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Rovere G, Smakaj A, De Mauro D, Marino S, Vitiello R, Meschini C, Ziranu A, Liuzza F, Maccauro G, Pataia E. Medial gastrocnemius flap for the treatment of infected knee prostheses. Eur Rev Med Pharmacol Sci 2022; 26:60-65. [PMID: 36448857 DOI: 10.26355/eurrev_202211_30283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Muscular flaps may represent a valid treatment option for prosthetic infection after knee arthroplasty. PATIENTS AND METHODS We present the results of 20 consecutive patients treated with the use of medial gastrocnemius flap for the management of different types of injuries or integumentary defects after total knee arthroplasty. Tissue necrosis or dehiscence occurred within 1 and 2 months after arthroplasty. The mean follow-up was 23.4 (12-60) months. Clinical outcome was evaluated according to the infection control rate and post-operative Knee Society Score (KSS). RESULTS Prosthesis salvage and complete restoration of skin coverage were achieved in all patients. Functional assessment was performed using the KSS score. The final knee KSS score was classified as excellent (score: 80-100) in 0 patients, good (score: 70-79) in 17 patients, fair (score: 60-69) in 2 patients, and poor (score: 60) in 1 patient. Residual Extension Deficit: 0-20°; Very Satisfactory in 17 patients. 30-70° Satisfactory in 2 patients, 80-90° Unsatisfactory in 1 patient. Patients who successfully underwent flap treatment experienced a much greater increase in both components of the KSS score. CONCLUSIONS The results highlight the effectiveness of medial gastrocnemius muscular flap for the treatment of prosthetic knee infection, in terms of function, limb salvage, cost-effectiveness and post-surgery quality of life. Further larger studies may consolidate these findings.
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Affiliation(s)
- G Rovere
- Orthopaedic Institute, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy.
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2
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Santagada DA, Perna A, Tullo G, Proietti L, Vitiello R, Ferraro S, Giovannini S, Gasbarrini A, Franceschi F, Maccauro G, Tamburrelli FC, Covino M. Could serum procalcitonin play a role in an emergency setting for patients with pyogenic spondylodiscitis? Eur Rev Med Pharmacol Sci 2022; 26:66-77. [PMID: 36448858 DOI: 10.26355/eurrev_202211_30284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Spinal infections, represent quite rare but often severe conditions. However, due to symptoms' non-specificity and the lack of specific laboratory tests, diagnosis is often delayed with serious consequences for the patient's outcomes. The present investigation aimed at evaluating the role of procalcitonin (PCT) and other clinical features on the risk stratification and the clinical outcomes in spondylodiscitis patients treated in our Emergency Department. PATIENTS AND METHODS The present investigation represents a single-center retrospective study. Clinical records of consecutive patients admitted to our Emergency Department from 1 January 2015 to 31 March 2021 were evaluated and patients with spondylodiscitis diagnosis in this period were recruited. Our primary outcome was the degree of autonomy of patients following the acute event. Our secondary outcome was the resolution of the infection. RESULTS In the study period, a total of 345 patients were evaluated. Among these, 165 met the inclusion criteria, and constituted the study cohort. Concerning the primary outcome, we observed that the most significant predictive factors for being non-autonomous were elevated serum creatinine (> 1.05 mg/dl), Blood Urea Nitrogen (BUN) > 23 mg/dl, Lactate dehydrogenase > 228 U/L, PCT > 0.11 ng/mL. Patients with higher PCT (PCT > 0.11 ng/mL) and higher BUN (BUN > 23 mg/dl) had higher odds of infection persistence (the Odd Ratio, OR, were respectively 3.78 for PCT and 3.14 for BUN). CONCLUSIONS PCT assay may play a role in diagnosing spondylodiscitis in an emergency setting. A PCT value > 0.11 ng/mL should be considered as a red flag, a predictor of worse clinical outcomes and persistence of infection.
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Affiliation(s)
- D A Santagada
- Department of Orthopedics, Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Rome, Italy.
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3
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Vitiello R, Smimmo A, De Fazio A, Bocchi MB, Oliva MS, Perna A, Maccauro G, Ziranu A. Megaprosthesis in articular fractures of the lower limbs in fragile patients: a proposal for the therapeutic algorithm. Eur Rev Med Pharmacol Sci 2022; 26:84-91. [PMID: 36448860 DOI: 10.26355/eurrev_202211_30286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The use of megaprosthetic implants could provide substantial advantages in elderly population affected by complex fractures. The aim of the study was to identify the patients suitable to megaprosthetic implants in the treatment of lower limbs fractures, as well as periprosthetic fractures. PATIENTS AND METHODS From January 1st, 2015, to December 31st, 2021, all patients affected by femoral fractures with severe bone loss or previous surgery failure were retrospectively reviewed. ADL, IADL, SF-12 values pre- and post-operative were recorded. Hemoglobin value, NLR, PLR were recorded pre- and peri-operatively for all patients. Complications were recorded. All patients underwent a radiological follow-up. Significance was set at p ≤ 0.05. RESULTS 23 patients were considered eligible, 10 males and 13 females; the mean age was 72.87 years old (± 12.33), while the mean BMI was 27.2 points (± 5.2). The mean follow-up was 2 years (± 1.4). The mean preoperative ADL and IADL scores were correlated with a positive independence of the patient, while the mean postoperative scores corresponded to a moderate-low independence. Also the mean Mental and Physical SF12 scores saw a decrease in values. NLR values were higher in the first group of patients with complications. CONCLUSIONS A careful multiparametric and multidisciplinary patient selection is required to identify the suitable patient to this treatment.
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Affiliation(s)
- R Vitiello
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy.
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4
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De Marco D, Meschini C, Caredda M, Messina F, Rovere G, Vitiello R, De Maio F, Ziranu A. COVID-19 lockdown and hip arthroplasty rehabilitation changes: mid-term clinical outcomes. Eur Rev Med Pharmacol Sci 2022; 26:53-59. [PMID: 36448856 DOI: 10.26355/eurrev_202211_30282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Hip arthroplasty is one of the most performed surgeries in orthopedics. Rehabilitation process after surgery allows rapid recovery of joint functions in absence of pain in most patients. During COVID-19 pandemic, rehabilitation clinics have reduced the number of beds available. Thus, an increasing number of patients were forced to home rehabilitation programs. Our study aimed at determining any significant differences in clinical and functional outcomes between those patients who underwent a home rehabilitation program and those others who were granted a place in a Rehabilitation clinic during COVID-19 pandemic, at mid-term follow-up. PATIENTS AND METHODS An observational retrospective single-center study was designed. The patients included were 63, divided into two groups: Group A (29 patients) for home rehabilitation, and Group B (34 patients) for clinic rehabilitation. Follow-up was performed at 1, 6 and 12 months after surgery. Clinical evaluation was assessed through Oxford Hip Score for hip function, Visual Analogue Scale (VAS) for pain and hip range of motion (ROM) to evaluate joint recovery. RESULTS ROM was compared at follow-up with significant differences 12 months after surgery (107.93° group A vs. 104.7° group B; p=0.0168). Pain felt by patients according to the VAS scale showed no significant differences at follow-up (1 month 3.27 vs. 3.65 p=0.1489; 6 months 1.89 vs. 2.18 p=0.105; 12 months 0.58 vs. 0.68 p=0.6263). Regarding the Oxford Hip score, significant differences emerged at 1-month follow-up (38.75 group A vs. 37.94 group B; p=0.0498). CONCLUSIONS At mid-term follow-up, little differences were found between patients who went through home rehabilitation and those who went to a rehabilitation clinic. Therefore, decreasing the number of beds available in rehab clinics during COVID-19 pandemic was not an obstacle for elective surgery for orthopedic surgeons.
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Affiliation(s)
- D De Marco
- Department of Orthopedics, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
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5
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Cianni L, Perna A, Pietramala S, De Fazio A, Oliva MS, Bocchi MB, Covino M, Ziranu A, Vitiello R. Correlation between Neutrophil-to-lymphocyte ratio and Euthyroid Sick Syndrome in elderly patients with proximal femur fractures. Eur Rev Med Pharmacol Sci 2022; 26:9-15. [PMID: 36448864 DOI: 10.26355/eurrev_202211_30277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Proximal femur fractures are among the most common type of trauma in elderly patients, and Euthyroid sick syndrome has already been related to fractures and trauma. The evidence of a consistent inflammatory state occurring during hip fracture, made us consider as a potential marker also the neutrophil-to-lymphocyte ratio (NLR), which is already in use to measure the prognosis and guide the therapeutic management in various conditions. PATIENTS AND METHODS A retrospective observational analysis on patients affected by proximal femur fractures was conducted. Patients were divided between affected and non-affected by Euthyroid Sick Syndrome (ESS). Standard follow up was conducted at 1, 3, 6 and 12 months. RESULTS 79 patients were enrolled in this study. There were 19 males and 60 females, the mean age was 83.8 ± 6.5 y.o., and 44 patients were affected by ESS. Affected patients showed higher NLR values (10.2 ± 9.4 vs. 6.9 ± 3.9; p= 0.001) and higher decrease in fT3 values in the 1st post-operative day (1.8 ± 0.4 vs. 2.2 ± 0.3; p= 0.001), higher values of PTH (97.9 ± 46.2 vs. 70.1 ± 36.2; p=0.004) and lower levels of Vitamin D (18.8 ± 7.8 vs. 23.5 ± 12.9; p= 0.04). As regards complications, we found them in 27% of patients in group A, while only in 8% in Group B, with a statistically significant difference (p= 0.03). CONCLUSIONS ESS and NLR are promising prognostic markers in PFF in the elderly patients. If used together, they could help in the pre- and post-operative management of the patients.
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Affiliation(s)
- L Cianni
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy.
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6
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Ziranu A, Bocchi MB, Oliva MS, Meschini C, Messina F, Calori S, Vitiello R. Survivorship of proximal femoral replacement in neoplastic and non-neoplastic elderly patients. Eur Rev Med Pharmacol Sci 2022; 26:106-112. [PMID: 36448862 DOI: 10.26355/eurrev_202211_30289] [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] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Massive bone loss is a serious problem in the elderly. Joint replacement with modular prostheses represents the most common reconstructive technique after oncological and non-oncological resections. Megaprostheses are broadly available, adaptable and versatile and allow early mobilization and rehabilitation. Although segmental endoprosthetic implants are now widely used and despite innovations, complications remain far high. Our purpose is to establish what happens to megaprostheses of a specific anatomical site in the long term in a population with oncologic and non-oncologic indications treated at a single center solely by a few skilled surgeons. MATERIALS AND METHODS We retrospectively reviewed our institutional database. We collected 35 patients who underwent endoprosthetic reconstruction exclusively of the proximal femur for neoplastic and non-neoplastic disease between 2008 and 2021. The minimum follow-up was 12 months. Complications were collected and classified, and also adapted to the non-oncological setting. RESULTS Taking into consideration the entire population, 94% of this survived the follow-up at 6 months, subsequently 85% at 1 year and 82% at 2 years. At follow-ups after 5 years, 79% of megaprostheses showed no mechanical failure. Analyzing prosthetic survival in the two groups, this was >50% at 24 months after surgery in both groups, with better survival for the oncological one. CONCLUSIONS Proximal femur replacement can be a valid option in treatment of oncological and non-oncological cases. Due to the high complication rate, only selected cases should undergo this kind of surgical procedure.
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Affiliation(s)
- A Ziranu
- Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
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7
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Vitiello R, Bocchi MB, Gessi M, Greco T, Cianni L, de Maio F, Pesce V, Maccauro G, Perisano C. Induced membrane by silver-coated knee megaprosthesis: keep or toss? J BIOL REG HOMEOS AG 2021; 34:101-106. IORS Special Issue on Orthopedics. [PMID: 33739013] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2022]
Abstract
In the orthopaedic field the foreign body reaction is well known for therapeutic purposes in the alleged Masquelet technique consisting of segmental bone loss two-stage reconstruction. The induced membrane creates advantageous local conditions that promote bone graft remodeling and osteointegration. The aim of our study was to describe the first two cases in Literature of induced membrane observed following silver-coated knee megaprosthesis reconstruction. In addition, it was our interest to evaluate their histological features.
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Affiliation(s)
- R Vitiello
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - M B Bocchi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - M Gessi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - T Greco
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - L Cianni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - F de Maio
- Università di Roma "Tor Vergata", Italia
| | - V Pesce
- Policlinico Riuniti di Foggia, Italia.,Università degli studi di Foggia, Italia
| | - G Maccauro
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - C Perisano
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
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8
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Perisano C, Vitiello R, Sgambato A, Greco T, Cianni L, Ragonesi G, Malara T, Maccauro G, Martini M. Evaluation of PD1 and PD-L1 expression in high-grade sarcomas of the limbs in the adults: possible implications of immunotherapy. J BIOL REG HOMEOS AG 2020; 34:289-294. Congress of the Italian Orthopaedic Research Society. [PMID: 33261292] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2022]
Abstract
Sarcomas are a heterogeneous group of rare tumours. Improvements in immunotherapy and the important role of PD1 and PD-L1 expression in advancement and prognosis have opened new fields of research for the treatment of these neoplasia. We evaluated the immunohistochemistry of PD1 and PD-L1 expression in 60 adults' patients affected by high-grade sarcomas of the limbs. PD1 expression was 65% while PD-L1 was 68.3%. PD-L1 expression seems to correlate to Ki67 in liposarcomas, fibrosarcoma's and pleomorphic sarcomas, while it does not show any correlation to chondrosarcomas, while in rhabdomyosarcomas there is a correlation but, given the small sample size, it was not possible to perform a statistic analysis. Our study shows positivity among the different subgroups of positive PD1 lymphocytes infiltration and PD-L1 expression in high-grade sarcomas of the limbs.
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Affiliation(s)
- C Perisano
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - R Vitiello
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - A Sgambato
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - T Greco
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - L Cianni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - G Ragonesi
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - T Malara
- Università di Messina, Messina, Italia
| | - G Maccauro
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - M Martini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
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Galli M, Vergari A, Vitiello R, Nestorini R, Peruzzi M, Chierichini A, Spinazzola G, Rossi M. Comparative Evaluation of Two Different Post-Operative Analgesia after Hallux Valgus Correction in Day Surgery Patients. Malays Orthop J 2020; 14:57-63. [PMID: 32983378 PMCID: PMC7513642 DOI: 10.5704/moj.2007.013] [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] [Indexed: 11/05/2022] Open
Abstract
Introduction The aim of this study was the evaluation of two different techniques on post-operative analgesia and motor recovery after hallux valgus correction in one-day surgery patients. Material and Methods We enrolled 26 patients scheduled for hallux valgus surgery and treated with the same surgical technique (SCARF osteotomy). After subgluteal sciatic nerve block with a short acting local anaesthetic (Mepivacaine 1.5%, 15ml), each patient received an ultrasound-guided Posterior Tibialis Nerve Block (PTNB) with Levobupivacaine 0.5% (7-8ml). We measured the postoperative intensity of pain using a Visual Analogue Scale (VAS), the consumption of oxycodone after operative treatment and the motor recovery. VAS was detected at baseline (time 0, before the surgery) and at 3, 6, 12 and 24 hours after the operative procedure (T1, T2, T3, T4 respectively). Control group of 26 patients were treated with another post-operative analgesia technique: local infiltration (Local Infiltration Anaesthesia, LIA) with Levobupivacaine 0.5% (15ml) performed by the surgeon. Results PTNB group showed a significant reduction of VAS score from the sixth hour after surgery compared to LIA group (p<0.028 at T2, p<0.05 at T3 and p<0.002 at T4, respectively). Instead, no significant differences were found in terms of post-operative oxycodone consumption and motor recovery after surgery.Conclusions: PTNB resulted in a valid alternative to LIA approach for post-operative pain control due to its better control of post-operative pain along the first 24 hours. In a multimodal pain management according to ERAS protocol, both PTNB and LIA should be considered as clinically effective analgesic techniques.
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Affiliation(s)
- M Galli
- Department of Orthopaedics and Traumatology, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - A Vergari
- Department of Anaesthesiology, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - R Vitiello
- Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - R Nestorini
- Department of Anaesthesiology, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - M Peruzzi
- Department of Orthopaedics and Traumatology, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - A Chierichini
- Department of Anaesthesiology, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - G Spinazzola
- Department of Anaesthesiology, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - M Rossi
- Department of Anaesthesiology, Universita Cattolica del Sacro Cuore, Rome, Italy
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10
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Greco T, Vitiello R, Cazzato G, Cianni L, Malerba G, Maccauro G, Perisano C. Intramedullary antibiotic coated nail in tibial fracture: a systematic review. J BIOL REG HOMEOS AG 2020; 34:63-69. ADVANCES IN MUSCULOSKELETAL DISEASES AND INFECTIONS - SOTIMI 2019. [PMID: 32856442] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2022]
Abstract
Implant-associated infections remain one of the main problems in trauma surgery, particularly for treatment of open tibial fractures. The role of systemic antibiotic prophylaxis is now established and accepted, but recent literature also seems to emphasize the importance of local antibiotic prophylaxis. Antibiotic coated nails play a crucial role, allowing at the same time the prevention of infections and favoring the stabilization of fractures. These devices appear to be a clinically effective and safe solution. The purpose of the study was to investigate the role of antibiotic coated nails in the treatment of tibia fractures. A literature review was performed on MEDLINE through PubMed to identify scientific publications relevant to the use of antibiotic coated nails in tibial fractures. Primary outcomes were infection rate and bone union rate. This review present numerous limits due primarily to the small number and different nature of studies published; the heterogeneity of the devices used.
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Affiliation(s)
- T Greco
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - R Vitiello
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - G Cazzato
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - L Cianni
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - G Malerba
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - G Maccauro
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - C Perisano
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
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11
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Basilico M, Vitiello R, Oliva MS, Covino M, Greco T, Cianni L, Dughiero G, Ziranu A, Perisano C, Maccauro G. Predictable risk factors for infections in proximal femur fractures. J BIOL REG HOMEOS AG 2020; 34:77-81. ADVANCES IN MUSCULOSKELETAL DISEASES AND INFECTIONS - SOTIMI 2019. [PMID: 32856444] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2022]
Abstract
Proximal femur fractures are increasing, together with the aging of world population. One of the complications worsening this condition is infection. In this study, we try to identify risk factors that can lead to infection. We identified 122 patients with femoral neck fracture. The occurrence of infectious events were recorded (respiratory, urinary, superficial wound and periprostethic infection). There were 15 infections, mostly urinary and pulmonary, and all were treated using antibiotics. No statistical differences were found between infection and control group regarding waiting time for surgery, mean time of surgery, age, kind of fracture, type of surgery. Fever onset >38° within 72 hours from surgery was statistically correlated with early infections. Future studies must be led to identify risk factors for infection and to create a strategy to prevent this possibly lethal complication.
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Affiliation(s)
- M Basilico
- Institute of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, Rome, Italy.,Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
| | - R Vitiello
- Institute of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, Rome, Italy.,Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
| | - M S Oliva
- Institute of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, Rome, Italy.,Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
| | - M Covino
- Institute of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, Rome, Italy.,Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
| | - T Greco
- Institute of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, Rome, Italy.,Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
| | - L Cianni
- Institute of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, Rome, Italy.,Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
| | - G Dughiero
- Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
| | - A Ziranu
- Institute of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, Rome, Italy.,Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
| | - C Perisano
- Institute of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, Rome, Italy.,Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
| | - G Maccauro
- Institute of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, Rome, Italy.,Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
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12
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Careri S, Vitiello R, Oliva MS, Ziranu A, Maccauro G, Perisano C. Masquelet technique and osteomyelitis: innovations and literature review. Eur Rev Med Pharmacol Sci 2020; 23:210-216. [PMID: 30977888 DOI: 10.26355/eurrev_201904_17495] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Wide diaphyseal bone defects, above all those infected, encounter into Masquelet technique a suitable treatment. The two-step procedure allows the surgeon to eliminate the infected tissues and then to promote new bone formation. We analyzed the literature about the use of the induced membrane technique in osteomyelitis and the innovations recently suggested. MATERIALS AND METHODS We reviewed some of the most common web databases using the key-words: Masquelet technique, induced membrane, and osteomyelitis. 66 studies were analyzed. RESULTS Comparing the Masquelet technique to other surgical procedures it shows better functional results in large bone defects due to infection. The induced membrane is like a biological chamber that protects the autograft and induces new bone formation promoting growth factors secretion. Different authors tried to improve one or more steps of the surgical procedure. Some studies focused on polymethyl methacrylate role and the possibility to use different materials instead of cement to induce the membrane. Others analyzed the autograft harvesting and placing techniques trying to reduce the amount of bone essential to fill the gap, like the RIA technique. Moreover, bone substitutes have been used, as beta-tricalcium phosphate, that showed an osteoconductive ability. CONCLUSIONS The survey is not a systematic review. Nevertheless, new concepts are introduced and analyzed identifying 6 areas of interest and induced membrane technique development.
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Affiliation(s)
- S Careri
- Department of Orthopaedics and Traumatology, Institute of Scientific Research, Children's Hospital Bambino Gesù, Rome, Italy.
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13
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Pitocco D, Spanu T, Di Leo M, Vitiello R, Rizzi A, Tartaglione L, Fiori B, Caputo S, Tinelli G, Zaccardi F, Flex A, Galli M, Pontecorvi A, Sanguinetti M. Diabetic foot infections: a comprehensive overview. Eur Rev Med Pharmacol Sci 2020; 23:26-37. [PMID: 30977868 DOI: 10.26355/eurrev_201904_17471] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Diabetic foot ulcers (DFUs), a micro-vascular complication, are associated with a substantial increase in morbidity and mortality. DFUs are a complicated mixture of neuropathy, peripheral arterial diseases, foot deformities, and infections. Foot infections are frequent and potentially devastating complications. Infection prospers in more than half of all foot ulcers and is the factor that most often leads to lower extremity amputation. The complications of microbial flora span the spectrum from superficial cellulitis to chronic osteomyelitis and gangrenous extremity lower limb amputations. Wounds without confirmed soft tissue or bone infections do not require antibiotic therapy. Mild and moderate infections need empiric therapy covering Gram-positive cocci, while severe infections caused by drug-resistant organisms require broad-spectrum anti-microbials targeting aggressive Gram-negative aerobes and obligate anaerobes.
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Affiliation(s)
- D Pitocco
- Diabetes Care Unit, Endocrinology, University Hospital "A. Gemelli", Catholic University of the Sacred Heart, Rome, Italy.
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14
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El Ezzo O, Oliva MS, Cauteruccio M, Saracco M, Vitiello R, Maccauro G, Perisano C. Innovations in prevention of infections in oncological megaprostheses: a narrative review. J BIOL REG HOMEOS AG 2020; 34:275-278. Congress of the Italian Orthopaedic Research Society. [PMID: 33261289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Infection is a significant complication in oncological megaprostheses. The purpose of our study is to indagate the innovations and new trend about the prevention of infection in this kind of surgery. The research focused on the use of antimicrobic prophylaxis, the defensive antibacterial coating and the use of silver coated.
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Affiliation(s)
- O El Ezzo
- Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
| | - M S Oliva
- Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
| | - M Cauteruccio
- Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
| | - M Saracco
- Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
| | - R Vitiello
- Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
| | - G Maccauro
- Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
| | - C Perisano
- Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
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15
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Vitiello R, Segala FV, Oliva MS, Cauteruccio M, Novarese C, Perisano C, Maccauro G, Fantoni M. Ankle fracture and necrotizing fasciitis: a common fracture and a dreadful complication. J BIOL REG HOMEOS AG 2020; 34:71-75. ADVANCES IN MUSCULOSKELETAL DISEASES AND INFECTIONS-SOTIMI 2019. [PMID: 32856443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Necrotizing fasciitis is a dreadful complication of the soft tissue. This pathology could be triggered by many factors, such as a fracture. We present a case of case of a necrotizing fasciitis in ankle fracture.
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Affiliation(s)
- R Vitiello
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - F V Segala
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - M S Oliva
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - M Cauteruccio
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - C Novarese
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - C Perisano
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - G Maccauro
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - M Fantoni
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
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16
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Cauteruccio M, Perna A, Vitiello R, Oliva MS, Pesare E, Ziranu A, Merendi G. A rare case of post-traumatic infected pilomatricoma of the finger of the hand diagnosed after performing radioiodine therapy. J BIOL REG HOMEOS AG 2020; 34:83-87. ADVANCES IN MUSCULOSKELETAL DISEASES AND INFECTIONS-SOTIMI 2019. [PMID: 32856445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We present the clinical case of a young woman with pilomatricoma of the finger, a very rare location. The patient got infected after receiving radioiodine therapy to treat a thyroid carcinoma. Given the patient's high functional requirements we choose a minimal treatment which allowed her to maintain a sufficient functionality.
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Affiliation(s)
- M Cauteruccio
- Institute of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, Rome, Italy
- Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
| | - A Perna
- Institute of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, Rome, Italy
- Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
| | - R Vitiello
- Institute of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, Rome, Italy
- Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
| | - M S Oliva
- Institute of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, Rome, Italy
- Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
| | - E Pesare
- Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
| | - A Ziranu
- Institute of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, Rome, Italy
- Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
| | - G Merendi
- Institute of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, Rome, Italy
- Institute of Orthopedics, Università Cattolica del Sacro Cuore - Largo Francesco Vito 1, Rome, Italy
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17
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Oliva MS, Masci G, Vitiello R, De Santis V, Liuzza F, Grasso A, Minutillo F, Maccauro G, Cazzato G. Hip megaprosthesis in oncological surgery: open questions. J BIOL REG HOMEOS AG 2019; 33:45-49. XIX Congresso Nazionale S.I.C.O.O.P. Societa' Italiana Chirurghi Ortopedici Dell'ospedalita' Privata Accreditata. [PMID: 31169002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Prosthetic replacement with modular implants has become the most common reconstructive tech¬nique of bone loss of the lower limb after tumour resection. The use of the megaprosthesis in bone metastasis, silver-coated megaprosthesis and the use of Trevira tube are not uniform and represent an "open question" about the use of megaprosthesis. The following paper aims to review the current literature in this topic.
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Affiliation(s)
- M S Oliva
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - G Masci
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - R Vitiello
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - V De Santis
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - F Liuzza
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - A Grasso
- Villa Valeria Clinic, Rome, Italy
| | - F Minutillo
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - G Maccauro
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - G Cazzato
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
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18
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Perisano C, Greco T, Vitiello R, Maccauro G, Liuzza F, Tamburelli FC, Forconi F. Mueller-Weiss disease: review of the literature. J BIOL REG HOMEOS AG 2019; 32:157-162. [PMID: 30644297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2022]
Abstract
Müller-Weiss (MW) disease is a spontaneous osteonecrosis of the tarsal navicular bone in adults. It is a rare cause of chronic medial midfoot pain and deformity characterized by the collapse of the dorso-lateral part of the navicular, progressive navicular fragmentation and talonavicular joint destruction. This study provides a review of the literature about the epidemiology, etio-pathogenesis, clinical, radiological findings and therapeutic alternatives.
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Affiliation(s)
- C Perisano
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - T Greco
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - R Vitiello
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - G Maccauro
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - F Liuzza
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - F C Tamburelli
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - F Forconi
- Ospedale San Giovanni Calibita, Fatebenefratelli, Ordine Ospedaliero San Giovanni di Dio, Roma, Italia
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19
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Russo V, Santacesaria E, Tesser R, Turco R, Vitiello R, Di Serio M. Validation of the Kinetics of the Hydrogen Peroxide Propene Oxide Process in a Dynamic Continuous Stirred Tank Reactor. Ind Eng Chem Res 2018. [DOI: 10.1021/acs.iecr.8b03233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- V. Russo
- Chemical Sciences Department, and CIRCC, Università di Napoli Federico II, IT-80126 Napoli, Italy
| | | | - R. Tesser
- Chemical Sciences Department, and CIRCC, Università di Napoli Federico II, IT-80126 Napoli, Italy
| | - R. Turco
- Chemical Sciences Department, and CIRCC, Università di Napoli Federico II, IT-80126 Napoli, Italy
| | - R. Vitiello
- Chemical Sciences Department, and CIRCC, Università di Napoli Federico II, IT-80126 Napoli, Italy
| | - M. Di Serio
- Chemical Sciences Department, and CIRCC, Università di Napoli Federico II, IT-80126 Napoli, Italy
- International Research Organization for Advanced Science and Technology, University of Kumamoto, 860-8555 Kumamoto, Japan
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20
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Cazzato G, Masci G, Liuzza F, Capasso L, Florio M, Perisano C, Vitiello R, Ciolli G, Maccauro G. Secondary femur fracture following treatment with anterograde nailing: the state of the art. J BIOL REG HOMEOS AG 2018; 32:151-155. [PMID: 30644296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Cephalomedullary nailing (CMN) currently represents the best surgical technique for the treatment of intertrochanteric hip fractures. Although the success of CMN in terms of functional recovery and fracture healing, in clinical practice there are many complications. Later femur fracture following treatment of trochanteric fracture with CMN is not a very frequent complication but, when it occurs, its treatment is the most complex, because of the increase of peri-operative mortality. There are studies in literature, which have demonstrated that the incidence of this complication is about 0.5-3%. Diagnosis and classification are made with standard radiographs, using the AO classification and the modified Vancouver classification. In the actual literature, to determinate the predisposing factor to the secondary fractures, the authors focused their attention on patient-related and surgical related risk factors. The treatment is variable and it depends on the type and characteristics of fracture and device. Outcomes analyzed in literature were mortality and bone healing. The aim of this manuscript is to provide an overview of this topic and to describe the state of the art of the secondary fracture after surgical treatment with intramedullary nailing.
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Affiliation(s)
- G Cazzato
- Ortopedia e Traumatologia, Istituto di Clinica Ortopedica, Dipartimento di Geriatria, Neuroscienze ed Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - G Masci
- Ortopedia e Traumatologia, Istituto di Clinica Ortopedica, Dipartimento di Geriatria, Neuroscienze ed Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - F Liuzza
- Ortopedia e Traumatologia, Istituto di Clinica Ortopedica, Dipartimento di Geriatria, Neuroscienze ed Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - L Capasso
- Ortopedia e Traumatologia, Istituto di Clinica Ortopedica, Dipartimento di Geriatria, Neuroscienze ed Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - M Florio
- Ortopedia e Traumatologia, Istituto di Clinica Ortopedica, Dipartimento di Geriatria, Neuroscienze ed Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - C Perisano
- Ortopedia e Traumatologia, Istituto di Clinica Ortopedica, Dipartimento di Geriatria, Neuroscienze ed Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - R Vitiello
- Ortopedia e Traumatologia, Istituto di Clinica Ortopedica, Dipartimento di Geriatria, Neuroscienze ed Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - G Ciolli
- Ortopedia e Traumatologia, Istituto di Clinica Ortopedica, Dipartimento di Geriatria, Neuroscienze ed Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - G Maccauro
- Ortopedia e Traumatologia, Istituto di Clinica Ortopedica, Dipartimento di Geriatria, Neuroscienze ed Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
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Rampello G, Zaiat M, Leonardi P, Guida L, Benenati S, Vitiello R, Perticone S, Titone V, Possumato R, Siddi V, Grisetti R. The evolution of palliative care from the oncology patient to the chronic illness. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx436.020] [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: 11/12/2022] Open
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Vitiello R, Tesser R, Turco R, Santacesaria E, Compagnone G, Di Serio M. A critical review on analytical methods and characterization of butyl and bromobutyl rubber. International Journal of Polymer Analysis and Characterization 2017. [DOI: 10.1080/1023666x.2017.1297887] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- R. Vitiello
- Department of Chemical Sciences, University of Naples “Federico II,” Naples, Italy
| | - R. Tesser
- Department of Chemical Sciences, University of Naples “Federico II,” Naples, Italy
| | - R. Turco
- Department of Chemical Sciences, University of Naples “Federico II,” Naples, Italy
| | | | | | - M. Di Serio
- Department of Chemical Sciences, University of Naples “Federico II,” Naples, Italy
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Vitiello R, Tesser R, Santacesaria E, Di Serio M. New Production Processes of Dichlorohydrins from Glycerol Using Acyl Chlorides as Catalysts or Reactants. Ind Eng Chem Res 2016. [DOI: 10.1021/acs.iecr.5b03765] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R. Vitiello
- Department
of Chemical Sciences, University of Naples “Federico II”, Via Cinthia 80126, Naples, Italy
- Consorzio Interuniversitario di Reattività Chimica e Catalisi (CIRCC), Via Celso Ulpiani 70126, Bari, Italy
| | - R. Tesser
- Department
of Chemical Sciences, University of Naples “Federico II”, Via Cinthia 80126, Naples, Italy
- Consorzio Interuniversitario di Reattività Chimica e Catalisi (CIRCC), Via Celso Ulpiani 70126, Bari, Italy
| | | | - M. Di Serio
- Department
of Chemical Sciences, University of Naples “Federico II”, Via Cinthia 80126, Naples, Italy
- Consorzio Interuniversitario di Reattività Chimica e Catalisi (CIRCC), Via Celso Ulpiani 70126, Bari, Italy
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Tesser R, Vitiello R, Carotenuto G, Garcia Sancho C, Vergara A, Maireles Torres P, Li C, Di Serio M. Niobia supported on silica as a catalyst for Biodiesel production from waste oil. ACTA ACUST UNITED AC 2015. [DOI: 10.1515/cse-2015-0002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractThe activity and stability of niobia supported
on silica catalyst have been tested in continuous
micro-pilot reactors, for biodiesel production starting
from acid vegetable oils. A catalyst was prepared
by the impregnation of silica pellets with a loading
of 12% of Nb and was extensively characterized.
The activity of this catalyst in both esterification and
transesterification was tested in a continuous micro-pilot
laboratory plant in which acid oil was fed (FFA 10% w/w)
at a temperature of 220°C and at a pressure of 60 bar.
The niobia based catalyst resulted in a very active
catalyst in both esterification (FFA conversion =
95-90%) and transesterification reactions (FAME
yield = 80-90%), and the activity remained
quite constant for more than 100 h on stream.
Notwithstanding this stability, a non-negligible leaching
phenomena has been detected, in the case of long-time
continuous runs, as the Nb concentration on the spent
catalyst resulted lower than that on the fresh one. The
obtained result confirms that the leaching of the active
specie is one of the most strong problem in heterogeneous
catalysis for biodiesel production.
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Affiliation(s)
- R. Tesser
- 1University of Naples ‘’Federico II’, Faculty of Science MM.FF.NN., Department of Chemical Science
- 2CIRCC, Italy
| | - R. Vitiello
- 1University of Naples ‘’Federico II’, Faculty of Science MM.FF.NN., Department of Chemical Science
- 2CIRCC, Italy
| | - G. Carotenuto
- 1University of Naples ‘’Federico II’, Faculty of Science MM.FF.NN., Department of Chemical Science
| | - C. Garcia Sancho
- 3University of Málaga, Faculty of Sciences, Department of Inorganic Chemistry, Crystallography and Mineralogy
| | - A. Vergara
- 1University of Naples ‘’Federico II’, Faculty of Science MM.FF.NN., Department of Chemical Science
| | - P.J. Maireles Torres
- 1University of Naples ‘’Federico II’, Faculty of Science MM.FF.NN., Department of Chemical Science
- 3University of Málaga, Faculty of Sciences, Department of Inorganic Chemistry, Crystallography and Mineralogy
| | | | - M. Di Serio
- 1University of Naples ‘’Federico II’, Faculty of Science MM.FF.NN., Department of Chemical Science
- 2CIRCC, Italy
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25
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Vitiello R, Russo V, Turco R, Tesser R, Di Serio M, Santacesaria E. Glycerol chlorination in a gas-liquid semibatch reactor: New catalysts for chlorohydrin production. Chinese Journal of Catalysis 2014. [DOI: 10.1016/s1872-2067(14)60069-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Denaro N, Russi EG, Numico G, Pazzaia T, Vitiello R, Merlano MC. The role of neck dissection after radical chemoradiation for locally advanced head and neck cancer: should we move back? Oncology 2013; 84:174-85. [PMID: 23306430 DOI: 10.1159/000346132] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 11/19/2012] [Indexed: 01/12/2023]
Abstract
Until a few decades ago neck dissection (ND) was the standard surgical approach for node-positive tumours. Nowadays patients with locally advanced head and neck cancer can be treated with definitive chemoradiation (CRT), which includes the treatment of the neck; however, results on residual viable tumour after conservative treatment are heterogeneous and depend on initial node stage and primary treatment. Many authors accept adjuvant surgery in patients with N2-3 disease. Regardless of the results of upfront CRT, even if there is no evidence of lymph node metastases, when the risk for persistent positive neck nodes exceeds 15-20%, elective ND might be indicated. However, despite the diffusion of innovative technologies and therapies, there are controversies about both response evaluation and surgical management of initially involved neck nodes after definitive CRT and organ preservation treatment. In this paper we will analyse state of art of neck evaluation after CRT and discuss the role of ND.
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Affiliation(s)
- N Denaro
- Messina University, Messina, Italy.
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Tesser R, Di Serio M, Vitiello R, Russo V, Ranieri E, Speranza E, Santacesaria E. Glycerol Chlorination in Gas–Liquid Semibatch Reactor: An Alternative Route for Chlorohydrins Production. Ind Eng Chem Res 2011. [DOI: 10.1021/ie201629z] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- R. Tesser
- Department of Chemistry of the University of Naples “Federico II”, Complesso Universitario Monte S. Angelo, Via Cintia 4, IT 80126 Naples, Italy
| | - M. Di Serio
- Department of Chemistry of the University of Naples “Federico II”, Complesso Universitario Monte S. Angelo, Via Cintia 4, IT 80126 Naples, Italy
| | - R. Vitiello
- Department of Chemistry of the University of Naples “Federico II”, Complesso Universitario Monte S. Angelo, Via Cintia 4, IT 80126 Naples, Italy
| | - V. Russo
- Department of Chemistry of the University of Naples “Federico II”, Complesso Universitario Monte S. Angelo, Via Cintia 4, IT 80126 Naples, Italy
| | - E. Ranieri
- Department of Chemistry of the University of Naples “Federico II”, Complesso Universitario Monte S. Angelo, Via Cintia 4, IT 80126 Naples, Italy
| | - E. Speranza
- Department of Chemistry of the University of Naples “Federico II”, Complesso Universitario Monte S. Angelo, Via Cintia 4, IT 80126 Naples, Italy
| | - E. Santacesaria
- Department of Chemistry of the University of Naples “Federico II”, Complesso Universitario Monte S. Angelo, Via Cintia 4, IT 80126 Naples, Italy
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Merlano M, Russi E, Benasso M, Corvò R, Colantonio I, Vigna-Taglianti R, Vigo V, Bacigalupo A, Numico G, Crosetto N, Gasco M, Lo Nigro C, Vitiello R, Violante S, Garrone O. Cisplatin-based chemoradiation plus cetuximab in locally advanced head and neck cancer: a phase II clinical study. Ann Oncol 2010; 22:712-717. [PMID: 20810547 DOI: 10.1093/annonc/mdq412] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Intensification of chemoradiation for advanced head and neck squamous cell carcinoma (HNSCC) is unlikely due to toxicity. Cetuximab combined either with radiotherapy or with chemotherapy showed favourable toxic profile with positive results in both combinations. Therefore, cetuximab could intensify chemoradiation without worsening toxicity. We conducted a phase II study of chemoradiation and cetuximab. PATIENTS AND METHODS Eligible patients had stage III-IV M0 HNSCC. Treatment consisted of three cycles of cisplatin (20 mg/m(2)/day × 5 days) and fluorouracil (200 mg/m(2)/day × 5 days) rapidly alternated to three split courses of radiotherapy up to 70 Gy and concurrent weekly cetuximab. The primary end point of the study was complete response (CR) rate. Secondary end points were toxicity, progression-free survival (PFS) and overall survival (OS). RESULTS Fourty-five patients were enrolled: median age was 56 years, 38 had stage IV disease and 40 nodal involvement. CR occurred in 32 patients (71%). PFS and OS was 21+ months and 32.6+, respectively. Acute grade 3-4 toxic effects were in the expected range, but grade 3 radiodermatitis occurred in 33 patients. CONCLUSIONS The combination of cetuximab, cisplatin, fluorouracil and radiotherapy leads to a very high proportion of CR and it is feasible with toxic effects similar to those expected by radiochemotherapy. The only unexpected toxicity was skin toxicity: grade 3 radiodermatitis occurred in 73% of the patients.
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Affiliation(s)
| | - E Russi
- Department of Radiation Therapy, S. Croce General Hospital, Cuneo
| | - M Benasso
- Department of Medical Oncology, La Spezia General Hospital, La Spezia
| | - R Corvò
- Department of Radiation Therapy, National Institute for Cancer Research, Genoa
| | | | | | - V Vigo
- Department of Medical Oncology, La Spezia General Hospital, La Spezia
| | - A Bacigalupo
- Department of Radiation Therapy, National Institute for Cancer Research, Genoa
| | - G Numico
- Department of Medical Oncology, Aosta General Hospital, Aosta
| | | | - M Gasco
- Department of Medical Oncology
| | | | | | - S Violante
- Clinical Trials Office, Department of Medical Oncology, S. Croce General Hospital, Cuneo, Italy
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Pisanti R, Vitiello R, Formicola S, Pisanti A. Infant botulism mimicking an acute abdomen. Infez Med 2009; 17:254-256. [PMID: 20046108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Botulism is the acute, flaccid paralysis caused by a neurotoxin produced by Clostridium botulinum. In the infant, clinical symptoms are usually unspecific such as poor feeding, weak suck, feeble cry, drooling, followed by a symmetric, descending, flaccid paralysis beginning with the cranial nerve musculature. The initial symptoms of the disease are often similar to several diseases and therefore differential diagnosis is very difficult and rarely suspected by the physician. Since 2004 only 22 cases of infant botulism have been reported in Italy. Since most paediatricians are unfamiliar with the clinical manifestations of infant botulism, the diagnosis can be easily missed. Hence the disease may well be underestimated and underreported. We report a clinical case of botulism presenting initially with abdominal distention, thereby mimicking acute abdomen.
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Affiliation(s)
- R Pisanti
- Dipartimento di Pediatria, Universita degli Studi di Napoli Federico II, Napoli, Italy
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30
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Colantonio I, Russi E, Numico G, Cipolat M, Mattiot VP, Vitiello R, Merlano M. 8579 Re-irradiation with Cetuximab in relapsed squamous cell carcinoma of the head and neck (HNC). EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71670-2] [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: 10/20/2022] Open
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31
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Faglia E, Clerici G, Clerissi J, Caminiti M, Quarantiello A, Curci V, Losa S, Vitiello R, Lupattelli T, Somalvico F. Angioplasty for Diabetic Patients with Failing Bypass Graft or Residual Critical Ischemia after Bypass Graft. J Vasc Surg 2008. [DOI: 10.1016/j.jvs.2008.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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32
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Gasco M, Syed N, Taylor J, Smith P, Crook T, Vitiello R, Merlano M. Transcriptional silencing of dual specificity phosphatase type 2 (DUSP2) abrogates drug-induced apoptosis and predicts cisplatin resistance in head and neck squamous carcinomas. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.11030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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33
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Sorrentino R, Vitiello R, Castelli ML. Angiosarcoma of the larynx. Case report and review of the literature. Acta Otorhinolaryngol Ital 2003; 23:191-3. [PMID: 14677313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Angiosarcoma of the larynx is a rare malignant tumour of vascular origin, accounting for less than 1% of all malignant tumours of the larynx. Angiosarcoma involves, in particular, the head and neck in areas such as the scalp and face. The causes are unknown, even if, in some cases, it is believed to be radiation-induced. The case is described of a patient with hypopharyngolaryngeal angiosarcoma, which became manifest with dysphagia, dysphonia and a palpable right latero-cervical mass about 7 cm in length. The patient underwent total pharyngolaryngectomy, right hemithyroidectomy, and bilateral neck dissection. Histological examination of the surgical specimen revealed a large haemorrhagic lesion involving the right pyriform sinus and homolateral hemilarynx. Right radical neck dissection revealed 9 metastatic lymph nodes, 1 of which with capsular invasion. Upon complete recovery the patient, underwent adjuvant post-operative radiotherapy. Six months later she is still alive with no clinical or radiological signs of disease. A careful review of the literature produced very few reports of such cases, only 6 of which in the last 30 years. Survival rate is very low, even if feasible average can be advanced, in view of the paucity of the case reports. Histological diagnosis is not always straightforward, as this neoplasm may be misdiagnosed as other vascular tumours (Kaposi's sarcoma, haemangiopericytoma), as non-neoplastic lesions (granulomas secondary to intubation) and as poorly differentiated squamous cell carcinoma. Immunohistochemical evaluation by means of markers, such as vimentin and factor VIII, offers a significant contribution to the diagnosis of angiosarcoma. The treatment of choice for laryngeal angiosarcoma is surgical excision, ample and radical, whenever possible, followed by adjuvant post-operative radiotherapy.
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Affiliation(s)
- R Sorrentino
- Department of Otorhinolaryngology, Regione Piemonte, ASL 17, SS. Annunziata Hospital, Savigliano, CN, Italy.
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Abstract
Cardiac malformations involving low-pressure chambers (i.e., either of the atria) are more often diagnosed later in life than lesions that involve high-pressure systems such as ventricular septal defects or persistent ducti arteriosi. Patients with congenital heart disease involving the atria may present only symptoms suggesting lung disease. We report on a child with recurrent episodes of wheezing, which did not respond to albuterol nebulizations and intravenous corticosteroids; he was subsequently found to have cor triatriatum. When a patient suffers from recurrent episodes of lower pulmonary infection and wheezing, despite appropriate management for asthma, less common (including cardiac) causes should be considered.
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Affiliation(s)
- A Pisanti
- IV Divisione di Pediatria, Modulo di Broncopneumologia, I Divisione di Pediatria, Modulo di Ecocardiografia Pediatrica, Ospedale per Bambini della SS. Annunziata ASL NA1, Naples, Italy
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35
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Tirri R, Vitiello R, Di Martino G. Pott's disease of the lower cervical spine in a diabetic patient. Monaldi Arch Chest Dis 2000; 55:205-7. [PMID: 10948666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Over the last few years, tuberculosis has steadily been returning to the worlds attention as a major health threat. The spinal localization of tuberculosis (Pott's Disease) represents around 1% of the case histories, in 3-5% of which there is cervical involvement. Diabetes mellitus increases the risk of infectious disease and predisposes to tuberculosis. Here, a rare case is presented of Pott's disease in the lower cervical spine, associated with retropharyngeal abscess in a diabetic patient. The aim of this study is to emphasize the importance of early diagnosis in such patients, so that adequate pharmacological and/or surgical treatment can be initiated to avoid serious complications.
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Affiliation(s)
- R Tirri
- Second University of Naples, Dept of Clinical and Experimental Medicine F. Magrassi, Italy
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36
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Pisanti A, Di Martino L, Vitiello R, Pisanti C, Natale A. Foreign body aspiration. An atypical clinical case. Minerva Pediatr 1999; 51:279-82. [PMID: 10634061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The case of a 3-year-old female with an atypical presentation of foreign body aspiration is described. Resistance to the therapy, mild radiological signs and a high index of suspicion of the clinician could lead to the right diagnosis.
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Abstract
OBJECTIVES The aim of this study was to determine the relative risks of pediatric diagnostic, interventional and electrophysiologic catheterizations. BACKGROUND The role of the pediatric catheterization laboratory has evolved in the last decade as a therapeutic modality, although remaining an important tool for anatomic and hemodynamic diagnosis. METHODS A study of 4,952 consecutive pediatric catheterization procedures was undertaken. RESULTS Patient ages ranged from 1 day to 20 years (median 2.9 years). One or more complications occurred in 436 studies (8.8%) and were classified as major in 102 and minor in 458, with vascular complications (n=189; 3.8% of procedures) the most common adverse event. Arrhythmic complications (n=24) were the most common major complication. Death occurred in seven cases (0.14%) as a direct complication of the procedure and was more common in infants (n=5). Independent risk factors for complications included a young patient age and undergoing an interventional procedure. CONCLUSIONS Complications continue to be associated with pediatric cardiac catheterization. Efforts should be directed to improving equipment for flexibility and size, and finding alternative methods for vascular access. Patient age and interventional studies are risk factors for morbidity and mortality.
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Affiliation(s)
- R Vitiello
- Department of Pediatrics, The University of Toronto School of Medicine, The Hospital for Sick Children, Ontario, Canada
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38
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Bonalumi F, Vitiello R, Miglierina L, Campanati B, Bianchi F, Marrocu R. [Carotid endarterectomy under locoregional anesthesia]. Ann Ital Chir 1997; 68:453-61. [PMID: 9494174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The purpose of carotid surgery is to prevent the incidence of stroke in patients with cerebrovascular disease. It's important, therefore, to find the most useful methods of cerebral protection and flow monitorization during carotid endarterectomy. It is well known that patient's clamping tolerance changes according to his anatomical and physiopathological conditions (contralateral carotid patency, stenosis, occlusion), and compensative circles efficiency (Willis). General anaesthesia reduces cerebral metabolic requests and allows a better pressure control, but requires difficult, expensive and complex monitoring techniques. On the contrary loco-regional anaesthesia alone can't assure cerebral protection, but allows to test in real-time patient's reaction at clamping. If an ischaemia occurs, carotid shunting allows to perform endarterectomy, but this method might produce any complication: distal plaque dissection, embolizations. Authors show their 10 years (1986-1996) experience of 624 carotid endarterectomies performed on 580 patients evaluated by: -symptomatic or asymptomatic lesions -mono-bilateral stenosis -general or loco-regional anaesthesia -clamping tolerance -carotid shunting -intra-postoperative complications (temporary or persistent). According to results, authors propose loco-regional anaesthesia in carotid endarterectomy as a simply available and at low costs method to monitorize cerebral functions. In addition it has low rate complications, few contra-indications and may be selected like first-choice anaesthesiological method.
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Affiliation(s)
- F Bonalumi
- Istituto di Chirurgia Vascolare ed Angiologia dell'Università di Milano
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Abstract
OBJECTIVE The goal of this study was to determine the patterns of the pulmonary circulation in patients with pulmonary atresia and asplenia. BACKGROUND The asplenic cardiac syndromes characteristically have complex cardiac anomalies including pulmonary stenosis or atresia. Definition of the pulmonary artery circulation and pulmonary venous connections is needed for consideration of surgical procedures. METHODS In 35 patients, the sources of pulmonary blood flow, anatomic features of pulmonary arteries and pulmonary venous connections were determined from angiograms or autopsy specimens. RESULTS The main pulmonary artery was absent or hypoplastic in 91% of patients; most had a ductus arteriosus. The right and left pulmonary arteries were confluent in 90% and usually of normal size (right 71%, left 63%). Total anomalous pulmonary venous connections were present in 38%. CONCLUSIONS The anatomic features of the pulmonary arteries in pulmonary atresia associated with the asplenic cardiac syndrome are usually favorable for palliative surgical procedures. Total anomalous pulmonary venous connection may exist as a complicating factor.
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Affiliation(s)
- R Vitiello
- Department of Pediatrics, University of Minnesota, Minneapolis
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Marcato P, Giuritti P, Pozzo T, Vitiello R, Valente G, Giordano C, Sartoris A. [Chronic cholesteatomatous otitis media: the histopathological and clinical aspects]. Acta Otorhinolaryngol Ital 1991; 11:465-70. [PMID: 1820721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In recent years the immunologic aspects of the normal and pathological ear have been studied by several authors, with particular attention given to the histopathologic aspects of the epidermis of the tympanic membranes of the outer ear canal and of the middle ear mucosa in normal physiologic as well as in inflammatory conditions. Such studies may help in giving a more precise definition to the pathogenesis and clinical behavior of middle ear cholesteatoma. In this paper we report the results of an immunohistopathologic study carried out using the immunohistochemical technique of monoclonal antibodies on cholesteatoma matrix samples taken during radical mastoidectomy or tympanoplasty. In particular, the presence of T-lymphocytes and Langerhans cells was evaluated using selective monoclonal antibodies and a relationship between the data collected and the clinical expression of the disease in each case was sought. In this study it was not possible to establish a close relationship between clinical behavior and immunohistopathological findings, which appeared rather similar in all the cases. The presence of Langerhans' cells may confirm the hypothesized role they play in phlogistic reactions and bone reabsorption due to the presence of the cholesteatoma in the middle ear. Yet, in order to evaluate their true role correctly, more detailed studies should be carried out on the spatial distribution of T-lymphocytes and Langerhans' cells in the cholesteatoma matrix as well as on their ultrastructural characteristics.
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Vitiello R, Benson L, Musewe N, Freedom R. Factors influencing the persistence of shunting within 24 hours of catheter occlusion of the ductus arteriosus. Br Heart J 1991; 65:211-2. [PMID: 2029443 PMCID: PMC1024582 DOI: 10.1136/hrt.65.4.211] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Catheter occlusion of the persistent ductus arteriosus recently became clinically available with a Rashkind (USCI Bellerica, Massachusetts, USA) umbrella occluder system. A few patients, however, had residual left to right shunting after the procedure. The impact of soaking the foam of the device in a thrombin solution to enhance clotting and of using a device with a diameter of 12 or 17 mm was assessed in 117 consecutive patients undergoing catheter closure. The frequency of residual shunting detected by colour flow Doppler 24 hours after the procedure was the same whether or not thrombin was used.
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Affiliation(s)
- R Vitiello
- Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
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Vitiello R, Giordano C, Macchieraldo A, Pecorari G, Sartoris A. [Prostaglandins, suppressive action cells and carcinoma of the larynx: preliminary data]. Acta Otorhinolaryngol Ital 1990; 10:73-8. [PMID: 2392924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The purpose of the present work was to analyze the role of PgE2 and indomethacin in the regulation of immune response. 18 patients with laryngeal cancer were chosen for the study. Three cultures on peripheral venous blood were taken from each subject in order to evaluate the variation in the different lymphocyte groups after the addition of PgE2 and its inhibiting factor: indomethacin. In the cultures with PgE2, an increase in T suppressor lymphocytes was observed while the T helper group showed a significant reduction (cultures with indomethacin produced the opposite effect). This result bears witness to the inhibiting effect PgE2 has on the immune system in subjects with laryngeal cancer. On the basis of these results, while awaiting further data, it can be suggested that future therapy be based on the administration of indomethacin in patients suffering from this disease.
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Affiliation(s)
- R Vitiello
- I Clinica Otorinolaringoiatrica dell'Università di Torino
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Sartoris A, Cortesina G, Vitiello R, Di Fortunato V, Ponzo S, Poggio E, Petitti G, Baiocchi C. [Importance of aryl hydrocarbon hydroxylase in laryngeal oncogenesis. Preliminary data]. Acta Otorhinolaryngol Ital 1985; 5:579-87. [PMID: 3834737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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44
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Vitiello R, Molino R, Cortesina G. [Extranodal malignant lymphoma of the head and neck]. Acta Otorhinolaryngol Ital 1984; 4:297-304. [PMID: 6549099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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45
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Vitiello R, Molino R, di Fortunato V, Bongioannini G, Vercellino M. [Pathogenetic, histopathologic and clinical aspects of amyloidosis: apropos of 2 cases in sites of otorhinolaryngologic importance]. Acta Otorhinolaryngol Ital 1984; 4:207-12. [PMID: 6475534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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46
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Vitiello R, Molino R, Bongioannini G, Cortesina G. [Malignant lymphomas: apropos of 2 unusual cases of lymphoma of otorhinolaryngologic interest]. Acta Otorhinolaryngol Ital 1983; 3:55-62. [PMID: 6880703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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47
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Cesarotti E, Ugo R, Vitiello R. Chiral cyclopentadienyl as ligands in homogeneous asymmetric catalysis Part 1. Asymmetric hydrogenation of simple olefins by Ti(IV) complexes. ACTA ACUST UNITED AC 1981. [DOI: 10.1016/0304-5102(81)80019-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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