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Chiloiro S, Moroni R, Giampietro A, Angelini F, Gessi M, Lauretti L, Mattogno PP, Calandrelli R, Tartaglione T, Carlino A, Gaudino S, Olivi A, Rindi G, De Marinis L, Pontecorvi A, Doglietto F, Bianchi A. The Multibiomarker Acro-TIME Score Predicts fg-SRLs Response: Preliminary Results of a Retrospective Acromegaly Cohort. J Clin Endocrinol Metab 2024; 109:1341-1350. [PMID: 37975821 DOI: 10.1210/clinem/dgad673] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/15/2023] [Accepted: 11/15/2023] [Indexed: 11/19/2023]
Abstract
CONTEXT The prompt control of acromegaly is a primary treatment aim for reducing related disease morbidity and mortality. First-generation somatostatin receptor ligands (fg-SRLs) are the cornerstone of medical therapies. A non-negligible number of patients do not respond to this treatment. Several predictors of fg-SRL response were identified, but a comprehensive prognostic model is lacking. OBJECTIVE We aimed to design a prognostic model based on clinical and biochemical parameters, and pathological features, including data on immune tumor microenvironment. METHODS A retrospective, monocenter, cohort study was performed on 67 medically naïve patients with acromegaly. Fifteen clinical, pathological, and radiological features were collected and analyzed as independent risk factors of fg-SRLs response, using univariable and multivariable logistic regression analyses. A stepwise selection method was applied to identify the final regression model. A nomogram was then obtained. RESULTS Thirty-seven patients were fg-SRLs responders. An increased risk to poor response to fg-SRLs were observed in somatotropinomas with absent/cytoplasmatic SSTR2 expression (OR 5.493 95% CI 1.19-25.16, P = .028), with low CD68+/CD8+ ratio (OR 1.162, 95% CI 1.01-1.33, P = .032). Radical surgical resection was associated with a low risk of poor fg-SRLs response (OR 0.106, 95% CI 0.025-0.447 P = .002). The nomogram obtained from the stepwise regression model was based on the CD68+/CD8+ ratio, SSTR2 score, and the persistence of postsurgery residual tumor and was able to predict the response to fg-SRLs with good accuracy (area under the curve 0.85). CONCLUSION Although our predictive model should be validated in prospective studies, our data suggest that this nomogram may represent an easy to use tool for predicting the fg-SRL outcome early.
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Affiliation(s)
- Sabrina Chiloiro
- UOC Endocrinology and Diabetology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 00168 Roma, Italy
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 00168 Roma, Italy
| | | | - Antonella Giampietro
- UOC Endocrinology and Diabetology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 00168 Roma, Italy
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 00168 Roma, Italy
| | - Flavia Angelini
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 00168 Roma, Italy
| | - Marco Gessi
- Department of Woman and Child Health Sciences and Public Health, Anatomic Pathology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 00168 Roma, Italy
| | - Liverana Lauretti
- Neurosurgery Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Largo A. Gemelli, 00168 Roma, Italy
| | - Pier Paolo Mattogno
- Neurosurgery Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Largo A. Gemelli, 00168 Roma, Italy
| | - Rosalinda Calandrelli
- UOSD Neuroradiologia Diagnostica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del S. Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy
| | - Tommaso Tartaglione
- UOSD Neuroradiologia Diagnostica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del S. Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy
| | - Angela Carlino
- Department of Woman and Child Health Sciences and Public Health, Anatomic Pathology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 00168 Roma, Italy
| | - Simona Gaudino
- UOSD Neuroradiologia Diagnostica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del S. Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy
| | - Alessandro Olivi
- Neurosurgery Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Largo A. Gemelli, 00168 Roma, Italy
| | - Guido Rindi
- Department of Woman and Child Health Sciences and Public Health, Anatomic Pathology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 00168 Roma, Italy
| | - Laura De Marinis
- UOC Endocrinology and Diabetology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 00168 Roma, Italy
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 00168 Roma, Italy
| | - Alfredo Pontecorvi
- UOC Endocrinology and Diabetology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 00168 Roma, Italy
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 00168 Roma, Italy
| | - Francesco Doglietto
- Neurosurgery Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Largo A. Gemelli, 00168 Roma, Italy
| | - Antonio Bianchi
- UOC Endocrinology and Diabetology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 00168 Roma, Italy
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 00168 Roma, Italy
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Costantini B, Rosati A, Vargiu V, Gallitelli V, Di Ilio C, Moroni R, Scambia G, Fagotti A. ASO Visual Abstract: Visual Peritoneal Evaluation of Residual Disease After Neoadjuvant Chemotherapy in Advanced Ovarian Cancer Patients-The VIPER Study. Ann Surg Oncol 2023; 30:2329-2330. [PMID: 36729352 DOI: 10.1245/s10434-022-12919-w] [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: 02/03/2023]
Affiliation(s)
- Barbara Costantini
- Department Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Rosati
- Department Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Virginia Vargiu
- Department of Gynecologic Oncology, Gemelli Molise SpA, Campobasso, Italy
| | - Vitalba Gallitelli
- Department Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Chiara Di Ilio
- Department Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rossana Moroni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Scambia
- Department Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
- Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Anna Fagotti
- Department Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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3
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Costantini B, Rosati A, Vargiu V, Gallitelli V, Di Ilio C, Moroni R, Scambia G, Fagotti A. Visual Peritoneal Evaluation of Residual Disease After Neoadjuvant Chemotherapy in Advanced Ovarian Cancer Patients: The VIPER Study. Ann Surg Oncol 2023; 30:2319-2328. [PMID: 36745255 DOI: 10.1245/s10434-022-12861-x] [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: 03/10/2022] [Accepted: 11/09/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Chemotherapy induces histopathological tumor necrosis and fibrosis which results in macroscopic tissue changes, making surgeons' intraoperative visual evaluation of the disease distribution more difficult to interpret. The aim of the study was to assess the sensitivity, specificity, and accuracy of intraoperative laparoscopic visual evaluation of the diaphragmatic peritoneum and compare it with histopathological examination. METHODS Patients receiving diaphragmatic peritonectomy at time of IDS were retrospectively included. The population was grouped based on the surgeon's assessment of the diaphragmatic peritoneum during diagnostic laparoscopy. Group 1 included patients with a "visually pathologic" diaphragmatic peritoneum, and group 2 included patients with a "visually dubious" diaphragmatic peritoneum. Sensitivity, specificity, predictive values, and accuracy were calculated considering the final formalin-fixed pathology as the reference standard. RESULTS 155 patients were included (92 in group 1 and 63 in group 2). The accuracy rate of visual examination was 67.1%, the negative predictive value was 19%, specificity was 100%, and sensitivity was 64.3%. CONCLUSION NACT strongly affects the ability of the surgeon to discern between peritoneal scars and truly pathologic peritoneum. The diaphragmatic laparoscopic visual examination showed a low overall accuracy. We propose an algorithm that can guide the surgeon towards a more tailored approach to diaphragmatic peritonectomy during IDS.
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Affiliation(s)
- Barbara Costantini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Andrea Rosati
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Virginia Vargiu
- Department of Gynecologic Oncology, Gemelli Molise SpA, Campobasso, Italy
| | - Vitalba Gallitelli
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Chiara Di Ilio
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rossana Moroni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Scambia
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
- Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Anna Fagotti
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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Buonsenso D, Noguera-Julian A, Moroni R, Hernández-Bartolomé A, Fritschi N, Lancella L, Cursi L, Soler-Garcia A, Krüger R, Feiterna-Sperling C, Sali M, Lo Vecchio A, Scarano S, Hernanz Lobo A, Espiau M, Soriano-Arandes A, Cetin BS, Brinkmann F, Ozere I, Baquero-Artigao F, Tsolia M, Milheiro Silva T, Bustillo-Alonso M, Martín Nalda A, Mancini M, Starshinova A, Ritz N, Velizarova S, Ferreras-Antolín L, Götzinger F, Bilogortseva O, Chechenyeva V, Tebruegge M, Santiago-García B. Performance of QuantiFERON-TB Gold Plus assays in paediatric tuberculosis: a multicentre PTBNET study. Thorax 2023; 78:288-296. [PMID: 36283826 DOI: 10.1136/thorax-2022-218929] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 03/03/2022] [Accepted: 07/26/2022] [Indexed: 11/11/2022]
Abstract
RATIONALE In 2016, a new interferon-gamma release assay (IGRA) was introduced, QuantiFERON-TB Gold Plus (QFT-Plus), claimed to have improved sensitivity in active tuberculosis (TB). OBJECTIVES This study aimed to determine the performance of QFT-Plus, compared with previous generation IGRAs and the tuberculin skin test (TST), in children with TB in Europe. METHODS Multicentre, ambispective cohort study within the Paediatric Tuberculosis Network European Trials Group (ptbnet), a dedicated paediatric TB research network comprising >300 members, capturing TB cases <18 years-of-age diagnosed between January 2009 and December 2019. MEASUREMENTS AND MAIN RESULTS 1001 TB cases from 16 countries were included (mean age (IQR) 5.6 (2.4-12.1) years). QFT-Plus was performed in 358, QFT Gold in-Tube (QFT-GIT) in 600, T-SPOT.TB in 58 and TST in 636 cases. The overall test sensitivities were: QFT-Plus 83.8% (95% CI 80.2% to 87.8%), QFT-GIT 85.5% (95% CI 82.7% to 88.3%), T-SPOT.TB 77.6% (95% CI 66.9% to 88.3%) and TST (cut-off ≥10 mm) 83.3% (95% CI 83.3% to 86.2%). There was a trend for tests to have lower sensitivity in patients with miliary and/or central nervous system (CNS) TB (73.1%, 70.9%, 63.6% and 43.5%, respectively), and in immunocompromised patients (75.0%, 59.6%, 45.5% and 59.1%, respectively). CONCLUSIONS The results indicate that the latest generation IGRA assay, QFT-Plus, does not perform better than previous generation IGRAs or the TST in children with TB disease. Overall, tests performed worse in CNS and miliary TB, and in immunocompromised children. None of the tests evaluated had sufficiently high sensitivity to be used as a rule-out test in children with suspected TB.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie - Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Milano, Italy.,Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Antoni Noguera-Julian
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d'Infeccions, Servei de Pediatria, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.,Departament de Pediatria, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain
| | - Rossana Moroni
- Direzione Scientifica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Angel Hernández-Bartolomé
- Paediatric Infectious Diseases Department, Gregorio Marañón University Hospital, Madrid, Spain. Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas {CIBER INFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Nora Fritschi
- Mycobacterial and Migrant Health Research Group, University of Basel Children's Hospital Basel and Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Laura Lancella
- Paediatric Infectious Diseases Unit, Bambino Gesù Children Hospital, Rome, Italy
| | - Laura Cursi
- Paediatric Infectious Diseases Unit, Bambino Gesù Children Hospital, Rome, Italy
| | - Aleix Soler-Garcia
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d'Infeccions, Servei de Pediatria, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Renate Krüger
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin, Berlin, Germany
| | - Cornelia Feiterna-Sperling
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin, Berlin, Germany
| | - Michela Sali
- Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie - Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Milano, Italy.,Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy
| | - Andrea Lo Vecchio
- Department of Translational Medical Sciences, Pediatric Infectious Diseases Unit, University of Naples Federico II, Naples, Italy
| | - Sara Scarano
- Department of Translational Medical Sciences, Pediatric Infectious Diseases Unit, University of Naples Federico II, Naples, Italy
| | - Alicia Hernanz Lobo
- Paediatric Infectious Diseases Department, Gregorio Marañón University Hospital, Madrid, Spain. Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas {CIBER INFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Espiau
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Antonio Soriano-Arandes
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Benhur Sirvan Cetin
- Department of Pediatric Infectious Diseases, Erciyes University, Kayseri, Turkey
| | - Folke Brinkmann
- Department of Paediatric Pulmonology, Children's Hospital, Ruhr-University, Bochum, Germany
| | | | - Fernando Baquero-Artigao
- Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain.,Hospital Infantil La Paz, Madrid, Spain.,CIBERINFEC, ISCIII, Madrid, Spain
| | - Maria Tsolia
- Panagiotis & Aglaia Kyriakou Children's Hospital, Athens, Greece
| | | | | | - Andrea Martín Nalda
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Margherita Mancini
- Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Anna Starshinova
- St. Petersburg Scientific Research Institute of Phthisiopulmonology, St. Petersburg, Russian Federation
| | - Nicole Ritz
- Mycobacterial and Migrant Health Research Group, University of Basel Children's Hospital Basel and Department of Clinical Research, University of Basel, Basel, Switzerland.,Department of Paediatrics and Paediatric Infectious Diseases, Children's Hospital Lucerne Lucerne Cantonal Hospital, Lucerne, Switzerland.,Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | | | - Laura Ferreras-Antolín
- Paediatric Infectious Diseases Unit, St. George's University Hospitals NHS Foundation Trust, London, UK
| | - Florian Götzinger
- Department of Paediatric and Adolescent Medicine, National Reference Centre for Childhood Tuberculosis, Klinik Ottakring, Vienna, Austria
| | - Olga Bilogortseva
- Ukraine. Department of Children Phthisiology, National Institution of Phthisiology and Pulmonology of National Academy of Medical sciences of Ukraine, Kiev, Ukraine.,Infectious diseases Centre «Clinic for treatment of children with HIV/AIDS» National Specialized Children's Hospital 'OKHMATDYT', Kiev, Ukraine
| | - Vira Chechenyeva
- Ukraine. Department of Children Phthisiology, National Institution of Phthisiology and Pulmonology of National Academy of Medical sciences of Ukraine, Kiev, Ukraine.,Infectious diseases Centre «Clinic for treatment of children with HIV/AIDS» National Specialized Children's Hospital 'OKHMATDYT', Kiev, Ukraine
| | - Marc Tebruegge
- Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia .,Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Begoña Santiago-García
- Paediatric Infectious Diseases Department, Gregorio Marañón University Hospital, Madrid, Spain. Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas {CIBER INFEC), Instituto de Salud Carlos III, Madrid, Spain
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Luigetti M, Guglielmino V, Romano A, Sciarrone MA, Vitali F, Sabino A, Gervasoni J, Primiano A, Santucci L, Moroni R, Primiano G. A Metabolic Signature of Hereditary Transthyretin Amyloidosis: A Pilot Study. Int J Mol Sci 2022; 23:ijms232416133. [PMID: 36555770 PMCID: PMC9783933 DOI: 10.3390/ijms232416133] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/08/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Hereditary transthyretin amyloidosis is the most common form of hereditary amyloidosis, with an autosomal dominant inheritance and a variable penetrance. ATTRv amyloidosis can present as a progressive, axonal sensory autonomic and motor neuropathy or as an infiltrative cardiomyopathy. The definition of biomarkers for the early diagnosis of ATTRv is particularly important in the current era of emerging treatments. In this sense, metabolomics could be an instrument able to provide metabolic profiles with their related metabolic pathways, and we would propose them as possible fluid biomarkers. The aim of this study is to identify altered metabolites (free fatty acids and amino acids) in subjects with a confirmed pathogenic TTR variant. Out of the studied total free fatty acids and amino acids, the serum values of palmitic acid are significantly lower in the ATTRv patients compared to the recruited healthy subjects. The metabolic remodeling identified in this neurogenetic disorder could be the manifestation of pathophysiological processes of the disease, such as mitochondrial dysfunction and neuroinflammation, and contribute to explaining some of its clinical manifestations.
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Affiliation(s)
- Marco Luigetti
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-06-3015-4435
| | | | - Angela Romano
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | | | | | - Andrea Sabino
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Jacopo Gervasoni
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Aniello Primiano
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Lavinia Santucci
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Rossana Moroni
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Guido Primiano
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Maccora D, Fortini D, Moroni R, Sprecacenere G, Annunziata S, Bruno I. Comparison between MIBI-based radiopharmaceuticals for parathyroid scintigraphy: quantitative evaluation and correlation with clinical-laboratory parameters. J Endocrinol Invest 2022; 45:2139-2147. [PMID: 35792999 DOI: 10.1007/s40618-022-01847-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 06/21/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Parathyroid scintigraphy is mandatory for the identification of hyperfunctioning parathyroid glands in hyperparathyroidism (HPT). The use of 99mTc-methoxy-isobutyl-isonitrile (MIBI) as radiopharmaceutical for parathyroid scintigraphy is considered the most valid and useful considering its uptake mechanism. Several MIBI-based radiopharmaceuticals are commercially available (i.e., MediMIBI, TechneMIBI, Stamicis). They seem to have similar physico-chemical characteristics and the choice between them is based on commercial criteria, even though some differences in qualitative scintigraphic results have been appreciated. Aims of the study were: first, to compare the scintigraphic quantitative data of MediMIBI, TechneMIBI, and Stamicis, particularly in the view of a personalized medicine approach; second, to investigate the potential effect of clinical-laboratory data on image quality using one of these radiopharmaceuticals. METHODS Patients with diagnosis of HPT, who underwent a parathyroid scintigraphy using one of the three MIBI-based radiopharmaceuticals between December 2018 and October 2020, have been retrospectively identified. Parameters derived from regions of interest (ROIs) drawn on three different sites were obtained: a reasonable parathyroid lesion detected, an area in the lateral neck considered as the background, and the hepatic dome as the site of MIBI physiological uptake. Laboratory and clinical data, such as serum calcium, PTH, vitamin D, and creatinine levels, as well as possible drug-mediated interferences were considered. RESULTS Among 250 patients included, 83 (33.2%) had the parathyroid scintigraphy using MediMIBI, 84 (33.6%) using TechneMIBI and 83 (33.2%) using Stamicis. The ROIs on the parathyroid uptake at early images, on the background, and on the hepatic dome were statistically different among the three groups (p < 0.05). No significant differences were found in the remaining semi-quantitative parameters among the three groups, not even considering clinical-laboratory data. CONCLUSIONS Some differences in semi-quantitative parameters emerged among MIBI-based radiopharmaceuticals for parathyroid scintigraphy. This might justify the different qualitative scintigraphic results obtained using one or another of the cited radiopharmaceuticals.
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Affiliation(s)
- D Maccora
- Institute of Nuclear Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del S. Cuore, L.go A. Gemelli 8, 00168, Rome, Italy.
- Nuclear Medicine Unit, IRCCS Regina Elena National Cancer Institute, Via E. Chianesi 53, 00144, Rome, Italy.
| | - D Fortini
- Nuclear Medicine Unit, Fondazione Policlinico A. Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
| | - R Moroni
- Scientific Management, Fondazione Policlinico A. Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
| | - G Sprecacenere
- Nuclear Medicine Unit, Fondazione Policlinico A. Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
| | - S Annunziata
- Nuclear Medicine Unit, Fondazione Policlinico A. Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
| | - I Bruno
- Nuclear Medicine Unit, Fondazione Policlinico A. Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
- Nuclear Medicine Unit, Ospedale Generale Regionale F. Miulli, Strada Prov. 127 Acquaviva-Santeramo Km. 4, 70021, Acquaviva delle Fonti, BA, Italy
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Moruzzi MC, Bolomini G, Esposito R, Mascilini F, Ciccarone F, Quagliozzi L, Giudice MT, Beneduce G, Ficarelli S, Moroni R, Scambia G, Fagotti A, Testa AC, Moro F. Diagnostic performance of ultrasound in assessing the extension of disease in advanced ovarian cancer. Am J Obstet Gynecol 2022; 227:601.e1-601.e20. [PMID: 35752305 DOI: 10.1016/j.ajog.2022.05.029] [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] [Received: 12/24/2021] [Revised: 05/04/2022] [Accepted: 05/10/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Surgical exploration remains the gold standard to evaluate the extension of disease and predict resectability. A laparoscopy-based scoring model was developed by Fagotti and colleagues in 2006 and updated in 2015, based on the intraoperative presence or absence of some specific cancer features. The model proved an overall accuracy rate of 77-100% and is considered the reference test to assess resectability in our Institution. OBJECTIVES The primary aim of the study was to analyze the agreement between preoperative ultrasound examination and laparoscopic findings in assessing the extension of intra-abdominal disease using six parameters described by Fagotti's score. STUDY DESIGN This is a prospective single-center observational study. Between January 2019 and June 2020, consecutive patients with clinical or radiological suspicion of ovarian/peritoneal cancer were assessed with preoperative ultrasound examination and assigned a score based on the six Fagotti's score parameters (great omentum, liver surface, lesser omentum/stomach/spleen, parietal peritoneum, diaphragms, bowel disease). Presence of mesenteral retraction of the small bowel and miliaric carcinomatosis on the serosa were also evaluated. Each parameter was correlated with laparoscopic findings. Concordance was calculated between ultrasound and laparoscopic parameters using Cohen's kappa(κ). RESULTS Cohen's κ ranged from 0.70 to 0.90 for carcinomatosis on the small/large bowel, supracolic omentum, liver surface and diaphragms. Cohen's κ test was lower for carcinomatosis on the parietal peritoneum (k=0.63) and on the lesser omentum/lesser curvature of the stomach/spleen (k=0.54). The agreement between ultrasound and surgical predictive index value (score) was κ=0.74. For the evaluation of mesenteral retraction and miliaric carcinomatosis, the agreement was low (k=0.57 and k=0.36 respectively). CONCLUSIONS The results of ultrasound and laparoscopy in the assessment of intra-abdominal tumor spread were in substantial agreement for almost all the parameters. Ultrasound examination can play a useful role in the preoperative management of patients with ovarian cancer when used in dedicated referral centers.
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Affiliation(s)
- Maria Cristina Moruzzi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - Giulia Bolomini
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - Rosanna Esposito
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - Floriana Mascilini
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - Francesca Ciccarone
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - Lorena Quagliozzi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - Maria Teresa Giudice
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - Giuliana Beneduce
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - Silvia Ficarelli
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - Rossana Moroni
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Direzione Scientifica, Rome, Italy
| | - Giovanni Scambia
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy; Università Cattolica del Sacro Cuore, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
| | - Anna Fagotti
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy; Università Cattolica del Sacro Cuore, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
| | - Antonia Carla Testa
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy; Università Cattolica del Sacro Cuore, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
| | - Francesca Moro
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy.
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De Simone V, Litta F, Persiani R, Rizzo G, Sofo L, Menghi R, Santullo F, Biondi A, Coco C, Sacchetti F, Longo F, Attalla El Halabieh M, Moroni R, Ratto C. Effectiveness and Validation of the Italian Translation of the Low Anterior Resection Syndrome Score in an Italian High-Volume University Hospital. Front Surg 2022; 9:917224. [PMID: 35795231 PMCID: PMC9251199 DOI: 10.3389/fsurg.2022.917224] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background The low anterior resection syndrome (LARS) score is a validated questionnaire developed in Denmark to measure the severity of bowel dysfunction after low anterior resection. This retrospective study aimed to assess the effectiveness of the LARS score in the Italian language in a population of Italian patients who underwent low anterior resection for rectal cancer. The convergent and discriminative validity and the test-retest reliability of the score were investigated. Methods A cohort of two hundred and five patients treated with low anterior resection were enrolled in an Italian high-volume university hospital between January 2000 and April 2018. The Italian version of the LARS score (tested twice), as translated from English original version, a single question on quality of life and the EORTC QLQ-C30 questionnaire were submitted to patients. Results A high proportion of patients showed a perfect or moderate fit between the LARS score and QoL categories (convergent validity, p < 0.0005). All differences regarding the items of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Core 30 (EORTC QLQ-C30) functional scales were statistically significant (p < 0.0005). The LARS score was able to discriminate between groups of patients who received or did not receive preoperative chemoradiotherapy (p < 0.0005) and those who received total or partial mesorectal excision (p < 0.0005). The test-retest reliability was excellent (intraclass correlation coefficient 0.96). Conclusion The Italian translation of the LARS score is an easy and reliable tool for assessing bowel dysfunction after low anterior resection and its routine use in clinical practice should be recommended. Trial registration number at www.clinicaltrials.gov: NCT04406311.
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Affiliation(s)
- Veronica De Simone
- Proctology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Correspondence: Veronica De Simone
| | - Francesco Litta
- Proctology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Roberto Persiani
- General Surgery Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Gianluca Rizzo
- General Surgery II Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Luigi Sofo
- Abdominal Surgery Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Roberta Menghi
- Digestive Surgery Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Francesco Santullo
- Peritoneal and Retroperitoneal Surgery Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Alberto Biondi
- General Surgery Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Claudio Coco
- General Surgery II Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Franco Sacchetti
- Abdominal Surgery Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Fabio Longo
- Digestive Surgery Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Miriam Attalla El Halabieh
- Peritoneal and Retroperitoneal Surgery Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Rossana Moroni
- Scientific Direction, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Carlo Ratto
- Proctology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
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9
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Restaino S, Bizzarri N, Tarantino V, Pelligra S, Moroni R, Palmieri E, Monterossi G, Costantini B, Scambia G, Fanfani F. Comparison of Different Near-Infrared Technologies to Detect Sentinel Lymph Node in Uterine Cancer: A Prospective Comparative Cohort Study. Int J Environ Res Public Health 2022; 19:ijerph19127377. [PMID: 35742629 PMCID: PMC9224254 DOI: 10.3390/ijerph19127377] [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] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Sentinel lymph node biopsy is considered a crucial step in endometrial cancer staging. Cervical injection has become the most favored technique and indocyanine green has been demonstrated to be more accurate than other tracers. Different near-infrared camera systems are currently being used to detect indocyanine green in sentinel lymph nodes and have been compared in different patients. The present study aimed to determine the number and site of sentinel lymph nodes detected in the same patients with two different near-infrared technologies. METHODS This is a prospective, single-center, observational, non-sponsored study. Patients with presumed uterine-confined endometrial cancer were prospectively enrolled. After cervical injection, two different near-infrared cameras were used to detect sentinel lymph nodes at the same time: Olympus, Tokyo, Japan-considered the standard (SNIR); and Medtronic, Minneapolis, MN, USA with VISION SENSE® which is a new laser near-infrared (LNIR) fluorescence laparoscope. The two cameras were alternatively switched on to detect sentinel lymph nodes in the same patients. RESULTS Seventy-four consecutive patients were included in the study. Most of the patients were diagnosed with endometrioid histology (62, 83.8%), FIGO stage IA (48, 64.9%), grade 2 (43, 58.1%), and underwent surgery with laparoscopic approach (70, 94.0%). The bilateral detection rate was 56/74 (75.7%) with SNIR and 63/74 (85.1%) with LNIR (p = 0.214). The total number of sentinel lymph nodes identified in the left hemipelvis was 65 and 70 with SNIR and LNIR, respectively; while in the right hemipelvis, there were 74 and 76, respectively. The median number of sentinel lymph nodes identified with SNIR and LNIR was 2 (range, 0-4) and 2 (range, 0-4), respectively (p = 0.370). No difference in site of sentinel lymph node detection was evident between the two technologies (p = 0.994). Twelve patients (16.2%) had sentinel lymph node metastasis: in all cases metastatic sentinel lymph nodes were detected both with Olympus and LNIR. CONCLUSIONS No difference in bilateral detection rate and number or site of sentinel lymph node detection was evident comparing two different technologies of near-infrared camera for ICG detection in endometrial cancer patients. No difference in sentinel lymph node metastases identification was detected between the two technologies.
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Affiliation(s)
- Stefano Restaino
- Department of Obstetrics, Gynecology, and Pediatrics, Obstetrics and Gynecology Unit, Udine University Hospital, DAME, 33100 Udine, Italy;
| | - Nicolò Bizzarri
- UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (S.P.); (G.M.); (B.C.); (G.S.)
| | | | - Silvia Pelligra
- UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (S.P.); (G.M.); (B.C.); (G.S.)
| | - Rossana Moroni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Direzione Scientifica IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy;
| | - Emilia Palmieri
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (V.T.); (E.P.)
| | - Giorgia Monterossi
- UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (S.P.); (G.M.); (B.C.); (G.S.)
| | - Barbara Costantini
- UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (S.P.); (G.M.); (B.C.); (G.S.)
| | - Giovanni Scambia
- UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (S.P.); (G.M.); (B.C.); (G.S.)
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (V.T.); (E.P.)
| | - Francesco Fanfani
- UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (S.P.); (G.M.); (B.C.); (G.S.)
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (V.T.); (E.P.)
- Correspondence: ; Tel.: +39-06-30154979
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10
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Moroni R, Fanelli D, Tesi M, Cerretini B, Lomet D, Rota A, Beltramo M, Camillo F, Panzani D. Effect of administration of the C6 Kisspeptin analogue in jennies in estrus. J Equine Vet Sci 2022. [DOI: 10.1016/j.jevs.2022.103997] [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: 11/28/2022]
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11
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Bocci C, Fanelli D, Moroni R, Tesi M, Camillo F, Rota A, Panzani D. Pregnancy rates in Equids after Interspecific and Intraspecific Artificial Insemination. J Equine Vet Sci 2022. [DOI: 10.1016/j.jevs.2022.103998] [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: 10/18/2022]
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12
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Costantini B, Vargiu V, Santullo F, Rosati A, Bruno M, Gallotta V, Lodoli C, Moroni R, Pacelli F, Scambia G, Fagotti A. ASO Visual Abstract: Risk Factors for Anastomotic Leakage in Advanced Ovarian Cancer Surgery: A large Single-Center Experience. Ann Surg Oncol 2022. [PMID: 35482265 DOI: 10.1245/s10434-022-11706-x] [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: 11/18/2022]
Affiliation(s)
- Barbara Costantini
- Division of Gynecologic Oncology, Department Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Virginia Vargiu
- Department of Oncology, Gemelli Molise SpA, Campobasso, Italy
| | - Francesco Santullo
- Surgical Unit of Peritoneum and Retroperitoneum, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Andrea Rosati
- Division of Gynecologic Oncology, Department Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Matteo Bruno
- Division of Gynecologic Oncology, Department Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Valerio Gallotta
- Division of Gynecologic Oncology, Department Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Claudio Lodoli
- Surgical Unit of Peritoneum and Retroperitoneum, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rossana Moroni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Fabio Pacelli
- Surgical Unit of Peritoneum and Retroperitoneum, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Scambia
- Division of Gynecologic Oncology, Department Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. .,Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Anna Fagotti
- Division of Gynecologic Oncology, Department Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
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13
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Costantini B, Vargiu V, Santullo F, Rosati A, Bruno M, Gallotta V, Lodoli C, Moroni R, Pacelli F, Scambia G, Fagotti A. Risk Factors for Anastomotic Leakage in Advanced Ovarian Cancer Surgery: A Large Single-Center Experience. Ann Surg Oncol 2022; 29:4791-4802. [PMID: 35435561 PMCID: PMC9246984 DOI: 10.1245/s10434-022-11686-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/08/2022] [Indexed: 12/23/2022]
Abstract
Background Cytoreductive surgery is currently the main treatment for advanced epithelial ovarian cancer (OC), and several surgical maneuvers, including colorectal resection, are often needed to achieve no residual disease. High surgical complexity carries an inherent risk of postoperative complications, including anastomosis leakage (AL). Albeit rare, AL is a life-threatening condition. The aim of this single-center retrospective study is to assess the AL rate in patients undergoing colorectal resection and anastomosis during primary surgery for advanced epithelial OC through a standardized surgical technique and to evaluate possible pre/intra- and postoperative risk factors to identify the population at greatest risk. Methods A retrospective analysis of clinical and surgical characteristics of 515 patients undergoing colorectal resection and anastomosis during primary or interval debulking surgery between December 2011 and October 2019 was performed. Several pre/intra- and postoperative variables were evaluated by multivariate analysis as potential risk factors for AL. Results The overall anastomotic leakage rate was 2.9% (15/515) with a significant negative impact on postoperative course. Body mass index < 18 kg/m2, preoperative albumin value lower than 30 mg/dL, section of the inferior mesenteric artery at its origin, and medium–low colorectal anastomosis (< 10 cm from the anal verge) were identified as independent risk factors for AL on multivariate analysis. Conclusions AL is confirmed to be an extremely rare but severe postoperative complication of OC surgery, being responsible for increased early postoperative mortality. Preoperative nutritional status and surgical characteristics, such as blood supply and anastomosis level, appear to be the most significant risk factors. Supplementary Information The online version contains supplementary material available at 10.1245/s10434-022-11686-y.
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Affiliation(s)
- Barbara Costantini
- Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Virginia Vargiu
- Department of Oncology, Gemelli Molise Spa, Campobasso, Italy
| | - Francesco Santullo
- Surgical Unit of Peritoneum and Retroperitoneum, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Andrea Rosati
- Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Matteo Bruno
- Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valerio Gallotta
- Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Claudio Lodoli
- Surgical Unit of Peritoneum and Retroperitoneum, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rossana Moroni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Fabio Pacelli
- Surgical Unit of Peritoneum and Retroperitoneum, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Scambia
- Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. .,Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Anna Fagotti
- Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
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14
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Rossi S, Rubegni A, Riso V, Barghigiani M, Bassi MT, Battini R, Bertini E, Cereda C, Cioffi E, Criscuolo C, Dal Fabbro B, Dato C, D'Angelo MG, Di Muzio A, Diamanti L, Dotti MT, Filla A, Gioiosa V, Liguori R, Martinuzzi A, Massa R, Mignarri A, Moroni R, Musumeci O, Nicita F, Orologio I, Orsi L, Pegoraro E, Petrucci A, Plumari M, Ricca I, Rizzo G, Romano S, Rumore R, Sampaolo S, Scarlato M, Seri M, Stefan C, Straccia G, Tessa A, Travaglini L, Trovato R, Ulgheri L, Vazza G, Orlacchio A, Silvestri G, Santorelli FM, Melone MAB, Casali C. Clinical-Genetic Features Influencing Disability in Spastic Paraplegia Type 4. Neurol Genet 2022; 8:e664. [PMID: 35372684 PMCID: PMC8969300 DOI: 10.1212/nxg.0000000000000664] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/31/2022] [Indexed: 11/15/2022]
Abstract
Background and ObjectivesHereditary spastic paraplegias (HSPs) are a group of inherited rare neurologic disorders characterized by length-dependent degeneration of the corticospinal tracts and dorsal columns, whose prominent clinical feature is represented by spastic gait. Spastic paraplegia type 4 (SPG4, SPAST-HSP) is the most common form. We present both clinical and molecular findings of a large cohort of patients, with the aim of (1) defining the clinical spectrum of SPAST-HSP in Italy; (2) describing their molecular features; and (3) assessing genotype-phenotype correlations to identify features associated with worse disability.MethodsA cross-sectional retrospective study with molecular and clinical data collected in an anonymized database was performed.ResultsA total of 723 Italian patients with SPAST-HSP (58% men) from 316 families, with a median age at onset of 35 years, were included. Penetrance was 97.8%, with men showing higher Spastic Paraplegia Rating Scale (SPRS) scores (19.67 ± 12.58 vs 16.15 ± 12.61, p = 0.009). In 26.6% of patients with SPAST-HSP, we observed a complicated phenotype, mainly including intellectual disability (8%), polyneuropathy (6.7%), and cognitive decline (6.5%). Late-onset cases seemed to progress more rapidly, and patients with a longer disease course displayed a more severe neurologic disability, with higher SPATAX (3.61 ± 1.46 vs 2.71 ± 1.20, p < 0.001) and SPRS scores (22.63 ± 11.81 vs 12.40 ± 8.83, p < 0.001). Overall, 186 different variants in the SPAST gene were recorded, of which 48 were novel. Patients with SPAST-HSP harboring missense variants displayed intellectual disability (14.5% vs 4.4%, p < 0.001) more frequently, whereas patients with truncating variants presented more commonly cognitive decline (9.7% vs 2.6%, p = 0.001), cerebral atrophy (11.2% vs 3.4%, p = 0.003), lower limb spasticity (61.5% vs 44.5%), urinary symptoms (50.0% vs 31.3%, p < 0.001), and sensorimotor polyneuropathy (11.1% vs 1.1%, p < 0.001). Increasing disease duration (DD) and abnormal motor evoked potentials (MEPs) were also associated with increased likelihood of worse disability (SPATAX score>3).DiscussionThe SPAST-HSP phenotypic spectrum in Italian patients confirms a predominantly pure form of HSP with mild-to-moderate disability in 75% of cases, and slight prevalence of men, who appeared more severely affected. Early-onset cases with intellectual disability were more frequent among patients carrying missense SPAST variants, whereas patients with truncating variants showed a more complicated disease. Both longer DD and altered MEPs are associated with worse disability.
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15
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Moro F, Bertoldo V, Avesani G, Moruzzi MC, Mascilini F, Bolomini G, Caliolo G, Esposito R, Moroni R, Zannoni GF, Fagotti A, Manfredi R, Scambia G, Testa AC. Fusion imaging in preoperative assessment of extent of disease in patients with advanced ovarian cancer: feasibility and agreement with laparoscopic findings. Ultrasound Obstet Gynecol 2021; 58:916-925. [PMID: 33847427 DOI: 10.1002/uog.23650] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/19/2021] [Accepted: 03/30/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Fusion imaging is an emerging technique that combines real-time ultrasound examination with images acquired previously using other modalities, such as computed tomography (CT), magnetic resonance imaging and positron emission tomography. The primary aim of this study was to evaluate the feasibility of fusion imaging in patients with suspicion of ovarian or peritoneal cancer. Secondary aims were: to compare the agreement of findings on fusion imaging, CT alone and ultrasound imaging alone with laparoscopic findings, in the assessment of extent of intra-abdominal disease; and to evaluate the time required for the fusion imaging technique. METHODS Patients with clinical and/or radiographic suspicion of advanced ovarian or peritoneal cancer who were candidates for surgery were enrolled prospectively between December 2019 and September 2020. All patients underwent a CT scan and ultrasound and fusion imaging to evaluate the presence or absence of the following abdominal-cancer features according to the laparoscopy-based scoring model (predictive index value (PIV)): supracolic omental disease, visceral carcinomatosis on the liver, lesser omental carcinomatosis and/or visceral carcinomatosis on the lesser curvature of the stomach and/or spleen, involvement of the paracolic gutter(s) and/or anterior abdominal wall, involvement of the diaphragm and visceral carcinomatosis on the small and/or large bowel (regardless of rectosigmoid involvement). The feasibility of the fusion examination in these patients was evaluated. Agreement of each imaging method (ultrasound, CT and fusion imaging) with laparoscopy (considered as reference standard) was calculated using Cohen's kappa coefficient. RESULTS Fifty-two patients were enrolled into the study. Fusion imaging was feasible in 51 (98%) of these patients (in one patient, it was not possible for technical reasons). Two patients were excluded because laparoscopy was not performed, leaving 49 women in the final analysis. Kappa values for CT, ultrasound and fusion imaging, using laparoscopy as the reference standard, in assessing the PIV parameters were, respectively: 0.781, 0.845 and 0.896 for the great omentum; 0.329, 0.608 and 0.847 for the liver surface; 0.472, 0.549 and 0.756 for the lesser omentum and/or stomach and/or spleen; 0.385, 0.588 and 0.795 for the paracolic gutter(s) and/or anterior abdominal wall; 0.385, 0.497 and 0.657 for the diaphragm; and 0.336, 0.410 and 0.469 for the bowel. The median time needed to perform the fusion examination was 20 (range, 10-40) min. CONCLUSION Fusion of CT images and real-time ultrasound imaging is feasible in patients with suspicion of ovarian or peritoneal cancer and improves the agreement with surgical findings when compared with ultrasound or CT scan alone. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- F Moro
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - V Bertoldo
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Avesani
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - M C Moruzzi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - F Mascilini
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Bolomini
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Caliolo
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - R Esposito
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - R Moroni
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Direzione Scientifica, Rome, Italy
| | - G F Zannoni
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Fagotti
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanità Pubblica, Rome, Italy
| | - R Manfredi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Scambia
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanità Pubblica, Rome, Italy
| | - A C Testa
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanità Pubblica, Rome, Italy
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Giansante F, Valentini P, Longo D, Chiaretti A, De Rose C, Moroni R, Buonsenso D. Hospital child social work interventions increased during the COVID-19 pandemic in 2020 and socioeconomic distress was the main cause. Acta Paediatr 2021; 110:3322-3324. [PMID: 34228824 PMCID: PMC8444648 DOI: 10.1111/apa.16022] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/23/2021] [Accepted: 07/05/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Francesca Giansante
- Risk Management Unit Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Desirèe Longo
- Risk Management Unit Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Antonio Chiaretti
- Department of Woman and Child Health and Public Health Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Rossana Moroni
- Biostatistics Fondazione Policlinico Universitario A. Gemelli ‐ IRCCS Rome Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
- Dipartimento di Scienze Biotecnologiche di Base Cliniche Intensivologiche e Perioperatorie Università Cattolica del Sacro Cuore Rome Italy
- Global Health Research Institute Istituto di Igiene Università Cattolica del Sacro Cuore Roma Italy
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17
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Moro F, Bertoldo V, Avesani G, Moruzzi MC, Mascilini F, Bolomini G, Caliolo G, Esposito R, Moroni R, Zannoni GF, Fagotti A, Manfredi R, Scambia G, Testa AC. Fusion imaging in preoperative assessment of extent of disease in patients with advanced ovarian cancer: feasibility and agreement with laparoscopic findings. Ultrasound Obstet Gynecol 2021; 60:256-268. [PMID: 33847427 DOI: 10.1002/uog.24805] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 12/24/2020] [Revised: 10/07/2021] [Accepted: 10/13/2021] [Indexed: 05/25/2023]
Abstract
OBJECTIVES Fusion imaging is an emerging technique that combines real-time ultrasound examination with images acquired previously using other modalities, such as computed tomography (CT), magnetic resonance imaging and positron emission tomography. The primary aim of this study was to evaluate the feasibility of fusion imaging in patients with suspicion of ovarian or peritoneal cancer. Secondary aims were: to compare the agreement of findings on fusion imaging, CT alone and ultrasound imaging alone with laparoscopic findings, in the assessment of extent of intra-abdominal disease; and to evaluate the time required for the fusion imaging technique. METHODS Patients with clinical and/or radiographic suspicion of advanced ovarian or peritoneal cancer who were candidates for surgery were enrolled prospectively between December 2019 and September 2020. All patients underwent a CT scan and ultrasound and fusion imaging to evaluate the presence or absence of the following abdominal-cancer features according to the laparoscopy-based scoring model (predictive index value (PIV)): supracolic omental disease, visceral carcinomatosis on the liver, lesser omental carcinomatosis and/or visceral carcinomatosis on the lesser curvature of the stomach and/or spleen, involvement of the paracolic gutter(s) and/or anterior abdominal wall, involvement of the diaphragm and visceral carcinomatosis on the small and/or large bowel (regardless of rectosigmoid involvement). The feasibility of the fusion examination in these patients was evaluated. Agreement of each imaging method (ultrasound, CT and fusion imaging) with laparoscopy (considered as reference standard) was calculated using Cohen's kappa coefficient. RESULTS Fifty-two patients were enrolled into the study. Fusion imaging was feasible in 51 (98%) of these patients (in one patient, it was not possible for technical reasons). Two patients were excluded because laparoscopy was not performed, leaving 49 women in the final analysis. Kappa values for CT, ultrasound and fusion imaging, using laparoscopy as the reference standard, in assessing the PIV parameters were, respectively: 0.781, 0.845 and 0.896 for the great omentum; 0.329, 0.608 and 0.847 for the liver surface; 0.472, 0.549 and 0.756 for the lesser omentum and/or stomach and/or spleen; 0.385, 0.588 and 0.795 for the paracolic gutter(s) and/or anterior abdominal wall; 0.385, 0.497 and 0.657 for the diaphragm; and 0.336, 0.410 and 0.469 for the bowel. The median time needed to perform the fusion examination was 20 (range, 10-40) min. CONCLUSION Fusion of CT images and real-time ultrasound imaging is feasible in patients with suspicion of ovarian or peritoneal cancer and improves the agreement with surgical findings when compared with ultrasound or CT scan alone. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- F Moro
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - V Bertoldo
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Avesani
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - M C Moruzzi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - F Mascilini
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Bolomini
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Caliolo
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - R Esposito
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - R Moroni
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Direzione Scientifica, Rome, Italy
| | - G F Zannoni
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Fagotti
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanità Pubblica, Rome, Italy
| | - R Manfredi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Scambia
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanità Pubblica, Rome, Italy
| | - A C Testa
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanità Pubblica, Rome, Italy
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Savastano MC, Gambini G, Savastano A, Falsini B, De Vico U, Sanguinetti M, Cattani P, Marchetti S, Larici AR, Franceschi F, Santoliquido A, Moroni R, Cambieri A, Bellantone R, Landi F, Scambia G, Rizzo S. Evidence-based of conjunctival COVID-19 positivity: An Italian experience: Gemelli Against COVID Group. Eur J Ophthalmol 2021; 31:2886-2893. [PMID: 33356534 PMCID: PMC7768604 DOI: 10.1177/1120672120976548] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 10/18/2020] [Accepted: 11/05/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The possible transmission of severe acute respiratory coronavirus 2 (SARS-CoV-2) by tears and conjunctiva is still debated. METHODS Main outcome was to investigate the agreement between nasopharyngeal swab (NPs) and conjunctival swabs (Cs) in patients with SARS-CoV-2 infection. We divided patients into four groups: (1) NPs and Cs both negative (C-NF-), (2) NPs positive and Cs negative (NFs+Cs-), (3) NPs negative and Cs positive (NFs-Cs+), and (4) NPs and Cs both positive (NFs-Cs+). The secondary outcomes were to correlate Cs results with systemic clinical parameters such as: oxygen saturation (SpO2), dyspnea degree (DP), radiologic pulmonary impairment based on chest radiography (XR) or computed tomography (CT), blood chemistry as D-Dimer (D-Dimer), fibrinogen, ferritin, lactate dehydrogenase (LDH), and C-reactive protein (C-RP). RESULTS A total of 100 conjunctival swabs in 50 patients with SARS-CoV-2 have been enrolled in this interventional clinical trials. Ocular signs (conjunctivitis) were present in five patients (10%). NPs and Cs highlighted a poor level of agreement (0.025; p = 0.404). Median SpO2 levels are the highest in the NF-C- group (98%) and the lowest (90%) in the group NF+C+ (p = 0.001). Pulmonary impairment was statistically significantly different between NFs and Cs groups (p = 0.019). Pulmonary impairment score increased from NFs-Cs- group (3.8 ± 3.9), to NFs+Cs+ group (6.7 ± 4.1). Intensive care unit patients showed higher COVID-19 Cs positivity in conjunctiva (12.5%) against hospitalized ones (5.8%). CONCLUSIONS In patients hospitalized for SARS-CoV-2 the virus can be detected in conjunctival swab. Intensive care unit patients may reveal a higher COVID-19 presence in the conjunctiva. The most severe pulmonary impairment can be observed in NFs and Cs positivity. TRIAL REGISTRATION Clinicaltrials.gov registration. ETHICAL COMMITTEE AUTHORIZATION ID number: 0013008/20.
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Affiliation(s)
- Maria Cristina Savastano
- Ophthalmology Unit, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Italy
- Catholic University “Sacro Cuore”, Rome, Italy
| | - Gloria Gambini
- Ophthalmology Unit, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Italy
- Catholic University “Sacro Cuore”, Rome, Italy
| | - Alfonso Savastano
- Ophthalmology Unit, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Italy
- Catholic University “Sacro Cuore”, Rome, Italy
| | - Benedetto Falsini
- Ophthalmology Unit, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Italy
- Catholic University “Sacro Cuore”, Rome, Italy
| | - Umberto De Vico
- Ophthalmology Unit, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Italy
- Catholic University “Sacro Cuore”, Rome, Italy
| | - Maurizio Sanguinetti
- Institute of Microbiology, Catholic University of “Sacro Cuore”, Rome, Italy
- Department of Laboratory and Infectious Science, “FondazionePoliclinico Universitario A. Gemelli IRCCS”, Rome, Lazio, Italy
| | - Paola Cattani
- Catholic University “Sacro Cuore”, Rome, Italy
- Department of Diagnostic and Laboratory Medicine, Institute of Microbiology, Catholic University of “Sacro Cuore”, Rome, Lazio, Italy
| | - Simona Marchetti
- Catholic University “Sacro Cuore”, Rome, Italy
- Department of Diagnostic and Laboratory Medicine, Institute of Microbiology, Catholic University of “Sacro Cuore”, Rome, Lazio, Italy
| | - Anna Rita Larici
- Catholic University “Sacro Cuore”, Rome, Italy
- Department of Radiology, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Lazio, Italy
| | - Francesco Franceschi
- Catholic University “Sacro Cuore”, Rome, Italy
- Emergency Medicine, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Lazio, Italy
| | - Angelo Santoliquido
- Catholic University “Sacro Cuore”, Rome, Italy
- Emergency Medicine, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Lazio, Italy
| | - Rossana Moroni
- Scientific Direction, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Lazio, Italy
| | - Andrea Cambieri
- Hospital Health Management, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Italy
| | - Rocco Bellantone
- Catholic University “Sacro Cuore”, Rome, Italy
- Division of Endocrine and Metabolic Surgery, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Lazio, Italy
| | - Francesco Landi
- Catholic University “Sacro Cuore”, Rome, Italy
- Department of Geriatrics, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Lazio, Italy
| | - Giovanni Scambia
- Catholic University “Sacro Cuore”, Rome, Italy
- “Dipartimento scienze della salute della donna e del bambino e di sanità pubblica”, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Lazio, Italy
| | - Stanislao Rizzo
- Ophthalmology Unit, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Italy
- Catholic University “Sacro Cuore”, Rome, Italy
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Pisa, Italy
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19
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Di Giorgio A, Rotolo S, Cintoni M, Rinninella E, Pulcini G, Schena CA, Ferracci F, Grassi F, Raoul P, Moroni R, Pacelli F, Gasbarrini A, Mele MC. The prognostic value of skeletal muscle index on clinical and survival outcomes after cytoreduction and HIPEC for peritoneal metastases from colorectal cancer: A systematic review and meta-analysis. Eur J Surg Oncol 2021; 48:649-656. [PMID: 34696936 DOI: 10.1016/j.ejso.2021.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/22/2021] [Revised: 09/30/2021] [Accepted: 10/12/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Cytoreductive surgery (CRS) and hypertermic intraperitoneal chemotherapy (HIPEC) represent the most effective strategy to manage peritoneal metastases (PM). This systematic review and meta-analysis aimed to assess the impact of body composition on clinical outcomes in patients with PM. METHODS A systematic literature search was performed using Medline, Web of Science and EMBASE databases from inception to the 20st August 2020. Data were independently extracted by 3 authors. Newcastle-Ottawa Scale was used to assess quality and risk of bias of studies. Pooled analyses were performed using Mantel-Haenszel method to estimate overall effect size with mean differences or odd ratios (ORs) and 95% confidence interval (CI). The primary outcome was postoperative complication (POC) rate, while secondary outcomes were severe POC and postoperative mortality. RESULTS A total of 4 studies were included in the systematic review and meta-analysis, including 582 patients. A significant association between low skeletal muscle mass and POC was found (OR 1.45, 95% CI 1.04 to 2.03; p = 0.03), while no differences were found in terms operative time, estimated blood loss, length of hospital stay, and postoperative mortality (p > 0.05). CONCLUSIONS Low skeletal muscle mass at diagnosis is a valid prognostic factor for POC development in colorectal and PM patients undergoing CRS. Prospective and larger studies are needed to better investigate the role of CT scan derived body composition and to understand how to implement this tool in clinical practice.
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Affiliation(s)
- Andrea Di Giorgio
- UOS Trattamenti Integrati Della Carcinosi Peritoneale Avanzata, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Stefano Rotolo
- UOC Chirurgia Del Peritoneo e Del Retroperitoneo, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy; Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche (Di.Chir.On.S.), Università Degli Studi di Palermo, Via Liborio Giuffrè 5, 90127, Palermo, Italy
| | - Marco Cintoni
- Scuola di Specializzazione in Scienza Dell'Alimentazione, Università di Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
| | - Emanuele Rinninella
- UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Gabriele Pulcini
- UOSD di Nutrizione Avanzata in Oncologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Carlo Alberto Schena
- UOC Chirurgia Del Peritoneo e Del Retroperitoneo, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Federica Ferracci
- UOC Chirurgia Del Peritoneo e Del Retroperitoneo, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Futura Grassi
- UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Pauline Raoul
- UOSD di Nutrizione Avanzata in Oncologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Rossana Moroni
- Direzione Scientifica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Fabio Pacelli
- UOC Chirurgia Del Peritoneo e Del Retroperitoneo, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Antonio Gasbarrini
- UOC Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy; Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica Del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy
| | - Maria Cristina Mele
- UOSD di Nutrizione Avanzata in Oncologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy; Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica Del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy
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Nero C, Romito I, Spadola S, Romito A, Turco LC, Cosentino F, De Ninno M, Catena U, De Cicco Nardone A, Moroni R, Zannoni G, Fagotti A, Scambia G. Infiltrating T lymphocytes and programmed cell death protein-1/programmed death-ligand 1 expression in endometriosis-associated ovarian cancer. Fertil Steril 2021; 117:160-168. [PMID: 34656305 DOI: 10.1016/j.fertnstert.2021.08.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 06/18/2021] [Revised: 08/15/2021] [Accepted: 08/19/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To characterize T lymphocyte infiltration and programmed cell death protein-1 (PD-1)/programmed death-ligand 1 (PD-L1) expression in early-stage endometriosis-associated ovarian cancer (EAOC), ovarian endometriosis (OE), atypical endometriosis (AE), and deep endometriosis (DE). DESIGN Case-control, retrospective study. SETTING Research University Hospital. PATIENT(S) A total of 362 patients with a histologic diagnosis of EAOC, OE, AE, or DE were identified between 2000 and 2019 from Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Gemelli Molise SpA tissue data banks. A 1:1 propensity score-matched method yielded matched pairs of 55 subjects with EAOC, 55 patients with OE, 12 patients with AE, and 42 patients with DE, resulting in no differences in family history of cancer, parity, and use of oral contraceptives. INTERVENTION(S) Immunohistochemistry assays using the following primary antibodies: CD3+; CD4+; CD8+; PD-1; and PD-L1. MAIN OUTCOME MEASURE(S) To characterize T lymphocyte infiltration and PD-1/PD-L1 expression in 4 different endometriosis-related diseases. RESULT(S) Endometriosis-associated ovarian cancer cases displayed significantly higher levels of PD-1/PD-L1 expression compared with all other endometriosis-related diseases (vs. OE vs. AE vs. DE). Moreover, a significantly lower count of infiltrating T lymphocytes was observed in EAOC cases compared with OE ones. Finally, one-third of OE cases showed a cancer-like PD-1/PD-L1 expression profile. CONCLUSION(S) Endometriosis-associated ovarian cancer is characterized by higher levels of PD-1/PD-L1 expression compared with benign endometriosis-related diseases. This profile was found in one-third of clinically benign cases, suggesting that it develops early in the carcinogenesis process.
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Affiliation(s)
- Camilla Nero
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento per le Scienze della salute della donna, del bambino e di Sanità Pubblica, Roma, Italia; Università Cattolica del Sacro Cuore, Roma, Italia.
| | | | - Saveria Spadola
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento per le Scienze della salute della donna, del bambino e di Sanità Pubblica, Roma, Italia
| | | | - Luigi Carlo Turco
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento per le Scienze della salute della donna, del bambino e di Sanità Pubblica, Roma, Italia
| | | | - Maria De Ninno
- Gynecologic Oncology Division, Gemelli Molise SpA, Campobasso, Italia
| | - Ursula Catena
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento per le Scienze della salute della donna, del bambino e di Sanità Pubblica, Roma, Italia
| | - Alessandra De Cicco Nardone
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento per le Scienze della salute della donna, del bambino e di Sanità Pubblica, Roma, Italia
| | - Rossana Moroni
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento per le Scienze della salute della donna, del bambino e di Sanità Pubblica, Roma, Italia
| | - Gianfranco Zannoni
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento per le Scienze della salute della donna, del bambino e di Sanità Pubblica, Roma, Italia; Università Cattolica del Sacro Cuore, Roma, Italia
| | - Anna Fagotti
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento per le Scienze della salute della donna, del bambino e di Sanità Pubblica, Roma, Italia; Università Cattolica del Sacro Cuore, Roma, Italia
| | - Giovanni Scambia
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento per le Scienze della salute della donna, del bambino e di Sanità Pubblica, Roma, Italia; Università Cattolica del Sacro Cuore, Roma, Italia
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21
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Rossi S, Santorelli FM, Silvestri G, Riso V, Moroni R, Ulgheri L, Cereda C, Diamanti L, Plumari M, Fabbro BD, Straccia G, Orologio I, Dato C, Filla A, Criscuolo C, Dotti MT, Mignarri A, Orsi L, D'Angelo MG, Bassi MT, Martinuzzi A, Stefan C, Scarlato M, Musumeci O, Bertini E, Nicita F, Massa R, Liguori R, Rizzo G, Seri M, Romano S, Di Muzio A, Petrucci A, Vazza G, Pegoraro E, Orlacchio A, Melone M, Casali C. Clinical and genetic features of a large cohort of Italian SPG4 patients from the D.A.I.S.Y. collaborative network. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.118251] [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]
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22
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Restaino S, Vargiu V, Rosati A, Bruno M, Dinoi G, Cola E, Moroni R, Scambia G, Fanfani F. 4K versus 3D total laparoscopic hysterectomy by resident in training: a prospective randomised trial. Facts Views Vis Obgyn 2021; 13:221-229. [PMID: 34555876 PMCID: PMC8823275 DOI: 10.52054/fvvo.13.3.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background The introduction of ultra-high-definition laparoscopic cameras (4K), by providing stronger monocular depth perception, could challenge the existing 3D technology. There are few available studies on this topic, especially in gynaecological setting. Objectives Prospective, single institution, randomised clinical trial (NCT04209036). Materials and Methods The two laparoscopes utilised were the 0°ULTRA Telescopes with 4K technology and the 0°3D-HD by Olympus. The surgeons were all trainees and in their last year of residency and who had obtained the certificate of first or second level of the Gynaecological Endoscopic Surgical Education and Assessment program - GESEA program. Twenty-nine patients with benign uterine pathology were enrolled. Main outcome measures To compare if the use three-dimensional (3D) versus ultra-high-definition laparoscopic vision system (4K) for total laparoscopic hysterectomy performed by trainees was associated with a shorter operative time. Results The 3D vision system did not prove to be superior to the 4K vision system. Operators reported significantly more vision-related side effects when using 3D than 4K. Completing the GESEA training program was the only factor with a positive and statistically significant impact on the overall time of the procedure, especially when greater dexterity and tissue handling were required. Conclusions Neither technology used proved superior to the other, although operators showed a preference for 4K over 3D due to the lower number of visual side effects. Attendance at courses on laparoscopic simulators and training programs allowed trainees to demonstrate excellent surgical skills.
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23
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Chiappetta M, Lococo F, Zanfrini E, Moroni R, Aprile V, Guerrera F, Nachira D, Congedo MT, Ambrogi MC, Korasidis S, Lucchi M, Filosso PL, Ruffini E, Sperduti I, Meacci E, Margaritora S. The International Thymic Malignancy Interest Group Classification of Thymoma Recurrence: Survival Analysis and Perspectives. J Thorac Oncol 2021; 16:1936-1945. [PMID: 34256111 DOI: 10.1016/j.jtho.2021.07.004] [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] [Received: 11/16/2020] [Revised: 06/09/2021] [Accepted: 07/04/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The International Thymic Malignancy Interest Group (ITMIG) classifies thymoma recurrences on the basis of the topographic location, but its effectiveness in prognosis prediction has not been well investigated yet. Aims of this study are to analyze survival outcome of patients surgically treated for thymoma recurrence according to the ITMIG recurrence classification and to investigate possible alternatives. METHODS From January 1, 1990, to January 7, 2017, data on 135 surgically treated patients for thymoma recurrence from three high-volume centers were collected and retrospectively analyzed. Patients were classified according to the ITMIG classification as local, regional, and distant. The ITMIG classification and alternative classifications were correlated to overall survival (OS). RESULTS According to the ITMIG classification, recurrence was local in 17 (12.5%), regional in 97 (71.8%), and distant in 21 (15.7%) patients, with single localization in 38 (28.2%) and multiple localizations in 97 (71.8%). The 5- and 10-year OS were 79.9% and 49.7% in local, 68.3% and 52.6% in regional, and 66.3% and 35.4% in distant recurrences, respectively, but differences were not statistically significant (p = 0.625). A significant difference in survival was present considering single versus multiple localizations: 5- and 10-year OS of 86.2% and 81.2% versus 61.3% and 31.5% (p = 0.005, hazard ratio = 7.22, 95% confidence interval: 0.147-0.740), respectively. Combining the localization number with the recurrence site, ITMIG locoregional single recurrence had a statistically significant better survival compared with patients with ITMIG locoregional multiple recurrence or ITMIG distant recurrence (p = 0.028). Similarly, a significant difference was present considering intrathoracic single versus intrathoracic multiple versus distant recurrence (p = 0.024). CONCLUSIONS The ITMIG classification for thymoma recurrence did not have significant survival differences comparing local, regional, and distant recurrences. Integrating this classification with the number of the localizations may improve its effectiveness in prognosis prediction.
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Affiliation(s)
- Marco Chiappetta
- Thoracic Surgery, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Filippo Lococo
- Thoracic Surgery, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Edoardo Zanfrini
- Thoracic Surgery, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rossana Moroni
- Office of the Scientific Director, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Vittorio Aprile
- Thoracic Surgery, Cardiac Thoracic and Vascular Department, University of Pisa, Pisa, Italy
| | | | - Dania Nachira
- Thoracic Surgery, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Teresa Congedo
- Thoracic Surgery, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marcello Carlo Ambrogi
- Thoracic Surgery, Cardiac Thoracic and Vascular Department, University of Pisa, Pisa, Italy
| | - Stylianos Korasidis
- Thoracic Surgery, Cardiac Thoracic and Vascular Department, University of Pisa, Pisa, Italy
| | - Marco Lucchi
- Thoracic Surgery, Cardiac Thoracic and Vascular Department, University of Pisa, Pisa, Italy
| | | | | | - Isabella Sperduti
- Biostatistics, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Elisa Meacci
- Thoracic Surgery, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefano Margaritora
- Thoracic Surgery, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
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24
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Savastano A, Bacherini D, Savastano MC, Finocchio L, Dragotto F, Lenzetti C, Moroni R, Caporossi T, Rizzo S. OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FINDINGS BEFORE AND AFTER VITRECTOMY FOR MACULAR HOLES: Useful or Useless? Retina 2021; 41:1379-1388. [PMID: 34137384 DOI: 10.1097/iae.0000000000003059] [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] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the vascular remodeling of optical coherence tomography angiography in full-thickness macular hole surgery. METHODS This retrospective, observational case series included 33 eyes of 33 patients with a full-thickness macular hole who underwent epiretinal membrane removal. Data were collected on best-corrected visual acuity, structural B-scan optical coherence tomography, and optical coherence tomography angiography preoperatively and at 1, 3, and 6 months postoperatively. Optical coherence tomography angiography was used to assess the retinal vascular density (VD) of the superficial vascular plexus and deep vascular plexus (DVP). Vascular density was assessed using the Early Treatment Diabetic Retinopathy Study grid for the whole, inner, and outer grids. RESULTS A statistically significant correlation was found between the VD (whole, inner, and outer grids) of the superficial vascular plexus alone from baseline to 1-month postoperatively (P < 0.001). Similarly, VD was correlated from baseline to 1, 3, and 6 months postoperatively to the whole (P < 0.0005, F = 23.22), inner (P < 0.0005, F = 28.23), and outer Early Treatment Diabetic Retinopathy Study grids of DVP (P = 0.033, F = 3.49). The best-corrected visual acuity and VD were significantly correlated with the superficial vascular plexus and DVP at baseline and 6 months (P < 0.05, all correlations). The most significant correlation was observed at 6 months between best-corrected visual acuity and DVP in the whole, inner, and outer Early Treatment Diabetic Retinopathy Study grids (P < 0.001). CONCLUSION Superficial vascular plexus and DVP are affected by full-thickness macular holes, with the most significant effects being on the DVP. Full-thickness macular hole surgery leads to an improvement in the best-corrected visual acuity in many eyes and the restoration of the VD, especially of the DVP.
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Affiliation(s)
- Alfonso Savastano
- Ophthalmology Unit, "Fondazione Policlinico Universitario "A. Gemelli" IRCCS," Rome, Italy
- Catholic University of "Sacro Cuore," Rome, Italy
| | - Daniela Bacherini
- Department of Translational Surgery and Medicine, Eye Clinic, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Maria C Savastano
- Ophthalmology Unit, "Fondazione Policlinico Universitario "A. Gemelli" IRCCS," Rome, Italy
- Catholic University of "Sacro Cuore," Rome, Italy
| | | | - Francesco Dragotto
- Ophthalmology Unit, "Fondazione Policlinico Universitario "A. Gemelli" IRCCS," Rome, Italy
| | - Chiara Lenzetti
- Ophthalmology Unit, "Fondazione Policlinico Universitario "A. Gemelli" IRCCS," Rome, Italy
| | - Rossana Moroni
- Scientific Direction, "Fondazione Policlinico Universitario "A. Gemelli" IRCCS," Rome, Italy ; and
| | - Tomaso Caporossi
- Department of Translational Surgery and Medicine, Eye Clinic, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Stanislao Rizzo
- Ophthalmology Unit, "Fondazione Policlinico Universitario "A. Gemelli" IRCCS," Rome, Italy
- Catholic University of "Sacro Cuore," Rome, Italy
- National Research Council, Institute of Neuroscience, Pisa, Italy
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25
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Mercurio G, D'Arrigo S, Moroni R, Grieco DL, Menga LS, Romano A, Annetta MG, Bocci MG, Eleuteri D, Bello G, Montini L, Pennisi MA, Conti G, Antonelli M. Diaphragm thickening fraction predicts noninvasive ventilation outcome: a preliminary physiological study. Crit Care 2021; 25:219. [PMID: 34174903 PMCID: PMC8233594 DOI: 10.1186/s13054-021-03638-x] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/09/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND A correlation between unsuccessful noninvasive ventilation (NIV) and poor outcome has been suggested in de-novo Acute Respiratory Failure (ARF) patients. Consequently, it is of paramount importance to identify accurate predictors of NIV outcome. The aim of our preliminary study is to evaluate the Diaphragmatic Thickening Fraction (DTF) and the respiratory rate/DTF ratio as predictors of NIV outcome in de-novo ARF patients. METHODS Over 36 months, we studied patients admitted to the emergency department with a diagnosis of de-novo ARF and requiring NIV treatment. DTF and respiratory rate/DTF ratio were measured by 2 trained operators at baseline, at 1, 4, 12, 24, 48, 72 and 96 h of NIV treatment and/or until NIV discontinuation or intubation. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the ability of DTF and respiratory rate/DTF ratio to distinguish between patients who were successfully weaned and those who failed. RESULTS Eighteen patients were included. We found overall good repeatability of DTF assessment, with Intra-class Correlation Coefficient (ICC) of 0.82 (95% confidence interval 0.72-0.88). The cut-off values of DTF for prediction of NIV failure were < 36.3% and < 37.1% for the operator 1 and 2 (p < 0.0001), respectively. The cut-off value of respiratory rate/DTF ratio for prediction of NIV failure was > 0.6 for both operators (p < 0.0001). CONCLUSION DTF and respiratory rate/DTF ratio may both represent valid, feasible and noninvasive tools to predict NIV outcome in patients with de-novo ARF. Trial registration ClinicalTrials.gov Identifier: NCT02976233, registered 26 November 2016.
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Affiliation(s)
- Giovanna Mercurio
- Department of Anesthesiology, Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.
| | - Sonia D'Arrigo
- Department of Anesthesiology, Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - Rossana Moroni
- Biostatistics, Office of the Scientific Director, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Domenico Luca Grieco
- Department of Anesthesiology, Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - Luca Salvatore Menga
- Department of Anesthesiology, Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - Anna Romano
- Institute of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Maria Giuseppina Annetta
- Department of Anesthesiology, Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - Maria Grazia Bocci
- Department of Anesthesiology, Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - Davide Eleuteri
- Department of Anesthesiology, Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - Giuseppe Bello
- Department of Anesthesiology, Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - Luca Montini
- Department of Anesthesiology, Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.,Institute of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Mariano Alberto Pennisi
- Department of Anesthesiology, Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.,Institute of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Giorgio Conti
- Department of Anesthesiology, Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.,Institute of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Massimo Antonelli
- Department of Anesthesiology, Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.,Institute of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy
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26
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Caruso C, Colantuono S, Urbani S, Heffler E, Canonica GW, Andriollo G, Di Michele L, Scarlata S, Zennaro D, Rigon A, Vadacca M, Moroni R, Nucera E, Gasbarrini A. Real-life survey on severe asthma patients during COVID-19 lockdown in Italy. Expert Rev Respir Med 2021; 15:1057-1060. [PMID: 33896350 DOI: 10.1080/17476348.2021.1917387] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Introduction: The SARS-CoV-2 pandemic has deeply revolutionized our lives and consequently the management of patients, specifically ones with severe asthma.Objective: A survey was conducted to evaluate the effects on adherence, exacerbations and quality of life in patients with severe asthma during the COVID-19 pandemic period.Methods: 100 severe asthma patients, who accepted to participate to the survey, were asked to respond to different questionnaires in order to assess asthma symptoms (Asthma Control Test - ACT, and Asthma Control Quality - ACQ) and rino-sinusal ones (Sino-nasal outcome test - SNOT-22).Results: 31 out of 100 patients reported worsening of respiratory symptoms requiring a step-up in therapy dosage or frequency during the observational period; however, exacerbation rate was very low. Only 17 (17%) of the 100 participants experienced a severe asthma exacerbation. Moreover, there was no confirmed diagnosis of COVID-19 in this population.Conclusion: Patients with severe asthma did not show higher rates of exacerbations during the pandemic outbreak as well as no increased risk of contracting COVID-19 infection or developing the disease. Self-administration of biological drugs could be useful to maintain high rates of adherence to therapy, and, at the same time, to decrease the risk of exacerbations or Intensive Care Unit (ICU) room access.
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Affiliation(s)
- Cristiano Caruso
- Allergy Unit, Fondazione Policlinico A. Gemelli, IRCCS, Rome, Italy
| | - Stefania Colantuono
- Allergy Unit, Fondazione Policlinico A. Gemelli, IRCCS, Rome, Italy.,Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Sara Urbani
- Allergy Unit, Fondazione Policlinico A. Gemelli, IRCCS, Rome, Italy
| | - Enrico Heffler
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Giorgio Walter Canonica
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Gloria Andriollo
- Allergy Unit, Fondazione Policlinico A. Gemelli, IRCCS, Rome, Italy
| | - Loreta Di Michele
- Pulmonary Interstitial Diseases Unit, UOS Interstiziopatie Polmonari Az Osp. S. Camillo-Forlanini, Roma, Italy
| | - Simone Scarlata
- Unit of Geriatrics, Campus Bio-Medico di Roma University, Rome, Italy
| | - Danila Zennaro
- Unit of Allergology, Clinical Immunology and Rheumatology, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy
| | - Amelia Rigon
- Unit of Allergology, Clinical Immunology and Rheumatology, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy
| | - Marta Vadacca
- Unit of Allergology, Clinical Immunology and Rheumatology, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy
| | - Rossana Moroni
- Biostatistico Presso Direzione Scientifica, Fondazione Policlinico A. Gemelli, IRCCS, Rome, Italy
| | - Eleonora Nucera
- Allergy Unit, Fondazione Policlinico A. Gemelli, IRCCS, Rome, Italy
| | - Antonio Gasbarrini
- Division of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Catholic University of the Sacred Heart, Rome, Italy
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27
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Litta F, Bracchitta S, Naldini G, Mistrangelo M, Tricomi N, La Torre M, Altomare DF, Mozzon M, Testa A, Zigiotto D, Sica G, Tutino R, Lisi G, Marino F, Luglio G, Vergari R, Terrosu G, Cantarella F, Foti N, Giuliani A, Moroni R, Ratto C. FISSIT (Fistula Surgery in Italy) study: A retrospective survey on the surgical management of anal fistulas in Italy over the last 15 years. Surgery 2021; 170:689-695. [PMID: 33846008 DOI: 10.1016/j.surg.2021.02.055] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Surgical treatment of anal fistulas is still a challenge. The aims of this study were to evaluate the adoption and healing rates for the different surgical techniques used in Italy over the past 15 years. METHODS This was a multicenter retrospective observational study of patients affected by simple and complex anal fistulas of cryptoglandular origin who were surgically treated in the period 2003-2017. Surgical techniques were grouped as sphincter-cutting or sphincter-sparing and as technology-assisted or techno-free. All patients included in the study were followed for at least 12 months. RESULTS A total of 9,536 patients (5,520 simple; 4,016 complex fistulas) entered the study. For simple fistulas, fistulotomy was the most frequently used procedure, although its adoption significantly decreased over the years (P < .0005), with an increase in sphincter-sparing approaches; the overall healing rate in simple fistulas was 81.1%, with a significant difference between sphincter-cutting (91.9%) and sphincter-sparing (65.1%) techniques (P = .001). For complex fistulas, the adoption of sphincter-cutting approaches decreased, while sphincter-sparing techniques were mildly preferred (P < .0005). Moreover, there was a significant trend toward the use of technology-assisted procedures. The overall healing rate for complex fistulas was 69.0%, with a measurable difference between sphincter-cutting (81.1%) and sphincter-sparing (61.4%; P = .001) techniques and between techno-free and technology-assisted techniques (72.5% and 55.0%, respectively; P = .001). CONCLUSION Surgical treatment of anal fistulas has changed, with a trend toward the use of sphincter-sparing techniques. The overall cure rate has remained stable, even if the most innovative procedures have achieved a lower success rate.
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Affiliation(s)
- Francesco Litta
- Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
| | | | - Gabriele Naldini
- Proctology and Pelvic Floor Clinical Centre, University Hospital of Pisa, Italy
| | - Massimiliano Mistrangelo
- Surgical Science Department, University of Turin, Città della Salute e della Scienza Hospital, Turin, Italy
| | | | - Marco La Torre
- Coloproctology Unit, Salvator Mundi International Hospital, UPMC (University of Pittsburgh Medical College), Rome, Italy
| | | | - Marta Mozzon
- Chirurgia Generale, Azienda Ospedaliero Universitaria Friuli Centrale, Udine, Italy
| | | | - Daniele Zigiotto
- Proctological and Perineal Surgical Unit, Ospedale Civile Maggiore, University of Verona, Verona, Italy
| | - Giuseppe Sica
- Department of Surgical Science, University Hospital Tor Vergata, Rome, Italy
| | - Roberta Tutino
- Department of Surgical, Oncological and Stomatological Disciplines (Di. Chir. On. S.), University of Palermo, Italy
| | - Giorgio Lisi
- General Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - Fabio Marino
- Unit of Surgery, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Gaetano Luglio
- Department of Public Health, School of Medicine Federico II of Naples, Naples, Italy
| | - Roberto Vergari
- Clinica Chirurgica, Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona, Italy
| | | | | | - Nicola Foti
- UOC Chirurgia Generale e Week Surgery, Ospedale "Andosilla" di Civita Castellana (VT), Italy
| | - Antonio Giuliani
- U.O.C. Chirurgia Generale Universitaria, San Salvatore Hospital. Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | - Rossana Moroni
- Direzione Scientifica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Carlo Ratto
- Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Catholic University of Rome, Italy
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Gallotta V, Jeong SY, Conte C, Trozzi R, Cappuccio S, Moroni R, Ferrandina G, Scambia G, Kim TJ, Fagotti A. Minimally invasive surgical staging for early stage ovarian cancer: A long-term follow up. Eur J Surg Oncol 2021; 47:1698-1704. [PMID: 33573854 DOI: 10.1016/j.ejso.2021.01.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/27/2021] [Accepted: 01/31/2021] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION The standard treatment for epithelial early stage ovarian cancer (eEOC) includes laparotomic surgical staging, according to ESGO-ESMO guidelines. In the last decade, many investigators have assessed the safety and feasibility of minimally invasive surgery (MIS) staging in properly selected patients. However, survival data related to different surgical approaches (open versus MIS) are extremely limited. The aim of this study is to analyze the long-term oncological outcomes in eEOC patients treated with MIS. MATERIALS AND METHODS This is a multicenter observational retrospective study conducted in two tertiary oncological centers. We selected all consecutive women who underwent a laparoscopic or robotic staging for eEOC. RESULTS From January 2008 to December 2016, 254 eEOC patients underwent a MIS staging (188 laparoscopic staging and 66 robotic staging). Overall, 18.1% of patients were upstaged due to pathological findings. A total of 203 (79.9%) patients received platinum-based adjuvant chemotherapy. After a median follow-up of 61 months (range 13-118), 39 (15.3%) patients experienced recurrence. The 5-years progression free survival (PFS) and overall survival rates were 84.0% and 93.8%, respectively. In the univariate analysis, favorable variables influencing PFS were young age (≤45 years), non-serous histotype, tumor grade 1-2, and FIGO stage IA/IB. In the multivariate analysis, only grade 3 was shown to keep its negative independent prognostic value (HR = 3.47; p = 0.004), whereas FIGO stage ≥ IC showed a trend toward significance (HR = 1.75; p = 0.099). CONCLUSION This retrospective study represents the longest follow-up of eEOC patients managed by MIS. The MIS is a valuable therapeutic option in appropriately selected patients, although a randomized controlled trial is needed.
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Affiliation(s)
- Valerio Gallotta
- Woman, Child and Public Health Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
| | - Soo Young Jeong
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea
| | - Carmine Conte
- Woman, Child and Public Health Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore Sede di Roma, Roma, Italy
| | - Rita Trozzi
- Università Cattolica del Sacro Cuore Sede di Roma, Roma, Italy
| | - Serena Cappuccio
- Woman, Child and Public Health Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Rossana Moroni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Gabriella Ferrandina
- Woman, Child and Public Health Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore Sede di Roma, Roma, Italy
| | - Giovanni Scambia
- Woman, Child and Public Health Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore Sede di Roma, Roma, Italy
| | - Tae-Joong Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea.
| | - Anna Fagotti
- Woman, Child and Public Health Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore Sede di Roma, Roma, Italy
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29
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Ferrandina G, Gallotta V, Federico A, Fanfani F, Ercoli A, Chiantera V, Cosentino F, Turco LC, Legge F, Anchora LP, Bizzarri N, Moroni R, Macchia G, Valentini V, Scambia G. Minimally Invasive Approaches in Locally Advanced Cervical Cancer Patients Undergoing Radical Surgery After Chemoradiotherapy: A Propensity Score Analysis. Ann Surg Oncol 2020; 28:3616-3626. [PMID: 33165720 PMCID: PMC8184543 DOI: 10.1245/s10434-020-09302-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 05/26/2020] [Accepted: 10/13/2020] [Indexed: 12/24/2022]
Abstract
Purpose Chemoradiation (CT/RT) followed by radical surgery (RS) may play a role in locally advanced cervical cancer (LACC) patients with suboptimal response to CT/RT or in low-income countries with limited access to radiotherapy. Our aim is to evaluate oncological and surgical outcomes of minimally invasive radical surgery (MI-RS) compared with open radical surgery (O-RS). Patients and Methods Data for stage IB2–IVA cervical cancer patients managed by CT/RT and RS were retrospectively analyzed. Results Beginning with 686 patients, propensity score matching resulted in 462 cases (231 per group), balanced for FIGO stage, lymph node status, histotype, tumor grade, and clinical response to CT/RT. The 5-year disease-free survival (DFS) was 73.7% in the O-RS patients and 73.0% in the MI-RS patients (HR 1.034, 95% CI 0.708–1.512, p = 0.861). The 5-year locoregional recurrence rate was 12.5% (O-RS) versus 15.2% (MI-RS) (HR 1.174, 95% CI 0.656–2.104, p = 0.588). The 5-year disease-specific survival (DSS) was 80.4% in O-RS patients and 85.3% in the MI-RS group (HR 0.731, 95% CI 0.438–1.220, p = 0.228). Estimated blood loss was lower in the MI-RS group (p < 0.001), as was length of hospital stay (p < 0.001). Early postoperative complications occurred in 77 patients (33.3%) in the O-RS group versus 88 patients (38.1%) in the MI-RS group (p = 0.331). Fifty-six (24.2%) patients experienced late postoperative complications in the O-RS group, versus 61 patients (26.4%) in the MI-RS group (p = 0.668). Conclusion MI-RS and O-RS are associated with similar rates of recurrence and death in LACC patients managed by surgery after CT/RT. No difference in early or late complications was reported. Electronic supplementary material The online version of this article (10.1245/s10434-020-09302-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- G Ferrandina
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - V Gallotta
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - A Federico
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
| | - F Fanfani
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Ercoli
- Department of Obstetrics and Gynecology, University of Messina, Messina, Italy
| | - V Chiantera
- Department of Gynecologic Oncology, University of Palermo, Palermo, Italy
| | - F Cosentino
- Gynecologic Oncology, Gemelli Molise, Campobasso, Italy
| | - L C Turco
- Gynecology and Breast Care Unit, Mater Olbia Hospital, Olbia, Italy
| | - F Legge
- Gynecologic Oncology Unit, Department Obstetrics/Gynecology "F. Miulli" General Regional Hospital, Acquaviva delle Fonti, Bari, Italy
| | - L Pedone Anchora
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - N Bizzarri
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - R Moroni
- Direzione Scientifica, Fondazione Policlinico Universitario A.Gemelli, IRCCS, Rome, Italy
| | - G Macchia
- Radiotherapy Unit, Gemelli Molise Hospital, Campobasso, Italy
| | - V Valentini
- Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC di Radioterapia, Rome, Italy.,Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Scambia
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy
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Primiano G, Brunetti V, Vollono C, Losurdo A, Moroni R, Della Marca G, Servidei S. Sleep-Disordered Breathing in Adult Patients With Mitochondrial Diseases: A Cohort Study. Neurology 2020; 96:e241-e249. [PMID: 33024021 DOI: 10.1212/wnl.0000000000011005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 08/25/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To describe the prevalence and characteristics of sleep-disordered breathing (SDB) in a large cohort of patients with genetically confirmed mitochondrial diseases. METHODS This is a prospective observational study performed at the Neurophysiopatology Unit of Fondazione Policlinico Universitario A. Gemelli IRCCS. All participants had a defined mitochondrial disease and were investigated by full-night polysomnography. RESULTS One hundred three consecutive patients were enrolled. SDB was demonstrated in 49 patients (47.6%). Regarding phenotypes, we found differences in distribution between the groups: patients affected by progressive external ophthalmoplegia with single or multiple mtDNA deletions frequently had obstructive apneas (50% and 43.8%) or REM-related hypoventilation when associated with m.3243A>G mutations (75%). Furthermore, a high percentage of participants with maternally inherited diabetes and deafness and myoclonic epilepsy with ragged-red fibers syndromes were characterized by obstructive sleep apnea and REM-related hypoventilation, respectively. In contrast to what has been described in previous studies, central sleep apnea was rarely reported in our cohort. CONCLUSIONS SDB has a higher prevalence in mitochondrial diseases compared to general population-based data. Overall, these results suggest that patients characterized by a specific phenotype-genotype combination are most at risk of developing a specific subgroup of SDB. The early identification of this disorder is crucial in the management of these fragile patients.
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Affiliation(s)
- Guido Primiano
- From UOC Neurofisiopatologia (G.P., C.V., A.L., S.S.), UOC Neurologia (V.B., G.D.M.), and Direzione Scientifica (R.M.), Fondazione Policlinico Universitario A. Gemelli IRCCS; and Dipartimento Universitario di Neuroscienze (G.P., G.D.M., S.S.), Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Valerio Brunetti
- From UOC Neurofisiopatologia (G.P., C.V., A.L., S.S.), UOC Neurologia (V.B., G.D.M.), and Direzione Scientifica (R.M.), Fondazione Policlinico Universitario A. Gemelli IRCCS; and Dipartimento Universitario di Neuroscienze (G.P., G.D.M., S.S.), Università Cattolica del Sacro Cuore, Rome, Italy
| | - Catello Vollono
- From UOC Neurofisiopatologia (G.P., C.V., A.L., S.S.), UOC Neurologia (V.B., G.D.M.), and Direzione Scientifica (R.M.), Fondazione Policlinico Universitario A. Gemelli IRCCS; and Dipartimento Universitario di Neuroscienze (G.P., G.D.M., S.S.), Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Losurdo
- From UOC Neurofisiopatologia (G.P., C.V., A.L., S.S.), UOC Neurologia (V.B., G.D.M.), and Direzione Scientifica (R.M.), Fondazione Policlinico Universitario A. Gemelli IRCCS; and Dipartimento Universitario di Neuroscienze (G.P., G.D.M., S.S.), Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rossana Moroni
- From UOC Neurofisiopatologia (G.P., C.V., A.L., S.S.), UOC Neurologia (V.B., G.D.M.), and Direzione Scientifica (R.M.), Fondazione Policlinico Universitario A. Gemelli IRCCS; and Dipartimento Universitario di Neuroscienze (G.P., G.D.M., S.S.), Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giacomo Della Marca
- From UOC Neurofisiopatologia (G.P., C.V., A.L., S.S.), UOC Neurologia (V.B., G.D.M.), and Direzione Scientifica (R.M.), Fondazione Policlinico Universitario A. Gemelli IRCCS; and Dipartimento Universitario di Neuroscienze (G.P., G.D.M., S.S.), Università Cattolica del Sacro Cuore, Rome, Italy
| | - Serenella Servidei
- From UOC Neurofisiopatologia (G.P., C.V., A.L., S.S.), UOC Neurologia (V.B., G.D.M.), and Direzione Scientifica (R.M.), Fondazione Policlinico Universitario A. Gemelli IRCCS; and Dipartimento Universitario di Neuroscienze (G.P., G.D.M., S.S.), Università Cattolica del Sacro Cuore, Rome, Italy
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31
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Moruzzi MC, Bolomini G, Moro F, Mascilini F, Ficarelli S, Beneduce G, Giudice MT, Pasciuto T, Moroni R, Scambia G, Fagotti A, Testa AC. Diagnostic performance of ultrasound in assessing the extension of the disease in patients with suspicion of malignant ovarian tumor: correlation between ultrasound parameters and Fagotti's score. Int J Gynecol Cancer 2020; 31:279-285. [PMID: 32900793 DOI: 10.1136/ijgc-2020-001606] [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] [Accepted: 07/30/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND A radical surgical approach represents the mainstay treatment for gynecological malignancy, and preoperative staging of ovarian cancer is crucial. Ultrasound evaluation is widely recognized as the gold standard technique for the characterization of ovarian masses due to a high sensitivity for malignancy. In addition, its accuracy in defining intra-abdominal ovarian cancer spread has been previously proposed. PRIMARY OBJECTIVE To analyze the agreement between preoperative ultrasound examination and laparoscopic findings in assessing the extension of intra-abdominal disease using six parameters as described by Fagotti's score. STUDY HYPOTHESIS When performed by expert examiners, ultrasound can be an accurate technique to assess tumor spread in ovarian cancer and therefore to predict surgical resectability. TRIAL DESIGN This is a single-center prospective observational study. Patients with clinical and/or radiological suspicion of advanced ovarian or peritoneal cancer will be assessed with preoperative ultrasound and assigned a score based on the six Fagotti's laparoscopic score parameters. Each parameter will then be correlated with laparoscopic findings. MAJOR INCLUSION/EXCLUSION CRITERIA Eligible patients include women 18-75 years of age with clinical and/or imaging suggestive of advanced ovarian or peritoneal cancer, and an ECOG performance status 0-3. PRIMARY ENDPOINTS Sensitivity and specificity of ultrasound in detecting carcinomatosis, using the parameters of Fagotti's score as a reference standard. Agreement between preoperative ultrasound examination and laparoscopic findings in assessing the extension of intra-abdominal disease as described in Fagotti's score. SAMPLE SIZE 240 patients. ESTIMATE DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS The accrual started in January 2019. Enrollment should be completed approximately by October 2020 and the results will be analyzed by December 2020. TRIAL REGISTRATION The study received the Ethical Committee approval on July 19 2018 (Protocol 28967/18 ID:2172).
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Affiliation(s)
- Maria Cristina Moruzzi
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Giulia Bolomini
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Francesca Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Floriana Mascilini
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Silvia Ficarelli
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Giuliana Beneduce
- Università Cattolica del Sacro Cure, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
| | - Maria Teresa Giudice
- Università Cattolica del Sacro Cure, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
| | - Tina Pasciuto
- STAR Center (Statistics Technology Archiving Research), Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Rossana Moroni
- Direzione Scientifica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Giovanni Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cure, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
| | - Anna Fagotti
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cure, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
| | - Antonia Carla Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cure, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
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32
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Gotter R, Verna A, Sbroscia M, Moroni R, Bisio F, Iacobucci S, Offi F, Vaidya SR, Ruocco A, Stefani G. Unexpectedly Large Electron Correlation Measured in Auger Spectra of Ferromagnetic Iron Thin Films: Orbital-Selected Coulomb and Exchange Contributions. Phys Rev Lett 2020; 125:067202. [PMID: 32845695 DOI: 10.1103/physrevlett.125.067202] [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] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/08/2020] [Indexed: 06/11/2023]
Abstract
A set of electron-correlation energies as large as 10 eV have been measured for a magnetic 2 ML Fe film deposited on Ag(001). By exploiting the spin selectivity in angle-resolved Auger-photoelectron coincidence spectroscopy and the Cini-Sawatzky theory, the core-valence-valence Auger spectrum of a spin-polarized system have been resolved: correlation energies have been determined for each individual combination of the two holes created in the four subbands involved in the decay: majority and minority spin, as well as e_{g} and t_{2g}. The energy difference between final states with parallel and antiparallel spin of the two emitted electrons is ascribed to the spin-flip energy for the final ion state, thus disentangling the contributions of Coulomb and exchange interactions.
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Affiliation(s)
- R Gotter
- CNR-IOM, Istituto Officina dei Materiali, c/o Area Science Park, SS14 km 163,5 I-34149 Basovizza-Trieste, Italy
| | - A Verna
- Dipartimento di Scienze, Università degli Studi Roma Tre, Via della Vasca Navale 84, I-00146 Rome, Italy
| | - M Sbroscia
- Dipartimento di Scienze, Università degli Studi Roma Tre, Via della Vasca Navale 84, I-00146 Rome, Italy
| | - R Moroni
- CNR-SPIN, Corso Perrone 24, I-16152 Genova, Italy
| | - F Bisio
- CNR-SPIN, Corso Perrone 24, I-16152 Genova, Italy
| | - S Iacobucci
- Dipartimento di Scienze, Università degli Studi Roma Tre, Via della Vasca Navale 84, I-00146 Rome, Italy
- CNR-ISM, Via Fosso del Cavaliere 100, 00133 Roma, Italy
| | - F Offi
- Dipartimento di Scienze, Università degli Studi Roma Tre, Via della Vasca Navale 84, I-00146 Rome, Italy
| | - S R Vaidya
- CNR-IOM, Istituto Officina dei Materiali, c/o Area Science Park, SS14 km 163,5 I-34149 Basovizza-Trieste, Italy
- Scuola di Dottorato in Nanotecnologie, Università di Trieste, Piazzale Europa 1, I-34127 Trieste, Italy
| | - A Ruocco
- Dipartimento di Scienze, Università degli Studi Roma Tre, Via della Vasca Navale 84, I-00146 Rome, Italy
| | - G Stefani
- Dipartimento di Scienze, Università degli Studi Roma Tre, Via della Vasca Navale 84, I-00146 Rome, Italy
- CNR-ISM, Via Fosso del Cavaliere 100, 00133 Roma, Italy
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Buonsenso D, Moro F, Inchingolo R, Smargiassi A, Demi L, Soldati G, Moroni R, Lanzone A, Scambia G, Testa AC. Effectiveness of rapid lung ultrasound training program for gynecologists and obstetricians managing pregnant women with suspected COVID-19. Ultrasound Obstet Gynecol 2020; 56:110-111. [PMID: 32349175 PMCID: PMC7267379 DOI: 10.1002/uog.22066] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/18/2020] [Accepted: 04/23/2020] [Indexed: 05/22/2023]
Affiliation(s)
- D. Buonsenso
- Dipartimento Scienze della Salute della Donnadel Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCSRomeItaly
| | - F. Moro
- Dipartimento Scienze della Salute della Donnadel Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCSRomeItaly
| | - R. Inchingolo
- Dipartimento Scienze Mediche e ChirurgicheFondazione Policlinico Universitario Agostino Gemelli, IRCCSRomeItaly
| | - A. Smargiassi
- Dipartimento Scienze Mediche e ChirurgicheFondazione Policlinico Universitario Agostino Gemelli, IRCCSRomeItaly
| | - L. Demi
- Department of Information Engineering and Computer ScienceUniversity of TrentoTrentoItaly
| | - G. Soldati
- Diagnostic and Interventional Ultrasound UnitValle del Serchio General HospitalLuccaItaly
| | - R. Moroni
- Direzione ScientificaFondazione Policlinico Universitario Agostino Gemelli IRCCSRomeItaly
| | - A. Lanzone
- Dipartimento Scienze della Salute della Donnadel Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCSRomeItaly
- Dipartimento Scienze della Vita e Sanità PubblicaUniversità Cattolica del Sacro CuoreRomeItaly
| | - G. Scambia
- Dipartimento Scienze della Salute della Donnadel Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCSRomeItaly
- Dipartimento Scienze della Vita e Sanità PubblicaUniversità Cattolica del Sacro CuoreRomeItaly
| | - A. C. Testa
- Dipartimento Scienze della Salute della Donnadel Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCSRomeItaly
- Dipartimento Scienze della Vita e Sanità PubblicaUniversità Cattolica del Sacro CuoreRomeItaly
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Restaino S, Mereu L, Finelli A, Spina MR, Marini G, Catena U, Turco LC, Moroni R, Milani M, Cela V, Scambia G, Fanfani F. Robotic surgery vs laparoscopic surgery in patients with diagnosis of endometriosis: a systematic review and meta-analysis. J Robot Surg 2020; 14:687-694. [DOI: 10.1007/s11701-020-01061-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/29/2020] [Indexed: 12/21/2022]
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35
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Cioce M, Moroni R, Gifuni MC, Botti S, Orlando L, Soave S, Serra I, Zega M, Gargiulo G. [Relevance of NANDA-I diagnoses in patients undergoing haematopoietic stem cell transplantation: a Delphi study]. Prof Inferm 2020; 72:120-128. [PMID: 31550428 DOI: 10.7429/pi.2019.722128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Haematopoietic Stem Cell Transplantation ( HSCT) has become the standard of care for some haematological diseases that do not respond to traditional treatments: pre-transplant therapy still causes high mortality and morbidity today. Due to the high risk, patient care requires careful evalua- tion and often complex, intensive and non-risk free interventions; the NANDA-I classification provides a way to classify and standardise areas of nursing interest. A previous consensus among experts had iden- tified 61 diagnoses, according to the classification NANDA-I 2018-2020, relevant in onco-haematolo- gical field. OBJECTIVE The aim of the study was to identify which of the 61 diagnoses were relevant for patients undergoing HSCT. METHOD A Delphi study was conducted in two rounds; a structured questionnaire on a 4 point Likert scale was used to build consensus, involving 57 experienced nurse enrolled in Italian GITMO Centres. RESULTS The present study has identified 34 relevant NANDA-I diagnoses in patients undergoing HSCT; it also defined 11 as important diagnoses having obtained absolute consensus. DISCUSSION Use the NANDA-I diagnoses to know, from a panel of experts, the most important and relevant health problems associated with the toxicity of pre- HCSE treatment, it can direct assistance and resources towards expercied and known outcomes so as to be able to intervene effectively with performances aimed at reducing risks and specific complications.
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Affiliation(s)
- Marco Cioce
- Fondazione Policlinico Gemelli IRCCS, Roma. UOC Ematologia e Trapianto di Cellule Staminali Emopoietiche. Cell +393472284176
| | - Rossana Moroni
- Fondazione Policlinico Gemelli IRCCS, Roma. Biostatistico presso Direzione Scientifica
| | - Maria Carola Gifuni
- Fondazione Policlinico Gemelli IRCC, Roma. UOC Ematologia e Trapianto di Cellule Staminali Emopoietiche
| | | | - Laura Orlando
- IEO Istituto Europeo di Oncologia, Milano. Area Assistenziale Omogenea Medica
| | - Sonia Soave
- Fondazione Policlinico Tor Vergata, Roma. UOC Ematologia
| | | | - Maurizio Zega
- Fondazione Policlinico Gemelli IRCCS, Roma. Direttore SITRA
| | - Giampaolo Gargiulo
- AOU Federico II, Napoli. UOC Ematologia e Trapianto di cellule Staminali Emopoie- tiche
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Litta F, Parello A, De Simone V, Campennì P, Orefice R, Marra AA, Goglia M, Moroni R, Ratto C. Efficacy of Sphinkeeper™ implant in treating faecal incontinence. Br J Surg 2020; 107:484-488. [PMID: 32064592 PMCID: PMC7154545 DOI: 10.1002/bjs.11558] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/16/2020] [Accepted: 01/24/2020] [Indexed: 12/14/2022]
Affiliation(s)
- F Litta
- Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - A Parello
- Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - V De Simone
- Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - P Campennì
- Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - R Orefice
- Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - A A Marra
- Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - M Goglia
- Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - R Moroni
- Direzione Scientifica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - C Ratto
- Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
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Buonsenso D, De Rose C, Moroni R, Valentini P. SARS-CoV-2 Infections in Italian Schools: Preliminary Findings After 1 Month of School Opening During the Second Wave of the Pandemic. Front Pediatr 2020; 8:615894. [PMID: 33520898 PMCID: PMC7841339 DOI: 10.3389/fped.2020.615894] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [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] [Received: 10/10/2020] [Accepted: 12/07/2020] [Indexed: 01/19/2023] Open
Abstract
Introduction: The impact of school opening on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is still unknown. This study aims to provide preliminary information about the number of SARS-CoV-2 cases among students attending Italian schools. Methods: Data are extracted and analyzed from an open-access, online dataset that monitor, on a daily basis, media news about SARS-CoV-2 infections of students attending Italian schools. Results: As of October 5, 2020, a total of 1,350 cases of SARS-CoV-2 infections have been registered in the Italian territory schools (involving 1,059 students, 145 teachers, and 146 other school members), for a total of 1,212 out of 65,104 (1.8%) Italian schools involved. National schools reported only one case of SARS-CoV-2 infection in more than 90% of cases, and only in one high school a cluster of more than 10 cases has been described (P = 0.015). The detection of one or more SARS-CoV-2 infections led to the closure of 192 (15.8%) entire schools, more frequently nursery/kindergartens (P < 0.0005). Discussion: Our preliminary data support low transmission of SARS-CoV-2 within schools, at least among younger students. However, entire schools are frequently closed in the fear of larger outbreaks. Continuous monitoring of school settings, hopefully through daily updated open-access datasets, is needed to better understand the impact of schools on the pandemic and provide guidelines that better consider different risks within different age groups.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.,Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Rossana Moroni
- Direzione Scientifica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
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Cafiero C, Re A, Stigliano E, Bassotti E, Moroni R, Grippaudo C. Optimization of DNA extraction from dental remains. Electrophoresis 2019; 40:1820-1823. [PMID: 31111969 PMCID: PMC6771583 DOI: 10.1002/elps.201900142] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 12/18/2022]
Abstract
Efficient DNA extraction procedures is a critical step involved in the process of successful DNA analysis of such samples. Various protocols have been devised for the genomic DNA extraction from human tissues and forensic stains, such as dental tissue that is the skeletal part that better preserves DNA over time. However DNA recovery is low and protocols require labor‐intensive and time‐consuming step prior to isolating genetic material. Herein, we describe an extremely fast procedure of DNA extraction from teeth compared to classical method. Sixteen teeth of 100‐year‐old human remains were divided into two groups of 8 teeth and we compared DNA yield, in term of quantity and quality, starting from two different sample preparation steps. Specifically, teeth of group 1 were treated with a classic technique based on several steps of pulverization and decalcification, while teeth of group 2 were processed following a new procedure to withdraw dental pulp. In the next phase, the samples of both group underwent the same procedure of extraction, quantification and DNA profile analysis. Our findings provide an alternative protocol to obtain a higher amount of good quality DNA in a fast time procedure, helpful for forensic and anthropological studies.
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Affiliation(s)
- Concetta Cafiero
- Università Cattolica del Sacro Cuore-Dental Institute, Rome, Italy
| | - Agnese Re
- Università Cattolica del Sacro Cuore-Dental Institute, Rome, Italy
| | - Egidio Stigliano
- Università Cattolica del Sacro Cuore-Institute of Pathological Anatomy, Rome, Italy
| | - Ezio Bassotti
- Università Cattolica del Sacro Cuore-Dental Institute, Rome, Italy
| | - Rossana Moroni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Cristina Grippaudo
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
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Rinninella E, Cintoni M, De Lorenzo A, Addolorato G, Vassallo G, Moroni R, Miggiano GAD, Gasbarrini A, Mele MC. Risk, prevalence, and impact of hospital malnutrition in a Tertiary Care Referral University Hospital: a cross-sectional study. Intern Emerg Med 2018; 13:689-697. [PMID: 29846875 DOI: 10.1007/s11739-018-1884-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 05/24/2018] [Indexed: 12/23/2022]
Abstract
Hospital malnutrition is still underestimated among physicians, even in internal medicine settings. This is a cross-sectional study, aiming to estimate the risk, the prevalence and the impact of malnutrition in an Internal Medicine and Gastroenterology Department of a large Italian hospital (Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome). Patients were evaluated within 72 h from admission according to Nutritional Risk Screening-2002 (NRS-2002) and European Society for Clinical Nutrition and Metabolism (ESPEN) Criteria. Anthropometric, laboratory tests and Bioelectrical Impedance Analysis (BIA) derived phase angle were also performed. Length of hospital stay (LOS) and in-hospital mortality were collected. Univariate and multivariate analyses were conducted to correlate nutritional status with LOS and hospital mortality. In 10 months, 300 patients were enrolled: male patients were 172 (57.3%); mean age was 63.7 (± 17.6). At admission, 157 (52.3%) patients were at risk of malnutrition; 116 (38.7%) were malnourished. Malnourished patients had a mean LOS of 11.5 (± 8.0) days, not-malnourished 9.4 (± 6.2) days (p < 0.05). In-hospital mortality did not significantly differ between the two groups. Multivariate analysis shows that both malnutrition (p = 0.04; 95% CI 0.03-3.41) and phase angle (p = 0.004; 95% CI - 1.92 to - 0.37) independently correlate with LOS. In an Internal Medicine and Gastroenterology Department, over half (52.3%) of the patients were found at risk of malnutrition, and over a third (38.7%) were malnourished at hospital admission. Malnutrition and BIA-derived phase angle are independently associated with LOS. ESPEN Criteria and phase angle could be performed at admission to identify patients deserving specific nutritional support.
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Affiliation(s)
- Emanuele Rinninella
- Clinical Nutrition Unit, Gastroenterology and Oncology Area, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Roma, Italy.
| | - Marco Cintoni
- Clinical Nutrition Unit, Gastroenterology and Oncology Area, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Roma, Italy
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Giovanni Addolorato
- Internal Medicine and Gastroenterology Unit, Gastroenterology and Oncology Area, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Gabriele Vassallo
- Internal Medicine and Gastroenterology Unit, Gastroenterology and Oncology Area, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Rossana Moroni
- Institute of Neurology, Neuroscience Area, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giacinto Abele Donato Miggiano
- Clinical Nutrition Unit, Gastroenterology and Oncology Area, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Roma, Italy
| | - Antonio Gasbarrini
- Internal Medicine and Gastroenterology Unit, Gastroenterology and Oncology Area, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Maria Cristina Mele
- Clinical Nutrition Unit, Gastroenterology and Oncology Area, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Roma, Italy
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Russo P, Kisialiou A, Moroni R, Prinzi G, Fini M. Effect of Genetic Polymorphisms (SNPs) in CHRNA7 Gene on Response to Acetylcholinesterase Inhibitors (AChEI) in Patients with Alzheimer's Disease. Curr Drug Targets 2018; 18:1179-1190. [PMID: 26424395 DOI: 10.2174/1389450116666151001111826] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 09/16/2015] [Accepted: 09/16/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cholinergic transmission loss is one of the major features in Alzheimer&#039;s Disease (AD). Acetylcholinesterase inhibitors (AChEI) are moderately active in AD. α7nAChR (alpha-7 nicotinic acetylcholine receptor), encoded by CHRNA7 (Nicotinic Cholinergic Receptor Alpha-7 gene), is involved in the cholinergic neurotransmission and AD pathogenesis. α7nAChR is a putative receptor of amyloid beta (Aβ). The complex α7nAChR-Aβ is found in neuritic plaques and AD cortical neurons. In normal physiologic conditions, α7nAChR-Aβ interaction leads to receptor activation. Genetic polymorphisms (SNPs) of CHRNA7 and/or CHRFAM7A (fusion gene containing CHRNA7 partial duplication) may be a possible susceptibility trait to dementia, potentially useful to identify high risk or responder individuals. CHRFAM7A-2-bp deletion or CHRNA7 SNPs (rs1514246, rs2337506, rs8027814) seem protective factors in different forms of dementia including AD. OBJECTIVE Correlation between(SNPs) of CHRNA7 and/or CHRFAM7A and cholinesterase inhibitors in AD. METHODS Literature review. RESULTS Among the leading AD therapeutics, Donepezil (DP) and galantamine (AChEI) induce upregulation of α7nAChR protein levels, protecting neurons from degeneration. Patients carrying rs8024987 (C/G) or rs6494223 (C/T) respond better to AChEI. In the caucasic population rs6494223 TT subjects are 7-15% of the total. α7nAChR upregulation induced by DP is higher in lymphocytes from TT subjects than in CC or CT as well as calcium uptake. CONCLUSION The correlation between genetic and functionality data may have an impact on several aspects of disease presentation and therapy, helping in prediction pattern of AD presentation and treatment efficacy. As a consequence it may lead to better patients quality of life and longer periods of self- sufficiency. Moreover, it may contribute to clarify AChEI mechanisms of action.
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Affiliation(s)
- Patrizia Russo
- Laboratory of Molecular Epidemiology, IRCCS "San Raffaele Pisana" Via di Valcannuta, 247 I- 00166 Rome, Italy
| | - Aliaksei Kisialiou
- Clinical and Molecular Epidemiology Division, IRCCS "San Raffaele Pisana" Via di Valcannuta, 247, I-00166 Rome, Italy
| | - Rossana Moroni
- Clinical and Molecular Epidemiology Division, IRCCS "San Raffaele Pisana" Via di Valcannuta, 247, I-00166 Rome, Italy
| | - Giulia Prinzi
- Clinical and Molecular Epidemiology Division, IRCCS "San Raffaele Pisana" Via di Valcannuta, 247, I-00166 Rome, Italy
| | - Massimo Fini
- Scientific Direction, IRCCS "San Raffaele Pisana" Via di Valcannuta, 247, I-00166 Rome, Italy
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LACCU I, Pisanu P, Lodde L, Gioi G, Figorilli M, Congiu P, Tamburrino L, Fantola G, Moroni R, Mascia M, Puligheddu M. Presurgical bariatric evaluation of sleep-disordered breathing in morbidly obese patients: sleep disruption and cognitive impairment. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Zielke L, Vierrath S, Moroni R, Mondon A, Zengerle R, Thiele S. Three-dimensional morphology of the interface between micro porous layer and catalyst layer in a polymer electrolyte membrane fuel cell. RSC Adv 2016. [DOI: 10.1039/c6ra16560e] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
FIB/SEM tomography and ALD infiltration are combined to analyse the interface between MPL and CL in a PEM fuel cell.
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Affiliation(s)
- L. Zielke
- Laboratory for MEMS Applications
- IMTEK
- Department of Microsystems Engineering
- University of Freiburg
- 79110 Freiburg
| | - S. Vierrath
- Laboratory for MEMS Applications
- IMTEK
- Department of Microsystems Engineering
- University of Freiburg
- 79110 Freiburg
| | - R. Moroni
- Laboratory for MEMS Applications
- IMTEK
- Department of Microsystems Engineering
- University of Freiburg
- 79110 Freiburg
| | - A. Mondon
- Fraunhofer Institute for Solar Energy Systems ISE
- Division Energy Technologies
- 79110 Freiburg
- Germany
| | - R. Zengerle
- Laboratory for MEMS Applications
- IMTEK
- Department of Microsystems Engineering
- University of Freiburg
- 79110 Freiburg
| | - S. Thiele
- Laboratory for MEMS Applications
- IMTEK
- Department of Microsystems Engineering
- University of Freiburg
- 79110 Freiburg
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Russo P, Kisialiou A, Lamonaca P, Moroni R, Prinzi G, Fini M. New Drugs from Marine Organisms in Alzheimer's Disease. Mar Drugs 2015; 14:5. [PMID: 26712769 PMCID: PMC4728502 DOI: 10.3390/md14010005] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [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: 11/05/2015] [Revised: 12/09/2015] [Accepted: 12/21/2015] [Indexed: 12/16/2022] Open
Abstract
Alzheimer’s disease (AD) is a multifactorial neurodegenerative disorder. Current approved drugs may only ameliorate symptoms in a restricted number of patients and for a restricted period of time. Currently, there is a translational research challenge into identifying the new effective drugs and their respective new therapeutic targets in AD and other neurodegenerative disorders. In this review, selected examples of marine-derived compounds in neurodegeneration, specifically in AD field are reported. The emphasis has been done on compounds and their possible relevant biological activities. The proposed drug development paradigm and current hypotheses should be accurately investigated in the future of AD therapy directions although taking into account successful examples of such approach represented by Cytarabine, Trabectedin, Eribulin and Ziconotide. We review a complexity of the translational research for such a development of new therapies for AD. Bryostatin is a prominent candidate for the therapy of AD and other types of dementia in humans.
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Affiliation(s)
- Patrizia Russo
- Clinical and Molecular Epidemiology Division, IRCCS "San RaffaelePisana" Via di Valcannuta, 247, RomeI-00166, Italy.
| | - Aliaksei Kisialiou
- Clinical and Molecular Epidemiology Division, IRCCS "San RaffaelePisana" Via di Valcannuta, 247, RomeI-00166, Italy.
| | - Palma Lamonaca
- Clinical and Molecular Epidemiology Division, IRCCS "San RaffaelePisana" Via di Valcannuta, 247, RomeI-00166, Italy.
| | - Rossana Moroni
- Clinical and Molecular Epidemiology Division, IRCCS "San RaffaelePisana" Via di Valcannuta, 247, RomeI-00166, Italy.
| | - Giulia Prinzi
- Clinical and Molecular Epidemiology Division, IRCCS "San RaffaelePisana" Via di Valcannuta, 247, RomeI-00166, Italy.
| | - Massimo Fini
- Scientific Direction, IRCCS "San RaffaelePisana" Via di Valcannuta, 247, Rome I-00166, Italy.
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Caminale M, Moroni R, Torelli P, Lin WC, Canepa M, Mattera L, Bisio F. Reentrant surface anisotropy in the antiferromagnetic/ferromagnetic bilayer Mn/Co/Cu(001). Phys Rev Lett 2014; 112:037201. [PMID: 24484162 DOI: 10.1103/physrevlett.112.037201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Indexed: 06/03/2023]
Abstract
We investigated the magnetic anisotropy energy of monatomic surface-step atoms in antiferromagnetic/ferromagnetic (AF/FM) epitaxial Mn/Co bilayers grown on vicinal Cu(001) surfaces. The step-induced anisotropy of the Co/Cu(001) films was quenched upon submonolayer Mn deposition, but a reentrant uniaxial surface anisotropy was observed for Mn thickness (tMn) between 1 and 2 monolayers, which disappears for Mn thickness above 2 monolayers. In the Mn/Co/Cu(001) system, Mn films undergo a tMn-dependent transition from FM to AF in the 1-2 Mn monolayer thickness range, which entails the coexistence of FM and AF Mn phases in the film. The observation of a sizeable uniaxial anisotropy exclusively in the Mn-thickness range of coexistence of the FM and AF phases points out the crucial role of the boundaries between FM and AF regions within the Mn film. A symmetry-breaking mechanism of a magnetic type, rather than a purely geometric one, is therefore proposed as the origin of the reentrant anisotropy.
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Affiliation(s)
- M Caminale
- Dipartimento di Fisica, Università di Genova and CNISM, Sede Consorziata di Genova, via Dodecaneso 33, I-16146 Genova, Italy
| | - R Moroni
- CNR-SPIN, Corso Perrone 24, I-16152 Genova, Italy
| | - P Torelli
- Laboratorio TASC, IOM-CNR, S.S. 14 km 163.5, Basovizza, I-34149 Trieste, Italy
| | - W C Lin
- Department of Physics, National Taiwan Normal University, 116 Taipei, Taiwan
| | - M Canepa
- Dipartimento di Fisica, Università di Genova and CNISM, Sede Consorziata di Genova, via Dodecaneso 33, I-16146 Genova, Italy
| | - L Mattera
- Dipartimento di Fisica, Università di Genova and CNISM, Sede Consorziata di Genova, via Dodecaneso 33, I-16146 Genova, Italy
| | - F Bisio
- CNR-SPIN, Corso Perrone 24, I-16152 Genova, Italy
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Gauriot R, Gunaratnam L, Moroni R, Reinikainen T, Corander J. Statistical challenges in the quantification of gunshot residue evidence. J Forensic Sci 2013; 58:1149-1155. [PMID: 23822522 DOI: 10.1111/1556-4029.12179] [Citation(s) in RCA: 16] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 07/24/2012] [Accepted: 07/29/2012] [Indexed: 11/27/2022]
Abstract
The discharging of a gun results in the formation of extremely small particles known as gunshot residues (GSR). These may be deposited on the skin and clothing of the shooter, on other persons present, and on nearby items or surfaces. Several factors and their complex interactions affect the number of detectable GSR particles, which can deeply influence the conclusions drawn from likelihood ratios or posterior probabilities for prosecution hypotheses of interest. We present Bayesian network models for casework examples and demonstrate that probabilistic quantification of GSR evidence can be very sensitive to the assumptions concerning the model structure, prior probabilities, and the likelihood components. This finding has considerable implications for the use of statistical quantification of GSR evidence in the legal process.
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Affiliation(s)
- Romain Gauriot
- Department of Mathematics and Statistics, University of Helsinki, FI-00014, Helsinki, Finland
| | - Lawrence Gunaratnam
- National Bureau of Investigation Forensic Laboratory, Jokiniemenkuja 4, FI-01370, Vantaa, Finland
| | - Rossana Moroni
- National Bureau of Investigation Forensic Laboratory, Jokiniemenkuja 4, FI-01370, Vantaa, Finland
- Department of Mathematics, Åbo Akademi University, Fänriksgatan 3B, FI-20500, Turku, Finland
| | - Tapani Reinikainen
- National Bureau of Investigation Forensic Laboratory, Jokiniemenkuja 4, FI-01370, Vantaa, Finland
| | - Jukka Corander
- Department of Mathematics and Statistics, University of Helsinki, FI-00014, Helsinki, Finland
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Abstract
A considerable amount of discussion can be found in the forensics literature about the issue of using statistical sampling to obtain for chemical analyses an appropriate subset of units from a police seizure suspected to contain illicit material. Use of the Bayesian paradigm has been suggested as the most suitable statistical approach to solving the question of how large a sample needs to be to ensure legally and practically acceptable purposes. Here, we introduce a hypergeometric sampling model combined with a specific prior distribution for the homogeneity of the seizure, where a parameter for the analyst's expectation of homogeneity (α) is included. Our results show how an adaptive approach to sampling can minimize the practical efforts needed in the laboratory analyses, as the model allows the scientist to decide sequentially how to proceed, while maintaining a sufficiently high confidence in the conclusions.
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Affiliation(s)
- Rossana Moroni
- National Bureau of Investigation Forensic Laboratory, Vantaa, Finland
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Moroni R, Blomstedt P, Wilhelm L, Reinikainen T, Sippola E, Corander J. Statistical modelling of measurement errors in gas chromatographic analyses of blood alcohol content. Forensic Sci Int 2010; 202:71-4. [PMID: 20494532 DOI: 10.1016/j.forsciint.2010.04.029] [Citation(s) in RCA: 7] [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: 11/02/2009] [Revised: 04/02/2010] [Accepted: 04/18/2010] [Indexed: 10/19/2022]
Abstract
Headspace gas chromatographic measurements of ethanol content in blood specimens from suspect drunk drivers are routinely carried out in forensic laboratories. In the widely established standard statistical framework, measurement errors in such data are represented by Gaussian distributions for the population of blood specimens at any given level of ethanol content. It is known that the variance of measurement errors increases as a function of the level of ethanol content and the standard statistical approach addresses this issue by replacing the unknown population variances by estimates derived from large sample using a linear regression model. Appropriate statistical analysis of the systematic and random components in the measurement errors is necessary in order to guarantee legally sound security corrections reported to the police authority. Here we address this issue by developing a novel statistical approach that takes into account any potential non-linearity in the relationship between the level of ethanol content and the variability of measurement errors. Our method is based on standard non-parametric kernel techniques for density estimation using a large database of laboratory measurements for blood specimens. Furthermore, we address also the issue of systematic errors in the measurement process by a statistical model that incorporates the sign of the error term in the security correction calculations. Analysis of a set of certified reference materials (CRMs) blood samples demonstrates the importance of explicitly handling the direction of the systematic errors in establishing the statistical uncertainty about the true level of ethanol content. Use of our statistical framework to aid quality control in the laboratory is also discussed.
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Affiliation(s)
- Rossana Moroni
- Keskusrikospoliisi, National Bureau of Investigation, Jokiniemenkuja 4, 01370 Vantaa, Finland.
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Canepa M, Lavagnino L, Pasquali L, Moroni R, Bisio F, De Renzi V, Terreni S, Mattera L. Growth dynamics of L-cysteine SAMs on single-crystal gold surfaces: a metastable deexcitation spectroscopy study. J Phys Condens Matter 2009; 21:264005. [PMID: 21828453 DOI: 10.1088/0953-8984/21/26/264005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We report on a metastable deexcitation spectroscopy investigation of the growth of L-cysteine layers deposited under UHV conditions on well-defined Au(110)- (1 × 2) and Au(111) surfaces. The interaction of He(*) with molecular orbitals gave rise to well-defined UPS-like Penning spectra which provided information on the SAM assembly dynamics and adsorption configurations. Penning spectra have been interpreted through comparison with molecular orbital DFT calculations of the free molecule and have been compared with XPS results of previous works. Regarding adsorption of first-layer molecules at room temperature (RT), two different growth regimes were observed. On Au(110), the absence of spectral features related to orbitals associated with SH groups indicated the formation of a compact SAM of thiolate molecules. On Au(111), the data demonstrated the simultaneous presence, since the early stages of growth, of strongly and weakly bound molecules, the latter showing intact SH groups. The different growth mode was tentatively assigned to the added rows of the reconstructed Au(110) surface which behave as extended defects effectively promoting the formation of the S-Au bond. The growth of the second molecular layer was instead observed to proceed similarly for both substrates. Second-layer molecules preferably adopt an adsorption configuration in which the SH group protrudes into the vacuum side.
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Affiliation(s)
- M Canepa
- CNISM and Department of Physics, University of Genova, via Dodecaneso 33, I-16145 Genova, Italy
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Moroni R, Gasbarra D, Arjas E, Lukka M, Ulmanen I. Effects of reference population and number of STR markers on paternity testing. Forensic Science International: Genetics Supplement Series 2008. [DOI: 10.1016/j.fsigss.2007.10.102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bisio F, Moroni R, Buatier de Mongeot F, Canepa M, Mattera L. Isolating the step contribution to the uniaxial magnetic anisotropy in nanostructured Fe/Ag(001) films. Phys Rev Lett 2006; 96:057204. [PMID: 16486975 DOI: 10.1103/physrevlett.96.057204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2005] [Indexed: 05/06/2023]
Abstract
We have investigated the possibility of isolating the step-induced in-plane uniaxial magnetic anisotropy in Fe/Ag(001) films on which nanoscale surface ripples were fabricated by the ion sculpting technique. For rippled Fe films deposited on flat Ag(001), the steps created along the ripple sidewalls are shown to be the only source of uniaxial anisotropy. Ion sculpting of ultrathin magnetic films allows one to selectively study the step-induced anisotropy and to investigate the correlation between local atomic environment and magnetic properties.
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Affiliation(s)
- F Bisio
- CNR-INFM Unità di Genova and Dipartimento di Fisica, Università di Genova, via Dodecaneso 33, I-16146 Genova, Italy
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