiochemotherapy. RESULTS Data concerning the treatment and follow-up were available for 115/146 patients (78.7%). We compared the prognostic importance of the two classification schemes for treatment response and the rate of local relapse (chi-squared test). A significantly greater proportion of T1-T2N0 lesions classified by ERUS had a complete response to treatment than those classified by conventional UICC staging (94.5% vs. 80%, respectively; P = 0.008). The ERUS T and N stage were significant predictors of relapse (P=0.001 and P=0.03, respectively) whereas the corresponding clinical (UICC) stages were not (P = 0.4 and P = 0.5, respectively). Using a Cox model, usT stage was the only significant predictive factor for patient survival. CONCLUSION This muticenter prospective study demonstrated the superiority of ERUS-based staging over traditional clinical staging in the prediction of important outcomes such as local tumor recurrence and patient survival.
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Affiliation(s)
- M Giovannini
- Oncology and Endoscopic Unit, Paoli-Calmettes Institute, Marseilles, France.
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Ruskoné-Fourmestraux A, Lavergne A, Aegerter PH, Megraud F, Palazzo L, de Mascarel A, Molina T, Rambaud JL. Predictive factors for regression of gastric MALT lymphoma after anti-Helicobacter pylori treatment. Gut 2001; 48:297-303. [PMID: 11171816 PMCID: PMC1760135 DOI: 10.1136/gut.48.3.297] [Citation(s) in RCA: 230] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS Discrepant remission rates (41-100%) have been reported for patients with localised low grade gastric mucosa associated lymphoid tissue (MALT) lymphoma after eradication of Helicobacter pylori. The aim of this study was to explain these discrepancies and to determine the predictive factors of gastric lymphoma regression after anti- H pylori treatment. PATIENTS AND METHODS Forty six consecutive patients with localised gastric MALT lymphoma (Ann Arbor stages I(E) and II(E)) were prospectively enrolled. All had gastric endoscopic ultrasonography and H pylori status assessment (histology, culture, polymerase chain reaction, and serology). After anti-H pylori treatment, patients were re-examined every four months. RESULTS Histological regression of the lymphoma was complete in 19/44 patients (43%) (two lost to follow up). Median follow up time for these 19 responders was 35 months (range 10-47). No regression was noted in the 10 H pylori negative patients. Among the 34 H pylori positive patients, the H pylori eradication rate was 100%; complete regression rate of the lymphoma increased from 56% (19/34) to 79% (19/24) when there was no nodal involvement at endoscopic ultrasonography. There was a significant difference between the response of the lymphoma restricted to the mucosa and other more deep seated lesions (p<0.006). However, using multivariate analysis, the only predictive factor of regression was the absence of nodal involvement (p<0.0001). CONCLUSION In H pylori positive patients with localised gastric MALT lymphoma, carefully evaluated and treated without any lymph node involvement assessed by endoscopic ultrasonography, complete remission of lymphoma was reached in 79% of cases.
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Affiliation(s)
- A Ruskoné-Fourmestraux
- Department of Gastroenterology, Hôtel-Dieu, 1 place du Parvis Notre Dame, 75181 Paris Cedex 4, France.
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Fabre A, Sauvanet A, Flejou JF, Belghiti J, Palazzo L, Ruszniewski P, Ruzniewski P, Degott C, Terris B. Intraductal acinar cell carcinoma of the pancreas. Virchows Arch 2001; 438:312-5. [PMID: 11315630 DOI: 10.1007/s004280000342] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.5] [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: 12/19/2022]
Abstract
We describe a purely intraductal acinar cell carcinoma involving branch ducts of the pancreas in a 74-year-old man, which presented as recurrent episodes of acute pancreatitis. Endoscopic ultrasound examination revealed an intraductal mass bulging into the main pancreatic duct suggesting, pre-operatively, an intraductal mucinous papillary tumour. Gross examination showed several dilated branch ducts that contained haemorrhagic tumour material without any solid or true cystic formation within the pancreatic parenchyma. Using histology, a purely intraductal acinar cell carcinoma was observed, involving branch ducts only, associated with foci of carcinoma in situ in adjacent exocrine parenchyma. The main pancreatic duct was free of disease except for its communication with a cancerous branch duct. A concomitant neuroendocrine microadenoma was incidentally found during slide screening. Immunohistochemistry performed on the intraductal proliferation confirmed zymogen secretion with positive staining for alpha-1 anti-chymotrypsin and anti-trypsin and the persistence of diastase-periodic acid-Schiff positive granules in the apical pole of the tumour cells. Neuroendocrine markers were negative in the acinar cell carcinoma and positive in the neuroendocrine microadenoma. To our knowledge, this is the first report of an intraductal acinar cell carcinoma of the pancreas involving branch ducts and sparing the main pancreatic duct.
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Affiliation(s)
- A Fabre
- Service d'Anatomie Pathologique, Hôpital Beaujon, 110 boulevard du Général Leclerc, 92118 Clichy, France
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Affiliation(s)
- M Greff
- French Society of Digestive Endoscopy, Institut Arnault Tzanck, St. Laurent du Var.
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Affiliation(s)
- V Vilgrain
- Department of Radiology, Hôpital Beaujon, 92118 Clichy Cedex, France
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Systchenko R, Marchetti B, Canard JN, Palazzo L, Ponchon T, Rey JF, Sautereau D. Guidelines of the French Society of Digestive Endoscopy: recommendations for setting up cleaning and disinfection procedures in gastrointestinal endoscopy. Endoscopy 2000; 32:807-18. [PMID: 11068843 DOI: 10.1055/s-2000-7710] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Lambert R, Caletti G, Cho E, Chang KJ, Fusaroli P, Feussner H, Fockens P, Hawes RH, Inui K, Kida M, Lightdale CJ, Matos C, Napoleon B, Palazzo L, Rösch T, Van Dam J. International Workshop on the clinical impact of endoscopic ultrasound in gastroenterology. Endoscopy 2000; 32:549-84. [PMID: 10917190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- R Lambert
- International Agency for Research on Cancer, Lyon, France.
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