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Rabiolo A, Toscani R, Sacchi M, Destefanis P, Bettin P, Ciampi C, Clemente A, Cutolo CA, Mercieca K, Iester M, Traverso CE, Di Maita M, Li Calzi G, Nucci P, Bandello F, Triolo G, De Cillà S. Risk Factors for Failure in Glaucoma Patients Undergoing Microshunt Implantation. Am J Ophthalmol 2024; 259:117-130. [PMID: 37979601 DOI: 10.1016/j.ajo.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/20/2023]
Abstract
PURPOSE To evaluate risk factors for failure of Microshunt in glaucoma patients. DESIGN Multicenter retrospective cohort study. METHODS The study included 220 eyes from 220 consecutive glaucoma patients undergoing Microshunt implantation at six glaucoma units. Four intraocular pressure (IOP) success criteria were defined: (A) IOP ≤21 mm Hg with ≥20% IOP reduction; (B) IOP ≤18 mm Hg with ≥20% IOP reduction; (C) IOP ≤15 mm Hg with ≥25% IOP reduction; and (D) IOP ≤12 mm Hg with ≥30% IOP reduction from baseline. Kaplan-Meier analysis was used to estimate success rates according to the criteria above, and multivariable Cox models were used to identified risk factors for failure according to criterion A. RESULTS Success rates varied based on different criteria, ranging from 43.3% to 62.5% (overall success for criteria D and A, respectively) and from 35.3% to 44.4% (complete success for criteria D and A, respectively) at 1-year follow-up. Higher intraoperative MMC concentration was associated with reduced risk of failure to maintain complete (0.4 vs 0.2 mg/mL: hazard ratio [HR] = 0.441, P < .001) and overall (0.4 vs 0.2 mg/mL: HR = 0.360, P = .004) success. For complete success, other risk factors for failure were pseudoexfoliation glaucoma/pigmentary glaucoma (HR = 1.641, P = .004), primary angle closure glaucoma (HR = 1.611, P < .001), and previous non-glaucomatous ocular surgeries (HR = 2.301, P = .002). For overall success, other risk factors for failure were lower preoperative IOP (for 1-mm Hg increase, HR = 0.934, P = .005), higher number of preoperative antiglaucoma agents (HR = 1.626, P < .001), and Microshunt combined with cataract surgery (HR = 1.526, P = .033). CONCLUSIONS This study identified risk factors for Microshunt failure, highlighting the importance of high intraoperative MMC dose and careful patient selection to optimize surgical success.
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Affiliation(s)
- Alessandro Rabiolo
- From the Department of Ophthalmology (A.R., P.D., A.C., S.D.C.), University Hospital Maggiore della Carità, Novara, Italy; Department of Health Sciences (A.R., S.D.C.), Università del Piemonte Orientale "Amedeo Avogadro", Novara, Italy.
| | - Rebecca Toscani
- Department of Ophthalmology (R.T., P.B., C.C., F.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Sacchi
- Department of Ophthalmology (M.S., G.L.C., P.N.), San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Pietro Destefanis
- From the Department of Ophthalmology (A.R., P.D., A.C., S.D.C.), University Hospital Maggiore della Carità, Novara, Italy
| | - Paolo Bettin
- Department of Ophthalmology (R.T., P.B., C.C., F.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carlo Ciampi
- Department of Ophthalmology (R.T., P.B., C.C., F.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Clemente
- From the Department of Ophthalmology (A.R., P.D., A.C., S.D.C.), University Hospital Maggiore della Carità, Novara, Italy
| | - Carlo Alberto Cutolo
- DiNOGMI (C.A.C., M.I., C.E.T.), Università di Genova, Genova, Italy; IRCCS Ospedale Policlinico San Martino (C.A.C., M.I., C.E.T.), Genova, Italy
| | - Karl Mercieca
- Department of Ophthalmology (K.M.), University Hospital Bonn, Bonn, Germany; Faculty of Biology (K.M.), Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Michele Iester
- DiNOGMI (C.A.C., M.I., C.E.T.), Università di Genova, Genova, Italy; IRCCS Ospedale Policlinico San Martino (C.A.C., M.I., C.E.T.), Genova, Italy
| | - Carlo Enrico Traverso
- DiNOGMI (C.A.C., M.I., C.E.T.), Università di Genova, Genova, Italy; IRCCS Ospedale Policlinico San Martino (C.A.C., M.I., C.E.T.), Genova, Italy
| | - Marco Di Maita
- Department of Ophthalmology (M.D.M.), Policlinico G.B. Morgagni, Catania, Italy
| | - Gaia Li Calzi
- Department of Ophthalmology (M.S., G.L.C., P.N.), San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Paolo Nucci
- Department of Ophthalmology (M.S., G.L.C., P.N.), San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Francesco Bandello
- Department of Ophthalmology (R.T., P.B., C.C., F.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giacinto Triolo
- Department of Ophthalmology (G.T.), Fatebenefratelli and Ophthalmic Hospital, ASST-Fatebenefratelli-Sacco, Milan, Italy
| | - Stefano De Cillà
- From the Department of Ophthalmology (A.R., P.D., A.C., S.D.C.), University Hospital Maggiore della Carità, Novara, Italy; Department of Health Sciences (A.R., S.D.C.), Università del Piemonte Orientale "Amedeo Avogadro", Novara, Italy
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Ali D, Mohsin H, Afzal MF, Batool S, Suleman A, Khalid J, Zafar M, Dilawar M, Janjua MH, Sarwar MZ, Naqi SA, Akbar A, Afzal A, Anwar J, Gondal KM, Shaukat M, Waheed M, Sohail M, Mukhtiar N, Ammar AS, Hussain A, Khan AN, Sarwar A, Khan I, Khattak S, Oqaili B, Saada B, Zatari D, Jubran F, Hamdan F, Emar M, Alawi R, Jacome G, Insturain I, Arauz J, Hurtado M, Beron RI, Castaño R, Cao VHB, Kwiatkowski A, Dobkowski G, Bartosiak K, Walędziak M, Możański M, Zadrożna M, Kowalewski P, Fiedziuk A, Wątroba A, Los A, Sitarska M, Rząca M, Zawadzki M, Czarnecki R, Tavares C, Santos F, Borges F, Real JC, Lima MJ, Carlos S, Pereira V, Pacheco A, Gomes G, Pimenta J, Elisiario L, Jervis M, Gonçalves V, Pedro V, Jordão D, Neves FR, Conceição L, Ângelo MD, Marques P, Saraiva RP, Caroço TV, Windels A, Machado A, Ribeiro C, Velez C, Oliveira J, Melo MR, Lima R, Pires A, Lareiro C, Martins R, Revez T, Martins A, Cardoso D, Alegre I, Estevão P, Andrade D, Gomes DC, Duarte MJ, Custódio P, Nemésio RA, Rodrigues S, Correia A, Domingos H, Herrando I, Azevedo J, Fernandez L, Azevedo P, Vieira P, Torre A, Amado A, Paiva M, Saraiva R, Costa S, Mendes T, Queirós T, Silva A, Faustino A, Freitas A, Mendes J, Amaral L, Quintanilha R, Silva R, Coelho AM, Ribeiro A, Pinto C, Ribeiro N, Reis R, Costa S, Fernandes V, Sanches A, Amorim E, Miguel I, Rachadell J, Sanches M, Oliveira S, Baptista V, Roxo A, Devesa H, Teslyak O, Barradas R, Marques S, Martins S, Pepino S, Silva A, Deus AC, Ferreira A, Marinho D, Sousa D, Martins MJ, Matias N, Pinto A, Correia D, Amado F, Cordeiro L, Morales M, Lamas M, Marçal S, Rodrigues AI, Santos A, Marçal A, Oliveira A, Gomes C, Ferreira C, Marques R, Chitul A, Alexandrescu C, Bezede C, Cristian D, Mandi D, Grama F, Ungureanu R, Stoica B, Diaconescu C, Ciubotaru C, Tanase I, Grintescu I, Negoita VM, Calin C, Simeanu C, Ciotarla DC, Caltea M, Mirica RM, Luca A, Pasca A, Vlad C, Bonci EA, Stefanescu I, Achimas-Cadariu PA, Gata VA, Capusan A, Petrisor C, Dindelegan G, Seicean R, Scurtu R, Bintintan V, Fagarasan V, Ionescu C, Crisan D, Zanc L, Ene-Cocis MV, Muresan MS, Mihalcea SM, Dudric V, Musina AM, Ristescu AI, Roata CE, Moglan M, Dimofte MG, Lunca S, Iacob S, Dychko A, Litvin A, Kapustina A, Provozina A, Anokhin E, Zabiyaka M, Shin A, Djumabayev K, Kuznetsova M, Gordeyev S, Kochkina S, Mamedli Z, Markaryan D, Galliamov E, Semina E, Agapov M, Malahov P, Garmanova T, Kakotkin V, Zaycev A, Sumbaev A, Bedzhanyan A, Orman E, Petrenko K, Bredikhin M, Frolova Y, Tulina I, Bashilkina O, Tsarkov P, Rodimov S, Stamov V, Balaban V, Alexnder A, Yanishev A, Rogozhev D, Yakunina N, Chubukova N, Nugmanov R, Karachun A, Petrov A, Domanskiy A, Panaiotti L, Smolina M, Sapronova T, Pelipas Y, Zagaynov E, Khrykov G, Davidovskaja L, Burlov N, Mankevich N, Tverdohlebova T, Bogatikov A, Lodygin AV, Krasnoselsky C, Vasiukova ES, Kopteyev NR, Ovchinnikov T, Kashchenko VA, Novikova A, Terentyeva E, Kuleshov O, Pavlov R, Koshel A, Kostromitsky D, Drozdov E, Klokov S, Camacho A, Khan FN, Bandar MA, Shamim R, Chowdhury S, Kovacevic B, Krdzic I, Zdravkovic M, Kenic M, Milentijevic M, Petkovic N, Radulovic R, Ngu J, Teo NZ, Singh PA, Ong SY, Li S, en Siew B, Chee C, Koh JJM, Lee KY, Tan KK, Wong SC, Loh W, Pujol AF, Rubio JC, Farrés LP, Vendrell LL, Del Olmo MIU, Pedregosa AB, Galmes C, Luckute D, Casanova D, Artigot M, Guedes X, Olivella Y, Sarda MS, Toscano MJ, Damieta MP, Pera M, Gonçalvez SA, Galvez ST, Ruiz SS, Espin-Basany E, Marinello F, Villarino-Villa L, Heras MVL, Martin-Sanchez R, Mata RM, Blanco-Colino R, Otero A, de Lacy AM, Sanahuja JM, Bravo R, Ferraz T, Gonzabay V, Gonzalez F, Menendez P, Del Castillo VCG, Lopez-Pelaez VM, Silva ÁS, Lillo-García C, Tauler EM, Manresa MCE, Pérez SL, Llopis SQ, Rubio AV, Castillo ER, Miramón FJJ, Rodriguez JLR, Rizo-Lamberti LA, Garrido PG, Carneros VJ, Alfonso BA, Sierra BG, Amador CG, Gomendio MDP, Palomino MVR, de La Plaza Llamas R, Cafranga EG, Ramos JLE, Estudillo MC, Pérez RE, Pernas RM, de Lebrusant Fernández S, Bautista WMS, Llamazares AL, Valbuena AL, Moran LA, Alvarez LJ, Raposo LG, Ceron SF, Calvo AC, Valcárcel CR, Peña JP, Gómez LMJ, Díez MC, Lindenbaum PD, Mata SK, Ruiz-De-La-Hermosa A, Abad-Motos A, Toribio-Combarro B, Ripollés-Melchor J, Fuenmayor-Valera ML, Ortega-Domene P, Loscos A, Del Pueblo CS, Dziakova J, Mugüerza JM, Carlin PS, Anula R, Mouvet Y, Forero-Torres A, Andrés BDS, Marcos CM, Rubio I, Pascual I, Yague J, Alcolea NG, Alonso A, Diéguez B, Ibañez I, Pérez JL, Losada M, García-Conde M, Hernández M, Blazquez-Martin A, Vera-Mansilla C, Mendoza-Moreno F, Hernandez-Salvan J, Diez-Alonso M, Hernandez-Juara P, Barrena-Blazquez S, Minaya-Bravo AM, Galván-Pérez A, Miguel-Méndez CS, Gonzalez-Gonzalez E, Alvarez-Díez M, García-Ureña MÁ, Llorente-Moreno M, Ruiz-Lozano C, Colás-Ruiz E, Pérez-Calvo J, Gomila-Sanso JA, Álvarez-Llano L, Serrano-Fuentes SC, Soto-Montesinos C, Dedeu-Bastardas I, Perez-Reche I, Labró-Ciurans M, Pardo-López S, Pérez EG, Fernández IO, Canals LO, Espino PC, Ruano PG, Ricardo V, Ros EP, Manuel EM, Buleje JAB, Prats MMC, Baños PAP, González PM, Celdrán RG, Pellicer-Franco EM, Valero-Navarro G, Vicente-Villena JP, Martinez-Mercader MM, Baeza-Murcia M, Mengual-Ballester M, Soria-Aledo V, Fernández-Martínez D, Varela-Rodríguez L, Garcia-Flórez LJ, Fernández-Hevia M, Gonzalez-Diaz MJ, Fernández-Arias S, Puertas CP, de San Pío Carvajal E, Cebolla ES, Brainsa E, Bayo JMM, Castro MC, Blanco RR, Gutierrez E, Pinto FL, Alegre JM, Flores N, ÓSullivan SN, Fernández BF, Alonso JE, Conde JGA, Ropero NM, Bayón RÁ, Dominguez SH, Ramirez S, Martin de Pablos A, Perez-Sanchez A, Cano-Matias A, Del-Rio-Lafuente FJ, Caballero-Delgado J, Valdes-Hernandez J, Gomez-Rosado JC, Martinez C, Cholewa H, Sancho-Muriel J, Alberola MJ, Navasquillo M, Primo V, Moreno V, Espí-Macías A, Moro-Valdezate D, Carrascosa-Morales I, Martín-Arévalo J, Soro-Domingo M, García-Botello S, Pla-Marti V, Abellán AM, Pérez CM, Cortés GFV, Blasco LF, Chornet MR, Martín RS, Diego ARD, Vázquez-Fernández A, Pascual A, de Andrés-Asenjo B, Beltrán de Heredia J, Ruiz-Soriano M, Rodríguez-Jiménez R, Iribarren EM, Rodríguez EVF, Del Carmen Casas García M, García-Señoráns MP, Valderrama ÓC, Rodríguez PF, Santos RS, Currás RP, Vigorita V, Roche CG, Delgado E, Lafuente F, Gascon I, Saudi S, Fraj V, Wickramasinghe D, de Zoysa I, Samarasekera N, Wickramarathne R, Dassanayake V, Balathayalan Y, de Silva D, Perera M, Pulleperuma S, Jayasekara S, Wijenayake W, Gunetilleke B, Abeysinghe N, Chandrasinghe P, Kumarage S, Abdalradiy AG, Widatalla ABH, Ahmed AY, Mohamed HA, Hamid HKS, Ali MH, Eldin SJ, Agger E, Jutesten H, Lindgren J, Lepsenyi M, Azhar N, Hansdotter P, Ekepil A, Lindén Å, Brandström G, Smedberg J, Schiffer E, Ris F, Longchamp G, Meyer J, Dupret L, Galetti K, Regusci L, Grischott M, Malugani M, Mouhandes AEF, Danial AK, Khayat M, Sbahi MHE, Marawy MK, Abdullah MA, Douba Z, Mansour A, Niazi A, Hamza A, Mohamad AH, Awead M, Mohammad S, Salloum S, Jabar AA, Zazo A, Shebli B, Ayoub K, Younes L, Bannoud MH, Zazo R, Saad A, Hamdan A, Wakkaf H, Adra L, Souliman M, Anton M, Hannouf S, Li KL, Cheng KI, Ji SJ, Hsieh YC, Parlak EA, Demir M, Kara U, Peker YS, Yiğit D, Unal N, Iflazoğlu N, Yalkin Ö, Topal S, Gulcu B, Ozturk E, Gümbelek G, Terkanlıoğlu S, Koklucan A, Ince G, Sen M, Isik O, Kural S, Akesen S, Yilmazlar T, Sungurtekin H, Sungurtekin U, Vural U, Ozgen U, Isik A, Onk D, Kurnaz E, Ozker TS, Ipek A, Ferlengez A, Erturk C, Tatar C, Sevik H, Akay O, Sensoy O, Hayirlioglu MB, Aktas S, Ozben V, Aliyeva Z, Mutlu AU, Gökay BV, Saraçoğlu C, Aytaç E, Gülmez M, Işık MÜ, Hacim A, Akbas A, Soyhan F, Turgut MA, Demirgan S, Meric S, Altinel Y, Baris B, Akova E, Kahraman E, Kucuk HF, Saracoglu KT, Kaya S, Lel S, Gurbulak EK, Caz E, Kostek M, Mihmanli M, Yazici P, Oba S, Kırkan EF, Ulgur HS, Kalın M, Dinkci MD, Duzgun O, Ozturk S, Zengin AK, Aşkar A, Şanlı AN, Erginöz E, Özçelik MF, Ergün S, Uludağ SS, Kara D, Yılmaz G, Sarıcı IŞ, Kara Y, Incesu A, Arican C, Atici SD, Kaya T, Gezer T, Kirmizi Y, Aydin G, Namdaroglu O, Adakaya S, Canda AE, Ozzeybek D, Coskun N, Sokmen S, Ozkardesler S, Bisgin T, Miftari A, Caliskan C, Akgun E, Avseren G, Deniz N, Yoldas T, Güreşin A, Zayakov G, Pösteki G, Utkan NZ, Tatar OC, Akçay Ö, Güler SA, Mantoğlu B, Demirel E, Akın E, Gonullu E, Altintoprak F, Palabıyık O, Bayhan Z, Ciftci AB, Colak E, Aybar E, Celik HK, Eraslan H, Yemez K, Ozbilgin SS, Senol S, Gultekin FA, Piskin O, Guler O, Karadere Y, Kakeeto A, Oguttu B, Sikakulya FK, Lule H, Rybachuk A, Shudrak A, Beznosenko A, Lisnyy I, Rozhkova V, Zvirych V, Alawlaqi D, El Jamali F, Balooshi IA, Ahmed M, Albers M, Ali NA, Church R, Dudas G, Wells J, Pavlova M, Sebastiani S, Paterson C, Kaushal M, Patel P, Panchal S, Handa S, Tezas S, Zaidi SN, Raj G, Wright J, Hallam S, Karandikar S, Gates Z, Marshall A, Thompson A, Tennakoon A, Rao M, Callan R, Tufail S, Rajendran G, Polisetty K, Husain N, Clarke N, Naranayanasamy S, Hallett A, Lorejo E, Ward N, Antakia R, Xanthis A, Simillis C, Tweedle E, Panagiotopoulou I, Grimes L, Mounstephen L, Bocancia R, Carden C, Lynch J, Noveros MS, Shaalan R, Khalil T, Marshall W, Hodge K, Balfour J, Mcintosh K, Buijs L, Yule M, Vaughan-Shaw PG, Smith S, Anderson T, Mcdermott FD, Daniels IR, Tapp J, Smart N, Rajaretnam N, Bethune R, Clark T, Delimpalta C, Liao C, Banham G, Induruwage L, Velchuru V, Lawrence A, Rahman A, Bennett J, Badawi M, Harshen R, Bhargava A, Gorrela K, Jumah M, Hanson M, Arya S, Atendido T, Shrestha A, Cook E, Rakhimov I, Collins J, Alamin N, Vigneswaran N, Basnyat P, Shamardal A, Chacko A, Wanshantha D, Bisheet G, Ebdewi H, Abdellatif M, Adu-Poku P, Tore A, Adams F, Allen K, Ahmed K, Kulkarni N, Chitnis A, Patel H, Magsino J, Sarodaya V, Minicozzi A, Dempsy C, Ahmed H, Jayasinghe JD, Okail MH, Thaha M, Hallworth S, Parmar C, Chua L, Pizanias M, Samin R, Young T, Sagar J, Yorkmui L, Cirocchi N, Ahmed S, Barreda SC, Kudchadkar S, Baker A, Jayasankar B, Jackson J, Abdelsaid K, Hassan M, Shetty S, Coldwell C, Davies E, Nader H, Raistrick M, Ryska O, Hawkin P, Raymond T, Witjes C, Van de Steen K, Crabtree N, Boyce S, Somera W, Woodward A, Ryan K, Kassai M, Aleem M, Ghosh A, Rixson D, Lewis E, Lynch N, Shovelton C, Zywicka E, Guest F, Barton J, Purnell R, Bamford R, Teare T, Adams B, Chmielewski G, Smith L, Connolly L, Niblett R, Singh A, Halliwell G, Paraoan M, Doree N, Asaad P, Kilbride C, Carpenter H, Wilson J, Fletcher J, Vijayagopal KA, Abbakar M, Zaimis T, Walsh A, Kubisz-Pudelko A, Nono J, Pippard L, Chowdhary M, Dalton R, Moussa T, Dominguez F, Solla G, Curbelo J, Laurini M, Viola M, Brito N, Al-Alnsi A, Al-Naggar H, Saryah L, Al-Shehari M, Alsayadi R, Al-Hutheifi R, Shream S, Saeed S, Spurring EM. Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries. Br J Surg 2024; 111:znad370. [PMID: 38029386 PMCID: PMC10771257 DOI: 10.1093/bjs/znad370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/10/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. METHODS The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. RESULTS A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). CONCLUSION Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov).
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Mastropasqua L, Agnifili L, Brescia L, Figus M, Posarelli C, Oddone F, Giammaria S, Sacchi M, Pavan M, Innocenti DD, Olivotto V, Sensi SL, Mastropasqua R. A deep learning approach to investigate the filtration bleb functionality after glaucoma surgery: a preliminary study. Graefes Arch Clin Exp Ophthalmol 2024; 262:149-160. [PMID: 37530849 PMCID: PMC10805808 DOI: 10.1007/s00417-023-06170-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 08/03/2023] Open
Abstract
PURPOSE To distinguish functioning from failed filtration blebs (FBs) implementing a deep learning (DL) model on slit-lamp images. METHODS Retrospective, cross-sectional, multicenter study for development and validation of an artificial intelligence classification algorithm. The dataset consisted of 119 post-trabeculectomy FB images of whom we were aware of the surgical outcome. The ground truth labels were annotated and images splitted into three outcome classes: complete (C) or qualified success (Q), and failure (F). Images were prepared implementing various data cleaning and data transformations techniques. A set of DL models were trained using different ResNet architectures as the backbone. Transfer and ensemble learning were then applied to obtain a final combined model. Accuracy, sensitivity, specificity, area under the ROC curve, and area under the precision-recall curve were calculated to evaluate the final model. Kappa coefficient and P value on the accuracy measure were used to prove the statistical significance level. RESULTS The DL approach reached good results in unraveling FB functionality. Overall, the model accuracy reached a score of 74%, with a sensitivity of 74% and a specificity of 87%. The area under the ROC curve was 0.8, whereas the area under the precision-recall curve was 0.74. The P value was equal to 0.00307, and the Kappa coefficient was 0.58. CONCLUSIONS All considered metrics supported that the final DL model was able to discriminate functioning from failed FBs, with good accuracy. This approach could support clinicians in the patients' management after glaucoma surgery in absence of adjunctive clinical data.
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Affiliation(s)
- Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Ageing Science, University "G. D'Annunzio" of Chieti-Pescara, Via Dei Vestini Snc, 66100, Chieti, Italy
| | - Luca Agnifili
- Ophthalmology Clinic, Department of Medicine and Ageing Science, University "G. D'Annunzio" of Chieti-Pescara, Via Dei Vestini Snc, 66100, Chieti, Italy.
| | - Lorenza Brescia
- Ophthalmology Clinic, Department of Medicine and Ageing Science, University "G. D'Annunzio" of Chieti-Pescara, Via Dei Vestini Snc, 66100, Chieti, Italy
| | - Michele Figus
- Ophthalmology Unit, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Chiara Posarelli
- Ophthalmology Unit, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | | | - Sara Giammaria
- IRCCS Fondazione Bietti, Via Livenza, 3, 00198, Rome, Italy
| | - Matteo Sacchi
- University Eye Clinic, San Giuseppe Hospital, University of Milan, Milan, Italy
| | - Marco Pavan
- Datamantix S.R.L. Artificial Intelligence Company, Via Paolo Sarpi, 14/15, 33100, Udine, Italy
| | - Dante Degli Innocenti
- Datamantix S.R.L. Artificial Intelligence Company, Via Paolo Sarpi, 14/15, 33100, Udine, Italy
| | - Valentina Olivotto
- Datamantix S.R.L. Artificial Intelligence Company, Via Paolo Sarpi, 14/15, 33100, Udine, Italy
| | - Stefano L Sensi
- Department of Neuroscience, Imaging and Clinical Sciences (DNISC), "G. d'Annunzio" University of Chieti-Pescara, Via Dei Vestini 31, 66100, Chieti, Italy
| | - Rodolfo Mastropasqua
- Department of Neuroscience, Imaging and Clinical Sciences (DNISC), "G. d'Annunzio" University of Chieti-Pescara, Via Dei Vestini 31, 66100, Chieti, Italy
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Oddone F, Roberti G, Giammaria S, Posarelli C, Ghirelli G, Mastropasqua L, Agnifili L, Micelli Ferrari T, Pace V, Nucci P, Sacchi M, Monsellato G, Altafini R, Scuderi G, Perdicchi A, Uva M, Carnevale C, Covello G, Maglionico MN, Fea A, Figus M. Effectiveness and safety of XEN45 implant over 12 months of follow-up: data from the XEN-Glaucoma Treatment Registry. Eye (Lond) 2024; 38:103-111. [PMID: 37414935 PMCID: PMC10764778 DOI: 10.1038/s41433-023-02642-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 05/29/2023] [Accepted: 06/15/2023] [Indexed: 07/08/2023] Open
Abstract
OBJECTIVES To evaluate the 1-year effectiveness and safety of the XEN45, either alone or in combination with phacoemulsification, in glaucoma patients. METHODS This multicentre, prospective, observational study included consecutive eyes of glaucoma patients from the Italian XEN-Glaucoma Treatment Registry (XEN-GTR) who underwent XEN45 alone or in combination with phacoemulsification, with at least 1 year of follow-up. Surgical success was defined as intraocular pressure (IOP) < 18 mmHg and ≥20% reduction from preoperative IOP, over 1 year of follow-up. RESULTS Two hundred thirty-nine eyes (239 patients) were analyzed, 144 (60.2%) eyes in the XEN-solo and 95 (39.8%) eyes in the XEN+Phaco groups. One hundred-sixty-eight (70.3%) eyes achieved overall success, without statistically significant differences between study groups (p = 0.07). Preoperative IOP dropped from a median (IQR) of 23.0 (20.0-26.0) mmHg to 14.0 (12.0-16.0) mmHg at month 12 (p < 0.001), with overall 39.9 ± 18.3% IOP reduction. The mean number of preoperative ocular hypotensive medications (OHM) was significantly reduced from 2.7 ± 0.9 to 0.5 ± 0.9 at month 12 (p < 0.001). Preoperative IOP < 15 mmHg (HR: 6.63; 95%CI: 2.61-16.84, p < 0.001) and temporal position of the surgeon (HR: 4.25; 95%CI: 2.62-6.88, p < 0.001) were significantly associated with surgery failure. One hundred-forty-six (61.1%) eyes had no intraoperative complications, whereas 91 (38.1%) and 56 (23.4%) eyes experienced at least one complication, respectively early (< month 1) and late (≥ month 1), all self-limiting or successfully treated without sequelae. Needling occurred in 55 (23.0%) eyes at least once during follow-up. CONCLUSION Over 1-year follow-up, XEN45 alone or in combination with phacoemulsification, had comparable success rates and effectively and safely lowered IOP and the need for OHM.
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Affiliation(s)
| | | | | | - Chiara Posarelli
- Department of Surgical, Medical, Molecular Pathology and of Critical Care Medicine, University of Pisa, Pisa, Italy
| | | | - Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Luca Agnifili
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Vincenzo Pace
- Regional General Hospital F. Miulli of Acquaviva delle Fonti, Bari, Italy
| | - Paolo Nucci
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Matteo Sacchi
- Eye Clinic, San Giuseppe Hospital - IRCCS Multimedica, Milan, Italy
| | | | | | - Gianluca Scuderi
- Ophthalmology Unit, St. Andrea Hospital, NESMOS Department, University of Rome "Sapienza", Rome, Italy
| | - Andrea Perdicchi
- Ophthalmology Unit, St. Andrea Hospital, NESMOS Department, University of Rome "Sapienza", Rome, Italy
| | - Maurizio Uva
- University Hospital "Policlinico Vittorio Emanuele", Catania, Italy
| | | | - Giuseppe Covello
- Department of Surgical, Medical, Molecular Pathology and of Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Maria Novella Maglionico
- Department of Surgical, Medical, Molecular Pathology and of Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Antonio Fea
- Struttura Complessa Oculistica, Città Della Salute e Della Scienza di Torino, Dipartimento di Scienze Chirurgiche-Università Degli Studi di Torino, 10126, Torino, Italy
| | - Michele Figus
- Department of Surgical, Medical, Molecular Pathology and of Critical Care Medicine, University of Pisa, Pisa, Italy
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Agnifili L, Figus M, Porreca A, Brescia L, Sacchi M, Covello G, Posarelli C, Di Nicola M, Mastropasqua R, Nucci P, Mastropasqua L. A machine learning approach to predict the glaucoma filtration surgery outcome. Sci Rep 2023; 13:18157. [PMID: 37875579 PMCID: PMC10598019 DOI: 10.1038/s41598-023-44659-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023] Open
Abstract
This study aimed at predicting the filtration surgery (FS) outcome using a machine learning (ML) approach. 102 glaucomatous patients undergoing FS were enrolled and underwent ocular surface clinical tests (OSCTs), determination of surgical site-related biometric parameters (SSPs) and conjunctival vascularization. Break-up-time, Schirmer test I, corneal fluorescein staining, Meibomian gland expressibility; conjunctival hyperemia, upper bulbar conjunctiva area of exposure, limbus to superior eyelid distance; and conjunctival epithelial and stromal (CET, CST) thickness and reflectivity (ECR, SCR) at AS-OCT were considered. Successful FS required a 30% baseline intraocular pressure reduction, with values ≤ 18 mmHg with or without medications. The classification tree (CT) was the ML algorithm used to analyze data. At the twelfth month, FS was successful in 60.8% of cases, whereas failed in 39.2%. At the variable importance ranking, CST and SCR were the predictors with the greater relative importance to the CART tree construction, followed by age. CET and ECR showed less relative importance, whereas OSCTs and SSPs were not important features. Within the CT, CST turned out the most important variable for discriminating success from failure, followed by SCR and age, with cut-off values of 75 µm, 169 on gray scale, and 62 years, respectively. The ROC curve for the classifier showed an AUC of 0.784 (0.692-0.860). In this ML approach, CT analysis found that conjunctival stroma thickness and reflectivity, along with age, can predict the FS outcome with good accuracy. A pre-operative thick and hyper-reflective stroma, and a younger age increase the risk of FS failure.
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Affiliation(s)
- Luca Agnifili
- Department of Medicine and Ageing Science, Ophthalmology Clinic, University "G. D'Annunzio" of Chieti-Pescara, Via Dei Vestini, 66100, Chieti, CH, Italy.
| | - Michele Figus
- Ophthalmology Unit, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Annamaria Porreca
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy.
| | - Lorenza Brescia
- Department of Medicine and Ageing Science, Ophthalmology Clinic, University "G. D'Annunzio" of Chieti-Pescara, Via Dei Vestini, 66100, Chieti, CH, Italy
| | - Matteo Sacchi
- University Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Giuseppe Covello
- Ophthalmology Unit, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Chiara Posarelli
- Ophthalmology Unit, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Paolo Nucci
- University Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Leonardo Mastropasqua
- Department of Medicine and Ageing Science, Ophthalmology Clinic, University "G. D'Annunzio" of Chieti-Pescara, Via Dei Vestini, 66100, Chieti, CH, Italy
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6
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Spinelli A, Foppa C, Maroli A, Sacchi M, Armuzzi A, Danese S, Bemelman W, Carvello M. Transanal transection and single-stapling techniques are associated with shorter rectal cuff and lower urgency rate after pouch surgery compared with the double-stapled approach. Surgery 2023; 174:808-812. [PMID: 37517895 DOI: 10.1016/j.surg.2023.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/01/2023] [Accepted: 06/18/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Ileal pouch-anal anastomosis is most commonly performed by double-stapling technique after rectal transection with a linear stapler. Double-stapling is increasingly criticized for the uneven longer cuffs and potential weak points. A transanal rectal transection and single-stapled anastomosis may potentially overcome the limitations of double-stapling. A single-stapled anastomosis may be accomplished through a transanal rectal transection followed by bottom-up dissection (transanal-ileal pouch-anal anastomosis) or through an abdominal, rectal dissection and subsequent transanal transection and single-stapled anastomosis. The purpose of this study is to compare short-term and functional outcomes of double-stapling versus single-stapled techniques for ileal pouch-anal anastomosis. METHODS This is a single-institution, ambidirectional study. Patients with ulcerative colitis undergoing ileal pouch-anal anastomosis between 2014 and 2021 were included in the study and allocated into 2 groups: group 1, including double stapled ileal pouch anal anastomosis, and group 2, including single-stapled-ileal pouch-anal anastomosis. The primary endpoint was the difference in functional parameters. RESULTS A total of 130 patients were included, 46 undergoing double-stapling-ileal pouch-anal anastomosis and 84 receiving single-stapled ileal pouch-anal anastomosis. Rectal-cuff length (defined as the distance between the dentate line and ileal pouch-anal anastomosis) was shorter after single-stapled compared with double-stapling ileal pouch-anal anastomosis (1.98 ± 0.21 vs 2.20 ± 0.53 cm, P = .01). Anastomotic leak rate was comparable between group 1 and group 2 (6% vs 5%, P = .69). Functional parameters were comparable except for urgency, which was lower for single-stapled compared with double-stapling ileal pouch-anal anastomosis (8%, vs 30%, P = .002). CONCLUSION Single-stapled ileal pouch-anal anastomosis was associated with a shorter rectal cuff and lower urgency than double-stapling ileal pouch-anal anastomosis. In our opinion, these results warrant a prospective multicentric trial to scrutinize and confirm these benefits on a larger scale.
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Affiliation(s)
- Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy; Division of Colon and Rectal Surgery, Institute for Treatment and Research (IRCCS) Humanitas Research Hospital, via Manzoni 56, Rozzano, Milan, Italy.
| | - Caterina Foppa
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy; Division of Colon and Rectal Surgery, Institute for Treatment and Research (IRCCS) Humanitas Research Hospital, via Manzoni 56, Rozzano, Milan, Italy
| | - Annalisa Maroli
- Division of Colon and Rectal Surgery, Institute for Treatment and Research (IRCCS) Humanitas Research Hospital, via Manzoni 56, Rozzano, Milan, Italy
| | - Matteo Sacchi
- Division of Colon and Rectal Surgery, Institute for Treatment and Research (IRCCS) Humanitas Research Hospital, via Manzoni 56, Rozzano, Milan, Italy
| | - Alessandro Armuzzi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy; Department of Gastroenterology, Inflammatory Bowel Disease Unit (IBD Unit), Institute for Treatment and Research (IRCCS) Humanitas Research Hospital, via Manzoni 56, Rozzano, Milan, Italy
| | - Silvio Danese
- Department of Gastroenterology, Inflammatory Bowel Disease Unit (IBD Unit), San Raffaele Hospital, Milan, Italy
| | - Willem Bemelman
- Department of Gastroenterology, Inflammatory Bowel Disease Unit (IBD Unit), San Raffaele Hospital, Milan, Italy
| | - Michele Carvello
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy; Division of Colon and Rectal Surgery, Institute for Treatment and Research (IRCCS) Humanitas Research Hospital, via Manzoni 56, Rozzano, Milan, Italy
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7
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Figus M, Sacchi M, Rossi GC, Babighian S, Del Castillo JMB, de Polo L, Melchionda E, Posarelli C. Ocular surface and glaucoma, a mutual relationship. Practical suggestions for classification and management. Eur J Ophthalmol 2023:11206721231199157. [PMID: 37649335 DOI: 10.1177/11206721231199157] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
The chronic use of glaucoma medications could improve the development of an ocular comorbidity, the glaucoma therapy-related ocular surface disease. This could be related to the exposure of the conjunctiva to preservatives, but also active compounds such as prostaglandin analogues may improve the risk of ocular surface inflammation. Inflammation has a negative impact on tolerability and adherence to eyedrops and to the outcome of filtration surgery as well. A stratification of glaucoma patients based not only on visual field progression but also on glaucoma therapy-related ocular surface disease would be desirable for a strategic management. Early diagnosis, individualized treatment, and safe surgical management should be the hallmarks of glaucoma treatment. One of the main issues for the proper and successful management of patients is the right timing, effectiveness and safety for both medical and surgical treatment options leading to a precision medicine in glaucoma disease as the best modern treatment.
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Affiliation(s)
- Michele Figus
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Matteo Sacchi
- Eye clinic, San Giuseppe Hospital - IRCCS Multimedica, Milan, Italy
| | - Gemma Caterina Rossi
- Department of Surgical Science, University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- ASST Bergamo Est, Ambulatorio di Oculistica, Ospedale MO A.Locatelli, Piario, Italy
| | - Silvia Babighian
- Department Ophthalmology, Sant'Antonio Hospital, Azienda Ospedaliera Padova, Padova, Italy
| | - José Manuel Benitez Del Castillo
- Hospital Clinico San Carlos de Madrid Department of Ophthalmology, Madrid, Spain
- Universidad Complutense de Madrid, Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Madrid, Spain
| | | | - Eugenio Melchionda
- UOC Chirurgica Oftalmologica e di Urgenza, Presidio Ospedaliero Oftalmico, ASL ROMA1, Roma, Italy
| | - Chiara Posarelli
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
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8
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Foppa C, Carvello M, Maroli A, Sacchi M, Gramellini M, Montorsi M, Spinelli A. Single-stapled anastomosis is associated with a lower anastomotic leak rate than double-stapled technique after minimally invasive total mesorectal excision for MRI-defined low rectal cancer. Surgery 2023; 173:1367-1373. [PMID: 36967334 DOI: 10.1016/j.surg.2023.02.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/13/2023] [Accepted: 02/11/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND After total mesorectal excision, distal rectal transection and anastomosis are critical for short-term, oncological, and functional outcomes, including anastomotic leak. A double-pursestring, single-stapled anastomosis avoids cross-stapling, overcoming the potential drawbacks of transabdominal rectal transection and double-stapled anastomosis. This study aims to compare the anastomotic leak rate in double-stapled and single-stapled anastomoses after minimally invasive total mesorectal excision for magnetic resonance imaging-defined low rectal cancer. METHODS Adult patients (>18 years old) undergoing minimally invasive total mesorectal excision for magnetic resonance imaging-defined low rectal cancer with a stapled low anastomosis (below 5 centimeters from the anal verge) between January 2010 and January 2022 at a single institution were allocated to 2 groups according to the anastomosis: double-stapled (abdominal stapled transection and double-stapled anastomosis) or single-stapled (transanal rectal transection and double-pursestring single-stapled anastomosis). The exclusion criteria were nonrestorative procedures or any type of manual anastomosis. The primary endpoint was the rate of 90-day clinical and radiologic anastomotic leak. RESULTS In total, 185 single-stapled and 458 double-stapled were included. Clinical and tumor characteristics were comparable between the groups. The 90-day anastomotic leak rate was significantly lower in the single-stapled group (6.48% vs 15.28%; P = .002), with similar rates of grade and timing. Thirty- and 90-day complication rates were higher in the double-stapled group (P = .0001; P = .02), with comparable Clavien-Dindo grades. At multivariable analysis, double-stapled anastomosis (P = .01), active smoking (P = .03), and the presence of comorbidities (P = .01) resulted as independent risk factors for an anastomotic leak. CONCLUSION Transanal transection and double-pursestring, single-stapled anastomosis were associated with a lower anastomotic leak rate after minimally invasive total mesorectal excision for magnetic resonance imaging-defined low rectal cancer.
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Affiliation(s)
- Caterina Foppa
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Rozzano, Milan, Italy
| | - Michele Carvello
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Rozzano, Milan, Italy
| | - Annalisa Maroli
- IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Rozzano, Milan, Italy
| | - Matteo Sacchi
- IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Rozzano, Milan, Italy
| | - Marco Gramellini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Rozzano, Milan, Italy
| | - Marco Montorsi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Rozzano, Milan, Italy
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Rozzano, Milan, Italy.
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9
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Sacchi M, Fea AM, Monsellato G, Tagliabue E, Villani E, Ranno S, Nucci P. Safety and Efficacy of Ab Interno XEN 45 Gel Stent in Patients with Glaucoma and High Myopia. J Clin Med 2023; 12:jcm12072477. [PMID: 37048569 PMCID: PMC10095138 DOI: 10.3390/jcm12072477] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
This study reports on the safety and efficacy of Xen 45 in patients with glaucoma and high myopia. It was a retrospective study including patients with high myopia (>6D) who underwent Xen implant with 2 years of follow-up. The primary outcome was to report the incidence of hypotony (IOP ≤ 5 mmHg) and hypotony-related complications. Patients with high myopia treated with mitomycin-C-augmented trabeculectomy were included as a control group. We included 14 consecutive patients who underwent Xen implant (seven eyes) and trabeculectomy (seven eyes). The mean myopia was −14.71 ± 5.36 and −15.07 ± 6.11 in the trabeculectomy and Xen groups, respectively (p > 0.05). The success rate and the mean IOP at 1 and 2 years from the intervention were statistically comparable between the two groups. The group undergoing trabeculectomy showed a higher incidence of hypotony (six eyes (85.71%) vs. two eyes (28.57%)) and hypotony maculopathy (three eyes (42.86%) vs. zero eyes (0%)) and required more postoperative procedures. Patients with high myopia were at higher risk of hypotony-related complications after trabeculectomy. The Xen implant can achieve an IOP control comparable to trabeculectomy with a significantly better safety profile and can be considered as an option for the management of patients with high myopia and glaucoma.
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Kassim G, Yzet C, Nair N, Debebe A, Rendon A, Colombel JF, Traboulsi C, Rubin DT, Maroli A, Coppola E, Carvello MM, Ben David N, De Lucia F, Sacchi M, Danese S, Spinelli A, Hirdes MMC, Ten Hove J, Oldenburg B, Cholapranee A, Riter M, Lukin D, Scherl E, Eren E, Sultan KS, Axelrad J, Sachar DB. Long-Term Outcomes of the Excluded Rectum in Crohn's Disease: A Multicenter International Study. Inflamm Bowel Dis 2023; 29:417-422. [PMID: 35522225 DOI: 10.1093/ibd/izac099] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND Many patients with Crohn's disease (CD) require fecal diversion. To understand the long-term outcomes, we performed a multicenter review of the experience with retained excluded rectums. METHODS We reviewed the medical records of all CD patients between 1990 and 2014 who had undergone diversionary surgery with retention of the excluded rectum for at least 6 months and who had at least 2 years of postoperative follow-up. RESULTS From all the CD patients in the institutions' databases, there were 197 who met all our inclusion criteria. A total of 92 (46.7%) of 197 patients ultimately underwent subsequent proctectomy, while 105 (53.3%) still had retained rectums at time of last follow-up. Among these 105 patients with retained rectums, 50 (47.6%) underwent reanastomosis, while the other 55 (52.4%) retained excluded rectums. Of these 55 patients whose rectums remained excluded, 20 (36.4%) were symptom-free, but the other 35 (63.6%) were symptomatic. Among the 50 patients who had been reconnected, 28 (56%) were symptom-free, while 22(44%) were symptomatic. From our entire cohort of 197 cases, 149 (75.6%) either ultimately lost their rectums or remained symptomatic with retained rectums, while only 28 (14.2%) of 197, and only 4 (5.9%) of 66 with initial perianal disease, were able to achieve reanastomosis without further problems. Four patients developed anorectal dysplasia or cancer. CONCLUSIONS In this multicenter cohort of patients with CD who had fecal diversion, fewer than 15%, and only 6% with perianal disease, achieved reanastomosis without experiencing disease persistence.
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Affiliation(s)
- Gassan Kassim
- Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Clara Yzet
- Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nilendra Nair
- Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anketse Debebe
- Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexa Rendon
- Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jean-Frédéric Colombel
- Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cindy Traboulsi
- University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA
| | - David T Rubin
- University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA
| | - Annalisa Maroli
- Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Humanitas University, Milan, Italy
| | - Elisabetta Coppola
- Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Humanitas University, Milan, Italy
| | - Michele M Carvello
- Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Humanitas University, Milan, Italy
| | - Nadat Ben David
- Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Humanitas University, Milan, Italy
| | - Francesca De Lucia
- Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Humanitas University, Milan, Italy
| | - Matteo Sacchi
- Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Humanitas University, Milan, Italy
| | - Silvio Danese
- Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Humanitas University, Milan, Italy
| | - Antonino Spinelli
- Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Humanitas University, Milan, Italy
| | - Meike M C Hirdes
- Division of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Joren Ten Hove
- Division of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Bas Oldenburg
- Division of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Aurada Cholapranee
- Division of Gastroenterology and Hepatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Maxine Riter
- Division of Gastroenterology and Hepatology, Weill Cornell Medical College, NY, USA
| | - Dana Lukin
- Jill Roberts Center for IBD, Weill Cornell Medicine, NY, USA
| | - Ellen Scherl
- Jill Roberts Center for IBD, Weill Cornell Medicine, NY, USA
| | - Esen Eren
- Inflammatory Bowel Disease Center at NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Keith S Sultan
- Division of Gastroenterology and Hepatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Jordan Axelrad
- Inflammatory Bowel Disease Center at NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - David B Sachar
- Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Fea A, Sacchi M, Franco F, Laffi GL, Oddone F, Costa G, Serino F, Giansanti F. Effectiveness and Safety of XEN45 in Eyes With High Myopia and Open Angle Glaucoma. J Glaucoma 2023; 32:178-185. [PMID: 36730214 DOI: 10.1097/ijg.0000000000002151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 11/14/2022] [Indexed: 02/03/2023]
Abstract
PRCIS XEN45 implant was an effective and safe procedure in primary open angle glaucoma (OAG) eyes with high myopia. Although the hypotony incidence rate was relatively high, it resolved with medical therapy and was of short duration. PURPOSE The purpose of this study is to evaluate the effectiveness and safety of the XEN45 stent in eyes with OAG and high myopia. DESIGN Retrospective and multicenter study. METHODS Consecutive OAG patients who underwent a XEN45, either alone or in combination with cataract surgery, and had a refractive error higher than -6 D and an axial length ≥26 mm. The primary endpoint was the mean intraocular pressure (IOP) lowering at the last follow-up visit. RESULTS Thirty-one eyes were included (96.8% with a primary OAG diagnosis). The mean refraction was -13.2±5.6 (range: -6.75 to-23.0) D. In the overall study sample, preoperative mean IOP (95% CI) was significantly lowered from 23.5 (20.5-26.4) mm Hg to 13.0 (12.2-13.8) mm Hg at the last follow-up visit, P <0.0001. At the last follow-up visit, 16 (57.1%) eyes achieved an IOP ≤14 mm Hg, 11 (68.9%) of them without treatment. The number of ocular hypotensive medications was significantly reduced from 3.0±1.1 drugs at preoperatively to 0.6±1.0 drugs at the last follow-up visit, P <0.0001. Median (95% CI) follow-up was 24.0 (12.0-24.0) months. Linear regression analysis showed a significant correlation between the preoperative refraction and the IOP lowering ( r =0.43, P =0.0155). Needling procedure was performed in 11 eyes (39.3%) and hypotony (defined as an IOP <6 mm Hg) was observed in 8 eyes (28.6%) during the first postoperative day and remained for a week. CONCLUSION Although the Xen implant effectively lowered IOP in highly myopic eyes with glaucoma, the incidence of hypotony was high, and in most cases, resolved within the first month with medical management and monitoring.
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Affiliation(s)
- Antonio Fea
- Complex Ophthalmology Structure, City of Health and Science of Turin, Department of Surgical Sciences - University of Turin, Turin
| | - Matteo Sacchi
- Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan
| | - Fabrizio Franco
- Ophthalmology Department, SOD Ophthalmology, AOU Careggi Florence, Florence, Italy
| | | | | | - Giacomo Costa
- Ophthalmology Department, SOD Ophthalmology, AOU Careggi Florence, Florence, Italy
| | - Federica Serino
- Ophthalmology Department, SOD Ophthalmology, AOU Careggi Florence, Florence, Italy
| | - Fabrizio Giansanti
- Ophthalmology Department, SOD Ophthalmology, AOU Careggi Florence, Florence, Italy
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12
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Lazzaro C, van Steen C, Ghirelli G, Sacchi M, Sisto D, Uva M, Varano L, Angelillo L. A latanoprost cationic emulsion (STN1013001) vs. other latanoprost formulations (Latanoprost) in open angle glaucoma/ocular hypertension and ocular surface disease: an Italian cost-utility analysis. Expert Rev Pharmacoecon Outcomes Res 2023; 23:251-265. [PMID: 36576091 DOI: 10.1080/14737167.2023.2161515] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND STN1013001 is an innovative latanoprost cationic emulsion for open-angle glaucoma/ocular hypertension (OAG/OHT) and ocular surface disease (OSD). METHODS AND FINDINGS A 5-year, 7 health states, 1-year cycle early Markov model-supported cost-utility analysis (CUA) of STN1013001 vs. other latanoprost formulations (Latanoprost) followed the Italian National Health Service (INHS) perspective.One-way, probabilistic and scenario sensitivity analyses tested the uncertainty of the baseline results. Value of information analysis (VOIA) investigated the potential cost-effectiveness of collecting further evidence. RESULTS Over 5 years, the Markov model-supported CUA predicts STN1013001 to be potentially highly cost-effective vs. Latanoprost (+€57.60 cost at €2020 values; +0.089 Quality-Adjusted Life Years).The Incremental Cost-Utility Ratio (€647.65) falls well below the lower limit of the acceptability range proposed for Italy (€25,000-€40,000).Sensitivity analyses confirmed the robustness of the baseline findings. VOIA highlighted that further information might only be cost-effective for OAG/OHT utilities and OSD-related disutility. CONCLUSION STN1013001 is potentially highly cost-effective and strongly dominant vs. Latanoprost for OAG/OHT+OSD patients from the INHS perspective. These findings should be re-assessed using the data from the ongoing Phase III trial (NCT04133311) comparing the efficacy and safety of STN1013001 vs. Latanoprost and with future real-world CUAs upon the availability of STN1013001 on the Italian market.
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Affiliation(s)
- Carlo Lazzaro
- Pharmacoeconomics and Health Economics Department, Studio di Economia Sanitaria, Milan, Italy.,School of Pharmacology, Biology and Biotechnologies Department "Lazzaro Spallanzani," University of Pavia, Pavia, Italy
| | | | - Giorgio Ghirelli
- Hospital ophthalmology unit, Italian National Health Service-endorsed hospital "San Pietro", Rome, Italy
| | - Matteo Sacchi
- University Eye Clinic, San Giuseppe Hospital, Multimedica, Milan, Italy
| | - Dario Sisto
- Academic ophthalmology unit, Azienda Ospedaliera Universitaria "Policlinico di Bari", Bari, Italy
| | - Maurizio Uva
- Academic ophthalmology unit, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico - San Marco", Catania, Italy
| | - Luigi Varano
- Hospital ophthalmology unit, Private eye clinic "Villa Richeldi", Carpi, Italy
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13
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Foppa C, Maroli A, Lauricella S, Luberto A, La Raja C, Bunino F, Carvello M, Sacchi M, De Lucia F, Clerico G, Montorsi M, Spinelli A. Different Oncologic Outcomes in Early-Onset and Late-Onset Sporadic Colorectal Cancer: A Regression Analysis on 2073 Patients. Cancers (Basel) 2022; 14:cancers14246239. [PMID: 36551724 PMCID: PMC9777335 DOI: 10.3390/cancers14246239] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/10/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
The incidence of colorectal cancer (CRC) is increasing in the population aged ≤ 49 (early-onset CRC-EOCRC). Recent studies highlighted the biological and clinical differences between EOCRC and late-onset CRC (LOCRC-age ≥ 50), while comparative results about long-term survival are still debated. This study aimed to investigate whether age of onset may impact on oncologic outcomes in a surgical population of sporadic CRC patients. Patients operated on for sporadic CRC from January 2010 to January 2022 were allocated to the EOCRC and LOCRC groups. The primary endpoint was the recurrence/progression-free survival (R/PFS). A total of 423 EOCRC and 1650 LOCRC was included. EOCRC had a worse R/PFS (p < 0.0001) and cancer specific survival (p < 0.0001) compared with LOCRC. At Cox regression analysis, age of onset, tumoral stage, signet ring cells, extramural/lymphovascular/perineural veins invasion, and neoadjuvant therapy were independent risk factors for R/P. The analysis by tumoral stage showed an increased incidence of recurrence in stage I EOCRC (p = 0.014), and early age of onset was an independent predictor for recurrence (p = 0.035). Early age of onset was an independent predictor for worse prognosis, this effect was stronger in stage I patients suggesting a potentially—and still unknown—more aggressive tumoral phenotype in EOCRC.
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Affiliation(s)
- Caterina Foppa
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Annalisa Maroli
- IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Sara Lauricella
- IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Antonio Luberto
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Carlotta La Raja
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Francesca Bunino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Michele Carvello
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Matteo Sacchi
- IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Francesca De Lucia
- IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Giuseppe Clerico
- IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Marco Montorsi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- IRCCS Humanitas Research Hospital, Division of Colon and Rectal Surgery, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Correspondence:
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14
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Luberto A, Crippa J, Foppa C, Maroli A, Sacchi M, De Lucia F, Carvello M, Spinelli A. Routine placement of abdominal drainage in pouch surgery does not impact on surgical outcomes. Updates Surg 2022; 75:619-626. [PMID: 36479676 PMCID: PMC9734453 DOI: 10.1007/s13304-022-01411-5] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/22/2022] [Indexed: 12/12/2022]
Abstract
The evidence does not support the routine use of abdominal drainage (AD) in colorectal surgery. However, there is no data on the usefulness of AD, specifically, after ileal pouch-anal anastomosis (IPAA). The aim of this study is to assess post-operative outcomes of patients undergoing IPAA with or without AD at a high volume referral center. A retrospective analysis of prospectively collected data of consecutive patients undergoing IPAA with AD (AD group) or without AD (NAD group) was performed. Baseline characteristics, operative, and postoperative data were analyzed and compared between the two groups. A total of 97 patients were included in the analysis, 46 were in AD group and 51 in NAD group. AD group had a higher BMI (23.9 ± 3.9 kg/m2 vs 21.9 ± 3.0 kg/m2; p = 0.007) and more commonly underwent two-stage proctocolectomy with IPAA compared to the NAD group (50.0% vs 3.9%; p < 0.001). There was no difference in anastomotic leak rate (6.5% AD vs 5.9% NAD group; p = 1.000), major post-operative complication (8.6% vs 7.9%; p = 0.893); median length of stay [IQR] (5 [5-7] days vs 5 [4-7] days; p = 0.305) and readmission < 90 days (8.7% vs 3.9%; p = 0.418). The use of AD does not impact on surgical outcome after IPAA and question the actual benefit of its routine placement.
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Affiliation(s)
- Antonio Luberto
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan Italy
| | - Jacopo Crippa
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan Italy
| | - Caterina Foppa
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan Italy ,IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan Italy
| | - Annalisa Maroli
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan Italy
| | - Matteo Sacchi
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan Italy
| | - Francesca De Lucia
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan Italy
| | - Michele Carvello
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan Italy ,IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan Italy
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan Italy ,IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan Italy
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15
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Sacchi M. How to best take care of young patients with glaucoma. Acta Ophthalmol 2022. [DOI: 10.1111/j.1755-3768.2022.15501] [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: 02/11/2023]
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16
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Sacchi M, Tamtögl A. Water adsorption and dynamics on graphene and other 2D materials: Computational and experimental advances. Adv Phys X 2022; 8:2134051. [PMID: 36816858 PMCID: PMC7614201 DOI: 10.1080/23746149.2022.2134051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 06/18/2023] Open
Abstract
The interaction of water and surfaces, at molecular level, is of critical importance for understanding processes such as corrosion, friction, catalysis and mass transport. The significant literature on interactions with single crystal metal surfaces should not obscure unknowns in the unique behaviour of ice and the complex relationships between adsorption, diffusion and long-range inter-molecular interactions. Even less is known about the atomic-scale behaviour of water on novel, non-metallic interfaces, in particular on graphene and other 2D materials. In this manuscript, we review recent progress in the characterisation of water adsorption on 2D materials, with a focus on the nano-material graphene and graphitic nanostructures; materials which are of paramount importance for separation technologies, electrochemistry and catalysis, to name a few. The adsorption of water on graphene has also become one of the benchmark systems for modern computational methods, in particular dispersion-corrected density functional theory (DFT). We then review recent experimental and theoretical advances in studying the single-molecular motion of water at surfaces, with a special emphasis on scattering approaches as they allow an unparalleled window of observation to water surface motion, including diffusion, vibration and self-assembly.
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Affiliation(s)
- M. Sacchi
- Department of Chemistry, University of Surrey, Guildford GU2 7XH, UK
| | - A. Tamtögl
- Institute of Experimental Physics, Graz University of Technology, 8010 Graz, Austria
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17
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Posarelli C, Figus M, Roberti G, Giammaria S, Ghirelli G, Quercioli P, Micelli Ferrari T, Pace V, Mastropasqua L, Agnifili L, Sacchi M, Scuderi G, Perdicchi A, Altafini R, Uva M, D’Andrea D, Covello G, Maglionico MN, Fea AM, Carnevale C, Oddone F. Italian Candidates for the XEN Implant: An Overview from the Glaucoma Treatment Registry (XEN-GTR). J Clin Med 2022; 11:jcm11185320. [PMID: 36142967 PMCID: PMC9500791 DOI: 10.3390/jcm11185320] [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: 08/09/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 11/16/2022] Open
Abstract
Background The Italian XEN Glaucoma Treatment Registry (XEN-GTR) was created to acquire a comprehensive prospective dataset that includes the patient characteristics, intraoperative variables, and postoperative management of glaucoma patients undergoing the XEN gel stent implantation. Methods This was a prospective observational, longitudinal clinical study involving 10 centres throughout Italy. The baseline examination included a comprehensive evaluation of demographic parameters (age, sex, ethnicity, and systemic condition), specific ophthalmological parameters, and quality of life questionnaire score collection. Results The baseline data of 273 patients were analysed. The median (IQR) age was 72 (65.0 to 78.0) years. Of the 273 patients, 123 (45%) were female and 150 (55%) were male. A total of 86% of the patients had open-angle glaucoma with a mean intraocular pressure of 24 ± 6 (range 12.0–60.0) mmHg. The mean number of medications was 2.7 ± 0.9 at baseline for the patients with a prevalence of prostaglandin analogues combined with a beta-blocker and anhydrase carbonic inhibitor (31.8%). The mean scores of the NEI-VFQ 25 and GSS questionnaires were 78 ± 18 (range 26.5–100) and 85 ± 14 (range 79–93), respectively. Combined XEN/cataract surgeries were scheduled in 73.7% of the patients. The preferred place for the XEN implant was the supero-nasal quadrant (91.6%). Conclusions Observing the baseline characteristics of the typical Italian candidates for the XEN gel implant shows that they are patients affected by POAG and cataracts, with moderate to severe glaucoma damage, all of which has an impact on their quality of life.
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Affiliation(s)
- Chiara Posarelli
- Department of Surgical, Medical, Molecular Pathology and of Critical Area, University of Pisa, 56124 Pisa, Italy
- Correspondence: ; Tel.: +39-050997675
| | - Michele Figus
- Department of Surgical, Medical, Molecular Pathology and of Critical Area, University of Pisa, 56124 Pisa, Italy
| | | | | | | | | | | | - Vincenzo Pace
- Ospedale Generale Regionale F. Miulli di Acquaviva delle Fonti, 70021 Bari, Italy
| | - Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. D’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Luca Agnifili
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. D’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Matteo Sacchi
- University Eye Clinic, San Giuseppe Hospital, University of Milan, 20162 Milan, Italy
| | - Gianluca Scuderi
- Ophthalmology Unit, NESMOS Department, S. Andrea Hospital, Faculty of Medicine and Psychology, University of Rome La Sapienza, 00189 Rome, Italy
| | - Andrea Perdicchi
- Ophthalmology Unit, NESMOS Department, S. Andrea Hospital, Faculty of Medicine and Psychology, University of Rome La Sapienza, 00189 Rome, Italy
| | | | - Maurizio Uva
- Azienda Ospedaliera Universitaria, “Policlinico Vittorio Emanuele”, P.O. Gaspare Rodolico, 95123 Catania, Italy
| | | | - Giuseppe Covello
- Department of Surgical, Medical, Molecular Pathology and of Critical Area, University of Pisa, 56124 Pisa, Italy
| | - Maria Novella Maglionico
- Department of Surgical, Medical, Molecular Pathology and of Critical Area, University of Pisa, 56124 Pisa, Italy
| | - Antonio Maria Fea
- Ophthalmic Eye Hospital, Department of Surgical Sciences, University of Turin, 10122 Turin, Italy
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Mastropasqua L, Agnifili L, Ferrante C, Sacchi M, Figus M, Rossi GCM, Brescia L, Aloia R, Orlando G. Citicoline/Coenzyme Q10/Vitamin B3 Fixed Combination Exerts Synergistic Protective Effects on Neuronal Cells Exposed to Oxidative Stress. Nutrients 2022; 14:nu14142963. [PMID: 35889920 PMCID: PMC9316190 DOI: 10.3390/nu14142963] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/14/2022] [Accepted: 07/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background: The present study aimed to investigate the rationale and efficacy of using a citicoline, coenzyme Q10 (CAVAQ10) and vitamin B3 fixed combination in combating inflammation and oxidation in neuronal cells exposed to oxidative stress. Methods: HypoE22 cells and isolated hypothalamic specimens were selected as in vitro models to conduct the experiments. The efficacy of citicoline, CAVAQ10, and vitamin B3, with their fixed combination, were assayed after the exposure of hypothalamic cells to hydrogen peroxide (concentration range 1 nM–10 µM), in order to evaluate the biocompatibility of treatments. The activity of neuroprotective and pro-inflammatory factors, namely, brain-derived neurotrophic factor (BDNF), interleukin-6 (IL-6), and tumor necrosis factor-α (TNFα), involved in the neuronal cell damage in neurodegenerative diseases, were assayed in isolated hypothalamus. Results: Neither citicoline, CAVAQ10, nor vitamin B3 significantly altered hypothalamic cell viability, thus suggesting the biocompatibility of single ingredients and fixed combination in the concentration range considered for the study. In the same condition, citicoline and CAVAQ10 were also effective in reducing the gene expression of monoaminoxidase-B, involved in dopamine degradation. However, only citicoline demonstrated an ability to reduce dopamine levels. Conversely, all compounds were effective in reducing the gene expression of IL-6, and TNFα, and in inducing the gene expression of BDNF, with the co-administration of citicoline/CAVAQ10/vitamin B3 being generally more effective than single ingredients. Conclusions: The present findings support the beneficial and synergistic effects of citicoline, CAVAQ10, and vitamin B3 in fixed combination in reducing inflammation and oxidation, and in stimulating neurotrophin production in neuronal cells.
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Affiliation(s)
- Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (R.A.)
| | - Luca Agnifili
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (R.A.)
- Correspondence: (L.A.); (L.B.); Tel.: +39-0871-358489 (L.A. & L.B.); Fax: +39-0871-358794 (L.A. & L.B.)
| | - Claudio Ferrante
- Department of Pharmacy, G. d’Annunzio University, 66013 Chieti, Italy; (C.F.); (G.O.)
| | - Matteo Sacchi
- University Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, 20900 Milan, Italy;
| | - Michele Figus
- Ophthalmology Unit, Department of Surgery, Medicine, Molecular and Emergency, University of Pisa, 56124 Pisa, Italy;
| | | | - Lorenza Brescia
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (R.A.)
- Correspondence: (L.A.); (L.B.); Tel.: +39-0871-358489 (L.A. & L.B.); Fax: +39-0871-358794 (L.A. & L.B.)
| | - Raffaella Aloia
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (R.A.)
| | - Giustino Orlando
- Department of Pharmacy, G. d’Annunzio University, 66013 Chieti, Italy; (C.F.); (G.O.)
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Lizzio RAU, Monfrini E, Romano S, Brescia G, Vujosevic S, Sacchi M, Di Fonzo A, Nucci P. Genetic evaluation in phenotypically discordant monozygotic twins with Coats Disease. Eur J Ophthalmol 2022:11206721221107798. [PMID: 35679086 DOI: 10.1177/11206721221107798] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To report the unique case of a pair of phenotypically discordant monozygotic twins, with one of them affected by unilateral Coats disease. CASE REPORT Both patients underwent a complete ophthalmologic evaluation and were genetically tested with whole-exome sequencing (WES). Any known or unknown potential genetic determinant of Coats disease wasn't found. CONCLUSION It may suggest a non-genetic etiology for this disorder. This represents, to the best of our knowledge, the first case of genetic analysis of monozygotic twins, one of whom is affected by Coats disease. Further studies are warranted, including performing genetic analysis directly on retinal biopsy tissue.
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Affiliation(s)
| | - Edoardo Monfrini
- Dino Ferrari Center, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Neurology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Simona Romano
- University Eye Clinic, 9339IRCCS Multimedica, Milan, Italy
| | - Gloria Brescia
- Neurology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Laboratory of Medical Genetics, Foundation IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Stela Vujosevic
- University Eye Clinic, 9339IRCCS Multimedica, Milan, Italy.,47224Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Matteo Sacchi
- University Eye Clinic, 9339IRCCS Multimedica, Milan, Italy
| | - Alessio Di Fonzo
- Dino Ferrari Center, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Neurology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Nucci
- 47224Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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Ansari E, Chappiti S, Pavicic-Astalos J, Pinto-Bonilla JC, Riva I, Sacchi M, Saénz-Francés F. Treatment of open-angle glaucoma and ocular hypertension with preservative-free tafluprost/timolol fixed-dose combination therapy: 6 case reports and clinical outcomes. BMC Ophthalmol 2022; 22:152. [PMID: 35366846 PMCID: PMC8977001 DOI: 10.1186/s12886-022-02361-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/20/2022] [Indexed: 01/11/2023] Open
Abstract
Abstract
Background
Treatment of open angle glaucoma (OAG) and/or ocular hypertension (OHT) focuses on achievement of target intraocular pressure (IOP), with the objective of slowing disease progression. However, ocular surface health is an important consideration in the optimization of treatment. We report 6 patient cases in which enhanced IOP control was achieved following appropriate management of ocular surface inflammation and a therapeutic switch to the preservative-free (PF) tafluprost (0.0015%)/timolol (0.5%) fixed-dose combination (FC).
Case presentation
Six patient cases, aged 48–74 years, presented with OAG or OHT. Each patient had signs and symptoms of ocular surface disease (OSD). Cases 1–3 were each receiving maximal medical therapy for OAG; regimens comprising prostaglandin analogue (PGA), β-blocker, carbonic anhydrase inhibitor (CAI) and α-2 agonist agents (including treatments containing preservative agent). Cases 1 and 2 reported IOP values ≥23 mmHg in each eye, and wide IOP fluctuations were identified when reviewing patient data concerning case 3 (11–20 mmHg). Maximal therapy was ceased and PF tafluprost/timolol FC was initiated, after which the signs and symptoms of OSD were improved and IOP was reduced (≤18 mmHg for cases 1–3) and stabilized. Cases 4 and 5 were diagnosed with OAG and case 6 had OHT. Each had symptoms and signs of OSD and were treated with a preserved PGA monotherapy (latanoprost 0.005% or bimatoprost 0.03%). At presentation, IOP was 24 mmHg in both eyes (case 4), ≥18 mmHg (case 5) and ≥ 22 mmHg (case 6). Following a switch to the PF tafluprost/timolol FC, OSD symptoms were improved and IOP was 14 mmHg (both eyes; case 4), ≤14 mmHg (case 5) and 16 mmHg (both eyes; case 6).
Conclusions
In addition to IOP-lowering efficacy, approaches to the management of OAG and OHT should consider the impact of treatment tolerability and the susceptibility of these patients to OSD. The presence of ocular surface inflammation appears to be detrimental to adherence and therefore to the effectiveness of topical medications. Addressing OSD through the use of PF FC formations, such as the PF tafluprost/timolol FC, reduces exposure to potentially toxic agents and facilitates improvements in IOP control.
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21
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Agnifili L, Sacchi M, Figus M, Posarelli C, Lizzio RAU, Nucci P, Mastropasqua L. Preparing the ocular surface for glaucoma filtration surgery: an unmet clinical need. Acta Ophthalmol 2022; 100:740-751. [PMID: 35088941 DOI: 10.1111/aos.15098] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/07/2021] [Accepted: 12/29/2021] [Indexed: 12/16/2022]
Abstract
The mutual relationship among medical therapy, ocular surface (OS) and filtration surgery (FS) represents one of the most crucial issues in glaucoma management. As the long-term use of intraocular pressure-lowering medications significantly affect the OS health, patients with an uncontrolled disease frequently undergo glaucoma surgery in less-than-ideal conditions. As we known, OS changes strongly affect the post-operative bleb filtration capability. Therefore, improving the OS conditions before proceeding with FS is needed. Currently, given the rapid diffusion of new surgical procedures, this need is even more perceived. Nevertheless, despite surgeons retain the OS preparation of primary importance, and recognize the OS disease (OSD) as the only modifiable risk factor for filtration failure, there is no agreement on which strategies should be preferred to prepare patients. This is largely due to the lack of validated guidelines, which forces clinicians to adopt personal approaches based on evidence derived from low-quality studies. In this review, we provided an overview of risk factors involved in the FS failure, with particular attention to those depending on OS changes, and how OSD negatively affects the aqueous humor resorption after surgery. Moreover, we reported the most exploited measures to mitigate the OSD before surgery, the possible reasons underlying the absence of shared approaches, and the upcoming area of intervention to preserve the OS health during glaucoma management. Finally, based on the current evidence, we proposed a pre-operative outline reporting the main risk factors that should be considered before surgery, and the therapeutical options available to improve the OS.
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Affiliation(s)
- Luca Agnifili
- Department of Medicine and Ageing Science, Ophthalmology Clinic University ‘G. D'Annunzio’ of Chieti‐Pescara Pescara Italy
| | - Matteo Sacchi
- San Giuseppe Hospital, University Eye Clinic IRCCS Multimedica Milan Italy
| | - Michele Figus
- Ophthalmology Unit, Department of Surgery, Medicine, Molecular and Emergency University of Pisa Pisa Italy
| | - Chiara Posarelli
- Ophthalmology Unit, Department of Surgery, Medicine, Molecular and Emergency University of Pisa Pisa Italy
| | | | - Paolo Nucci
- Department of Clinical Science and Community Health University of Milan Milan Italy
| | - Leonardo Mastropasqua
- Department of Medicine and Ageing Science, Ophthalmology Clinic University ‘G. D'Annunzio’ of Chieti‐Pescara Pescara Italy
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22
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Celentano V, Giglio MC, Pellino G, Rottoli M, Sampietro G, Spinelli A, Selvaggi F, Pellino G, Rottoli M, Poggioli G, Sica G, Giglio MC, Campanelli M, Coco C, Rizzo G, Sionne F, Colombo F, Sampietro G, Lamperti G, Foschi D, Ficari F, Vacca L, Cricchio M, Giudici F, Selvaggi L, Sciaudone G, Peltrini R, Manfreda A, Bucci L, Galleano R, Ghazouani O, Zorcolo L, Deidda S, Restivo A, Braini A, Di Candido F, Sacchi M, Carvello M, Martorana S, Bordignon G, Angriman I, Variola A, Di Ruscio M, Barugola G, Geccherle A, Tropeano FP, Luglio G, Tanzanu M, Sasia D, Migliore M, Giuffrida MC, Marrano E, Moretto G, Impellizzeri H, Gallo G, Vescio G, Sammarco G, Terrosu G, Calini G, Bondurri A, Maffioli MD A, Zaffaroni G, Resegotti A, Mistrangelo M, Allaix ME, Botti F, Prati M, Boni L, Perotti S, Mineccia M, Giuliani A, Romano L, Graziano GMP, Pugliese L, Pietrabissa A, Delaini GG, Spinelli A, Selvaggi F. High complication rate in Crohn's disease surgery following percutaneous drainage of intra-abdominal abscess: a multicentre study. Int J Colorectal Dis 2022; 37:1421-1428. [PMID: 35599268 PMCID: PMC9167187 DOI: 10.1007/s00384-022-04183-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Intra-abdominal abscesses complicating Crohn's disease (CD) present an additional challenge as their presence can contraindicate immunosuppressive treatment whilst emergency surgery is associated with high stoma rate and complications. Treatment options include a conservative approach, percutaneous drainage, and surgical intervention. The current multicentre study audited the short-term outcomes of patients who underwent preoperative radiological drainage of intra-abdominal abscesses up to 6 weeks prior to surgery for ileocolonic CD. METHODS This is a retrospective, multicentre, observational study promoted by the Italian Society of Colorectal Surgery (SICCR), including all adults undergoing ileocolic resection for primary or recurrent CD from June 2018 to May 2019. The outcomes of patients who underwent radiological guided drainage prior to ileocolonic resection were compared to the patients who did not require preoperative drainage. Postoperative morbidity within 30 days of surgery was the primary endpoint. Postoperative length of hospital stay (LOS) and anastomotic leak rate were the secondary outcomes. RESULTS Amongst a group of 575 included patients who had an ileocolic resection for CD, there were 36 patients (6.2%) who underwent abscess drainage prior to surgery. Postoperative morbidity (44.4%) and anastomotic leak (11.1%) were significantly higher in the group of patients who underwent preoperative drainage. CONCLUSIONS Patients with Crohn's disease who require preoperative radiological guided drainage of intra-abdominal abscesses are at increased risk of postoperative morbidity and septic complications following ileocaecal or re-do ileocolic resection.
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Affiliation(s)
- Valerio Celentano
- grid.428062.a0000 0004 0497 2835Chelsea and Westminster Hospital NHS Foundation Trust, London, UK ,grid.4701.20000 0001 0728 6636University of Portsmouth, Portsmouth, UK ,grid.7445.20000 0001 2113 8111Department of Surgery and Cancer, Imperial College, London, UK
| | - Mariano Cesare Giglio
- grid.4691.a0000 0001 0790 385XDepartment of Clinical Medical and Surgery, Federico II University, Naples, Italy
| | - Gianluca Pellino
- grid.9841.40000 0001 2200 8888Department of Advanced Medical and Surgical Science, Universita’ Degli Studi Della Campania Luigi Vanvitelli, Naples, Italy
| | - Matteo Rottoli
- grid.6292.f0000 0004 1757 1758Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy ,grid.6292.f0000 0004 1757 1758Alma Mater, Studiorum University of Bologna, Bologna, Italy
| | - Gianluca Sampietro
- Division of General and HPB Surgery, ASST Rhodense, Rho Memorial Hospital, Milan, Italy
| | - Antonino Spinelli
- grid.452490.eDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy ,grid.417728.f0000 0004 1756 8807IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Francesco Selvaggi
- grid.9841.40000 0001 2200 8888Department of Advanced Medical and Surgical Science, Universita’ Degli Studi Della Campania Luigi Vanvitelli, Naples, Italy
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23
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Sacchi M, Lizzio RAU, Villani E, Tagliabue E, Monsellato G, Pajardi G, Luccarelli S, Nucci P. Prevalence of SARS-CoV-2 amongst ophthalmologists throughout the first and second waves of the pandemic. Medicine (Baltimore) 2021; 100:e28192. [PMID: 34918674 PMCID: PMC8677999 DOI: 10.1097/md.0000000000028192] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/18/2021] [Indexed: 01/08/2023] Open
Abstract
The study aims to investigate the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among ophthalmology unit staff throughout the first and second waves of the outbreak, in order to verify the effectiveness of the measures adopted in containing the contagion.A retrospective observational study was conducted involving staff members, who received a naso/oropharyngeal swab when complaining of SARS-CoV-2 symptoms and once a month as a screening measure. They were tested for SARS-CoV-2 antibodies as a screening measure during the first and the second wave. Clinical activities performed during the outbreak were compared with those performed during the same period in 2019 and correlated with the number of coronavirus disease-2019 eye care workers.Analysis included 25 workers. Clinical infection was 0% and 12% whereas the prevalence of SARS-CoV-2 antibodies ranged from 4% to 8% in the first and second wave, respectively. The increase in the prevalence of SARS-CoV-2 infection between the first and the second wave was not significant (1/25 vs 3/25, P = .6092). Clinical activities significantly decreased during the first wave compared with the same period in 2019 (3256 vs 10,075, P < .0001, -68% to 2019), but increased during the second wave (8208 vs 3256, P < .0001, +152% to the first wave).Despite the increase in routine activities during the second wave, we did not observe a significant increase in SARS-CoV-2 prevalence. Strict protection measures seemed to contain the rate of contagion among the ophthalmology unit members even in a high-volume clinical setting in one of the most affected area by the coronavirus disease-2019 outbreak.
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Affiliation(s)
- Matteo Sacchi
- Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | | | - Edoardo Villani
- Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Elena Tagliabue
- Value-based Healthcare Unit, IRCCS Multimedica, Milan, Italy
| | | | - Giorgio Pajardi
- Plastic and Hand Surgery Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | | | - Paolo Nucci
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
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24
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Carrano FM, Maroli A, Carvello M, Foppa C, Sacchi M, Crippa J, Clerico G, De Lucia F, Coppola E, Ben David N, Spinelli A. Negative-pressure wound therapy after stoma reversal in colorectal surgery: a randomized controlled trial. BJS Open 2021; 5:6460900. [PMID: 34904647 PMCID: PMC8669787 DOI: 10.1093/bjsopen/zrab116] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/19/2021] [Indexed: 11/14/2022] Open
Abstract
Background Stoma-reversal surgery is associated with high postoperative morbidity, including wound complications and surgical-site infections (SSIs). This study aims to assess whether the application of negative-pressure wound therapy (NPWT) can improve wound healing compared with conventional wound dressing. Methods This was a single-centre, superiority, open-label, parallel, individually randomized controlled trial. Patients undergoing stoma reversal were randomized (1 : 1) to receive NPWT or conventional wound dressing. The primary endpoint of the study was the rate of wound complications and SSIs after stoma closure. The secondary endpoints were postoperative wound pain, rate of wound healing after 30 days from stoma closure, and wound aesthetic satisfaction. Results Between June 2019 and January 2021, 50 patients were allocated to the NPWT group (all received NPWT, 49 were analysed); 50 patients were allocated to the conventional wound dressing group (48 received the treatment, 45 were analysed). No significant difference was found in wound-complication rate (10 per cent NPWT versus 16 per cent controls; odds ratio 0.61 (95 per cent c.i. 0.18 to 2.10), P = 0.542) and incisional SSI rate (8 per cent NPWT versus 7 per cent controls; odds ratio 1.24 (95 per cent c.i. 0.26 to 5.99), P = 1.000). The NPWT group showed less pain, higher aesthetic satisfaction (P < 0.0001), and a higher proportion of wound healing (92 versus 78 per cent; P = 0.081) compared with the control group. Conclusion NPWT does not reduce the incidence of SSI after stoma-reversal surgery compared with conventional wound dressing. However, NPWT improved the healing of uninfected wounds, reduced wound pain and led to better aesthetic outcomes. Registration number: NCT037812016 (clinicaltrials.gov).
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Affiliation(s)
- Francesco M Carrano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Annalisa Maroli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Michele Carvello
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Caterina Foppa
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Matteo Sacchi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Jacopo Crippa
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Giuseppe Clerico
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Francesca De Lucia
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Elisabetta Coppola
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Nadav Ben David
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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25
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Iardino R, Sacchi M, Massari E, Iardino S, Brogonzoli L. “Ma sei fuori?”: a path to awareness on mental health and stigma. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Mental health issues, frequently associated with weirdness and danger, can easily derail the lives of the people who suffer from them, creating loneliness and isolation. Due to stigma, people with mental health disorders could experience limitation in their economic, social and cultural human rights. In the effort to fight stigma against mental health issues, Fondazione The Bridge promoted a contest called “Ma sei fuori?”, targeted to students from secondary school. “Ma sei fuori?” could be translated as “Are you off your rocker?” or, more simply, as “Are you crazy?”; this phrase has been adopted by our juvenile slang to identify a person who's generally considered “not in line”. To those who answered our public call, we sent the contest regulation and factsheets on schizophrenia and stigma, matched with a brief bibliography/filmography. Students involved had to develop a slogan on stigma linked with music and images; 140 classes competed. The best catchphrase had been voted by a jury composed of influencers, clinicians, policy makers, writers, patient associations and other KOLs; besides the winning class, the jury issued three special mentions. All the results had been broadcasted live on Facebook during a public event. The winning class, as prize, got access to financial resources for didactic use and its slogan will be the core of a TV spot. The project had been backed by a communication campaign on TikTok, Instagram, Facebook, with the involvement of the most famous italian tiktokers; just on TikTok the campaign reached 4.8 billion views. The project final scope was to raise young people's awareness about mental health issues and stigma, by stimulating a cultural shift. Students underlined another important result: working together online after school during the pandemic helped them filled the gap caused by the lack of socialization. Projects of this kind, easily replicable in other contests, could help creating a common language on the impact of stigma.
Key messages
Social stigma still has a great impact on the lives of people with mental issues and disorders. Tackling bias and discrimination is the first step to raise awareness and build a stronger community. As a community, we must promote a responsible behavior and a common language to tackle prejudice on mental health issues; starting from young people could be the key to boost a cultural shift.
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Affiliation(s)
| | - M Sacchi
- Fondazione The Bridge, Milan, Italy
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26
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Luccarelli SV, Villani E, Lucentini S, Bonsignore F, Sacchi M, Martellucci CA, Nucci P. Sutureless "Contact Lens Sandwich" Technique for Amniotic Membrane Therapy of Central Corneal Ulcers. Eur J Ophthalmol 2021; 32:2141-2147. [PMID: 34633886 DOI: 10.1177/11206721211049093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To describe a new technique for sutureless and glue-free amniotic membrane transplantation (AMT) and to investigate its effectiveness to treat corneal persistent epithelial defects (PEDs), compared to bandage contact lens (BCL) application alone. METHODS We performed AMT with "contact lens sandwich technique" (CLS-AMT) in 8 consecutive patients with central/para-central (up to 4.00 mm from the geometrical centre) PED/ulceration and we retrospectively compared the results with 11 BCL procedures. RESULTS The procedures were performed successfully with no complications.CLS-AMT showed significantly shorter healing time than BCL (24.0 ± 19.1 vs 42.9 ± 14.6 days; P < 0.05, Mann-Whitney test). Recurrence rates were 12% and 27% for CLS-AMT and BCL, respectively. CONCLUSION CLS-AMT technique, based on the suction effect due to the superposition of a bandage contact lens on the AM-ring complex, represents a quick, low cost, easy to perform and nearly non-invasive AMT technique. This approach is able to provide adequate fixation of AM, and it seems to be a safe and effective treatment for patients with PEDs.
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Affiliation(s)
| | - Edoardo Villani
- 18608Eye Clinic San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy.,Department of Clinical Sciences and Community Health, 9304University of Milan, Italy
| | - Stefano Lucentini
- 18608Eye Clinic San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | | | - Matteo Sacchi
- 18608Eye Clinic San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | | | - Paolo Nucci
- 18608Eye Clinic San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy.,Department of Clinical Sciences and Community Health, 9304University of Milan, Italy
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27
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Spinelli A, Foppa C, Carrano FM, Sacchi M, Carvello M. Transanal transection and single-stapled anastomosis for ileo-anal pouch surgery - a video vignette. Colorectal Dis 2021; 23:2483-2484. [PMID: 34051036 DOI: 10.1111/codi.15762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 05/22/2021] [Indexed: 01/19/2023]
Affiliation(s)
- Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,IRCCS Humanitas Research Hospital, Milan, Italy
| | | | | | | | - Michele Carvello
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,IRCCS Humanitas Research Hospital, Milan, Italy
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28
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Luccarelli SV, Lucentini S, Martellucci CA, Marelli L, Sacchi M, Nucci P. Impact of Adherence (Compliance) to Oral Acyclovir Prophylaxis in the Recurrence of Herpetic Keratitis: Long-Term Results From a Pediatric Cohort. Cornea 2021; 40:1126-1131. [PMID: 33201055 DOI: 10.1097/ico.0000000000002578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/09/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To evaluate the long-term role of adherence to oral acyclovir prophylaxis in reducing the risk for recurrent herpes simplex virus keratitis (HSK) in children. METHODS A retrospective cohort study was performed including all pediatric patients 16 years or younger) with their first HSK diagnosis and treatment at our center. Children were started on a standardized oral acyclovir prophylactic regimen after the acute phase. Adherence to prophylaxis was assessed monthly through parent interviews. The possible association between any recurrence (not only the first) and exposure to acyclovir prophylaxis was evaluated using random-effects multivariate logistic regression. RESULTS A total of 20 eyes of 17 patients (8 boys and 9 girls) were included. The mean follow-up time was 3.5 years. Adherence to acyclovir prophylaxis was registered in 100% of patients with no recurrences and in 36.4% of patients with 1 or more recurrences (P = 0.035). All other tested variables (time of follow-up, sex, age, infectious diseases, underlying hematological diseases, eye, and HSK type) did not differ between the 2 groups. The multivariate model confirmed the lower risk for recurrence in patients who were compliant to therapy (adjusted odds ratio 0.04, 95% confidence intervals 0.00-0.42, P = 0.008). No adverse effects were recorded during follow-up. CONCLUSIONS Oral acyclovir prophylaxis is a safe and an effective medical treatment for recurrent HSK and its long-term efficacy is associated with compliance to the therapy.
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Affiliation(s)
| | | | - Cecilia Acuti Martellucci
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy ; and
| | | | | | - Paolo Nucci
- Eye Clinic San Giuseppe Hospital, Milano, Italy
- Departement of Clinical Science and Community Health, University of Milan, Milano, Italy
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29
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Spinelli A, Foppa C, Carvello M, Sacchi M, De Lucia F, Clerico G, Carrano FM, Maroli A, Montorsi M, Heald RJ. Transanal Transection and Single-Stapled Anastomosis (TTSS): A comparison of anastomotic leak rates with the double-stapled technique and with transanal total mesorectal excision (TaTME) for rectal cancer. Eur J Surg Oncol 2021; 47:3123-3129. [PMID: 34384655 DOI: 10.1016/j.ejso.2021.08.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 08/04/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND in the literature on rectal cancer (RC) surgery many studies have focused on the quality of total mesorectal excision (TME) dissection, while there is a scarcity of comparative data on transection and anastomosis. No anastomosis has so far proved to be superior to any other. The aim of this study was to compare anastomotic leak (AL) rates between conventional laparoscopic double-stapled (DS), transanal total mesorectal excision (TaTME) and Transanal Transection and Single-Stapled anastomosis (TTSS) techniques. METHODS consecutive mid-low RC patients undergoing elective laparoscopic TME with stapled anastomosis and protective stoma, by either DS, TaTME or TTSS techniques were retrieved from a prospectively collected database. RESULTS 127 DS; 100 TaTME and 50 TTSS were included. Demographics, distance of the tumor from anal verge and neoadjuvant therapy were comparable. Operative time was longer in TaTME over DS and TTSS (p < 0.0001). More 90-days complications occurred in DS group vs TTSS (p = 0.029). The AL rate was 17.5% in DS, 6% in TaTME and 2% in TTSS group (p = 0.005). AL grade was: one B (2%) in TTSS; 2 grade B (2%) and 4 grade C (4%) in TaTME; 6 grade A (4.7%), 7 grade B (5.5%) and 9 grade C (7.1%) in DS group. Reintervention rate after AL was higher in DS group over TTSS (12.6% vs 2%; p = 0.003). The rate of stoma closure, pathology data and margin positivity did not differ. CONCLUSIONS TTSS strategy is feasible, safe and leads to very low AL rates after TME for RC.
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Affiliation(s)
- Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Division of General and Digestive Surgery, via Manzoni 56, 20089, Rozzano, Milan, Italy.
| | - Caterina Foppa
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Division of General and Digestive Surgery, via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Michele Carvello
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Division of General and Digestive Surgery, via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Matteo Sacchi
- IRCCS Humanitas Research Hospital, Division of General and Digestive Surgery, via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Francesca De Lucia
- IRCCS Humanitas Research Hospital, Division of General and Digestive Surgery, via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Giuseppe Clerico
- IRCCS Humanitas Research Hospital, Division of General and Digestive Surgery, via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Francesco Maria Carrano
- IRCCS Humanitas Research Hospital, Division of General and Digestive Surgery, via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Annalisa Maroli
- IRCCS Humanitas Research Hospital, Division of General and Digestive Surgery, via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Marco Montorsi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Division of General and Digestive Surgery, via Manzoni 56, 20089, Rozzano, Milan, Italy
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Oddone F, Roberti G, Posarelli C, Agnifili L, Mastropasqua L, Carnevale C, Micelli Ferrari T, Pace V, Sacchi M, Cremonesi E, Uva M, Menchini M, Brescia L, Figus M. Endothelial Cell Density After XEN Implant Surgery: Short-term Data From the Italian XEN Glaucoma Treatment Registry (XEN-GTR). J Glaucoma 2021; 30:559-565. [PMID: 33813558 DOI: 10.1097/ijg.0000000000001840] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 03/13/2021] [Indexed: 12/13/2022]
Abstract
PRECIS XEN implant was associated with low endothelial cell density (ECD) reduction. In fact, when combined with phacoemulsification, the reduction in ECD was similar to that expected after phacoemulsification alone. PURPOSE The purpose of this study was to assess the impact of XEN implant, either alone or in combination with phacoemulsification, on ECD. METHODS Multicenter, prospective, observational study conducted on consecutive open-angle glaucoma patients, who were enrolled in the Italian XEN Glaucoma Treatment Registry and have complete endothelial cell count data at baseline and at 6 months after implantation. The primary endpoint was the mean percentage change in ECD between baseline and month 6. RESULTS The study included 108 open-angle glaucoma eyes (68 in the XEN-solo and 40 eyes in the XEN+phaco groups) and 60 control eyes (phaco-solo group). As compared with baseline, mean (95% confidence interval, CI) ECD reduction was -5.6% (-7.0% to -4.9%), -11.3% (-13.8% to -10.9%), and -13.0% (14.8% to -11.8%) in the XEN-solo, XEN+phaco, and phaco-solo groups, respectively (P=0.0004, <0.0001, and <0.0001, respectively). As compared with the XEN-solo group, the ECD reduction was significantly greater in the XEN+phaco group (mean difference=5.7%; 95% CI: 4.1%-7.3%, P<0.0001) and in the phaco-solo group (mean difference=7.4%; 95% CI: 5.7%-9.1%, P<0.0001). ECD reduction was similar in XEN+phaco and phaco-solo groups (P=0.9). In absolute terms, ECD reduction was significantly greater in the XEN+phaco (mean difference=169±306, P=0.021) and in the phaco-solo (mean difference=192±302, P=0.0022) groups than in the XEN-solo group. CONCLUSIONS The mean ECD reduction 6 months after XEN implantation was low. The ECD reduction in the XEN+phaco group was larger than in the XEN-solo group but was similar to that observed in the phaco-solo group.
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Affiliation(s)
| | | | - Chiara Posarelli
- Department of Surgical, Medical, Molecular Pathology and of Critical Area, University of Pisa, Pisa
| | - Luca Agnifili
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. D'Annunzio of Chieti-Pescara, Chieti
| | - Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. D'Annunzio of Chieti-Pescara, Chieti
| | | | | | - Vincenzo Pace
- Regional General Hospital F. Miulli of Acquaviva delle Fonti, Bari
| | - Matteo Sacchi
- University Eye Clinic, San Giuseppe Hospital, University of Milan, Milan
| | - Elena Cremonesi
- University Eye Clinic, San Giuseppe Hospital, University of Milan, Milan
| | - Maurizio Uva
- University Hospital "Policlinico Vittorio Emanuele," Catania, Italy
| | - Martina Menchini
- Department of Surgical, Medical, Molecular Pathology and of Critical Area, University of Pisa, Pisa
| | - Lorenza Brescia
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. D'Annunzio of Chieti-Pescara, Chieti
| | - Michele Figus
- Department of Surgical, Medical, Molecular Pathology and of Critical Area, University of Pisa, Pisa
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Ansell SM, Bröckelmann PJ, Keudell G, Lee HJ, Santoro A, Zinzani PL, Collins GP, Cohen JB, Boer JP, Kuruvilla J, Savage KJ, Trneny M, Provencio M, Jaeger U, Willenbacher W, Swanink R, Sacchi M, Shipp MA, Engert A, Armand P. NIVOLUMAB FOR RELAPSED OR REFRACTORY (R/R) CLASSICAL HODGKIN LYMPHOMA (CHL) AFTER AUTOLOGOUS TRANSPLANTATION: 5‐YEAR OVERALL SURVIVAL FROM THE PHASE 2 CHECKMATE 205 STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.74_2879] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- S. M. Ansell
- Mayo Clinic Division of Hematology Rochester Minnesota USA
| | - P. J. Bröckelmann
- University Hospital of Cologne Department of Internal Medicine Cologne Germany
| | - G. Keudell
- Memorial Sloan Kettering Cancer Center Department of Hematology New York New York USA
| | - H. J. Lee
- University of Texas MD Anderson Cancer Center Department of Lymphoma and Myeloma Houston Texas USA
| | - A. Santoro
- Humanitas University Humanitas Cancer Center Rozzano Milan Italy
| | - P. L. Zinzani
- University of Bologna Institute of Hematology L. e A. Seràgnoli Bologna Italy
| | - G. P. Collins
- Churchill Hospital Oxford Cancer and Haematology Centre Oxford UK
| | - J. B. Cohen
- Emory University Winship Cancer Institute Atlanta Georgia USA
| | - J. P. Boer
- Antoni van Leeuwenhoek Hospital Netherlands Cancer Institute Amsterdam Netherlands
| | - J. Kuruvilla
- University of Toronto and Princess Margaret Cancer Centre Division of Medical Oncology and Hematology Toronto Canada
| | - K. J. Savage
- BC Cancer Department of Medical Oncology Vancouver Canada
| | - M. Trneny
- Charles University in Prague and General University Hospital in Prague Department of Haematology Prague Czech Republic
| | - M. Provencio
- Hospital Universitario Puerta de Hierro Department of Medical Oncology Madrid Spain
| | - U. Jaeger
- Medical University of Vienna Clinical Department for Hematology and Hemostaseology Vienna Austria
| | - W. Willenbacher
- Innsbruck Medical University Department of Internal Medicine V Innsbruck Austria
| | - R. Swanink
- Bristol Myers Squibb Global Biometrics and Data Sciences Braine l’Alleud Belgium
| | - M. Sacchi
- Bristol Myers Squibb, Global Drug Development Princeton New Jersey USA
| | - M. A. Shipp
- Dana‐Farber Cancer Institute Department of Medical Oncology Boston Massachusetts USA
| | - A. Engert
- University Hospital of Cologne Department of Internal Medicine Cologne Germany
| | - P. Armand
- Dana‐Farber Cancer Institute Department of Medical Oncology Boston Massachusetts USA
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32
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Slocombe L, Al-Khalili JS, Sacchi M. Quantum and classical effects in DNA point mutations: Watson-Crick tautomerism in AT and GC base pairs. Phys Chem Chem Phys 2021; 23:4141-4150. [PMID: 33533770 DOI: 10.1039/d0cp05781a] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Proton transfer along the hydrogen bonds of DNA can lead to the creation of short-lived, but biologically relevant point mutations that can further lead to gene mutation and, potentially, cancer. In this work, the energy landscape of the canonical A-T and G-C base pairs (standard, amino-keto) to tautomeric A*-T* and G*-C* (non-standard, imino-enol) Watson-Crick DNA base pairs is modelled with density functional theory and machine-learning nudge-elastic band methods. We calculate the energy barriers and tunnelling rates of hydrogen transfer between and within each base monomer (A, T, G and C). We show that the role of tunnelling in A-T tautomerisation is statistically unlikely due to the presence of a small reverse reaction barrier. On the contrary, the thermal populations of the G*-C* point mutation could be non-trivial and propagate through the replisome. For the direct intramolecular transfer, the reaction is hindered by a substantial energy barrier. However, our calculations indicate that tautomeric bases in their monomeric form have remarkably long lifetimes.
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Affiliation(s)
- L Slocombe
- Leverhulme Quantum Biology Doctoral Training Centre, UK.
| | - J S Al-Khalili
- Department of Physics, University of Surrey, Guildford, GU2 7XH, UK
| | - M Sacchi
- Department of Chemistry, University of Surrey, Guildford, GU2 7XH, UK.
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33
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Sacchi M, Monsellato G, Villani E, Lizzio RAU, Cremonesi E, Luccarelli S, Nucci P. Intraocular pressure control after combined phacotrabeculectomy versus trabeculectomy alone. Eur J Ophthalmol 2021; 32:327-335. [PMID: 33685259 DOI: 10.1177/1120672121999997] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 11/15/2022]
Abstract
PURPOSE We compared the efficacy and safety of trabeculectomy and phacotrabeculectomy in patients with glaucoma. MATERIALS AND METHODS We retrospectively analyzed consecutive patients who underwent trabeculectomy or phacotrabeculectomy. Patients in the trabeculectomy group were pseudophakic. We established three different intraocular pressure (IOP) thresholds (A: <21 mmHg, B: <18 mmHg, and C: <15 mmHg) to measure complete (without medication) and qualified (with medication) success. Success criteria were analyzed through Kaplan-Meier survival curves. RESULTS Sixty-seven eyes were included (40 trabeculectomy, 27 phacotrabeculectomy). The mean follow-up period was 25.70 ± 14.439 months. The baseline characteristics were similar between the groups. The complete and qualified success rates according to criterion C were significantly higher in the trabeculectomy group (p = 0.033, p = 0.021, respectively); however, there was a trend toward a higher success rate for all criteria in favor of trabeculectomy. Bleb needling was more frequent in the phacotrabeculectomy group. The mean IOP significantly decreased from 26.46 ± 7.07 to 12.27 ± 4.06 at 12 months (p < 0.001). The final mean IOP was significantly lower in the trabeculectomy than in the phacotrabeculectomy group (10.95 ± 3.08 vs 13.00 ± 4.56, p = 0.0003). CONCLUSION In pseudophakic eyes, trabeculectomy alone achieves a higher success rate, lower mean IOP, and less frequent bleb needlings. More frequent follow-up and prolonged postoperative use of high-dose topical steroids should be considered in patients undergoing phacotrabeculectomy.
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Affiliation(s)
- Matteo Sacchi
- University Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Gianluca Monsellato
- University Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Edoardo Villani
- University Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy.,Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | | | - Elena Cremonesi
- University Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Saverio Luccarelli
- University Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Paolo Nucci
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
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Celentano V, Pellino G, Rottoli M, Poggioli G, Sica G, Giglio MC, Campanelli M, Coco C, Rizzo G, Sionne F, Colombo F, Sampietro G, Lamperti G, Foschi D, Ficari F, Vacca L, Cricchio M, Giudici F, Selvaggi L, Sciaudone G, Peltrini R, Manfreda A, Bucci L, Galleano R, Ghazouani O, Zorcolo L, Deidda S, Restivo A, Braini A, Di Candido F, Sacchi M, Carvello M, Martorana S, Bordignon G, Angriman I, Variola A, Barugola G, Di Ruscio M, Tanzanu M, Geccherle A, Tropeano FP, Luglio G, Sasia D, Migliore M, Giuffrida MC, Marrano E, Moretto G, Impellizzeri H, Gallo G, Vescio G, Sammarco G, Terrosu G, Calini G, Bondurri A, Maffioli A, Zaffaroni G, Resegotti A, Mistrangelo M, Allaix ME, Botti F, Prati M, Boni L, Perotti S, Mineccia M, Giuliani A, Romano L, Graziano GMP, Pugliese L, Pietrabissa A, Delaini G, Spinelli A, Selvaggi F. Correction to: Surgical treatment of colonic Crohn's disease: a national snapshot study. Langenbecks Arch Surg 2021; 407:3921-3924. [PMID: 33651161 DOI: 10.1007/s00423-021-02119-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Valerio Celentano
- Portsmouth Hospitals NHS Trust, Portsmouth, UK. .,University of Portsmouth, Portsmouth, UK. .,Department of Surgery and Cancer, Imperial College, London, UK.
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Science, Universita' degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Matteo Rottoli
- Surgery of the Alimentary Tract, Sant'Orsola Hospital, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Gilberto Poggioli
- Surgery of the Alimentary Tract, Sant'Orsola Hospital, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Giuseppe Sica
- Minimally Invasive & Gastro-Intestinal Surgical Unit, Department of Surgery, Policlinico Tor Vergata, Rome, Italy
| | - Mariano Cesare Giglio
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Michela Campanelli
- Minimally Invasive & Gastro-Intestinal Surgical Unit, Department of Surgery, Policlinico Tor Vergata, Rome, Italy
| | - Claudio Coco
- U.O.C. Chirurgia Generale 2 - Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianluca Rizzo
- U.O.C. Chirurgia Generale 2 - Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Sionne
- U.O.C. Chirurgia Generale 2 - Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Colombo
- General Surgery Unit, Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Gianluca Sampietro
- Division of General and HPB Surgery, Department of Surgery, ASST Rhodense - Rho Memorial Hospital, 20017, Rho, Milan, Italy
| | - Giulia Lamperti
- General Surgery Unit, Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Diego Foschi
- General Surgery Unit, Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | | | | | | | - Lucio Selvaggi
- Department of Advanced Medical and Surgical Science, Universita' degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Guido Sciaudone
- Department of Advanced Medical and Surgical Science, Universita' degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | | | | | - Luigi Bucci
- University of Naples Federico II, Naples, Italy
| | | | | | - Luigi Zorcolo
- Colon and Rectal Surgery Unit, University of Cagliari, Cagliari, Italy
| | - Simona Deidda
- Colon and Rectal Surgery Unit, University of Cagliari, Cagliari, Italy
| | - Angelo Restivo
- Colon and Rectal Surgery Unit, University of Cagliari, Cagliari, Italy
| | | | - Francesca Di Candido
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Via Manzoni 56, 20089, Rozzano, Milano, Italy
| | - Matteo Sacchi
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Via Manzoni 56, 20089, Rozzano, Milano, Italy
| | - Michele Carvello
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Via Manzoni 56, 20089, Rozzano, Milano, Italy
| | - Stefania Martorana
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Via Manzoni 56, 20089, Rozzano, Milano, Italy
| | - Giovanni Bordignon
- Department of Surgical Oncological and Gastroenterological Sciences University of Padova, Surgical Unit, Padova, Italy
| | - Imerio Angriman
- Department of Surgical Oncological and Gastroenterological Sciences University of Padova, Surgical Unit, Padova, Italy
| | | | | | | | - Marta Tanzanu
- Surgery of the Alimentary Tract, Sant'Orsola Hospital, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | | | | | - Gaetano Luglio
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Diego Sasia
- Department of Surgery, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Marco Migliore
- Department of Surgery, Santa Croce e Carle Hospital, Cuneo, Italy
| | | | - Enrico Marrano
- Department of Surgery, "Pederzoli" Hospital, Peschiera del Garda, Verona, Italy
| | - Gianluigi Moretto
- Department of Surgery, "Pederzoli" Hospital, Peschiera del Garda, Verona, Italy
| | | | - Gaetano Gallo
- Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy
| | - Giuseppina Vescio
- Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy
| | - Giuseppe Sammarco
- Department of Health sciences, University of Catanzaro, Catanzaro, Italy
| | - Giovanni Terrosu
- Department of Surgery, University Hospital "Santa Maria della Misericordia", Udine, Italy
| | - Giacomo Calini
- Department of Surgery, University Hospital "Santa Maria della Misericordia", Udine, Italy
| | - Andrea Bondurri
- Unit 1, General Surgery, Luigi Sacco University Hospital, Milan, Italy
| | - Anna Maffioli
- Unit 1, General Surgery, Luigi Sacco University Hospital, Milan, Italy
| | - Gloria Zaffaroni
- Unit 1, General Surgery, Luigi Sacco University Hospital, Milan, Italy
| | - Andrea Resegotti
- Department of Surgical Sciences, Citta della Salute e della Scienza di Torino, Presidio Molinette, University Hospital, Turin, Italy
| | - Massimiliano Mistrangelo
- Department of Surgical Sciences, Citta della Salute e della Scienza di Torino, Presidio Molinette, University Hospital, Turin, Italy
| | - Marco Ettore Allaix
- Department of Surgical Sciences, Citta della Salute e della Scienza di Torino, Presidio Molinette, University Hospital, Turin, Italy
| | - Fiorenzo Botti
- Department of General Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Matteo Prati
- Department of General Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luigi Boni
- Department of General Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Serena Perotti
- Division of General and Oncologic Surgery, Mauriziano Hospital, Turin, Italy
| | - Michela Mineccia
- Division of General and Oncologic Surgery, Mauriziano Hospital, Turin, Italy
| | - Antonio Giuliani
- San Salvatore Hospital. Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Lucia Romano
- San Salvatore Hospital. Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | | | - Luigi Pugliese
- Fondazione IRCCS Policlinico San Matteo di Pavia, Università degli Studi di Pavia, Pavia, Italy
| | - Andrea Pietrabissa
- Fondazione IRCCS Policlinico San Matteo di Pavia, Università degli Studi di Pavia, Pavia, Italy
| | - GianGaetano Delaini
- Department of Surgery, "Pederzoli" Hospital, Peschiera del Garda, Verona, Italy
| | - Antonino Spinelli
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Via Manzoni 56, 20089, Rozzano, Milano, Italy.,Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milano, Italy
| | - Francesco Selvaggi
- Department of Advanced Medical and Surgical Science, Universita' degli Studi della Campania Luigi Vanvitelli, Naples, Italy
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Celentano V, Pellino G, Spinelli A, Selvaggi F, Celentano V, Pellino G, Rottoli M, Poggioli G, Sica G, Giglio MC, Campanelli M, Coco C, Rizzo G, Sionne F, Colombo F, Sampietro G, Lamperti G, Foschi D, Ficari F, Vacca L, Cricchio M, Giudici F, Selvaggi L, Sciaudone G, Peltrini R, Manfreda A, Bucci L, Galleano R, Ghazouani O, Zorcolo L, Deidda S, Restivo A, Braini A, Di Candido F, Sacchi M, Carvello M, Martorana S, Bordignon G, Angriman I, Variola A, Di Ruscio M, Barugola G, Geccherle A, Tropeano FP, Luglio G, Tanzanu M, Sasia D, Migliore M, Giuffrida MC, Marrano E, Moretto G, Impellizzeri H, Gallo G, Vescio G, Sammarco G, Terrosu G, Calini G, Bondurri A, Maffioli A, Zaffaroni G, Resegotti A, Mistrangelo M, Allaix ME, Botti F, Prati M, Boni L, Perotti S, Mineccia M, Giuliani A, Romano L, Graziano GMP, Pugliese L, Pietrabissa A, Delaini G, Spinelli A, Selvaggi F. Anastomosis configuration and technique following ileocaecal resection for Crohn's disease: a multicentre study. Updates Surg 2021; 73:149-156. [PMID: 33409848 DOI: 10.1007/s13304-020-00918-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/26/2020] [Indexed: 12/15/2022]
Abstract
A limited ileocaecal resection is the most frequently performed procedure for ileocaecal CD and different anastomotic configurations and techniques have been described. This manuscript audited the different anastomotic techniques used in a national study and evaluated their influence on postoperative outcomes following ileocaecal resection for primary CD. This is a retrospective, multicentre, observational study promoted by the Italian Society of Colorectal Surgery (SICCR), including all adults undergoing elective ileocaecal resection for primary CD from June 2018 May 2019. Postoperative morbidity within 30 days of surgery was the primary endpoint. Postoperative length of hospital stay (LOS) and anastomotic leak rate were the secondary outcomes. 427 patients were included. The side to side anastomosis was the chosen configuration in 380 patients (89%). The stapled anastomotic (n = 286; 67%), techniques were preferred to hand-sewn (n = 141; 33%). Postoperative morbidity was 20.3% and anastomotic leak 3.7%. Anastomotic leak was independent of the type of anastomosis performed, while was associated with an ASA grade ≥ 3, presence of perianal disease and ileocolonic localization of disease. Four predictors of LOS were identified after multivariate analysis. The laparoscopic approach was the only associated with a reduced LOS (p = 0.017), while age, ASA grade ≥ 3 or administration of preoperative TPN were associated with increased LOS. The side to side was the most commonly used anastomotic configuration for ileocolic reconstruction following primary CD resection. There was no difference in postoperative morbidity according to anastomotic technique and configuration. Anastomotic leak was associated with ASA grade ≥ 3, a penetrating phenotype of disease and ileo-colonic distribution of CD.
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Affiliation(s)
- Valerio Celentano
- Portsmouth Hospitals NHS Trust, Portsmouth, UK. .,University of Portsmouth, Portsmouth, UK. .,Department of Surgery and Cancer, Imperial College, London, UK.
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Science, Universita' degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Antonino Spinelli
- Colon and Rectal Surgery Unit, Humanitas Clinical and Research Center, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Francesco Selvaggi
- Department of Advanced Medical and Surgical Science, Universita' degli Studi della Campania Luigi Vanvitelli, Naples, Italy
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Sacchi M, Foppa C, Carrano FM, Clerico G, De Lucia F, Carvello M, Spinelli A. Laparoscopic right colectomy after previous colonic resection - the importance of three-dimensional CT angiography reconstruction and indocyanine green fluorescence - a video vignette. Colorectal Dis 2020; 22:1778-1779. [PMID: 32521571 DOI: 10.1111/codi.15182] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 04/16/2020] [Indexed: 02/08/2023]
Affiliation(s)
- M Sacchi
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Milan, Italy
| | - C Foppa
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Milan, Italy
| | - F M Carrano
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Milan, Italy
| | - G Clerico
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Milan, Italy
| | - F De Lucia
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Milan, Italy
| | - M Carvello
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Milan, Italy
| | - A Spinelli
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
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37
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Mastropasqua L, Brescia L, Oddone F, Sacchi M, Aloia R, Totta M, Scatena B, Mastropasqua R, Agnifili L. Conjunctival thickness as a predictive imaging biomarker for the glaucoma filtration surgery outcome: An optical coherence tomography study. Clin Exp Ophthalmol 2020; 48:1192-1200. [PMID: 32918375 DOI: 10.1111/ceo.13857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/10/2020] [Accepted: 09/03/2020] [Indexed: 11/27/2022]
Abstract
IMPORTANCE To analyse the preoperative conjunctival thickness in glaucomatous patients undergoing filtration surgery (FS), using optical coherence tomography (OCT). BACKGROUND The conjunctival status represents one of the most critical determinants of the FS outcome. DESIGN Retrospective study. PARTICIPANTS Sixty-seven patients candidate to FS for uncontrolled glaucoma were enrolled. METHODS OCT was performed at the superior bulbar conjunctiva before FS, and at bleb site at the last follow-up (LF-up) after surgery. MAIN OUTCOME MEASURES Preoperative full, epithelial, and stromal conjunctival thickness (FCT, CET, CST) and reflectivity (CR), and LF-up bleb-wall thickness (BT), reflectivity (BR) and intraocular pressure (IOP), were the major outcomes. The relations between preoperative parameters and LF-up-IOP, BT and BR were calculated. RESULTS FS was completely successful in 23 patients (group 1), successful with medications in 22 (group 2), and failed in 22 (group 3). FCT, CET and CST were lower, whereas CR higher, in group 3 compared to groups 1 and 2 (P < .05); BT was lower (P < .001), whereas BR higher (P < .05) in group 3 compared to group 1. FCT and CST were predictors of FS outcome with lower thickness associated with increased odds of failure (odds ratio 0.922, P = .08; 0.941, P = .025). LF-up-IOP inversely correlated with FCT and CST (r = -0.447, P = .003; r = -0.408, P = .007), whereas positively correlated with CR (r = 0.789, P < .001). CONCLUSIONS AND RELEVANCE Preoperative conjunctival thickness and reflectivity show significant correlations with the FS outcome, both in terms of IOP and bleb-wall features. Therefore, they may be proposed as predictive imaging biomarkers to estimate the risk of filtration failure.
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Affiliation(s)
- Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Lorenza Brescia
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Matteo Sacchi
- University Eye Clinic, San Giuseppe Hospital, University of Milan, Milan, Italy
| | - Raffaella Aloia
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Michele Totta
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Barbara Scatena
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Luca Agnifili
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
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38
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Tabbì L, Tonelli R, Fantini R, Castaniere I, Bruzzi G, Nani C, Caffarri L, Sacchi M, Spacone A, Dongilli R, Boni E, Falsini L, Ribuffo V, Marchioni A, Clini E. INCIDENCE AND PREDICTORS OF DELIRIUM IN PATIENTS WITH ACUTE RESPIRATORY FAILURE UNDERGOING NON-INVASIVE MECHANICAL VENTILATION. Chest 2020. [DOI: 10.1016/j.chest.2020.05.460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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39
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Gallo A, Guida M, Armiento G, Siciliano A, Mormile N, Carraturo F, Pellegrini D, Morroni L, Tosti E, Ferrante MI, Montresor M, Molisso F, Sacchi M, Danovaro R, Lofrano G, Libralato G. Species-specific sensitivity of three microalgae to sediment elutriates. Mar Environ Res 2020; 156:104901. [PMID: 32056796 DOI: 10.1016/j.marenvres.2020.104901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/03/2020] [Accepted: 02/03/2020] [Indexed: 06/10/2023]
Abstract
Microalgae are considered good bioindicators of marine environmental quality. Frequently, they are used to investigate the toxicity of sediment elutriates, but their sensitivity is disputed. This paper compared the sensitivity of Phaeodactylum tricornutum (diatom), Skeletonema costatum (diatom), and Dunaliella tertiolecta (green alga), analyzing 257 samples of elutriates (1:4 sediment: water ratio), considering growth inhibition (72 h) as the reference endpoint and sediment chemical (metals, metalloids and polyaromatic hydrocarbons) and grain size. Results of the toxicity tests showed that the microalgae sensitivity was not correlated. The integration of chemical data did not allow to discriminate toxicity effects but contributed to highlight that D. tertiolecta was the most sensitive microalgae (no cell wall) followed by P. tricornutum and S. costatum. Further analysis, including lines of evidence and weight of evidence approaches to calculate risk quotients of elutriate samples, confirmed these results.
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Affiliation(s)
- A Gallo
- Department of Biology and Evolution of Marine Organisms, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121, Naples, Italy
| | - M Guida
- Department of Biology, University of Naples Federico II, Via Cinthia, 21, 80126, Naples, Italy; Department of Marine Biotechnology, Stazione Zoologica Anton Dohrn, Naples, Italy
| | - G Armiento
- ENEA, Agenzia nazionale per le nuove tecnologie, l'energia e lo sviluppo economico sostenibile, Centro Ricerche Casaccia, Via Anguillarese, 301, 00123, Roma, Italy
| | - A Siciliano
- Department of Biology, University of Naples Federico II, Via Cinthia, 21, 80126, Naples, Italy
| | - N Mormile
- Department of Biology, University of Naples Federico II, Via Cinthia, 21, 80126, Naples, Italy
| | - F Carraturo
- Department of Biology, University of Naples Federico II, Via Cinthia, 21, 80126, Naples, Italy
| | - D Pellegrini
- ISPRA, Italian Institute for Environmental Protection and Research, Via del Cedro (c/o Dogana d'Acqua), 57122, Livorno, Italy
| | - L Morroni
- ISPRA, Italian Institute for Environmental Protection and Research, Via del Cedro (c/o Dogana d'Acqua), 57122, Livorno, Italy
| | - E Tosti
- Department of Biology and Evolution of Marine Organisms, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121, Naples, Italy
| | - M I Ferrante
- Department of Integrative Marine Ecology, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121, Naples, Italy
| | - M Montresor
- Department of Integrative Marine Ecology, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121, Naples, Italy
| | - F Molisso
- Istituto per le Scienze Marine (ISMAR), Consiglio Nazionale delle Ricerche (CNR), Calata Porta di Massa, 80133, Napoli, Italy
| | - M Sacchi
- Istituto per le Scienze Marine (ISMAR), Consiglio Nazionale delle Ricerche (CNR), Calata Porta di Massa, 80133, Napoli, Italy
| | - R Danovaro
- Stazione Zoologica Anton Dohrn, Villa Comunale, 80121, Naples, Italy; Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona, Italy
| | - G Lofrano
- Centro Servizi Metrologici e Tecnologici Avanzati (CeSMA), Complesso Universitario di Monte Sant'Angelo, Via Cinthia 21, 80126, Naples, Italy
| | - G Libralato
- Department of Biology, University of Naples Federico II, Via Cinthia, 21, 80126, Naples, Italy; Department of Marine Biotechnology, Stazione Zoologica Anton Dohrn, Naples, Italy.
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40
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Kolarsick PA, Sacchi M, Spinelli A, Wexner SD. Minimizing the impact of colorectal surgery in the older patient: The role of minimally invasive surgery in the geriatric population. Eur J Surg Oncol 2020; 46:333-337. [PMID: 31926606 DOI: 10.1016/j.ejso.2019.12.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 06/21/2019] [Revised: 09/24/2019] [Accepted: 12/19/2019] [Indexed: 11/18/2022] Open
Abstract
With an aging population comes a greater incidence of colorectal cancer and a corresponding need for surgical resection in the geriatric population. This heterogeneous group of patients may benefit from multidisciplinary pre-operative evaluation and optimization, prehabilitation, enhanced recovery protocols, and a minimally invasive approach to resection. Concerns regarding the ability of the older patient to tolerate the physiologic demands of pneumoperitoneum have not been validated. Conversely, these vulnerable patients may experience a greater reduction in morbidity than their younger counterparts through the use of minimally invasive techniques.
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Affiliation(s)
- Paul A Kolarsick
- Cleveland Clinic Florida, Department of Colorectal Surgery, Weston, FL, USA
| | - Matteo Sacchi
- Colon and Rectal Surgery, Humanitas Research Hospital, Humanitas University, Rozzano, Milano, Italy
| | - Antonino Spinelli
- Colon and Rectal Surgery, Humanitas Research Hospital, Humanitas University, Rozzano, Milano, Italy
| | - Steven D Wexner
- Cleveland Clinic Florida, Department of Colorectal Surgery, Weston, FL, USA.
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41
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Mikulak J, Oriolo F, Bruni E, Roberto A, Colombo FS, Villa A, Bosticardo M, Bortolomai I, Lo Presti E, Meraviglia S, Dieli F, Vetrano S, Danese S, Della Bella S, Carvello MM, Sacchi M, Cugini G, Colombo G, Klinger M, Spaggiari P, Roncalli M, Prinz I, Ravens S, di Lorenzo B, Marcenaro E, Silva-Santos B, Spinelli A, Mavilio D. NKp46-expressing human gut-resident intraepithelial Vδ1 T cell subpopulation exhibits high antitumor activity against colorectal cancer. JCI Insight 2019; 4:125884. [PMID: 31689241 DOI: 10.1172/jci.insight.125884] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 10/31/2019] [Indexed: 12/25/2022] Open
Abstract
γδ T cells account for a large fraction of human intestinal intraepithelial lymphocytes (IELs) endowed with potent antitumor activities. However, little is known about their origin, phenotype, and clinical relevance in colorectal cancer (CRC). To determine γδ IEL gut specificity, homing, and functions, γδ T cells were purified from human healthy blood, lymph nodes, liver, skin, and intestine, either disease-free, affected by CRC, or generated from thymic precursors. The constitutive expression of NKp46 specifically identifies a subset of cytotoxic Vδ1 T cells representing the largest fraction of gut-resident IELs. The ontogeny and gut-tropism of NKp46+/Vδ1 IELs depends both on distinctive features of Vδ1 thymic precursors and gut-environmental factors. Either the constitutive presence of NKp46 on tissue-resident Vδ1 intestinal IELs or its induced expression on IL-2/IL-15-activated Vδ1 thymocytes are associated with antitumor functions. Higher frequencies of NKp46+/Vδ1 IELs in tumor-free specimens from CRC patients correlate with a lower risk of developing metastatic III/IV disease stages. Additionally, our in vitro settings reproducing CRC tumor microenvironment inhibited the expansion of NKp46+/Vδ1 cells from activated thymic precursors. These results parallel the very low frequencies of NKp46+/Vδ1 IELs able to infiltrate CRC, thus providing insights to either follow-up cancer progression or to develop adoptive cellular therapies.
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Affiliation(s)
- Joanna Mikulak
- Unit of Clinical and Experimental Immunology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.,Department of Medical Biotechnologies and Translational Medicine (BioMeTra), University of Milan, Milan, Italy
| | - Ferdinando Oriolo
- Unit of Clinical and Experimental Immunology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.,Department of Medical Biotechnologies and Translational Medicine (BioMeTra), University of Milan, Milan, Italy
| | - Elena Bruni
- Unit of Clinical and Experimental Immunology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.,Department of Medical Biotechnologies and Translational Medicine (BioMeTra), University of Milan, Milan, Italy
| | | | - Federico S Colombo
- Humanitas Flow Cytometry Core, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Anna Villa
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy.,Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche, Milan, Italy
| | - Marita Bosticardo
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Ileana Bortolomai
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Elena Lo Presti
- Central Laboratory for Advanced Diagnostic and Biomedical Research (CLADIBIOR) and.,Department of Biopathology and Medical Biotechnologies (DIBIMED), University of Palermo, Palermo, Italy
| | - Serena Meraviglia
- Central Laboratory for Advanced Diagnostic and Biomedical Research (CLADIBIOR) and.,Department of Biopathology and Medical Biotechnologies (DIBIMED), University of Palermo, Palermo, Italy
| | - Francesco Dieli
- Central Laboratory for Advanced Diagnostic and Biomedical Research (CLADIBIOR) and.,Department of Biopathology and Medical Biotechnologies (DIBIMED), University of Palermo, Palermo, Italy
| | - Stefania Vetrano
- IBD Center, Laboratory of Gastrointestinal Immunopathology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
| | - Silvio Danese
- IBD Center, Laboratory of Gastrointestinal Immunopathology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
| | - Silvia Della Bella
- Unit of Clinical and Experimental Immunology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.,Department of Medical Biotechnologies and Translational Medicine (BioMeTra), University of Milan, Milan, Italy
| | | | | | | | | | - Marco Klinger
- Department of Medical Biotechnologies and Translational Medicine (BioMeTra), University of Milan, Milan, Italy.,Plastic Surgery Unit, and
| | - Paola Spaggiari
- Department of Pathology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Massimo Roncalli
- Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy.,Colon and Rectal Surgery Unit.,Otorhinolaryngology Department.,Plastic Surgery Unit, and.,Department of Pathology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Immo Prinz
- Institute of Immunology, Hannover Medical School, Hannover, Germany
| | - Sarina Ravens
- Institute of Immunology, Hannover Medical School, Hannover, Germany
| | - Biagio di Lorenzo
- Instituto de Medicina Molecular, Faculdade de Medicina, and.,Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - Emanuela Marcenaro
- Department of Experimental Medicine and.,Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | | | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy.,Colon and Rectal Surgery Unit
| | - Domenico Mavilio
- Unit of Clinical and Experimental Immunology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.,Department of Medical Biotechnologies and Translational Medicine (BioMeTra), University of Milan, Milan, Italy
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42
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Sacchi M, Serafino M, Villani E, Tagliabue E, Luccarelli S, Bonsignore F, Nucci P. Efficacy of atropine 0.01% for the treatment of childhood myopia in European patients. Acta Ophthalmol 2019; 97:e1136-e1140. [PMID: 31197953 DOI: 10.1111/aos.14166] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 05/21/2019] [Indexed: 01/25/2023]
Abstract
PURPOSE To evaluate the efficacy and safety of atropine 0.01% in slowing myopia progression in European paediatric patients. METHODS Retrospective, medical records review study. Medical charts of paediatric patients with a myopia progression > 0.5 D/year treated with atropine 0.01% for at least 1 year were included. Patients receive a complete ophthalmic examination before and 12 months after initiation of atropine treatment. A group of myopic untreated children serves as a control group. The rate of myopia progression at baseline and 12 months after treatment with atropine was evaluated. The rate of myopia progression in treated and untreated patients was also compared. Adverse events were recorded. RESULTS Medical records of 52 treated and 50 control subjects were analysed. In the atropine group, the mean rate of myopia progression after 12 months of treatment (-0.54 ± 0.61 D) was significantly slower compared with the baseline progression (-1.20 ± 0.64 D; p < 0.0001) and to the progression in the control group (-1.09 ± 0.64; p < 0.0001). The responders patients were 41/52 (79%), whereas 11/52 patients (21%) showed a progression > 0.50 D despite treatment. The only adverse event was temporary photophobia in five patients (9.6%), severe adverse events were not reported, and none of the patients discontinued the treatment. CONCLUSION Low-dose atropine significantly slowed the rate of myopia progression in European paediatric patients with a favourable safety profile.
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Affiliation(s)
- Matteo Sacchi
- University Eye Clinic, San Giuseppe Hospital, University of Milan, Milan, Italy
| | | | - Edoardo Villani
- University Eye Clinic, San Giuseppe Hospital, University of Milan, Milan, Italy
| | | | - Saverio Luccarelli
- University Eye Clinic, San Giuseppe Hospital, University of Milan, Milan, Italy
| | | | - Paolo Nucci
- University Eye Clinic, San Giuseppe Hospital, University of Milan, Milan, Italy
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43
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Ungaro F, Garlatti V, Massimino L, Spinelli A, Carvello M, Sacchi M, Spanò S, Colasante G, Valassina N, Vetrano S, Malesci A, Peyrin-Biroulet L, Danese S, D'Alessio S. mTOR-Dependent Stimulation of IL20RA Orchestrates Immune Cell Trafficking through Lymphatic Endothelium in Patients with Crohn's Disease. Cells 2019; 8:cells8080924. [PMID: 31426584 PMCID: PMC6721646 DOI: 10.3390/cells8080924] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/12/2019] [Accepted: 08/15/2019] [Indexed: 12/21/2022] Open
Abstract
Crohn’s disease (CD) is a chronic inflammatory condition that can affect different portions of the gastrointestinal tract. Lymphatic drainage was demonstrated to be dysfunctional in CD pathogenesis, ultimately causing the failure of the resolution of intestinal inflammation. To investigate the molecular mechanisms underlying these dysfunctions, we isolated human intestinal lymphatic endothelial cells (HILECs) from surgical specimens of patients undergoing resection for complicated CD (CD HILEC) and from a disease-free margin of surgical specimens of patients undergoing resection for cancer (healthy HILEC). Both cell types underwent transcriptomic profiling, and their barrier functionality was tested using a transwell-based co-culture system between HILEC and lamina propria mononuclear cells (LPMCs). Results showed CD HILEC displayed a peculiar transcriptomic signature that highlighted mTOR signaling as an orchestrator of leukocyte trafficking through the lymphatic barrier of CD patients. Moreover, we demonstrated that LPMC transmigration through the lymphatic endothelium of patients with CD depends on the capability of mTOR to trigger interleukin 20 receptor subunit α (IL20RA)-mediated intracellular signaling. Conclusively, our study suggests that leukocyte trafficking through the intestinal lymphatic microvasculature can be controlled by modulating IL20RA, thus leading to the resolution of chronic inflammation in patients with CD.
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Affiliation(s)
- Federica Ungaro
- IBD Center, Laboratory of Gastrointestinal Immunopathology, Humanitas Clinical and Research Center, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
| | - Valentina Garlatti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
| | - Luca Massimino
- Division of Neuroscience, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
- Colon and Rectal Surgery Unit, Humanitas Clinical and Research Center, Rozzano, 20089 Milan, Italy
| | - Michele Carvello
- Colon and Rectal Surgery Unit, Humanitas Clinical and Research Center, Rozzano, 20089 Milan, Italy
| | - Matteo Sacchi
- Colon and Rectal Surgery Unit, Humanitas Clinical and Research Center, Rozzano, 20089 Milan, Italy
| | - Salvatore Spanò
- IBD Center, Laboratory of Gastrointestinal Immunopathology, Humanitas Clinical and Research Center, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
| | - Gaia Colasante
- Division of Neuroscience, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Nicholas Valassina
- Division of Neuroscience, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Stefania Vetrano
- IBD Center, Laboratory of Gastrointestinal Immunopathology, Humanitas Clinical and Research Center, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
| | - Alberto Malesci
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, 200129 Milan, Italy
- Department of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, 20089 Milan, Italy
| | - Laurent Peyrin-Biroulet
- Inserm Ngere and Nancy University Hospital, Lorraine University, 54500 Vandoeuvre-lès-Nancy, France
| | - Silvio Danese
- IBD Center, Laboratory of Gastrointestinal Immunopathology, Humanitas Clinical and Research Center, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
| | - Silvia D'Alessio
- IBD Center, Laboratory of Gastrointestinal Immunopathology, Humanitas Clinical and Research Center, Rozzano, 20089 Milan, Italy.
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy.
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Ansell S, Ramchandren R, Domingo-Domènech E, Rueda A, Trněný M, Feldman T, Lee H, Provencio M, Sillaber C, Cohen J, Savage K, Willenbacher W, Sumbul A, Sacchi M, Armand P. NIVOLUMAB PLUS DOXORUBICIN, VINBLASTINE AND DACARBAZINE FOR NEWLY DIAGNOSED ADVANCED-STAGE CLASSICAL HODGKIN LYMPHOMA: CHECKMATE 205 COHORT D 2-YEAR FOLLOW-UP. Hematol Oncol 2019. [DOI: 10.1002/hon.104_2629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- S. Ansell
- Division of Hematology; Mayo Clinic; Rochester United States
| | - R. Ramchandren
- Division of Hematology and Oncology; University of Tennessee; Knoxville United States
| | | | - A. Rueda
- Servicio de Oncología; Hospital Costa del Sol; Marbella Spain
| | - M. Trněný
- Department of Haematology; Charles University in Prague and General University Hospital in Prague; Prague Czech Republic
| | - T. Feldman
- Hematology & Oncology; Hackensack University Medical Center; Hackensack United States
| | - H. Lee
- Department of Lymphoma and Myeloma; Division of Cancer Medicine, University of Texas MD Anderson Cancer Center; Houston United States
| | - M. Provencio
- Medical Oncology Department; Hospital Universitario Puerta de Hierro; Madrid Spain
| | - C. Sillaber
- Clinical Division of Oncology; Medical University of Vienna; Vienna Austria
| | - J. Cohen
- Department of Hematology and Medical Oncology; Winship Cancer Institute, Emory University; Atlanta United States
| | - K. Savage
- Department of Pathology and Laboratory Medicine; British Columbia Cancer Center for Lymphoid Cancer; Vancouver Canada
| | - W. Willenbacher
- Department of Internal Medicine; Innsbruck University Hospital & OncoTyrol - Center for Personalized Cancer Medicine; Innsbruck Austria
| | - A. Sumbul
- Bristol-Myers Squibb; Princeton United States
| | - M. Sacchi
- Bristol-Myers Squibb; Princeton United States
| | - P. Armand
- Department of Medical Oncology; Dana-Farber Cancer Institute; Boston United States
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45
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Grieco M, Lorenzon L, Marino P, Carlini M, Brescia A, Satntoro R, Crucitti A, Macarone Palmieri R, Santoro E, Stipa F, Sacchi M, Carlini M, Brescia A, Santoro R, Crucitti A, Macarone Palmieri R, Santoro E, Stipa F, Sacchi M, Persiani R. Eras program implementation in colorectal surgery: A multi-institution study based on the “lazio network” collective database including 1200 patients over two years. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2019.03.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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46
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Kelly K, Daw S, Mauz-Körholz C, Mascarin M, Michel G, Cooper S, Beishuizen A, Leger K, Garaventa A, Buffardi S, Brugières L, Harker-Murray P, Cole P, Drachtman R, Manley T, Francis S, Sacchi M, Leblanc T. RESPONSE-ADAPTED TREATMENT WITH NIVOLUMAB AND BRENTUXIMAB VEDOTIN IN YOUNG PATIENTS WITH RELAPSED/REFRACTORY CLASSICAL HODGKIN LYMPHOMA: CHECKMATE 744 SUBGROUP ANALYSES. Hematol Oncol 2019. [DOI: 10.1002/hon.26_2629] [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: 11/12/2022]
Affiliation(s)
- K.M. Kelly
- Department of Pediatric Oncology; Roswell Park Comprehensive Cancer Center; Buffalo United States
| | - S. Daw
- Paediatric and Adolescent Haemato-Oncology; University College Hospital; London United Kingdom
| | - C. Mauz-Körholz
- Department of Pediatric Hematology and Oncology; University Hospital Justus Liebig University; Giessen Germany
| | - M. Mascarin
- AYA and Pediatric Radiotherapy Unit; IRCCS Centro di Riferimento Oncologico; Aviano Italy
| | - G. Michel
- Service d'Hématologie pédiatrique; CHU de Marseille - Hôpital de la Timone; Maresille France
| | - S. Cooper
- Pediatric Oncology; Johns Hopkins Hospital; Baltimore United States
| | - A. Beishuizen
- Pediatric Oncology/Hematology; Princess Máxima Center for Pediatric Oncology; Utrecht Netherlands
| | - K.J. Leger
- Hematology-Oncology; Seattle Children's Hospital; Seattle United States
| | - A. Garaventa
- UOC Oncologia; Ematologia e Trapianto di Midollo, IRCCS Istituto Giannina Gaslini; Genoa Italy
| | - S. Buffardi
- Paediatric Haemato-Oncology; Santobono-Pausilipon Hospital; Naples Italy
| | - L. Brugières
- Department of Paediatrics; Institut Gustave Roussy; Villejuif France
| | - P. Harker-Murray
- Pediatric Hematology-Oncology; Children's Hospital of Wisconsin; Milwaukee United States
| | - P.D. Cole
- Division of Pediatric Hematology/Oncology; Rutgers Cancer Institute of New Jersey; New Brunswick United States
| | - R.A. Drachtman
- Division of Pediatric Hematology/Oncology; Rutgers Cancer Institute of New Jersey; New Brunswick United States
| | - T. Manley
- Seattle Genetics; Bothell United States
| | - S. Francis
- Bristol-Myers Squibb; Princeton United States
| | - M. Sacchi
- Bristol-Myers Squibb; Princeton United States
| | - T. Leblanc
- Service d'Hématologie Pédiatrique; Hôpital Robert-Debré APHP; Paris France
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47
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Spinelli A, Carvello M, Sacchi M, Bonifacio C, Bertuzzi A, Tuynman J, Montorsi M, Foppa C. Transanal minimally invasive surgery (TAMIS) for anterior rectal GIST. Tech Coloproctol 2019; 23:501-502. [PMID: 31037577 DOI: 10.1007/s10151-019-01979-y] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 03/29/2019] [Indexed: 11/26/2022]
Affiliation(s)
- A Spinelli
- Division of Colon and Rectal Surgery, Department of Surgery, Humanitas Clinical and Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
- Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy.
| | - M Carvello
- Division of Colon and Rectal Surgery, Department of Surgery, Humanitas Clinical and Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - M Sacchi
- Division of Colon and Rectal Surgery, Department of Surgery, Humanitas Clinical and Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - C Bonifacio
- Division of Diagnostic Radiology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - A Bertuzzi
- Division of Medical Oncology and Hematology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - J Tuynman
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - M Montorsi
- Division of General and Digestive Surgery, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - C Foppa
- Division of Colon and Rectal Surgery, Department of Surgery, Humanitas Clinical and Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
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48
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Ungaro F, Colombo P, Massimino L, Ugolini GS, Correale C, Rasponi M, Garlatti V, Rubbino F, Tacconi C, Spaggiari P, Spinelli A, Carvello M, Sacchi M, Spanò S, Vetrano S, Malesci A, Peyrin-Biroulet L, Danese S, D'Alessio S. Lymphatic endothelium contributes to colorectal cancer growth via the soluble matrisome component GDF11. Int J Cancer 2019; 145:1913-1920. [PMID: 30889293 DOI: 10.1002/ijc.32286] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 01/25/2019] [Accepted: 02/28/2019] [Indexed: 12/17/2022]
Abstract
Colorectal cancer (CRC) is one of the most malignant tumors worldwide. Stromal cells residing in the tumor microenvironment strongly contribute to cancer progression through their crosstalk with cancer cells and extracellular matrix. Here we provide the first evidence that CRC-associated lymphatic endothelium displays a distinct matrisome-associated transcriptomic signature, which distinguishes them from healthy intestinal lymphatics. We also demonstrate that CRC-associated human intestinal lymphatic endothelial cells regulate tumor cell growth via growth differentiation factor 11, a soluble matrisome component which in CRC patients was found to be associated with tumor progression. Our data provide new insights into lymphatic contribution to CRC growth, aside from their conventional role as conduits of metastasis.
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Affiliation(s)
- Federica Ungaro
- IBD Center, Laboratory of Gastrointestinal Immunopathology, Humanitas Clinical and Research Center, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Luca Massimino
- Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | | | - Carmen Correale
- IBD Center, Laboratory of Gastrointestinal Immunopathology, Humanitas Clinical and Research Center, Milan, Italy
| | - Marco Rasponi
- Department of Electronics, Information and Bioengineering, Milan, Italy
| | | | - Federica Rubbino
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Carlotta Tacconi
- Institute of Pharmaceutical Sciences, Pharmacogenomics, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Paola Spaggiari
- Department of Pathology, Humanitas Clinical and Research Center, Milan, Italy
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Colon and Rectal Surgery Unit, Humanitas Clinical and Research Center, Milan, Italy
| | - Michele Carvello
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Colon and Rectal Surgery Unit, Humanitas Clinical and Research Center, Milan, Italy
| | - Matteo Sacchi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Colon and Rectal Surgery Unit, Humanitas Clinical and Research Center, Milan, Italy
| | - Salvatore Spanò
- IBD Center, Laboratory of Gastrointestinal Immunopathology, Humanitas Clinical and Research Center, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Stefania Vetrano
- IBD Center, Laboratory of Gastrointestinal Immunopathology, Humanitas Clinical and Research Center, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alberto Malesci
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, Milan, Italy.,Department of Gastroenterology, Humanitas Clinical and Research Center, Milan, Italy
| | - Laurent Peyrin-Biroulet
- Institut National de la Santé et de la Recherche Médicale U954 and Department of Gastroenterology, Nancy University Hospital, Lorraine University, Nancy, France
| | - Silvio Danese
- IBD Center, Laboratory of Gastrointestinal Immunopathology, Humanitas Clinical and Research Center, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Silvia D'Alessio
- IBD Center, Laboratory of Gastrointestinal Immunopathology, Humanitas Clinical and Research Center, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
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49
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Carvello M, Sacchi M, Maroli A, Sharif A, Kotze P, Spinelli A. Redo pouch and re-stapled anastomosis after intra-operative detection of pouch ischaemia by fluorescence angiography - a video vignette. Colorectal Dis 2019; 21:374-375. [PMID: 30624850 DOI: 10.1111/codi.14550] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 02/08/2023]
Affiliation(s)
- M Carvello
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - M Sacchi
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - A Maroli
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - A Sharif
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - P Kotze
- Colorectal Unit, Department of Surgery, Pontifícias Universidade Católica (PUC-PR), Curitiba, Brazil
| | - A Spinelli
- Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
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50
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Popescu H, Perron J, Pilette B, Vacheresse R, Pinty V, Gaudemer R, Sacchi M, Delaunay R, Fortuna F, Medjoubi K, Desjardins K, Luning J, Jaouen N. COMET: a new end-station at SOLEIL for coherent magnetic scattering in transmission. J Synchrotron Radiat 2019; 26:280-290. [PMID: 30655496 DOI: 10.1107/s1600577518016612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 11/22/2018] [Indexed: 06/09/2023]
Abstract
A new instrument named COMET for COherent Magnetic scattering Experiments in Transmission using polarized soft X-rays has been designed and built. This high-vacuum setup is placed at the intermediate focal point of the elastic branch of the SEXTANTS beamline at Synchrotron SOLEIL. The main application is in solid state physics, the instrument being optimized for studying material properties using coherent scattering of soft X-rays with an emphasis on imaging, with chemical selectivity, the magnetic domains of artificially nano-structured materials. The instrument's principal features are presented and illustrated through recently performed experiments.
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Affiliation(s)
- H Popescu
- Synchrotron Soleil, Saint-Aubin, BP 48, 91192 Gif-sur-Yvette Cedex, France
| | - J Perron
- Synchrotron Soleil, Saint-Aubin, BP 48, 91192 Gif-sur-Yvette Cedex, France
| | - B Pilette
- Sorbonne Université, CNRS, UMR 7614, Laboratoire de Chimie Physique - Matière et Rayonnement, LCP-MR, 75005 Paris, France
| | - R Vacheresse
- Sorbonne Université, CNRS, UMR 7614, Laboratoire de Chimie Physique - Matière et Rayonnement, LCP-MR, 75005 Paris, France
| | - V Pinty
- Synchrotron Soleil, Saint-Aubin, BP 48, 91192 Gif-sur-Yvette Cedex, France
| | - R Gaudemer
- Synchrotron Soleil, Saint-Aubin, BP 48, 91192 Gif-sur-Yvette Cedex, France
| | - M Sacchi
- Synchrotron Soleil, Saint-Aubin, BP 48, 91192 Gif-sur-Yvette Cedex, France
| | - R Delaunay
- Sorbonne Université, CNRS, UMR 7614, Laboratoire de Chimie Physique - Matière et Rayonnement, LCP-MR, 75005 Paris, France
| | - F Fortuna
- CSNSM, Université Paris-Sud, Bâtiment 104, 91405 Orsay, France
| | - K Medjoubi
- Synchrotron Soleil, Saint-Aubin, BP 48, 91192 Gif-sur-Yvette Cedex, France
| | - K Desjardins
- Synchrotron Soleil, Saint-Aubin, BP 48, 91192 Gif-sur-Yvette Cedex, France
| | - J Luning
- Sorbonne Université, CNRS, UMR 7614, Laboratoire de Chimie Physique - Matière et Rayonnement, LCP-MR, 75005 Paris, France
| | - N Jaouen
- Synchrotron Soleil, Saint-Aubin, BP 48, 91192 Gif-sur-Yvette Cedex, France
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