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Massimi L, Cinalli G, Frassanito P, Arcangeli V, Auer C, Baro V, Bartoli A, Bianchi F, Dietvorst S, Di Rocco F, Gallo P, Giordano F, Hinojosa J, Iglesias S, Jecko V, Kahilogullari G, Knerlich-Lukoschus F, Laera R, Locatelli D, Luglietto D, Luzi M, Messing-Jünger M, Mura R, Ragazzi P, Riffaud L, Roth J, Sagarribay A, Pinheiro MS, Spazzapan P, Spennato P, Syrmos N, Talamonti G, Valentini L, Van Veelen ML, Zucchelli M, Tamburrini G. Intracranial complications of sinogenic and otogenic infections in children: an ESPN survey on their occurrence in the pre-COVID and post-COVID era. Childs Nerv Syst 2024; 40:1221-1237. [PMID: 38456922 DOI: 10.1007/s00381-024-06332-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/21/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND COVID-19 pandemic is thought to have changed the epidemiology of some pediatric neurosurgical disease: among them are the intracranial complications of sinusitis and otitis (ICSO). According to some studies on a limited number of cases, both streptococci-related sinusitis and ICSO would have increased immediately after the pandemic, although the reason is not clear yet (seasonal changes versus pandemic-related effects). The goal of the present survey of the European Society for Pediatric Neurosurgery (ESPN) was to collect a large number of cases from different European countries encompassing the pre-COVID (2017-2019), COVID (2020-2021), and post-COVID period (2022-June 2023) looking for possible epidemiological and/or clinical changes. MATERIAL AND METHODS An English language questionnaire was sent to ESPN members about year of the event, patient's age and gender, presence of immune-deficit or other favoring risk factors, COVID infection, signs and symptoms at onset, site of primary infection, type of intracranial complication, identified germ, type and number of surgical operations, type and duration of medical treatment, clinical and radiological outcome, duration of the follow-up. RESULTS Two hundred fifty-four cases were collected by 30 centers coming from 14 different European countries. There was a statistically significant difference between the post-COVID period (129 children, 86 cases/year, 50.7% of the whole series) and the COVID (40 children, 20 cases/year, 15.7%) or the pre-COVID period (85 children, 28.3 cases/year, 33.5%). Other significant differences concerned the presence of predisposing factors/concurrent diseases (higher in the pre-COVID period) and previous COVID infection (higher in the post-COVID period). No relevant differences occurred as far as demographic, microbiological, clinical, radiological, outcome, morbidity, and mortality data were concerned. Paranasal sinuses and middle ear/mastoid were the most involved primary site of infection (71% and 27%, respectively), while extradural or subdural empyema and brain abscess were the most common ICSO (73% and 17%, respectively). Surgery was required in 95% of cases (neurosurgical and ENT procedure in 71% and 62% of cases, respectively) while antibiotics in 99% of cases. After a 12.4-month follow-up, a full clinical and radiological recovery was obtained in 85% and 84% of cases, respectively. The mortality rate was 2.7%. CONCLUSIONS These results suggest that the occurrence of ICSO was significantly increased after the pandemic. Such an increase seems to be related to the indirect effects of the pandemic (e.g., immunity debt) rather than to a direct effect of COVID infection or to seasonal fluctuations. ICSO remain challenging diseases but the pandemic did not affect the management strategies nor their prognosis. The epidemiological change of sinusitis/otitis and ICSO should alert about the appropriate follow-up of children with sinusitis/otitis.
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Affiliation(s)
- L Massimi
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University Medical School, Rome, Italy
| | - G Cinalli
- Santobono-Pausilipon Children's Hospital, AORN, Naples, Italy
| | - P Frassanito
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - V Arcangeli
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C Auer
- Department of Neurosurgery, Johannes Kepler University Linz, Kepler University Hospital GmbH, Linz, Austria
| | - V Baro
- Pediatric and Functional Neurosurgery, Department of Neurosciences, University of Padova, Padua, Italy
| | - A Bartoli
- Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
| | - F Bianchi
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - S Dietvorst
- University Hospitals Leuven, Leuven, Belgium
| | - F Di Rocco
- Hôpital Femme-Mère-Enfant, Université de Lyon, Lyon, France
| | - P Gallo
- Birmingham Children's Hospital, Birmingham, UK
| | - F Giordano
- University of Florence, Florence, Italy
- Meyer Children's Hospital IRCCS, Florence, Italy
| | - J Hinojosa
- Hospital Sant Joan de Déu, Barcelona, Spain
| | - S Iglesias
- Hospital Regional Universitario de Malaga, Malaga, Spain
| | - V Jecko
- Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - G Kahilogullari
- Department of Neurosurgery, Ankara University, Ankara, Turkey
| | - F Knerlich-Lukoschus
- Division Pediatric Neurosurgery, Department of Neurosurgery, University Medical Center Göttingen, Göttingen, Germany
| | - R Laera
- Santobono-Pausilipon Children's Hospital, AORN, Naples, Italy
| | - D Locatelli
- Neurosurgery Department, Università Dell'Insubria, Ospedale di Circolo e Macchi Foundation, Varese, Italy
| | - D Luglietto
- Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - M Luzi
- Azienda Ospedaliero Universitaria Delle Marche, Ancona, Italy
| | | | - R Mura
- Meyer Children's Hospital IRCCS, Florence, Italy
| | - P Ragazzi
- Department of Pediatric Neurosurgery, Ospedale Infantile Regina Margherita, Città della Salute e della Scienza, Turin, Italy
| | - L Riffaud
- Rennes University Hospital, Rennes, France
| | - J Roth
- Dana Children's Hospital, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - A Sagarribay
- Hospital Dona Estefânia-Centro Hospitalar Universitário, Lisboa, Portugal
- Hospital CUF Descobertas, Lisboa, Portugal
| | - M Santos Pinheiro
- Centro Hospitalar Lisboa Norte-Hospital Santa Maria, Lisboa, Portugal
| | - P Spazzapan
- University Medical Center-Ljubljana, Ljubljana, Slovenia
| | - P Spennato
- Santobono-Pausilipon Children's Hospital, AORN, Naples, Italy
| | - N Syrmos
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - L Valentini
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - M L Van Veelen
- Erasmus MC Sophia Children's Hospital, Rotterdam, Netherlands
| | - M Zucchelli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto Scienze Neurologiche Di Bologna, Boulogne, Italy
| | - G Tamburrini
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University Medical School, Rome, Italy
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Rocca A, Avella P, Scacchi A, Brunese MC, Cappuccio M, De Rosa M, Bartoli A, Guerra G, Calise F, Ceccarelli G. Robotic versus open resection for colorectal liver metastases in a "referral centre Hub&Spoke learning program". A multicenter propensity score matching analysis of perioperative outcomes. Heliyon 2024; 10:e24800. [PMID: 38322841 PMCID: PMC10844024 DOI: 10.1016/j.heliyon.2024.e24800] [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: 09/08/2023] [Revised: 01/14/2024] [Accepted: 01/15/2024] [Indexed: 02/08/2024] Open
Abstract
Background Surgical resection is still considered the optimal treatment for colorectal liver metastasis (CRLM). Although laparoscopic and robotic surgery demonstrated their reliability especially in referral centers, the comparison between perioperative outcomes of robotic liver resection (RLR) and open (OLR) liver resection are still debated when performed in referral centers for robotic surgery, not dedicated to HPB. Our study aimed to verify the efficacy and safety of perioperative outcomes after RLR and OLR for CRLM in an HUB&Spoke learning program (H&S) between a high volume center for liver surgery and high volume center for robotic surgery. Methods We analyzed prospective databases of Pineta Grande Hospital (Castel Volturno) and Robotic Surgical Units (Foligno-Spoleto and Arezzo) from 2011 to 2021. A 1:1 propensity score matching (PSM) was performed according to baseline characteristics of patients, solitary/multiple CRLM, anterolateral/posterosuperior location. Results 383 patients accepted to be part of the study (268 ORL and 115 RLR). After PSM, 45 patients from each group were included. Conversion rate was 8.89 %. RLR group had a significantly lower blood loss (226 vs. 321 ml; p=0.0001), and fewer major complications (13.33 % vs. 17.78 %; p=0.7722). R0 resection was obtained in 100% of OLR (vs.95.55%, p =0.4944. Hospital stay was 8.8 days in RLR (vs. 15; p=0.0001).Conclusion: H&S represents a safe and effective program to train general surgeons also in Hepatobiliary surgery providing R0 resection rate, blood loss volume and morbidity rate superimposable to referral centers. Furthermore, H&S allow a reduction of health mobility with consequent money saving for patients and institutions.
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Affiliation(s)
- Aldo Rocca
- Department of Medicine and Health Science “V. Tiberio”, University of Molise, Campobasso, Italy
- Hepatobiliary and Pancreatic Surgery Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
| | - Pasquale Avella
- Hepatobiliary and Pancreatic Surgery Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Andrea Scacchi
- General Surgery Department, University of Milano-Bicocca, Milan, Italy
| | - Maria Chiara Brunese
- Department of Medicine and Health Science “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Micaela Cappuccio
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Michele De Rosa
- General Surgery Department, ASL 2 Umbria, San Giovanni Battista Hospital, Foligno, Italy
| | - Alberto Bartoli
- General Surgery Department, ASL 2 Umbria, San Giovanni Battista Hospital, Foligno, Italy
| | - Germano Guerra
- Department of Medicine and Health Science “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Fulvio Calise
- Department of Medicine and Health Science “V. Tiberio”, University of Molise, Campobasso, Italy
- Hepatobiliary and Pancreatic Surgery Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
| | - Graziano Ceccarelli
- General Surgery Department, ASL 2 Umbria, San Giovanni Battista Hospital, Foligno, Italy
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Colin J, Rossetti AO, Daniel RT, Bartoli A, Corniola MV, Vulliemoz S, Seeck M. The impact of a history of status epilepticus for epilepsy surgery outcome. Epilepsy Res 2024; 200:107308. [PMID: 38325236 DOI: 10.1016/j.eplepsyres.2024.107308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/17/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Patients with focal drug resistant epilepsy are excellent candidates for epilepsy surgery. Status epilepticus (SE) and seizure clusters (SC), described in a subset of patients, have both been associated with extended epileptogenic cerebral networks within one or both hemispheres. In this retrospective study, we were interested to determine if a history of SE or SC is associated with a worse surgical outcome. METHODS Data of 244 patients operated between 2000 to 2018 were reviewed, with a follow-up of at least 2 years. Patients with a previous history of SE or SC were compared to operated patients without these conditions (control group, CG). RESULTS We identified 27 (11%) and 38 (15.5%) patients with history of SE or SC, respectively. No difference in post-operative outcome was found for SE and SC patients. Compared to the control group, patients with a history of SE were diagnosed and operated significantly at earlier age(p = 0.01), and after a shorter duration of the disease (p = 0.027), but with a similar age of onset. SIGNIFICANCE A history of SE or SC was not associated with a worse post-operative prognosis. Earlier referral of SE patients for surgery suggests a heightened awareness regarding serious complications of recurrent SE by the referring neurologist or neuropediatrician. While the danger of SE is evident, policies to underline the impact for SC or very frequent seizures might be an efficient approach to accelerate patient referral also for this patient group.
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Affiliation(s)
- J Colin
- EEG and Epilepsy Unit and Neurosurgery Clinics, Department of Clinical Neurosciences, University Hospital of Geneva (HUG) and Faculty of Medicine, Geneva, Switzerland.
| | - A O Rossetti
- Neurology Service, Department of Clinical Neurosciences, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - R T Daniel
- Neurosurgery Service, Department of Clinical Neurosciences, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - A Bartoli
- EEG and Epilepsy Unit and Neurosurgery Clinics, Department of Clinical Neurosciences, University Hospital of Geneva (HUG) and Faculty of Medicine, Geneva, Switzerland
| | - M V Corniola
- EEG and Epilepsy Unit and Neurosurgery Clinics, Department of Clinical Neurosciences, University Hospital of Geneva (HUG) and Faculty of Medicine, Geneva, Switzerland
| | - S Vulliemoz
- EEG and Epilepsy Unit and Neurosurgery Clinics, Department of Clinical Neurosciences, University Hospital of Geneva (HUG) and Faculty of Medicine, Geneva, Switzerland
| | - M Seeck
- EEG and Epilepsy Unit and Neurosurgery Clinics, Department of Clinical Neurosciences, University Hospital of Geneva (HUG) and Faculty of Medicine, Geneva, Switzerland.
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Bartoli A, May A, Al-Awadhi A, Schaller K. Probing artificial intelligence in neurosurgical training: ChatGPT takes a neurosurgical residents written exam. Brain Spine 2023; 4:102715. [PMID: 38163001 PMCID: PMC10753430 DOI: 10.1016/j.bas.2023.102715] [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] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/12/2023] [Accepted: 11/17/2023] [Indexed: 01/03/2024]
Abstract
Introduction Artificial Intelligence tools are being introduced in almost every field of human life, including medical sciences and medical education, among scepticism and enthusiasm. Research question to assess how a generative language tool (Generative Pretrained Transformer 3.5, ChatGPT) performs at both generating questions and answering a neurosurgical residents' written exam. Namely, to assess how ChatGPT generates questions, how it answers human-generated questions, how residents answer AI-generated questions and how AI answers its self-generated question. Materials and methods 50 questions were included in the written exam, 46 questions were generated by humans (senior staff members) and 4 were generated by ChatGPT. 11 participants took the exam (ChatGPT and 10 residents). Questions were both open-ended and multiple-choice.8 questions were not submitted to ChatGPT since they contained images or schematic drawings to interpret. Results formulating requests to ChatGPT required an iterative process to precise both questions and answers. Chat GPT scored among the lowest ranks (9/11) among all the participants). There was no difference in response rate for residents' between human-generated vs AI-generated questions that could have been attributed to less clarity of the question. ChatGPT answered correctly to all its self-generated questions. Discussion and conclusions AI is a promising and powerful tool for medical education and for specific medical purposes, which need to be further determined. To request AI to generate logical and sound questions, that request must be formulated as precise as possible, framing the content, the type of question and its correct answers.
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Affiliation(s)
- A. Bartoli
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Medical Center, Geneva, Switzerland
- Switzerland & Faculty of Medicine, University of Geneva, Switzerland
| | - A.T. May
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Medical Center, Geneva, Switzerland
- Switzerland & Faculty of Medicine, University of Geneva, Switzerland
| | - A. Al-Awadhi
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Medical Center, Geneva, Switzerland
- Switzerland & Faculty of Medicine, University of Geneva, Switzerland
| | - K. Schaller
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Medical Center, Geneva, Switzerland
- Switzerland & Faculty of Medicine, University of Geneva, Switzerland
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Oliva F, Bartoli A, Garofalo E, Calabrese M, Oliva G, Maffulli N. Influence of Exercise on Musculoskeletal Disorders Associated with Gut Microbiota: A Narrative Review. Muscles Ligaments Tendons J 2023. [DOI: 10.32098/mltj.01.2023.01] [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: 03/16/2023]
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Khati I, Jacquier A, Cadour F, Bartoli A, Graber M, Hardwigsen J, Tradi F, Barral PA. Endovascular therapies for hepatic artery stenosis post liver transplantation. CVIR Endovasc 2022; 5:63. [PMID: 36478229 PMCID: PMC9729479 DOI: 10.1186/s42155-022-00338-7] [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: 06/27/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To evaluate primary patency at 12 months after endovascular therapies in hepatic artery stenosis. METHODS A retrospective review of all endovascular interventions for hepatic artery stenosis (HAS) after liver transplantation that occurred between June 2013 and November 2020 was performed at a single institution in France. Follow up occurred from 1 month to 4 years (median 15 months). The treatment consisted of dilation with a balloon or stent. We analyzed short-term (technical success and complications) and long-term outcomes (liver function, arterial patency, graft survival at 12 months (GS), and reintervention). We also compared percutaneous balloon angioplasty (PBA) with stent placement. PBA alone was used if < 30% residual stenosis of the hepatic artery was achieved. Stenting was performed if there was greater than 30% residual stenosis and in the case of complications (dissection or rupture). RESULTS A total of 18 stenoses were suspected on the basis of routine surveillance duplex ultrasound imaging (peak systolic velocity > 200 cm/s, systolic accelerating time > 10 ms and resistive index < 0.5), all of which were confirmed by angio CT, but only 17 were confirmed by angiography. Seventeen patients were included (14 males, mean age 57 years; and three females, mean age 58 years). Interventions were performed in 17 cases (95%) with PBA only (5/17), stent only (5/17) or both (4/17). Immediate technical success was 100%. Major complications occurred in 1 of 17 cases (5.8%), consisting of target vessel dissection. The analysis of the three (groups PBA only, stent only or both) showed the same procedural success (100%), GS (100%) and normal liver function after the procedures but different rates of complications (20% vs. 0% vs. 0%), arterial patency at 12 months (60% vs. 80% vs. 85%) (p = 0.4), early stenosis (40% vs. 80% vs. 0%) or late stenosis (60% vs. 20% vs. 100%) and requirement for reintervention (40% vs. 20% vs. 14%) (p = 0.56). CONCLUSION This study suggests that PBA, stent, or both procedures show the same primary patency at 12 months. It is probably not a definitive answer, but these treatments are safe and effective for extending graft survival in the context of graft shortages.
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Affiliation(s)
- I. Khati
- grid.411266.60000 0001 0404 1115Department of Radiology, CHU Timone 2, Marseille APHM, Marseille, France
| | - A. Jacquier
- grid.411266.60000 0001 0404 1115Department of Radiology, CHU Timone 2, Marseille APHM, Marseille, France
| | - F. Cadour
- grid.411266.60000 0001 0404 1115Department of Radiology, CHU Timone 2, Marseille APHM, Marseille, France
| | - A. Bartoli
- grid.411266.60000 0001 0404 1115Department of Radiology, CHU Timone 2, Marseille APHM, Marseille, France
| | - M. Graber
- grid.411266.60000 0001 0404 1115Department of Radiology, CHU Timone 2, Marseille APHM, Marseille, France
| | - J. Hardwigsen
- grid.411266.60000 0001 0404 1115Department of Surgery, CHU Timone 2, Marseille APHM, Marseille, France
| | - F. Tradi
- grid.411266.60000 0001 0404 1115Department of Radiology, CHU Timone 2, Marseille APHM, Marseille, France
| | - P.-A. Barral
- grid.411266.60000 0001 0404 1115Department of Radiology, CHU Timone 2, Marseille APHM, Marseille, France
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Khitri M, Bartoli A, Maalouf G, Deroux A, Salvarani C, Emmi G, Karadag O, Espinosa G, Leclercq M, Simonini G, Vautier M, Cacoub P, Saadoun D. Tocilizumab dans la maladie de Behçet : étude multicentrique sur 30 patients. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.078] [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: 12/12/2022]
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Rabbani N, Calvet L, Espinel Y, Le Roy B, Ribeiro M, Buc E, Bartoli A. A methodology and clinical dataset with ground-truth to evaluate registration accuracy quantitatively in computer-assisted Laparoscopic Liver Resection. Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization 2021. [DOI: 10.1080/21681163.2021.1997642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- N. Rabbani
- EnCoV, Institut Pascal, Clermont-Ferrand, France
| | - L. Calvet
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Clermont-Ferrand, France
- IRIT, University of Toulouse
| | - Y. Espinel
- EnCoV, Institut Pascal, Clermont-Ferrand, France
| | - B. Le Roy
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Saint-Etienne, France
| | - M. Ribeiro
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Clermont-Ferrand, France
| | - E. Buc
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Clermont-Ferrand, France
| | - A. Bartoli
- EnCoV, Institut Pascal, Clermont-Ferrand, France
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Ceccarelli G, Costa G, De Rosa M, Codacci Pisanelli M, Frezza B, De Prizio M, Bravi I, Scacchi A, Gallo G, Amato B, Bugiantella W, Tacchi P, Bartoli A, Patriti A, Cappuccio M, Komici K, Mariani L, Avella P, Rocca A. Minimally Invasive Approach to Gastric GISTs: Analysis of a Multicenter Robotic and Laparoscopic Experience with Literature Review. Cancers (Basel) 2021; 13:cancers13174351. [PMID: 34503161 PMCID: PMC8431126 DOI: 10.3390/cancers13174351] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/04/2021] [Accepted: 08/24/2021] [Indexed: 01/07/2023] Open
Abstract
Simple Summary Gastrointestinal stromal tumors (GISTs) represent about 1–3% of all gastrointestinal malignancies, of which 50–60% are gastric GISTs (GGs). To the date, surgery represents the best therapeutic option, and the robotic gastric surgery could gain an important role, overcoming many laparoscopic drawbacks. The aim of this study is to evaluate safety and effectiveness of minimally invasive surgery (MIS) for GGs, reporting 10-year experience of three different centers. We included a population of 81 patients who underwent MIS approaches (36 laparoscopy vs. 45 robotic surgery). Seventy-two (72) patients were enrolled in a follow-up program to evaluate the long-term oncological outcomes. Furthermore, we discussed some technical notes and also we analyzed the operative and peri-operative outcomes. In conclusion, our results suggest that the robotic approach might be a suitable treatment, especially for GISTs >5 cm, even located in unfavorable places, despite longer operative time and costs than laparoscopic approach. Abstract Background: Gastrointestinal stromal tumors (GISTs) are most frequently located in the stomach. In the setting of a multidisciplinary approach, surgery represents the best therapeutic option, consisting mainly in a wedge gastric resection. (1) Materials and methods: Between January 2010 to September 2020, 105 patients with a primary gastrointestinal stromal tumor (GISTs) located in the stomach, underwent surgery at three surgical units. (2) Results: A multi-institutional analysis of minimally invasive series including 81 cases (36 laparoscopic and 45 robotic) from 3 referral centers was performed. Males were 35 (43.2%), the average age was 66.64 years old. ASA score ≥3 was 6 (13.3%) in the RS and 4 (11.1%) in the LS and the average tumor size was 4.4 cm. Most of the procedures were wedge resections (N = 76; 93.8%) and the main operative time was 151 min in the RS and 97 min in the LS. Conversion was necessary in five cases (6.2%). (3) Conclusions: Minimal invasive approaches for gastric GISTs performed in selected patients and experienced centers are safe. A robotic approach represents a useful option, especially for GISTs that are more than 5 cm, even located in unfavorable places.
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Affiliation(s)
- Graziano Ceccarelli
- General Surgery Department, ASL 2 Umbria, San Giovanni Battista Hospital, 06034 Foligno, Italy; (G.C.); (G.C.); (W.B.); (P.T.); (A.B.); (A.P.); (L.M.)
- General, Minimally Invasive and Robotic Surgery, Department of Surgery, ASL 2 Umbria, San Matteo Hospital, 06049 Spoleto, Italy
- General Surgery Unit, San Donato Hospital, 52100 Arezzo, Italy; (B.F.); (M.D.P.)
| | - Gianluca Costa
- General Surgery Department, ASL 2 Umbria, San Giovanni Battista Hospital, 06034 Foligno, Italy; (G.C.); (G.C.); (W.B.); (P.T.); (A.B.); (A.P.); (L.M.)
- General, Minimally Invasive and Robotic Surgery, Department of Surgery, ASL 2 Umbria, San Matteo Hospital, 06049 Spoleto, Italy
- Surgery Center, University Campus Bio-Medico of Rome, 00128 Rome, Italy
| | - Michele De Rosa
- Department of General Surgery, San Giovanni Battista Hospital, 06034 Perugia, Italy;
| | - Massimo Codacci Pisanelli
- UOC General Surgery and Laparoscopic Surgery, Department of Surgery P. Valdoni, Policlinic Umberto I, Sapienza University of Study of Rome, 00161 Rome, Italy;
| | - Barbara Frezza
- General Surgery Unit, San Donato Hospital, 52100 Arezzo, Italy; (B.F.); (M.D.P.)
| | - Marco De Prizio
- General Surgery Unit, San Donato Hospital, 52100 Arezzo, Italy; (B.F.); (M.D.P.)
| | - Ilaria Bravi
- Histopathology Department, Usl Umbria 2, San Giovanni Battista Hospital, 06034 Foligno, Italy;
| | - Andrea Scacchi
- Department of Medicine and Health Sciences V. Tiberio, University of Molise, 86100 Campobasso, Italy; (A.S.); (M.C.); (K.K.); (P.A.)
| | - Gaetano Gallo
- Department of Medical and Surgical Sciences, University of Catanzaro, 88100 Catanzaro, Italy;
- Department of Colorectal Surgery, S. Rita Clinic, 13100 Vercelli, Italy
| | - Bruno Amato
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80126 Naples, Italy;
| | - Walter Bugiantella
- General Surgery Department, ASL 2 Umbria, San Giovanni Battista Hospital, 06034 Foligno, Italy; (G.C.); (G.C.); (W.B.); (P.T.); (A.B.); (A.P.); (L.M.)
- General, Minimally Invasive and Robotic Surgery, Department of Surgery, ASL 2 Umbria, San Matteo Hospital, 06049 Spoleto, Italy
| | - Piergiorgio Tacchi
- General Surgery Department, ASL 2 Umbria, San Giovanni Battista Hospital, 06034 Foligno, Italy; (G.C.); (G.C.); (W.B.); (P.T.); (A.B.); (A.P.); (L.M.)
- General, Minimally Invasive and Robotic Surgery, Department of Surgery, ASL 2 Umbria, San Matteo Hospital, 06049 Spoleto, Italy
| | - Alberto Bartoli
- General Surgery Department, ASL 2 Umbria, San Giovanni Battista Hospital, 06034 Foligno, Italy; (G.C.); (G.C.); (W.B.); (P.T.); (A.B.); (A.P.); (L.M.)
- General, Minimally Invasive and Robotic Surgery, Department of Surgery, ASL 2 Umbria, San Matteo Hospital, 06049 Spoleto, Italy
| | - Alberto Patriti
- General Surgery Department, ASL 2 Umbria, San Giovanni Battista Hospital, 06034 Foligno, Italy; (G.C.); (G.C.); (W.B.); (P.T.); (A.B.); (A.P.); (L.M.)
- General, Minimally Invasive and Robotic Surgery, Department of Surgery, ASL 2 Umbria, San Matteo Hospital, 06049 Spoleto, Italy
- Division of General Surgery, Ospedali Riuniti Marche Nord, 61121 Pesaro, Italy
| | - Micaela Cappuccio
- Department of Medicine and Health Sciences V. Tiberio, University of Molise, 86100 Campobasso, Italy; (A.S.); (M.C.); (K.K.); (P.A.)
| | - Klara Komici
- Department of Medicine and Health Sciences V. Tiberio, University of Molise, 86100 Campobasso, Italy; (A.S.); (M.C.); (K.K.); (P.A.)
| | - Lorenzo Mariani
- General Surgery Department, ASL 2 Umbria, San Giovanni Battista Hospital, 06034 Foligno, Italy; (G.C.); (G.C.); (W.B.); (P.T.); (A.B.); (A.P.); (L.M.)
- General, Minimally Invasive and Robotic Surgery, Department of Surgery, ASL 2 Umbria, San Matteo Hospital, 06049 Spoleto, Italy
| | - Pasquale Avella
- Department of Medicine and Health Sciences V. Tiberio, University of Molise, 86100 Campobasso, Italy; (A.S.); (M.C.); (K.K.); (P.A.)
| | - Aldo Rocca
- General Surgery Unit, San Donato Hospital, 52100 Arezzo, Italy; (B.F.); (M.D.P.)
- Department of Medicine and Health Sciences V. Tiberio, University of Molise, 86100 Campobasso, Italy; (A.S.); (M.C.); (K.K.); (P.A.)
- Correspondence:
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Bartoli A, De Lorenzo A, Medvet E, Tarlao F. Automatic Search-and-Replace From Examples With Coevolutionary Genetic Programming. IEEE Trans Cybern 2021; 51:2612-2624. [PMID: 31199282 DOI: 10.1109/tcyb.2019.2918337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We describe the design and implementation of a system for executing search-and-replace text processing tasks automatically, based only on examples of the desired behavior. The examples consist of pairs describing the original string and the desired modified string. Their construction, thus, does not require any specific technical skill. The system constructs a solution to the specified task that can be used unchanged on popular existing software for text processing. The solution consists of a search pattern coupled with a replacement expression: the former is a regular expression which describes both the strings to be replaced and their portions to be reused in the latter, which describes how to build the modified strings. Our proposed system is internally based on genetic programming and implements a form of cooperative coevolution in which two separate populations are evolved independently, one for search patterns and the other for replacement expressions. We assess our proposal on six tasks of realistic complexity obtaining very good results, both in terms of absolute quality of the solutions and with respect to the challenging baselines considered.
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Collins T, Pizarro D, Gasparini S, Bourdel N, Chauvet P, Canis M, Calvet L, Bartoli A. Augmented Reality Guided Laparoscopic Surgery of the Uterus. IEEE Trans Med Imaging 2021; 40:371-380. [PMID: 32986548 DOI: 10.1109/tmi.2020.3027442] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
A major research area in Computer Assisted Intervention (CAI) is to aid laparoscopic surgery teams with Augmented Reality (AR) guidance. This involves registering data from other modalities such as MR and fusing it with the laparoscopic video in real-time, to reveal the location of hidden critical structures. We present the first system for AR guided laparoscopic surgery of the uterus. This works with pre-operative MR or CT data and monocular laparoscopes, without requiring any additional interventional hardware such as optical trackers. We present novel and robust solutions to two main sub-problems: the initial registration, which is solved using a short exploratory video, and update registration, which is solved with real-time tracking-by-detection. These problems are challenging for the uterus because it is a weakly-textured, highly mobile organ that moves independently of surrounding structures. In the broader context, our system is the first that has successfully performed markerless real-time registration and AR of a mobile human organ with monocular laparoscopes in the OR.
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Capron T, Cautela J, Scemama U, Miola C, Bartoli A, Theron A, Pinto J, Porto A, Collart F, Lepidi H, Bernard M, Guye M, Thuny F, Avierinos JF, Jacquier A. Cardiac magnetic resonance assessment of left ventricular dilatation in chronic severe left-sided regurgitations: comparison with standard echocardiography. Diagn Interv Imaging 2020; 101:657-665. [DOI: 10.1016/j.diii.2020.04.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/05/2020] [Accepted: 04/18/2020] [Indexed: 12/19/2022]
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Dacher JN, Gandjbakhch E, Taieb J, Chauvin M, Anselme F, Bartoli A, Boyer L, Cassagnes L, Cochet H, Dubourg B, Fauchier L, Gras D, Klug D, Laurent G, Mansourati J, Marijon E, Maury P, Piot O, Pontana F, Sacher F, Sadoul N, Boveda S, Jacquier A. Joint Position Paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology (SFC) and the Société française d'imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV) on magnetic resonance imaging in patients with cardiac electronic implantable devices. Diagn Interv Imaging 2020; 101:507-517. [PMID: 32094095 DOI: 10.1016/j.diii.2020.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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] [Received: 01/28/2020] [Revised: 02/02/2020] [Accepted: 02/03/2020] [Indexed: 11/15/2022]
Abstract
Magnetic resonance imaging (MRI) has become the reference imaging for the management of a large number of diseases. The number of MR examinations increases every year, simultaneously with the number of patients receiving a cardiac electronic implantable device (CEID). A CEID was considered an absolute contraindication for MRI for years. The progressive replacement of conventional pacemakers and defibrillators by MR-conditional CEIDs and recent data on the safety of MRI in patients with "MR-nonconditional" CEIDs have progressively increased the demand for MRI in patients with a CEID. However, some risks are associated with MRI in CEID carriers, even with "MR-conditional" devices because these devices are not "MR-safe". A specific programing of the device in "MR-mode" and monitoring patients during MRI remain mandatory for all patients with a CEID. A standardized patient workflow based on an institutional protocol should be established in each institution performing such examinations. This joint position paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the Société française d'imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV) describes the effect and risks associated with MRI in CEID carriers. We propose recommendations for patient workflow and monitoring and CEID programming in MR-conditional, "MR-conditional nonguaranteed" and MR-nonconditional devices.
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Affiliation(s)
- J-N Dacher
- Normandie UNIV, UNIROUEN, Inserm U1096, CHU Rouen, Department of Radiology, Cardiac Imaging Unit, 76000 Rouen, France.
| | - E Gandjbakhch
- Sorbonne Universités, AP-HP, Heart Institute, La Pitié-Salpêtrière University Hospital, 75013 Paris, France
| | - J Taieb
- Hospital of Aix-en-Provence, Department of Cardiology, 13100 Aix-en-Provence, France
| | - M Chauvin
- Université de Strasbourg, CHU Strasbourg, Department of Cardiology, 67000 Strasbourg, France
| | - F Anselme
- Normandie UNIV, UNIROUEN, CHU Rouen, Department of Cardiology, 76000 Rouen, France
| | - A Bartoli
- Université Aix-Marseille, Centre Hospitalo-Universitaire Timone, AP-HM, Department of Radiology, CNRS, CRMBM, CEMEREM, 13005 Marseille, France
| | - L Boyer
- Université Clermont Auvergne, CHU Clermont-Ferrand, Department of Radiology, 63000 Clermont-Ferrand, France
| | - L Cassagnes
- Université Clermont Auvergne, CHU Clermont-Ferrand, Department of Radiology, 63000 Clermont-Ferrand, France
| | - H Cochet
- Université de Bordeaux-Inserm, IHU LIRYC, CHU de Bordeaux, Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, 33600 Pessac, France
| | - B Dubourg
- Normandie UNIV, UNIROUEN, Inserm U1096, CHU Rouen, Department of Radiology, Cardiac Imaging Unit, 76000 Rouen, France
| | - L Fauchier
- Université de Tours, CHU de Tours, Department of Cardiology, 37000 Tours, France
| | - D Gras
- Nouvelles Cliniques Nantaises, Department of Cardiology, 44200 Nantes, France
| | - D Klug
- Université de Lille, CHRU de Lille, Department of Cardiology, 59000 Lille, France
| | - G Laurent
- Université de Dijon, CHU de Dijon, Department of Cardiology, 21000 Dijon, France
| | - J Mansourati
- Université de Bretagne Occidentale, CHU de Brest, Department of Cardiology, 29200 Brest, France
| | - E Marijon
- Université de Paris, AP-HP, Department of Cardiology, Georges-Pompidou European University Hospital, 75015 Paris, France
| | - P Maury
- Université de Toulouse, Inserm U1048, Department of Cardiology, Hospital Rangueil, 31059 Toulouse, France
| | - O Piot
- Centre Cardiologique du Nord, Department of Cardiology, 93200 Saint-Denis, France
| | - F Pontana
- Université de Lille, Inserm U1011, Department of Cardiovascular Radiology, Institut Cœur-Poumon, 59000 Lille, France
| | - F Sacher
- Université de Bordeaux-Inserm, IHU LIRYC, CHU de Bordeaux, Department of Cardiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, 33600 Pessac, France
| | - N Sadoul
- Université de Nancy Lorraine, CHU de Nancy, Department of Cardiology, 54511 Vandœuvre-lès-Nancy, France
| | - S Boveda
- Clinique Pasteur, Department of Cardiology, 31076 Toulouse, France
| | - A Jacquier
- Université Aix-Marseille, Centre Hospitalo-Universitaire Timone, AP-HM, Department of Radiology, CNRS, CRMBM, CEMEREM, 13005 Marseille, France
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Foussier C, Barral PA, Jerosh-Herold M, Gariboldi V, Rapacchi S, Gallon A, Bartoli A, Bentatou Z, Guye M, Bernard M, Jacquier A. Quantification of diffuse myocardial fibrosis using CMR extracellular volume fraction and serum biomarkers of collagen turnover with histologic quantification as standard of reference. Diagn Interv Imaging 2020; 102:163-169. [PMID: 32830084 DOI: 10.1016/j.diii.2020.07.005] [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] [Received: 02/20/2020] [Revised: 06/16/2020] [Accepted: 07/28/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE To compare the assessment of diffuse interstitial myocardial fibrosis in valvular diseases using cardiac magnetic resonance (CMR) extracellular volume fraction (ECV) quantification and serum biomarkers of collagen turnover using results of myocardial biopsy as standard of reference. MATERIALS AND METHODS This prospective monocentric study included consecutive patients before aortic valvular replacement. All patients underwent: i), 1.5T CMR with pre and post contrast T1 mapping sequence and ECV computation; ii), serum quantification of matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases (TIMPs) and iii), myocardial biopsies were collected during surgery to assess collagen volume fraction (CVF). Patients with coronary artery disease were excluded. Correlation between native T1, ECV, CVF and serum biomarkers were assessed using Pearson correlation test. Agreement between basal anteroseptal ECV with global ECV was assessed using Bland-Altman test. RESULTS Twenty-one patients, 16 with aortic stenosis and 5 with aortic regurgitation were included. There were 12 men and 9 women with a mean age of 74.1±6.8 (SD) years (range: 32-84 years). Mean global ECV value was 26.7±2.7 (SD) % (range: 23.4-32.5%) and mean CVF value was 12.4±9.7% (range: 3.2-25.7%). ECV assessed at the basal anteroseptal segment correlated moderately with CVF (r=0.6; P=0.0026). There was a strong correlation and agreement between basal anteroseptal ECV and global ECV, (r=0.8; P<0.0001; bias 5.4±6.1%) but no correlation between global ECV and CVF (r=0.5; P=0.10). Global ECV poorly correlated with serum TIMP-1 (r=0.4; P=0.037) and MMP-2 (r=0.4; P=0.047). No correlation was found between serum biomarkers and basal anteroseptal- ECV or native T1. CONCLUSION In patients with severe aortic valvulopathy, diffuse myocardial fibrosis assessed by anterosepto-basal ECV correlates with histological myocardial fibrosis. Anteroseptobasal ECV strongly correlates with global ECV, which poorly correlates with TIMP-1 and MMP-2, serum biomarkers involved in the progression of heart failure.
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Affiliation(s)
- C Foussier
- Department of Radiology, Hôpital de la Timone, 13385 Marseille, France; UMR CNRS 7339, Aix-Marseille University, 13385 Marseille, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France
| | - P A Barral
- Department of Radiology, Hôpital de la Timone, 13385 Marseille, France; UMR CNRS 7339, Aix-Marseille University, 13385 Marseille, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France
| | - M Jerosh-Herold
- Non-Invasive Cardiovascular Imaging Section, Brigham and Women's Hospital, Boston, MA 02215, USA
| | - V Gariboldi
- Department of Heart Surgery, Hôpital de la Timone, 13385 Marseille cedex 05, France
| | - S Rapacchi
- UMR CNRS 7339, Aix-Marseille University, 13385 Marseille, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France
| | - A Gallon
- Department of Radiology, Hôpital de la Timone, 13385 Marseille, France
| | - A Bartoli
- Department of Radiology, Hôpital de la Timone, 13385 Marseille, France
| | - Z Bentatou
- UMR CNRS 7339, Aix-Marseille University, 13385 Marseille, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France
| | - M Guye
- UMR CNRS 7339, Aix-Marseille University, 13385 Marseille, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France
| | - M Bernard
- UMR CNRS 7339, Aix-Marseille University, 13385 Marseille, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France; Aix-Marseille Univ, CNRS, CRMBM, 13000 Marseille, France
| | - A Jacquier
- Department of Radiology, Hôpital de la Timone, 13385 Marseille, France; UMR CNRS 7339, Aix-Marseille University, 13385 Marseille, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France.
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Habert P, Capron T, Hubert S, Bentatou Z, Bartoli A, Tradi F, Renard S, Rapacchi S, Guye M, Bernard M, Habib G, Jacquier A. Quantification of right ventricular extracellular volume in pulmonary hypertension using cardiac magnetic resonance imaging. Diagn Interv Imaging 2020; 101:311-320. [DOI: 10.1016/j.diii.2019.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 12/30/2022]
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Abstract
Grammatical evolution (GE) is one of the most widespread techniques in evolutionary computation. Genotypes in GE are bit strings while phenotypes are strings, of a language defined by a user-provided context-free grammar. In this paper, we propose a novel procedure for mapping genotypes to phenotypes that we call weighted hierarchical GE (WHGE). WHGE imposes a form of hierarchy on the genotype and encodes grammar symbols with a varying number of bits based on the relative expressive power of those symbols. WHGE does not impose any constraint on the overall GE framework, in particular, WHGE may handle recursive grammars, uses the classical genetic operators, and does not need to define any bound in advance on the size of phenotypes. We assessed experimentally our proposal in depth on a set of challenging and carefully selected benchmarks, comparing the results of the standard GE framework as well as two of the most significant enhancements proposed in the literature: 1) position-independent GE and 2) structured GE. Our results show that WHGE delivers very good results in terms of fitness as well as in terms of the properties of the genotype-phenotype mapping procedure.
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Bartoli A, De Lorenzo A, Medvet E, Squillero G. Multi-level diversity promotion strategies for Grammar-guided Genetic Programming. Appl Soft Comput 2019. [DOI: 10.1016/j.asoc.2019.105599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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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Ratto F, Schiavinato DJ, Bartoli A. Tipificación en <em>Gutierrezia</em> (Asteraceae, Astereae). Collect Bot 2019. [DOI: 10.3989/collectbot.2019.v38.001] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Durante el transcurso de la revisión de las especies sudamericanas de Gutierrezia, hemos podido hallar nombres que requieren tipificación. Luego del análisis de los protologos y especímenes de herbario, hemos designado ocho lectótipos y un neótipo para nueve nombres del género Gutierrezia. Además, se asignó la categoría de hólotipo a un especimen. Se provee una discusión detallada para cada nombre.
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Toti MS, Ghirri P, Bartoli A, Caputo C, Laudani E, Masoni F, Mele L, Bernardini R. Adrenal hemorrhage in newborn: how, when and why- from case report to literature review. Ital J Pediatr 2019; 45:58. [PMID: 31068206 PMCID: PMC6507044 DOI: 10.1186/s13052-019-0651-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 04/18/2019] [Indexed: 12/01/2022] Open
Abstract
Background Neonatal adrenal hemorrhage is a relatively uncommon condition (0.2–0.55%). Various risk factors have been reported in addition to birth asphyxia, such as sepsis, coagulation disorders, traumatic delivery, and perinatal injuries. Adrenal hemorrhage usually affects the right adrenal gland (about 70% of cases) while it involves the bilateral adrenal gland only in 10% of cases. In most cases, the event is asymptomatic but, in others, it may be so devastating to determine death by bleeding or adrenal insufficiency. Case presentation A case of bilateral neonatal adrenal hemorrhage, with adrenal insufficiency, but with no important risk factors and favorable evolution in a male infant. Conclusions This case emphasizes the importance of keeping a non-interventional attitude, avoiding early surgery but carrying out a serial sonographic follow-up. Serial ultrasound monitoring is the most reliable approach during conservative management. Electronic supplementary material The online version of this article (10.1186/s13052-019-0651-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M S Toti
- Pediatric Unit, San Giuseppe Hospital, Empoli, Florence, Italy.
| | - P Ghirri
- Neonatology and Neonatal Intensive Care Unit, Santa Chiara University Hospital, Pisa, Italy
| | - A Bartoli
- Pediatric Unit, San Giuseppe Hospital, Empoli, Florence, Italy
| | - C Caputo
- Pediatric Unit, San Giuseppe Hospital, Empoli, Florence, Italy
| | - E Laudani
- Pediatric Unit, San Giuseppe Hospital, Empoli, Florence, Italy
| | - F Masoni
- Pediatric Unit, San Giuseppe Hospital, Empoli, Florence, Italy
| | - L Mele
- Pediatric Unit, San Giuseppe Hospital, Empoli, Florence, Italy
| | - R Bernardini
- Pediatric Unit, San Giuseppe Hospital, Empoli, Florence, Italy
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Marano L, Bartoli A, Polom K, Bellochi R, Spaziani A, Castagnoli G. The unwanted third wheel in the Calot's triangle: Incidence and surgical significance of caterpillar hump of right hepatic artery with a systematic review of the literature. J Minim Access Surg 2019; 15:185-191. [PMID: 29737324 PMCID: PMC6561071 DOI: 10.4103/jmas.jmas_75_18] [Citation(s) in RCA: 5] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Caterpillar hump of the right hepatic artery is a rare variation increasing the risk of vascular and biliary injuries during hepatobiliary surgery. The aim of this study is to record the cases of the right hepatic artery forming caterpillar hump in a cohort of patients underwent laparoscopic cholecystectomy and to report a review of the literature systematically conducted. Methods: We reviewed clinical and surgical video data of 230 patients with symptomatic cholelithiasis treated with laparoscopic cholecystectomy between January 2016 and August 2017. A systematic literature search in PubMed, Medline, Cochrane and Ovid databases until 30th June 2017 was also performed in accordance with the PRISMA statement. Results: Our institutional data indicated that 1.3% of 230 patients presented caterpillar hump right hepatic artery. The systematic review included 16 studies reporting data from a total of 498 human cadavers and 579 patients submitted to cholecystectomy. The overall proportion of surgical patients with the caterpillar hump right hepatic artery was 6.9%. Conclusions: Variations of the cystic artery are not just an anatomical dissertation, assuming a very crucial role in surgical strategies to avoid uncontrolled vascular lesions. A meticulous knowledge of the hepatobiliary triangle in association with all elements of ‘Culture of Safety in Cholecystectomy’ is mandatory for surgeons facing more than two structures within Calot's triangle.
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Affiliation(s)
- Luigi Marano
- Department of Surgery, 'San Matteo Degli Infermi Hospital', Spoleto (PG), Italy
| | - Alberto Bartoli
- Department of Surgery, 'San Matteo Degli Infermi Hospital', Spoleto (PG), Italy
| | - Karol Polom
- Department of Surgical Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Raffaele Bellochi
- Department of Surgery, 'San Matteo Degli Infermi Hospital', Spoleto (PG), Italy
| | - Alessandro Spaziani
- Department of Surgery, 'San Matteo Degli Infermi Hospital', Spoleto (PG), Italy
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Talamonti C, Bartoli A, Scaringella M, Baldi A, Masi L, Pallotta S, Bruzzi M. 213. Pre-treatment verification of stereotactic plans using a bi-dimensional diamond detector. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.224] [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: 10/27/2022] Open
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Bartoli A, King A, Hornberger K, Klepacka D, Young D, Schoolcraft W, Katz-Jaffe M. The impact of aneuploidy screening for embryo selection in preimplantation genetic testing for monogenenic disorders. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.424] [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: 10/28/2022]
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Marano L, Rondelli F, Bartoli A, Testini M, Castagnoli G, Ceccarelli G. Oncologic Effectiveness and Safety of Splenectomy in Total Gastrectomy for Proximal Gastric Carcinoma: Meta-analysis of Randomized Controlled Trials. Anticancer Res 2018; 38:3609-3617. [PMID: 29848717 DOI: 10.21873/anticanres.12635] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/15/2018] [Accepted: 04/17/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The role of splenectomy as an essential component of radical surgery for proximal gastric cancer, from an oncological point of view, is still debated, and no consistent recommendations have been proposed. The aim of this systematic review with meta-analysis was to provide a more robust answer regarding the oncological effectiveness and safety of splenectomy in total gastrectomy for proximal gastric carcinoma. MATERIALS AND METHODS A systematic review and meta-analysis of randomized controlled trials was planned and performed in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement and Cochrane Handbook for Systematic Reviews of Intervention. Patients with a histological diagnosis of gastric adenocarcinoma located in the upper third of the stomach who underwent D2 total gastrectomy with or without splenectomy were selected. The primary outcome was to analyze the influence of splenectomy on the overall survival of patients. Additionally, the mean difference in procedure time, length of hospital stay, number of retrieved lymph nodes, as well as the odds ratio of postoperative complications comparing splenectomy to spleen preservation were investigated in a secondary analysis Results: Overall, four studies with a total of 978 patients met the inclusion criteria. The pooled analysis showed no difference in overall survival rates between those who underwent spleen preservation compared to the splenectomy-treated group (risk ratio=0.92, 95% confidence interval=0.79 to 1.06, p=0.277). Interestingly, all studies reporting overall morbidity data highlighted statistically significant differences in favor of spleen-preservation group (odds ratio=2.11, 95% confidence interval=1.44 to 3.09, p<0.001). CONCLUSION In total, gastrectomy for proximal gastric cancer, splenectomy should not be recommended as it increases operative morbidity without improving survival when compared to spleen preservation. Furthermore, our results may help in planning the updated versions of Gastric Cancer Treatment Guidelines. This meta-analysis, however, points to the urgent need for high-quality, well-designed, large-scale, clinical trials, with short-as well as long-term evaluation comparing splenectomy with spleen-preserving procedures, in a controlled randomized manner to help future research and to establish an evidence-based approach to gastric cancer treatment.
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Affiliation(s)
- Luigi Marano
- General, Minimally Invasive and Robotic Surgery, Department of Surgery, San Matteo degli Infermi Hospital- AUSL Umbria 2, Spoleto, Italy
| | - Fabio Rondelli
- General and Oncologic Surgery, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy.,General Surgery, Department of Surgery, San Giovanni Battista Hospital-AUSL Umbria 2, Foligno, Italy
| | - Alberto Bartoli
- General, Minimally Invasive and Robotic Surgery, Department of Surgery, San Matteo degli Infermi Hospital- AUSL Umbria 2, Spoleto, Italy
| | - Mario Testini
- Department of Biomedical Sciences and Human Oncology, Unit of Endocrine, Digestive and Emergency Surgery, A. Moro University Medical School of Bari, Bari, Italy
| | - Giampaolo Castagnoli
- General, Minimally Invasive and Robotic Surgery, Department of Surgery, San Matteo degli Infermi Hospital- AUSL Umbria 2, Spoleto, Italy
| | - Graziano Ceccarelli
- General Surgery, Department of Surgery, San Giovanni Battista Hospital-AUSL Umbria 2, Foligno, Italy
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Bartoli A, De Lorenzo A, Medvet E, Tarlao F. Active Learning of Regular Expressions for Entity Extraction. IEEE Trans Cybern 2018; 48:1067-1080. [PMID: 28358694 DOI: 10.1109/tcyb.2017.2680466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We consider the automatic synthesis of an entity extractor, in the form of a regular expression, from examples of the desired extractions in an unstructured text stream. This is a long-standing problem for which many different approaches have been proposed, which all require the preliminary construction of a large dataset fully annotated by the user. In this paper, we propose an active learning approach aimed at minimizing the user annotation effort: the user annotates only one desired extraction and then merely answers extraction queries generated by the system. During the learning process, the system digs into the input text for selecting the most appropriate extraction query to be submitted to the user in order to improve the current extractor. We construct candidate solutions with genetic programming (GP) and select queries with a form of querying-by-committee, i.e., based on a measure of disagreement within the best candidate solutions. All the components of our system are carefully tailored to the peculiarities of active learning with GP and of entity extraction from unstructured text. We evaluate our proposal in depth, on a number of challenging datasets and based on a realistic estimate of the user effort involved in answering each single query. The results demonstrate high accuracy with significant savings in terms of computational effort, annotated characters, and execution time over a state-of-the-art baseline.
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Marano L, Polom K, Bartoli A, Spaziani A, De Luca R, Lorenzon L, Di Martino N, Marrelli D, Roviello F, Castagnoli G. Oncologic Effectiveness and Safety of Bursectomy in Patients with Advanced Gastric Cancer: A Systematic Review and Updated Meta-Analysis. J INVEST SURG 2017; 31:529-538. [DOI: 10.1080/08941939.2017.1355942] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Luigi Marano
- General, Minimally Invasive and Robotic Surgery, Department of Surgery, “San Matteo degli Infermi Hospital”—ASL Umbria 2, Spoleto (PG), Italy
| | - Karol Polom
- Department of Medical, Surgical and Neuroscience; Unit of General and Minimally Invasive Surgery, University of Siena, Viale Bracci, Italy
| | - Alberto Bartoli
- General, Minimally Invasive and Robotic Surgery, Department of Surgery, “San Matteo degli Infermi Hospital”—ASL Umbria 2, Spoleto (PG), Italy
| | - Alessandro Spaziani
- General, Minimally Invasive and Robotic Surgery, Department of Surgery, “San Matteo degli Infermi Hospital”—ASL Umbria 2, Spoleto (PG), Italy
| | - Raffaele De Luca
- Department of Surgical Oncology, National Cancer Research Centre—Istituto Tumori “G. Paolo II”, Bari, Italy
| | - Laura Lorenzon
- Surgical and Medical Department of Translational Medicine, University of Rome “La Sapienza”, Sant'Andrea Hospital of Rome, Rome, Italy
| | - Natale Di Martino
- Department of Surgical Sciences, Second University of Naples, Naples, Italy
| | - Daniele Marrelli
- Department of Medical, Surgical and Neuroscience; Unit of General and Minimally Invasive Surgery, University of Siena, Viale Bracci, Italy
| | - Franco Roviello
- Department of Medical, Surgical and Neuroscience; Unit of General and Minimally Invasive Surgery, University of Siena, Viale Bracci, Italy
| | - Giampaolo Castagnoli
- General, Minimally Invasive and Robotic Surgery, Department of Surgery, “San Matteo degli Infermi Hospital”—ASL Umbria 2, Spoleto (PG), Italy
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Hornberger K, Bartoli A, King A, Bachman N, Young D, Klepacka D, Schoolcraft W, Katz-Jaffe M. Maternal obesity is not associated with increased miscarriage rates following euploid blastocyst transfer. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.756] [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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Bourdel N, Collins T, Pizarro D, Chauvet P, Debize C, Bartoli A, Canis M. First Use of Augmented Reality in Gynecology. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bourdel N, Collins T, Pizarro D, Pereira B, Canis M, Bartoli A. Augmented Reality Evaluation of Potential Benefits for Myomectomy in an Experimental Uterine Model. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.104] [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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Talamonti C, Falco M, Bartoli A, Russo S, Iervolino C, Menghi E, Moretti E, Mones E, Fiandra C, Casale M, Pastore G, Oliviero C, DiCastro E, Luxardo S, Vaiano A, Raza G, Borzi G, Carbonini C, Consorti R, Pressello M, Gasperi C, Tonghi LB, Palleri F, Marino C, Ardu V, Linsalata S, Riccardi S, Vittorini F, Spiazzi L, Rosica F, Iervolino C, Villaggi E, Mancosu P. Small field relative dosimetry using a silicon diode of new generation. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.725] [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: 11/16/2022] Open
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Bartoli A, De Lorenzo A, Medvet E, Tarlao F. Regex-based entity extraction with active learning and genetic programming. SIGAPP Appl Comput Rev 2016. [DOI: 10.1145/2993231.2993232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We consider the long-standing problem of the automatic generation of regular expressions for text extraction, based solely on examples of the desired behavior. We investigate several active learning approaches in which the user annotates only one desired extraction and then merely answers extraction queries generated by the system.
The resulting framework is attractive because it is the system, not the user, which digs out the data in search of the samples most suitable to the specific learning task. We tailor our proposals to a state-of-the-art learner based on Genetic Programming and we assess them experimentally on a number of challenging tasks of realistic complexity. The results indicate that active learning is indeed a viable framework in this application domain and may thus significantly decrease the amount of costly annotation effort required.
We consider the long-standing problem of the automatic generation of regular expressions for text extraction, based solely on examples of the desired behavior. We investigate several active learning approaches in which the user anno- tates only one desired extraction and then merely answers extraction queries generated by the system.
The resulting framework is attractive because it is the sys- tem, not the user, which digs out the data in search of the samples most suitable to the specific learning task. We tailor our proposals to a state-of-the-art learner based on Genetic Programming and we assess them experimentally on a num- ber of challenging tasks of realistic complexity. The results indicate that active learning is indeed a viable framework in this application domain and may thus significantly decrease the amount of costly annotation effort required.
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Abstract
Se describe e ilustra Gutierrezia tortosae Ratto & Adr. Bartoli, una nueva especie de Argentina. Se asemeja a Gutierrezia mandonii (Sch. Bip.) Solbrig por presentar xilopodio, por la forma de las hojas y por el color amarillo de las flores liguladas, pero difiere de ella por tener tallos erectos y rígidos, hojas erectas y capítulos menores. Se presenta una clave para diferenciarla de las especies que habitan en el noroeste de Argentina.
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Patriti A, Cipriani F, Ratti F, Bartoli A, Ceccarelli G, Casciola L, Aldrighetti L. Robot-assisted versus open liver resection in the right posterior section. JSLS 2016; 18:JSLS.2014.00040. [PMID: 25516700 PMCID: PMC4266223 DOI: 10.4293/jsls.2014.00040] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Open liver resection is the current standard of care for lesions in the right posterior liver section. The objective of this study was to determine the safety of robot-assisted liver resection for lesions located in segments 6 and 7 in comparison with open surgery. METHODS Demographics, comorbidities, clinicopathologic characteristics, surgical treatments, and outcomes from patients who underwent open and robot-assisted liver resection at 2 centers for lesions in the right posterior section between January 2007 and June 2012 were reviewed. A 1:3 matched analysis was performed by individually matching patients in the robotic cohort to patients in the open cohort on the basis of demographics, comorbidities, performance status, tumor stage, and location. RESULTS Matched patients undergoing robotic and open liver resections displayed no significant differences in postoperative outcomes as measured by blood loss, transfusion rate, hospital stay, overall complication rate (15.8% vs 13%), R0 negative margin rate, and mortality. Patients undergoing robotic liver surgery had significantly longer operative time (mean, 303 vs 233 minutes) and inflow occlusion time (mean, 75 vs 29 minutes) compared with their open counterparts. CONCLUSIONS Robotic and open liver resections in the right posterior section display similar safety and feasibility.
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Affiliation(s)
- Alberto Patriti
- Department of Surgery, Division of General, Minimally Invasive and Robotic Surgery, ASL Umbria Hospital San Matteo degli Infermi
| | - Federica Cipriani
- Department of Surgery, Hepatobiliary Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Francesca Ratti
- Department of Surgery, Hepatobiliary Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | - Graziano Ceccarelli
- Department of Surgery, Division of General Surgery, Hospital of Nuoro, Italy
| | - Luciano Casciola
- Division of Minimally Invasive Surgery, Clinica Privata Città di Roma, Roma, Italy
| | - Luca Aldrighetti
- Department of Surgery, Hepatobiliary Unit, San Raffaele Scientific Institute, Milan, Italy
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Bartoli A, De Lorenzo A, Medvet E, Tarlao F. Your Paper has been Accepted, Rejected, or Whatever: Automatic Generation of Scientific Paper Reviews. Lecture Notes in Computer Science 2016. [DOI: 10.1007/978-3-319-45507-5_2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Mariani A, Mai TT, Zacharioudakis E, Hienzsch A, Bartoli A, Cañeque T, Rodriguez R. Iron-dependent lysosomal dysfunction mediated by a natural product hybrid. Chem Commun (Camb) 2016; 52:1358-60. [DOI: 10.1039/c5cc09255h] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Marmycin A and artemisinin join forces as the molecular hybrid artesumycin, a new fluorescent lysosomotropic small molecule that targets lysosomal iron to kill cancer cells.
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Affiliation(s)
- A. Mariani
- Centre de Recherche de Gif
- Institut de Chimie des Substances Naturelles du CNRS
- 91198 Gif sur-Yvette
- France
| | - T. T. Mai
- Centre de Recherche de Gif
- Institut de Chimie des Substances Naturelles du CNRS
- 91198 Gif sur-Yvette
- France
- Institut Curie Research Center
| | - E. Zacharioudakis
- Centre de Recherche de Gif
- Institut de Chimie des Substances Naturelles du CNRS
- 91198 Gif sur-Yvette
- France
| | - A. Hienzsch
- Centre de Recherche de Gif
- Institut de Chimie des Substances Naturelles du CNRS
- 91198 Gif sur-Yvette
- France
| | - A. Bartoli
- Centre de Recherche de Gif
- Institut de Chimie des Substances Naturelles du CNRS
- 91198 Gif sur-Yvette
- France
| | - T. Cañeque
- Centre de Recherche de Gif
- Institut de Chimie des Substances Naturelles du CNRS
- 91198 Gif sur-Yvette
- France
- Institut Curie Research Center
| | - R. Rodriguez
- Centre de Recherche de Gif
- Institut de Chimie des Substances Naturelles du CNRS
- 91198 Gif sur-Yvette
- France
- Institut Curie Research Center
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Moretti S, Bartolommei L, Galosi C, Renga G, Oikonomou V, Zamparini F, Ricci G, Borghi M, Puccetti M, Piobbico D, Eramo S, Conti C, Lomurno G, Bartoli A, Napolioni V, Romani L. Fine-tuning of Th17 Cytokines in Periodontal Disease by IL-10. J Dent Res 2015; 94:1267-75. [PMID: 26092379 DOI: 10.1177/0022034515591790] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Periodontitis (PD) is a chronic disease caused by the host inflammatory response to bacteria colonizing the oral cavity. In addition to tolerance to oral microbiome, a fine-tuned balance of IL-10 levels is critical to efficiently mount antimicrobial resistance without causing immunopathology. Clinical and animal studies support that adaptive T-helper (Th) cytokines are involved in the pathogenesis of alveolar bone destruction in PD. However, it remains unclear what type of Th response is related to human PD progression and what role IL-10 has on this process. We addressed the contribution of IL-10 in limiting Th1 and Th17 inflammatory response in murine and human PD. Through a combination of basic and translational approaches involving selected cytokine-deficient mice as well as human genetic epidemiology, our results demonstrate the requirement for IL-10 in fine-tuning the levels of Th17 (IL-17A and IL-17F) cytokines in experimental and human PD. Of novelty, we found that IL-17F correlated with protection in murine and human PD and was positively regulated by IL-10. To our knowledge, this is the first demonstration of the protective role for IL-17F in PD, its positive regulation by IL-10, and the potential differential role for IL-17A and IL-17F in periodontal disease.
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Affiliation(s)
- S Moretti
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - L Bartolommei
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - C Galosi
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - G Renga
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - V Oikonomou
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - F Zamparini
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - G Ricci
- Department of Veterinary Pathology, University of Perugia, Perugia, Italy
| | - M Borghi
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - M Puccetti
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - D Piobbico
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - S Eramo
- Department of Surgical and Biochemical Sciences, University of Perugia, Perugia, Italy
| | - C Conti
- Dental Clinic, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - G Lomurno
- Dental Clinic, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - A Bartoli
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - V Napolioni
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - L Romani
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
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Abstract
En el marco de la revisión taxonómica del género Gutierrezia para Sudamérica fue hallada una nueva especie de Argentina, caracterizada por sus tallos con la porción basal postrada, enraizante en los nudos, capítulos con involucro turbinado y flores liguladas blancas. Se describe e ilustra la especie encontrada en el Departamento de Tunuyán de la Provincia de Mendoza (Argentina), y se incluye una clave para diferenciarla de las especies afines.
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Maier-Hein L, Groch A, Bartoli A, Bodenstedt S, Boissonnat G, Chang PL, Clancy NT, Elson DS, Haase S, Heim E, Hornegger J, Jannin P, Kenngott H, Kilgus T, Müller-Stich B, Oladokun D, Röhl S, Dos Santos TR, Schlemmer HP, Seitel A, Speidel S, Wagner M, Stoyanov D. Comparative validation of single-shot optical techniques for laparoscopic 3-D surface reconstruction. IEEE Trans Med Imaging 2014; 33:1913-1930. [PMID: 24876109 DOI: 10.1109/tmi.2014.2325607] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Intra-operative imaging techniques for obtaining the shape and morphology of soft-tissue surfaces in vivo are a key enabling technology for advanced surgical systems. Different optical techniques for 3-D surface reconstruction in laparoscopy have been proposed, however, so far no quantitative and comparative validation has been performed. Furthermore, robustness of the methods to clinically important factors like smoke or bleeding has not yet been assessed. To address these issues, we have formed a joint international initiative with the aim of validating different state-of-the-art passive and active reconstruction methods in a comparative manner. In this comprehensive in vitro study, we investigated reconstruction accuracy using different organs with various shape and texture and also tested reconstruction robustness with respect to a number of factors like the pose of the endoscope as well as the amount of blood or smoke present in the scene. The study suggests complementary advantages of the different techniques with respect to accuracy, robustness, point density, hardware complexity and computation time. While reconstruction accuracy under ideal conditions was generally high, robustness is a remaining issue to be addressed. Future work should include sensor fusion and in vivo validation studies in a specific clinical context. To trigger further research in surface reconstruction, stereoscopic data of the study will be made publically available at www.open-CAS.com upon publication of the paper.
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Chadebecq F, Tilmant C, Bartoli A. How big is this neoplasia? live colonoscopic size measurement using the Infocus-Breakpoint. Med Image Anal 2014; 19:58-74. [PMID: 25277373 DOI: 10.1016/j.media.2014.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 06/26/2014] [Accepted: 09/01/2014] [Indexed: 01/25/2023]
Abstract
Colonoscopy is the reference medical examination for early diagnosis and treatment of colonic diseases. This minimally invasive technique allows endoscopists to explore the colon cavity and remove neoplasias - abnormal growths of tissue - which may develop into malignant tumors. The size, shape and appearance of a neoplasia are essential cues for diagnostic. However, the size is difficult to estimate because the absolute scale of the observed tissue is not directly conveyed in the 2D colonoscopic images. An erroneous size estimate may lead to inappropriate treatment. There currently exist no solutions to reproducible neoplasia size measurement adapted to colonoscopy. We propose a colonoscopic size measurement system for neoplasias. By using a simple planar geometry, the key technical problem is reduced to resolving scale. Our core contribution is introducing the Infocus-Breakpoint (IB) that allows us to resolve scale from a regular colonoscopic video. We define the IB as the lower limit of the colonoscope's depth of field. The IB corresponds to a precise colonoscope to tissue distance, called the reference depth, which we calibrate preoperatively. We detect the IB intraoperatively thanks to two novel modules: deformable Blur-Estimating Tracking (BET) and Blur-Model Fitting (BMF). With our system, the endoscopist may interactively measure the length and area of a neoplasia in a 2D colonoscopic image directly. Our system needs no hardware modification to standard monocular colonoscopes, yet reaching a size measurement accuracy of the order of a millimeter, as shown on several phantom and patient datasets.
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Affiliation(s)
- F Chadebecq
- ISIT UMR 6284 CNRS/Université d'Auvergne, Bâtiment 3C, Faculté de Médecine, 28 place Henri Dunant, BP 38, 63001 Clermont-Ferrand, France; Institut Pascal UMR 6602 CNRS/Université Blaise Pascal/IFMA, Complexe Universitaire des Cézeaux, 24 Avenue des Landais, BP 80026, 63171 Aubière Cedex, France
| | - C Tilmant
- Institut Pascal UMR 6602 CNRS/Université Blaise Pascal/IFMA, Complexe Universitaire des Cézeaux, 24 Avenue des Landais, BP 80026, 63171 Aubière Cedex, France
| | - A Bartoli
- ISIT UMR 6284 CNRS/Université d'Auvergne, Bâtiment 3C, Faculté de Médecine, 28 place Henri Dunant, BP 38, 63001 Clermont-Ferrand, France
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Guarnieri B, Musicco M, Caffarra P, Adorni F, Appollonio I, Arnaldi D, Bartoli A, Bonanni E, Bonuccelli U, Caltagirone C, Cerroni G, Concari L, Cosentino FII, Fermi S, Ferri R, Gelosa G, Lombardi G, Mearelli S, Nobili F, Passero S, Perri R, Rocchi R, Sucapane P, Tognoni G, Zabberoni S, Sorbi S. Recommendations of the Sleep Study Group of the Italian Dementia Research Association (SINDem) on clinical assessment and management of sleep disorders in individuals with mild cognitive impairment and dementia: a clinical review. Neurol Sci 2014; 35:1329-48. [PMID: 25037740 DOI: 10.1007/s10072-014-1873-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 06/26/2014] [Indexed: 02/02/2023]
Abstract
Clinical assessment and management of sleep disturbances in patients with mild cognitive impairment and dementia has important clinical and social implications. Poor sleep results in an increased risk of morbidities and mortality in demented patients and is a source of stress for caregivers. Sleep disturbances show high prevalence in mild cognitive impairment and dementia patients and they are often associated one to another in the same patient. A careful clinical evaluation of sleep disorders should be performed routinely in the clinical setting of individuals with cognitive decline. The Sleep Study Group of the Italian Dementia Research Association (SINDem) reviewed evidence from original research articles, meta-analyses and systematic reviews published up to December 2013. The evidence was classified in quality levels (I, II, III) and strength of recommendations (A, B, C, D, E). Where there was a lack of evidence, but clear consensus, good practice points were provided. These recommendations may not be appropriate for all circumstances and should therefore be adopted only after a patient's individual characteristics have been carefully evaluated.
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Affiliation(s)
- B Guarnieri
- Center of Sleep Medicine, Villa Serena Hospital, Città S. Angelo, Pescara, Italy,
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Ceribelli C, Patriti A, Ceccarelli G, Spaziani A, Bartoli A, Casciola L. Totally laparoscopic right colectomy in situs viscerum inversus totalis. MINERVA CHIR 2012; 67:459-461. [PMID: 23232486] [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: 06/01/2023]
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Tyrand R, Momjian S, Bartoli A, Jenny B, Schaller K, Pollak P, Seeck M, Boëx C. 11. Microelectrode recordings in the framework of neuromodulation. Clin Neurophysiol 2012. [DOI: 10.1016/j.clinph.2012.03.075] [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: 10/27/2022]
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Patriti A, Ceribelli C, Ceccarelli G, Bartoli A, Bellochi R, Casciola L. Non-cirrhotic liver tolerance to intermittent inflow occlusion during laparoscopic liver resection. Updates Surg 2012; 64:87-93. [PMID: 22392578 DOI: 10.1007/s13304-012-0144-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Accepted: 02/21/2012] [Indexed: 12/24/2022]
Abstract
While inflow occlusion techniques are accepted methods to reduce bleeding during open liver surgery, their use in laparoscopic liver resections are limited by possible effects of pneumoperitoneum on ischemia-reperfusion liver damage. This retrospective study was designed to investigate the impact of intermittent pedicle clamping (IPC) on patients with normal liver undergoing minor laparoscopic liver resections. Three matched groups of patients were retrospectively selected from our in-house database: 11 patients who underwent robot-assisted liver resection with IPC, and 16 and 11 patients who underwent robot-assisted liver resection without IPC and open liver resection with IPC, respectively. The primary end point was to assess differences in postoperative serum alanine, aspartate aminotransferase (ALT and AST) and bilirubin levels. The curves of serum AST, ALT and bilirubin levels in a span of time of five postoperative days were not significantly different between the three groups. IPC has no relevant effects on ischemia-reperfusion liver damage even in the presence of pneumoperitoneum.
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Affiliation(s)
- Alberto Patriti
- Department of Surgery, Hospital San Matteo degli Infermi, Spoleto, Via Loreto, Spoleto, PG, Italy.
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Belcari F, Placidi G, Guzzetta A, Tonacchera M, Ciampi M, Bartoli A, Scaramuzzo RT, Frumento P, Cioni G, Pinchera A, Boldrini A, Ghirri P. Thyroid-stimulating hormone levels in the first days of life and perinatal factors associated with sub-optimal neuromotor outcome in pre-term infants. J Endocrinol Invest 2011; 34:e308-13. [PMID: 21659794 DOI: 10.3275/7795] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To identify perinatal factors associated with sub-optimal neuromotor outcome in infants without evident central nervous system lesions (intraventricular hemorrhage/ periventricular leukomalacia), with gestational age ≤30 (group I) and of 31-32 weeks (group II). PATIENTS AND METHODS A total of 102 premature infants admitted to the Neonatal Intensive Care Unit of Pisa, at 26-32 weeks of gestation, were studied. Data about perinatal factors and TSH values at 3-4 days of life were collected. The assessment of neuromotor development was performed at 18 months of corrected age, using the locomotor subscale of the Griffiths Scales of Mental Development. RESULTS Risk factors supposed to be predictive of sub-optimal neuromotor outcome (odds ratio >1) were at ≤30 weeks: male sex, small for gestational age, patent duct arterious, respiratory distress syndrome, and at 31-32 weeks: Apgar at 5 min <7, respiratory distress syndrome, patent duct arterious and birth weight <1500 g. A strong correlation was also found between TSH screening values >4,3 mU/l and suboptimal neuromotor outcome in both groups. CONCLUSIONS Several perinatal factors, acting on an immature and more vulnerable nervous system, such as the pre-term one, different for different gestational ages, are associated with a sub-optimal neuromotor outcome. Higher, but within the normal range, TSH values at screening seem to be a strong risk factor for neuromotor outcome in preterm infants without intraventricular hemorrhage or periventricular leukomalacia.
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Affiliation(s)
- F Belcari
- Division of Neonatology and Neonatal Intensive Care Unit, Department of Maternal and Child Health, S. Chiara Hospital, University of Pisa, Via Roma 35, 56100 Pisa, Italy
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Casciola L, Patriti A, Ceccarelli G, Bartoli A, Ceribelli C, Spaziani A. Robot-assisted parenchymal-sparing liver surgery including lesions located in the posterosuperior segments. Surg Endosc 2011; 25:3815-24. [PMID: 21656067 DOI: 10.1007/s00464-011-1796-9] [Citation(s) in RCA: 135] [Impact Index Per Article: 10.4] [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: 11/03/2010] [Accepted: 05/19/2011] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The aim of the study is to describe techniques of robot-assisted parenchymal-sparing liver surgery. BACKGROUND Laparoscopy provides the same oncologic outcomes as open liver resection and better early outcome. Limitations of laparoscopy remain resections in posterior and superior liver segments, frequently approached with laparoscopic right hepatectomy, bleeding from the section line, and prolonged operative times when a combined procedure is needed. METHODS We retrospectively analyzed our series of robot-assisted liver resections between 2008 and September 2010 to evaluate whether robot assistance can overcome the limitations of laparoscopy. RESULTS A total of 23 patients underwent robot-assisted liver resection for a total of 21 subsegmentectomies, 6 segmentectomies, 2 segmentectomies S6 + subsegmentectomies S7, 1 bisegmentectomy S2-3, and 2 pericystectomies. In ten cases (47.8%) liver nodules were located in the posterior and superior liver segments. In three cases the tumor was in contact with a main portal branch and in two cases with a hepatic vein. In one case the tumor had contact with both hepatic vein and portal branch. In the latter cases a no-margin resection was carried out. In 16 cases (65.5%) liver resection was associated with a concomitant procedure (10 laparoscopic colectomies, 1 robotic rectal resection, 3 laparoscopic radiofrequency ablations, and 2 extensive adhesiolyses). Mean operative time was 280 ± 101 min, blood loss was 245 ± 254 ml, and mean hospital stay was 8.9 ± 9.4 days. Mortality was nil. One case of biliary leakage and two of intraoperative hemorrhage requiring transfusion were the main complications encountered. CONCLUSIONS Robot assistance allows optimal access to all liver segments and facilitates parenchymal-sparing surgery also for lesions located in the posterosuperior segments or in contact with main liver vessels.
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Affiliation(s)
- Luciano Casciola
- Division of General, Minimally Invasive and Robotic Surgery, ASL 3 Umbria, Department of Surgery, Hospital San Matteo degli Infermi, Via Loreto, 3, 06049 Spoleto, PG, Italy
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Patriti A, Ceccarelli G, Ceribelli C, Bartoli A, Spaziani A, Cisano C, Cigliano S, Casciola L. Robot-assisted laparoscopic management of cardia carcinoma according to Siewert recommendations. Int J Med Robot 2011; 7:170-7. [DOI: 10.1002/rcs.385] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2011] [Indexed: 12/14/2022]
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Patriti A, Ceccarelli G, Bartoli A, Casciola L. Perspective of robotic rectal surgery. MINERVA CHIR 2010; 65:153-159. [PMID: 20548271] [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: 05/29/2023]
Abstract
Laparoscopy is widely recognized as a feasible and safe approach to rectal cancer associated with an improved early outcome. Robotic surgery overcomes intrinsic limitation of laparoscopic surgery by a three-dimensional view and wristed instruments, improving its outcome as well. Robot-assisted rectal surgery resulted to be safe and feasible. Prospective studies demonstrated its efficacy in allowing a high rate of negative circumferential resection margins with a consequent reduction in solitary loco-regional recurrences. A better local disease control and a reduced surgical trauma will be the conceivable benefit of this surgery.
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Affiliation(s)
- A Patriti
- Division of General, Vascular, Minimally Invasive and Robotic Surgery, Department of Surgery, San Matteo degli Infermi Hospital, Spoleto, Perugia, Italy.
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Giacomozzi C, Ghirri P, Lapolla R, Bartoli A, Scirè G, Serino L, Germani D, Boldrini A, Cianfarani S. Retinol-binding protein 4 in neonates born small for gestational age. J Endocrinol Invest 2010; 33:218-21. [PMID: 20503483 DOI: 10.1007/bf03345782] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Retinol-binding protein 4 (RBP4) is an adipocyte-derived 'signal' that may contribute to the pathogenesis of insulin resistance and Type 2 diabetes. The relationship of RBP4 with insulin resistance and metabolic risk in human beings has been the subject of several studies. Subjects born small for gestational age (SGA) are at risk of insulin resistance and Type 2 diabetes. Though RBP4 could represent an early marker of insulin resistance, to date, none have determined RBP4 in SGA children. AIM Our aim was to measure RBP4 concentrations in cord blood of SGA newborns compared with those in children born with a birth weight appropriate for gestational age (AGA) and to determine whether serum RBP4 levels at birth correlate with insulin sensitivity markers. SUBJECTS AND METHODS Sixty-four newborns, 17 born SGA (mean gestational age: 36.4+/-2.1 weeks), and 47 born AGA (mean gestational age: 37.0+/-3.6 weeks) were studied. The main outcome measures included anthropometry, lipid profile, insulin, homeostasis model assessment, quantitative insulin-sensitivity check index, adiponectin, and RBP4. RESULTS RBP4 concentrations were significantly reduced in SGA newborns (p<0.002). No relationship was found between RBP4 and insulin sensitivity parameters. Stepwise regression analysis revealed that birth weight was the major predictor of RBP4 serum concentrations (p<0.001). CONCLUSION RBP4 is reduced in SGA newborns, birth weight representing the major determinant of RBP4 concentrations, and is not related to insulin sensitivity. No significant difference in adiponectin levels and insulin sensitivity markers was found between SGA and AGA neonates.
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Affiliation(s)
- C Giacomozzi
- Molecular Endocrinology Unit, D.P.U.O. Bambino Gesù Children's Hospital, Rina Balducci Center of Pediatric Endocrinology, Tor Vergata University, Rome, Italy
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Ceccarelli G, Casciola L, Codacci-Pisanelli M, Bartoli A, Di Zitti L, Spaziani A, Biancafarina A, Stefanoni M, Patriti A. Reply to: "Requirements for applying a case-control study model and clinical significance of changes in the visual analogue scale score in abdominal pain". Surg Endosc 2009; 23:1918. [PMID: 19440789 DOI: 10.1007/s00464-009-0494-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Accepted: 03/27/2009] [Indexed: 11/30/2022]
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