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Saccone G, Maruotti GM, Morlando M, Visentin S, De Angelis C, Sarno L, Cosmi E, Torcia F, Costanzi F, Gragnano E, Bartolini G, La Verde M, Borelli F, Savoia F, Schiatterella A, De Franciscis P, Locci M, Guida M. Randomized trial of screening for preterm birth in low-risk women - the preterm birth screening study. Am J Obstet Gynecol MFM 2024; 6:101267. [PMID: 38642994 DOI: 10.1016/j.ajogmf.2023.101267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 04/22/2024]
Abstract
BACKGROUND Preterm birth is a major cause of perinatal morbidity and mortality. It is unclear whether the introduction of a universal transvaginal ultrasound cervical length screening program in women at low risk for preterm delivery is associated with a reduction in the frequency of preterm birth. OBJECTIVE To test the hypothesis that the introduction of a midtrimester universal transvaginal ultrasound cervical length screening program in asymptomatic singleton pregnancies without prior preterm delivery would reduce the rate of preterm birth at <37 weeks of gestation. STUDY DESIGN This study was a multicenter nonblinded randomized trial of screening of asymptomatic singleton pregnancies without prior spontaneous preterm birth, who were randomized to either cervical length screening program (ie, intervention group) or no screening (ie, control group). Participants were randomized at the time of their routine anatomy scan between 18 0/7 and 23 6/7 weeks of gestation. Women randomized in the screening group received cervical length measurement. Those who were found to have cervical length ≤25 mm were offered 200 mg vaginal progesterone daily along with cervical pessary. The primary outcome was preterm birth at <37 weeks. The risk of primary outcome was quantified by the relative risk with 95% confidence interval, and was based on the intention-to-screen principle. RESULTS A total of 1334 asymptomatic women with singleton pregnancies and without prior preterm birth, were included in the trial. Out of the 675 women randomized in the transvaginal ultrasound cervical length screening group, 13 (1.9%) were found to have transvaginal ultrasound cervical length ≤25 mm during the screening. Preterm birth at <37 weeks of gestation occurred in 48 women in the transvaginal ultrasound cervical length screening group (7.5%), and 54 women in the control group (8.7%) (relative risk, 0.86; 95% confidence interval, 0.59-1.25). Women randomized in the transvaginal ultrasound cervical length screening group had no significant differences in the incidence of preterm birth at less than 34, 32, 30, 28, and 24 weeks of gestation. CONCLUSION The introduction of a universal transvaginal ultrasound cervical length screening program at 18 0/6 to 23 6/7 weeks of gestation in singleton pregnancies without prior spontaneous preterm birth, with treatment for those with cervical length ≤25 mm, did not result in significant lower incidence of preterm delivery than the incidence without the screening program.
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Affiliation(s)
- Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Saccone, Maruotti, and Sarno; Ms Gragnano; Drs Bartolini, Borrelli, Locci, and Guida).
| | - Giuseppe Maria Maruotti
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Saccone, Maruotti, and Sarno; Ms Gragnano; Drs Bartolini, Borrelli, Locci, and Guida)
| | - Maddalena Morlando
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Drs Morlando, La Verde, Savoia, Schiatterella and De Franciscis)
| | - Silvia Visentin
- Department of Woman's and Child's Health, University of Padua, Padua, Italy (Drs Visentin and Cosmi)
| | - Carlo De Angelis
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy (Drs De Angelis, Torcia, and Costanzi)
| | - Laura Sarno
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Saccone, Maruotti, and Sarno; Ms Gragnano; Drs Bartolini, Borrelli, Locci, and Guida)
| | - Erich Cosmi
- Department of Woman's and Child's Health, University of Padua, Padua, Italy (Drs Visentin and Cosmi)
| | - Francesco Torcia
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy (Drs De Angelis, Torcia, and Costanzi)
| | - Flavia Costanzi
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy (Drs De Angelis, Torcia, and Costanzi)
| | - Elisabetta Gragnano
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Saccone, Maruotti, and Sarno; Ms Gragnano; Drs Bartolini, Borrelli, Locci, and Guida)
| | - Giorgia Bartolini
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Saccone, Maruotti, and Sarno; Ms Gragnano; Drs Bartolini, Borrelli, Locci, and Guida)
| | - Marco La Verde
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Drs Morlando, La Verde, Savoia, Schiatterella and De Franciscis)
| | - Felice Borelli
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Saccone, Maruotti, and Sarno; Ms Gragnano; Drs Bartolini, Borrelli, Locci, and Guida)
| | - Fabiana Savoia
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Drs Morlando, La Verde, Savoia, Schiatterella and De Franciscis)
| | - Antonio Schiatterella
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Drs Morlando, La Verde, Savoia, Schiatterella and De Franciscis)
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Drs Morlando, La Verde, Savoia, Schiatterella and De Franciscis)
| | - Mariavittoria Locci
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Saccone, Maruotti, and Sarno; Ms Gragnano; Drs Bartolini, Borrelli, Locci, and Guida)
| | - Maurizio Guida
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Saccone, Maruotti, and Sarno; Ms Gragnano; Drs Bartolini, Borrelli, Locci, and Guida)
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La Verde M, Savoia F, Riemma G, Schiattarella A, Conte A, Hidar S, Torella M, Colacurci N, De Franciscis P, Morlando M. Fetal aortic isthmus Doppler assessment to predict the adverse perinatal outcomes associated with fetal growth restriction: systematic review and meta-analysis. Arch Gynecol Obstet 2024; 309:79-92. [PMID: 37072584 PMCID: PMC10769912 DOI: 10.1007/s00404-023-06963-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/01/2023] [Indexed: 04/20/2023]
Abstract
PURPOSE Fetal growth restriction (FGR) management and delivery planning is based on a multimodal approach. This meta-analysis aimed to evaluate the prognostic accuracies of the aortic isthmus Doppler to predict adverse perinatal outcomes in singleton pregnancies with FGR. METHODS PubMed, EMBASE, the Cochrane Library, ClinicalTrials.gov and Google scholar were searched from inception to May 2021, for studies on the prognostic accuracy of anterograde aortic isthmus flow compared with retrograde aortic isthmus flow in singleton pregnancy with FGR. The meta-analysis was registered on PROSPERO and was assessed according to PRISMA and Newcastle-Ottawa Scale. DerSimonian and Laird's random-effect model was used for relative risks, Freeman-Tukey Double Arcsine for pooled estimates and exact method to stabilize variances and CIs. Heterogeneity was quantified using I2 statistics. RESULTS A total of 2933 articles were identified through the electronic search, of which 6 studies (involving 240 women) were included. The quality evaluation of studies revealed an overall acceptable score for study group selection and comparability and substantial heterogeneity. The risk of perinatal death was significantly greater in fetuses with retrograde Aortic Isthmus blood flow, with a RR of 5.17 (p value 0.00001). Similarly, the stillbirth rate was found to have a RR of 5.39 (p value 0.00001). Respiratory distress syndrome had a RR of 2.64 (p value = 0.03) in the group of fetuses with retrograde Aortic Isthmus blood flow. CONCLUSION Aortic Isthmus Doppler study may add information for FGR management. However, additional clinical trial are required to assess its applicability in clinical practice.
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Affiliation(s)
- M La Verde
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie 1, 80138, Naples, Italy.
| | - F Savoia
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie 1, 80138, Naples, Italy
| | - G Riemma
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie 1, 80138, Naples, Italy
| | - A Schiattarella
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie 1, 80138, Naples, Italy
| | - A Conte
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie 1, 80138, Naples, Italy
| | - S Hidar
- Obstetrics and Gynecology Department, F. Hached University Teaching Hospital, 4000, Sousse, Tunisia
| | - M Torella
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie 1, 80138, Naples, Italy
| | - N Colacurci
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie 1, 80138, Naples, Italy
| | - P De Franciscis
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie 1, 80138, Naples, Italy
| | - M Morlando
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie 1, 80138, Naples, Italy
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Savoia F, Scala C, Coppola M, Riemma G, Vitale SG, Mikuš M, Schiattarella A, La Verde M, Colacurci N, De Franciscis P, Morlando M. The diagnostic performance of the ductus venosus for the detection of cardiac defects in the first trimester: a systematic review and diagnostic test accuracy meta-analysis. Arch Gynecol Obstet 2023; 308:435-451. [PMID: 36315269 PMCID: PMC10293352 DOI: 10.1007/s00404-022-06812-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 10/03/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE Abnormal flow in the ductus venosus (DV) has been reported to be associated with adverse perinatal outcome, chromosomal abnormalities, and congenital heart defects (CHD). Aneuploid fetuses have increased risk of CHD, but there are discrepancies on the performance of this markers in euploid fetuses. The aim of this meta-analysis was to establish the predictive accuracy of DV for CHD. METHODS MEDLINE, EMBASE, and CINAHL were searched from inception to February 2022. No language or geographical restrictions were applied. Inclusion criteria regarded observational and randomized studies concerning first-trimester DV flow as CHD marker. Random effect meta-analyses to calculate risk ratio (RR) with 95% confidence interval (CI), hierarchical summary receiver-operating characteristics (HSROC), and bivariate models to evaluate diagnostic accuracy were used. Primary outcome was the diagnostic performance of DV in detecting prenatal CHD by means of area under the curve (AUROC). Subgroup analysis for euploid, high-risk, and normal NT fetuses was performed. Quality assessment of included papers was performed using QUADAS-2. RESULTS Twenty two studies, with a total of 204.829 fetuses undergoing first trimester scan with DV Doppler evaluation, fulfilled the inclusion criteria for this systematic review. Overall, abnormal DV flow at the time of first trimester screening was associated to an increased risk of CHD (RR 6.9, 95% CI 3.7-12.6; I2 = 95.2%) as well in unselected (RR: 6.4, 95% CI 2.5-16.4; I2 = 93.3%) and in euploid (RR: 6.45, 95% CI 3.3-12.6; I2 = 95.8%) fetuses. The overall diagnostic accuracy of abnormal DV in detecting CHD was good in euploid fetuses with an AUROC of 0.81 (95% CI 0.78-0.84), but it was poor in the high-risk group with an AUROC of 0.66 (95% CI 0.62-0.70) and in the unselected population with an AUROC of 0.44 (95% CI 0.40-0.49). CONCLUSIONS Abnormal DV in the first trimester increases the risk of CHD with a moderate sensitivity for euploid fetuses. In combination with other markers (NT, TV regurgitation) could be helpful to identify fetuses otherwise considered to be at low risk for CHD. In addition to the improvement of the fetal heart examination in the first trimester, this strategy can increase the detection of major CHD at earlier stage of pregnancy.
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Affiliation(s)
- Fabiana Savoia
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Carolina Scala
- Division of Obstetrics and Gynecology, Gaslini Institute, Genoa, Italy
| | - Marlene Coppola
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gaetano Riemma
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Salvatore Giovanni Vitale
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Mislav Mikuš
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco La Verde
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Nicola Colacurci
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maddalena Morlando
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
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Turco R, Russo M, Lenta S, Apicella A, Gagliardo T, Savoia F, Corona AM, De Fazio F, Bernardo P, Tipo V. Pediatric emergency care admissions for somatic symptom disorders during the COVID-19 pandemic. Eur J Pediatr 2023; 182:957-964. [PMID: 36459226 PMCID: PMC9716529 DOI: 10.1007/s00431-022-04687-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 12/03/2022]
Abstract
During the COVID-19 pandemic, children and adolescents with psychiatric disorders experienced an exacerbation of their symptoms with more access to the emergency department (ED). However, little is known about the experience of somatic symptom disorders (SSDs) during the COVID-19 pandemic in children. Therefore, we aimed to compare the rates of pediatric ED admissions for SSDs before and during the COVID-19 pandemic and to understand whether the relative risk of ED admissions for SSDs changed between the two periods. We retrospectively enrolled all children between 4 and 14 years admitted for SSDs in the pediatric ED of Santobono-Pausilipon Hospital, Naples, Italy, from March 11th, 2020, to March 11th, 2021 (pandemic period), and in the same time period of the previous year (pre-pandemic period). We identified 205/95,743 (0,21%) children with SSDs presenting in ED in the pre-pandemic year and 160/40,165 (0,39%) in the pandemic year (p < 0.05). Considering the accesses for age, we observed a relative decrease of the accesses for SSDs over 12 years old (IRR 0,59; CI 0,39-0,88), while we found no differences under 12 years old (IRR 0,87; CI 0,68-1,10). Conclusion: In this study, we found that despite the massive decrease in pediatric admissions due to the COVID-19 pandemic, somatic symptom disorders' admissions to the pediatric ED increased, suggesting an impact of the pandemic also on pediatric psychiatric disorders. What is Known: • During the COVID -19 pandemic, children and adolescents with a psychiatric disorder experienced exacerbation of their symptoms with more accesses in Emergency Department. What is New: • We found that despite the massive decrease of the pediatric admissions due to the COVID-19 pandemic, somatic symptom disorders admissions in healthy children to the pediatric Emergency Department increased ,suggesting an impact of the pandemic also on the pediatric psychiatric disorders.
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Affiliation(s)
- R. Turco
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - M. Russo
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - S. Lenta
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - A. Apicella
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - T. Gagliardo
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - F. Savoia
- grid.415247.10000 0004 1756 8081Childhood Cancer Registry of Campania, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy
| | - A. M. Corona
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - F. De Fazio
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - P. Bernardo
- grid.415247.10000 0004 1756 8081Department of Neurosciences, Pediatric Psychiatry and Neurology, Santobono-Pausilipon Children’s Hospital, 80120 Naples, Italy
| | - V. Tipo
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
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Savoia F, Muscettola G, Iliodromiti S, Greco E. Open Questions on Gestational Diabetes Mellitus in Twin Pregnancies. Curr Diabetes Rev 2023; 19:111-121. [PMID: 36960648 DOI: 10.2174/1573399818666220426085843] [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: 11/11/2021] [Revised: 01/29/2022] [Accepted: 03/08/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The concurrent, recent increase in prevalence of Gestational Diabetes Mellitus (GDM) and twin pregnancy, in combination with the shared risk factors, has led to speculation that multiples are a risk factor for GDM and, GDM may contribute to twin complications. Twin pregnancies have different physiology and greater obstetric risks compared to singletons, including prematurity and growth restriction. However, in twins methods of GDM screening, thresholds for diagnosis and treatment, as well as glycaemic control targets, have been predominantly extrapolated from singletons. Studies investigating the impact of GDM on pregnancy outcomes in twin pregnancies are conflicting. OBJECTIVE To provide a comprehensive, critical overview of evidence on GDM in twin pregnancies with an emphasis on prevalence, methods of screening, thresholds for diagnosis, risk of pregnancy complications and the impact of treatment on perinatal outcomes. METHODS Review of retrospective and prospective cohort, case-control, and case-series studies on twin pregnancies with GDM published between 1980 and 2021. RESULTS Glucose tolerance in twin pregnancies is poorly studied. Specific guidance for screening, diagnosis, and treatment of GDM in twins is lacking. Studies evaluating pregnancy outcomes in twins with GDM are few and heterogeneous. The absolute risk of maternal complications is greater in twins with GDM compared to singletons; conversely, differences in risks between twins with and without GDM may be due to maternal confounders rather than to GDM. Most studies agree on a positive effect of GDM on neonatal outcomes in twins, likely mediated by the hyperglycaemia improving fetal growth. The impact of lifestyle-measures versus medical management on pregnancy outcomes in twins with GDM is unknown. CONCLUSION Larger longitudinal studies evaluating glucose tolerance, pregnancy outcomes and the impact of treatment both in mono and di-chorionic twins with GDM are warranted to gain further insight into the pathophysiology of this condition and guide optimal management.
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Affiliation(s)
- Fabiana Savoia
- Department of Obstetrics and Gynecology, Universita' degli Studi della Campania, Luigi Vanvitelli, Naples, Italy
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Schiattarella A, Riemma G, Sisti G, Savoia F, Rapisarda A, De Franciscis P, Morlando M. Efficacy of phloroglucinol in shortening the first stage of labor: systematic review and meta-analysis of randomized controlled trials. J Matern Fetal Neonatal Med 2021; 35:7036-7042. [PMID: 34102932 DOI: 10.1080/14767058.2021.1936488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Protracted labor is associated with an elevated risk of maternal and fetal complications. Results of randomized controlled trials on the efficacy in labor of phloroglucinol (PHL), a pure antispasmodic drug, are uncertain. OBJECTIVES To evaluate whether PHL is effective in shortening the first stage of labor. SEARCH STRATEGY MEDLINE, EMBASE, LILACS, Scopus, ClinicalTrials.gov, and the Cochrane Library were searched from inception to July 2020. SELECTION CRITERIA Randomized controlled trials (RCTs) concerning women with a singleton vertex pregnancy at term who were treated with PHL. DATA COLLECTION AND ANALYSIS Relevant data were extracted and tabulated. Review Manager 5.3 was used for data analysis. Primary outcome evaluated was the mean reduction of the first stage of labor. MAIN RESULTS Five RCTs, including 487 pregnant women, were analyzed. The first stage of labor duration was significantly shorter in the treatment arm compared to the control group [MD-113.21 min (95% CI-119.63,-106.79)]. A significant shortening of the second stage was achieved in the PHL group [MD-11.12 min (95% CI-12.64,-9.75)] while no differences were reported for the third stage. CONCLUSIONS PHL might represent an effective treatment to shorten the duration of the first and second stage of labor. SYNOPSIS A meta-analysis of 5 trials found that Phloroglucinol favorably impacts on the total duration of the labor in primiparae and multiparae women with a singleton pregnancy.
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Affiliation(s)
- Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gaetano Riemma
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giovanni Sisti
- Department of Obstetrics and Gynecology, New York Health and Hospitals/Lincoln, Bronx, NY, USA
| | - Fabiana Savoia
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Agnese Rapisarda
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maddalena Morlando
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
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La Verde M, Riemma G, Torella M, Cianci S, Savoia F, Licciardi F, Scida S, Morlando M, Colacurci N, De Franciscis P. Maternal death related to COVID-19: A systematic review and meta-analysis focused on maternal co-morbidities and clinical characteristics. Int J Gynaecol Obstet 2021; 154:212-219. [PMID: 33930185 PMCID: PMC9087672 DOI: 10.1002/ijgo.13726] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 04/28/2021] [Indexed: 12/11/2022]
Abstract
Background Besides reducing the quality of obstetric care, the direct impact of COVID‐19 on pregnancy and postpartum is uncertain. Objective To evaluate the characteristics of pregnant women who died due to COVID‐19. Search strategy Cochrane Library, Embase, MEDLINE, Scopus, and Google Scholar were searched from inception to February 2021. Selection criteria Studies that compared deceased and survived pregnant women with COVID‐19. Data collection and analysis Relevant data were extracted and tabulated. The primary outcome was maternal co‐morbidity. Main results Thirteen studies with 154 deceased patients were included. Obesity doubled the risk of death (relative risk [RR] 2.48, 95% confidence interval [CI] 1.41–4.36, I2 = 0%). No differences were found for gestational diabetes (RR 5.71; 95% CI 0.77–42.44, I2 = 94%) or asthma (RR 2.05, 95% CI 0.81–5.15, I2 = 0%). Overall, at least one severe co‐morbidity showed a twofold increased risk of death (RR 2.26, 95% CI 1.77–2.89, I2 = 76%). Admission to intensive care was related to a fivefold increased risk of death (RR 5.09, 95% CI 2.00–12.98, I2 = 56%), with no difference in need for respiratory support (RR 0.53, 95% CI 0.23–1.48, I2 = 95%) or mechanical ventilation (RR 4.34, 95% CI 0.96–19.60, I2 = 58%). Conclusion COVID‐19 with at least one co‐morbidity increases risk of intensive care and mortality. Pregnant women with COVID‐19 infection and at least one severe co‐morbidity experience increased risk of death and admission to the intensive care unit.
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Affiliation(s)
- Marco La Verde
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gaetano Riemma
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco Torella
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Stefano Cianci
- Dipartimento di Ginecologia Oncologica e Chirurgia Ginecologica Miniinvasiva, Policlinico G. Martino, Università degli studi di Messina, Messina, Italy
| | - Fabiana Savoia
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Federico Licciardi
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Serena Scida
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maddalena Morlando
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Nicola Colacurci
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
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8
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Castellucci P, Savoia F, Farina A, Lima GM, Patrizi A, Baraldi C, Zagni F, Vichi S, Pettinato C, Morganti AG, Strigari L, Fanti S. Correction to: High dose brachytherapy with non sealed 188Re (rhenium) resin in patients with non-melanoma skin cancers (NMSCs): single center preliminary results. Eur J Nucl Med Mol Imaging 2021; 48:1706. [PMID: 33871669 DOI: 10.1007/s00259-021-05363-7] [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: 10/21/2022]
Affiliation(s)
- Paolo Castellucci
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy.
| | - F Savoia
- Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - A Farina
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - G M Lima
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - A Patrizi
- Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - C Baraldi
- Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - F Zagni
- Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - S Vichi
- Department of Industrial Engineering, Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - C Pettinato
- Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy.,Medical Physics Unit, Fondazione IRCCS Ca Granda Ospedale Maggiore Milano, Milan, Italy
| | - A G Morganti
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - L Strigari
- Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - S Fanti
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
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9
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Morlando M, Savoia F, Conte A, Schiattarella A, La Verde M, Petrizzo M, Carpentieri M, Capristo C, Esposito K, Colacurci N. Maternal and Fetal Outcomes in Women with Diabetes in Pregnancy Treated before and after the Introduction of a Standardized Multidisciplinary Management Protocol. J Diabetes Res 2021; 2021:9959606. [PMID: 34805415 PMCID: PMC8604598 DOI: 10.1155/2021/9959606] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 10/03/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Diabetes in pregnancy is associated with an increased risk to the woman and to the developing fetus. Currently, there is no consensus on the optimal management strategies for the follow-up and the timing of delivery of pregnancies affected by gestational and pregestational diabetes, with different international guidelines suggesting different management options. MATERIALS AND METHODS We conducted a retrospective cohort study from January 2017 to January 2021, to compare maternal and neonatal outcomes of pregnancies complicated by gestational and pregestational diabetes, followed-up and delivered in a third level referral center before and after the introduction of a standardized multidisciplinary management protocol including diagnostic, screening, and management criteria. RESULTS Of the 131 women included, 55 were managed before the introduction of the multidisciplinary management protocol and included in group 1 (preprotocol), while 76 were managed according to the newly introduced multidisciplinary protocol and included in group 2 (after protocol). We observed an increase in the rates of vaginal delivery, rising from 32.7% to 64.5% (<0.001), and the rate of successful induction of labor improved from 28.6% to 86.2% (P < 0.001). No differences were found in neonatal outcomes, and the only significant difference was demonstrated for the rates of fetal macrosomia (20% versus 5.3%, P: 0.012). Therefore, the improvements observed in the maternal outcomes did not impact negatively on fetal and neonatal outcomes. CONCLUSION The introduction of a standardized multidisciplinary management protocol led to an improvement in the rates of vaginal delivery and in the rate of successful induction of labor in our center. A strong cooperation between obstetricians, diabetologists, and neonatologists is crucial to obtain a successful outcome in women with diabetes in pregnancy.
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Affiliation(s)
- Maddalena Morlando
- Prenatal Diagnosis and High-Risk Pregnancy Unit, Department of Woman, Child, and General and Specialised Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Fabiana Savoia
- Prenatal Diagnosis and High-Risk Pregnancy Unit, Department of Woman, Child, and General and Specialised Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Anna Conte
- Prenatal Diagnosis and High-Risk Pregnancy Unit, Department of Woman, Child, and General and Specialised Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Antonio Schiattarella
- Prenatal Diagnosis and High-Risk Pregnancy Unit, Department of Woman, Child, and General and Specialised Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Marco La Verde
- Prenatal Diagnosis and High-Risk Pregnancy Unit, Department of Woman, Child, and General and Specialised Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Michela Petrizzo
- Unit of Diabetes, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Mauro Carpentieri
- Neonatal Intensive Care Unit, Department of Woman, Child, and General and Specialised Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Carlo Capristo
- Neonatal Care Unit, Department of Woman, Child, and General and Specialised Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Katherine Esposito
- Unit of Diabetes, Department of Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Nicola Colacurci
- Prenatal Diagnosis and High-Risk Pregnancy Unit, Department of Woman, Child, and General and Specialised Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
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10
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Riemma G, Schiattarella A, La Verde M, Cianci S, Savoia F, De Franciscis P, Cobellis L, Colacurci N, Morlando M. Usefulness of atosiban for tocolysis during external cephalic version: Systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2020; 258:86-92. [PMID: 33421816 DOI: 10.1016/j.ejogrb.2020.12.053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/11/2020] [Accepted: 12/28/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Breech/transverse presentation is responsible for about 30-50 % of cesarean sections in the world. Cesarean section carries a five-fold greater morbidity than vaginal delivery, deeply impacting on women's health. External Cephalic Version (ECV) is an external manipulation used to convert a non-cephalic to a cephalic presentation. The use of tocolysis might facilitate this procedure; however, it is still controversial which drug should be considered as first choice. OBJECTIVE To assess the effectiveness of tocolysis with atosiban, a competitive oxytocin receptor antagonist, in order to increase the rate of successful ECV. STUDY DESIGN Nine databases (including MEDLINE, CINAHL, LILACS, EMBASE, Scopus, ClinicalTrials.gov, Scielo, PROSPERO, Cochrane at CENTRAL) were searched from the inception to August 2020 using a combination of MeSH terms and keywords regarding "atosiban" and "external cephalic version". We included trials of women with a singleton pregnancy who reached at least 36 weeks of gestation and were scheduled to ECV and tocolysis with atosiban (intervention group) compared to beta-agonists or other drugs (control group). The primary outcome was the incidence of successful ECV. Summary measures were reported as relative risk (RR) with 95 % confidence interval (CI). DATA COLLECTION AND ANALYSIS Four studies (1534 women) were eligible for analysis. ECV success rate was significantly lower in women randomized to atosiban (36.7 % vs 45.3 %; RR 0.78 [95 % CI 0.6 to 0.98]). Cesarean section and vaginal delivery rates did not differ between intervention and control group ((59.8 % vs 52.6 %; RR 1.17 [0.98-1.38] and (38.6 % vs 45.0 %; RR 0.83 [95 % CI 0.69-1.01] respectively). Cephalic (36.9 % vs 44.6 %; RR 0.81 [95 % CI 0.65 to 1.01], or breech/transverse presentation at labor (63.4 % vs 55.1 %; RR 1.18 [95 % CI 0.99-1.40]), APGAR score less than 7 at 5 min (1.6 % vs 2.0 %; RR 1.14 [95 % CI 0.27-4.73], NICU admissions (44.2 % vs 48.1 %; RR 0.92 [95 % CI 0.58-1.46] and Umbilical cord pH were similar in both groups. Drug-related side effects were lower in women randomized to atosiban, compared with control group (16.0 % vs 42.9 %; RR 0.38 [95 % CI 0.31 to 0.47]. CONCLUSION The use of atosiban for tocolysis does not improve the rate of successful ECVs when compared to beta-agonists. However, atosiban was associated with a significantly lower incidence of side effects and comparable cesarean section rates.
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Affiliation(s)
- Gaetano Riemma
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Antonio Schiattarella
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco La Verde
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Stefano Cianci
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Fabiana Savoia
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Pasquale De Franciscis
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luigi Cobellis
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Nicola Colacurci
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maddalena Morlando
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
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11
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Castellucci P, Savoia F, Farina A, Lima GM, Patrizi A, Baraldi C, Zagni F, Vichi S, Pettinato C, Morganti AG, Strigari L, Fanti S. High dose brachytherapy with non sealed 188Re (rhenium) resin in patients with non-melanoma skin cancers (NMSCs): single center preliminary results. Eur J Nucl Med Mol Imaging 2020; 48:1511-1521. [PMID: 33140131 PMCID: PMC8113182 DOI: 10.1007/s00259-020-05088-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/20/2020] [Indexed: 12/02/2022]
Abstract
Background and aim High dose brachytherapy using a non sealed 188Re-resin (Rhenium-SCT®, Oncobeta® GmbH, Munich, Germany) is a treatment option for non-melanoma skin cancer (NMSC). The aim of this prospective study was to assess the efficacy and the safety of a single application of Rhenium-SCT® in NMSC. Materials and method Fifty consecutive patients (15F, 35 M, range of age 56–97, mean 81) showing 60 histologically proven NMSCs were enrolled and treated with the Rhenium-SCT® between October 2017 and January 2020. Lesions were located on the face, ears, nose or scalp (n = 46), extremities (n = 9), and trunk (n = 5). Mean surface areas were 7.0 cm2 (1–36 cm2), mean thickness invasion was 1.1 mm (0.2–2.5 mm), and mean treatment time was 79 min (21–85 min). Superficial, mean, and target absorbed dose were 185 Gy, 63 Gy, and 31 Gy respectively. Patients were followed-up at 14, 30, 60, 90, and 180 days posttreatment, when dermoscopy and biopsy were performed. Mean follow-up was 20 months (range 3–33 months). Early skin toxicity was classified according to Common Terminology Criteria for Adverse Events (CTCAE). Cosmetic results were evaluated after at least 12 months according to Radiation Therapy Oncology Group (RTOG) scale. Results At 6 months follow-up, histology and dermoscopy were available for 54/60 lesions, of which 53/54 (98%) completely responded. One patient showed a 1-cm2 residual lesion that was subsequently surgically excised. Twelve months after treatment, 41/41 evaluable lesions were free from relapse. Twenty four months after treatment, 23/24 evaluable lesions were free of relapse. In 56/60 lesions early side effects, resolving within 32 days were classified as grades 1–2 (CTCAE). In the remaining 4/60 lesions, these findings were classified as grade 3 (CTCAE) and lasted up to 8–12 weeks but all resolved within 90 days. After at least 12 months (12–33 months), cosmetic results were excellent (30 lesions) or good (11 lesions). Conclusion High dose brachytherapy with Rhenium-SCT® is a noninvasive, reasonably safe, easy to perform, effective and well-tolerated approach to treat NMSCs, and it seems to be a useful alternative option when surgery or radiation therapy are difficult to perform or not recommended. In our population 98% of the treated lesions resolved completely after a single application and only one relapsed after 2 years. Larger patients’ population and longer follow-up are needed to confirm these preliminary data and to find the optimal dose to administer in order to achieve complete response without significant side effects.
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Affiliation(s)
- Paolo Castellucci
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy.
| | - F Savoia
- Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - A Farina
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - G M Lima
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - A Patrizi
- Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - C Baraldi
- Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - F Zagni
- Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - S Vichi
- Department of Industrial Engineering, Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - C Pettinato
- Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy.,Medical Physics Unit, Fondazione IRCCS Ca Granda Ospedale Maggiore Milano, Milan, Italy
| | - A G Morganti
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - L Strigari
- Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - S Fanti
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy
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12
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Gualdi G, Monari P, Soglia S, Taddeucci P, Fimiani M, Savoia F, Melandri D, Caccavale S, Argenziano G, Calzavara-Pinton P, Amerio P. Dermatologic surgery in centenarians. J Eur Acad Dermatol Venereol 2020; 34:e830-e832. [PMID: 32495459 DOI: 10.1111/jdv.16708] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/16/2020] [Accepted: 05/22/2020] [Indexed: 11/30/2022]
Affiliation(s)
- G Gualdi
- Department of Medicine and Aging Science and Dermatologic Clinic, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
| | - P Monari
- Department of Dermatology, University of Brescia, Spedali civili Brescia, Italy
| | - S Soglia
- Department of Dermatology, University of Brescia, Spedali civili Brescia, Italy
| | - P Taddeucci
- Department of Dermatology, University of Siena, Siena, Italy
| | - M Fimiani
- Department of Dermatology, University of Siena, Siena, Italy
| | - F Savoia
- UO Dermatologia, AUSL dela Romagna, Ravenna, Italia
| | - D Melandri
- UO Dermatologia, AUSL dela Romagna, Ravenna, Italia
| | - S Caccavale
- Department of Dermatology, Second University of Naples, Naples, Italy
| | - G Argenziano
- Department of Dermatology, Second University of Naples, Naples, Italy
| | - P Calzavara-Pinton
- Department of Dermatology, University of Brescia, Spedali civili Brescia, Italy
| | - P Amerio
- Department of Medicine and Aging Science and Dermatologic Clinic, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
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13
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Apalla Z, Errichetti E, Kyrgidis A, Stolz W, Puig S, Malvehy J, Zalaudek I, Moscarella E, Longo C, Blum A, Lanssens S, Savoia F, Tschandl P, Kittler H, Sinz C, Stinco G, Argenziano G, Lazaridou E, Lallas A. Dermoscopic features of mammary Paget’s disease: a retrospective case‐control study by the International Dermoscopy Society. J Eur Acad Dermatol Venereol 2019; 33:1892-1898. [DOI: 10.1111/jdv.15732] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/17/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Z. Apalla
- State Dermatology Department Hippokratio General Hospital Thessaloniki Greece
| | - E. Errichetti
- Institute of Dermatology ‘Santa Maria della Misericordia’ University Hospital Udine Italy
| | - A. Kyrgidis
- Department of Clinical Pharmacology Aristotle University of Thessaloniki Thessaloniki Greece
| | - W. Stolz
- Clinic of Dermatology II Munich Hospital Munich Germany
| | - S. Puig
- Department of Dermatology Hospital Clinic Barcelona Spain
| | - J. Malvehy
- Department of Dermatology Hospital Clinic Barcelona Spain
| | - I. Zalaudek
- Department of Dermatology University of Trieste Trieste Italy
| | - E. Moscarella
- Dermatology Unit University of Campania Naples Italy
| | - C. Longo
- Department of Dermatology University of Modena and Reggio Emilia Modena Italy
- Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia Centro Oncologico ad Alta Tecnologia Diagnostica‐Dermatologia Reggio Emilia Italy
| | - A. Blum
- Public, Private and Teaching Practice of Dermatology Konstanz Germany
| | | | - F. Savoia
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, S.Orsola‐Malpighi Hospital University of Bologna Bologna Italy
| | - P. Tschandl
- Department of Dermatology Medical University of Vienna Vienna Austria
| | - H. Kittler
- Department of Dermatology Medical University of Vienna Vienna Austria
| | - C. Sinz
- Department of Dermatology Medical University of Vienna Vienna Austria
| | - G. Stinco
- Institute of Dermatology ‘Santa Maria della Misericordia’ University Hospital Udine Italy
| | - G. Argenziano
- Dermatology Unit University of Campania Naples Italy
| | - E. Lazaridou
- Second Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - A. Lallas
- First Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
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14
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Zagni F, Lima G, Farina A, Castellucci P, Savoia F, Kirikova A, Wendler T, Fanti S, Marengo M. 361. A new therapy with 188Re for non-melanoma skin cancers. First experiences. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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15
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Neri I, Savoia F, Tengattini V, Sechi A, Rucci P, Patrizi A. Terra firma‐forme dermatosis is underestimated in children and is associated with atopic dermatitis. J Eur Acad Dermatol Venereol 2018; 32:e421-e422. [DOI: 10.1111/jdv.15009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- I. Neri
- Dermatology Unit Department of Specialized, Diagnostic and Experimental Medicine University of Bologna Bologna Italy
| | - F. Savoia
- Dermatology Unit Department of Specialized, Diagnostic and Experimental Medicine University of Bologna Bologna Italy
| | - V. Tengattini
- Dermatology Unit Department of Specialized, Diagnostic and Experimental Medicine University of Bologna Bologna Italy
| | - A. Sechi
- Dermatology Unit Department of Specialized, Diagnostic and Experimental Medicine University of Bologna Bologna Italy
| | - P. Rucci
- Department of Biomedical and Neuromotor Sciences Division of Hygiene and Biostatistics University of Bologna Bologna Italy
| | - A. Patrizi
- Dermatology Unit Department of Specialized, Diagnostic and Experimental Medicine University of Bologna Bologna Italy
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16
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Pileri A, Agostinelli C, Sabattini E, Tabanelli M, Gaspari V, Leuzzi M, Patrizi A, Savoia F. Primary cutaneous small/medium-sized pleomorphic T-cell lymphoproliferative disorder shows a common vascular pattern at dermoscopy. J Eur Acad Dermatol Venereol 2018; 32:e318-e321. [DOI: 10.1111/jdv.14872] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A. Pileri
- Dermatology Unit; Department of Experimental, Diagnostic and Specialty Medicine; Università degli Studi di Bologna Azienda Ospedaliera Sant'Orsola-Malpighi; University of Bologna; via Massarenti 1 40138 Bologna Italy
- Dermatology Section; Department of Surgery and Translational Medicine; University of Florence; Viale Michelangielo 41 Florence Italy
| | - C. Agostinelli
- Hematopathology Unit; Department of Experimental; Diagnostic and Specialty Medicine; University of Bologna; via Massarenti 9 Bologna Italy
| | - E. Sabattini
- Hematopathology Unit; Department of Experimental; Diagnostic and Specialty Medicine; University of Bologna; via Massarenti 9 Bologna Italy
| | - M. Tabanelli
- Dermatology Unit; AUSL della Romagna; Viale Randi 5 Ravenna Italy
| | - V. Gaspari
- Dermatology Unit; Department of Experimental, Diagnostic and Specialty Medicine; Università degli Studi di Bologna Azienda Ospedaliera Sant'Orsola-Malpighi; University of Bologna; via Massarenti 1 40138 Bologna Italy
| | - M. Leuzzi
- Dermatology Unit; Department of Experimental, Diagnostic and Specialty Medicine; Università degli Studi di Bologna Azienda Ospedaliera Sant'Orsola-Malpighi; University of Bologna; via Massarenti 1 40138 Bologna Italy
| | - A. Patrizi
- Dermatology Unit; Department of Experimental, Diagnostic and Specialty Medicine; Università degli Studi di Bologna Azienda Ospedaliera Sant'Orsola-Malpighi; University of Bologna; via Massarenti 1 40138 Bologna Italy
| | - F. Savoia
- Dermatology Unit; Department of Experimental, Diagnostic and Specialty Medicine; Università degli Studi di Bologna Azienda Ospedaliera Sant'Orsola-Malpighi; University of Bologna; via Massarenti 1 40138 Bologna Italy
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17
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Gisondi P, Bianchi L, Conti A, Dapavo P, Malagoli P, Piaserico S, Savoia F, Prignano F, Girolomoni G. Infliximab biosimilar CT-P13 in the treatment of chronic plaque psoriasis: data from the Psobiosimilars registry. Br J Dermatol 2017; 177:e325-e326. [PMID: 28498543 DOI: 10.1111/bjd.15659] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- P Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - L Bianchi
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - A Conti
- Department of Head and Neck Surgery, Section of Dermatology, Azienda Ospedaliero Universitaria Policlinico di Modena, Modena, Italy
| | - P Dapavo
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - P Malagoli
- Section of Dermatology, I.R.C.C.S. Policlinico San Donato, Milan, Italy
| | - S Piaserico
- Department of Medicine, Section of Dermatology, University of Padua, Padua, Italy
| | - F Savoia
- Dermatology, Ospedale 'Umberto I' di Lugo, Ravenna, Italy
| | - F Prignano
- Department of Surgery and Translational Medicine, Section of Dermatology, University of Florence, Florence, Italy
| | - G Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
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Bardazzi F, Savoia F, Di Lernia V, Tengattini V, Balestri R, Patrizi A, Magnano M. To pretreat or not to pretreat? The experience of three Italian Psoriasis centres on the use of premedication with Infliximab. J Eur Acad Dermatol Venereol 2016; 30:e55-e57. [DOI: 10.1111/jdv.13298] [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: 11/27/2022]
Affiliation(s)
- F. Bardazzi
- Division of Dermatology; Department of Specialistic, Clinical and Experimental Medicine; University of Bologna; Bologna Italy
| | - F. Savoia
- Dermatology Unit; Azienda Unità Sanitaria Locale della Romagna; Ravenna Italy
| | - V. Di Lernia
- Dermatology Unit; Arcispedale Santa Maria Nuova; IRCCS, Reggio Emilia Italy
| | - V. Tengattini
- Division of Dermatology; Department of Specialistic, Clinical and Experimental Medicine; University of Bologna; Bologna Italy
| | - R. Balestri
- Division of Dermatology; Department of Specialistic, Clinical and Experimental Medicine; University of Bologna; Bologna Italy
| | - A. Patrizi
- Division of Dermatology; Department of Specialistic, Clinical and Experimental Medicine; University of Bologna; Bologna Italy
| | - M. Magnano
- Division of Dermatology; Department of Specialistic, Clinical and Experimental Medicine; University of Bologna; Bologna Italy
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Di Carlo C, Savoia F, Ferrara C, Sglavo G, Tommaselli GA, Giampaolino P, Cagnacci A, Nappi C. "In patient" medical abortion versus surgical abortion: patient's satisfaction. Gynecol Endocrinol 2016; 32:650-654. [PMID: 26928271 DOI: 10.3109/09513590.2016.1149162] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To compare patients' satisfaction with medical and surgical abortion, implementing the Italian guidelines on medical abortion entailing an "in patient" procedure. METHODS A total of 1832 pregnant chose between surgical (vacuum aspiration) or medical abortion (mifepristone p.o. followed after 3 days by sublingual misoprostol) and expressed their expected satisfaction on a visual analog scale (VAS). A total of 885 women chose surgical and 947 medical abortion. The primary end-point was satisfaction VAS score 20 days after the procedure. Secondary end-points were: difference between pre- and post-abortion VAS score; difference in satisfaction VAS scores according to parity and previous abortion; incidence of side effects. RESULTS VAS score was high in each group but significantly higher for the 1-day surgical than for the 3-day medical abortion procedure (7.9 ± 1.0 versus 7.2 ± 1.2; p < 0.0001). In the surgical group the VAS score increased after the treatment (6.9 ± 1.6 versus 7.9 ± 1.0, p < 0.0001), while it decreased in the medical group (7.5 ± 1.0 versus 7.2 ± 1.2; p < 0.0001). Multiparous women reported higher satisfaction with medical abortion; women with a previous abortion preferred surgical abortion. CONCLUSIONS Both procedures are considered satisfactory by the patients. Performing medical abortion as a 3-day "in patient" procedure, decreased women's satisfaction scores from their baseline expectations.
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Affiliation(s)
- Costantino Di Carlo
- a Department of Obstetrics and Gynaecology and Pathophysiology of Human Reproduction , University of Naples "Federico II" , Italy and
| | - Fabiana Savoia
- a Department of Obstetrics and Gynaecology and Pathophysiology of Human Reproduction , University of Naples "Federico II" , Italy and
| | - Cinzia Ferrara
- a Department of Obstetrics and Gynaecology and Pathophysiology of Human Reproduction , University of Naples "Federico II" , Italy and
| | - Gabriella Sglavo
- a Department of Obstetrics and Gynaecology and Pathophysiology of Human Reproduction , University of Naples "Federico II" , Italy and
| | - Giovanni Antonio Tommaselli
- a Department of Obstetrics and Gynaecology and Pathophysiology of Human Reproduction , University of Naples "Federico II" , Italy and
| | - Pierluigi Giampaolino
- a Department of Obstetrics and Gynaecology and Pathophysiology of Human Reproduction , University of Naples "Federico II" , Italy and
| | - Angelo Cagnacci
- b Division of Obstetrics and Gynecology, Department of Obstetrics and Pediatrics , Azienda Policlinico of Modena , Modena , Italy
| | - Carmine Nappi
- a Department of Obstetrics and Gynaecology and Pathophysiology of Human Reproduction , University of Naples "Federico II" , Italy and
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Di Carlo C, Savoia F, Fabozzi A, Gargano V, Nappi C. A case of ovarian torsion in a patient carrier of a FSH receptor gene mutation previously affected by spontaneous ovarian hyperstimulation syndrome. Gynecol Endocrinol 2015; 31:105-8. [PMID: 25495063 DOI: 10.3109/09513590.2014.987229] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [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] [Indexed: 11/13/2022] Open
Abstract
We here report a case of ovarian torsion in a patient with an history of two previous episodes of spontaneous ovarian hyperstimulation syndrome during her two pregnancies. A mutation of follicle-stimulating hormone receptor (FSHr) gene was identified in this patient and in other members of the family. Two years after her successful second pregnancy, the patient showed signs of severe thyroiditis during administration of oral contraceptive, with suppressed TSH and increased thyreoglobulin, in the absence of any abnormalities of the auto-antibodies. In few days, she developed severe pelvic pain and ultrasonographic evidence of increased ovarian volume. She underwent laparoscopy with unilateral adnexectomy for ovarian ischemic necrosis due to adnexal torsion. Our experience suggests that patients' carrier of a mutation of FSHr gene are at risk of ovarian pathologies also when non-pregnant and in the presence of low TSH levels. Further investigations are needed for an appropriate knowledge of typical and atypical manifestations of spontaneous ovarian hyperstimulation syndrome.
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Affiliation(s)
- C Di Carlo
- Dipartimento di Neuroscienze e Scienze della Riproduzione, Università degli Studi di Napoli Federico II , Naples , Italy and
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Di Carlo C, Savoia F, Morra I, Ferrara C, Sglavo G, Nappi C. Effects of a prolonged, 72 hours, interval between mifepristone and gemeprost in second trimester termination of pregnancy: a retrospective analysis. Gynecol Endocrinol 2014; 30:605-7. [PMID: 24905726 DOI: 10.3109/09513590.2014.930123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate if the 72 hours interval between mifepristone and gemeprost has a similar efficacy compared to the 48 hours interval for second trimester termination of pregnancy STUDY DESIGN Two-hundred and fifteen consecutive pregnant women, admitted to our hospital, for second trimester TOP, were included in this retrospective analysis. Standard protocol was followed for all patients. On the first day of the procedure oral mifepristone 200 mg was administered. After 72 (group A, n = 78) or 48 hours (group B, n = 113) women were admitted for administration of gemeprost 1 mg pessary as per protocol. The induction to abortion time was defined as the interval between the insertion of the first gemeprost pessary and the expulsion of the fetus. RESULTS There are no significant differences in the number of pessaries in the two groups. The induction to abortion interval was longer in group A than in group B. Twenty-one women required surgical evacuation of the uterus for retained placenta or incomplete abortion without difference between groups. CONCLUSION A 48-hours interval between mifepristone and gemeprost leads to better results than a 72-hours interval, with a shorter abortion length and represents the elective method for second trimester TOP.
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Affiliation(s)
- Costantino Di Carlo
- Dipartimento di Neuroscienze e Scienze della Riproduzione, Università degli studi di Napoli Federico II - Napoli , Italia
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Argenziano G, Moscarella E, Annetta A, Battarra VC, Brunetti B, Buligan C, Cantisani C, Capizzi R, Carbone A, Carlino A, Corsetti V, Damiano A, De Salvo V, De Simone P, Di Caterino P, Fargnoli MC, Ferrari A, Fossati B, Frascione P, Ghigliotti G, González Inchaurraga MA, Guerriero C, Landi C, Mazzoni L, Mirizzi S, Palazzo G, Pedretti A, Peris K, Piemonte P, Rossi A, Satta R, Savoia F, Scalvenzi M, Stanganelli I, Stinco G, Zampieri P, Zalaudek I. Melanoma detection in Italian pigmented lesion clinics. GIORN ITAL DERMAT V 2014; 149:161-166. [PMID: 24819635] [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: 06/03/2023]
Abstract
AIM Accuracy in melanoma detection is important to recognize early curable melanomas and to minimize the unnecessary excision of benign lesions. The aim of this paper was to evaluate melanoma screening accuracy of Italian pigmented lesion clinics in terms of number needed to excise (NNE), melanoma thickness, and number of melanomas diagnosed during patient follow-up. METHODS Information on all skin tumors excised in 2011 were extracted from the databases of the participating centers. Information whether the lesion was excised at the baseline examination or during patient follow-up was recorded, as well as the overall number of patients examined in each center in 2011. RESULTS After e-mail solicitation, 22 of 40 centers agreed to participate. A total of 8229 excised lesions were collected. The overall number of examined patients was 86.564, thus 9.5% of screened patients had a lesion removed. Of the excised lesions, 866 were diagnosed as melanoma (1% of examined patients) and 5311 (88.9%) were melanocytic nevi. Three NNE were calculated giving values of 7.9 excised lesions to find 1 melanoma, 7.1 melanocytic lesions to find 1 melanoma, and 3.7 lesions to find 1 skin malignancy. The median melanoma thickness was 0.6 mm, with only 15.1% of melanomas ≥ 1 mm of thickness. Melanomas detected over time were 96 (11.1%; mean thickness, 0.3 mm), with 15.6% of lesions excised after short-term follow-up and 84.4% after long-term follow-up. CONCLUSION The NNE values comparable to those achieved in specialized clinical settings and the high number of early melanomas diagnosed at the baseline examination or during patient follow-up indicate a high level of accuracy in melanoma screening achieved by Italian pigmented lesion clinics.
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MESH Headings
- Adolescent
- Adult
- Aged
- Ambulatory Care Facilities/statistics & numerical data
- Carcinoma, Basal Cell/diagnosis
- Carcinoma, Basal Cell/epidemiology
- Carcinoma, Basal Cell/surgery
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/epidemiology
- Carcinoma, Squamous Cell/surgery
- Dermatology/organization & administration
- Dermoscopy
- Early Detection of Cancer
- Female
- Follow-Up Studies
- Humans
- Italy/epidemiology
- Keratosis, Seborrheic/diagnosis
- Keratosis, Seborrheic/epidemiology
- Keratosis, Seborrheic/surgery
- Male
- Melanoma/diagnosis
- Melanoma/epidemiology
- Melanoma/pathology
- Melanoma/surgery
- Middle Aged
- Neoplasm Grading
- Nevus, Pigmented/diagnosis
- Nevus, Pigmented/epidemiology
- Nevus, Pigmented/pathology
- Nevus, Pigmented/surgery
- Skin Neoplasms/diagnosis
- Skin Neoplasms/epidemiology
- Skin Neoplasms/pathology
- Skin Neoplasms/surgery
- Young Adult
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Affiliation(s)
- G Argenziano
- Skin Cancer Unit Arcispedale Santa Maria Nuova IRCCS Reggio Emilia, Italy -
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Bronzetti G, Patrizi A, Giacomini F, Savoia F, Raone B, Brighenti M, Bonvicini M, Neri I, Gargiulo GD. A PHACES syndrome unmasked by propranolol interruption in a tetralogy of Fallot patient: case report and extensive review on new indications of beta blockers. Curr Med Chem 2014; 21:3153-64. [PMID: 24606509 DOI: 10.2174/0929867321666140304094345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Revised: 06/16/2013] [Accepted: 12/15/2013] [Indexed: 11/22/2022]
Abstract
Infantile hemangiomas (IHs) are the most common benign tumors of infancy and usually they don't require specific therapy. In 10-20% of cases IHs are able to generate complication and medical/surgical intervention is needed. For many decades standard treatment consisted in oral or intralesional corticosteroids until Leaute-Labreze and colleagues published the first report on the efficacy of propranolol for cutaneous infantile hemangiomas in 2008. IHs can be sometimes part of complex syndrome. Here we report the case of a patient with tetralogy of Fallot operated at 5 month of age who stopped propranolol treatment for hypoxic spells and unusually developed facial and subglottic IHs configuring the diagnosis of PHACES syndrome (posterior fossa brain malformations, hemangioma, arterial anomalies, cardiac defects and/or aortic coarctation, ocular anomalies and sternal defects). To our knowledge this is the first report in the international literature of a delayed appearance of an infantile hemangioma involving the skin and the airways (PHACES syndrome). The pathophysiological explanation relies on the mechanism of action of propranolol which seems to act initially with vasoconstriction, down-regulating proangiogenetic factors and inducing endothelial cell apoptosis. Many decades since their introduction β-blockers are useful in a growing group of diseases. The pleiotropic effect of β-adrenoceptors antagonists is not yet deeply understood, residing in neurohormonal regulation systems and angiogenesis and proving to be an effective treatment from cardiovascular to oncological illnesses.
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Affiliation(s)
| | | | | | | | | | | | | | | | - G D Gargiulo
- Clinica Dermatologica, via Massarenti 1, 40138, Bologna, Italy.
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Di Carlo C, Savoia F, Gargano V, Sparice S, Bifulco G, Nappi C. Successful pregnancy complicated by spontaneous, familial, recurrent ovarian hyperstimulation syndrome: report of two cases. Gynecol Endocrinol 2013; 29:897-900. [PMID: 23952048 DOI: 10.3109/09513590.2013.825713] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We here report two cases of spontaneous, familial, recurrent ovarian hyperstimulation syndrome ended in a successful pregnancy. First case was a 26-year-old woman, gravida 3 para 0 and two previous terminations of pregnancy due to spontaneous ovarian hyperstimulation syndrome (OHSS). During her pregnancy, patient was treated with IV fluid therapy, albumin and thromboembolic prophylaxis and required pleural and peritoneal drainage. She was referred to the hospital twice, at 8 and 28 weeks'. At 32 weeks due to worsening of clinical condition, decision was made for a caesarean section. A live, healthy preterm baby of 1950 g was delivered. Second case was a 27-year-old woman, gravida 2 para 0 with one previous termination of pregnancy due to spontaneous OHSS. During her pregnancy patient was treated with IV fluid therapy, albumin, and thromboembolic prophylaxis. She did not require any pleural or peritoneal drainage. She was referred to the hospital twice, at 8 and 30 weeks. At 37 weeks of gestation, due to worsening of clinical condition decision for a caesarean section was made. A live, healthy term baby of 2700 g was delivered. Our experience seems to confirm that management of spontaneous OHSS during pregnancy should be conservative and treatment tailored to severity of symptoms.
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Affiliation(s)
- Costantino Di Carlo
- Department of Obstetrics and Gynecology, University of Naples Federico II, Via S. Pansini 5, Naples, Italy.
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Savoia F, Gaddoni G, Patrizi A, Misciali C, Odorici G, Tampieri G, Tampieri E, Cantelli S, Aldi M. Calciphylaxis in dialysis patients, a severe disease poorly responding to therapies: report of 4 cases. GIORN ITAL DERMAT V 2013; 148:531-536. [PMID: 24005147] [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: 06/02/2023]
Abstract
Calciphylaxis or calciphic uremic arteriolopathy (CUA) is a rare syndrome characterized by the deposition of calcium within the walls of small and medium size vessels in the dermis and in the subcutaneous tissue. The disease mainly affects patients with end-stage renal disease. We report here our experience with 4 cases of calciphylaxis in dialysis patients. The main predisposing factor observed in our 4 patients was warfarin use (2 patients, 50%), while local traumas and diabetes were respectively present in only one patient. None of our patients was obese. Lower legs were the most frequently involved site of CUA (3/4 patients, 75%). In our experience biopsy was crucial to achieve a correct diagnosis and did not cause aggravation of the ulcers. Therapeutic approach was multimodal: mainly hyperbaric oxygen therapy, cinacalcet and sodium thiosulphate. Although many recent case reports have shown exceptional results and healing with the use of sodium thiosulphate, we did not experience any change in the poor prognosis of our patients with the use of this drug, at a dosage of 5 g thrice weekly endovenously.
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Affiliation(s)
- F Savoia
- Unit of Dermatology, AUSL Ravenna, Ravenna, Italy -
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Di Carlo C, Savoia F, Ferrara C, Tommaselli GA, Bifulco G, Nappi C. Case report: a most peculiar family with spontaneous, recurrent ovarian hyperstimulation syndrome. Gynecol Endocrinol 2012; 28:649-51. [PMID: 22313155 DOI: 10.3109/09513590.2011.650763] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Ovarian hyperstimulation syndrome (OHSS) mostly occurs as a complication of induction of ovulation. However, rarely, it may occur spontaneously at the beginning of a natural pregnancy and in the absence of any assisted reproductive treatment. Spontaneous OHSS has been reported in pregnant women affected by hypothyroidism, polycystic ovary syndrome, gonadotropin-producing pituitary adenoma, but also in normal pregnancies. The aetiology of this condition is still unclear. We hereby report on a case of spontaneous, familial, recurrent OHSS in a 26-year-old primipara whose first-degree cousin, paternal grandmother and a number of other members of her father's family had suffered from a similar condition. This case seems to support the concept of a genetic predisposition for spontaneous OHSS thereby suggesting the need for preventive and therapeutic strategies.
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Affiliation(s)
- Costantino Di Carlo
- Department of Obstetrics and Gynecology, University of Naples Federico II, Naples, Italy.
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Savoia F, Gaddoni G, Casadio C, Spadola G, Patrizi A, Giacomini F, Aldi M. A case of eczematous and vesicular dermatitis during anti-TNFalpha therapy for rheumatoid arthritis. GIORN ITAL DERMAT V 2011; 146:308-309. [PMID: 21785399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Di Carlo C, Tommaselli GA, Gargano V, Savoia F, Bifulco G, Nappi C. Transdermal estradiol and oral or vaginal natural progesterone: bleeding patterns. Climacteric 2010; 13:442-6. [DOI: 10.3109/13697137.2010.490605] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bardazzi F, Giacomini F, Savoia F, Misciali C, Patrizi A. Discoid chronic lupus erythematosus at the site of a previously healed cutaneous leishmaniasis: an example of isotopic response. Dermatol Ther 2010; 23 Suppl 2:S44-6. [DOI: 10.1111/j.1529-8019.2010.01300.x] [Citation(s) in RCA: 8] [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: 11/29/2022]
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Patrizi A, Savoia F, Giacomini F, Tabanelli M, Gurioli C. The effect of summer holidays and sun exposure on atopic dermatitis. GIORN ITAL DERMAT V 2009; 144:463-466. [PMID: 19755951] [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: 05/28/2023]
Abstract
AIM The aim of this study was to investigate the effect of sunlight during summer holidays and to assess the seasonability of atopic dermatitis in 43 consecutive patients with mild-moderate atopic dermatitis referring to the Pediatric Outpatient Clinic of the University of Bologna. METHODS Patients had to answer an open questionnaire. RESULTS The collected data showed that 74.4% of the patients affected by mild-moderate atopic dermatitis had complete resolution during summer holidays, 16.3% had improvement and only 9.3% had no modification of atopic dermatitis severity, confirming the seasonability of the disease, with improvement during summertime and worsening in the other seasons. Seaside holidays produced a significantly greater improvement than mountains holidays, with complete resolution of the disease in 91.2% versus 11.1% of patients, P<0.01. Conclusion. These data support the hypothesis on the positive effect of UV radiation on atopic dermatitis in patients without eczema after local therapy with corticosteroids or immunomodulators, but are in contrast with those reported by other authors from Northern Europe. This discrepancy is probably due to the latitude and different climate. In the Mediterranean area and in southern locations greater improvements are observable.
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Affiliation(s)
- A Patrizi
- Division of Dermatology, Department of Internal Medicine, Geriatrics and Nephrology, University of Bologna, 40138 Bologna, Italy.
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Neri I, Savoia F, Giacomini F, Raone B, Aprile S, Patrizi A. Usefulness of dermatoscopy for the early diagnosis of sebaceous naevus and differentiation from aplasia cutis congenita. Clin Exp Dermatol 2009; 34:e50-2. [DOI: 10.1111/j.1365-2230.2008.03189.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [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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Neri I, Savoia F, Giacomini F, Patrizi A. Anonychia, hyponychia and spontaneous amputation of the distal phalanges as a consequence of ischaemic necrosis of the extremities after umbilical catheterization. Br J Dermatol 2007; 157:1299-301. [PMID: 17927789 DOI: 10.1111/j.1365-2133.2007.08228.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Affiliation(s)
- F Bardazzi
- Department of Clinical and Experimental Medicine, Division of Dermatology, University of Bologna, via Massarenti, 140138, Bologna, Italy.
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Abstract
Henna is a shrub cultivated in India, Sri Lanka, and North Africa; it is used, mixed with other substances, as a hair and body dye. Several cases are reported in the literature of sensitization to para-phenylenediamine (PPD) contained in the henna tincture, but few of these are pediatric cases. We report two instances of allergic contact dermatitis due to temporary tattoos in children. In one case a patch test was positive for PPD. We suggest that the fashion of temporary henna tattoos in children is to be discouraged due to the serious consequences that a sensitization to PPD could have in their future.
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Affiliation(s)
- I Neri
- Department of Clinical and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, Italy
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Savoia F. [Simultaneous spectrophotometric determination of the components of a binary mixture with graphic resolution. II]. Boll Soc Ital Biol Sper 1969; 45:942-3. [PMID: 5399995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Savoia F. [Simultaneous spectrophotometric determination of the components of a binary mixture with graphic resolution. I]. Boll Soc Ital Biol Sper 1969; 45:939-41. [PMID: 5400786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Savoia F. [Graphical evaluation for the contemporaneous UV spectrophotometric determination of p-ethoxyacetanilide and o-ethoxybenzamide]. Boll Chim Farm 1969; 108:196-9. [PMID: 5806408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Savoia F. [The simultaneous ultraviolet spectrophotometric determination of p-ethoxy-acetanilide and o-ethoxy-benzammide]. Boll Chim Farm 1967; 106:761-6. [PMID: 5608215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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