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Montali F, Virgilio E, Ballabeni L, Bignone M, Rollo A, Costi R. Open surgical cholecystostomy under local anaesthesia as salvage therapy of acute cholecystitis during the 4th COVID-19 wave in Northern Italy: experience from a rural hospital. Acta Biomed 2023; 94:e2023208. [PMID: 37486595 DOI: 10.23750/abm.v94is1.13586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 03/02/2023] [Indexed: 07/25/2023]
Abstract
The COVID-19 pandemic outbreak delayed interventions of elective surgery worldwide. In Italy, the first western country to be affected, 410000 operations formerly planned were cancelled with the beginning of the first wave. Symptomatic cholelithiasis represents one of the most common, benign medical conditions in the world leading the affected patients to general surgeons'attention; in 0.5% of cases gallstones (symptomatic or not) can complicate with acute lithiasic cholecystitis (ALC) whose universally acknowledged treatment of choice is laparoscopic cholecystectomy. Delaying in surgery of ALC can increase the rate of complications like severe ALC, acute cholangitis and sepsis. The 4th wave of COVID 19 in Northern Italy induced further stress on the healthcare system. In fact, the occurrence of difficult communication and delays in ALC patients transfer between first and second level hospitals lead to the re-emergence of obsolete surgical procedures. In our rural hospital, in fact, a 92 years old patient affected with ALC and several comorbidities was treated with a successful emergency surgical procedure of transperitoneal cholecistostomy in lieu of a radiological transperitoneal approach. Such a choice was dictated by the absence of an interventional radiology unit in our hospital as well as the unavailability of patient transfer to our central referral hub (the hospital of Parma) due to hospital overcrowding secondary to the 4th wave of COVID 19 pandemic.
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Picchetto A, Cinelli L, Bannone E, Baiocchi GL, Morales-Conde S, Casali L, Spinoglio G, Franzini C, Santi C, D'Ambrosio G, Copaescu C, Rollo A, Balla A, Lepiane P, Paganini AM, Detullio P, Quaresima S, Pesce A, Luciano T, Bianchi G, Marescaux J, Diana M. Fluorescence-based sentinel lymph node mapping and lymphography evaluation: results from the IHU-IRCAD-EAES EURO-FIGS registry. Surg Endosc 2023:10.1007/s00464-023-10043-8. [PMID: 37043006 DOI: 10.1007/s00464-023-10043-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/25/2023] [Indexed: 04/13/2023]
Abstract
BACKGROUND The identification of metastatic lymph nodes is one of the most important prognostic factors in gastrointestinal (GI) cancers. Near-infrared fluorescence (NIRF) imaging has been successfully used in GI tumors to detect the lymphatic pathway and the sentinel lymph node (SLN), facilitating fluorescence image-guided surgery (FIGS) with the purpose to achieve a correct nodal staging. The aim of this study was to analyze the current results of NIRF SLN navigation and lymphography through data collected in the EURO-FIGS registry. METHODS Prospectively collected data regarding patients and ICG-guided lymphadenectomies were analyzed. Additional analyses were performed to identify predictors of metastatic SLN and determinants of fluorescence positivity and nodal metastases outside the boundaries of standard lymphadenectomies. RESULTS Overall, 188 patients were included by 18 surgeons from 10 different centers. Colorectal cancer was the most reported pathology (77.7%), followed by gastric (19.1%) and esophageal tumors (3.2%). ICG was injected with higher doses (p < 0.001) via extraparietal side (63.3%), and with higher volumes (p < 0.001) via endoluminal side (36.7%). Overall, NIRF SLN navigation was positive in 75.5% of all cases and 95.5% of positive SLNs were retrieved, with a metastatic rate of 14.7%. NIRF identification of lymph nodes outside standard lymphatic stations occurred in 52.1% of all cases, 43.8% of which were positive for metastatic involvement. Positive NIRF SLN identification was an independent predictor of metastasis outside standard lymphatic stations (OR = 4.392, p = 0.029), while BMI independently predicted metastasis in retrieved SLNs (OR = 1.187, p = 0.013). Lower doses of ICG were protective against NIRF identification outside standard of care lymphadenectomy (OR = 0.596, p = 0.006), while higher volumes of ICG were predictive of metastatic involvement outside standard of care lymphadenectomy (OR = 1.597, p = 0.001). CONCLUSIONS SLN mapping helps identifying potentially metastatic lymph nodes outside the boundaries of standard lymphadenectomies. The EURO-FIGS registry is a valuable tool to share and analyze European surgeons' practices.
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Affiliation(s)
- Andrea Picchetto
- Department of General Surgery and Surgical Specialties "Paride Stefanini", Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
| | - Lorenzo Cinelli
- Research Institute Against Digestive Cancer (IRCAD), Strasbourg, France
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Bannone
- Research Institute Against Digestive Cancer (IRCAD), Strasbourg, France
- Department of Surgery, Istituto Fondazione Poliambulanza, Brescia, Italy
- Department of Pancreatic Surgery, Verona University, Verona, Italy
| | - Gian Luca Baiocchi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Salvador Morales-Conde
- Unit of Innovation in Minimally Invasive Surgery, Department of General Surgery, University Hospital Virgen del Rocío, University of Sevilla, Seville, Spain
- General and Digestive Unit, Hospital Quironsalud Sagrado Corazon, Seville, Spain
| | | | | | | | | | - Giancarlo D'Ambrosio
- Department of General Surgery and Surgical Specialties "Paride Stefanini", Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | | | | | - Andrea Balla
- UOC of General and Minimally Invasive Surgery, Hospital "San Paolo", Largo Donatori del Sangue 1, 00053, Rome, Civitavecchia, Italy
| | - Pasquale Lepiane
- UOC of General and Minimally Invasive Surgery, Hospital "San Paolo", Largo Donatori del Sangue 1, 00053, Rome, Civitavecchia, Italy
| | - Alessandro M Paganini
- Department of General Surgery and Surgical Specialties "Paride Stefanini", Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | | | - Silvia Quaresima
- Department of General Surgery and Surgical Specialties "Paride Stefanini", Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | | | | | | | - Jacques Marescaux
- Research Institute Against Digestive Cancer (IRCAD), Strasbourg, France
| | - Michele Diana
- Research Institute Against Digestive Cancer (IRCAD), Strasbourg, France
- University of Strasbourg, Strasbourg, France
- Department of General, Digestive, and Endocrine Surgery, University Hospital of Strasbourg, Strasbourg, France
- ICube Laboratory, Photonics for Health, University of Strasbourg, Strasbourg, France
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Rollo A, Lugani P, Casali L, Montali F, Scaramuzza L, Gandolfi G, Thai E, Costi R. Intussusception of the bowel in adult women due to bulky inflammatory fibroid polyp treated in emergency. A case report. Acta Biomed 2022; 93:e2022117. [PMID: 35684995 PMCID: PMC10510983 DOI: 10.23750/abm.v93is1.11492] [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] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/27/2021] [Indexed: 06/15/2023]
Abstract
Introduction: Intussusception represents a rare form of bowel obstruction in the adult, which is defined as the telescoping of a proximal segment of the gastrointestinal tract into the lumen of the adjacent distal segment of the GI tract Case Report: We report the case of a 50-year-old woman was admitted in our hospital with acute bowel obstruction. CT showed intestinal occlusion secondary to intussusception. the patient underwent emergency surgery. Surgery confirmed intussusception at the level of the distal ileum (about 30 cm from the ileocecal valve) due to a 3-4 oval mass of hard consistency that appeared to be suspicious for GIST. Was performed a resection of the ileal segment involved associated with oncologically radical lymphadenectomy. The histological examination reported benign ileal mesenchymal neoformation compatible with inflammatory fibroid polyp. Patient had a regular course Discussion: In adults, 90% of invaginations manifest as a result of an organic lesion caused by benign or malignant tumors. The clinical presentation in adults is generally chronic or nonspecific. The emergence of acute symptoms due to complete intestinal obstruction occours in fewer than 20% of patients. Abdominal computed tomography (CT) is the most sensitive radiologic method to confirm intussusception. As many cases are secondary to organic pathologies with malignant potential, surgical resection of the affected bowel segment with oncological procedures is the primary method of treatment Conclusion: Due to the fact that adult intussusception is often frequently associated with organic lesions, surgical intervention is necessary. Treatment usually requires formal resection of the involved bowel segment. (www.actabiomedica.it).
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Spota A, Al-Taher M, Felli E, Morales Conde S, Dal Dosso I, Moretto G, Spinoglio G, Baiocchi G, Vilallonga R, Impellizzeri H, Martin-Martin GP, Casali L, Franzini C, Silvestri M, de Manzini N, Castagnola M, Filauro M, Cosola D, Copaescu C, Garbarino GM, Pesce A, Calabrò M, de Nardi P, Anania G, Carus T, Boni L, Patané A, Santi C, Saadi A, Rollo A, Chautems R, Noguera J, Grosek J, D'Ambrosio G, Ferreira CM, Norcic G, Navarra G, Riva P, Quaresima S, Paganini A, Rosso N, De Paolis P, Balla A, Sauvain MO, Gialamas E, Bianchi G, La Greca G, Castoro C, Picchetto A, Franchello A, Tartamella L, Juvan R, Ioannidis O, Kosir JA, Bertani E, Stassen L, Marescaux J, Diana M. Fluorescence-based bowel anastomosis perfusion evaluation: results from the IHU-IRCAD-EAES EURO-FIGS registry. Surg Endosc 2021; 35:7142-7153. [PMID: 33492508 DOI: 10.1007/s00464-020-08234-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/03/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Anastomotic leakage (AL) is one of the dreaded complications following surgery in the digestive tract. Near-infrared fluorescence (NIRF) imaging is a means to intraoperatively visualize anastomotic perfusion, facilitating fluorescence image-guided surgery (FIGS) with the purpose to reduce the incidence of AL. The aim of this study was to analyze the current practices and results of NIRF imaging of the anastomosis in digestive tract surgery through the EURO-FIGS registry. METHODS Analysis of data prospectively collected by the registry members provided patient and procedural data along with the ICG dose, timing, and consequences of NIRF imaging. Among the included upper-GI, colorectal, and bariatric surgeries, subgroup analysis was performed to identify risk factors associated with complications. RESULTS A total of 1240 patients were included in the study. The included patients, 74.8% of whom were operated on for cancer, originated from 8 European countries and 30 hospitals. A total of 54 surgeons performed the procedures. In 83.8% of cases, a pre-anastomotic ICG dose was administered, and in 60.1% of cases, a post-anastomotic ICG dose was administered. A significant difference (p < 0.001) was found in the ICG dose given in the four pathology groups registered (range: 0.013-0.89 mg/kg) and a significant (p < 0.001) negative correlation was found between the ICG dose and BMI. In 27.3% of the procedures, the choice of the anastomotic level was guided by means of NIRF imaging which means that in these cases NIRF imaging changed the level of anastomosis which was first decided based on visual findings in conventional white light imaging. In 98.7% of the procedures, the use of ICG partly or strongly provided a sense of confidence about the anastomosis. A total of 133 complications occurred, without any statistical significance in the incidence of complications in the anastomoses, whether they were ICG-guided or not. CONCLUSION The EURO-FIGS registry provides an insight into the current clinical practice across Europe with respect to NIRF imaging of anastomotic perfusion during digestive tract surgery.
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Affiliation(s)
- Andrea Spota
- IRCAD Research Institute Against Digestive Cancer, Strasbourg, France
- Scuola di Specializzazione in Chirurgia Generale, Università Degli Studi di Milano, Milano, Italy
| | - Mahdi Al-Taher
- IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
| | - Eric Felli
- IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
| | - Salvador Morales Conde
- Unit of Innovation in Minimally Invasive Surgery, Department of General Surgery, University Hospital Virgen del Rocío, University of Sevilla, Sevilla, Spain
- General and Digestive Unit, Hospital Quironsalud Sagrado Corazon, Sevilla, Spain
| | | | | | | | - Gianluca Baiocchi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | | | | | | | | | | | | | | | | | | | - Davide Cosola
- Clinica Chirurgica, University of Trieste, Trieste, Italy
| | | | - Giovanni Maria Garbarino
- San Pietro Fatebenefratelli Hospital, Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Roma, Italy
| | | | | | | | | | | | - Luigi Boni
- Fondazione IRCCS - Ca' Granda - Ospedale Maggiore Policlinico di Milano, University of Milan, Milano, Italy
| | | | | | - Alend Saadi
- Réseau Hospitalier Neuchâtelois, Neuchatel, Switzerland
| | | | | | | | - Jan Grosek
- University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Giancarlo D'Ambrosio
- Department of General Surgery and Surgical Specialties "Paride Stefanini", Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | | | - Gregor Norcic
- University Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | - Pietro Riva
- Unit of Foregut Surgery, IRCCS Humanitas Clinical and Research Center, Rozzano, Milano, Italy
| | - Silvia Quaresima
- Department of General Surgery and Surgical Specialties "Paride Stefanini", Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Alessandro Paganini
- Department of General Surgery and Surgical Specialties "Paride Stefanini", Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | | | | | - Andrea Balla
- Department of General Surgery and Surgical Specialties "Paride Stefanini", Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | | | | | | | | | - Carlo Castoro
- Unit of Foregut Surgery, IRCCS Humanitas Clinical and Research Center, Rozzano, Milano, Italy
| | - Andrea Picchetto
- Department of General Surgery and Surgical Specialties "Paride Stefanini", Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | | | | | - Robert Juvan
- University Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | | | | | - Laurents Stassen
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jacques Marescaux
- IRCAD Research Institute Against Digestive Cancer, Strasbourg, France
| | - Michele Diana
- IRCAD Research Institute Against Digestive Cancer, Strasbourg, France.
- IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France.
- Department of General, Digestive and Endocrine Surgery, University Hospital of Strasbourg, Strasbourg, France.
- ICube Lab, Photonics for Health, University of Strasbourg, Strasbourg, France.
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Rollo A, Franzini C, Casali L, Santi C, Lombardo E, Violi V. De Garengeot hernia: laparoscopic treatment in emergency. Acta Biomed 2019; 90:568-571. [PMID: 31910186 PMCID: PMC7233761 DOI: 10.23750/abm.v90i4.7901] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 12/03/2018] [Indexed: 11/29/2022]
Abstract
Introduction: De Garengeot Hernia is described as the presence of an appendix within a femoral hernia. Case Report: We report the case of an elderly woman, who presented with incarcerated femoral hernia without signs of bowel obstruction. CT showed a femoral hernia with appendix in the femoral canal with signs of strangulation. the patient underwent emergency surgery. Diagnostic laparoscopy revelead a non-reducible appendix in the femoral canal, in the absence of signs of peritonitis. An infrainguinal incision was performed. An gangrenous appendix within the sac was revealed, detached from the sac and reintroduced into the abdomen through the femoral canal. The laparoscopic appendectomy was then performed. The hernia repair was performed by suturing the iliopubic tract to Cooper’s ligament. Patient had a regular course. Discussion: De Garengeot’s hernia is a rare occurrence. After the year 2000 a total of 32articles, wich presented 34 cases of de Garengeot’s hernia have been published. Due to the rarity of this disease there is not standard procedure; laparoscopy may be a valid technique for determining the condition of the hernia, but due to the difficulty of preoperative diagnosis it is unlikely to be the first choice for the surgical approach. The use of CT can therefore be decisive to help the surgeon in the choice of the approach. Conclusion: De Garengeot’s hernia can be approached in urgent laparoscopy even in the complicated forms of appendicular inflammation. (www.actabiomedica.it)
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Miroddi M, Sterrantino C, Conti V, Rollo A, Calapai G. Anti-EGFR monoclonal antibodies increase the risk of Pulmonary Embolism in Cancer Patients. a systematic review and meta-analysis. Clin Ther 2015. [DOI: 10.1016/j.clinthera.2015.05.240] [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]
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Balsamo C, Zucchini S, Maltoni G, Rollo A, Martini AL, Mazzanti L, Pession A, Cassio A. Relationships between thyroid function and autoimmunity with metabolic derangement at the onset of type 1 diabetes: a cross-sectional and longitudinal study. J Endocrinol Invest 2015; 38:701-7. [PMID: 25722223 DOI: 10.1007/s40618-015-0248-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 10/17/2014] [Accepted: 01/25/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Type 1 diabetes (T1DM) is an autoimmune disease often associated with thyroid abnormalities. PURPOSE We investigated the correlation between thyroid function and metabolic derangement at onset and the influence of autoimmunity on thyroid function at onset and subsequently. METHODS We evaluated 152 patients diagnosed with T1DM between 2000 and 2012 at onset and during a mean follow-up of 5.45 ± 2.8 years. Thyroid function at onset was correlated with metabolic derangement (degree of acidosis, metabolic control and adrenal function) and compared with that of 78 healthy children. Follow-up consisted of regular evaluation of thyroid function and autoimmunity. RESULTS Thyroid hormonal pattern was not influenced at onset by thyroid autoimmunity, but only by metabolic derangement: pH and base excess in fact were significantly lower in patients with impaired thyroid function (p < 0.0001). Patients presenting normal thyroid function at onset showed a reduced conversion from FT4 to FT3 compared to nondiabetic children (FT3/FT4 0.3 ± 0.4 in the control group, 0.24 ± 0.4 in diabetic patients, p < 0.0001). Multiple regression analysis showed the highest correlation (negative) between FT3 levels at onset and base excess (p < 0.005). Thyroid abnormalities related to metabolic derangement disappeared during follow-up. Patients with thyroid antibodies at T1DM onset were at higher risk to require levothyroxine treatment during follow-up (p < 0.05). CONCLUSIONS Thyroid function at T1DM onset is mainly influenced by metabolic derangement, irrespective of thyroid autoimmunity. Antithyroid antibodies evaluation at T1DM onset may be helpful to define which patients are at higher risk of developing hypothyroidism.
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Affiliation(s)
- C Balsamo
- Pediatric Department, Ospedale Sant'Orsola-Malpighi Hospital, University of Bologna, via Massarenti 9, 40100, Bologna, Italy
| | - S Zucchini
- Pediatric Department, Ospedale Sant'Orsola-Malpighi Hospital, University of Bologna, via Massarenti 9, 40100, Bologna, Italy.
| | - G Maltoni
- Pediatric Department, Ospedale Sant'Orsola-Malpighi Hospital, University of Bologna, via Massarenti 9, 40100, Bologna, Italy
| | - A Rollo
- Pediatric Department, Ospedale Sant'Orsola-Malpighi Hospital, University of Bologna, via Massarenti 9, 40100, Bologna, Italy
| | - A L Martini
- Pediatric Department, Ospedale Sant'Orsola-Malpighi Hospital, University of Bologna, via Massarenti 9, 40100, Bologna, Italy
| | - L Mazzanti
- Pediatric Department, Ospedale Sant'Orsola-Malpighi Hospital, University of Bologna, via Massarenti 9, 40100, Bologna, Italy
| | - A Pession
- Pediatric Department, Ospedale Sant'Orsola-Malpighi Hospital, University of Bologna, via Massarenti 9, 40100, Bologna, Italy
| | - A Cassio
- Pediatric Department, Ospedale Sant'Orsola-Malpighi Hospital, University of Bologna, via Massarenti 9, 40100, Bologna, Italy
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Maltoni G, Zucchini S, Scipione M, Rollo A, Balsamo C, Bertolini C, Baronio F, Rondelli R, Pession A. Severe hypoglycemic episodes: a persistent threat for children with Type 1 diabetes mellitus and their families. J Endocrinol Invest 2013; 36:617-21. [PMID: 23511311 DOI: 10.3275/8896] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND As lowering glycated hemoglobin (HbA1c) levels is still the main goal of insulin treatment, severe hypoglycemia (SH) remains a common experience in children with Type 1 diabetes mellitus (T1DM) and their families. AIM This study aims to evaluate the incidence and the clinical features of SH episodes in our Centre in the last 20 yr. SUBJECTS AND METHODS We analyzed SH incidence in 269 patients (pts) diagnosed from 1990 to 2010 (total follow-up 2212.9 pts/yr). Inclusion criteria were at least 3 visits/yr and 1-yr follow- up. SH episode was defined as any condition of low blood glucose requiring third-party assistance. RESULTS 50.2% of patients experienced at least 1 SH episode for a total of 345 episodes. Whole incidence was 15.6/100 pts/yr, slightly different between first and second decade (12.6 vs 16.5, p=0.047). HbA1c at the time of SH was lower in the non-basal bolus group (7.4±1.3 vs 8.2±1.4; p=0.0001) and worsened 3 months later (p=0.0001). Impaired awareness was the main or only symptom in 43.5%. SH occurred at night in 32% of patients; they were significantly younger than those with SH at other times. Five SH episodes or more occurred in 8.1% of patients who presented a lower HbA1c, a younger age and shorter disease duration than the other patients. HbA1c at first SH was negatively correlated with number of SH (r=-0.20; p=0.05). CONCLUSIONS Despite the advent of new insulin regimens, we confirm that SH still represents a relevant risk and a current threat for patients with T1DM and their families.
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Affiliation(s)
- G Maltoni
- Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 11, 40138 Bologna, Italy.
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Donato V, Monaco A, Rollo A, Messineo D, Santuari L, Castrichino A, Caiazzo R, Salvati M, Delfini R, Banelli E. Elderly and poor prognosis patients with high grade glioma: hypofractionated radiotherapy. Clin Ter 2007; 158:227-30. [PMID: 17612282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
AIM To evaluate efficacy of short-course radiotherapy in elderly and/or poor performance status patients with high grade glioma. MATERIALS AND METHODS Twenty-one patients with high grade astrocytoma were selected in our Institute to receive hypofractionated radiotherapy. We considered two radiotherapy treatment arms: in arm I there were 22 patients treated with 60 Gy in 30 fractions at 5 fractions per week; in arm 2 there were 21 patients who received hypofractionated radiotherapy course of 30 Gy in 10 fractions at 5 fractions per week. RESULTS In arm1 the median survival time was 8.2 months and the 1 year overall survival was 36%; in arm 2 the estimated median survival was 6.2 months and the 1 year overall survival was 23%. Treatment was without acute toxicity. CONCLUSIONS In our experience, hypofractionated radiotherapy seems to be a reasonable treatment option for poor prognosis patients with high grade astrocytoma. It is well tolerated and can reduce the overall treatment time without negative effects on survival compared with conventional fractionation.
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Affiliation(s)
- V Donato
- Department of Radiology, Policlinico Umberto I, University La Sapienza, Rome, Italy
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Herrmann IF, Arce Recio S, Rollo A, Aquilini M. Somnoskopie und Polysomnographie on-line. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Munoz-Blay T, Rollo A, Cone RE, Cohen S. Characterization of the molecules involved in thymocyte thymic epithelial cell adhesion. Clin Immunol Immunopathol 1988; 48:343-53. [PMID: 3042213 DOI: 10.1016/0090-1229(88)90028-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Cell to cell adhesion is important for mechanisms of cellular recognition, growth, and differentiation. The identification of molecules involved in these interactions is necessary in order to understand the molecular basis of these processes. We have previously described the development of two different thymic epithelial cell lines (TECS and TECL). Using an assay with radiolabeled thymocytes we found that thymocytes can adhere specifically to these thymic epithelial cells. This adhesion is trypsin sensitive, suggesting that involvement of specific cell surface proteins. In the present study we further characterize and begin identification of the molecules involved in this interaction. We found that thymocyte binding to thymic epithelial cells requires the presence of Ca2+ and Mg2+ and is mediated by a molecule greater than 10,000 MW. Also, we identified several antibodies which inhibit the adhesion of thymocytes to TECS. The membrane nature of the molecule mediating this interaction was confirmed by the ability of thymocyte membranes to block the inhibitory antibodies.
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Affiliation(s)
- T Munoz-Blay
- Department of Pathology, University of Connecticut Health Center, Farmington 06032
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12
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Pihl E, Nairn RC, Milne BJ, Cuthbertson AM, Hughes ES, Rollo A. Lymphoid hyperplasia: a major prognostic feature in 519 cases of colorectal carcinoma. Am J Pathol 1980; 100:469-80. [PMID: 7406021 PMCID: PMC1903530] [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: 01/25/2023]
Abstract
The size of the regional lymph nodes, germinal center, and paracortical areas, and the degree of perivascular lymphocyte cuffing (PLC) at the edges of 519 carcinomas of the large bowel have been analyzed microscopically and assessed quantitatively. Hyperplasia of these lymphoid areas, defined as relative or absolute size exceeding the median for the tumor stage, has been related to cancer-specific survival data for each of Dukes' Stages A, B, and C, and for disseminated disease commonly referred to as Stage D. Germinal center hyperplasia was associated with a major survival advantage in Stage B (P = 0.003) and in Stage C (P = 0.04) if present in tumor-involved lymph nodes. Paracortical hyperplasia related favorably to survival in Stages B and C; in Stage C such hyperplasia was most favorable if present in tumor-involved lymph nodes (P = 0.009). PLC related to favorable survival data only in Stage B. Lymphoid hyperplasia showed no correlation with survival in Stages A and D.
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