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Manigrasso M, D'Amore A, Benatti E, Bracchitta LM, Bracchitta S, Cantarella F, Carpino A, Ferrari F, Gallo G, La Torre M, Magnani C, Magni E, Margiotta A, Masetti M, Mori L, Pata F, Pezza M, Tierno S, Tomassini F, Vanini P, De Palma GD, Milone M. Five-year recurrence after endoscopic approach to pilonidal sinus disease: A multicentre experience. Tech Coloproctol 2023; 27:929-935. [PMID: 37597082 DOI: 10.1007/s10151-023-02846-7] [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: 03/14/2023] [Accepted: 07/21/2023] [Indexed: 08/21/2023]
Abstract
PURPOSE The aim of this study was to evaluate the 5-year recurrence rate of pilonidal sinus disease (PSD) after endoscopic sinusectomy and identify risk factors for recurrence. METHODS All consecutive patients from September 2011 through December 2017 who underwent endoscopic sinusectomy at seven referral centres for pilonidal sinus treatment were retrospectively analysed from a prospectively maintained database. RESULTS Out of 290 patients (185 males versus 105 female, with a mean age of 25.5±6.9), 73 presented recurrence at 5-year follow-up with a recurrence rate of 25.2%. The number of pilonidal sinus with pits off the midline (p = 0.001) and the mean (SD) distance from the most lateral orifice to the midline (p = 0.001) were higher in the group of patients with recurrence at 5-year follow-up. Multivariate analysis demonstrated that the position of the pits off the midline (p = 0.001) and the distance of the most lateral orifice from the midline (p = 0.001) were independent risk factors for recurrence at 5-year follow-up. Receiver operating characteristic (ROC) curve analysis showed that the distance of lateral orifice from midline predicted an 82.2% possibility of recurrence at 5-year follow-up and Youden's test identified the best cut-off as 2 cm for this variable. Out of 195 cases with the most lateral orifice less than 2 cm from the midline, 13 presented recurrence at 5-year follow-up with a recurrence rate of 6.7%. Out of 95 cases with the most lateral orifice more than 2 cm from midline, 60 showed recurrence at 5-year follow-up with a recurrence rate of 63.2%. CONCLUSIONS This data may help guide which disease characteristics predict the optimal use of an endoscopic pilonidal sinus technique.
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Affiliation(s)
- M Manigrasso
- Department of Advanced Biomedical Sciences, "Federico II" University of Naples, Naples, Italy.
| | - A D'Amore
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
| | - E Benatti
- Proctology Unit, ASL 4 Chiavarese, "E. Riboli" Hospital, Lavagna, GE, Italy
| | - L M Bracchitta
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - S Bracchitta
- Coloproctolgy Center, Clinica del Mediterraneo, Ragusa, Italy
| | - F Cantarella
- Centro Proctologico e Perineologico, Ospedali Privati Forlì, Forlì, Italy
| | - A Carpino
- Department of Health Sciences, University of Catanzaro, Catanzaro, Italy
| | - F Ferrari
- Department of Health Sciences, University of Catanzaro, Catanzaro, Italy
| | - G Gallo
- Department of Health Sciences, University of Catanzaro, Catanzaro, Italy
- Department of Surgery, Sapienza University of Rome, Rome, Italy
| | - M La Torre
- Department of Surgery, Sapienza University of Rome, Rome, Italy
| | - C Magnani
- Department of Surgery, AUSL of Imola (BO), Bologna, Italy
| | - E Magni
- Centro Proctologico e Perineologico, Ospedali Privati Forlì, Forlì, Italy
| | - A Margiotta
- Department of Surgery, AUSL of Imola (BO), Bologna, Italy
| | - M Masetti
- Department of Surgery, AUSL of Imola (BO), Bologna, Italy
| | - L Mori
- Proctology Unit, ASL 4 Chiavarese, "E. Riboli" Hospital, Lavagna, GE, Italy
| | - F Pata
- Department of Surgery, Nicola Giannettasio Hospital, Corigliano-Rossano, CS, Italy
| | - M Pezza
- Proctology Unit, ASL 4 Chiavarese, "E. Riboli" Hospital, Lavagna, GE, Italy
| | - S Tierno
- Department of Surgery, Ospedale Vannini, Rome, Italy
| | - F Tomassini
- Department of Surgery, Ospedale Grassi, Rome, Italy
| | - P Vanini
- Centro Proctologico e Perineologico, Ospedali Privati Forlì, Forlì, Italy
| | - G D De Palma
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
| | - M Milone
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
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Bruno F, Elia E, D'Ascenzo F, Marengo G, De Filippo O, Gallone G, Andreis A, Fortuni F, Salizzoni S, Rinaldi M, La Torre M, Conrotto F, De Ferrari GM. Valve-in-valve transcatheter aortic valve replacement or re-surgical aortic valve replacement in degenerated bioprostheses: a systematic review and meta-analysis of short and mid-term results. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2188] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
Despite limited to short and mid-term outcomes, Valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) has emerged as a less invasive alternative to redo surgery for high and intermediate-risk patients with good outcomes across different surgical risk profiles.
Purpose
The aim of the resent meta-analysis is to compare short and mid-term outcomes of VIV and surgical redo fo patients with a degenerative aortic bioprosthesis.
Methods
All studies comparing with multivariate adjustment between ViV TAVI and re-SAVR were screened. All-cause mortality at 30-day and at follow-up were the primary endpoints, while Valve Academy research Consortium (VARC) endpoints at 30 days including stroke, myocardial infarction (MI), major vascular complications, major bleeding, new onset atrial fibrillation (AF) and permanent pacemaker implantation (PPI) during the index hospitalization were the secondary endpoints. Subgroup analysis were performed according to the surgical risk. All the analyses were stratified according to the design of the study (observational vs propensity-matched study).
Results
We obtained data from 11 studies, encompassing 8570 patients, 4224 undergoing ViV TAVI and 4346 re-SAVR. Four studies included intermediate-risk patients and seven high-risk patients. Mean age was 76 and 71.5 years in the ViV and re-SAVR group respectively, with a 60.2% and 61.3% of male. For the ViV procedure, BE prostheses were used in the 49.6% of patients and SE prostheses in the 45.8%. The ViV group have higher prevalence of previous CAD (53.8% vs 41.1%) and CABG (35% vs 23.6%) and more history of HF (72.1% vs 65.6%), CKD (26.6% vs 14.8%) and COPD (25.4 vs 14.8%). 30-day all-cause and CV mortality were significantly lower in ViV (OR 0.43, 0.29–0.64 and OR 0.44, 0.26–0.73 respectively), while after a mean follow-up of 717 (180–1825) days, there were no difference between the two groups (OR 1.04, 0.87–1.25 and OR 1.05, 0.78–1.43 respectively). The result were consistent both in intermediate and high-risk classes. The risk of stroke (OR 1.03, 0.59–1.82), MI (OR 0.70, 0.34–1.44), major vascular complications (OR 0.92, 0.50–1.67) and permanent pacemaker implantation (OR 0.67, 0.36–1.25) at 30 days did not differ, while major bleedings and new onset atrial fibrillation were significantly lower in ViV patients (OR 0.41, 0.25–0.67 and OR 0.23, 0.12–0.42 respectively, all CI 95%).
Conclusions
In patients with a degenerated aortic bioprosthesis, ViV TAVI is associated with better short-term outcomes, including all-cause mortality, without any difference in all-cause and cardiovascular mortality at mid-term follow-up compared to surgical redo.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Bruno
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - E Elia
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - F D'Ascenzo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - G Marengo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - O De Filippo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - G Gallone
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - A Andreis
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - F Fortuni
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - S Salizzoni
- A.O.U. Citta della Salute e della Scienza di Torino, Cardiosurgery, Turin, Italy
| | - M Rinaldi
- A.O.U. Citta della Salute e della Scienza di Torino, Cardiosurgery, Turin, Italy
| | - M La Torre
- A.O.U. Citta della Salute e della Scienza di Torino, Cardiosurgery, Turin, Italy
| | - F Conrotto
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - G M De Ferrari
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
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3
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Bruno F, D'Ascenzo F, Giordana F, Saglietto A, Conrotto F, De Filippo O, Grosso Marra W, Salizzoni S, Trompeo A, La Torre M, D'Amico M, Rinaldi M, Giustetto C, De Ferrari G. Incidence, predictors and outcomes of Valve-in-valve (ViV) Transcatheter aortic valve replacement (TAVR): a systematic review and meta-analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1947] [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
Surgical aortic valve replacement has been the treatment of choice for patients with aortic valve disease before the arrival of transcatheter aortic valve replacement (TAVI), although limited by degeneration of the bioprosthesis. “Redo” intervention itself is burdened by high risk of complications and valve-in-valve (ViV) TAVI could be a valid strategy of redo for patients with comorbidities. The aim of this meta-analysis is to give an overview of the state of the art of ViV TAVI in high-risk patients, analyzing efficacy, safety, intra-hospital outcomes and 1-year outcomes and assess predictors of survival at short and mid-term follow up.
Methods
Two independent reviewers screened all studies investigating patients undergoing ViV TAVI. PubMed database was searched for reports published in English according to the following highly sensitive strategy: (Transcatheter[All Fields] AND “aortic”[All Fields]) AND valve-in-valve[All Fields] AND “implantation”[All Fields] NOT (review[pt] OR editorial[pt] OR letter[pt])AND “humans”[MeSH Terms]). Mortality at 30 days and at 1 year were the primary end point, while procedural and short-term outcomes and echocardiographic parameters at hospital discharge were the secondary end points.
Results
Of 286 studies identified, 26 articles were included, with a total of 1448 patients. Median age was 78.8 years, 57.7% of the patients were male. Median STS-predicted risk of mortality was 9.4% while median Logistic EuroSCORE was 31.3%. Median age of bioprosthesis was 10 years with 84.6% of stented valves. Stenosis (45%), followed by regurgitation (31%) and mixed defects (21%) were the causes of prosthesis failure. Diameter of the degenerated valve was ≤21 mm in 25.4%, 22–25 mm in 55% and >25mm in 11.7% of the patients. Transfemoral approach was preferred (76%), with a prevalence of balloon expandable valve (73.3%). Mean post procedural gradient was 16.7±0.8 mmHg. Mean follow up was 376 days. Overall and cardiovascular mortality at 30 days was 6.5% and 5.5% respectively, while at 1 year it was 14.5% and 8.9% respectively. Regarding short-term outcomes, overall bleeding (10.4%), pacemaker implantation (9.4%) and vascular complications (8.3%) were the most common peri-procedural complications, while stroke (2.3%), myocardial infarction (2.7%) and coronary obstruction (2.8%) were less frequent. At meta-regression analysis study year (p<0.001), Logistic Euroscore (p<0.01) and valve diameter ≤21 mm (p<0.05) at 30 days, and stenosis as reason for failure (p=0.05) at 1 year were identified as possible predictors of survival.
Conclusions
Percutaneous valve-in-valve aortic valve implantation offers a valid strategy to treat high risk patients with a degenerative bioprosthesis. Short and mid-term outcomes are substantially superimposable to those of TAVI, except for coronary obstruction which appears more frequent. Future studies are needed to find predictors of long- term survival and outcomes in lower risk patients.
Outcome of VIV TAVI
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- F Bruno
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - F D'Ascenzo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - F Giordana
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - A Saglietto
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - F Conrotto
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - O De Filippo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - W Grosso Marra
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - S Salizzoni
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - A Trompeo
- A.O.U. Citta della Salute e della Scienza di Torino, Cardiosurgery, Turin, Italy
| | - M La Torre
- A.O.U. Citta della Salute e della Scienza di Torino, Cardiosurgery, Turin, Italy
| | - M D'Amico
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - M Rinaldi
- A.O.U. Citta della Salute e della Scienza di Torino, Cardiosurgery, Turin, Italy
| | - C Giustetto
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - G De Ferrari
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
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4
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Vicchio TM, Aliquò F, Ruggeri RM, Ragonese M, Giuffrida G, Cotta OR, Spagnolo F, Torre ML, Alibrandi A, Asmundo A, Angileri FF, Esposito F, Polito F, Oteri R, Aguennouz MH, Cannavò S, Ferraù F. MicroRNAs expression in pituitary tumors: differences related to functional status, pathological features, and clinical behavior. J Endocrinol Invest 2020; 43:947-958. [PMID: 31939196 DOI: 10.1007/s40618-019-01178-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 07/03/2019] [Accepted: 12/31/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND MicroRNAs (miRNAs) are small non-coding RNA molecules that regulate gene expression at post-transcriptional level, having a role in many biological processes, such as control of cell proliferation, cell cycle, and cell death. Altered miRNA expression has been reported in many neoplasms, including pituitary adenomas (PAs). PURPOSE In this study, we aimed to evaluate the expression of 20 miRNAs involved in pathways relevant to pituitary pathophysiology, in PAs and normal pituitary tissue and to correlate their expression profile with clinical and pathological features. METHODS Pituitary tumor samples were obtained during transphenoidal surgery from patients with non-functioning (NFPA, n = 12) and functioning (n = 11, 5 GH-, 3 ACTH-, 3 PRL-omas) PAs. The expression of selected miRNAs in PAs and in normal pituitary was analyzed by RT-qPCR. miRNAs expression was correlated with demographic, clinical, and neuroradiological data and with histopathological features including pituitary hormones immunostaining, Ki-67 proliferation index, and p53 immunohistochemistry evaluation. RESULTS All evaluated miRNAs except miR-711 were expressed in both normal and tumor pituitary tissue. Seventeen miRNAs were significantly down-regulated in pituitary tumors compared to normal pituitary. miRNAs were differentially expressed in functioning PAs or in NFPAs, as in the latter group miR-149-3p (p = 0.036), miR-130a-3p (p = 0.014), and miR-370-3p (p = 0.026) were significantly under expressed as compared to functioning tumors. Point-biserial correlation analysis demonstrated a negative correlation between miR-26b-5p and Ki-67 (p = 0.031) and between miR-30a-5p and 'atypical' morphological features (p = 0.038) or cavernous sinus invasion (p = 0.049), while 508-5p was inversely correlated with clinical aggressiveness (p = 0.043). CONCLUSIONS In this study, we found a significant down-regulation of 17 miRNAs in PAs vs normal pituitary, with differential expression profile related to functional status and tumor aggressiveness.
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Affiliation(s)
- T M Vicchio
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
| | - F Aliquò
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - R M Ruggeri
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - M Ragonese
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
| | - G Giuffrida
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - O R Cotta
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
| | - F Spagnolo
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
| | - M L Torre
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
| | - A Alibrandi
- Department of Economics, University of Messina, Messina, Italy
| | - A Asmundo
- Department of Biomedical Sciences, Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - F F Angileri
- Department of Biomedical Sciences, Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - F Esposito
- Department of Biomedical Sciences, Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - F Polito
- Department of Human Pathology of Adulthood and Childhood 'G. Barresi', University of Messina, UOC di Endocrinologia, Pad. H, 4° Piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - R Oteri
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - M H Aguennouz
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - S Cannavò
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
- Department of Human Pathology of Adulthood and Childhood 'G. Barresi', University of Messina, UOC di Endocrinologia, Pad. H, 4° Piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - F Ferraù
- Department of Human Pathology of Adulthood and Childhood 'G. Barresi', University of Messina, UOC di Endocrinologia, Pad. H, 4° Piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy.
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5
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Gallo G, La Torre M, Pietroletti R, Bianco F, Altomare DF, Pucciarelli S, Gagliardi G, Perinotti R. Italian society of colorectal surgery recommendations for good clinical practice in colorectal surgery during the novel coronavirus pandemic. Tech Coloproctol 2020; 24:501-505. [PMID: 32291566 PMCID: PMC7154569 DOI: 10.1007/s10151-020-02209-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 01/12/2023]
Affiliation(s)
- G Gallo
- Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
| | - M La Torre
- Coloproctology Unit, S. Anna Clinic, Pomezia, Italy
| | - R Pietroletti
- Coloproctology Unit, Hospital Val Vibrata, University of L'Aquila, L'Aquila, Italy
| | - F Bianco
- General Surgery Unit, S. Leonardo Hospital, Castellammare Di Stabia, Napoli, Italy
| | - D F Altomare
- Functional and Oncologic Colorectal Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
- IRCCS Ospedale Oncologico Giovanni Paolo II, Bari, Italy
| | - S Pucciarelli
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - G Gagliardi
- Department of Surgery, University of Illinois At Chicago, Chicago, IL, USA
| | - R Perinotti
- Colorectal Surgical Unit, Department of Surgery, Infermi Hospital, Biella, Italy
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La Torre M, Pata F, Gallo G. Delayed benign surgery during the COVID-19 pandemic: the other side of the coin. Br J Surg 2020; 107:e258. [PMID: 32441318 PMCID: PMC7280568 DOI: 10.1002/bjs.11712] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 04/28/2020] [Indexed: 11/24/2022]
Affiliation(s)
| | - F Pata
- Nicola Giannettasio Hospital, Corigliano-Rossano, La Sapienza University, Rome, Italy
| | - G Gallo
- Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy
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Abstract
AIM A new artificial anal sphincter placed into the intersphincteric space, SphinKeeper™, has recently been proposed to improve outcomes in the treatment of faecal incontinence (FI). We report our preliminary results with short-term follow-up, comparing preoperative and postoperative data after implant of SphinKeeper™ in patients suffering from FI. METHODS All patients older than 18 years were included with FI of at least 6 months, incontinence episodes occurring more than once a week and resistance to other conservative treatments. Anorectal manometry, endoanal ultrasound, Cleveland Clinic FI Score, FI Quality of Life score and total number of episodes of FI per week were recorded preoperatively and at the end of the 6-month follow-up period. RESULTS Thirteen consecutive patients were treated with SphinKeeper™. No intra-operative nor postoperative complications were reported. Two cases of prosthesis extrusion occurred, and in one case an anterior dislocation was detected. Maximum resting pressure, total number of episodes of FI per week and Cleveland Clinic FI Score were improved after 6 months (P < 0.05). CONCLUSIONS SphinKeeper™ could be a minimally invasive procedure for FI with good postoperative outcomes. If these results are confirmed by studies with more patients and longer follow-up, it could be a first-line approach in FI.
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Affiliation(s)
- M. La Torre
- Department of SurgeryPoliclinico Umberto PrimoSapienza UniversityRomeItaly
| | - G. Lisi
- Department of General SurgerySant'Eugenio HospitalRomeItaly
| | - G. Milito
- Department of General SurgeryClinica Valle GiuliaRomeItaly
| | - M. Campanelli
- Department of General SurgeryUniversity of Modena and Reggio EmiliaModenaItaly
| | - I. Clementi
- Department of EmergencyPoliclinico Umberto PrimoSapienza UniversityRomeItaly
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8
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Bruno F, Errica N, D'Ascenzo F, Conrotto F, De Filippo O, Salizzoni S, La Torre M, D'Amico M, Omede P, Tarantini G, Dowling C, Shamsi A, Rinaldi M. P1789Outcomes of different approaches for severe aortic stenosis: “"The Deferred-TAVI”, a multicentre study investigating medical and percutaneous therapy in the era of TAVI. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0541] [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: 11/12/2022] Open
Abstract
Abstract
Background
In the era of TAVI, also very high surgical risk patients can be treated and the importance of the Heart Team is to address the patient to the right therapy. In some cases due to comorbidities, lack of symptoms and patients' decision not always a final decision is achieved after the first clinical evaluation and the final strategy could be deferred for months.
Purpose
The study aims to analyze outcomes in patients with severe aortic stenosis differently treated according to the various approaches proposed by the Heart Team.
Methods
All the patients with a diagnosis of severe aortic stenosis considered at high and very high surgical risk were enrolled. Three international cardiology departments participated in this multicentre study. All the patients were divided into four groups according to the Heart Team decision of approach. Patients with indication to medical therapy only (DTO Drug therapy only), Patients first deferred from heart team decision, personal reasons or lack of symptoms and then addressed to medical therapy (D-DTO Deferred-Drug therapy only), Patients deferred and then addressed to TAVI within 3 months (D-TP Deferred TAVI Procedure), Patients with direct indication to TAVI (ITP Immediate TAVI procedure). Primary endpoint were overall survive at follow up comparing the differences between the four groups and the impact of the deferred strategy.
Results
795 patients were enrolled (80 DTO, 451 ITP, 264 initially deferred and then 155 D-DTO and 109 D-TP). Median follow-up was 465 days. Overall survive of the four groups at 1 year was 74% DTO, 73% D-DTO, 77% D-TP and 78% ITP, at 2 years 62% DTO, 38% D-DTO, 62% D-TP and 68% ITP, at 3 years 39% DTO, 11% D-DTO, 25% D-TP and 56% ITP (p≤0,001 at log rank test). At the multivariate analysis, compared to the referral group DTO, D-DTO was associated with higher mortality (HR=1,90; IC [95%]: 1,05–3,58; p=0,03 at 2 years; HR 1,66; IC [95%]: 1,01–2,76; p<0,05, at 3 years), while D-TP was not associated with lower mortality risk (HR 1,31 IC [95%]: 0,62–2,76; p=0,72 at 2 years, HR 1,37 IC [95%]: 0,77–2,44; p=0,77 at 3 years). ITP was associated with lower mortality risk only at 3 years (HR 0,60; IC [95%]: 0,42–0,99; p<0.05). Comparing the group deferred (D-DTO and D-TP) to the group not deferred (DTO and ITP), the deferred group was associated with higher mortality risk (HR 1,86; IC [95%]: 1,30–2.65; p=0,001 at 2 years, HR 2,21; IC [95%]: 1,61–3,05; p<0,001 at 3 years).
Conclusions
The Heart team decision on the approach of treatment strongly influence the survive of the patient. Compared to direct medical therapy, there is a higher risk of mortality for patients initially deferred and then treated with medical therapy and there is no survival benefit for patients initially deferred and then treated with TAVI. The choice of deferring the treatment of patients with severe aortic stenosis clearly decrease long term survive at follow up regardless the strategy of the approach.
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Affiliation(s)
- F Bruno
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - N Errica
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - F D'Ascenzo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - F Conrotto
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - O De Filippo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - S Salizzoni
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiosurgery, Turin, Italy
| | - M La Torre
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiosurgery, Turin, Italy
| | - M D'Amico
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - P Omede
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - G Tarantini
- University Hospital of Padova, Cardiology, Padua, Italy
| | - C Dowling
- St Georges Hospital, Cardiology, London, United Kingdom
| | - A Shamsi
- St Georges Hospital, Cardiology, London, United Kingdom
| | - M Rinaldi
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiosurgery, Turin, Italy
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9
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Rosa de Olivera W, Onodera A, La Torre M. Influence of Cleat Design on Knee Joint Moments During Cutting Maneuver and Instep Kick in Soccer. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.03.2019.13] [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: 11/05/2022]
Affiliation(s)
- W. Rosa de Olivera
- Dass Nordeste Calçados e Artigos Esportivos S.A Biomechanics Laboratory, Ivoti, Rio Grande do Sul state (RS), Brazil
- Universidade do Vale do Rio dos Sinos , São Leopoldo, RS, Brazil
| | - A.N. Onodera
- Universidade do Vale do Rio dos Sinos , São Leopoldo, RS, Brazil
| | - M. La Torre
- Universidade do Vale do Rio dos Sinos , São Leopoldo, RS, Brazil
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10
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Bianco F, De Franciscis S, Belli A, Falato A, Fusco R, Altomare DF, Amato A, Asteria CR, Avallone A, Binda GA, Boccia L, Buzzo P, Carvello M, Coco C, Delrio P, De Nardi P, Di Lena M, Failla A, La Torre F, La Torre M, Lemma M, Luffarelli P, Manca G, Maretto I, Marino F, Muratore A, Pascariello A, Pucciarelli S, Rega D, Ripetti V, Rizzo G, Serventi A, Spinelli A, Tatangelo F, Urso EDL, Romano GM. T1 colon cancer in the era of screening: risk factors and treatment. Tech Coloproctol 2017; 21:139-147. [DOI: 10.1007/s10151-017-1586-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 10/03/2016] [Indexed: 02/07/2023]
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11
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Ferraù F, Romeo PD, Puglisi S, Ragonese M, Torre ML, Scaroni C, Occhi G, De Menis E, Arnaldi G, Trimarchi F, Cannavò S. Analysis of GPR101 and AIP genes mutations in acromegaly: a multicentric study. Endocrine 2016; 54:762-767. [PMID: 26815903 DOI: 10.1007/s12020-016-0862-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 11/06/2015] [Accepted: 01/08/2016] [Indexed: 12/17/2022]
Abstract
This multicentric study aimed to investigate the prevalence of the G protein-coupled receptor 101 (GPR101) p.E308D variant and aryl hydrocarbon receptor interacting protein (AIP) gene mutations in a representative cohort of Italian patients with acromegaly. 215 patients with GH-secreting pituitary adenomas, referred to 4 Italian referral centres for pituitary diseases, have been included. Three cases of gigantism were present. Five cases were classified as FIPA. All the patients have been screened for germline AIP gene mutations and GPR101 gene p.E308D variant. Heterozygous AIP gene variants have been found in 7 patients (3.2 %). Five patients carried an AIP mutation (2.3 %; 4 females): 3 patients harboured the p.R3O4Q mutation, one had the p.R304* mutation and the last one the IVS3+1G>A mutation. The prevalence of AIP mutations was 3.3 % and 2.8 % when considering only the patients diagnosed when they were <30 or <40-year old, respectively. Furthermore, 2.0 % of the patients with a pituitary macroadenoma and 4.2 % of patients resistant to somatostatin analogues treatment were found to harbour an AIP gene mutation. None of the patients was found to carry the GPR101 p.E308D variant. The prevalence of AIP gene mutations among our sporadic and familial acromegaly cases was similar to that one reported in previous studies, but lower when considering only the cases diagnosed before 40 years of age. The GPR101 p.E308D change is unlikely to have a role in somatotroph adenomas tumorigenesis, since none of our sporadic or familial patients tested positive for this variant.
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Affiliation(s)
- Francesco Ferraù
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Messina, UOC di Endocrinologia, Pad. H, 4° piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy.
| | - P D Romeo
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Messina, UOC di Endocrinologia, Pad. H, 4° piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - S Puglisi
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Messina, UOC di Endocrinologia, Pad. H, 4° piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - M Ragonese
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Messina, UOC di Endocrinologia, Pad. H, 4° piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - M L Torre
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Messina, UOC di Endocrinologia, Pad. H, 4° piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - C Scaroni
- Endocrinology Unit, Department of Medicine, Padova University Hospital, Padua, Italy
| | - G Occhi
- Department of Biology, University of Padova, Padua, Italy
| | - E De Menis
- Department of Internal Medicine, General Hospital of Montebelluna, Treviso, Italy
| | - G Arnaldi
- Department of Endocrinology and Metabolic Diseases, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| | - F Trimarchi
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Messina, UOC di Endocrinologia, Pad. H, 4° piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - S Cannavò
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Messina, UOC di Endocrinologia, Pad. H, 4° piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
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12
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Giuliani G, Guerra F, Coletta D, La Torre M, Franco G, Leonardo C, Infantino A, La Torre F. Repair of transperineal recto-urethral fistula using a fibrin sealant haemostatic patch. Colorectal Dis 2016; 18:O432-O435. [PMID: 27629783 DOI: 10.1111/codi.13518] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 07/18/2016] [Indexed: 02/08/2023]
Abstract
AIM Recto-urethral fistula (RUF) is a rare complication of radical prostatectomy. We report a transperineal approach using a fibrin sealant haemostatic patch. METHOD Five consecutive patients who developed RUF following radical prostatectomy had a direct transperineal repair with a haemostatic patch (TachoSil®) and were assessed at a median follow-up of 35.5 (21-45) months. RESULTS There were no early postoperative complications. The average length of hospital stay was 5 (4-7) days. One patient developed recurrence 4 weeks after removal of the urethral catheter. Following healing in four patients the stoma was reversed at a median interval of 3 months, and 9.5 (7-10) months following the prostatic surgery. In the four patients with successful closure there was no case of recurrence or anorectal or urinary dysfunction at a median follow-up of 35.5 (21-45) months. CONCLUSION Direct transperineal repair of RUF reinforced with a fibrin haemostatic patch of TachoSil is safe and effective.
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Affiliation(s)
- G Giuliani
- Surgical Department, Sapienza University, Policlinico 'Umberto I', Rome, Italy.
| | - F Guerra
- Surgical Department, Sapienza University, Policlinico 'Umberto I', Rome, Italy
| | - D Coletta
- Surgical Department, Sapienza University, Policlinico 'Umberto I', Rome, Italy
| | - M La Torre
- Surgical Department, Sapienza University, Policlinico 'Umberto I', Rome, Italy
| | - G Franco
- Department of Obstetrics, Gynecology and Urology, 'Sapienza' University, Rome, Italy
| | - C Leonardo
- Department of Obstetrics, Gynecology and Urology, 'Sapienza' University, Rome, Italy
| | - A Infantino
- Department of Surgery, Santa Maria dei Battuti Hospital, San Vito al Tagliamento, PN, Italy
| | - F La Torre
- Surgical Department, Sapienza University, Policlinico 'Umberto I', Rome, Italy
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Meinero P, Stazi A, Carbone A, Fasolini F, Regusci L, La Torre M. Endoscopic pilonidal sinus treatment: a prospective multicentre trial. Colorectal Dis 2016; 18:O164-70. [PMID: 26946340 DOI: 10.1111/codi.13322] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 02/11/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Pilonidal disease (PD) is a common inflammatory disease of the gluteal fold, resulting in recurrent acute/chronic infection at the level of the natal cleft. In this study, endoscopic pilonidal sinus treatment (EPSiT), a new endoscopic minimally invasive procedure, was evaluated for its effectiveness in treating PD. METHODS Two hundred and fifty prospective patients with chronic PD were enrolled in a prospective multicentre study conducted at a secondary and tertiary colorectal surgery centre. The primary end-point of this study was wound healing, and the short-/long-term outcomes such as healing time, morbidity rate and recurrence rate were analysed. The secondary end-point of this study was quality of life (QoL). RESULTS The complete wound healing rate was 94.8%, and the mean complete wound healing time was 26.7 ± 10.4 days. The incomplete healing rate (5.2%) was significantly related to the number of external openings (P = 0.01). There was no difference in the failure rate when EPSiT was performed as the first-line treatment for PD or when it was used after unsuccessful procedures (P = n.s.). Recurrence occurred in 12 cases (5%). The QoL significantly increased from preoperative levels 15 days after the EPSiT procedure (45.3 vs 7.9; P < 0.0001). CONCLUSIONS The EPSiT procedure is a safe and effective technique for treating PD. It provides better short- and long-term outcomes than various other techniques that are more invasive. EPSiT is a minimally invasive outpatient procedure, which is associated with a quick recovery and a good QoL outcome.
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Affiliation(s)
- P Meinero
- Colorectal Unit Sanatrix Clinic, Rome and Sestri Levante Hospital, Genova, Italy.,Department of Surgery, EOC Hospital, Mendrisio, Switzerland
| | - A Stazi
- Pelvic Care Center, Madonna delle Grazie Hospital, Velletri, Rome, Italy
| | - A Carbone
- Colorectal Unit Sanatrix Clinic, Rome and Sestri Levante Hospital, Genova, Italy.,Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - F Fasolini
- Department of Surgery, EOC Hospital, Mendrisio, Switzerland
| | - L Regusci
- Department of Surgery, EOC Hospital, Mendrisio, Switzerland
| | - M La Torre
- Colorectal Unit Sanatrix Clinic, Rome and Sestri Levante Hospital, Genova, Italy.,Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
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14
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Cannavo S, Ragonese M, Puglisi S, Romeo PD, Torre ML, Alibrandi A, Scaroni C, Occhi G, Ceccato F, Regazzo D, De Menis E, Sartorato P, Arnaldi G, Trementino L, Trimarchi F, Ferrau F. Acromegaly Is More Severe in Patients With AHR or AIP Gene Variants Living in Highly Polluted Areas. J Clin Endocrinol Metab 2016; 101:1872-9. [PMID: 26963951 DOI: 10.1210/jc.2015-4191] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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: 02/13/2023]
Abstract
CONTEXT An increased prevalence of acromegaly was found some years ago in a highly polluted area in North-Eastern Sicily, where high concentration of nonmethane hydrocarbons, volatile organic compounds, and cadmium was found. Aryl hydrocarbon receptor (AHR) pathway has a key role in detoxification of these compounds and in tumorigenesis. OBJECTIVE We correlated the occurrence of AHR and/or AHR-interacting protein (AIP) gene variants with acromegaly severity according to pollution exposition. DESIGN, SETTING, AND PATIENTS This was an observational, perspective study conducted over 7 years in four Italian referral centers for pituitary diseases in which 210 patients with acromegaly were enrolled between 2008 and 2015. INTERVENTION Genetic screening of patients for AHR and AIP variants. MAIN OUTCOME MEASURES Clinical, biochemical, and radiological data of patients with and without AIP and/or AHR gene variants, living in polluted (high-risk for health, [HR]) or nonpolluted (NP) areas of five Italian regions were evaluated and compared. RESULTS Among the 23 patients from HR areas, nine showed AHR or AIP variants. Mean IGF-I levels and pituitary tumor diameter were significantly higher in these nine patients (HR/VAR+) than in the other 14 (HR/VAR−) and in the 187 from NP areas (44 NP/VAR+). Somatostatin analogs significantly decreased mean GH and IGF-I levels in patients from NP areas and in HR/VAR− (GH P < .05; IGF-I times the upper limit of normal P < .01) but not in HR/VAR+ group. CONCLUSIONS Genetic variants potentially inducing functional abnormalities of the aryl hydrocarbon receptor (AHR) pathway are associated with a more severe acromegaly, increased pituitary tumor size, and somatostatin analog resistance in patients living in HR areas.
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Affiliation(s)
- S Cannavo
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - M Ragonese
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - S Puglisi
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - P D Romeo
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - M L Torre
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - A Alibrandi
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - C Scaroni
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - G Occhi
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - F Ceccato
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - D Regazzo
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - E De Menis
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - P Sartorato
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - G Arnaldi
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - L Trementino
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - F Trimarchi
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - F Ferrau
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
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Serra E Moura Garcia C, Sokolova A, Torre ML, Amaro C. Acute Hemorrhagic Edema of Infancy. Eur Ann Allergy Clin Immunol 2016; 48:22-26. [PMID: 26808448] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Acute Hemorrhagic Edema of Infancy is a small vessel leucocytoclastic vasculitis affecting young infants. It is characterized by large, target-like, macular to purpuric plaques predominantly affecting the face, ear lobes and extremities. Non-pitting edema of the distal extremities and low-grade fever may also be present. Extra-cutaneous involvement is very rare. Although the lesions have a dramatic onset in a twenty-four to forty-eight hour period, usually the child has a non-toxic appearance. In most cases there are no changes in laboratory parameters. The cutaneous biopsy reveals an inflammatory perivascular infiltrate. It is a benign and auto-limited disease, with complete resolution within two to three weeks leaving no sequelae in the majority of cases. No recurrences are described. We report a case of a 42-day old girl admitted at our hospital with Acute Hemorrhagic Edema of Infancy.
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Affiliation(s)
- C Serra E Moura Garcia
- Department of Paediatrics, Hospital Prof. Doutor Fernando Fonseca EPE, Amadora, Portugal. E-Mail:
| | - A Sokolova
- Department of Paediatrics, Hospital Prof. Doutor Fernando Fonseca EPE, Amadora, Portugal
| | - M L Torre
- Department of Paediatrics, Hospital Prof. Doutor Fernando Fonseca EPE, Amadora, Portugal
| | - C Amaro
- Department of Dermatology, Hospital CurryCabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal
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Perteghella S, Vigani B, Crivelli B, Spinaci M, Galeati G, Bucci D, Vigo D, Torre ML, Chlapanidas T. Sperm Encapsulation from 1985 to Date: Technology Evolution and New Challenges in Swine Reproduction. Reprod Domest Anim 2015; 50 Suppl 2:98-102. [DOI: 10.1111/rda.12538] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 04/20/2015] [Indexed: 11/29/2022]
Affiliation(s)
- S Perteghella
- Department of Drug Sciences; University of Pavia; Pavia Italy
| | - B Vigani
- Department of Drug Sciences; University of Pavia; Pavia Italy
| | - B Crivelli
- Department of Drug Sciences; University of Pavia; Pavia Italy
| | - M Spinaci
- Department of Veterinary Medical Sciences-DIMEVET; University of Bologna; Ozzano dell'Emilia Bologna Italy
| | - G Galeati
- Department of Veterinary Medical Sciences-DIMEVET; University of Bologna; Ozzano dell'Emilia Bologna Italy
| | - D Bucci
- Department of Veterinary Medical Sciences-DIMEVET; University of Bologna; Ozzano dell'Emilia Bologna Italy
| | - D Vigo
- Department of Veterinary Sciences and Public Health; University of Milan; Milan Italy
| | - ML Torre
- Department of Drug Sciences; University of Pavia; Pavia Italy
| | - T Chlapanidas
- Department of Drug Sciences; University of Pavia; Pavia Italy
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Mazzuca F, Botticelli A, Lionetto L, La Torre M, Giusti R, Maddalena C, Pellegrini P, Gentile G, Ciabatta F, Borro M, Ziparo V, Simmaco M, Marchetti P. Effect of Degradation Rate of 5-Fu and Genetic Polymorphisms of Dpd, Tser and Mthrf on Toxicity and Survival of 5-Fu-Based Chemotherapy in Gastric Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.55] [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: 11/14/2022] Open
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18
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Cannavo S, Ferrau F, Ragonese M, Romeo PD, Torre ML, Puglisi S, De Menis E, Arnaldi G, Salpietro C, Cotta OR, Albani A, Ruggeri RM, Trimarchi F. Increased frequency of the rs2066853 variant of aryl hydrocarbon receptor gene in patients with acromegaly. Clin Endocrinol (Oxf) 2014; 81:249-53. [PMID: 24521362 DOI: 10.1111/cen.12424] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 11/11/2013] [Revised: 12/03/2013] [Accepted: 02/03/2014] [Indexed: 12/13/2022]
Abstract
CONTEXT Aryl hydrocarbon receptor (AHR) pathway has a key role in cellular detoxification mechanisms and seems implicated in tumorigenesis. Moreover, polymorphisms and mutations of AHR gene have been associated with several human and animal tumours. Although AHR has been found differently expressed in pituitary adenomas, AHR gene mutation status has never been investigated in acromegalic patients. DESIGN In this study, we evaluated patients with apparently sporadic GH-secreting pituitary adenoma for AHR gene variants. PATIENTS AND METHODS Seventy patients with sporadic GH-secreting pituitary adenoma (M = 27, age 59.1 ± 1.6 years) and 157 sex- and age-matched controls were enrolled in the study. In all patients and controls, the exons 1, 2, 3, 5 and 10 of AHR gene were evaluated for nucleotide variants by sequencing analysis. RESULTS The rs2066853 polymorphism was identified in the exon 10 of 18/70 acromegalic patients and 9/157 healthy subjects (25.7 vs. 5.7%, χ(2) = 18.98 P < 0.0001), in homozygosis in one patient and in heterozygosis in the other 17 and in the 9 healthy subjects. Moreover, a heterozygous rs4986826 variant in exon 10 was identified in a patient with heterozygous rs2066853 polymorphism, and in the patient with homozygous rs2066853 variant. This second polymorphism was not detected in the control group. Patients with rs2066853 polymorphism showed increased IGF-1 ULN (P < 0.05) and prevalence of cavernous sinus invasion (P = 0.05), thyroid (P = 0.02), bladder (P = 0.0001) or lymphohematopoietic (P < 0.05) tumours. CONCLUSIONS AHR gene rs2066853 polymorphism is significantly more frequent in acromegalic patients than in healthy subjects and is associated with increased disease aggressivity. Moreover, the rs4986826 variant was detected in few patients with rs2066853 polymorphism, but its role is to be cleared.
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Affiliation(s)
- S Cannavo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Chlapanidas T, Tosca MC, Faragò S, Perteghella S, Galuzzi M, Lucconi G, Antonioli B, Ciancio F, Rapisarda V, Vigo D, Marazzi M, Faustini M, Torre ML. Formulation and characterization of silk fibroin films as a scaffold for adipose-derived stem cells in skin tissue engineering. Int J Immunopathol Pharmacol 2013; 26:43-9. [PMID: 24046948 DOI: 10.1177/03946320130260s106] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Skin substitutes are epidermal, dermal or complete bilayered constructs, composed by natural or synthetic scaffolds and by adherent cells such as fibroblasts, keratinocytes or mesenchymal stem cells. Silk fibroin is a promising polymer to realize scaffolds, since it is biocompatible, biodegradable, and exhibits excellent mechanical properties in terms of tensile strength. Moreover, fibroin can be added of others components in order to modify the biomaterial properties for the purpose. The aim of this work is to prepare silk fibroin films for adipose-derived stem cell (ADSCs) culture as a novel feeder layer for skin tissue engineering. Pectin has been added to promote the protein conformational transition and construct strength, while glycerol as plasticizer, providing biomaterial flexibility. Eighteen formulations were prepared by casting method using fibroin, pectin (range 1-10% w/w), and glycerol (range 0-20% w/w); films were characterized by Fourier transform infrared spectroscopy and differential scanning calorimetry assay, to select the optimal composition. A stable fibroin conformation was obtained using 6% w/w pectin, and the best mechanical properties were obtained using 12% w/w glycerol. Films were sterilized, and human ADSCs were seeded and cultured for 15 days. Cells adhere to the support assuming a fibroblastic-like shape and reaching confluence. The ultrastructural analysis evidences typical active-cell features and adhesion structures that promote cell anchorage to the film, thus developing a multilayered cell structure. This construct could be advantageously employed in cutaneous wound healing or where the use of ADSCs scaffold is indicated either in human or veterinary field.
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Affiliation(s)
- T Chlapanidas
- Dipartimento di Scienze del Farmaco, Università degli Studi di Pavia, Pavia, Italy
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Moretti C, Colaci C, D'Ascenzo F, Salizzoni S, La Torre M, Barbanti M, Sheiban I, Tamburino C, Marra S, Gaita F. A mid-term follow-up of a multicentre prospective study about life-threatening and major bleedings after TAVI. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5430] [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: 11/13/2022] Open
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21
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Attisani M, Centofanti P, La Torre M, Boffini M, Ricci D, Ribezzo M, Baronetto A, Simonato E, Rinaldi M. Transapical Left Ventricular Vent (TLVV) during veno-arterial ECMO support: a bridge to solution in acute cardiogenic shock. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.3724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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22
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La Torre M, Mazzuca F, Ferri M, Mari FS, Botticelli A, Pilozzi E, Lorenzon L, Osti MF, Marchetti P, Enrici RM, Ziparo V. The importance of lymph node retrieval and lymph node ratio following preoperative chemoradiation of rectal cancer. Colorectal Dis 2013; 15:e382-8. [PMID: 23581854 DOI: 10.1111/codi.12242] [Citation(s) in RCA: 23] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 02/05/2013] [Indexed: 12/13/2022]
Abstract
AIM Preoperative chemoradiation (CRT) for rectal cancer decreases the number of examined lymph nodes (NELN) found in the resected specimen. However, the prognostic role of lymph node evaluation including overall numbers and the lymph node ratio (LNR) in patients having preoperative CRT have not yet been defined. The study has assessed the influence of CRT on the NELN and on lymph node number and LNR on the survival of patients with rectal cancer. METHOD Between 2003 and 2011, 508 patients with nonmetastatic rectal cancer underwent mesorectal excision. Of these 123 (24.2%) received preoperative CRT. Univariate and multivariate analysis was performed to define the role of NELN and LNR as prognostic indicators of survival. RESULTS Neoadjuvant CRT significantly reduced the NELN (P < 0.0001). Disease-free survival (DFS) and overall survival (OS) of patients with fewer or more than 12 nodes retrieved did not differ statistically. Node-negative patients with six or fewer lymph nodes were significantly associated with a poor DFS and OS on univariate analysis (P = 0.03 and P = 0.03). LNR significantly influenced the DFS and OS on multivariate analysis [DFS, P = 0.0473, hazard ratio (HR) 2.4980, 95% confidence interval (CI) 1.2631-9.4097; OS, P = 0.0419, HR 1.1820, 95% CI 1.1812-10,710]. CONCLUSION The cut-off of 12 lymph nodes does not influence survival and should not be considered for cancer-specific prediction of patients having neoadjuvant CRT. In contrast LNR is an independent prognostic predictor of DFS and OS in such patients.
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Affiliation(s)
- M La Torre
- Surgical Department of Clinical Sciences, Faculty of Medicine and Psychology, Biomedical Technologies and Translational Medicine 'La Sapienza', Sant'Andrea Hospital, University of Rome 'La Sapienza', Rome, Italy.
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23
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Cavallini M, La Torre M, Ferri M, Vitale V, Mercantini P, Dente M, Ziparo V. Safety of a new biological adhesive after pancreatic resection. MINERVA CHIR 2012; 67:407-413. [PMID: 23232478] [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: 06/01/2023]
Abstract
AIM Pancreatic fistula (PF) represents the main complication (10%-29%) after pancreatic surgery. Soft pancreatic texture with a not dilated pancreatic duct represent the major risk factors for PF. Mortality after pancreaticoduodenectomy (PD) is reported in several large series to be <5%. PF and local sepsis are the main causes of delayed arterial hemorrage with a high mortality rate (14-38%). Therefore, any effort should be implemented in order to reduce the incidence of PF. METHODS In the present study we have extended the use of the biological adhesive Bioglue® to coat pancreatic resection surface after distal pancreasectomy (DP, N.=5) and pancreatico-jejunostomy (PJ) after PD (N.=18) in a RESULTS Operative mortality was observed in 2 instances: one case after PJ leakage (1/18, 5.5%) and one case after DP not related to PF (1/5, 20%). PF has been documented in 7/23 (30,4%) after pancreatic resection, and in all cases after PD. In 3 cases PF has been successfully treated conservatively by NPO and octreotide. 2 patients required radiological percutaneous transhepatic biliary drainage and 2 patients required surgical drainage of multiple intrabdominal collections and radiological PTBD. CONCLUSION On the basis of these observations Bioglue® can be safely utilized to coat pancreatic surface after DP and pancreatico-jejunostomy after PD. This experience warrants further larger controlled studies of the potential value of Bioglue® in reducing the incidence of PF after major pancreatic surgery.
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Affiliation(s)
- M Cavallini
- Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Sant'Andrea Hospital, Faculty of Medicine and Psychology University, "La Sapienza" University, Rome, Italy
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Faustini M, Vigo D, Spinaci M, Galeati G, Torre ML. Enhancing Insemination Performance in Pigs Through Controlled Release of Encapsulated Spermatozoa. Reprod Domest Anim 2012; 47 Suppl 4:353-8. [DOI: 10.1111/j.1439-0531.2012.02098.x] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Abstract
AIM The authors present their experience of colonoscopic perforation and its management, with an analysis of factors affecting outcome. METHOD During the last 10 years, 22 cases of colonoscopic perforation (CP) were identified in two different institutions. Multiple logistic regression analysis was used to identify significant predictors of morbidity and mortality. RESULTS Morbidity and mortality rates were 31% and 13.6%, respectively. Prompt diagnosis was the most powerful predictor of outcome of CP. Multiple logistic regression analysis showed that morbidity and mortality were significantly related to a delay in diagnosis of more than 24 h (P = 0.03 and P = 0.04). CONCLUSION The results emphasize the importance of prompt assessment of a patient who develops symptoms after colonoscopy.
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Affiliation(s)
- M La Torre
- Faculty of Medicine and Psychology, Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Sant'Andrea Hospital, University of Rome 'Sapienza', Rome, Italy.
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Ziparo V, La Torre M. What's new in oncologic pancreatic surgery. G Chir 2011; 32:401-403. [PMID: 22018213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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La Torre M, Rossi Del Monte S, Ferri M, Cosenza G, Mercantini P, Ziparo V. Peritoneal washing cytology in gastric cancer. How, when and who will get a benefit? A review. MINERVA GASTROENTERO 2011; 57:43-51. [PMID: 21372769] [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: 05/30/2023]
Abstract
The most frequent cause of treatment failure following surgery for gastric cancer is peritoneal metastasis. The ability to predict the likelihood of peritoneal recurrence should improve the therapeutic approach to gastric cancer. Cytological analysis of peritoneal washings is thought to be useful for direct detection of free cancer cells in the peritoneal cavity. Intraperitoneal free cancer cells (IFCC) isolated during peritoneal washing in patients with gastric cancer, have been demonstrated to be significantly and independently related to the prognosis, influencing both early recurrence and poor survival, so that since 1998 the Japanese Classification of Gastric Carcinoma (JCGC) recommend peritoneal wash cytology (PWC) for the local staging. In Western countries PWC is not uniform practice, because of several controversies regarding the low sensitivity rate of conventional cytology, the correct application of molecular diagnosis (immunostaining and RT_PCR) and the exact role of PWC in the clinical practice. The authors examine the current apply of peritoneal washing in gastric cancer, emphasizing the clinical implication of peritoneal cytology by analyzing the different modality and techniques to perform it (conventional cytology, immunocytochemistry, RT-PCR), when to achieve it during the diagnostic or clinical work-up (at the staging or during the surgical treatment), and who will get a benefit (all patients or selected patients).
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Affiliation(s)
- M La Torre
- Department of Surgery, S. Andrea Hospital, La Sapienza University of Rome, Rome, Italy.
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Cannavò S, Marini F, Curtò L, Torre ML, de Gregorio C, Salamone I, Alibrandi A, Trimarchi F. High prevalence of coronary calcifications and increased risk for coronary heart disease in adults with growth hormone deficiency. J Endocrinol Invest 2011; 34:32-7. [PMID: 20511726 DOI: 10.1007/bf03346692] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [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: 01/07/2023]
Abstract
Assessment of coronary calcium deposits (CCD) by coronary computed tomography (CT) was recently introduced for evaluation of risk to develop events related to coronary heart disease (CHD). We investigated occurrence of CCD in 19 hypopituitary patients (patients), 34 healthy (H) subjects (H controls) and 36 patients with a similar rate of diabetes mellitus and hypertension (morbid, M), but without pituitary diseases (M controls). Patients were replaced with L-thyroxine, cortone acetate, sex hormones and/or desmopressin, but never with GH. Unenhanced coronary CT was performed by 16-row multislice scanner. Framingham score (FS) was calculated and CCD were measured by Agatston score (AS) in all subjects. AS>10 indicates increased CHD risk. CCD and AS >10 were detected in 50% and 33% of patients, respectively. Prevalence of CCD and mean AS were higher in patients than in H and M controls. In patients, AS was negatively dependent on IGF-I levels (p<0.01) and IGF-I SD (p<0.05), and AS >10 was associated with occurrence of hypertension (p<0.02) and hyperinsulinism (p<0.05). Men and women showed the same prevalence of AS >10 (25 vs 31%). FS and AS correlated significantly (rs=0.33, p<0.001), but CCD were detected also in 3/11 patients with low FS. In conclusion, 58% of patients were at CHD risk on the basis of increased FS and/or AS, above all if they were hypertensive and/or showed hyperinsulinism. CCD were detected also in patients with low FS. CHD risk is higher in women. Risk of CCD is increased in patients with low IGF-I levels.
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Affiliation(s)
- S Cannavò
- Section of Endocrinology, Department of Medicine and Pharmacology, University of Messina, 98125 Messina, Italy
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Attisani M, Centofanti P, La Torre M, Rinaldi M. Multiple splenic infarctions due to septic embolization in a patient supported with Berlin Heart-EXCOR biventricular assist device. Interact Cardiovasc Thorac Surg 2010; 12:497-9. [DOI: 10.1510/icvts.2010.251264] [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: 11/06/2022] Open
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Cannavò S, Ferraù F, Ragonese M, Curtò L, Torre ML, Magistri M, Marchese A, Alibrandi A, Trimarchi F. Increased prevalence of acromegaly in a highly polluted area. Eur J Endocrinol 2010; 163:509-13. [PMID: 20621957 DOI: 10.1530/eje-10-0465] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Despite the contribution of national registries and population-based reports, data concerning the epidemiology of acromegaly is scanty. In addition, the role of the environmental context has not been investigated. DESIGN Epidemiology of acromegaly was studied in the province of Messina (Sicily, Italy), focusing on the influence of environmental factors. METHODS Four zones, characterized by different degrees of exposition to environmental toxins due to industrial pollution, were identified in the province: area A (76,338 inhabitants), area B (287,328 inhabitants), area C (243,381 inhabitants), and area D (47,554 inhabitants) at low, middle-low, middle, and high industrial density respectively. We identified all acromegalics who were born and resided in the province of Messina, among patients either referred to our endocrine unit or referred elsewhere but recorded in the archives of the provincial healthcare agency. RESULTS In the province of Messina, we found 64 patients (2 in area A, 24 in area B, 28 in area C, and 10 in area D). Macroadenomas were 60%, the male/female ratio was 1, and mean age at diagnosis (±s.e.m.) was 45.4±1.6 years. Overall, prevalence was 97 c.p.m. in the province (26 c.p.m. in area A, 84 c.p.m. in area B, 115 c.p.m. in area C, and 210 c.p.m. in area D). Risk ratio (RR), calculated in every area assuming area A as a reference, showed an increased risk of developing acromegaly in people residing in area D (RR=8.03; P<0.0014). CONCLUSION This study confirms the prevalence of acromegaly reported recently. The increased risk of developing this disease in area D suggests that the pathogenetic role of environmental context needs to be better evaluated.
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Affiliation(s)
- S Cannavò
- Section of Endocrinology, Department of Medicine and Pharmacology, University of Messina, Messina, Italy
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La Torre M, Ferri M, Giovagnoli MR, Sforza N, Cosenza G, Giarnieri E, Ziparo V. Peritoneal wash cytology in gastric carcinoma. Prognostic significance and therapeutic consequences. Eur J Surg Oncol 2010; 36:982-6. [PMID: 20591604 DOI: 10.1016/j.ejso.2010.06.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Accepted: 06/07/2010] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND AIMS The prognosis of patients with gastric cancer is poor, even following curative resection, and is related primarily to the extent of disease at presentation. In locally advanced gastric tumors, peritoneal lavage cytology (PLC) is a relevant prognostic factor. The Authors present their results of peritoneal washing cytology, evaluating the prognostic value of this technique, and discussing the clinical impact. PATIENTS AND METHODS From July 2003 to May 2008, results of PLC in 64 patients with histologically proven primary gastric adenocarcinomas were analyzed. At laparotomy the abdomen was irrigated with 200 ml of normal saline, and ≥50 ml were aspirated and examined by means of cytology and immunocytopathology. RESULTS PLC was positive in 7 cases (11%). Overall, 86% of patients with a positive PLC had a pT3/pT4 tumor and 100% with a positive PLC had an N-positive tumor (p < 0.001); 71% of patients with a positive PLC had a grade G3/G4 tumor (p = 0.001). At a median follow-up of 32 months, the cumulative 5-year survival was 28%. The median survival of patients presenting positive PLC (19 months) was significantly lower than that of patients with negative peritoneal cytology (38 months) (p = 0.0001). Multivariate analysis identified cytology as a significant predictor of outcome (p = 0.018). CONCLUSIONS Results in the present series demonstrated that patients with a positive peritoneal cytology had advanced disease and poor prognosis, thus indicating that patients with locally advanced gastric cancer should undergo staging laparoscopy and PLC examination in order to select those requiring more aggressive treatment. Future therapeutic strategies should include PLC examination in preoperative staging, in order to select patients for more aggressive treatment.
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Affiliation(s)
- M La Torre
- Department of Surgery, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy.
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Sansone F, Boffini M, Comoglio C, Checco L, Saviolo R, Centofanti P, La Torre M, Rinaldi M. Results With Cyclosporine Monotherapy in Long-Term Cardiac Transplant Recipients. Transplant Proc 2010; 42:1291-3. [DOI: 10.1016/j.transproceed.2010.03.126] [Citation(s) in RCA: 6] [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: 11/25/2022]
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Faustini M, Bucco M, Galeati G, Spinaci M, Villani S, Chlapanidas T, Ghidoni I, Vigo D, Torre ML. Boar Sperm Encapsulation ReducesIn VitroPolyspermy. Reprod Domest Anim 2010; 45:359-62. [DOI: 10.1111/j.1439-0531.2008.01213.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Curtò L, Granata F, Torre ML, Trimarchi F, Cannavò S. Unusual magnetic resonance imaging finding in a male with lymphocytic hypophysitis mimicking a pituitary tumor. J Endocrinol Invest 2010; 33:128-9. [PMID: 19498319 DOI: 10.1007/bf03346567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/30/2022]
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Vigo D, Faustini M, Villani S, Orsini F, Bucco M, Chlapanidas T, Conte U, Ellis K, Torre ML. Semen controlled-release capsules allow a single artificial insemination in sows. Theriogenology 2009; 72:439-44. [PMID: 19505716 DOI: 10.1016/j.theriogenology.2009.03.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Revised: 02/18/2009] [Accepted: 03/29/2009] [Indexed: 11/28/2022]
Abstract
Controlled-release capsules containing boar spermatozoa were developed to extend the preservation time of spermatozoa and maximize the efficiency of a single artificial insemination. A large trial (4245 sows) was performed with these capsules using double/triple conventional artificial insemination as a control. The effect of treatment on pregnancy diagnosis, delivery, and born piglets was investigated, with allowance being made for considering season, spermatozoa amount, and the weaning-to-estrus interval as confounding variables. The same pregnancy rate and prolificacy were obtained by two insemination techniques, and a higher parturition frequency was reached with capsules. The reproductive performance in pigs has therefore been optimized by a single instrumental insemination with controlled-release capsules.
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Affiliation(s)
- D Vigo
- Dipartimento di Scienze e Tecnologie Veterinarie per la Sicurezza Alimentare, University of Milan, 20133 Milan, Italy
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Meurette G, La Torre M, Regenet N, Robert-Yap J, Lehur PA. Value of sacral nerve stimulation in the treatment of severe faecal incontinence: a comparison to the artificial bowel sphincter. Colorectal Dis 2009; 11:631-5. [PMID: 18637936 DOI: 10.1111/j.1463-1318.2008.01633.x] [Citation(s) in RCA: 29] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Sacral nerve stimulation (SNS) is a recent treatment option in the management of severe faecal incontinence (FI) that offers promising results. The aim of this study was to compare SNS to artificial bowel sphincter (ABS) implanted patients to assess the rationale of this approach in achieving satisfying functional results and improved quality of life (QoL). METHOD Among 27 patients tested (December 2001 and April 2004), 15 patients were successfully managed with SNS. They were compared to 15 matched patients implanted with ABS in a previous period (control group). Assessment of continence level (Cleveland Clinic score), constipation score (Knowles, Eccersley, Scott Score) and QoL (Short-Form 36) were prospectively collected. RESULTS Both groups were comparable for clinical parameters (age, gender, anal testing and aetiology of incontinence) and anal physiology. The mean postoperative continence score was significantly higher in the SNS group [9.4 (+/-3.3) vs 5.7 (+/-3.9), P < 0.01]; however, the mean constipation score was higher in the ABS group (6.3 +/- 6.3 vs 12.8 +/- 5.7, P < 0.01). The mean QoL score was similar in both groups. The mean follow-up after implantation was 15 (+/-9) months in the SNS group, and 43 (+/-33) months in the ABS group. CONCLUSION In this study, SNS offers satisfying results in terms of QoL, similar to that of ABS. Although it seems to be less effective in restoring continence level, symptoms of outlet obstruction are more frequent after ABS. This SNS approach should be proposed as a first-line treatment of FI in selected patients. ABS should remain an option that can improve function.
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Affiliation(s)
- G Meurette
- Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif, Hôtel-Dieu, Nantes, France.
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Ruggeri RM, Santarpia L, Curtò L, Torre ML, Galatioto M, Galatioto S, Trimarchi F, Cannavò S. Non-functioning pituitary adenomas infrequently harbor G-protein gene mutations. J Endocrinol Invest 2008; 31:946-9. [PMID: 19169048 DOI: 10.1007/bf03345630] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Mutations of the genes encoding the alpha subunit of the stimulatory G protein (Gs) and of the inhibiting Gi2 protein (GNAS1 and GNAI2 genes, respectively) have been described in various endocrine neoplasias, including pituitary tumors. AIM To search for mutations of GNAS1 and GNAI2 in a continuous series of non-functioning pituitary adenoma (NFPA) patients neurosurgically treated. SUBJECTS AND METHODS The surgical samples of 22 patients who have been defined and characterized on a clinical, biochemical, histological, and immunohistochemical point of view have been processed for investigating the presence of the above mutations by PCR amplification of the hot spots exons 8 and 9 of GNAS1, and exons 5 and 6 of GNAI2, followed by direct sequencing. Moreover, the promoter region of GNAI2, in order to assess the prevalence of single nucleotide polymorphisms (SNP), was investigated in the same series. RESULTS A CGT>TGT mutation at codon 201 of GNAS1 gene in a single case of NFPA was found, but no mutation of GNAI2A was demonstrated. CONCLUSIONS This finding suggests and confirms that G-protein mutations are rare and not crucial in NFPA development. Additionally, we found a silent SNP at codon 318 in the promoter of the Gi2alpha gene in one out of the 22 NFPA.
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Affiliation(s)
- R M Ruggeri
- Department of Medicine and Pharmacology, Section of Endocrinology, University of Messina, 98125 Messina, Italy.
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Centofanti P, Savia F, La Torre M, Ceresa F, Sansone F, Veglio V, Fossati L, Guglielmi E, Rinaldi M. A prospective study of prevalence of 60-days postoperative wound infections after cardiac surgery. An updated risk factor analysis. J Cardiovasc Surg (Torino) 2007; 48:641-646. [PMID: 17989634] [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: 05/25/2023]
Abstract
AIM Postoperative wound infections generally cause considerable extra morbidity, mortality and costs. The prevalence of total wound infections after cardiac surgery, including both sternal wound and donor site infections, ranges from 1.3 to 12.8%. The present study was conducted to identify the incidence of wound infections following cardiac surgery, to identify the risk factors and evaluate the efficacy of present modes of management. METHODS From September 2004 to May 2005, 493 consecutive patients undergoing cardiac surgery were included in the study and were followed for the prevalence of surgical site infection (SSI) up to 60 days postoperatively. The wound infections were defined according to the Centers for Disease Control and Prevention (CDC) and U.S. National Nosocomial Infections Surveillance (NNIS) system criteria. RESULTS The total incidence of SSI was 3.9%. Sternal wound infection (SWI) occurred in 17 patients (3.4%). Superficial wound infection was diagnosed in 10 patients (2%) and deep wound infection in 7 patients (1.4%). Donor site infection (DSI) occurred in 2 patients (0.4%). Early reoperation for bleeding, postoperative dialysis and the use of one internal mammary artery were independently associated with an increased risk of SWI. CONCLUSION Preventing SSI in the operating room is the primary goal of the surgical team. Attention should be paid to antibiotic prophylaxis and Methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage treatment. The identification of risk factors will help to further reduce the incidence of wound infection.
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Affiliation(s)
- P Centofanti
- Department of Cardiac Surgery University of Turin, Turin, Italy.
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Nicotra M, Bottini N, La Torre M, Amante A, Bottini E, Gloria-Bottini F. Repeated spontaneous abortion. Cooperative effects of ADA and ACP1 genetic polymorphisms. Am J Reprod Immunol 2007; 58:1-10. [PMID: 17565542 DOI: 10.1111/j.1600-0897.2007.00483.x] [Citation(s) in RCA: 8] [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: 11/27/2022] Open
Abstract
PROBLEM In consideration of the effect of adenosine deaminase (ADA) and ACP1 (a low-molecular-weight protein tyrosine phosphatase) on T-cell receptor activity, we have analysed the joint distribution of these polymorphisms in a sample of women with primary repeated spontaneous abortion (RSA) to search for possible interactive effects on susceptibility to RSA. METHOD OF STUDY ACP1 and ADA phenotypes were determined in 170 women with primary RSA in 79 healthy consecutive puerperae and in 160 female newborns from the Caucasian population of Rome and in 357 healthy consecutive puerperae from the Caucasian population of Penne. Chi-square test of independence and three way contingency table analysis by a log-linear model were performed. RESULTS Women with low-ADA activity and high-ACP1 activity show the lowest susceptibility to RSA. Women with high-ADA activity and low-ACP1 activity, on the contrary, show the highest susceptibility to RSA and also the highest incidence of auto antibodies and of A blood group incompatibility. CONCLUSION The data are in agreement with those expected on the basis of the effects of ACP1 and ADA genetic variability on T-cell receptor activity and suggest a cooperative effect of the two polymorphic systems in the susceptibility/resistance to repeated spontaneous abortion.
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Affiliation(s)
- M Nicotra
- Institute of Gynaecology, Perinatology and Child Disease, University of Rome La Sapienza, School of Medicine, Rome, Italy
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Munari E, Asti A, Colombani C, Benzoni E, Faustini M, Torre ML, Riccardi A, Villani S, Sesso L, Conte U, Vigo D. Competence of Swine Oocytes Matured by Three-dimensional Gonadotropin-free Co-culture. Vet Res Commun 2007; 31 Suppl 1:181-4. [PMID: 17682870 DOI: 10.1007/s11259-007-0091-7] [Citation(s) in RCA: 3] [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: 10/23/2022]
Affiliation(s)
- E Munari
- Department of Veterinary Sciences and Technologies for Food Safety, Faculty of Vetrinary Medicine, University of Milan, Milan, Italy.
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La Torre M, Penteriani R, La Pinta M, Farina M, Vitelli C, Fortunato L. 279 POSTER Intraoperative ultrasound for nonpalpable breast lesions: a preliminary report. Eur J Surg Oncol 2006. [DOI: 10.1016/s0748-7983(06)70714-4] [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: 11/29/2022] Open
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Balducci G, Dente M, Ferri M, Rebonato A, La Torre M, Mercantini P. [Bleeding caused by pseudoaneurysm rupture after pancreaticoduodenectomy]. G Chir 2006; 27:318-20. [PMID: 17064491] [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: 05/12/2023]
Abstract
The Authors describe two cases of delayed hemorrhage due to ruptured gastroduodenal artery pseudoaneurysm, after pancreatoduodenectomy. The first case underwent surgical treatment, the second underwent interventional radiological procedure. The Authors analyze diagnostic and therapeutic options for early diagnosis in high risk patients, supporting preventive treatment of asymptomatic pseudoaneurysms.
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Affiliation(s)
- G Balducci
- Università degli Studi di Roma, "La Sapienza" Seconda Facoltà di Medicina e Chirurgia Azienda Ospedaliera "Sant'Andrea" UOC Chirurgia Generale A, Italy
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Benzoni E, Torre ML, Faustini M, Stacchezzini S, Cremonesi F, Conte U, Villani S, Russo V, Ricevuti G, Vigo D. Transient transfection of porcine granulosa cells after 3D culture in barium alginate capsules. Int J Immunopathol Pharmacol 2006; 18:677-82. [PMID: 16388715 DOI: 10.1177/039463200501800409] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Three-dimensional culture systems in barium alginate capsules can be employed to maintain primary granulosa cells in an undifferentiated state for almost 6 days. This is due to a self-organization of cells in a pseudofollicular structure. The transfection of primary granulosa cells is a necessary condition when employing these culture systems for several purposes, for example as an in vitro toxicity test or the development of oocytes or zygotes. In this work, the feasibility of two transient transfection techniques (liposome-mediated and electroporation) was assessed in primary porcine granulosa cells after a 6-day culture in an artificial extracellular matrix (barium alginate membrane). Human recombinant green fluorescent protein was chosen as a molecular readout, and protein expression was assessed after 48 hours from transfection. Liposome-mediated transfection gave low transfection levels, with increasing yields from 2 to 12 microgDNA/ml of medium; the maximum percentage (85.7%) was reached at 12 microgDNA/ml of medium. Electroporation-mediated transfection yields were higher: the best results (81.7% of transfected cells) were achieved with two 50V pulses and 12 microg/ml DNA. The application of a single or double pulse (50V) at 4 mgDNA/ml gave negligible results. These results indicate that primary granulosa cell cultured in barium alginate capsules can be transfected by electroporation with high transfection yields.
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Affiliation(s)
- E Benzoni
- Dipartimento di Scienze e Tecnologie Veterinarie per la Sicurezza Alimentare, Milan, Italy
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Vigo D, Villani S, Faustini M, Accorsi PA, Galeati G, Spinaci M, Munari E, Russo V, Asti A, Conte U, Torre ML. Follicle-Like Model by Granulosa Cell Encapsulation in a Barium Alginate–Protamine Membrane. ACTA ACUST UNITED AC 2005; 11:709-14. [PMID: 15998212 DOI: 10.1089/ten.2005.11.709] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [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: 11/13/2022]
Abstract
Granulosa cells from bovine and porcine ovaries were cultured either in monolayer or in follicle-like barium alginate capsules for 6 days. Morphological investigation by electron scanning microscopy indicated that culture in a three-dimensional (3D) system allows self-organization of spherical-polyhedral shape cells. The luteinization index (progesterone:17beta-estradiol ratio) was significantly higher for monolayer cells than for the 3D cell culture system, confirming the results of morphological analysis and indicating more physiological growth. The encapsulated 3D culture system appears to be a promising way of obtaining in vitro maturation and development of follicles and oocytes.
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Affiliation(s)
- D Vigo
- Dipartimento di Scienze e Tecnologie Veterinarie per la Sicurezza Alimentare, Milan, Italy
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Gloria-Bottini F, La Torre M, Lucarini N, Cosmi E, Bottini E. Evidence of association of the ratio birth weight/placental weight with genetic factors located in the short arm of chromosome 1. Placenta 2003; 24:571-3. [PMID: 12744935 DOI: 10.1053/plac.2002.0961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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: 11/11/2022]
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Torre ML, Faustini M, Norberti R, Stacchezzini S, Maggi L, Maffeo G, Conte U, Vigo D. Boar semen controlled delivery system: storage and in vitro spermatozoa release. J Control Release 2002; 85:83-9. [PMID: 12480314 DOI: 10.1016/s0168-3659(02)00290-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [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: 10/27/2022]
Abstract
Swine spermatozoa were encapsulated in barium alginate and protamine-barium alginate membranes to lengthen their preservation time and to provide a means of controlling their release. Precocious acrosome reactions and secondary anomalies were measured as indices of semen quality. These characteristics were observed for two forms of encapsulated spermatozoa when stored at 18 and 38 degrees C for 24 h and for semen diluted in a classical extender at both temperatures. The results indicate that encapsulation enhances semen preservation, providing protection against membrane damage upon dilution. The effect is even more evident at the higher temperature (38 degrees C), where cell metabolism is higher. An in vitro release test of spermatozoa showed a massive cell delivery from barium alginate capsules within 6 h, and a slow release from protamine-barium alginate capsules. The properties of spermatozoa 24 h after release did not differ from the semen stored at the same temperature in capsules, indicating that the release process does not impair semen quality.
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Affiliation(s)
- M L Torre
- Department of Pharmaceutical Chemistry, University of Pavia, 27100, Pavia, Italy.
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Abstract
A new encapsulation technology of swine semen is proposed to improve the quality of stored spermatozoa and to obtain the controlled release of viable cells, reducing the number of instrumental inseminations. This technology has been employed to produce barium alginate gel capsules in different seasons; an analysis of batch reproducibility was performed, and total capsule diameter, gel thickness and weight of capsules were determined as indices of batch properties. A seasonal variability was found but each batch was substantially homogeneous. The variability could be related to the biological variability of the semen employed as raw material as well as to the technological process.
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Affiliation(s)
- M L Torre
- Department of Pharmaceutical Chemistry, Via Taramelli 12, 27100, Pavia, Italy.
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Torre ML, Faustini M, Norberti R, Maggi L, Maffeo G, Conte U, Vigo D. Barium alginate cell-delivery systems: correlation between technological parameters. Int J Pharm 2002; 242:389-91. [PMID: 12176286 DOI: 10.1016/s0378-5173(02)00223-5] [Citation(s) in RCA: 10] [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: 11/21/2022]
Abstract
The most recent trends for the development of several in vitro cell cultures have been oriented towards the cell immobilisation in 3-dimensional scaffolds and cell encapsulation. In fact, an important requirement of cell survival is self-assembly in functional communities, in the presence of an artificial extracellular matrix. In our research, a previously described technique for spermatozoa encapsulation was applied to obtain capsules loaded with an opaque agent as a model, and to perform a formulative study. A process variable, barium ion concentration, was correlated to some capsule properties, such as weight, gel thickness, total and core diameter. Ion concentration can be modified to obtain capsules with predictable characteristics.
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Affiliation(s)
- M L Torre
- Department of Pharmaceutical Chemistry, Via Taramelli 12, 27100, Pavia, Italy.
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Maggi L, Segale L, Torre ML, Ochoa ME, Conte U. Dissolution behaviour of hydrophilic matrix tablets containing two different polyethylene oxides (PEOs) for the controlled release of a water-soluble drug. Dimensionality study. Biomaterials 2002; 23:1113-9. [PMID: 11791914 DOI: 10.1016/s0142-9612(01)00223-x] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.6] [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: 11/21/2022]
Abstract
Hydrophilic matrix tablets containing polyethylene oxides as the retarding polymer have been successfully employed in the controlled release of drugs. To evaluate the relative influence of drug diffusion and polymer erosion mechanisms in the drug delivery process, we studied the hydration behaviour of matrix tablets containing a water-soluble drug and PEOs of two different molecular weights: Polyox WSRN 1105 (Mw = 0.9 x 10(6)) and Polyox WSRN 301 (Mw = 4 x 10(6)). The hydration rate, the extent of swelling, and the erosion rate of matrices containing the polymer, the drug and tableting excipients were evaluated in comparison to tablets made of pure polymer. The results of these studies on function of the release behaviour were then discussed. The results show that the higher molecular weight PEO swells to a greater extent and tends to form, upon hydration, a stronger gel, which is therefore less liable to erosion, if compared to the lower molecular weight PEO. This difference in the erosion behaviour can explain the different efficiencies of the two polymeric products in modulating the delivery rate of the water-soluble drug. Moreover, the presence of other soluble components (drug and excipients) in the dosage form enhances the erosion trend of the tablets with a consequent reduction of the efficiency of the polymer in drug release control.
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Affiliation(s)
- L Maggi
- Department of Pharmaceutical Chemistry, University of Pavia, Italy.
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Bottini E, Gloria-Bottini F, La Torre M, Lucarini N. The genetics of signal transduction and the effect of smoking on intrauterine growth. Int J Epidemiol 2001; 30:400-2. [PMID: 11369750 DOI: 10.1093/ije/30.2.400] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We have studied cytosolic low molecular weight phosphotyrosine phosphatase (cLMWPTP or ACP1) in 364 healthy puerperae from the population of Penne, in 155 diabetic puerperae from the population of Rome and in 349 consecutive normal newborn infants from the population of Rome. The data from these independent samples point to a protective role of maternal ACP1 genotypes with medium-high activity against intrauterine growth retardation caused by smoking.
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Affiliation(s)
- E Bottini
- Chair of Preventive and Social Pediatrics, University of Rome, Tor Vergata, School of Medicine, Rome, Italy.
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