1
|
Bianchi L, Gaudiano C, Mottola M, Corcioni B, Tonin E, Droghetti M, Cattabriga A, Cocozza M, Palmeri A, Coppola F, Giunchi F, Schiavina R, Fiorentino M, Brunocilla E, Golfieri R, Bevilacqua A. Beyond multiparametric MRI and towards radiomics to detect prostate cancer: A machine learning model to predict clinically significant lesions. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01021-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
2
|
Donato G, Forti E, Mutignani M, Laterra MA, Arese D, Coppola F, Zaccari P, Mariani A, Arcidiacono PG, Pigò F, Conigliaro R, Costa D, Tringali A, Lavagna A, Rocca R, Gabbiadini R, Fugazza A, Repici A, Fava G, Marini F, Mosca P, Urban F, Monica F, Crinò SF, Gabbrielli A, Blois M, Binda C, Sbrancia M, Fabbri C, Frego R, Dinelli M, Imbesi V, Gambitta P, Balzarini M, Segato S, Grazioli LM, Spada C, Amato A, Venezia G, Aragona G, Rosa C, Alvisi C, Devani M, Manes G, Dell’Amico I, Gemme C, Reati R, Auriemma F, Mangiavillano B, Rodi M, Bertani H, Mazzucco D, Armellini E, Cantù P, Penagini R, Occhipinti P. A multicenter survey on endoscopic retrograde cholangiopancreatography during the COVID-19 pandemic in northern and central Italy. Endosc Int Open 2021; 9:E629-E634. [PMID: 33880397 PMCID: PMC8050562 DOI: 10.1055/a-1380-3419] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 01/13/2021] [Indexed: 12/12/2022] Open
Abstract
Background and study aims COVID-19 has dramatically impacted endoscopy practice because upper endoscopy procedures can be aerosol-generating. Most elective procedures have been rescheduled. Endoscopic retrograde cholangiopancreatography (ERCP) is frequently performed in emergency or urgent settings in which rescheduling is not possible. We evaluated the impact of the COVID-19 pandemic on ERCP in Italy during the SARS-CoV-2 lockdown, in areas with high incidence of COVID-19. Patients and methods We performed a retrospective survey of centers performing ERCP in high COVID-19 prevalence areas in Italy to collect information regarding clinical data from patients undergoing ERCP, staff, case-volume and organization of endoscopy units from March 8, 2020 to April 30, 2020. Results We collected data from 31 centers and 804 patients. All centers adopted a triage and/or screening protocol for SARS-CoV-2 and performed follow-up of patients 2 weeks after the procedure. ERCP case-volume was reduced by 44.1 % compared to the respective 2019 timeframe. Of the 804 patients undergoing ERCP, 22 (2.7 %) were positive for COVID-19. Adverse events occurred at a similar rate to previously published data. Of the patients, endoscopists, and nurses, 1.6 %, 11.7 %, and 4.9 %, respectively, tested positive for SARS-CoV-2 at follow up. Only 38.7 % of centers had access to a negative-pressure room for ERCP. Conclusion The case-volume reduction for ERCP during lockdown was lower than for other gastrointestinal endoscopy procedures. No definitive conclusions can be drawn about the percentage of SARS-CoV-2-positive patients and healthcare workers observed after ERCP. Appropriate triage and screening of patients and adherence to society recommendations are paramount.
Collapse
Affiliation(s)
- Giulio Donato
- Gastroenterology Unit, Department of Oncological and Specialty Medicine, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy
| | - Edoardo Forti
- Digestive and Operative Endoscopy Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Massimiliano Mutignani
- Digestive and Operative Endoscopy Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Daniele Arese
- Gastroenterology Unit, Ospedale San Giovanni Bosco, Torino, Italy
| | - Franco Coppola
- Gastroenterology Unit, Ospedale San Giovanni Bosco, Torino, Italy
| | - Piera Zaccari
- Pancreatobiliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy
| | - Alberto Mariani
- Pancreatobiliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy
| | - Paolo Giorgio Arcidiacono
- Pancreatobiliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy
| | - Flavia Pigò
- Gastroenterology and Digestive Endoscopy – Azienda Ospedaliero-Universitaria Modena, Ospedale di Baggiovara, Italy
| | - Rita Conigliaro
- Gastroenterology and Digestive Endoscopy – Azienda Ospedaliero-Universitaria Modena, Ospedale di Baggiovara, Italy,Digestive Endoscopy Unit, Azienda Ospedaliero-Universitaria Modena, Policlinico di Modena, Italy
| | - Deborah Costa
- Gastroenterology Unit, ULSS 2 Marca Trevigiana, Ospedale Conegliano-Vittorio Veneto, Italy
| | - Alberto Tringali
- Gastroenterology Unit, ULSS 2 Marca Trevigiana, Ospedale Conegliano-Vittorio Veneto, Italy
| | | | - Rodolfo Rocca
- Gastroenterology Unit, AO Ordine Mauriziano, Torino, Italy
| | - Roberto Gabbiadini
- Digestive Endoscopy Unit, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
| | - Alessandro Fugazza
- Digestive Endoscopy Unit, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
| | - Alessandro Repici
- Digestive Endoscopy Unit, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
| | - Giammarco Fava
- SOD Malattie Apparato Digerente, Endoscopia Digestiva, Malattie Infiammatorie Croniche Intestinali, Ospedali Riuniti, Ancona, Italy
| | - Francesco Marini
- SOD Malattie Apparato Digerente, Endoscopia Digestiva, Malattie Infiammatorie Croniche Intestinali, Ospedali Riuniti, Ancona, Italy
| | - Piergiorgio Mosca
- SOD Malattie Apparato Digerente, Endoscopia Digestiva, Malattie Infiammatorie Croniche Intestinali, Ospedali Riuniti, Ancona, Italy
| | - Flavia Urban
- Gastroenterology Unit, ASU GI Ospedale di Cattinara Trieste, Italy
| | - Fabio Monica
- Gastroenterology Unit, ASU GI Ospedale di Cattinara Trieste, Italy
| | | | - Armando Gabbrielli
- Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, Verona, Italy
| | - Matteo Blois
- Operative Endoscopy Unit, Azienda Usl Toscana Nord-Ovest, Livorno, Italy
| | - Cecilia Binda
- Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Italy
| | - Monica Sbrancia
- Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Italy
| | - Carlo Fabbri
- Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Italy
| | | | | | - Venerina Imbesi
- Gastroenterology and Digestive Endoscopy Unit, ASST Ovest Milanese, Legnano, Milan, Italy
| | - Pietro Gambitta
- Gastroenterology and Digestive Endoscopy Unit, ASST Ovest Milanese, Legnano, Milan, Italy
| | | | - Sergio Segato
- Gastroenterology Unit, ASST Sette-Laghi, Varese, Italy
| | | | - Cristiano Spada
- Digestive Endoscopy Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Arnaldo Amato
- Gastroenterology Unit, Ospedale Valduce, Como, Italy
| | - Giovanna Venezia
- Gastroenterology Unit, Azienda Ospedaliera S.Croce e Carle, Cuneo, Italy
| | - Giovanni Aragona
- Gastroenterology and Hepatology Unit, Ospedale Civile, AUSL Piacenza, Italy
| | - Cesare Rosa
- Digestive Endoscopy Unit, ASST Pavia, Ospedali Voghera-Vigevano, Pavia, Italy
| | - Costanza Alvisi
- Digestive Endoscopy Unit, ASST Pavia, Ospedali Voghera-Vigevano, Pavia, Italy
| | | | | | - Iginio Dell’Amico
- Endoscopy Unit, Azienda Usl Toscana Nord-Ovest, Massa Carrara, Italy
| | - Carlo Gemme
- Gastroenterology Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Raffaella Reati
- ASST Rhodense, Presidio di Garbagnate Milanese, Milan, Italy
| | - Francesco Auriemma
- Gastrointestinal Endoscopy Unit, Humanitas – Mater Domini, Castellanza, Varese, Italy
| | | | - Marcello Rodi
- Gastroenterology and Digestive Endoscopy Unit, Ospedale S. Andrea, ASL VC, Vercelli, Italy
| | - Helga Bertani
- Digestive Endoscopy Unit, Azienda Ospedaliero-Universitaria Modena, Policlinico di Modena, Italy
| | | | - Elia Armellini
- Gastroenterology and Digestive Endoscopy Unit, ASST Bergamo Est, Bergamo, Italy
| | - Paolo Cantù
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Roberto Penagini
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Pietro Occhipinti
- Gastroenterology Unit, Department of Oncological and Specialty Medicine, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy
| |
Collapse
|
3
|
Neri E, Coppola F, Larici AR, Sverzellati N, Mazzei MA, Sacco P, Dalpiaz G, Feragalli B, Miele V, Grassi R. Structured reporting of chest CT in COVID-19 pneumonia: a consensus proposal. Insights Imaging 2020; 11:92. [PMID: 32785803 PMCID: PMC7422456 DOI: 10.1186/s13244-020-00901-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 07/21/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The need of a standardized reporting scheme and language, in imaging of COVID-19 pneumonia, has been welcomed by major scientific societies. The aim of the study was to build the reporting scheme of chest CT in COVID-19 pneumonia. METHODS A team of experts, of the Italian Society of Medical and Interventional Radiology (SIRM), has been recruited to compose a consensus panel. They used a modified Delphi process to build a reporting scheme and expressed a level of agreement for each section of the report. To measure the internal consistency of the panelist ratings for each section of the report, a quality analysis based on the average inter-item correlation was performed with Cronbach's alpha (Cα) correlation coefficient. RESULTS The overall mean score of the experts and the sum of score were 3.1 (std.dev. ± 0.11) and 122 in the second round, and improved to 3.75 (std.dev. ± 0.40) and 154 in the third round. The Cronbach's alpha (Cα) correlation coefficient was 0.741 (acceptable) in the second round and improved to 0.789 in the third round. The final report was built in the management of radiology report template (MRRT) and includes n = 4 items in the procedure information, n = 5 items in the clinical information, n = 16 in the findings, and n = 3 in the impression, with overall 28 items. CONCLUSIONS The proposed structured report could be of help both for expert radiologists and for the less experienced who are faced with the management of these patients. The structured report is conceived as a guideline, to recommend the key items/findings of chest CT in COVID-19 pneumonia.
Collapse
Affiliation(s)
- E Neri
- Diagnostic and Interventional Radiology, Department of Translational Research, Università degli Studi di Pisa, Radiodiagnostica 3, Via Roma 67 -, 56126, Pisa, SD, Italy.
| | - F Coppola
- Malpighi Radiology Unit, Department of Diagnostic and Preventive Medicine, University Hospital of Bologna Sant'Orsola-Malpighi Polyclinic, Bologna, Italy
| | - A R Larici
- Section of Radiology, Department of Radiological and Hematological Sciences, Catholic University of the Sacred Heart Rome Campus, "Agostino Gemelli" University Polyclinic Foundation IRCCS, Roma, Italy
| | - N Sverzellati
- Division of Radiology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - M A Mazzei
- Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - P Sacco
- Diagnostic Imaging Unit, Department of Medical, Surgical and Neuro Sciences, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - G Dalpiaz
- Department of Radiology, Bellaria Carlo Alberto Pizzardi Hospital, Bologna, Italy
| | - B Feragalli
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - V Miele
- Department of Radiology, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy
| | - R Grassi
- Department of Clinical and Experimental Medicine, "F. Magrassi-A. Lanzara", University of Campania Luigi Vanvitelli, Naples, Italy
| |
Collapse
|
4
|
Maselli R, Iacopini F, Azzolini F, Petruzziello L, Manno M, De Luca L, Cecinato P, Fiori G, Staiano T, Rosa Rizzotto E, Angeletti S, Caruso A, Coppola F, Andrisani G, Viale E, Missale G, Panarese A, Mazzocchi A, Cesaro P, Campanale M, Occhipinti P, Tarantino O, Crosta C, Brosolo P, Sferrazza S, Rondonotti E, Amato A, Fuccio L, Costamagna G, Repici A. Endoscopic submucosal dissection: Italian national survey on current practices, training and outcomes. Dig Liver Dis 2020; 52:64-71. [PMID: 31629705 DOI: 10.1016/j.dld.2019.09.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 09/05/2019] [Accepted: 09/11/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Most of the evidence supporting endoscopic submucosal dissection (ESD) comes from Asia. European data are primarily reported by specialized referral centers and thus may not be representative of common European ESD practice. The aim of this study is to understand the current state of ESD practice across Italian endoscopy centers. METHODS All Italian endoscopists who were known to perform ESD were invited to complete a structured questionnaire including: operator features and competencies, ESD training details and clinical outcomes over a 2-year period. RESULTS Twenty-nine operators from 23 centers (69% response rate) completed the questionnaire: 18 (62%) were <50 years old; 7 (24%) were female; 16 (70%) were located in Northern Italy. Overall ESD volume was <40 cases in 9 (31%) operators, 40-80 in 8 (27.5%), 80-150 in 4 (13.8%) and >150 in 8 (27.5%). Colorectal ESD was predominant for operators with an experience >80 cases. En-bloc resection rates ranged from 77.2 to 97.2% depending on the anatomic location with an R0 resection rate range of 75.3-93.6%. ESD perforation rates in the colon and rectum were significantly lower when experience was >150 compared to 80-150 cases (p < 0.0001 and p = 0.006 for colon and rectum, respectively). CONCLUSION ESD in Italy is performed by a significant number of operators. Overall, Italian endoscopists performing ESD have achieved a good competence level. However, there is much variability in training protocols, initial supervision of procedures, practice settings, case mix and procedural volume/year that are likely responsible for some of the suboptimal resectional outcomes and increased perforation risk, mainly in the colon. Standardized training programs, practice parameters and auditing of outcomes are required.
Collapse
Affiliation(s)
- Roberta Maselli
- Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Humanitas University, Milan, Italy.
| | | | - Francesco Azzolini
- Division of Gastroenterology & G.I. Endoscopy, Vita Salute San Raffaele University, Milan, Italy
| | - Lucio Petruzziello
- Digestive Endoscopy Unit, Division of Gastroenterology Fondazione A. Gemelli-Università Cattolica del Sacro Cuore Hospital, IRCCS, Rome, Italy
| | - Mauro Manno
- Digestive Endoscopy Unit, USL Modena, Carpi Hospital, Italy
| | - Luca De Luca
- Division of Gastroenterology & G.I. Endoscopy, Ospedali Riuniti Marche Nord Hospital, Pesaro, Italy
| | - Paolo Cecinato
- Unit of Gastroenterology and Digestive Endoscopy, USL-IRCCS Reggio Emilia Hospital, Reggio Emilia,Italy
| | - Giancarla Fiori
- IEO, Digestive Endoscopy Unit, Istituto Europeo di Oncologia IRCCS Hospital, Milano, Italy
| | - Teresa Staiano
- Digestive Endoscopy Unit, FPO-IRCCS Candiolo Cancer Institute, Candiolo, TO, Italy
| | - Erik Rosa Rizzotto
- Division of Gastroenterology & G.I. Endoscopy, S. Antonio Hospital, Padova, Italy
| | - Stefano Angeletti
- Digestive Endoscopy Unit, Sant'Andrea Hospital, a Sapienza university, Roma, Italy
| | - Angelo Caruso
- Division of Gastroenterology & G.I. Endoscopy, Baggiovara Hospital, AOU di Modena, Italy
| | - Franco Coppola
- Digestive Endoscopy Unit, Division of Gastroenterology, ASLTO4, Turin, Italy
| | | | - Edi Viale
- Division of Gastroenterology & G.I. Endoscopy, Vita Salute San Raffaele University, Milan, Italy
| | - Guido Missale
- Digestive Endoscopy Unit, ASST Spedali Civili, Brescia University, Italy
| | - Alba Panarese
- Department of Gastroenterology and Digestive Endoscopy, National Research Institute specialized in Gastroenterology ¨S. De Bellis¨ , Castellana Grotte, BA, Italy
| | - Alessandro Mazzocchi
- Gastroenterology Endoscopy Unit, San Giovanni Battista Hospital, San Giovanni battista, Italy
| | - Paola Cesaro
- Endoscopy Unit, Fondazione Poliambulanza, Brescia, Italy
| | - Mariachiara Campanale
- Digestive Endoscopy Unit, Division of Gastroenterology Fondazione A. Gemelli-Università Cattolica del Sacro Cuore Hospital, IRCCS, Rome, Italy
| | - Pietro Occhipinti
- Division of Gastroenterology, ¨ Maggiore della CaritਠHospital and University, Novara, Italy
| | - Ottaviano Tarantino
- Division of Gastroenterology & G.I. Endoscopy, San Giuseppe Hospital, ASL Toscana centro, Empoli, Italy
| | - Cristiano Crosta
- IEO, Digestive Endoscopy Unit, Istituto Europeo di Oncologia IRCCS Hospital, Milano, Italy
| | - Piero Brosolo
- Division of Gastroenterology, Hospital of Pordenone, Pordenone, Italy
| | - Sandro Sferrazza
- Gastroenterology and Endoscopy Unit, Santa Chiara Hospital, APSS, Trento, Italy
| | - Emanuele Rondonotti
- Gastroenterology and Digestive Endoscopy Unit, Valduce Hospital, Como, Italy
| | - Arnaldo Amato
- Gastroenterology and Digestive Endoscopy Unit, Valduce Hospital, Como, Italy
| | - Lorenzo Fuccio
- Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Guido Costamagna
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Cattolica del Sacro CuoreUniversity, Centre for Endoscopic Research Therapeutics and Training CERTT, Roma, Italy; Université de Strasbourg Institut d'Etudes Avancées USIAS, Strasbourg, France
| | - Alessandro Repici
- Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Humanitas University, Milan, Italy; Humanitas University, Department of Biomedical Science, Milan, Italy
| |
Collapse
|
5
|
Andrisani G, Soriani P, Manno M, Pizzicannella M, Pugliese F, Mutignani M, Naspetti R, Petruzziello L, Iacopini F, Grossi C, Lagoussis P, Vavassori S, Coppola F, La Terra A, Ghersi S, Cecinato P, De Nucci G, Salerno R, Pandolfi M, Costamagna G, Di Matteo FM. Colo-rectal endoscopic full-thickness resection (EFTR) with the over-the-scope device (FTRD ®): A multicenter Italian experience. Dig Liver Dis 2019; 51:375-381. [PMID: 30377063 DOI: 10.1016/j.dld.2018.09.030] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/15/2018] [Accepted: 09/27/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM Endoscopic full-thickness resection(EFTR) with FTRD® in colo-rectum may be useful for several indications.The aim was to assess its efficacy and safety. MATERIAL AND METHODS In this retrospective multicenter study 114 patients were screened; 110 (61M/49F, mean age 68 ± 11 years, range 20-90) underwent EFTR using FTRD®. Indications were:residual/recurrent adenoma (39), incomplete resection at histology (R1 resection) (26), non-lifting lesion (12), adenoma involving the appendix (2) or diverticulum (2), subepithelial lesions(10), suspected T1 carcinoma (16), diagnostic resection (3). Technical success (TS: lesion reached and resected), R0 resection (negative lateral and deep margins),EFTR rate(all layers documented in the specimen) and safety have been evaluated. RESULTS TS was achieved in 94.4% of cases. EFTR was achieved in 91% with lateral and deep R0 resection in 90% and 92%. Mean size of specimens was 20 mm (range 6-42). In residual/recurrent adenomas, final analysis revealed: low-risk T1 (11), adenoma with low-grade dysplasia (LGD) (24) and high-grade dysplasia (HGD) (3), scar tissue (1). Histology reports of R1 resections were: adenoma with LGD (6), with HGD (1), low-risk (6) and high-risk (1) T1, scar tissue (12). Non-lifting lesions were diagnosed as: adenoma with HGD (3), low-risk (7) and high risk (2) T1. Adverse clinical events occurred in 12 patients (11%),while adverse technical events in11%. Three-months follow-up was available in 100 cases and residual disease was evident in only seven patients. CONCLUSIONS EFTR using FTRD® seems to be a feasible, effective and safe technique for treating selected colo-rectal lesions. Comparative prospective studies are needed to confirm these promising results.
Collapse
Affiliation(s)
- G Andrisani
- Digestive Endoscopy Unit, Campus Bio-Medico, Rome, Italy.
| | - P Soriani
- Digestive Endoscopy Unit, Ramazzini Hospital, Carpi, Modena, Italy
| | - M Manno
- Digestive Endoscopy Unit, Ramazzini Hospital, Carpi, Modena, Italy
| | | | - F Pugliese
- Diagnostic and Interventional Digestive Endoscopy, Niguarda Ca-Granda Hospital, Milan, Italy
| | - M Mutignani
- Diagnostic and Interventional Digestive Endoscopy, Niguarda Ca-Granda Hospital, Milan, Italy
| | - R Naspetti
- Surgical Endoscopy Unit, Careggi Hospital, Florence, Italy
| | - L Petruzziello
- Digestive Endoscopy Unit, Gemelli University Hospital, Rome, Italy
| | - F Iacopini
- Gastroenterology Endoscopy Unit, S.Giuseppe Hospital, Albano Laziale, Rome,Italy
| | - C Grossi
- Gastroenterology Endoscopy Unit, S.Giuseppe Hospital, Albano Laziale, Rome,Italy
| | - P Lagoussis
- Division Of General Surgery I, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - S Vavassori
- Division Of General Surgery I, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - F Coppola
- Department Gastroenterology, San Giovanni Bosco Hospital, Torino, Italy
| | - A La Terra
- Department Gastroenterology, San Giovanni Bosco Hospital, Torino, Italy
| | - S Ghersi
- Gastroenterology and Digestive Endoscopy Unit, AUSL Bologna, Bologna, Italy
| | - P Cecinato
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - G De Nucci
- Gastroenterology and Digestive Endoscopy Unit, A.O. Salvini, Garbagnate Milanese, Italy
| | - R Salerno
- Endoscopy Unit, ASST Fatebenefratelli Sacco, Milan, Italy
| | - M Pandolfi
- Digestive Endoscopy Unit, Campus Bio-Medico, Rome, Italy
| | - G Costamagna
- Digestive Endoscopy Unit, Gemelli University Hospital, Rome, Italy
| | - F M Di Matteo
- Digestive Endoscopy Unit, Campus Bio-Medico, Rome, Italy
| |
Collapse
|
6
|
Coppola F. Atrial septal defect occluder devices for closure of tracheoesophageal fistulas: are they safe? Ann Gastroenterol 2019; 32:112. [PMID: 30598605 PMCID: PMC6302187 DOI: 10.20524/aog.2018.0333] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 11/28/2018] [Indexed: 11/16/2022] Open
|
7
|
Abstract
One hundred and sixty-three consecutive patients (129 females and 34 males) over 60 years of age attending the Headache Centre of the University of Perugia in the period January 2000-December 2001 were included in the study. One hundred and fifty-two (93.3%) were affected by a primary headache disorder. According to the 1988 IHS Criteria, their prevailing attacks could be diagnosed as migraine without aura (MwoA) in 57.2% of cases ( n = 87) and as migraine with aura (MwA) in 11.8% of cases ( n = 18). Attacks both in MwoA and MwA were unilateral and of severe-to-moderate intensity in 45% and 50% of cases. Head pain was referred as pulsating by 56% and 38.9% of MwoA patients MwA patients, respectively. Aggravation with routine daily activities was present in 72.4% and 61.1% in MwoA and MwA patient groups. The most frequent accompanying symptoms were photophobia and phonophobia. Headache attacks were of shorter duration in MwA patients, but in 3.4% of MwoA patients attacks lasted between 2 and 4 h. Of patients affected by MwA, 55% referred, together with the typical attacks, symptoms of aura not followed by headache. A worsening of headache in the last 5 years was reported by 67.8% and 44.4% of MwoA and MwA patients, respectively. Of the patients with MwoA, 86.2% ( n = 75), and 83.3% ( n = 15) of those with MwA used symptomatic drugs for their attacks. In the majority of cases they took more than one analgesic or non steroidal anti-inflammatory drug. A total of 51.7% of patients with MwoA and 55.5% of patients with MwA were under prophylactic treatment. Preventive drugs included antidepressants, beta-blockers, calcium channel antagonists and antiepileptic drugs. The choice of symptomatic or prophylactic drugs was made, in the majority of cases, on the basis of concomitant diseases.
Collapse
Affiliation(s)
- G Mazzotta
- Department of Neuroscience, University of Perugia, Italy
| | | | | | | | | | | |
Collapse
|
8
|
Quaranta N, Taliente S, Coppola F, Salonna I. Cartilage ossiculoplasty in cholesteatoma surgery: hearing results and prognostic factors. Acta Otorhinolaryngol Ital 2016; 35:338-42. [PMID: 26824916 PMCID: PMC4720926 DOI: 10.14639/0392-100x-590] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Cartilage tympanoplasty is an established procedure for tympanic membrane and attic reconstruction. Cartilage has been used as an ossiculoplasty material for many years. The aim of this study was to evaluate hearing results of costal cartilage prostheses in ossicular chain reconstruction procedures in subjects operated on for middle ear cholesteatoma and to determine the presence of prognostic factors. Candidates for this study were patients affected by middle ear cholesteatoma whose ossicular chain was reconstructed with a chondroprosthesis. 67 cases of ossiculoplasty with total (TORP) or partial (PORP) chondroprosthesis were performed between January 2011 and December 2013. Follow-up examination included micro-otoscopy and pure tone audiometry. The guidelines of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology Head and Neck Surgery were followed and pure-tone average (PTA) was calculated as the mean of 0.5, 1, 2 and 4 kHz thresholds. Statistical analysis was performed with ANOVA tests and regression models. Average air-bone gap (ABG) significantly improved from 39.2 dB HL (SD 9.1 dB HL) to 25.4 dB HL (SD 11 dB HL) (p < 0.001). Linear regression analysis showed that the only prognostic factor was the type of operation (p = 0.02). In fact, patients submitted to ICWT presented better post-operative ABG compared to CWDT. None of the other variables influenced the results. The present study proposes costal cartilage as material of choice when autologous ossicles are not available. The maintenance of the posterior canal wall was the only prognostic factor identified.
Collapse
Affiliation(s)
- N Quaranta
- UOC Otorinolaringoiatria Universitaria, Azienda Ospedaliero-Universitaria Policlinico di Bari, Italy
| | - S Taliente
- UOC Otorinolaringoiatria Universitaria, Azienda Ospedaliero-Universitaria Policlinico di Bari, Italy
| | - F Coppola
- UOC Otorinolaringoiatria Universitaria, Azienda Ospedaliero-Universitaria Policlinico di Bari, Italy
| | - I Salonna
- UOC Otorinolaringoiatria Universitaria, Azienda Ospedaliero-Universitaria Policlinico di Bari, Italy
| |
Collapse
|
9
|
Schettino MT, Gallo P, Rappa C, Coppola F, Tormettino B, Del Deo F, Grimaldi A, Torella M. Sexual function in patients who underwent surgery for stress urinary incontinence. Minerva Ginecol 2014; 66:355-363. [PMID: 23903373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM Stress urinary incontinence (SUI) has been reported to have a negative impact on sexual relations in up to 68% of women. The effect of suburethral sling on sexual functioning has been studies, but the results are still inhomogeneous. This study was undertaken to assess the effect of the transvaginal tension free vaginal tape (TVT), transvaginal tension free vaginal tape - obturate (TVT-O) and minisling procedures (SIS) on sexual function and to also evaluate the male experience respect to sexual activity before and after surgery of partners of women underwent surgery. METHODS We enrolled 150 patients underwent a TVT/TVT-O or SIS for female stress urinary incontinence. All patients enrolled were invited to fill out the Female Sexual Function Index (FSFI) Questionnaire, before surgery and 12 months after surgery. We also evaluate the male experience, through questionnaire, respect to sexual activity before and after surgery of female partner. RESULTS At month 12, the mean follow-up FSFI total score in SIS group improved from baseline 22.7±3.83 to 26.2±4.01 (P=0.001), in the TVT group from baseline 22.5±4.11 to 28.5±3.87 (P=0.001) and in the TVT-O group from baseline 23.5±4.48 to 27.7±3.68. The male questionnaires reported an improvement of the sexual function of 84% for TVT group, 82.9% for SIS group and 80,9% for TVT-O group. CONCLUSION In our present study, patients underwent TVT, TVT-O or SIS showed comparable significant improvement of sexual function after sling procedure as evaluated by FSFI.
Collapse
Affiliation(s)
- M T Schettino
- Department of Woman, Child and of General and Specialized Surgery Second University of Studies of Naples, Naples, Italy -
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Abstract
Idiopathic achalasia is a motor disorder of the esophagus of unknown etiology caused by loss of motor neurons determining an altered motility. It may determine severe symptoms such as progressive dysphagia, regurgitations, and pulmonary aspirations. Many therapeutic options may be offered to patients with achalasia, from surgery to endoscopic treatments such as pneumatic dilation, botulinum injection, peroral endoscopic myotomy, or endoscopic stenting. Recently, temporary placement of a stent was proposed by Cheng as therapy for achalasia disorders, whereas no Western authors have dealt with it up to date. The present study reports our preliminary experience in 7 patients with achalasia treated with a temporary stent. Partially covered self-expanding metallic stents (Micro-Tech, Nanjin, China) 80 mm long and 30 mm wide were placed under fluoroscopic control and removed after 6 days. Clinical follow-up was scheduled to check endoscopic success, symptoms release, and complications. The placement and the removal of the stents were obtained in all patients without complications. Mean clinical follow-up was 19 months. Five out of 7 patients referred total symptoms release and 2 experienced significant improvement of dysphagia. The procedure was not time consuming and was safe; no mild or severe complications were registered. In conclusion, our results may suggest a possible safe and effective endoscopic alternative treatment in patients with achalasia; however, further larger studies are necessary to confirm these promising, but very preliminary, data.
Collapse
Affiliation(s)
- Franco Coppola
- 1Department Gastroenterology, San Giovanni Bosco Hospital, Turin, Italy
| | | | | | | |
Collapse
|
11
|
Abstract
Idiopathic achalasia is a motor disorder of the esophagus of unknown etiology caused by loss of motor neurons determining an altered motility. It may determine severe symptoms such as progressive dysphagia, regurgitations, and pulmonary aspirations. Many therapeutic options may be offered to patients with achalasia, from surgery to endoscopic treatments such as pneumatic dilation, botulinum injection, peroral endoscopic myotomy, or endoscopic stenting. Recently, temporary placement of a stent was proposed by Cheng as therapy for achalasia disorders, whereas no Western authors have dealt with it up to date. The present study reports our preliminary experience in 7 patients with achalasia treated with a temporary stent. Partially covered self-expanding metallic stents (Micro-Tech, Nanjin, China) 80 mm long and 30 mm wide were placed under fluoroscopic control and removed after 6 days. Clinical follow-up was scheduled to check endoscopic success, symptoms release, and complications. The placement and the removal of the stents were obtained in all patients without complications. Mean clinical follow-up was 19 months. Five out of 7 patients referred total symptoms release and 2 experienced significant improvement of dysphagia. The procedure was not time consuming and was safe; no mild or severe complications were registered. In conclusion, our results may suggest a possible safe and effective endoscopic alternative treatment in patients with achalasia; however, further larger studies are necessary to confirm these promising, but very preliminary, data.
Collapse
Affiliation(s)
- Franco Coppola
- 1Department Gastroenterology, San Giovanni Bosco Hospital, Turin, Italy
| | | | | | | |
Collapse
|
12
|
Coppola F, Gaia S, Rolle E, Recchia S. Use of temporary self expanding metallic stent in a stenosing/perforated colo-rectal anastomosis. MINERVA GASTROENTERO 2013; 59:113-115. [PMID: 23478249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
13
|
Coppola F, Gaia S, Recchia S, Rolle E. Duodenoscope entrapped by over-the-scope clip: paradoxical image. Dig Liver Dis 2013; 45:e4. [PMID: 22985788 DOI: 10.1016/j.dld.2012.08.004] [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] [Received: 07/07/2012] [Revised: 07/29/2012] [Accepted: 08/04/2012] [Indexed: 12/11/2022]
Affiliation(s)
- Franco Coppola
- Department of Gastroenterology, San Giovanni Bosco Hospital, Torino, Italy.
| | | | | | | |
Collapse
|
14
|
Coppola F, Gaia S, Anglesio A. A case of postcholecystectomy porto-biliary fistula. MINERVA GASTROENTERO 2011; 57:433-434. [PMID: 22105732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
|
15
|
Coppola F, Bini R, Gaia S, Cosimato M, Recchia S. ERCP after Fag Kan Roux-en-Y-hepatojejunostomy in Caroli's syndrome. Gastrointest Endosc 2011; 74:235-6. [PMID: 21704824 DOI: 10.1016/j.gie.2011.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Accepted: 02/14/2011] [Indexed: 12/11/2022]
|
16
|
Coppola F, Gaia S, Cosimato M, Recchia S. Enteroscope without overtube for cecal intubation after an incomplete colonoscopy. Dig Liver Dis 2011; 43:475-7. [PMID: 21334994 DOI: 10.1016/j.dld.2011.01.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 01/03/2011] [Accepted: 01/17/2011] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cecal intubation is one of the targets of colon endoscopic evaluation, however even under experienced hands 5-10% of colonoscopies are incomplete. AIMS The aim of the study is to evaluate the usefulness of single balloon enteroscope (SBE) without employing overtube-balloon equipment in patients with incomplete colonoscopy. METHODS Between January 2009 and July 2010, patients with an incomplete standard colonscopy were prospectively enrolled to perform a colonoscopy with a single balloon enteroscope. Examinations were performed by the same expert operator during the same session. RESULTS Enteroscopy was performed on 79 patients, cecal intubation were obtained in 93.6% of the cases (74/79). It provided a new diagnosis in 43% of cases (34/79). Procedure was safe and well tolerated. Overall the additional use of single balloon enteroscope allowed to obtain the cecal intubation in up to 99.2% cases (898/905). CONCLUSIONS The use of the enteroscope without overtube-balloon equipment may be an effective method to increase the cecal intubation rate after failure of a standard colonoscopy.
Collapse
Affiliation(s)
- Franco Coppola
- Department of Gastroenterology, San Giovanni Bosco Hospital, Torino, Italy.
| | | | | | | |
Collapse
|
17
|
Affiliation(s)
- F Coppola
- Department of Gastroenterology, San Giovanni Bosco Hospital, Torino, Italy.
| | | | | | | | | | | |
Collapse
|
18
|
Bini R, Coppola F, Recchia S, Fusca M, Gaia S, Leli R. Endoscopic treatment of postgastrectomy duodenal fistula with an over-the-scope clip. Surg Innov 2011; 18:102-4. [PMID: 21245069 DOI: 10.1177/1553350610392244] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Bleeding peptic ulcer is a life threatening condition with high mortality rate but often treatable by endoscopy. Surgical indications in case of gastroduodenal ulcers are confined to endoscopic and radiological failures in bleeding control. Duodenal fistula (DF) is a rare complication of gastric resection and even if a rare event it may be a life threatening condition. Surgical and medical options could not solve the DF. Herein we report a case of an old patient underwent emergency gastrectomy for ulcer's bleeding who developed DF associated to sepsis, malnutrition and, hydro-electrolyte disorders not responding to surgical and medical attempts. We demonstrated, for the first time, the efficacy of over the scope clips (OTSC®) in the treatment of postoperative duodenal fistulas not responding to surgical and medical treatment in high risk patient.
Collapse
|
19
|
Coppola F, Durante M, Gialanella G, Grossi G, Manti L, Pugliese M, Scampoli P. Development of an automated scanning system for the analysis of heavy ions' fragmentation reaction by nuclear track detectors. RADIAT MEAS 2009. [DOI: 10.1016/j.radmeas.2009.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
20
|
Sarchielli P, Rainero I, Coppola F, Rossi C, Mancini ML, Pinessi L, Calabresi P. Involvement of Corticotrophin-Releasing Factor and Orexin-A in Chronic Migraine and Medication-Overuse Headache: Findings From Cerebrospinal Fluid. Cephalalgia 2008; 28:714-22. [DOI: 10.1111/j.1468-2982.2008.01566.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The study set out to investigate the role of corticotrophin-releasing factor (CRF) and orexin-A in chronic migraine (CM) and medication-overuse headache (MOH). Twenty-seven patients affected by CM and 30 with MOH were enrolled. Control CSF specimens were obtained from 20 age-matched subjects who underwent lumbar puncture for diagnostic purposes, and in all of them CSF and blood tests excluded central nervous system or systemic diseases. Orexin-A and CRF were determined by radioimmunoassay methods. Significantly higher levels of orexin-A and CRF were found in the CSF of MOH and to a lesser extent in patients with CM compared with control subjects (orexin-A: P < 0.001 and P < 0.02; CRF: P < 0.002 and P < 0.0003). A significant positive correlation was also found between CSF orexin-A values and those of CRF ( R = 0.71; P < 0.0008), monthly drug intake group ( R = 0.39; P < 0.03) and scores of a self-completion 10-item instrument to measure dependence upon a variety of substances, the Leeds Dependence Questionnaire (LDQ) in the MOH group ( R = 0.68; P < 0.0003). The significantly higher orexin-A levels found in CM and MOH can be interpreted as a compensatory response to chronic head pain or, alternatively, as an expression of hypothalamic response to stress due to chronic pain. A potential role for orexin-A in driving drug seeking in MOH patients through activation of stress pathways in the brain can also be hypothesized.
Collapse
Affiliation(s)
- P Sarchielli
- Neurologic Clinic, University of Perugia, Perugia, Italy
| | - I Rainero
- Neurology II-Headache Centre, Department of Neuroscience, University of Turin, Turin, Italy
| | - F Coppola
- Neurologic Clinic, University of Perugia, Perugia, Italy
| | - C Rossi
- Neurologic Clinic, University of Perugia, Perugia, Italy
| | - ML Mancini
- Neurologic Clinic, University of Perugia, Perugia, Italy
| | - L Pinessi
- Neurology II-Headache Centre, Department of Neuroscience, University of Turin, Turin, Italy
| | - P Calabresi
- Neurologic Clinic, University of Perugia, Perugia, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| |
Collapse
|
21
|
Golfieri R, Coppola F, Fusco F, Li Bassi S, Caraceni P, Bernardi M, Trevisani F. Malignant progression of a small HCC nodule: hypovascular 'early HCC' converted to hypervascular 'small HCC' within six months. Dig Liver Dis 2007; 39:883-90. [PMID: 17045857 DOI: 10.1016/j.dld.2006.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2006] [Revised: 07/17/2006] [Accepted: 09/05/2006] [Indexed: 12/11/2022]
Abstract
We report a case of hepatocellular carcinoma superimposed on chronic hepatitis C virus (HCV) hepatitis in which final diagnosis of hepatocellular carcinoma was delayed because there was no consensus on hypervascularity with two diagnostic methods at the time of presentation. A 3 cm lesion was initially observed as hypovascular at multidetector-row computed tomography. Conversely, two months later the lesion appeared hypervascular at contrast-ultrasonography and gadolinium-enhanced dynamic magnetic resonance, and hyperintense after superparamagnetic iron oxide-enhanced T2W studies. Only in the late follow-up it was definitively confirmed as hypervascular in the arterial phase of multidetector-row computed tomography. This case clearly highlights some pitfalls in the European Association for the study of the liver guidelines for hepatocellular carcinoma management, which were readdressed in the last American Association for the Study of Liver Diseases (AASLD) and in the forthcoming international proposals, leading to more pragmatic suggestions for clinical practice.
Collapse
Affiliation(s)
- R Golfieri
- Department of Radiology, Sant'Orsola-Malpighi Hospital, University of Bologna, Italy.
| | | | | | | | | | | | | |
Collapse
|
22
|
Sarchielli P, Floridi A, Mancini ML, Rossi C, Coppola F, Baldi A, Pini LA, Calabresi P. NF-kappaB activity and iNOS expression in monocytes from internal jugular blood of migraine without aura patients during attacks. Cephalalgia 2006; 26:1071-9. [PMID: 16919057 DOI: 10.1111/j.1468-2982.2006.01164.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This study investigated nuclear factor-kappa B (NF-kappaB) activity by electrophoresis mobility gel shift assay and IkappaBalpha expression by Western blot analysis in monocytes obtained from serial samples of internal jugular venous blood taken from seven migraine patients without aura during attacks. Inducible nitric oxide synthase (iNOS) expression was also assessed by reverse transcription-polymerase chain reaction. An increase in NF-kappaB activity peaked 2 h after attack onset. This was accompanied by a transient reduction in IkappaBalpha expression. Up-regulation of iNOS was evident at 4 h, maintained at 6 h and reduced at the end of the attack. These findings substantiate the hypothesis of transitory delayed inflammation, as suggested by the animal model, and suggest the possibility of using therapeutic approaches to target NF-kappaB transcription in the treatment of migraine.
Collapse
Affiliation(s)
- P Sarchielli
- Neurologic Clinic, Department of Medical Specialties and Public Health, University of Perugia, Perugia, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Santoro N, Perrone L, Cirillo G, Raimondo P, Amato A, Coppola F, Santarpia M, D'Aniello A, Miraglia Del Giudice E. Weight loss in obese children carrying the proopiomelanocortin R236G variant. J Endocrinol Invest 2006; 29:226-30. [PMID: 16682835 DOI: 10.1007/bf03345544] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
To acquire more information relative to the course of obesity in conditions of food restriction in subjects carrying mutations in the melanocortin signaling pathway, 710 obese children (mean age: 9.5+/-2.1 yr; mean z-score body mass index: 3.63+/-1.6) were genotyped for the proopiomelanocortin (POMC) R236G substitution, a variant which has been associated to early onset obesity, by restriction fragment length polymorphism (RFLP) analysis. Three children were heterozygotes for the R236G variant (0.4%). One of them had the metabolic syndrome. This variant was not found in 400 controls. The 3 probands followed a hypocaloric balanced diet and, after about 12 months, normalized their weight as well as fat mass and insulin resistance. The patient with the metabolic syndrome reversed this condition. These results show that a) the R236G substitution of POMC gene, although not a major cause of obesity among Italian obese children and adolescents, is associated with early onset obesity, and that b) inherited alterations of the melanocortin signaling pathway, independently of the degree of obesity, do not preclude the possibility to lose weight in mutated individuals following a hypocaloric diet.
Collapse
Affiliation(s)
- N Santoro
- Department of Pediatrics F. Fede, Second University of Naples, 80138 Naples, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Ferrari B, Pezzuto A, Barusi L, Coppola F. Follicular fluid vascular endothelial growth factor concentrations are increased during GnRH antagonist/FSH ovarian stimulation cycles. Eur J Obstet Gynecol Reprod Biol 2006; 124:70-6. [PMID: 16183188 DOI: 10.1016/j.ejogrb.2005.08.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2005] [Revised: 08/22/2005] [Accepted: 08/22/2005] [Indexed: 11/22/2022]
Abstract
BACKGROUND The aim of this study was to investigate the effect of GnRH antagonists (GnRH-ant) on follicular fluid vascular endothelial growth factor (FF VEGF). METHODS Sixty women undergoing assisted reproduction were randomised (computer-generated randomisation list) and assigned to two different GnRH analogue regimens: GnRH agonist (GnRH-a) (Group A; n = 30) and GnRH-ant (Group B; n = 30). RESULTS Mean (+/-S.D.) FF VEGF concentrations were 1598+/-612 pg/mL and 2906+/-1558 pg/mL for Groups A and B, respectively (p < 0.001). In the women treated with GnRH-ant, we found a statistically significant reduction in serum LH levels (1.72+/-0.74 IU/L in Group A versus 0.93+/-0.43 IU/L in Group B, p < 0.001), in serum oestradiol (E2) levels (1562.1+/-410.7 pg/mL in Group A versus 1214.67+/-779.9 pg/mL in Group B, p < 0.05), in FF E2 levels (1146+/-593 ng/mL in Group A versus 621+/-435 ng/mL in Group B, p < 0.05), and in FF androstenedione levels (136+/-55 ng/mL in Group A versus 78+/-31 ng/mL in Group B, p < 0.001), as well as a reduction in the number of pregnancies, though not statistically significant (23.3% in Group A versus 16.6% in Group B). CONCLUSION The increase in FF VEGF levels in women treated with GnRH-ant might be explained by a suppression of LH and E2 levels.
Collapse
Affiliation(s)
- B Ferrari
- Centre for Reproductive Medicine, Department of Obstetrics, Gynaecology and Neonatology, University of Parma, Via Gramsci 14, 43100 Parma, Italy.
| | | | | | | |
Collapse
|
25
|
Coppola F, Ferrari B, Barusi L, Caccavari V, Salvarani MC, Piantelli G. Follicular fluid levels of vascular endothelial growth factor and early corpus luteum function during assisted reproductive technology cycles. J Exp Clin Assist Reprod 2005; 2:13. [PMID: 16197554 PMCID: PMC1262751 DOI: 10.1186/1743-1050-2-13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2005] [Accepted: 09/30/2005] [Indexed: 11/25/2022]
Abstract
Background The relation between vascular endothelial growth factor (VEGF) and early luteal function has rarely been proven in humans. The purpose of this study was to define the relation between follicular fluid concentrations of VEGF (FF VEGF) and early luteal function at the preimplantation stage during assisted reproductive technology (ART) cycles. Methods 71 women were divided into two groups, based on reproductive outcome: women who became pregnant after embryo transfer (ET) (n = 18, Group A) and non-pregnant women (n = 53, Group B). Serum progesterone (Se P) and inhibin A on ET day, and FF VEGF levels were measured in all women. Data were expressed as mean ± standard deviation. Statistical analysis was performed using Excel Office 98 for Student's t-test, linear regression test and chi-square test. A p value of < 0.05 was considered statistically significant. Results The groups were comparable for age, ovarian reserve, number and quality of the oocytes retrieved and of the embryos obtained and transferred. FF VEGF levels were increased (4235 ± 1433 vs 3432 ± 1231 pg/ml), while Se P and inhibin A levels were significantly reduced (83.1 ± 34.1 vs 112.0 ± 58.8 ng/ml and 397.4 ± 223 vs 533.5 ± 283 pg/ml, respectively) in the non-pregnant group and were negatively correlated with FF VEGF (r = -0.482, p < 0.05; r = -0.468, p < 0.05) only in pregnant women. Conclusion Much has to be learned about the regulation and role of VEGF during the early luteal phase. We advance the hypothesis that the existence of a negative correlation between FF VEGF/Se P and FF VEGF/inhibin A in pregnant women might indicate the existence of a normal VEGF-mediated paracrine response when Se P and inhibin A levels are decreased. Excess production of FF VEGF and the absence of a correlation between FF VEGF/Se P and FF VEGF/inhibin A in non-pregnant women may be a paracrine reaction to immature luteal vasculature, resulting in luteal dysfunction.
Collapse
Affiliation(s)
- F Coppola
- Center for Reproductive Medicine – Department of Obstetrics, Gynecology and Neonatology – University of Parma – 43100 Parma – Italy
| | - B Ferrari
- Center for Reproductive Medicine – Department of Obstetrics, Gynecology and Neonatology – University of Parma – 43100 Parma – Italy
| | - L Barusi
- Center for Reproductive Medicine – Department of Obstetrics, Gynecology and Neonatology – University of Parma – 43100 Parma – Italy
| | - V Caccavari
- Center for Reproductive Medicine – Department of Obstetrics, Gynecology and Neonatology – University of Parma – 43100 Parma – Italy
| | - MC Salvarani
- Center for Reproductive Medicine – Department of Obstetrics, Gynecology and Neonatology – University of Parma – 43100 Parma – Italy
| | - G Piantelli
- Center for Reproductive Medicine – Department of Obstetrics, Gynecology and Neonatology – University of Parma – 43100 Parma – Italy
| |
Collapse
|
26
|
Trappoliere M, Tuccillo C, Federico A, Di Leva A, Niosi M, D'Alessio C, Capasso R, Coppola F, Dauria M, Loguercio C. The treatment of NAFLD. Eur Rev Med Pharmacol Sci 2005; 9:299-304. [PMID: 16231594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is becoming an increasing cause of chronic liver damage. The decision of start a medical treatment is based on the documented risk of progression to cirrhosis and liver cancer, when steatohepatitis (NASH) occurs. The therapy of this syndrome requires, as obviously, some considerations on the natural history of the condition, on the efficacy and safety of various therapeutic options, as well as on the costs. Treatment of patients with NAFLD has typically been focused on the management of associated conditions such as obesity, diabetes mellitus and hyperlipemia. Weight loss improves insulin sensitivity, and NASH may resolve with weight reduction. Insulin resistance seems to be the common denominator in many cases of NAFLD. Two classes of drugs have been shown to correct insulin resistance: biguanides (e.g., metformin) and thiazolidinediones (e.g., rosiglitazone and pioglitazone). The last two decades have witnessed a considerable progress in the understanding of the mechanisms respon-sible for the fibrogenic progression of chronic liver diseases. Several drugs believed to be hepatoprotective or antifibrotic agent as UDCA, betaine, vitamin E, lecithin, beta-carotene and selenium have been used in patients with NASH. Silybin is the main component of silymarin that is absorbed when linked whith a phytosome. This substance reduces in rats the lipid-peroxidation and the activaction of hepatic stellate cells. In humans, some non controlled data show that silybin is able to reduce insulin resistance, liver steatosis and plasma markers of liver fibrosis.
Collapse
Affiliation(s)
- M Trappoliere
- Intern University Research Center on Foods, Nutrition and Gastrointestinal Tract (CIRANAD), Unit of Gastroenterology, II University of Naples, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Fiorella R, Di Nicola V, Fiorella ML, Spinelli DA, Coppola F, Luperto P, Madami L. Major salivary gland diseases. Multicentre study. Acta Otorhinolaryngol Ital 2005; 25:182-90. [PMID: 16450775 PMCID: PMC2639866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
This multicentre study involved 28 Italian ORL Centres responding to a questionnaire sent by us which allowed recruitment of a high large number of cases of parotid neoplasms observed over a 10-year period. Statistical data obtained partly confirmed previous findings. Benign tumours account for 80% of case histories with a relationship 1:4 M/F, the most frequent being pleomorphic adenoma (57.3% of cases), followed by Warthin's tumour (32.4%), this rating not having been confirmed in case histories (8-10%) in the literature. Malignant tumours instead were fewer in number compared to the literature (14% vs 25-30%); the most frequent being mucoepidermoid carcinoma (18.2%) of which 44% G1, 33% G2 and 23% G3. Adenoid-cystic carcinoma was observed in 15.3% and < or = 10% for all the other most frequent histological malignant neoplasms. Diagnostic work-up included echotomography and fine-needle aspiration biopsy, less used imaging techniques were computed tomography, magnetic resonance imaging, Sialo-computed tomography. During this multicentre investigation more widespread use of imaging techniques has, however, been observed. The greater use of ecotomography and of fine-needle aspiration biopsy was due to simplicity of application and low cost offering good sensitivity and specificity. Surgical treatment of benign tumours consisted, in 50% of cases, in superficial paroditectomy and in approximately 30% of total paroditectomy. Enucleoresection was limited to approximately 15% of neoplasms, enucleation to <10% of cases with only 2% of pleomorph adenoma due to the well-known anatomo-pathological characteristics which may lead to relapse. For malignant neoplasms, total parotidectomy was performed in approximately 50% of cases, while in the remaining 50% an almost equal rate of superficial parotidectomy was carried out and enlarged parotidectomy, with or without sacrificing the facial nerve, which was rebuilt in 60% of cases. The lateral neck dissection most frequently carried out was of functional type in 54% and selective type in 46% with removal of levels I-III and II-IV in approximately 60% of cases. Sentinel lymph node was observed in a limited number of centres. When no clinically evident lymph nodes were present (NO) considering the tumour histotype, two thirds of patients underwent surgery or radiotherapy, while in the remainder the wait-and-see attitude was prefered. Post-operative-complementary radiotherapy was very frequently performed instead of chemotherapy. Oncological results obtained were compared with those reported in the literature: in fact for all benign neoplasms relapse ratings are about 5%, while for malignant tumours the worst prognosis was in squamous cell carcinoma with median of 37.7 on survival and metastasis rate of 16.5%. Finally, mucoepidermoid carcinoma tumours showed best survival, followed by adenoid-cystic carcinoma with ranges, respectively, 83 and 81.
Collapse
Affiliation(s)
- R Fiorella
- Department of Otorhinolaryngology, University of Bari, Italy
| | | | | | | | | | | | | |
Collapse
|
28
|
Sarchielli P, Alberti A, Coppola F, Baldi A, Gallai B, Floridi A, Floridi A, Capocchi G, Gallai V. Platelet-activating factor (PAF) in internal jugular venous blood of migraine without aura patients assessed during migraine attacks. Cephalalgia 2004; 24:623-30. [PMID: 15265050 DOI: 10.1111/j.1468-2982.2003.00717.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of the study was to verify the production of PAF and the activity of PAF acetyl-hydrolase (PAF-AH), the enzyme involved in the catabolism of this phospholipid mediator, in migraine attacks. Their levels were determined during migraine crises in serial samples of internal jugular venous blood taken from five migraine patients without aura, who were admitted to the hospital during the crises. Internal jugular venous blood samples were taken immediately after catheter insertion at 1, 2, and 4 h after attack onset, and within 2 h from its cessation. PAF was purified by high-performance liquid chromatography (HPLC) and determined by radioimmunoassay method. The enzymatic activity of PAF-AH was measured by reverse-phase HPLC, based on the derivatization with 7-diethylaminocoumarin-3-carbonylazide. In the internal jugular venous blood of migraine patients without aura (MO), an increase was observed in PAF levels, which was already evident at the time of catheter insertion (885.6 +/- 82.8) and at the first hour (868.4 +/- 65.24) (ANOVA: P < 0.0001). PAF levels remained elevated through the second (746.8 +/- 82.95), fourth (700.6 +/- 34.93) and sixth hours (644.4 +/- 42.85), and then decreased at the end of the attack, reaching levels significantly lower than those measured at the time of catheter insertion (565.5 +/- 38.34). The activity of PAF-AH showed an opposite trend with higher values at the first hour and significantly lower values at the second and fourth hours from the beginning of the migraine attack (ANOVA: P < 0.02). The increased production of PAF may account for persistent platelet activation during migraine crises, even in the presence of an increased production of nitric oxide (NO) end-products which, on the other hand, should instead intervene in counteracting and limiting platelet activation. Potential sources of PAF production are the endothelial cells from cerebral vessels, stimulated by trigeminal neuropeptides, platelets themselves, and mast cells, as suggested by the neurogenic inflammation model.
Collapse
Affiliation(s)
- P Sarchielli
- Department of Neuroscience, Institute of Clinical and Applied Biochemistry, University of Perugia, Perugia, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Piolanti M, Coppola F, Papa S, Pilotti V, Mattioli S, Gavelli G. Ultrasonographic localization of occult pulmonary nodules during video-assisted thoracic surgery. Eur Radiol 2003; 13:2358-64. [PMID: 12736756 DOI: 10.1007/s00330-003-1916-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2002] [Revised: 03/21/2003] [Accepted: 04/01/2003] [Indexed: 10/26/2022]
Abstract
The aim of our study was to evaluate the role of ultrasonography in the localization of pulmonary nodules during video-assisted thoracic surgery (VATS). Ultrasonography was performed in 35 patients for the localization of pulmonary nodules during VATS. Indication for VATS was excisional biopsy of undetermined nodules in 22 patients, single or multiple metastasectomy in 12 patients and resection of primitive pulmonary cancer in 1 patient with reduced pulmonary reserve. A laparoscopic probe with flexible head and multi-frequency transducer (5-7.5 MHz) was used. Intraoperative ultrasonography localized 37 of 40 nodules preoperatively detected by CT and/or by positron emission tomography in 35 patients. Furthermore, ultrasonography localized two nodules not visualized at spiral CT. Eighteen nodules were not visible or palpable at thoracoscopic examination and were found by intraoperative sonography only. In 6 patients in whom thoracotomy was performed, manual palpation did not reveal more lesions than ultrasonography. In our experience, ultrasonography was very helpful when lesions were not visible or palpable during thoracoscopy, showing high sensitivity (92.5%) in finding pulmonary nodules. Since it is not possible to determine preoperatively whether a localization technique will be necessary during the operation or not, and ultrasonography is a non-invasive technique, we think that, at present, this technique can be considered as the first-instance localization technique during thoracoscopic resection of pulmonary nodules.
Collapse
Affiliation(s)
- M Piolanti
- Dipartimento di Scienze Radiologiche ed Istocitopatologiche, Policlinico S. Orsola-Malpighi, Università di Bologna, Via Massarenti 9, 40100 Bologna, Italy
| | | | | | | | | | | |
Collapse
|
30
|
Gallai V, Alberti A, Gallai B, Coppola F, Floridi A, Sarchielli P. Glutamate and nitric oxide pathway in chronic daily headache: evidence from cerebrospinal fluid. Cephalalgia 2003; 23:166-74. [PMID: 12662182 DOI: 10.1046/j.1468-2982.2003.00552.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A central sensitization has been advocated to explain chronic daily headache (CDH) due to sustained peripheral sensitization of allogenic structures responsible for sustained trigeminovascular system activation. Several mechanisms have been suggested to underlie central sensitization, but have been poorly investigated in CDH. They involve N-methyl-D-aspartate (NMDA) receptor activation and nitric oxide (NO) production and supersensitivity and increased and maintained production of sensory neuropeptides. The present study supports the above pathogenic mechanisms demonstrating a significant increase in glutamate and nitrite levels in the CSF of CDH patients, without a significant difference between patients without and those with analgesic overuse headache (P < 0.0001 and P < 0.002). The increase in CSF nitrites was accompanied by a significant rise in the CSF values of cyclic guanosine monophosphate (cGMP) in patients in comparison with controls (P < 0.0001). A statistically significant correlation emerged between visual analogic scale (VAS) values and glutamate, nitrites and cGMP. Although substance P (SP) and calcitonin gene-related peptide (CGRP), and to a lesser extent neurokinin A, were significantly increased in CSF compared with control subjects, their values did not correlate with glutamate, nitrites and cGMP levels in CSF in the patient group. The present study confirms the involvement of glutamate-NO-cGMP-mediated events underlying chronic head pain that could be the target of a new therapeutic approach which should be investigated.
Collapse
Affiliation(s)
- V Gallai
- Interuniversity Centre for the Study of Headache and Neurotransmitter Disorders, Perugia, Italy
| | | | | | | | | | | |
Collapse
|
31
|
Coppola F, Ferrari B, Barusi L, Poti E, Lanna M. Increased follicular vascular endothelial growth factor (VEGF) as paracrine reaction to hostile follicular environment in profound GnRH agonist suppression in ART. Fertil Steril 2001. [DOI: 10.1016/s0015-0282(01)02278-6] [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: 11/15/2022]
|
32
|
Salvatore P, Gariboldi S, Offidani A, Coppola F, Amore M, Maggini C. Psychopathology, personality, and marital relationship in patients undergoing in vitro fertilization procedures. Fertil Steril 2001; 75:1119-25. [PMID: 11384636 DOI: 10.1016/s0015-0282(01)01775-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To compare the psychopathology, personality features, and marital relationships of women undergoing in vitro fertilization (IVF) with those of control patients, and to compare IVF inductees with program veterans. DESIGN Cross-sectional clinical study. SETTING A university hospital. PATIENT(S) One hundred and one women undergoing IVF treatment. INTERVENTION(S) Psychometric tests were administered at first visit (baseline) of index treatment cycle. MAIN OUTCOME MEASURE(S) Achievement of pregnancy. RESULT(S) Women undergoing IVF show higher levels of anxiety and emotional tension than do controls. Although the infertile women showed no abnormal personality dimensions, the IVF group did have a particular psychological profile and a different marital relationship pattern when compared with the control participants. Between IVF veterans and inductees, there are significant differences with respect to psychopathology, psychological dimensions, and couple dynamics. The achievement of pregnancy is not associated with any special psychopathological, personality, or marital characteristics among the IVF women. CONCLUSION(S) The most crucial period in IVF procedures may immediately follow the end of the first cycle because of the high risk of patients dropping out of the program. To determine the most effective supporting therapies for women undergoing fertilization procedures it could be useful to consider the psychological and relational differences between veterans and inductees.
Collapse
Affiliation(s)
- P Salvatore
- Instituto di Clinica Psichiatrica, University of Parma, Parma, Italy
| | | | | | | | | | | |
Collapse
|
33
|
Albini Riccioli L, Pazienza L, Coppola F, Molinari M, Nocco AM, Fusari M, Papa S, Gavelli G. [Lung base disease after orthotopic liver transplantation. Functional ultrasonography of the diaphragm and correlated alterations]. Radiol Med 2001; 101:133-9. [PMID: 11402950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
PURPOSE To demonstrate the greater accuracy of B- and M-probe ultrasound (US) compared to traditional examinations in the evaluation of diseases of the lung-base, a frequent localisation of pathology in patients undergoing orthotopic liver transplantation (OLT). MATERIAL AND METHODS Twenty-one patients, 13 males and 8 females aged 24 to 63, awaiting OLT were examined using the three modalities. B-mode US was performed as a preliminary study to identify the districts of interest and the profile of the diaphragm wall, searching for any related alterations. This was followed by M-mode US, with an approach along the left and right posterior axillary lines during spontaneous and forced maximal expiration, to calculate and document the curve representing diaphragm mobility. All patients were also studied pre- and postoperatively by standard chest X-ray double projections. The parameters evaluated by US were diaphragmatic inspiratory slant and diaphragm range while the standard chest X-ray was used to assess hypoventilation, diaphragm range and pleural effusion. RESULTS For each parameter considered we obtained the following results: presence or absence of pleural effusion (sensitivity: 100% with US vs 64% with chest X-ray) and diaphragmatic hypomobility with related hypoventilatory phenomena (sensitivity: 85% with US, with 15% false negatives). In 15 cases the chest X-ray revealed a clear elevation of the diaphragm, a finding supported by US in 11 cases. In 7 cases US showed a reduction in the diaphragm range curve without, however, any radiological evidence of any ventilatory dysfunction of the lung base and/or elevation of the corresponding hemidiaphragm. CONCLUSION Our results suggest that radiology, B-mode US and color Doppler US, which are widely used for monitoring OLT patients, can be usefully integrated by M-mode US to evaluate diaphragmatic mobility both pre- and post-operatively. This method is fast, easy to use and widely available.
Collapse
Affiliation(s)
- L Albini Riccioli
- Dipartimento Clinico di Scienze Radiologiche e Istocitopatologiche, Radiodiagnostica III, Via Massarenti n 9, 40100 Bologna BO
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Gruppioni F, Piolanti M, Coppola F, Papa S, Di Simone M, Albini L, Mattioli S, Gavelli G. [Intraoperative echography in the localization of pulmonary nodules during video-assisted thoracic surgery]. Radiol Med 2000; 100:223-8. [PMID: 11155447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
PURPOSE One of the major limitations of thoracoscopic resection of lung nodules is localization of the target, especially when the lesion is deep or very small: we investigated the efficacy of US as a technique for intraoperative localization. MATERIAL AND METHODS We examined 11 patients who underwent diagnostic and/or curative thoracoscopic resection of benign or malignant, primary or metastatic lung nodules. The study was preceded by a preliminary phase in which we examined with US 5 patients that underwent thoracotomy. A multifrequency laparoscopic US probe with a deflectable linear headpiece mounted on a portable Esaote-Hitachi Spazio US unit was used. RESULTS The US exploration of the lung requires the complete collapse of the parenchyma and is therefore particularly difficult in patients with severe chronic obstructive pulmonary disease (COPD). In the patients examined during thoracotomy US showed all the lesions but one 7-mm nodule in an emphysematous patient in whom complete parenchyma collapse could not be achieved. Also in the patients examined during thoracoscopy US detected all the targets (13/13), even a 13-mm metastatic nodule which had been visualized preoperatively by PET only. The smallest lesion found was a 4-mm fibrosarcoma metastasis. The mean time to achieve adequate lung collapse was about 40 minutes from selective exclusion of the affected lung. DISCUSSION Thoracoscopic US has been recently introduced for the intraoperative localization of pulmonary nodules. In our experience this technique is helpful in localizing the targets, assessing the extent of surgical resection and studying possible vascular involvement. Considering the easy execution, the low cost, the lack of contraindications and complications of the technique and its accuracy when performed under optimal technical conditions, we think there are enough reasons to investigate this approach further. CONCLUSIONS Intraoperative US proved to be a useful technique of easy execution, even though it is heavily operator-dependent and limited in patients with severe COPD.
Collapse
Affiliation(s)
- F Gruppioni
- Dipartimento Clinico di Scienze Radiologiche ed Istocitopatologiche, Radiodiagnostica III, Policlinico S. Orsola-Malpighi dell'Università , Bologna
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Albini Riccioli L, Coppola F, Pazienza L, Piolanti M, Papa S. [Pulmonary invasive inflammatory pseudotumor. Description of a case]. Radiol Med 2000; 100:282-4. [PMID: 11155457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- L Albini Riccioli
- Dipartimento Clinico di Scienze Radiologiche e Istocitopatologiche, Radiologia III, Policlinico S. Orsola-Malpighi, Bologna
| | | | | | | | | |
Collapse
|
36
|
Richardet E, Pedraza C, Mickiewicz E, Lerzo G, Bonamasa M, Coppola F, Elli A, Uranga G, Jovtis S, Bruno M, Ventriglia M, Cuevas MA, Alvarez AM, Suarez LA, Fein L. Uracil/tegafur plus oral calcium folinate in advanced breast cancer. Oncology (Williston Park) 1999; 13:96-7. [PMID: 10442373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Uracil and tegafur (in a molar ratio of 4:1 [UFT]) has proven activity against breast cancer and is delivered in an easy-to-administer oral formulation. Orzel, which combines UFT with the oral biomodulator, calcium folinate, may provide even greater antitumor efficacy against breast cancer. Here, we describe the preliminary results of this phase II trial investigating the feasibility of 250 mg/m2/day of UFT plus 45 mg/day of oral calcium folinate administered to highly pretreated patients with advanced breast cancer. The results indicate a highly tolerable regimen and an overall response rate of 27.8% in a group of poor-prognosis patients. These findings warrant continued investigation.
Collapse
|
37
|
Affiliation(s)
- A Cervio
- Neurology Department, Raul Carrea Institute for Neurological Research-Foundation Against Childhood Neurological Diseases, Buenos Aires, Argentina
| | | | | | | | | |
Collapse
|
38
|
Blajman C, Balbiani L, Block J, Coppola F, Chacon R, Fein L, Bonicatto S, Alvarez A, Schmilovich A, Delgado FM. A prospective, randomized Phase III trial comparing combination chemotherapy with cyclophosphamide, doxorubicin, and 5-fluorouracil with vinorelbine plus doxorubicin in the treatment of advanced breast carcinoma. Cancer 1999; 85:1091-7. [PMID: 10091793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND A prospective, multicenter, randomized, Phase III trial comparing the efficacy of combination chemotherapy with 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC) with a combination of vinorelbine and doxorubicin (NA) in the treatment of patients with advanced breast carcinoma was undertaken. METHODS One hundred and seventy-seven patients who previously were untreated for recurrent or metastatic breast carcinoma were entered into the study; 7 patients could not be assessed. The final analysis relates to 85 patients who were treated with FAC and 85 patients who were treated with NA, of whom 21 (25%) and 44 (52%), respectively, had received prior adjuvant chemotherapy. RESULTS The overall response rates were similar for the two treatments and were unaffected by prior exposure to adjuvant therapy; overall response rate (ORR) for FAC was 74% (95% confidence interval [95% CI], 65-83%), and the ORR for NA was 75% (95% CI, 66-84%). The activity of NA in patients with liver involvement was greater than that of FAC in terms of survival. Overall survivals were similar, with a median of 17.3 months for patients receiving FAC and 17.8 months for patients receiving NA. Severe toxicity was uncommon with World Health Organization Grade 3-4 neutropenia affecting only 7% of patients in each arm of the study. NA was associated with a higher incidence of mild to moderate constipation, neurotoxicity, and phlebitis, whereas FAC produced a slight excess of mild cardiotoxicity. CONCLUSIONS The efficacy of these two regimens is very similar, although NA may be more active in a subset of patients with visceral metastatic disease, particularly liver involvement. It is clear that, in a direct comparison with an established three-drug regimen, the newer two-drug combination of NA demonstrated equivalent activity with no significant excess of Grade 3-4 toxicity.
Collapse
Affiliation(s)
- C Blajman
- Argentina Oncology Group, Buenos Aires
| | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Blajman C, Balbiani L, Block J, Coppola F, Chacon R, Fein L, Bonicatto S, Alvarez A, Schmilovich A, Delgado FM. A prospective, randomized phase III trial comparing combination chemotherapy with cyclophosphamide, doxorubicin, and 5-fluorouracil with vinorelbine plus doxorubicin in the treatment of advanced breast carcinoma. Cancer 1999. [DOI: 10.1002/(sici)1097-0142(19990301)85:5<1091::aid-cncr12>3.0.co;2-a] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
40
|
Senore C, Segnan N, Rossini FP, Ferraris R, Cavallero M, Coppola F, Pennazio M, Atkin WS. Screening for colorectal cancer by once only sigmoidoscopy: a feasibility study in Turin, Italy. J Med Screen 1996; 3:72-8. [PMID: 8849763 DOI: 10.1177/096914139600300205] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To assess the impact on compliance of three invitation methods, as well as the acceptability and efficacy of two bowel preparation regimens, for endoscopic screening in the general population. METHODS 1170 subjects (men and women aged 55 to 59, in the rosters of a sample of general practitioners (GPs) in Turin), were randomly allocated to one of three invitation groups (A: personal letter, signed by GP, with a pre-fixed appointment; B: same as for A + letter supporting the study by a well known scientist; C: letter signed by the study coordinator, NS) and two preparation regimens (i: one enema, self administered at home two hours before the test; ii: two enemas, administered the night before and two hours before the test). A postal reminder was mailed to non-attenders. A sample of non-responders was contacted for a telephone interview by a trained nurse. Written consent was obtained from all subjects undergoing the test. RESULTS A total of 278 subjects attended for sigmoidoscopic screening. An invitation from the GP alone produced the highest response rate (compliance: A = 29.3%; B = 24.9%; C = 26.8%). A single enema was as effective as two enemas in achieving satisfactory preparation for the test: the proportion of subjects invited to repeat the test was 8.1% in the single enema group, and 9.6% in the group receiving two enemas. CONCLUSIONS Compliance with this screening procedure tends to be low. One enema, self administered two hours before sigmoidoscopy, can ensure a satisfactory bowel preparation.
Collapse
Affiliation(s)
- C Senore
- Unita' di Epidemiologia dei Tumori, Dipartimento di Oncologia, Ospedale S Giovanni As, Torino, Italy
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Pezzarossa A, Orlandi N, Baggi V, Dazzi D, Ricciarelli E, Coppola F. Effects of maternal weight variations and gestational diabetes mellitus on neonatal birth weight. J Diabetes Complications 1996; 10:78-83. [PMID: 8777334 DOI: 10.1016/1056-8727(94)00065-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We evaluated the effects of gestational weight gain on neonatal birthweight women in whom gestational diabetes mellitus (GDM) was diagnosed after the 32nd week of gestation. The prevalence of macrosomia, the birthweight differences from 50th percentile value of a reference population, and the relationships among plasma glucose values during oral glucose tolerance test and neonatal birthweight were evaluated in 60 newborns from mothers with gestational diabetes mellitus divided according to pregravid body-mass index. Serving as controls were 132 newborns of mothers with normal glucose tolerance. The prevalence of macrosomia was higher in the GDM group; the neonatal birthweight difference above 50th percentile value was higher in newborns of mothers with GDM; and a strong relationship between maternal gestational weight gain and neonatal birth weight was present in all pregnant women. In conclusion, (1) the gestational weight gain is a good predictor of neonatal birth weight in all pregnant women; (2) GDM enhances the increase in neonatal size induced by excessive gestational weight gain alone, and (3) a weight gain of more than 9 kg makes the relative risk of macrosomia twofold higher in GDM than in control mothers.
Collapse
Affiliation(s)
- A Pezzarossa
- Chair of Endocrinology, University of Parma, Italy
| | | | | | | | | | | |
Collapse
|
42
|
Tridenti G, Bruni V, Ghirardini G, Gualerzi C, Coppola F, Benassi L, Vadora E. Double uterus with a blind hemivagina and ipsilateral renal agenesis: Clinical variants in three adolescent women: Case reports and literature review. ACTA ACUST UNITED AC 1995. [DOI: 10.1016/s0932-8610(19)80143-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
43
|
Recchia S, Coppola F, Ferrari A, Righi D, Zanon E, Verme G. Fistulosphincterotomy in the endoscopic approach to biliary tract diseases. Am J Gastroenterol 1992; 87:1607-9. [PMID: 1442683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We report our experience with 49 patients who underwent fistulosphincterotomy (FS) after cannulation of the common bile duct (CBD) by standard approaches had failed, due to suspected CBD obstruction. Only 4% of our cases turned out to have no biliary obstruction at all. The morbidity rate was 16%, and the mortality rate was 2%. In our series, FS raised the success rate of CBD cannulation from 90% to 96%. Ninety-five percent of successful cannulations were followed by endoscopic treatment. There were no cases of perforation or hemorrhage, and no difference in the success rate between FS in flat papillas and FS in bulging papillas, thanks, perhaps, to the technique we used. Our findings would indicate that FS is a useful procedure involving additional but not prohibitive risks. Nonetheless, it should be used only when CBD obstruction is strongly suspected and standard methods are not successful.
Collapse
Affiliation(s)
- S Recchia
- Divisione di Gastroenterologia, Ospedale San Giovanni Battista, Torino, Italy
| | | | | | | | | | | |
Collapse
|
44
|
Calestani V, Filippini F, Merialdi M, Coppola F, Raboni S, Vadora E. [Resectoscopic endometrial ablation in the treatment of recurrent, dysfunctional menometrorrhagia: our experience]. Ann Ostet Ginecol Med Perinat 1992; 113:195-200. [PMID: 1345437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
UNLABELLED Advances in hysteroscopic surgery provide additional options to hysterectomy for the treatment of dysfunctional uterine bleeding resistant to medical therapy and multiple curettages. Two techniques are now available: (a) Resectoscopic endometrial ablation. (b) Electrocoagulation or laser photovaporisation of endometrium. 52 patients underwent resectoscopic endometrial ablation at the Gynaecology Department of Parma University from January 1991 to April 1993. All patients suffered from dysfunctional uterine bleeding without atypical histologic findings on endometrial biopsies and had a normal shaped uterine cavity. 41 patients were subsequently contacted for follow-up. Follow-up period ranged from a minimum of 3 months to a maximum of 24 months. 78.1% of the patients reported a satisfactory outcome (amenorrhea or decreased menstrual flow). No operative complication occurred. Post operative complications included one case of hematometra. CONCLUSIONS resectoscopic endometrial ablation is an advantageous technique but our follow-up period is relatively short and long term sequelae have yet to be determined.
Collapse
Affiliation(s)
- V Calestani
- Clinica Ostetrica e Ginecologica, Università degli Studi di Parma
| | | | | | | | | | | |
Collapse
|
45
|
Affiliation(s)
- F Coppola
- Division of Gastroenterology, Ospedale San Giovanni Battista, Torino, Italy
| | | | | | | |
Collapse
|
46
|
Ferrari A, Recchia S, Coppola F, Perotto C, Campra D, Gandini G, Righi D, De Maio G, Verme G. [Endoscopic therapy of giant choledochal calculosis]. MINERVA GASTROENTERO 1991; 37:157-61. [PMID: 1790204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The paper reports the results of conventional endoscopic treatment in 100 consecutive cases of giant lithiasis of the common bile duct. A giant calculus is one whose dimensions exceed 2 cm. Endoscopic therapy proved successful in 73% of cases, with an 8% incidence of complications. The success of endoscopic treatment is related to the anatomical conditions of the biliary tract and the diameter of calculi. Mechanical lithotripsy has proved efficacious in all cases where it was used, whereas poor results were obtained using MTBE infusion through a naso-biliary tube. ESWL provided encouraging results. Cases which were not resolved using endoscopic methods were treated using intervention radiology or surgery, or both.
Collapse
Affiliation(s)
- A Ferrari
- Divisione di Gastroenterologia, Ospedale Molinette, Università degli Studi di Torino
| | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Affiliation(s)
- L Delsedime
- Department of Biomedical Sciences and Human Oncology, University of Turin, Italy
| | | | | |
Collapse
|
48
|
Bacilieri P, Remiddi E, Todesco GM, Bernaschi M, Cabasino S, Cabibbo N, Fernández LA, Marinari E, Paolucci P, Parisi G, Salina G, Tarancón A, Coppola F, Lombardo MP, Simeone E, Tripiccione R, Fiorentini G, Lai A, Marchesini PA, Marzano F, Rapuano F, Tross W. Order of the deconfining phase transition in pure-gauge QCD. Phys Rev Lett 1988; 61:1545-1548. [PMID: 10038833 DOI: 10.1103/physrevlett.61.1545] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
|
49
|
Coppola F, Greco R, Martuscelli E, Kammer H, Kummerlowe C. Mechanical properties and morphology of isotactic polypropylene/ethylene-propylene copolymer blends. POLYMER 1987. [DOI: 10.1016/0032-3861(87)90317-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
50
|
Cimmino S, Coppola F, D'Orazio L, Greco R, Maglio G, Malinconico M, Mancarella C, Martuscelli E, Ragosta G. Ternary nylon-6/rubber/modified rubber blends: Effect of the mixing procedure on morphology, mechanical and impact properties. POLYMER 1986. [DOI: 10.1016/0032-3861(86)90175-8] [Citation(s) in RCA: 88] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|