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Komici K, Verderosa S, D'Amico F, Parente A, Persichini L, Guerra G. The role of body composition on cardio-respiratory fitness in futsal competitive athletes. Eur J Transl Myol 2023; 33:11479. [PMID: 37667864 PMCID: PMC10583136 DOI: 10.4081/ejtm.2023.11479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 07/06/2023] [Indexed: 09/06/2023] Open
Abstract
Futsal is an intermittent high intensity sport which has become popular worldwide. Body composition and physical fitness have been studied in different sports disciplines. However, little is known regarding body composition and cardio-respiratory performance in competitive futsal players. Body composition parameters were analyzed by electrical impedance body composition analyzer in 31 competitive male futsal players. All participants performed spirometry, handgrip strength and cardiopulmonary exercise testing. Significant correlations were observed between muscle mass and spirometry parameters and peak VO2 (p≤0.05). Fat mass resulted inversely correlated with peak VO2% predicted and hand grip strength (p≤0.05). Regression analysis showed that muscle mass significantly predicts respiratory parameters (p<0.01) and reduced fat mass is associated with increased peak VO2 % predicted and handgrip strength (p<0.01). In futsal competitive athletes increased muscle mass is associated with higher spirometry parameters and fat mass is inversely associated with lower cardiorespiratory fitness.
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Affiliation(s)
- Klara Komici
- Department of Medicine and Health Science, University of Molise.
| | - Sofia Verderosa
- Department of Medicine and Health Science, University of Molise.
| | - Fabio D'Amico
- Department of Medicine and Health Science, University of Molise.
| | - Albino Parente
- Department of Medicine and Health Science, University of Molise.
| | | | - Germano Guerra
- Department of Medicine and Health Science, University of Molise.
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Bada Bosch I, De Palacio A, Fernández Bautista B, Ordóñez J, Ortiz R, Burgos L, Parente A, Angulo JM. Endourological treatment of ectopic ureterocele. Our experience in the last 15 years. Cir Pediatr 2023; 36:78-82. [PMID: 37093117 DOI: 10.54847/cp.2023.02.15] [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] [Indexed: 04/25/2023]
Abstract
OBJECTIVE To assess the efficacy of the endourological treatment of ectopic ureterocele in children in a large series and with a long-term follow-up. MATERIALS AND METHODS A retrospective, descriptive study of patients with ectopic ureterocele who had undergone surgery in our institution in the last 15 years was carried out. All patients were treated using an endourological approach, both for ureterocele and postoperative vesicoureteral reflux (VUR). RESULTS 40 patients were treated -55% with left involvement and 5% with bilateral involvement. Mean age at diagnosis was 4.97 months, with diagnosis being established prenatally in 54.1% of cases. In all patients but one, endourological puncture of the ureterocele was conducted. Mean age at surgery was 6.96 months (0-1.11). Surgery was performed on an outpatient basis in 94.9% of patients. No perioperative complications were recorded. In the last 30 patients, preoperative voiding cystourethrography was not carried out. 72.5% of patients had postoperative VUR (44.8% into the upper pyelon, 10.3% into the lower pyelon, 17.2% into both, 6.9% into the contralateral system, and 20.7% into the bilateral system), but it was resolved with a single endoscopic procedure in 48.1% of cases (65% of patients were healed with two procedures). VUR was not endoscopically resolved in 3 patients who required ureteral re-implantation. 6 patients required heminephrectomy (n=3) or nephrectomy (n=3) as a result of functional impairment and infections. CONCLUSION The endourological treatment of ectopic ureterocele is a little aggressive and little invasive technique that allows the obstruction to be resolved on an outpatient basis, which means bladder surgery -if required- can be performed outside the neonatal period.
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Affiliation(s)
- I Bada Bosch
- Pediatric Surgery Department. Hospital General Universitario Gregorio Marañón. Madrid (Spain)
| | - A De Palacio
- Urology Department. Hospital Central de la Defensa Gómez Ulla. Madrid (Spain)
| | - B Fernández Bautista
- Pediatric Surgery Department. Hospital General Universitario Gregorio Marañón. Madrid (Spain)
| | - J Ordóñez
- Pediatric Surgery Department. Hospital General Universitario Gregorio Marañón. Madrid (Spain)
| | - R Ortiz
- Pediatric Surgery Department. Hospital General Universitario Gregorio Marañón. Madrid (Spain)
| | - L Burgos
- Pediatric Surgery Department. Hospital General Universitario Gregorio Marañón. Madrid (Spain)
| | - A Parente
- Pediatric Surgery Department. Hospital Universitario Reina Sofía. Córdoba (Spain)
| | - J M Angulo
- Pediatric Surgery Department. Hospital General Universitario Gregorio Marañón. Madrid (Spain)
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Parente A, Navarro H, Vargas NM, Lapa P, Basaran AC, González EM, Redondo C, Morales R, Munoz Noval A, Schuller IK, Vicent JL. Unusual Magnetic Hysteresis and Transition between Vortex and Double Pole States Arising from Interlayer Coupling in Diamond-Shaped Nanostructures. ACS Appl Mater Interfaces 2022; 14:54961-54968. [PMID: 36469495 DOI: 10.1021/acsami.2c16950] [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] [Indexed: 06/17/2023]
Abstract
Controlling the magnetic ground states at the nanoscale is a long-standing basic research problem and an important issue in magnetic storage technologies. Here, we designed a nanostructured material that exhibits very unusual hysteresis loops due to a transition between vortex and double pole states. Arrays of 700 nm diamond-shaped nanodots consisting of Py(30 nm)/Ru(tRu)/Py(30 nm) (Py, permalloy (Ni80Fe20)) trilayers were fabricated by interference lithography and e-beam evaporation. We show that varying the Ru interlayer spacer thickness (tRu) governs the interaction between the Py layers. We found this interaction mainly mediated by two mechanisms: magnetostatic interaction that favors antiparallel (antiferromagnetic, AFM) alignment of the Py layers and exchange interaction that oscillates between ferromagnetic (FM) and AFM couplings. For a certain range of Ru thicknesses, FM coupling dominates and forms magnetic vortices in the upper and lower Py layers. For Ru thicknesses at which AFM coupling dominates, the magnetic state in remanence is a double pole structure. Our results showed that the interlayer exchange coupling interaction remains finite even at 4 nm Ru thickness. The magnetic states in remanence, observed by magnetic force microscopy (MFM), are in good agreement with corresponding hysteresis loops obtained by the magneto-optic Kerr effect (MOKE) and micromagnetic simulations.
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Affiliation(s)
- A Parente
- Departamento de Física de Materiales, Facultad de Física, Universidad Complutense de Madrid, Pl. Ciencias, 1, 28040 Madrid, Spain
| | - H Navarro
- Department of Physics and Center for Advanced Nanoscience, University of California San Diego, La Jolla, California 92093, United States
| | - N M Vargas
- Department of Physics and Center for Advanced Nanoscience, University of California San Diego, La Jolla, California 92093, United States
| | - P Lapa
- Department of Physics and Center for Advanced Nanoscience, University of California San Diego, La Jolla, California 92093, United States
| | - Ali C Basaran
- Department of Physics and Center for Advanced Nanoscience, University of California San Diego, La Jolla, California 92093, United States
| | - E M González
- Departamento de Física de Materiales, Facultad de Física, Universidad Complutense de Madrid, Pl. Ciencias, 1, 28040 Madrid, Spain
- IMDEA Nanociencia, c/ Faraday, 9, 28049 Madrid, Spain
| | - C Redondo
- Department of Physical Chemistry, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
| | - R Morales
- Department of Physical Chemistry, University of the Basque Country UPV/EHU & BCMaterials, 48940 Leioa, Spain
- IKERBASQUE. Basque Foundation for Science, 48009 Bilbao, Spain
| | - A Munoz Noval
- Departamento de Física de Materiales, Facultad de Física, Universidad Complutense de Madrid, Pl. Ciencias, 1, 28040 Madrid, Spain
- IMDEA Nanociencia, c/ Faraday, 9, 28049 Madrid, Spain
| | - Ivan K Schuller
- Department of Physics and Center for Advanced Nanoscience, University of California San Diego, La Jolla, California 92093, United States
| | - J L Vicent
- Departamento de Física de Materiales, Facultad de Física, Universidad Complutense de Madrid, Pl. Ciencias, 1, 28040 Madrid, Spain
- IMDEA Nanociencia, c/ Faraday, 9, 28049 Madrid, Spain
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Infantino R, Boccella S, Scuteri D, Perrone M, Ricciardi F, Vitale R, Bonsale R, Parente A, Allocca I, Virtuoso A, De Luca C, Belardo C, Amodeo P, Gentile V, Cirillo G, Bagetta G, Luongo L, Maione S, Guida F. 2-pentadecyl-2-oxazoline prevents cognitive and social behaviour impairments in the Amyloid β-induced Alzheimer-like mice model: Bring the α2 adrenergic receptor back into play. Biomed Pharmacother 2022; 156:113844. [DOI: 10.1016/j.biopha.2022.113844] [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] [Received: 09/12/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 11/15/2022] Open
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Ripabelli G, Sammarco ML, D'Amico A, De Dona R, Iafigliola M, Parente A, Samprati N, Santagata A, Adesso C, Natale A, Di Palma MA, Cannizzaro F, Romano R, Licianci A, Tamburro M. Safety of mRNA BNT162b2 COVID-19 (Pfizer-BioNtech) vaccine in children aged 5-11 years: Results from an active pharmacovigilance study in central Italy. Hum Vaccin Immunother 2022; 18:2126668. [PMID: 36315849 PMCID: PMC9746364 DOI: 10.1080/21645515.2022.2126668] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 11/04/2022] Open
Abstract
This survey investigated on adverse events after vaccination with mRNA BNT162b2 (Comirnaty, Pfizer-BioNTech) vaccine in children aged 5-11 years in central Italy through active surveillance reporting. During December 2021-January 2022, parents of children who undergone vaccination were interviewed using a structured questionnaire. 197 out of 208 contacted parents participated (94.7% response rate), of whom 166 (84.3%) had one child. Of the 229 children, the mean age was 8.9 years, 50.7% were female. 193 (84.3%) had at least one adverse event after the first dose (mean age 9.1 years; 54.4% female), and 146 (73.4%) of 199 after the second (mean age 8.9 years; 54.8% female), which was not administered to 30 children due to previous COVID-19 history. Local symptoms after the first and second dose occurred in 183 (94.8%) and 141 (96.6%) recipients (p = .435), respectively, while systemic reactions in 62 (32.1%) and 34 (23.3%) (p = .074). Mild events were reported by 81.7% and 69.8% children after the first and second dose, followed by moderate (3.9% and 10.6%) and severe (1.3% and 0.5%). After each dose, injection site reactions (79.5% and 68.8%) were the most frequent, followed by headache (13.1%) and lymphadenopathy (8.5%) after the first and second dose, respectively. The adverse events were reported to pediatricians only for 5.7% and 3.9% of children and treated for 17.6% and 15.8%. This is the first report about safety profile through active surveillance of mRNA BNT162b2 among children in Italy, revealing temporary and mild-to-moderate symptoms with no serious events after each vaccine dose.
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Affiliation(s)
- Giancarlo Ripabelli
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy.,School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Michela Lucia Sammarco
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Antonio D'Amico
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Roberta De Dona
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Mariagrazia Iafigliola
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Albino Parente
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Nicandro Samprati
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Arturo Santagata
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Carmen Adesso
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Anna Natale
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Michela Anna Di Palma
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Fabio Cannizzaro
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Roberto Romano
- Antonio Cardarelli Hospital, Azienda Sanitaria Regionale del Molise, Campobasso, Italy
| | - Antonietta Licianci
- Antonio Cardarelli Hospital, Azienda Sanitaria Regionale del Molise, Campobasso, Italy
| | - Manuela Tamburro
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
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Tamburro M, Ripabelli G, D’Amico A, De Dona R, Iafigliola M, Parente A, Samprati N, Santagata A, Adesso C, Natale A, Di Palma MA, Cannizzaro F, Sammarco ML. A Cross-Sectional Study of Untoward Reactions Following Homologous and Heterologous COVID-19 Booster Immunizations in Recipients Seventeen Years of Age and Older. J Community Health 2022; 47:814-821. [PMID: 35750980 PMCID: PMC9244372 DOI: 10.1007/s10900-022-01112-5] [Citation(s) in RCA: 3] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 02/06/2023]
Abstract
A booster dose after primary COVID-19 vaccination series was considered crucial after the emergence of the B.1.617.2 (Delta) and B.1.1.529 (Omicron) variants. Active surveillance was used to investigate reporting of adverse events post-booster dose of either of the licensed mRNA Comirnaty (Pfizer/BioNTech) or Spikevax (Moderna) vaccines in adult (17 years and older) recipients in central Italy. Eligible participants were enrolled and interviewed via phone using a structured questionnaire. Primary outcomes related to the occurrence of adverse events post-booster were stratified by vaccine, and frequency of local/systemic, mild/moderate/severe events. Of a total of 622 participants interviewed, 554 (89.1%) reported at least one adverse event (88.2% and 92.9% after the Comirnaty or Spikevax vaccine, respectively): 63.4% were female, and 78.5% aged 17 to 64 years, regardless of vaccine. 87.7% and 68.2% of all recipients described at least one local or systemic reaction, respectively: 97.3, 38.6 and 4.7% reported mild, moderate, or severe events, respectively. The most frequent adverse reactions were pain, redness, or swelling at the injection site and fatigue, while malaise and fever significantly occurred after the Comirnaty, and vomiting after the Spikevax booster. Compared to the primary vaccination, lymphadenopathy was more common after the booster (p < 0.001), especially after Comirnaty vaccine. The study findings revealed no serious or unexpected adverse events, and are in agreement with data available on booster dose for both mRNA vaccines. The transient, mild to moderate, and common to very common side reactions reported should be used to reassure potential recipients of the lack of safety concerns.
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Affiliation(s)
- Manuela Tamburro
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Via De Sanctis, 86100 Campobasso, Italy
| | - Giancarlo Ripabelli
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Via De Sanctis, 86100 Campobasso, Italy
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Antonio D’Amico
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Roberta De Dona
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Mariagrazia Iafigliola
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Albino Parente
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Nicandro Samprati
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Arturo Santagata
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Carmen Adesso
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Anna Natale
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Michela Anna Di Palma
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Fabio Cannizzaro
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Michela Lucia Sammarco
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Via De Sanctis, 86100 Campobasso, Italy
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Tipler S, D’Alessio G, Van Haute Q, Parente A, Contino F, Coussement A. Predicting octane numbers relying on principal component analysis and artificial neural network. Comput Chem Eng 2022. [DOI: 10.1016/j.compchemeng.2022.107784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bianco M, Parente A, Biolè C, Righetti C, Spirito A, Luciano A, Destefanis P, Nangeroni G, Angusti T, Anselmino M, Montagna L. The prevalence of TTR cardiac amyloidosis among patients undergoing bone scintigraphy. J Nucl Cardiol 2021; 28:825-830. [PMID: 33728572 DOI: 10.1007/s12350-021-02575-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 12/04/2020] [Accepted: 02/09/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Radiolabeled bisphosphonates bone scintigraphy is highly sensitive in detecting transthyretin (TTR) cardiac amyloidosis; data on the true prevalence of cardiac involvement in TTR amyloidosis are lacking. METHODS AND RESULTS This retrospective observational, monocentric study aims to estimate the prevalence of positive bone scan suspect for TTR cardiac amyloidosis among an all-comers population who underwent a bone scintigraphy. ECG, echocardiography and clinical status of patients with unexpected cardiac uptake (Perugini score 2-3) who underwent bone scintigraphy with [99mTc]-HDP or [99mTc]-DPD at San Luigi Gonzaga University Hospital between January 2015 and May 2020 have been collected. The prevalence of bone scintigraphy suspect for cardiac involvement was 0.54% (23/4,228). The bone scintigraphy was mainly performed using [99mTc]-HDP (82.9%) and the dominant indication for the test was oncology in the 47.9% of cases. 8 Subjects had a history of neuropathy (34.8%) and 5 of carpal tunnel syndrome (21.7%). 11 Patients suffered a previous episode of heart failure (48%) while 5 patients (21.7%) were totally asymptomatic, without any sign or symptom before the bone scintigraphy making the nuclear examination crucial for an early diagnosis of TTR amyloidosis. CONCLUSION Bone scintigraphy allows suspecting TTR amyloidosis in a pre-clinical stage of the disease in an all-comers population of patients undergoing bone scintigraphy mainly for oncology reasons.
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Affiliation(s)
- Matteo Bianco
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy.
| | - A Parente
- Division of Nuclear Medicine, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - C Biolè
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - C Righetti
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - A Spirito
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - A Luciano
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - P Destefanis
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - G Nangeroni
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - T Angusti
- Division of Nuclear Medicine, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - M Anselmino
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza di Torino" Hospital, University of Turin, Turin, Italy
| | - L Montagna
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
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Sforza D, Iaria G, Petagna L, Parente A, Anselmo A, Sergi F, Marzio S, Corrado F, Telli S, Manzia TM, Tisone G. Switch From Twice-daily Tacrolimus to Once-daily, Prolonged-release Tacrolimus in Kidney Transplantation: Long-term Outcome. Transplant Proc 2018; 51:140-142. [PMID: 30655129 DOI: 10.1016/j.transproceed.2018.04.079] [Citation(s) in RCA: 3] [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: 03/07/2018] [Accepted: 04/13/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND One daily dose of tacrolimus (QDT) improves adherence in kidney transplant (KT) recipients. A switch from twice-daily tacrolimus (BDT) to QDT showed similar efficacy and safety. METHODS The aim of our study was to demonstrate the long-term efficacy and safety of switching from BDT to QDT in KT recipients. Preliminary results have already been published. Forty-one patients (34 men and 7 women), mean age at KT of 43.9 ± 12.7 years, underwent a 1:1 dose switch from BDT to QDT; the mean time from KT to switch was 36.6 ± 16.1 months. In our study population, 4 patients received a living donor KT and 2 received a second allograft. RESULTS The mean follow-up was 86.8 ± 13 months from the switch and 126.2 ± 22.3 months from KT. Graft and patient survival rates were 90.2% and 95.1%, respectively. All patients maintained stable renal function during follow-up. During the first 3 months after the switch we observed a significant decrease in tacrolimus blood level (P = .0001). No significant differences were observed regarding tacrolimus dose before and after QDT introduction (P = not significant [NS]). Fourteen patients who stopped steroids under BDT treatment and 16 patients who stopped steroids after the switch are currently steroid-free. CONCLUSION Our study showed safety and efficacy in switching from BDT to QDT. After early (<1 year) dose adjustment, tacrolimus blood levels remained stable throughout follow-up. Moreover, QDT represented a valid alternative for patients showing steroid side effects.
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Affiliation(s)
- D Sforza
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy.
| | - G Iaria
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - L Petagna
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - A Parente
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - A Anselmo
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - F Sergi
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - S Marzio
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - F Corrado
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - S Telli
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - T M Manzia
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - G Tisone
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
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D'Amore C, Marsico F, Parente A, Paolillo S, De Martino F, Gargiulo P, Ferrazzano F, De Roberto AM, La Mura L, Marciano C, Dellegrottaglie S, Trimarco B, Perrone Filardi P. Vitamin D deficiency and clinical outcome in patients with chronic heart failure: A review. Nutr Metab Cardiovasc Dis 2017; 27:837-849. [PMID: 28954706 DOI: 10.1016/j.numecd.2017.07.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 07/17/2017] [Accepted: 07/23/2017] [Indexed: 12/26/2022]
Abstract
AIM The aim of this review was to summarize evidence on the role of Vitamin D deficiency in heart failure (HF), from pathophysiological mechanisms to clinical effects of Vitamin D supplementation. DATA SYNTHESIS Chronic HF secondary to left ventricular (LV) systolic dysfunction is a growing health problem, still associated with poor clinical outcome. In recent years, experimental and epidemiological evidence focused on the role of Vitamin D in HF. Cross sectional studies demonstrated that prevalence of HF is increased in patients with Vitamin D deficiency or parathyroid hormone (PTH) plasma level increase, whereas longitudinal studies showed enhanced risk of developing new HF in patients with Vitamin D deficiency. In addition, in patients with established HF, low plasma levels of Vitamin D are associated with worsening clinical outcome. Yet, clinical studies did not definitively demonstrate a benefit of Vitamin D supplementation for preventing HF or ameliorating clinical outcome in patients with established HF. CONCLUSIONS Despite convincing experimental and epidemiological data, treatment with Vitamin D supplementation did not show clear evidence of benefit for preventing HF or influencing its clinical course. Ongoing clinical studies will hopefully shed lights on the effects of Vitamin D supplementation on clinical endpoints along the spectrum of HF.
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Affiliation(s)
| | - F Marsico
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - A Parente
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | | | - F De Martino
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | | | - F Ferrazzano
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - A M De Roberto
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - L La Mura
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - C Marciano
- Istituto Diagnostico Varelli, Naples, Italy
| | | | - B Trimarco
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - P Perrone Filardi
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
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Simal I, Parente A, Burgos L, Ortiz R, Martínez AB, Rojo R, Pérez-Egido L, Angulo JM. Therapeutic possibilities for urolithiasis in childhood. Actas Urol Esp 2016; 40:577-584. [PMID: 27289139 DOI: 10.1016/j.acuro.2016.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 03/18/2016] [Accepted: 03/28/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We present our case studies on paediatric urolithiasis, the techniques employed in its treatment and its results. MATERIAL AND METHODS A retrospective study of paediatric urolithiasis of the upper urinary tract (UUT) treated at our centre between 2003 and 2014. We recorded demographic, clinical, diagnostic and therapeutic data and the complications. The therapeutic plan was recorded as isolated (extracorporeal lithotripsy, ureterorenoscopy, nephrolithotomy or surgery) or combined therapy. RESULTS We examined 41 renal/urethral units in 32 patients. The median age was 5 years (range, 11 months-14 years). The mean size was 12.9cm (±7.3mm). The locations were as follows: 23 (56%) in the renal pelvis (staghorn in 15 cases), 10 (24) in lower calyx and 8 (20%) in the urethra. We performed 80 procedures, with no differences in the age groups, which resulted in 12 complications (15%) but no septic condition secondary to lithotripsy. Stone removal from the urethra had a 100% success rate with the ureterorenoscopy. The overall cure rate was 90%. CONCLUSION The paediatric urolithiasis approach offers multiple alternatives. It is therefore important to tailor the procedure according to the size, location and composition of the stone. In our centre, the use of paediatric extracorporeal shock wave lithotripsy is safer. Ureterorenoscopy, semirigid or flexible, provides excellent results in ureters. Percutaneous nephrolithotomy with minimal access can be performed on small children and nursing infants.
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Affiliation(s)
- I Simal
- Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | - A Parente
- Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - L Burgos
- Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - R Ortiz
- Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - A B Martínez
- Servicio de Nefrología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - R Rojo
- Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - L Pérez-Egido
- Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - J M Angulo
- Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
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Giovagnoli AR, Parente A, Didato G, Manfredi V, Deleo F, Tringali G, Villani F. The course of language functions after temporal lobe epilepsy surgery: a prospective study. Eur J Neurol 2016; 23:1713-1721. [PMID: 27529582 DOI: 10.1111/ene.13113] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 10/18/2015] [Accepted: 06/08/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Anterior temporal lobectomy (ATL) within the language-dominant hemisphere can impair naming. This prospective study examined the pre-operative to post-operative course of different language components, clarifying which changes are relevant within the short-term and long-term outcome of language. METHODS Patients with drug-resistant temporal lobe epilepsy (TLE) were evaluated using the Token, Boston Naming and Word Fluency tests assessing sentence comprehension and word-finding on visual, semantic or phonemic cues. RESULTS A total of 106 patients were evaluated before and 6 months, 1 and 2 years after ATL; 60 patients were also evaluated after 5 years and 38 controls were assessed at baseline. Seizure outcome was comparable between the left and right TLE patients. Before surgery, naming and word fluency were impaired in the left and right TLE patients, whereas sentence comprehension was normal. After left or right ATL, word fluency progressively improved, naming showed early worsening and late improvement after left ATL and progressive improvement after right ATL, and sentence comprehension did not change. At the 5-year follow-up, naming improvement was clinically significant in 31% and 71% of the left and right TLE patients, respectively. Pre-operative naming, ATL laterality, schooling, and post-operative seizure frequency and number of antiepileptic drugs predicted post-operative naming. Pre-operative word fluency and schooling predicted post-operative word fluency. CONCLUSIONS Left or right TLE can impair word-finding but not sentence comprehension. After ATL, word-finding may improve for a long time, depending on TLE laterality, seizure control and mental reserve. These findings may clarify prognosis prior to treatment.
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Affiliation(s)
- A R Giovagnoli
- Unit of Neurology and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - A Parente
- Unit of Neurology and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - G Didato
- Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - V Manfredi
- Unit of Neurology and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - F Deleo
- Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - G Tringali
- Neurosurgery III, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - F Villani
- Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
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13
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Zornoza M, Angulo JM, Parente A, Simal S, Burgos L, Ortiz R. Late diagnosis of posterior urethral valves. Actas Urol Esp 2015; 39:646-50. [PMID: 26112258 DOI: 10.1016/j.acuro.2015.05.005] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 05/17/2015] [Accepted: 05/18/2015] [Indexed: 11/28/2022]
Abstract
CLINICAL PROBLEM We diagnosed 8 patients with late-stage posterior urethral valves (PUV) between 1 and 14 years of age. Five patients complained of symptoms related to voiding dysfunction. The other 3 patients required urethrocystoscopy for other reasons (hypospadias fistulae, difficulty with catheterisation and high-grade vesicoureteral reflux [VUR]). A second review of the first 2 patients' medical history showed voiding dysfunction symptoms. All patients underwent preoperative ultrasonography: 3 patients had normal results and 5 had renal or vesical disorders. The diagnosis was reached through voiding cystourethrogram (VCUG), and 4 patients underwent urodynamic studies. The diagnosis was confirmed by urethrocystoscopy, performing valve electrofulguration. We performed urethrocystoscopy during the check-ups at 3-6 weeks and observed no stenosis. The symptoms disappeared for all patients after 20 months of follow-up. The patient with VUR was cured. The ultrasounds showed no progression of the renal involvement and showed improvement in the vesical involvement. The velocimetries during check-ups presented curves within normal ranges. DISCUSSION Most children with PUV are diagnosed through ultrasound during the neonatal period. Some patients present PUV at later ages with diverse symptoms, which impedes its diagnosis. We should suspect PUV in male patients with symptoms of voiding dysfunction, either when they have normal or pathological results from ultrasounds or VCUG. We recommend performing urethrocystoscopy to rule out urethral obstruction.
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Affiliation(s)
- M Zornoza
- Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España.
| | - J M Angulo
- Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España
| | - A Parente
- Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España
| | - S Simal
- Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España
| | - L Burgos
- Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España
| | - R Ortiz
- Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España
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14
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Fanjul M, Pérez L, Cerdá J, Zornoza M, Rojo R, Simal I, García-Casillas MA, Corona C, Peláez D, Molina E, Parente A, Rivas S, Angulo JM, De Tomás E. [Fast track protocol for children undergoing appendicectomy]. Cir Pediatr 2015; 28:177-183. [PMID: 27775294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Multiple approaches to the treatment of simple and complicated (gangrenous or perforated) appendicitis in children have been promoted. Our goal is to develop a new protocol for these patients that allows shorter hospital stays without increasing complications rates. METHODS Prospective collected data of patients undergoing appendicitis treated according to the new protocol for a period of 7 months were reviewed. This protocol consists on antibiotic prophylaxis in all cases continued with triple antibiotic regimen in complicated appendicitis. Antibiotics were stopped when specific clinical and laboratory criteria were met. Outcomes are compared to a historical group of patients treated under standard protocol (antibiotic prophylaxis followed by 48 hours of dual antibiotic therapy in simple appendicitis or 5 day-course of triple antibiotic therapy in complicated as postooperative antibiotic regimen). RESULTS A total of 196 patients (96 current group and 100 historical group) were reviewed. In simple appendicitis average length of postoperative hospitalization was significantly lower in the current group (no statistical difference). 52.9% of complicated appendicitis in the current group were discharged home before 5th day without increasing the complication rate. When a wound infection or intraabdominal abscess occurs thrombocytosis (52%) and prolonged vomiting are the most frequent symptoms. CONCLUSION No further postoperative treatment is needed in simple appendicitis. In complicated appendictis a short course of antibiotics according to clinical and laboratory criteria allows early discharge without major morbidity. Prolonged postoperative vomiting and thrombocytosis suggest infectious complications.
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Affiliation(s)
- M Fanjul
- Hospital General Universitario Gregorio Marañón. Madrid
| | - L Pérez
- Hospital General Universitario Gregorio Marañón. Madrid
| | - J Cerdá
- Hospital General Universitario Gregorio Marañón. Madrid
| | - M Zornoza
- Hospital General Universitario Gregorio Marañón. Madrid
| | - R Rojo
- Hospital General Universitario Gregorio Marañón. Madrid
| | - I Simal
- Hospital General Universitario Gregorio Marañón. Madrid
| | | | - C Corona
- Hospital General Universitario Gregorio Marañón. Madrid
| | - D Peláez
- Hospital General Universitario Gregorio Marañón. Madrid
| | - E Molina
- Hospital General Universitario Gregorio Marañón. Madrid
| | - A Parente
- Hospital General Universitario Gregorio Marañón. Madrid
| | - S Rivas
- Hospital General Universitario Gregorio Marañón. Madrid
| | - J M Angulo
- Hospital General Universitario Gregorio Marañón. Madrid
| | - E De Tomás
- Hospital General Universitario Gregorio Marañón. Madrid
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15
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Parente A, Angulo J, Burgos L, Romero R, Rivas S, Ortiz R. Percutaneous Endopyelotomy over High Pressure Balloon for Recurrent Ureteropelvic Junction Obstruction in Children. J Urol 2015; 194:184-9. [DOI: 10.1016/j.juro.2015.01.074] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2015] [Indexed: 11/16/2022]
Affiliation(s)
- A. Parente
- Pediatric Urology Department, Gregorio Marañón University Hospital, Madrid, Spain
| | - J.M. Angulo
- Pediatric Urology Department, Gregorio Marañón University Hospital, Madrid, Spain
| | - L. Burgos
- Pediatric Urology Department, Gregorio Marañón University Hospital, Madrid, Spain
| | - R.M. Romero
- Pediatric Urology Department, Gregorio Marañón University Hospital, Madrid, Spain
| | - S. Rivas
- Pediatric Urology Department, Gregorio Marañón University Hospital, Madrid, Spain
| | - R. Ortiz
- Pediatric Urology Department, Gregorio Marañón University Hospital, Madrid, Spain
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Dello Monaco A, Nuzzi A, Parente A, Lavermicocca V, Chiarelli T, De Tommaso M, Fiore P, Megna M. I03 Swallowing Function In The Early, Middle And Late Stages Of Huntington's Disease. J Neurol Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309032.165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Montesano F, Parente A, Grassi F, Santamaria P. POSIDONIA-BASED COMPOST AS A GROWING MEDIUM FOR THE SOILLESS CULTIVATION OF TOMATO. ACTA ACUST UNITED AC 2014. [DOI: 10.17660/actahortic.2014.1034.34] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Guida V, Ferrari G, Pataro G, Chambery A, Di Maro A, Parente A. The effects of ohmic and conventional blanching on the nutritional, bioactive compounds and quality parameters of artichoke heads. Lebensm Wiss Technol 2013. [DOI: 10.1016/j.lwt.2013.04.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [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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19
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Rosazza C, Ghielmetti F, Minati L, Vitali P, Giovagnoli A, Deleo F, Didato G, Parente A, Marras C, Bruzzone M, D'Incerti L, Spreafico R, Villani F. Preoperative language lateralization in temporal lobe epilepsy (TLE) predicts peri-ictal, pre- and post-operative language performance: An fMRI study. Neuroimage Clin 2013; 3:73-83. [PMID: 24179851 PMCID: PMC3807502 DOI: 10.1016/j.nicl.2013.07.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 05/31/2013] [Accepted: 07/01/2013] [Indexed: 11/15/2022]
Abstract
In patients with temporal lobe epilepsy (TLE), assessment of language lateralization is important as anterior temporal lobectomy may lead to language impairments. Despite the widespread use of fMRI, evidence of its usefulness in predicting postsurgical language performance is scant. We investigated whether preoperative functional lateralization is related to the preoperative language performance, peri-ictal aphasia, and can predict language outcome one year post-surgery. We studied a total of 72 TLE patients (42 left, 30 right), by using three fMRI tasks: Naming, Verb Generation and Fluency. Functional lateralization indices were analyzed with neuropsychological scores and presence of peri-ictal aphasia. The key findings are:1)Both left and right TLE patients show decreased left lateralization compared to controls.2)Lateralization correlates with language performance before surgery. In left TLE, decreased left lateralization correlates with better fluency performance. In right TLE, increased left lateralization during the Naming task correlates with better naming.3)Left lateralization correlates with peri-ictal aphasia in left TLE patients.4)Lateralization correlates with language performance after surgery. In a subgroup of left TLE who underwent surgery (17 left), decreased left lateralization is predictive of better naming performance at 6 and 12 months after surgery. The present study highlights the clinical relevance of fMRI language lateralization in TLE, especially to predict language outcome one year post-surgery. We also underline the importance of using fMRI tasks eliciting frontal and anterior temporal activations, when studying left and right TLE patients.
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Affiliation(s)
- C. Rosazza
- Neuroradiology Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
- Scientific Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - F. Ghielmetti
- Neuroradiology Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
- Health Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - L. Minati
- Scientific Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - P. Vitali
- Brain MRI 3T Mondino Research Center, Istituto Neurologico “C. Mondino”, Pavia, Italy
| | - A.R. Giovagnoli
- Neuropsychology Laboratory, Dept. of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - F. Deleo
- Division of Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - G. Didato
- Division of Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - A. Parente
- Neuropsychology Laboratory, Dept. of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - C. Marras
- Neurosurgery Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
- Dept. of Neuroscience Bambino Gesù Children Hospital, Rome, Italy
| | - M.G. Bruzzone
- Neuroradiology Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - L. D'Incerti
- Neuroradiology Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - R. Spreafico
- Division of Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - F. Villani
- Division of Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
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Parente A, Lima M, Januarioda Silvad C, Fernandes R, Lamas C. P66 DAPTOMYCIN USE IN INFECTIVE ENDOCARDITIS AT A CARDIAC SURGERY REFERRAL HOSPITAL, 20092012, RIO DE JANEIRO, BRAZIL. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70090-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Tardáguila AR, Romero R, Parente A, Rivas S, Fanjul M, Corona C, Angulo JM. ["Fast-track" in pediatric urologic surgery: pronenephrectomy]. Cir Pediatr 2013; 26:81-85. [PMID: 24228358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
UNLABELLED INTRODUCTION AND OBJETIVES: Minimal invasive surgery trends to get prompt recovery in terms of inmediate deambulation and early discharge from hospital, without increasing patient's discomfort neither postoperative complications. This "fast-track" protocol is being progresively introduced in a crescent number of urological procedures. We are evaluating the viability of applying it in retroperitoneoscopic prone- position nephrectomy. METHODS AND MATERIALS We have performed a retrospective review of the clinical reports of the patients submitted to prone nephrectomy with hospitalization between 2007 and 2011 and we present patients submitted to this procedure in an outpatient basis (less than 8 hours hospital stay) from 2011. We have recorded epidemiological factors, diagnosis, surgical time, first postoperative week analgesic requirements, parents cofort and postoperative complications. RESULTS All the procedures were performed retroperitoneoscopically in prone position using two trocars. We included 34 nephrectomies with a mean surgical time of 107 minutes. Mean postoperative stay was under 24 hours in 23 patients, two of them were discharged in the first 8 hours after the procedure. Hospital stay over this time was due to concomitant pre-existent pathology in 6 patients and to non urological fever in the remaining 3. Analgesia was excellent in every patient with endovenous non-steroid drugs, registering no pain after administering them orally. There were no complications. CONCLUSIONS We believe that "fast-track" requirements can be applied to prone-retroperitoneoscopic nephrectomy in pediatric population, as long as they have no associated pathology. In our experience this surgical procedure can be included in day-case surgery, increasing patient's confort and with a positive economical impact.
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Affiliation(s)
- A R Tardáguila
- Sección de Urología Infantil, Servicio de Cirugía Pediátrica, Hospital Materno Infantil Gregorio Marañón, Madrid.
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Rojo R, Fanjul M, García-Casillas MA, Corona C, Tardáguila AR, Zornoza M, Simal I, Cañizo A, Molina E, Peláez D, Angulo JM, Romero R, Rivas S, Parente A, de Tomás E, Cerdá JA. [Surgical wound infections in newborns: analysis of risk factors]. Cir Pediatr 2012; 25:129-134. [PMID: 23480008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED The incidence of surgical wound infections in neonates is high and it has an associated morbidity which extends hospital stay and gets a worse prognosis. The purpose of this study is to analyze the risk factors associated with the development of surgical wound infection and to identify susceptible patients with modifiable factors. MATERIAL AND METHODS Case-control study of 90 surgical procedures underwent in newborns. We analyze pre-, intra- and postoperative risk factors. MAIN RESULTS There are statically significant differences in terms of wound infection in dirty and contaminated surgery, reoperation, lavage of abdominal cavity, preoperative hospital stay longer than 8 days and wound closure with reabsorbable material. Furthermore, the surgical site infection is more likely in preterms patients, with a previous positive culture infection and the use of invasive devices as mechanical ventilation or central venous access. We found no relationship between wound infection and surgical time, bleeding during surgery and preoperative skin preparation with antiseptics. CONCLUSIONS Reoperative patients, in which dirty and contaminated surgery is performed, absorbable material for skin is used and who have a preoperative hospital stay longer than 8 days, are in risk of developping wound infection and they will require an aggressive antibiotic treatment and special postsurgical care.
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Affiliation(s)
- R Rojo
- Servicio de Cirugía Pediátrica, Hospital Universitario Materno-lnfantil Gregorio Marañón, Madrid.
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23
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Parente A, Angulo J, Romero R, Rivas S, Tardáguila A, Corona C. [High-pressure balloon dilatation for treatment of orthotopic ureterocele]. Actas Urol Esp 2012; 36:117-20. [PMID: 21955558 DOI: 10.1016/j.acuro.2011.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Accepted: 07/19/2011] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Transurethral puncture or endoscopic unroofing is the best treatment currently used for both orthotopic and ectopic ureteroceles. However, they have a high incidence of secondary vesicoureteral reflux and subsequent procedures in both groups. We present a new technique for treatment of orthotopic ureterocele. MATERIAL AND METHODS We have analyzed 4 patients with orthotopic ureterocele (9.7 ± 6.2 months old) treated by dilatation of the meatus of the ureterocele. No patient had vesicoureteral reflux or duplicate systems. The indication was pyonephrosis in 2 children and progressive worsening of hydronephrosis in 2. Dilatation was performed with 5 or 6mm high-pressure balloon after inserting a stent with guidewire of 0.014" to the ureterocele. RESULTS There were no intraoperative or postoperative complications, surgical time being 24 ± 9minutes. All patients were discharged at 24 postoperative hours. Ureterohydronephrosis disappeared in all the children and they continue asymptomatic after 35 ± 22.5 months of follow-up. There were no cases of secondary vesicoureteral reflux and renal scan was unchanged after treatment. CONCLUSIONS High pressure balloon dilatation of the meatus in cases of orthotopic ureterocele is a fast, safe and successful surgical technique. We did not find any cases of secondary vesicoureteral reflux or subsequent procedures in our series, so we believe this may offer significant benefits over the transurethral puncture in such patients.
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Tardáguila AR, Del Cañizo A, Santos MM, Fanjul M, Corona C, Zornoza M, Parente A, Carrera N, Beléndez C, Cerdá J, Saavedra J, Molina E, García-Casillas MA, Peláez D. [Subcutaneously inserted central intravascular devices in the pediatric oncology patient: can we minimize their infection]. Cir Pediatr 2011; 24:208-213. [PMID: 23155633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Long-term indwelling central venous access devices are frequently used in pediatric patients. Their main complication is infection, that can even mean their removal. We try to identify the risk factors really involved in this complication and in their removal. We have made a retrospective review of 120 oncologic pediatric patients who received a central venous device between 2003 and 2009. We searched for epidemiologic, clinic, microbiologic and surgical risk factors. We made a comparative data analysis among: GROUP A, children who suffered device infection, GROUP B the others. Group A was divided into early infection (first month after implantation)/late infection, removed/not removed. Data were analized with statistical program SPSS. 29 suffered from leukemia, 19 from lymphoma and the main part, 72, from solid tumour. 31% experienced infection (GROUP A), being early in the 36% of them. 16% had to be withdrawn. Data analysis revealed statistical association with the age (p=0.015) and with the reception of chemiotherapic treatment the week before the surgical insertion. The rest of the studied factors did not revealed a real association, but could be guess a relationship among infection and leukemia, subclavian catheters, those patients whose deviced was introduced using a guide over a previous catheter and also transplanted. Related to early infection the only associateon founded was with the subclavian access (p=0.018). In conclusion, in our serie long-term central venous access infection was more frequent in the younger patients and also in those who had received chemotherapy the week before the catheter implantation. The tendency towards infection in leukemia, transplanted and subclavian carriers has to be studied in a prospective way with a larger number of oncologic children.
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Affiliation(s)
- A R Tardáguila
- Servicio de Cirugía Pediátrica, Hospital Gregorio Marañón, Madrid.
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Carrera N, Parente A, Rivas S, Romero R, Angulo JM. [Cold-knife retrograde endoscopic endopyelotomy (Cutting-Balloon) in children with ureteropelvic junction obstruction: early results]. Cir Pediatr 2011; 24:192-195. [PMID: 23155630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND To present our early experience in the use of Cutting-Balloon for the treatment of resistant or relapsed ureteropelvic junction obstruction (UPJO) after a prior endourological retrograde high-pressure balloon dilatation (RHPBD). MATERIALS AND METHODS Patients with progressive hydronephrosis and impaired drainage of the renal pelvis on a diuretic renal scan were treated with RHPBD. In those patients with resistant UPJO (waist persistence after dilatation) or relapsed UPJO, we consider using a Cutting-Balloon as an alternative to our current protocol (second RHPBD or open surgery). A JJ stent was placed following the procedure, and removed at 4-6 weeks. Outcomes were evaluated 3 and 6 months after stent removal, and every 6 months thereafter, repeating renal ultrasonography and diuretic renal scan. RESULTS Between 2008 and 2010 we treated with Cutting-balloon 5 patients (4 male, 1 woman) with UPJO (left side: 3 cases, right side: 1 case, bilateral: 1 case) with a mean age of 3 months (range, 10 days to 7 months). Four cases had resistant UPJO and 1 case relapsed UPJO. After the procedure, and during the follow-up period of 12 months (range, 9-18 months), no further treatment was necessary. Four patients had improvement of hydronephrosis, with normal relative renal function (RRF). One patient (RRF 18% before treatment) did not improve. No periprocedural complications occurred. CONCLUSIONS Cutting-balloon retrograde endopyelotomy seems to be a treatment with encouraging early results for resistant and relapsed UPJO, after a prior RHPBD. We believe that further clinical evaluation is needed to confirm these findings.
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Affiliation(s)
- N Carrera
- Hospital General Universitario Gregorio Marañón, Madrid.
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Parente A, Angulo J, Romero R, Rivas S, Corona C, Tardáguila A. Toxina botulínica en el fracaso del cierre de derivaciones urinarias altas. Actas Urol Esp 2011. [DOI: 10.4321/s0210-48062011000700009] [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: 11/11/2022]
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Rivas S, Romero R, Parente A, Fanjul M, Angulo J. Simplificación del tratamiento quirúrgico del pene oculto. Actas Urol Esp 2011. [DOI: 10.4321/s0210-48062011000500011] [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: 11/11/2022]
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Ferrara L, Dosi R, Di Maro A, Guida V, Cefarelli G, Pacifico S, Mastellone C, Fiorentino A, Rosati A, Parente A. Nutritional values, metabolic profile and radical scavenging capacities of wild asparagus (A. acutifolius L.). J Food Compost Anal 2011. [DOI: 10.1016/j.jfca.2010.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rivas S, Romero R, Parente A, Fanjul M, Angulo J. [Simplification of the surgical treatment of a hidden penis]. Actas Urol Esp 2011; 35:310-4. [PMID: 21453989 DOI: 10.1016/j.acuro.2010.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Accepted: 08/09/2010] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The treatment of a hidden penis consists of completely and effectively exteriorizing the penile shaft from a functional and aesthetic point of view. PATIENTS AND METHODS Over a period of 15 months (02/2008-05/2009), we treated 7 children (mean age 4.6 years) with hidden penis (five had a buried penis, one had a webbed penis and another a trapped penis) using the Borsellino reconstruction technique modified with an "S" dorsal incision. We performed a pubic lipectomy in one patient through the same incision. Surgical indication was for aesthetic reasons in all the cases, secondary phimosis in four, repeated balanitis in one and pain in another. RESULTS Hospital stay was 24 hours. With a short-term follow-up (1-12 months), we detected the following complications: partial recurrence, post-surgical lymphedema and hypertrophic scarring, each of them in one case. Patients and parents were satisfied with the result. CONCLUSIONS The technique that we present achieves good cosmetic results and has few immediate complications. The substitution of the two dorsal incisions with one "S" incision allows simultaneous lipectomy without the need for another incision.
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Romero RM, Rivas S, Parente A, Fanjul M, Angulo JM. [Injection of botulinum toxin (BTX-A) in children with bladder dysfunction due to detrusor overactivity]. Actas Urol Esp 2011; 35:89-92. [PMID: 21256633 DOI: 10.1016/j.acuro.2010.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 04/22/2010] [Revised: 08/08/2010] [Accepted: 08/31/2010] [Indexed: 11/30/2022]
Abstract
INTRODUCTION bladder dysfunction causes urinary incontinence and kidney damage in children. When treatment with anticholinergics and intermittent bladder catheterization fails, the alternative therapy is bladder augmentation. PATIENTS AND METHODS between 2005 and 2009, a prospective study was carried out with Botox(®) injected into the detrusor of children suffering from high-pressure bladder despite anticholinergic treatment. We assessed their urodynamic, clinical and radiological evolution prior to and at 4 weeks, 6 months and 1 year after the injection (10 u/kg of weight up to 300 u). Reinjection was indicated in the event of clinical or urodynamic worsening. We employed the Wilcoxom test to statistically analyze the urodynamic parameters. RESULTS 12 patients were treated, 11 with neurogenic bladder (91.7%) and 1 with posterior urethral valves (8.4%). The mean age was 12.6 (4.3-17.8) years and follow-up took place after 40.8 (16.9-45-7) months. Bladder capacity, detrusor accommodation and pressure improved after 4 weeks in all the patients except in 2 (16.7%). This improvement decreased after 6 months, although successive injections produced similar changes. One patient (8.3%) received 1 dose, six (50%) two doses and five (41.7%) received three. Clinical and urodynamic improvement in 8 patients (66.7%) prevented bladder augmentation. CONCLUSIONS repeated botulinum toxin injection in the detrusor is a therapeutic instrument for high pressure and low accommodation bladders in children. It could replace bladder augmentation in some cases, however further studies with long-term follow-up care are required to appropriately evaluate its safety and effectiveness.
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Affiliation(s)
- R M Romero
- Sección de Urología Infantil, Servicio de Cirugía Pediátrica, Hospital Materno Infantil Gregorio Marañón, Madrid, España.
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Romero R, Rivas S, Parente A, Fanjul M, Angulo J. Es la inyección de Toxina botulínica-A en el detrusor una alternativa a la ampliación vesical en niños. Actas Urol Esp 2011. [DOI: 10.4321/s0210-48062011000200006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Romero R, Rivas S, Parente A, Fanjul M, Angulo J. Injection of botulinum toxin (BTX-A) in children with bladder dysfunction due to detrusor overactivity. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s2173-5786(11)70025-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Corona C, Cañizo A, Cerda J, Fanjul M, Carrera N, Tardáguila A, Zornoza M, Parente A, Angulo JM, De Tomás E, Molina E, Peláez D, García Casillas MA, Rivas S, Romero R, Marín MC. [Phimosis: dorsal slit or circumcision?]. Cir Pediatr 2011; 24:51-54. [PMID: 23155652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Phimosis is perhaps one of the most frequent consultation on pediatric surgery clinics throught the world. The aim of this study is to compare the two procedures more frequently performed in our hospital: dorsal slit and circumcision. PATIENTS Y METHODS: Retrospective study of 1698 patients who were admitted for elective surgical treatment of phimosis between 2003 and 2009. We analyzed age, surgical and anesthethic times, surgical technique and complications. We also did transversal descriptive study through telephonic survey on parents and patients older than 16 years old. RESULTS There was 76.6% of dorsal slit (n = 1300) and 23.4% (n= 398) of circumcisions. Mean age was 7.15 years y mean time of follow up was 42.3 months. Surgical time was significantly higher in circumcision (p < 0.0001). There were 3% (n = 51) of reoperations, no differences between groups. We didn't find differences in postoperative stenosis, but bleeding was more frequent in circumcision group (1.7%; p = 0.03). There were no differences on parental appreciation of postoperative pain, or functional and esthetic satisfaction between groups. CONCLUSIONS We didn't find differences on subjective satisfaction between groups. Even if there are differences n postoperative bleeding, global incidence is very low. In our experience both techniques are valid and safe, so surgeon and parents must jointly make the decision.
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Affiliation(s)
- C Corona
- Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid.
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Corona C, Cañizo A, Cerda J, Laín A, Fanjul M, Carrera N, Tardáguila A, García-Casillas MA, Parente A, Molina E, Matute JA, Peláez D. [Percutaneous gastrostomy: when should antireflux surgery be associated?]. Cir Pediatr 2010; 23:189-192. [PMID: 23155668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Percutaneus gastrostomy placement is a procedure widely performed in children with failure to thrive or intolerance to oral feeding. At the moment of making the indication, the need of an antir-reflux surgery in the same procedure comes to question. The aim of this study was to analyse which preoperative factors are associated with a higher risk of a posterior fundoplication. MATERIAL AND METHODS We realized a retrospective review of 67 patients divided in 2 groups (cases and controls) in which a percutaneus gastrostomy (PEG) had been made by our service in the period of 1997 to 2008. We compared these two groups: Group A (n=11) - patients with severe gastroesophageal reflux who required a Nissen procedure afterwards; Group B (n=56) - patients who kept without reflux after PEG. We analyzed the different preoperative factors that could have been in association to severe reflux after gastrostomy. RESULTS Mean age at the moment of undergoing PEG was 15 months. Mean time of follow up was 3,5 years. Only neurological impairment and documented reflux pregastrostomy were associated with the need of an antirreflux surgery after PEG. CONCLUSIONS Neurological impairment and documented pregastrosotmy GER could be an indication of concurrent antirreflux surgery at the time of gastrostomy.
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Affiliation(s)
- C Corona
- Hospital Materno Infantil Gregorio Marañón, Madrid.
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Carrera N, Cerdá JA, Cañizo A, Parente A, Laín A, Fanjul M, Corona C, Molina E, de Tomás E, Vázquez J. [Hypertrophic pyloric stenosis: comparison between transversal and supraumbilical incision]. Cir Pediatr 2010; 23:77-81. [PMID: 21298914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND/PURPOSE The treatment of hypertrophic pyloric stenosis is the Fredet-Ramstedt pyloromyotomy. It is controversial what surgical approach to choose. We evaluate our outcome with the right upper quadrant (RUQ) and the supraumbilical (SU) approach. METHODS Between 2003 and 2007, we performed 38 pyloromyotomies through a RUQ incision and 18 through a SU approach. We analyze patient demographics and pre and postoperative data. We group the complications in major (duodenal perforation, inadequate pyloromyotomy, and wound dehiscence) and minor (seroma, hematoma, wound infection and incisional hernia). A nonrandomized comparison was performed between the two groups. RESULTS We find significant differences in morbidity: 22.2% of major complications ocurred in the SU group versus 2.6% in the RUQ group, and 44.4% of minor complications were encountered in the SU group versus 2.6% in the RUQ group (P < 0.005). CONCLUSIONS In our study we found a significantly higher overall complication rate in the SU group (p < 0.005), possibly because of a more difficult delivery of the pylorus through the SU incision and because of a probably increased rate of wound infection associated with the supraumbilical approach in the pediatric population.
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Affiliation(s)
- N Carrera
- Hospital General Universitario Gregorio Marañón, Madrid.
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Sedda A, Manfredi V, Parente A, Bottini G. Motion influences emotion, but also structural facial features recognition. Behav Neurol 2010; 23:253-4. [PMID: 21422568 PMCID: PMC5434324 DOI: 10.3233/ben-2010-0308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A. Sedda
- Psychology DepartmentUniversity of Paviapiazza Botta 627100 PaviaItaly,*A. Sedda:
| | - V. Manfredi
- Psychology DepartmentUniversity of Paviapiazza Botta 627100 PaviaItaly
| | - A. Parente
- Psychology DepartmentUniversity of Paviapiazza Botta 627100 PaviaItaly
| | - G. Bottini
- Psychology DepartmentUniversity of Paviapiazza Botta 627100 PaviaItaly,Cognitive Neuropsychology CenterNiguarda Ca' Granda HospitalMilanItaly
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Menéndez C, Fariñas M, Parente A, Laín A, Fanjul M, Chimenti P, Carrera N, Huerga A, Corona C, Marsinyach I, Cañizo A, Villar S, Sánchez-Luna M, Vázquez J. [Long-term results of patients with congenital diaphragmatic hernia]. Cir Pediatr 2009; 22:205-209. [PMID: 20405656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE Introduction of advanced therapeutic modalities for diaphragmatic congenital hernia (CDH) has allowed to reach considerable improvements in survival rate. Nevertheless, there are few studies which analyze the clinical evolution of the long-term survivors. The aim of this work is to analyze the outcomes of the patients with CDH in our hospital. METHODS Fifty-five neonates with CDH were treated in our center between 1998 and 2005. We included in the study those patients that were alive at the moment of first hospital discharge (72%; n=40 patients). ECMO therapy was needed in 6 of them during neonatal treatment. A descriptive transverse review of the clinical record as well as a telephonic interview to the parents was performed for the respiratory, cardiological, digestive and neurological conditions, following standard diagnostic studies in every case. The mean age of the children in the moment of the study was 4.2 years (1-9). RESULTS The 8.3% of the children needed domiciliary oxygen therapy during a maximum of 3 months in all the cases. 22% of the cases suffered from respiratory problems, being bronchiolitis and pneumonia the most frequent diagnoses. Only a patient developed asthma. The gastroesophageal reflux is the most frequent long-term condition (47%), but only 8.3% needs surgical treatment. Regarding to cardiological problems, 14% developed pulmonary hypertension, being slight - moderate in all the cases but in one case who was the only deceased of the series. Regarding to neurological problems only 1 patient developed serious alterations (brain paralysis), having suffered a hemorrhage parenquimatosa during the treatment with ECMO. No other patient presents motor, visual nor auditory alterations in the development, last mild alteration in language (4 patients). Differences do not exist with the group of patients that did not need ECMO during the treatment in cardiological and digestive complications, being higher percentage with respiratory problems. CONCLUSION In our sample only 2 patients present serious sequels (5%). Of this preliminary study we can conclude that the comorbility in the CDH is very low having these patient a good development and good quality of life.
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Affiliation(s)
- C Menéndez
- Servicio Neonatología, Hospital Infantil Gregorio Marañón, Madrid
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Fanjul M, García-Casillas MA, Laín A, Matute JA, Parente A, Corona C, Vázquez J. [Prognostic value of pH and glucose in complicated parapneumonic pleural effusion]. Cir Pediatr 2009; 22:173-176. [PMID: 20405648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION AND AIMS Although the incidence of emphyema is increasing it continues to be a widely debated pathology in relation to its management. We analyzed the last 36 cases treated by our service in the last 2 years. MATERIAL AND METHODS We retrospectively studied the last 36 cases of parapneum6nic pleural effusions that needed some type of treatment at our service from March, 2005 to May, 2007. For this we analyzed: average age, time of evolution before admission to hospital, time of evolution from admission to surgery, location of the pneumonia, echographic characteristics, value of the pH and glucose, the relation between the presence of echoes in the ultrasound scan with the value of the pH and of the glucose, the relation between value of the pH and glucose with the evolution, type of treatment and evolution. We used for the statistical study ANOVA's test and paired t-test and the student's T test. RESULT The average age was 5.4 years (range 9 months-15 years). The average time of evolution prior to admission to the hospital was 5.6 days (range 0.5-20 days) and the average time from admission to surgery was 5.1 days (range 0-65 days). The pneumonia was multilobar in 38.2% of the cases, in low lobes in 52.9% (29.4% in the left lower lobe and 23.5% in the right lower lobe). Ultrasound scan was performed in 97.2% of the patients, being severely septated in 31.4% of the cases, clear liquid 25.7%, moderately septated 22.8% and minimally septated 17.1%. The pH was analyzed in 69.4% of the effusions, the average value being 7.16 (range 6.75-7.45). The glucose was analyzed in 61.1% of the effusions, the average value being 61.1 (range 1-123). Septated effusions in the ultrasound scans were related to the lowest values of pH and glucose (p = 0.0001 in both cases). When we analyzed the relationship between clinical evolution and the pH we observed that a lower value of pH was related to a worse evolution, finding that pH values below 7 are related to a bad evolution (p = 0.001). The same results were found when we analyzed the relationship between the evolution and glucose (p < 0.005). CONCLUSIONS The pH and the glucose in complicated parapneumonic pleural effusion have a pronostic value for evolution, regardless of what treatment was used. We found that pH values below 7 are related to a bad evolution.
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Affiliation(s)
- M Fanjul
- Servicio de Cirugía Torácica y Vía Aérea, Hospital infantil Gregorio Marañón, Madrid.
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Laín A, García-Casillas MA, Matute JA, Parente A, Fanjul M, Corona C, Vázquez J. [Analysis of the surgical treatment of complex subglottic stenosis]. Cir Pediatr 2009; 22:197-200. [PMID: 20405654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION The management of complex subglottic stenosis is difficult, existing different surgical techniques for its treatment, depending on type and grade of stenosis, comorbidities and the state of the patient. We studied the management of the complicated patients in our centre analyzing the applied treatment, the type and grade of stenosis, and the results in order to develop a treatment protocol of complex subglottic stenosis. MATERIAL AND METHODS Of a total of 120 patients diagnosed of subglottic stenosis in follow-up in our centre we retrospectively reviewed 15 patients (5 boys, 10 girls; medium age 1.63 years, range 0.05 to 13 years) who had suffered mayor complications and who had required reinterventions (1 to 6). We analyzed the employed techniques in relation to the observed complications and the previous treatment, the results and the decanulation index. All diagnoses were established by fiberbronchoscopy and the initial treatment was realized following the actuation guidelines of Cotton. RESULTS The global decanulation index in this group of patients was 80%. The patients in who initially a anterior cricoid split had been done and who developed a subglottic stenosis grade III were 8. Rescue treatment consisted in anterior laringotracheoplasty in 7 cases managing decanulation in 6 patients (75%). The medium number of reinterventions was 2.5. Patients treated initially with Laser (n=4) developed a subglottic stenosis grade III in two cases and grade IV in the rest. Subglottic stenosis grade IV were corrected by cricotracheal resection and subglottic stenosis grade IV by anterior laringotracheoplasties with a medium reoperation Lumber of 1.25. All patients achieved decanulation (100%). Failed anterior laringotracheoplasties with cartilaginous grafts (n=2) developed grade III subglottic stenosis, one was treated with a double laringotracheoplasty and the other with a cricotracheal resection reaching decanu-lation in both patients (100%). Reintervention number was one to four. Only one cricotracheal resection as initial treatment failed. This patient required 3 reinterventions not being decanulation possible (0%). CONCLUSIONS Patients with complex subglottic stenosis often require more than one reintervention until reaching decanulation. Decanulation index in these patients is satisfactory. The development of a management protocol for these cases is very difficult and treatment should be individualized.
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Affiliation(s)
- A Laín
- Servicio Cirugía Pedidtrica, Unidad Cirugía Vía Aérea y Cirugía Torácica, Hospital Infantil Gregorio Marañón, Madrid.
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Severino V, Paiardini A, Pascarella S, Parente A, Chambery A. Structural analysis of toxic volkensin, a type 2 ribosome inactivating protein from Adenia volkensii Harm (kilyambiti plant): molecular modeling and surface analysis by computational methods and limited proteolysis. Int J Biol Macromol 2009; 45:407-13. [PMID: 19591862 DOI: 10.1016/j.ijbiomac.2009.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Revised: 06/29/2009] [Accepted: 06/30/2009] [Indexed: 11/24/2022]
Abstract
Volkensin, isolated from Adenia volkensii, is one of the most toxic type 2 ribosome-inactivating protein (RIP), exerting its biological function by inhibiting protein synthesis. Despite the high sequence identity with type 2 RIPs, including ricin, volkensin shows interesting peculiar properties. In this work a computational model building of volkensin was performed. The volkensin electrostatic potential charge distribution, the hydrophobic profile and the surface topology analyses were also carried out to aid the understanding of structure-function relationships of this potent toxin. Volkensin surface topology was probed by applying a limited proteolysis approach with the aim to gain insights into volkensin conformational features.
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Affiliation(s)
- V Severino
- Dipartimento di Scienze della Vita, Seconda Università di Napoli, I-81100 Caserta, Italy
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Parente A, Cañizo A, Huerga A, Laín A, Fanjul M, Carrera N, Corona C, Fariñas M, Menéndez C, Cerdá J, Molina E, Vázquez J. [Is it correct to use neonatal intensive care units as operating rooms?]. Cir Pediatr 2009; 22:61-64. [PMID: 19715126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM The neonatal intensive care unit (NICU) is used in many centres as operating room in order to avoid the co-morbidities that there produces the movement of critical patients. The motive of this work is to analyze the advantages and disadvantages of this type of surgical interventions. METHODOLOGY Between January, 2004 and December, 2007 405 newborns were operated in the NICU. The most frequent surgical realized interventions were: deferred closing breastbone (172), placement of ECMO (42), ligation of patent ductus arteriosus (45), laparotomies for necrotising enterocolitis (27), repair of congenital diaphragmatic hernia (20), plicate of diaphragms (5) and closing of gastroschisis (4). We realize a retrospective study of a group of 40 patients operated by diaphragmatic hernia and necrotising enterocolitis in the UCIN (group A) and compare them with a group of patients operated in the operating room with the same pathology (group B). We study 22 variables preoperatory, intraoperatory and postoperatory. For the statistical analysis T-student and Chi-square was in use, being considered to be statistically significant p < 0.05. RESULTS The average ages of the patients to the intervention were 11.1 +/- 8 days being the predominant sex the masculine one (60 %). The age gestational and the average weight for the group A was 31.9 +/- 5.7 weeks and 1,735 +/- 123 grams being for the group B of 34 +/- 3.5 weeks and 2,037 +/- 728 grams respectively (p = N.S.). 89.3% of the patients of the group A was with intubation orotracheal before the surgery, being 57.2% for the group B. The needs of high frequency ventilation and vasoactives drugs were higher for the group A (p < 0.01) and the operative time was similar in both groups (81 +/- 34 vs. 98 +/- 33 minutes). We find a difference of corporal temperature pre-post surgery of 0.60 +/- 0.48 degrees C for the group A and 2.18 +/- 0.93 degrees C in the B (p < 0.01). We don't estimate differences as for episodes of infection of wound, intraabdominal infection or need of reintervention. The survival of the patients was discreetly higher for the group operated in the operating room (82.3%) with regard to the group operated in the NICU (60%) without statistically significant differences existed. CONCLUSIONS In our experience the NICU is a suitable place to realize surgical interventions in critical patients. The higher mortality for the group controlled in the UCIN explains for a major instability preoperatory. The maintenance of the corporal temperature avoiding the hypothermia it's one of the decisive factors to diminish the morbi-mortality.
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Affiliation(s)
- A Parente
- Servicio Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid.
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Fanjul M, Molina E, Cerdá J, Parente A, Laín A, Cañizo A, Carrera N. [Characteristics of the anorectal atresia without fistula. Based on 12 cases]. Cir Pediatr 2009; 22:45-48. [PMID: 19323083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Imperforate anus without fistula is an uncommon anorectal malformation, in association to Down syndrome in 50% of cases. This anomaly is described as a lack of annus, with a blind rectal pouch, located about 2 cm above perineal skin, and sharing a common wall with the urethra or vagina. The aim of this work is to present our experience in this condition and to determine the differences between the diagnosis, treatment and long-term outcome of these patients in relation to other forms of anorectal malformation. MATERIALS AND METHODS We reviewed the medical records of 12 patients treated in our department from 1998 to 2008. Eight were boys and 4 girls. Eleven of these patients had significant associated congenital diseases: Down syndrome (6), cardiovascular anomalies (6), urinary tract malformations (5), esophageal atresia (1). In all cases neonatal colostomy was performed, being 7 months (range between 1 and 19 months) the average age of the definitive surgery through posterior sagital approach. In one case a laparotomy was performed. The distance from the rectal pouch to the skin ranged from 1 to 5 cm, founding a very dilatated rectum in 4 patients. RESULTS The postoperative outcome was favorable. Four patients required removal of a small anal prolapse. All patients older than 2 years (7) have urinary continence, while 5 of them have a significant constipation, resistant to treatment with diet and laxatives, requiring medical management with enemas. CONCLUSIONS Our study confirms the high incidence of Down syndrome in patients with imperforate anus without fistula, and shows a higher incidence of other congenital comobidities. A colostrogram prior to definitive repair seems to be mandatory taking into account the intraopetative findings (height and diameter of rectal pouch). The incidence of anal prolapse is very high and may be related to the hypotonia present in patients with Down syndrome. Since the constipation is very severe in these patients, it should be controlled early in the follow up.
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Affiliation(s)
- M Fanjul
- Servicio de Cirugía Pediátrica, Hospital infantil Gregorio Marañón, Madrid.
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Laín A, García-Casillas MA, Matute JA, Cañizo A, Parente A, Fanjul M, Carrera N, Vázquez J. [Tracheal stenosis: outcome analysis of the last 14 years]. Cir Pediatr 2008; 21:138-142. [PMID: 18756866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
UNLABELLED Tracheal stenosis (TS) is an unusual and sometimes lethal condition. It's treatment is basically surgical and different techniques have been proposed. AIM Analyze the outcome of patients with TS diagnosed and treated in our institution realted to the applied surgical technique during the study period. MATERIAL AND METHODS The clinical records of patients with TS (period 1991 to 2006) were reviewed analyzing the following variables: age, gender, associated malformations, intubation time, medium hospital stay and outcome. Patients were divided in 4 groups: conservative and endoscopic management (2 conservative, 1 dilatation, 1 laser), tracheal resection with termino-terminal anastomosis (RTA) (9 patients), tracheoplasties (slide or modified plasties) (20 patients) and anterior tracheoplasty with costal cartilage graft (TAIC) (6 patients). Results are expressed as media +/- standard error, comparative analysis was done using Chi square with continuity correction. Differences were considered statistically significant with a p < 0.05. RESULTS 39 patients were reviewed (23 male, 16 female), medium age was 2.23 years. Associated malformations were: 12 vascular rings, 7 cardiac malformations, 4 Down syndromes, 1 pulmonary agenesia, 2 hemivertebtebrae, 1 renal agenesia and 1 cervicothoracic angiomatosis. Nineteen patients had short segment stenosis, 15 long segment stenosis (more than 1/3 of tracheal length) and 5 patients presented associated bronchial stenosis (most frequently right main bronchus). All TAIC failed: 4 deaths, 1 reestenosis and 1 persistent stenosis. In the tracheoplasty-group there were 2 exitus (1 due to a neurological lesion after a prolonged preoperative cardiorrespiratory arrest, one due to a surgical treatment delay with previous inadequate management). Patients treated with tracheoplasties and RTA had a favourable evolution and are asymptomatic in more than 80% of the cases after a mean follow-up of 59.9 +/- 7.4 months. In the conservative management group 2 patients died and 2 had a uneventful outcome. Global mortality was 20.5% (8 deaths). Differences observed in the mortality percentage between the study groups were statistically significant. (p = 0.0034) (50% in conservative management, 0% in RTA, 10% in tracheoplasties, 66.67% in TAIC). No statistically significant differences were found in the medium intubation time, medium hospital stay and medium follow-up time. CONCLUSIONS The fundamental treatment of the tracheal stenosis is the surgical approach. Patients should be studied with great detail taking into account associated malformations (mostly heart defects and vascular rings) and should be treated by a multidisciplinary group. Short segmental TS should be corrected with RTA, long TS with tracheoplasties (slide), remaining the TAIC technique obsolete.
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Affiliation(s)
- A Laín
- Unidad de Cirugía Torácica y Vía Aérea, Servicio de Cirugía Pediátrica, Hospital Gregorio Marañón, Madrid.
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Fanjul M, García-Casillas MA, Parente A, Cañizo A, Laín A, Matute JA, Vázquez J. [Diode laser application for the treatment of pediatric airway pathologies]. Cir Pediatr 2008; 21:79-83. [PMID: 18624274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
UNLABELLED Laser application for the treatment of pediatric airway pathologies represents a very attractive option because of the limited inflammatory reaction after photocoagulation. One novel laser used for such pathologies is the diode laser. AIM The purpose of this report is to present our preliminary experience in the use of diode laser in the treatment of pediatric airway lesions. METHODS A retrospective review of 22 patients (11 males and 11 females) who underwent laser procedures from 1999 to 2006 was performed. Nineteen patients were treated at our center while 3 were referred after a laser application from other institution. In all procedures flexible bronchoscopy was used. The mean age was 1.25 years (range 1 month-4.8 years). Lasers were applied for various lesions: laryngomalacia and arytenoid lesions (n = 5), angiomas (n = 3), lymphangiomas (n = 3), sacular cyst and other mucous lesions (n = 3), granulomas, scarring lesions (n = 4) and paralysis of vocal cord in adduction (n = 1). RESULTS None of the patient developed complications related to the endoscopic laser application. The mean number of laser therapy attempts were 1.4 per patient (range 1-3). The patients remained intubated for a mean of 2.8 days (range 4 hours-13 days) after the procedure. The duration of PICU stay after laser therapy was a mean of 4.6 days (range 1-8 days). The best outcomes were seen in sacular cysts (excelent in 3 patients). Also, all 3 patients with granulomas showed a good response to treatment. Multiple laser sessions (1-3; mean 1.4) were required to sucessfully manage the artynenoid lesions. However, the children with vascular lesions demonstrated differents outcomes. Of the 3 patients with subglottic angioma, 2 underwent a subsequent surgical procedure due to the development of subglottic stenosis; and one requiered further systemic steroid therapy. Of the children with lymphangioma, one needed 3 laser sessions and two required surgi- cal resections. Despite laser treatment, 3 of the 4 patients with scarring lesions required surgery. CONCLUSIONS The endoscopic application of diode laser for the management of pediatric airways lesions provides good outcomes in selected patients. Sacular lesions, granulomas and arytenoid lesions are, in our experience, excellents indications. In other anomalies laser is a good adjuvant. The application of laser should be tailored according to the pathology.
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Affiliation(s)
- M Fanjul
- Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid.
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Laín A, Parente A, Cañiizo A, Fanjul M, García-Casillas MA, Matute JA, Vázquez J. [Modified "trap-door" thoracotomy for pediatric patients]. Cir Pediatr 2008; 21:111-115. [PMID: 18624282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Surgical approach of the cervicothoracic junction has been traditionally done by cervicotomy and/or thoracotomy. Nevertheless, this access does not allow a suitable control of vasculonervous structures. Due to this we present our experience with a variation of the "Trap-door" thoracotomy which gives the best access to this area applied to pediatric patients METHODS We present 4 patients of 2.8 +/- 1.9 years of age treated in our hospital by a cervicothoracotomy transmanubrial approach without clavicular luxation. One patient presented a stage IV cervicothoracic neuroblastoma, 1 patient had a cervicothoracic lymphangioma, one a severe cervicothoracic scoliosis and one a total cricoid atresia associated to an oesophageal atresia type IIIc (Vogt). This surgical approach allowed a perfect control of brachiocefalic and nervous structures as well as a correct visualization of all the cervicothoracic intervertebral foramina. Postoperative pain was controlled by epidural catheters, oral analgesic treatment was introduced in the fifth postoperative day. RESULTS Complete resection and surgical treatment was possible in all patients, not being necessary the section of any vascular or nervous structure. There were no intraoperatory or postoperative complications. One patient presented a temporary Homer's syndrome. No tumoral recurrence has been noted after a mean follow-up of 2.3 +/- 3.1 years. CONCLUSION. The modified "Trap-door" approach allows a good control of the brachiocephalic structures and a complete visualization of the upper thorax and posterior mediastinum. Due to its low morbidity this access may be very useful since it allows an important vascular control and an excellent surgical field. Our modification of the "Trap-door" approach avoids clavicular luxation and has the advantage of no sequelaes in the functionality of the escapulo-humeral articulation.
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Affiliation(s)
- A Laín
- Servicio Cirugía Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid.
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Cañizo A, Fanjul M, Cerdá J, Menárguez J, Parente A, Laín A, Carrera N, Rodríguez-Arnao MD, Rodríguez-Sánchez A, Polo JR, Vázquez J. [Is immediate prophylactic thyroidectomy indispensable in familiar medullary thyroid carcinoma?]. Cir Pediatr 2008; 21:100-103. [PMID: 18624279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE To emphasize the importance of genetic studies in family members and early prophylactic thyroidectomy in oncogene mutation carriers in the management of familiar medullary thyroid carcinoma. METHODS A retrospective review of families with familiar medullary thyroid carcinoma treated at our center in the last 7 years was performed. We identified a total of 7 families who has isolated prevalences with thyroid malignancies. Forty members of the 7 families were screened for gene RET mutations. Prophylactic total thyroidectomy was performed in every RET mutation gene carriers. RESULTS In all families the index case were patients with medullary thyroid carcinoma presenting at a mean age of 37.25 years (range 23-42). The RET oncogen mutation was in codon 634 in exon 11 (multiple endocrine neoplasia type 2A) in all these patients. Fourteen gene carriers were identified with a mean age of 20 years (range 7-37), eleven of whom had medullary thyroid carcinoma at the time of surgery. Five of the gene carriers were children, with a mean age of 11 years (range 7-16), four of whom had microcarcinoma and one had metastatic carcinoma at the time of surgery. After surgery no hypoparathyroidism or recurrent nerve paralysis were documented. No pediatric patient has presented with phaeochromocytoma or hypoparathyroidism to date Four of the five children have normal calcitonin levels (< 2 pg/ml) and they are free of disease. The one who presented metastatic carcinoma has recurrent disease and is awaiting surgical treatment. CONCLUSIONS Genetic studies of family members related to patients with familiar medullary thyroid carcinoma and RET mutations is indispensable. The RET mutation in codon 634 exon 11 was found to be the most frequent association. Prophylactic thyroidectomy is the only curative treatment and has minimal complications when performed by expert surgeons. Early thyroidectomy is recommended since distant metastatic spread can occur at early age.
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Affiliation(s)
- A Cañizo
- Servicio de Cirugía Pediátrica, Hospital infantil Gregorio Marañón, Madrid.
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Chambery A, Severino V, D’Aniello A, Parente A. Precursor ion discovery on a hybrid quadrupole–time-of-flight mass spectrometer for gonadotropin-releasing hormone detection in complex biological mixtures. Anal Biochem 2008; 374:335-45. [DOI: 10.1016/j.ab.2007.11.017] [Citation(s) in RCA: 9] [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] [Received: 09/20/2007] [Revised: 11/08/2007] [Accepted: 11/12/2007] [Indexed: 11/16/2022]
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Parente A, Molina E, Cerdá J, Cañizo A, Rodriguez A, Laín A, Fanjul M, Vázquez J. [Neovagina with intestine: 13 cases]. Cir Pediatr 2008; 21:37-42. [PMID: 18444389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION The absence or hipoplasia vaginal can turn out to be isolated, associated with ambiguous genitalia, or as anatomical variant in a syndrome of sewer. The fundamental aim in the creation of a new vagina is: to obtain a good aesthetic result, to fulfil functional criteria (elasticity, sensibility, physiological inclination) and to improve the quality of life of the patients avoiding the use of molds and minimizing the morbidity of the zones donors. In this work let's sense beforehand our experience in the accomplishment of neovaginas with intestine. AIM AND METHODS We analyze the clinical record of 13 patients treated surgically in the last ten years. We differentiate two groups according to the age, the diagnosis and the type of surgery: a) the first group of 8 patients present syndrome of insensibility to the androgens (4), syndrome of Rokitansky (2), extrofia of sewer (1) and mixed gonadal disgenesia (1). This group of patients were controlled in the adolescence by an average of age of 19 years (11-35 years), they fulfilling a neovagina with sigma; b) the second group of 5 patients with sewer (3), extrofia of sewer (1) and congenital suprarrenal hiperplasia (1). This group was controlled prematurely by a middle ages of one year (4 months-3 years). The intestinal segment used as neovagina was sigma (2), ileon (2) and rectum (1), and was performed during the surgical correction of her congenital malformation. RESULTS Two patients have presented intestinal obstruction in the postoperatory immediate one. Four patients have needed removal of a small vaginal prolapse, and three have needed vaginal transitory expansions for introit stenosis. The long-term evolution has been favorable with an excellent aesthetic aspect. Four patients recount sexual fully satisfactory relations. CONCLUSIONS We believe that the neovagina with sigma is at present the best option in patients with absence or hipoplasia vaginal. The advantages are the possibility of precocious and one time correction, a neovagina of dimensions and oiling adapted without need of expansions or molds, an aesthetic excellent aspect, and sexual satisfactory sexual relations.
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Affiliation(s)
- A Parente
- Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid
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Laín A, Cerdá J, Cañizo A, Parente A, Fanjul M, Molina E, Romero R, García-Casillas MA, Matute J, Peláez D, Vázquez J. [Analysis of esophageal strictures secondary to surgical correction of esophageal atresia]. Cir Pediatr 2007; 20:203-208. [PMID: 18351240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
UNLABELLED Oesophageal Stricture (ES) is one of the most frequent complications of oesophageal atresia repair surgery. The treatment consists of dilatation of the stricture. Mostly more than one procedure is necessary for its correction. AIM Present our experience in balloon dilatation in the treatment of ES post-correction of oesophageal atresia. PATIENTS AND METHODS A retrospective study of 34 children diagnosed and treated of oesophageal atresia was done. In all cases the surgical repair included a termino-terminal oesophageal anastomosis. Prevalence of ES (requiring dilatation), number of necessary dilatations, time between the correcting atresia surgery and the first dilatation, time between the first and the last dilatation and complications were analyzed. Dilatations were done under direct radioscopic control with general anesthesia using balloons of 6 to 20 mm diameter. Afterwards esophageal lumen was checked by oral endoscopy. RESULTS Thirty-four patients were studied (19 male, 16 female) with a medium weight of 2474 g (rango 1800 to 3300 g). Twenty-nine patients had a type III oesophageal atresia (Vogt classification) which was corrected in their first 24-48 hours of life, five patients had a type I oesophageal atresia and repair surgery was done with a medium age of five months. All patients received medical treatment for the gastroesophageal reflux and 11 patients needed a surgical antireflux surgery. Sixty-eight endoscopic procedures were done. Seventy-nine % of the children required some endoscopic dilatation (27 patients) and received an average of 2.5 dilatations (1 to 8 dilatations): 55.5% between 1 and 2 dilatations, 37% between 3 and 4, and 7.5% more than 5. The first dilatation took place in the average of 49.4 days post-correction surgery (15 days to 1 year). The medium time interval between the first dilatation and the last one was 131 days, although in more than 50% of the cases it did not reach 2 months. Only 2 oesophageal perforations were observed (2.3% of the dilatations), one of which had a favourable outcome with conservative management and the second one required surgery. All patients except for one are alive at this time and in more than 90% of the cases they have a complete and normal oral intake. CONCLUSIONS Es requiring dilatations after oesophageal atresia repair are a frequent problem, appearing generally in an early period. Balloon dilatation under radioscopic control is an efficient and safe procedure for its treatment. Usually more than 1 dilatation is needed being the time period between two dilatations small. We think that associated medical antirreflux treatment is necessary in all cases, but only in specific cases surgical management of the gastroesophageal reflux.
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Affiliation(s)
- A Laín
- Servicio Cirugía Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid.
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Laín A, Fanjul M, García-Casillas MA, Parente A, Cañizo A, Carreras N, Matute JA, Vázquez J. [Airway foreign bodies removal with flexible bronchoscopy in children]. Cir Pediatr 2007; 20:194-198. [PMID: 18351238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Aspiration of foreign bodies in children is a frequent and potentially serious condition. Traditionally it has been solved by rigid bronchoscopy. Nowadays an increasing number of authors support the use of flexible bronchoscopy for its resolution. AIM Analyze our experience in airway foreign body removal in children using flexible bronchoscopy. MATERIAL AND METHODS We retrospectively analyzed 65 patients diagnosed of foreign body aspiration with a mean age of 3.65 + 3.1; 60% males and 40% females. We compared two historical cohorts of homogeneous distribution. The first one (group A), from 1994 to 1998, included 41 children treated by rigid bronchoscopy, and the second one (Group B) (1999-2006) 24 patients treated with the flexible bronchoscope. We studied: rate of success of initial extraction (RSIE), foreign body localization, type of foreign body, hospital stay, complications and mortality. Statistical analysis was done using t-student for cuantitative variables, and chi square for cualitative. Only a p < 0.05 was considered statistically significant. Data are presented as mean +/- standard error of the mean. RESULTS Group A had a medium hospital stay of 1.89 + 2.6 days. RSIE was 85.36%. Six patients needed a second therapeutic procedure (5 rigid bronchoscopies, 1 flexible brochoscopy). Complication rate was 4.87%: 2 cases of bronchitis. Group B presented a medium hospital stay of 1.34 +/- 0.27 days with a RSIE of 70.83%, needing a second intervention 7 children (4 fiberbonchoscopies, 3 rigid bronchoscopies). Postextraction complications in this group consisted of 1 bronchitis episode and a pneumothorax in 2 patients (8.33%). No deaths occurred in any group. No statistically significant differences were found in hospital stay, RSIE, type of second therapeutic procedure and complication rate. CONCLUSIONS Our experience shows that flexible bronchoscopy removal of airway foreign bodies is safe and efficient; therefore, we think that it should be taken into account as first choice method of treatment at any age.
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Affiliation(s)
- A Laín
- Servicio Cirugía Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid.
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