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Meyer Y, Bohlok A, Olthof P, Donckier V, Doukas M, Lucidi V, Vermeulen P, Grünhagen D, Verhoef C. Histopathological growth patterns of neuroendocrine tumor liver metastases. Clin Exp Metastasis 2023:10.1007/s10585-023-10211-z. [PMID: 37183203 DOI: 10.1007/s10585-023-10211-z] [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: 02/05/2023] [Accepted: 05/09/2023] [Indexed: 05/16/2023]
Abstract
Histopathological growth patterns (HGPs) of liver metastases represent a potential biomarker for prognosis after resection. They have never been studied in neuroendocrine tumor liver metastases (NETLM). This study evaluated if distinct HGPs can be observed in resected NETLM and if they have prognostic value. Sixty-three patients who underwent resection of NETLM between 01-01-2001 and 31-12-2021 were retrospectively included. HGPs were scored on Haematoxylin&Eosin slides using light microscopy, distinguishing desmoplastic- (dHGP), pushing- (pHGP) and replacement HGP (rHGP). Average HGP scores were calculated per patient. Each patient was classified according to predominant HGP. Overall and Disease-Free Survival (OS and DFS) were evaluated through Kaplan-Meier analysis and Cox regression. Eighteen patients had predominant dHGP (29%), 33 had predominant pHGP (52%) and 11 had predominant rHGP (17%). One patient had mixed HGP (2%). Five-year OS was 76% (95%CI: 66-87%) for the overall cohort. Five-year OS was 92% (95%CI: 77-100%) for dHGP, was 73% (95%CI: 59-91%) for pHGP, 50% (95%CI: 25-100%) for rHGP. Five-year DFS was 39% (95%CI: 19-83%) for dHGP, 44% (95%CI: 27-71%) for rHGP and 50% (95%CI: 23-100%) for pHGP. There was no significant association between HGP and OS or DFS in multivariable analysis. Distinct HGPs could be identified in NETLM. In patients who underwent resection of NETLM, no association was found between HGPs and postoperative survival. Half of the patients with NETLM have a predominant pushing growth pattern, which is a rare growth pattern in liver metastases from breast and colorectal cancer.
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Affiliation(s)
- Y Meyer
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus University Hospital, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - A Bohlok
- Institut Jules Bordet, Surgical Oncology, Université Libre de Bruxelles, Brussels, Belgium
| | - P Olthof
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus University Hospital, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - V Donckier
- Institut Jules Bordet, Surgical Oncology, Université Libre de Bruxelles, Brussels, Belgium
| | - M Doukas
- Department of Pathology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - V Lucidi
- Hôpital Erasme, Department of Abdominal Surgery, Université Libre de Bruxelles, Brussels, Belgium
| | - P Vermeulen
- Translational Cancer Research Unit (GZA Hospitals and University of Antwerp), Antwerp, Belgium
| | - D Grünhagen
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus University Hospital, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - C Verhoef
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus University Hospital, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
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Poras M, Katsanos G, Agrafiotis AC, Demetter P, Pezzullo M, Lucidi V. Case report: Sclerosed hemangioma of the liver: A diagnostic challenge. Front Surg 2022; 9:985849. [PMID: 36644528 PMCID: PMC9834279 DOI: 10.3389/fsurg.2022.985849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 12/05/2022] [Indexed: 12/30/2022] Open
Abstract
Hemangiomas are the most common noncystic benign hepatic tumors and are usually incidentally discovered during routine radiological examinations. The diagnosis of hepatic hemangiomas with a typical presentation is generally easy with plain and cross-sectional imaging; however, it can be complicated when hemangiomas undergo histological changes such as fibrosis. Sclerosed hepatic hemangioma (SHH) is the extreme presentation of this fibrotic process. These atypical lesions can be misdiagnosed as primary hepatic malignancies or metastasis. Their diagnosis is established by histological examination. We report the case of a patient with an SHH, which was misdiagnosed as an intrahepatic cholangiocarcinoma. This article's aim is to draw attention to this infrequent pathology and underline the features of this benign tumor that could suggest its diagnosis prior to surgery to avoid unnecessary hepatic resections.
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Affiliation(s)
- M. Poras
- Department of Abdominal Surgery, St Pierre University Hospital (Université Libre de Bruxelles), Brussels, Belgium,Department of Abdominal Surgery, Erasme University Hospital (Université Libre de Bruxelles), Brussels, Belgium,Correspondence: Mathilde Poras
| | - G. Katsanos
- Department of Abdominal Surgery, Erasme University Hospital (Université Libre de Bruxelles), Brussels, Belgium
| | - A. C. Agrafiotis
- Department of Abdominal Surgery, Erasme University Hospital (Université Libre de Bruxelles), Brussels, Belgium
| | - P. Demetter
- Department of Pathology, Erasme University Hospital (Université Libre de Bruxelles), Brussels, Belgium
| | - M. Pezzullo
- Department of Radiology, Erasme University Hospital (Université Libre de Bruxelles), Brussels, Belgium
| | - V. Lucidi
- Department of Abdominal Surgery, Erasme University Hospital (Université Libre de Bruxelles), Brussels, Belgium
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Korenblik R, van Zon JFJA, Olij B, Heil J, Dewulf MJL, Neumann UP, Olde Damink SWM, Binkert CA, Schadde E, van der Leij C, van Dam RM, van Baardewijk LJ, Barbier L, Binkert CA, Billingsley K, Björnsson B, Andorrà EC, Arslan B, Baclija I, Bemelmans MHA, Bent C, de Boer MT, Bokkers RPH, de Boo DW, Breen D, Breitenstein S, Bruners P, Cappelli A, Carling U, Robert MCI, Chan B, De Cobelli F, Choi J, Crawford M, Croagh D, van Dam RM, Deprez F, Detry O, Dewulf MJL, Díaz-Nieto R, Dili A, Erdmann JI, Font JC, Davis R, Delle M, Fernando R, Fisher O, Fouraschen SMG, Fretland ÅA, Fundora Y, Gelabert A, Gerard L, Gobardhan P, Gómez F, Guiliante F, Grünberger T, Grochola LF, Grünhagen DJ, Guitart J, Hagendoorn J, Heil J, Heise D, Herrero E, Hess G, Hilal MA, Hoffmann M, Iezzi R, Imani F, Inmutto N, James S, Borobia FJG, Jovine E, Kalil J, Kingham P, Kollmar O, Kleeff J, van der Leij C, Lopez-Ben S, Macdonald A, Meijerink M, Korenblik R, Lapisatepun W, Leclercq WKG, Lindsay R, Lucidi V, Madoff DC, Martel G, Mehrzad H, Menon K, Metrakos P, Modi S, Moelker A, Montanari N, Moragues JS, Navinés-López J, Neumann UP, Nguyen J, Peddu P, Primrose JN, Olde Damink SWM, Qu X, Raptis DA, Ratti F, Ryan S, Ridouani F, Rinkes IHMB, Rogan C, Ronellenfitsch U, Serenari M, Salik A, Sallemi C, Sandström P, Martin ES, Sarría L, Schadde E, Serrablo A, Settmacher U, Smits J, Smits MLJ, Snitzbauer A, Soonawalla Z, Sparrelid E, Spuentrup E, Stavrou GA, Sutcliffe R, Tancredi I, Tasse JC, Teichgräber U, Udupa V, Valenti DA, Vass D, Vogl TJ, Wang X, White S, De Wispelaere JF, Wohlgemuth WA, Yu D, Zijlstra IJAJ. Resectability of bilobar liver tumours after simultaneous portal and hepatic vein embolization versus portal vein embolization alone: meta-analysis. BJS Open 2022; 6:6844022. [PMID: 36437731 PMCID: PMC9702575 DOI: 10.1093/bjsopen/zrac141] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/09/2022] [Accepted: 10/05/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Many patients with bi-lobar liver tumours are not eligible for liver resection due to an insufficient future liver remnant (FLR). To reduce the risk of posthepatectomy liver failure and the primary cause of death, regenerative procedures intent to increase the FLR before surgery. The aim of this systematic review is to provide an overview of the available literature and outcomes on the effectiveness of simultaneous portal and hepatic vein embolization (PVE/HVE) versus portal vein embolization (PVE) alone. METHODS A systematic literature search was conducted in PubMed, Web of Science, and Embase up to September 2022. The primary outcome was resectability and the secondary outcome was the FLR volume increase. RESULTS Eight studies comparing PVE/HVE with PVE and six retrospective PVE/HVE case series were included. Pooled resectability within the comparative studies was 75 per cent in the PVE group (n = 252) versus 87 per cent in the PVE/HVE group (n = 166, OR 1.92 (95% c.i., 1.13-3.25)) favouring PVE/HVE (P = 0.015). After PVE, FLR hypertrophy between 12 per cent and 48 per cent (after a median of 21-30 days) was observed, whereas growth between 36 per cent and 67 per cent was reported after PVE/HVE (after a median of 17-31 days). In the comparative studies, 90-day primary cause of death was similar between groups (2.5 per cent after PVE versus 2.2 per cent after PVE/HVE), but a higher 90-day primary cause of death was reported in single-arm PVE/HVE cohort studies (6.9 per cent, 12 of 175 patients). CONCLUSION Based on moderate/weak evidence, PVE/HVE seems to increase resectability of bi-lobar liver tumours with a comparable safety profile. Additionally, PVE/HVE resulted in faster and more pronounced hypertrophy compared with PVE alone.
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Affiliation(s)
- Remon Korenblik
- Correspondence to: R. K., Universiteigssingel 50 (room 5.452) 6229 ER Maastricht, The Netherlands (e-mail: ); R. M. v. D., Maastricht UMC+, Dept. of Surgery, Level 4, PO Box 5800, 6202 AZ Maastricht, The Netherlands (e-mail: )
| | - Jasper F J A van Zon
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bram Olij
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands,GROW—Department of Surgery, School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands,Department of General, Visceral and Transplant Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Jan Heil
- Department of General, Visceral and Transplant Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Maxime J L Dewulf
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ulf P Neumann
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands,Department of General, Visceral and Transplant Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Steven W M Olde Damink
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands,Department of General, Visceral and Transplant Surgery, University Hospital RWTH Aachen, Aachen, Germany,NUTRIM—Department of Surgery, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Christoph A Binkert
- Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Erik Schadde
- Department of General, Visceral and Transplant Surgery, Klinik Hirslanden, Zurich, Switzerland,Department of General, Visceral and Transplant Surgery, Hirslanden Klink St. Anna Luzern, Luzern, Switzerland
| | | | - Ronald M van Dam
- Correspondence to: R. K., Universiteigssingel 50 (room 5.452) 6229 ER Maastricht, The Netherlands (e-mail: ); R. M. v. D., Maastricht UMC+, Dept. of Surgery, Level 4, PO Box 5800, 6202 AZ Maastricht, The Netherlands (e-mail: )
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4
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Korenblik R, Olij B, Aldrighetti LA, Hilal MA, Ahle M, Arslan B, van Baardewijk LJ, Baclija I, Bent C, Bertrand CL, Björnsson B, de Boer MT, de Boer SW, Bokkers RPH, Rinkes IHMB, Breitenstein S, Bruijnen RCG, Bruners P, Büchler MW, Camacho JC, Cappelli A, Carling U, Chan BKY, Chang DH, Choi J, Font JC, Crawford M, Croagh D, Cugat E, Davis R, De Boo DW, De Cobelli F, De Wispelaere JF, van Delden OM, Delle M, Detry O, Díaz-Nieto R, Dili A, Erdmann JI, Fisher O, Fondevila C, Fretland Å, Borobia FG, Gelabert A, Gérard L, Giuliante F, Gobardhan PD, Gómez F, Grünberger T, Grünhagen DJ, Guitart J, Hagendoorn J, Heil J, Heise D, Herrero E, Hess GF, Hoffmann MH, Iezzi R, Imani F, Nguyen J, Jovine E, Kalff JC, Kazemier G, Kingham TP, Kleeff J, Kollmar O, Leclercq WKG, Ben SL, Lucidi V, MacDonald A, Madoff DC, Manekeller S, Martel G, Mehrabi A, Mehrzad H, Meijerink MR, Menon K, Metrakos P, Meyer C, Moelker A, Modi S, Montanari N, Navines J, Neumann UP, Peddu P, Primrose JN, Qu X, Raptis D, Ratti F, Ridouani F, Rogan C, Ronellenfitsch U, Ryan S, Sallemi C, Moragues JS, Sandström P, Sarriá L, Schnitzbauer A, Serenari M, Serrablo A, Smits MLJ, Sparrelid E, Spüntrup E, Stavrou GA, Sutcliffe RP, Tancredi I, Tasse JC, Udupa V, Valenti D, Fundora Y, Vogl TJ, Wang X, White SA, Wohlgemuth WA, Yu D, Zijlstra IAJ, Binkert CA, Bemelmans MHA, van der Leij C, Schadde E, van Dam RM. Dragon 1 Protocol Manuscript: Training, Accreditation, Implementation and Safety Evaluation of Portal and Hepatic Vein Embolization (PVE/HVE) to Accelerate Future Liver Remnant (FLR) Hypertrophy. Cardiovasc Intervent Radiol 2022; 45:1391-1398. [PMID: 35790566 PMCID: PMC9458562 DOI: 10.1007/s00270-022-03176-1] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 05/08/2022] [Indexed: 12/02/2022]
Abstract
STUDY PURPOSE The DRAGON 1 trial aims to assess training, implementation, safety and feasibility of combined portal- and hepatic-vein embolization (PVE/HVE) to accelerate future liver remnant (FLR) hypertrophy in patients with borderline resectable colorectal cancer liver metastases. METHODS The DRAGON 1 trial is a worldwide multicenter prospective single arm trial. The primary endpoint is a composite of the safety of PVE/HVE, 90-day mortality, and one year accrual monitoring of each participating center. Secondary endpoints include: feasibility of resection, the used PVE and HVE techniques, FLR-hypertrophy, liver function (subset of centers), overall survival, and disease-free survival. All complications after the PVE/HVE procedure are documented. Liver volumes will be measured at week 1 and if applicable at week 3 and 6 after PVE/HVE and follow-up visits will be held at 1, 3, 6, and 12 months after the resection. RESULTS Not applicable. CONCLUSION DRAGON 1 is a prospective trial to assess the safety and feasibility of PVE/HVE. Participating study centers will be trained, and procedures standardized using Work Instructions (WI) to prepare for the DRAGON 2 randomized controlled trial. Outcomes should reveal the accrual potential of centers, safety profile of combined PVE/HVE and the effect of FLR-hypertrophy induction by PVE/HVE in patients with CRLM and a small FLR. TRIAL REGISTRATION Clinicaltrials.gov: NCT04272931 (February 17, 2020). Toestingonline.nl: NL71535.068.19 (September 20, 2019).
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Affiliation(s)
- R Korenblik
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht Universiteitssingel 40 room 5.452, 6229 ET, Maastricht, The Netherlands.
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - B Olij
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht Universiteitssingel 40 room 5.452, 6229 ET, Maastricht, The Netherlands
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - M Abu Hilal
- Department of Surgery, Fondazione Poliambulanza, Brescia, Italy
| | - M Ahle
- Deparment of Radiology, University Hospital, Linköping, Sweden
| | - B Arslan
- Department of Radiology, Rush University Medical Center, Chicago, USA
| | - L J van Baardewijk
- Department of Radiology, Maxima Medisch Centrum, Eindhoven, The Netherlands
| | - I Baclija
- Department of Radiology, Clinic Favoriten, Vienna, Austria
| | - C Bent
- Department of Radiology, Bournemouth and Christuchurch, The Royal Bournemouth and Christchurch Hospitals, Bournemouth and Christuchurch, UK
| | - C L Bertrand
- Department of Surgery, CHU UCLouvain Namur, Namur, Belgium
| | - B Björnsson
- Department of Surgery, Biomedical and Clinical Sciences, Linköping University Hospital, Linköping, Sweden
| | - M T de Boer
- Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - S W de Boer
- Deparment of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - R P H Bokkers
- Department of Radiology, University Medical Center Groningen, Groningen, The Netherlands
| | - I H M Borel Rinkes
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S Breitenstein
- Department of General and Visceral Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - R C G Bruijnen
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P Bruners
- Department of Radiology, University Hospital Aachen, Aachen, Germany
| | - M W Büchler
- Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - J C Camacho
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - A Cappelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - U Carling
- Department of Radiology, University Hospital Oslo, Oslo, Norway
| | - B K Y Chan
- Department of Surgery, Aintree University Hospitals NHS, Liverpool, UK
| | - D H Chang
- Department of Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - J Choi
- Department of Surgery, Western Health Footscray, Footscray, Australia
| | - J Codina Font
- Department of Radiology, University Hospital Dr. Josep Trueta de Girona, Girona, Spain
| | - M Crawford
- Department of Surgery, Royal Prince Alfred Hospital, Camperdown, Australia
| | - D Croagh
- Department of Surgery, Monash Health, Clayton, Australia
| | - E Cugat
- Department of Surgery, University Hospital Germans Trias I Pujol, Badalona, Spain
| | - R Davis
- Department of Radiology, Aintree University Hospitals NHS, Liverpool, UK
| | - D W De Boo
- Department of Radiology, Monash Health, Clayton, Australia
| | - F De Cobelli
- Department of Radiology, Ospedale San Raffaele, Milan, Italy
| | | | - O M van Delden
- Department of Radiology, Amsterdam University Medical Centers Location AMC, Amsterdam, The Netherlands
| | - M Delle
- Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - O Detry
- Department of Surgery, CHU de Liège, Liège, Belgium
| | - R Díaz-Nieto
- Department of Surgery, Aintree University Hospitals NHS, Liverpool, UK
| | - A Dili
- Department of Surgery, CHU UCLouvain Namur, Namur, Belgium
| | - J I Erdmann
- Department of Surgery, Amsterdam University Medical Centers Location AMC, Amsterdam, The Netherlands
| | - O Fisher
- Department of Surgery, Royal Prince Alfred Hospital, Camperdown, Australia
| | - C Fondevila
- Department of Surgery, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Å Fretland
- Department of Surgery, University Hospital Oslo, Oslo, Norway
| | - F Garcia Borobia
- Department of Surgery, Hospital Parc Taulí de Sabadell, Sabadell, Spain
| | - A Gelabert
- Department of Radiology, Hospital Parc Taulí de Sabadell, Sabadell, Spain
- Department of Radiology, University Hospital Mútua Terassa, Terassa, Spain
| | - L Gérard
- Department of Radiology, CHU de Liège, Liège, Belgium
| | - F Giuliante
- Department of Surgery, Gemelli University Hospital Rome, Rome, Italy
| | - P D Gobardhan
- Department of Surgery, Amphia, Breda, The Netherlands
| | - F Gómez
- Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - T Grünberger
- Department of Surgery, HPB Center Vienna Health Network, Clinic Favoriten, Vienna, Austria
| | - D J Grünhagen
- Department of Surgery, Erasmus Medisch Centrum, Rotterdam, The Netherlands
| | - J Guitart
- Department of Radiology, University Hospital Mútua Terassa, Terassa, Spain
| | - J Hagendoorn
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J Heil
- Department of Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - D Heise
- Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Aachen, Germany
| | - E Herrero
- Department of Surgery, University Hospital Mútua Terassa, Terassa, Spain
| | - G F Hess
- Department of Surgery, Clarunis University Hospital, Basel, Switzerland
| | - M H Hoffmann
- Department of Radiology, St. Clara Spital, Basel, Switzerland
| | - R Iezzi
- Department of Radiology, Gemelli University Hospital, Rome, Italy
| | - F Imani
- Department of Radiology, Amphia, Breda, The Netherlands
| | - J Nguyen
- Department of Radiology, Western Health Footscray, Footscray, Australia
| | - E Jovine
- Department of Surgery, Ospedale Maggiore di Bologna, Bologna, Italy
| | - J C Kalff
- Department of Surgery, University Hospital Bonn, Bonn, Germany
| | - G Kazemier
- Department of Surgery, Amsterdam University Medical Centers Location VU, Amsterdam, The Netherlands
| | - T P Kingham
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - J Kleeff
- Department of Surgery, University Hospital Halle (Saale), Halle, Germany
| | - O Kollmar
- Department of Surgery, Clarunis University Hospital, Basel, Switzerland
| | - W K G Leclercq
- Department of Surgery, Maxima Medisch Centrum, Eindhoven, The Netherlands
| | - S Lopez Ben
- Department of Surgery, University Hospital Dr. Josep Trueta de Girona, Girona, Spain
| | - V Lucidi
- Department of Surgery, Hôpital Erasme, Brussels, Belgium
| | - A MacDonald
- Department of Radiology, Oxford University Hospital NHS, Oxford, UK
| | - D C Madoff
- Department of Radiology, Yale School of Medicine, New Haven, USA
| | - S Manekeller
- Department of Surgery, University Hospital Bonn, Bonn, Germany
| | - G Martel
- Department of Surgery, The Ottawa Hospital, Ottawa, Canada
| | - A Mehrabi
- Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - H Mehrzad
- Department of Radiology, Queen Elizabeth Hospital Birmingham NHS, Birmingham, UK
| | - M R Meijerink
- Department of Radiology, Amsterdam University Medical Centers Location VU, Amsterdam, The Netherlands
| | - K Menon
- Department of Surgery, King's College Hospital NHS, London, UK
| | - P Metrakos
- Department of Surgery, McGill University Health Centre, Montréal, Canada
| | - C Meyer
- Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - A Moelker
- Department of Radiology and Nuclear Medicine, Erasmus Medisch Centrum, Rotterdam, The Netherlands
| | - S Modi
- Department of Radiology, University Hospital Southampton NHS, Southampton, UK
| | - N Montanari
- Department of Radiology, Ospedale Maggiore Di Bologna, Bologna, Italy
| | - J Navines
- Department of Surgery, University Hospital Germans Trias I Pujol, Badalona, Spain
| | - U P Neumann
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Aachen, Germany
| | - P Peddu
- Department of Radiology, King's College Hospital NHS, London, UK
| | - J N Primrose
- Department of Surgery, University Hospital Southampton NHS, Southampton, UK
| | - X Qu
- Department of Radiology, Zhongshan Hospital, Fundan University, Shanghai, China
| | - D Raptis
- Department of Surgery, Royal Free Hospital NHS, London, UK
| | - F Ratti
- Department of Surgery, Ospedale San Raffaele, Milan, Italy
| | - F Ridouani
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - C Rogan
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Australia
| | - U Ronellenfitsch
- Department of Surgery, University Hospital Halle (Saale), Halle, Germany
| | - S Ryan
- Department of Radiology, The Ottawa Hospital, Ottawa, Canada
| | - C Sallemi
- Department of Radiology, Fondazione Poliambulanza, Brescia, Italy
| | - J Sampere Moragues
- Department of Radiology, University Hospital Germans Trias I Pujol, Badalona, Spain
| | - P Sandström
- Department of Surgery, Biomedical and Clinical Sciences, Linköping University Hospital, Linköping, Sweden
| | - L Sarriá
- Department of Radiology, University Hospital Miguel Servet, Saragossa, Spain
| | - A Schnitzbauer
- Department of Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - M Serenari
- Department of Surgery, General Surgery and Transplant Unit, IRCCS Azienda Ospedaliero- Universitaria di Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - A Serrablo
- Department of Surgery, University Hospital Miguel Servet, Saragossa, Spain
| | - M L J Smits
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E Sparrelid
- Department of Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - E Spüntrup
- Department of Radiology, Klinikum Saarbrücken gGmbH, Saarbrücken, Germany
| | - G A Stavrou
- Department of Surgery, Klinikum Saarbrücken gGmbH, Saarbrücken, Germany
| | - R P Sutcliffe
- Department of Surgery, Queen Elizabeth Hospital Birmingham NHS, Birmingham, UK
| | - I Tancredi
- Department of Radiology, Hôpital Erasme, Brussels, Belgium
| | - J C Tasse
- Department of Radiology, Rush University Medical Center, Chicago, USA
| | - V Udupa
- Department of Surgery, Oxford University Hospital NHS, Oxford, UK
| | - D Valenti
- Department of Radiology, McGill University Health Centre, Montréal, Canada
| | - Y Fundora
- Department of Surgery, Hospital Clínic de Barcelona, Barcelona, Spain
| | - T J Vogl
- Department of Radiology, University Hosptital Frankfurt, Frankfurt, Germany
| | - X Wang
- Department of Surgery, Zhongshan Hospital, Fundan University, Shanghai, China
| | - S A White
- Department of Surgery, Newcastle Upon Tyne Hospitals NHS, Newcastle upon Tyne, UK
| | - W A Wohlgemuth
- Department of Radiology, University Hospital Halle (Saale), Halle, Germany
| | - D Yu
- Department of Radiology, Royal Free Hospital NHS, London, UK
| | - I A J Zijlstra
- Department of Radiology, Amsterdam University Medical Centers Location VU, Amsterdam, The Netherlands
| | - C A Binkert
- Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - M H A Bemelmans
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Aachen, Germany
| | - C van der Leij
- Deparment of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - E Schadde
- Department of General and Visceral Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland
- Department of Surgery, Rush University Medical Center Chicago, Chicago, USA
| | - R M van Dam
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht Universiteitssingel 40 room 5.452, 6229 ET, Maastricht, The Netherlands.
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
- Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Aachen, Germany.
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5
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Germanova D, Lucidi V, Gustot T, Baudoux T, Etienne I, Sokolow Y, Vander Kuylen M, Knoop C. P202 CFTR modulation may help refine transplant decisions in lung-liver transplant candidates. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00531-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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6
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De Biase RV, Cristiani L, Paglia C, Alghisi F, Giordani B, Lucidi V, Bella S. Clinical and microbiological monitoring of Cystic Fibrosis patients, three years of follow-up via Tele-Medicine: an empirical research. Clin Ter 2020; 171:e381-e384. [PMID: 32901778 DOI: 10.7417/ct.2020.2244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Evaluation of the effectiveness of home care through a telemonitoring system in reducing the incidence of new colonization by Pseudomonas Aeruginosa in a population of patients with Cystic Fibrosis (CF) followed by the CF clinic of the Bambino Gesù Hospital in Rome over a period of 36 months. MATERIALS AND METHODS Two groups of patients were recruited, homogeneous for age, sex, BMI, FEV1, prevalence of CF-related Diabetes and CF-related Hepatopathy, access to new therapies with modulators: a) an IN group (N = 44 ) followed through a home telemonitoring system, b) an OUT control group (N = 110) followed according to the standards of care. The following parameters were detected for all patients: pulmonary colonization of the lungs, number and type of hospital admissions, respiratory function, BMI. RESULT The OUT group had a statistically significant increase in the prevalence of Pseudomonas Aeruginosa infections during the observation period. Furthermore, a significant decrease in lung function assessed through FEV1 was also observed in the OUT group. CONCLUSION Adolescent and adult patients belonging to the CF center who are not followed through the dedicated home telemonitoring service show, in the three-year period 2017-19, an increase in Pseudomonas Aeruginosa infections and a greater decrease in respiratory function. The use of telemedicine in CF is therefore an effective system not only in monitoring the disease but also as a treatment strategy, in the context of an evolving multidisciplinary model. As advantages, telemedicine can reduce the number of Pseudomonas Aeruginosa lung infections and the greater stability of respiratory function over time.
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Affiliation(s)
- R V De Biase
- Cystic Fibrosis Center, Children's Hospital and Research Institute Bambino Gesù, Rome
| | - L Cristiani
- Department of Pediatrics, Sapienza University of Rome
| | - C Paglia
- Cystic Fibrosis Center, Children's Hospital and Research Institute Bambino Gesù, Rome
| | - F Alghisi
- Cystic Fibrosis Center, Children's Hospital and Research Institute Bambino Gesù, Rome
| | - B Giordani
- Italian League Cystic Fibrosis Onlus-LIFC
| | - V Lucidi
- Cystic Fibrosis Center, Children's Hospital and Research Institute Bambino Gesù, Rome
| | - S Bella
- Cystic Fibrosis Center, Children's Hospital and Research Institute Bambino Gesù, Rome
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7
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Demols A, Perez-Casanova L, Rocq L, Charry M, De Nève N, Verrellen A, Ramadhan A, Van Campenhout C, De Clercq S, Maris C, Closset J, Lucidi V, Salmon I, D'Haene N. 71P NTRK gene fusions in bilio-pancreatic cancers. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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8
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Demols A, Perez-Casanova L, Rocq L, Charry M, Nève ND, Verrellen A, Ramadhan A, Campenhout CV, De Clercq S, Maris C, Closset J, Lucidi V, Salmon I, D'Haene N. O-4 NTRK gene fusions in bilio-pancreatic cancers. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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9
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Graziano S, Ciciriello F, Alghisi F, Righelli D, Quittner A, Boldrini F, Lucidi V, Tabarini P. P379 Relationship between psychological symptoms, gastrointestinal symptoms, and Health-Related Quality of Life in cystic fibrosis (HRQoL). J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30707-4] [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: 11/30/2022]
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10
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De Marchis M, Piermarini I, Giacomodonato B, Majo F, Graziano S, Ciciriello F, Montemitro E, Rivolta M, Boldrini F, Ianni A, Tabarini P, Lucidi V, Leone P. P325 Physiotherapy home care: satisfaction and health-related quality of life in a group of cystic fibrosis patients. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30654-8] [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: 10/24/2022]
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11
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Dahlqvist G, Ciccarelli O, Van Vlierberghe H, Berrevoet F, Vanwolleghem T, Ysebaert D, Gustot T, Lucidi V, Delwaide J, Detry O, Delbouille MH, Sokal E, Nevens F, Pirenne J. Liver transplantation during the COVID-19 epidemic : recommendations from the Belgian Liver Intestine Transplant Committee (BeLIAC). Acta Gastroenterol Belg 2020; 83:340-343. [PMID: 32603060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Since January 2020, the Novel Coronavirus Disease 2019 (COVID-19) pandemic has dramatically impacted the world. In March 2020, the COVID-19 epidemic reached Belgium creating uncertainty towards all aspects of life. There has been an impressive capacity and solidarity of all healthcare professionals to acutely reconvert facilities to treat these patients. In the context of liver transplantation (LTx), concerns are raised about organ donation shortage and safety, the ethics of using limited healthcare resources for LTx, selection criteria for LTx during the epidemic and the risk of de novo COVID-19 infection on the waiting list and after LTx. BeLIAC makes several recommendations to try to mitigate the deleterious effect that this epidemic has/will have on donation and LTx, taking into account the available resources, and trying to maximize patients and healthcare professionals' safety.
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Affiliation(s)
- G Dahlqvist
- UCL Liver Transplant Program; Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - O Ciccarelli
- UCL Liver Transplant Program; Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - H Van Vlierberghe
- UZ Gent Liver Transplant Program, Universitair Ziekenhuis, Gent, Belgium
| | - F Berrevoet
- UZ Gent Liver Transplant Program, Universitair Ziekenhuis, Gent, Belgium
| | - T Vanwolleghem
- UZ Antwerpen Liver Transplant Program, Universitair Ziekenhuis, Antwerpen, Belgium
| | - D Ysebaert
- UZ Antwerpen Liver Transplant Program, Universitair Ziekenhuis, Antwerpen, Belgium
| | - T Gustot
- ULB Liver Transplant Program; Hopital Universitaire Erasme, Brussels, Belgium
| | - V Lucidi
- ULB Liver Transplant Program; Hopital Universitaire Erasme, Brussels, Belgium
| | - J Delwaide
- ULg Liver Transplant Program, Hopital Universitaire du Sart Tilman, Liège, Belgium
| | - O Detry
- ULg Liver Transplant Program, Hopital Universitaire du Sart Tilman, Liège, Belgium
| | - M H Delbouille
- BTS Section of the Transplant Coordinators, Hopital Universitaire du Sart Tilman, Liège, Belgium
| | - E Sokal
- Pediatric Liver Transplantation, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - F Nevens
- KUL Liver Transplant Program, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium
| | - J Pirenne
- KUL Liver Transplant Program, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium
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12
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Bohlok A, Botzenhart L, Lucidi V, Noël J, Demetter P, Larsimont D, Donckier V, Vermeulen P. Prognostic value of histological growth pattern in patients operated for breast cancer liver metastases. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.069] [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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13
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Savi D, Graziano S, Majo F, Alghisi F, Montemitro E, de Biase R, Bella S, Lancellotti G, Di Toppa M, Tabarini P, Lucidi V. P470 Transition readiness, clinical and psychological variables in patients with cystic fibrosis: a single centre experience in Italy. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30762-3] [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: 10/26/2022]
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14
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Graziano S, Alghisi F, Ciciriello F, Lucidi V, Tabarini P, Quittner A. P419 Italian translation of gastrointestinal symptom tracker in patients with cystic fibrosis. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30711-8] [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: 10/26/2022]
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15
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Bevivino A, Bacci G, Taccetti G, Lucidi V, Dolce D, Fiscarelli E, Di Cesare F, Armanini F, Negroni A, Morelli P, Casciaro R, Segata N, Mengoni A. WS19-4 The personalised temporal dynamics of microbiome in the airways of cystic fibrosis patients. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30231-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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16
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Devereux G, Bourke S, Daines C, Doe S, Dougherty R, Franco R, Innes A, Kopp B, Lascano J, Layish D, McGregor G, Murray L, Peckham D, Smith T, Lucidi V, Volpi S, Lovie E, Robertson J, Fraser-Pitt D, O'Neil D. WS12-6 Evaluating appropriate PROMs in CARE-CF-1 trial: Lynovex® (cysteamine) an oral adjunct to SOC interventions in cystic fibrosis infectious exacebations. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30191-2] [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: 10/26/2022]
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17
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Bohlok A, Daher A, Bouazza F, Germanova D, Lucidi V, Donckier V. Hepatic resection for non-colorectal non endocrine liver metastases; lack of clinical predictive factors or scores able to guide surgical decision. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.173] [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: 11/30/2022] Open
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18
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Bohlok A, Tessely H, Naets E, Bouazza F, Germanova D, Van Laethem J, Hendlisz A, Lucidi V, Donckier V. Clinical factors are unable to accurately predict the absence of benefit of surgery in patients operated for resection of colorectal liver metastasis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.064] [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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19
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Lucidi V, Liberale G, Germanova D, Bez M, Donckier V. Liver surgery of breast cancer liver metastases: Rapid surgical decision after diagnosis does not negatively impact long-term results. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy272.340] [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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20
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Bacci G, Armanini F, Taccetti G, Lucidi V, Dolce D, Fiscarelli E, Negroni A, Morelli P, Casciaro R, Segata N, Mengoni A, Bevivino A. P072 Taxonomic and functional microbial signatures of cystic fibrosis lung disease. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30369-2] [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: 10/14/2022]
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21
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Iacotucci P, Carnovale V, Blasi F, Braggion C, Castellani C, Cipolli M, Collura M, Colombo C, Lucidi V, Minicucci L, Manca A, Magazzù G, Ferrara N. IPD2.07 Retrospective observational study in cystic fibrosis patients homozygous for F508del treated with lumacaftor/ivacaftor in a compassionate use programme. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30291-1] [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: 11/17/2022]
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22
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Di Pietro ML, Teleman AA, Gonzalez-Melado FJ, Zace D, Di Raimo FR, Lucidi V, Refolo P. Implementing carrier screening for cystic fibrosis outside the clinic: ethical analysis in the light of the personalist view. Clin Ter 2018; 169:e71-e76. [PMID: 29595869 DOI: 10.7417/t.2018.2057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Cystic Fibrosis (CF) is an autosomal recessive genetic disease. Two models for screening CF are normally used: newborn screening and population-based CF carrier screening. In turn, there are three main models of population-based CF carrier screening: prenatal carrier screening, preconception carrier screening, and carrier screening outside clinical settings. AIM To evaluate, in the light of the personalist view, the use of carrier screenings for CF outside the clinic, i.e. in non-clinical settings, such as school and workplaces. METHODS Analysis has been carried out according to the "Personalist approach" (also called "Triangular model"), an ethical method for performing ethical analysis within HTA process. It includes factual, anthropological and ethical data in a ''triangular'' normative reflection process. FINDINGS Implementing carrier screening for cystic fibrosis outside the clinical settings allows acquisition of knowledge for informing reproductive choices, that can be considered as valuable; benefit-risk ratio seems to be not much favorable; autonomous and responsible decisions can be taken only under certain conditions; economic advantage is difficult to determine; therefore, from a personalist view, implementing carrier screenings outside the clinic seems not to be ethically justified. CONCLUSIONS In accordance with the personalist perspective, public health programs providing carrier screenings outside the clinic should not be implemented.
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Affiliation(s)
- M L Di Pietro
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome
| | - A A Teleman
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome
| | - F J Gonzalez-Melado
- Department of Bioethics, High Centre for Theological Studies, Pontifical University of Salamanca, Badajoz, Spain
| | - D Zace
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome
| | - F R Di Raimo
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome
| | - V Lucidi
- Pediatrics Medicine Department and Cystic Fibrosis Unit, Bambino Gesù Children's Hospital, IRCCS, Rome
| | - P Refolo
- Institute of Bioethics and Medical Humanities, Università Cattolica del Sacro Cuore,Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
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23
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Craciun L, De Wind R, Demetter P, Lucidi V, Michiels S, Garaud S, Naveaux C, Gomez Galdon M, Hendlisz A, Willard Gallo K, Flamen P, Larsimont D, Donckier V. Selective internal radiation therapy (SIRT) promotes the recruitment of tumor-infiltrating lymphocytes and enhances cytotoxic activity in hepatocellular carcinoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx710.001] [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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24
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Allard MA, Adam R, Giuliante F, Lapointe R, Hubert C, Ijzermans JNM, Mirza DF, Elias D, Laurent C, Gruenberger T, Poston G, Letoublon C, Isoniemi H, Lucidi V, Popescu I, Figueras J. Long-term outcomes of patients with 10 or more colorectal liver metastases. Br J Cancer 2017; 117:604-611. [PMID: 28728167 PMCID: PMC5572175 DOI: 10.1038/bjc.2017.218] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [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: 11/25/2016] [Revised: 04/25/2017] [Accepted: 06/19/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Although the number of colorectal liver metastases (CLM) is decreasingly considered as a contraindication to surgery, patients with 10 CLM or more are often denied liver surgery. This study aimed to evaluate the outcome after liver surgery and to identify prognostic factors of survival in such patients. METHODS The study population consisted of a multicentre cohort of patients with CLM (N=12 406) operated on, with intention to resect, from January 2005-June 2013 and whose data were prospectively collected in the LiverMetSurvey registry. RESULTS Overall, the group ⩾10 CLM (N=529, 4.3%) experienced a 5-year overall survival (OS) of 30%. A macroscopically complete (R0/R1) resection (72.8% of patients) was associated with a 3- and 5-year OS of 61% and 39% vs 29% and 5% for R2/no resection patients (P<0.0001). At multivariate analysis, R0/R1 resection emerged as the strongest favourable factor of OS (HR 0.35 (0.26-0.48)). Other independent favourable factors were as follows: maximal tumour size <40 mm (HR 0.67 (0.49-0.92)); age <60 years (HR 0.66 (0.50-0.88)); preoperative MRI (HR 0.65 (0.47-0.89)); and adjuvant chemotherapy (HR 0.73 (0.55-0.98)). The model showed that 5-year OS rates of 30% was possible provided R0/R1 resection associated with at least an additional favourable factor. CONCLUSIONS Liver resection might provide long-term survival in patients with ⩾10 CLM staged with preoperative MRI, provided R0/R1 resection followed by adjuvant therapy. A validation of these results in another cohort is needed.
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Affiliation(s)
- M A Allard
- Centre Hépato-biliaire, APHP Paul Brousse Hospital, Univ. Paris-Sud, INSERM U 935, Villejuif, France
| | - R Adam
- Centre Hépato-biliaire, APHP Paul Brousse Hospital, Univ. Paris-Sud, INSERM U 935, Villejuif, France
| | - F Giuliante
- Department of HBP Surgery, Catholic University of the Sacred Heart School of Medicine, Rome, Italy
| | - R Lapointe
- Department of HBP Surgery, University of Montreal, Montreal, QC, Canada
| | - C Hubert
- Department of HBP Surgery, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Louvain, Belgium
| | - J N M Ijzermans
- Department of HBP surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - D F Mirza
- Department of HBP surgery, University Hospital Birmingham, Birmingham, UK
| | - D Elias
- Department of Oncological Surgery, Gustave Roussy, Villejuif, France
| | - C Laurent
- Department of Surgery, Saint André Hospital, Bordeaux, France
| | - T Gruenberger
- Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - G Poston
- Department of Surgery, University Hospital Aintree, Liverpool, UK
| | - C Letoublon
- Department of Surgery, University Joseph Fournier, Grenoble, France
| | - H Isoniemi
- Department of Liver Surgery and Transplantation, Helsinki University, Helsinki, Finland
| | - V Lucidi
- Department of Surgery, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - I Popescu
- Department of Surgery and Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | - J Figueras
- Department of Surgery, Dr Josep Trueta Hospital, Girona, Spain
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25
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Vernocchi P, Del Chierico F, Russo A, Majo F, Valerio M, Casadei L, La Storia A, De Filippis F, Rizzo C, Manetti C, Paci P, Ercolini D, Marini F, Fiscarelli E, Dallapiccola B, Lucidi V, Miccheli A, Putignani L. 168 Loss of CFTR function drives the host-gut microbiota interaction: from omics data to clinical cue. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30532-5] [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: 10/19/2022]
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26
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Lemaire M, Lucidi V, Katsanos G, Bouazza F, Gomez Galdon M, Larsimont D, Delatte P, Vouche M, Hendlisz A, Flamen P, Donckier V. Feasibility and safety of a therapeutic strategy using selective transarterial radioembolization followed by surgery for hepatocellular carcinoma in cirrhotic patients. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30358-1] [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: 11/29/2022]
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27
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Janssen F, Richet I, Caekelberghs E, Attyia R, Gauthier M, Gergely T, Mayer M, Sosnowski M, Lucidi V, Berré J, Preiser JC. [Religious and cultural aspects of organ transplantation]. Rev Med Brux 2017; 38:490-493. [PMID: 29318805] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The number of transplantations is mainly limited by the shortage of organs, thereby leading to potentially lethal delays for patients registered on waiting lists. Among the causes of refusals of organ donation, religious reasons are often advocated. In order to make the point, we organized a debate between representatives of secularism ( " laïcité ") and of the most represented religions in Belgium, i.e. catholic, Islamic and Judaic. Even though the representation of death was variable, organ donation is authorized and even encouraged by the fundamental texts. Refusals of organ donation result more often from personal interpretations by local preachers. Therefore, the gathering of political and religious authorities in order to promote organ donation is desirable instead of sowing doubt for pseudo-religious reasons.
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Affiliation(s)
| | - I Richet
- Service de Néonatalogie, H.I.S. (Site Etterbeek-Ixelles)
| | | | - R Attyia
- Service de langue arabe, études islamiques et histoire de l'art musulman, ULg
| | | | | | - M Mayer
- Aumônerie catholique, Hôpital Erasme
| | | | - V Lucidi
- Service de Chirurgie digestive, Hôpital Erasme
| | - J Berré
- Service des Soins intensifs, Hôpital Erasme
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28
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Bacci G, Paganin P, Segata N, Armanini F, Taccetti G, Dolce D, Alessandri AD, Morelli P, Tuccio V, Fiscarelli E, Lucidi V, Mengoni A, Bevivino A. 99 Investigating the airway microbiome in cystic fibrosis patients with normal and severe pulmonary function decline: an opportunity for a personalized microbiome-based therapy. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30338-1] [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]
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29
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Dolce D, Campana S, Ravenni N, Camera E, Neri S, Cariani L, Colombo C, Fiscarelli E, Lucidi V, Raia V, Iula D, Braggion C, Taccetti G. 55 CA-MRSA and HA-MRSA persistent infection and pulmonary function: a multicenter longitudinal study. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30295-8] [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: 10/21/2022]
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Majo F, Di Carlo M, Piga S, Atti MCD, Lucidi V. 40 Use of hypertonic saline solution + hyaluronic acid in patients with cystic fibrosis: a retrospective evaluation. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30280-6] [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: 10/21/2022]
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Graziano S, Lucidi V, Tabarini P. 249 Screening of depression and anxiety symptoms in patients with cystic fibrosis and parent caregivers using international guidelines. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30488-x] [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: 11/24/2022]
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Della Corte C, Mosca A, Majo F, Lucidi V, Panera N, Giglioni E, Monti L, Stronati L, Alisi A, Nobili V. Nonalcoholic fatty pancreas disease and Nonalcoholic fatty liver disease: more than ectopic fat. Clin Endocrinol (Oxf) 2015. [PMID: 26201937 DOI: 10.1111/cen.12862] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the metabolic effects of fatty pancreas (nonalcoholic fatty pancreas disease - NAFPD) in a group of obese paediatric patients with nonalcoholic fatty liver disease (NAFLD). METHODS We included 121 consecutive children with echographic evidence of hepatic steatosis. All patients underwent to abdominal ultrasound to evaluate pancreatic echogenic pattern. We divided the patients into two groups on the basis of the presence of fatty pancreas. In all patients liver function tests, lipid and gluco-insulinemic profile were evaluated. A selected subset of patients (67) underwent to liver biopsy. RESULTS Of these 121 patients, 58 showed NAFPD and 63 patients exhibited a normal pancreatic echogenic pattern. No differences were found in age, transaminases serum levels, lipid profile and pancreatic enzymes between the two groups. The patients with NAFPD had a significantly higher z-BMI, fasting insulin, insulin resistance (HOMA-IR) and lower ISI respect to the group without fatty pancreas. The patients with fatty pancreas showed a more advanced form of liver disease, with higher values of fibrosis, ballooning and NAS score with respect to the group without NAFPD. CONCLUSIONS Our study demonstrated that NAFPD is a frequent condition in obese paediatric patients affected by NAFLD. Our data suggest that pancreatic fat should not be considered an inert accumulation of fat, but as an additional factor able to affect glucose metabolism and severity of liver disease, increasing the risk of develop metabolic syndrome.
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Affiliation(s)
- C Della Corte
- Hepato-Metabolic Department, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - A Mosca
- Hepato-Metabolic Department, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - F Majo
- Cystic Fibrosis Unit, Pediatric Department, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - V Lucidi
- Cystic Fibrosis Unit, Pediatric Department, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - N Panera
- Liver Research Unit, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - E Giglioni
- Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - L Monti
- Liver and Digestive Radiology Unit, Department of Imaging, Bambino Gesu' Children's Hospital, IRCCS, Rome, Italy
| | - L Stronati
- Institute of Biology, Molecular Medicine and Nanobiotechnology, CNR, Rome, Italy
| | - A Alisi
- Liver Research Unit, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - V Nobili
- Hepato-Metabolic Department, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
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Campana S, Ravenni N, Cariani L, Colombo C, Fiscarelli E, Lucidi V, Raia V, Iula D, Pensabene T, Collura M, Braggion C, Taccetti G. 73 Impact of community-acquired MRSA and hospital-acquired MRSA on pulmonary function of CF patients. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30250-2] [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: 12/01/2022]
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Truant S, Scatton O, Dokmak S, Regimbeau JM, Lucidi V, Laurent A, Gauzolino R, Castro Benitez C, Pequignot A, Donckier V, Lim C, Blanleuil ML, Brustia R, Le Treut YP, Soubrane O, Azoulay D, Farges O, Adam R, Pruvot FR. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): impact of the inter-stages course on morbi-mortality and implications for management. Eur J Surg Oncol 2015; 41:674-82. [PMID: 25630689 DOI: 10.1016/j.ejso.2015.01.004] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 12/09/2014] [Accepted: 01/07/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) was recently developed to induce rapid hypertrophy and reduce post-hepatectomy liver failure in patients with insufficient remnant liver volume (RLV). However, mortality rates >12% have been reported. This study aimed to analyze the perioperative course of ALPPS and to identify factors associated with morbi-mortality. METHODS Between April 2011 and September 2013, 62 patients operated in 9 Franco-Belgian hepatobiliary centres underwent ALPPS for colorectal metastases (N = 50) or primary tumors, following chemotherapy (N = 50) and/or portal vein embolization (PVE; N = 9). RESULTS Most patients had right (N = 31) or right extended hepatectomy (N = 25) (median RLV/body weight ratio of 0.54% [0.21-0.77%]). RLV increased by 48.6% [-15.3 to 192%] 7.8 ± 4.5 days after stage1, but the hypertrophy decelerated beyond 7 days. Stage2 was cancelled in 3 patients (4.8%) for insufficient hypertrophy, portal vein thrombosis or death and delayed to ≥9 days in 32 (54.2%). Overall, 25 patients (40.3%) had major complication(s) and 8 (12.9%) died. Fourteen patients (22.6%) had post-stage1 complication of whom 5 (35.7%) died after stage2. Factors associated with major morbi-mortality were obesity, post-stage1 biliary fistula or ascites, and infected and/or bilious peritoneal fluid at stage2. The latter was the only predictor of Clavien ≥3 by multivariate analysis (OR: 4.9; 95% CI: 1.227-19.97; p = 0.025). PVE did not impact the morbi-mortality rates but prevented major cytolysis that was associated with poor outcome. CONCLUSIONS The inter-stages course was crucial in determining ALPPS outcome. The factors of high morbi-mortality rates associated with ALPPS are linked to the technique complexity.
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Affiliation(s)
- S Truant
- Department of Digestive Surgery and Transplantation, CHU, Univ Nord de France, Lille, France.
| | - O Scatton
- Department of Hepatobiliary Surgery and Liver Transplant, St Antoine Hospital, France
| | - S Dokmak
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Beaujon Hospital, Clichy, France
| | - J-M Regimbeau
- Department of Digestive Surgery, Amiens University Medical Centre, Amiens, France
| | - V Lucidi
- Department of Abdominal Surgery and Transplantation, Hospital Erasme, Brussels University, Belgium
| | - A Laurent
- Department of Digestive and Hepatobiliary Surgery, AP-HP, Henri Mondor University Hospital, Créteil, France
| | - R Gauzolino
- Department of General and Visceral Surgery, University Hospital of Poitiers, France
| | - C Castro Benitez
- Hepatobiliary Centre, Paul Brousse Hospital, AP-HP, Univ Paris-Sud, Villejuif, France
| | - A Pequignot
- Department of Digestive Surgery, Amiens University Medical Centre, Amiens, France
| | - V Donckier
- Department of Abdominal Surgery and Transplantation, Hospital Erasme, Brussels University, Belgium
| | - C Lim
- Department of Digestive and Hepatobiliary Surgery, AP-HP, Henri Mondor University Hospital, Créteil, France
| | - M-L Blanleuil
- Department of General and Visceral Surgery, University Hospital of Poitiers, France
| | - R Brustia
- Department of Hepatobiliary Surgery and Liver Transplant, St Antoine Hospital, France
| | - Y-P Le Treut
- Department of Digestive Surgery and Liver Transplantation, AP-HM, La Conception Hospital, Aix-Marseille University, France
| | - O Soubrane
- Department of Hepatobiliary Surgery and Liver Transplant, St Antoine Hospital, France
| | - D Azoulay
- Department of Digestive and Hepatobiliary Surgery, AP-HP, Henri Mondor University Hospital, Créteil, France
| | - O Farges
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Beaujon Hospital, Clichy, France
| | - R Adam
- Hepatobiliary Centre, Paul Brousse Hospital, AP-HP, Univ Paris-Sud, Villejuif, France
| | - F-R Pruvot
- Department of Digestive Surgery and Transplantation, CHU, Univ Nord de France, Lille, France
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Granito A, Galassi M, Piscaglia F, Romanini L, Lucidi V, Renzulli M, Borghi A, Grazioli L, Golfieri R, Bolondi L. Impact of gadoxetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance on the non-invasive diagnosis of small hepatocellular carcinoma: a prospective study. Aliment Pharmacol Ther 2013. [PMID: 23199022 DOI: 10.1111/apt.12166] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [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] [Indexed: 12/12/2022]
Abstract
BACKGROUND Gadoxetic acid (Gd-EOB-DTPA) is a 'hepatocyte-specific' contrast agent for magnetic resonance (MR) in both the vascular and the hepatobiliary phases. AIM To evaluate the contribution of the hepatobiliary phase of Gd-EOB-DTPA MR in the diagnosis of small hepatocellular carcinoma (HCC) in cirrhotic patients under surveillance. METHODS Between 2008 and 2011, 48 consecutive small (10-30 mm) liver nodules were detected in 33 patients, who prospectively underwent contrast-enhanced ultrasound (CEUS), Gd-EOB-DTPA-enhanced MR and helical-computed tomography (CT) in a blind study. The diagnosis of HCC was established according to AASLD 2005 criteria. RESULTS Of the 48 nodules, 38 (79%) were diagnosed as HCC, 24 (63%) of them based on AASLD non-invasive criteria, 11 diagnosed at histology and 3 during follow-up. The typical vascular pattern (arterial hypervascularisation and venous/late washout) was detected in 30 (79%) HCC nodules by MR, in 22 (58%) by CT and in 17 (45%) by CEUS. Hypointensity during the MR hepatobiliary phase was observed in all HCC nodules and in 3 nonmalignant nodules (sensitivity 100%, specificity 70%, positive predictive value 93%, negative predictive value 100%, positive likelihood ratio 3.33, negative likelihood ratio 0). Eight (21%) of the 38 HCC nodules, 7 of which lacked the typical vascular features at any of the imaging modalities, showed washout in the portal/venous phase and hypointensity in the hepatobiliary phase at MRI, while this pattern was not detected in any nonmalignant lesion. CONCLUSIONS Gadoxetic acid magnetic resonance may enhance the sensitivity of the non-invasive diagnosis of small hepatocellular carcinoma nodules in cirrhotic patients under surveillance. Double hypointensity in the portal/venous and hepatobiliary phases could be considered a new magnetic resonance pattern, highly suggestive of hypovascular hepatocellular carcinoma.
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Affiliation(s)
- A Granito
- Department of Medical and Surgical Sciences, University of Bologna, S. Orsola-Malpighi Hospital, Via Albertoni 15, Bologna, Italy.
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Monti L, Manco M, Lo Zupone C, Latini A, D'Andrea ML, Alghisi F, Lucidi V, Tomà P, Bonomo L. Acoustic radiation force impulse (ARFI) imaging with Virtual Touch Tissue Quantification in liver disease associated with cystic fibrosis in children. Radiol Med 2012; 117:1408-18. [PMID: 22986694 DOI: 10.1007/s11547-012-0874-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Accepted: 01/10/2012] [Indexed: 12/28/2022]
Abstract
PURPOSE Cystic-fibrosis-associated liver disease (CFLD) may lead to portal hypertension (PHT) and cirrhosis. Clinical signs and biochemistry of liver involvement are not discriminating. The aim of the study was to evaluate the performance of acoustic radiation force impulse (ARFI) with virtual tissue quantification in comparison with clinical signs, biochemistry and standard hepatic ultrasound (US) patterns. MATERIALS AND METHODS Virtual Touch Tissue Quantification, an implementation of US ARFI with shear-wave velocity (SWV) measurements was used in 75 children with cystic fibrosis (CF) and suspected CFLD to quantify hepatic stiffness. In each patient, ten measurements of SWV were performed on the right hepatic lobe. Patients were also evaluated by standard diagnostic tools (standard US, liver- and lung function tests, oesophagogastroscopy). RESULTS Among CF patients, median SWV was significantly higher in patients with clinical, biochemical and US signs of hepatic involvement than in patients without US evidence of liver disease 1.08 m/s [(95% confidence interval (CI), 1.02-1.14]. Median SWV values in patients with portal hypertension, splenomegaly and oesophageal varices were 1.30 (95% CI, 1.17-1.43), 1.54 (95% CI, 1.32-1.75) and 1.63 (95% CI, 1.26-1.99), respectively. Differences were significant (p<0.001). CONCLUSIONS ARFI is an innovative screening technique able to help identify CFLD in children.
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Affiliation(s)
- L Monti
- Radiology Department, Bambino Gesù Hospital, IRCCS, Rome, Italy.
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Lucidi V, Katsanos G, Buggenhout A, Moreno C, Gustot T, Boon N, Degré D, Bourgeois N, Brisbois D, Bali MA, Demetter P, Van Laethem JL, Donckier V. [Multidisciplinary management of hepatocellular carcinoma in cirrhotic patients]. Rev Med Brux 2012; 33:229-236. [PMID: 23091926] [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: 06/01/2023]
Abstract
The treatment of hepatocellular carcinoma (HCC) in cirrhotic patients is challenging: the incidence is increasing, the cirrhosis dramatically limits the tolerance to treatment possibilities, there are many therapeutic modalities but resources are limited, namely in the context of organ shortage for transplantation. Liver transplantation (LT) is the optimal treatment as it combines the largest tumor resection possible and the correction of the underlying liver disease. Due to organ shortage however, LT is reserved for early-stages HCC. Surgical resection and radiofrequency destruction represent potentially curative options in highly selected patients. Arterial embolizations, chemo- or radio-embolizations, allow local tumor control but are not curative. These techniques could be performed before surgical resection or LT, to downstage the tumor and/or to control tumor progression while waiting for a graft. Finally, sorafenib is the only systemic treatment which has shown a survival benefit in advanced HCC. The benefit of combination of sorafenib and surgical treatments remains undetermined. The challenge in the management of HCC in cirrhotic patients is to integrate both individual (age, comorbidities, cirrhosis stage, tumor stage, specific contraindications to LT, etc.) and collective variables (expected waiting time before LT) to determine the best therapeutic option for each patient. In this process, multidisciplinarity is a key for success.
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Affiliation(s)
- V Lucidi
- Service de Chirurgie Digestive, Hôpital Erasme, Bruxelles
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Majo F, Allemand A, Alghisi F, Montemitro E, Bella S, Giampaolo R, Lucidi V. WS13.2 Cystic fibrosis bone disease: is there a need for an earlier evaluation? J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60092-7] [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]
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Murgia F, Cotognini C, Montemitro E, Cilli M, Renzetti E, Lucidi V, Bella S. Evaluation of compliance to telehomecare (THC) in a group of patients with cystic fibrosis (CF) in a period of 2 years. Clin Ter 2012; 163:e111-e114. [PMID: 22964701] [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: 06/01/2023]
Abstract
OBJECTIVES In the present study, we examined data related to adherence to telemonitoring in our CF patients followed at home for a period of 2 years, in the aim to improve the follow-up in terms of efficiency and appropriateness. MATERIALS AND METHODS We kept electronic records of transmissions, in spreadsheet format. For each transmission, the main parameters and any action taken were collected. We carried out automatically a monthly summary of activities, a monthly average percentage of adherence to prescribed frequency of transmissions, monitored the contacts and phone calls. RESULTS We received in the period from February 15, 2010 to February 15, 2012 overall 1364 transmissions in 515 days (1817 spirometry, 414 nocturnal pulse-oximetry and 398 questionnaires on symptoms) The average compliance in the reporting period was 10,16%, with an increasing trend. CONCLUSIONS The improvement of outcome in FC necessarily passes through an improvement of the adherence to treatment. More psychological and behavioural studies are needed in order to gradually remove the obstacles which still prevent a further improvement in long-term outcome.
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Affiliation(s)
- F Murgia
- Cystic Fibrosis Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
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Germanova D, Lucidi V, Buggenhout A, Boon N, Bourgeois N, Degré D, Gustot T, Moreno C, Bali M, Brisbois D, Donckier V. Liver Transplantation in Cases of Portal Vein Thrombosis in the Recipient: A Case Report and Review of the Various Options. Transplant Proc 2011; 43:3490-2. [DOI: 10.1016/j.transproceed.2011.09.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Alghisi F, Montemitro E, Bella S, Lucidi V. 47 CFTR gene mutations and the risk for developing a pancreatic cancer: is it only a consequence of chronic inflammation? J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60067-2] [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]
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Alghisi F, Montemitro E, Bella S, Lucidi V. 43 Atypical forms of cystic fibrosis (CF): The emerging diagnostic challenge for diagnosing CF in children and adolescents with a single-organ involvement. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60063-5] [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: 10/18/2022]
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Murgia F, Cilli M, Renzetti E, Majo F, Soldi D, Lucidi V, Bella F, Bella S. Remote telematic control in cystic fibrosis. Clin Ter 2011; 162:e121-e124. [PMID: 21912814] [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: 05/31/2023]
Abstract
INTRODUCTION In this study we describe and discuss the way we daily act in remote telematic tracking of CF outpatients, a procedure which has been improved through our daily experience in telehomecare. MATERIALS AND METHODS Currently, there are almost 30 patients involved in our telehomecare project. We describe and discuss intervention parameters and the way we manage a register of performances in spreadsheet format. We also describe the training program for the patients and their and the procedures through which we maintain contacts with patients and Vivisol assistance and the periodical satisfaction surveys. RESULTS (from 15 of february 2010 to 24 of may 2011). Total transmissions 882, Spirometry 1317, SaO2 291, Compliance (transmissions/patient days) 8,91%, Hospital controls 19, Total contacts 722, Phone calls 494. DISCUSSION We analyze the 2010 - 2011 data. We discuss the compliance of patients toward Telehomecare, the efficacy of cell phone in establishing contact with patients and the relevancy of symptoms' rescue in diagnosing the pulmonary relapse episodes. We discuss medico-legal aspects of telemedicine activity, in the light of standards and legislation, including issues related to the processing of privacy and security data. We discuss the professional team needs and requirements, dedicated to the activities of telemedicine and procedures related to clinical risk management. We conclude by underlying how telemedicine represents a promising new tool for patients and health professionals, and that under certain conditions it can improve the assistance, working conditions and also to reduce costs. However, its usage has to be followed by precise studies about its efficacy, and also by paying particular attention to the partly new issues that derive from it.
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Affiliation(s)
- F Murgia
- Cystic Fibrosis Unit, Pediatric Medicine Department, Epidemiology Unit, Bambino Gesù Pediatric Hospital, IRCCS, Rome, Italy.
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Bella S, Murgia F, Alghisi F, Lucidi V. Is telemedicine useful in home management of cystic fibrosis patients? J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60239-1] [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: 10/19/2022]
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Colombo C, Lucidi V, Collura M, Terlizzi V, Bignamini E, Assael B, Quattrucci S, Gagliardini R, Manca A, Ratclif L, Salvatore D, Magazzù G, Padoan R, Poli F, Negri A, Pizzamiglio G, Motta V, Repetto T. Influenza A/H1N1 in patients with cystic fibrosis in Italy: a multicenter survey of the Italian CF Society. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60144-0] [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: 10/19/2022]
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Donckier V, Sanchez-Fueyo A, Craciun L, Lucidi V, Buggenhout A, Troisi R, Rogiers X, Bourgeois N, Boon N, Moreno C, Colle I, Van Vlierberghe H, de Hemptinne B, Goldman M. Induction of tolerance in solid organ transplantation: the rationale to develop clinical protocols in liver transplantation. Transplant Proc 2009; 41:603-6. [PMID: 19328936 DOI: 10.1016/j.transproceed.2009.01.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Minimization or withdrawal of immunosuppressive treatments after organ transplantation represents a major objective for improving quality of life and long-term survival of grafted patients. Such a goal may be reached under some clinical conditions, particularly in liver transplantation, making these patients good candidates for tolerance trials. In this context in liver transplantation, the central questions are (1) how to promote the natural propensity of the liver graft to be accepted, (2) which type of immunosuppressive drug should be used for induction and maintenance, and (3) which biomarkers could be used to discriminate tolerant patients from those requiring long-term immunosuppression. Induction therapies using aggressive T-cell-depleting agents may favor graft acceptance. However, persistent and/or rapidly reemerging cell lines, such as memory-type cells or CD8(+) T cells, could represent a significant barrier for induction of tolerance. The type of maintenance drugs also remains questionable. Calcineurin inhibitors may be eventually deleterious in the context of tolerance protocols, through inhibitory effects on regulatory T cells, that are not observed with rapamycin. In conclusion, significant efforts must be made to achieve reliable strategies for immunosuppression minimization or withdrawal after organ transplantation into the clinics.
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Affiliation(s)
- V Donckier
- Medicosurgical Department of Gastroenterology, Clinic of Abdominal Transplantation, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
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Abstract
Cholecystectomy in cirrhotic patients remains a high risk procedure. The recent literature was reviewed in the objective to elaborate (evidence-based) recommendations for therapeutic decision. In patients with Child Pugh A or B cirrhosis, the laparoscopic approach should be preferred as it is associated with reduced morbidity and mortality as compared with open surgery (level B). In patients with decompensated Child Pugh C cirrhosis, the scarcity of literature data renders much more hazardous the definition of robust recommendations. In these patients, two options have to be considered beyond early laparoscopic cholecystectomy: first, a delayed surgery, in order to improve the preoperative patient's general condition and namely the coagulation, and second, a percutaneous drainage in very severe cases (level C).
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Bella S, Murgia F, Tozzi AE, Cotognini C, Lucidi V. Five years of Telemedicine in Cystic Fibrosis Disease. Clin Ter 2009; 160:457-460. [PMID: 20198287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIMS We studied the effect of Telehomecare (THC) in a group of Cystic Fibrosis (CF) patients, with the aim to early recognize the relapses of pulmonary infections. Data obtained with Vivisol (OXYTEL) instrumentation were collected from 2001 to 2005. MATERIALS AND METHODS The study has involved 17 patients (11 f, 6 m) affected by CF, treated with THC, in addition to the usual therapeutic protocol, for an average period of 29.6 months +/- 13.5. The mean age for THC enrollment was 15.74 years +/- 5.8. As controls, the study has involved the same patients during the 12 months prior to THC start-up and 28 patients affected by CF treated at our Unit (13 f, 15 m; average age 14.77 +/- 5.22). RESULTS The results show a statistically significant decrease of outpatient accesses and increase of therapy cycles, and a trend of higher stability of the respiratory function, in THC treated subjects compared to controls. CONCLUSIONS Our study suggests that THC programs may not be optimally accepted by CF patients, and that its use seems to increase in general the rate of access to health care without demonstrating any clear effect of pulmonary function.
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Affiliation(s)
- S Bella
- Cystic Fibrosis diagnosis and treatment Unit, Children's Hospital Bambino Gesù, Research and Care Institute, Rome, Italy.
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Donckier V, Buggenhout A, Troisi R, Lucidi V, Rogiers X, Nagy N, Craciun L, Bourgeois N, de Hemptinne B, Goldman M. EARLY IMMUNOSUPPRESSION WEANING AFTER CADAVER LIVER TRANSPLANTATION USING ATG INDUCTION AND RAPAMYCIN. Transplantation 2008. [DOI: 10.1097/01.tp.0000332466.38335.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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50
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Alghisi F, Angioni A, Tomaiuolo A, D'Apice M, Bella S, Novelli G, Lucidi V. Diagnosis of atypical CF: A case-report to reflect. J Cyst Fibros 2008; 7:292-294. [DOI: 10.1016/j.jcf.2007.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2007] [Revised: 11/12/2007] [Accepted: 11/13/2007] [Indexed: 11/28/2022]
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