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Rubilotta E, Chiarulli EF, Ammirati E, Bevacqua MC, Manodoro S, Chierchia S, Fragalà E, Masiello G, Marzi VL, Giammò A, Musco S, Savoca F, Balzarro M, De Nunzio C, De Rienzo G, Fusco F, Lamberti G, Soligo M, De Palma L, Fasano M, Carretta A, Tumietto F, Finazzi-Agrò E, Russo E, Antonelli A, Gubbiotti M, Sampogna G, Spinelli M, Carone R, Martino L, Mancini V. Antibiotic prophylaxis in invasive urodynamics, a Delphi consensus of the Italian Society of Urodynamics (SIUD). Neurourol Urodyn 2024. [PMID: 38587242 DOI: 10.1002/nau.25463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 03/23/2024] [Indexed: 04/09/2024]
Abstract
INTRODUCTION Although antibiotic prophylaxis (AB) demonstrated a statistically significant reduction in bacteriuria after invasive urodynamics (UDS), no significant decrease in the incidence of urinary tract infections (UTI) has been confirmed. No absolute recommendations on the use of AB in case of relevant potential risk of UTI have been reported, though some categories of patients at increased infective probability after UDS have been recognized. The aim of this study is to report the experts' consensus on the best practice for the use of AB before UDS in the main categories of patients at potential risk of developing UTI. MATERIALS AND METHODS A systematic literature review was performed on AB before UDS in males and females. A panel of experts from the Italian Society of Urodynamics, Continence, Neuro-Urology, and Pelvic Floor (SIUD) assessed the review data and decided by a modified Delphi method on 16 statements proposed and discussed by the panel. The cut-off percentage for the consensus was a ≥70% of positive responses to the survey. The study was a Delphi consensus with experts' opinions, not a clinical trial involving directly patients. RESULTS The panel group was composed of 57 experts in functional urology and UDS, mainly urologists, likewise gynaecologists, physiatrists, infectivologists, pediatric urologists, and nurses. A positive consensus was achieved on 9/16 (56.25%) of the statements, especially on the need for performing AB before UD in patients with neurogenic bladder and immunosuppression. Urine analysis and urine culture before UDS are mandatory, and in the event of their positivity, UDS should be postponed. A consensus was reached on avoiding AB in menopausal status, diabetes, age, gender, bladder outlet obstruction, high postvoid residual, chronic catheterization, previous urological surgery, lack of urological abnormalities, pelvic organ prolapse, and negative urine analysis. CONCLUSIONS Antibiotic prophylaxis is not recommended for patients without notable risk factors and with a negative urine test due to the potential morbidities that may result from antibiotic administration. However, AB can be used for risk categories such as neurogenic bladder and immunosuppression. The evaluation of urine analysis and urine culture and postponing UDS in cases of positive tests were considered good practices, as well as performing AB in the neurogenic bladder and immunosuppression.
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Affiliation(s)
- Emanuele Rubilotta
- Department of Urology, Azienda Ospedaliera Universitaria Verona, Verona, Italy
| | | | - Enrico Ammirati
- Neuro-Urologia, CTO Unità spinale unipolare, Città della Salute e della Scienza, Torino, Italy
| | - Marianna C Bevacqua
- UOC Urologia Abilitata al Trapianto, Grande Ospedale Metropolitano di Reggio Calabria, Milano, Italy
| | - Stefano Manodoro
- UO Ostetricia e Ginecologia Ospedale San Paolo, ASST Santi Paolo e Carlo, Milano, Italy
| | - Stefania Chierchia
- Neuro-Urologia, CTO Unità spinale unipolare, Città della Salute e della Scienza, Torino, Italy
| | - Eugenia Fragalà
- UO Urologia Ospedale G.B. Morgagni - L. Pierantoni, AUSL Romagna, Forlì, Italy
| | | | - Vincenzo L Marzi
- Unit of Urological Robotic Surgery and Renal Transplantation, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, Firenze, Italy
| | | | - Stefania Musco
- Unit of Neuro-Urology, Azienda Ospedaliera Careggi, Firenze, Italy
| | | | - Matteo Balzarro
- Department of Urology, Azienda Ospedaliera Universitaria Verona, Verona, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sapienza University, Ospedale Sant'Andrea, Roma, Italy
| | - Gaetano De Rienzo
- Urology and Andrology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | | | | | - Marco Soligo
- Unit of Obstetrics and Gynecology, Ospedale Maggiore, Lodi, Italy
| | - Luisa De Palma
- UOC Medicina Fisica e Riabilitazione, Policlinico di Bari, Italy
| | - Massimo Fasano
- UO Malattie Infettive, Ospedale Perinei, Altamura, Bari, Italy
| | - Anna Carretta
- UOC Malattie Infettive, Policlinico di Foggia, Foggia, Italy
| | | | - Enrico Finazzi-Agrò
- Department of Surgical Sciences, Urology Unit, University of Rome Tor Vergata, Roma, Italy
| | - Eleonora Russo
- UO Ginecologia e Ostetricia Universitaria I Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | | | | | - Gianluca Sampogna
- Unipolar Spinal Unit and Neurourology Service, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Michele Spinelli
- Unipolar Spinal Unit and Neurourology Service, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | | | - Leonardo Martino
- Urology Unit and Renal Transplantation, Policlinico di Foggia, Università di Foggia, Foggia, Italy
| | - Vito Mancini
- Urology Unit and Renal Transplantation, Policlinico di Foggia, Università di Foggia, Foggia, Italy
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Barone B, Napolitano L, Reccia P, Calace FP, De Luca L, Olivetta M, Stizzo M, Rubinacci A, Della Rosa G, Lecce A, Romano L, Sciorio C, Spirito L, Mattiello G, Vastarella MG, Papi S, Calogero A, Varlese F, Tataru OS, Ferro M, Del Biondo D, Napodano G, Vastarella V, Lucarelli G, Balsamo R, Fusco F, Crocetto F, Amicuzi U. Advances in Urinary Diversion: From Cutaneous Ureterostomy to Orthotopic Neobladder Reconstruction-A Comprehensive Review. J Pers Med 2024; 14:392. [PMID: 38673019 PMCID: PMC11051023 DOI: 10.3390/jpm14040392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/01/2024] [Accepted: 04/06/2024] [Indexed: 04/28/2024] Open
Abstract
Bladder cancer ranks as the 10th most prevalent cancer globally with an increasing incidence. Radical cystectomy combined with urinary diversion represents the standard treatment for muscle-invasive bladder cancer, offering a range of techniques tailored to patient factors. Overall, urinary diversions are divided into non-continent and continent. Among the first category, cutaneous ureterostomy and ileal conduit represent the most common procedures while in the second category, it could be possible to describe another subclassification which includes ureterosigmoidostomy, continent diversions requiring catheterization and orthotopic voiding pouches and neobladders. In this comprehensive review, urinary diversions are described in their technical aspects, providing a summary of almost all alternatives to urinary diversion post-radical cystectomy.
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Affiliation(s)
- Biagio Barone
- Division of Urology, Department of Surgical Sciences, AORN Sant’Anna e San Sebastiano, 81100 Caserta, Italy; (F.F.); (U.A.)
| | - Luigi Napolitano
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (L.N.); (A.R.); (G.D.R.); (A.L.); (L.R.); (G.M.); (S.P.); (F.C.)
| | - Pasquale Reccia
- Urology Unit, AORN Ospedali dei Colli, Monaldi Hospital, 80131 Naples, Italy; (P.R.); (F.P.C.); (R.B.)
| | - Francesco Paolo Calace
- Urology Unit, AORN Ospedali dei Colli, Monaldi Hospital, 80131 Naples, Italy; (P.R.); (F.P.C.); (R.B.)
| | - Luigi De Luca
- Division of Urology, Department of Surgical Multispecialty, AORN Antonio Cardarelli, 80131 Naples, Italy;
| | - Michelangelo Olivetta
- Urology Unit, Gaetano Fucito Hospital, AOU San Giovanni di Dio e Ruggi d’Aragona, 84085 Mercato San Severino, Italy;
| | - Marco Stizzo
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (M.S.); (L.S.)
| | - Andrea Rubinacci
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (L.N.); (A.R.); (G.D.R.); (A.L.); (L.R.); (G.M.); (S.P.); (F.C.)
| | - Giampiero Della Rosa
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (L.N.); (A.R.); (G.D.R.); (A.L.); (L.R.); (G.M.); (S.P.); (F.C.)
| | - Arturo Lecce
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (L.N.); (A.R.); (G.D.R.); (A.L.); (L.R.); (G.M.); (S.P.); (F.C.)
| | - Lorenzo Romano
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (L.N.); (A.R.); (G.D.R.); (A.L.); (L.R.); (G.M.); (S.P.); (F.C.)
| | | | - Lorenzo Spirito
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (M.S.); (L.S.)
| | - Gennaro Mattiello
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (L.N.); (A.R.); (G.D.R.); (A.L.); (L.R.); (G.M.); (S.P.); (F.C.)
| | - Maria Giovanna Vastarella
- Gynaecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| | - Salvatore Papi
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (L.N.); (A.R.); (G.D.R.); (A.L.); (L.R.); (G.M.); (S.P.); (F.C.)
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, Section of General Surgery, University of Naples Federico II, 80131 Naples, Italy; (A.C.); (F.V.)
| | - Filippo Varlese
- Department of Advanced Biomedical Sciences, Section of General Surgery, University of Naples Federico II, 80131 Naples, Italy; (A.C.); (F.V.)
| | - Octavian Sabin Tataru
- Department of Simulation Applied in Medicine, The Institution Organizing University Doctoral Studies (I.O.S.U.D.), George Emil Palade University of Medicine, Pharmacy, Sciences, and Technology from Târgu Mureș, 540142 Târgu Mureș, Romania;
| | - Matteo Ferro
- Department of Urology, European Institute of Oncology (IEO) IRCCS, 20141 Milan, Italy;
| | - Dario Del Biondo
- Department of Urology, Ospedale del Mare, ASL NA1 Centro, 80147 Naples, Italy; (D.D.B.); (G.N.)
| | - Giorgio Napodano
- Department of Urology, Ospedale del Mare, ASL NA1 Centro, 80147 Naples, Italy; (D.D.B.); (G.N.)
| | - Vincenzo Vastarella
- Department of Translational Medical Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
- Division of Cardiology, Cardiovascular Department, AORN Sant’Anna e San Sebastiano, 81100 Caserta, Italy
| | - Giuseppe Lucarelli
- Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy;
| | - Raffaele Balsamo
- Urology Unit, AORN Ospedali dei Colli, Monaldi Hospital, 80131 Naples, Italy; (P.R.); (F.P.C.); (R.B.)
| | - Ferdinando Fusco
- Division of Urology, Department of Surgical Sciences, AORN Sant’Anna e San Sebastiano, 81100 Caserta, Italy; (F.F.); (U.A.)
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (M.S.); (L.S.)
| | - Felice Crocetto
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (L.N.); (A.R.); (G.D.R.); (A.L.); (L.R.); (G.M.); (S.P.); (F.C.)
| | - Ugo Amicuzi
- Division of Urology, Department of Surgical Sciences, AORN Sant’Anna e San Sebastiano, 81100 Caserta, Italy; (F.F.); (U.A.)
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Creta M, Manfredi C, Arcaniolo D, De Sio M, Longo N, De Nunzio C, Fusco F. Mobile health: a promising tool for the management of male patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Prostate Cancer Prostatic Dis 2023; 26:712-714. [PMID: 36697921 PMCID: PMC9874176 DOI: 10.1038/s41391-023-00649-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023]
Affiliation(s)
- Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, (IT), Italy.
| | - Celeste Manfredi
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, (IT), Italy
| | - Davide Arcaniolo
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, (IT), Italy
| | - Marco De Sio
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, (IT), Italy
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, (IT), Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, (IT), Italy
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, (IT), Italy
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Fusco F, Emberton M, Arcaniolo D, De Nunzio C, Manfredi C, Creta M. Prostatic high-resolution micro-ultrasound: an attractive step-forward in the management of prostate cancer patients. Prostate Cancer Prostatic Dis 2023; 26:521-522. [PMID: 36509929 DOI: 10.1038/s41391-022-00611-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/18/2022] [Accepted: 10/31/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy.
| | - Mark Emberton
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Davide Arcaniolo
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Celeste Manfredi
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
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Spirito L, Marra A, Mirone V, Manfredi C, Fusco F, Napolitano L, Servillo G, Lo Grieco N, Buonanno P. Role of spinal anesthesia in robot-assisted radical prostatectomy: Gamble or opportunity? Arch Ital Urol Androl 2023. [PMID: 37278379 DOI: 10.4081/aiua.2023.11311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 03/23/2023] [Indexed: 06/07/2023] Open
Abstract
To the Editor, Although postoperative pain associated with robot-assisted radical prostatectomy (RARP) is less than pain following the open technique, it remains a fundamental issue as it can be a significant source of discomfort for the patient and lengthen recovery times after surgery. The optimal management of pain after RARP is far from being fully elucidated and many factors have to be evaluated to choose the best analgesic approach. [...].
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Affiliation(s)
- Lorenzo Spirito
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples.
| | - Annachiara Marra
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples.
| | - Vincenzo Mirone
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples.
| | - Celeste Manfredi
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples.
| | - Ferdinando Fusco
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples.
| | - Luigi Napolitano
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples.
| | - Giuseppe Servillo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples.
| | - Nicola Lo Grieco
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples.
| | - Pasquale Buonanno
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples.
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Creta M, Manfredi C, Arcaniolo D, Spirito L, Kaplan SA, Woo HH, De Nunzio C, Gilling P, Bach T, De Sio M, Imbimbo C, Mirone V, Longo N, Fusco F. Functional and oncological outcomes after radical prostatectomy in patients with history of surgery for lower urinary tract symptoms related to benign prostatic enlargement: A systematic review with meta-analysis. Prostate Cancer Prostatic Dis 2023:10.1038/s41391-023-00678-y. [PMID: 37244971 DOI: 10.1038/s41391-023-00678-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/02/2023] [Accepted: 05/12/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Outcomes of radical prostatectomy (RP) in men with history of lower urinary tract symptoms related to benign prostatic enlargement (LUTS/BPE) surgery represents a controversial issue. We performed an updated systematic review and meta- analysis evaluating oncological and functional outcomes of RP in this subset of patients. METHODS Eligible studies were identified from MEDLINE, Web of Science and the Scopus databases. The following outcomes were evaluated: incidence of positive surgical margins (PSM), incidence of biochemical recurrence (BCR), 3-mo and 1-year urinary continence (UC) rates, incidence of nerve-sparing (NS) procedures, 1-year erectile function (EF) recovery rates. We estimated pooled Odds ratios (OR) and 95% confidence intervals (CI) using random effects models. Sub-analyses were performed according to the type of RP and LUTS/BPE surgery. RESULTS Twenty-five retrospective studies including 11,101 patients undergoing RP were included in the analysis (2113 with history of LUTS/BPE surgery, and 8898 controls). PSM rate was significantly higher in patients with history of LUTS/BPE surgery (OR 1.39, 95% CI 1.18-1.63, p < 0.001). No statistically significant difference in terms of BCR emerged between patients with or without history of LUTS/BPE surgery (OR 1.46, 95% CI 0.97-2.18, p = 0.066). Three-months and 1-year UC rates were significantly lower in patients with previous LUTS/BPE surgery (OR 0.48, 95% CI 0.34-0.68, p < 0.001 and OR 0.44, 95% CI 0.31-0.62, p < 0.001; respectively). Although not statistically significant differences between the two groups emerged in terms of adoption of NS procedures (OR 0.59, 95% CI 0.32-1.12, p = 0.107), 1-year EF recovery was significantly lower in patients with history of LUTS/BPE procedures (OR 0.60, 95% CI 0.40-0.89, p = 0.010). CONCLUSIONS In conclusions, RP in patients with history of previous LUTS/BPE surgery is associated with increased incidence of PSM, lower UC rates at both 3-months and 1-year follow-up as well as lower rates of EF recovery at 1-year follow-up.
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Affiliation(s)
- Massimiliano Creta
- Interdepartmental Center for Advances in Robotic Surgery, University of Naples Federico II, Naples, Italy
| | - Celeste Manfredi
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, (IT), Italy
| | - Davide Arcaniolo
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, (IT), Italy.
| | - Lorenzo Spirito
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, (IT), Italy
| | - Steven A Kaplan
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Henry H Woo
- Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Peter Gilling
- Department of Urology, Bay of Plenty District Health Board Clinical School, Tauranga, New Zealand
| | - Thorsten Bach
- Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany
| | - Marco De Sio
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, (IT), Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, (IT), Italy
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Orciuolo C, Sorrentino R, Colarusso C, Ceddia S, Minuti G, Conti L, Mandoj C, Carpano S, Canali L, Fucci C, Brandi M, Fusco F, Giammaruco M, Resuli B, Landi L, Cappuzzo F. PP01.54 ImmunoBlood: A Prospective Study Evaluating the Development of Anti-Checkpoint Inhibitor Antibodies in Patients with Advanced Non-Small Cell Lung Cancer Treated with Immunotherapy. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.080] [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: 01/30/2023]
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Napolitano L, Barone B, Spirito L, Trama F, Pandolfo SD, Capece M, García-Rojo E, Fernández-Pascual E, Crocetto F, Fusco F, De Sio M, Arcaniolo D, Manfredi C. Voice Assistants as Consultants for Male Patients with Sexual Dysfunction: A Reliable Option? Int J Environ Res Public Health 2023; 20:2612. [PMID: 36767978 PMCID: PMC9914936 DOI: 10.3390/ijerph20032612] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to evaluate the ability of Google Assistant, Alexa, and Siri to recognize and answer questions about male sexual health. Each VA was tested on a smart speaker: Alexa on Amazon Echo Dot 4th Gen., Google Assistant on Google Home Mini, and Siri on Apple HomePod. A pool of patients' frequently asked questions regarding erectile dysfunction (ED), premature ejaculation (PE), Peyronie's disease (PD), male infertility, and other aspects of male sexual health were identified by authors. The recognition of question was evaluated ("yes" or "not"). For each recognized question, the response characteristics (domains) were rated on a scale from 0 to 10 (according to the quality). We chose the recognition rate of the questions as the primary outcome and the quality of the answers as the secondary outcome. Overall, the best VA in recognizing questions was Siri, with a total of 83.3% questions compared with 64.0% for Alexa (p = 0.024) and 74.0% for Google Assistant (p = 0.061). Siri was associated with a significantly higher recognition rate than Alexa for PE (80% vs. 40%; p = 0.002) and PD (66.7% vs. 33.3%; p = 0.010). The quality of the responses was classified as low in 57 out of 105 cases (54.3%), intermediate in 46 cases (43.8%), and high in only 2 cases (1.9%), highlighting an overall intermediate-low quality of the answers. Male infertility was the condition associated with the highest mean scores in "Targeted response to the problem" (7.32 ± 2.57), "Scientific correctness of the answer", (5.9 ± 2.76) "Completeness of the answer" (5.14 ± 2.56), and "Understandability of the response for a patient" (5.3 ± 2.51) domains. Siri was associated with significantly higher scores than Alexa (p < 0.05) in several domains of all conditions evaluated. The question recognition rate of VAs is quite high; however, the quality of the answers is still intermediate-low. Siri seems superior to Alexa in both question recognition and response quality. Male infertility appears to be the sexual dysfunction best addressed by VAs.
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Affiliation(s)
- Luigi Napolitano
- Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy
| | - Biagio Barone
- Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy
| | - Lorenzo Spirito
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Francesco Trama
- Urology Unit, “Santa Maria Delle Grazie” Hospital, 80078 Pozzuoli, Italy
| | - Savio Domenico Pandolfo
- Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy
| | - Marco Capece
- Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy
| | - Esther García-Rojo
- Department of Urology, Hospital Universitario HM Sanchinarro, 28050 Madrid, Spain
| | - Esaú Fernández-Pascual
- LYX Institute of Urology, Faculty of Medicine, Universidad Francisco de Vitoria, 28006 Madrid, Spain
| | - Felice Crocetto
- Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy
| | - Ferdinando Fusco
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Marco De Sio
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Davide Arcaniolo
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Celeste Manfredi
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
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Brillantino A, Sandoval Sotelo ML, Cricrì AM, Geraci A, Cricrì M, Scardi F, Monte G, Fusco F, Atelli PF, Antropoli M, Lanza M, Squillante S, Benassai G, Quarto G, Castriconi M. Hand-Sewn Versus Stapled Small Bowel Anastomoses in Patients With Secondary Mesenteric Ischemia. J Surg Res 2023; 281:52-56. [PMID: 36115149 DOI: 10.1016/j.jss.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 06/18/2022] [Accepted: 08/15/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Although stapled anastomoses have been widely evaluated in the context of the elective surgery, few reports compared manual with stapled anastomoses in patients undergoing emergency surgery. The aim of this study is to compare the outcome of hand-sewn end-to-end anastomoses with stapled side-to-side and stapled end-to-side anastomoses in patients undergoing small bowel resection for acute mesenteric ischemia secondary to intestinal obstruction. METHODS From January 2015 to June 2021 all the hemodynamically stable patients undergoing emergency surgery with small bowel resection for intestinal obstruction were enrolled in this study. According to surgical technique in performing anastomosis, the patients were divided into three groups: group 1: hand-sewn end-to-end anastomosis, group 2: stapled end-to-side anastomosis, and group 3: stapled side-to-side anastomosis. RESULTS Although the anastomosis failure rate was higher in group 3, it was not significantly different between the three groups (P = 0.78: chi-square test). Likewise, no significant differences in the median hospital stay were found between the patients' groups (P = 0.87: Kruskal-Wallis test). The median operating time was similar in patients undergoing stapled anastomoses and was significantly higher in patients undergoing hand-sewn anastomoses (P = 0.0009: Kruskal-Wallis test). CONCLUSIONS In patients undergoing emergency small bowel resection for complicated intestinal obstruction, a similar outcome in terms of dehiscence rate and hospital stay can be achieved performing stapled or hand-sewn anastomoses, even if restoring the intestinal continuity with stapled technique is associated with lower operating time.
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Affiliation(s)
| | | | | | - Antonella Geraci
- Emergency Surgery Department "A. Cardarelli" Hospital, Naples Italy
| | | | - Francesco Scardi
- Emergency Surgery Department "A. Cardarelli" Hospital, Naples Italy
| | - Giovanni Monte
- Emergency Surgery Department "A. Cardarelli" Hospital, Naples Italy
| | - Ferdinando Fusco
- Emergency Surgery Department "A. Cardarelli" Hospital, Naples Italy
| | | | | | - Michele Lanza
- Emergency Surgery Department "A. Cardarelli" Hospital, Naples Italy
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10
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Borrelli N, Di Salvo G, Ciriello GD, Sabatino J, Grimaldi N, Barracano R, Fusco F, Merola A, Correra A, Romeo E, Colonna D, Palma M, Scognamiglio G, Russo MG, Sarubbi B. Myocardial work impairment in children with Wolff-Parkinson-White syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Wolf-Parkinson-White Syndrome (WPW) has been associated with reduced local myocardium deformation during systole. According to guidelines, when the left ventricle (LV) dysfunction is present catheter ablation of the accessory pathway may be required, even in asymptomatic patients.
Purpose
The study aimed to assess the diagnostic value of non-invasive myocardial work in predicting subtle myocardial abnormalities in children with WPW.
Methods
Eighty pediatric patients (age 7.91±3.2 years) were included in the study: 20 cases with manifest WPW and 60 age- and sex-matched controls (CTR). Global myocardial work index (MWI) was measured as the area of the LV pressure-strain loops. From MWI, global Constructive Work (MCW), Wasted Work (MWW) and Work Efficiency (MWE) were estimated. In addition, standard echocardiographic parameters of LV function were evaluated.
Results
Patients characteristics are summarized in the table. Despite normal LV EF and GLS, children with WPW had worse MWI (WPW 1292.90±307.67 mmHg% vs CTR 1658.73±241.74 mmHg%, p=0.0000005), MCW (WPW 1844.15±267.96 mmHg% vs CTR 2104.90±237.85 mmHg%, p=0.00009), MWW (WPW 101.5 [85–148.25] mmHg% vs CTR 72 [54.75–109.25] mmHg%, p=0.004) and GWE (WPW 94 [91.75–95] mmHg% vs 96 [95–97] mmHg%, p=0.00012) (table). In the WPW group, MWE (r=−0.6, p=0.009) and MWW (r=0.6, p=0.01) was found to correlate with a prolonged QRS (figure).
A multiple regression model was generated to identify the relation between abnormal myocardial work indices (worst interquartile range as dependent variable) and several independent variables. QRS was the best independent predictor of impaired myocardial work. In particular, a QRS>110 msec showed an 86% sensibility and 85% specificity for abnormal MWE (AUC of 0.85), and a 75% sensibility and 83% specificity for abnormal MWW (AUC of 0.83) (figure).
Conclusion
In children with WPW, myocardial work indices were found significantly reduced, even in presence of normal LV EF and GLS. Prolonged QRS independently predicted myocardial impairment. In pediatric patients with WPW, myocardial work may represent a sensitive measure of LV dysfunction and help in the decision-making.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Borrelli
- AO dei Colli - Monaldi Hospital , Naples , Italy
| | - G Di Salvo
- University Hospital of Padova , Padua , Italy
| | - G D Ciriello
- AO dei Colli - Monaldi Hospital , Naples , Italy
| | - J Sabatino
- University Hospital of Padova , Padua , Italy
| | - N Grimaldi
- AO dei Colli - Monaldi Hospital , Naples , Italy
| | - R Barracano
- AO dei Colli - Monaldi Hospital , Naples , Italy
| | - F Fusco
- AO dei Colli - Monaldi Hospital , Naples , Italy
| | - A Merola
- AO dei Colli - Monaldi Hospital , Naples , Italy
| | - A Correra
- AO dei Colli - Monaldi Hospital , Naples , Italy
| | - E Romeo
- AO dei Colli - Monaldi Hospital , Naples , Italy
| | - D Colonna
- AO dei Colli - Monaldi Hospital , Naples , Italy
| | - M Palma
- AO dei Colli - Monaldi Hospital , Naples , Italy
| | | | - M G Russo
- AO dei Colli - Monaldi Hospital , Naples , Italy
| | - B Sarubbi
- AO dei Colli - Monaldi Hospital , Naples , Italy
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11
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Roma AS, Fusco F, Papaccioli G, Abbate M, Scognamiglio G, Merola A, Palma M, Correra A, Borrelli N, Barracano R, Grimaldi N, Colonna D, Romeo E, Sarubbi B. COVID-19 vaccination in adults with congenital heart disease: results of 1-year prospective study. Eur Heart J 2022. [PMCID: PMC9619553 DOI: 10.1093/eurheartj/ehac544.1857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Adults with congenital heart disease (ACHD) are a vulnerable population. Routine vaccination is the only strategy to prevent a life-threatening infection. However, concerns on the cardiac safety and efficacy of COVID-19 vaccines have been raised. Aim To assess safety and efficacy of available COVID-19 vaccines in ACHD patients. Methods Data on COVID-19 infection and vaccines including booster doses and any suspected or confirmed adverse events were prospectively collected for all ACHD patients attending our tertiary centre from the beginning of the vaccination campaign (March 2021). A group of 75 healthy volunteers, matched per age and sex, was included for comparison. Antispike IgG titre was routinely obtained at the ACHD clinic. Patients' attitude towards COVID-19 was explored with a questionnaire. Results As of February 2022, 498 ACHD patients (36.7±16 years, 54% male,69% with moderate-complex defects, 48% with advanced physiological stage) were enrolled. Four hundred and sixty-one (92%) were fully vaccinated: the type of vaccine was Pfizer-BioNTech for 399 (86%) patients, Moderna for 20 (4%) and AstraZeneca for 26 (6%), 9 received a mixed vaccine regimen (2%). Forty-two (9%) had a history of previous COVID-19 infection and therefore received only one dose. Two-hundred and sixty-nine (58%) patients received a booster dose. Adverse events were mainly mild and transient. One patient complaining of chest pain following administration of mRNA-based vaccination was diagnosed with acute pericarditis, which made full remission after appropriate therapy. Two patients reported a non-specific increment of inflammatory markers. No other severe adverse events were reported. Thirty-seven (7%) refused COVID-19 vaccination being scared of potential cardiac/extra-cardiac adverse events. Among those not-vaccinated, 9 (24%) had a history of previous mild COVID-19 infection. IgG titre was measured in 243 patients at 1915 [835–5934] BAU/ml, which was significantly higher compared to controls (1196 [827–2048] BAU/ml, p=0.002). Three ACHD patients contracted COVID-19 infection after the first dose, while 65 (14%) fully vaccinated patients tested positive for COVID-19, all with mild to moderate symptoms. COVID-19 symptoms duration was significantly longer in case of infection before vaccination (10 [2.7–15] vs 3 [1.2–7], p=0.03). One Fontan patient was tested positive for COVID-19 twice, before and after COVID-19 vaccination, requiring hospitalization in both cases. Four hundred and seven patients completed the questionnaire: 128 (31%) declared to be scared of potential cardiac effects of the vaccine and that the discussion with the ACHD cardiologist was crucial to decide to undergo COVID-19 vaccination. Conclusions Our data provide real-world evidence on COVID-19 vaccines safety and efficacy in ACHD patients. Patients' education from the ACHD team may play a key role in vaccine acceptance in this vulnerable population. Funding Acknowledgement Type of funding sources: None.
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Affiliation(s)
- A S Roma
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - F Fusco
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - G Papaccioli
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - M Abbate
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - G Scognamiglio
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - A Merola
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - M Palma
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - A Correra
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - N Borrelli
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - R Barracano
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - N Grimaldi
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - D Colonna
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - E Romeo
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - B Sarubbi
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
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12
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Fusco F, Scognamiglio G, Merola A, Iannuzzi A, Palma M, Borrelli N, Barracano R, Correra A, Ciriello GD, Grimaldi N, Colonna D, Romeo E, Sarubbi B. Effects of sacubitril/valsartan in patients with a systemic right ventricle. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Sacubitril/valsartan has been proved to reduce mortality in heart failure and reduced ejection fraction (EF) and is currently recommended as first-line therapy. However, effects in patients with a systemic right ventricle (sRV) have not been systematically investigated yet.
Purpose
We aimed to assess safety and efficacy of sacubitril/valsartan in patients with a sRV
Methods
From September 2020 to April 2021, all patients with congenitally corrected transposition of the great arteries (TGA) or TGA after Senning/Mustard repair attending our tertiary centre were prospectively enrolled. Inclusion criteria were: age ≥18 years, 3-months of optimal medical therapy including ACEi/ARB and sRV EF≤40%. Patients with univentricular physiology, systolic blood pressure (SBP) <90 mmHg, glomerular filtration rate (GFR) <30 ml/min or K >5.5 mEq/L were excluded. SBP and blood samples were obtained at 1-month of treatment. Other clinical and echocardiographic variables were reassessed at 6 and 12-month follow-up and the medication was progressively up-titrated to the highest tolerated dose.
Results
Fifty-one patients (38±11 years, 60% male, 34% ccTGA) were included. Up to March 2022, 48 (92%) patients were reviewed after 6 months of therapy and 35 (68%) completed the first year of follow-up. Baseline patients' characteristics are summarized in Table 1. At 1 month, treatment did not impact on the serum potassium values (4.5±0.3 vs 4.4±0.3 mEq/L, p=0.9) and GFR (112±33 vs 112±31 ml/min, p=0.3), while SBP dropped significantly (119±13 vs 108±18 mmHg, p=0.003). Two patients ceased the treatment due to symptomatic hypotension during the first month. One patient developed a nephrotic syndrome at 4 months of follow-up, which was likely unrelated to the treatment. No other major adverse events were reported. One patient was lost to follow-up after 3 months. Despite no significant change in the NYHA class (p=0.9), the 6-minute walking distance increased significantly at 6-month (Table 2). Nt pro BNP values were significantly decreased at 6-month, and returned to baseline at 12-month. Improved sRV systolic function was demonstrated at 6 and 12-month by significant increase in fractional area change, RV global longitudinal strain and sRV EF measured with 3D echocardiography.
Conclusions
Our mid-term results showed that sacubitril/valsartan is well tolerated in patients with a sRV and leads to signficant improvement of sRV systolic function, supporting its use in this complex population.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Fusco
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - G Scognamiglio
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - A Merola
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - A Iannuzzi
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - M Palma
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - N Borrelli
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - R Barracano
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - A Correra
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - G D Ciriello
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - N Grimaldi
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - D Colonna
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - E Romeo
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - B Sarubbi
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
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13
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Gallina F, Marinelli D, Forcella D, Tajè R, Ceddia S, Fusco F, Melis E, Buglioni S, Visca P, Cappuzzo F, Facciolo F. 56P The prognostic role of KRAS mutations in patients with early-stage lung adenocarcinoma after robotic lobectomy and systematic lymphadenectomy. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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14
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Manfredi C, Fernández-Pascual E, Arcaniolo D, Spirito L, Quattrone C, Stizzo M, Fusco F, De Sio M, Bianco F, Martínez-Salamanca J. mpMRI-US fusion guided targeted cryotherapy in patients with primary localized prostate cancer: a prospective analysis of oncological and functional outcomes. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01173-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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15
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Morra S, Napolitano L, Collà Ruvolo C, Celentano G, La Rocca R, Capece M, Creta M, Passaro F, Di Bello F, Cirillo L, Turco C, Di Mauro E, Pezone G, Fraia A, Mangiapia F, Fusco F, Mirone V, Califano G, Longo N. Could YouTubeTM encourage men on prostate checks? A contemporary analysis. Arch Ital Urol Androl 2022; 94:285-290. [DOI: 10.4081/aiua.2022.3.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/14/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives: To assess YouTube™ videos’ quality on prostate checks, especially on the digital rectal exam (DRE), and to investigate if they can inform patients correctly and eradicate their beliefs and myths.Methods: A search using as keywords “digital rectal exam for prostate cancer” was performed on the YouTubeTM platform. We selected the first 100 videos. To assess video quality content, Patient Education Materials Assessment Tool for audio-visual content (PEMAT A/V) and Misinformation tool were used.Results: Seventy-three videos were suitable for the analyses. The median PEMAT A/V Understandability score and PEMAT A/V Actionability score were 46.2% (interquartile range [IQR]: 30.8-76.9) and 50.0% (IQR: 25.0-75.0), respectively. The medi-an PEMAT A/V Understandability and Actionability scores were 69.2% (IQR: 46.2-88.5) vs 46.2% (IQR: 30.8-61.5) (p = 0.01) and 100.0% (IQR: 87.5-100.0) vs 25.0% (IQR: 25.0-68.8)(p < 0.001), for healthcare workers vs patients, respectively. According to the Misinformation tool, the median misinforma-tion score of the overall videos was 2.2 (IQR:1.7-2.8). According to the target audience, the misinformation score was 2.8 (IQR: 2.4-3.5) vs 2.0 (IQR: 1.5-2.8) (p = 0.02), for healthcare workers vs patients, respectively. Conclusions: Currently, based on our analyses, YouTubeTM videos’ quality on DRE resulted unsatisfactory according to the PEMAT A/V score and the Misinformation tool. Videos targeted to healthcare workers got higher quality scores if compared to videos targeted to patients. Therefore, YouTubeTM videos’ may not be considered a reliable source of information on DRE for patients.
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Albertini M, Fusco F, Sarubbi B, Gallego P, Rodriguez-Puras M, Prokselj K, Kauling M, Roos-Hesselink J, Labombarda F, Van De Bruaene A, Santes B, Buts W, Iserin L, Woudstra O, Bouma B, Ladouceur M. External validation of a risk score model for predicting major clinical events in adults after atrial switch. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Stizzo M, Manfredi C, Spirito L, Sciorio C, Otero JR, Salamanca JIM, Crocetto F, Verze P, Imbimbo C, Fusco F, De Sio M, Arcaniolo D. Hyperbaric oxygen therapy as adjuvant treatment for surgical site infections after male-to-female gender affirmation surgery: A ten-year experience. Andrology 2022; 10:1310-1316. [PMID: 35726785 PMCID: PMC9541545 DOI: 10.1111/andr.13214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Several urological conditions that share an impairment of tissue oxygenation can benefit from hyperbaric oxygen therapy (HBO), limited evidence is available on the impact of HBO in patients undergoing male-to-female (MtF) Gender Affirmation Surgery (GAS). AIM To evaluate the efficacy and safety of HBO as adjuvant treatment for surgical site infections in patients undergoing MtF GAS. METHODS This research was conducted as an observational retrospective study. Patients undergoing MtF GAS at the principal investigators' Institution from January 2009 to September 2019, with a discharge diagnosis of complicated superficial or deep wound infections, were included. All patients underwent standard management of wound infection. Subjects received HBO or not at the surgeon's discretion and were assigned to the HBO vs. non-HBO group accordingly. Complete wound healing rate (primary outcome), duration of antibiotic therapy, perineal drain time, bladder catheter time, and hospital stay were recorded. All adverse events that occurred during the study period were described. RESULTS A total of 156 patients underwent MtF GAS in the study period. Thirty-three patients were enrolled. Fifteen subjects belonged to the HBO group, the other 18 to the non-HBO group. No statistically significant differences were found between the two groups at baseline. Penile inversion vaginoplasty and intestinal vaginoplasty were performed in 9 (60%) and 6 (40%) patients of the HBO group. Only penile inversion vaginoplasty was performed in subjects of the non-HBO group. Complete wound healing was obtained in 15 patients (100%) of the HBO group and 17 patients (94.4%) of the non-HBO group (p = 0.35). Duration of antibiotic therapy, perineal drain time, bladder catheter time, and hospital stay were significantly lower in the HBO group (p<0.05). CONCLUSION Our preliminary data suggest a role of HBO as adjuvant treatment for surgical site infection in patients undergoing MtF GAS. Randomized controlled trials properly powered are needed to confirm our findings. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Marco Stizzo
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Celeste Manfredi
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Lorenzo Spirito
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.,Department of General and Specialized Surgeries, Renal Transplantation, Nephrology, Care and Pain Management, University of Naples Federico II, Naples, Italy
| | | | - Javier Romero Otero
- Department of Urology, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Hospital Universitario 12 Octubre, Madrid, Spain
| | | | - Felice Crocetto
- Department of General and Specialized Surgeries, Renal Transplantation, Nephrology, Care and Pain Management, University of Naples Federico II, Naples, Italy
| | - Paolo Verze
- Urology Unit, Department of Medicine, University of Salerno, Salerno, Italy
| | - Ciro Imbimbo
- Department of General and Specialized Surgeries, Renal Transplantation, Nephrology, Care and Pain Management, University of Naples Federico II, Naples, Italy
| | - Ferdinando Fusco
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco De Sio
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Davide Arcaniolo
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
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18
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Celentano G, Creta M, Napolitano L, Abate M, La Rocca R, Capece M, Mirone C, Morra S, Di Bello F, Cirillo L, Mangiapia F, Califano G, Collà Ruvolo C, Sagnelli C, Sica A, Calogero A, Iacono F, Fusco F, Mirone V, Longo N. Prostate Cancer Diagnosis, Treatment and Outcomes in Patients with Previous or Synchronous Colorectal Cancer: A Systematic Review of Published Evidence. Diagnostics (Basel) 2022; 12:diagnostics12061475. [PMID: 35741285 PMCID: PMC9221875 DOI: 10.3390/diagnostics12061475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 11/18/2022] Open
Abstract
The management of patients with prostate cancer (PCa) and previous or synchronous colorectal cancer (CRC) represents a challenging issue. A systematic review was performed in May 2022 to summarize available evidence about the diagnosis, management, and outcomes of these patients. Twenty-seven studies involving 252 patients were identified. Overall, 163 (64.7%) and 89 (35.3%) patients had synchronous and metachronous PCa and CRC, respectively. In patients with synchronous diseases, PCa treatment involved active surveillance in 1 patient, radical prostatectomy (RP) in 36 patients, radiotherapy (RT) in 60 patients, RP plus RT in 1 patient, proton beam therapy in 1 patient, and cryoablation in 1 patient. In patients with previous CRC treatment, prostate biopsy was mostly performed by transrectal approach (n = 24). The trans-perineal and suprapubic approaches were adopted in 12 and 6 cases, respectively. Surgical PCa treatment in these cases involved endoscopic extraperitoneal RP, robot-assisted RP, and not otherwise specified RP in 30, 15, and 2 cases, respectively. Biochemical recurrence rates ranged from 20% to 28%. Non-surgical PCa treatment options included brachytherapy, RT plus androgen deprivation therapy, and RT alone in 23, 2 and 4 patients, respectively. PCa specific survival was reported by one study and was 100%.
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Affiliation(s)
- Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
- Correspondence: ; Tel./Fax: +39-081-7462-611
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Marco Abate
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Claudia Mirone
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy;
| | - Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Francesco Di Bello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Luigi Cirillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Antonello Sica
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy;
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80130 Naples, Italy;
| | - Fabrizio Iacono
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Ferdinando Fusco
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
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Longo N, Celentano G, Napolitano L, La Rocca R, Capece M, Califano G, Collà Ruvolo C, Mangiapia F, Fusco F, Morra S, Turco C, Di Bello F, Fusco GM, Cirillo L, Cacciapuoti C, Spirito L, Calogero A, Sica A, Sagnelli C, Creta M. Metastasis-Directed Radiation Therapy with Consolidative Intent for Oligometastatic Urothelial Carcinoma: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:cancers14102373. [PMID: 35625979 PMCID: PMC9139743 DOI: 10.3390/cancers14102373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Patients with oligometastatic urothelial carcinoma represent a challenging subset of subjects to manage. Herein we summarized evidence about the role of metastasis-directed radiation therapy in this clinical setting. Available preliminary evidence supports the role of metastasis-directed radiation therapy as a safe and efficacious option as it has the potential to facilitate local disease control and overall survival. However, in the absence of data from high-quality trials, definitive recommendations cannot be provided, and patients should be counseled on an individual basis. Abstract The management of patients with oligometastatic urothelial carcinoma (UC) represents an evolving field in uro-oncology, and the role of metastasis-directed therapies, including metastasectomy and metastasis-directed radiation therapy (MDRT), is gaining increasing attention. Herein, we summarize available evidence about the role of MDRT with consolidative intent in oligometastatic UC patients. A systematic review was performed in December 2021. Six studies involving 158 patients were identified. Most patients (n = 120, 90.2%) had a history of bladder cancer and the most frequent sites of metastases were lymph nodes (n= 61, 52.1%) followed by the lungs (n = 34, 29%). Overall, 144 metastases were treated with MDRT. Median follow-up ranged from 17.2 to 25 months. Local control rates ranged from 57% to 100%. Median Overall Survival (OS) ranged from 14.9 to 51.0 months and median progression-free survival ranged from 2.9 to 10.1 months. Rates of OS at one and two years ranged from 78.9% to 96% and from 26% to 63%, respectively. Treatment-related toxicity was recorded in few patients and in most cases a low-grade toxicity was evident. MDRT with consolidative intent represents a potential treatment option for selected patients with oligometastatic UC.
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Affiliation(s)
- Nicola Longo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (N.L.); (G.C.); (R.L.R.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (F.D.B.); (G.M.F.); (L.C.); (C.C.); (M.C.)
| | - Giuseppe Celentano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (N.L.); (G.C.); (R.L.R.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (F.D.B.); (G.M.F.); (L.C.); (C.C.); (M.C.)
| | - Luigi Napolitano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (N.L.); (G.C.); (R.L.R.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (F.D.B.); (G.M.F.); (L.C.); (C.C.); (M.C.)
- Correspondence: ; Tel.: +39-0817462611
| | - Roberto La Rocca
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (N.L.); (G.C.); (R.L.R.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (F.D.B.); (G.M.F.); (L.C.); (C.C.); (M.C.)
| | - Marco Capece
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (N.L.); (G.C.); (R.L.R.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (F.D.B.); (G.M.F.); (L.C.); (C.C.); (M.C.)
| | - Gianluigi Califano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (N.L.); (G.C.); (R.L.R.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (F.D.B.); (G.M.F.); (L.C.); (C.C.); (M.C.)
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (N.L.); (G.C.); (R.L.R.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (F.D.B.); (G.M.F.); (L.C.); (C.C.); (M.C.)
| | - Francesco Mangiapia
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (N.L.); (G.C.); (R.L.R.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (F.D.B.); (G.M.F.); (L.C.); (C.C.); (M.C.)
| | - Ferdinando Fusco
- Department of Woman, Child and General, Specialized Surgery, Urology Unit, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (F.F.); (L.S.)
| | - Simone Morra
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (N.L.); (G.C.); (R.L.R.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (F.D.B.); (G.M.F.); (L.C.); (C.C.); (M.C.)
| | - Carmine Turco
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (N.L.); (G.C.); (R.L.R.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (F.D.B.); (G.M.F.); (L.C.); (C.C.); (M.C.)
| | - Francesco Di Bello
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (N.L.); (G.C.); (R.L.R.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (F.D.B.); (G.M.F.); (L.C.); (C.C.); (M.C.)
| | - Giovanni Maria Fusco
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (N.L.); (G.C.); (R.L.R.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (F.D.B.); (G.M.F.); (L.C.); (C.C.); (M.C.)
| | - Luigi Cirillo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (N.L.); (G.C.); (R.L.R.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (F.D.B.); (G.M.F.); (L.C.); (C.C.); (M.C.)
| | - Crescenzo Cacciapuoti
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (N.L.); (G.C.); (R.L.R.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (F.D.B.); (G.M.F.); (L.C.); (C.C.); (M.C.)
| | - Lorenzo Spirito
- Department of Woman, Child and General, Specialized Surgery, Urology Unit, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (F.F.); (L.S.)
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Va Pansini, 5, 80131 Naples, Italy;
| | - Antonello Sica
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie n. 1, 80138 Naples, Italy;
| | - Massimiliano Creta
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (N.L.); (G.C.); (R.L.R.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (F.D.B.); (G.M.F.); (L.C.); (C.C.); (M.C.)
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Morra S, Collà Ruvolo C, Napolitano L, La Rocca R, Celentano G, Califano G, Creta M, Capece M, Turco C, Cilio S, Melchionna A, Gerundo G, Trama F, Mangiapia F, Fusco F, Mirone V, Longo N. Reply to a letter to the editor regarding the published article: "YouTube™ as a source of information on bladder pain syndrome: A contemporary analysis". Neurourol Urodyn 2022; 41:1194-1196. [PMID: 35488738 DOI: 10.1002/nau.24945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 01/23/2023]
Affiliation(s)
- Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
| | - Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
| | - Carmine Turco
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
| | - Simone Cilio
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
| | - Alberto Melchionna
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
| | - Gerardo Gerundo
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Francesco Trama
- Department of Surgical and Biomedical Science, Andrology and Urogynecology Clinic, Santa Maria Terni Hospital, University of Perugia, Terni, Italy
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania 'Luigi Vanvitelli', Caserta, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
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DE Nunzio C, Fiori C, Fusco F, Gregori A, Pagliarulo V, Alongi F. Androgen deprivation therapy and cardiovascular risk in prostate cancer. Minerva Urol Nephrol 2022; 74:508-517. [PMID: 35470648 DOI: 10.23736/s2724-6051.22.04847-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Androgen-deprivation therapy (ADT), with or without palliative local treatments, is the standard of care for many patients with locally-advanced and/or metastatic prostate cancer. However, the possible cardiovascular (CV) risks associated with gonadotropin-releasing hormone (GnRH) antagonists and agonists continue to be the subject of concern, especially in a patient population that may already be at increased CV risk. EVIDENCE ACQUISITION The present review provides a narrative summary of the evidence regarding the CV risks associated with GnRH antagonists and agonists from randomized clinical trials (RCTs), real-world evidence, and meta-analyses. EVIDENCE SYNTHESIS From RCTs, it appears clear that there is a direct class effect for CV risk in patients with prostate cancer being administered GnRH agonists and antagonists, with the latter being associated with reduced CV risk. Real-world data and the available meta-analyses largely indicate that CV risk is lower with GnRH antagonists than with GnRH agonists. CONCLUSIONS A review of the pathophysiological mechanisms of gives further support to the possibility that GnRH antagonists are associated with lower CV risk than agonists. It can be highlighted that when treating patients with advanced or metastatic prostate cancer it is important to screen for underlying comorbidities prior to choosing the most appropriate therapy; moreover, patients should be closely monitored for factors associated with CV risk in order to optimize outcomes. Further studies are needed to define the most appropriate treatment according to the individual patient characteristics.
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Affiliation(s)
| | - Cristian Fiori
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Ferdinando Fusco
- Urology Unit, Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy
| | | | | | - Filippo Alongi
- Advanced Radiation Oncology Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy.,University of Brescia, Brescia, Italy
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22
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Turco C, Collà Ruvolo C, Cilio S, Celentano G, Califano G, Creta M, Capece M, La Rocca R, Napolitano L, Mangiapia F, Spirito L, Morra S, Melchionna A, Fusco F, Mirone V, Longo N. Looking for cystoscopy on YouTube: Are videos a reliable information tool for internet users? Arch Ital Urol Androl 2022; 94:57-61. [PMID: 35352526 DOI: 10.4081/aiua.2022.1.57] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/20/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The Internet is an important and easily accessible source of information. The aim of the current study was to investigate the quality of YouTube videos on cystoscopy and to establish if they can be used as a reliable information tool for internet users. MATERIALS AND METHODS The search term "cystoscopy" was used on YouTube platform and the first 120 YouTube videos were analyzed. To assess the video quality Patient Education Materials Assessment Tool (PEMAT) for Audiovisual (A/V) Materials (Understandability and Actionability sections), Misinformation score and Global Quality Score (GQS) were used. RESULTS Of all 120 videos, 72 were included in the analyses. Of all videos, 59.7% (n = 43), and 40.3% (n = 29) were targeted to General Public and Healthcare Workers. Moreover, "technical aspects" was the main topic addressed (n = 29, 40.3%). The median PEMAT A/V Understandability and Actionability scores were 50.0% (IQR: 39.1-70.0) and 66.7% (IQR: 33.3- 100.0), respectively. The median Misinformation score ranged from 1.0 to 3.0. According to GQS, 22 (30.6%), 26 (36.1%), 16 (22.2%), 8 (11.1%) videos were poor, generally poor, moderate, and good, respectively. No video was evaluated as excellent. CONCLUSIONS Today, YouTube videos on cystoscopy are more frequently uploaded by healthcare workers, who share information about specific aspects of this procedure. However, the quality of YouTube contents on cystoscopy is still poor. Therefore, currently users interested in cystoscopy cannot rely on YouTube to get good informative material on this topic. In consequence, future authors should focus on improving the quality of video contents on cystoscopy.
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Affiliation(s)
- Carmine Turco
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II".
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II".
| | - Simone Cilio
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II".
| | - Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II".
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II".
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II".
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II".
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II".
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II".
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II".
| | - Lorenzo Spirito
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II".
| | | | - Alberto Melchionna
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II".
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples.
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II".
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II".
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Di Bello F, Collà Ruvolo C, Cilio S, La Rocca R, Capece M, Creta M, Celentano G, Califano G, Morra S, Iacovazzo C, Coviello A, Buonanno P, Fusco F, Imbimbo C, Mirone V, Longo N. Testicular cancer and YouTube: What do you expect from a social media platform? Int J Urol 2022; 29:685-691. [PMID: 35318754 DOI: 10.1111/iju.14871] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/11/2022] [Accepted: 03/08/2022] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the quality information on testicular cancer uploaded on YouTube™ videos. METHODS YouTube™ videos were searched using "Testicular cancer" as a keyword. The Patient Education Materials Assessment Tool, the Misinformation scale, and the DISCERN tool were used to assess the quality information of YouTube™ videos on testicular cancer. RESULTS According to the selection criteria, 121 YouTube™ videos were collected for the analysis and stratified according to uploading year (2009-2014 vs 2015-2020). According to the Patient Education Materials Assessment Tool for audio-visual content, the overall Understandability score was 60% (interquartile range 45.5-75) and the overall Actionability score was 100% (interquartile range 66.7-100). According to the Misinformation scale, the lowest median was recorded for item 6 ("Effects on fertility") and the overall median Misinformation score was 2 (interquartile range 1.3-2.8). No statistically significant differences were observed according to uploading year (all P > 0.05). Of all, only 54 (44.6%) videos mentioning treatment were subsequently analyzed. Of these videos, the overall Understandability was 71.4% (interquartile range 56.3-84.6) and the overall Actionability was 100% (interquartile range 66.7-100). The overall Misinformation score was 2.8 (interquartile range 2.2-3.5). The median DISCERN score recorded for question 16 was 5 (interquartile range 3-5). CONCLUSIONS YouTube™ is a fast and open-access source for mass information. The overall quality of the testicular cancer contents provided is sadly unsatisfactory, in the present likewise in the past. However, YouTube™ videos mentioning treatment options showed higher quality content, than the remaining one. Nevertheless, all the videos analyzed underestimated the testicular cancer effects on fertility. Nowadays, YouTube™ cannot be recommended as a reliable source of information on testicular cancer.
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Affiliation(s)
- Francesco Di Bello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Simone Cilio
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Carmine Iacovazzo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Antonio Coviello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Pasquale Buonanno
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Ferdinando Fusco
- Urology Unit, Department of Woman Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
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24
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Borrelli N, Di Salvo G, Ciriello GD, Grimaldi N, Barracano R, Fusco F, Merola A, Correra A, Colonna D, Palma M, Scognamiglio G, Russo MG, Sarubbi B. Blood flow vortices adapt their behaviour to the presence of kent accessory pathway. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Blood speckle imaging (BSI) is a new speckle-tracking-based technique for the evaluation of blood flow. Ventricular flow vortices have been studied in sinus rhythm in normal and dysfunctional hearts, however, data are lacking in patients with Kent accessory pathway (KAP) and short atrio-ventricular (AV) conduction.
Purpose
We aimed to evaluate the characteristics of left ventricle blood vortices in children with KAP.
Methods
Nineteen paediatric patients (age 7 ± 2.9 years) were included in the study: 13 patients with manifest KAP (KAP group) and 6 age and sex -matched controls with normal AV conduction (CTR group). A thorough echocardiographic evaluation with 2D, color doppler and BSI was performed in all the included patients. BSI was recorded in apical 3-chamber view with a 6S-D probe. Vortices characteristic were analysed during filling phase of the left ventricle. We focused on the anterior vortex generated by mitral valve, which persisted longer during the cardiac cycle and is assumed to contribute to optimizing cardiac function. A standard 12-lead ECG was also recorded for each child in KAP group to esteem KAP localization.
Results
According to Arruda criteria for KAP localization, all patients in KAP group manifested the accessory pathway in the septal region. All patients in CTR group presented one major anterior vortex during filling phase, while in KAP group 10 patients out of 13 (p= 0.009) lacked of this main anterior vortex, showing instead fragmented different vortices. There were no differences in term of left ventricle function (KAPg 59.8 ± 4.02% vs CTRg 59.0 ± 2.5%, p= 0.6) and global longitudinal strain (KAPg -18.6 ± 1.0% vs CTRg -19.6 ± 3.1%, p= 0.5) between the two groups.
Conclusion
In our preliminary analysis, in patients with septal KAP, blood vortices adapted their diastolic traces to the septal dyssynchrony showing a fragmented pattern. We speculate this fragmentation may contribute to impair the performance of the left ventricle. Abstract Figure. BSI in control vs patient with WPW
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Affiliation(s)
- N Borrelli
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - G Di Salvo
- University Hospital of Padova, Padua, Italy
| | - GD Ciriello
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - N Grimaldi
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - R Barracano
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - F Fusco
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - A Merola
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - A Correra
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - D Colonna
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - M Palma
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | | | - MG Russo
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - B Sarubbi
- AO dei Colli - Monaldi Hospital, Naples, Italy
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25
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Fusco F, Scognamiglio G, Merola A, Roma AS, Del Giudice C, Abbate M, Palma M, Correra A, Borrelli N, Barracano R, Grimaldi N, Colonna D, Romeo E, Sarubbi B. Myocardial work indices and ventricular dyssynchrony in adults with aortic coarctation. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Adults with coarctation of the aorta (CoA) may present residual aortic obstruction and develop arterial vasculopathy and subclinical left ventricular (LV) dysfunction. Myocardial work (MW) is a novel non-invasive index of myocardial efficiency calculated from echocardiographic LV pressure-strain loops, which yields incremental information over ejection fraction and global longitudinal strain. (GLS)
Purpose
Aim of the present study is to analyze LVMW in a cohort of adult patients with operated aortic CoA
Methods
CoA patients aged > 18 years who underwent transthoracic echocardiography between September 2020 and July 2021 at our tertiary centre were included. Exclusion criteria were significant recoarctation, impaired LVEF, significant valvular disease and suboptimal image quality. A group of healthy individuals with no cardiac abnormalities. GLS and peak strain dispersion(PSD) were measured. MW indices were calculated using the blood pressure measured in the right arm at the time of the exam.
Results
Sixty patients (26[22-33]years, 66%male) were included. Data on previous medical history, clinical status at last assessment and Coa-related echocardiographic findings are showed in table 1. No significant differences in traditional parameters of LV systolic and diastolic function were found between groups (EF 60[57-64] vs 57[53-61],p = 0.6), however Coa patients had higher LVmass (84[75-97] vs 68[56-75]g). GLS and MW indices in the study population and in the control group are reported in table 2. Coa group showed lower GLS values and higher PSD (p < 0.0001 for both). Global work index(GWI) and global constructive work(GCW) values were not significantly different between groups, whereas CoA group showed significant increase of global wasted work(GWW) and impaired global work efficiency(GWE,p = 0.003 and 0.0005 respectively). Spearman’s linear method illustrated that both GCW and GWI had a moderate positive relation with mean gradient across the descending aorta at continuous wave Doppler. PSD was positively related to GWW and inversely related to GWE(Figure 1). Using linear regression model with the log of GWE values as dependent variable,PSD,age(β:-0.002,p = 0.03) and LVmass(β:-0.06,p = 0.004)were related to GWE. However, only PSD retained a significant relation on multivariable analysis(β:-0.002,p > 0.0001).
Conclusion
MW indices assessment is feasible in Coa patients may provide a more comprehensive understanding of the overall myocardial mechanics and performance. In particular, MW demonstrated impaired LV efficiency, which was strongly related to increased mechanical dispersion in Coa patients. Abstract Figure. Abstract Figure.
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Affiliation(s)
- F Fusco
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - G Scognamiglio
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - A Merola
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - AS Roma
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - C Del Giudice
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - M Abbate
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - M Palma
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - A Correra
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - N Borrelli
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - R Barracano
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - N Grimaldi
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - D Colonna
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - E Romeo
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - B Sarubbi
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
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26
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Borrelli N, Di Salvo G, Ciriello GD, Sabatino J, Bucciarelli V, Grimaldi N, Barracano R, Fusco F, Merola A, Correra A, Romeo E, Palma M, Scognamiglio G, Russo MG, Sarubbi B. Impaired myocardial work in paediatric patients with wolff-parkinson-white syndrome. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Wolff-Parkinson-White Syndrome (WPW) has been associated with reduced local myocardium deformation during systole. Left ventricle (LV) dysfunction due to electrical dyssynchrony may require catheter ablation of the accessory pathway, even in asymptomatic patients.
Purpose
The study aimed to assess the diagnostic value of non-invasive myocardial work in predicting subtle myocardial abnormalities in patients with WPW.
Methods
Forty-four paediatric patients (age 8.2 ± 4.3 years) were included in the study: 12 cases with manifest WPW and 32 age-, sex- and arterial pressure- matched controls (CTR). LV ejection fraction (EF) and global longitudinal strain (GLS) were evaluated. Global myocardial work index (MWI) was measured as the area of the LV pressure-strain loops. From MWI, global Constructive Work (MCW), Wasted Work (MWW) and Work Efficiency (MWE) were estimated.
Results
Despite normal LV systolic function by standard echocardiographic parameters, patients with WPW had lower MWI (1233.5 ± 281.6 mmHg% in WPW vs 1624.0 ± 305.8 mmHg% in CTR, p = 0.0004), MCW (1833.4 ± 257.9 mmHg% in WPW vs 2069.0 ± 319.9 mmHg% in CTR, p= 0.03), MWW (187.6 ± 117.7 mmHg% in WPW vs 90.9 ± 58.9 mmHg% in CTR, p= 0.0008) and GWE (90.5 ± 4.8% in WPW vs 95.2 ± 2.2% in CTR, p= 0.00006). There were no significant differences in GLS and EF between patients with WPW and controls.
Conclusion
Myocardial work indices were found significantly reduced in patients with WPW, even in presence of normal LV EF and GLS. In patients with WPW, MWI may represent a sensitive measure of myocardial dysfunction and help in the decision-making for catheter ablation. Abstract Figure. Myocardial work in WPW Abstract Figure. Myocardial work in control patient
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Affiliation(s)
- N Borrelli
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - G Di Salvo
- University Hospital of Padova, Padua, Italy
| | - GD Ciriello
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - J Sabatino
- University Hospital of Padova, Padua, Italy
| | | | - N Grimaldi
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - R Barracano
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - F Fusco
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - A Merola
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - A Correra
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - E Romeo
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - M Palma
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | | | - MG Russo
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - B Sarubbi
- AO dei Colli - Monaldi Hospital, Naples, Italy
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27
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Mirone V, Creta M, Capece M, Celentano G, Califano G, Collà Ruvolo C, Spirito L, Fusco GM, Cirillo L, Longo N, Fusco F, Mirone C, La Rocca R, Napolitano L. Telementoring for communication between residents and faculty physicians: Results from a survey on attitudes and perceptions in an Academic Tertiary Urology Referral Department in Italy. Arch Ital Urol Androl 2021; 93:450-454. [PMID: 34933529 DOI: 10.4081/aiua.2021.4.450] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/02/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Telemedicine has been adopted successfully in various urological scenarios. The aim of the present study was to explore attitudes and perceptions by urology residents toward the use of telementoring in the context of residents-faculty physicians communication for patient-related care. METHODS An online survey consisting of 19 multiple choice questions was designed including three sections: respondents' demographics, attitudes and perceptions towards the use of telementoring. Invitations to participate in this anonymous survey were e-mailed to urology residents at University of Naples Federico II. RESULTS In total 60 responses were received (participation rate 86%). The frequency of telementoring use was described as occasional, frequent, very frequent, and rare by 51,3%, 41.0%, 5,1%, and 2,6% of respondents, respectively. WhatsApp messenger was used by 89.5% of respondents and photos were the most common type of media content shared (73.7%). Most of respondents declared a moderate and a strong agreement with respect to the utility of telementoring in improving the communication in relation to the interpretation of clinical, radiological, endoscopic, and functional findings. Overall, 78% of participants individuated risks of information flow distortions and misinterpretations as the major limit of telementoring. CONCLUSIONS The use of telementoring is widespread and perceived as useful by urology residents in the context of residentsfaculty physicians communication in multiple settings of patientrelated care.
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Affiliation(s)
- Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Lorenzo Spirito
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Giovanni Maria Fusco
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania "Luigi Vanvitelli'" Naples.
| | - Luigi Cirillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | | | - Claudia Mirone
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania "Luigi Vanvitelli", Naples.
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
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28
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Fusco F, Merola A, Scognamiglio G, Palma M, Correra A, Barracano R, Borrelli N, Grimaldi N, Spinelli Barrile C, Puzone N, Ciriello GD, Colonna D, Romeo E, Sarubbi B. Effects of sacubitril/valsartan in patients with a systemic right ventricle: early evidence of exercise tolerance and systolic function improvement. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Sacubitril/valsartan has been shown to reduce mortality and morbidity inpatients with heart failure and reduced systolic function. However, the effects of this novel association in patients with congenital heart disease and a systemic right ventricle (sRV) have not been investigated yet.
Purpose
We aimed to assess tolerability and efficacy of sacubitril/valsartan in patients with a sRV
Methods
From September 2020 to March 2021, 38 patients with congenitally corrected transposition of the great arteries or transposition of the great arteries after Senning or Mustard repair were prospectively enrolled. Inclusion criteria were: age ≥18 years, optimal medical therapy including ACEi/ARB for at least 6 months and EF of the sRV ≤40%. Patients with univentricular physiology, systolic blood pressure (SBP) <90mmHg, glomerular filtration rate (GFR) <30ml/min or K >5.5mEq/L were excluded. RV systolic function was assessed on echocardiography using a multiparametric evaluation. The study protocol contemplates serial assessments at 1, 3, 6 and 12 months after treatment initiation.
Results
Up to March 31th, 23 patients completed 1-month and 15 completed 3-month assessment after treatment initiation. Baseline patients' characteristics are summarized in table 1. The medication dose was up-titrated to the highest tolerated dose during follow-up. During early follow-up, no major adverse events were reported. Treatment did not impact significantly on the values of serum potassium (basal K+ 4.4 [4.2–4.6] mEq/L, K+ at 3 months 4.4 [4.3–4.6] mEq/L, p=0.7) and GFR (basal GFR 113.9±35ml/min, GFR at 3 months 107.8±21 ml/min, p=0.7). Although SBP did not change significantly (114±12 vs 113.9±19 mmHg at 1-month and 117.3±12 mmHg at 3 months; p=0.9 for both), 2 (5%) patients ceased the treatment due to symptomatic hypotension during the first month of treatment. There was no significant change in the NYHA class. However, the 6-minute walking distance increased significantly after 3 months (365±120 vs 498.3±71 min; p=0.01). Furthermore, while traditional echocardiographic parameters of RV systolic function (TAPSE, s wave and FAC) did not change significantly, RV global longitudinal strain (GLS) and RV free wall GLS demonstrated subclinical improvement in right ventricular systolic function (table 2).
Conclusions
Our short-term results from an ongoing prospective study showed that sacubitril/valsartan is well tolerated in patients with a sRV with early evidence of improvement in exercise tolerance and sRV systolic function. Longer follow-up is warranted to confirm these data.
Funding Acknowledgement
Type of funding sources: None. Table 1Table 2
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Affiliation(s)
- F Fusco
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - A Merola
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - G Scognamiglio
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - M Palma
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - A Correra
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - R Barracano
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - N Borrelli
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - N Grimaldi
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - C Spinelli Barrile
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - N Puzone
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - G D Ciriello
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - D Colonna
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - E Romeo
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - B Sarubbi
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
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29
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Fusco F, Scognamiglio G, Guarguagli S, Merola A, Palma M, Borrelli N, Barracano R, Grimaldi N, Correra A, Piccolo G, La Rocca F, Del Giudice C, Colonna D, Romeo E, Sarubbi B. Prognostic relevance of thyroid disease in adults with congenital heart disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Adults with congenital heart disease (ACHD) are frequently affected by thyroid diseases (TD). However, the clinical relevance of TD in ACHD remains unknown.
Purpose
We aimed to describe the prevalence of TD in the ACHD population and to ascertain whether TD are associated with worse outcome.
Methods
Clinical data on all consecutive patients aged >18 years attending our ACHD unit for a day-case between 2014 and 2019 were retrospectively collected. For statistical analysis, a composite endpoint was created combining the following events at follow-up: hospitalization for heart failure, new-onset tachyarrhythmic or bradyarrhythmic events and death.
Results
Four hundred ninety-five ACHD patients with a median age of 32.2 [24.5–45.6] years (46% male) were included. There was an overall prevalence of patients with moderate or complex lesions (414=84%). Compared to the group with no history of TD, patients in the TD were older, (41.9 [29.7–53.5] vs 30.2 [24.3–39] years; p<0.0001) and mainly female (77% vs 46%; p<0.0001) and more likely to have undergone at least two cardiac catheterization procedures (29 vs 13%; p<0.0001). Genetic disorders including Down syndrome were more prevalent in the group with TD (p<0.0001). Moreover, at last follow-up, those with TD had higher pro-BNP-nt values (243.5 [96.5–523] pg/ml Vs 94 [45–207] pg/ml; p<0.0001) and were in a more advanced NYHA class (27% vs 13% in class III-IV; p=0.0002). Echocardiography showed lower EF in the TD group (55 [55–60]% vs 60 [55–65]%; p=0.0002).
Median follow-up was 9.4 [4.5–13.1] years. Patients with TD had a higher unadjusted mortality rate, with a trend towards statistical significance (p=0.07). Sixty-four (42%) patients in the TD group and 43 (12.5%) met our composite endpoint, leading to a 10-year survival free from events of 53.7% Vs 86.5%, respectively (p<0.0001, Figure1). Multivariate analysis showed that age, ejection fraction, previous surgical palliation, advanced physiological stage and TD were independent predictors of our composite endpoint, even after stratification for genetic disorders as reported in table1. After adjustment for baseline differences between groups with propensity matching score using age, sex, disease complexity, physiological stage, previous palliative or reparative surgery, normal or reduced systemic ventricle ejection fraction, pulmonary arterial hypertension, cyanosis and presence of systemic right ventricle as independent variables, TD remained a strong predictor of cardiac events at follow-up with an hazard ratio of 4.47 (95% CI 2.42–8.28; p<0.0001).
Conclusion
TD is a strong predictor of adverse outcome in the ACHD population after exclusion of potential confounding factors, being related to a fourfold increased risk of events at follow-up.
Funding Acknowledgement
Type of funding sources: None. Figure 1Table 1
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Affiliation(s)
- F Fusco
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - G Scognamiglio
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - S Guarguagli
- Ospedale SS Giovanni e Paolo AULSS3 Serenissima Venezia, Venice, Italy
| | - A Merola
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - M Palma
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - N Borrelli
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - R Barracano
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - N Grimaldi
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - A Correra
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - G Piccolo
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - F La Rocca
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - C Del Giudice
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - D Colonna
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - E Romeo
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
| | - B Sarubbi
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, Italy
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Manfredi C, Krishnappa P, Pascual EF, Arcaniolo D, Quattrone C, Bottone F, Stizzo M, Oliva F, Olivetta M, Amicuzi U, Calace F, Fusco F, Giordano D, De Sio M, Salamanca JM. Risk factors for revision after artificial urinary sphincter implantation in male patients with stress urinary incontinence. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00837-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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De Luca L, Barone B, Napolitano L, Crocetto F, Caputo V, Creta M, Fusco F. Effects of virtual reality on perceived pain during transrectal biopsy. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00905-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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32
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Morra S, Collà Ruvolo C, Napolitano L, La Rocca R, Celentano G, Califano G, Creta M, Capece M, Turco C, Cilio S, Melchionna A, Gerundo G, Trama F, Mangiapia F, Fusco F, Mirone V, Longo N. YouTube TM as a source of information on bladder pain syndrome: A contemporary analysis. Neurourol Urodyn 2021; 41:237-245. [PMID: 34559920 DOI: 10.1002/nau.24802] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/09/2021] [Accepted: 09/06/2021] [Indexed: 01/02/2023]
Abstract
AIM To evaluate the quality of YouTube™ videos on bladder pain syndrome (BPS) and to investigate whether they can be used as a reliable source of information. METHODS The search term "bladder pain syndrome" was used on YouTubeTM platform. The first 100 videos were selected. Patient Education Materials Assessment Tool for audio-visual content (PEMAT A/V), Global Quality Score (GQS), Misinformation tool, and DISCERN score were used to assess videos' quality content. Pearson's test was used to assess potential correlations between variables. RESULTS Seventy-nine videos were suitable for the analyses. The median PEMAT A/V Understandability score and PEMAT A/V Actionability score were 66.7% (interquartile range [IQR]: 46.2-100.0) and 75.0% (IQR: 37.5-100.0), respectively. According to GQS, 26 (32.9%), 32 (40.5%), 3 (3.8%), 15 (19.0%), and 3 (3.8%) videos were excellent, good, moderate, generally poor, and poor, respectively. According to Misinformation tool, of all videos, 81% (n = 64), 6.3% (n = 5), 5.1% (n = 4), 5.1% (n = 4), 2.5% (n = 2) had respectively no, very little, moderate, high, and extreme misinformation. The overall median DISCERN score ranged from 5.0 (IQR: 2.0-5.0) to 5.0 (IQR: 5.0-5.0). A positive statistically significant correlation was found between video length and PEMAT A/V Understandability (r = 0.27, p = 0.01), video length and PEMAT A/V Actionability (r = .26, p = 0.02), and video length and DISCERN Question 16 (r = 0.28, p = 0.01). CONCLUSIONS Nowaday, the overall quality of YouTubeTM videos on BPS have been evaluated good according to PEMAT A/V, GQS, Misinformation tool, and DISCERN score. It is possible to assume that YouTubeTM may be considered as a reliable source of information on BPS.
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Affiliation(s)
- Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Carmine Turco
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Simone Cilio
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Alberto Melchionna
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Gerardo Gerundo
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Francesco Trama
- Andrology and Urogynecology Clinic, Santa Maria Terni Hospital, University of Perugia, Terni, Italy
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Ferdinando Fusco
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Caserta, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
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Ferro M, Crocetto F, Bruzzese D, Imbriaco M, Fusco F, Longo N, Napolitano L, La Civita E, Cennamo M, Liotti A, Lecce M, Russo G, Insabato L, Imbimbo C, Terracciano D. Prostate Health Index and Multiparametric MRI: Partners in Crime Fighting Overdiagnosis and Overtreatment in Prostate Cancer. Cancers (Basel) 2021; 13:cancers13184723. [PMID: 34572950 PMCID: PMC8466029 DOI: 10.3390/cancers13184723] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 12/01/2022] Open
Abstract
Simple Summary In the last decades, the widespread use of PSA as the standard tool for prostate cancer diagnosis led to a high rate of overdiagnosis and overtreatment. More recently, multiparametric magnetic resonance imaging (mpMRI) became part of the diagnostic pathway, and several next-generation PSA-based tests (PHI, PHI density, 4Kscore, STHLM3) have been proposed. The multivariable approach promises to help with a better stratification of PCa patients at initial diagnosis. In this study, we evaluated the performance of the prostate health index (PHI) and mpMRI for the prediction of positive biopsy and of high-grade PCa at radical prostatectomy (RP). Our findings suggested that PHI had a better ability than mpMRI to predict positive biopsy, whereas a comparable performance in the identification of pathological aggressive PCa was pointed out. Notably, PHI and PHI density might represent useful biomarkers to recognize high-grade PCa in patients with low or uncertain PI-RADS scores on mpMRI. Abstract Widespread use of PSA as the standard tool for prostate cancer (PCa) diagnosis led to a high rate of overdiagnosis and overtreatment. In this study, we evaluated the performance of the prostate health index (PHI) and multiparametric magnetic resonance imaging (mpMRI) for the prediction of positive biopsy and of high-grade PCa at radical prostatectomy (RP). To this end, we prospectively enrolled 196 biopsy-naïve patients who underwent mpMRI. A subgroup of 116 subjects with biopsy-proven PCa underwent surgery. We found that PHI significantly outperformed both PI-RADS score (difference in AUC: 0.14; p < 0.001) and PHI density (difference in AUC: 0.08; p = 0.002) in the ability to predict positive biopsy with a cut-off value of 42.7 as the best threshold. Conversely, comparing the performance in the identification of clinically significant prostate cancer (csPCa) at RP, we found that PHI ≥ 61.68 and PI-RADS score ≥ 4 were able to identify csPCa (Gleason score ≥ 7 (3 + 4)) both alone and added to a base model including age, PSA, fPSA-to-tPSA ratio and prostate volume. In conclusion, PHI had a better ability than PI-RADS score to predict positive biopsy, whereas it had a comparable performance in the identification of pathological csPCa.
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Affiliation(s)
- Matteo Ferro
- Division of Urology, European Institute of Oncology (IEO), IRCCS, 20141 Milan, Italy;
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.C.); (N.L.); (L.N.); (C.I.)
| | - Dario Bruzzese
- Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy; (D.B.); (G.R.)
| | - Massimo Imbriaco
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (M.I.); (L.I.)
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.C.); (N.L.); (L.N.); (C.I.)
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.C.); (N.L.); (L.N.); (C.I.)
| | - Evelina La Civita
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (M.C.); (A.L.); (M.L.)
| | - Michele Cennamo
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (M.C.); (A.L.); (M.L.)
| | - Antonietta Liotti
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (M.C.); (A.L.); (M.L.)
| | - Manuela Lecce
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (M.C.); (A.L.); (M.L.)
| | - Gianluca Russo
- Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy; (D.B.); (G.R.)
| | - Luigi Insabato
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (M.I.); (L.I.)
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.C.); (N.L.); (L.N.); (C.I.)
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (M.C.); (A.L.); (M.L.)
- Correspondence: ; Tel.: +39-8-1746-2038
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Creta M, Sica A, Napolitano L, Celentano G, La Rocca R, Capece M, Calogero A, Califano G, Vanni L, Mangiapia F, Arcaniolo D, Spirito L, Fusco F, De Sio M, Imbimbo C, Mirone V, Sagnelli C, Longo N. Fournier's Gangrene in Patients with Oncohematological Diseases: A Systematic Review of Published Cases. Healthcare (Basel) 2021; 9:healthcare9091123. [PMID: 34574898 PMCID: PMC8469850 DOI: 10.3390/healthcare9091123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 12/29/2022] Open
Abstract
Patients suffering from hematological malignancies are at increased risk of Fournier's gangrene (FG) due to immunosuppression caused by the disease itself or by disease-related treatments. A systematic review of PubMed, ISI Web of Knowledge, and Scopus databases was performed in June 2021. We included full papers that met the following criteria: original research, human studies, and describing clinical presentation, treatment, and outcomes of FG in patients with oncohematological diseases. We identified 35 papers published from 1983 to 2021 involving 44 patients (34 males, 8 females) aged between 4 days and 83 years. The most common malignant hematological disorders were acute myeloid leukemia (n = 21) and acute lymphocytic leukemia (n = 9). In 10 patients FG represented the first presentation of hematological malignancy. Scrotum (n= 27) and perineum (n = 11) were the sites most commonly involved. Pseudomonas aeruginosa (n = 21) and Escherichia coli (n = 6) were the most commonly isolated microorganisms. Surgery was performed in 39 patients. Vacuum-assisted closure and hyperbaric oxygen therapy were adopted in 4 and in 3 patients, respectively. Recovery was achieved in 30 patients. FG-related mortality was observed in 11 patients. FG should be carefully considered in patients with oncohematological diseases.
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Affiliation(s)
- Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (L.N.); (G.C.); (R.L.R.); (M.C.); (G.C.); (F.M.); (L.S.); (C.I.); (V.M.); (N.L.)
- Correspondence: ; Tel./Fax: +39-081-7462-611
| | - Antonello Sica
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy;
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (L.N.); (G.C.); (R.L.R.); (M.C.); (G.C.); (F.M.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (L.N.); (G.C.); (R.L.R.); (M.C.); (G.C.); (F.M.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (L.N.); (G.C.); (R.L.R.); (M.C.); (G.C.); (F.M.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (L.N.); (G.C.); (R.L.R.); (M.C.); (G.C.); (F.M.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80130 Naples, Italy;
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (L.N.); (G.C.); (R.L.R.); (M.C.); (G.C.); (F.M.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Luigi Vanni
- Department of Public Health, University of Naples Federico II, 80130 Naples, Italy;
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (L.N.); (G.C.); (R.L.R.); (M.C.); (G.C.); (F.M.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Davide Arcaniolo
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (D.A.); (F.F.); (M.D.S.)
| | - Lorenzo Spirito
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (L.N.); (G.C.); (R.L.R.); (M.C.); (G.C.); (F.M.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (D.A.); (F.F.); (M.D.S.)
| | - Marco De Sio
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (D.A.); (F.F.); (M.D.S.)
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (L.N.); (G.C.); (R.L.R.); (M.C.); (G.C.); (F.M.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (L.N.); (G.C.); (R.L.R.); (M.C.); (G.C.); (F.M.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (L.N.); (G.C.); (R.L.R.); (M.C.); (G.C.); (F.M.); (L.S.); (C.I.); (V.M.); (N.L.)
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Romano L, Granata L, Fusco F, Napolitano L, Cerbone R, Priadko K, Sciorio C, Mirone V, Romano M. Sexual Dysfunction in Patients With Chronic Gastrointestinal and Liver Diseases: A neglected Issue. Sex Med Rev 2021; 10:620-631. [PMID: PMID: 37051954 DOI: 10.1016/j.sxmr.2021.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/20/2021] [Accepted: 02/25/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Normal sexual activity is an important determinant of quality of life. Unfortunately, several chronic health disorders are associated with an impaired sexual function. OBJECTIVE To provide coverage of the current literature on prevalence and pathophysiology of sexual dysfunction in patients with gastrointestinal and liver disorders METHODS: A Comprehensive review of the literature on the prevalence of sexual dysfunction in chronic gastrointestinal and liver disorders, assessing the underlying mechanism (s) was performed. RESULTS Many gastrointestinal disorders, either functional or organic, are associated with some degree of sexual dysfunction. The main pathogenic mechanisms are: (i) the disease itself causing fatigue, anxiety or depression with a potential alteration of self-esteem; (ii) worry of transmitting a potential infectious agent through sexual activity; (iii) alteration of the endocrine mechanisms which are necessary for normal sexual functioning; (iv) chronic pro- inflammatory conditions which may cause endothelial dysfunction and abnormal vascular responses; (v) iatrogenic. CONCLUSION Based on this review, a thorough evaluation of sexual function through validated questionnaires and/or psychological interviews with patients with chronic gastrointestinal disorders should be part of the clinical assessment in order to timely diagnose and possibly treat sexual dysfunction in this clinical setting. L Romano, L Granata, F Fusco, et al. Sexual Dysfunction in Patients With Chronic Gastrointestinal and Liver Diseases: A neglected Issue. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
- Lorenzo Romano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Lucia Granata
- Dipartimento di Medicina di Precisione, Hepato-Gastroenterology Unit, Università della Campania Luigi Vanvitelli, Napoli, Italy
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Rosa Cerbone
- Dipartimento di Medicina di Precisione, Hepato-Gastroenterology Unit, Università della Campania Luigi Vanvitelli, Napoli, Italy
| | - Kateryna Priadko
- Dipartimento di Medicina di Precisione, Hepato-Gastroenterology Unit, Università della Campania Luigi Vanvitelli, Napoli, Italy
| | | | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Marco Romano
- Dipartimento di Medicina di Precisione, Hepato-Gastroenterology Unit, Università della Campania Luigi Vanvitelli, Napoli, Italy
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Manfredi C, Arcaniolo D, Spatafora P, Crocerossa F, Fusco F, Verze P, Fiori C, Damiano R, Cindolo L, DE Sio M, Otero JR. Emerging minimally invasive transurethral treatments for benign prostatic hyperplasia: a systematic review with meta-analysis of functional outcomes and description of complications. Minerva Urol Nephrol 2021; 74:389-399. [PMID: 34308611 DOI: 10.23736/s2724-6051.21.04530-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Several minimally invasive surgical procedures have been proposed as alternative therapies for benign prostatic hyperplasia (BPH). The present systematic review aimed to describe the functional outcomes and complications of emerging minimally invasive transurethral treatments for BPH. EVIDENCE ACQUISITION A comprehensive bibliographic search on the MEDLINE and Cochrane Library databases was conducted. No chronological restriction was applied. Retrospective and prospective primary studies were included. A meta-analysis of IPSS, IPSS-QoL, Qmax, and PVR was performed. Data on adverse events were presented narratively. EVIDENCE SYNTHESIS A total of 18 studies were included. Thirteen papers were eligible for the meta-analysis. iTIND, Rezūm, and Aquablation were associated with a significant improvement in IPSS (p<0.001), IPSS-QoL (p<0.001), and Qmax (p<0.001) compared to baseline. A significant reduction of PVR from baseline was found with Rezūm (p<0.001) and Aquablation (p<0.001) but not iTIND (p=0.22). A significant difference in IPSS, IPSS-QoL, and Qmax was shown in favor of Aquablation compared to Rezūm and iTIND (p<0.001). Rezūm and iTIND were mainly associated with mild to moderate adverse effects. Hematuria or bleeding was reported in all studies regarding Aquablation (0.8%-26%), the need for transfusion or intervention for bleeding varied between 1.8% and 9%. CONCLUSIONS Aquablation, Rezūm, and iTIND significantly improve urinary functional outcomes compared to baseline; however, Aquablation would seem to lead to better functional results compared to the other procedures. Rezūm and iTIND appear to have an excellent safety profile, while Aquablation would seem to expose patients to a nonnegligible risk of bleeding.
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Affiliation(s)
- Celeste Manfredi
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy -
| | - Davide Arcaniolo
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Pietro Spatafora
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Ferdinando Fusco
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Paolo Verze
- Department of Medicine, Surgery, Dentistry Scuola Medica Salernitana, University of, Salerno, Salerno, Italy
| | - Cristian Fiori
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Rocco Damiano
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Luca Cindolo
- Department of Urology, Villa Stuart Private Hospital, Rome, Italy
| | - Marco DE Sio
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Javier R Otero
- Department of Urology, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Unit of Urology, HM Hospitales, Montepríncipe, Puerta del Sur, Sanchinarro, Madrid, Spain
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Bodemer C, Diociaiuti A, Hadj-Rabia S, Robert MP, Desguerre I, Manière MC, de la Dure-Molla M, De Liso P, Federici M, Galeotti A, Fusco F, Fraitag S, Demily C, Taieb C, Valeria Ursini M, El Hachem M, Steffann J. Multidisciplinary consensus recommendations from a European network for the diagnosis and practical management of patients with incontinentia pigmenti. J Eur Acad Dermatol Venereol 2021; 34:1415-1424. [PMID: 32678511 DOI: 10.1111/jdv.16403] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 02/28/2020] [Accepted: 03/10/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Incontinentia pigmenti (IP) is a rare multisystemic X-linked dominant genetic disorder characterized by highly diagnostic skin lesions. The disease can be misdiagnosed in infants, and complications affecting the eyes and/or the brain can be severe. Our objective was to highlight the urgency of an appropriate diagnosis and management strategy, as soon as the first symptoms appear, and the need for a well-codified monitoring strategy for each child. METHODS An in-depth literature review using a large number of databases was conducted. The selection criteria for articles were literature review articles on the disease, case series and retrospective studies based on the disease, clinical studies (randomized or not) on treatment, articles discussing patient care and management (treatment, diagnosis, care pathways), and recommendations. The research period was from 2000 until 2018. A group of multidisciplinary experts in IP management was involved, issued from different healthcare providers of the European Network for Rare Skin Diseases (ERN-Skin). The final recommendations have been submitted to two patient representative associations and to a general practitioner and a neonatal specialist prior to their finalization. RESULTS AND CONCLUSION The diagnosis of IP must be promptly performed to detect potential extracutaneous manifestations, thus allowing the timely implementation of specific therapeutic and monitoring strategies. Eye involvement can be a therapeutic urgency, and central nervous system (CNS) involvement requires a very rigorous long-term follow-up. Assessments and patient support should take into account the possible co-occurrence of various symptoms (including motor, visual and cognitive symptoms).
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Affiliation(s)
- C Bodemer
- Department of Dermatology, Reference Centre for Genodermatoses (MAGEC) Necker Enfants Malades Hospital, Imagine Institute, FIMARAD, ERN-Skin, Paris Centre University, Paris, France
| | - A Diociaiuti
- Department of Dermatology, ERN-Skin, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - S Hadj-Rabia
- Department of Dermatology, Reference Centre for Genodermatoses (MAGEC) Necker Enfants Malades Hospital, Imagine Institute, FIMARAD, ERN-Skin, Paris Centre University, Paris, France
| | - M P Robert
- Department of Ophthalmology, Imagine Institute, Necker Enfants Malades Hospital, Paris Centre University France, Paris, France
| | - I Desguerre
- Department of Pediatric Neurology, Imagine Institute, Necker Enfants Malades Hospital, Paris Centre University France, Paris, France
| | - M-C Manière
- Department of Pediatric Odontology, Expert Centre (MAFACE), Strasbourg Hospital, Université de Chirurgie Dentaire, Strasbourg, France
| | - M de la Dure-Molla
- Expert Centre for Rare Face and Oral Cavity Malformations, Rothschild Cavity, Paris, France
| | - P De Liso
- Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Federici
- Ophthalmology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - A Galeotti
- Dentistry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - F Fusco
- Institute of Genetics and Biophysics 'Adriano Buzzati-Traverso', IGB-CNR, Naples, Italy
| | - S Fraitag
- Department of Pathology, Necker Enfants Malades Hospital, Paris, France
| | - C Demily
- Reference Centre Génopsy, CRMR Maladies Rares à Expression Psychiatrique, Centre Hospitalier Le Vinatier, Bron, France
| | - C Taieb
- National Network for Rare Diseases FIMARA, Necker Enfants Malades Hospital, Paris, France
| | - M Valeria Ursini
- Institute of Genetics and Biophysics 'Adriano Buzzati-Traverso', IGB-CNR, Naples, Italy
| | - M El Hachem
- Department of Dermatology, ERN-Skin, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - J Steffann
- Department of Genetics, Imagine Institute, Necker Enfants Malades Hospital, Paris Centre Université, Paris, France
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Mari A, Antonelli A, Cindolo L, Fusco F, Minervini A, De Nunzio C. Alfuzosin for the medical treatment of benign prostatic hyperplasia and lower urinary tract symptoms: a systematic review of the literature and narrative synthesis. Ther Adv Urol 2021; 13:1756287221993283. [PMID: 33912246 PMCID: PMC8047826 DOI: 10.1177/1756287221993283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 01/05/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) are a bothersome frequent symptom in adult males. This systematic review analyzed the available evidence on the pharmacokinetic and pharmacodynamic features of alfuzosin, and its clinical efficacy both as monotherapy and in combination with other drugs for the treatment of male LUTS/BPH. Methods: A systematic review of the last 10 years was performed using the MEDLINE, EMBASE and Cochrane libraries in March 2020. The protocol for this systematic review was registered on PROSPERO (Central Registration Depository: CRD42020136120) and is available in full on the University of York website. Results: Alfuzosin is a quinazoline derivative and, although a nonspecific α1-blocker, exhibits a selective concentration in the prostate compared with plasma in patients with BPH. Three registration trials assessed the safety and efficacy of alfuzosin. The 10 mg daily formulation has a three-layered matrix containing the active substance between two inactive coats allowing a drug release over 20 h. Alfuzosin showed high tolerability, few vasodilatory effects and a low rate of ejaculation disorders over older alpha-blocking compounds thanks to the high uroselectivity of alfuzosin and its preferential concentration at urinary level. Six randomized clinical trials (RCTs) assessed efficacy and safety of alfuzosin versus other alpha-blockers ± placebo: three studies comparing with tamsulosin, one with doxazosin, and two with silodosin or tamsulosin. One RCT investigated the clinical outcomes of alfuzosin with finasteride, two with propiverine and two with phosphodiesterase-5 inhibitors. Conclusions: Alfuzosin is an effective drug for the treatment of LUTS/BPH, with a lower rate of sexual disorders compared with other alpha-blockers. Alfuzosin is also safe with low adverse events in case of concomitant antihypertensive therapy and in patients with cardiovascular morbidity. Safety and efficacy of alfuzosin has been reported also in case of combination therapy with antimuscarinic agents and PDE5i.
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Affiliation(s)
- Andrea Mari
- Department of Urology, University of Florence, Careggi Hospital, San Luca Nuovo, Florence, Italy
| | - Alessandro Antonelli
- Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Italy
| | - Luca Cindolo
- Department of Urology, Villa Stuart Private Hospital, Rome, Italy
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Minervini
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi University Hospital, Florence, Italy
| | - Cosimo De Nunzio
- Division of Urology, Ospedale Sant'Andrea, Sapienza University of Rome, Rome, Italy
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De Nunzio C, Brucker B, Bschleipfer T, Cornu JN, Drake MJ, Fusco F, Gravas S, Oelke M, Peyronnet B, Tutolo M, van Koeveringe G, Madersbacher S. Reply to Satoshi Funada, Takashi Yoshioka, and Yan Luo's Letter to the Editor re: Cosimo De Nunzio, Benjamin Brucker, Thomas Bschleipfer, et al. Beyond Antimuscarinics: A Review of Pharmacological and Interventional Options for Overactive Bladder Management in Men. Eur Urol 2021;79:492-504. Eur Urol 2021; 79:e147-e148. [PMID: 33685837 DOI: 10.1016/j.eururo.2021.02.033] [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] [Received: 02/08/2021] [Accepted: 02/17/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Cosimo De Nunzio
- Urology Unit, Ospedale Sant'Andrea, Sapienza University of Rome, Rome, Italy.
| | | | - Thomas Bschleipfer
- Clinic for Urology, Andrology and Pediatric Urology, Clinics of Nordoberpfalz AG, Weiden, Germany
| | - Jean-Nicolas Cornu
- Urology Department, Charles Nicolle University Hospital, University of Rouen, Rouen, France
| | - Marcus J Drake
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
| | - Ferdinando Fusco
- Urology Unit, University of Campania L. Vanvitelli, Naples, Italy
| | - Stavros Gravas
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Matthias Oelke
- Department of Urology, Pediatric Urology & Urological Oncology, St. Antonius Hospital, Gronau, Germany
| | | | - Manuela Tutolo
- Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Gommert van Koeveringe
- Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Stephan Madersbacher
- Department of Urology, Clinic Favoriten and Sigmund Freud Private University, Vienna, Austria
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Creta M, Sagnelli C, Celentano G, Napolitano L, La Rocca R, Capece M, Califano G, Calogero A, Sica A, Mangiapia F, Ciccozzi M, Fusco F, Mirone V, Sagnelli E, Longo N. SARS-CoV-2 infection affects the lower urinary tract and male genital system: A systematic review. J Med Virol 2021; 93:3133-3142. [PMID: 33595134 PMCID: PMC8013185 DOI: 10.1002/jmv.26883] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [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: 01/09/2021] [Revised: 01/21/2021] [Accepted: 02/09/2021] [Indexed: 12/16/2022]
Abstract
PubMed, Scopus, and ISI Web of Knowledge databases were searched to identify studies published up to December 2020 on the involvement of urinary and male genital systems in COVID‐19. Sixteen studies involving a total of 575 patients (538 males and 37 females) were included in this systematic review. The COVID‐19 phase was available for 479 patients: 426 in the acute and 53 in the recovery phase. De novo lower urinary tract symptoms (LUTS) were observed in 43 patients and deterioration of pre‐existing LUTS in 7. Bladder hemorrhage was observed in three patients and acute urinary retention in one. Regarding the male genital system, scrotal discomfort was observed in 8 patients, swelling in 14, pain in 16, and erythema in 1; low flow priapism was observed in 2 patients. Ultrasound examination identified acute orchitis in 10 patients, acute epididymitis in 7, and acute epididymo‐orchitis in 16. A case–control study reported that patients with moderate COVID‐19 show a significant reduction in sperm concertation, the total number of sperms per ejaculate, progressive motility, and complete motility. In contrast to what is known from the first studies on the subject, this review also includes subsequent studies that give evidence of the involvement of the lower urinary tract and male genital system in COVID‐19.
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Affiliation(s)
- Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Caterina Sagnelli
- Department of Mental health and Public Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Antonello Sica
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Massimo Ciccozzi
- Medical Statistics and Molecular Epidemiology Unit, Campus Bio-Medico University, Rome, Italy
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Evangelista Sagnelli
- Department of Mental health and Public Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
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Creta M, Celentano G, Napolitano L, La Rocca R, Capece M, Califano G, Collà Ruvolo C, Mangiapia F, Morra S, Turco C, Spirito L, Fusco F, Imbimbo C, Mirone V, Longo N. Inhibition of Androgen Signalling Improves the Outcomes of Therapies for Bladder Cancer: Results from a Systematic Review of Preclinical and Clinical Evidence and Meta-Analysis of Clinical Studies. Diagnostics (Basel) 2021; 11:diagnostics11020351. [PMID: 33672461 PMCID: PMC7923424 DOI: 10.3390/diagnostics11020351] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 12/11/2022] Open
Abstract
Bladder cancer (BCa) is an endocrine-related tumour and the activation of androgen signalling pathways may promote bladder tumorigenesis. We summarized the available preclinical and clinical evidence on the implications of the manipulation of androgen signalling pathways on the outcomes of BCa therapies. A systematic review was performed in December 2020. We included papers that met the following criteria: original preclinical and clinical research; evaluating the impact of androgen signalling modulation on the outcomes of BCa therapies. Six preclinical and eight clinical studies were identified. The preclinical evidence demonstrates that the modulation of androgen receptor-related pathways has the potential to interfere with the activity of the Bacillus Calmette Guerin, doxorubicin, cisplatin, gemcitabine, and radiotherapy. The relative risk of BCa recurrence after transurethral resection of the bladder tumour (TURBT) is significantly lower in patients undergoing therapy with 5 alpha reductase inhibitors (5-ARIs) or androgen deprivation therapy (ADT) (Relative risk: 0.50, 95% CI: 0.30–0.82; p = 0.006). Subgroup analysis in patients receiving 5-ARIs revealed a relative risk of BCa recurrence of 0.46 (95% CI: 0.22–0.95; p = 0.040). A significant negative association between the ratio of T1 BCa patients in treated/control groups and the relative risk of BCa recurrence was observed. Therapy with 5-ARIs may represent a potential strategy aimed at reducing BCa recurrence rate, mainly in patients with low stage disease. Further studies are needed to confirm these preliminary data.
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Affiliation(s)
- Massimiliano Creta
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Giuseppe Celentano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Luigi Napolitano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Roberto La Rocca
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
- Correspondence:
| | - Marco Capece
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Gianluigi Califano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Francesco Mangiapia
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Simone Morra
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Carmine Turco
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Lorenzo Spirito
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania ‘Luigi Vanvitelli’, 80131 Naples, Italy;
| | - Ciro Imbimbo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Vincenzo Mirone
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Nicola Longo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
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Li Marzi V, Morselli S, Fusco F, Baldesi R, Campi R, Liaci A, Gemma L, Morelli G, Serni S. Advance Xp® Male Sling can be an Effective and Safe Treatment for Post-Prostatectomy Stress Urinary Incontinence Also in Patients with Prior History of External Beam Radiation Therapy: A Multicentric Experience. Surg Innov 2021; 28:723-730. [PMID: 33599558 DOI: 10.1177/1553350621995042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Post-prostatectomy stress urinary incontinence (PPSUI) is one of the major complaints after radical prostatectomy. Transoburator male sling (TMS) placement is indicated in persistent mild to moderate PPSUI. External beam radiation therapy (EBRT) might be a negative prognostic factor for TMS outcomes. Study objective was to analyze EBRT impact on TMS outcome. Methods. We retrospectively investigated patients submitted to TMS for PPSUI, with or without previous EBRT, in two tertiary referral centers since 2010. Objective outcome was measured through ICIQ-SF, 1-hour pad test, and pad per die and subjective improvement through PGI-I. Patients were divided according to EBRT to make in-group and between-group comparisons. Results. Patients were 56, 18 (32.1%) had previous EBRT. Median follow-up was 43.0 months (IQR: 22.3-64.0). TMS was placed at mean 18.8 months (SD 4.6) after EBRT. TMS determined a statistically significant reduction of pads, 1-hour pad test, and ICIQ-SF score (P<.05). Improvement diminished during long-term follow-up. At last follow-up, 12 patients (21.4%) used 1 safety pad, while 15 (26.8%) used 0 pads. Median PGI-I was 2 (IQR 2-3). Recorded complications were 9 (16.1%) and none exceeded Clavien-Dindo grade 2. There were no differences in outcomes, failures, and complications between groups. TMS failures were 6 (10.7%), 2 of whom in the EBRT group. Four of them (7.1%) subsequently placed an artificial urinary sphincter (AUS). Conclusion. Advance XP© placement seems effective and safe in well-selected patients complaining with PPSUI, even after EBRT. Surgical outcomes slightly deteriorate over time. Further studies are needed in these patients to assess TMS efficacy.
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Affiliation(s)
- Vincenzo Li Marzi
- Chirurgia Urologica Robotica Mininvasiva e dei Trapianti Renali, Azienda Ospedaliero-Universitaria Careggi, Università di Firenze, Italy
| | - Simone Morselli
- Chirurgia Urologica Robotica Mininvasiva e dei Trapianti Renali, Azienda Ospedaliero-Universitaria Careggi, Università di Firenze, Italy
| | - Ferdinando Fusco
- Dipartimento della donna, del bambino e di chirurgia generale e specialistica. Università della Campania "Luigi Vanvitelli", Italy
| | | | - Riccardo Campi
- Chirurgia Urologica Robotica Mininvasiva e dei Trapianti Renali, Azienda Ospedaliero-Universitaria Careggi, Università di Firenze, Italy
| | - Andrea Liaci
- Chirurgia Urologica Robotica Mininvasiva e dei Trapianti Renali, Azienda Ospedaliero-Universitaria Careggi, Università di Firenze, Italy
| | - Luca Gemma
- Chirurgia Urologica Robotica Mininvasiva e dei Trapianti Renali, Azienda Ospedaliero-Universitaria Careggi, Università di Firenze, Italy
| | | | - Sergio Serni
- Chirurgia Urologica Robotica Mininvasiva e dei Trapianti Renali, Azienda Ospedaliero-Universitaria Careggi, Università di Firenze, Italy
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De Nunzio C, Brucker B, Bschleipfer T, Cornu JN, Drake MJ, Fusco F, Gravas S, Oelke M, Peyronnet B, Tutolo M, van Koeveringe G, Madersbacher S. Beyond Antimuscarinics: A Review of Pharmacological and Interventional Options for Overactive Bladder Management in Men. Eur Urol 2021; 79:492-504. [PMID: 33402296 DOI: 10.1016/j.eururo.2020.12.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/17/2020] [Indexed: 12/20/2022]
Abstract
CONTEXT The role of overactive bladder (OAB) treatment in women beyond antimuscarinics has been evaluated extensively. Beta-3 agonists, botulinum toxin-A (BTX-A), and nerve stimulation are indicated in these patients. However, data on male patients in this clinical scenario are scarce. OBJECTIVE The aim of this systematic review was to evaluate the evidence on treatment options beyond antimuscarinics in men with OAB. EVIDENCE ACQUISITION A search of PubMed, EMBASE, Scopus, Web of science, Cochrane Central Register of Controlled Trials, and Cochrane Central Database of Systematic Reviews databases was performed for relevant articles published between January 2000 and October 2020, using the following Medical Subject Headings: "male/man," "LUTS," "overactive bladder," "storage symptoms," "urgency," "nocturia," "incontinence," "beta-3 agonist," "PDE-5 inhibitors," "botulinum toxin," "sacral nerve stimulation/neurostimulation," "percutaneous/transcutaneous tibial nerve stimulation," "PTENS," and "combination therapy." Evidence acquisition was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. PROSPERO registration number is CRD42020201223. EVIDENCE SYNTHESIS Overall, 24 studies were retrieved. In male OAB, mirabegron (MIRA) is the most intensively investigated pharmacological option. A pooled analysis of five randomized clinical trials (RCTs), including 1187 patients, concluded that MIRA 50 mg was associated with a greater reduction in frequency versus placebo (-0.37, 95% confidence interval [CI]: -0.74, -0.01, p < 0.05). A pooled analysis of three RCTs, including 1317 male patients, has also shown that the addition of MIRA 50 mg in men receiving the α1-blocker tamsulosin improved the mean number of micturitions per day (-0.27, 95% CI: -0.46 to -0.09, p < 0.05), urgency episodes (-0.50, 95% CI: -0.77 to -0.22, p < 0.05), total OAB symptom score (-0.66, 95% CI: -1.00 to -0.38, p < 0.05), and mean volume voided (+10.76 ml, 95% CI: 4.87-16.64, p < 0.05). MIRA treatment is well tolerated in men. Other pharmacological treatment options, such as phosphodiesterase-5 (PDE-5) inhibitors, should be considered investigational. BTX-A seems to be effective as third-line treatment in male OAB patients. A higher rate of intermittent self-catheterization (5-42%) is observed in male than in female patients. Data on nerve stimulation are scarce. CONCLUSIONS MIRA has the most robust data in terms of safety and efficacy in this patient population. Preliminary data in men suggest that BTX-A is indicated as an interventional treatment. Evidence for PDE-5 inhibitors and nerve stimulation is too limited to provide recommendations. Future studies in this population should aim to better define the best treatment sequence and to identify predictors for treatment response and failure, to determine a therapeutic approach tailored to patients' characteristics. PATIENT SUMMARY Overactive bladder is highly prevalent in men. Mirabegron 50 mg is the treatment option supported by the highest level of evidence when antimuscarinics failed. Botulinum toxin A injections seems to be an effective treatment as interventional option. Roles of nerve stimulation and phosphodiesterase inhibitors in male OAB patients are still to be defined.
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Affiliation(s)
- Cosimo De Nunzio
- Urology Unit, Ospedale Sant'Andrea, Sapienza University of Rome, Rome, Italy.
| | | | - Thomas Bschleipfer
- Clinic for Urology, Andrology and Pediatric Urology, Clinics of Nordoberpfalz AG, Weiden, Germany
| | - Jean-Nicolas Cornu
- Urology Department, Charles Nicolle University Hospital, University of Rouen F-76000, Rouen, France
| | - Marcus J Drake
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
| | - Ferdinando Fusco
- Urology Unit, University of Campania L. Vanvitelli, Naples, Italy
| | - Stavros Gravas
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Matthias Oelke
- Department of Urology, Pediatric Urology & Urological Oncology, St. Antonius Hospital, Gronau, Germany
| | | | - Manuela Tutolo
- Division of Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Gommert van Koeveringe
- Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Stephan Madersbacher
- Department of Urology, Clinic Favoriten and Sigmund Freud Private University, Vienna, Austria
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Fusco F, Longo N, De Sio M, Arcaniolo D, Celentano G, Capece M, La Rocca R, Mangiapia F, Califano G, Morra S, Turco C, Spena G, Spirito L, Fusco GM, Cirillo L, De Luca L, Napolitano L, Mirone V, Creta M. Impact of Circadian Desynchrony on Spermatogenesis: A Mini Review. Front Endocrinol (Lausanne) 2021; 12:800693. [PMID: 34975770 PMCID: PMC8717881 DOI: 10.3389/fendo.2021.800693] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 11/24/2021] [Indexed: 12/21/2022] Open
Abstract
The purpose of this mini review is to provide data about pre-clinical and clinical evidence exploring the impact of circadian desynchrony on spermatogenesis. Several lines of evidence exist demonstrating that disruption of circadian rhythms may interfere with male fertility. Experimental knock-out or knock-down of clock genes, physiologically involved in the regulation of circadian rhythms, are associated with impairments of fertility pathways in both animal and human models. Moreover, disruption of circadian rhythms, due to reduction of sleep duration and/or alteration of its architecture can negatively interfere in humans with circulating levels of male sexual hormones as well as with semen parameters. Unfortunately, current evidence remains low due to study heterogeneity.
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Affiliation(s)
- Ferdinando Fusco
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Caserta, Italy
- *Correspondence: Ferdinando Fusco,
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
| | - Marco De Sio
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Davide Arcaniolo
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
| | - Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
| | - Carmine Turco
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
| | - Gianluca Spena
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
| | - Lorenzo Spirito
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
| | - Giovanni Maria Fusco
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
| | - Luigi Cirillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
| | - Luigi De Luca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy
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45
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Amendola A, Palomba G, Gaudiello M, Dinuzzi VP, Marra E, Fusco F, Lanza M, Antropoli M, Brillantino A, Mastella F, Castriconi M. Impact of SARS-Cov-2 pandemic on Emergency General Surgery. A single-center observational study. Ann Ital Chir 2021; 92:317-322. [PMID: 34312333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Several articles have been published on impact COVID-19 infection about reduction of surgical activity. We have focused on the differences between our surgical activity in an Emergency General Surgery department in "Cardarelli" Hospital in Naples. METHODS This retrospective study compared the patients treated from March 9, 2020 to April 27, 2020 (Italian lockdown time) and the patients treated in the same period of 2019. We recruited 75 patients in Group A (2020) and 165 patients in Group B (2019). RESULTS There was a reduction in hospitalizations for non-trauma disease (69 in group A and 122 in group B with p: 0.001), a reduction in transfers from other hospitals (2 patients in group A and 17 in group B with p. 0.04) and a reduction in hospitalizations for trauma disease (6 in group A and 43 in group B with p: 0.001). The severity of the disease in 2020 was greater than in the same period in 2019 and there was a higher rate of high-grade complications CONCLUSION: From data analysis, we conclude that there has been a reduction in hospitalizations and surgical interventions in our emergency surgery department. The patients, however, had a much more severe disease that resulted in a greater number of complications in the peri and post-operative time. KEY WORDS COVID-19, Lockdown, Emergency Surgery, Severity of disease.
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46
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Califano G, Collà Ruvolo C, Creta M, Capece M, La Rocca R, Celentano G, Napolitano L, Calace FP, Spena G, Trama F, Crocetto F, Mangiapia F, Longo N, Fusco F. Focus on Silodosin: Pros and Cons of Uroselectivity. Res Rep Urol 2020; 12:669-672. [PMID: 33381467 PMCID: PMC7767706 DOI: 10.2147/rru.s287129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 12/17/2020] [Indexed: 12/30/2022] Open
Abstract
Medical management of lower urinary tract symptoms related to benign prostatic obstruction engages healthcare professionals worldwide. Currently, alpha-1 adrenergic antagonists are strongly recommended as first-line therapy for patients with moderate to severe symptoms because of their safety, efficacy and good tolerability. These agents are highly heterogeneous in terms of pharmacological selectivity for the adrenergic receptor subtypes with silodosin being the agent characterized by the highest α1A/α1B affinity ratio. This property has been proposed to confer to silodosin advantages in terms of bladder outlet obstruction improvement and lower incidence of cardiovascular side effects at the cost of a higher incidence of ejaculatory dysfunction. These aspects should be carefully taken in consideration when personalizing medical therapy for lower urinary tract symptoms related to benign prostatic obstruction.
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Affiliation(s)
- Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology - Federico II University of Naples, Naples, Italy
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology - Federico II University of Naples, Naples, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology - Federico II University of Naples, Naples, Italy
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology - Federico II University of Naples, Naples, Italy
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology - Federico II University of Naples, Naples, Italy
| | - Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology - Federico II University of Naples, Naples, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology - Federico II University of Naples, Naples, Italy
| | - Francesco Paolo Calace
- Department of Neurosciences, Reproductive Sciences and Odontostomatology - Federico II University of Naples, Naples, Italy
| | - Gianluca Spena
- Department of Neurosciences, Reproductive Sciences and Odontostomatology - Federico II University of Naples, Naples, Italy
| | - Francesco Trama
- Department of Neurosciences, Reproductive Sciences and Odontostomatology - Federico II University of Naples, Naples, Italy
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology - Federico II University of Naples, Naples, Italy
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology - Federico II University of Naples, Naples, Italy
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology - Federico II University of Naples, Naples, Italy
| | - Ferdinando Fusco
- Department of Urology, Luigi Vanvitelli University of Naples, Naples, Italy
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47
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Stanzione A, Creta M, Imbriaco M, La Rocca R, Capece M, Esposito F, Imbimbo C, Fusco F, Celentano G, Napolitano L, Mangiapia F, Mirone V, Longo N. Attitudes and perceptions towards multiparametric magnetic resonance imaging of the prostate: A national survey among Italian urologists. ACTA ACUST UNITED AC 2020; 92. [PMID: 33348956 DOI: 10.4081/aiua.2020.4.291] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 09/03/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We aimed to assess the attitudes and perceptions towards multiparametric magnetic resonance imaging (mpMRI) of the prostate among Italian urologists. MATERIAL AND METHODS A national, web-based survey was performed. A questionnaire composed of 18 multiple choice questions was e-mailed to 941 currently active urologists, members of the Italian Society of Urology. Preserving anonymity, respondents' demographics were collected (e.g. geographic region, type of workplace, prostate procedures performed) as well as data concerning their attitudes and perceptions towards mpMRI (e.g. indications deemed appropriate, degree of confidence in mpMRI results). Data were expressed as raw numbers and percentages of survey answers. RESULTS In total, 98 responses were received (participation rate = 10.4%). Respondents mostly worked in urban areas (96%) and primarily in hospital settings (89%), while 48% of them worked in southern Italy. 97% of respondents considered mpMRI useful to detect Prostate Cancer (PCa) in patients with prior negative biopsy, 64% in biopsy-naïve patients and 60% for PCa pre-operatory staging. About half (42%) of the participants declared that mpMRI results frequently lead them to change PCa management strategy. Standardization of mpMRI acquisition and reporting was partially unsatisfactory. Reported waiting time for mpMRI scans was longer than 4 weeks for 51% of respondents. The major limitation of this survey includes the small number of participants. CONCLUSIONS Prostate mpMRI is used by Italian urologists mainly for detection and for pre-operative staging of PCa. Further improvements in terms of mpMRI availability and report standardization are required.
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Affiliation(s)
- Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples.
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Massimo Imbriaco
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples.
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Fabio Esposito
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy..
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Ferdinando Fusco
- Department of Woman Child and of General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples.
| | - Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
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Fusco F, Verze P, Capece M, Napolitano L. Suppression of spermatogenesis by exogenous testosterone. Curr Pharm Des 2020; 27:2750-2753. [DOI: 10.2174/1381612826666201207104340] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/27/2020] [Indexed: 11/22/2022]
Abstract
:
Sperm production starts from puberty in the seminiferous tubules providing for testosterone production by the
Leydig cells taking place in the interstice of the testicles. Normal spermatogenesis depends on specific signalling from the
hypothalamic-pituitary-gonadal axis. GnRH, FSH and LH are the main hormones involved in the production and
maturation of spermatozoa. Exogenous administration of androgens influences the hypothalamic-pituitary-gonadal axis
with negative feedback that may lead to partial or complete cessation of spermatogenesis by decreasing FSH and LH.
Despite the fact that many trials have confirmed that exogenous testosterone affects male fertility status, evidence
regarding the long-term effects of treatment is conflicting. Regarding this aspect, many studies have confirmed a return to
baseline sperm concentration after testosterone treatment discontinuation, however none of them can specify how long
recovery will take nor whether the sperm count is sufficient for fertility.
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Affiliation(s)
- Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Paolo Verze
- Urology Department,School of Medicine, Surgery, Odontostomatology “Scuola Medica Salernitana” Salerno, Italy
| | - Marco Capece
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples Federico II, Naples, Italy
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Longo N, Calogero A, Creta M, Celentano G, Napolitano L, Capece M, La Rocca R, Sagnelli C, Carlomagno N, Peluso G, Pagano T, Campanile S, Dodaro CA, Sica A, Califano G, Crocetto F, Fusco F, Mangiapia F, Santangelo M. Outcomes of Renal Stone Surgery Performed Either as Predonation or Ex Vivo Bench Procedure in Renal Grafts from Living Donors: A Systematic Review. Biomed Res Int 2020; 2020:6625882. [PMID: 33335926 PMCID: PMC7723480 DOI: 10.1155/2020/6625882] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/15/2020] [Accepted: 11/18/2020] [Indexed: 12/26/2022]
Abstract
AIMS We aimed to summarize available evidence about intraoperative and postoperative donors' and recipients' outcomes following stone surgery in renal grafts from living donors performed either before donation or as ex vivo bench surgery at the time of living-donor nephrectomy. METHODS A systematic review of PubMed, ISI Web of Knowledge, and Scopus databases was performed in September 2020. We included full papers that met the following criteria: original research, English language, human studies, and describing the results of stone surgery in renal grafts from living donors performed either before transplantation or as ex vivo bench surgery. RESULTS We identified 11 studies involving 106 patients aged between 22 and 72 years. Predonation and bench stone surgery was performed in 9 (8.5%) and 96 (90.6%) patients, respectively. Predonation stone surgery involved extracorporeal shock wave lithotripsy, retrograde intrarenal surgery, and percutaneous nephrolithotomy in 8, 1, and 1 patient, respectively. The overall success rate of predonation stone surgery was 78%, and the complication rate was 0%. Bench stone surgery involved ureteroscopy, pyelolithotomy, or a combination of both in 79 (82.3%), 10 (10.4%), and 7 (7.3%) cases, respectively, with an overall success rate of 95.8% and an overall complication rate of 9.37%. CONCLUSIONS Predonation and bench stone surgery in grafts from living donors represents efficacious and safe procedures. Further studies on wider series with a longer follow-up are required.
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Affiliation(s)
- Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Nicola Carlomagno
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Gaia Peluso
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Teresa Pagano
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Silvia Campanile
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Concetta Anna Dodaro
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Michele Santangelo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
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50
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Gacci M, Greco I, Artibani W, Bassi P, Bertoni F, Bracarda S, Briganti A, Carmignani G, Carmignani L, Conti GN, Corvò R, DE Nunzio C, Fusco F, Graziotti P, Maggi S, Magrini SM, Mirone V, Montironi R, Muto G, Noale M, Pecoraro S, Porreca A, Ricardi U, Russi E, Salonia A, Simonato A, Serni S, Tubaro A, Zagonel V, Crepaldi G. The waiting time for prostate cancer treatment in Italy: analysis from the PROS-IT CNR Study. Minerva Urol Nephrol 2020; 74:38-48. [PMID: 33200896 DOI: 10.23736/s2724-6051.20.03925-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Prostate cancer (PCa) is the second most common neoplasm in male patients. To date, there's no certain indication about the maximum waiting time (WT) acceptable for treatment beginning and the impact on oncological and functional outcomes has not been well established. METHODS Data from the National Research Council PCa monitoring multicenter project in Italy (Pros-IT CNR) were prospectively collected and analyzed. WT was defined as the time from the bioptical diagnosis of PCa to the first treatment received. Patients were divided in two groups, using a time frame of 90 days. Quality of life was measured through the Italian version of the University of California Los Angeles-Prostate Cancer Index (UCLA-PCI) and of the Short-Form Health Survey (SF-12). The occurrence of upgrading, upstaging, presence of lymph node metastasis and positive surgical margins at the final histopathological diagnosis, and PSA at 12 months follow-up were evaluated. RESULTS The overall median WT was 93 days. The logistic multivariable model confirmed that age, being resident in Southern regions of Italy and T staging at diagnosis were significantly associated with a WT>90 days. At 6 months from diagnosis the mean SF-12 score for the emotional-psychological component was significantly lower in WT≥90 days group (P=0.0428). Among patients treated with surgical approach, no significant differences in oncological outcomes were found in the two groups. CONCLUSIONS In our study age, clinical T stage and provenance from Southern regions of Italy are associated with a WT>90 days. WT might have no impact on functional and oncological outcome.
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Affiliation(s)
- Mauro Gacci
- Department of Urology, University of Florence, Florence, Italy -
| | - Isabella Greco
- Department of Urology, University of Florence, Florence, Italy
| | - Walter Artibani
- Urologic Clinic, Department of Oncological and Surgical Sciences, AOU Integrata and University of Verona, Verona, Italy
| | | | - Filippo Bertoni
- Italian Association for Radiation Oncology (AIRO), Milan, Italy
| | | | - Alberto Briganti
- Department of Urology, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Luca Carmignani
- Department of Urology, San Donato Policlinic Hospital, Milan, Italy
| | | | - Renzo Corvò
- Department of Radiation Oncology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Cosimo DE Nunzio
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Ferdinando Fusco
- Department of Urology, University of Naples Federico II, Naples, Italy
| | | | - Stefania Maggi
- Institute of Neuroscience, National Research Council (CNR), Padua, Italy
| | - Stefano M Magrini
- Radiation Oncology Unit, Spedali Civili Hospital, University of Brescia, Brescia, Italy
| | - Vincenzo Mirone
- Department of Urology, University of Naples Federico II, Naples, Italy
| | - Rodolfo Montironi
- Section of Pathological Anatomy, Polytechnic University of Marche, Ancona, Italy
| | - Giovanni Muto
- Department of Urology, Humanitas, Gradenigo Hospital, Turin, Italy
| | - Marianna Noale
- Institute of Neuroscience, National Research Council (CNR), Padua, Italy
| | | | - Angelo Porreca
- Department of Urology, Abano Terme General Hospital, Padua, Italy
| | - Umberto Ricardi
- Department of Oncology, Radiation Oncology, University of Turin, Turin, Italy
| | - Elvio Russi
- Radiation Unit, San Croce e Carle Hospital, Cuneo, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology (URI), IRCCS San Raffaele Hospital, Milan, Italy
| | - Alchiede Simonato
- Section of Urology, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - Sergio Serni
- Department of Urology, University of Florence, Florence, Italy
| | - Andrea Tubaro
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Vittorina Zagonel
- Oncology Unit, Veneto Institute of Oncology (IOV-IRCCS), Padua, Italy
| | - Gaetano Crepaldi
- Institute of Neuroscience, National Research Council (CNR), Padua, Italy
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