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Fasulo V, Buffi N, Chiarelli G, Lughezzani G, Zuradelli M, Ripamonti CB, Barile M, Bianchi P, Benetti A, Paciotti M, Uleri A, Avolio PP, Saita A, Hurle R, Maura F, Germagnoli L, Asselta R, Soldà G, Casale P, Lazzeri M. Male awareness of prostate cancer risk remains poor in relatives of women with germline variants in DNA-repair genes. BJUI Compass 2023; 4:738-745. [PMID: 37818031 PMCID: PMC10560622 DOI: 10.1002/bco2.252] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/25/2023] [Accepted: 05/07/2023] [Indexed: 10/12/2023] Open
Abstract
Abstract. Objective The aim of this study is to evaluate male awareness of developing prostate cancer (PCa) in families with germline DNA-repair genes (DRG) variants. Materials and methods Data were collected from a prospective, monocentric cohort study. The study was conducted in a university hospital with a multidisciplinary approach to the patient (collaboration of the Departments of Oncology, Urology, Pathology, Radiology, and Medical Genetics Laboratory). We recruited healthy males, relatives of families of women with breast or ovarian cancer who tested positive for pathogenic variants (PVs) or likely pathogenic variants (LPVs) in DRGs. A dedicated PCa screening was designed and offered to men aged 35 to 69 years, based on early visits with digital rectal examination (DRE), prostate health index (PHI) measurement, multiparametric magnetic resonance imaging (mpMRI) and, if necessary, targeted/systematic prostate biopsies. The primary endpoint was to evaluate the willingness of healthy men from families with a DRG variants detected in female relatives affected with breast and/or ovarian cancer to be tested for the presence of familial PVs. The secondary endpoints were the acceptance to participate if resulted positive and compliance with the screening programme. Results Over 1256 families, of which 139 resulted positive for PVs in DRGs, we identified 378 'healthy' men aged between 35 and 69 years old. Two hundred sixty-one (69.0%) refused to be tested for DRG variants, 66 (17.5%) declared to have been previously tested, and 51 (13.5%) males were interested to be tested. Between those previously tested and those who accepted to be tested, 62 (53.0%) were positive for a DRG variant, and all of them accepted to participate in the subsequent surveillance steps. The main limitation is that is a single-centre study and a short follow-up. Conclusions All men tested positive for a DRG variants agreed to go under the surveillance scheme. However, only 31% of 'men at risk' (i.e., relative of a DRG variant carrier) expressed their willingness to be tested for the familial DRG variant. This observation strongly supports the urgent need to implement awareness of genetic risk for PCa within the male population.
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Affiliation(s)
- Vittorio Fasulo
- Department of Biomedical SciencesHumanitas UniversityPieve EmanueleMIItaly
- Department of UrologyIRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - NicolòMaria Buffi
- Department of Biomedical SciencesHumanitas UniversityPieve EmanueleMIItaly
- Department of UrologyIRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Giuseppe Chiarelli
- Department of Biomedical SciencesHumanitas UniversityPieve EmanueleMIItaly
- Department of UrologyIRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Giovanni Lughezzani
- Department of Biomedical SciencesHumanitas UniversityPieve EmanueleMIItaly
- Department of UrologyIRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Monica Zuradelli
- Department of Biomedical SciencesHumanitas UniversityPieve EmanueleMIItaly
- Medical Oncology and Hematology UnitIRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | | | - Monica Barile
- Laboratory Analysis UnitIRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Paolo Bianchi
- Laboratory Analysis UnitIRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Alessio Benetti
- Department of UrologyIRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Marco Paciotti
- Department of Biomedical SciencesHumanitas UniversityPieve EmanueleMIItaly
- Department of UrologyIRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Alessandro Uleri
- Department of Biomedical SciencesHumanitas UniversityPieve EmanueleMIItaly
- Department of UrologyIRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Pier Paolo Avolio
- Department of Biomedical SciencesHumanitas UniversityPieve EmanueleMIItaly
- Department of UrologyIRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Alberto Saita
- Department of UrologyIRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Rodolfo Hurle
- Department of UrologyIRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Federica Maura
- Department of Biomedical SciencesHumanitas UniversityPieve EmanueleMIItaly
- Laboratory Analysis UnitIRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Luca Germagnoli
- Department of Biomedical SciencesHumanitas UniversityPieve EmanueleMIItaly
- IRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Rosanna Asselta
- Department of Biomedical SciencesHumanitas UniversityPieve EmanueleMIItaly
- IRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Giulia Soldà
- Department of Biomedical SciencesHumanitas UniversityPieve EmanueleMIItaly
- IRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Paolo Casale
- Department of UrologyIRCCS‐Humanitas Research HospitalRozzanoMIItaly
| | - Massimo Lazzeri
- Department of UrologyIRCCS‐Humanitas Research HospitalRozzanoMIItaly
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Saitta C, De Simone I, Fasulo V, Corbetta M, Duga S, Chiereghin C, Colombo FS, Benetti A, Contieri R, Avolio PP, Uleri A, Saita A, Guazzoni GF, Hurle R, Colombo P, Buffi NM, Casale P, Lughezzani G, Asselta R, Soldà G, Lazzeri M. Evaluation of Semen Self-Sampling Yield Predictors and CTC Isolation by Multi-Color Flow Cytometry for Liquid Biopsy of Localized Prostate Cancer. Cancers (Basel) 2023; 15:2666. [PMID: 37345004 DOI: 10.3390/cancers15102666] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/01/2023] [Accepted: 05/06/2023] [Indexed: 06/23/2023] Open
Abstract
Liquid biopsy (LB) for prostate cancer (PCa) detection could represent an alternative to biopsy. Seminal fluid (SF) is a source of PCa-specific biomarkers, as 40% of ejaculate derives from the prostate. We tested the feasibility of an SF-based LB by evaluating the yield of semen self-sampling in a cohort of >750 patients with clinically localized PCa. The overall SF collection yield was 18.2% (39% when considering only compliant patients), with about a half of the patients (53.15%) not consenting to SF donation. Independent favorable predictors for SF collection were younger age and lower prostate volume. We implemented a protocol to enrich prostate-derived cells by multi-color flow cytometry and applied it on SF and urine samples from 100 patients. The number of prostate-enriched cells (SYTO-16+ PSMA+ CD45-) was variable, with higher numbers of cells isolated from SF than urine (p value < 0.001). Putative cancer cells (EpCAMhigh) were 2% of isolated cells in both specimens. The fraction of EpCAMhigh cells over prostate-enriched cells (PSMA+) significantly correlated with patient age in both semen and urine, but not with other clinical parameters, such as Gleason Score, ISUP, or TNM stage. Hence, enumeration of prostate-derived cells is not sufficient to guide PCa diagnosis; additional molecular analyses to detect patient-specific cancer lesions will be needed.
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Affiliation(s)
- Cesare Saitta
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Ilaria De Simone
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Vittorio Fasulo
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Marinella Corbetta
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Stefano Duga
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
- Flow Cytometry Core, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Chiara Chiereghin
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | | | - Alessio Benetti
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Roberto Contieri
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Pier Paolo Avolio
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Alessandro Uleri
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Alberto Saita
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Giorgio Ferruccio Guazzoni
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Rodolfo Hurle
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Piergiuseppe Colombo
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
- Department of Pathology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Nicolò Maria Buffi
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Paolo Casale
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Giovanni Lughezzani
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Rosanna Asselta
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
- Flow Cytometry Core, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Giulia Soldà
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
- Flow Cytometry Core, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Massimo Lazzeri
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
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Lazzeri M, Fasulo V, Buffi N, Lughezzani G, Casale P, Benetti A, Saita A, Hurle R, Guazzoni GF, Chiarelli G, Asselta R, Soldà G. Awareness of genetic risk for prostate cancer (PCa) in men from families with germline mutations in DNA-repair genes. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
328 Background: Although one of the most important risk factors for prostate cancer (PCa) is a family history of the disease, there is a poor awareness of genetic risk. The aim of the current study is to investigate the awareness of genetic risk for PCa in men belonging to female families with germline variants in DNA-repair genes (DRGs). Methods: Data were extracted by a prospective observational study designed to select men with germline pathogenic variants (PVs) and offer them a dedicated PCa screening. The selection of probands was performed by genetic counseling and testing of male grade I relatives of female patients with a PVs. Male candidates were identified after reviewing the genealogical trees of all women who had received the diagnosis of breast and/or ovarian cancer and tested positive for a PVs. All the probands, 35-69 yrs old, who resulted positive for PVs were offered to participate to a specific PCa screening based on annually digital rectal examination (DRE), detection of PHI, which is a blood test including total PSA, free PSA, free/total PSA and -2proPSA, and multiparametric MRI. The primary outcome was the “willing to be tested”, defined as a proxy for male awareness of PCa risk. The secondary endpoint was the acceptance rate to be screened. Results: We reviewed the genealogical trees of breast/ovarian cancer female patients from January 2017 to December 2021 and we identified, over 1256 families, 139 positive cases for PVs in DRGs. Among 139 families, we identified 378 “healthy” 35-69 yrs old men, who were offered a genetic counseling, and if they agree a genetic testing. Overall 117/378 (31%) healthy males declared to be interested to be tested. Out of the 51 new tests (66 men already tested out of the study), we found 30 (58.8%) positive men. All the new positive tested men accepted to attend the PCa screening. Living in Northern Italy, having at least one child and higher (degree) level of education were the strongest predictors of willing for testing (p<0.01). Conclusions: Our data reveals a limited will to be tested, but all men tested positive for PVs accepted to participate to the PCa screening. These findings strongly support the urgent need to implement awareness of genetic risk for PCa.
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Affiliation(s)
| | | | | | | | - Paolo Casale
- IRCCS Humanitas Research Hospital, Rozzano, Italy
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Lopci E, Lazzeri M, Disconzi L, Maffei D, Fasulo V, Avolio P, Paciotti M, Pasini L, Benetti A, Hurle R, Saita A, Colombo P, Marzo K, Leonardi L, Balzarini L, Chiti A, Guazzoni G, Casale P, Buffi N, Lughezzani G. Prospective comparison of PSMA PET/CT vs. mpMRI in patients with a high suspicion of prostate cancer and previously negative biopsy: Preliminary data from PROSPET-BX trial. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01013-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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5
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Lazzeri M, Fasulo V, Lughezzani G, Benetti A, Soldà G, Asselta R, De Simone I, Paciotti M, Avolio PP, Contieri R, Saitta C, Saita A, Hurle R, Guazzoni G, Buffi NM, Casale P. Prospective evaluation of the role of imaging techniques and TMPRSS2:ERG mutation for the diagnosis of clinically significant prostate cancer. Front Oncol 2022; 12:968384. [PMID: 36147926 PMCID: PMC9487838 DOI: 10.3389/fonc.2022.968384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To test the hypothesis of a relationship between a specific genetic lesion (T2:ERG) and imaging scores, such as PI-RADS and PRI-MUS, and to test the effectiveness of these parameters for the diagnosis of prostate cancer (PCa) and clinically significant PCa (csPCa). Materials and methods This is a prospective study of men with suspected PCa enrolled between 2016 and 2019 at a high-volume tertiary hospital. Patients underwent systematic US-guided biopsy, plus targeted biopsy if they were presenting with >=1 suspicious lesion (PI-RADS>2) at mpMRI or PR-IMUS >2 at micro-ultrasound assessment. For each patient, one core from the highest PI-RADS or PRI-MUS lesion was collected for T2:ERG analysis. Multivariable logistic regression models (LRMs) were fitted for csPCa with a clinical model (age, total PSA, previous biopsy, family history for PCa), a clinical plus PI-RADS, clinical plus T2:ERG, clinical plus PI-RADS plus T2:ERG, and T2:ERG plus PI-RADS alone. Results The cohort consists of 158 patients: 83.5% and 66.2% had respectively a diagnosis of PCa and csPCa after biopsy. A T2:ERG fusion was found in 37 men and 97.3% of these patients harbored PCa, while 81.1% were diagnosed with csPCa. SE of T2:ERG assay for csPCa was 28.8%, SP 87.0%, NPV 38.8%, and PPV 81.1%. Of 105 patients who performed mpMRI 93.% had PIRADS ≥3. SE of mpMRI for csPCa was 98.5%, SP was 12.8%, NPV was 83.3%, and PPV was 65.7%. Among 67 patients who were subjected to micro-US, 90% had a PRI-MUS ≥3. SE of micro-US for csPCa was 89.1%, SP was 9.52%, NPV was 28.6%, and PPV was 68.3%. At univariable LRM T2:ERG was confirmed as independent of mpMRI and micro-US result (OR 1.49, p=0.133 and OR 1.82, p=0.592, respectively). At multivariable LRM the clinical model alone had an AUC for csPCa of 0.74 while the clinical model including PI-RADS and T2:ERG achieved an AUC of 0.83. Conclusions T2:ERG translocation and imaging results are independent of each other, but both are related csPCa. To evaluate the best diagnostic work-up for PCa and csPCa detection, all available tools (T2:ERG detection and imaging techniques) should be employed together as they appear to have a complementary role.
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Affiliation(s)
- Massimo Lazzeri
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
| | - Vittorio Fasulo
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Giovanni Lughezzani
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- *Correspondence: Giovanni Lughezzani,
| | - Alessio Benetti
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
| | - Giulia Soldà
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Rosanna Asselta
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Ilaria De Simone
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Marco Paciotti
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Pier Paolo Avolio
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Roberto Contieri
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Cesare Saitta
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alberto Saita
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
| | - Rodolfo Hurle
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
| | - Giorgio Guazzoni
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Nicolò Maria Buffi
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Paolo Casale
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
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Santangelo G, Bursi F, Toriello F, Tamagni ME, Fior G, Massironi L, Bertelli S, Fanin A, Gambini O, Carugo S, Benetti A. Echocardiographic changes in anorexia nervosa: a pathophysiological adaptation or a disease? Intern Emerg Med 2022; 17:777-787. [PMID: 34677790 DOI: 10.1007/s11739-021-02871-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/12/2021] [Indexed: 11/25/2022]
Abstract
Anorexia Nervosa is one of the most common form of eating disorders. Cardiac involvement occurs in approximately 80% of patients. Few reports focused on the association between body weight fluctuations and echocardiographic abnormalities, considering linear measurements. We describe echocardiographic and clinical features among male and female patients with anorexia nervosa and the effect of weight gain on these parameters. We performed a single center, retrospective study of patients followed at a dedicated multidisciplinary Unit. The study population consisted of 81 patients, mean age 25 ± 11 years, 94% female. Median body mass index was 14.4 kg/m2 (25th-75th percentile 12.7-15.6 kg/m2). Patients with body mass index below the median value had more often pericardial effusion, smaller left ventricular mass and left ventricular end-diastolic volume and thinner interventricular septum. However, when indexed to body surface area, left ventricular mass and volumes were within the normal range in 90% of population. Patients with pericardial effusion showed mitral valve abnormalities and lower values of white blood cells and platelets, although within normal limits. Presence of pericardial effusion was not related to inflammatory parameters or low plasma protein levels. In 39 patients who displayed weight gain during a median follow-up of 189 days (25th-75th percentile 47-471), increased left ventricular mass, interventricular septum thickness, white blood cells and platelet count and decreased pericardial effusion were observed. Patients with anorexia nervosa have a specific echocardiographic pattern which seems to be proportional to the body size, suggesting a pathophysiological adaptation to the lack of substrates.
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Affiliation(s)
- G Santangelo
- Division of Cardiology, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy.
| | - F Bursi
- Division of Cardiology, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - F Toriello
- Division of Cardiology, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - M E Tamagni
- Division of Internal Medicine, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - G Fior
- Division of Psychiatry, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - L Massironi
- Division of Cardiology, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - S Bertelli
- Division of Psychiatry, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - A Fanin
- Division of Internal Medicine, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - O Gambini
- Division of Psychiatry, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - S Carugo
- Division of Cardiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - A Benetti
- Division of Internal Medicine, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
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Lazzeri M, Chiarelli G, Corbetta M, Asselta R, De Simone I, Soldà G, Duga S, Zuradelli M, Casale P, Saita A, Lughezzani G, Guazzoni G, Hurle R, Benetti A, Saitta C, Fasulo V, Buffi N. Post-biopsy cell-free DNA from blood in primary prostate cancer: How to get genetics data for decision making. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00573-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chiarelli G, Fasulo V, Zuradelli M, Buffi N, Lughezzani G, Guazzoni G, Ripamonti C, Benetti A, Casale P, Saita A, Hurle R, Avolio P, Lazzeri M. Awareness of risk of prostate cancer (PCa) remains poor in families with germline mutations in DNA-repair genes. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00439-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Taverna G, Thiel LM, Miller DL, Tidu L, Sardella P, Camp P, Zanoni ML, Vota P, Mazzieri C, Toia G, Fasulo V, Avolio P, Benetti A, Buffi N, Lughezzani G, Lazzeri M, Casale P, Guazzoni G, Grizzi F, Stork B. Hope for Ostomates: A Carbon and Zeolite Impregnated Polyester Fabric Inhibits Urine Odor in Cancer Patients: A Randomized Experimental Study. Asian Pac J Cancer Prev 2021; 22:2917-2921. [PMID: 34582662 PMCID: PMC8850874 DOI: 10.31557/apjcp.2021.22.9.2917] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Many individuals with bladder cancer have undergone a surgical urostomy and often complain of being self-conscious of the unpleasant smell of their own urine. The focus of this study was to test the efficacy of a pouch cover made of a carbon and zeolite containing polyester material to inhibit the smell of urine by comparing two trained dogs' response time in detecting volatile organic compounds (VOCs) in urine, with and without the fabric covering the samples. METHODS This study used a randomized, blinded experimental design to evaluate the efficacy of a fabric to interfere with two highly trained dogs' ability to detect specific VOCs present in the urine of prostate cancer patient. Ninety urine samples were analyzed in this study. RESULTS Prior to the experiment, both dogs accurately detected VOCs in the uncovered test urine samples of men with prostate cancer with a sensitivity and specificity of nearly 100%. Both dogs recognized the "uncovered" urine samples of men with prostate cancer within two seconds. When the test sample was covered with the study fabric, the test urine samples were detected within 30-40 seconds and in some instances the dogs were not able to identify the covered samples, whatsoever. CONCLUSION The findings of this study demonstrate that the carbon and zeolite containing polyester fabric did significantly interfere with the ability of the dogs to detect VOCs in urine of men with prostate cancer. The fabric may show promise as a pouch cover in controlling offensive urine odor which many ostomates experience.
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Affiliation(s)
- Gianluigi Taverna
- Department of Urology, Humanitas Mater Domini, Castellanza, Varese, Italy.,Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Linda M Thiel
- McAuley School of Nursing, College of Health Professions, University of Detroit Mercy, Detroit, Michigan, USA
| | - Desiree L Miller
- Mercy Health Visiting Nurses Services and Hospice Services, Muskegon, Michigan, USA
| | - Lorenzo Tidu
- Italian Ministry of Defenses, Military Veterinary Center, CEMIVET, Grosseto, Italy
| | - Paolo Sardella
- Italian Ministry of Defenses, Military Veterinary Center, CEMIVET, Grosseto, Italy
| | - Patricia Camp
- Muskegon Ostomy Association, Muskegon, Michigan, USA
| | | | - Paolo Vota
- Department of Urology, Humanitas Mater Domini, Castellanza, Varese, Italy
| | - Cinzia Mazzieri
- Department of Urology, Humanitas Mater Domini, Castellanza, Varese, Italy
| | - Giovanni Toia
- Department of Urology, Humanitas Mater Domini, Castellanza, Varese, Italy
| | - Vittorio Fasulo
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Pierpaolo Avolio
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Alessio Benetti
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Niccolò Buffi
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Giovanni Lughezzani
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Massimo Lazzeri
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Paolo Casale
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giorgio Guazzoni
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Fabio Grizzi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Department of Immunology and Inflammation, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Brian Stork
- University of Michigan, Department of Urology, Ann Arbor, Michigan, USA
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10
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Toriello F, Santangelo G, Bursi F, Epis E, Tamagni ME, Massironi L, Bertelli S, Benetti A, Cattaneo M, Carugo S. Echocardographic changes in anorexia nervosa: a pathophysiological adaptation or a disease? Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Anorexia nervosa (AN) is one of the most common form of eating disorders and it is a severe and potentially fatal disease with high rates of morbidity and mortality especially in the population aged 15-25 years. Cardiac involvement occurs in approximately 80% of patients with AN. Cardiovascular complications include changes in the autonomic regulation (increased vagal tone, bradycardia, orthostatic hypotension, syncope), arrhythmias, congestive heart failure and sudden death. Few reports have described, in small series, a variety of echocardiographic abnormalities including decreased cardiac mass, mitral valve prolapse, pericardial effusion and reduced left ventricular (LV) dimensions. No previous studies, however, examined if there is a change in these abnormalities with weight fluctuations.
Purpose
To describe echocardiographic findings among male and female patients with AN and to examine the effect of weight gain on clinical and echocardiographic parameters.
Methods
We performed a single center, retrospective, study of patients diagnosed with AN using the diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). Clinical, laboratory and ECG-graphic data were obtained by reviewing each patient’s medical records. Echocardiographic parameters were measured off-line.
Results
The study population consisted of 81 patients, mean age 24.5 ± 11.6 years, 92.6% females. 75% showed an extreme AN degree. Mean body mass index (BMI) was 15.2 ± 2.1 kg/m2. Mean heart rate was 57.2 ± 12.7 beats per minute. Some patients showed right bundle branch block (7.4%) or prolonged QT interval (14.8%). Patients with BMI below the mean value had more often pericardial effusion, smaller LV mass and LV end-diastolic volume and thinner interventricular septum (all p < 0.05). However, when index to BSA, LV mass and volumes were within normal range in the 90% of the population. They also showed mitral valve abnormalities and low values of white blood cells and platelets. The presence of pericardial effusion was not related to inflammatory parameters or protein deficiency. For 39 patients echocardiographic exams at the highest and the lowest weight were available. With weight gain, there was an improvement in LV mass, interventricular septum thickness, pericardial effusion and an increase in white blood cells and platelet count.
Conclusions
Our study showed that patients with AN have a specific echocardiographic pattern which seems to be proportional to the body size, suggesting a pathophysiological adaptation to the lack of substrates, hypothesis confirmed by the regression with weight gain. It is possible that pericardic effusion fills the gap left by mass loss.
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Affiliation(s)
- F Toriello
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Cardiology, University of Milan, Milan, Italy
| | - G Santangelo
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Cardiology, University of Milan, Milan, Italy
| | - F Bursi
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Cardiology, University of Milan, Milan, Italy
| | - E Epis
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Cardiology, University of Milan, Milan, Italy
| | - ME Tamagni
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Internal Medicine, University of Milan, Milan, Italy
| | - L Massironi
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Cardiology, University of Milan, Milan, Italy
| | - S Bertelli
- ASST Santi Paolo e Carlo, Department of Mental Health, Milan, Italy
| | - A Benetti
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Internal Medicine, University of Milan, Milan, Italy
| | - M Cattaneo
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Internal Medicine, University of Milan, Milan, Italy
| | - S Carugo
- ASST Santi Paolo e Carlo, Department of Health Sciences, Division of Cardiology, University of Milan, Milan, Italy
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11
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Maffei D, Paciotti M, Regis F, Frego N, Diana P, Fasulo V, Peschechera R, Benetti A, Lazzeri M, Hurle R, Saita A, Casale P, Buffi N, Guazzoni G, Lughezzani G. Clinically significant prostate cancer diagnosis by micro-ultrasound guided prostate biopsies: A real-life single centre experience. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34173-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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12
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Hurle R, Lazzeri M, Saita A, Naselli A, Guarneri A, Buffi NM, Lughezzani G, Fasulo V, Mondellini GM, Paciotti M, Domanico L, Peschechera R, Benetti A, Zandegiacomo S, Lista G, Pasini L, Guazzoni G, Casale P. Predictive factors for progression of patients with carcinoma in situ of the bladder at long-term follow-up: pure versus non-pure CIS. MINERVA UROL NEFROL 2019; 71:406-412. [PMID: 31144485 DOI: 10.23736/s0393-2249.19.03254-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to identify the predictive factors for progression defined as any event that shifted the management of the disease from a bladder sparing approach, by comparing patients with pure versus non-pure carcinoma in situ (CIS) of the bladder. METHODS A retrospective analysis was carried out in consecutive patients affected by newly-diagnosed pure CIS and non-pure CIS (excluding cases with concomitant muscle invasive cancer). All patients were enrolled a in our institution from 1998 to 2010. Data was prospectively collected. Main end point was progression-free survival. RESULTS Overall, 149 patients with CIS were identified for the analysis. A total of 98 patients had pure CIS (66%). Median follow-up was 103 months (range: 40-206 months). Progression occurred in 29 patients (19%). A total of 30 patients died during the follow-up (20%). In 13 cases (9%), the death was cancer specific. Progression-free survival estimate was 181 months (95% CI: 169-193 months) and 154 months (95% CI: 133-176 months) respectively for pure and non-pure CIS population (P=0.03). Among examined variables (age, gender, symptoms, smoking habit, ASA score, number of bacillus Calmette-Guérin [BCG] instillations), multivariate analysis disclosed that only CIS type was an independent predictor of progression (P=0.03) with a relative risk of 0.37 in favor of pure CIS. CONCLUSIONS Pure and non-pure CIS are efficiently treated by BCG therapy combined with trans-urethral resection and/or radical cystectomy, with relatively low rate of progression. CIS type was the only significant predictor of progression.
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Affiliation(s)
- Rodolfo Hurle
- Department of Urology, Humanitas Clinic IRCCS, Rozzano, Milan, Italy
| | - Massimo Lazzeri
- Department of Urology, Humanitas Clinic IRCCS, Rozzano, Milan, Italy
| | - Alberto Saita
- Department of Urology, Humanitas Clinic IRCCS, Rozzano, Milan, Italy -
| | - Angelo Naselli
- Unit of Urology, San Giuseppe Hospital, MultiMedica, Milan, Italy
| | - Andrea Guarneri
- University Unit of Urology, San Giuseppe Hospital, MultiMedica, Milan, Italy
| | - Nicolò M Buffi
- Department of Urology, Humanitas Clinic IRCCS, Rozzano, Milan, Italy
| | | | - Vittorio Fasulo
- Department of Urology, Humanitas Clinic IRCCS, Rozzano, Milan, Italy
| | | | - Marco Paciotti
- Department of Urology, Humanitas Clinic IRCCS, Rozzano, Milan, Italy
| | - Luigi Domanico
- Department of Urology, Humanitas Clinic IRCCS, Rozzano, Milan, Italy
| | | | - Alessio Benetti
- Department of Urology, Humanitas Clinic IRCCS, Rozzano, Milan, Italy
| | | | - Giuliana Lista
- Department of Urology, Humanitas Clinic IRCCS, Rozzano, Milan, Italy
| | - Luisa Pasini
- Department of Urology, Humanitas Clinic IRCCS, Rozzano, Milan, Italy
| | - Giorgio Guazzoni
- Department of Urology, Humanitas Clinic IRCCS, Rozzano, Milan, Italy.,Humanitas University, Pieve Emanuele, Milan, Italy
| | - Paolo Casale
- Department of Urology, Humanitas Clinic IRCCS, Rozzano, Milan, Italy
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13
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Gallucci A, Mattavelli G, Schiena G, D’Agostino A, Sassetti T, Bonora S, Bertelli S, Benetti A, Tugnoli E, Ruggiero G, Sassaroli S, Lauro LR, Gambini O, Papagno C. Transcranial direct current stimulation (tdcs) modulates implicit attitudes towards food in eating disorders. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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14
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Hurle R, Buffi N, Lista G, Cardone P, Forni G, Maffei D, Peschechera R, Zandegiacomo S, Pasini L, Benetti A, Colombo P, Lazzeri M, Casale P, Guazzoni G, Lughezzani G. Long-term outcomes of high-grade T1 bladder cancer treated with intravesical bacillus Calmette-Guérin: experience of a single center. MINERVA UROL NEFROL 2018; 70:501-508. [PMID: 29968999 DOI: 10.23736/s0393-2249.18.03042-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND To assess the outcomes of patients with high-grade (HG) pT1 bladder cancer (BC) treated with intravesical BCG therapy. METHODS The study population consisted of 185 patients with HG pT1 BC treated between 1998 and 2010. We aimed to determine recurrence-free (RFS) and progression-free survival (PFS), as well as the predictors of RFS and PFS. RESULTS Overall, 143 (77.3%) patients were males. Median age was 72 years (IQR: 66-78). Tumor size was ≥3 cm in 100 (54.1%) individuals. Most patients had single tumors (125; 67.6%). Primary, progressive and recurrent patterns of presentation were observed in 146 (78.9%), 21 (11.4%), and 18 (9.7%) cases, respectively. After 2nd-look TURB, 127 (68.6%) patients had no residual disease, 44 (23.8%) had Ta/CIS, and 14 (7.6%) had T1 HG BC. Twenty-two (11.9%) patients experience early recurrence after BCG. Of these, 12 patients (54.5%) were diagnosed with Ta/CIS, while 10 (45.5%) were diagnosed with HG pT1 BC. The median follow-up was 93 months (IQR: 63-147). Ten-year RFS and PFS rates were 69.6 and 79.2%. In multivariable Cox regression models, female gender (HR=2.41; P=0.001), progressive (HR=2.03; P=0.030) and recurrent (HR=3.87; P<0.001) pattern of presentation emerged as independent predictors of RFS, while age ≥70 years (HR=2.13; P=0.027), presence of multiple tumors (HR=2.06; P=0.019), and early recurrence (HR=3.88; P<0.001) emerged as independent predictors of PFS. CONCLUSIONS Intravesical BCG appears to be an effective treatment for HG pT1 BC. Caution should be used in patients aged ≥70 years, with multiple tumors or experiencing early recurrence.
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Affiliation(s)
- Rodolfo Hurle
- Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Nicolò Buffi
- Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Giuliana Lista
- Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Pasquale Cardone
- Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Giovanni Forni
- Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Davide Maffei
- Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Roberto Peschechera
- Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Silvia Zandegiacomo
- Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Luisa Pasini
- Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Alessio Benetti
- Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Piergiuseppe Colombo
- Department of Pathology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Massimo Lazzeri
- Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Paolo Casale
- Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Giorgio Guazzoni
- Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Giovanni Lughezzani
- Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy -
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15
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Grigolato P, Benetti A, Berenzi A, Villanacci V, Tardanico R. PNA: A Marker of Neoplastic Progression and Differentiation in the Gastrointestinal Tract. Int J Biol Markers 2018. [DOI: 10.1177/172460089000500206] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We examined 35 cases of stomach carcinoma and 40 cases of colonic carcinoma with PNA associated with peroxidase (peanut agglutinin, lectin which binds to the terminal disaccharide galactose β (1, 3)-N-acetil-galacto-samine). In this way evaluation of the functional aspects of the normal-neoplastic sequence was undertaken. This method was carried out for histological and ultrastructural investigations. The results obtained in both cases showed a different reactivity in the evolution of neoplastic disease: in fact, positivity in dysplasia is finely granular intracytoplasmic, whereas in well-differentiated neoplastic transformation such a reactivity is preferentially localized along the cellular membranes, with restoration of gross positivity in the cytoplasm for the poorly-differentiated neoplasm. We therefore believe PNA to be a marker not only of neoplastic progression but of differentiation as well: we also hypothesize it to reveal glycoprotein groups with possible antigenic power, involved in immunologic interactions between tumor and host.
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Affiliation(s)
- P. Grigolato
- Institute of Anatomy and Histological Pathology, University of Brescia - Italy
| | - A. Benetti
- Institute of Anatomy and Histological Pathology, University of Brescia - Italy
| | - A. Berenzi
- Institute of Anatomy and Histological Pathology, University of Brescia - Italy
| | - V. Villanacci
- Institute of Anatomy and Histological Pathology, University of Brescia - Italy
| | - R. Tardanico
- Institute of Anatomy and Histological Pathology, University of Brescia - Italy
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16
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Saita A, Lazzeri M, Buffi N, Casale P, Hurle R, Peschechera R, Lughezzani G, Benetti A, Pasini L, Zandegiacomo S, Lista G, Cardone P, Guazzoni G. PD35-12 RETROGRADE INTRARENAL SURGERY - SINGLE HAND (RIRS-SH) BY NEW A SEMI-FLEXIBLE URETEROSCOPY FOR MEDIUM SIZE (1.5 TO 2 CM) RENAL STONE: PRELIMINARY RESULTS FROM A SINGLE CENTRE STAGE 2A STUDY. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Lazzeri M, Lopci E, Lughezzani G, Casale P, Hurle R, Saita A, Peschechera R, Benetti A, Pasini L, Zandegiacomo S, Lista G, Cardone P, Chiti A, Guazzoni G, Colombo F, Chiereghin C, Asselta R, Colombo P, Monterisi S, Soldà G, Veronesi G, Duga S. MP20-14 POSITIVE PROSTATE 68GAPSMA-PET/CT CORRELATES WITH DETECTION OF CD45-/PSMA+ NON-SPERM EPITHELIAL CELLS OBTAINED BY LIQUID BIOPSY OF SEMINAL FLUID IN PATIENTS WITH PROSTATE CANCER (PCA). J Urol 2018. [DOI: 10.1016/j.juro.2018.02.684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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18
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Grizzi F, Mandressi A, Colombo P, Melegari S, Justich M, Bozzini G, Seveso M, De Francesco O, Buffi N, Lughezzani G, Lazzeri M, Hurle R, Pasini L, Benetti A, Zandegiacomo S, Peschechera R, Casale P, Guazzoni GF, Taverna G. MP64-17 EXTRACELLULAR COLLAGENIC TYPE AND STRUCTURAL ORGANIZATION CHANGES IN PROSTATE CANCER AND BENIGN PROSTATIC HYPERPLASIA. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.2062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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19
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Lazzeri M, Lopci E, Lughezzani G, Buffi N, Casale P, Hurle R, Saita A, Peschechera R, Benetti A, Pasini L, Zandegiacomo S, Lista G, Cardone P, Chiti A, Guazzoni G. PD06-11 68GA-PSMA PET/CT FOR PRIMARY DIAGNOSIS OF PROSTATE CANCER IN MEN WITH CONTRAINDICATIONS TO OR NEGATIVE MRI: A PROSPECTIVE OBSERVATIONAL STUDY. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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20
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Grizzi F, Mandressi A, Colombo P, Melegari S, Justich M, Bozzini G, Seveso M, De Francesco O, Buffi N, Lughezzani G, Lazzeri M, Hurle R, Pasini L, Benetti A, Zandegiacomo S, Peschechera R, Casale P, Guazzoni GF, Taverna G. MP64-07 VASCULAR HURST INDEX IN NON-TUMORAL BIOPSY CORES AS POTENTIAL HISTOPATHOLOGICAL PARAMETER TO SELECT PATIENTS WITH HIDDEN PROSTATE CANCER. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.2052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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21
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Saita A, Casale P, Lazzeri M, Buffi N, Hurle R, Peschechera R, Lughezzani G, Benetti A, Pasini L, Zandegiacomo S, Lista G, Cardone P, Guazzoni G. MP55-17 NEW CONCEPTION FOR FLEXOR VUE DEFLECTING ENDOSCOPIC SYSTEM USE, IN ORDER TO IMPROVE STONE FREE RATE (SFR) AFTER RIRS: PRELIMINARY RESULTS FROM A SINGLE CENTRE STAGE 2A STUDY. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
We studied the growth fraction of55 resected colorectal adenocarcinomas by means of a three-step immunoperoxidase technique (avidin-biotin-peroxidase) using the monoclonal antibody Ki67 directed against a cell proliferation-associated nuclear antigen. The percentage of Ki67-positive cells was evaluated independently by two observers, and a Ki67 score was obtained for each case. No correlation was observed between Ki67 staining and patient's age and sex, tumor size and localization or grading and staging according to Dukes’ method (modified by Astler-Coller and Turnbull). The growth fraction showed extreme heterogeneity in the cases examined, within each grade of differentiation.
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Affiliation(s)
- A Benetti
- Department of Pathology, University of Brescia, Italy
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23
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Lazzeri M, Lopci E, Lughezzani G, Colombo P, Casale P, Hurle R, Saita A, Leonardi L, Lista G, Peschechera R, Pasini L, Rodari M, Zandegiacomo S, Benetti A, Cardone P, Mrakic F, Balzarini L, Chiti A, Guazzoni G, Buffi NM. Targeted 11C-choline PET-CT/TRUS software fusion-guided prostate biopsy in men with persistently elevated PSA and negative mpMRI after previous negative biopsy. Eur J Hybrid Imaging 2017; 1:9. [PMID: 29782590 PMCID: PMC5954704 DOI: 10.1186/s41824-017-0011-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 09/18/2017] [Indexed: 12/22/2022] Open
Abstract
Background We evaluated the feasibility and accuracy of 11C–choline PET-CT/TRUS fusion-guided prostate biopsy in men with persistently elevated PSA and negative mpMRI or contraindication to MRI, after previous negative biopsy. Clinical data were part of a prospective on-going observational clinical study: “Diagnostic accuracy of target mpMRI/US fusion biopsy in patients with suspected prostate cancer after initial negative biopsy”. Patients with a negative biopsy and negative mpMRI (PI-RADS v.2 < 3) or absolute contraindications to MRI and persistently elevated PSA, were included. All patients underwent 11C–choline PET with dedicated acquisition of the pelvis and PET-CT/TRUS-guided prostate biopsy by Bio-Jet™ fusion system (D&K Technologies, Germany). The primary endpoint was to assess the accuracy of 11C–choline PET-CT to determine the presence and the topographical distribution of PCa. Results Overall, 15 patients (median age 71 yrs. ± 8.89; tPSA 13.5 ng/ml ± 4.3) were analysed. Fourteen had a positive PET scan, which revealed 30 lesions. PCa was detected in 7/15 patients (46.7%) and four patients presented a clinically significant PCa: GS > 6. Over 58 cores, 25 (43.1%) were positive. No statistically significant difference in terms of mean and median values for SUVmax and SUVratio between benign and malignant lesions was found. PCa lesions with GS 3 + 3 (n = 3) showed a median SUVmax and SUVratio of 4.01 and 1.46, compared to 5.45 and 1.57, respectively for lesions with GS >6 (n = 4). Conclusion Software PET-CT/TRUS fusion-guided target biopsy could be a diagnostic alternative in patients with a suspected primary PCa and negative mpMRI, but its specificity appeared low.
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Affiliation(s)
- Massimo Lazzeri
- Department of Urology, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089 Milan, Rozzano Italy
| | - Egesta Lopci
- Department of Nuclear-Medicine, Humanitas Clinical and Research Hospital, Milan, Rozzano Italy
| | - Giovanni Lughezzani
- Department of Urology, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089 Milan, Rozzano Italy
| | - Piergiuseppe Colombo
- Department of Pathology, Humanitas Clinical and Research Hospital, Milan, Rozzano Italy
| | - Paolo Casale
- Department of Urology, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089 Milan, Rozzano Italy
| | - Rodolfo Hurle
- Department of Urology, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089 Milan, Rozzano Italy
| | - Alberto Saita
- Department of Urology, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089 Milan, Rozzano Italy
| | - Lorenzo Leonardi
- Department of Nuclear-Medicine, Humanitas Clinical and Research Hospital, Milan, Rozzano Italy
| | - Giuliana Lista
- Department of Urology, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089 Milan, Rozzano Italy
| | - Roberto Peschechera
- Department of Urology, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089 Milan, Rozzano Italy
| | - Luisa Pasini
- Department of Urology, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089 Milan, Rozzano Italy
| | - Marcello Rodari
- Department of Nuclear-Medicine, Humanitas Clinical and Research Hospital, Milan, Rozzano Italy
| | - Silvia Zandegiacomo
- Department of Urology, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089 Milan, Rozzano Italy
| | - Alessio Benetti
- Department of Urology, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089 Milan, Rozzano Italy
| | - Pasquale Cardone
- Department of Urology, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089 Milan, Rozzano Italy
| | - Federica Mrakic
- Department of Radiology, Humanitas Clinical and Research Hospital, Milan, Rozzano Italy
| | - Luca Balzarini
- Department of Radiology, Humanitas Clinical and Research Hospital, Milan, Rozzano Italy
| | - Arturo Chiti
- Department of Nuclear-Medicine, Humanitas Clinical and Research Hospital, Milan, Rozzano Italy.,Department of Urology, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089 Milan, Rozzano Italy.,Department of Pathology, Humanitas Clinical and Research Hospital, Milan, Rozzano Italy.,Department of Radiology, Humanitas Clinical and Research Hospital, Milan, Rozzano Italy.,5Humanitas University, Milan, Rozzano Italy
| | - Giorgio Guazzoni
- Department of Urology, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089 Milan, Rozzano Italy.,Department of Pathology, Humanitas Clinical and Research Hospital, Milan, Rozzano Italy.,Department of Radiology, Humanitas Clinical and Research Hospital, Milan, Rozzano Italy.,5Humanitas University, Milan, Rozzano Italy
| | - Nicolò Maria Buffi
- Department of Urology, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089 Milan, Rozzano Italy
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Di Brina L, D'agostino G, Franzese C, Franceschini D, Comito T, De Rose F, Navarria P, Tozzi A, Iftode C, Ascolese A, Clerici E, Pasini L, Benetti A, Scorsetti M. EP-1337: High hypofractionation using beacon transponders in intermediate-risk prostate cancer: first results. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31772-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hurle R, Lazzeri M, Lughezzani G, Buffi N, Saita A, Pasini L, Zandegiacomo S, Benetti A, Forni G, Colombo P, Peschechera R, Casale P, Lista G, Cardone P, Guazzoni G. PD19-01 ACTIVE SURVEILLANCE FOR NON-MUSCLE INVASIVE BLADDER CANCER (NMIBC): RESULT FROM BLADDER CANCER ITALIAN ACTIVE SURVEILLANCE (BIAS) PROJECT. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hurle R, Peschechera R, Buffi NM, Lughezzani G, Morenghi E, Saita A, Pasini L, Casale P, Seveso M, Zandegiacomo S, Taverna G, Benetti A, Vavassori I, Colombo P, Lazzeri M, Guazzoni G. Impact of a teaching program on outcome quality of white light transurethral resection for bladder tumor: A cohort study. ACTA ACUST UNITED AC 2016. [DOI: 10.5430/jst.v6n2p56] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Hurle R, Pasini L, Lazzeri M, Colombo P, Buffi N, Lughezzani G, Casale P, Morenghi E, Peschechera R, Zandegiacomo S, Benetti A, Saita A, Cardone P, Guazzoni G. Active surveillance for low-risk non-muscle-invasive bladder cancer: mid-term results from the Bladder cancer Italian Active Surveillance (BIAS) project. BJU Int 2016; 118:935-939. [DOI: 10.1111/bju.13536] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Rodolfo Hurle
- Department of Urology; Istituto Clinico Humanitas IRCCS; Clinical and Research Hospital; Milan Italy
| | - Luisa Pasini
- Department of Urology; Istituto Clinico Humanitas IRCCS; Clinical and Research Hospital; Milan Italy
| | - Massimo Lazzeri
- Department of Urology; Istituto Clinico Humanitas IRCCS; Clinical and Research Hospital; Milan Italy
| | - Piergiuseppe Colombo
- Department of Pathology; Istituto Clinico Humanitas IRCCS; Clinical and Research Hospital; Milan Italy
| | - NicolòMaria Buffi
- Department of Urology; Istituto Clinico Humanitas IRCCS; Clinical and Research Hospital; Milan Italy
| | - Giovanni Lughezzani
- Department of Urology; Istituto Clinico Humanitas IRCCS; Clinical and Research Hospital; Milan Italy
| | - Paolo Casale
- Department of Urology; Istituto Clinico Humanitas IRCCS; Clinical and Research Hospital; Milan Italy
| | - Emanuela Morenghi
- Department of Biostatistic Unit; Istituto Clinico Humanitas IRCCS; Clinical and Research Hospital; Milan Italy
| | - Roberto Peschechera
- Department of Urology; Istituto Clinico Humanitas IRCCS; Clinical and Research Hospital; Milan Italy
| | - Silvia Zandegiacomo
- Department of Urology; Istituto Clinico Humanitas IRCCS; Clinical and Research Hospital; Milan Italy
| | - Alessio Benetti
- Department of Urology; Istituto Clinico Humanitas IRCCS; Clinical and Research Hospital; Milan Italy
| | - Alberto Saita
- Department of Urology; Istituto Clinico Humanitas IRCCS; Clinical and Research Hospital; Milan Italy
| | - Pasquale Cardone
- Department of Urology; Istituto Clinico Humanitas IRCCS; Clinical and Research Hospital; Milan Italy
| | - Giorgio Guazzoni
- Department of Urology; Istituto Clinico Humanitas IRCCS; Clinical and Research Hospital; Milan Italy
- Department of Urology; Humanitas University; Milan Italy
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Lazzeri M, Hurle R, Casale P, Buffi N, Lughezzani G, Fiorini G, Peschechera R, Pasini L, Zandegiacomo S, Benetti A, Taverna G, Guazzoni G, Barbagli G. Managing chronic bladder diseases with the administration of exogenous glycosaminoglycans: an update on the evidence. Ther Adv Urol 2016; 8:91-9. [PMID: 27034722 PMCID: PMC4772357 DOI: 10.1177/1756287215621234] [Citation(s) in RCA: 20] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although the pathophysiology of acute chronic cystitis and other 'sensory' disorders, i.e. painful bladder syndrome (PBS) or interstitial cystitis (IC), often remains multifactorial, there is a wide consensus that such clinical conditions may arise from a primary defective urothelium lining or from damaged glycosaminoglycans (GAGs). A 'cascade' of events starting from GAG injury, which fails to heal, may lead to chronic bladder epithelial damage and neurogenic inflammation. To restore the GAG layer is becoming the main aim of new therapies for the treatment of chronic cystitis and PBS/IC. Preliminary experiences with GAG replenishment for different pathological conditions involving the lower urinary tract have been reported. There is a range of commercially available intravesical formulations of these components, alone or in combination. Literature evidence shows that exogenous intravesical hyaluronic acid markedly reduces recurrences of urinary tract infections (UTIs). Patients treated with exogenous GAGs have fewer UTI recurrences, a longer time to recurrence and a greater improvement in quality of life. Exogenous intravesical GAGs have been used for the treatment of PBS/IC. Despite the limitations of most of the studies, findings confirmed the role of combination therapy with hyaluronic acid and chondroitin sulfate as a safe and effective option for the treatment of PBS/IC. To prevent and/or treat radiotherapy and chemotherapy induced cystitis, GAG replenishment therapy has been used showing preliminary encouraging results. The safety profile of exogenous GAGs has been reported to be very favourable, without adverse events of particular significance.
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Affiliation(s)
- Massimo Lazzeri
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, via Manzoni 56, 20089 Rozzano, MI, Italy
| | - Rodolfo Hurle
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, Rozzano, MI, Italy
| | - Paolo Casale
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, Rozzano, MI, Italy
| | - NicolòMaria Buffi
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, Rozzano, MI, Italy
| | - Giovanni Lughezzani
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, Rozzano, MI, Italy
| | - Girolamo Fiorini
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, Rozzano, MI, Italy
| | - Roberto Peschechera
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, Rozzano, MI, Italy
| | - Luisa Pasini
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, Rozzano, MI, Italy
| | - Silvia Zandegiacomo
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, Rozzano, MI, Italy
| | - Alessio Benetti
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, Rozzano, MI, Italy
| | - Gianluigi Taverna
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, Rozzano, MI, Italy
| | - Giorgio Guazzoni
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, Humanitas University, Rozzano, MI, Italy
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Lughezzani G, Lazzeri M, Hurle R, Buffi N, Casale P, Fiorini G, Peschechera R, Pasini L, Zandegiacomo S, Bini V, Benetti A, Haese A, Palou Redorta J, McNicholas T, de la Taille A, Guazzoni G. MP02-01 CLINICAL UTILITY OF PHI (PROSTATE HEALTH INDEX) IN MEN WITH TPSA > 10 NG/ML. RESULTS FROM A MULTICENTRIC EUROPEAN STUDY. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.1873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lopci E, Lazzeri M, Lughezzani G, Pasini L, Hurle R, Leonardi L, Casale P, Buffi N, Peschechera R, Rodari M, Zandegiacomo S, Benetti A, Fiorini G, Chiti A, Guazzoni G. 505 Targeted PET/TRUS software fusion-guided biopsy in men with persistently elevated PSA and negative mpMRI after previous negative biopsy: A feasibility study and preliminary results. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/s1569-9056(16)60507-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Fanin A, Benetti A, Ceriani V, Pontiroli AE. Bariatric surgery versus medications in the treatment of type 2 diabetes. MINERVA ENDOCRINOL 2015; 40:297-306. [PMID: 26365477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is associated with increased risk of severe comorbidities and mortality; its prevalence is increasing worldwide, linked with the increasing prevalence of obesity. Weight loss prevents the development of T2DM in obese subjects, and can reverse T2DM in morbid obesity. This paper reviews bariatric surgery as a means for prevention and treatment of T2DM and its complications, in comparison with medical treatment, and analyzes the possible mechanisms involved. In morbidly obese patients bariatric surgery results in stable weight loss and long-term reduction in incidence and prevalence of obesity-related comorbidities, especially T2DM. The efficacy of bariatric surgery in improving and normalizing glucose levels has been confirmed by a large number of studies, comparing surgery with medical therapy. When compared to each other, malabsorptive and mixed malabsorptive/restrictive surgery techniques have shown better outcomes than restrictive techniques in terms of T2DM remission. However it is demonstrated that T2DM can reappear in the following years, especially in patients with advanced age, female sex, longer duration of T2DM, poorer glycemic control, use of insulin before surgery and weight regain. Bariatric surgery is superior to conventional medical therapy in inducing significant weight loss and control of T2DM. Weight loss has pleiotropic effects: T2DM can disappear and then re-appear as a result of persistent beta-cells impairment, while other effects last much longer, as reduction of blood pressure and improvement of lipids and of kidney function. This is probably the reason for long-term prevention of cardiovascular events and of mortality in obese and in obese-diabetic patients. The effect of bariatric surgery on diabetic retinopathy is still controversial.
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Affiliation(s)
- A Fanin
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy -
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Pontiroli AE, Benetti A, Folini L, Merlotti C, Frigè F. Other aspects of bariatric surgery: liver steatosis, ferritin and cholesterol metabolism. NUTR HOSP 2014; 28 Suppl 2:104-8. [PMID: 23834053 DOI: 10.3305/nh.2013.28.sup2.6720] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Bariatric surgery developed in the late 1970 to treat severe hyperlipidemias in overweight individuals, not necessarily obese. Several techniques have been developed, and the concept has come first of a surgery for morbid obesity, then of a cure for diabetes in morbid obesity. There are other aspects of bariatric surgery that deserve attention, beyond BMI and diabetes, such as hypertension, poor life expectancy, increased prevalence of cancer, congestive heart failure, social inadequacy. The aim of this presentation is to review some recent development in clinical research, in the fields of liver steatosis, ferritin metabolism, and cholesterol metabolism. Liver steatosis, also called fatty liver encompasses a graduation of diseases with different clinical relevance and prognosis. NAFLD correlates with atherosclerosis, insulin resistance and diabetes mellitus. There is now evidence that weight loss, obtained through diet or restrictive surgery, reduces the prevalence (and the severity) of NAFLD. An other issue is represented by serum ferritin concentrations, that are strongly associated with fibrosis, portal and lobular inflammation in NAFLD patients, especially in the presence of obesity. Body iron contributes to excess oxidative stress already at non iron overload concentrations. Moreover, serum ferritin is an important and independent predictor of the development of diabetes. Weight loss is accompanied by reduction of ferritin, more after restrictive than malabsorptive surgery. Metabolic changes are greater after malabsorptive or mixed surgery than after purely restrictive surgery, and this has been ascribed to a greater weight loss. Studies comparing the two kinds of surgery indicate that, for the same amount of weight loss, decrease of cholesterol is greater with the former than with the latter techniques, and this difference is mainly due to a greater reduction of intestinal absorption of cholesterol. In the choice of surgery for the single patient, among other aspects, malabsorptive surgery seems to be more indicated in subjects with hyperlipidemia, especially with high cholesterol levels.
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Affiliation(s)
- A E Pontiroli
- Dipartamento di Medicina, Chirurgia e Odonoiatria, Universitá degli Studi di Milano, Ospedale San Paolo, Via A di Rudini 8, Milan, Italy.
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Taverna G, Tidu L, Grizzi F, Giusti G, Seveso M, Benetti A, Hurle R, Zandegiacomo S, Pasini L, Mandressi A, Graziotti P. PD19-01 PROSTATE CANCER URINE DETECTION THROUGH HIGHLY-TRAINED DOGS’ OLFACTORY SYSTEM: A REAL CLINICAL OPPORTUNITY. J Urol 2014. [DOI: 10.1016/j.juro.2014.02.1520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
The aim of this work is to present an application of the urban water use (UWU) model, which is a support decision tool to define the best group of efficient water use measures for UWU management purposes. Therefore, the UWU was developed under integrated urban water management (IUWM) and strategic planning principles to promote a systemic approach for decision taking. The IUWM considers the interfaces between water service systems, while by strategic planning it is possible to elaborate a vision to be achieved in future scenarios. Specifically to define the best measure group of efficient water use, the UWU has many alternatives for these measures, which are based on water demand management, decentralized sanitation, ecological sanitation and sustainable urban drainage system philosophies. In this context, the UWU application presented was developed for Seara city, Santa Catarina State, Brazil. In this application a vision and five scenarios were built. The measure groups were composed by greywater systems, filterstrips, water saving devices in buildings, and water loss reduction in water supply systems and wastewater treatment system. In this context the UWU model was applied. The measure group that presented the highest effectiveness was based on the water demand management and decentralized sanitation strategies.
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Affiliation(s)
- D Costa Dos Santos
- Federal University of Paraná, Moysés Marcondes Street, 55, Apt.101, Juvevê, Curitiba, Paraná ZIP 80030410, Brazil E-mail:
| | - A Benetti
- Federal University of Paraná, Paraná Avenue, 1251, Apt. 73, Cabral, Curitiba, Paraná, ZIP 80035130, Brazil
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Pugliese M, Benetti A, Gilardi G, Gullino ML, Garibaldi A. CONTROL OF SOIL-BORNE DISEASES BY DIFFERENT COMPOSTS IN POTTED VEGETABLE CROPS. Commun Agric Appl Biol Sci 2014; 79:37-40. [PMID: 26084080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The composting process and the type and nature of wastes and raw materials influence the maturity, quality and suppressiveness of composts. Variability in disease suppression also depends on the pathosystem, on soil or substrate type, on chemical-physical conditions, like pH and moisture, and on the microbial component of compost. The aim of the research was to evaluate the suppressiveness of composts, originated from green wastes and/or municipal biowastes, and produced by different composting plants located in Europe. The composts were tested against soil-borne pathogens in greenhouse on potted plants: Fusarium oxysporum f.sp. busilici/basil, Pythium ultimum/cucumber, Rhizoctonia solani/bean. Composts were blended with a peat substrate at different dosages (10, 20 and 50% vol./vol.) 14 days before seeding or transplanting. Pythium ultimum and Rhizoctonia solani were mixed into the substrate at 0.5 g of wheat kernels L(-1) 7 days before seeding, while, in the case of Fusarium oxysporum f.sp. basilici, chlamydospores were applied at 1 x 10(4) CFU/g. Seeds of basil, cucumber and bean were sown into 2 L pots in greenhouse. The number of alive plants was counted and above ground biomass was weighed 30 days after seeding. The number of infected cucumber and basil plants was significantly reduced by increasing dosages of composts, but municipal compost was phytotoxic when applied at high dosages compared to green compost. Moreover, municipal compost increased the disease caused by Rhizoctonia solani on bean. The use of compost in substrates can be a suitable strategy for controlling soil-borne diseases on vegetable crops, but results depend on type of composts, application rates and pathosystems.
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Petrelli A, Perra A, Schernhuber K, Cargnelutti M, Salvi A, Migliore C, Ghiso E, Benetti A, Barlati S, Ledda-Columbano GM, Portolani N, De Petro G, Columbano A, Giordano S. Sequential analysis of multistage hepatocarcinogenesis reveals that miR-100 and PLK1 dysregulation is an early event maintained along tumor progression. Oncogene 2012; 31:4517-26. [PMID: 22249248 DOI: 10.1038/onc.2011.631] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Revised: 10/26/2011] [Accepted: 12/08/2011] [Indexed: 12/26/2022]
Abstract
MicroRNAs (miRNAs) have an important role in a wide range of physiological and pathological processes, and their dysregulation has been reported to affect the development and progression of cancers, including hepatocellular carcinoma (HCC). However, in the plethora of dysregulated miRNAs, it is largely unknown which of them have a causative role in the hepatocarcinogenic process. In the present study, we first aimed to determine changes in the expression profile of miRNAs in human HCCs and to compare them with liver tumors generated in a rat model of chemically induced HCC. We found that members of the miR-100 family (miR-100, miR-99a) were downregulated in human HCCs; a similar downregulation was also observed in rat HCCs. Their reduction was paralleled by an increased expression of polo like kinase 1 (PLK1), a target of these miRNAs. The introduction of miR-100 in HCC cells impaired their growth ability and their capability to form colonies in soft agar. Next, we aimed at investigating, in the same animal model, if dysregulation of miR-100 and PLK1 is an early or late event along the multistep process of hepatocarcinogenesis. The obtained results showed that miR-100 downregulation (i) is already evident in very early preneoplastic lesions generated 9 weeks after carcinogenic treatment; (ii) is also observed in adenomas and early HCCs; and (iii) is not simply a marker of proliferating hepatocytes. To our knowledge, this is the first work unveiling the role of a miRNA family along HCC progression.
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Affiliation(s)
- A Petrelli
- IRCC, Institute for Cancer Research and Treatment, University of Torino School of Medicine, Torino, Italy.
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Taverna G, Benecchi L, Grizzi F, Giusti G, Seveso M, Benetti A, Colombo P, Minuti F, Graziotti P. 2208 CAN A GLEASON 6 OR LESS MICRO-FOCUS OF PROSTATE CANCER IN ONE BIOPSY AND PROSTATE SPECIFIC ANTIGEN LEVEL < 10 NG/ML BE DEFINED AS ARCHETYPE OF LOW-RISK PROSTATE DISEASE? J Urol 2012. [DOI: 10.1016/j.juro.2012.02.2383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Benetti A, Garbossa SG, Veronelli A, Pontiroli AE. Acute renal failure after intragastric balloon in morbidly-obese metformin-treated diabetic patients. Report of two cases. Nutr Metab Cardiovasc Dis 2012; 22:e7-e8. [PMID: 22197398 DOI: 10.1016/j.numecd.2011.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 08/01/2011] [Indexed: 10/14/2022]
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Taverna G, Morandi G, Seveso M, Giusti G, Benetti A, Colombo P, Minuti F, Grizzi F, Graziotti P. Colour Doppler and microbubble contrast agent ultrasonography do not improve cancer detection rate in transrectal systematic prostate biopsy sampling. BJU Int 2011; 108:1723-7. [PMID: 21756276 DOI: 10.1111/j.1464-410x.2011.10199.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Seveso M, Taverna G, Giusti G, Benetti A, Maugeri O, Piccinelli A, Graziotti P. Corporoplasty by plication: out patient surgery for the correction of penile curvature. Arch Ital Urol Androl 2010; 82:164-166. [PMID: 21121435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
OBJECTIVE Corporoplasty using plication of the albuginea is a simple technique but considered by many Authors at high risk for recurrence in respect to other corrective techniques using excision of the albuginea tunica. The aim of this study was to assess long-term functional and cosmetic results of this approach done in an outpatient environment. MATERIAL AND METHODS From January 1997 to December 2008 we submitted 217 patients presenting induratio penis plastica (183) or congenital curvature (34) to corporoplasty with albuginea plication. All patients were assessed preoperatively with history, physical examination and photographic documention of the erectile penis. These patients, all with vaginal penetration problems, were submitted to corporoplication with 2-4 sutures 2/0 (polyglycolic) contralateral to the curvature, using local anaesthesia on outpatient basis. Follow-up included functional and cosmetic results, eventual complications and level of patient satisfaction. RESULTS Median follow-up of our study was 44 months (range 2-58). Complete correction of curvature was achieved in 206 patients (95%) whereas 87% reported good erectile function (IIEF-5 > 21). 145 patients (67%) reported penis shortening and 41% complained of palpating the sutures. Two patients required reoperation for recurring curvature. No perioperative complications or altered sensitivity of the glans were reported. CONCLUSIONS Simple plication of the corpora cavernosa can be done on an outpatient basis using local anaesthesia with optimal functional and cosmetic results. The success of this minimally invasive approach makes it a valid alternative to standard excision of the tunica albuginea procedure. Detailed preoperative information concerning procedure expectations and treatment course are extremely important in obtaining complete functional and cosmetic patient satisfaction.
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Affiliation(s)
- Mauro Seveso
- Istituto Clinico Humanitas, Unità Operativa di Urologia, Rozzano, Milano, Italy.
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Giusti G, Maugeri O, Benetti A, Piccinelli A, Taverna G, Zandegiacomo S, Peschechera R, Graziotti P. 1806 RETROGRADE INTRARENAL SURGERY (RIRS) IN THE TREATMENT OF RENAL STONES BETWEEN 2 AND 4 CM. J Urol 2010. [DOI: 10.1016/j.juro.2010.02.1731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Giusti G, Maugeri O, Taverna G, Benetti A, Zandegiacomo S, Peschechera R, Graziotti P. Tubeless percutaneous nephrolithotomy: Our experience. Arch Ital Urol Androl 2010; 82:34-36. [PMID: 20593716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
PURPOSE To evaluate safety and outcomes of tubeless PCNL in comparison with standard PCNL. MATERIALS AND METHODS Since June 2002 we have performed 99 tubeless PCNL. Tubeless technique involves antegrade placement of a 6Fr double-J stent without nephrostomy tube at the end of the procedure. This series has been compared with a total of 110 patients in which revision of operative reports ruled out the presence of intraoperative conditions necessary to candidate a patient to tubeless procedure but standard PCNL was performed because prior to its introduction or because of surgeon's attitude afterward. Mean stone burden was 5.4 for standard group and 4.9 cm2 for tubeless group respectively. Mean BMI was 24.1 in the first group and 23.6 in the second one. In this retrospective study, complications rate, postoperative pain, length of hospitalization and convalescence were evaluated by chart review. RESULTS Hematocrit drop did not differ significantly between tubeless PCNL and standard PCNL (5.5% vs 5.90%). Conversely, there was statistically significant difference between tubeless and standard PCNL in terms of the amount of analgesics (49.5 vs. 84.2 mg), immediate postoperative patients' discomfort, hospitalization (2.2 vs 5.3 days) and time to resume normal activities (11.0 vs 16.5 days). CONCLUSIONS In our series, tubeless approach did not determine increase in complication rate. Conversely, tubeless PCNL reduced analgesics' requirement, patients' discomfort, hospitalization and time to recovery. As such, at our Institution, tubeless PCNL has become routine procedure that actually is feasible in almost 2/3 of renal calculi suitable for percutaneous treatment.
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Affiliation(s)
- Guido Giusti
- Stone Center, Department of Urology, Istituto Clinico Humanitas, IRCCS, Rozzano, Milano, Italy.
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Taverna G, Corinti M, Colombo P, Grizzi F, Severo M, Piccinelli A, Giusti G, Benetti A, Zucali PA, Graziotti P. Bladder metastases of appendiceal mucinous adenocarcinoma: a case presentation. BMC Cancer 2010; 10:62. [PMID: 20178637 PMCID: PMC2836301 DOI: 10.1186/1471-2407-10-62] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2009] [Accepted: 02/23/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Appendiceal adenocarcinoma is rare with a frequency of 0.08% of all surgically removed appendices. Few cases of appendiceal carcinoma infiltrating the bladder wall for spatial contiguity have been documented. CASE PRESENTATION A case is reported of a 45-years old woman with mucinous cystadenocarcinoma of the appendix with bladder metastasis. Although ultrasonography and voided urinary cytology were negative, abdomen computed tomography (CT) scan and cystoscopy and subsequent pathological examination revealed a mass exclusively located in the anterior wall of the bladder. Histopathology of the transurethral bladder resection revealed a bladder adenocarcinoma [6 cm (at the maximum diameter) x 2,5 cm; approximate weight: 10 gr] with focal mucinous aspects penetrating the muscle and perivisceral fat. Laparotomy evidenced the presence of a solid mass of the appendix (2,5 cm x 3 cm x 2 cm) extending to the loco-regional lymph nodes. Appendectomy and right hemicolectomy, linfoadenectomy and partial cystectomy were performed. The subsequent pathological examination revealed a mucinous cystadenocarcinoma of the appendix with metastatic cells colonising the anterior bladder wall and several colic lymph nodes. CONCLUSIONS The rarity of the appendiceal carcinoma invading the urinary bladder and its usual involvement of nearest organs and the posterior bladder wall, led us to describe this case which demonstrates the ability of the appendiceal cancer to metastasize different regions of urinary bladder.
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Affiliation(s)
- Gianluigi Taverna
- Department of Urology, Via Manzoni 56 - 20089 Rozzano, Milan, Italy.
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Taverna G, Grizzi F, Minuti F, Seveso M, Piccinelli A, Giusti G, Benetti A, Maugeri O, Pasini L, Zandegiacomo S, Colombo P, Di Biccari S, Graziotti P. PSA repeatedly fluctuating levels are reassuring enough to avoid biopsy? Arch Ital Urol Androl 2009; 81:203-208. [PMID: 20608141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
INTRODUCTION Prostate-specific antigen (PSA) levels can show wide fluctuations when repeatedly measured. Here we investigatewd if: (a) biopsy timing influences the prostate cancer (PC) detection rate in patients with fluctuating PSA (flu-PSA) in comparison with patients with steadily increasing PSA (si-PSA); (b) PSA slope estimated in patients with flu-PSA predicts a different risk of cancer detection; (c) flu-PSA and si-PSA patients develop PC in topographically different sites; (d) the behaviour of pre-operative PSA is an expression of a disease with defferent characteristics to the following radical prostatectomy. METHODS The study involved 211 patients who underwent at least a second biopsy after a first negative prostate biopsy. PSA Slope, PSA velocity (PSAV) and PSA doubling time (PSADT) were estimated. Flu-PSA level was defined as a PSA series with at least one PSA value lower than the one immediately preceding it. RESULTS 82 patients had flu-PSA levels and 129 si-PSA levels. There were no significant differences between the two groups in terms of cancer detection, clinical or pathological stage, but the si-PSA group with cancer had a higher Gleason score. No difference was found for PSA Slope between flu-PSA patients with cancer and those without. CONCLUSIONS Our study demonstrates no difference in PC detection rate at repeat biopsy between patients with flu or si-PSA levels. PSA Slope, PSAV and PSADT were not found helpful tools in cancer detection.
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Affiliation(s)
- Gianluigi Taverna
- Department of Urology Service, Istituto Clinico Humanitas IRCCS, Rozzano, Milan, Italy.
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Zuin M, Giorgini A, Selmi C, Battezzati PM, Cocchi CA, Crosignani A, Benetti A, Invernizzi P, Podda M. Acute liver and renal failure during treatment with buprenorphine at therapeutic dose. Dig Liver Dis 2009; 41:e8-e10. [PMID: 18294936 DOI: 10.1016/j.dld.2007.12.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2007] [Revised: 12/14/2007] [Accepted: 12/17/2007] [Indexed: 12/11/2022]
Abstract
Buprenorphine is a semi-synthetic opioid derivative commonly used in the treatment of heroin addiction. Life-threatening complications have been described following overdoses while few cases of hepatotoxicity due to drug use at therapeutic doses have been recently described in hepatitis C virus carriers. In these cases, however, histological assessment was not exhaustive and no extra-hepatic organ failure was observed. We describe herein a case of acute liver and kidney failure in a patient with previously latent hepatitis C virus chronic infection following recommended doses of buprenorphine. Histology did not demonstrate any feature compatible with hepatitis C virus reactivation or liver cirrhosis and suspension of the treatment led to the resolution of both liver and kidney failure. Causality criteria fulfillment indicates a high probability of buprenorphine-induced liver toxicity. No signs of pre-existant kidney impairment or of pre- or post-renal causes were observed. Since buprenorphine is metabolized through cytochrome P450 3A4, we genotyped six genetic polymorphisms previously described in poor metabolizers but could not confirm these pharmacogenetic bases in this case. In conclusion, we surmise that buprenorphine at suggested doses can induce liver and kidney failure in susceptible individuals, possibly through direct mitochondrial toxicity.
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Affiliation(s)
- M Zuin
- Department of Medicine, Division of Internal Medicine, San Paolo School of Medicine, University of Milan, Milan, Italy.
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Dessy E, Rossi E, Berenzi A, Tironi A, Benetti A, Grigolato P. Chromosome 9 instability and alterations of p16 gene in squamous cell carcinoma of the lung and in adjacent normal bronchi: FISH and immunohistochemical study. Histopathology 2008; 52:475-82. [PMID: 18315600 DOI: 10.1111/j.1365-2559.2008.02969.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS p16, a tumour suppressor gene located at 9p21 chromosome and involved in cell cycle regulation, is often inactivated in lung carcinoma. Inactivation is also supported by the loss of p16 protein, a strong inhibitor of cyclin-dependent kinase (CDK) 4 and 6. The aim of this study was to examine alterations of p16 both in pulmonary squamous cell carcinoma (SCC) and in morphological normal bronchi contiguous with neoplasia. METHODS AND RESULTS p16 gene and chromosome 9 alterations were examined by fluorescence in situ hybridization and the expression of p16 protein by immunohistochemistry in pulmonary surgical specimens from 31 patients with SCC. As controls, surgical specimens from 13 patients with non-neoplastic pathology were examined. Tumours showed molecular alterations for p16 gene and chromosome 9 abnormalities in, respectively, 29/31 and 19/31 cases respectively. p16 protein was unexpressed in 29/31 cases. In morphologically normal bronchi p16 gene and chromosome 9 alterations occurred in, respectively, 13/31 and 4/31 cases respectively; loss of protein immunoreactivity occurred in 14/31 cases. No alterations were seen in any of the control cases. CONCLUSIONS Inactivation of p16 gene in histologically normal bronchi could aid the identification of individuals at risk of developing SCC of the lung.
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Affiliation(s)
- E Dessy
- Second Department of Pathologic Anatomy, School of Medicine, University of Brescia, Brescia, Italy.
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Giusti G, Piccinelli A, Taverna G, Pasini L, Maugeri O, Benetti A, Corinti M, Zandegiacomo S, Graziotti P. RETROGRADE INTRARENAL SURGERY IN THE TREATMENT OF RENAL CALCULI LARGER THAN 2 CM: MYTH OR REALITY? J Urol 2008. [DOI: 10.1016/s0022-5347(08)61075-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Giusti G, Piccinelli A, Taverna G, Maugeri O, Corinti M, Pasini L, Benetti A, Teppa A, Zandegiacomo De Zorzi S, Graziotti P. 880 COMPARISON BETWEEN RETROGRADE INTRARENAL SURGERY (RIRS) AND PERCUTANEOUS NEPHROLITHOTOMY (PNL) IN THE TREATMENT OF RENAL STONES OF 1 TO 2.5 CM IN DIAMETER. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/s1569-9056(07)60875-6] [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: 11/30/2022]
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Seveso M, Taverna G, Giusti G, Benetti A, Piccinelli A, Graziotti P. Nephron sparing surgery of parenchymal kidney tumours in solitary kidney. Arch Ital Urol Androl 2007; 79:12-6. [PMID: 17484397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
INTRODUCTION The aim of this study is to assess the therapeutic efficacy of nephron sparing surgery (NSS) in our experience applied to patients with either bilateral renal cancer or patients with cancer in a solitary functioning kidney, from an oncological viewpoint as well as renal function. MATERIALS AND METHODS From January 1997 to March 2006 we submitted 185 patients to NSS. Twenty-seven presented absolute indications with disease in functionally or anatomically solitary kidney. All but six patients presented with preoperative creatinine levels lower than 2 mg/dL. Access was always lombotomic. Nineteen patients underwent renal artery clamping and cold ischemia. Lesions were between 2 and 14 cm in size. In six cases the collecting system was formally opened. RESULTS Follow-up was between 2 and 108 months. Final histology showed 17 patients with clear cell renal carcinoma, six papillary cell carcinomas, one chromophobe carcinoma, one oncocytoma and two angiomyolipomas. No major perioperative complications were recorded. Two patients died of lung metastases. Two patients present secondary tumours (lung and liver), whereas one patient is being treated with chemotherapy for colon cancer Twenty-two patients are disease-free. None of the 10 patients discharged with creatinine levels >2 mg/dL, were submitted to dialytic therapy during follow-up. None of the patients discharged with normal renal function developed kidney failure. CONCLUSIONS Conservative surgery for patients with absolute indications, is a valid alternative to radical surgery that obviously commits patients to long-term dialysis or renal transplantation. Our cases showed minimal surgical complications, brief hospital stay and limited invasiveness for patients with small incidence of kidney failure associated to the all important cancer control.
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Affiliation(s)
- Mauro Seveso
- Department of Urology, Istituto Clinico Humanitas, Rozzano, Milan, Italy.
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