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Papaccio M, Bernardi M, Tonegatti LG, Alberti D, Sartori E, Signorelli M. A case series of fetal lymphatic malformations and a review of the literature. J Neonatal Perinatal Med 2023; 16:747-754. [PMID: 38007678 DOI: 10.3233/npm-230160] [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] [Indexed: 11/27/2023]
Abstract
Lymphatic malformations are rare benign developmental anomalies of the lymphatic system that can be diagnosed by prenatal ultrasound. Depending on their anatomical site and size, the lesions can cause a variety of aesthetic and functional deficits. Several treatment options are available, the most suitable is still under debate. The experience gained at our Centre and the review of the literature can be useful to improve prenatal counseling, that is challenging due to the heterogeneity of clinical presentation and treatment.
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Affiliation(s)
- M Papaccio
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - M Bernardi
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - L G Tonegatti
- Department of Pediatric Surgery, Spedali Civili Children's Hospital of Brescia, Brescia BS, Italy
| | - D Alberti
- Department of Pediatric Surgery, Spedali Civili Children's Hospital of Brescia, Brescia BS, Italy
| | - E Sartori
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - M Signorelli
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
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Leone Roberti Maggiore U, Bogani G, Martinelli F, Signorelli M, Chiappa V, Lopez S, Granato V, Ditto A, Raspagliesi F. Response to treatment and prognostic significance of supradiaphragmatic disease in patients with high-grade serous ovarian cancer. Eur J Surg Oncol 2022; 48:2551-2557. [PMID: 36089452 DOI: 10.1016/j.ejso.2022.08.026] [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: 05/31/2022] [Revised: 08/15/2022] [Accepted: 08/23/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES This study was designed to investigate the response to chemotherapy of supradiaphragmatic disease diagnosed by preoperative imaging. As secondary objectives, oncologic outcomes of patients affected by supradiaphragmatic disease and their pattern of recurrence were also evaluated. METHODS Data of consecutive patients with newly diagnosed FIGO stage IV (for supradiaphragmatic disease) epithelial ovarian cancer undergoing either primary debulking surgery or neoadjuvant chemotherapy plus interval debulking surgery between 2004 and 2021, were retrospectively collected. All patients were preoperatively evaluated by chest/abdominal CT scan or 18F-FDG PET/CT preoperatively and at follow-up to evaluate response to chemotherapy. At follow-up visits, site of recurrence diagnosed by imaging techniques was systematically recorded as it occurred. Progression-free and overall survival were measured by using Kaplan-Meier and Cox models. RESULTS A total of 130 patients was included in this study with a median (range) follow-up of 32.9 (12.8-176.7) months. Complete or partial response was achieved in most of the patients after 3 cycles (77.7%) and 6 cycles (85.4%) of chemotherapy. At follow-up, recurrence occurred in 96 (73.8%) patients and the main site of recurrence was abdomen only in 64 (66.7%) patients. At multivariate analysis, residual disease after surgery was the only variable influencing survival outcomes. CONCLUSIONS Supradiaphragmatic disease respond to chemotherapy in most patients affected by advanced EOC and recurrence mainly occurs in the abdomen. Results from this study confirms that abdominal optimal cytoreduction is the main surgical goal in the treatment of women affected by FIGO stage IV EOC.
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Affiliation(s)
| | - G Bogani
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Martinelli
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Signorelli
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - V Chiappa
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Lopez
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - V Granato
- Obstetric and Gynecology Unit, University of Insubria, Ospedale di Circolo Fondazione Macchi, Varese, Italy
| | - A Ditto
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Raspagliesi
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Lucchesi V, Signorelli M, Priotto E, Hooker L, Taft A, Hegarty K. Capacity building primary care responses to domestic violence in Brazil: designing a training model. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.672] [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
Background
Violence against women (VAW) is a public health challenge in Brazil. The country ranks 6th globally for femicide, with a high prevalence of domestic violence, amplified by the pandemic. Primary healthcare (PHC) workers can play a significant role caring for survivors, but their training on how to identify and respond to survivors is a major gap. This study aimed to investigate frontline PHC workers' needs and concerns in the care of VAW survivors, aiming to co-design a participatory model of capacity building to be implemented in the Brazilian PHC.
Methods
This study is based on participatory action-research (PAR) through participant observation and in-depth interviews with an interdisciplinary team of 13 PHC workers from Paranaguá, South of Brazil. Data were collected between Aug/2020-Jan/2021, transcribed, coded and synthetized through thematic analysis.
Results
Major needs and concerns were: 1) unanimous need of capacity building for all PHC workers and managers; 2) training ideally should be face-to-face, and more than one day, based in practical cases (not just in theory); 3) clarifying the role of the cross-sectoral network and referral options; 4) contents needs to address confidentiality, qualified listening, empathy and respect, with practical guidance on how to approach survivors. Other issues included: integrating VAW approaches with violence against children and adolescents; ensuring PHC units have a private room to care for survivors; and electing a key professional in each unit, with more specialized knowledge, to support survivors and staff.
Conclusions
This PAR revealed key issues to collaboratively design a capacity building model for PHC in Brazil, tailored to local needs. The next step will be applying for funding to implement a pilot training.
Key messages
Frontline PHC workers routinely attend cases of VAW, therefore their insights are essential to design capacity building to care for survivors in PHC settings. Training healthcare workers to care for survivors of violence needs to address local concerns, targeting knowledge, skills and competences.
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Affiliation(s)
- V Lucchesi
- Post Graduation in Sustainable Territorial Development, Federal University of Parana, Matinhos, Brazil
| | - M Signorelli
- Post Graduation in Sustainable Territorial Development, Federal University of Parana, Matinhos, Brazil
| | - E Priotto
- Department of Nursing, State University of West of Parana, Foz do Iguaçu, Brazil
| | - L Hooker
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - A Taft
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - K Hegarty
- Department of General Practice, University of Melbourne, Melbourne, Australia
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Signorelli M, Polidoro M, Canavese D. Online-based intervention on LGBTI+ health promotion in Brazil: development and preliminary impacts. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.875] [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: 11/14/2022] Open
Abstract
Abstract
Background
Brazil reports public healthcare gaps concerning lesbian, gay, bisexual, transgender, and intersex (LGBTI+) people. Massive Open Online Courses (MOOCs) are online-based teaching interventions, however their use is still scarce in Brazil. We aim to describe the development and to analyze preliminary impacts of the first online-based intervention through MOOCs for LGBTI+ health promotion in Brazil.
Methods
We adopted mixed qualitative and quantitative approaches, based on participatory-action research: 1) to design the content and format of the MOOC, we conducted 10 focus groups during 2018 and 2019 with key stakeholders in three different Brazilian State capitals, identifying needs and challenges and linking it with guidelines of the National Policy for Comprehensive Health of LGBTI+ people; 2) based on step 1, we developed the MOOC, producing reading content, video-classes and multimedia; 3) we quantitatively analyzed, through a survey, its impact and reach after six months.
Results
The results showed that: a) focus groups were essentials to inform the priorities to design a tailored MOOC; b) the MOOC had 30 hours of autonomous learning activities divided into two modules, with problem-based evaluation; c) the first ten-month of the course had a total of 5,000 people enrolled with a completion rate of approximately 30%; d) 1,700 successfully completed the course; e) 582 participants joined the survey post-course evaluation and for 370 (63.6%) of them, this was the first training activity on LGBTI+ health.
Conclusions
Results point to a high interest in LGBTI+ health and high demand for training on this topic among health professionals. The MOOC format was successful and reliable in enabling the teaching-learning process.
Key messages
Participatory action research was able to inform the content of the first MOOC for LGBTI+ health in Brazil. The MOCC had high interest, and for the majority of concluding participants it was the first activity and formal education about LGBTI+ health.
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Affiliation(s)
- M Signorelli
- Chamber of Public Health, Federal University of Parana, Matinhos, Brazil
| | - M Polidoro
- Campus Restinga, Federal Institute of Rio Grande do Sul, Porto Alegre, Brazil
| | - D Canavese
- Department of Public Health, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Mazzoni G, Alberti D, Torri F, Motta M, Platto C, Franceschetti L, Sartori E E, Signorelli M. Prediction of complex gastroschisis: The evolution of therapeutic techniques and their relation with fetal sonographic features. J Neonatal Perinatal Med 2021; 15:137-145. [PMID: 34334428 DOI: 10.3233/npm-210746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND To analyze prenatal ultrasound (US) markers to predict treatment and adverse neonatal outcome in fetal gastroschisis. METHODS It was conducted a retrospective single-center study considering all pregnancies with isolated gastroschisis that were treated in our department between 2008 and 2020. 17 US markers were analyzed. Moreover, the association between prenatal ultrasound signs and neonatal outcomes was analyzed: need of bowel resection, techniques of reduction, type of closure, adverse neonatal outcomes, time to full enteral feeding, length of total parenteral nutrition and length of hospitalization. RESULTS The analysis included 21 cases. We found significant associations between intestinal dilation (≥10 mm) appeared before 30 weeks of gestation and the need of bowel resection (p = 0.001), the length of total parenteral nutrition (p = 0,0013) and the length of hospitalization (p = 0,0017). Intrauterine growth restriction (IUGR) is a risk factor for serial reduction (p = 0,035). There were no signs significantly associated with the type of closure. Hyperbilirubinemia is related with gestational age (GA) at the diagnosis of intra-abdominal bowel dilation (IABD) (p = 0.0376) and maximum IABD (p = 0.05). All newborns with sepsis had echogenic loops in uterus (p = 0.026). The relation between the GA at delivery and the GA at the extra-abdominal bowel dilation (EABD)≥10 mm was r = 0.70. CONCLUSION We showed the significant role of the early presence of bowel dilation in predicting intestinal resection and adverse outcomes. All IUGR fetuses needed staged reduction through the silo-bag technique. The echogenic bowel was related to neonatal sepsis, while IABD was associated with hyperbilirubinemia.
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Affiliation(s)
- G Mazzoni
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - D Alberti
- Department of Pediatric Surgery, Spedali Civili Children's Hospital of Brescia, Brescia BS, Italy
| | - F Torri
- Department of Pediatric Surgery, Spedali Civili Children's Hospital of Brescia, Brescia BS, Italy
| | - M Motta
- Department of Neonatology, University of Brescia, Brescia BS, Italy
| | - C Platto
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - L Franceschetti
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - E Sartori E
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - M Signorelli
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
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Sheftman D, Signorelli M, Gupta D. Measurement of E × B drift of impurities in the C-2W inner divertor using spatial heterodyne spectroscopy. Rev Sci Instrum 2021; 92:043541. [PMID: 34243420 DOI: 10.1063/5.0043832] [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] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/02/2021] [Indexed: 06/13/2023]
Abstract
Edge control in the C-2W field-reversed configuration experiment is crucial for the stability and energy confinement of the core plasma. Such edge control is achieved by electrical biasing on the end-on electrode plates. The radial electric field generated by the electrode biasing can be measured by E × B induced drift of impurity ions. Spatial heterodyne spectroscopy (SHS) is a promising method of high light throughput spectroscopy. Doppler shifted spectra of O4+ ion emission lines have been measured using a novel, in-house built SHS system. The electric field in the jet plasma inside the inner divertor of C-2W was estimated using the temporal profile of the rotational velocity of the oxygen ions. SHS system details, obtained measurements, and the methods of improving the system performance will be discussed.
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Affiliation(s)
- D Sheftman
- TAE Technologies, Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688-7010, USA
| | - M Signorelli
- TAE Technologies, Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688-7010, USA
| | - D Gupta
- TAE Technologies, Inc., P.O. Box 7010, Rancho Santa Margarita, California 92688-7010, USA
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7
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Koeks Z, Janson AA, Beekman C, Signorelli M, van Duyvenvoorde HA, van den Bergen JC, Hooijmans MT, Alleman I, Hegeman IM, Verschuuren JJGM, V Deutekom JC, Spitali P, Datson NA, Niks EH. Low dystrophin variability between muscles and stable expression over time in Becker muscular dystrophy using capillary Western immunoassay. Sci Rep 2021; 11:5952. [PMID: 33723284 PMCID: PMC7971009 DOI: 10.1038/s41598-021-84863-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 08/27/2020] [Accepted: 02/16/2021] [Indexed: 12/13/2022] Open
Abstract
Becker muscular dystrophy (BMD) is the milder allelic variant of Duchenne muscular dystrophy, with higher dystrophin levels. To anticipate on results of interventions targeting dystrophin expression it is important to know the natural variation of dystrophin expression between different muscles and over time. Dystrophin was quantified using capillary Western immunoassay (Wes) in the anterior tibial (TA) muscle of 37 BMD patients. Variability was studied using two samples from the same TA biopsy site in nine patients, assessing nine longitudinal TA biopsies, and eight simultaneously obtained vastus lateralis (VL) muscle biopsies. Measurements were performed in duplicate with two primary antibodies. Baseline dystrophin levels were correlated to longitudinal muscle strength and functional outcomes. Results showed low technical variability and high precision for both antibodies. Dystrophin TA levels ranged from 4.8 to 97.7%, remained stable over a 3–5 year period, and did not correlate with changes in longitudinal muscle function. Dystrophin levels were comparable between TA and VL muscles. Intra-muscle biopsy variability was low (5.2% and 11.4% of the total variability of the two antibodies). These observations are relevant for the design of clinical trials targeting dystrophin production, and may urge the need for other biomarkers or surrogate endpoints.
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Affiliation(s)
- Z Koeks
- Department of Neurology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - A A Janson
- BioMarin Nederland BV, Leiden, The Netherlands
| | - C Beekman
- BioMarin Nederland BV, Leiden, The Netherlands
| | - M Signorelli
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - H A van Duyvenvoorde
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands.,Duchenne Center Netherlands, Leiden, The Netherlands
| | - J C van den Bergen
- Department of Neurology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - M T Hooijmans
- Department of Radiology, Leiden University Medical Center, C.J. Gorter Center for High Field MRI, Leiden, The Netherlands
| | - I Alleman
- Department of Physiotherapy, Leiden University Medical Center, Leiden, The Netherlands
| | - I M Hegeman
- Department of Neurology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - J J G M Verschuuren
- Department of Neurology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.,Duchenne Center Netherlands, Leiden, The Netherlands
| | | | - P Spitali
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands.,Duchenne Center Netherlands, Leiden, The Netherlands
| | - N A Datson
- BioMarin Nederland BV, Leiden, The Netherlands
| | - E H Niks
- Department of Neurology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. .,Duchenne Center Netherlands, Leiden, The Netherlands.
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Almeida J, Rocha R, Signorelli M, Silva V, Prado S, Evans D. The House of the Brazilian Woman: impacts of a cross-sectoral public health policy for abused women. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.945] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Issue
Violence against women is a serious public health concern in Brazil; the country ranks 5th globally for femicide and has high rates of intimate partner violence. In response, a national policy created the House of the Brazilian Woman (HBW). HBWs aimed at caring for abused women, are staffed 24/7 with multi-disciplinary teams; cross-sectoral services include: psychosocial support; healthcare; specialized police; courts; public attorney's offices; temporary shelter; and access to financial support.
Description of the Problem
The purpose of this study was to characterize the preliminary impacts of the HBW of Curitiba. Based on mixed-methods participatory action-research, data were collected between 2018-2020. We present quantitative measures describing the individuals served and a thematic analysis of in-depth interviews with HBW staff.
Results
Since its opening, in 2016, the HBW of Curitiba has served around 50,000 users, including women and perpetrators. The most prevalent type of violence reported was psychological (67%, n = 14,343), followed by physical (25.8%, n = 5,531), economic (5.2%, n = 1,104) and sexual (2%, n = 428). Positive qualitative impacts perceived by staff were: 1) improved women's empowerment; 2) the importance of centralized resources; 3) acting as a support to ensure existing legal protections. The main challenges were: 1) high demand; 2) discontinuous care; 3) negative impacts on staff's health.
Lessons
The HBW of Curitiba is a key cross-sectoral service for abused women, part of a greater national policy to prevent violence and support women. Despite serving a large number of women in a short period of time challenges remain including integration with other parts of the network and considerations of staff burnout.
Key messages
Effective cross-sectoral policies for abused women are paramount for comprehensive women’s health. Having cross-sectoral services in just one place operating 24/7 has high impact for abused women.
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Affiliation(s)
- J Almeida
- Chamber of Public Health, Federal University of Parana, Matinhos, Brazil
| | - R Rocha
- Post Graduation in Public Health, Federal University of Parana, Curitiba, Brazil
| | - M Signorelli
- Chamber of Public Health, Federal University of Parana, Matinhos, Brazil
- Post Graduation in Public Health, Federal University of Parana, Curitiba, Brazil
| | - V Silva
- Chamber of Public Health, Federal University of Parana, Matinhos, Brazil
| | - S Prado
- House of the Brazilian Woman, Curitiba, Brazil
| | - D Evans
- Department of Public Health, Emory University, Atlanta, USA
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Signorelli M, Gregorini M, Platto C, Orabona R, Zambelloni C, Torri F, Franceschetti L, Gambino A, Sartori E. The prognostic value of antenatal ultrasound in cases complicated by fetal ovarian cysts. J Neonatal Perinatal Med 2020; 12:339-343. [PMID: 30883366 DOI: 10.3233/npm-1870] [Citation(s) in RCA: 4] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Ovarian cysts are relatively common prenatal findings in female fetuses. The aim of this study is to evaluate the ability of antenatal ultrasound in predicting spontaneous regression or a need for surgery. DESIGN All cases of fetal ovarian cysts treated in our Department between 2007 and 2016 were included. Patients underwent a sonographic monitoring in utero and after birth until spontaneous or surgical resolution. Subjects were divided into two groups according to their postnatal management. Receiver-operating characteristics (ROC) curves were used to test the predictive ability for postnatal surgery of the cyst's mean and maximum diameters; their optimal cut off points were also determined. RESULTS 38 cases of antenatally-detected fetal ovarian cysts were included. 12/38 cases underwent surgery (Group A). 26/38 cases were resolved spontaneously (Group B). Cyst size of those which were surgically excised significantly differed from those that regressed spontaneously. ROC curve pointed to 45 mm and 47 mm as optimal cut off points for the mean and the maximum cystic diameters, respectively. CONCLUSIONS Cyst size and echo-structure seemed good predictors for prognosis after birth. The optimal cut off points of the cysts mean and maximum diameters in predicting postnatal surgery have been identified as 45 mm and 47 mm, respectively.
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Affiliation(s)
- M Signorelli
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - M Gregorini
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - C Platto
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - R Orabona
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - C Zambelloni
- Department of Neonatology, University of Brescia, Brescia BS, Italy
| | - F Torri
- Department of Pediatric Surgery, Spedali Civili Children's Hospital of Bescia, Brescia BS, Italy
| | - L Franceschetti
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - A Gambino
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - E Sartori
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
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10
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Loardi C, Signorelli M, Gregorini M, Marella D, Torri F, Zambelloni CM, Omodei U, Odicino F. Moderate and severe fetal pyelectasis: Correlation between prenatal aspects and postnatal outcome. J Neonatal Perinatal Med 2020; 13:91-96. [PMID: 31609706 DOI: 10.3233/npm-180071] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Renal pelvic dilatation (RPD) is a frequent finding in fetal ultrasound. The aim of the study is to correlate the prenatally detected moderate and severe pyelectasis with the postnatal outcome. METHODS A retrospective analysis involving 90 cases of prenatally detected moderate and severe RPD referred to our prenatal diagnosis centre with 18 months of urological follow-up. Prenatal ultrasound was correlated with postnatal renal function, assessed by plasmatic creatinine and/or renal scintigraphy performed before surgery. RESULTS Cases were divided between two groups according to postnatal management: group A including 35 newborns (38.9%) that needed surgical treatment and group B with 55 patients (61.1%) who were managed conservatively. The group A presented higher median RPD (18 mm, IQR 12-25 mm) compared to the group B (11 mm, IQR 10-14 mm). The most common anomaly detected within group A was pelvi-ureteric junction (PUI) obstruction (43%). Within group B 32 cases (58%) showed spontaneous resolution of hydronephrosis during postnatal follow up. In case of moderate pyelectasis the risk of postnatal surgery was 25% and raised to 60% for severe RPD. In our study, 29 newborns showed pathologic scintigraphies: 25 required surgery while 4 did not find indication for surgery due to ipsilateral renal function irreversible damage. 6 patients had high creatinine level (>0.6 mg/dl). 35 cases out of 90 (39%) developed monolateral irreversible renal function impairment. CONCLUSION Moderate and severe RPD are often correlated with postnatal renal damage, therefore a close multidisciplinary follow-up is required. Prenatal scanning is highly predictive of postnatal outcome and can address properly the prenatal counseling.
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Affiliation(s)
- C Loardi
- Department of Obstetrics and Gynecology, Prenatal Diagnosis Unit, ASST Spedali Civili Brescia, University of Brescia, Italy
| | - M Signorelli
- Department of Obstetrics and Gynecology, Prenatal Diagnosis Unit, ASST Spedali Civili Brescia, University of Brescia, Italy
| | - M Gregorini
- Department of Obstetrics and Gynecology, Prenatal Diagnosis Unit, ASST Spedali Civili Brescia, University of Brescia, Italy
| | - D Marella
- Department of Obstetrics and Gynecology, Prenatal Diagnosis Unit, ASST Spedali Civili Brescia, University of Brescia, Italy
| | - F Torri
- Department of Pediatric Surgery, ASST Spedali Civili Brescia, University of Brescia, Italy
| | - C Mario Zambelloni
- Department of Neonatology, ASST Spedali Civili Brescia, University of Brescia, Italy
| | - U Omodei
- Department of Obstetrics and Gynecology, ASST Spedali Civili Brescia, University of Brescia, Italy
| | - F Odicino
- Department of Obstetrics and Gynecology, ASST Spedali Civili Brescia, University of Brescia, Italy
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Bogani G, Ditto A, Martinelli F, Signorelli M, Raspagliesi F, Lorusso D. Neoadjuvant chemotherapy-related leukopoenia as a biomarkers predicting survival outcomes in locally advanced cervical cancer. Eur J Surg Oncol 2018. [DOI: 10.1016/j.ejso.2018.01.056] [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: 10/17/2022] Open
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Martinelli F, Ditto A, Bogani G, Signorelli M, Chiappa V, Perotto S, Scaffa C, Recalcati D, Lorusso D, Raspagliesi F. Sentinel Node Detection in Endometrial Cancer: A Single Center Experience Over 200 Cases of Hysteroscopic Injection of Tracers. J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.170] [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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Bogani G, Martinelli F, Ditto A, Signorelli M, Chiappa V, Leone Roberti Maggiore U, Lorusso D, Raspagliesi F. Assessing the Risk of Pelvic and Para-Aortic Nodal Involvement in Apparent Early-Stage Ovarian Cancer Undergoing Retroperitoneal Staging. J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.169] [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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Bogani G, Maltese G, Morano F, Lorusso D, Ditto A, Signorelli M, Raspagliesi F. Assessing the risk of pelvic and para-aortic nodal involvement in apparent early-stage ovarian cancer: a predictors- and nomogram-based analyses. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx429] [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: 11/14/2022] Open
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Lepori S, Fontanella C, Maltese G, Tripodi E, Martinelli F, Bogani G, Ditto A, Signorelli M, Scaffa C, Raspagliesi F, Lorusso D. Phase II study of the safety and efficacy of oral capecitabine in patients with platinum-pretreated advanced or recurrent cervical carcinoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx429.001] [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: 11/14/2022] Open
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Signorelli M, Bogani G, Morano F, Maltese G, Ditto A, Raspagliesi F, Lorusso D. The impact of chemotherapy-related leukopenia on survival outcomes in locally advanced cervical cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx429.003] [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: 11/13/2022] Open
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Fontanella C, Barcellini A, Vitale M, Lepori S, Maltese G, Tripodi E, Cerrotta A, Martinelli F, Andreetta C, Bogani G, Ditto A, Signorelli M, Scaffa C, Sacco C, Raspagliesi F, Lorusso D. Is chemotherapy worthwhile in patients with high-risk, lymph node negative, FIGO stage 1, endometrial cancer? Ann Oncol 2017. [DOI: 10.1093/annonc/mdx429.002] [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: 11/14/2022] Open
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Lepori S, Fontanella C, Maltese G, Tripodi E, Martinelli F, Bogani G, Ditto A, Signorelli M, Scaffa C, Raspagliesi F, Lorusso D. Phase II study of the safety and efficacy of oral capecitabine in patients with platinum-pretreated advanced or recurrent cervical carcinoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx372.053] [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: 11/14/2022] Open
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Fontanella C, Lepori S, Barcellini A, Maltese G, Andreetta C, Tripodi E, Martinelli F, Cerrotta A, Bogani G, Ditto A, Signorelli M, Scaffa C, Sacco C, Raspagliesi F, Lorusso D. Is chemotherapy worthwhile in patients with FIGO stage 1B, lymph nodes negative, grade 3 endometrial cancer? Ann Oncol 2017. [DOI: 10.1093/annonc/mdx372.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Falcone F, Scambia G, Benedetti Panici P, Signorelli M, Cormio G, Giorda G, Bogliolo S, Marinaccio M, Ghezzi F, Rabaiotti E, Breda E, Casella G, Fanfani F, Di Donato V, Leone Roberti Maggiore U, Greggi S. Tertiary cytoreductive surgery in recurrent epithelial ovarian cancer: A multicentre MITO retrospective study. Gynecol Oncol 2017; 147:66-72. [PMID: 28716306 DOI: 10.1016/j.ygyno.2017.07.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 07/01/2017] [Accepted: 07/06/2017] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To evaluate the impact of tertiary cytoreductive surgery (TCS) on survival in recurrent epithelial ovarian cancer (EOC), and to determine predictors of complete cytoreduction. METHODS A multi-institutional retrospective study was conducted within the MITO Group on a 5-year observation period. RESULTS A total of 103 EOC patients with a ≥6month treatment-free interval (TFI) undergoing TCS were included. Complete cytoreduction was achieved in 71 patients (68.9%), with severe post-operative complications in 9.7%, and no cases of mortality within 60days from surgery. Multivariate analysis identified the complete tertiary cytoreduction as the most potent predictor of survival followed by FIGO stage I-II at initial diagnosis, exclusive retroperitoneal recurrence, and TCS performed ≥3years after primary diagnosis. Patients with complete tertiary cytoreduction had a significantly longer overall survival (median OS: 43months, 95% CI 31-58) compared to those with residual tumor (median OS: 33months, 95% CI 28-46; p<0.001). After multivariate adjustment the presence of a single lesion and good (ECOG 0) performance status were the only significant predictors of complete surgical cytoreduction. CONCLUSIONS This is the only large multicentre study published so far on TCS in EOC with ≥6month TFI. The achievement of postoperative no residual disease is confirmed as the primary objective also in a TCS setting, with significant survival benefit and acceptable morbidity. Accurate patient selection is of utmost importance to have the best chance of complete cytoreduction.
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Affiliation(s)
- F Falcone
- Gynecologic Oncology Surgery, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy; Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - G Scambia
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | - P Benedetti Panici
- Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Rome, Italy
| | - M Signorelli
- Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
| | - G Cormio
- Department of Obstetrics and Gynecology, University of Bari, Bari, Italy; Gynecologic Oncology Unit, National Cancer Institute, Bari, Italy
| | - G Giorda
- Department of Gynecological Oncology, CRO National Cancer Institute, Aviano, Italy
| | - S Bogliolo
- Department of Obstetrics and Gynaecology, IRCCS Fondazione Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - M Marinaccio
- Department of Obstetrics and Gynecology, University of Bari, Bari, Italy
| | - F Ghezzi
- Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy
| | - E Rabaiotti
- Department of Obstetrics and Gynecology, San Raffaele Hospital, Milan, Italy
| | - E Breda
- Medical Oncology Unit Ospedale S Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - G Casella
- Gynecologic Oncology Surgery, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy
| | - F Fanfani
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | - V Di Donato
- Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Rome, Italy
| | | | - S Greggi
- Gynecologic Oncology Surgery, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy.
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Dell'Osso L, Gesi C, Massimetti E, Cremone IM, Barbuti M, Maccariello G, Moroni I, Barlati S, Castellini G, Luciano M, Bossini L, Rocchetti M, Signorelli M, Aguglia E, Fagiolini A, Politi P, Ricca V, Vita A, Carmassi C, Maj M. Adult Autism Subthreshold Spectrum (AdAS Spectrum): Validation of a questionnaire investigating subthreshold autism spectrum. Compr Psychiatry 2017; 73:61-83. [PMID: 27918948 DOI: 10.1016/j.comppsych.2016.11.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 10/25/2016] [Accepted: 11/02/2016] [Indexed: 01/01/2023] Open
Abstract
AIM Increasing literature has shown the usefulness of a dimensional approach to autism. The present study aimed to determine the psychometric properties of the Adult Autism Subthreshold Spectrum (AdAS Spectrum), a new questionnaire specifically tailored to assess subthreshold forms of autism spectrum disorder (ASD) in adulthood. METHODS 102 adults endorsing at least one DSM-5 symptom criterion for ASD (ASDc), 143 adults diagnosed with a feeding and eating disorder (FED), and 160 subjects with no mental disorders (CTL), were recruited from 7 Italian University Departments of Psychiatry and administered the following: SCID-5, Autism-Spectrum Quotient (AQ), Ritvo Autism and Asperger Diagnostic Scale 14-item version (RAADS-14), and AdAS Spectrum. RESULTS The AdAS Spectrum demonstrated excellent internal consistency for the total score (Kuder-Richardson's coefficient=.964) as well as for five out of seven domains (all coefficients>.80) and sound test-retest reliability (ICC=.976). The total and domain AdAS Spectrum scores showed a moderate to strong (>.50) positive correlation with one another and with the AQ and RAADS-14 total scores. ASDc subjects reported significantly higher AdAS Spectrum total scores than both FED (p<.001) and CTL (p<.001), and significantly higher scores on the Childhood/adolescence, Verbal communication, Empathy, Inflexibility and adherence to routine, and Restricted interests and rumination domains (all p<.001) than FED, while on all domains compared to CTL. CTL displayed significantly lower total and domain scores than FED (all p<.001). A significant effect of gender emerged for the Hyper- and hyporeactivity to sensory input domain, with women showing higher scores than men (p=.003). A Diagnosis* Gender interaction was also found for the Verbal communication (p=.019) and Empathy (p=.023) domains. When splitting the ASDc in subjects with one symptom criterion (ASD1) and those with a ASD, and the FED in subjects with no ASD symptom criteria (FED0) and those with one ASD symptom criterion (FED1), a gradient of severity in AdAS Spectrum scores from CTL subjects to ASD patients, across FED0, ASD1, FED1 was shown. CONCLUSIONS The AdAS Spectrum showed excellent internal consistency and test-retest reliability and strong convergent validity with alternative dimensional measures of ASD. The questionnaire performed differently among the three diagnostic groups and enlightened some significant effects of gender in the expression of autistic traits.
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Affiliation(s)
- L Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - C Gesi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - E Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - I M Cremone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Barbuti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - G Maccariello
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - I Moroni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - S Barlati
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - G Castellini
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - M Luciano
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - L Bossini
- Department of Mental Health and Department of Molecular Medicine, University of Siena, Siena, Italy
| | - M Rocchetti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - M Signorelli
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | - E Aguglia
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | - A Fagiolini
- Department of Mental Health and Department of Molecular Medicine, University of Siena, Siena, Italy
| | - P Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - V Ricca
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - A Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - C Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - M Maj
- Department of Psychiatry, University of Naples SUN, Naples, Italy
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Martinelli F, Ditto A, Bogani G, Signorelli M, Chiappa V, Lorusso D, Raspagliesi F. Laparoscopic Mapping in Endometrial Cancer Following Hysteroscopic Injection of Indocyanine Green. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.244] [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: 12/01/2022]
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Martinelli F, Ditto A, Bogani G, Signorelli M, Raspagliesi F. SLN in Endometrial Cancer by Hysteroscopic Injection of ICG and Laparoscopic-NIR Mapping. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.556] [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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Martinelli F, Signorelli M, Bogani G, Ditto A, Chiappa V, Perotto S, Scaffa C, Lorusso D, Raspagliesi F. Is aortic lymphadenectomy indicated in locally advanced cervical cancer after neoadjuvant chemotherapy followed by radical surgery? A retrospective study on 261 women. Eur J Surg Oncol 2016; 42:1512-8. [PMID: 27378160 DOI: 10.1016/j.ejso.2016.06.004] [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: 12/06/2015] [Revised: 05/02/2016] [Accepted: 06/09/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of this study was to estimate the rate of aortic lymph nodes (LN) metastases/recurrences among patients affected by locally advanced stage cancer patients (LACC), treated with neoadjuvant chemotherapy (NACT) and radical surgery. METHODS Retrospective evaluation of consecutive 261 patients affected by LACC (stage IB2-IIB), treated with NACT followed by radical surgery at National Cancer Institute, Milan, Italy, between 1990 and 2011. RESULTS Stage at presentation included stage IB2, IIA and IIB in 100 (38.3%), 50 (19.2%) and 111 (42.5%) patients, respectively. Squamous cell carcinoma accounted for more than 80%, followed by adenocarcinoma or adenosquamous cancers (20%). Overall, 56 women (21.5%) had LN metastases. Four out of 83 women (5%) who underwent both pelvic and aortic LN dissection had aortic LN metastases, and all women had concomitant pelvic and aortic LN metastases. Only one woman out of 178 (0.5%) who underwent pelvic lymphadenectomy only, had an aortic LN recurrence. Overall 2% of women (5/261) had aortic LN metastases/recurrence. CONCLUSIONS Our data suggest that aortic lymphadenectomy at the time of surgery is not routinely indicated in LACC after NACT, but should reserved in case of bulky LN in both pelvic and/or aortic area. The risk of isolated aortic LN relapse is negligible. Further prospective studies are warranted.
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Affiliation(s)
- F Martinelli
- Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
| | - M Signorelli
- Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
| | - G Bogani
- Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
| | - A Ditto
- Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
| | - V Chiappa
- Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
| | - S Perotto
- Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
| | - C Scaffa
- Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
| | - D Lorusso
- Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
| | - F Raspagliesi
- Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
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Signorelli M, Calati R, McMurray J, Comings D, Aguglia E, Serretti A. EPA-1307 - Associations between genetic polymorphisms and personality traits in healthy subjects. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78529-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Signorelli M, Battaglia F, Aguglia E. EPA-0741 – Comorbid depression and diabetes: an observational study. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78091-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Signorelli M, Geraci A, Aguglia E. P01-248-Theory of mind, moral judgments and neuropsychological functioning in patients with bipolar disorders. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)71959-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
IntroductionSeveral studies revealed that cognitive functioning in BPD are impaired not only in the acute phase but over time (Mur et al., 2008). On Theory of Mind (ToM) recent studies found a impairment of this ability in remitted patients, supporting the theory that ToM deficits are trait-dependent (Bora et al., 2009) in contrast with another study that suggest a partially dependence(Wolf et al. 2010).ObjectivesWe explored: a) ToM in BPD investigating two cognitive processes: emotional recognition, second order beliefs attribution; b) Moral judgments in BPD; c) possible effects of neuropsychological functioning on ToM task and moral dilemmas.AimsThe principal aim is to investigate the domain specificity of ToM and Moral sense, studying selective impairments.MethodA total of 20 patients with bipolar I disorder were tested and 20 healthy controls. We use a complete neuropsychological assessment, two ToM tasks (Eyes test, Sullivan's stories) and we added two moral dilemmas to asses moral judgment Results: We found ToM deficits in BDP, with a multiple correlation between ToM and neuropsychological functioning. Also we found for the first time a impairment on personal moral dilemma, with a correlation between emotional recognition and moral judgments.ConclusionPatients with BPD are impaired in ToM partially independent of other cognitive dysfunctions and in moral reasoning.
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Panici PB, Basile S, De Falco C, Lissoni AA, Signorelli M, Giannarelli D, Fossati R. Response: Re: Systematic Pelvic Lymphadenectomy vs No Lymphadenectomy in Early-Stage Endometrial Carcinoma: Randomized Clinical Trial. J Natl Cancer Inst 2009. [DOI: 10.1093/jnci/djp125] [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: 11/14/2022] Open
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Lissoni AA, Colombo N, Pellegrino A, Parma G, Zola P, Katsaros D, Chiari S, Buda A, Landoni F, Peiretti M, Dell'anna T, Fruscio R, Signorelli M, Grassi R, Floriani I, Fossati R, Torri V, Rulli E. A phase II, randomized trial of neo-adjuvant chemotherapy comparing a three-drug combination of paclitaxel, ifosfamide, and cisplatin (TIP) versus paclitaxel and cisplatin (TP) followed by radical surgery in patients with locally advanced squamous cell cervical carcinoma: the Snap-02 Italian Collaborative Study. Ann Oncol 2009; 20:660-5. [PMID: 19181826 DOI: 10.1093/annonc/mdn690] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The efficacy and tolerability of the regimen containing paclitaxel and cisplatin (TP) in the neo-adjuvant treatment of locally advanced squamous cell cervical cancer are unknown. The TIP regimen (TP plus ifosfamide) showed high efficacy but high toxicity and it is used as an internal control. PATIENTS AND METHODS In all, 154 patients were randomized to TP (paclitaxel 175 mg/m(2) + cisplatin 75 mg/m(2); n = 80) or TIP (TP + ifosfamide 5 g/m(2); n = 74), three cycles, followed by radical surgery. Pathological response to chemotherapy was classified as optimal [no residual tumor (complete response) or residual disease with < or = 3 mm stromal invasion (PR1)] or suboptimal response. RESULTS Patient characteristics (TP/TIP): stage IB2 (56%/64%), IIA (18%/14%), IIB (20%/19%), III-IVA (5%/4%) and median age (42 years/45 years). The optimal response rate in the TP group was 25%, 95% confidence interval (CI) = 16% to 37% and 43%, 95% CI = 31% to 55% in the TIP group. Grades 3-4 leukopenia (6%/53%) and neutropenia (26%/76%) were significantly more frequent on TIP. CONCLUSION TP performance was below expectation since the lower 95% confidence limit of the optimal response rate failed to reach the prespecified minimum requirement of efficacy, i.e. 22%. The TIP regimen confirmed its activity but was associated with higher haematological toxicity than TP.
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Affiliation(s)
- A A Lissoni
- Department of Obstetrics and Gynecology, University of Milano-Bicocca, S Gerardo Hospital, Monza, Italy
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Signorelli M, Caspani G, Bonazzi C, Chiappa V, Perego P, Mangioni C. Fertility-sparing treatment in young women with endometrial cancer or atypical complex hyperplasia: a prospective single-institution experience of 21 cases. BJOG 2008; 116:114-8. [DOI: 10.1111/j.1471-0528.2008.02024.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Signorelli M, Magri R, Taddei F, Groli C, Rebufflni E, Zuccarino L, Merulla V, Burlini D. O.073 Prenatal diagnosis accuracy of apparently isolated facial CLP. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71197-1] [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: 10/21/2022] Open
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Signorelli M, Taddei F, Frusca T. Reversal of compensatory flow in severe intrauterine growth restriction: middle cerebral artery and intracardiac volume flow modifications. Minerva Ginecol 2008; 60:287-293. [PMID: 18560343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
AIM The aim of the study was to investigate cerebral and cardiac volume flow modifications in a group of preterm severely growth restricted (GR) fetuses with absent end diastolic flow (AEDF) in the umbilical artery. METHODS Doppler indices of GR fetuses born at less than 32 weeks of gestation with AEDF in umbilical artery were longitudinally analyzed. Ductus venosus S/A, umbilical artery PI, middle cerebral artery (MCA) pulsatility index (PI), MCA volume flow and intracardiac flows were checked daily. The value of volume flow was determined by multiplying the vessel area obtained by means of a power angiography by the integral of the velocimetric curve. In Group 1 the time of delivery was decided when abnormal Doppler index in ductus venosus (S/A>3) was detected. In Group 2, decisions about delivery were based on maternal indications or on various cardiotocographic (CTG) abnormalities. The division in the two groups was made with a retrospective method. RESULTS Fifteen GR fetuses were studied: seven cases entered Group 1 and eight cases Group 2. In Group 2 velocimetric (PI) and quantitative (volume flow) values remained stable until delivery. In all cases in Group 1 ductus venosus anomalies (S/A>3) were preceded by 24 hours by cerebral volume flow indices indicating the loss of MCA vasodilatation and by changes in intracardiac volume flow indices, while the PI increase in MCA was present only 24 hours after the changes detected by the volume flow study and were simultaneous to ductus venosus modifications. CONCLUSION The decrease in volume flow through the middle cerebral artery occurs at least 24 hours before the increase of middle cerebral artery PI and before the ductus venosus anomalies. Flow through the four cardiac valves show modification in agreement to the changes of the middle cerebral artery flow.
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Affiliation(s)
- M Signorelli
- Department of Obstetrics and Gynecology, University of Brescia, Brescia, Italy.
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Taddei F, Signorelli M, Prefumo F, Franceschetti L, Marasini M, Groli C. Prenatal imaging of ductus venosus agenesis using 4D ultrasound with a matrix array transducer. Ultrasound Obstet Gynecol 2008; 31:477-479. [PMID: 18383474 DOI: 10.1002/uog.5281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Signorelli M, Lissoni AA, Garbi A, Perego P, Mangioni C. Primary malignant vaginal melanoma treated with adriamycin and ifosfamide: A case report and literature review. Gynecol Oncol 2005; 97:700-3. [PMID: 15863186 DOI: 10.1016/j.ygyno.2005.02.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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: 11/09/2004] [Revised: 02/01/2005] [Accepted: 02/02/2005] [Indexed: 11/17/2022]
Abstract
BACKGROUND Vaginal melanoma is a very rare but highly malignant gynecological disease, usually diagnosed in postmenopausal woman. The prognosis tends to be poor and it is associated with high rate of recurrence and short survival rates. CASE The following paper describes a case report regarding a 72-year-old woman with a locally advanced malignant melanoma. The previous erroneous histopathological diagnosis was leiomyosarcoma. She underwent chemotherapy with 3 courses of doxorubicin and ifosfamide. The diagnosis of malignant melanoma was obtained after a repeated biopsy and further pathological investigations. She later underwent radical surgery and 2 additional cycles of the same chemotherapy. At present, 7 months after the last cycle, the patient was locally disease-free, but developed brain metastases, requiring chemotherapy treatment. CONCLUSION In view of poor survival, this chemotherapy regimen may be an interesting alternative to the traditional treatment of vaginal melanoma.
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Affiliation(s)
- M Signorelli
- Department of Obstetrics and Gynecology, Division of Gynecology/Oncology, University of Milan-Bicocca, Milan, Italy.
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Signorelli M, Tiberti A, Valseriati D, Molin E, Cerri V, Groli C, Bianchi UA. Width of the fetal lateral ventricular atrium between 10 and 12 mm: a simple variation of the norm? Ultrasound Obstet Gynecol 2004; 23:14-18. [PMID: 14970992 DOI: 10.1002/uog.941] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVES The prognosis of borderline forms of anomalies that can be detected by ultrasound is one of the most challenging issues in prenatal diagnosis. The aim of this study was to determine the prognosis for fetuses presenting with isolated mild ventriculomegaly (MVM). METHODS Fetuses in which the width of the lateral ventricular atria was 10-12 mm and which had no other detectable chromosomal or morphological anomalies were followed by monthly ultrasound examinations until delivery. For the cases identified up to December 1997, postnatal information was gathered retrospectively through interviews. Children born from January 1998 onwards were included in a protocol involving planned neuropsychiatric visits at 12 and 18 months of age in which the Griffith scale was used to assess neurodevelopment. RESULTS Between September 1992 and January 2001, 60 fetuses with isolated MVM were identified. Ventricular dilatation diminished in 18 cases (and became normal in nine of these) and stabilized in 42 cases. Information was obtained on 38 children born up to December 1997 and their neurodevelopment was found to be completely normal. The 22 children born from January 1998 onwards showed normal development at 12 and 18 months of age. CONCLUSIONS When MVM is observed on prenatal ultrasound examination it can be very difficult to offer parents appropriate counseling. It is important to exclude aneuploidy or morphological abnormalities but even then there will be anxieties about long-term neurological outcome. Our data, which show normal neurodevelopment between 18 months and 10 years after birth in cases of MVM (10-12 mm), should provide a basis for reassuring counseling.
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Affiliation(s)
- M Signorelli
- Department of Obstetrics and Gynaecology, University of Brescia, Brescia, Italy.
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Abstract
Ifosfamide, a cyclophosphamide analogue, has demonstrated a wide spectrum of activity against numerous neoplasms in different oncologic areas, including paediatric, haematological, breast, lung and testicular cancers, soft tissue sarcomas and gynaecological cancer. In gynaecologic cancers in particular, evidence suggests activity in the treatment of epithelial ovarian cancer, cervical carcinoma, germ cell carcinoma of the ovary. Cervical cancer has long been considered a poorly chemosensitive tumour and for several years the role of chemotherapy in the treatment of this tumour was confined to persistent or recurrent disease after failure of surgery and/or radiotherapy. In the management of cervical cancer, chemotherapy has received increasing attention in the last two decades and is currently used in neoadjuvant regimens, as salvage treatment in patients with disseminated or recurrent disease, or as a radiosensitizer. Over the past 30 years, several agents have been tested but cisplatin and ifosfamide are the agents that have attracted the greater attention. Cisplatin represents the cornerstone of chemotherapy for cervical cancer. Ifosfamide has been studied as a single agent or in combination with other drugs in different studies. In this paper we reviewed the approach with systemic therapy and, in particular, the role of ifosfamide in advanced or recurrent, and less advanced cervical cancer.
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Affiliation(s)
- A Buda
- Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milan-Bicocca, Monza, Italy.
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Taddei F, Signorelli M, Groli C, Scalchi S, Bianchi UA. Prenatal diagnosis of ventriculocoronary arterial communication associated with pulmonary atresia. Ultrasound Obstet Gynecol 2003; 21:413-415. [PMID: 12704757 DOI: 10.1002/uog.98] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- F Taddei
- Department of Obstetrics and Gynecology, University of Brescia, Italy.
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Signorelli M, Tosini S, Gaeta A, De Nale A, Malacrida G, Tealdi DG. [Aneurysms of the abdominal aorta in elderly patients]. MINERVA CHIR 1991; 46:947-51. [PMID: 1754091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Aneurysms of the abdominal aorta are often diagnosed in the over-75s. Although for many Authors the presence of risk factors such as cardiopathies, cerebrovascular problems, renal or respiratory insufficiency, which are clearly more frequent in elderly patients, represent a contraindication to the intervention of choice, personal experience has shown that surgery remains the best solution. In fact, in a group of patients operated on for aneurysm of the abdominal aorta in a heart, no significant differences in age-related mortality were observed. Surgery therefore remains the treatment of choice in the elderly too for it must also be remembered that the natural history of the disease has shown that, in a comparatively short time, the aneurysm ruptures and operating mortality is markedly higher.
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Affiliation(s)
- M Signorelli
- Ospedale Clinicizzato S. Donato, Università degli Studi di Milano
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Tealdi DG, Signorelli M, De Nale A, Sciolla AG. Epidural spinal electric stimulation in the treatment of ischemic pain. INT ANGIOL 1987; 6:435-7. [PMID: 3502473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Among the analgetic methodologies, epidural spinal stimulation is playing an important role in the treatment of obliterating arteriopathies. Physiopathogenetic hypotheses as well as the main indications, contra-indications and the technique performed are examined. Twenty-four patients (18 males and 6 females) underwent spinal electric stimulation and were all monitored through angiography and preliminary examinations (Doppler velocimetry, plethysmography, Laser Flo, cycloergometer test) which were repeated during the period of temporary and after the permanent stimulator was implanted. The results obtained show that electric stimulation is a reliable technique when the medical or surgical treatments are successful.
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Affiliation(s)
- D G Tealdi
- Istituto di Scienze Medico-Chirurgiche S. Donato, Università di Milano, Italy
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Tealdi DG, Odero A, Biasi G, Signorelli M, Gaeta A, Ruberti U. [Use of the extra-anatomic bypass in the reconstruction of the aorto-iliaco-femoral axis]. Minerva Cardioangiol 1986; 34:255-7. [PMID: 3725031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Signorelli M, Gaeta A, De Nale A, Malacarne Z, Tosini S, Tealdi D. [First experiences on the use of a "non-bleeding" prosthesis in the reconstruction of the aorto-iliac region]. Minerva Cardioangiol 1986; 34:259-62. [PMID: 3725032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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dos Santos Damasco MH, Talhari S, Viana SM, Signorelli M, Saad MH, Andrade LM. Secondary dapsone-resistant leprosy in Brazil: a preliminary report. LEPROSY REV 1986; 57:5-8. [PMID: 3517536 DOI: 10.5935/0305-7518.19860002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Vegeto A, Berardinelli L, Storelli G, Beretta C, Pozzoli E, Signorelli M, Ruberti U. Spontaneous rupture of the renal artery in kidney transplantation. Transplant Proc 1979; 11:1276. [PMID: 382508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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