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Carlà MM, Sammarco MG, Giannuzzi F, Savino G, Blasi MA, Fionda B, Tagliaferri L, Pagliara MM. Exclusive Ru-106 brachytherapy for the management of a recurrent corneo: Conjunctival squamous cell carcinoma. Brachytherapy 2024:S1538-4721(24)00018-7. [PMID: 38556408 DOI: 10.1016/j.brachy.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/18/2023] [Accepted: 02/12/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND We report a case of personalized exclusive brachytherapy treatment for the management of a highly recurrent squamous cell conjunctival carcinoma with corneal invasion. CASE DESCRIPTION This is a case of a Caucasian 81-years-old man who presented 10 years ago to our clinic with a pink-white para-limbal mass with dilated feeder arteries and mild leukoplakia. Excisional biopsy confirmed the presence of conjunctival intraepithelial neoplasia (CIN). Successively, he underwent two 4-weeks cycles of Mytomicin C topical therapy and a second excisional surgery, due to several recurrences of the lesion. At the last relapse, the pink-white peri-limbic mass which invaded the corneal limbus, determining corneal opacification from 5- to 7-clock hours, was confirmed by anterior segment optical coherence tomography (AS-OCT). Due to resistance to MMC therapy and chronic epitheliopathy, an AS-OCT guided exclusive radiotherapy plan was set: a Rhutenium-106 CCD plaque was applied directly over the afflicted corneal surface, the corneal limbus and the neighboring sclera for 24 hours. The remission of both conjunctival and corneal malignancy was complete 2 months after surgery and no signs of recurrence were highlighted at AS-OCT analysis at the 2-year follow up. CONCLUSION Brachytherapy treatment showed optimal management of both corneal and conjunctival involvement, with a free-of-disease follow-up of 24-months. This result suggests that, in specific conditions, Ru-106 brachytherapy could be an effective option of treatment even if not associated with surgical excision.
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Affiliation(s)
- Matteo Mario Carlà
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Catholic University "Sacro Cuore", Rome, Italy.
| | - Maria Grazia Sammarco
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Catholic University "Sacro Cuore", Rome, Italy
| | - Federico Giannuzzi
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Catholic University "Sacro Cuore", Rome, Italy
| | - Gustavo Savino
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Catholic University "Sacro Cuore", Rome, Italy
| | - Maria Antonietta Blasi
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Catholic University "Sacro Cuore", Rome, Italy
| | - Bruno Fionda
- Catholic University "Sacro Cuore", Rome, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Gemelli ART (Advanced Radiation Therapy) - Interventional Oncology Center (IOC), Rome, Italy
| | - Luca Tagliaferri
- Catholic University "Sacro Cuore", Rome, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Gemelli ART (Advanced Radiation Therapy) - Interventional Oncology Center (IOC), Rome, Italy
| | - Monica Maria Pagliara
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Catholic University "Sacro Cuore", Rome, Italy
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Giannuzzi F, Blasi MA, Caputo CG, Sammarco MG, Carlà MM, Savino G, Rizzo S, Pagliara MM. Incidental Finding of Suprachoroidal Space's Silicone Oil Migration: A Tumor-Mimicking Lesion and Its Clinical Management. Ophthalmic Surg Lasers Imaging Retina 2024; 55:104-108. [PMID: 38198610 DOI: 10.3928/23258160-20231129-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
The migration of silicone oil into the suprachoroidal region is a rare complication of vitrectomy. A 70-year-old man was admitted to our ocular oncology unit with a choroidal elevation in the nasal area, as well as signs of pars plana vitrectomy surgery performed about 5 years ago for retinal detachment. The patient underwent ocular ultrasound, visual field test, fluorangiography, and magnetic resonance imaging, which led to the diagnosis of silicone oil migration in the suprachoroidal space. Silicone oil may move into the suprachoroidal area, mimicking choroidal neoformation. It is important to have a comprehensive diagnosis and then set up the appropriate treatment. [Ophthalmic Surg Lasers Imaging Retina 2024;55:104-108.].
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Cuffaro G, Fionda B, Piccinni F, Pagliara MM, Sammarco MG, Blasi MA, Molinario C, Castri F, Tagliaferri L, Massi D, Savino G. Post-operative interventional radiotherapy (brachytherapy) in advanced ocular surface and eyelid tumors as an alternative to surgical retreatment. Eur J Ophthalmol 2023:11206721231215105. [PMID: 38105586 DOI: 10.1177/11206721231215105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
PURPOSE The main purpose of treatment of advanced ocular surface and periocular malignant tumors is to eradicate the tumor while trying to preserve visual function and aesthetics. Our purpose is to describe the outcome of a retrospective case series of 10 patients with advanced ocular surface and periocular tumors treated surgically in first instance and then with postoperative interventional radiotherapy (IRT/Brachiterapy). MATERIALS AND METHODS We describe the clinicopathological features, treatments and outcome, in a retrospective case series of 10 patients with advanced tumors involving ocular surface (staging ≥ T2) and eyelids (staging ≥ T3), with involvement of periocular and/or orbit tissues. Patients were first surgically treated, most of them with incomplete excision, and then underwent a post-operative interventional radiotherapy (IRT/Brachytherapy) as an alternative to more invasive and disfiguring surgical retreatment. Tumor location, risk factors, staging, histological features, and follow-up timing were analyzed. RESULTS Three patients had advanced eyelid basal cell carcinomas, 2 patients were diagnosed with eyelid and conjunctival squamous cell carcinomas, 3 as sebaceous carcinomas, and 2 as primary conjunctival melanomas. The mean follow-up time from IRT to last clinical follow-up was 58.6 weeks, range 28.4-168 (median 43.65, IQR 28.9-72.9). Two patients - one with ocular surface SCC, the other with conjunctival melanoma - had a local recurrence 23.4 and 40,9 weeks after IRT, respectively. An overview of the current knowledge on adjuvant or post-operative IRT is also provided. CONCLUSIONS IRT can be considered an effective therapeutic option to avoid more invasive surgical retreatment in advanced tumors involving eyelids and ocular surface.
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Affiliation(s)
- Giovanni Cuffaro
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Bruno Fionda
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fabrizio Piccinni
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Monica Maria Pagliara
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Grazia Sammarco
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Antonietta Blasi
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Clelia Molinario
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Federica Castri
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Tagliaferri
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniela Massi
- Section of Pathology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Gustavo Savino
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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Peyronel F, Haroche J, Campochiaro C, Pegoraro F, Amoura Z, Tomelleri A, Mazzariol M, Papo M, Cavalli G, Benigno GD, Fenaroli P, Grigoratos C, Mengoli MC, Bonometti A, Berti E, Savino G, Cives M, Neri I, Pacinella G, Tuttolomondo A, Marano M, Muratore F, Manfredi A, Broccoli A, Zinzani PL, Didona B, Massaccesi C, Buono A, Ammirati E, Di Lernia V, Dagna L, Vaglio A, Cohen-Aubart F. Epidemiology and geographic clustering of Erdheim-Chester disease in Italy and France. Blood 2023; 142:2119-2123. [PMID: 37871575 DOI: 10.1182/blood.2023021670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/07/2023] [Accepted: 09/24/2023] [Indexed: 10/25/2023] Open
Abstract
This geoepidemiological study, performed in Italy and France, shows that Erdheim-Chester disease is increasingly diagnosed and cases cluster in specific geographic areas, namely southern Italy and central France. Disease frequency inversely correlates with the Human Development Index.
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Affiliation(s)
- Francesco Peyronel
- Nephrology and Dialysis Unit, Azienda Ospedaliera Universitaria Meyer IRCCS, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Julien Haroche
- Sorbonne University, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Internal Medicine Department 2, French National Referral Center for Rare Systemic Diseases and Histiocytoses, Centre d'immunologie et des maladies infectieuses (Cimi INSERM Unité Mixte de Recherche Scientifique-1135), Paris, France
| | - Corrado Campochiaro
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | | | - Zahir Amoura
- Sorbonne University, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Internal Medicine Department 2, French National Referral Center for Rare Systemic Diseases and Histiocytoses, Centre d'immunologie et des maladies infectieuses (Cimi INSERM Unité Mixte de Recherche Scientifique-1135), Paris, France
| | - Alessandro Tomelleri
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | | | - Matthias Papo
- Sorbonne University, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Internal Medicine Department 2, French National Referral Center for Rare Systemic Diseases and Histiocytoses, Centre d'immunologie et des maladies infectieuses (Cimi INSERM Unité Mixte de Recherche Scientifique-1135), Paris, France
| | - Giulio Cavalli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy
| | | | - Paride Fenaroli
- Nephrology and Dialysis Unit, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Reggio Emilia, Reggio Emilia, Italy
| | | | - Maria C Mengoli
- Operative Unit of Pathology, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Reggio Emilia, Reggio Emilia, Italy
| | - Arturo Bonometti
- Pathology Unit, Istituto di Ricovero e Cura a Carattere Scientifico Humanitas Clinical and Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Emilio Berti
- Dermatology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gustavo Savino
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Università Cattolica del Sacro Cuore, UCSC, Rome, Italy
| | - Mauro Cives
- Division of Medical Oncology, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Bari, Italy
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro," Bari, Italy
| | - Iria Neri
- Dermatology Unit, Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliero Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Gaetano Pacinella
- Internal Medicine and Stroke Care Ward, Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine G. D'Alessandro, University of Palermo, Palermo, Italy
| | - Antonino Tuttolomondo
- Internal Medicine and Stroke Care Ward, Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine G. D'Alessandro, University of Palermo, Palermo, Italy
| | - Massimo Marano
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Francesco Muratore
- Rheumatology Unit, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico di Reggio Emilia, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Andreina Manfredi
- Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Policlinico of Modena, Modena, Italy
| | - Alessandro Broccoli
- Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Pier L Zinzani
- Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Biagio Didona
- Istituto Dermopatico dell'Immacolata-Istituto di Ricovero e Cura a Carattere Scientifico Rare Disease Center, Rome, Italy
| | | | - Andrea Buono
- De Gasperis Cardio Center, Transplant Center, Niguarda Hospital, Milan, Italy
| | - Enrico Ammirati
- De Gasperis Cardio Center, Transplant Center, Niguarda Hospital, Milan, Italy
- Department of Health Sciences, University of Milan-Bicocca, Monza, Italy
| | - Vito Di Lernia
- Dermatology Unit, S. Maria Nuova, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Reggio Emilia, Italy
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Augusto Vaglio
- Nephrology and Dialysis Unit, Azienda Ospedaliera Universitaria Meyer IRCCS, Florence, Italy
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio," University of Florence, Florence, Italy
| | - Fleur Cohen-Aubart
- Sorbonne University, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Internal Medicine Department 2, French National Referral Center for Rare Systemic Diseases and Histiocytoses, Centre d'immunologie et des maladies infectieuses (Cimi INSERM Unité Mixte de Recherche Scientifique-1135), Paris, France
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Sangiorgi E, Giannuzzi F, Molinario C, Rapari G, Riccio M, Cuffaro G, Castri F, Benvenuto R, Genuardi M, Massi D, Savino G. Base-Excision Repair Mutational Signature in Two Sebaceous Carcinomas of the Eyelid. Genes (Basel) 2023; 14:2055. [PMID: 38002998 PMCID: PMC10671510 DOI: 10.3390/genes14112055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Personalized medicine aims to develop tailored treatments for individual patients based on specific mutations present in the affected organ. This approach has proven paramount in cancer treatment, as each tumor carries distinct driver mutations that respond to targeted drugs and, in some cases, may confer resistance to other therapies. Particularly for rare conditions, personalized medicine has the potential to revolutionize treatment strategies. Rare cancers often lack extensive datasets of molecular and pathological information, large-scale trials for novel therapies, and established treatment guidelines. Consequently, surgery is frequently the only viable option for many rare tumors, when feasible, as traditional multimodal approaches employed for more common cancers often play a limited role. Sebaceous carcinoma of the eyelid is an exceptionally rare cancer affecting the eye's adnexal tissues, most frequently reported in Asia, but whose prevalence is significantly increasing even in Europe and the US. The sole established curative treatment is surgical excision, which can lead to significant disfigurement. In cases of metastatic sebaceous carcinoma, validated drug options are currently lacking. In this project, we set out to characterize the mutational landscape of two sebaceous carcinomas of the eyelid following surgical excision. Utilizing available bioinformatics tools, we demonstrated our ability to identify common features promptly and accurately in both tumors. These features included a Base-Excision Repair mutational signature, a notably high tumor mutational burden, and key driver mutations in somatic tissues. These findings had not been previously reported in similar studies. This report underscores how, in the case of rare tumors, it is possible to comprehensively characterize the mutational landscape of each individual case, potentially opening doors to targeted therapeutic options.
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Affiliation(s)
- Eugenio Sangiorgi
- Sezione di Medicina Genomica, Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (G.R.); (M.R.); (M.G.)
| | - Federico Giannuzzi
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (F.G.); (G.C.); (G.S.)
| | - Clelia Molinario
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (C.M.); (F.C.); (R.B.)
| | - Giulia Rapari
- Sezione di Medicina Genomica, Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (G.R.); (M.R.); (M.G.)
| | - Melania Riccio
- Sezione di Medicina Genomica, Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (G.R.); (M.R.); (M.G.)
| | - Giovanni Cuffaro
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (F.G.); (G.C.); (G.S.)
| | - Federica Castri
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (C.M.); (F.C.); (R.B.)
| | - Roberta Benvenuto
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (C.M.); (F.C.); (R.B.)
| | - Maurizio Genuardi
- Sezione di Medicina Genomica, Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (G.R.); (M.R.); (M.G.)
- UOC Genetica Medica, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Roma, Italy
| | - Daniela Massi
- Section of Pathology, Department of Health Sciences, University of Florence, 50121 Florence, Italy;
| | - Gustavo Savino
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (F.G.); (G.C.); (G.S.)
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Savino G, Gambini G, Scorcia G, Comi N, Fossataro C, Stanislao Rizzo. Orbital myositis and scleritis after anti-SARS-CoV-2 mRNA vaccines: A report of three cases. Eur J Ophthalmol 2023; 33:NP29-NP34. [PMID: 36062603 PMCID: PMC9444811 DOI: 10.1177/11206721221123780] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 07/05/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE To report three cases of ocular myositis and scleritis, bilateral scleritis and unilateral single muscle myositis after mRNA COVID-19 vaccination. METHODS Case series of three patients who presented to the Orbit Outpatient Service of Fondazione Policlinico Universitario A. Gemelli with a history of unilateral proptosis, diplopia and pain, bilateral red eye and pain during eye movements and unilateral proptosis and inconstant diplopia respectively with onset 5-10 days after m-RNA COVID-19 vaccine. A thorough hematologic work up and orbital contrast enhanced magnetic resonance imaging (MRI) in patients with proptosis was performed. RESULTS Patients were females, 64, 58 and 45 years old respectively. MRI showed enlargement of all right rectus muscles, with both muscle belly and insertion involvement in the first case associated to right scleritis. A bilateral scleritis was diagnosed in the second patient and a single muscle myositis in the third patient. Serological tests excluded thyroid diseases. The first and second patient were treated respectively with oral and topical glucorticoids with a complete clinical response. Two 2 cycles of oral non-steroidal anti-inflammatory drugs were administered to the third patient with a partial response. CONCLUSION As far as we know these are the first report of orbital myositis and scleritis presenting after mRNA BNT162b2 vaccine (Pfizer/BioNTech) and mRNA-1273-(Moderna) vaccine, an uncommon effect of a likely autoimmune reaction triggered by the virus antigen.
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Affiliation(s)
- Gustavo Savino
- Ophthalmology Unit, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Italy
- Catholic University “Sacro Cuore”, Rome, Italy
| | - Gloria Gambini
- Ophthalmology Unit, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Italy
- Catholic University “Sacro Cuore”, Rome, Italy
| | - Giovanni Scorcia
- Department of Ophthalmology, Magna Græcia University, Catanzaro, Italy
| | - Nicolino Comi
- Azienda Ospadaliera Universitaria Mater Domini, Catanzaro, Italy
| | - Claudia Fossataro
- Ophthalmology Unit, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Italy
- Catholic University “Sacro Cuore”, Rome, Italy
| | - Stanislao Rizzo
- Ophthalmology Unit, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, Rome, Italy
- Catholic University “Sacro Cuore”, Rome, Italy
- Department of Ophthalmology, Magna Græcia University, Catanzaro, Italy
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Chiricozzi A, Di Nardo L, Gori N, Antonelli F, Pinto L, Cuffaro G, Piro G, Savino G, Tortora G, Peris K. Dupilumab-associated ocular adverse events are predicted by low tear break-up time and correlate with high IL-33 tear concentrations in patients with atopic dermatitis. Exp Dermatol 2023; 32:1531-1537. [PMID: 37357541 DOI: 10.1111/exd.14859] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/24/2023] [Accepted: 06/09/2023] [Indexed: 06/27/2023]
Abstract
Dupilumab, blocking IL-4 and IL-13 signals, improves atopic dermatitis and Quality of Life but might be also associated with the occurrence of ocular adverse events (OAEs). The main objective of our prospective study was to characterize the cytokine and chemokine profile in the tear fluid of dupilumab-treated patients with moderate-to- severe atopic dermatitis and to identify biomarkers predicting the occurrence of ocular adverse events. Patients with moderate-to-severe AD underwent dermatological and ophthalmological evaluation at the baseline (T0) and week 16 or at the time of an eventual ocular adverse events (T1). A multiplex immunoassay measuring multiple cytokines and chemokines in the tear fluid extracted during ocular examination at both T0 and T1 was performed. Thirty-nine patients with moderate-to-severe AD and treated with dupilumab were included in the study. Baseline tear fluid levels revealed a significantly higher concentration of type 2 cytokines and chemokines in AD patients than healthy controls. The occurrence of ocular adverse events during dupilumab therapy was associated with a significant increase of IL-33 tear fluid levels and a significantly lower tear break-up time, this latter also identified as predictive factor. Our findings suggest that the ophthalmological examination should be considered a valid support to identify patients at risk of developing OAEs and to provide their appropriate management.
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Affiliation(s)
- A Chiricozzi
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - L Di Nardo
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - N Gori
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - F Antonelli
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - L Pinto
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - G Cuffaro
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - G Piro
- Medical Oncology, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - G Savino
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Ophthalmology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Tortora
- Medical Oncology, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Medical Oncology, Department of Translational Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - K Peris
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
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8
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Huertas-Leyva P, Savino G, Baldanzini N, Pierini M. Does ABS ensure good performance in emergency braking for less skilled motorcyclists? Accid Anal Prev 2023; 190:107148. [PMID: 37348453 DOI: 10.1016/j.aap.2023.107148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/14/2023] [Accepted: 05/30/2023] [Indexed: 06/24/2023]
Abstract
This study aims to investigate whether motorcyclists are able to use the full potential of anti-lock braking systems (ABS) in demanding braking situations that maintain the natural coupling of action and perception of emergency events, or whether instead the lack of braking skills in riders makes ABS almost ineffective and comparable to non-ABS brakes on dry pavement. Six experienced riders performed two experimental tests. First test included 12 emergency braking trials in a realistic scenario using a mock-up of an intersection conflict with a car initiating a left turn manoeuvre across the path (LTAP) of a motorcycle approaching from the opposite direction as an unpredicted moving hazard. Second test included three trials in a planned self-timed hard braking. The speed at the onset of braking was 35-45 km/h. The braking performance was measured from the initiation of brake pressure until the full stop of the vehicle. Front wheel ABS usage was determined by the pressure in the master cylinder and wheel callipers. The testing resulted in 85 data runs with full stop braking manoeuvres. Results revealed four categories of riders classified by their front wheel ABS usage during the emergency braking tests, which included two riders who underused front wheel ABS (9.6% and 27.4% of braking time on average). The worst case resulted in a significantly longer braking distance (braking deceleration of 5.2 m/s2). The highest skilled rider, who reached initial jerks close to 30 m/s3, used the ABS of the front wheel 93.7% of the braking time on average, resulting in a braking deceleration of 7.71 m/s2. Overall, the best braking performance was achieved in trials where the front ABS was activated for more than 80% of the braking. In planned self-timed hard braking test, where riders have more time to plan the braking manoeuvre, the experience rider with lowest performance during the emergency braking test improved braking efficiency and was able to increase ABS activation from 9.6% to 26.8% of the time, achieving a deceleration of 6.24 m/s2. ABS is demonstrated to reduce stopping distances and to improve stability under all braking conditions, but such features are not enough to guarantee a good braking performance in emergency events if the riders have not the skills to utilize the full braking power of the motorcycle. Less skilled riders, even with ABS, may not have the confidence to increase braking power further when reaching high decelerations that push them to the limit of their stabilisation control in emergency braking, thus increasing braking distance with potentially life-threatening consequences. Our results suggest that many experience riders still need knowledge and skill to make the ABS work to its optimum in emergency events to avoid crashes. Further research with larger sample sizes including the full diversity of the motorcyclist population is recommended to determine the actual proportion of motorcyclists underusing ABS.
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Affiliation(s)
- P Huertas-Leyva
- Dipartimento di Ingegneria Industriale, Università degli Studi di Firenze, Via di Santa Marta 3, Firenze 50139, Italy.
| | - G Savino
- Dipartimento di Ingegneria Industriale, Università degli Studi di Firenze, Via di Santa Marta 3, Firenze 50139, Italy
| | - N Baldanzini
- Dipartimento di Ingegneria Industriale, Università degli Studi di Firenze, Via di Santa Marta 3, Firenze 50139, Italy
| | - M Pierini
- Dipartimento di Ingegneria Industriale, Università degli Studi di Firenze, Via di Santa Marta 3, Firenze 50139, Italy
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9
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Romozzi M, Cuffaro G, Rollo E, Mattei R, Marcelli S, Rizzo S, Calabresi P, Servidei S, Savino G, Vollono C. Microvascular involvement in migraine: an optical coherence tomography angiography study. J Neurol 2023:10.1007/s00415-023-11697-z. [PMID: 37154891 DOI: 10.1007/s00415-023-11697-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the microvasculature of the macula and the optic nerve in patients affected by migraine with aura (MA) and without aura (MO) by optical coherence tomography angiography (OCTA), comparing the findings with healthy controls (HC). METHODS We collected data from ocular and orthotic examinations, including eye motility, intraocular pressure measurement, best-corrected visual acuity (BCVA) measurement, objective refraction measurement, fundus examination, macular and optic disk OCTA examination. All subjects were imaged with solix fullrange OCT. The following OCTA parameters were recorded: macular vessel density (VD), inside disc VD, peripapillary VD, disc whole image VD, fovea choriocapillaris VD, fovea VD, parafovea VD, peripapillary thickness, fovea thickness, parafovea thickness, macular full retinal thickness, and foveal avascular zone (FAZ) parameters. Clinical and demographical data about migraine patients were collected by a neurologist. RESULTS We included 56 eyes from 28 patients with a diagnosis of MO, 32 eyes from 16 patients with a diagnosis of MA, and 32 eyes from 16 HC subjects. The FAZ area was 0.230 ± 0.099 mm2 in the MO group, 0.248 ± 0.091 mm2 in the MA group and 0.184 ± 0.061 mm2 in the control group. The FAZ area was significantly larger in the MA group than in the HC group (p = 0.007). The foveal choriocapillaris VD was significantly lower in MA patients (63.6 ± 2.49%) when compared with MO patients (65.27 ± 3.29%) (p = 0.02). CONCLUSION An impairment of retinal microcirculation can be detected in patients with MA, as demonstrated by the enlargement of FAZ. Moreover, the study of choroid circulation may reveal microvascular damage in patients with migraine with aura. OCTA is a useful non-invasive screening tool for the detection of microcirculatory disturbance in patients with migraine.
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Affiliation(s)
- Marina Romozzi
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giovanni Cuffaro
- Oculistica, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Eleonora Rollo
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Roberta Mattei
- Oculistica, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sofia Marcelli
- Oculistica, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Stanislao Rizzo
- Oculistica, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Testa-Collo e Organi di Senso, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Calabresi
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Serenella Servidei
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurofisiopatologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli N° 8, 00168, Rome, Italy
| | - Gustavo Savino
- Oculistica, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Testa-Collo e Organi di Senso, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Catello Vollono
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy.
- Neurofisiopatologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli N° 8, 00168, Rome, Italy.
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10
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Savino G, Piccinni F, Pagliara MM, Sammarco MG, Caputo CG, Moro A, Barbera G, Tagliaferri L, Fionda B, Schinzari G, Rossi E, Zagaria L, Peris K, Di Stefani A, Musarra T, Ausili Cefaro L, Martucci M, Blasi MA. Multidisciplinary ocular and periocular cancers meetings: implementation in a tertiary referral center and analysis over a 12-months period. BMC Ophthalmol 2022; 22:497. [PMID: 36536312 PMCID: PMC9762050 DOI: 10.1186/s12886-022-02694-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 11/18/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE The complexity of multimodal approaches in cancer management has lately led to the establishment of multidisciplinary tumor boards (MDTBs) to define targeted, patient-centered treatment strategies. However, few data are available regarding the application of this approach in Ocular Oncology. Hereby, the Authors analyze the implementation and outcomes of a trained MDTB in a tertiary ocular oncology referral center. METHODS A retrospective descriptive analysis of MDTB meetings discussing patients with ocular and periocular cancers, over a 12-months period, was carried out. Data were grouped by main site involved, topics discussed and final clinical decisions therefore taken. Meetings were held by a constant 'Core team' or - when required - by a broader 'Extended team'. RESULTS During the observational period 86 cases were discussed. In 27 patients ocular surface tissues were involved (31%), in 25 patients orbital tissues (29%), in 22 patients eyelids (26%), and in 12 patients intraocular tissues (14%). In 13 cases (15%) naïve or referred new patients, in 34 cases (40%) imaging or histopathologic reports and in 39 cases (45%) treatment plans were discussed. Regarding final decisions, a treatment plan was scheduled in 47 cases (55%) and a diagnostic ascertainment was required in 27 patients (31%); locally advanced and/or systemic diseases were referred or teamed up with other specialists in 12 cases (14%). CONCLUSIONS Ocular Oncology multidisciplinary team, by sharing expertise of different specialists, ensures a comprehensive evaluation of patients improving the accuracy of diagnosis and staging upon which planning a proper treatment. Further studies are needed to assess if this approach may also improve the outcomes and prognosis of patients.
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Affiliation(s)
- Gustavo Savino
- grid.414603.4Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy ,grid.8142.f0000 0001 0941 3192 Università Cattolica del Sacro Cuore, UCSC, Rome, Italy
| | - Fabrizio Piccinni
- grid.414603.4Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy ,grid.8142.f0000 0001 0941 3192 Università Cattolica del Sacro Cuore, UCSC, Rome, Italy
| | - Monica Maria Pagliara
- grid.414603.4Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Grazia Sammarco
- grid.414603.4Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Carmela Grazia Caputo
- grid.414603.4Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alessandro Moro
- grid.8142.f0000 0001 0941 3192 Università Cattolica del Sacro Cuore, UCSC, Rome, Italy ,grid.414603.4Maxillo-Facial Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giorgio Barbera
- grid.414603.4Maxillo-Facial Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luca Tagliaferri
- grid.414603.4UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Bruno Fionda
- grid.414603.4UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Schinzari
- grid.8142.f0000 0001 0941 3192 Università Cattolica del Sacro Cuore, UCSC, Rome, Italy ,grid.414603.4Medical Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ernesto Rossi
- grid.414603.4Medical Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luca Zagaria
- grid.414603.4Nuclear Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ketty Peris
- grid.8142.f0000 0001 0941 3192 Università Cattolica del Sacro Cuore, UCSC, Rome, Italy ,grid.414603.4Dermatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alessandro Di Stefani
- grid.8142.f0000 0001 0941 3192 Università Cattolica del Sacro Cuore, UCSC, Rome, Italy ,grid.414603.4Dermatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Teresa Musarra
- grid.414603.4Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luca Ausili Cefaro
- grid.414603.4UOSD Neuroradiologia Diagnostica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Matia Martucci
- grid.414603.4UOSD Neuroradiologia Diagnostica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Antonietta Blasi
- grid.414603.4Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy ,grid.8142.f0000 0001 0941 3192 Università Cattolica del Sacro Cuore, UCSC, Rome, Italy
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11
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Selleri V, Zanini G, Coppi F, Pinti M, D’alisera R, Latessa PM, Tripi F, Savino G, Cossarizza A, Nasi M, Mattioli AV. 798 CARDIOVASCULAR EFFECTS OF WHOLE-BODY CRYOTHERAPY IN NON-PROFESSIONAL ATHLETES. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Whole-body cryotherapy (WBC) is a method of cold therapy widely applied for muscle recovery after injury to counteract the inflammatory response due to specific diseases, characterized by high levels of inflammation. WBC consists of short exposure, of about 2-3 minutes, to dry air at cryogenic temperatures (up to -190°C) in a special chamber. Our study aimed to investigate changes in respiratory rate, oxygen saturation, blood pressure, heart rate and body temperature induced by WBC sessions in athletes.
Ten volunteer middle-distance non-professional runners (age: 38±12 years) received 3 once-a-day sessions of WBC. Subjects underwent blood pressure measurements and ECG recorded before and immediately after the daily session. During WBC we recorded a single lead trace (D1) for heart rhythm control. Moreover, we monitored the 5 vital signs, such as blood pressure, heart rate, respiratory rate, oxygen saturation and body temperature, during, and after all WBC session.
We did not report significant changes in ECG main intervals (PR, QT, and QTc) and in the mean systolic blood pressure during and after WBC [baseline: 118 ± 5 mmHg, changed to 120 ± 3 mmHg during WBC, and to 121 ± 2 mmHg after session]. Mean respiratory rate did not change significantly during WBC as well as oxygen saturation (98 vs. 99%). Mean heart rate changed from 50.98 ± 4.43 bpm (before) to 56.83 ± 4.26 bpm after WBC session (p < 0.05) and body temperature was slightly increased after WBC, however it remains within physiological values. In non-professional athletes WBC did not affect cardiovascular response and can be safely used. However, further studies are required to confirm these promising results of safety in elderly non-athlete subjects.
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Affiliation(s)
- Valentina Selleri
- Department Of Life Science, University Of Modena And Reggio Emilia , Italy
- National Institute For Cardiovascular Research-Inrc , Bologna , Italy
| | - Giada Zanini
- Department Of Life Science, University Of Modena And Reggio Emilia , Italy
| | - Francesca Coppi
- Department Of Surgery, Medicine, Dentistry And Morphological Sciences, University Of Modena And Reggio Emilia , Italy
| | - Marcello Pinti
- Department Of Life Science, University Of Modena And Reggio Emilia , Italy
| | - Roberta D’alisera
- Department Of Public Healthcare , Sport Medicine Service Azienda Usl Of Modena, Modena , Italy
| | | | - Ferdinando Tripi
- ”La Fratellanza 1874” Not-For-Profit Association , Modena , Italy
| | - Gustavo Savino
- Department Of Public Healthcare , Sport Medicine Service Azienda Usl Of Modena, Modena , Italy
| | - Andrea Cossarizza
- Department Of Medical And Surgical Sciences For Children And Adults, University Of Modena And Reggio Emilia , Modena , Italy
| | - Milena Nasi
- Department Of Surgery, Medicine, Dentistry And Morphological Sciences, University Of Modena And Reggio Emilia , Italy
| | - Anna Vittoria Mattioli
- National Institute For Cardiovascular Research-Inrc , Bologna , Italy
- Department Of Surgery, Medicine, Dentistry And Morphological Sciences, University Of Modena And Reggio Emilia , Italy
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12
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Selleri V, Mattioli M, Lo Tartaro D, Paolini A, Zanini G, De Gaetano A, D’Alisera R, Roli L, Melegari A, Maietta P, Tripi F, Guerra E, Chester J, Savino G, Trenti T, Cossarizza A, Mattioli AV, Pinti M, Nasi M. Innate immunity changes in soccer players after whole-body cryotherapy. BMC Sports Sci Med Rehabil 2022; 14:185. [PMID: 36284345 PMCID: PMC9594892 DOI: 10.1186/s13102-022-00578-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/30/2022] [Indexed: 11/26/2022]
Abstract
Whole-body cryotherapy (WBC) consists of short exposure (up to 2–3 min) to dry air at cryogenic temperatures (up to -190 °C) and has recently been applied for muscle recovery after injury to reduce the inflammation process. We aimed to determine the impact of cryotherapy on immunological, hormonal, and metabolic responses in non-professional soccer players (NPSPs). Nine male NPSPs (age: 20 ± 2 years) who trained regularly over 5 consecutive days, immediately before and after each training session, were subjected to WBC treatment (WBC-t). Blood samples were collected for the evaluation of fifty analytes including hematologic parameters, serum chemistry, and hormone profiles. Monocytes phenotyping (Mo) was performed and plasmatic markers, usually increased during inflammation [CCL2, IL-18, free mitochondrial (mt)DNA] or with anti-inflammatory effects (IL2RA, IL1RN), were quantified. After WBC-t, we observed reduced levels of ferritin, mean corpuscular hemoglobin, mean platelet volume, testosterone, and estradiol, which however remain within the normal ranges. The percentage of the total, intermediates and non-classical Mo increased, while classical Mo decreased. CXCR4 expression decreased in each Mo subset. Plasma IL18 and IL2RA levels decreased, while IL1RN only exhibited a tendency to decrease and CCL2 showed a tendency to increase. Circulating mtDNA levels were not altered following WBC-t. The differences observed in monocyte subsets after WBC-t may be attributable to their redistribution into the surrounding tissue. Moreover, the decrease of CXCR4 in Mo subpopulations could be coherent with their differentiation process. Thus, WBC through yet unknown mechanisms could promote their differentiation having a role in tissue repair.
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Affiliation(s)
- Valentina Selleri
- grid.7548.e0000000121697570Department of Life Sciences, University of Modena and Reggio Emilia, via Campi, 287, 41125 Modena, Italy ,grid.493113.dNational Institute for Cardiovascular Research - INRC, 40126 Bologna, Italy
| | - Marco Mattioli
- grid.7548.e0000000121697570Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Domenico Lo Tartaro
- grid.7548.e0000000121697570Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Annamaria Paolini
- grid.7548.e0000000121697570Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Giada Zanini
- grid.7548.e0000000121697570Department of Life Sciences, University of Modena and Reggio Emilia, via Campi, 287, 41125 Modena, Italy
| | - Anna De Gaetano
- grid.493113.dNational Institute for Cardiovascular Research - INRC, 40126 Bologna, Italy
| | - Roberta D’Alisera
- grid.476047.60000 0004 1756 2640Department of Public Healthcare, Sports Medicine Service, Azienda USL of Modena, 41121 Modena, Italy
| | - Laura Roli
- grid.476047.60000 0004 1756 2640Department of Laboratory Medicine and Pathology, Azienda USL of Modena, 41121 Modena, Italy
| | - Alessandra Melegari
- grid.476047.60000 0004 1756 2640Department of Laboratory Medicine and Pathology, Azienda USL of Modena, 41121 Modena, Italy
| | - Pasqualino Maietta
- Department of Quality of Life, “Alma Mater Studiorum”, 40126 Bologna, Italy
| | - Ferdinando Tripi
- “La Fratellanza 1874” Not-for-profit sport Association, 41126 Modena, Italy
| | - Emanuele Guerra
- grid.476047.60000 0004 1756 2640Department of Public Healthcare, Sports Medicine Service, Azienda USL of Modena, 41121 Modena, Italy
| | - Johanna Chester
- grid.7548.e0000000121697570Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Gustavo Savino
- grid.476047.60000 0004 1756 2640Department of Public Healthcare, Sports Medicine Service, Azienda USL of Modena, 41121 Modena, Italy
| | - Tommaso Trenti
- grid.476047.60000 0004 1756 2640Department of Laboratory Medicine and Pathology, Azienda USL of Modena, 41121 Modena, Italy
| | - Andrea Cossarizza
- grid.493113.dNational Institute for Cardiovascular Research - INRC, 40126 Bologna, Italy ,grid.7548.e0000000121697570Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Anna Vittoria Mattioli
- grid.493113.dNational Institute for Cardiovascular Research - INRC, 40126 Bologna, Italy ,grid.7548.e0000000121697570Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Marcello Pinti
- grid.7548.e0000000121697570Department of Life Sciences, University of Modena and Reggio Emilia, via Campi, 287, 41125 Modena, Italy
| | - Milena Nasi
- grid.7548.e0000000121697570Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
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13
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Agresta F, Licitra E, Mazzarolo G, Savino G, Pontarolo N, Montori G. V-034 IPOM PLUS: IS THERE ANY PLACE LEFT? WHY WE (STILL) DO IT. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Aim
In this video, we want to share and discuss what we have learned from our 20-year experience in IPOM PLUS, for scheduled as emergencies
Material and Methods
We use only all 5 mm trocars, instruments, and 30-degree optics and we always use low intra-abdominal pressure - 10mmHg.
The technical trick is to carefully prepare and manage the abdominal wall context, to free all the hernia areas.
Results
Our experience is almost more than 500 cases, elective as an emergency. In the last years, we normally use a prosthesis, made with a monofilament macroporous mesh and transparent film(with the film versus the intestine), with a 5 cm overlap. Besides the well known needed physical characteristics of the mesh, on the surgeon's side, a mesh should be smooth, stiff, wide enough to cover all the possible defects, easy to handle, and, especially for its possible use in laparoscopy, with a certain degree of and thickness just what it is needed to let it pass through a 5 mm trocar once rolled up. We use to close the defect to avoid serosa and SS - Morbidity and we use to fix the mesh with absorbable tackers. Above all we do believe in the diagnostic value of the technique, cause allows us to better see and judge the intraabdominal context
Conclusions
The advantages of laparoscopy rely on the minimal access and the possibility to manage and examine the abdominal context, especially in emergencies, close the defect, and fix the mesh with tackers.
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Affiliation(s)
- F Agresta
- General Surgery , AULSS2 Trevigiana, Vittorio Veneto (TV) , Italy
| | - E Licitra
- General Surgery , AULSS2 Trevigiana, Vittorio Veneto (TV) , Italy
| | - G Mazzarolo
- General Surgery , AULSS2 Trevigiana, Vittorio Veneto (TV) , Italy
| | - G Savino
- General Surgery , AULSS2 Trevigiana, Vittorio Veneto (TV) , Italy
| | - N Pontarolo
- General Surgery , AULSS2 Trevigiana, Vittorio Veneto (TV) , Italy
| | - G Montori
- General Surgery , AULSS2 Trevigiana, Vittorio Veneto (TV) , Italy
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14
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Agresta F, Mazzarolo G, Licitra E, Pontarolo N, Savino G, Montori G. P-078 LAPAROSCOPIC TREATMENT OF UMBILICAL HERNIA IN A COMMUNITY HOSPITAL SETTING. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Umbilical Hernia is a common ventral hernia in the adult population. The classical approach was represented by open repair, but in recent years laparoscopic treatment is increasingly adopted and it can present some intraoperative and post-operative advantages.
Materials and methods
We prospectively analyzed a case series of 50 laparoscopic primary and incisional umbilical hernia repairs performed between January 1st, 2020, and December 31st, 2021. We collected data concerning age, sex, hernia defect size, operative time, and complications according to Clavien-DindoClassification, recurrence at 6 months, and 1-year follow-up.
Results
We performed laparoscopic umbilical hernia repairs in 50 patients (32males,18females);mean age52.1year-old(range30–82y.o.).Mean defect size was4.5cm(3–6.8cm).All procedures were performed under general anesthesia and with 5mm trocars and optic and under pneumoperitoneum pressure set until 10 mmHg as the maximum value. In all cases we applied a transparent, lightweight, ultra-thin, nonabsorbable surgical prosthesis in polypropylene, made by a monofilament macroporous mesh and a transparent film. and we performed closure of fascia with adsorbable stitches. Mean Operative time:40minutes(30–65min.).No complications and recurrences were reported.
Conclusions
Laparoscopic treatment of umbilical hernia is a safe and feasible procedure; indeed, we consider reducing hernia from the abdominal cavity generally better than the open approach and composite mesh positioning with direct fascial closure usually allows a satisfying repair of the defect.
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Affiliation(s)
- F Agresta
- General Surgery , AULSS2 Trevigiana, Vittorio Veneto (TV) , Italy
| | - G Mazzarolo
- General Surgery , AULSS2 Trevigiana del Veneto, Vittorio Veneto (TV) , Italy
| | - E Licitra
- General Surgery , AULSS2 Trevigiana del Veneto, Vittorio Veneto (TV) , Italy
| | - N Pontarolo
- General Surgery , AULSS2 Trevigiana del Veneto, Vittorio Veneto (TV) , Italy
| | - G Savino
- General Surgery , AULSS2 Trevigiana del Veneto, Vittorio Veneto (TV) , Italy
| | - G Montori
- General Surgery , AULSS2 Trevigiana del Veneto, Vittorio Veneto (TV) , Italy
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15
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Agresta F, Licitra E, Mazzarolo G, Savino G, Pontarolo N, Montori G. P-051 TAPP IN A COMMUNITY HOSPITAL SETTING : AN EXPERIENCE OF OVER 1000 CASES. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
We want to share and discuss what we have learned from our 20-year experience in TAPP procedures
Material and Methods
We use only all 5 mm trocars, instruments, and 30-degree optics and we always use low intraabdominal pressure (10mmHg).
The major technical trick is to carefully prepare the peritoneum flap all around, like a cone, just in order to let the mesh perfectly lie down on the inguinal area.
Results
Our TAPP experience is almost more than 1000 cases, elective as an emergency. We use a 10×15 cm LW macroporous monofilament polypropylene mesh. Besides the well known needed physical characteristics of the mesh, on the surgeon's side, a mesh should be smooth, stiff, wide enough to cover all the possible defects, easy to handle, and, especially for its possible use in laparoscopy, with a certain degree of and thickness just what it is needed in order to let it pass through a 5 mm trocar once rolled up. We do not use to fix the mesh anymore because we do believe in the mesh pushed versus the abdominal wall by the intra-abdominal pressure, and in the exact size of the (10×15 cm). Only in case of huge direct hernia we do “lift” without tension the transversalis fascia.
Conclusions
Most of the advantages of laparoscopy rely on the minimal access and therefore the benefits of this technique will be greater as the access becomes smaller, together with a no fixed LW mesh.
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Affiliation(s)
- F Agresta
- General Surgery, AULSS2 Trevigiana del veneto , Vittorio Veneto (TV) , Italy
| | - E Licitra
- General Surgery, AULSS2 Trevigiana del veneto , Vittorio Veneto (TV) , Italy
| | - G Mazzarolo
- General Surgery, AULSS2 Trevigiana del veneto , Vittorio Veneto (TV) , Italy
| | - G Savino
- General Surgery, AULSS2 Trevigiana del veneto , Vittorio Veneto (TV) , Italy
| | - N Pontarolo
- General Surgery, AULSS2 Trevigiana del veneto , Vittorio Veneto (TV) , Italy
| | - G Montori
- General Surgery, AULSS2 Trevigiana del veneto , Vittorio Veneto (TV) , Italy
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16
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Sammarco MG, Pagliara MM, Savino G, Giannuzzi F, Carlà MM, Caputo CG, Blasi MA. Supportive treatment to chemotherapy with MMC, in patients with ocular surface squamous neoplasia or conjunctival melanocytic tumor. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04241-5. [PMID: 36074189 DOI: 10.1007/s00432-022-04241-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 07/27/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Since there is a lack of clear information regarding the benefit to combine supportive therapies (such as artificial tears) to mitomycin C (MMC) in the treatment of ocular surface neoplasia, the primary purpose of the study was to evaluate hyaluronic acid eye drops and hyaluronic acid-conjugated lactobionic acid (LACTOyal FREE) eye drops as supportive therapy. METHODS Retrospective evaluation of patients with ocular surface squamous neoplasia or conjunctival melanocytic tumor treated with MMC, who had used also artificial tears as supportive treatment. A 6-month follow-up with evaluation of subjective and objective tests for ocular surface integrity was conducted. RESULTS A total of 35 patients were analyzed, most of them with squamous disease (71.4%). The break-up time (BUT), Ocular Surface Disease Index (OSDI) and Schirmer test values showed a significant difference at any time point with overall population. No statistical difference was found among subgroups (Lactoyal vs No Lactoyal). CONCLUSION The use of an ancillary therapy based on hyaluronic acid allows to improve both subjective and objective ocular parameters, reducing MMC induced adverse effects. Meantime, hyaluronic acid-conjugated lactobionic acid eye drops highlighted the same advantages with a more positive trend in OSDI results.
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Affiliation(s)
- Maria Grazia Sammarco
- Ocular Oncology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Rome, Italy
| | - Monica Maria Pagliara
- Ocular Oncology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Rome, Italy
| | - Gustavo Savino
- Ocular Oncology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Rome, Italy.,Catholic University "Sacro Cuore", Largo A. Gemelli 8, Rome, Italy
| | - Federico Giannuzzi
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Rome, Italy. .,Catholic University "Sacro Cuore", Largo A. Gemelli 8, Rome, Italy.
| | - Matteo Mario Carlà
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Rome, Italy.,Catholic University "Sacro Cuore", Largo A. Gemelli 8, Rome, Italy
| | - Carmela Grazia Caputo
- Ocular Oncology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Rome, Italy
| | - Maria Antonietta Blasi
- Ocular Oncology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Rome, Italy.,Catholic University "Sacro Cuore", Largo A. Gemelli 8, Rome, Italy
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17
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Fionda B, Pagliara MM, Lancellotta V, Sammarco MG, Casà C, Savino G, Deodato F, Morganti AG, Gambacorta MA, Tagliaferri L, Blasi MA. The Role of Radiotherapy in Orbital Pseudotumor: A Systematic Review of Literature. Ocul Immunol Inflamm 2022; 30:1162-1167. [PMID: 33561371 DOI: 10.1080/09273948.2020.1871493] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Orbital pseudotumor (or pseudotumor orbitae) is a benign entity, also known as idiopathic orbital inflammatory syndrome (IOIS), which encompasses a wide range of non-tumoral, space occupying lesions of the orbit. In selected cases of refractory disease or presence of side effects or even comorbidities that limit systemic therapies, radiotherapy could play a role in the management because it has been demonstrated that irradiation is effective in suppressing the inflammatory process. METHODS A systematic review of the literature about the main scientific databases was launched and the time interval included all published articles present in the databases from their inception until September 2020. RESULTS We were able to identify 19 studies eligible for inclusion in this review from 1978 to 2018. Overall the data of 241 patients were collected and are presented in this systematic review. The response rate varied between 74% and 100% with a median recurrence rate of 10%. The median total dose was 20 Gy whereas the mean total dose was 21 Gy with a range from 4 to 36 Gy. Regarding the fractionation, 2 Gy/fraction daily was the most widely used. CONCLUSIONS Radiotherapy seemed to achieve good response rates however, in most of the studies, inclusion criteria and outcome parameters are not uniform and therefore the results are difficult to compare. Often important parameters such as chronic pain and permanent functional deficits are not assessed in the outcome. Therefore, prospective studies, with good cohort characteristics and a clear definition of the outcome, are required.
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Affiliation(s)
- Bruno Fionda
- U.O.C. Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Monica Maria Pagliara
- U.O.C. Oncologia Oculare, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Valentina Lancellotta
- U.O.C. Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Grazia Sammarco
- U.O.C. Oncologia Oculare, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Calogero Casà
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gustavo Savino
- U.O.C. Oncologia Oculare, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Deodato
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
- Radiotherapy Unit, Gemelli Molise Hospital, Fondazione Policlinico Universitario A. Gemelli IRCCS, Campobasso, Italy
| | - Alessio Giuseppe Morganti
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, DIMES, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Maria Antonietta Gambacorta
- U.O.C. Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Tagliaferri
- U.O.C. Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Antonietta Blasi
- U.O.C. Oncologia Oculare, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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18
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Coppi F, Pinti M, Selleri V, Zanini G, D'Alisera R, Latessa PM, Tripi F, Savino G, Cossarizza A, Nasi M, Mattioli AV. Cardiovascular Effects of Whole-Body Cryotherapy in Non-professional Athletes. Front Cardiovasc Med 2022; 9:905790. [PMID: 35757346 PMCID: PMC9227663 DOI: 10.3389/fcvm.2022.905790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 04/28/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives: The study aimed to investigate changes in heart rate, blood pressure, respiratory rate, oxygen saturation, and body temperature in non-professional trained runners during whole body cryotherapy (WBC). Methods Ten middle-distance runners received 3 once-a-day sessions of WBC. Subjects underwent BP measurements and ECG recorded before and immediately after the daily WBC session. During WBC we recorded a single lead trace (D1) for heart rhythm control. In addition, the 5 vital signs Blood pressure, heart rate, respiratory rate, oxygen saturation, and body temperature were monitored before, during, and after all WBC session. Results We did not report significant changes in ECG main intervals (PR, QT, and QTc). Mean heart rate changed from 50.98 ± 4.43 bpm (before) to 56.83 ± 4.26 bpm after WBC session (p < 0.05). The mean systolic blood pressure did not change significantly during and after WBC [b baseline: 118 ± 5 mmHg, changed to 120 ± 3 mmHg during WBC, and to 121 ± 2 mmHg after session (p < 0.05 vs. baseline)]. Mean respiratory rate did not change during WBC as well as oxygen saturations (98 vs. 99%). Body temperature was slightly increased after WBC, however it remains within physiological values Conclusion In non-professional athletes WBC did not affect cardiovascular response and can be safely used. However, further studies are required to confirm these promising results of safety in elderly non-athlete subjects.
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Affiliation(s)
- Francesca Coppi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marcello Pinti
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Valentina Selleri
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
- National Institute for Cardiovascular Research—INRC, Bologna, Italy
| | - Giada Zanini
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Roberta D'Alisera
- Department of Public Healthcare, Sport Medicine Service Azienda USL of Modena, Modena, Italy
| | | | - Ferdinando Tripi
- “La Fratellanza 1874” Not-for-profit sport Association, Modena, Italy
| | - Gustavo Savino
- Department of Public Healthcare, Sport Medicine Service Azienda USL of Modena, Modena, Italy
| | - Andrea Cossarizza
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Milena Nasi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Vittoria Mattioli
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
- National Institute for Cardiovascular Research—INRC, Bologna, Italy
- *Correspondence: Anna Vittoria Mattioli
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19
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Ripa M, Cuffaro G, Pafundi PC, Valente P, Battendieri R, Buzzonetti L, Mattei R, Rizzo S, Savino G. An epidemiologic analysis of the association between eyelid disorders and ocular motility disorders in pediatric age. Sci Rep 2022; 12:8840. [PMID: 35614310 PMCID: PMC9132918 DOI: 10.1038/s41598-022-12883-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/06/2022] [Indexed: 11/09/2022] Open
Abstract
Aim of the study was to assess: (a) the prevalence and type of strabismus, ptosis and eyelid dynamic disorders features, (b) the prevalence of refractive errors, amblyopia and, (c) their association with ocular/systemic syndromes in a cohort of patients. This is a retrospective observational multicenter cohort study. Patients with coexisting ocular motility disorders, comitant and incomitant strabismus, ptosis and dynamic eyelid disorders who have never undergone surgery were enrolled throughout a 3-years a study period. 137 out of 19,089 patients were enrolled, of which 97 with uniocular and 40 with binocular disease. Isolated congenital ptosis was observed in 84 patients. A polymalformative syndrome was present in almost one third of cases, whilst among strabismus type, esotropia was slightly more prevalent. Most patients were hypermetropic. In monocular disease, myopia mainly affected older patients, who were characterized by a worse ptosis margin reflex distance and levator function, and significantly higher astigmatism. Amblyopia occurred in 67.4% of the study sub-population. Of note, in monocular disease this was mild in 25.8%, moderate in 24.2% and severe in 11.3% of cases, whilst in binocular disease it was mild in 25%, moderate in 41.7% and severe in 16.7%. All patients with coexisting eyelid and ocular motility dysfunctions in pediatric age need ophthalmologic and systemic evaluation to accurately assess amblyopia, refractive errors and systemic/ocular disorders.
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Affiliation(s)
- Matteo Ripa
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Largo Agostino Gemelli, 8, 00168, Rome, Italy
| | - Giovanni Cuffaro
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
- Catholic University of Sacred Heart, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
| | - Pia Clara Pafundi
- Facility of Epidemiology and Biostatistics, Gemelli Generator, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Paola Valente
- Ophthalmology Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy
| | - Remo Battendieri
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Largo Agostino Gemelli, 8, 00168, Rome, Italy
| | - Luca Buzzonetti
- Ophthalmology Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy
| | - Roberta Mattei
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Stanislao Rizzo
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Largo Agostino Gemelli, 8, 00168, Rome, Italy
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Pisa, Italy
| | - Gustavo Savino
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Largo Agostino Gemelli, 8, 00168, Rome, Italy
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20
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Gore S, Grimaldi G, Mazzone G, Collin R, Savino G, Pagnoni M, Modugno A. Treatment strategies and long-term outcomes in patients with congenital microphthalmia-anophthalmia with cyst. Br J Ophthalmol 2022; 107:750-755. [PMID: 35101939 DOI: 10.1136/bjophthalmol-2020-318089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 12/13/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS Microphthalmia and anophthalmia are rare conditions, which represent ocular maldevelopment; both may be associated with orbital cysts. Current literature recommends retention to stimulate orbital growth during socket rehabilitation but does not illustrate their potential to deform the periocular tissues. This study aims to illustrate the long-term outcomes when other elements, such as forniceal and lid development, are also considered when formulating bespoke treatment plans for patients. METHODS Retrospective case series of 78 patients attending a single prosthetics clinic between 1988 and 2020. Clinical and surgical notes, radiological imaging, clinical photographs and patient/doctor satisfaction questionnaires were used to report patient outcomes and natural history data. RESULTS 89 sockets of 78 patients (11 bilateral) were included; average age of presentation being 2.8 years (9 days to 29.5 years). Cysts were clinically detected (48%) or were incidental findings (52%). The mean follow-up time was 7.2 years (6 months to 28 years). Cysts in 46% of sockets underwent surgical excision while the remainder were retained. Satisfaction surveys were obtained for 75 patients, with cosmetic outcomes rated as 'excellent' or 'good' in 90% of cases by physicians and 97% of cases by patients or guardians. CONCLUSION The favourable long-term outcomes in this study have resulted from bespoke plans which considered periocular tissue development, regional orbital growth and orbital volume replacement. The authors contemplate cyst excision if the prosthetic fitting or retention is impeded by the cyst as this often heralds the increased risk of long-term periocular distortion.
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Affiliation(s)
- Sri Gore
- Department of Ophthalmology, Great Ormond Street Hospital for Children, London, UK .,Department of Ophthalmology, Ocularistica Italiana, Rome, Italy
| | - Gabriela Grimaldi
- Department of Ophthalmology, Ocularistica Italiana, Rome, Italy.,Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | | | - Richard Collin
- Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Gustavo Savino
- Opthalmology, Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, Roma, Italy
| | - Mario Pagnoni
- Department of Maxillo-facial surgery, Your Face Surgery Villa Parioli Clinic, Rome, Italy
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21
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Savino G, Mattei R, Salerni A, Fossataro C, Pafundi PC. Long-term follow-up of surgical treatment of thyroid-associated orbitopathy restrictive strabismus. Front Endocrinol (Lausanne) 2022; 13:1030422. [PMID: 36440235 PMCID: PMC9684631 DOI: 10.3389/fendo.2022.1030422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 10/18/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Thyroid-associated orbitopathy (TAO) is the most frequent cause of extraocular muscle enlargement, with consecutive restrictive strabismus. The main muscles involved are inferior and medial rectus, resulting in horizontal esotropia and/or vertical strabismus. Surgery may either establish or improve binocular single vision. The aim of the present study is to describe long-term follow-up of patients who underwent horizontal or vertical TAO strabismus surgery. METHODS This observational retrospective study included 29 patients suffering from either vertical or horizontal TAO strabismus and diplopia, of whom 11 underwent bilateral medial recti muscle recession (Group A) and 18 underwent unilateral inferior rectus muscle recession (Group B). The endpoint of the study was the assessment of changes in deviation angle and diplopia across four time points (baseline, 7 days, 6 months, and 24 months) in each group. RESULTS In Group A, the horizontal deviation angle significantly decreased 7 days after intervention (p < 0.001), without modifications overtime. In Group B, both deviation angles in primary and down-gaze position significantly decreased from baseline, both 7 days after surgery (p < 0.001) and at 6 months (p = 0.040). An overcorrection, with an inversion of vertical deviation angle, was observed across the different time points. CONCLUSIONS Horizontal TAO strabismus correction leads to significant improvements of deviation angle and diplopia, with a stable undercorrection overtime. Inferior rectus recession leads to more unstable results, with a trend towards overcorrection limited to the first 6 months after surgery.
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Affiliation(s)
- Gustavo Savino
- Department of Ophthalmology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Roberta Mattei
- Department of Ophthalmology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Annabella Salerni
- Department of Ophthalmology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Claudia Fossataro
- Department of Ophthalmology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- *Correspondence: Claudia Fossataro,
| | - Pia Clara Pafundi
- Facility of Epidemiology and Biostatistics, Gemelli Generator, Fondazione Policlinico Universitario A. Gemelli Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
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22
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Selleri V, De Gaetano A, Zanini G, Malerba M, Pinti M, Tripi F, Mattioli AV, Savino G, Nasi M. 162 Whole-body cryotherapy treatment modulates the innate immune response in non-professional football players. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab144.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
Whole-body cryotherapy (WBC) is a recently widely strategy used for muscle recovery after injury that can to activate inflammatory response. WBC consists of short exposure, of about 2-3 minutes, to dry air at cryogenic temperatures up to -190 °C. The aim of our study is to analyze WBC effects on metabolic, hormonal, and immunological responses of non-professional football players (NPFPs).
Methods and results
Nine male NPFPs (age: 20 ± 2 years) on the same team are recruited and, in particular, they played and trained each day before, during, and after WBC treatment. We collected NPFPs blood samples immediately before WBC and after 5 once-day sessions, then we evaluated a set consisting of 50 analytes, including hormones profile, haematologic parameters, and serum chemistry. We proceeded with monocytes (Mo) phenotyping and then we investigated the concentration of some plasmatic markers with anti-inflammatory effects (IL2RA, IL1RN) or typically increased during inflammation [CCL2, IL-18, free mitochondrial DNA (mtDNA)]. WBC treatment (WBC-t) lead to a decrease not only in mean platelet volume, mean corpuscular haemoglobin, and ferritin levels, but also in testosterone and estradiol levels, even if they remain within the normal ranges. This treatment is also responsible for total Mo increased and, in particular, a reduction of classical Mo has been demonstrated in parallel with an increase of non-classical ones. Moreover, each Mo subset shows lower expression of CXCR4. Considering pro-inflammatory molecules, IL1RA showed a tendency to decrease, while IL1RN and IL18 decreased in plasma after WBC-t. Conversely, circulating mtDNA levels appeared unaltered by treatment.
Conclusions
The differences detected in monocyte subset after WBC-t suggest that, in this condition, Mo could be redistributed into the surrounding tissue. In addition, CXCR4 reduction in Mo subsets could be due to their differentiation process. Hence, WBC could promote Mo differentiation through a mechanism that is still unknown. Since WBC seems to regulate the innate immune system in the enrolled NPFPs, it could have a role in tissue repair beyond a beneficial anti-inflammatory effect.
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Affiliation(s)
- Valentina Selleri
- Department of Life Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna De Gaetano
- Department of Life Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Giada Zanini
- Department of Life Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Mara Malerba
- Department of Life Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Marcello Pinti
- Department of Life Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Ferdinando Tripi
- La Fratellanza 1874 ‘Not-For-Profit Sport Association’, Modena, Italy
| | - Anna Vittoria Mattioli
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
- National Institute for Cardiovascular Research—INRC, Bologna, Italy
| | - Gustavo Savino
- Department of Public Healthcare, Sports Medicine Service, Azienda USL of Modena, Italy
| | - Milena Nasi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Zanini G, De Gaetano A, Selleri V, Savino G, Cossarizza A, Pinti M, Mattioli AV, Nasi M. Mitochondrial DNA and Exercise: Implications for Health and Injuries in Sports. Cells 2021; 10:cells10102575. [PMID: 34685555 PMCID: PMC8533813 DOI: 10.3390/cells10102575] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 12/31/2022] Open
Abstract
Recently, several studies have highlighted the tight connection between mitochondria and physical activity. Mitochondrial functions are important in high-demanding metabolic activities, such as endurance sports. Moreover, regular training positively affects metabolic health by increasing mitochondrial oxidative capacity and regulating glucose metabolism. Exercise could have multiple effects, also on the mitochondrial DNA (mtDNA) and vice versa; some studies have investigated how mtDNA polymorphisms can affect the performance of general athletes and mtDNA haplogroups seem to be related to the performance of elite endurance athletes. Along with several stimuli, including pathogens, stress, trauma, and reactive oxygen species, acute and intense exercise also seem to be responsible for mtDNA release into the cytoplasm and extracellular space, leading to the activation of the innate immune response. In addition, several sports are characterized by a higher frequency of injuries, including cranial trauma, associated with neurological consequences. However, with regular exercise, circulating cell-free mtDNA levels are kept low, perhaps promoting cf-mtDNA removal, acting as a protective factor against inflammation.
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Affiliation(s)
- Giada Zanini
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (G.Z.); (A.D.G.); (V.S.); (M.P.)
| | - Anna De Gaetano
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (G.Z.); (A.D.G.); (V.S.); (M.P.)
- National Institute for Cardiovascular Research-INRC, 40126 Bologna, Italy; (A.C.); (A.V.M.)
| | - Valentina Selleri
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (G.Z.); (A.D.G.); (V.S.); (M.P.)
| | - Gustavo Savino
- Department of Public Healthcare, Sports Medicine Service, Azienda USL of Modena, 41121 Modena, Italy;
| | - Andrea Cossarizza
- National Institute for Cardiovascular Research-INRC, 40126 Bologna, Italy; (A.C.); (A.V.M.)
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Marcello Pinti
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (G.Z.); (A.D.G.); (V.S.); (M.P.)
| | - Anna Vittoria Mattioli
- National Institute for Cardiovascular Research-INRC, 40126 Bologna, Italy; (A.C.); (A.V.M.)
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Milena Nasi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Correspondence: ; Tel.: +39-059-205-5422
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Parrilla C, Mele DA, Gelli S, Zelano L, Bussu F, Rigante M, Savino G, Scarano E. Multidisciplinary approach to orbital decompression. A review. ACTA ACUST UNITED AC 2021; 41:S90-S101. [PMID: 34060524 PMCID: PMC8172106 DOI: 10.14639/0392-100x-suppl.1-41-2021-09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/15/2021] [Indexed: 12/02/2022]
Abstract
Endoscopic orbital surgery has become a highly evolving multidisciplinary surgical field thanks to development in technical skills of ophthalmologists and otolaryngologists. These advances expanded the clinical application of orbital decompression, with a growing body of literature describing the multidisciplinary management of thyroid eye disease and compressive optic neuropathy, since 1990. Although techniques have improved considerably, only few Randomized Control Trials (RCT) provide evidence to support recommendations in clinical practice. This review provides an overview of the current knowledge of orbital decompression to clarify which is the most standardized therapeutic strategy. In the literature, we observed several approaches with contradicting results and the comparison of different surgical techniques was biased by inclusion of patients at different stage of disease (active or inactive), different surgical indications (dysthyroid neuropathy or disfiguring proptosis) and measures of outcomes (such as different system for ocular motility evaluation). The timing of surgical decompression is one of the debated issues. One RCT focusing on Graves’ orbitopathy showed how intravenous corticosteroids achieve better visual recovery than surgical orbital decompression; but in case of absent or poor response to medical therapy the patient should undergo surgery within two weeks. There is slight evidence that the removal of the medial and lateral wall (so-called balanced decompression) with or without fat removal could be the most effective surgical technique, with low complication rate, but an increasing number of authors are promoting, for selected cases, a pure endoscopic surgical approach (with removal of medial and infero-medial orbital wall), less invasive than the balanced one; the latter indicated to more severe proptosis or diplopia after endoscopic procedure. Three-wall decompression is chosen for high degrees of proptosis, but complications are more frequent. Timing of surgical orbital decompression, in particular when a concomitant optic neuropathy is present, is still to be determined. Additional ophthalmological procedures are needed to restore normal eye function and cosmesis. Strabismus surgery to address diplopia and lowering the position of the upper eyelid represent some of the additional steps for the final rehabilitation of Graves’ orbitopathy. The main clinical outcomes including visual acuity, proptosis, and new-onset diplopia are changing. Recent studies focused on the development of imaging measurements in order to objectively evaluate the surgical results and QOL questionnaires are gaining increasing importance.
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Affiliation(s)
- Claudio Parrilla
- Otorhinolaryngology and Head-Neck Surgery Unit, "A. Gemelli" Hospital Foundation IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Dario Antonio Mele
- Otorhinolaryngology and Head-Neck Surgery Unit, "A. Gemelli" Hospital Foundation IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Silvia Gelli
- Endocrinology Unit, "A. Gemelli" Hospital Foundation IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Lorenzo Zelano
- Endocrinology Unit, "A. Gemelli" Hospital Foundation IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | | | - Mario Rigante
- Otorhinolaryngology and Head-Neck Surgery Unit, "A. Gemelli" Hospital Foundation IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Gustavo Savino
- Ophthalmology Unit, "A. Gemelli" Hospital Foundation IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Emanuele Scarano
- Division of Otolaryngology, Azienda Ospedaliera Pia Fondazione di Culto e Religione Cardinale G. Panico, Tricase, Italy
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Aldrovandi A, Patrizi G, Iadanza M, Tardini L, Lodi E, Sansone R, Savino G, Cappelli S. Cardiac magnetic resonance in athletes with ventricular arrhythmias. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Ventricular arrhythmias in athletes represent an important issue in sport eligibility as they may be a marker of a concealed cardiomyopathy, potentially at risk of sudden cardiac death during sport activity.
Purpose
to assess the utility of cardiac magnetic resonance (CMR) to identify cardiac abnormalities in athletes with documented frequent premature ventricular beats (PVB) or complex ventricular arrhythmias (VA) undergoing competitive sport eligibility screening.
Methods
We enrolled 65 athletes with documented ventricular arrhythmias as follows: 1) frequent PVB at 24-hour ambulatory ECG monitoring (>100 PVB/24h); 2) polymorphic PVB; 3) repetitive PVB (couplets, triplets, or nonsustained ventricular tachicardia). All athletes were studied with rest ECG, exercise stress testing, 24-hour ambulatory ECG monitoring, transthoracic echocardiography and contrast-enhanced CMR.
Results
Sixty-five athletes (56 males, 9 females, age 30 ± 15years) underwent CMR with gadolinium contrast. In 55 patients (84.6%) CMR was normal, in 10 patients (15.4%) the following abnormalities were reported at CMR: four patients with isolated late gadolinium enhancement (LGE) of whom 3 patients with subepicardial LGE in the inferolateral wall and 1 patient with intramyocardial basal inferior LGE; 1 patient with hypertrophic cardiomyopathy with septal LGE; 1 patient with left ventricular non compaction; 3 patients with right ventricular abnormalities (a 13-year-old patient with dilated right ventricle and LGE located at the superior interventricular insertion point, 1 patient with a dilated and hypokinetic right ventricle, 1 patient with a focal right ventricular aneurysm). Transthoracic echocardiography was normal in 7/10 (70%) athletes with CMR abnormalities.
Conclusion
In athletes with frequent or complex ventricular arrhythmias cardiac magnetic resonance identifies cardiac abnormalities in a significant proportion of subjects and it may offer a diagnostic incremental value.
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Affiliation(s)
- A Aldrovandi
- B.Ramazzini Hospital, AUSL Modena, Cardiology, Carpi, Italy
| | - G Patrizi
- B.Ramazzini Hospital, AUSL Modena, Cardiology, Carpi, Italy
| | - M Iadanza
- B.Ramazzini Hospital, AUSL Modena, Radiology, Carpi, Italy
| | | | - E Lodi
- B.Ramazzini Hospital, AUSL Modena, Cardiology, Carpi, Italy
| | - R Sansone
- B.Ramazzini Hospital, AUSL Modena, Radiology, Carpi, Italy
| | - G Savino
- AUSL Modena, Sports Medicine, Modena, Italy
| | - S Cappelli
- B.Ramazzini Hospital, AUSL Modena, Cardiology, Carpi, Italy
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26
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Lodi E, Lodi G, Reggianini L, Savino G, Modena MG. [Sports activity and COVID-19: what's new?]. G Ital Cardiol (Rome) 2021; 22:529-534. [PMID: 34175907 DOI: 10.1714/3629.36102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Growing evidence about COVID-19 and its possible cardiopulmonary complications have raised concerns about a potential subclinical heart damage even in asymptomatic patients. Many countries worldwide provided recommendations for a safe return to play and sports activity for athletes with previous COVID-19 disease. Italy was among the first nations to deal with the problem of protecting athletes' health. In this regard, after an initial version released on April 2020, on December 11, 2020 the Italian Sports Medicine Federation (FMSI) updated the recommendations for the return play of non-professional athletes. The purpose of this article is to analyze and deepen the contents of the new FMSI recommendations, integrating and comparing them with the previous ones. Further updates may occur if new scientific and epidemiological evidence will rise regarding COVID-19.
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Affiliation(s)
- Elisa Lodi
- Centro P.A.S.C.I.A. (Programma Assistenziale Scompenso cardiaco, Cardiopatie dell'Infanzia e A rischio), Università degli Studi di Modena e Reggio Emilia, AOU Policlinico di Modena - Servizio di Medicina dello Sport, Azienda USL di Modena
| | - Giovanni Lodi
- Centro P.A.S.C.I.A. (Programma Assistenziale Scompenso cardiaco, Cardiopatie dell'Infanzia e A rischio), Università degli Studi di Modena e Reggio Emilia, AOU Policlinico di Modena
| | - Letizia Reggianini
- Centro P.A.S.C.I.A. (Programma Assistenziale Scompenso cardiaco, Cardiopatie dell'Infanzia e A rischio), Università degli Studi di Modena e Reggio Emilia, AOU Policlinico di Modena
| | | | - Maria Grazia Modena
- Centro P.A.S.C.I.A. (Programma Assistenziale Scompenso cardiaco, Cardiopatie dell'Infanzia e A rischio), Università degli Studi di Modena e Reggio Emilia, AOU Policlinico di Modena
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27
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Pellegrini F, Mandarà E, Savino G. Reply to: Rezkallah et al. "Unexpected amaurosis occurring after peribulbar anesthesia: Exploring the causes in two cases". Eur J Ophthalmol 2021; 32:NP330-NP331. [PMID: 34030505 DOI: 10.1177/11206721211019592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Francesco Pellegrini
- Ophthalmology Department, "Santo Spirito" Hospital, Pescara, AUSL Pescara, Pescara, Italy
| | - Erika Mandarà
- Ophthalmology Department, "Maria Paternò Arezzo" Hospital, Ragusa, Italy
| | - Gustavo Savino
- Ophthalmology Department, Università Cattolica del Sacro Cuore, Rome, Italy
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28
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Pagliara MM, Tagliaferri L, Savino G, Fionda B, D'Aviero A, Lanza A, Lancellotta V, Midena G, Gambacorta MA, Blasi MA. High-Dose-Rate Interstitial Brachytherapy (Interventional Radiotherapy) for Conjunctival Melanoma with Orbital Extension. Ocul Oncol Pathol 2021; 7:199-205. [PMID: 34307333 DOI: 10.1159/000512344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/15/2020] [Indexed: 11/19/2022] Open
Abstract
Purpose To evaluate local control and functional and cosmetic outcomes of postoperative high-dose-rate interventional radiotherapy (HDR-IRT) in patients affected by conjunctival melanoma with orbit invasion. Methods A retrospective study was conducted in 2 patients affected by conjunctival melanoma infiltrating the orbit, treated with surgical excision and HDR-IRT. The treatment procedures consisted of surgical excision of the orbital infiltrating nodule followed, 1 month after surgery, by adjuvant HDR-IRT. A target dose of 34 Gy was delivered in 10 twice-a-day fractions over 5 consecutive days. Data analysis included local tumor control and metastatic rate, acute and late toxicity, functional and aesthetic results. Results In both patients, treatment was well tolerated, and there was no orbital recurrence at a median follow-up of 37-40 months. There was an excellent functional outcome, without no significant acute or late side effects. Conclusions HDR-IRT could be considered a promising, feasible, successful, and well-tolerated option for selected patients affected by ocular tumors with orbital invasion.
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Affiliation(s)
- Monica Maria Pagliara
- UOC Oncologia Oculare, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luca Tagliaferri
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Gustavo Savino
- UOC Oncologia Oculare, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Bruno Fionda
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Andrea D'Aviero
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Angela Lanza
- Ocular Unit, Ospedale Teresa Masselli, Foggia, Italy
| | - Valentina Lancellotta
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giulia Midena
- UOC Oncologia Oculare, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Antonietta Gambacorta
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS - Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Antonietta Blasi
- UOC Oncologia Oculare, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
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Marra M, Lucci C, Huertas-Leyva P, Baldanzini N, Pierini M, Savino G. The future of the Autonomous Emergency Braking for Powered-Two-Wheelers: field testing end-users’ acceptability in realistic riding manoeuvres. ACTA ACUST UNITED AC 2021. [DOI: 10.1088/1757-899x/1038/1/012016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Nasi M, D'alisera R, Cossarizza A, Guerra E, Savino G, Mattioli AV. Sex Difference in Access to Sports: A 1-Year Retrospective Study. Am J Lifestyle Med 2020; 15:108-112. [PMID: 33456422 DOI: 10.1177/1559827620911610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Purpose. Regular physical activity is a cornerstone in the prevention and treatment of cardiovascular disease thanks to its anti-inflammatory effects. Thus, favoring the access to sports is of importance for promoting well-being. The aim of the present study was to investigate how the practice of different sports is distributed among different age groups and between men and women, by taking a picture of the medical certificate request in 2017 for sports in the population of the province of Modena, Italy. Methods. We analyzed the difference in distribution of requested medical certificate from 18 874 males and 7625 females stratified for age (<18 years, 18-40 years, and >40 years) and for different sporting disciplines (athletics, football, bike, swimming, basketball, volleyball, tennis, other team sports, other individual sports, and disabled sports). Results. Men requested medical certificates more than women (more than 2.5 times). The distribution of requested certificates differs significantly (chi-square test P < .0001) at different ages and between males and females of same age. Certificate for men aged less than 18 years were 7550 and for women were 4131 and the difference increase with age. Conclusions. In order to decrease the imbalance between men and women access to sports, it is mandatory to promote a healthy lifestyle and reduce, as consequence, cardiovascular risks, mostly in women after 40 years.
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Affiliation(s)
- Milena Nasi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy (MN, AVM).,National Health Service, Unit of Sports Medicine, Department of Public Health, AUSL Modena, Modena, Italy (RD, EG, GS).,Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy (AC)
| | - Roberta D'alisera
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy (MN, AVM).,National Health Service, Unit of Sports Medicine, Department of Public Health, AUSL Modena, Modena, Italy (RD, EG, GS).,Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy (AC)
| | - Andrea Cossarizza
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy (MN, AVM).,National Health Service, Unit of Sports Medicine, Department of Public Health, AUSL Modena, Modena, Italy (RD, EG, GS).,Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy (AC)
| | - Emanuele Guerra
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy (MN, AVM).,National Health Service, Unit of Sports Medicine, Department of Public Health, AUSL Modena, Modena, Italy (RD, EG, GS).,Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy (AC)
| | - Gustavo Savino
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy (MN, AVM).,National Health Service, Unit of Sports Medicine, Department of Public Health, AUSL Modena, Modena, Italy (RD, EG, GS).,Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy (AC)
| | - Anna Vittoria Mattioli
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy (MN, AVM).,National Health Service, Unit of Sports Medicine, Department of Public Health, AUSL Modena, Modena, Italy (RD, EG, GS).,Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy (AC)
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31
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Savino G, Valenti L, D'Alisera R, Pinelli M, Persi Y, Trenti T. Dietary supplements, drugs and doping in the sport society. Ann Ig 2020; 31:548-555. [PMID: 31616899 DOI: 10.7416/ai.2019.2315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Consumption of supplements and the use/abuse of drugs to support athletic performance is increasingly growing. The aim of this paper is to approach the phenomenon by providing a tool to develop critical awareness of these problems. By reviewing scientific articles, we collected information on the use of licit and illicit substances among professional and non-professional athletes, showing a widespread scenario also based on false myths. The use of supplements, drugs and doping substances represents a complex and still debated issue, that deserves greater consideration among both sportsmen and health operators. A more critical and informed approach to these topics can support empowerment and a conscious use of drugs by respecting eating habits, own health and healthy lifestyles.
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Affiliation(s)
- G Savino
- Emilia-Romagna Antidoping Center, AUSL Modena, Modena, Italy
| | - L Valenti
- National Health Service, Unit of Sports Medicine, Department of Public Health, AUSL Modena, Modena, Italy
| | - R D'Alisera
- Emilia-Romagna Antidoping Center, AUSL Modena, Modena, Italy
| | - M Pinelli
- National Health Service, Unit of Sports Medicine, Department of Public Health, AUSL Modena, Modena, Italy
| | - Y Persi
- National Health Service, Unit of Sports Medicine, Department of Public Health, AUSL Modena, Modena, Italy
| | - T Trenti
- Intercompany Department with Integrated Activity in Laboratory Medicine and Pathological Anatomy, Hospital Company University of Modena, Modena, Italy - WDPP, Working Group Doping Prevention Project
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32
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Pasquarella C, Pompili M, Valeriani F, Morgado M, Milicia GM, Veronesi L, Odone A, Zoni R, Saccani E, Savino G, Persi Y, Pinelli M, Liguori G, Gallè F, Di Onofrio V, Fallace P, Romano Spica V. The prevention of doping and the improper use of drugs and food supplements in sports and physical activities: a survey on the activity of the prevention departments of Italian local health authorities. Ann Ig 2020; 31:533-547. [PMID: 31616898 DOI: 10.7416/ai.2019.2314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Doping is an important public health problem widespread not only among elite athletes, but also among amateur and recreational athletes and the general population. In Italy the introduction of doping prevention within the Essential Levels of Care (LEA) with the DPCM 12/1/2017 represents a crucial step towards the implementation of education and health promotion interventions. In this context, the Departments of Prevention (DP) of the Local Health Authorities (LHA) have to play a fundamental role, becoming the cultural and operational reference on this issue. As part of the "Doping prevention: development of a permanent educational tool coordinated by the National Health Service Prevention Departments" project, funded by the Italian Ministry of Health, a survey was conducted on the activities carried out by the DP regarding doping prevention and improper use and abuse of drugs and food supplements in sports and physical activities, as a basis for the harmonization of organizational structures and prevention programs and the creation of a collaboration network at a regional and national level. METHODS A semi-structured questionnaire consisting of 11 questions, prepared on an electronic platform, was sent to the DP of all the Italian LHA. RESULTS A total of 38 DP out of 131 (29%) completed the questionnaire, with representation from all regions. 42.1% of DP carried out or are still running programs for the prevention of doping, a percentage that decreases to 27% considering the programs for the prevention of misuse and abuse of drugs and food supplements in sports and in physical activities; in less than half of the DP, 37.5% and 41.7%, respectively, dedicated funds have been allocated. The professionals most involved in prevention of doping are the Specialists in Sport Medicine (81.3%) followed by Specialists in Hygiene (43.8%) and Psychologists (37.5%), while Health Care Assistants (50%) are the professionals most involved in the prevention of the improper use of drugs and food supplements, followed by Specialists in Hygiene and Specialists in Sport Medicine (40%). Most of the DP (71.9%) believe that the introduction of programs to prevent and counteract doping in the LEA will have repercussions on their approach against doping. CONCLUSIONS The survey, although conducted on a limited sample, has provided an important framework relating to programs for the prevention of doping and the misuse and abuse of drugs and food supplements in sports and in the physical activities carried out by DP. A remarkable heterogeneity has been highlighted, both at national and regional level. It is urgent to provide DP with homogeneous and effective organizational models and adequate operational tools, paying particular attention to the training of all the professionals involved. It is also essential to implement permanent monitoring tools.
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Affiliation(s)
- C Pasquarella
- Department of Medicine and Surgery, University of Parma, Parma, Italy - WDPP, Working Group Doping Prevention Project
| | - M Pompili
- Local Health Autority Area Vasta n.1, Fano, Italy - RRN, Regional Referents Network
| | - F Valeriani
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - M Morgado
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - G M Milicia
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - L Veronesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - A Odone
- University Vita-Salute San Raffaele, Milan, Italy
| | - R Zoni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - E Saccani
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - G Savino
- Emilia-Romagna Antidoping Center, AUSL Modena, Modena, Italy - WDPP, Working Group Doping Prevention Project
| | - Y Persi
- Emilia-Romagna Antidoping Center, AUSL Modena, Modena, Italy
| | - M Pinelli
- Emilia-Romagna Antidoping Center, AUSL Modena, Modena, Italy
| | - G Liguori
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy - GSMS-SItI, Working Group on Movement Sciences for Health, Italian Society of Hygiene Preventive Medicine and Public Health - WDPP, Working Group Doping Prevention Project
| | - F Gallè
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - V Di Onofrio
- Department of Sciences and Technologies, University of Naples "Parthenope", Naples, Ital
| | - P Fallace
- Prevention Department of ASL Napoli 2 Nord, Naples, Italy - WDPP, Working Group Doping Prevention Project - RRN, Regional Referents Network
| | - V Romano Spica
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy - WDPP, Working Group Doping Prevention Project
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Savino G, Petrone G, Volpe G, Midena G, Grimaldi G, Fiorentino V, Maceroni M. Vertical restrictive strabismus associated with proptosis: Similar clinical signs, different etiopathogenetic causes. A report of three patients. Eur J Ophthalmol 2020; 32:1120672120946929. [PMID: 32720817 DOI: 10.1177/1120672120946929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To report the different uncommon pathogenesis of three cases of severe vertical restrictive strabismus associated with progressive unilateral proptosis with similar clinical features. METHODS Case series of three patients who presented to the Orbit Outpatient Service of Policlinico Gemelli with a history of left progressive unilateral proptosis, slowly worsening vertical strabismus and the left eye fixed in downward position. A thorough hematologic work up was performed. All patients underwent complete abdomen ultrasonography, orbital contrast enhanced magnetic resonance imaging, forced duction test under general anesthesia, and orbital biopsy. RESULTS Patients were 30, 60, and 46 years old respectively. MRI showed left inferior rectus enlargement in two cases and superior rectus enlargement in one case, with contrast enhanced combined muscle belly and tendon enlargement in all cases. Patients underwent forced duction test, muscle weakening (in two cases), and muscle biopsy with histopathologic examination. The superior rectus appeared infiltrated by an undifferentiated high-grade pleomorphic sarcoma, whereas the two inferior recti were positive for idiopathic orbital inflammatory disease with fibrosis areas and neuromuscular choristoma, respectively. CONCLUSION Although proptosis and acquired vertical restrictive strabismus are most commonly associated with thyroid associated orbitopathy (TAO), they can also be a manifestation of many other conditions and the differential diagnosis can be particularly challenging. The three reported cases presented indeed with similar clinical features but had three distinct underlying orbital etiologies, two of which were extremely uncommon.
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Affiliation(s)
- Gustavo Savino
- UOC Oncologia Oculare, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianluigi Petrone
- Università Cattolica del Sacro Cuore, Rome, Italy
- Istituto di Patologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giulio Volpe
- UOC Oncologia Oculare, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulia Midena
- UOC Oncologia Oculare, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gabriela Grimaldi
- UOC Oncologia Oculare, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vincenzo Fiorentino
- Università Cattolica del Sacro Cuore, Rome, Italy
- Istituto di Patologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Martina Maceroni
- UOC Oncologia Oculare, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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Lodi E, Scavone A, Carollo A, Guicciardi C, Reggianini L, Savino G, Modena MG. [Return to sport after the COVID-19 pandemic. How to behave?]. G Ital Cardiol (Rome) 2020; 21:514-522. [PMID: 32555567 DOI: 10.1714/3386.33637] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Italy, and all the world, has recently faced the arduous battle against the spread of a new coronavirus: SARS-CoV-2. This unexpected pandemic dramatically upended all areas of life, leading to a profound change in priorities, both in the medical as well as the social-economic field; and sports is no exception. Not surprisingly, the COVID-19 pandemic also walloped the world of sports. Every aspect of sports has been affected, leading professional and amateur leagues to stop their activities, in order to limit the spread of the virus, a painful but mandatory choice. Even the most popular sports in the world had to deal with the massive global threat of SARS-CoV-2. The Italian Sports Medical Federation (FMSI) has recently drawn up a protocol to be implemented when teams will receive from the authorities the permission to return to competitive activities. The purpose of this paper is to deepen the FMSI indications and allow wider dissemination and understanding.
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Affiliation(s)
- Elisa Lodi
- Centro P.A.S.C.I.A. (Programma Assistenziale Scompenso cardiaco, Cardiopatie dell'Infanzia e A rischio), Università degli Studi di Modena e Reggio Emilia, AOU Policlinico di Modena - Servizio di Medicina dello Sport, Azienda USL di Modena
| | - Alberto Scavone
- Centro P.A.S.C.I.A. (Programma Assistenziale Scompenso cardiaco, Cardiopatie dell'Infanzia e A rischio), Università degli Studi di Modena e Reggio Emilia, AOU Policlinico di Modena - Servizio di Medicina dello Sport, Azienda USL di Modena
| | - Alberto Carollo
- Centro P.A.S.C.I.A. (Programma Assistenziale Scompenso cardiaco, Cardiopatie dell'Infanzia e A rischio), Università degli Studi di Modena e Reggio Emilia, AOU Policlinico di Modena - Servizio di Medicina dello Sport, Azienda USL di Modena
| | - Claudio Guicciardi
- Centro P.A.S.C.I.A. (Programma Assistenziale Scompenso cardiaco, Cardiopatie dell'Infanzia e A rischio), Università degli Studi di Modena e Reggio Emilia, AOU Policlinico di Modena - Servizio di Medicina dello Sport, Azienda USL di Modena
| | - Letizia Reggianini
- Centro P.A.S.C.I.A. (Programma Assistenziale Scompenso cardiaco, Cardiopatie dell'Infanzia e A rischio), Università degli Studi di Modena e Reggio Emilia, AOU Policlinico di Modena
| | | | - Maria Grazia Modena
- Centro P.A.S.C.I.A. (Programma Assistenziale Scompenso cardiaco, Cardiopatie dell'Infanzia e A rischio), Università degli Studi di Modena e Reggio Emilia, AOU Policlinico di Modena
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Savino G, Volpe G, Grimaldi G, Battendieri R, Midena G, Lanni V, Bernardo R, Iuliano A. Relation of the eighth edition of the American Joint Committee on Cancer staging system with histological risk classification for primary eyelid basal cell carcinoma. Eur J Ophthalmol 2020; 31:1399-1404. [PMID: 32418449 DOI: 10.1177/1120672120922455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the relation between the eighth edition of the American Joint Committee on Cancer staging system and histological risk classification for primary eyelid basal cell carcinoma. METHODS Retrospective, observational case series of patients undergoing excisional biopsy for primary eyelid basal cell carcinoma in two tertiary centres between 2008 and 2018. Patients with <6 months of follow-up were excluded. Outcomes measured included histological subtype, American Joint Committee on Cancer 7 and 8 staging. RESULTS A total of 222 cases were included over a 10-year period, with a mean (range) follow-up of 25.74 (6-120) months and a median (range) age of 70 (28-93) years. According to American Joint Committee on Cancer 8, the most common T category was T1a (64%), followed by T1b (18%) and T2a (8%). Of the 222 specimens, 183 (82.43%), 17 (7.66%), 19 (8.56%) and 3 (1.35%) were staged as IA, IB, IIA and IIB, respectively. The most common histological subtype was nodular in IA category and infiltrative in categories IB and IIA. Histologically, low-risk basal cell carcinomas were related to lower American Joint Committee on Cancer staging (IA), whereas high-risk basal cell carcinomas were related to American Joint Committee on Cancer stages IB and IIA (p < 0.001). No significant relation was found between T categorisation and risk stratification when adopting American Joint Committee on Cancer 7. CONCLUSION American Joint Committee on Cancer 8 staging system is strongly related to primary eyelid basal cell carcinoma histological risk classification.
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Affiliation(s)
- Gustavo Savino
- UOC Oncologia Oculare, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulio Volpe
- Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Remo Battendieri
- UOC Oncologia Oculare, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Vittoria Lanni
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Roberta Bernardo
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Adriana Iuliano
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
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Romano Spica V, Di Rosa E, Savino G, Pasquarella C, Liguori G, Fallace P, Fara GM, Giammanco G. Erice 2018 Charter on the role of the National Health Service in the prevention of doping. Ann Ig 2019; 31:523-532. [PMID: 31637905 DOI: 10.7416/ai.2019.2313] [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: 06/10/2023]
Abstract
The Erice 2018 Charter was unanimously approved at the conclusion of the 53rd Residential Course of the International School of Epidemiology and Preventive Medicine “Adapted Physical Activity in Sport, Wellness and Fitness; the role of the Departments of Prevention and of the National Health Service in doping prevention and health promotion”, held on 15-19 May 2018 in Erice, Italy, at the “Ettore Majorana” Foundation and Centre for Scientific Culture, and promoted by the Study Group on “Movement Sciences for Health” of the Italian Society of Hygiene, Preventive Medicine and Public Health. The event was part of a larger project supported by the Ministry of Health aimed at preventing doping in the general population involved in sport and physical activities. After an intense discussion the participants focused on ten statements involving the following critical issues: responsibility, priority, message, alphabetization, networks and alliances, school promoting health, player and opportunities, competences, know-how, programming and acting. These statements provide hints to approach doping within a public health frame and summarize the role of the Departments of Prevention and NHS in promoting and coordinating preventive actions with other institutions and stakeholders. Doping represents a complex phenomenon related to cultural, social, economic and legal issues. In addition to regulatory or repressive actions, education to health and legality is proposed as the fundamental strategy to contrast doping by promoting healthy lifestyles, based on scientific knowledge and respect for legality.
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Affiliation(s)
- V Romano Spica
- University of Rome “Foro Italico”, Rome, Italy
- WDPP, Working Group Doping Prevention Project
- GSMS-SItI, Working Group on Movement Sciences for Health, Italian Society of Hygiene Preventive Medicine and Public
Health
| | - E Di Rosa
- ASL ROMA1, Rome, Italy
- GSMS-SItI, Working Group on Movement Sciences for Health, Italian Society of Hygiene Preventive Medicine and Public
Health
| | - G Savino
- Emilia-Romagna Antidoping Center, AUSL Modena, Modena, Italy
| | - C Pasquarella
- University of Parma, Parma, Italy
- WDPP, Working Group Doping Prevention Project
| | - G Liguori
- University of Napoli “Parthenope”, Naples, Italy
- WDPP, Working Group Doping Prevention Project
- GSMS-SItI, Working Group on Movement Sciences for Health, Italian Society of Hygiene Preventive Medicine and Public
Health
| | - P Fallace
- Prevention Department, ASL Napoli 2 Nord, Napoli, Italy
- WDPP, Working Group Doping Prevention Project
- RRN, Regional Referents Network
| | - G M Fara
- Sapienza University of Rome, Rome, Italy
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Fallace P, Aiese P, Bianco E, Bolognini I, Costa MP, Esposito R, Gallé F, Liguori G, Pandolfi R, Pasquarella C, Savino G, Valeriani F, Romano Spica V. Peer Education strategies for promoting prevention of doping in different populations. Ann Ig 2019; 31:556-575. [PMID: 31616900 DOI: 10.7416/ai.2019.2316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND In the field of doping prevention, alongside the traditional functions of repression and control of the phenomenon, educational aspects are becoming increasingly important. Article 18 of the World Anti doping Code obliges the signatories to invest in anti-doping education with the aim of preserving the spirit of sport. The educational commitment should involve young people in health promotion interventions for the prevention of risk behaviors. Therefore, our attention has focused on finding the mechanisms that lead people to make certain behavioral choices. MATERIAL AND METHODS In the context of preventive programs, to counter the doping phenomenon through health promotion programs, the most recognized method is peer education, particularly with adolescents. It is an educational method according to which some members of a group are empowered and trained to carry out specific activities with their peers. It is constituted as an example of equal relationship and finds its basis in cooperation and solidarity with the aim of increasing empowerment and a healthy development of the identity and collective dimension in young people. RESULTS Numerous experts - biologists / nutritionists, hygienists, sports coaches, psychologists, teachers of physical education in secondary schools and other stakeholders have actively participated in the co-construction of a training package aimed at activating cascade training processes on the knowledge and skills of peer education in contexts of youth aggregation, such as schools, gyms, sports associations, social gatherings of all kinds. The path allowed to define a peer education model capable of enabling the participants to activate health promotion interventions for the prevention of doping risk behaviors, each in their own setting. CONCLUSIONS In conclusion, we can say that prevention programs are the more effective the more they are addressed to young people and adolescents and provide interactive and action-oriented interventions. Successful initiatives aim to emphasize the development of life skills and to influence numerous determinants of behavior, including individual attitudes, knowledge, motivations, interpersonal relationships and social norms. If the aim is to act on the change of behavior, the efforts will be more successful if the content of the intervention will give due consideration to the context in which it applies and the target population, involving it and addressing its specific needs and values.
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Affiliation(s)
- P Fallace
- Prevention Department, ASL Napoli 2 Nord, Frattamaggiore, Italy - WDPP, Working Group Doping Prevention Project
| | - P Aiese
- Prevention Department, ASL Napoli 2 Nord, Frattamaggiore, Italy
| | - E Bianco
- Prevention Department, ASL Napoli 2 Nord, Frattamaggiore, Italy
| | - I Bolognini
- Prevention Department, ASL Napoli 2 Nord, Frattamaggiore, Italy
| | - M P Costa
- Prevention Department, ASL Napoli 2 Nord, Frattamaggiore, Italy
| | - R Esposito
- Prevention Department, ASL Napoli 2 Nord, Frattamaggiore, Italy
| | - F Gallé
- Department of Motor and Wellness Sciences, University of Naples "Parthenope", Naples, Italy
| | - G Liguori
- Department of Motor and Wellness Sciences, University of Naples "Parthenope", Naples, Italy - WDPP, Working Group Doping Prevention Project
| | - R Pandolfi
- Prevention Department, ASL Napoli 2 Nord, Frattamaggiore, Italy
| | - C Pasquarella
- Department of Medicine and Surgery, University of Parma, Italy - WDPP, Working Group Doping Prevention Project
| | - G Savino
- Ausl Modena and Antidoping Regional Center, Emilia-Romagna Region, Italy - WDPP, Working Group Doping Prevention Project
| | - F Valeriani
- Department of Movement, Human, and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - V Romano Spica
- Department of Movement, Human, and Health Sciences, University of Rome "Foro Italico", Rome, Italy - WDPP, Working Group Doping Prevention Project
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Roli L, Tagliavini S, Trenti T, Savino G, D'alisera R, Nasi M, Cossarizza A, Varani M. Benefits of high-sensitivity cardiac troponin assay for athletes’ cardiac health monitoring. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1042] [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: 11/29/2022]
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Sao Miguel Morgado M, Odone A, Milicia GM, Valeriani F, Veronesi L, Liguori G, Fallace P, Savino G, Romano Spica V, Pasquarella C. Prevalence of doping and dietary supplements use in Europe. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - A Odone
- University Vita-Salute San Raffaele, Milan, Italy
| | | | - F Valeriani
- Department of Movement, Human and Health Sciences, University of Rome, Rome, Italy
| | | | - G Liguori
- Department of Movement and Wellbeing Sciences, University of Naples, Naples, Italy
| | - P Fallace
- Local Health Unit, Naples 2 Nord, Naples, Italy
| | - G Savino
- Regional Centre Anti-Doping Emilia-Romagna Region, Local Health Unit, Modena, Italy
| | - V Romano Spica
- Department of Movement, Human and Health Sciences, University of Rome, Rome, Italy
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Modugno AC, Resti AG, Mazzone G, Moretti C, Terreni MR, Albanese G, Savino G, Grimaldi G, Collin R. Long-term outcomes after cosmetic customized prostheses and dermis fat graft in congenital anophthalmia: a retrospective multicentre study. Eye (Lond) 2018; 32:1803-1810. [PMID: 30042409 DOI: 10.1038/s41433-018-0179-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 06/04/2018] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate long-term outcomes of progressively enlarging cosmetic customized prostheses (CCP) early after birth followed by dermis fat graft (DFG), as a strategy of socket rehabilitation in children with clinical congenital anophthalmia (CCA). METHODS Twenty patients with unilateral and two patients with bilateral CCA were enrolled. All patients were treated by inserting a CCP at the time of their first assessment which was then enlarged. Subsequently they underwent DFG. Differences in vertical palpebral aperture (VPA) and horizontal palpebral length (HPL), between affected and unaffected sides, were recorded at the first CCP fitting as well as before and after DFG. Satisfaction with cosmetic results, prosthetic retention, and complications rate were assessed. Magnetic resonance imaging of the orbit was performed in all patients before and after surgery. RESULTS A significant decrease in the difference between the normal and the anophthalmic side of both PA and HPL was found over follow-up. Both VPA and HPL differences decreased by 47.6% (10.5 mm, range 1-28 mm) and by 7.1% (5.8 mm, range 0-18 mm), respectively. Satisfaction in terms of cosmetic outcomes proved to be very positive, being "very satisfied" for families and "satisfied" for physicians. Excellent retention of prostheses was observed in all cases. CONCLUSIONS A rehabilitating strategy combining early CCP and further DFG proved to be a valuable approach in children with CCA, offering significant benefits in terms of socket expansion, prosthetic retention, psychological impact, and cosmetic outcomes.
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Affiliation(s)
| | | | | | | | | | | | - Gustavo Savino
- Institute of Ophthalmology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gabriela Grimaldi
- Institute of Ophthalmology, Università Cattolica del Sacro Cuore, Rome, Italy
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Roli L, De Vincentis S, Rocchi MBL, Trenti T, De Santis MC, Savino G. Testosterone, cortisol, hGH, and IGF-1 levels in an Italian female elite volleyball team. Health Sci Rep 2018; 1:e32. [PMID: 30623067 PMCID: PMC6266423 DOI: 10.1002/hsr2.32] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 12/12/2017] [Accepted: 02/01/2018] [Indexed: 01/03/2023] Open
Abstract
PURPOSE To assess the transferability of the reference intervals (RI) of testosterone (T), cortisol (C), human growth hormone (hGH), and insulin-like growth factor (IGF)-1, calculated on a normal healthy population, to a population of female elite volleyball players. Secondary aim of this study is the evaluation of the T/C ratio as predictive tool of overtraining during the annual regular season. METHODS A retrospective, longitudinal, observational study was performed, enrolling 58 professional female volleyball players periodically evaluated during the regular sportive season, which lasts from September to May. RESULTS Statistically significant differences between the volleyball players and reference populations for T (P = .010), C (P < .001), and IGF-1 (P < .001) were found. Three different statistical approaches to calculate the RI in the athlete group showed a high degree of concordance and pointed out a shift upwards of both lower and upper reference limits. The T/C ratio significantly changed among visits (P = .009). In particular, an overall decrease of about 30% was observed for this ratio during the season, suggesting a state of overtraining. CONCLUSION T, C, hGH, and IGF-1 reference values calculated on elite volleyball female players are higher than those of the reference population used in normal clinical practice, suggesting that the health status of highly trained subjects needs the definition of tailored RI for these variables. Moreover, the utility of T/C ratio in the evaluation of overtraining is confirmed.
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Affiliation(s)
- Laura Roli
- Department of Laboratory Medicine and PathologyAzienda USL of ModenaItaly
| | - Sara De Vincentis
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural SciencesUniversity of Modena and Reggio EmiliaItaly
- Department of Medicine, Endocrinology, Metabolism and GeriatricsAzienda Ospedaliero‐Universitaria of ModenaItaly
| | | | - Tommaso Trenti
- Department of Laboratory Medicine and PathologyAzienda USL of ModenaItaly
| | | | - Gustavo Savino
- Department of Public Healthcare, Sport Medicine ServiceAzienda USL of ModenaItaly
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Calandriello L, Grimaldi G, Petrone G, Rigante M, Petroni S, Riso M, Savino G. Cavernous venous malformation (cavernous hemangioma) of the orbit: Current concepts and a review of the literature. Surv Ophthalmol 2017; 62:393-403. [PMID: 28131871 DOI: 10.1016/j.survophthal.2017.01.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 01/03/2017] [Accepted: 01/04/2017] [Indexed: 12/14/2022]
Abstract
The cavernous venous malformation of the orbit, previously called cavernous hemangioma, is the most common primary orbital lesion of adults. Cavernous venous malformation occurs more often in women and typically presents in the fourth and fifth decades of life. It is a benign vascular malformation characterized by a well-defined capsule and numerous large vascular channels. The most common sign of cavernous venous malformation is progressive axial proptosis from the preferential involvement of the intraconal orbital space. Optic nerve damage and other signs of orbital pathology may be present, with a variable degree of visual impairment. The combination of ultrasound, computed tomography, and magnetic resonance imaging leads to an accurate diagnosis in the vast majority of cases. Surgical and nonsurgical treatments are required in case of symptomatic lesions, with a characteristic multidisciplinary management influencing optimal outcome. Orbitotomy represents the traditional surgical approach. Recently, the endoscopic transnasal approach to the orbital cavity has gained interest, representing a feasible and safe, less-invasive surgical technique for the management of cavernous venous malformation.
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Affiliation(s)
- Luigi Calandriello
- Department of Ophthalmology, Università Cattolica del Sacro Cuore, Rome, Italy; Ophthalmology, Fondazione G. B. Bietti-IRCCS, Rome, Italy
| | - Gabriela Grimaldi
- Department of Ophthalmology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianluigi Petrone
- Department of Pathology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mario Rigante
- Department of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sergio Petroni
- Department of Pediatrics, Bambino Gesù IRCCS Children's Hospital, Rome, Italy
| | - Monica Riso
- Department of Ophthalmology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gustavo Savino
- Department of Ophthalmology, Università Cattolica del Sacro Cuore, Rome, Italy.
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Savino G, Abed E, Rebecchi MT, Spreca M, Tredici C, Dickmann A. Acute acquired concomitant esotropia and decompensated monofixation syndrome: a sensory-motor status assessment. Can J Ophthalmol 2016; 51:258-264. [DOI: 10.1016/j.jcjo.2016.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 12/29/2015] [Accepted: 02/10/2016] [Indexed: 12/01/2022]
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Ferrari A, Pasciullo G, Savino G, Cicero AFG, Ottani A, Bertolini A, Sternieri E. Headache Treatment Before and After the Consultation of a Specialized Centre: A Pharmacoepidemiology Study. Cephalalgia 2016; 24:356-62. [PMID: 15096224 DOI: 10.1111/j.1468-2982.2004.00678.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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: 11/29/2022]
Abstract
Our aim was to study and compare pharmacoepidemiology of headache treatment in two different settings: inside and outside a specialized Centre. We analysed the differences in headache treatment between 612 subjects admitted for the first visit (‘naive’) (F/M: 2.41; mean age = 37.31 ± 14.09 years) and 620 subjects admitted for a control visit (F/M: 3.18; mean age = 44.30 ± 15.37 years) to the Headache Centre of the University of Modena and Reggio Emilia. Most patients suffered from migraine. As acute treatment, on the first visit, 49.4% of them were taking drugs prescribed by a doctor; 41.5% were taking over-the-counter analgesics (OTCAs); 9.1% were not taking any drug. On the control visit, 81.3% of patients were taking prescription drugs; 15.8% OTCAs; 2.9% were not taking drugs (overall chi-square = 139.229, P < 0.001). Non-selective analgesics were the most-used drugs. Triptans were used by 9.1% of ‘naive’ patients and by 31.8% of patients attending for the control visit (Fisher's Z = 7.655, P < 0.001). Nimesulide was the most-used drug. A prophylactic treatment was made by 16.8% of ‘naive’ patients, and by 58.2% of patients admitted to the control visit (Fisher's Z = 12.135, P < 0.001). Antidepressants were the class of drugs most used for prophylaxis. Amitriptyline was the drug for prophylaxis most frequently used by patients attending the control visit, while flunarizine was the most frequently used by ‘naive’ patients. Before being examined in a specialized centre, few patients take prescription drugs, triptans, or prophylactic drugs; specialized care increases the proportion of patients taking prophylactic drugs, and changes the type of acute treatment used into disease-specific medication for headache.
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Affiliation(s)
- A Ferrari
- Headache Centre, Toxicology and Clinical Pharmacology Section, Department of Internal Medicine, University of Modena and Reggio Emilia, Italy.
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Abstract
PURPOSE To investigate the efficacy of a one-stage early correction of blepharophimosis-ptosis-epicanthus inversus syndrome (BPES), using bovine pericardium derived membrane (TUTOPATCH(®)) for the frontalis suspension. METHODS We prospectively studied 12 eyes from 6 patients (median age 14 months) affected by BPES with severe ptosis. All patients were submitted to a one-stage early correction of ptosis (frontalis suspension with TUTOPACH(®)) and telecanthus and epicanthus inversus. Upper margin reflex distance (MRD), nasal inner intercanthal distance (IICD), horizontal fissure length (HFL), and IICD/HFL ratio were evaluated using photographs. RESULTS The Wilcoxon signed-rank test showed a statistically significant difference between pre- and post-operative MRD, IICD, HFL, and the IICD/HFL ratio. CONCLUSION An early TUTOPATCH-assisted frontalis suspension, together with the correction of telecanthus and epicanthus inversus, is an effective procedure for BPES cases with severe ptosis.
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Affiliation(s)
- Gustavo Savino
- Institute of Ophthalmology, Policlinico Gemelli, Catholic University of Sacred Heart , Rome , Italy and
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Savino G, Mandarà E, Gari M, Battendieri R, Corsello SM, Pontecorvi A. Intraorbital injection of rituximab versus high dose of systemic glucocorticoids in the treatment of thyroid-associated orbitopathy. Endocrine 2015; 48:241-7. [PMID: 24880619 DOI: 10.1007/s12020-014-0283-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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] [Received: 02/17/2014] [Accepted: 04/29/2014] [Indexed: 12/15/2022]
Abstract
The aim of the study was to compare, in a randomized prospective study, the efficacy and safety of intraorbital administration of low doses of RTX versus intravenous glucocorticoids (GCs) to treat patients affected by moderately severe thyroid-associated active orbitopathy. Twenty patients with active, moderately severe TAO, whose mean age was 56.7 years±10.2 SD participated in the study. Patients were randomly selected and treated with intraorbital injections of RTX or with i.v. GCs. Disease activity and severity were assessed by the Clinical Activity Score (CAS) and the NOSPECS. Computed tomography or magnetic resonance scans were performed in all patients. In the RTX group, full blood cell count and flow cytometric analysis on peripheral blood lymphocytes were done. The patients were followed for 20 months. In both groups, CAS and NOSPECS indexes were significantly reduced (p<0.005). In particular, CAS reduction was evident since the first follow-up with both treatments. Proptosis decreased significantly only in group B and diplopia showed no significant changes during follow-up times in both groups. Neither of the treatments affected the peripheral TRab. In group A, 5 weeks after the first injection, the CD20+ peripheral lymphocytes value was nearly zero. One patient treated with rituximab progressed to severe TAO (optic neuropathy) following the second injection so the treatment was discontinued. The data confirm the therapeutic efficacy of RTX in active TAO, even in low doses and locally administered. The efficacy on the inflammatory component of the disease is comparable to that of steroids and seems to be related with the reduction of peripheral CD20+ lymphocytes. Caution should be given to an accurate patient selection.
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Affiliation(s)
- Gustavo Savino
- Institute of Ophthalmology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy,
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47
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Pitocco D, Marano R, Di Stasio E, Scavone G, Savino G, Zaccardi F, Rizzi A, Martini F, Musella T, Silvestri V, Costantini F, Galli M, Caputo S, Bonomo L, Ghirlanda G. Atherosclerotic coronary plaque in subjects with diabetic neuropathy: the prognostic cardiovascular role of Charcot neuroarthropathy--a case-control study. Acta Diabetol 2014; 51:587-93. [PMID: 24509841 DOI: 10.1007/s00592-014-0559-1] [Citation(s) in RCA: 4] [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] [Received: 12/03/2013] [Accepted: 01/15/2014] [Indexed: 11/24/2022]
Abstract
The aim of this study was to investigate the severity of coronary artery disease (CAD) and the plaque composition in neuropathic type 2 diabetic subjects with and without Charcot neuroarthropathy (CN) undergoing multidetector computed tomography coronary angiography (MDCT-CA). The study was a single-center, observational, with unmatched case-control design. We selected 17 CN patients and 18 patients with diabetic neuropathy (DN) without CN. In all the patients, multidetector computed tomography was performed to assess the coronary artery calcium score (CACS) and degree of coronary artery stenosis. Patients were classified as positive in the presence of significant CAD if there was at least one stenosis >50 % on MDCT-CA. The invasive coronary angiography was performed in case of significant stenosis detected with MDCT-CA, both as reference to standard and eventually as treatment. Groups were matched for age, sex, and traditional CAD risk factors. As compared to DN individuals, CN exhibited higher rates of significant coronary stenoses (p = 0.027; OR 7.7 [1.3-43.5]). However, no significant differences were observed in the CACS, which reflects plaque burden, in the two groups (p = 0.759). No significant differences were observed comparing CACS distribution in all subjects for stenosis higher/equal or lower than 50 % (p = 0.320). Finally, no significant differences were observed comparing CACS distribution in CN and DN subjects for coronary stenoses higher/equal or lower than 50 %. Our results suggest that CN patients have a higher prevalence of severe coronary plaques compared to DN patients. Nevertheless, coronary plaques in CN patients did not exhibit an increased degree of calcification.
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Affiliation(s)
- D Pitocco
- Department of Internal Medicine, Catholic University School of Medicine, Rome, Italy,
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48
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Sbaraglia F, Mores N, Garra R, Giuratrabocchetta G, Lepore D, Molle F, Savino G, Piastra M, Pulitano' S, Sammartino M. Phenylephrine eye drops in pediatric patients undergoing ophthalmic surgery: incidence, presentation, and management of complications during general anesthesia. Paediatr Anaesth 2014; 24:400-5. [PMID: 24354865 DOI: 10.1111/pan.12329] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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] [Accepted: 11/16/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Phenylephrine eye drops are widely used as mydriatic agent to reach the posterior segment of the eye. In literature, many reports suggest a systemic absorption of this agent as a source of severe adverse drug reactions. Hence, we reviewed our experience with topical phenylephrine in ophthalmic surgery. METHODS In May 2006, following US guidelines publication, a standard operating procedure was issued in our operating rooms to standardize the use of phenylephrine eye drops in our practice. Two years later, after the occurrence of a cluster of serious adverse drug reactions in infants undergoing surgery, a review of phenylephrine safety and systemic complications incidence was performed. RESULTS We observed 451 pediatric patients, and 187 met the inclusions criteria: Among them, 4 experienced hemodynamic complications due to phenylephrine eye drops. The incidence of major complications was 2.1%. CONCLUSIONS Two different patterns of side effects occurred. The first one was a cardiovascular derangement with severe hypertension and heart rate alterations; the other one involved exclusively pulmonary circuit causing early edema. These clinical manifestations, their duration, and treatment responses are all explainable by alfa1-adrenergic action of phenylephrine. This hypothetic pathogenesis has been confirmed also by the usefulness of direct vasodilators (anesthetic agents) and by the negative outcome occurred in the past with the use of beta-blockers.
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Affiliation(s)
- Fabio Sbaraglia
- Department of Anaesthesia and Intensive Care, Catholic University of Sacred Heart, Rome, Italy
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Savino G, Balia L, Colucci D, Battendieri R, Gari M, Corsello SM, Pontecorvi A, Dickmann A. Intraorbital injection of rituximab: a new approach for active thyroid-associated orbitopathy, a prospective case series. MINERVA ENDOCRINOL 2013; 38:173-179. [PMID: 23732371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM The aim of this paper was to examine the efficacy and the safety of intraorbital administration of the monoclonal anti-CD20 antibody rituximab (RTX) to treat patients affected by thyroid-associated orbitopathy (TAO) unresponsive to conventional therapy. METHODS Five patients with active moderately-severe TAO unresponsive to systemic glucocorticoids were studied. After a complete ophthalmological examination, disease activity and severity were assessed by the clinical activity score (CAS) and the NO SPECS scoring system. Computed tomography scans were performed in all patients. Patients were treated with intraorbital injection of RTX 10 mg once a week for one month repeated once one month apart. The patients were followed every three months until 18 months. RESULTS In all patients treated with RTX, CAS was significantly reduced (p< 0,005), inactive phase of TAO was reached in four out of five patients. No patients experienced major side effects, minor side effects were reported in two patients. CONCLUSION Intraorbital injection of RTX is a safe and useful promising therapeutic option for active TAO.
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Affiliation(s)
- G Savino
- Institute of Ophthalmology, Catholic University of the Sacred Heart, Rome, Italy.
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Garavelli L, Simonte G, Rosato S, Wischmeijer A, Albertini E, Guareschi E, Longo C, Albertini G, Gelmini C, Greco C, Errico S, Savino G, Pavanello M, Happle R, Unger S, Superti-Furga A, Grzeschik KH. Focal dermal hypoplasia (Goltz-Gorlin syndrome): a new case with a novel variant in the PORCN gene (c.1250T>C:p.F417S) and unusual spinal anomaly. Am J Med Genet A 2013; 161A:1750-4. [PMID: 23696273 DOI: 10.1002/ajmg.a.35964] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Accepted: 03/04/2013] [Indexed: 11/06/2022]
Abstract
Focal dermal hypoplasia (FDH; Goltz-Gorlin syndrome; OMIM 305600) is a disorder that features involvement of the skin, skeletal system, and eyes. It is caused by loss-of-function mutations in the PORCN gene. We report a young girl with FDH, microphthalmos associated with colobomatous orbital cyst, dural ectasia and cystic malformation of the spinal cord, and a de novo variant in PORCN. This association has not been previously reported, and based on these observations the phenotypic spectrum of FDH might be broader than previously appreciated. It would be prudent to alter the suggested surveillance for this rare disorder.
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Affiliation(s)
- Livia Garavelli
- Clinical Genetics Unit, Obstetric and Pediatric Department, Istituto di Ricovero e Cura a Carattere Scientifico, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
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