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Pecci V, Troisi F, Aiello A, De Martino S, Carlino A, Fiorentino V, Ripoli C, Rotili D, Pierconti F, Martini M, Porru M, Pinto F, Mai A, Bassi PF, Grassi C, Gaetano C, Pontecorvi A, Strigari L, Farsetti A, Nanni S. Targeting of H19/cell adhesion molecules circuitry by GSK-J4 epidrug inhibits metastatic progression in prostate cancer. Cancer Cell Int 2024; 24:56. [PMID: 38317193 PMCID: PMC10845766 DOI: 10.1186/s12935-024-03231-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/18/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND About 30% of Prostate cancer (PCa) patients progress to metastatic PCa that remains largely incurable. This evidence underlines the need for the development of innovative therapies. In this direction, the potential research focus might be on long non-coding RNAs (lncRNAs) like H19, which serve critical biological functions and show significant dysregulation in cancer. Previously, we showed a transcriptional down-regulation of H19 under combined pro-tumoral estrogen and hypoxia treatment in PCa cells that, in turn, induced both E-cadherin and β4 integrin expression. H19, indeed, acts as transcriptional repressor of cell adhesion molecules affecting the PCa metastatic properties. Here, we investigated the role of H19/cell adhesion molecules circuitry on in vivo PCa experimental tumor growth and metastatic dissemination models. METHODS H19 was silenced in luciferase-positive PC-3 and 22Rv1 cells and in vitro effect was evaluated by gene expression, proliferation and invasion assays before and after treatment with the histone lysine demethylase inhibitor, GSK-J4. In vivo tumor growth and metastasis dissemination, in the presence or absence of GSK-J4, were analyzed in two models of human tumor in immunodeficient mice by in vivo bioluminescent imaging and immunohistochemistry (IHC) on explanted tissues. Organotypic Slice Cultures (OSCs) from fresh PCa-explant were used as ex vivo model to test GSK-J4 effects. RESULTS H19 silencing in both PC-3 and 22Rv1 cells increased: i) E-cadherin and β4 integrin expression as well as proliferation and invasion, ii) in vivo tumor growth, and iii) metastasis formation at bone, lung, and liver. Of note, treatment with GSK-J4 reduced lesions. In parallel, GSK-J4 efficiently induced cell death in PCa-derived OSCs. CONCLUSIONS Our findings underscore the potential of the H19/cell adhesion molecules circuitry as a targeted approach in PCa treatment. Modulating this interaction has proven effective in inhibiting tumor growth and metastasis, presenting a logical foundation for targeted therapy.
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Affiliation(s)
- Valeria Pecci
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Rome, 00168, Italy
| | - Fabiola Troisi
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Rome, 00168, Italy
| | | | - Sara De Martino
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Rome, 00168, Italy
- National Research Council (CNR)-IASI, Rome, Italy
| | - Angela Carlino
- Fondazione "Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
| | - Vincenzo Fiorentino
- Fondazione "Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
- Department of Woman, Child and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cristian Ripoli
- Fondazione "Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
- Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Dante Rotili
- Dipartimento di Chimica e Tecnologie del Farmaco, Sapienza Università di Roma, Rome, Italy
| | - Francesco Pierconti
- Fondazione "Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
- Department of Woman, Child and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maurizio Martini
- Fondazione "Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
- Department of Woman, Child and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Manuela Porru
- Translational Oncology Research Unit, IRCCS- Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Pinto
- Fondazione "Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
| | - Antonello Mai
- Dipartimento di Chimica e Tecnologie del Farmaco, Sapienza Università di Roma, Rome, Italy
| | - Pier Francesco Bassi
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Rome, 00168, Italy
- Fondazione "Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
| | - Claudio Grassi
- Fondazione "Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
- Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carlo Gaetano
- Laboratory of Epigenetics, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Alfredo Pontecorvi
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Rome, 00168, Italy
- Fondazione "Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
| | - Lidia Strigari
- Department of Medical Physics, S. Orsola, Malpighi University Hospital, Bologna, Italy
| | | | - Simona Nanni
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Rome, 00168, Italy.
- Fondazione "Policlinico Universitario A. Gemelli IRCCS", Rome, Italy.
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Russo P, Palermo G, Iacovelli R, Ragonese M, Ciccarese C, Maioriello G, Fantasia F, Bizzarri FP, Marino F, Moosavi K, Nigro D, Filomena GB, Gavi F, Rossi F, Pinto F, Racioppi M, Foschi N. Comparison of PIV and Other Immune Inflammation Markers of Oncological and Survival Outcomes in Patients Undergoing Radical Cystectomy. Cancers (Basel) 2024; 16:651. [PMID: 38339402 PMCID: PMC10854772 DOI: 10.3390/cancers16030651] [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: 12/29/2023] [Revised: 01/27/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Inflammation is widely acknowledged as a significant characteristic of cancer, playing a substantial function in both the initiation and advancement of cancers. In this research, we planned to compare pan-immune inflammation markers and other well-known markers (systemic immune inflammation index and neutrophil to lymphocyte ratio) to predict prognosis in individuals treated with radical cystectomy for bladder cancer. METHODS In this retrospective analysis, we focused on preoperative PIV, systemic immune inflammation index (SII), and neutrophil-lymphocyte ratio (NLR) in 193 individuals managed with radical cystectomy for bladder cancer between January 2016 and November 2022. Multivariable logistic regression assessments were performed to assess the predictive capabilities of PIV, SII, and NLR for infiltration of lymph nodes (N), aggressive tumor stage (pT3/pT4), and any non-organ limited disease at the time of RC. Multivariable Cox regression analyses were conducted to assess the predictive impact of PIV on Relapse-free survival (RFS), Cancer-specific survival (CSS), and Overall survival (OS). RESULTS Our individuals were divided into high PIV and low PIV cohorts using the optimal cut-off value (340.96 × 109/L) based on receiver operating characteristic curve analysis for relapse-free survival. In multivariable preoperative logistic regression models, only SII and PIV correlated with the infiltration of lymph nodes, aggressive disease, and any non-organ confined disease. In multivariable Cox regression models considering presurgical clinicopathological variables, a higher PIV was associated with diminished RFS (p = 0.017) and OS (p = 0.029). In addition, in multivariable Cox regression models for postoperative outcomes, a high PIV correlated with both RFS (p = 0.034) and OS (p = 0.048). CONCLUSIONS Our study suggests that PIV and SII are two very similar markers that may serve as independent and significant predictors of aggressive disease and worse survival impacts on individuals undergoing radical cystectomy for bladder neoplasm.
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Affiliation(s)
- Pierluigi Russo
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Giuseppe Palermo
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Roberto Iacovelli
- Department of Oncology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (R.I.); (C.C.)
| | - Mauro Ragonese
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Chiara Ciccarese
- Department of Oncology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (R.I.); (C.C.)
| | - Giuseppe Maioriello
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Fabrizio Fantasia
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Francesco Pio Bizzarri
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Filippo Marino
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Koosha Moosavi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Domenico Nigro
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Giovanni Battista Filomena
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Filippo Gavi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Francesco Rossi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Francesco Pinto
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Marco Racioppi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Nazario Foschi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
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Pinto F, Russo P. Brachytherapy: The urologist opinion. Urologia 2024; 91:5-7. [PMID: 38362868 DOI: 10.1177/03915603241231355] [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] [Indexed: 02/17/2024]
Abstract
Prostate cancer remains a prevalent concern worldwide, necessitating continual advancements in treatment modalities. This abstract explores the role of brachytherapy as a viable and effective option in the management of prostate cancer. Brachytherapy involves the implantation of radioactive sources directly into the prostate, providing a localized dose of radiation. n recent studies and clinical trials, brachytherapy has demonstrated promising outcomes, particularly in terms of disease control and patient outcomes. The treatment's ability to deliver a concentrated intraprostatic dose, often in combination with external beam radiotherapy, has shown favorable results. Furthermore, brachytherapy's impact on disease-free survival and its potential in reducing urinary and bowel toxicity have been subjects of investigation. This abstract delves into the technical aspects, patient outcomes, and emerging trends in brachytherapy for prostate cancer. By examining the current literature and research findings, we aim to shed light on the evolving role of brachytherapy in the comprehensive management of prostate cancer, emphasizing its potential as a valuable therapeutic option.
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Affiliation(s)
| | - Pierluigi Russo
- Università Cattolica del Sacro Cuore, Roma, Italy
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
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Bargagli M, Pinto F, De Leonardis R, Ragonese M, Totaro A, Recupero S, Vittori M, Bassi P, Gambaro G, Ferraro PM. Determinants of renal papillary appearance in kidney stone formers: An in-depth examination. Arch Ital Urol Androl 2023; 95:10748. [PMID: 36924385 DOI: 10.4081/aiua.2023.10748] [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: 07/19/2022] [Accepted: 08/20/2022] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVES The aim of this study is to investi-gate the association between the urinary metabolic milieu and kidney stone recurrence with a validated papillary evaluation score (PPLA). MATERIALS AND METHODS We prospectively enrolled 30 stone for-mers who underwent retrograde intrarenal surgery procedures. Visual inspection of the accessible renal papillae was performed to calculate PPLA score, based on the characterization of ductal plugging, surface pitting, loss of papillary contour and Randall's plaque extension. Stone compositions, 24h urine collections and kidney stone events during follow-up were collected. Relative supersaturation ratios (RSS) for calcium oxalate (CaOx), brushite and uric acid were calculated using EQUIL-2. PPLA score > 3 was defined as high. RESULTS Median follow-up period was 11 months (5, 34). PPLA score was inversely correlated with BMI (OR 0.59, 95% CI 0.38, 0.91, p = 0.018), type 2 diabetes (OR 0.04, 95% CI 0.003, 0.58, p = 0.018) and history of recurrent kidney stones (OR 0.17, 95%CI 0.04, 0.75, p = 0.019). The associations between PPLA score, diabetes and BMI were not confirmed after excluding patients with uric acid stones. Higher PPLA score was associated with lower odds of new kidney stone events during follow-up (OR 0.15, 95% CI 0.02, 1.00, p = 0.05). No other significant correla-tions were found. CONCLUSIONS Our results confirm the lack of efficacy of PPLA score in phenotyping patients affected by kidney stone disease or in predicting the risk of stone recurrence. Larger, long-term studies need to be performed to clarify the role of PPLA on the risk of stone recurrence.
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Affiliation(s)
- Matteo Bargagli
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma; U.O.S. Terapia Conservativa della Malattia Renale Cronica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma.
| | - Francesco Pinto
- U.O.C. Clinica Urologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma.
| | - Rossella De Leonardis
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma.
| | - Mauro Ragonese
- U.O.C. Clinica Urologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma.
| | - Angelo Totaro
- U.O.C. Clinica Urologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma.
| | | | - Matteo Vittori
- Department of Urology, San Carlo di Nancy Hospital, Rome.
| | - PierFrancesco Bassi
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma; U.O.C. Clinica Urologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma.
| | - Giovanni Gambaro
- Renal Unit, Department of Medicine, University-Hospital of Verona, Verona.
| | - Pietro Manuel Ferraro
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma; U.O.S. Terapia Conservativa della Malattia Renale Cronica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma.
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Anchuelo J, Rivero A, Galdós P, Alonso L, Astudillo R, Navarrete P, Arrojo E, Jimeno J, Albendea J, Pinto F, Fabregat R, De Juan A, Hinojo C, Hernanz F, Merino P, Díaz de Tuesta M, Borniquel F, Mazaira J, Muñoz P, Prada P. Accelerated partial breast irradiation (APBI) in a single 18 Gy fraction with high-dose-rate brachytherapy (HDR). Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01483-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Ferreira R, Velho T, Sena A, Goncalves J, Junqueira N, Pereira R, Almeida A, Pinto F, Nobre A. Rapid deployment bioprostesis for aortic valve stenosis: single center short and long-term outcomes. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1574] [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
Despite recent advances, surgical aortic valve replacement (SAVR) remains the gold standard for most of the patients with aortic valve stenosis. The ageing population, with increased comorbidities and the rising of minimally invasive techniques, led to the development of new prosthetic devices of easier and faster implantation.
Purpose
This study aimed to analyse short and long-term outcomes of SAVR with rapid-deployment (RD) aortic bioprosthesis for isolated aortic valve stenosis
Method
Singe center, retrospective longitudinal cohort study of patients with isolated aortic valve stenosis who underwent elective aortic valve replacement using RD devices between 2014 and December 2021.
Continuous variables are presented with median (IQR) and were analyzed using Mann-Whitney test. Categorical variables are presented in percentage or frequency and were analyzed using chi-square test. Kaplan-Meyer survival curve was constructed base on collected data from national registry.
Results
A RD device was implanted in 358 patients with a median age of 75,8 years and Euroscore II of 2,3. Median cross clamp and extracorporeal circulation time were 27,4 and 36,7 min, respectively. No significant paravalvular leaks.
Intensive care unit (ICU) length of stay was 3 days with acute renal lesion (any stage-53,2%; Dialysis-2,5%), need for hemodynamic support (63,1%) and new onset atrial fibrillation (33,6%) being the most frequent post-operative complications. Stroke occurred in 0,6% of cases and mortality was 1,1%. Pacemaker implementation rate of 11%.
The mean follow-up time was 6,7 years with 90% 5-years survival rate. Mean gradients of 11,2±4,8 mmHg at 6 months
Conclusion
Surgical treatment of aortic valve stenosis using RD devices is safe, with a low mortality rate. ICU length of stay and hospital length of stay are reduced. Follow-up shows an excellent long-term survival and hemodynamic performance.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Ferreira
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - T Velho
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - A Sena
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - J Goncalves
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - N Junqueira
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - R Pereira
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - A Almeida
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - F Pinto
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - A Nobre
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
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Lopes J, Pinto R, Borges M, Pires M, Nunes A, Brito J, Silva P, Ricardo I, Pinto F, Abreu A. Cardiorespiratory fitness assessment on active patients who kept attending their phase III exercise-based cardiac rehabilitation during the COVID-19 era. Eur J Prev Cardiol 2022. [PMCID: PMC9383978 DOI: 10.1093/eurjpc/zwac056.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Funding Acknowledgements Type of funding sources: None. Background Cardiorespiratory fitness (CRF) is a powerful predictor of all-cause mortality among individuals with coronary artery disease (CAD). A structured community-based phase III cardiac rehabilitation (CR) is very important in lifelong maintenance of phase II CRF and health gains. During the COVID-19 pandemic, CR programs had to adapt, mainly using new technologies and remote follow-up. The CRF impact in patients (Ps) who kept going their phase III program, during this troubled era is still unknown. Purpose Assess the variation in CRF and prognostic parameters in Ps with CAD who maintain high adherence levels in their phase III CR before and during the COVID-19 pandemic. Methods A cohort of Ps enrolled in a community-based phase 3 CR program, with active participation at the end of 2019, was included in this retrospective study. The inclusion criteria for this study were high levels of attendance (>80%) to the CR program before and during COVID-19 and high levels of physical activity with more than 150 mins of moderate to vigorous physical activity (MVPA). All Ps were evaluated with transthoracic echocardiography (TTE) and a cardiorespiratory exercise test (CPET) in a cycloergometer in 2019 and between october and november of 2021. All Ps had used accelerometers to measure their physical activity levels and dual-energy absorptiometry (DEXA) scan to evaluate their body composition. Between 2020 and 2021, Ps had online (in lockdown periods) and face to face exercise training sessions, 3xtimes per week, 60 mins each exercise session. A t-test paired two sample for means was used to compare CPET variables before the beginning of the first COVID lockdown (end of 2019) and after the removal of the majority of restrictions (end of 2021). Results A total of 30 Ps with high levels of adherence were included (99.6% male, 65 ± 9 years old). In this cohort, the majority had history of an ACS before the referral to the CR program (73.3%) and 55.6 ± 10.4% of left ventricular ejection fraction. There was no significant difference in body mass index (27.9 ± 3.2 kg/m2 vs 28.1 ± 3.6 kg/m2, p=0.493 but there was a significant increase in the percentage of body fat mass (30.1 ± 5.7% vs 31.0 ± 6.6%, p= 0.042). There was a maintenance on MVPA levels (352 ± 137 minutes/week vs 313 ± 194 minutes/week, p = 0.106) during this period. When comparing the 2 CPET results, Ps achieved higher exercise loads in the 2021 test (175 ± 51W vs 185 ± 52W, p=0.005), higher VO2 peak (25.3 ± 6.9 ml/kg/min vs 21.5 ± 6.3 ml/kg/min, p =0.001) and higher percentage of predicted VO2max (78.8 ± 16.8% vs 95.27 ± 20.8%, p = 0.001). Conclusion In spite of all the difficulties in maintaining a phase III CR program during the COVID-19 pandemic, we observed that in physically active CAD Ps, with the aid of new technologies and remote follow-up (during the lockdown periods) and face to face exercise sessions, it is still possible to have functional gains and improvements in CRF.
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Affiliation(s)
- J Lopes
- University Hospitals of Coimbra, Cardiology, Coimbra, Portugal
| | - R Pinto
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - M Borges
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - M Pires
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - A Nunes
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - J Brito
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - P Silva
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - I Ricardo
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - F Pinto
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - A Abreu
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
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8
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Ragonese M, Pinto F, Foschi N, Dibitetto F, Akhundov A, Distante F, Bassi P. Endoneedle laser lithotripsy during percutaneous nephrolitotomy: The advantage of ecirs in the management of intra-operative complications. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00099-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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9
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Ragonese M, Dibitetto F, Bassi P, Pinto F. Laser technology in urologic oncology. Urologia 2022; 89:338-346. [PMID: 35422152 DOI: 10.1177/03915603221088721] [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] [Indexed: 11/16/2022]
Abstract
Laser technology has been used in Urology since the 80s with a lot of different applications in endoscopic and open surgery. With the developments of the technology and the introduction of new active medium and source of laser energy, this technology have become the gold standard not only in stone surgery but even in benign prostate enlargement (BPE) surgical treatment. Regarding urologic oncology, laser energy has now reached an important role in focal therapy and in conservative treatment. The possibility of having better functional outcomes without any relevant impact on oncological results led to an increased use of laser in penile surgery, with a significant mention in urological guidelines for this option. In urothelial cancers as well, both in conservative management of upper tract tumors that in the treatment of non muscle invasive bladder cancer, a clear role of these relatively new source of energy have been demonstrated. Finally, both in prostate that in renal cancer the strategy of focal therapy may take advantage from this precise and fine technology. In this review we analyzed and described the applications of laser energy in urological cancers with a specific focus on penile, urothelial and prostate cancer.
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Affiliation(s)
- Mauro Ragonese
- Unit of Urology, Department of Surgical and Medical Sciences, University Hospital Agostino Gemelli-IRCCS, Rome, Italy
| | - Francesco Dibitetto
- Unit of Urology, Department of Surgical and Medical Sciences, University Hospital Agostino Gemelli-IRCCS, Rome, Italy
| | - PierFrancesco Bassi
- Unit of Urology, Department of Surgical and Medical Sciences, University Hospital Agostino Gemelli-IRCCS, Rome, Italy
| | - Francesco Pinto
- Unit of Urology, Department of Surgical and Medical Sciences, University Hospital Agostino Gemelli-IRCCS, Rome, Italy
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10
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Mauricio AR, Goncalves S, Santiago H, Santos L, Prata S, Vaz R, Ribeiro F, Almeida AG, Pinto F. Transcatheter aortic valve implantation (balloon-expandable versus self-expandable valves) - what echocardiographic parameters should we evaluted? Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.307] [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.
Introduction
Transcatheter aortic valve implantation (TAVI) is currently the recommended treatment for aortic stenosis (AS) in high or intermediate-risk or inoperable patients. Balloon-expandable valve (BEV) and self-expanding valve (SEV) are the two major types of transcatheter heart valves (TTHV). Despite major diferences, both designs are recomended, however, there are only limited data available for the comparison of newer generation BEV and SEV.
Purpose
Compare echocardiographic and clinical parameters, during 1 year of follow-up of a balloon-expandable (BS) versus self-expanding (SE) transcatheter aortic valve implantantation, with emphasis on the composite endpoits proposed by uptade Valve Academic Researc Consortium (VARC-2).
Methods
Retrospective, comparative study in patients with symptomatic severe AS with a high operative risk, who implanted BEV or SEV between January 2016 and December 2019. All patients underwent echocardiographic study before an after the procedure (on the day , 6 months and 1 year of follow up), clinical data were collected. The following ecocardiographic parameters were evaluated: transvalvular and prosthetic aortic gradientes and paravalvular leak (PVL).
Results
We studied 106 patients (81 ± 8 years, 60% female) with severe AS (mean gradient of 49 ± 12 mmHg), who were threated with BE or SE transcatheter aortic valve. Comparative analysis between BEV vs SEV, showed: there were no statistically significant in mean transprosthetic gradients (9.5 ± 4.8 vs 10 ±6.2; p = 0.49). There were no statistically significant differences between BE and SE valves in the cumulative incidence of death from any cause (21% vs. 28%; p = 0.49), death from cardiovascular causes (3.3% vs. 0%; p= 0.26), all strokes (1.6% vs. 1.6%; p = 0.85), pacemaker implatation (18% vs. 15% p = 0.79); major bleeding (3.3% vs 6.5%; p = 0.18) and renal injury (1.6% vs. 2.1%: p = 0.67). There were statistically significant differences between BE and SE valves in the cumulative incidence of moderate or severe PVL (5% vs. 23.9%; p = 0.009) and repeat hospitalization (11.6% vs. 28%;p = 0.04). Device sucess was achieved in 97 % for BEV vs 91% for SEV (p = 0,39). The early safety at 30 days was observed in 5% for BVE vs. 4.3% for SVE (p = 0.87). The clinical efficacy after 30 days was achieved in 1,6% for BVE vs. 4.3% for SVE (p = 0.03), with higher incidence of moderate or severe PVL. The composite endpoint valve safety occured in 3,3 % for BVE vs 26% for SVE (p < 0,001), with moderate or severe PVL in 23%.
Conclusion(s): In patients with symptomatic severe aortic stenosis who implanted BEV or SEV transcatheter aortic valve there was a significant improvement in the hemodynamic status. The present study suggests that use of SEV was associated with a higher risk of PVL and repeat hospitalization, with a endpoint clinical efficacy after 30 days (4,3%) and time-related valve safety (26%).
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Affiliation(s)
- AR Mauricio
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - S Goncalves
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - H Santiago
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - L Santos
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - S Prata
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - R Vaz
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - F Ribeiro
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - AG Almeida
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - F Pinto
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
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11
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Costa Mauricio AR, Goncalves S, Santiago H, Prata S, Santos L, Vaz R, Ribeiro F, Almeida A, Pinto F. Regression of left ventricular mass after transcatheter aortic valve implantation. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.331] [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: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Regression of left ventricular mass (LVM) after transcatheter aortic valve implantation (TAVI) is an important parameter of left ventricular reverse remodeling and is associated with less hospitalizations 1year after TAVI. The association between LVM índex (LVMi) at 6 months and outcome 1 year after TAVI is unclear.
Purpose
Evaluate and compare LVMi, before TAVI and 6 months after, and determine the association between LVMi regression and clinical outcomes at 1-year follow-up.
Methods
Retrospective, comparative study in patients with symptomatic severe aortic stenosis with a high operative risk, after TAVI. All patients underwent echocardiographic study before TAVI and 6 months of follow-up, the LVMi (by the Devereux formula) was evaluated. Associations between LVMi regression (percent change between baseline and 6 months after TAVI), rehospitalization rate and death at 1 year of follow-up were examined.
Results
We studied 50 patients, 82% with moderade or severe LVMi before TAVI. Comparative analysis between ecocardiography study before and 6 months after TAVI, showed there was statistically significant decrease in LVMi (150,7 ± 38 g/m2 vs 132 ± 36 g/m2; p = 0.03). LVMi moderate or severe (between 130 and 154 g/m2) at 6 months was associated with biggest hospitalization rate (p = 0,03).Comparative analysis between regression of LVMi (before and 6 months after TAVI) and death, showed: decrease of 5% and 10% in LVMi was independently associated with death at 1 year (p = 0,77 vs p = 0,4).
Conclusions
Patients with severe symptomatic aortic stenosis treated with TAVI who had a significant decrease of LVMi after 6 months of follow-up had lower hospitalization rates, but decrease of LVMi is independently associated with death at 1 year of follow-up.
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Affiliation(s)
| | - S Goncalves
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - H Santiago
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - S Prata
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - L Santos
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - R Vaz
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - F Ribeiro
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - A Almeida
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - F Pinto
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
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12
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Mano T, Viegas J, Bras P, Rito T, Agapito A, Pinto F, Cruz Ferreira R, De Sousa L. Trends in mortality of adult congenital heart disease patients in the last 4 decades. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1844] [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
Introduction
Medical, surgical, and technological advances over the past decades increased the life expectancy of congenital heart disease (CHD) patients (pts), with >90% reaching adulthood. Nonetheless, mortality for adults with CHD (ACHD) is still higher than for the general population.
Purpose
To analyse trends in mortality and causes of death of ACHD.
Methods
Retrospective analysis of pts followed in an ACHD outpatient clinic, in one tertiary center, who died between 1980 and December 2020. Data relating to the cardiac diagnosis, symptoms, interventions, comorbidities, and causes of death were analysed.
Results
During a median follow-up of 8.9 years (IQR 2.2–17), 251 pts of 3725 (6.7%) died during the study period: 127 males (51%), mean age at death 44.9±18.1 years, 54% with severe CHD. The majority of these death was CHD-related (171 pts – 68.1%) with no statistically significant differences over the years vs non-cardiovascular death (Table 1). However, a paradigm shift was noticed: in the first years the main cardiac cause was sudden-death that was replaced by heart failure in the last decade. Also, the mean age at death increased over the years (33±14.9 years until 2000 vs 52.3±17 years after the year 2010, p<0.001) as the number of implantable devices (4 vs 20, p=0.05).
Conclusion
Causes of death of ACHD patients are in the majority still CHD-related. However, in the last decade, according to the increase in life expectancy, heart failure became the leading cause of death.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Mano
- Hospital de Santa Marta, Lisbon, Portugal
| | - J Viegas
- Hospital de Santa Marta, Lisbon, Portugal
| | - P Bras
- Hospital de Santa Marta, Lisbon, Portugal
| | - T Rito
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Agapito
- Hospital de Santa Marta, Lisbon, Portugal
| | - F Pinto
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - L De Sousa
- Hospital de Santa Marta, Lisbon, Portugal
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13
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Mano T, Ferreira V, Moreira RI, Teixeira B, Agapito A, Rito T, Pinto F, Cruz Ferreira R, De Sousa L. Fetal and maternal outcomes in patients with tetralogy of Fallot. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2899] [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
Introduction
Women with tetralogy of Fallot (TOF) have an increased risk of adverse cardiac and neonatal events during pregnancy. The aim was to assess fetal and maternal outcomes in patients (pts) with uncorrected and corrected TOF.
Methods
Retrospective analysis of cardiological and obstetric data in women with TOF followed at our institution. Pregnancy and neonatal outcomes were compared in patients (pts) submitted to corrective surgery vs pts with no previous intervention and in pts with or without cyanosis.
Results
51 women (median age 27 years; median number of previous interventions of 2), 22% with cyanosis, who experienced 126 pregnancies resulting in 73 live births A previous corrective surgery was found in 78% (40 pts), while 4% (2 pts) had previous palliative surgery and 18% (9 pts) no previous procedure. We found that women that were not submitted to previous intervention had a significant higher incidence of preterm birth (56% vs 17.5%, p=0.029), spontaneous abortion (56% vs 10%, p=0.006) and stillbirth (22% vs 0%). No difference was found for obstetric complications between groups. Cyanotic pts also demonstrated higher incidence of low birth weight (LBW) (36% vs 7.5%, p=0.031), preterm birth (54% vs 17.5%, p=0.021), spontaneous abortion (55% vs 10%, p=0.004) and stillbirth (18% vs 0%). There were no cardiac complications during pregnancy nor evident deterioration on cardiac status. Congenital heart disease was reported in 2 infants (3% of live births).
Conclusions
Pregnancy is well tolerated in pts with TOF. In our population, even in uncorrected TOF and in pts with cyanosis, there were no cardiac complications during pregnancy, although those pts had worse fetal outcomes. An explanation for the low incidence of cardiac events may be less severe forms of the disease, allowing survival into adulthood without intervention.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Mano
- Hospital de Santa Marta, Lisbon, Portugal
| | - V Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - B Teixeira
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Agapito
- Hospital de Santa Marta, Lisbon, Portugal
| | - T Rito
- Hospital de Santa Marta, Lisbon, Portugal
| | - F Pinto
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - L De Sousa
- Hospital de Santa Marta, Lisbon, Portugal
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14
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Azevedo Coutinho MDC, Cortez-Dias N, Cantinho G, Goncalves S, Cunha N, Rodrigues T, Santos L, Conceicao I, Pinto F. Diagnostic and prognostic contribution of 99mTc-DPD scintigraphy in transthyretin V30M cardiac amyloidosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0278] [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
Early diagnosis and prognostic stratification of hereditary transthyretin amyloidosis (ATTR) are crucial. Previous findings suggested that 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) scintigraphy presents suboptimal accuracy to detect ATTR cardiomyopathy caused by V30M mutation, particularly in patients with onset of symptoms under 50 years of age. Furthermore, its prognostic value has never been evaluated in ATTR caused by this mutation.
Purpose
To assess the diagnostic value of DPD scintigraphy to detect cardiomyopathy in a large cohort of patients with ATTR-V30M mutation and to explore its prognostic value regarding mortality.
Methods
Of the 305 ATTR-V30M mutation carriers followed prospectively and who underwent DPD scintigraphy, 288 individuals [median age 46 (39–56); 49% male] without myocardial thickening attributable to other causes were enrolled in the study. Amyloid cardiomyopathy was defined by septal thickness ≥13mm not attributable to other causes plus at least one of the following criteria: (1) late heart-to-mediastinum (H/M) 123I-metaiodobenzylguanidine (MIBG) ratio <1.60; (2) electrical heart disease (arrhythmia or cardiac conduction defect); or (3) amyloid infiltration documented in biopsy.
Results
Amyloid cardiomyopathy was identified in 41 (14.2%) patients and 44 (15.3%) individuals presented abnormal cardiac DPD uptake. Individuals with cardiac DPD retention had 27-fold higher likelihood of having amyloid cardiomyopathy (OR: 27.4; 95% CI 11.6–65.0; P<0.001). However, DPD scintigraphy presented suboptimal accuracy to detect ATTR cardiomyopathy (89.9%) with limitations in sensitivity (56.1%), specificity (95.6%), positive predictive value (67.7%) and negative predictive value (92.9%).
During a mean follow-up 33.6±1.2 months, 16 patients died (5.6%). Mortality was 14 times higher in patients with amyloid cardiomyopathy (HR: 14.1; 95% CI 4.9–40.7; P<0.001), 13 times higher in those with abnormal cardiac DPD uptake (HR: 12.59; 95% CI % 4.56–34.72; P<0.001) and 10 times higher in those with H/M MIBG ratio <1.60 (HR: 10.40; 95% CI 2.95–36.69; P<0.001). The prognostic value of ventricular thickness and cardiac DPD uptake was additive: patients without septal thickening and no cardiac DPD retention had excellent prognosis (5-year mortality of 0.75%), while those with septal thickening and/or abnormal DPD retention presented 5-year mortality rates ranging from 39.9 to 53.3%.
Conclusions
DPD scintigraphy is valuable in the evaluation of ATTR-V30M mutation carriers, particularly for prognostic stratification purposes, identifying patients at higher risk of death.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - N Cortez-Dias
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - G Cantinho
- Faculty of Medicine of the University of Lisbon, Lisbon, Portugal
| | - S Goncalves
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - N Cunha
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - T Rodrigues
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - L Santos
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - I Conceicao
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - F Pinto
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
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15
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Ferreira V, Branco Mano T, Rito T, Ilhao Moreira R, Agapito A, Pinto F, Sousa L. Pregnancy outcomes in women with severe congenital heart disease – a specialized centre experience. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2898] [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
Introduction
Progress in pediatric cardiology and cardiac surgery has dramatically raised the number of women with severe complex congenital heart disease (SC-CHD) that reach reproductive age. Pregnancy (P) in this group of women has an increased risk of adverse cardiac and neonatal events and its predictive factors are not fully defined. Our purpose was to assess the experience of our center regarding P and neonatal outcomes in women with SC-CHD.
Methods
Retrospective analysis of obstetric data in women with CHD followed at our institution. P and neonatal outcomes were evaluated regarding patients presenting SC-CHD and mild and moderate complexity CHD (MMC-CHD), according to ESC guidelines CHD complexity classification.
Results
The study enrolled 680 women with CHD (median age, 27.2 years) who experienced 1262 pregnancies, resulting in 998 live births. A previous corrective procedure was found in 334 women (49.1%). CHD complexity was considered mild, moderate and severe in 263 (38.7%), 359 (52.8%) and 58 (8.5%), respectively. SC-CHD included 38 women with cyanotic CHD and 18 with pulmonary vascular disease. The most common heart defect in SC-CHD pts was cyanotic tetralogy of Fallot (19.0%), followed by dextro-transposition of the great arteries with atrial switch /palliative procedure (13.8%) – Figure 1.
Pts with SC-CHD had successful deliveries in 56.1% comparing with 82.1% in MMC-CHD. Women with SC-CHD had significantly higher incidence of preterm birth (24.6% vs 7.4%, p<0.001), spontaneous abortion (26.3% vs 12.3%, p=0.004) and neonatal mortality (10.3% vs 2.3%) comparing with MMC-CHD. Low birth weight was also extremely more frequent in the SC-CHD group (44.7% vs 8.5%, p<0.001). No difference was found relating to the presence of CHD in infants from SC-CHD mothers compared to off-spring from MMC-CHD (8.4 vs 5.3%, p=0.407). Cesarian deliveries had similar rates independently of increased CHD complexity (34.2% vs 32.1%). Overall, pregnancy was quite well tolerated, although cardiac complications were more common in SC-CHD P (0.4% vs 4.3%, p 0.013). Only one maternal death was registered, during 1st trimester, in a woman with a large unrepaired ventricular septal defect and cyanosis.
Conclusion
Severe complex CHD remains a challenging condition for pregnancy with increased maternal and neonatal morbimortality. This emphasizes the importance of extensive prepregnancy counselling and centralization of care to address specific risks and requirements of the condition.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Severe CHD
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Affiliation(s)
- V Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - T Rito
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - A Agapito
- Hospital de Santa Marta, Lisbon, Portugal
| | - F Pinto
- Hospital de Santa Marta, Lisbon, Portugal
| | - L Sousa
- Hospital de Santa Marta, Lisbon, Portugal
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16
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Di Gianfrancesco L, Foti M, Ragonese M, Palermo G, Sacco E, Pinto F, Totaro A, Marino F, Akhundov A, Bassi P, Racioppi M. A large pilot study on the diagnostic performance of electronic nose in detecting Bladder Cancer. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)01227-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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17
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Pinto F, Simonetti CS, Paz SM, Orlandi F. 1183P Survival impact of concurrent chemoradiotherapy (CRT) with weekly cisplatin doses in patients with unresectable stage III non-small cell lung cancer (NSCLC) in a clinical referral center in Chile. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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18
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Santoro AA, Di Gianfrancesco L, Racioppi M, Pinto F, Palermo G, Sacco E, Campetella M, Scarciglia E, Bientinesi R, Di Paola V, Totaro A. Multiparametric magnetic resonance imaging of the prostate: Lights and shadows. Urologia 2021; 88:280-286. [PMID: 34075837 DOI: 10.1177/03915603211019982] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Prostate cancer is the second most commonly diagnosed cancer in man. Since the first MRI was performed, enormous progress has been made in diagnosis, treatment, and follow up of PCa, mainly due to multiparametric prostatic MRI (mpMRI). Although mpMRI has become the best imaging tool for identifying PCa, some limitations still exist. Prostate imaging with mpMRI is, to date, the best way to locate suspicious lesions to trigger prostate biopsy, plan active surveillance, or definitive treatment. In case of relapse, mpMRI can help detect local disease and provide specific management. It is well known that there is a subset of patients in whom mpMRI fails to depict csPCa. These missed significant cancers demand great attention. Prostate mpMRI quality depends on several factors related to equipment (including equipment vendor, magnet field and gradient strength, coil set used, software and hardware levels, sequence parameter choices), patient (medications, body habitus, motion, metal implants, rectal gas), and most importantly the radiologic interpretation of images (learning curve effects, subjectivity of observations, interobserver variations, and reporting styles). Inter-reader variability represents a huge current limitation of this method. Therefore, mpMRI remains the best imaging tool available to detect PCa, guiding diagnosis, treatment, and follow up while inter-reader variability represents the best limitation. Radiomics can help identifying imaging biomarkers to help radiologist in detecting significant PCa, reducing examination times, and costs.
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Affiliation(s)
- Agostino Antonio Santoro
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Luca Di Gianfrancesco
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Marco Racioppi
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Francesco Pinto
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Giuseppe Palermo
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Emilio Sacco
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Marco Campetella
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Eros Scarciglia
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Riccardo Bientinesi
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Valerio Di Paola
- Department of Radiology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Angelo Totaro
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
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Totaro A, Di Gianfrancesco L, Pinto F, Racioppi M, Palermo G, Campetella M, Santoro AA, Arbia G, Sacco E. Rate of clinically significant prostate cancer on repeat saturation biopsy after a diagnosis of atypical small acinar proliferation. Urologia 2021; 88:194-199. [PMID: 33579180 DOI: 10.1177/0391560321993595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Atypical small acinar proliferation (ASAP) occurs in approximately 5% of prostate biopsies. Approximately 30%-40% of these patients may develop prostate cancer (PCa) within a 5-year period, often not clinically significant. Current guidelines recommend a repeat biopsy within 3-6 months after the initial diagnosis, but it seem not to be the best strategy. METHODS Objectives-evaluating the natural history of ASAP, stratifying the risk of csPCa after ASAP, identifying predictive factors of PCa after atypical diagnosis. Materials and methods-retrospective single-institutional study on patients undergoing prostate biopsy for suspicious PCa (2005-2016). We evaluated the incidence of overall PCa, intermediate-high risk of PCa and csPCa in case of ASAP, according to D'Amico classification and Epstein modified criteria. RESULTS Out of 4.567 patients undergoing prostate biopsy, ASAP was detected in 2.6% of cases. All patients with ASAP underwent repeat saturation biopsy within 6 months and PCa was diagnosed in 34.5%. According to D'Amico classification, 26%, 5.9%, and 2.5% had low, intermediate, and high-risk disease, respectively. According modified Epstein criteria, the incidence of csPCa was 12.6%. LRT showed that the overall probability to develop PCa doubled when PSA density (PSAD) moved from values lower than 0.13 ng/ml/cc to class 0.13-0.30 ng/ml/cc, and it tripled when PSAD was higher than 0.30 ng/ml/cc. CONCLUSIONS The rate of csPCa in patients with an initial diagnosis of ASAP who had repeat biopsy was 12.6%. The overall PCa rate was 34.5%. Among patient undergoing RP, an upgrading from ncsPCa to csPCa was reported in 35% of cases. PSAD is the only predictive factor directly associated to the risk of developing PCa on repeat biopsy. These findings suggest that immediate repeat biopsy remains the correct strategy in absence of novel predictor factors and non-invasive diagnostic evaluations.
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Affiliation(s)
- Angelo Totaro
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Luca Di Gianfrancesco
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Francesco Pinto
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Marco Racioppi
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Giuseppe Palermo
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Marco Campetella
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Agostino Antonio Santoro
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
| | - Giuseppe Arbia
- Department of Statistical Science, Faculty of Economics, Catholic University of the Sacred Heart, Rome, Italy
| | - Emilio Sacco
- Department of Urology, Catholic University of the Sacred Heart - Fondazione Policlinico Universitario "A. Gemelli" - IRCSS, Rome, Italy
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Fiorentino V, Martini M, Dell’Aquila M, Musarra T, Orticelli E, Larocca LM, Rossi E, Totaro A, Pinto F, Lenci N, Di Paola V, Manfredi R, Bassi PF, Pierconti F. Histopathological Ratios to Predict Gleason Score Agreement between Biopsy and Radical Prostatectomy. Diagnostics (Basel) 2020; 11:diagnostics11010010. [PMID: 33374618 PMCID: PMC7822416 DOI: 10.3390/diagnostics11010010] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 01/03/2023] Open
Abstract
Biopsy proven Gleason score is essential to decide treatment modalities for prostate cancer, either surgical (radical prostatectomy) or non-surgical (active surveillance, watchful waiting, radiation therapy and hormone therapy). Several studies indicated that biopsy proven Gleason score may underestimate Gleason score at radical prostatectomy, hence we aimed to calculate the minimum length of biopsy cores needed to have Gleason score agreement. We evaluated 115 prostate cancer patients who underwent multiparametric magnetic resonance/transperineal ultrasonography fusion biopsy and subsequently, radical prostatectomy. Biopsy proven Gleason score was consistent with Gleason score at subsequent radical prostatectomy in 82.6% of patients, while in 17.4% of patients, Gleason score was higher at radical prostatectomy. Gleason score agreement showed a strong direct association with a ratio > 0.05 between the total volume of biopsies performed in tumor area and the volume of the corresponding tumor at radical prostatectomy. A significant association was also found with a ratio ≥ 0.0034 between the tumor volume in the biopsy and the volume of the corresponding tumor at radical prostatectomy and with a ratio ≥ 0.086 between the tumor volume in the biopsy and the total volume of biopsies performed in the tumor area. These results could be exploited to calculate the minimum length of biopsy cores needed to have a correct Gleason score estimation and therefore be used in fusion targeted biopsies with volume adjustments.
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Affiliation(s)
- Vincenzo Fiorentino
- Institute of Pathology, Università Cattolica del S. Cuore, Fondazione Policlinico “A. Gemelli”, 00168 Rome, Italy; (V.F.); (M.M.); (M.D.); (T.M.); (E.O.); (L.M.L.)
| | - Maurizio Martini
- Institute of Pathology, Università Cattolica del S. Cuore, Fondazione Policlinico “A. Gemelli”, 00168 Rome, Italy; (V.F.); (M.M.); (M.D.); (T.M.); (E.O.); (L.M.L.)
| | - Marco Dell’Aquila
- Institute of Pathology, Università Cattolica del S. Cuore, Fondazione Policlinico “A. Gemelli”, 00168 Rome, Italy; (V.F.); (M.M.); (M.D.); (T.M.); (E.O.); (L.M.L.)
| | - Teresa Musarra
- Institute of Pathology, Università Cattolica del S. Cuore, Fondazione Policlinico “A. Gemelli”, 00168 Rome, Italy; (V.F.); (M.M.); (M.D.); (T.M.); (E.O.); (L.M.L.)
| | - Ersilia Orticelli
- Institute of Pathology, Università Cattolica del S. Cuore, Fondazione Policlinico “A. Gemelli”, 00168 Rome, Italy; (V.F.); (M.M.); (M.D.); (T.M.); (E.O.); (L.M.L.)
| | - Luigi Maria Larocca
- Institute of Pathology, Università Cattolica del S. Cuore, Fondazione Policlinico “A. Gemelli”, 00168 Rome, Italy; (V.F.); (M.M.); (M.D.); (T.M.); (E.O.); (L.M.L.)
| | - Ernesto Rossi
- Institute of Medical Oncology, Università Cattolica del S. Cuore, Fondazione Policlinico “A. Gemelli”, 00168 Rome, Italy;
| | - Angelo Totaro
- Institute of Urology, Università Cattolica del S. Cuore, Fondazione Policlinico “A. Gemelli”, 00168 Rome, Italy; (A.T.); (F.P.); (N.L.); (P.F.B.)
| | - Francesco Pinto
- Institute of Urology, Università Cattolica del S. Cuore, Fondazione Policlinico “A. Gemelli”, 00168 Rome, Italy; (A.T.); (F.P.); (N.L.); (P.F.B.)
| | - Niccolò Lenci
- Institute of Urology, Università Cattolica del S. Cuore, Fondazione Policlinico “A. Gemelli”, 00168 Rome, Italy; (A.T.); (F.P.); (N.L.); (P.F.B.)
| | - Valerio Di Paola
- Department of Radiology, Università Cattolica del S. Cuore, Fondazione Policlinico “A. Gemelli”, 00168 Rome, Italy; (V.D.P.); (R.M.)
| | - Riccardo Manfredi
- Department of Radiology, Università Cattolica del S. Cuore, Fondazione Policlinico “A. Gemelli”, 00168 Rome, Italy; (V.D.P.); (R.M.)
| | - Pier Francesco Bassi
- Institute of Urology, Università Cattolica del S. Cuore, Fondazione Policlinico “A. Gemelli”, 00168 Rome, Italy; (A.T.); (F.P.); (N.L.); (P.F.B.)
| | - Francesco Pierconti
- Institute of Pathology, Università Cattolica del S. Cuore, Fondazione Policlinico “A. Gemelli”, 00168 Rome, Italy; (V.F.); (M.M.); (M.D.); (T.M.); (E.O.); (L.M.L.)
- Correspondence: ; Tel.: +39-06-3015-4433
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Antonucci M, Recupero SM, Marzio V, De Dominicis M, Pinto F, Foschi N, Di Gianfrancesco L, Bassi P, Ragonese M. The impact of COVID-19 outbreak on urolithiasis emergency department admissions, hospitalizations and clinical management in central Italy: a multicentric analysis. Actas Urológicas Españolas (English Edition) 2020. [PMCID: PMC7598308 DOI: 10.1016/j.acuroe.2020.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Introduction and objectives Patients and methods Results Conclusions
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Antonucci M, Recupero S, Marzio V, De Dominicis M, Pinto F, Foschi N, Di Gianfrancesco L, Bassi P, Ragonese M. The impact of COVID-19 outbreak on urolithiasis emergency department admissions, hospitalizations and clinical management in central Italy: a multicentric analysis. Actas Urol Esp 2020; 44:611-616. [PMID: 32713658 PMCID: PMC7332912 DOI: 10.1016/j.acuro.2020.06.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/07/2020] [Indexed: 11/17/2022]
Abstract
Introducción y objetivos Nuestro objetivo fue evaluar el impacto de la enfermedad del coronavirus de 2019 (COVID-19) en los ingresos en los servicios de urgencias (SU), las hospitalizaciones y el manejo clínico de los pacientes con urolitiasis. Pacientes y métodos Realizamos un análisis retrospectivo multicéntrico de las admisiones en los servicios de urgencias de tres departamentos de urología de gran volumen (uno directamente implicado en el tratamiento de los pacientes de COVID-19 y dos no implicados) en Roma (Italia) entre marzo y abril de 2020 y en el mismo período de 2019. Se realizó un análisis estadístico del número de admisiones por urolitiasis, la tasa de complicaciones, hospitalización y el tipo de tratamiento recibido. Resultados Fueron incluidos 304 pacientes en el análisis. Se observó una reducción significativa en el número global de pacientes ingresados en urgencias por urolitiasis entre 2019 y 2020 (48,8%). Además, con respecto a la elección del tratamiento de los pacientes hospitalizados, se informó un aumento estadísticamente significativo de los procedimientos de extracción de cálculos en comparación con el drenaje urinario en 2020 (p = 0,015). Conclusiones Durante la pandemia de la COVID-19 en Roma ha habido una reducción significativa de los ingresos en urgencias por urolitiasis. Los pacientes ingresados en el SU tuvieron más complicaciones, necesitaron hospitalización con más frecuencia y en cuanto al manejo clínico, se prefirió la extracción temprana de los cálculos, en vez del drenaje urinario. Todos los urólogos deben ser conscientes de que en los próximos meses podrían enfrentar un mayor número de admisiones por urolitiasis y un manejo de casos más complicados.
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Ferreira V, Almeida Morais L, Sousa L, Fiarresga A, Martins J, Timoteo A, Viveiros Monteiro A, Loureiro P, Soares C, Castelo A, Garcia Bras P, Reis J, Pinto F, Agapito A, Cruz Ferreira R. New onset atrial fibrillation after percutaneous Patent Foramen Ovale closure: how serious is this problem? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2195] [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
Percutaneous Patent Foramen Ovale (pPFO) closure benefits for secondary prevention after cardio-embolic stroke have recently been proved. With the increasing number of cases and procedures, a concern with new onset atrial fibrillation (NOAF) has been raised.
Purpose
To evaluate long-term outcome regarding NOAF rate and to identify its predictors and clinical impact, in a real population submitted to pPFO closure.
Methods
From 2000 to 2017, consecutive patients (P) submitted to pPFO closure in a tertiary centre were prospectively enrolled. The primary endpoint was NOAF rate and secondary endpoints were all-cause, neurologic and cardiac mortality rates and recurrent ischemic events. Previous and follow-up electrocardiographic, echocardiographic and 24-hour heart rhythm monitoring data were analysed. Follow-up was performed through medical visits, medical charts consultation and a phone call based system, in order to assess clinical status, on-going treatment and events.
Results
496 patients were submitted to pPFO. Immediate success was achieved in 98.8% and 9.1% presented a residual shunt on the 1st year TEE. Mean age was 45.0±11.2 years-old with 50.2% of males. The prevalence of hypertension, hypercholesterolemia and atrial septum aneurysm (ASA) was 25.7%, 45.0% and 46.3%, respectively. Pre-procedural mean left atrial (LA) diameter was 36.0±5.3 mm. FU data was available for 490 (98.6%), for a mean FU time of 7.41±3.51 years. 34 P (6.9%) presented ischemic events recurrence (26 strokes and 8 TIA). The primary endpoint was observed in 21 P (4.3%) during the FU period.
Median time to 1st AF episode since PFO closure was 5.90±5.53 years. 11 P (52.3%) initiated oral anticoagulation. In univariate analysis, age (44.6±11.3 vs 51.8±6.0 years, p=0.005) and hypertension (24.7% vs 47.6%, p=0.019) were predictors of NOAF in this population. In multivariated analysis, only age remained a predictor of NOAF (OR 1.05 (1.007–1.101), p=0.025). LA pre pPFO closure dimensions, ASA, device type or size and the presence of residual shunt in TEE were not determinants of AF occurrence. The incidence of NOAF was associated with the need for hospitalization due to cardiac causes (19% vs 3.2%, p=0.001) and a trend towards higher rate of recurrent stroke (4.9% vs 14.3%, p=0.06).
Conclusion
Despite being a highly successful and safe procedure in most patients, pPFO closure was associated with a non-negligenciable rate of NOAF during long-term follow-up. NOAF predictors were related with classical cardiovascular risk factors, such as age and hypertension. None of the procedure or device features were associated with NOAF. Yet, a clinical impact was attributed to NOAF, with more hospitalizations and a trend towards ischemic events recurrence.
As young patients submitted to pPFO closure grow older, prevention strategies to diagnose and treat NOAF should be endeavoured.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- V Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - L Sousa
- Hospital de Santa Marta, Lisbon, Portugal
| | | | | | | | | | - P Loureiro
- Hospital de Santa Marta, Lisbon, Portugal
| | - C Soares
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Castelo
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - J Reis
- Hospital de Santa Marta, Lisbon, Portugal
| | - F Pinto
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Agapito
- Hospital de Santa Marta, Lisbon, Portugal
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Ragonese M, Foschi N, Pinto F, Di Gianfrancesco L, Bassi P, Racioppi M. Immediate ileal ureter replacement for ureteral avulsion during ureterescopy. IJU Case Rep 2020; 3:241-243. [PMID: 33163914 PMCID: PMC7609185 DOI: 10.1002/iju5.12202] [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: 04/15/2019] [Accepted: 07/06/2020] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Complete ureteral avulsion represents a rare and fearsome complication of ureteroscopy, reported in less than 1% of cases. In literature there are few reports and different options are presented for its treatment. We present a case of a ureteral avulsion managed with ileal ureter replacement. CASE PRESENTATION A 67-year-old man with a left proximal ureter stone was treated at our department with ureteroscopy. During retrieval of the instrument a complete ureteral avulsion was discovered, with a so-called "scabbard lesion". We decided to proceed with immediate laparotomy and we performed a ileal ureter replacement. CONCLUSION Ureteral avulsion is a rare complication but must be known as a possible complication in high volume center. There is no standard definition regarding its treatment, and in our experience immediate treatment with ileal ureter replacement proved to be safe and effective without any changes in renal function.
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Affiliation(s)
- Mauro Ragonese
- Urology ClinicA. Gemelli HospitalCatholic University of the Sacred HeartRomeItaly
| | - Nazario Foschi
- Urology ClinicA. Gemelli HospitalCatholic University of the Sacred HeartRomeItaly
| | - Francesco Pinto
- Urology ClinicA. Gemelli HospitalCatholic University of the Sacred HeartRomeItaly
| | | | - Pierfrancesco Bassi
- Urology ClinicA. Gemelli HospitalCatholic University of the Sacred HeartRomeItaly
| | - Marco Racioppi
- Urology ClinicA. Gemelli HospitalCatholic University of the Sacred HeartRomeItaly
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Bargagli M, De Leonardis R, Ragonese M, Totaro A, Pinto F, Recupero S, Bassi P, Ferraro P. Determinants of renal papillary appearance in renal stone formers: An in-depth examination. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33383-8] [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: 10/23/2022] Open
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Bargagli M, De Leonardis R, Ragonese M, Totaro A, Pinto F, Recupero S, Bassi P, Gambaro G, Ferraro PM. P0175DETERMINANTS OF RENAL PAPILLARY APPEARANCE IN RENAL STONE FORMERS: AN IN-DEPTH EXAMINATION. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0175] [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: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Nephrolithiasis is a medical condition characterized by high prevalence among the general population both in Europe and in the U.S. and it is responsible for high costs reaching up to $10 billion per year. It is associated with specific comorbidities such as obesity, arterial hypertension, diabetes mellitus, metabolic syndrome and chronic kidney disease.
Kidney stones development is believed to start either from Randall’s plaques or from stone plugs. Both these lesions can be seen on renal papillary surfaces, but what promotes the formation of plaques and plugs is not entirely understood.
The aim of this study is to investigate the association between the urinary metabolic milieu and a published endoscopic papillary evaluation score (PPLA). We also evaluated the correlation of PPLA score with kidney stone recurrence during follow-up.
Method
We prospectively enrolled 31 stone forming patients who undergone retrograde intrarenal surgery procedures. Visual inspection of the accessible renal papillae was performed in order to calculate the PPLA score based on the appearance of ductal plugging, surface pitting, loss of papillary contour and Randall’s plaque extension.
Demographic information, blood samples, 24h urine collections and kidney stone events during follow-up were collected. Stone composition was analyzed using infrared-spectroscopy. Relative urinary supersaturations (RSS) for calcium oxalate (CaOx), calcium phosphate (CaPi) and uric acid (UA) were calculated using the Equil2 software. PPLA score > 3 was defined as high.
Results
Median follow-up period was 11 (min/max 5, 34) months. PPLA score was inversely correlated with BMI (rho = −0.39, p = 0.035) and history of recurrent kidney stones (median PPLA 5.0 vs 2.5, p = 0.029), these results were confirmed when PPLA was considered as a categorical variable (median BMI 27 vs 24, recurrent stone disease 12 vs 62%, p= 0.006). Furthermore, high PPLA score was associated with lower odds of new kidney stone events during follow-up (OR 0.154, 95% confidence interval 0.024, 0.998, p = 0.05). No significant correlations were found between PPLA score, stone composition, blood parameters, 24h urine solute excretions and RSS for CaOx, CaPi and UA.
Conclusion
Different papillary abnormalities seem to be linked to specific mechanisms of stone formation. Although data regarding PPLA score are inconsistent, it may be a valid asset for both medical and surgical management of nephrolithiasis. Larger, long-term prospective clinical studies need to be conducted to assess the validity of PPLA score system in evaluating risk of stone recurrence.
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Affiliation(s)
| | | | - Mauro Ragonese
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Clinica Urologica, Roma, Italy
| | - Angelo Totaro
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Clinica Urologica, Roma, Italy
| | - Francesco Pinto
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Clinica Urologica, Roma, Italy
| | | | - PierFrancesco Bassi
- Università Cattolica del Sacro Cuore, Roma, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Clinica Urologica, Roma, Italy
| | - Giovanni Gambaro
- University-Hospital of Verona, Renal Unit, Department of Medicine, Verona, Italy
| | - Pietro Manuel Ferraro
- Università Cattolica del Sacro Cuore, Roma, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, U.O.C. Nefrologia, Roma, Italy
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Oliveira S, Abreu A, Cunha P, Carmo MM, Valente B, Ricardo I, Delgado AS, Oliveira L, Pinto F, Oliveira MM. P542Cardiac autonomic dysfunction and inflammatory response in heart failure - markers for cardiac resynchronization therapy response? Europace 2020. [DOI: 10.1093/europace/euaa162.215] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
FCP
Introduction
Cardiac sympathetic activation and inflammatory response are involved in chronic heart failure (HF) pathophysiology. The severity of autonomic dysfunction and inflammation might be responsible for different responses to HF treatment.
Aim
To evaluate the impact of cardiac autonomic dysfunction, and it´s association with systemic inflammation, on cardiac resynchronization therapy (CRT) response in severe HF patients.
Methods
Single centre, prospective, longitudinal study, including consecutive patients, referred to CRT. Demographic data, HF aetiology and NYHA class were evaluated. Left ventricular (LV) function data (LV ejection fraction - LVEF) by echocardiography, heart to mediastinum early ratio (HMRe) by 123I-MIBG cardiac scintigraphy, and plasmatic TNF-α levels (pg/mL) were determined, at baseline and 4 months after CRT implantation. CRT response was defined by an absolute increase of at least 5% in LVEF at 4 months evaluation after CRT. Patients were divided in 4 groups according to HMRe and TNF-α cut-points: Group I (TNF-α > 2.0 pg/ml + HMRe ≥ 1.6), Group II (TNF-α > 2.0 pg/ml + HMRe < 1.6), Group III (TNF-α ≤ 2.0 pg/ml + HMRe ≥ 1.6) and Group IV (TNF-α ≤ 2.0 pg/ml + HMRe < 1.6). Data was analyzed using descriptive statistics and groups were compared by Fisher"s exact test.
Results
A total of 95 patients were included (age 68.6 ± 10.2 years), 67.4% male and 32.6% female, 40% with diabetes mellitus, 30.5% with ischemic cardiomyopathy, 23.2% in NYHA III/IV, baseline LVEF - 26 ± 7%. At 4 months, LVEF was 40 ± 11%. In total, 73.7% were responders and 26.3% were non-responders to CRT. There were 28 patients (29.5%) with HMRe ≥ 1.6, with 25 responders (89.3%) and 48 patients (50.5%) with TNF-α ≤ 2.0 pg/ml, with 38 responders (79.2%). Group I had 16 patients (16.8%), with 81.2% responders; Group II had 31 patients (32.7%), with 61.3% responders; Group III had 12 patients (12.6%), with 100% responders, and Group IV had 36 patients (37.9%), with 72.2% responders. Conclusion: In patients with severe HF submitted to CRT, combining cardiac autonomic dysfunction and inflammation, associated to high rate of CRT non response. Contrarily, those with preserved cardiac autonomic function and no increased levels of inflammation identified most significantly CRT responders.
CRT response according to HMRe and TNFα HMRe ≥ 1.6 (n = 28) HMRe < 1.6 (n = 67) Responders NO Respondersn (%) Responders NO Respondersn (%) TNF α > 2 pg/mL (n = 47) G I: 13 (81.2%) 3 (18.8%) GII: 19 (61.3%) 12 (38.7%) * TNF α ≤ 2 pg/mL (n = 48) G III: 12 (100%) 0 (0%)* G IV: 26 (72.2%) 10 (27.8%)
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Affiliation(s)
- S Oliveira
- Faculty of Medicine of the University of Lisbon, Cardiovascular Exercise & Rehabilitation Laboratory, Cardiovascular Centre of the University of Lisb, Lisbon, Portugal
| | - A Abreu
- Faculty of Medicine of the University of Lisbon, Cardiovascular Exercise & Rehabilitation Laboratory, Cardiovascular Centre of the University of Lisb, Lisbon, Portugal
| | - P Cunha
- Hospital de Santa Marta, Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central , Lisbon, Portugal
| | - M M Carmo
- University of Lisbon, Nova Medical School, CEDOC Chronic Diseases, Lisbon, Portugal, Lisbon, Portugal
| | - B Valente
- Hospital de Santa Marta, Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central , Lisbon, Portugal
| | - I Ricardo
- Faculty of Medicine of the University of Lisbon, Cardiovascular Exercise & Rehabilitation Laboratory, Cardiovascular Centre of the University of Lisb, Lisbon, Portugal
| | - A S Delgado
- Hospital de Santa Marta, Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central , Lisbon, Portugal
| | - L Oliveira
- Quadrantes Clinic, Nuclear Medicine Department, Clinic Quadrantes, Lisbon, Portugal, Lisbon, Portugal
| | - F Pinto
- Faculty of Medicine of the University of Lisbon, Cardiovascular Exercise & Rehabilitation Laboratory, Cardiovascular Centre of the University of Lisb, Lisbon, Portugal
| | - M M Oliveira
- Hospital de Santa Marta, Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central , Lisbon, Portugal
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De Sousa J, Cortez-Dias N, Carpinteiro L, Silva G, Nunes Ferreira A, Silverio Antonio P, Bernardes A, Barreiros C, Ribeiro J, Sobral S, Pinto F. P1402Isolation of pulmonary veins with duty-cycled circular multi-polar catheter: randomized controlled clinical trial. Europace 2020. [DOI: 10.1093/europace/euaa162.088] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Pulmonary vein isolation (PVI) is the central element in the ablation of atrial fibrillation (AF), and can be obtained with different ablation modalities. The duty-cycled circular multi-pole catheter PVAC® (Medtronic) allows linear application of radiofrequency energy, with the production of circumferential lesions. Conceptually, it can make ablation simpler and faster in patients with favorable anatomy.
Objectives
To evaluate the safety and efficacy of ablation with a PVAC® catheter and to compare it with the conventional technique point-by-point (PbP) with irrigated catheter.
Methods
Clinical trial with single-blinded patients with AF refractory to antiarrhythmic therapy, randomized (1: 1) for ablation with PVAC® or PbP. The ablation strategy consisted of PVI, complemented with ablation of the cavo-tricuspid isthmus in patients with history of concomitant flutter. Monitoring was performed with a 7-day event loop recorder at 3, 6 and 12 months and annually from the 2nd year. Success was defined by AF-free survival or any maintained supraventricular tachycardia (duration > 30seconds).
Results
354 patients (67.5% males, 58 ± 12 years, PbP: 175, PVAC: 179) were included, of which 59.1% had paroxysmal, 26.2% short-standing persistent and 14.7% had long-standing persistent AF. Baseline characteristics were similar between groups. Among patients treated with PVAC, 93.1% of the pulmonary veins were isolated (620/666), similar to the 98.3% immediate success of the PbP group (697/709). Although the complication rate was similar in both groups (PVAC: 4.9% vs. PbP: 7.8%; P = NS), the risk of hemopericardium was lower with PVAC (0% vs. 4.6%; P = 0.013). Two patients treated with PVAC developed stroke (1.13% vs. 0%; P = NS). The duration of the procedure was lower among the patients treated with PVAC [136 (100-180) vs. 230 (188-270) min; P <0.001], with no difference in fluoroscopy time [24.4 (14.5-36.8) vs. 27.1 (17.0-45.0) min]. The success rate after 1st ablation at 36 months was 68%, with no differences between groups. The success rate after multiple ablations increased to 85.8%, with no differences between groups.
Conclusion
The multipolar PVAC catheter can represent an added value in AF ablation, making the procedure simpler and faster, ensuring similar efficacy to the conventional technique and with a lower risk of cardiac tamponade. The present trial suggests the need for clinically manifested stroke risk surveillance, which may be increased with this technique.
Abstract Figure.
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Affiliation(s)
- J De Sousa
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - N Cortez-Dias
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - L Carpinteiro
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - G Silva
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - A Nunes Ferreira
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - P Silverio Antonio
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - A Bernardes
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - C Barreiros
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - J Ribeiro
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - S Sobral
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - F Pinto
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
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Federico A, Gallotta V, Foschi N, Costantini B, Conte C, Pinto F, Ercoli A, Ferrandina G, Dal Moro F, Bassi P, Zattoni F, Scambia G, Vizzielli G. Surgical outcomes of segmental ureteral resection with ureteroneocystostomy after major gynecologic surgery. Eur J Surg Oncol 2020; 46:1366-1372. [PMID: 32278519 DOI: 10.1016/j.ejso.2020.03.216] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 03/09/2020] [Accepted: 03/21/2020] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Describing the surgical and oncological outcome of bladder-preserving ureter reconstruction (BPUR) with segmental ureteral resection after major gynecologic surgery. MATHERIALS AND METHODS Patients with BPUR admitted at a single institution between March 2012 and July 2018 were retrospectively analyzed. Surgical and oncological data were assessed. RESULTS Forty-six women with gynecologic tumors involving the ureter were treated with BPUR. R0 resection was achieved in 40/46 patients (86.9%), while pathologic margins were microscopically positive in 6 women (13.1%). Overall, 12 women (26.0%) received radiotherapy before surgery: among them, 8 patients received neoadjuvant chemoradiotherapy. Twenty-six women underwent BPUR during primary surgery, whereas 20 (43.4%) required BPUR upon recurrence. Twenty-six patients (56.2%) were found to have hydronephrosis at pre-operative workup. The psoas bladder hitch was the most common procedure performed for urinary reconstruction (63%) with respect to direct reimplantation (37%). Fourteen patients (14/46 = 30.4%) experienced urological complications. Urinary leakage occurred in 9 patients (19.5%), specifically: 5 uretero-vaginal fistula, 3 uroperitoneum, 1 uretero-enteral fistula. There were 3 cases (6.5%) of hydronephrosis at the side of ureteroneocystostomy and 2 cases (4.3%) of unilateral renal impairment requiring nephrectomy. At multivariate analysis only pre-operative radiotherapy (p = 0.047) and a history of pelvic irradiation (p = 0.025) were independently associated with an increased risk of developing severe urinary complications. CONCLUSIONS BPUR is feasible in gynecologic cancer with invasion of the urinary tract. However, since a slight increase of post-operative urological complications was observed in the previously irradiated fields, a personalized surgical planning is recommended for these women in the next future.
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Affiliation(s)
- Alex Federico
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Valerio Gallotta
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Nazario Foschi
- Division of Urology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Barbara Costantini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Carmine Conte
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Francesco Pinto
- Division of Urology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Alfredo Ercoli
- Department of Obstetrics and Gynecology, University of Messina, Messina, Italy
| | - Gabriella Ferrandina
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Department of Woman and Child Health and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fabrizio Dal Moro
- Department of Surgery, Oncology and Gastroenterology-Urology, University of Padua, Padua, Italy
| | - Pierfrancesco Bassi
- Division of Urology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Filiberto Zattoni
- Department of Surgery, Oncology and Gastroenterology-Urology, University of Padua, Padua, Italy
| | - Giovanni Scambia
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Department of Woman and Child Health and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Vizzielli
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Department of Surgery, Oncology and Gastroenterology-Urology, University of Padua, Padua, Italy.
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Almendra A, Pinto F, Carvalho J, Pinto P, Bárbara C. Sleeping habits in students from a medical school in Portugal. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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31
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Palermo G, Bassi P, Racioppi M, Recupero SM, Sacco E, Campetella M, Canu G, Pinto F. Circulating tumor cells as prognostic biological marker in different stages prostate cancer and the effect of different therapeutic approaches on their expression. MINERVA UROL NEFROL 2019; 72:214-222. [PMID: 31144490 DOI: 10.23736/s0393-2249.19.03377-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Circulating tumor cells (CTCs) represent a prerequisite for the formation of metastases. The aim of the study was to identify the role of CTCs as a biological marker of aggressiveness of prostate cancer and verify the expression of molecular markers predictive of response to different therapeutic approaches. METHODS Prospective, single-arm, non-randomized trial. Twenty-four patients with prostate cancer were enrolled into two groups: group 1 (N.=11) with localized prostate cancer treated with radical prostatectomy; group 2 (N.=13) with metastatic disease. We performed, dosage of blood PSA and testosterone, detection of EGFR, PSMA, PSA and Androgen Receptor (AR) expression on CTC during pre-treatment and follow-up at 1, 3, 9 and 18 months. RESULTS A total of 65 blood samples were evaluated. In group 1, pre-treatment sampling was negative for the expression of markers on CTC in 90% of the patients while group 2 pre-treatment sampling was positive for the expression of at least one biomarker in seven of 13 patients (54%). After treatment, four patients in group 2 experienced a reduced expression of the markers on CTC, however, in one case there was a new increase of PSA and PSMA at 3 months. One patient had a positivity of AR at 3 months. CONCLUSIONS The expression of PSA, PSMA, EGFR and AR on CTCs appears to be absent in the pre-treatment samplings in cases of localized prostate cancer. The same markers are hyper-expressed before treatment mostly in metastatic prostate cancer and can relate with early biochemical relapse.
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Affiliation(s)
- Giuseppe Palermo
- Department of Urology, A. Gemelli University Polyclinic, IRCCS and Foundation, Rome, Italy -
| | - Pierfrancesco Bassi
- Department of Urology, A. Gemelli University Polyclinic, IRCCS and Foundation, Rome, Italy
| | - Marco Racioppi
- Department of Urology, A. Gemelli University Polyclinic, IRCCS and Foundation, Rome, Italy
| | - Salvatore M Recupero
- Department of Urology, A. Gemelli University Polyclinic, IRCCS and Foundation, Rome, Italy
| | - Emilio Sacco
- Department of Urology, A. Gemelli University Polyclinic, IRCCS and Foundation, Rome, Italy
| | - Marco Campetella
- Department of Urology, A. Gemelli University Polyclinic, IRCCS and Foundation, Rome, Italy
| | - Giulia Canu
- Department of Biochemistry, A. Gemelli University Polyclinic, IRCCS and Foundation, Rome, Italy
| | - Francesco Pinto
- Department of Urology, A. Gemelli University Polyclinic, IRCCS and Foundation, Rome, Italy
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Yeshaw WM, van der Zwaag M, Pinto F, Lahaye LL, Faber AI, Gómez-Sánchez R, Dolga AM, Poland C, Monaco AP, van IJzendoorn SC, Grzeschik NA, Velayos-Baeza A, Sibon OC. Human VPS13A is associated with multiple organelles and influences mitochondrial morphology and lipid droplet motility. eLife 2019; 8:43561. [PMID: 30741634 PMCID: PMC6389287 DOI: 10.7554/elife.43561] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [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: 11/12/2018] [Accepted: 02/10/2019] [Indexed: 02/03/2023] Open
Abstract
The VPS13A gene is associated with the neurodegenerative disorder Chorea Acanthocytosis. It is unknown what the consequences are of impaired function of VPS13A at the subcellular level. We demonstrate that VPS13A is a peripheral membrane protein, associated with mitochondria, the endoplasmic reticulum and lipid droplets. VPS13A is localized at sites where the endoplasmic reticulum and mitochondria are in close contact. VPS13A interacts with the ER residing protein VAP-A via its FFAT domain. Interaction with mitochondria is mediated via its C-terminal domain. In VPS13A-depleted cells, ER-mitochondria contact sites are decreased, mitochondria are fragmented and mitophagy is decreased. VPS13A also localizes to lipid droplets and affects lipid droplet motility. In VPS13A-depleted mammalian cells lipid droplet numbers are increased. Our data, together with recently published data from others, indicate that VPS13A is required for establishing membrane contact sites between various organelles to enable lipid transfer required for mitochondria and lipid droplet related processes.
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Affiliation(s)
- Wondwossen M Yeshaw
- Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marianne van der Zwaag
- Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Francesco Pinto
- Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Liza L Lahaye
- Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anita Ie Faber
- Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rubén Gómez-Sánchez
- Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Amalia M Dolga
- Department of Molecular Pharmacology, Groningen Research Institute of Pharmacy (GRIP), Faculty of Science and Engineering, University of Groningen, Groningen, The Netherlands
| | - Conor Poland
- Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom
| | - Anthony P Monaco
- Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom.,Office of the President, Tufts University, Medford, United States
| | - Sven Cd van IJzendoorn
- Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nicola A Grzeschik
- Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Ody Cm Sibon
- Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Dias D, Lapa N, Bernardo M, Ribeiro W, Matos I, Fonseca I, Pinto F. Cr(III) removal from synthetic and industrial wastewaters by using co-gasification chars of rice waste streams. Bioresour Technol 2018; 266:139-150. [PMID: 29960244 DOI: 10.1016/j.biortech.2018.06.054] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/15/2018] [Accepted: 06/16/2018] [Indexed: 06/08/2023]
Abstract
Blends of rice waste streams were submitted to co-gasification assays. The resulting chars (G1C and G2C) were characterized and used in Cr(III) removal assays from a synthetic solution. A Commercial Activated Carbon (CAC) was used for comparison purposes. The chars were non-porous materials mainly composed by ashes (68.3-92.6% w/w). The influences of adsorbent loading (solid/liquid ratio - S/L) and initial pH in Cr(III) removal were tested. G2C at a S/L of 5 mg L-1 and an initial pH of 4.50 presented an uptake capacity significantly higher than CAC (7.29 and 2.59 mg g-1, respectively). G2C was used in Cr(III) removal assays from an industrial wastewater with Cr(III) concentrations of 50, 100 and 200 mg L-1. Cr(III) removal by precipitation (uptake capacity ranging from 11.1 to 14.9 mg g-1) was more effective in G2C, while adsorption (uptake capacity of 16.1 mg g-1) was the main removal mechanism in CAC.
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Affiliation(s)
- D Dias
- LAQV/REQUIMTE, Departamento de Ciências e Tecnologia da Biomassa (DCTB), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal.
| | - N Lapa
- LAQV/REQUIMTE, Departamento de Ciências e Tecnologia da Biomassa (DCTB), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal
| | - M Bernardo
- LAQV/REQUIMTE, Departamento de Química (DQ), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal
| | - W Ribeiro
- LAQV/REQUIMTE, Departamento de Ciências e Tecnologia da Biomassa (DCTB), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal
| | - I Matos
- LAQV/REQUIMTE, Departamento de Química (DQ), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal
| | - I Fonseca
- LAQV/REQUIMTE, Departamento de Química (DQ), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal
| | - F Pinto
- Unidade de Bioenergia (UB), Laboratório Nacional de Energia e Geologia (LNEG), Estrada do Paço do Lumiar, Ed. J, 1649-038 Lisboa, Portugal
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Grattagliano I, Craig F, Lisi A, Pierri G, Stallone V, Margari L, Lecce P, Lafortezza E, Pinto F, Pisani R, Zagaria G, Tangari D, Margari F. Awareness of the offense and perception of the victim among juvenile sex offenders. Clin Ter 2018; 169:e155-e164. [PMID: 30151548 DOI: 10.7417/t.2018.2072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The present work presents data on research into adolescents who committed sex offenses, carried out in the Apulia Region of southern Italy and focused in particular on the perpetrators' perception of the peculiar profile of the criminal act committed. MATERIALS AND METHODS Three University sections of the School of Medicine, Bari University, took part in this research: Criminology and Forensic Psychopathology, Psychiatry and Juvenile Neuropsichiatry, working in collaboration with the Department for Juvenile Justice and the Community, and the Center for Juvenile Justice in Apulia. In total, 31 subjects were included in the study, all Juvenile Sex Offenders. A detailed questionnaire was employed to obtain all the relevant information of criminological concern. DISCUSSION Among most of the minors considered, a very poor awareness emerged of the peculiar type of offense committed, and of its consequences on the victims and the social context. RESULTS This finding highlights an evident contradiction and confusion between legislative provisions in the area of sex offenses and rape, and the perspectives of juveniles and adolescents. CONSLUSIONS There is an evident need for legislative norms to adopt registers that are more accessible to the complex juvenile world, that cannot be assimilated to the adult world.
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Affiliation(s)
- I Grattagliano
- Department of Educational Sciences, Psychology, Communication University of Bari Aldo Moro
| | - F Craig
- Scientific Institute I.R.C.C.S. "Eugenio Medea"- "La Nostra Famiglia", Unit for Severe disabilities in developmental age and young adults, Developmental Neurology and Neurorehabilitation, Brindisi Research Centre, Brindisi, Italy
| | - A Lisi
- Department of Educational Sciences, Psychology, Communication University of Bari Aldo Moro
| | - G Pierri
- Department of Educational Sciences, Psychology, Communication University of Bari Aldo Moro
| | - V Stallone
- Department of Educational Sciences, Psychology, Communication University of Bari Aldo Moro
| | - L Margari
- Department of neuroscience and sense organs, University of Bari Aldo Moro
| | - P Lecce
- Department of neuroscience and sense organs, University of Bari Aldo Moro
| | - E Lafortezza
- Department of neuroscience and sense organs, University of Bari Aldo Moro
| | - F Pinto
- Department of neuroscience and sense organs, University of Bari Aldo Moro
| | - R Pisani
- Department of neuroscience and sense organs, University of Bari Aldo Moro
| | - G Zagaria
- Department of neuroscience and sense organs, University of Bari Aldo Moro
| | - D Tangari
- Department of Educational Sciences, Psychology, Communication University of Bari Aldo Moro
| | - F Margari
- Department of neuroscience and sense organs, University of Bari Aldo Moro
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35
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Dias Ferreira Reis JP, Branco Mano T, Viveiros Monteiros A, Sousa L, Oliveira JA, Branco L, Galrinho A, Fragata J, Pinto F, Cruz Ferreira R. P5484Marfan syndrome - clinical evaluation and long-term prognosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5484] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | - L Sousa
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - L Branco
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Galrinho
- Hospital de Santa Marta, Lisbon, Portugal
| | - J Fragata
- Hospital de Santa Marta, Lisbon, Portugal
| | - F Pinto
- Hospital de Santa Marta, Lisbon, Portugal
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Gomes, Abreu S, Bourbon M, Pinto F. Familial Hypercholesterolemia study in dyslipidemic children and adolescents: “Like father, Like son”. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vered Z, Manouras A, Adirevitz L, Dragu R, Karev E, Malka Y, Jorde UP, Pinto F. P5110A novel method for accurate noninvasive assessment of LV filling pressures. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5110] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Z Vered
- Assaf Harofeh Medical Center, Zerifin, Israel
| | - A Manouras
- Karolinska University Hospital, Cardiology, Stockholm, Sweden
| | | | - R Dragu
- Rambam Medical Center, Department of Cardiology, Technion Institute of Science, Haifa, Israel
| | - E Karev
- CardiArt Technologies, Or Yehuda, Israel
| | - Y Malka
- CardiArt Technologies, Or Yehuda, Israel
| | - U P Jorde
- Albert Einstein College of Medicine, Cardiology, New York, United States of America
| | - F Pinto
- University Hospital De Santa Maria, Cardiology, Lisbon, Portugal
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Abstract
Kidney stones are a common condition with high direct and indirect costs; to date, the optimal urological approach for some particular presentations including non-lower pole kidney stones between 10 and 20 mm of diameter is not clear. A limited number of randomized controlled trials and observational longitudinal studies suggests that ureterorenoscopy (URS) could be superior to shock-wave lithotripsy (SWL) in achieving stone-free rates in this setting; however, such reports are generally weakened by a number of limitations including small sample size and scarce control for confounding. In this issue, Fankhauser et al. [1] report the results of a large observational retrospective study on the comparative efficacy and safety of URS and SWL for the treatment of previously untreated kidney stones.
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Affiliation(s)
- Pietro Manuel Ferraro
- Nefrologia, Fondazione Policlinico Universitario A. Gemelli–Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesco Pinto
- Urologia, Fondazione Policlinico Universitario A. Gemelli – Università Cattolica del Sacro Cuore, Roma, Italy
| | - Giovanni Gambaro
- Nefrologia, Fondazione Policlinico Universitario A. Gemelli–Università Cattolica del Sacro Cuore, Roma, Italy
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Pinto F, Cárcano FM, da Silva ECA, Vidal DO, Scapulatempo-Neto C, Lopes LF, Reis RM. Brachyury oncogene is a prognostic factor in high-risk testicular germ cell tumors. Andrology 2018; 6:597-604. [PMID: 29749711 DOI: 10.1111/andr.12495] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/06/2018] [Accepted: 03/27/2018] [Indexed: 02/06/2023]
Abstract
The T-box transcription factor Brachyury has been considered a cancer-specific marker and a novel oncotarget in solid tumors. Brachyury overexpression has been described in various cancers, being associated with epithelial-mesenchymal transition, metastasis, and poor prognosis. However, its clinical association with testicular germ cell tumor is unknown. We analyzed the expression of Brachyury by immunohistochemistry in a series of well-characterized testicular germ cell tumor samples and at transcript level by in silico analysis. Additionally, we aimed to investigate the clinical significance of Brachyury in testicular germ cell tumor. Brachyury cytoplasm immunostaining was present in 89.6% (86/96) of cases with nuclear staining observed in 24% (23/96) of testicular germ cell tumor. Bioinformatics microarray expression analysis of two independent cohorts of testicular germ cell tumors showed similar results with increased levels of Brachyury in testicular germ cell tumors and metastasis compared with normal testis. Clinically, Brachyury nuclear staining was statistically associated with lower event-free survival (p = 0.04) and overall survival (p = 0.01) in intermediate/high-risk testicular germ cell tumors. Univariate analysis showed that Brachyury nuclear subcellular localization was a predictor of poor prognosis (p = 0.02), while a tendency was observed by multivariate analysis (HR: 3.56, p = 0.06). In conclusion, these results indicate that Brachyury plays an oncogenic role in testicular germ cell tumors and its subcellular localization in the nucleus may constitute a novel biomarker of poor prognosis and a putative oncotarget for intermediate/high-risk testicular germ cell tumor patients.
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Affiliation(s)
- F Pinto
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,I3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.,Institute of Molecular Pathology and Immunology of the University of Porto - IPATIMUP, Porto, Portugal
| | - F M Cárcano
- Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil.,Barretos School of Health Sciences, Dr. Paulo Prata-FACISB, Barretos, Sao Paulo, Brazil.,Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - E C A da Silva
- Department of Pathology, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - D O Vidal
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil.,Children's Cancer Hospital, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - C Scapulatempo-Neto
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - L F Lopes
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil.,Children's Cancer Hospital, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - R M Reis
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
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40
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Sacco E, Gandi C, Vaccarella L, Recupero S, Racioppi M, Pinto F, Totaro A, Foschi N, Palermo G, Pierconti F, Bassi P. Titanized Transobturator Sling Placement for Male Stress Urinary Incontinence Using an Inside-out Single-incision Technique: Minimum 12-Months Follow-up Study. Urology 2018; 115:144-150. [DOI: 10.1016/j.urology.2018.02.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 02/14/2018] [Accepted: 02/17/2018] [Indexed: 11/16/2022]
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41
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Sacco E, Pinto F, Tienforti D, Marangi F, Destito A, Racioppi M, Gardi M, Volpe A, Bassi P. Investigational Drug Therapies for Overactive Bladder Syndrome: The Potential Alternatives to Anticolinergics. Urologia 2018. [DOI: 10.1177/039156030907600301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background Overactive bladder is a high prevalent and quality of life affecting disease. The mainstay of the medical therapy is represented by antimuscarinic drugs, but their side effects markedly affect patient compliance and prompt studies on novel investigational drugs. Methods A systematic literature search of peer-reviewed papers and meeting abstracts published by December 2008 was performed. PubMed databank was searched for original English articles, by using the following search terms: “overactive bladder” or “detrusor overactivity” or “urinary incontinence” and “treatment”, alone and linked to any potential molecular target or novel drug cited in the literature. Results Effective alternative pharmacological treatments are currently scarce, but many new promising compounds are emerging which target key molecular pathways involved in micturition control. The most promising potential therapeutic targets include central nervous system GABAergic inhibitory pathway, dopaminergic and serotoninergic systems, b-adrenoceptors and cAMP metabolism, nonadrenergic-noncholinergic mechanisms such as purinergic and neuropeptidergic systems, vanilloid receptor, bladder sensory nervous terminals, nonneuronal bladder signalling systems including urothelium and interstitial cells, prostanoids, Rho-kinase and different subtypes of potassium and calcium channels. Conclusions Despite the enormous amount of new biologic insight, very few novel pharmacological therapies seems to have passed the proof-of-concept clinical stage. The ultimate clinical utility of new drugs will depend on the ability to exploit tissue-specific differences and disease-related changes in molecular expression/function and to improve storage phase dysfunctions without interfering with the emptying phase. Further preclinical investigations and controlled clinical trials are urgently needed in this challenging field.
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Affiliation(s)
- E. Sacco
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - F. Pinto
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - D. Tienforti
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - F. Marangi
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - A. Destito
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - M. Racioppi
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - M. Gardi
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - A. Volpe
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - P.F. Bassi
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
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Abstract
In the last decades a growing interest has been dedicated to prevention, diagnosis and therapy of male genital pathologies, such as varicocele, infertility and erectile dysfunction in the population involved in sport activities. High incidence (up to 30%) of varicocele has been reported in a population of athletes and up to 60–80% in the subgroup of body-builders. The incidence of varicocele specifically increases with hours of training, in a linear model. Controversial data come from literature about the effects of physical activity on fertility, with prevalence of trials demonstrating worsening of seminal parameters. Furthermore, it has been demonstrated that physical stress in healthy male athletes can interfere with LH levels. Bicycling is one of the major risk factors for erectile dysfunction, with incidence of 13–24%. This is due to the prolonged compression of perineal arteries leading to reduced chronic penile perfusion. Bioengineering studies have been the basis for industry to produce specifically shaped saddles that significantly reduce and minimize compressive effects. Finally, high frequency of lower urinary tract symptoms (LUTS) in cyclists has been related to increased incidence of erectile dysfunction in comparison with normal population.
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Affiliation(s)
- G. Gulino
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Sasso
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - A. D'Onofrio
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - G. Palermo
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - Di Luigi
- Servizio di Endocrinologia, Facoltà Scienze Motorie, ISUM, Roma
| | - E. Sacco
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Pinto
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - P.F. Bassi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
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Abstract
Introduction Statistical data referring to sports-related traumas of the urinary tract are quite scarce; nevertheless, it is possible to draw general data on the relationship between sports and urological traumas. Methods Literature review of peer-reviewed articles published by May 2009. Results Urological traumas account for about 10% of all traumas, and about 13% of them is sports-related. Genitourinary traumas are among the most common cause of abdominal injuries in sports. Blunt injuries are more common than penetrating ones and renal injuries are by far the most common, followed by testicular injuries; ureters, bladder and penis injuries are much more infrequent. Considering chronic microtraumas, injuries of bulbar urethra are also common in sports that involve riding. Overall, the incidence of genitourinary trauma due to sports is low. Renal traumas in sports injuries usually consist of grade 1–11 lesions and usually do not require surgical treatment. Cycling is the sporting activity most commonly associated with genitourinary injuries, followed by winter sports, horse riding and contact/collision sports. Literature data suggest that significant injuries are rare also in athletes with only one testicle or kidney. General preventive measures against sport-related injuries, along with the use of protective cups for male external genitalia, are generally sufficient to reduce the incidence of urogenital trauma. Conclusions Overall, studies show that urogenital injuries are uncommon in team and individual sports, and that most of them are low-grade injuries. Participation in sports that involve the potential for contact or collision needs to be carefully assessed in the athletes with only one testicle or kidney, even though urogenital injuries should not preclude sports participation to an appropriately informed and counseled patient. Further research is needed to acquire more knowledge on genitourinary injuries according to age, sports type and technical skill.
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Affiliation(s)
- E. Sacco
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Marangi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Pinto
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - A. D'Addessi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - M. Racioppi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - G. Gulino
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - A. Volpe
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - M. Gardi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - P.F. Bassi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
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Abstract
Clinical effectiveness of botulinum toxin (BTX) in the treatment of both neurogenic and idiopathic detrusor overactivity has been demonstrated in several studies. However, different protocols and techniques have been used by authors. Methods. Literature review on intradetrusor injection of BTX for detrusor overactivity. Results. The greatest clinical experience reports the use of 200 and 300 U Botox®. Available data suggest that clinical efficacy, duration, and the side effect profile is similar at these doses. Very few data, on the other hand, are available regarding the clinical outcomes using the Dysport® preparation; isolated reports support that efficacy is similar when using a dosing range of 500 to 1000 SU with increased risk of systemic side effects using 1000 SU. A variety of injection volumes was used, demonstrating similar efficacy and tolerability profile. Clinical effect duration extends six to ten months in the majority of studies. Data suggest that a repeated injection scheme proves successful in the vast majority of initial responders. Conclusions. Safety, effectiveness, specificity and reversibility make BTX a new attractive treatment modality for overactive bladder syndrome. However, more experience is needed to standardize the injection protocol with respect to therapeutic outcomes and adverse effects.
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Affiliation(s)
- E. Sacco
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università Cattolica del Sacro Cuore, Roma
| | - M. Paolillo
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università Cattolica del Sacro Cuore, Roma
| | - A. Totaro
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università Cattolica del Sacro Cuore, Roma
| | - F. Pinto
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università Cattolica del Sacro Cuore, Roma
| | - A. Volpe
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università Cattolica del Sacro Cuore, Roma
| | - M. Gardi
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università Cattolica del Sacro Cuore, Roma
| | - P.F. Bassi
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università Cattolica del Sacro Cuore, Roma
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Abstract
Introduction Prostatitis-like syndromes are high prevalent health problems and frequently considered by patients and physicians as strictly correlated to sports causing perineal compression. These syndromes and their relationships with sporting activities have been discussed in this report. Methods We reviewed peer-reviewed scientific articles published by May 2009 and searched according to the following term selection: prostatitis, pudendal nerve, sport, cycling. Results Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a major healthcare burden heavily affecting patients’ Quality of Life. No clear evidence of any direct etiologic relationship has been found in literature between prostatitis, either bacterial or non-bacterial, and sports activities. On the other hand, some types of sport causing perineal compression, such as cycling, can exacerbate symptoms of acute and chronic prostatitis; a temporary sport discontinuation is justified in these patients. CP/CPPS may be often caused by pudendal nerve entrapment (PNE). Prostatitis-like urogenital neuropathic pain together with voiding and sexual dysfunctions are the hallmark of PNE. A common feature is that flexion activities of the hip, such as climbing, squatting, cycling provoke or worsen urogenital pain or pelvic pain. Many of the patients with PNE are cyclists, played American football, lifted weights, or wrestled as teenagers and young adults. PNE represents the most common bicycling associated urogenital problems. Conclusions Overall, studies show that no causal relationship has been demonstrated between prostatitis and sporting activities. Conversely, urologists should be aware that sports involving vigorous hip flexion activities or prolonged perineal compression are a potential and not an infrequent cause of uroand rological symptoms caused by pudendal nerve entrapment.
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Affiliation(s)
- E. Sacco
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - A. Totaro
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Marangi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Pinto
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - M. Racioppi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - G. Gulino
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - A. Volpe
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - M. Gardi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - P.F. Bassi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
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Volpe A, Racioppi M, D'Agostino D, Cappa E, Gardi M, Totaro A, Pinto F, Sacco E, Marangi F, Palermo G, Bassi P. Bladder Tumor Markers: A Review of the Literature. Int J Biol Markers 2018; 23:249-61. [DOI: 10.1177/172460080802300409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Bladder cancer is among the top eight most frequent cancers. Its natural history is related to a combination of factors that impact on its aggressiveness. Cystoscopy and urine cytology are the currently used techniques for the diagnosis and surveillance of non-invasive bladder tumors. The sensitivity of urine cytology for diagnosis is not high, particularly in low-grade tumors. The combination of voided urine cytology and new diagnostic urine tests would be ideal for the diagnosis and follow-up of bladder cancer. However, in order to have some clinical utility, new diagnostic and/or prognostic markers should achieve better predictive capacity that the currently used diagnostic tools. None of the markers evaluated over the last years showed remarkable sensitivity or specificity for the identification of any of the diverse types of bladder cancer in clinical practice. The limitations of the known prognostic markers have led to the research of new molecular markers for early detection of bladder cancer. This research focused in particular on the discovery of biomarkers capable of reducing the need for periodic cystoscopies or, ideally, offering a non-invasive examination instead. In this review, we will examine various new markers of bladder cancer and their value in the diagnosis and follow-up of non-muscle-invasive bladder cancer. When compared with urine cytology, which showed the highest specificity, most of these markers demonstrated an increased sensitivity.
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Affiliation(s)
- A. Volpe
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - M. Racioppi
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - D. D'Agostino
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - E. Cappa
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - M. Gardi
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - A. Totaro
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - F. Pinto
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - E. Sacco
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - F. Marangi
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - G. Palermo
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - P.F. Bassi
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
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Marinho-Rito T, Freitas I, Diogo MJ, Rodrigues R, Fragata J, Pinto F. Aorto-left ventricular tunnel: a rare cause of heart failure in the newborn. Images Paediatr Cardiol 2018; 20:8-11. [PMID: 30792742 PMCID: PMC6360498] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Aorto-left ventricular tunnel is a rare congenital cardiac anomaly, consisting of a short abnormal pathway, usually from a sinus of Valsalva into the left ventricular cavity. It is usually diagnosed with echocardiography. We report a case of a newborn presenting with heart murmur and rapid progression to heart failure and left ventricular enlargement due to an aorto-left ventricular tunnel. Despite successful closure of the tunnel, the patient required a Ross procedure due to progressive aortic disease.
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Affiliation(s)
- T Marinho-Rito
- aPediatric Cardiology Department, Hospital de Santa Marta - CHLC, EPE, Lisbon, Portugal.,Tiago Filipe Marinho-Rito: Serviço de Cardiologia Pediátrica - Hospital de Santa Marta. Rua de Santa Marta. 1169-024 Lisboa, PortugalTelephone: +351 213 594 332; Fax: +351 213 594 034
| | - I Freitas
- aPediatric Cardiology Department, Hospital de Santa Marta - CHLC, EPE, Lisbon, Portugal
| | - Martins J Diogo
- aPediatric Cardiology Department, Hospital de Santa Marta - CHLC, EPE, Lisbon, Portugal
| | - R Rodrigues
- bCardiothoracic Surgery Department, Hospital de Santa Marta - CHLC, EPE, Lisbon, Portugal
| | - J Fragata
- bCardiothoracic Surgery Department, Hospital de Santa Marta - CHLC, EPE, Lisbon, Portugal
| | - F Pinto
- aPediatric Cardiology Department, Hospital de Santa Marta - CHLC, EPE, Lisbon, Portugal
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Abreu D, Sousa P, Matias-Dias C, Pinto F. Impact of public health initiatives in acute coronary syndrome and stroke. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Daisy Abreu
- Escola Nacional de Saúde Pública, Lisbon, Portugal
| | - P Sousa
- Escola Nacional de Saúde Pública, Lisbon, Portugal
| | - C Matias-Dias
- Department of Epidemiology of the Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - F Pinto
- Serviço de Cardiologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte - EPE, Lisbon, Portugal
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Barata A, Leal I, Sousa F, Teixeira F, Henriques J, Pinto F. Macular thickness changes using spectral-domain optical coherence tomography automated layer segmentation in multiple sclerosis. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0t025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A. Barata
- Ophthalmology; Hospital de Santa Maria; Lisbon Portugal
| | - I. Leal
- Ophthalmology; Hospital de Santa Maria; Lisbon Portugal
| | - F. Sousa
- Ophthalmology; Hospital de Santa Maria; Lisbon Portugal
| | - F. Teixeira
- Ophthalmology; Hospital de Santa Maria; Lisbon Portugal
| | - J. Henriques
- Ophthalmology; Instituto de Retina de Lisboa; Lisbon Portugal
| | - F. Pinto
- Ophthalmology; Hospital de Santa Maria; Lisbon Portugal
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Barata A, Teixeira F, Pinto F. ISNT rule applicability based on optical coherence tomography parameters in a normal Portuguese population. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0s060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. Barata
- Ophthalmology; Hospital de Santa Maria; Lisboa Portugal
| | - F. Teixeira
- Ophthalmology; Hospital de Santa Maria; Lisboa Portugal
| | - F. Pinto
- Ophthalmology; Hospital de Santa Maria; Lisboa Portugal
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