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Tanas R, Gil B, Marsella M, Nowicka P, Pezzoli V, Phelan SM, Queirolo S, Stanford FC, Pettoello-Mantovani M, Bernasconi S. Addressing Weight Stigma and Weight-Based Discrimination in Children: Preparing Pediatricians to Meet the Challenge. J Pediatr 2022; 248:135-136.e3. [PMID: 35714964 PMCID: PMC9999724 DOI: 10.1016/j.jpeds.2022.06.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 06/09/2022] [Indexed: 11/22/2022]
Affiliation(s)
- Rita Tanas
- Department of Pediatrics, Arcispedale S. Anna, Ferrara, Italy
| | - Begoña Gil
- Comprehensive Childhood Obesity Plan of Andalusia, Health Counseling, Andalusian Government, Sevilla, Spain
| | - Maria Marsella
- Department of Pediatrics, San G. Moscati Hospital, Avellino, Italy
| | - Paulina Nowicka
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Solna, Sweden; Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Valdo Pezzoli
- Pediatric Institute of Southern Switzerland, EOC Lugano, Lugano, Switzerland
| | - Sean M Phelan
- Division of Health Care Delivery Research, Robert D. & Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Sara Queirolo
- Pediatric Institute of Southern Switzerland, EOC Lugano, Lugano, Switzerland
| | - Fatima Cody Stanford
- Departments of Medicine, Neuroendocrine Unit and Pediatrics, Pediatric Endocrinology, Boston, MA; Nutrition Obesity Research Center at Harvard, MGH Weight Center, Massachusetts General Hospital, Boston, MA
| | - Massimo Pettoello-Mantovani
- European Pediatric Association, Union of National Pediatric Societies and Associations, Berlin, Germany; Department of Pediatrics, Scientific Institute "Casa Sollievo," Univeristy of Foggia, Foggia, Italy.
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Tosti F, Nardinocchi C, Wahbeh W, Ciampini C, Marsella M, Lopes P, Giuliani S. Human height estimation from highly distorted surveillance image. J Forensic Sci 2021; 67:332-344. [PMID: 34596235 PMCID: PMC9291900 DOI: 10.1111/1556-4029.14888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/27/2021] [Accepted: 08/25/2021] [Indexed: 11/30/2022]
Abstract
Video surveillance camera (VSC) is an important source of information during investigations especially if used as a tool for the extraction of verified and reliable forensic measurements. In this study, some aspects of human height extraction from VSC video frames are analyzed with the aim of identifying and mitigating error sources that can strongly affect the measurement. More specifically, those introduced by lens distortion are present in wide-field-of-view lens such as VSCs. A weak model, which is not able to properly describe and correct the lens distortion, could introduce systematic errors. This study focuses on the aspect of camera calibration to verify human height extraction by Amped FIVE software, which is adopted by the Forensic science laboratories of Carabinieri Force (RaCIS), Italy. A stable and reliable approach of camera calibration is needed since investigators have to deal with different cameras while inspecting the crime scene. The performance of the software in correcting distorted images is compared with a technique of single view self-calibration. Both approaches were applied to several frames acquired by a fish-eye camera and then measuring the height of five different people. Moreover, two actual cases, both characterized by common low-resolution and distorted images, were also analyzed. The height of four known persons was measured and used as reference value for validation. Results show no significant difference between the two calibration approaches working with fish-eye camera in test field, while evidence of differences was found in the measurement on the actual cases.
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Affiliation(s)
| | | | - Wissam Wahbeh
- IDIBAU, University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland
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Abstract
Childhood obesity has spread worldwide, it is on the rise, starts earlier and is more severe, despite all treatment attempts. According to recent studies, weight stigma is a factor that can hinder the success of therapies. Healthcare workers, mainly paediatricians, need to feel the urgency of anti-stigma training. The use of non-stigmatizing terminologies and images in various areas (school, sports clubs, healthcare, media, society in general) can improve disease management.
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Affiliation(s)
- Rita Tanas
- Advisor of the Adolescence Study Group, Italian Pediatric Society, Ferrara, Italy.
| | | | - Maria Marsella
- UOC di Pediatria, Azienda Ospedaliera San G. Moscati, Avellino, Italy
| | - Giovanni Corsello
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile "G. D'Alessandro" Università, Palermo, Italy
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Abstract
The increased survival and lifespan of thalassemia patients, in the setting of better iron overload monitoring and chelation, have also however increased the incidence of diseases and complications, which were less likely to develop. Among these, one of the most worrying in recent years is hepatocellular carcinoma (HCC). Due to blood transfusions, many patients with thalassemia are or have been infected with hepatitis C virus (HCV) or hepatitis B virus (HBV), especially those born before the 1990s or in countries in which universal HBV vaccination and safe blood programs are still not completely implemented. However, HCC has also been described in nontransfused patients and in those who are HCV- and HBV-negative. Therefore, other risk factors are involved in hepatocarcinogenesis in thalassemia. The following review analyzes recent literature on the role of different risk factors in the progression of liver disease in thalassemia as well as the importance of surveillance. Treatment of HCC in thalassemia is still highly debated and requires further studies.
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Affiliation(s)
- Maria Marsella
- Department of Woman and Child, Pediatric Unit, San Giuseppe Moscati Hospital, Avellino, Italy
| | - Paolo Ricchi
- Unità Operativa Semplice Dipartimentale (UOSD) Malattie Rare Del Globulo Rosso, Dipartimento di oncoematologia, Azienda Ospedaliera Di Rilievo Nazionale "A. Cardarelli", Napoli, Italy
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Marsella M, Scaioni M. Sensors for Deformation Monitoring of Large Civil Infrastructures. Sensors (Basel) 2018; 18:s18113941. [PMID: 30441853 PMCID: PMC6263963 DOI: 10.3390/s18113941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 11/09/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Maria Marsella
- Department of Civil, Environmental and Building Engineering (DICEA), Università degli Studi di Roma 'La Sapienza', 00184 Roma, Italy.
| | - Marco Scaioni
- Department of Architecture, Built Environment and Construction Engineering (DABC), Politecnico di Milano, 20133 Milano, Italy.
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Scaioni M, Marsella M, Crosetto M, Tornatore V, Wang J. Geodetic and Remote-Sensing Sensors for Dam Deformation Monitoring. Sensors (Basel) 2018; 18:s18113682. [PMID: 30380693 PMCID: PMC6263878 DOI: 10.3390/s18113682] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/22/2018] [Accepted: 10/25/2018] [Indexed: 12/04/2022]
Abstract
In recent years, the measurement of dam displacements has benefited from a great improvement of existing technology, which has allowed a higher degree of automation. This has led to data collection with an improved temporal and spatial resolution. Robotic total stations and GNSS (Global Navigation Satellite System) techniques, often in an integrated manner, may provide efficient solutions for measuring 3D displacements on precise locations on the outer surfaces of dams. On the other hand, remote-sensing techniques, such as terrestrial laser scanning, ground-based SAR (synthetic aperture radar) and satellite differential interferometric SAR offer the chance to extend the observed region to a large portion of a structure and its surrounding areas, integrating the information that is usually provided in a limited number of in-situ control points. The design and implementation of integrated monitoring systems have been revealed as a strategic solution to analyze different situations in a spatial and temporal context. Research devoted to the optimization of data processing tools has evolved with the aim of improving the accuracy and reliability of the measured deformations. The analysis of the observed data for the interpretation and prediction of dam deformations under external loads has been largely investigated on the basis of purely statistical or deterministic methods. The latter may integrate observation from geodetic, remote-sensing and geotechnical/structural sensors with mechanical models of the dam structure. In this paper, a review of the available technologies for dam deformation monitoring is provided, including those sensors that are already applied in routinary operations and some experimental solutions. The aim was to support people who are working in this field to have a complete view of existing solutions, as well as to understand future directions and trends.
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Affiliation(s)
- Marco Scaioni
- Department of Architecture, Built Environment and Construction Engineering (DABC), Politecnico di Milano, 20133 Milano, Italy.
- College of Surveying and Geo-Informatics, Tongji University, Shanghai 200092, China.
| | - Maria Marsella
- Department of Civil, Environmental and Building Engineering (DICEA), Università degli Studi di Roma 'La Sapienza', 00184 Roma, Italy.
| | - Michele Crosetto
- Division of Geomatics, Centre Tecnològic de Telecomunicacions de Catalunya (CTTC/CERCA), E-08860 Castelldefels, Barcelona, Spain.
| | - Vincenza Tornatore
- Department of Civil and Environmental Engineering (DICA), Politecnico di Milano, 20133 Milano, Italy.
| | - Jin Wang
- Beijing Key Laboratory of Traffic Engineering, Beijing University of Technology, Beijing 100124, China.
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Marsella M, Ammirabile M, Di Matola T, Pepe A, Costantini S, Filosa A, Ricchi P. Is there a difference in phenotype between males and females with non-transfusion-dependent thalassemia? A cross-sectional evaluation. Hematology 2018; 23:522-525. [DOI: 10.1080/10245332.2017.1413789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
| | - Massimiliano Ammirabile
- Laboratory of Clinical Chemistry and Microbiology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- UOSD Malattie Rare del Globulo Rosso, AORN A. Cardarelli, Naples, Italy
| | - Tiziana Di Matola
- UOC Biochimica Clinica, AORN Ospedale dei Colli, P.O. Monaldi, Naples, Italy
| | - Alessia Pepe
- Magnetic Resonance Imaging Unit, Fondazione G. Monasterio, CNR-Regione Toscana, Pisa, Italy
| | - Silvia Costantini
- UOSD Malattie Rare del Globulo Rosso, AORN A. Cardarelli, Naples, Italy
| | - Aldo Filosa
- UOSD Malattie Rare del Globulo Rosso, AORN A. Cardarelli, Naples, Italy
| | - Paolo Ricchi
- UOSD Malattie Rare del Globulo Rosso, AORN A. Cardarelli, Naples, Italy
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Ricchi P, Costantini S, Spasiano A, De Dominicis G, Di Matola T, Cinque P, Ammirabile M, Marsella M, Filosa A. The long-term and extensive efficacy of low dose thalidomide in a case of an untransfusable patient with Non-Transfusion-Dependent Thalassemia. Blood Cells Mol Dis 2016; 57:97-9. [DOI: 10.1016/j.bcmd.2016.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 01/13/2016] [Accepted: 01/15/2016] [Indexed: 12/31/2022]
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Abstract
It has been clearly shown that iron overload adds progressively significant morbidity and mortality in patients with non-transfusion-dependent thalassemia (NTDT). The lack of physiological mechanisms to eliminate the excess of iron requires effective iron chelation therapy. The reduced compliance to deferoxamine and the risk of severe hematological adverse events during deferiprone treatment have limited the use of both these drugs to correct iron imbalance in NTDT. According to the principles of evidence-based medicine, following the demonstration of the effectiveness and the safety of deferasirox (Exjade®) in a prospective, randomized, controlled trial, deferasirox was approved by the US Food and Drug Administration in May 2013 for the treatment of iron overload associated with NTDT. This review, assessing the available scientific literature, will focus on the profile of DFX in the treatment of non-transfusional hemosiderosis in patients with NTDT.
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Affiliation(s)
- Paolo Ricchi
- UOSD Malattie Rare del Globulo Rosso, Azienda Ospedaliera di Rilievo Nazionale "Antonio Cardarelli", Naples, Italy
| | - Maria Marsella
- UOSD Malattie Rare del Globulo Rosso, Azienda Ospedaliera di Rilievo Nazionale "Antonio Cardarelli", Naples, Italy ; UOC Pediatria, Azienda Ospedaliera di Rilievo Nazionale G. Rummo, Benevento, Italy
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Abstract
PURPOSE Iron chelation has improved survival and quality of life of patients with thalassemia major. there are currently 3 commercially available iron-chelating drugs with different pharmacokinetic and pharmacodynamic activity. The choice of adequate chelation treatment should be tailored to patient needs and based on up-to-date scientific evidence. METHODS A review of the most recent literature was performed. FINDINGS The ability of the chelators to bind the redox active component of iron, labile plasma iron, is crucial for protecting the cells. Chelation therapy should be guided by magnetic resonance imaging that permits the tailoring of therapy according to the needs of the patient because different chelators preferentially clear iron from different sites. Normal levels of body iron seem to decrease the need for hormonal and cardiac therapy. IMPLICATIONS The 3 chelators currently available have different benefits, different safety profiles, and different acceptance on the part of the patients. Good-quality, well-designed, randomized, long-term clinical trials continue to be needed.
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Affiliation(s)
| | - Maria Marsella
- Pediatrics and Adolescentology Unit, Maternal and Child Health Department, "G. Rummo" Hospital, Benevento, Italy
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Abstract
Patients with thalassemia major suffer from many complications, but in the last two decades their lives have improved both in length and quality. We report herein the most common complications and the recent advances that have changed the course of this disease. Also, we report in detail some of the new therapeutic strategies already introduced in practice and briefly some that are still being developed.
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Affiliation(s)
- Raffaella Origa
- a Department of Public Health, Clinical and Molecular Medicine, Thalassemia Unit , University of Cagliari , Cagliari , Italy
| | - Alessandro Baldan
- b Department of Medical Sciences, Section of Pediatrics , University of Ferrara , Ferrara , Italy
| | - Maria Marsella
- c Pediatrics and Adolescentology Unit, Maternal and Child Health Department , "G. Rummo" Hospital , Benevento , Italy
| | - Caterina Borgna-Pignatti
- b Department of Medical Sciences, Section of Pediatrics , University of Ferrara , Ferrara , Italy
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Marsella M, Borgna-Pignatti C. Transfusional iron overload and iron chelation therapy in thalassemia major and sickle cell disease. Hematol Oncol Clin North Am 2015; 28:703-27, vi. [PMID: 25064709 DOI: 10.1016/j.hoc.2014.04.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Iron overload is an inevitable consequence of blood transfusions and is often accompanied by increased iron absorption from the gut. Chelation therapy is necessary to prevent the consequences of hemosiderosis. Three chelators, deferoxamine, deferiprone, and deferasirox, are presently available and a fourth is undergoing clinical trials. The efficacy of all 3 available chelators has been demonstrated. Also, many studies have shown the efficacy of the combination of deferoxamine plus deferiprone as an intensive treatment of severe iron overload. Alternating chelators can reduce adverse effects and improve compliance. Adherence to therapy is crucial for good results.
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Affiliation(s)
- Maria Marsella
- Department of Medical Sciences, University of Ferrara, Azienda Ospedale-Università Via Aldo Moro 8, Cona, Ferrara, Italy
| | - Caterina Borgna-Pignatti
- Department of Medical Sciences, University of Ferrara, Azienda Ospedale-Università Via Aldo Moro 8, Cona, Ferrara, Italy.
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Marsella M, Salvagno G, Dolcini B, Ferlini A, Ravani A, Harteveld CL, Giordano PC, Borgna-Pignatti C. Characterization of Hb Calvino (HBB: c.406G > A): a new silent β-globin gene variant found in coexistence with α-thalassemia in a family of African origin. Hemoglobin 2014; 38:369-72. [PMID: 25222042 DOI: 10.3109/03630269.2014.948186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We report a new silent β-globin gene variant found in a family from Angola living in the north eastern Italian city of Ferrara. The probands, two young sisters, presented with hematological parameters compatible with a β-thalassemia (β-thal) minor but with normal Hb A₂ levels and normal hemoglobin (Hb) separation on high performance liquid chromatography (HPLC). Molecular analyses revealed a homozygosity for the common -α(3.7) (rightward) deletion and heterozygosity for a novel transition (GCT > ACT) at codon 135 of the β-globin gene, leading to an Ala → Thr single amino acid substitution that was inherited from the healthy father.
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Affiliation(s)
- Maria Marsella
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Ferrara , Ferrara , Italy
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De Sanctis V, Marsella M, Soliman A, Yassin M. Macroorchidism in childhood and adolescence: an update. Pediatr Endocrinol Rev 2014; 11 Suppl 2:263-273. [PMID: 24683950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In the last 30 years, scientific literature has been enriched with studies which demonstrate the importance of evaluating testis volume to recognize certain genetic and endocrine diseases. Macroorchidism is defined as an increase of testicular volume at least twice the norm for age. In clinical practice, when macroorchidism is suspected, the testicular volume may be evaluated with the Prader orchidometer and/or US, calculated by this formula: L x W x H x 0.71 and the resulting value should be compared with a table of percentiles for each age. Macroorchidism is a relatively uncommon sign; however, when present, it almost always has clinical relevance. Five groups of conditions are reviewed: genetic, endocrine, idiopathic and secondary to neoplasm or testicular torsions. An X-linked mental retardation syndrome must be suspected in all patients with macrorchidism, phenotypic abnormalities, and mental retardation. Furthermore, it is important to identify other males affected in the same family to confirm the X-linked transmission. In these cases, the patient must be referred to specialized cytogenetic centres for determination of fragile sites. Other possible etiologies of macroorchidism are long-standing primary hypothyroidism, adrenal remnants in congenital adrenal hyperplasia, follicle stimulating hormone (FSH)-secreting pituitary macroadenomas, local tumors, lymphomas, and aromatase deficiency. Early diagnosis is important in order to identify and reduce the incidence of X-linked mental retardation in affected families and to begin treatment in endocrinologic, tumoral and surgical disorders.
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Chibbaro S, Tigan L, Marsella M, George B, Galzio R, Kehrli P, Vicaut E, Diemidio P. The "Skull Flap" a new conceived device for decompressive craniectomy/cranioplasty: Feasibility study on cadaver specimen. J Neurosci Rural Pract 2013; 4:283-7. [PMID: 24250160 PMCID: PMC3821413 DOI: 10.4103/0976-3147.118779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: Decompressive craniectomy (DC) is a procedure that is currently performed with increasing frequency. The reason is that its indications have become much broader. This procedure may be associated with the relevant morbidity in the postoperative stage due to the creation of a large bone defect. On the other hand, cranioplasty is associated too with some of the common complications related to any reconstructive head surgery. The authors present a newly developed device: The “Skull Flap” (SF). This new device allows the surgeon to complete a DC, yet providing at the same time a cranial reconstruction that will not require the patient to undergo a second reconstructive procedure. Materials and Methods: Different size and location craniectomies were carried out on four human cadaveric heads; the bone flaps were then repositioned in a more elevated position with respect to the skull edges. The flaps were placed at a distance of 12 and 15 mm from the skull edges using the SF system. Crash tests were conducted on each flap while in open and closed positions to assess its reliability and efficacy. Results: SF was shown to be a strong fixation device that allows satisfactory brain decompression by keeping the original bone flap away from the swollen brain; at the same time, in a later stage, it allows cranial reconstruction in a simple way. Conclusion: The SF device was shown to be very easy to use, adaptable, and practical to apply; thus, allowing both satisfactory brain decompression as well as bone flap repositioning at a later time after the brain swelling has subsided.
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Affiliation(s)
- Salvatore Chibbaro
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
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Chibbaro S, Makiese O, Bresson D, Hamdi S, Cornelius J, Guichard J, Reiss A, Bouazza S, Vicaut E, Ricci A, Galzio R, Poczos P, George B, Marsella M, Di Emidio P. Skull Bone Flap Fixation – Reliability and Efficacy of a New Grip-Like Titanium Device (Skull Grip) versus Traditional Sutures: A Clinical Randomized Trial. ACTA ACUST UNITED AC 2012; 54:282-5. [DOI: 10.1055/s-0031-1297246] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | - A. Ricci
- Department of Neurosurgery University Hospital of Aquila
| | - R. Galzio
- Department of Neurosurgery University Hospital of Aquila
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Makiese O, Chibbaro S, Marsella M, Tran Ba Huy P, George B. Jugular foramen paragangliomas: management, outcome and avoidance of complications in a series of 75 cases. Neurosurg Rev 2011; 35:185-94; discussion 194. [PMID: 21947488 DOI: 10.1007/s10143-011-0346-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Revised: 05/24/2011] [Accepted: 05/24/2011] [Indexed: 11/24/2022]
Abstract
Jugular foramen paragangliomas are rare skull base tumours posing multiple complex diagnostic and management problems. We did a study to evaluate surgical technique, outcome and complications in 75 cases of tumours treated by multidisciplinary approach (i.e. combined neurosurgery, neuroradiology, ear, nose and throat surgery and intensive care unit team). Retrospective study on 75 consecutive patients with jugular foramen paragangliomas treated surgically from 1989 to 2005. Preoperative balloon occlusion test was performed in all patients as well as embolization (100%). A combined limited infratemporal and juxtacondylar approach was used in all patients. Gross total resection was achieved in 59 patients (78.7%). The most common complication was represented by lower cranial nerve deficits in five patients (6.6%), which was only temporary in three. Postoperative facial nerve weakness occurred in five cases (6.6%) and resolved in three of them. The remaining two patients underwent facial nerve reconstruction by hypoglossal/facial nerve anastomosis. Four patients (5.3%) had a postoperative cerebrospinal fluid leak, which was successfully treated by lumbar drainage. Two patients (2.7%) died because of complications related to surgical injury of lower cranial nerves: one patient developed aspiration pneumonia and septicemia and the second one developed a large cervico-bulbar hematoma that led to severe respiratory distress and ultimately global cerebral hypoxia. Paragangliomas are rare and complex skull base lesions that may be managed with low morbidity and mortality if a multidisciplinary approach is considered. Facial and lower cranial nerve postoperative deficits can be limited.
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Affiliation(s)
- Orphée Makiese
- Department of Neurosurgery, Lariboisiere Hospital Paris, Paris, France.
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De Sanctis V, Marsella M. Unilateral asymptomatic testis enlargement in children and adolescents. Georgian Med News 2011:25-29. [PMID: 21617270] [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: 05/30/2023]
Abstract
In literature a well codified definition of unilateral asymptomatic testis enlargement does not exist. Therefore in these cases the pediatrician or adolescentologist will have to make a clinical and diagnostic evaluation in order to exclude: a) an enlarged testis secondary to tumors, surgery, or endocrinological diseases; b) a small testis due to a previous (ex. cryptorchidism) or current disease (e.g. varicocele).The presence of a mild difference in testis volumes during puberty is not at all rare. This situation may be due to the technique used for evaluation of testis volume or secondary to a varicocele. The identification of variants of testis enlargement is important, because, while on one hand there are conditions without clinical relevance, on the other hand, there are diseases that require early diagnosis and immediate treatment. The Authors report a brief review of the literature and their own clinical experience. 14 patients with unilateral testis enlargement were observed. At the first examination, mean age was 12.3±1.2 years and the volume of the enlarged testis varied between 4 ml and 20 ml (mean volume 10±4 ml) versus 1.5 ml and 10 ml (mean volume 5±2 ml) of the contralateral testis. In 75% of cases the right testis was affected. During the ten year follow-up, the volume of the enlarged testis never exceeded 25 ml and progressive reduction of the difference between the two testes was demonstrated. Therefore, they propose another clinical condition defined as transitory unilateral testis enlargement of puberty.
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Affiliation(s)
- V De Sanctis
- Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy
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Marsella M, Borgna-Pignatti C, Meloni A, Caldarelli V, Dell’Amico MC, Spasiano A, Pitrolo L, Cracolici E, Valeri G, Positano V, Lombardi M, Pepe A. Cardiac iron and cardiac disease in males and females with transfusion-dependent thalassemia major: a T2* magnetic resonance imaging study. Haematologica 2011; 96:515-20. [PMID: 21228034 PMCID: PMC3069227 DOI: 10.3324/haematol.2010.025510] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 12/01/2010] [Accepted: 12/27/2010] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND It has been repeatedly reported that female patients with thalassemia major survive longer than males and that the difference is due to a lower rate of cardiac disease in females. DESIGN AND METHODS We compared the cardiac iron load as measured by T2* magnetic resonance imaging in 776 patients (370 males) examined at the National Research Council as part of an Italian cooperative study. We also established normal left ventricular ejection fraction values for our population. RESULTS The prevalence of cardiac disease was higher in males than in females (105 males versus 69 females; P < 0.0001). Cardiac T2* was significantly lower in patients with heart dysfunction (P < 0.0001), but no difference was observed according to sex. Twenty males and five females had a history of cardiac arrhythmias. Their cardiac T2* was not significantly lower than that of patients without arrhythmias (24 ms versus 26 ms; P = 0.381), nor was there a difference between sexes. Liver T2* was significantly lower in males and females with heart dysfunction compared to those without. Ferritin levels were higher in patients of both sexes with heart dysfunction without significant differences between males and females. Conclusions Males and females are at the same risk of accumulating iron in their hearts, but females tolerate iron toxicity better, possibly as an effect of reduced sensitivity to chronic oxidative stress.
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Affiliation(s)
- Maria Marsella
- Department of Clinical and Experimental Medicine (Pediatrics), Ferrara
| | | | - Antonella Meloni
- MRI Laboratory, Institute of Clinical Physiology, “G. Monasterio” Foundation/CNR, Pisa
| | | | | | | | - Lorella Pitrolo
- Pediatria II Emopatie Ereditarie, Villa Sofia-CTO Hospital, Palermo
| | | | - Gianluca Valeri
- Department of Radiology, University of Ancona, Ancona, Italy
| | - Vincenzo Positano
- MRI Laboratory, Institute of Clinical Physiology, “G. Monasterio” Foundation/CNR, Pisa
| | - Massimo Lombardi
- MRI Laboratory, Institute of Clinical Physiology, “G. Monasterio” Foundation/CNR, Pisa
| | - Alessia Pepe
- MRI Laboratory, Institute of Clinical Physiology, “G. Monasterio” Foundation/CNR, Pisa
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Chibbaro S, Mirone G, Nouri M, Di Emidio P, Polivka M, Marsella M, George B. Dorsal epidural spinal lipomatosis. BMJ Case Rep 2011; 2011:2011/feb12_1/bcr0920103365. [PMID: 22707370 DOI: 10.1136/bcr.09.2010.3365] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The authors report a case of a thoracic epidural spinal lipomatosis causing severe neurological deficits along the review of pertinent literature. The patient is a 56-year-old woman who presented with acute onset of severe paraparesis; she was investigated with cervical and thoracic MRI and then surgically managed because of an intraspinal mass compressing the cord. The operation consisted in the excision of the mass confirmed to be a fibrolipoma by pathological analysis. The patient attained complete neurological recovery and at 18 months follow-up she reported a generalised well-being. Thoracic lipomas are rare lesions that presenting mostly with back pain; however, in rare instances they may cause progressive and/or abrupt neurological dysfunction. Appropriate imaging can help in the diagnosis and management of such cases.
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Affiliation(s)
- S Chibbaro
- Department of Neurosurgery, Hôpital Lariboisière, Paris, France.
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21
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Chibbaro S, Di Rocco F, Makiese O, Mirone G, Marsella M, Lukaszewicz AC, Vicaut E, Turner B, Hamdi S, Spiriev T, Di Emidio P, Pirracchio R, Payen D, George B, Bresson D. Neurosurgery and elderly: analysis through the years. Neurosurg Rev 2011; 34:229-34. [PMID: 21301916 DOI: 10.1007/s10143-010-0301-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Revised: 11/07/2010] [Accepted: 11/10/2010] [Indexed: 11/26/2022]
Abstract
The aging of the population in westernized countries constitutes an important issue for the health systems struggling with limited resources and increasing costs. Morbidity and mortality rates reported for neurosurgical procedures in the elderly vary widely. The lack of data on risk benefit ratios may result in challenging clinical decisions in this expanding group of patients. The aim of this paper is to analyze the elderly patients cohort undergoing neurosurgical procedures and any trend variations over time. The medical records of elderly patients (defined as an individual of 70 years of age and over) admitted to the Neurosurgical and Neuro-ICU Departments of a major University Hospital in Paris over a 25-year period were retrospectively reviewed. The analysis included: (1) number of admissions, (2) percentage of surgically treated patients, (3) type of procedures performed, (4) length of hospital stay, and (5) mortality. The analysis showed a progressive and significant increase in the proportion of elderly presenting for neurosurgical elective and/or emergency procedures over the last 25 years. The number of procedures on patients over 70 years of age increased significantly whereas the mortality dropped. Though the length of hospital stay was reduced, it remained significantly higher than the average stay. The types of procedures also changed over time with more craniotomies and endovascular procedures being performed. Age should not be considered as a contraindication for complex procedures in neurosurgery. However, downstream structures for postoperative elderly patients must be further developed to reduce the mean hospital stay in neurosurgical departments because this trend is likely to continue to grow.
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Affiliation(s)
- Salvatore Chibbaro
- Neurosurgery Department, Lariboisiere University Hospital, Paris, France.
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Banin P, Rimondi F, De Togni A, Cantoni S, Chiari G, Iughetti L, Salardi S, Zucchini S, Marsciani A, Suprani T, Tarchini L, Tozzola A, Xella R, Marsella M, De Sanctis V. Type 1 diabetes (T1DM) in children and adolescents of immigrated families in Emilia-Romagna (Italy). Acta Biomed 2010; 81:35-39. [PMID: 20857851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND AND AIM OF THE WORK The etiology and natural history of T1DM are still unknown but certainly both genetics and environmental factors contribute to the development of the disease. Migration studies are an important tool to better understand the role of the environment. The aim of this study was to investigate some variables in diabetic children of immigrant families living in Emilia-Romagna compared with Italian diabetic children living in the same region. METHODS We recruited 73 diabetic children from immigrant families and 707 Italian diabetic children. All children were cared by Pediatric Diabetes Units of Emilia-Romagna (10 centers). The investigated variables were: gender, current age, place of birth, parents' country of origin, age at diagnosis, HbA1c and insulin regimen. RESULTS No significant difference with reference to gender neither among the two ethnic groups, nor in the current mean age was observed. Mean age at diagnosis in the Italian children was lower than in immigrant patients born outside Italy--group A- (7.4 vs. 9.6, p < 0.000) and higher compared to those born in Italy--group B- (7.4 vs. 5.7 p < 0.003; A vs. B p < 0.000). The immigrant patients showed higher mean HbA1c than Italian patients (8.8 vs. 8.2, p < 0.009). CONCLUSIONS A younger age at diagnosis of T1DM in immigrant children, born in Italy compared with those born in the country of origin, and with Italian patients, suggests the existence of some environmental determinants acquired with a more westernised lifestyle. Immigrant children have significantly poorer metabolic control compared with western patients. (www.actabiomedica.it)
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Affiliation(s)
- Patrizia Banin
- Paediatric and Adolescent Unit, Department of Growth and Reproduction, Sant'Anna Hospital of Ferrara, Ferrara, Italy.
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23
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Clarke JL, Ennis MM, Lamborn KR, Prados MD, Puduvalli VK, Penas-Prado M, Gilbert MR, Groves MD, Hess KR, Levin VA, de Groot J, Colman H, Conrad CA, Loghin ME, Hunter K, Yung WK, Chen C, Damek D, Liu A, Gaspar LE, Waziri A, Lillehei K, Kavanagh B, Finlay JL, Haley K, Dhall G, Gardner S, Allen J, Cornelius A, Olshefski R, Garvin J, Pradhan K, Etzl M, Goldman S, Atlas M, Thompson S, Hirt A, Hukin J, Comito M, Bertolone S, Torkildson J, Joyce M, Moertel C, Letterio J, Kennedy G, Walter A, Ji L, Sposto R, Dorris K, Wagner L, Hummel T, Drissi R, Miles L, Leach J, Chow L, Turner R, Gragert MN, Pruitt D, Sutton M, Breneman J, Crone K, Fouladi M, Friday BB, Buckner J, Anderson SK, Giannini C, Kugler J, Mazurczac M, Flynn P, Gross H, Pajon E, Jaeckle K, Galanis E, Badruddoja MA, Pazzi MA, Stea B, Lefferts P, Contreras N, Bishop M, Seeger J, Carmody R, Rance N, Marsella M, Schroeder K, Sanan A, Swinnen LJ, Rankin C, Rushing EJ, Hutchins LF, Damek DM, Barger GR, Norden AD, Lesser G, Hammond SN, Drappatz J, Fadul CE, Batchelor TT, Quant EC, Beroukhim R, Ciampa A, Doherty L, LaFrankie D, Ruland S, Bochacki C, Phan P, Faroh E, McNamara B, David K, Rosenfeld MR, Wen PY, Hammond SN, Norden AD, Drappatz J, Phuphanich S, Reardon D, Wong ET, Plotkin SR, Lesser G, Mintz A, Raizer JJ, Batchelor TT, Quant EC, Beroukhim R, Kaley TJ, Ciampa A, Doherty L, LaFrankie D, Ruland S, Smith KH, Wen PY, Chamberlain MC, Graham C, Mrugala M, Johnston S, Kreisl TN, Smith P, Iwamoto F, Sul J, Butman JA, Fine HA, Westphal M, Heese O, Warmuth-Metz M, Pietsch T, Schlegel U, Tonn JC, Schramm J, Schackert G, Melms A, Mehdorn HM, Seifert V, Geletneky K, Reuter D, Bach F, Khasraw M, Abrey LE, Lassman AB, Hormigo A, Nolan C, Gavrilovic IT, Mellinghoff IK, Reiner AS, DeAngelis L, Omuro AM, Burzynski SR, Weaver RA, Janicki TJ, Burzynski GS, Szymkowski B, Acelar SS, Mechtler LL, O'Connor PC, Kroon HA, Vora T, Kurkure P, Arora B, Gupta T, Dhamankar V, Banavali S, Moiyadi A, Epari S, Merchant N, Jalali R, Moller S, Grunnet K, Hansen S, Schultz H, Holmberg M, Sorensen MM, Poulsen HS, Lassen U, Reardon DA, Vredenburgh JJ, Desjardins A, Janney DE, Peters K, Sampson J, Gururangan S, Friedman HS, Jeyapalan S, Constantinou M, Evans D, Elinzano H, O'Connor B, Puthawala MY, Goldman M, Oyelese A, Cielo D, Dipetrillo T, Safran H, Anan M, Seyed Sadr M, Alshami J, Sabau C, Seyed Sadr E, Siu V, Guiot MC, Samani A, Del Maestro R, Bogdahn U, Stockhammer G, Mahapatra AK, Venkataramana NK, Oliushine VE, Parfenov VE, Poverennova IE, Hau P, Jachimczak P, Heinrichs H, Schlingensiepen KH, Shibui S, Kayama T, Wakabayashi T, Nishikawa R, de Groot M, Aronica E, Vecht CJ, Toering ST, Heimans JJ, Reijneveld JC, Batchelor T, Mulholland P, Neyns B, Nabors LB, Campone M, Wick A, Mason W, Mikkelsen T, Phuphanich S, Ashby LS, DeGroot JF, Gattamaneni HR, Cher LM, Rosenthal MA, Payer F, Xu J, Liu Q, van den Bent M, Nabors B, Fink K, Mikkelsen T, Chan M, Trusheim J, Raval S, Hicking C, Henslee-Downey J, Picard M, Reardon D, Kaley TJ, Wen PY, Schiff D, Karimi S, DeAngelis LM, Nolan CP, Omuro A, Gavrilovic I, Norden A, Drappatz J, Purow BW, Lieberman FS, Hariharan S, Abrey LE, Lassman AB, Perez-Larraya JG, Honnorat J, Chinot O, Catry-Thomas I, Taillandier L, Guillamo JS, Campello C, Monjour A, Tanguy ML, Delattre JY, Franz DN, Krueger DA, Care MM, Holland-Bouley K, Agricola K, Tudor C, Mangeshkar P, Byars AW, Sahmoud T, Alonso-Basanta M, Lustig RA, Dorsey JF, Lai RK, Recht LD, Reardon DA, Paleologos N, Groves M, Rosenfeld MR, Meech S, Davis T, Pavlov D, Marshall MA, Sampson J, Slot M, Peerdeman SM, Beauchesne PD, Faure G, Noel G, Schmitt T, Kerr C, Jadaud E, Martin L, Taillandier L, Carnin C, Desjardins A, Reardon DA, Peters KB, Herndon JE, Kirkpatrick JP, Friedman HS, Vredenburgh JJ, Nayak L, Panageas KS, Deangelis LM, Abrey LE, Lassman AB. Ongoing Clinical Trials. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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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Bernard R, Vallee F, Mateo J, Marsella M, George B, Payen D, Chibbaro S. Uncontrollable high-frequency tachypnea: a rare and nearly fatal complication of endoscopic third ventriculostomy: case report and literature review. Minim Invasive Neurosurg 2010; 53:270-272. [PMID: 21302196 DOI: 10.1055/s-0030-1269874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Endoscopic third ventriculostomy (ETV) is considered a safe procedure although it carries its rate of risks and complications that may occasionally be life-threatening. CASE REPORT This is a report about a 48-year-old woman presenting with progressive gait unsteadiness, weakness of the lower extremities and cognitive impairment due to tri-ventricular hydrocephalus. This was treated with standard ETV. In the immediate post-operative period the patient developed a severe and uncontrollable tachypnea requiring sedation, intubation and mechanical ventilation. CONCLUSION Tachypnea may be an early complication after standard ETV and although its mechanism remains yet unclear, we speculate that it may be related to excessive traction and/or surgical manipulation of the floor of the third ventricle. Supportive care with mechanical ventilation is the mainstay of treatment until spontaneous normalization of the respiratory mechanism occurs.
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Affiliation(s)
- R Bernard
- Neuro-ICU, Lariboisere University Hospital, Paris, France
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25
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26
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Marsella M, Pepe A, Borgna-Pignatti C. Better survival and less cardiac morbidity in female patients with thalassemia major: a review of the literature. Ann N Y Acad Sci 2010; 1202:129-33. [DOI: 10.1111/j.1749-6632.2010.05588.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Badruddoja MA, Pazzi M, Stea B, Kuzma KM, Bishop MC, Carmody R, Schroeder K, Seeger J, Marsella M, Sanan A. Phase II study of biweekly temozolomide plus bevacizumab for adult patients with recurrent glioblastoma multiforme. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e12554] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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28
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Abstract
Classical Poland Syndrome (PS) is characterized by unilateral, partial or complete absence of the sternocostal head of the major pectoral muscle and brachysyndactyly of fingers on the same side. We report the case of a newborn infant with dextrocardia and PS located on the left side. This association is very rare: to date only 19 cases have been described in scientific literature. In all reported cases, as in the present, the Poland defect involved the left side and was associated to rib defects, whereas most cases of PS are on the right side and few have rib defects. This case supports the view that dextrocardia follows the loss of volume of the left hemithorax caused by Poland sequence and that the combination of PS and dextrocardia is not coincidental.
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Affiliation(s)
- Doriana Lacorte
- Neonatal Intensive Care Unit, Department of Clinical and Experimental Medicine, Pediatrics, University of Ferrara, Italy
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Romano A, Chibbaro S, Makiese O, Marsella M, Mainini P, Benericetti E. Endoscopic removal of a central neurocytoma from the posterior third ventricle. J Clin Neurosci 2008; 16:312-6. [PMID: 19084413 DOI: 10.1016/j.jocn.2008.03.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2008] [Revised: 03/21/2008] [Accepted: 03/26/2008] [Indexed: 11/17/2022]
Abstract
Central neurocytoma is a rare benign tumor that most commonly arises within the ventricular system of young adults. Its occurrence in the posterior third ventricle is one of the least reported presentations. These tumors are usually treated by a combination of either biopsy or open surgical resection, often followed by radiation (Gamma knife or Novalis) with or without chemotherapy. A 37-year-old woman with a posterior third ventricle neurocytoma presented with acute signs of aqueductal stenosis. The patient underwent endoscopic assisted gross total resection of the tumor with the aid of intraoperative laser followed by standard third ventriculostomy; no further treatment was required. The patient did not develop any subsequent neurological deficit. A 36-month follow-up was still consistent with a normal neurological examination. Serial post-operative MRIs show neither residual nor recurrent tumor. Thus, posterior third ventricle central neurocytomas are relatively benign tumors that can be successfully removed using a minimally invasive approach, thereby avoiding both the morbidity related to conventional open craniotomy and the potential toxicity of any adjuvant treatment.
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Affiliation(s)
- A Romano
- Department of Neurosurgery, Parma University Hospital, Via Gramsci 14-43100, Parma, Italy.
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De Sanctis V, Tanas R, Gamberini MR, Sprocati M, Govoni MR, Marsella M. Exaggerated TSH response to TRH ("sub-biochemical" hypothyroidism) in prepubertal and adolescent thalassaemic patients with iron overload: prevalence and 20-year natural history. Pediatr Endocrinol Rev 2008; 6 Suppl 1:170-173. [PMID: 19337173] [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: 05/27/2023]
Abstract
The severity of thyroid dysfunction in patients with beta-thalassaemia major is variable in different series. An exaggerated thyrotropin response to thyrotropin-releasing-hormone (TRH) has been found in 1 out of 5 beta-thalassaemia major patients. Because it is not well known how many of these patients will develop overt or subclinical hypothyroidism, we reviewed retrospectively the thyroid status (thyroid hormones, TBG, TG basal and TSH peak after TRH test) of 24 children and adolescents with beta-thalassemia major (mean age 12.1+/-3.9 years) on periodic transfusion therapy, regularly followed in our Centre during the last 20 years. As controls we studied 30 normal subjects aged 13.4+/-2.5 years. In our group of 24 thalassaemics an exaggerated TSH response to TRH test was found in 8 (33.3%), 3 of whom developed subclinical or overt hypothyroidism from 3 to 11 years later. TSH peak values correlated directly with ferritin levels, ALT, and compliance index to chelation therapy. Our data suggest that an exaggerated TSH response to TRH test is frequent in beta-thalassemia major, and may evolve into subclinical or overt hypothyroidism as we found in 37.5% of our patients with sub-biochemical hypothyroidism.
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Affiliation(s)
- Vincenzo De Sanctis
- Department of Reproduction, Paediatric and Thalassaemia Unit, St. Anna Hospital, Ferrara, Italy.
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De Sanctis V, Govoni MR, Sprocati M, Marsella M, Conti E. Cardiomyopathy and pericardial effusion in a 7 year-old boy with beta-thalassaemia major, severe primary hypothyroidism and hypoparathyroidism due to iron overload. Pediatr Endocrinol Rev 2008; 6 Suppl 1:181-184. [PMID: 19337175] [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: 05/27/2023]
Abstract
The primary cause of cardiac dysfunction in thalassemia is believed to be myocardial iron overload. Besides iron, other factors may play a role in the impairment of myocardial contractility, including prolonged heart tissue hypoxia, pericardial involvement, arrhythmias, endocrine complications and vitamin D deficiency. We present the case of a 7 year-old boy with ?-thalassaemia major and cardiac dysfunction, pericardial effusion and associated endocrinopathies. His serum thyrotropin (TSH) level was increased, and total and free thyroxine (FT4) were low. In addition, biochemical results and serum PTH level were compatible with a diagnosis of hypoparathyroidism. Other laboratory findings were not consistent with rheumatic heart disease, viral myocarditis or autoimmune disease. The child was treated with digoxin, diuretics, oral calcium, vitamin D, L-thyroxine (25 microg daily, which was later gradually increased) and subcutaneous iron chelation therapy (45 mg/kg, six days/week). The patient was discharged from our Unit after 7 days and within 3 months he had appreciable myocardial improvement and disappearance of the pericardial effusion.
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Affiliation(s)
- Vincenzo De Sanctis
- Department of Reproduction, Paediatric and Thalassaemia Unit, St. Anna Hospital, Ferrara, Italy.
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Mangiagli A, Campisi S, Marsella M, De Sanctis V. Vertebral collapse in thalassemia intermedia: case report. Pediatr Endocrinol Rev 2008; 6 Suppl 1:136-139. [PMID: 19337167] [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: 05/27/2023]
Abstract
Over the last few decades, the use of regular blood transfusions and adequate iron chelation beginning in the first years of life has modified the clinical picture and the natural course of thalassemia major. With the rise in the average age of these patients new problems have emerged, in particular bone disease: osteopenia, osteoporosis and the increased risk of fractures have become important causes of morbidity in a population whose longevity is continuously increasing. The Authors describe the case of a 41 year old patient affected by clinical thalassemia intermedia who presented with vertebral collapse after mild trauma. The physiopathology of osteoporosis and vertebral fractures in thalassemic patients and related management is presented.
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Affiliation(s)
- Antonino Mangiagli
- Unit for the Diagnosis and Treatment of Thalassemia, Umberto I Hospital, Siracusa, Italy.
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Ellsworth R, Welsh J, Mahadevan D, Bearrs D, Hsieh D, Fjerstad K, Marsella M, Sanan A, Badrudojja M, Stea B. The Radiosensitizing Effects of a Novel Tyrosine Kinase Inhibitor, Mp470 in Glioblastoma Multiforme Stem Cells. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Soma PF, Chibbaro S, Makiese O, Marsella M, Diemidio P, Fricia M, Passanisi M, Catania V, Siragò P, Ventura F. Aggressive scalp carcinoma with intracranial extension: a multidisciplinary experience of 25 patients with long-term follow-up. J Clin Neurosci 2008; 15:988-92. [PMID: 18653348 DOI: 10.1016/j.jocn.2007.09.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2007] [Revised: 09/12/2007] [Accepted: 09/16/2007] [Indexed: 10/21/2022]
Abstract
Malignant skin cancer of the scalp with skull invasion, dural infiltration and brain involvement is a uncommon lesion. This scenario is most often encountered in patients where initial scalp lesions are not appropriately diagnosed or their extent is underestimated by the patient and/or the doctor. Our study is a retrospective review of 25 patients treated using a multidisciplinary approach (combined plastic surgery/neurosurgery procedure and neuro-oncological management). After a mean follow-up of 7 years, 22 patients did not show local recurrence or distant metastases of their primary disease. Overall, these 22 patients had excellent quality of life; however, three patients died from causes not related to their primary pathology. To obtain a complete and definitive cure, prompt diagnosis of scalp cancers followed by appropriate multidisciplinary management is strongly advised.
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Affiliation(s)
- P F Soma
- Department of Plastic Surgery, University Hospital, Catania, Italy
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Gabutti G, Lazzara C, Marsella M, Bergamini M, Malaventura C, Borgna-Pignatti C. Burden of hospitalizations due to Rotavirus infection in Emilia Romagna, Italy. Acta Biomed 2007; 78:176-181. [PMID: 18330076] [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: 05/26/2023]
Abstract
The aim of this study was to collect data on hospitalizations due to gastrointestinal diseases, in particular Rotavirus gastroenteritis (RVGE), in the Region of Emilia Romagna, Italy. The national hospital discharge database was used to evaluate the epidemiology of RV infections in the 2000-2003 period, analyzing only the principal diagnosis. The available age groups were 0-14 years, 15-64 years and, >64 years. Hospitalization related costs were estimated through Diagnosis Related Group (DRG) rates even though a specific DRG for RVGE does not exist. In the 0-14yr. old subjects, RV were responsible for an average of 310 GE-related hospitalizations per year and globally represented 17% of admissions for enteritis and 84% of hospitalized viral GE. Fifty-six percent of the enteritis was of undefined origin. Considering the three possible DRG codes to which the disease can be referred (184, 298, 422) and the classification of hospitals in two categories, the cost of each admission for RVGE ranged between 1,293.83 Euro and 2,263.79 Euro. RV seems to play an important role as a cause of severe viral gastroenteritis, although RV infections are certainly underestimated for several reasons, one of them being the low sensitivity of hospital discharge forms. Today we have safe and effective vaccines that can be used in order to protect from moderate/severe forms of RV-related diarrhea. The extensive use of these vaccines could reduce hospitalizations and related costs in industrialized countries.
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Affiliation(s)
- Giovanni Gabutti
- Section of Hygiene and Occupational Health, Department of Clinical and Experimental Medicine, University of Ferrara.
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Gabutti G, Marsella M, Lazzara C, Fiumana E, Cavallaro A, Borgna-Pignatti C. Epidemiology and burden of rotavirus-associated hospitalizations in Ferrara, Italy. J Prev Med Hyg 2007; 48:5-9. [PMID: 17506231] [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: 05/15/2023]
Abstract
Objective of this study was to provide data on hospitalizations for rotavirus gastroenteritis (RVGE) in Ferrara, Italy. The study was conducted analyzing the hospital discharge forms of all children admitted to the Pediatric Department of the University of Ferrara, Arcispedale Sant'Anna, from January 2001 through December 2005. The database was searched for all gastrointestinal diseases and in particular RVGE. During the period under study 3277 children, of which 2038 <60 months of age, were hospitalized; 247 children < 5 years old were admitted for acute gastroenteritis and 89 (4.4% of all and 36% of gastroenteritis-related hospitalizations) had rapid screening tests positive for rotavirus. A seasonal pattern was observed for RVGE with an increase in winter and early spring. The average length of hospital stay was 5.7 days. The median cost of each hospitalized case of RVGE ranged between 1417 and 1595 Euros. The present research confirms that rotavirus gastroenteritis represents an important cause of hospitalization in children and is responsible for significant costs for the Public Health Care System. An effective vaccination program could significantly reduce the incidence of hospitalization and the associated costs.
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Affiliation(s)
- G Gabutti
- Section of Hygiene and Industrial Medicine, Department of Clinical and Sperimental Medicine, University of Ferrara, Italy
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Romano A, Chibbaro S, Marsella M, Ippolito S, Benericetti E. Carotid cavernous aneurysm presenting as pituitary apoplexy. J Clin Neurosci 2006; 13:476-9. [PMID: 16678729 DOI: 10.1016/j.jocn.2005.05.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2004] [Accepted: 05/03/2005] [Indexed: 11/25/2022]
Abstract
The authors report an interesting case with a ruptured internal carotid artery aneurysm that presented as a sellar haematoma mimicking radiologically a pituitary adenoma, and clinically a pituitary apoplexy. A 53-year-old woman presented with a 2-week history of episodic severe headache and vomiting associated, 3 days prior to admission, with left ophthalmoparesis and transient right hemiparesis. Brain MRI showed a large intra- and suprasellar mass suggestive of a pituitary macroadenoma. Hormonal profiles showed hyperprolactinaemia and subsequent cerebral angiography demonstrated a carotid cavernous aneurysm. The patient underwent surgery via a subfrontal approach to manage both lesions. At operation, the suspected pituitary adenoma was revealed to be a sellar haematoma; the aneurysm was successfully clipped. Postoperatively, the patient developed hypotension and right hemiparesis which, as well as the third nerve paresis, progressively improved to full recovery. At 12 months follow-up the patient is neurologically intact and generally well. The clinical features, the management of such a case and the importance of differential diagnosis in the acute stage are emphasised and discussed along with relevant literature.
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Affiliation(s)
- A Romano
- Department of Neurosurgery, Palma University Hospital, Palma, Italy
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Chibbaro S, Benvenuti L, Carnesecchi S, Marsella M, Pulerà F, Serino D, Gagliardi R. Anterior cervical corpectomy for cervical spondylotic myelopathy: Experience and surgical results in a series of 70 consecutive patients. J Clin Neurosci 2006; 13:233-8. [PMID: 16503487 DOI: 10.1016/j.jocn.2005.04.011] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2004] [Accepted: 04/08/2005] [Indexed: 11/18/2022]
Abstract
Recently the debate over the management of cervical spondylotic myelopathy (CSM) has regained interest; more specifically whether treatment should be operative versus non-operative, raising the question about the real effectiveness of surgery in influencing the natural history of this pathology and about the choice of the most appropriate approach (anterior vs. posterior). The authors report a retrospective review of 70 consecutive patients who underwent elective anterior cervical corpectomy and fusion with iliac crest autograft or titanium mesh and placement of an anterior cervical plate for the treatment of CSM. The patients underwent pre-and postoperative evaluation, including history, and physical and neurological examination. Patients were also evaluated pre-and postoperatively using a modified version of the Japanese Orthopedics Association Scale (mJOA), which provides a fine semi-quantitative graded evaluation of overall function. Upon discharge home, patients were followed for an average of 42 months (range, 12-63 months). Following an anterior cervical decompression of the spinal cord, 94.2% of patients improved their functional status and 5.8% were unchanged; the mean preoperative mJOA score of all patients was 12.2, the postoperative was 15.4 and the amelioration was also documented by neurophysiological studies which showed an increase in amplitude and decrease in latency of somatosensory evoked potentials and motor evoked potential in 47 patients (67%). Older age and longer duration of preoperative symptoms both were not associated with a lower postoperative mJOA score (p < 0.47, p < 0.29, respectively). Single versus multiple level decompression was not predictive of a lower postoperative mJOA score (p < 0.18). Preoperative spinal cord low signal intensity changes on T1-weighted MRI were related to a lower postoperative mJOA score (p < 0.05), whereas spinal cord high-signal intensity changes on T2-weighted MRI were related to a higher postoperative mJOA score (p < 0.01); finally a lower preoperative mJOA score was highly predictive of a lower postoperative mJOA score (p < 0.0005). Anterior cervical corpectomy and fusion for CSM appears to be an effective procedure with a more favorable neurological improvement when compared to posterior decompressive laminectomy, minimally invasive procedures or non-surgical treatment. It is also a safe procedure even in the elderly population, with low morbidity and the potential for permanent spinal cord decompression and excellent bone stability.
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Affiliation(s)
- S Chibbaro
- Department of Neurosurgery, Livorno City Hospital, Livorno, Italy.
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Chibbaro S, Benvenuti L, Carnesecchi S, Marsella M, Serino D, Gagliardi R. The use of virtual fluoroscopy in managing acute type II odontoid fracture with anterior single-screw fixation. A safe, effective, elegant and fast form of treatment. Acta Neurochir (Wien) 2005; 147:735-9; discussion 739. [PMID: 15868098 DOI: 10.1007/s00701-005-0522-6] [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] [Received: 01/15/2004] [Accepted: 02/23/2004] [Indexed: 11/25/2022]
Abstract
BACKGROUND The management of odontoid fractures represents both a clinical and a technical challenge due to the singular anatomy and biomechanics of the region. At present there is still much controversy as far as any form of management (surgical vs. conservative) is concerned and in any case there is not sufficient evidence to support a standardized form of treatment. This study was designed to further evaluate safety and efficacy of anterior odontoid single-screw fixation and to better determine the usefulness of Image Guided Surgery Virtual Fluoroscopy in treating such cases assessing also its advantages over traditional fluoroscopy and CT-guided frameless stereotaxy in the upper cervical spine surgery. METHODS This was a retrospective review of ten patients presented during a short period of 18 months with acute traumatic Type II odontoid fractures. Nine underwent fixation within a mean of 3 days after injury, whereas a patient had to be operated upon on the 22nd day due to poor alignment with conservative treatment and ongoing instability. All patients postoperatively were fitted in a collar and then followed-up with serial clinical and radiographic examinations. FINDINGS Radiological signs of fusion were seen in 10 cases (100%) (mean follow-up: 16 months). No complications occurred during the surgical procedure, nor were any instrumentation failures recorded; all patients remained neurologically intact. CONCLUSIONS We believe that anterior odontoid screw fixation using Image Guided Surgery virtual fluoroscopy is a safe, effective, less time consuming and low x-ray exposure technique and we recommend this as the preferred treatment method for acute Type II odontoid fractures. Moreover, the use of image guided technology affords more precision, confidence and safety enabling the surgeon to approach the upper cervical spine in an easier and faster way.
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Affiliation(s)
- S Chibbaro
- Department of Neurosurgery, Livorno City Hospital, Livorno, Italy.
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Abstract
OBJECTIVE AND IMPORTANCE Spontaneous spinal subarachnoid hematoma is rare, having been reported in the English literature in only seven other cases. We describe the first case of spontaneous subarachnoid hematoma located in the cervical spinal cord of a 43-year-old man. The pathologic examination showed no apparent source of bleeding, but there was evidence of cervical spondylotic myelopathy. CLINICAL PRESENTATION The patient presented with a 10-day history of severe neck pain, followed by the onset of quadriparesis that was more evident on the left side, urinary retention, and sensory loss below C5. His medical history included hypertension. Magnetic resonance imaging showed a massive hemorrhage in the cervical spinal canal. INTERVENTION A C4-C5 subarachnoid hematoma was removed. The patient died due to respiratory distress and uncontrollable hypotension on day 6 after surgery. Surgical exploration, neuroradiologic examinations, and autopsy showed no evidence of vascular malformations, tumors, or other possible sources of bleeding. CONCLUSION After excluding more common causes of spontaneous subarachnoid hematoma in this patient, we suggest that chronic spinal cord compression (spondylotic myelopathy) and arterial hypertension in this patient may have caused the pathogenesis of this rare clinical entity. Experimental data supporting this hypothesis are discussed.
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Affiliation(s)
- A Romano
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0515, USA
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Pavone P, Marsella M, Panebianco V, Catalano C, Laghi A, Campanella V, Passariello R. Radiology information and image management system: new approach to PACS with hypermedia capabilities of personal computers. Radiographics 1996; 16:421-7. [PMID: 8966298 DOI: 10.1148/radiographics.16.2.8966298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A system for archiving patient data and images was developed, installed, and evaluated in a radiology department. The system was developed with a relational database program for use with commercially available computers linked with an Ethernet network. The main options of the system are those of a conventional radiology information system: scheduling, registration, examination execution, reporting, archives and statistics, and system administration. However, the main feature of the system is the image archiving capability. Images are associated with patient records after capture by direct acquisition of the video signal or by scanning. Only relevant pathologic images are archived and a commonly employed compression algorithm is used, reducing the total memory requirement for each case to 200-600 kbytes. The diagnosis is still made by reading the original images. The low-resolution images stored in the system have an important role in teaching and consultation and as a first-line archive. Good results have been obtained with this system, which is used by medical and nonmedical staff without any special training.
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Affiliation(s)
- P Pavone
- Department of Radiology II, University of Rome La Sapienza, Italy
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Pavone P, Marsella M, Catalano C, Laghi A, Panebianco V, Campanella V, Passariello R. [The information management of a radiology department: the development of a new type of software for the archiving of alphanumeric data and images]. Radiol Med 1996; 91:111-6. [PMID: 8614711] [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: 01/31/2023]
Abstract
The authors report the main characteristics and the goals of the development of the RIS of the II Chair of the Institute of Radiology, La Sapienza University, Rome. The system was developed with a commercial software (4th Dimension), for use with an Ethernet network and Macintosh Apple computers. One of the main problems was to obtain a user-friendly system. The main options of our system are: booking, registration, exam execution, reporting, archives and statistics and system administration. The main characteristics of our RIS is that it allows important images to be archived in limited number and at low resolution. The aim is to use images for consultation and teaching purposes, not for diagnosis which is made on the original images. Low resolution images permit to use limited storage space. Image quality is very similar to that of the original images for the equipment connected on line with the RIS--i.e., US and MR units in our institute. Conventional radiographic and CT images are digitalized by two scanners with maximum resolution of 4k x 4k x 11 bits. To date, good results have been obtained. Our RIS has been used by the medical and non-medical staffs, without any particular instruction and has allowed us to organize and make faster department management and reporting.
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Affiliation(s)
- P Pavone
- Istituto di Radiologia, II Cattedra, Università degli Studi La Sapienza, Roma
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Marsella M, Benvenuti L, Gagliardi R, Gargani G. [Cerebral aspergillosis: presentation of a case]. Arch De Vecchi Anat Patol 1983; 65:169-174. [PMID: 6391387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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