1
|
Kobidze G, Sprega G, Montanari E, Taoussi O, Bambagiotti G, Fede MS, Di Trana A, Pichini S, Busardò FP, Tini A, Chankvetadze B, Faro AFL. The first LC-MS/MS stereoselective bioanalytical methods to quantitatively detect 9R- and 9S-hexahydrocannabinols and their metabolites in human blood, oral fluid and urine. J Pharm Biomed Anal 2024; 240:115918. [PMID: 38181553 DOI: 10.1016/j.jpba.2023.115918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/01/2023] [Accepted: 12/10/2023] [Indexed: 01/07/2024]
Abstract
A sensitive LC-MS/MS method for the simultaneous quantification of the (9 R)- and (9 S)- hexahydrocannabinols (HHCs), and their metabolites, in human urine, oral fluid (OF) and blood samples were developed, validated and used to the biological samples of volunteers. The analytes were extracted from 100 μL human samples. An isocratic elution mode with methanol was used for chromatographic separation of (9 R)- and (9 S)-HHC on an immobilized amylose tris(3-chloro-5-methylphenylcarbamate)-based chiral column Lux i-Amylose-3. The flow-rate of the mobile phase was 0.5 mL/min. An isocratic elution mode of methanol and water (80/20, v/v) was used for chromatographic separation of metabolites of (9 R)- and (9 S)-HHC on a Lux AMP chiral column (with a proprietary chiral selector) at a flow rate of 0.5 mL/min. MS/MS analysis was performed in positive ionization mode for HHC epimers, while in negative ionization mode was used for metabolites of HHCs. The calibration curves for HHCs and their metabolites in human samples ranged from 0.25- 240 ng mL-1 and 1 - 100 ng mL-1, respectively, with determination coefficients (r2) of ≥ 0.99. All analytes were stable at room temperature, 4 °C, in the autosampler (+10 °C) and -20 °C for 24 h, after three freeze/thaw cycles, and when stored at -20 °C up to one week after quality control (QC) sample preparation (concentration differences less than 20% with respect to time zero response), in blood, urine and OF.
Collapse
Affiliation(s)
- Giorgi Kobidze
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Giorgia Sprega
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Eva Montanari
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Omayema Taoussi
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Giulia Bambagiotti
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Maria Sofia Fede
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Annagiulia Di Trana
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy.
| | - Anastasio Tini
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Bezhan Chankvetadze
- Tbilisi State University, Institute of Physical and Analytical Chemistry, School of Exact and Natural Sciences, 0179 Tbilisi, Georgia
| | - Alfredo Fabrizio Lo Faro
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| |
Collapse
|
2
|
Di Trana A, Di Giorgi A, Sprega G, Carlier J, Kobidze G, Montanari E, Taoussi O, Bambagiotti G, Fede MS, Lo Faro AF, Tini A, Busardò FP, Pichini S. Disposition of Hexahydrocannabinol Epimers and Their Metabolites in Biological Matrices following a Single Administration of Smoked Hexahydrocannabinol: A Preliminary Study. Pharmaceuticals (Basel) 2024; 17:249. [PMID: 38399464 PMCID: PMC10892555 DOI: 10.3390/ph17020249] [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: 12/30/2023] [Revised: 01/22/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
In 2023, hexahydrocannabinol (HHC) attracted the attention of international agencies due to its rapid spread in the illegal market. Although it was discovered in 1940, less is known about the pharmacology of its two naturally occurring epimers, 9(R)-HHC and 9(S)-HHC. Thus, we aimed to investigate the disposition of hexahydrocannabinol epimers and their metabolites in whole blood, urine and oral fluid following a single controlled administration of a 50:50 mixture of 9(R)-HHC and 9(S)-HHC smoked with tobacco. To this end, six non-user volunteers smoked 25 mg of the HHC mixture in 500 mg of tobacco. Blood and oral fluid were sampled at different time points up to 3 h after the intake, while urine was collected between 0 and 2 h and between 2 and 6 h. The samples were analyzed with a validated HPLC-MS/MS method to quantify 9(R)-HHC, 9(S)-HHC and eight metabolites. 9(R)-HHC showed the highest Cmax and AUC0-3h in all the investigated matrices, with an average concentration 3-fold higher than that of 9(S)-HHC. In oral fluid, no metabolites were detected, while they were observed as glucuronides in urine and blood, but with different profiles. Indeed, 11nor-9(R)-HHC was the most abundant metabolite in blood, while 8(R)OH-9(R) HHC was the most prevalent in urine. Interestingly, 11nor 9(S) COOH HHC was detected only in blood, whereas 8(S)OH-9(S) HHC was detected only in urine.
Collapse
Affiliation(s)
- Annagiulia Di Trana
- National Centre on Addiction and Doping, National Institute of Health, 00161 Rome, Italy;
| | - Alessandro Di Giorgi
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Giorgia Sprega
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Jeremy Carlier
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Giorgi Kobidze
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Eva Montanari
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Omayema Taoussi
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Giulia Bambagiotti
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Maria Sofia Fede
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Alfredo Fabrizio Lo Faro
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Anastasio Tini
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Francesco Paolo Busardò
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Simona Pichini
- National Centre on Addiction and Doping, National Institute of Health, 00161 Rome, Italy;
| |
Collapse
|
3
|
Daziani G, Lo Faro AF, Montana V, Goteri G, Pesaresi M, Bambagiotti G, Montanari E, Giorgetti R, Montana A. Synthetic Cathinones and Neurotoxicity Risks: A Systematic Review. Int J Mol Sci 2023; 24:ijms24076230. [PMID: 37047201 PMCID: PMC10093970 DOI: 10.3390/ijms24076230] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 03/09/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
According to the EU Early Warning System (EWS), synthetic cathinones (SCs) are the second largest new psychoactive substances (NPS) class, with 162 synthetic cathinones monitored by the EU EWS. They have a similar structure to cathinone, principally found in Catha Edulis; they have a phenethylamine related structure but also exhibit amphetamine-like stimulant effects. Illegal laboratories regularly develop new substances and place them on the market. For this reason, during the last decade this class of substances has presented a great challenge for public health and forensic toxicologists. Acting on different systems and with various mechanisms of action, the spectrum of side effects caused by the intake of these drugs of abuse is very broad. To date, most studies have focused on the substances’ cardiac effects, and very few on their associated neurotoxicity. Specifically, synthetic cathinones appear to be involved in different neurological events, including increased alertness, mild agitation, severe psychosis, hyperthermia and death. A systematic literature search in PubMed and Scopus databases according to PRISMA guidelines was performed. A total of 515 studies published from 2005 to 2022 (350 articles from PubMed and 165 from Scopus) were initially screened for eligibility. The papers excluded, according to the criteria described in the Method Section (n = 401) and after full text analyses (n = 82), were 483 in total. The remaining 76 were included in the present review, as they met fully the inclusion criteria. The present work provides a comprehensive review on neurotoxic mechanisms of synthetic cathinones highlighting intoxication cases and fatalities in humans, as well as the toxic effects on animals (in particular rats, mice and zebrafish larvae). The reviewed studies showed brain-related adverse effects, including encephalopathy, coma and convulsions, and sympathomimetic and hallucinogenic toxidromes, together with the risk of developing excited/agitated delirium syndrome and serotonin syndrome.
Collapse
Affiliation(s)
- Gloria Daziani
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Alfredo Fabrizio Lo Faro
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Vincenzo Montana
- Dipartimento di Anestesia, Rianimazione e Emergenza-Urgenza, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Gaia Goteri
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Mauro Pesaresi
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Giulia Bambagiotti
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Eva Montanari
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Raffaele Giorgetti
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Angelo Montana
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
- Correspondence:
| |
Collapse
|
4
|
Tafuri A, Marchioni M, Cerrato C, Mari A, Tellini R, Odorizzi K, Veccia A, Amparore D, Shakir A, Carbonara U, Trovato F, Catellani M, Janello L, Bianchi L, Novara G, Dal Moro F, Schiavina R, De Lorenzis E, Parma P, Cimino S, de Cobelli O, Maiorino F, Bove P, Crocerossa F, Cantiello F, D’andrea D, Di Cosmo F, Porpiglia F, Ditonno P, Montanari E, Soria F, Gontero P, Liguori G, Trombetta C, Mantica G, Borghesi M, Terrone C, Del Giudice F, Sciarra A, Galosi A, Moschini M, Shariat S, Di Nicola M, Minervini A, Ferro M, Cerruto M, Schips L, Pagliarulo V, Antonelli A. Changes in renal function after nephroureterectomy for upper urinary tract carcinoma: analysis of a large multicenter cohort (radical nephroureterectomy outcomes (RANEO) research consortium). EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01230-7] [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: 11/07/2022] Open
|
5
|
Nazzani S, Catanzaro M, Macchi A, Torelli T, Stagni S, Biasoni D, Lorusso V, Darisi R, Lanocita R, Cascella T, Maccauro M, Lorenzoni A, Cattaneo L, Montanari E, Salvioni R, Nicolai N. Bilateral inguinal lymph-node dissection versus unilateral inguinal lymph-node dissection and contralateral dynamic sentinel node biopsy in clinical N1 squamous cell carcinoma of the penis. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01215-0] [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: 11/06/2022] Open
|
6
|
Silvani C, Turetti M, Jannello L, Galbiati G, Garbagnati S, Pozzi E, Lucignani G, Bebi C, Ripa F, Malfatto M, Zanetti S, Longo F, de Lorenzis E, Albo G, Montanari E, Boeri L. Comparison between spinal and general anesthesia in patients undergoing endoscopic enucleation of the prostate: is there a clinical advantage? EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01073-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
7
|
Claps F, Pavan N, d’Altilia N, Maggi M, Checcucci E, Napolitano L, Morlacco A, Tafuri A, Palumbo C, Mazzon G, Del Giudice F, Campi R, Signorini C, Boeri L, Giannarini G, Esperto F, Tulone G, Finati M, Sica M, La Rocca R, Bignù C, Celentano G, Falagario U, Traunero F, Panunzio A, Zucchi A, Sciarra A, Liguori G, Busetto G, Bartoletti R, Simonato A, Minervini A, Papalia R, Scarpa R, Serni S, Montanari E, Carmignani L, Celia A, Volpe A, Antonelli A, Dal Moro F, Mirone V, Porpiglia F, Tubaro A, Cormio L, Carrieri G, Trombetta C. Predictors of residual tumor at re-staging transurethral resection for high-risk non-muscle invasive bladder cancer: insights from a large multi-institutional collaboration. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01227-7] [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: 11/05/2022] Open
|
8
|
Berardinelli D, Montanari E, Malaca S, Zaami S, Busardò FP, Huestis MA, Carlier J. 4-Hydroxy-N,N-methylpropyltryptamine (4-OH-MPT) in vitro human metabolism. Toxicologie Analytique et Clinique 2022. [DOI: 10.1016/j.toxac.2022.06.147] [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: 10/15/2022]
|
9
|
Montanari E, Madeo G, Pichini S, Busardò FP, Carlier J. Acute Intoxications and Fatalities Associated With Benzimidazole Opioid (Nitazene Analog) Use: A Systematic Review. Ther Drug Monit 2022; 44:494-510. [PMID: 35149665 DOI: 10.1097/ftd.0000000000000970] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/17/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Synthetic benzimidazole opioids (BOs) are highly potent µ-opioid receptor agonists with heroin-like effects. Isotonitazene was first available in 2019 in the drug market, although new analogs have multiplied recently. The authors aimed to identify BO use trends and gather toxicological data from BO-related cases to assist in clinical and forensic investigations. METHODS A systematic literature search was conducted according to the PRISMA guidelines. PubMed and Scopus databases were accessed in October 2021 to identify scientific reports of BO-related intoxication and fatalities. Publication dates, case descriptions, symptoms, autopsy findings, and concentrations of BOs and metabolites in biological matrices were compiled. RESULTS Data from 8 case reports with 93 fatalities involving isotonitazene ( n = 65), metonitazene ( n = 20), etonitazepyne ( N -pyrrolidino etonitazene) ( n = 8), flunitazene ( n = 4), and/or butonitazene ( n = 1), and 1 acute intoxication involving etonitazepyne were collected. Autopsy findings included pulmonary congestion/high lung weight (66%), cardiomegaly/high cardiac weight (39%), cerebral edema (22%), gastric contents in the airways (22%), and organ congestion (22%). Median peripheral blood concentrations were 1.7 ng/mL for isotonitazene (0.4-9.5 ng/mL, n = 13), 5.4 ng/mL for metonitazene (0.52-33 ng/mL, n = 17), 5.4 ng/mL for etonitazepyne (2.4-8.3 ng/mL, n = 2), 1.3 ng/mL for flunitazene (0.58-2.1 ng/mL, n = 2), and 3.2 ng/mL for butonitazene ( n = 1). Central nervous system depressants were almost always coadministered. CONCLUSIONS Isotonitazene was predominant in cases from 2019 to mid-2020 and was replaced by metonitazene after scheduling in the United States. Typical findings on opioid overdoses have been reported. Peripheral blood concentrations were consistent with a potency similar to that of fentanyl. These results must be interpreted carefully, considering the scarcity of reports on BO-related cases and drug co-exposures.
Collapse
Affiliation(s)
- Eva Montanari
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Graziella Madeo
- Brain&Care, Neuromodulation and Clinical Research Unit, Rimini, Italy
| | - Simona Pichini
- Istituto Superiore di Sanità, National Centre on Addiction and Doping, Rome, Italy; and
| | - Francesco Paolo Busardò
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Jeremy Carlier
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
10
|
Reh LM, Darici E, Montanari E, Keckstein J, Senft B, Dauser B, Hudelist G. Differences in intensity and quality of bowel symptoms in patients with colorectal endometriosis: a case-control study. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- L M Reh
- Department of Gynecology, Center for Endometriosis, Hospital St. John of God, Vienna, Austria
| | - E Darici
- Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Zeynep Kâmil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey
| | - E Montanari
- Department of Gynecology, Center for Endometriosis, Hospital St. John of God, Vienna, Austria
- Department of Obstetrics and Gynecology, Medical University of Vienna, Austria
| | - J Keckstein
- Practice Drs. Keckstein, Villach, Austria
- Stiftung Endometrioseforschung SEF
| | - B Senft
- Freelance psychologist, Vienna, Austria
| | - B Dauser
- Department of General Surgery, Center for Endometriosis, Hospital St. John of God, Vienna, Austria
| | - G Hudelist
- Department of Gynecology, Center for Endometriosis, Hospital St. John of God, Vienna, Austria
- Stiftung Endometrioseforschung SEF
| |
Collapse
|
11
|
Boeri L, Silvani C, Malfatto M, Turetti M, Longo F, Albo G, De Lorenzis E, Zanetti S, Montanari E. A new tool for reporting complications after percutaneous nephrolithotomy: The comprehensive complication index. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00165-3] [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: 11/26/2022] Open
|
12
|
Boeri L, Silvani C, Turetti M, Bebi C, Malfatto M, Longo F, Rocchini L, Montanari E. Clinical and functional outcomes of transperineal interstitial laser ablation of the prostate at medium term follow up: A single center experience. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00214-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
13
|
Turetti M, Boeri L, Malfatto M, Silvani C, Zanetti S, Longo F, De Lorenzis E, Albo G, Montanari E. Urologists are optimistic surgeons: Prevalence and predictors of discordance between intraoperative stone free rate and cross-sectional imaging evaluation after vacuum-assisted mini-percutaneous nephrolithotomy. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00183-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
14
|
Zanetti S, Silvani C, Turetti M, Malfatto M, Boeri L, De Lorenzis E, Longo F, Albo G, Montanari E. Which stones should be treated by vacuum assisted mini-PCNL? EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00196-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
15
|
Carlier J, Berardinelli D, Montanari E, Sirignano A, Di Trana A, Busardò FP. 3F-α-pyrrolydinovalerophenone (3F-α-PVP) in vitro human metabolism: Multiple in silico predictions to assist in LC-HRMS/MS analysis and targeted/untargeted data mining. J Chromatogr B Analyt Technol Biomed Life Sci 2022; 1193:123162. [PMID: 35180546 DOI: 10.1016/j.jchromb.2022.123162] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 12/13/2021] [Revised: 01/25/2022] [Accepted: 02/04/2022] [Indexed: 10/19/2022]
Abstract
Synthetic cathinones (SCs) constitute a heterogenous class of new psychoactive substances (NPS), structurally related to cathinone. SCs represent the widest NPS class, second to synthetic cannabinoids, accounting for approximately 160 different analogues with substitution at the phenyl group, the amine group, or the alkyl chain. In 2020, α-pyrrolidonophenone analogues were the most trafficked SCs, and were involved in many fatalities and intoxication cases. In particular, 3F-α-pyrrolidinovalerophenone (3F-α-PVP) was the cause of the highest number of SC-related fatal intoxications in Sweden in 2018. Minor structural modifications are used to avoid legal controls and analytical detection, but may also induce different toxicological profile. Therefore, the identification of specific markers of consumption is essential to discriminate SCs in clinical and forensic toxicology. In this study, we assessed 3F-α-PVP metabolic profile. 3F-α-PVP was incubated with 10-donor-pooled human hepatocytes, LC-HRMS/MS analysis, and software-assisted data mining. This well-established workflow was completed by in silico metabolite predictions using three different freeware. Ten metabolites were identified after 3 h incubation, including hydrogenated, hydroxylated, oxidated, and N-dealkylated metabolites. A total of 51 phase I and II metabolites were predicted, among which 7 were detected in the incubations. We suggest 3F-α-PVP N-butanoic acid, 3F-α-PVP pentanol, and 3F-α-PVP 2-ketopyrrolidinyl-pentanol as specific biomarkers of 3F-α-PVP consumption. This is the first time that an N-ethanoic acid is detected in the metabolic pathway of a pyrrolidine SC, demonstrating the importance of a dual targeted/untargeted data mining strategy.
Collapse
Affiliation(s)
- Jeremy Carlier
- Marche Polytechnic University, Department of Excellence of Biomedical Sciences and Public Health, Section of Legal Medicine, Unit of Forensic Toxicology, via Tronto 10, 60126, Ancona AN, Italy; Sapienza University of Rome, Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Section of Legal Medicine, Unit of Forensic Toxicology, Viale Regina Elena 336, 00161, Rome RM, Italy
| | - Diletta Berardinelli
- Marche Polytechnic University, Department of Excellence of Biomedical Sciences and Public Health, Section of Legal Medicine, Unit of Forensic Toxicology, via Tronto 10, 60126, Ancona AN, Italy
| | - Eva Montanari
- Department of Legal medicine, Azienda Ospedaliero Universitaria Ospedali Riuniti, Via Conca 71, 60126, Ancona, Italy
| | - Ascanio Sirignano
- University of Camerino, Department of Legal Medicine, School of Law, Via Andrea D'Accorso, 16, 62032, Camerino (MC), Italy
| | - Annagiulia Di Trana
- Marche Polytechnic University, Department of Excellence of Biomedical Sciences and Public Health, Section of Legal Medicine, Unit of Forensic Toxicology, via Tronto 10, 60126, Ancona AN, Italy.
| | - Francesco P Busardò
- Marche Polytechnic University, Department of Excellence of Biomedical Sciences and Public Health, Section of Legal Medicine, Unit of Forensic Toxicology, via Tronto 10, 60126, Ancona AN, Italy
| |
Collapse
|
16
|
Montanari E, Bokor A, Szabó G, Kondo W, Trippia CH, Malzoni M, Di Giovanni A, Tinneberg HR, Oberstein A, Rocha RM, Leonardi M, Condous G, Alsalem H, Keckstein J, Hudelist G. Accuracy of sonography for non-invasive detection of ovarian and deep endometriosis using #Enzian classification: prospective multicenter diagnostic accuracy study. Ultrasound Obstet Gynecol 2022; 59:385-391. [PMID: 34919760 DOI: 10.1002/uog.24833] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To compare the preoperative detection of endometriosis using transvaginal sonography (TVS) supplemented by transabdominal sonography (TAS) with surgical assessment of disease, using the #Enzian classification for endometriosis. METHODS This was a prospective multicenter diagnostic accuracy study of women undergoing TVS/TAS and radical surgery for deep endometriosis (DE) at different tertiary referral centers. The localization and grade of severity of the endometriotic lesions and adhesions were described according to the criteria of the #Enzian classification, both at preoperative ultrasound examination and during surgery. According to the #Enzian classification, the small pelvis is divided into three compartments for DE: A (rectovaginal septum and vagina); B (uterosacral and cardinal ligaments, parametrium and pelvic sidewalls); and C (rectum). In addition, further locations (F) are classified as adenomyosis (FA), urinary bladder involvement (FB) and ureteric involvement with signs of obstruction (FU). Other intestinal locations (FI) and other extragenital locations (FO) are also included. Ovarian endometriosis and adhesions at the level of the tubo-ovarian unit are listed as O and T, respectively. The #Enzian grade of severity (Grade 1-3) was determined for #Enzian compartments O, T, A, B and C based on the size of the lesion or the severity of the adhesions. Concordance between preoperative assessment using TVS/TAS and evaluation at surgery was assessed. The sensitivity, specificity, positive and negative predictive values and accuracy of TVS/TAS in the detection of endometriotic lesions/adhesions in the different #Enzian compartments were calculated. RESULTS In total, 745 women were included in the analysis. Preoperative TVS/TAS and surgical findings showed a concordance rate ranging between 86% and 99% for the presence or absence of endometriotic lesions/adhesions, depending on the evaluated #Enzian compartment. The concordance rate between TVS and surgery ranged between 71% and 92% for different severity grades, in #Enzian compartments O, T, A, B and C. Determining the presence or absence of adhesions at the level of the tubo-ovarian unit and classifying them accurately as Grade 1, 2 or 3 on TVS was more difficult than determining the presence and severity of endometriotic lesions in #Enzian compartments O, A, B and C. The sensitivity of TVS/TAS for the detection of endometriotic lesions ranged from 50% (#Enzian compartment FI) to 95% (#Enzian compartment A), specificity from 86% (#Enzian compartment Tleft ) to 99% (#Enzian compartment FI) and 100% (#Enzian compartments FB, FU and FO), positive predictive value from 90% (#Enzian compartment Tright ) to 100% (#Enzian compartment FO), negative predictive value from 74% (#Enzian compartment Bleft ) to 99% (#Enzian compartments FB and FU) and accuracy from 88% (#Enzian compartment Bright ) to 99% (#Enzian compartment FB). CONCLUSIONS The localization and severity of endometriotic lesions/adhesions, as described and classified according to the #Enzian classification, can be diagnosed accurately and non-invasively using TVS/TAS. The #Enzian classification provides a uniform classification system for describing endometriotic lesions, which can be used both at TVS/TAS and during surgical evaluation. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
Collapse
Affiliation(s)
- E Montanari
- Department of Gynecology, Center for Endometriosis, Hospital St John of God, Vienna, Austria
| | - A Bokor
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - G Szabó
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - W Kondo
- Department of Gynecology and Minimally Invasive Unit, Vita Batel Hospital, Curitiba, Brazil
| | - C H Trippia
- Department of Radiology, Roentgen Diagnóstico Institute, Curitiba, Brazil
| | - M Malzoni
- Endoscopica Malzoni, Centre for Advanced Pelvic Surgery, Avellino, Italy
| | - A Di Giovanni
- Endoscopica Malzoni, Centre for Advanced Pelvic Surgery, Avellino, Italy
| | - H R Tinneberg
- Department of Obstetrics and Gynecology, Nordwest Hospital, Frankfurt, Germany
| | - A Oberstein
- Department of Obstetrics and Gynecology, Nordwest Hospital, Frankfurt, Germany
| | - R M Rocha
- Acute Gynaecology, Early Pregnancy and Advanced Endoscopy Surgery Unit, Nepean Hospital, Kingswood, NSW, Australia
- Sydney Medical School Nepean, University of Sydney, Sydney, NSW, Australia
| | - M Leonardi
- Sydney Medical School Nepean, University of Sydney, Sydney, NSW, Australia
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
| | - G Condous
- Acute Gynaecology, Early Pregnancy and Advanced Endoscopy Surgery Unit, Nepean Hospital, Kingswood, NSW, Australia
- Sydney Medical School Nepean, University of Sydney, Sydney, NSW, Australia
| | - H Alsalem
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
| | - J Keckstein
- Stiftung Endometrioseforschung (SEF), Westerstede, Germany
| | - G Hudelist
- Department of Gynecology, Center for Endometriosis, Hospital St John of God, Vienna, Austria
- Stiftung Endometrioseforschung (SEF), Westerstede, Germany
- Rudolfinerhaus Private Clinic, Vienna, Austria
| |
Collapse
|
17
|
Abstract
The adulteration of drugs of abuse is a well-known practice with alarming public health implications. In fact, the presence of other substances than those declared by the drug dealers may expose the consumers to unexpected adverse effects, even potentially fatal ones depending on the adulterant. Various adulterants are often added during the manufacturing process as cutting agent for deliberate underdosing, such as in case of levamisole for cocaine, or to strengthen the drug ef-fect, as in case of fentanyl for heroin. The authors aimed to elaborate on such unfolding dynamics and concluded that continuous development of effective analytical tools, along with a closely focused evaluation of each case by the medical doctor is essential to clarify the origin of the intoxications, so as to undertake the best therapeutic pathway.
Collapse
Affiliation(s)
- A Di Trana
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Poly-technic University of Marche, Ancona, Italy
| | - E Montanari
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Poly-technic University of Marche, Ancona, Italy
| |
Collapse
|
18
|
Falagario U, Lantz A, Jambor I, Busetto G, Carmignani L, Montanari E, Bove P, Gontero P, Sciarra A, Di Tonno P, Trombetta C, Bassi P, Simone G, Mirone V, Antonelli A, Schips L, Bostrom P, Porpiglia F, Nordström T, De Cobelli O, Cormio L, Carrieri G, Ferro M. Diagnosis of prostate cancer in men treated with 5-alpha-reducates inhibitors with multi-parametric MRI: Results of a multicenter international collaboration. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00832-6] [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]
|
19
|
Boeri L, Lucignani G, Ierardi A, Piasentin A, Trombetta C, Liguori G, Bertolotto M, Rizzo M, Carrafiello G, Montanari E. Percutaneous microwave ablation is comparable to cryoablation for the treatment of T1a renal masses: Results from a cross-sectional study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00304-9] [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]
|
20
|
Tafuri A, Marchioni M, Cerrato C, Mari A, Veccia A, Parma P, Dal Moro F, Schiavina R, Bove P, Cantiello F, Porpiglia F, Ditonno P, Montanari E, Gontero P, Trombetta C, Terrone C, Schips L, Sciarra A, Galosi A, Ferro M, Shariat S, Di Nicola M, Minervini A, Pagliarulo V, Antonelli A. Renal function variation after nephroureterectomy for upper urinary tract carcinoma: Evaluation in a large multicenter cohort (Radical Nephroureterectomy Outcomes (RaNeO) Research Consortium). Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00380-3] [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: 11/04/2022]
|
21
|
Bebi C, Ripa F, Malfatto M, Lucignani G, Turetti M, Silvani C, Rocchin L, Serrago M, De Lorenzis E, Albo G, Montanari E, Boeri L. Transperineal interstitial laser ablation of the prostate as a minimally-invasive and effective therapeutic option for benign prostatic hyperplasia. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00807-7] [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: 11/04/2022]
|
22
|
Claps F, Pavan N, D'Altilia N, Checcucci E, Napolitano L, Morlacco A, Tafuri A, Palumbo C, Boeri L, Tulone G, Bignù C, Liguori G, Busetto G, Simonato A, Montanari E, Carmignani L, Celia A, Volpe A, Antonelli A, Dal Moro F, Mirone V, Porpiglia F, Cormio L, Carrieri G, Trombetta C. Predictors of residual tumor at re-staging transurethral resection for high-risk non-muscle invasive bladder cancer: Insights from a large multi-institutional collaboration. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00237-8] [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: 11/24/2022]
|
23
|
Pignot G, Lorusso V, Le Quellec A, Pacchetti A, Rion C, Branger N, Maubon T, Rybikowski S, Sypre D, Lannes F, Musi G, Montanari E, De Cobelli O, Walz J. Robot-assisted Diverticulectomy for an early-stage squamous cell carcinoma of the bladder. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)02298-9] [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: 10/19/2022] Open
|
24
|
Silvani C, De Lorenzis E, Bebi C, Boeri L, Ripa F, Lievore E, Gallioli A, Turetti M, Lucignani G, Lo Baido V, Longo F, Teri A, Dodaro A, Vignati C, Matinato C, Albo G, Colombo R, Montanari E. Real-time PCR-based bacterial detection versus traditional culture of percutaneous nephrolithotomy derived stones: an investigational study. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00933-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
25
|
Boeri L, Spinelli M, Lievore E, Lucignani G, Turetti M, Ripa F, Bebi C, Silvani C, Lo Baido V, Biondetti P, Martinelli L, De Lorenzis E, Albo G, Ierardi A, Carrafiello G, Montanari E. External validation and clinical significance of a radiologic classification system for spontaneous upper urinary tract rupture. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00775-8] [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: 11/16/2022] Open
|
26
|
Morelli M, Baboudjian M, Vanacore D, Gondran-Tellier B, McManus R, Karsenty G, Lechevallier E, Montanari E, Boissier R. Early PDD cystoscopy after BCG induction for high-risk non-muscle invasive bladder cancer significantly increased the detection of BCG-refractory tumors. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00935-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
27
|
Tellini R, Mari A, Antonelli A, Grosso A, Bove P, Brunocilla E, Capitanio U, Checcucci E, Di Maida F, Gontero P, Longo N, Montanari E, Montorsi F, Porpiglia F, Porreca A, Rocco B, Schiavina R, Serni S, Simeone C, Trombetta C, Ficarra V, Carini M, Minervini A. Laparoscopic versus robotic partial nephrectomy in obese patients: perioperative and early functional outcomes from a large prospective contemporary series (RECORd2 project). EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00949-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
28
|
Albo G, Ripa F, Rosti V, Petrini C, Lembo G, Hariprakash J, Ferrari F, De Lorenzis E, Lanzuolo C, Montanari E. Chromatin texture remodeling underlying the epigenomic dysfunction in prostate cancer. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00873-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
29
|
Lievore E, Zanetti S, Fulgheri I, Turetti M, Bebi C, Ripa F, Silvani C, Lucignani G, Lo Baido V, Rocchini L, De Lorenzis E, Albo G, Longo F, Montanari E, Boeri L. Vacuum cleaner effect or vacuum assisted sheath for mini-percutaneous nephrolitotomy: outcomes and cost analysis from a tertiary referral center. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00773-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
30
|
Gontero P, Longo F, Montanari E, Roupret M, Stockley J, Kennedy A, Dudderidge T, Witjes J, McCracken S, Colombel M, Palou J, Sylvester R. Reducing the frequency of surveillance cystoscopies through the use of ADXBLADDER in the follow up of patients with non-muscle invasive bladder cancer. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00704-7] [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: 11/16/2022] Open
|
31
|
Montanari E, Longo F, Gontero P, Roupret M, Stockley J, Kennedy A, Witjes J, McCracken S, Dudderidge T, Columbel M, Sylvester R, Palou J. Adxbladder exhibits anticipatory effects in the follow up of non-muscle invasive bladder cancer in a large multicentric european cohort. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00939-3] [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: 11/17/2022] Open
|
32
|
Sampogna G, Barbosa F, Brambillasca P, Montanari E, Rampoldi A, Spinelli M. Prostatic artery embolization in people with spinal cord injury: a safe and effective technique to ease clean intermittent catheterizations in case of concomitant benign prostatic hyperplasia. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00809-0] [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: 11/16/2022] Open
|
33
|
Boeri L, Dente D, Greco E, Turetti M, Capece M, Cocci A, Preto M, Pescatori E, Gadda F, Franco G, Palmieri A, Rolle L, Montorsi F, Salonia A, Montanari E. P–095 Outcomes and predictive factors of successful salvage microdissection testicular sperm extraction (mTESE) after failed TESE in men with non-obstructive azoospermia: results from a multicenter study. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
We assessed the outcome and predictors of successful salvage microdissection testicular sperm extraction (mTESE) in non-obstructive azoospermia (NOA) men previously submitted to unfruitful classic (cTESE).
Summary answer
The sperm retrieval rate at salvage mTESE was almost 50%. Hypospermatogenesis and low FSH values were associated with positive outcomes at salvage mTESE
What is known already
In men with NOA testicular sperm can be retrieved using cTESE in approximately 50% of cases. mTESE has been proposed as a salvage treatment option for men with a previously failed TESE, but data are scarce.
Study design, size, duration
Multicenter, cross-sectional study. Complete data from 61 NOA men who underwent mTESE after a failed cTESE between 01/2014 and 10/2020, at 6 tertiary referral centers in Italy were analysed.
Participants/materials, setting, methods
All men underwent testicular ultrasound, hormonal and genetic blood testing. Histopathological diagnosis from TESE was collected in every man. Semen analyses were based on the 2010 WHO reference criteria. mTESE was performed according to the technique of Schlegel et al. (1999). Descriptive statistics and logistic regression models were used to investigate potential predictors of positive sperm retrieval (SR+) after salvage mTESE.
Main results and the role of chance
Overall, median (IQR) age and testicular volume were 35 (31–38) years and 10 (6–15) ml, respectively. Baseline serum FSH and total testosterone levels were 17.1 (8.6–30.4) mUI/mL and 4.7 (3.5–6.4) ng/mL, respectively. Sertoli-cell-only (SCO) syndrome, maturation arrest (MA) and hypospermatogenesis were found in 24 (39.3%), 21 (34.4%) and 16 (26.2%) men after cTESE, respectively. Spermatozoa were retrieved in 30 (49.2%) men at salvage mTESE. Patients with a diagnosis of hypospermatogenesis had a higher rate of SR + [12/16 (75%)] than those with MA [12/21 (57.1%)] and SCOS [6/24 (25%)] after salvage mTESE (p < 0.01), which was bilateral in 36 (59%) cases. FSH was higher [16.5 (8–22) vs. 8.9 (5–13) mUI/mL, p < 0.01] in SR- patients compared to SR+. No difference in clinical characteristics was found between patients with SR+ and SR- at salvage mTESE. There were no significant complications after mTESE. Multivariable logistic regression analysis showed that hypospermatogenesis (OR 9.7; p < 0.01) and low FSH levels (OR 0.9, p < 0.001) were independent predictors of SR+ after salvage mTESE, after accounting for age.
Limitations, reasons for caution
Despite we analysed one of the largest series of salvage mTESE, the samples size is too small to draw general conclusions. Because of the multicenter nature of the study we cannot rely on standardization of surgical techniques for TESE.
Wider implications of the findings: This is one of the larger studies on salvage mTESE. The selection of patients for salvage mTESE is of critical importance.
Trial registration number
na
Collapse
Affiliation(s)
- L Boeri
- Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico- University of Milan- Milan- Italy, Urology, Milan, Italy
| | - D Dente
- Unit of Robotic & Mininvasive Surgery - Casa Di Cura Villa Igea- Ancona, Urology, Ancona, Italy
| | - E Greco
- Centre for Reproductive Medicine- European Hospital- Rome- Italy, ivf, Rome, Italy
| | - M Turetti
- Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico- University of Milan- Milan- Italy, Urology, Milan, Italy
| | - M Capece
- Department of Neurosciences- Reproductive Sciences and Odontostomatology- University of Naples “Federico II”- Naples, Urology, Naples, Italy
| | - A Cocci
- Department of Urology and Andrology Surgery- University of Florence, Urology, Florence, Italy
| | - M Preto
- Division of Urology- A.O.U. Città della Salute e della Scienza di Torino - Presidio Molinette, Urology, Turin, Italy
| | - E Pescatori
- Reproductive Medicine Unit- GynePro Medical Centers- NextClinics International- Bologna- Italy, Urology, Bologna, Italy
| | - F Gadda
- Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico- University of Milan- Milan- Italy, Urology, Milan, Italy
| | - G Franco
- Department Gynaecological-Obstetrical and Urological Sciences- Sapienza University of Rome, Urology, Rome, Italy
| | - A Palmieri
- Department of Neurosciences- Reproductive Sciences and Odontostomatology- University of Naples “Federico II”- Naples, Urology, Naples, Italy
| | - L Rolle
- Division of Urology- A.O.U. Città della Salute e della Scienza di Torino - Presidio Molinette, Urology, Turin, Italy
| | - F Montorsi
- Division of Experimental Oncology/Unit of Urology- URI- IRCCS Ospedale San Raffaele- Milan- Italy, Urology, Milan, Italy
| | - A Salonia
- Division of Experimental Oncology/Unit of Urology- URI- IRCCS Ospedale San Raffaele- Milan- Italy, Urology, Milan, Italy
| | - E Montanari
- Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico- University of Milan- Milan- Italy, Urology, Milan, Italy
| |
Collapse
|
34
|
Bebi C, Fulgheri I, Spinelli M, Turetti M, Lievore E, Ripa F, Rocchini L, De Lorenzis E, Albo G, D’Amico M, Carrafiello G, Montanari E, Boeri L. Development of a novel clinical and radiological risk score to predict septic complications in patients with obstructive uropathy. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00532-7] [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: 11/17/2022]
|
35
|
Rouprêt M, Gontero P, Montanari E, Longo F, Witjes J, Dudderidge T, Stockley J, Kennedy A, Vanie F, Rodriguez O, Allasia M, Mccracken S, Sylvester R, Palou J. Anticipatory effects of ADXBLADDER test results in the follow up of cystoscopy negative non muscle invasive bladder cancer patients in a large multicentric European cohort. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01100-3] [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]
|
36
|
Sampogna G, Berrettini A, Zanetti S, Gallioli A, Gnech M, De Marco E, Minoli D, Longo F, Manzoni G, Montanari E. Semi-closed-circuit vacuum-assisted Mini-PCNL system for renal stones in pediatric patients: The experience by a tertiary referral center. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01660-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
37
|
Gontero P, Roupret M, Witjes J, Montanari E, Longo F, Kennedy A, Stockley J, Colombel M, Dudderidge T, Mccracken S, Palou J, Sylvester R. Reducing the frequency of follow up cystoscopies for recurrence through the utilization of the urinary biomarker test ADXBLADDER in patients with Low grade, Low stage non-muscle invasive bladder cancer. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01101-5] [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]
|
38
|
Morelli M, Baboudjian M, Boissier R, Vanacore D, Karsenty G, Montanari E, Lechevallier E. Early PDD cystoscopy after BCG induction for high-risk non-muscle invasive bladder cancer significantly increased the detection of BCG-refractory tumors. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01092-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
39
|
Lorenzi T, Sagrati A, Montanari E, Senzacqua M, Morroni M, Fabri M. Hypoxia-induced expression of neuronal nitric oxide synthase in astrocytes of human corpus callosum. Brain Struct Funct 2021; 226:1353-1361. [PMID: 33709161 DOI: 10.1007/s00429-021-02244-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 02/22/2021] [Indexed: 10/22/2022]
Abstract
Nitric oxide (NO) is a gaseous neurotransmitter largely diffused in the brain; among other functions, it regulates the cerebral blood flow in response to hypoxia. NO can be synthetized by three different isoforms of the enzyme NO synthase: neuronal (nNOS), typical of neurons, endothelial and inducible. The aim of this study was to assess nNOS expression in human corpus callosum (CC) astrocytes, and its relationship with the hypoxia duration. Autoptic samples of CC from adult human subjects have been processed with immunohistochemistry and immunofluorescence using antibodies anti-nNOS and anti-glial fibrillary acidic protein (GFAP), the astrocyte marker. Results demonstrated for the first time the presence of nNOS-immunopositive astrocytes in the human CC. In particular, nNOS-positive astrocytes were absent in subjects deceased after a short hypoxia; their number and labeling intensity, however, increased with hypoxia prolongation. Neuronal NOS immunopositivity of CC astrocytes seems thus related to the hypoxia duration and the consequent brain damage.
Collapse
Affiliation(s)
- Teresa Lorenzi
- Department of Experimental and Clinical Medicine, Section of Neuroscience and Cell Biology, School of Medicine, Università Politecnica delle Marche, Via Tronto 10/A, 60126, Ancona, Italy
| | - Andrea Sagrati
- Department of Experimental and Clinical Medicine, Section of Neuroscience and Cell Biology, School of Medicine, Università Politecnica delle Marche, Via Tronto 10/A, 60126, Ancona, Italy
| | - Eva Montanari
- Department of Biomedical Sciences and Public Health, Section of Legal Medicine, Università Politecnica delle Marche, Via Tronto 10/A, 60126, Ancona, Italy
| | - Martina Senzacqua
- Department of Experimental and Clinical Medicine, Section of Neuroscience and Cell Biology, School of Medicine, Università Politecnica delle Marche, Via Tronto 10/A, 60126, Ancona, Italy
| | - Manrico Morroni
- Department of Experimental and Clinical Medicine, Section of Neuroscience and Cell Biology, School of Medicine, Università Politecnica delle Marche, Via Tronto 10/A, 60126, Ancona, Italy.,Electron Microscopy Unit, United Hospitals, Via Conca 71, 60020, Ancona, Italy
| | - Mara Fabri
- Department of Experimental and Clinical Medicine, Section of Neuroscience and Cell Biology, School of Medicine, Università Politecnica delle Marche, Via Tronto 10/A, 60126, Ancona, Italy.
| |
Collapse
|
40
|
Morelli M, Macchione N, Piacentini I, Itri E, Bernardini P, Sampogna G, Del Nero A, Montanari E. Treatment of reno-ureteral stones in people with disabilities: 10 years of experience by the center for Disabled Advanced Medical Assistance (DAMA). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35419-7] [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: 11/26/2022] Open
|
41
|
Boeri L, Capogrosso P, Cazzaniga W, Alfano M, Pederzoli F, Pozzi E, Belladelli F, Baudo A, Ventimiglia E, Abate C, Montanari E, Montorsi F, Salonia A. infertile men have higher PSA values than aged-matched fertile controls: Potential implications for personalized prevention strategies. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35348-9] [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: 10/23/2022] Open
|
42
|
Nazzani S, Catanzaro M, Macchi A, Tesone A, Aceti A, Torelli T, Stagni S, Maccauro M, Colecchia M, Lanocita R, Cascella T, Piva L, Biasoni D, Carmignani L, Montanari E, Salvioni R, Nicolai N. Dynamic sentinel node biopsy versus observation in clinical N0 penile squamous cell carcinoma: a large tertiary national referral center experience. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35546-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
43
|
Turetti M, Gallioli A, De Lorenzis E, Zanetti S, Fontana M, Talso M, Sampogna G, Boeri L, Rocchini L, Longo F, Trinchieri A, Montanari E. How to prevent and manage infections in endourology for urolithiasis: an eulis survey. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35428-8] [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: 11/26/2022] Open
|
44
|
Ripa F, Rocchini L, Bebi C, Boeri L, Longo F, De Lorenzis E, Albo G, Mangioni D, Bandera A, Montanari E. 10-Year microbiological scenario of uropathogens in a single tertiary centre and the distinctive features of the urology department. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35430-6] [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: 10/23/2022] Open
|
45
|
Gontero P, Longo F, Allasia M, Roupret M, Stockley J, Kennedy A, Rodriguez O, Sieverink C, Vanie F, Witjes J, Colombel M, McCracken S, Dudderidge T, Sylvester R, Palou J, Montanari E. Comparison of performance of ADXBLADDER with urine cytology in NMIBC follow up: a blinded prospective multicentric study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35622-6] [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: 10/23/2022] Open
|
46
|
Pozzi E, Boeri L, Capogrosso P, Cazzaniga W, Ventimiglia E, Belladelli F, Schifano N, Candela L, Alfano M, Abate C, Montanari E, Montorsi F, Salonia A. Clomiphene citrate and FSH treatment in men with elevated sperm DNA fragmentation index: Findings from a cross-sectional study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35346-5] [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: 11/26/2022] Open
|
47
|
Bertini R, Cazzaniga W, Larcher A, Castiglione F, Nini A, Carenzi C, Canibus D, Matloob R, Villa L, Conti G, Maccagnano C, Simeone C, Montanari E, Albo G, Salvioni R, Stagni S, Catanzaro M, Antonelli A, Montorsi F, Capitanio U. Active surveillance for small renal masses: a prospective translational study update (NCT03804320). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35508-7] [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: 10/23/2022] Open
|
48
|
Lievore E, Zanetti S, Boeri L, Turetti M, Gallioli A, Fontana M, Longo F, De Lorenzis E, Albo G, Montanari E. Holmium laser lithotripsy enhanced by Moses™ technology in percutaneous nephrolithotomy: preliminary results from a comparative study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35424-0] [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: 10/23/2022] Open
|
49
|
Botticelli F, De Lorenzis E, Bebi C, Gallioli A, Boeri L, Albo G, Longo F, Cappellini M, Montanari E. Application of patient blood management protocols vs liberal blood transfusions: a single center experience. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35602-0] [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: 11/27/2022] Open
|
50
|
Sampogna G, Gallioli A, Berrettini A, Llorens E, Quiróz Y, Gnech M, De Lorenzis E, Albo G, Palou J, Manzoni G, Bujons A, Montanari E. Semi-closed-circuit vacuum-assisted mini-PCNL in the pediatric population: the initial experience by two tertiary referral centers. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35668-8] [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: 10/23/2022] Open
|