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Ruggiero M, Conforti A, Culcasi A, Mazzanti C, Sibahi G, Rani N, Sartini S. A focus on melorheostosis disease: a literature review and case report of femoral-acetabular impingement due to melorheostosis treated with surgical hip osteoplasty. Reumatismo 2024; 76. [PMID: 38523583 DOI: 10.4081/reumatismo.2024.1621] [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: 07/22/2023] [Accepted: 10/25/2023] [Indexed: 03/26/2024] Open
Abstract
OBJECTIVE Melorheostosis is a rare, non-hereditary, benign bone disease characterized by abnormal bone growth. Generally, melorheostosis develops during childhood or adolescence and progresses gradually over time. This disease represents a true challenge to the physician because of its variability due to location, extension of the affected bone, and involvement of associated soft tissue. Pain management, physical therapy, and surgery may be recommended, depending on the individual case. This review aims to get an overview of the latest evidence relating to epidemiology, clinical and radiographic characteristics, diagnosis, and possible therapeutic strategies for melorheostosis and describe our experience through a clinical case. METHODS We designed a comprehensive literature search on melorheostosis in MEDLINE (via Pubmed) up to April 2023 and reviewed reports published in international journals. RESULTS The purpose is to highlight the importance of a multidisciplinary approach in the management of a rare disease such as melorheostosis. We discuss the role of different physicians, including genetists, rheumatologists, physiatrists, physical therapists, and orthopedic surgeons, in providing accurate diagnoses and effective treatments. We conducted a comprehensive review of the literature on the treatment of melorheostosis to support these findings. In addition, the article presents a case study of a patient suffering from melorheostosis, focusing on difficulties in reaching a correct diagnosis and attempts towards conservative and surgical interventions. The patient underwent hip arthroplasty, and the final result was an improvement in function and a reduction in pain. CONCLUSIONS Managing melorheostosis can be challenging, and there is no standardized treatment for this condition at the moment.
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Affiliation(s)
- M Ruggiero
- Physical and Rehabilitation Medicine 2, Rizzoli Orthopedic Institute, Bologna.
| | - A Conforti
- Local Health Unit Roma 4, Civitavecchia, Rome.
| | - A Culcasi
- Technical and Rehabilitation Nursing Service, Rizzoli Orthopedic Institute, Bologna.
| | - C Mazzanti
- Physical and Rehabilitation Medicine 2, Rizzoli Orthopedic Institute, Bologna.
| | - G Sibahi
- Physical and Rehabilitation Medicine 2, Rizzoli Orthopedic Institute, Bologna.
| | - N Rani
- Conservative Orthopaedic Surgery and Innovative Techniques, Rizzoli Orthopedic Institute, Bologna.
| | - S Sartini
- Physical and Rehabilitation Medicine 2, Rizzoli Orthopedic Institute, Bologna.
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Ruggiero M, Pinar U, Popelin M, Rod X, Denys P, Chartier-Kastler E. Single centre experience and long-term outcomes of implantable devices ACT and Pro- ACT (Uromedica, Irvin, CA, USA) - adjustable continence therapy for treatment of stress urinary incontinence. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00928-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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3
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Ruggiero M, Pinar U, Popelin MB, Rod X, Denys P, Bazinet A, Chartier-Kastler E. Single center experience and long-term outcomes of implantable devices ACT and Pro-ACT (Uromedica, Irvin, CA, USA) - Adjustable continence Therapy for treatment of stress urinary incontinence. Prog Urol 2023; 33:96-102. [PMID: 36572628 DOI: 10.1016/j.purol.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/27/2022] [Accepted: 12/07/2022] [Indexed: 12/25/2022]
Abstract
PURPOSE In this study, we aimed at evaluating the long-term adjustable peri-urethral balloons (PUB) durability in both male and female with neurogenic or non-neurogenic stress urinary incontinence. MATERIAL AND METHODS Each consecutive patient who underwent surgery for PUB placement before 2008 was included in this study. A PUB was proposed for patients with refractory to perineal reeducation stress urinary incontinence (SUI) caused by intrinsic sphincter deficiency. There were no exclusion criteria. Demographic, clinical and perioperative data were collected retrospectively from our clinical follow-up notes. RESULTS A total of 177 patients were included in the study. Median [IQR] follow-up was 5 years [1.8-11.2]. The 3 main causes of SUI were radical prostatectomy (n=82, 46.3%), idiopathic intrinsic sphincter deficiency (n=55, 31.1%) and neurogenic sphincter deficiency (n=32, 18.1%). Complete continence (no pad necessary) was achieved for 109 patients (61.6%). At the end of the follow-up, the PUB global survival rate was 47.5% (Fig. 1). Median [IQR] PUB survival without removal was 57.8 months [42.3-81.7]. PUB survival without failure rate was 68.4% accounting for a median [IQR] survival duration of 116.9 months [86.2-176.9] CONCLUSION: In this study, we evidenced acceptable long-term efficiency and survival of PUB in the management of SUI in both neurogenic and non-neurogenic population. Given those results it could be a good alternative to AUS on unfit or unwilling population. LEVEL OF EVIDENCE: 5
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Affiliation(s)
- M Ruggiero
- Sorbonne université, hôpital Pitié-Salpêtrière, AP-HP, department of urology, Paris, France
| | - U Pinar
- Sorbonne université, hôpital Pitié-Salpêtrière, AP-HP, department of urology, Paris, France
| | - M-B Popelin
- Sorbonne université, hôpital Pitié-Salpêtrière, AP-HP, department of urology, Paris, France
| | - X Rod
- Sorbonne université, hôpital Pitié-Salpêtrière, AP-HP, department of urology, Paris, France
| | - P Denys
- Université Paris Saclay, hôpital R.-Poincaré, AP-HP, neurourology department, Garches, France
| | - A Bazinet
- Sorbonne université, hôpital Pitié-Salpêtrière, AP-HP, department of urology, Paris, France
| | - E Chartier-Kastler
- Sorbonne université, hôpital Pitié-Salpêtrière, AP-HP, department of urology, Paris, France.
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Mokhtari N, Bazinet A, Pinar U, Ruggiero M, Robain G, Chartier-Kastler E. Neurogenic stress urinary incontinence management. From past to recent techniques: What have we learnt? Prog Urol 2022; 32:809-812. [PMID: 35840454 DOI: 10.1016/j.purol.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/10/2022] [Accepted: 06/16/2022] [Indexed: 10/17/2022]
Abstract
Urinary prostheses for the treatment of male stress urinary incontinence ranged from simple to adjustable bulbourethral compressing devices to complex artificial urinary sphincter. Those devices have remarkably evolved since the 1950s. In this article, we review the story of a patient who experienced this device evolution. His history provides us with the opportunity to retrieve the historical transformation of the incontinence prostheses around time. Moreover, this patient story challenges us on those devices past and present limitations.
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Affiliation(s)
- N Mokhtari
- Urologie, Sorbonne université, hôpital universitaire Pitié-Salpétrière, Paris, France
| | - A Bazinet
- Urologie, Sorbonne université, hôpital universitaire Pitié-Salpétrière, Paris, France; Department of Urology, University of Montreal, Maisonneuve-Rosemont Hospital, Montreal, Canada.
| | - U Pinar
- Urologie, Sorbonne université, hôpital universitaire Pitié-Salpétrière, Paris, France
| | - M Ruggiero
- Urologie, Sorbonne université, hôpital universitaire Pitié-Salpétrière, Paris, France
| | - G Robain
- Médecine physique et réadaptation, Sorbonne université, hôpital Rotschild, Paris, France
| | - E Chartier-Kastler
- Urologie, Sorbonne université, hôpital universitaire Pitié-Salpétrière, Paris, France
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Baloche P, Szabla N, Freton L, Hutin M, Ruggiero M, Dominique I, Millet C, Bergerat S, Panayotopoulos P, Betari R, Matillon X, Chebbi A, Caes T, Patard P, Brichart N, Dariane C, Lebacle C, Gondran-Tellier B, Pradere B, Peyronnet B. Y a-t-il un effet centre dans la prise en charge des traumatismes du rein ? Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.055] [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: 11/30/2022]
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Guillot-Tantay C, Chartier-Kastler E, Ruggiero M, Cancrini F, Vaessen C, Phé V. Résultats fonctionnels de l’implantation laparoscopique robot-assistée du sphincter urinaire artificiel dans le traitement de l’incontinence urinaire d’effort masculine d’origine neurologique. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.233] [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: 11/30/2022]
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Pinar U, Clerget A, Perrot O, Beaud N, Akakpo W, Ruggiero M, Parra J, Vaessen C, Guillot-Tantay C, Conort P, Campedel L, Girault J, Simon J, Maingon P, Renard-Penna R, Mozer P, Chartier-Kastler E, Roupret M, Seisen T. Assessment of physicians’ satisfaction with a virtual tumour board in a French academic centre during the COVID-19 pandemic. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01362-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Guillot-Tantay C, Chartier-Kastler E, Ruggiero M, Cancrini F, Vaessen C, Phé V. Functional outcomes of robot-assisted laparoscopic artificial urinary sphincter implantation for the treatment of adult male neurogenic stress urinary incontinence. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00510-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
ABSTRACT In 2020 the World Health Organization declared the Covid-19 to be a pandemic. Governments around the world are facing a tough challenge that could jeopardise the national healthcare systems. Safeguarding the rights of Covid patients and all citizens - especially those who are now even more vulnerable than they were before - is part of this challenge. This work aims to examine the issues arising from the current emergency in terms of how individuals' constitutional rights have been balanced and how much people at the highest risk amid this pandemic - the homeless, the inmates in prison, geriatric and psychiatric patients, and doctors on the Covid frontline - have been protected. This analysis focuses mostly on one of the worst-hit countries by the SARS-CoV-2: Italy.
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Affiliation(s)
- A Cioffi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome
| | | | - R Rinaldi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome
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Alexandre AM, Valente I, Consoli A, Piano M, Renieri L, Gabrieli JD, Russo R, Caragliano AA, Ruggiero M, Saletti A, Lazzarotti GA, Pileggi M, Limbucci N, Cosottini M, Cervo A, Viaro F, Vinci SL, Commodaro C, Pilato F, Pedicelli A. Posterior Circulation Endovascular Thrombectomy for Large-Vessel Occlusion: Predictors of Favorable Clinical Outcome and Analysis of First-Pass Effect. AJNR Am J Neuroradiol 2021; 42:896-903. [PMID: 33664106 DOI: 10.3174/ajnr.a7023] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/19/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Successful vessel recanalization in posterior circulation large-vessel occlusion is considered crucial, though the evidence of clinical usefulness, compared with the anterior circulation, is not still determined. The aim of this study was to evaluate predictors of favorable clinical outcome and to analyze the effect of first-pass thrombectomy. MATERIALS AND METHODS A retrospective, multicenter, observational study was conducted in 10 high-volume stroke centers in Europe, including the period from January 2016 to July 2019. Only patients with an acute basilar artery occlusion or a single, dominant vertebral artery occlusion ("functional" basilar artery occlusion) who had a 3-month mRS were included. Clinical, procedural, and radiologic data were evaluated, and the association between these parameters and both the functional outcome and the first-pass effect was assessed. RESULTS A total of 191 patients were included. A lower baseline NIHSS score (adjusted OR, 0.77; 95% CI, 0.61-0.96; P = .025) and higher baseline MR imaging posterior circulation ASPECTS (adjusted OR, 3.01; 95% CI, 1.03-8.76; P = .043) were predictors of better outcomes. The use of large-bore catheters (adjusted OR, 2.25; 95% CI, 1.08-4.67; P = .030) was a positive predictor of successful reperfusion at first-pass, while the use of a combined technique was a negative predictor (adjusted OR, 0.26; 95% CI, 0.09-0.76; P = .014). CONCLUSIONS The analysis of our retrospective series demonstrates that a lower baseline NIHSS score and a higher MR imaging posterior circulation ASPECTS were predictors of good clinical outcome. The use of large-bore catheters was a positive predictor of first-pass modified TICI 2b/3; the use of a combined technique was a negative predictor.
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Affiliation(s)
- A M Alexandre
- From the Unità Operativa Complessa Radiologia e Neuroradiologia (A.M.A., I.V., A.P.), Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia. Fondazione Policlinico Universitario A. Gemelli Istituto Di Ricovero e Cura a Carattere Scientifico, Roma, Italia
| | - I Valente
- From the Unità Operativa Complessa Radiologia e Neuroradiologia (A.M.A., I.V., A.P.), Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia. Fondazione Policlinico Universitario A. Gemelli Istituto Di Ricovero e Cura a Carattere Scientifico, Roma, Italia
| | - A Consoli
- Diagnostic and Interventional Neuroradiology (A.Consoli, R.R.), Foch Hospital, Suresnes, France
| | - M Piano
- Neuroradiologia (M.Piano, A.Cervo), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - L Renieri
- UOC Interventistica Neurovascolare (L.R., N.L.), Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - J D Gabrieli
- Neuroradiology Unit (J.D.G.), Policlinico Universitario di Padova, Padua, Italy
| | - R Russo
- Diagnostic and Interventional Neuroradiology (A.Consoli, R.R.), Foch Hospital, Suresnes, France
| | - A A Caragliano
- Neuroradiology Unit, Biomedical Sciences and Morphologic and Functional Images (A.A.C., S.L.V.), Azienda Ospedaliera Universitaria Policlinico G. Martino, Messina, Italy
| | - M Ruggiero
- Neuroradiology Unit (M.R., C.C.), Azienda Unità Sanitaria Locale Romagna, Cesena, Italy
| | - A Saletti
- Interventional Neuroradiology (A.S.), S. Anna University Hospital of Ferrara, Ferrara, Italy
| | - G A Lazzarotti
- Department of Neuroradiology (G.A.L., M.C.), Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - M Pileggi
- Department of Neuroradiology (M.Pileggi), Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - N Limbucci
- UOC Interventistica Neurovascolare (L.R., N.L.), Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - M Cosottini
- Department of Neuroradiology (G.A.L., M.C.), Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - A Cervo
- Neuroradiologia (M.Piano, A.Cervo), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - F Viaro
- UOC Neurologia (F.V.), Policlinico Universitario di Padova, Padua, Italy
| | - S L Vinci
- Neuroradiology Unit, Biomedical Sciences and Morphologic and Functional Images (A.A.C., S.L.V.), Azienda Ospedaliera Universitaria Policlinico G. Martino, Messina, Italy
| | - C Commodaro
- Neuroradiology Unit (M.R., C.C.), Azienda Unità Sanitaria Locale Romagna, Cesena, Italy
| | - F Pilato
- UOC Neurologia (F.P.), Fondazione Policlinico Universitario A. Gemelli, Istituto Di Ricovero e Cura a Carattere Scientifico, Roma, Italy
| | - A Pedicelli
- From the Unità Operativa Complessa Radiologia e Neuroradiologia (A.M.A., I.V., A.P.), Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia. Fondazione Policlinico Universitario A. Gemelli Istituto Di Ricovero e Cura a Carattere Scientifico, Roma, Italia
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Taylor J, Ruggiero M, Maity A, Ko K, Greenberger B, Donofree D, Sherif K, Lazar M, Jaslow R, Richard S, Mitchell E, Anne P, Trabulsi E, Leader A, Simone N. Sexual Health Toxicity in Cancer Survivors: Is There a Gender Disparity in Physician Evaluation and Intervention? Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Cappellari M, Saia V, Pracucci G, Sallustio F, Gandini R, Nappini S, Nencini P, Vallone S, Zini A, Bigliardi G, Granata F, Grillo F, Cioni S, Tassi R, Bergui M, Cerrato P, Saletti A, De Vito A, Gasparotti R, Magoni M, Taglialatela F, Ruggiero M, Longoni M, Castellan L, Malfatto L, Menozzi R, Castellini P, Cosottini M, Mancuso M, Comai A, Franchini E, Lozupone E, Della Marca G, Ciceri EFM, Bonetti B, Zampieri P, Inzitari D, Mangiafico S, Toni D. Functional and radiological outcomes after bridging therapy versus direct thrombectomy in stroke patients with unknown onset: Bridging therapy versus direct thrombectomy in unknown onset stroke patients with 10-point ASPECTS. Eur J Neurol 2020; 28:209-219. [PMID: 32924246 DOI: 10.1111/ene.14529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/03/2020] [Accepted: 09/05/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE The aim was to assess functional and radiological outcomes after bridging therapy (intravenous thrombolysis plus mechanical thrombectomy) versus direct mechanical thrombectomy (MT) in unknown onset stroke patients. METHODS A cohort study was conducted on prospectively collected data from unknown onset stroke patients who received endovascular procedures at ≤6 h from symptom recognition or awakening time. RESULTS Of the 349 patients with a 10-point Alberta Stroke Program Early Computed Tomography Score (ASPECTS), 248 received bridging and 101 received direct MT. Of the 134 patients with 6-9-point ASPECTS, 123 received bridging and 111 received direct MT. Each patient treated with bridging was propensity score matched with a patient treated with direct MT for age, sex, study period, pre-stroke disability, stroke severity, type of stroke onset, symptom recognition to groin time (or awakening to groin time), ASPECTS and procedure time. In the two matched groups with 10-point ASPECTS (n = 73 vs. n = 73), bridging was associated with higher rates of excellent outcome (46.6% vs. 28.8%; odds ratio 2.302, 95% confidence interval 1.010-5.244) and successful recanalization (83.6% vs. 63%; odds ratio 3.028, 95% confidence interval 1.369-6.693) compared with direct MT; no significant association was found between bridging and direct MT with regard to rate of symptomatic intracerebral hemorrhage (0% vs. 1.4%). In the two matched groups with 6-9-point ASPECTS (n = 45 vs. n = 45), no significant associations were found between bridging and direct MT with regard to rates of excellent functional outcome (44.4% vs. 31.1%), successful recanalization (73.3% vs. 76.5%) and symptomatic intracerebral hemorrhage (0% vs. 0%). CONCLUSIONS Bridging at ≤ 6 h of symptom recognition or awakening time was associated with better functional and radiological outcomes in unknown onset stroke patients with 10-point ASPECTS.
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Affiliation(s)
- M Cappellari
- Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - V Saia
- Santa Corona Hospital, Pietra Ligure, Italy
| | | | | | - R Gandini
- Policlinico Tor Vergata, Roma, Italy
| | - S Nappini
- Careggi University Hospital, Firenze, Italy
| | - P Nencini
- Careggi University Hospital, Firenze, Italy
| | - S Vallone
- Ospedale Civile S. Agostino-Estense-University Hospital, Modena, Italy
| | - A Zini
- IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - G Bigliardi
- Ospedale Civile S. Agostino-Estense-University Hospital, Modena, Italy
| | - F Granata
- Policlinico G. Martino, Messina, Italy
| | - F Grillo
- Policlinico G. Martino, Messina, Italy
| | - S Cioni
- Ospedale S. Maria delle Scotte-University Hospital, Siena, Italy
| | - R Tassi
- Ospedale S. Maria delle Scotte-University Hospital, Siena, Italy
| | - M Bergui
- Città della Salute e della Scienza-Molinette, Torino, Italy
| | - P Cerrato
- Città della Salute e della Scienza-Molinette, Torino, Italy
| | - A Saletti
- Arcispedale S. Anna-University Hospital, Ferrara, Italy
| | - A De Vito
- Arcispedale S. Anna-University Hospital, Ferrara, Italy
| | | | | | - F Taglialatela
- IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | | | | | | | | | - R Menozzi
- Ospedale Universitario, Parma, Italy
| | | | | | | | - A Comai
- Ospedale Provinciale, Bolzano, Italy
| | | | | | | | - E F M Ciceri
- Fondazione IRCSS-Istituto Neurologico Carlo Besta, Milano, Italy
| | - B Bonetti
- Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - P Zampieri
- Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | | | - D Toni
- Sapienza University Hospital, Roma, Italy
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Da Ros V, Scaggiante J, Sallustio F, Lattanzi S, Bandettini M, Sgreccia A, Rolla-Bigliani C, Lafe E, Sanfilippo G, Diomedi M, Ruggiero M, Haznedari N, Giannoni M, Finocchi C, Floris R. Carotid Stenting and Mechanical Thrombectomy in Patients with Acute Ischemic Stroke and Tandem Occlusions: Antithrombotic Treatment and Functional Outcome. AJNR Am J Neuroradiol 2020; 41:2088-2093. [PMID: 32972953 DOI: 10.3174/ajnr.a6768] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/07/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE There is no consensus on the optimal antithrombotic medication for patients with acute ischemic stroke with anterior circulation tandem occlusions treated with emergent carotid stent placement and mechanical thrombectomy. The identification of factors influencing hemorrhagic risks can assist in creating appropriate therapeutic algorithms for such patients. This study aimed to investigate the impact of medical therapy on functional and safety outcomes in patients treated with carotid stent placement and mechanical thrombectomy for tandem occlusions. MATERIALS AND METHODS A multicenter retrospective study on prospectively collected data was conducted. Only patients treated with carotid stent placement and mechanical thrombectomy for tandem occlusions of the anterior circulation were included. Univariate and multivariate analyses were performed on preprocedural, procedural, and postprocedural variables to assess factors influencing clinical outcome, symptomatic intracranial hemorrhage, stent patency, and successful intracranial vessel recanalization. RESULTS Ninety-five patients with acute ischemic stroke and tandem occlusions were included. Good clinical outcome (mRS ≤ 2) at 3 months was reached by 33 (39.3%) patients and was associated with baseline ASPECTS ≥ 8 (OR = 1.53; 95% CI, 1.16-2.00), ≤2 mechanical thrombectomy attempts (OR = 0.71; 95% CI, 0.55-0.99), and the absence of symptomatic intracranial hemorrhage (OR = 0.13; 95% CI , 0.03-0.51). Symptomatic intracranial hemorrhage was associated with a higher amount of intraprocedural heparin, ASPECTS ≤ 7, and ≥3 mechanical thrombectomy attempts. No relationships among types of acute antiplatelet regimen, intravenous thrombolysis, and symptomatic intracranial hemorrhage were observed. Patients receiving dual-antiplatelet therapy after hemorrhagic transformation had been ruled out on 24-hour CT were more likely to achieve functional independence and had a lower risk of symptomatic intracranial hemorrhage. CONCLUSIONS During carotid stent placement and mechanical thrombectomy for tandem occlusion treatment, higher intraprocedural heparin dosage (≥3000 IU) increased symptomatic intracranial hemorrhage risk when the initial ASPECTS was ≤7, and mechanical thrombectomy needs more than one passage for complete recanalization. Antiplatelets antiplatelets use were safe, and dual-antiaggregation therapy was related to better functional outcomes.
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Affiliation(s)
- V Da Ros
- From the Department of Biomedicine and Prevention (V.D.R., J.S., R.F.), Interventional Neuroradiology Unit
| | - J Scaggiante
- From the Department of Biomedicine and Prevention (V.D.R., J.S., R.F.), Interventional Neuroradiology Unit
| | - F Sallustio
- Comprehensive Stroke Center (F.S., M.D.), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - S Lattanzi
- Neurological Clinic (S.L.), Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | | | - A Sgreccia
- Department of Neurosciences and Interventional Neuroradiology Unit (A.S., E.L., G.S.), IRCCS Policlinico San Matteo, Pavia, Italy
| | - C Rolla-Bigliani
- Department of Diagnostic and Interventional Neuroradiology (C.R.-B.), Policlinico Universitario, San Martino, Italy
| | - E Lafe
- Department of Neurosciences and Interventional Neuroradiology Unit (A.S., E.L., G.S.), IRCCS Policlinico San Matteo, Pavia, Italy
| | - G Sanfilippo
- Department of Neurosciences and Interventional Neuroradiology Unit (A.S., E.L., G.S.), IRCCS Policlinico San Matteo, Pavia, Italy
| | - M Diomedi
- Comprehensive Stroke Center (F.S., M.D.), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - M Ruggiero
- Neuroradiology Unit (M.R., N.H.), AUSL Romagna, Cesena, Italy
| | - N Haznedari
- Neuroradiology Unit (M.R., N.H.), AUSL Romagna, Cesena, Italy
| | - M Giannoni
- Neuroradiological Clinic (M.G.), Department of Radiological Sciences, AOU Ospedali Riuniti, Ancona, Italy
| | | | - R Floris
- From the Department of Biomedicine and Prevention (V.D.R., J.S., R.F.), Interventional Neuroradiology Unit
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14
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Freton L, Pradere B, Fiard G, Chebbi A, Caes T, Hutin M, Olivier J, Ruggiero M, Dominique I, Millet C, Bergerat S, Panayatopoulos P, Betari R, Patard PM, Szabla N, Brichart N, Sabourin L, Guleryuz K, Dariane C, Lebacle C, Rizk J, Gryn A, Madec FX, Rod X, Nouhaud FX, Matillon X, Peyronnet B. [Renal Trauma]. Prog Urol 2019; 29:936-942. [PMID: 31668829 DOI: 10.1016/j.purol.2019.09.007] [Citation(s) in RCA: 2] [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: 09/08/2019] [Revised: 09/25/2019] [Accepted: 09/28/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Renal traumas are common, observed in 10% of patients with abdominal trauma. Most renal traumas are blunt, resulting from a direct hit or from an abrupt deceleration. MATERIAL AND METHODS We realized a synthesis of renal trauma management for nurses. RESULTS Clinical presentation often encompasses gross hematuria and lumbar pain. The best diagnostic tool is computed tomography (CT) urogram. Based on CT urogram images, renal traumas are classified according to the American Association for the Surgery of Trauma (AAST) classification in five grades of increasing severity. The management is conservative in the vast majority of cases and has been largely simplified over the past few years, being now mostly based on observation. Radiological interventional and endoscopic procedures are used only in very selected cases and surgical exploration has become extremely rare. CONCLUSION The prognosis has also considerably improved and renal trauma rarely result in death or loss of the kidney nowadays.
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Affiliation(s)
- L Freton
- Service d'urologie, université de Rennes, 35000 Rennes, France.
| | - B Pradere
- Service d'urologie, PRES Centre Val-de-Loire, CHRU de Tours et université François-Rabelais de Tours, 37000 Tours, France
| | - G Fiard
- Service d'urologie, université de Grenoble, 38700 Grenoble, France
| | - A Chebbi
- Service d'urologie, université de Rouen, 76000 Rouen, France
| | - T Caes
- Service d'urologie, université de Lille, 59000 Lille, France
| | - M Hutin
- Service d'urologie, université de Montpellier, 34000 Montpellier, France
| | - J Olivier
- Service d'urologie, université de Lille, 59000 Lille, France
| | - M Ruggiero
- Service d'urologie, université de Paris Sud, CHU de Bicêtre, 94270 Paris, France
| | - I Dominique
- Service d'urologie, université de Lyon, 69002 Lyon, France
| | - C Millet
- Service d'urologie, université de Clermont-Ferrand, 63100 Clermont-Ferrand, France
| | - S Bergerat
- Service d'urologie, université de Strasbourg, 67000 Strasbourg, France
| | | | - R Betari
- Service d'urologie, université de Brest, 29200 Brest, France
| | - P-M Patard
- Service d'urologie, université de Toulouse, 31300 Toulouse, France
| | - N Szabla
- Service d'urologie, université de Caen, 14033 Caen, France
| | - N Brichart
- Service d'urologie, CHR d'Orléans, 45100 Orléans, France
| | - L Sabourin
- Service d'urologie, université de Clermont-Ferrand, 63100 Clermont-Ferrand, France
| | - K Guleryuz
- Service d'urologie, université de Caen, 14033 Caen, France
| | - C Dariane
- Service d'urologie, université de Paris-Descartes, 75006 Paris, France
| | - C Lebacle
- Service d'urologie, université de Paris Sud, CHU de Bicêtre, 94270 Paris, France
| | - J Rizk
- Service d'urologie, université de Lille, 59000 Lille, France
| | - A Gryn
- Service d'urologie, université de Toulouse, 31300 Toulouse, France
| | - F-X Madec
- Service d'urologie, hôpital Saint-Joseph, 75014 Paris, France
| | - X Rod
- Service d'urologie, université de Nantes, 44000 Nantes, France
| | - F-X Nouhaud
- Service d'urologie, université de Rouen, 76000 Rouen, France
| | - X Matillon
- Service d'urologie, université de Lyon, 69002 Lyon, France
| | - B Peyronnet
- Service d'urologie, université de Rennes, 35000 Rennes, France
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15
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Branca JJV, Pacini S, Morucci G, Bocchi L, Cosentino A, Boni E, Ruggiero M. Effects of ultrasound and selenium on human neurons in vitro. Arch Ital Biol 2018; 156:153-163. [PMID: 30796759 DOI: 10.12871/00039829201842] [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: 11/03/2022]
Abstract
As the effects of ultrasound on human brain functions might bear therapeutic potential, in this study, we examined the effects of diagnostic, i.e. non-thermal, ultrasound, on morphology, networking, and metabolic activity of SH- SY5Y human neurons in culture, as well as on the expression of GAP-43, Hsp90 and VEGF proteins, with and without selenium in the culture medium. The rationale for studying selenium lays in the observation that selenium improves functional neurologic outcome in traumatic brain injury and, therefore, analysis of the interactions between ultrasound and selenium may be of clinical interest. In the presence of selenium, ultrasound increased the overall number and length of elongations arising from the neuron bodies, thus reflecting an increase in the complexity of neuronal networks and circuits. The expression of GAP-43, Hsp90 and VEGF and metabolic activity of SH-SY5Y neurons, studied as markers of cell damage, were not affected by ultrasound or selenium. This study suggests that ultrasound may modulate neuronal networking in vitro without inducing cellular or molecular damage and highlights the potential role of selenium in the ultrasound-elicited cellular responses.
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Affiliation(s)
| | - S Pacini
- Department of Experimental and Clinical Medicine,University of Firenze,Largo Brambilla 3, 50134 Firenze, Italy -
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16
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Toscano M, Viganò A, Rea A, Verzina A, Sasso D'Elia T, Puledda F, Longo L, Mancini V, Ruggiero M, Jannini TB, Giuliani G, Albino F, Altieri M, Vicenzini E, Fattapposta F, Pauri F, Giacomini P, Ruoppolo G, Di Piero V. Sapienza Global Bedside Evaluation of Swallowing after Stroke: the GLOBE-3S study. Eur J Neurol 2018; 26:596-602. [PMID: 30414300 DOI: 10.1111/ene.13862] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 04/23/2018] [Accepted: 11/06/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Dysphagia occurs in up to 50% of all patients with acute stroke. There is debate regarding which is the most effective screening tool in identifying aspiration in patients with acute stroke. We assessed the accuracy of the Sapienza Global Bedside Evaluation of Swallowing after Stroke (GLOBE-3S), which combines the Toronto Bedside Swallowing Screening Test (TOR-BSST©) with oxygen desaturation and laryngeal elevation measurement during swallowing. METHODS We prospectively enrolled consecutive patients with stroke within 72 h of symptom onset. All patients with stroke firstly underwent a standard neurological examination, then the GLOBE-3S evaluation and finally the fiberoptic endoscopic evaluation of swallowing (FEES). Two different assessors, a neurologist and a speech pathologist, blind to both the clinical data and each other's evaluation, administered the GLOBE-3S and FEES examination. We assessed the accuracy of the GLOBE-3S in detecting post-stroke swallow impairment with aspiration using the FEES as the standard. RESULTS We enrolled 50 patients with acute stroke, 28 of whom (56%) had swallowing impairment with aspiration at FEES evaluation. A total of 33 patients (66%) failed the GLOBE-3S evaluation. The GLOBE-3S reached a sensitivity of 100% and a specificity of 77.3% (negative predictive value, 100%; positive likelihood ratio, 4.34). The median time required for the GLOBE-3S to be performed was 297 s. CONCLUSIONS GLOBE-3S is quick to perform at the bedside and can accurately identify aspiration in patients with acute stroke. By including the measurement of laryngeal elevation and monitoring of oxygen desaturation, it could represent a highly sensitive instrument to avoid the misdiagnosis of silent aspirators.
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Affiliation(s)
- M Toscano
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy.,Department of Neurology, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - A Viganò
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy.,Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, 'Sapienza' University of Rome, Rome, Italy
| | - A Rea
- Department of Sensorial Organs, 'Sapienza' University of Rome, Rome, Italy
| | - A Verzina
- Neurology Clinic, University of Perugia - Perugia General Hospital, Perugia, Italy
| | - T Sasso D'Elia
- Physical Medicine and Rehabilitation Division, 'Sapienza' University of Rome, Rome, Italy
| | - F Puledda
- Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - L Longo
- Department of Sensorial Organs, 'Sapienza' University of Rome, Rome, Italy
| | - V Mancini
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - M Ruggiero
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - T B Jannini
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - G Giuliani
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - F Albino
- Department of Sensorial Organs, 'Sapienza' University of Rome, Rome, Italy
| | - M Altieri
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - E Vicenzini
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - F Fattapposta
- Department of Sensorial Organs, 'Sapienza' University of Rome, Rome, Italy
| | - F Pauri
- Department of Sensorial Organs, 'Sapienza' University of Rome, Rome, Italy
| | - P Giacomini
- Department of Sensorial Organs, 'Sapienza' University of Rome, Rome, Italy
| | - G Ruoppolo
- Department of Sensorial Organs, 'Sapienza' University of Rome, Rome, Italy
| | - V Di Piero
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
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Freton L, Scailteux L, Olivier J, Langouet Q, Ruggiero M, Dominique I, Millet C, Bergerat S, Panayotopoulos P, Lebacle C, Rizk J, Matillon X, Gryn A, Madec F, Nouhaud F, Rod X, Hutin M, Fiard G, Pradere B, Peyronnet B. Traumatisme rénal de bas grade et durée de séjour : vers une prise en charge ambulatoire ? Résultats de l’étude multicentrique traumAFUf avec analyse par score de propension. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Novel aspects of cytokine receptor signal transduction are discussed and cytokine receptors classified based on ligand-dependent signalling. An introductory section presents an overview of the role of cytokines in hematopoiesis. A brief explanation of basic concepts, such as redundancy, pleiotropy, synergism, etc., important for the understanding of cell response to cytokines, is also included. Three of five classes of receptors show the involvement of tyrosine kinase activity as the key step in signal transduction. The importance of tyrosine phosphorylation in cellular response to cytokines is pointed out.
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Affiliation(s)
- V Chiarugi
- Laboratory of Molecular Biology, University of Florence
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Pacini S, Milano F, Pinzani P, Pazzagli M, Gulisano M, Ruggiero M, Casamassima F. Effects of Gemcitabine in Normaland Transformed Human Lung Cell Cultures: Cytotoxicity and Increase in Radiation Sensitivity. Tumori 2018; 85:503-7. [PMID: 10774574 DOI: 10.1177/030089169908500615] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and Background Several anticancer drugs increase cell sensitivity to irradiation. Gemcitabine (2′, 2′ difluorodeoxycytidine) decreases the cellular dNTP pools and thus significantly increases the sensitivity to the DNA damaging effects of low-dose radiation. In this study we have investigated whether gemcitabine may play a role as radiosensitizer also in lung adenocarcinoma treatment. Methods & Study Design We studied this nucleoside analogue in normal and transformed human cell lines (fetal lung and lung adenocarcinoma). After drug treatment, cell lines were irradiated with different doses. Cell damage following drug treatment and/or irradiation was assessed by measuring intracellular ATP level and by the colony forming assay. Results The two cell lines significantly differed in their sensitivity to the toxic effects of the drug; the normal cell line was much more resistant than its transformed counterpart. This difference was observed in both assays, although it was more evident in the colony forming assay. A low radiation dose (50-100 cGy) did not cause any significant damage to transformed cells; normal cells were more resistant and doses up to 500 cGy caused little damage. However, when transformed cells were pretreated for three hours with gemcitabine, even a nontoxic concentration of the drug (1-10 nM) caused a marked sensitization of the cells to irradiation (50-100 cGy). The radiosensitizing effect of gemcitabine could be observed also in normal cells, although these cells were more resistant to the damaging effects of both anticancer treatments. Conclusions This study demonstrates that gemcitabine, a chemotherapeutic agent already used in the clinic, could be proposed as a radiosensitizer for radiation therapy of lung adenocarcinoma, having a clearly potentiating effect on low-dose radiation.
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Affiliation(s)
- S Pacini
- Department of Anatomy, Histology and Forensic Medicine, University of Florence, Policlinico di Careggi, Italy.
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20
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Chiarugi VP, Fibbi G, Del Rosso M, Ruggiero M, Pasquali F, Viti M, Vannucchi S. Cooperative Effect of Exogenous Heparin-Like Compounds and Secreted Glucocorticoid-Induced Inhibitor on Plasminogen Activator in 3T3 Cell Cultures. Tumori 2018; 70:301-6. [PMID: 6433523 DOI: 10.1177/030089168407000401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Balb/c 3T3 cultures grown in the absence of serum release both plasminogen activator and plasminogen activator inhibitor in the culture medium. Cellular transformation with SV-40 virus increased the level of the activator, whereas dexamethasone increased the level of the inhibitor. Heparin added to the medium potentiated the glucocorticoid-induced inhibitory activity, strongly decreasing or completely abolishing the activity of plasminogen activator. Heparin sulfate showed similar effects to heparin, although at higher concentrations. It is suggested that heparin-like compounds are involved in the regulation of plasminogen activator, acting as inhibitory cofactors.
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Caës T, Rizk J, Olivier J, Hutin M, Bergerat S, Betari R, Freton L, Ruggiero M, Panayatopoulos P, Patard P, Dariane C, Fiard G, Peyronnet B, Pradere B, Nouhaud FX, Langouet Q, Dominique I, Matillon X, Chebbi A, Szabla N, Brichart N, Sabourin L, Guleryuz K, Bohem A, Millet C, Rod X, Lebacle C, Gryn A, Madec FX. Facteurs de risque d’échec du traitement conservateur des traumatismes du rein : une étude multicentrique (TRAUMAFUF). Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Patard P, Abbo O, Gryn A, Bergerat S, Matillon X, Betari R, Ruggiero M, Dominique I, Freton L, Rod X, Dariane C, Lebacle C, Pradere B, Fiard G, Peyronnet B, Panayatopoulos P, Olivier J, Langouet Q, Millet C, Hutin M, Chebbi A, Caes T, Szabla N, Brichart N, Sabourin L, Guleryuz K, Rizk J, Madec FX, Nouhaud FX. Comparaison des caractéristiques et de la prise en charge des traumatismes rénaux entre la population adulte et pédiatrique. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Panayotopoulos P, Peyronnet B, Bergerat S, Betari R, Freton L, Olivier J, Ruggiero M, Langouet Q, Dominique I, Matillon X, Chebbi A, Caes T, Patard P, Szabla N, Brichart N. Quelle est la place de la radio-embolisation en urgence dans la prise en charge de patients traumatisés rénaux en instabilité hémodynamique ? Résultats de l’étude multicentrique nationale TRAUMAFUF. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Freton L, Olivier J, Langouet Q, Ruggiero M, Dominique I, Millet C, Bergerat S, Panayatopoulos P, Betari R, Matillon X, Chebbi A, Caes T, Patard P, Szabla N, Brichart N, Sabourin L, Guleryuz K, Dariane C, Lebacle C, Rizk J, Gryn A, Madec F, Nouhaud F, Pradere B, Bensalah K, Fiard G, Peyronnet B. Traumatismes du rein de bas grade : vers une prise en charge en ambulatoire ? Résultats de l’étude multicentrique nationale Traumafuf. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.256] [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: 11/28/2022]
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Pradere B, Freton L, Olivier J, Langouet Q, Ruggiero M, Dominique I, Millet C, Bergerat S, Panayotopoulos P, Betari R, Matillon X, Chebbi A, Caes T, Boehm A, Patard P, Szabla N, Brichart N, Sabourin L, Guleryuz K, Lebacle C, Rizk J, Gryn A, Nouhaud F, Madec F, Dariane C, Bensalah K, Fiard G, Peyronnet B. Incidence et facteur prédictifs des pseudo-anévrysmes au cours des traumatismes du rein : résultats de l’étude multicentrique nationale Traumafuf. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Peyronnet B, Bergerat S, Betari R, Freton L, Olivier J, Ruggiero M, Panayatopoulos P, Langouet Q, Dominique I, Matillon X, Chebbi A, Caes T, Patard P, Szabla N, Brichart N, Bohem A, Sabourin L, Guleryuz K, Millet C, Dariane C, Lebacle C, Rizk J, Gryn A, Madec F, Nouhaud F, Pradère B, Bensalah K, Fiard G. Faut-il maintenir les patients en décubitus dorsal après un traumatisme du rein ? Résultats de l’étude multicentrique nationale Traumafuf. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Dominique I, Ruffion A, Matillon X, Freton L, Betari R, Dariane C, Millet C, Ruggiero M, Chebbi A, Olivier J, Langouet Q, Bergerat S, Panayotopoulos P, Caes T, Patard P, Szabla N, Brichart N, Sabourin L, Guleryuz K, Lebacle C, Rizk J, Madec F, Nouhaud F, Pradere B, Saint F, Fiard G, Peyronnet B. Complications rénales à long terme des traumatismes rénaux : résultats de l’étude multicentrique nationale Traumafuf. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.260] [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: 11/16/2022]
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Peyronnet B, Vaessen C, Grassano Y, Benoit T, Carrouget J, Fardoun T, Masson-lecomte A, Khene Z, Pradère B, Girwec A, Ruggiero M, Beauval J, Nouhaud F, Brichart N, Baumert H, Bigot P, Droupy S, Bruyère F, De la taille A, Doumerc N, Bernhard J, Roupret M, Mejean A, Bensalah K. Comparaison de 1800 néphrectomies partielles ouvertes et robot-assistées pour tumeur rénale unique. Prog Urol 2015; 25:822. [DOI: 10.1016/j.purol.2015.08.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Pradère B, Peyronnet B, Ruggiero M, Khene Z, Seisen T, Parra J, Verhoest G, Vaessen C, Rouprêt M, Bensalah K. Étude multicentrique sur l’impact des anticoagulants et antiagrégants sur la morbidité de la néphrectomie partielle robotique. Prog Urol 2015; 25:824. [DOI: 10.1016/j.purol.2015.08.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cosentino A, Boni E, Pacini S, Branca J, Morucci G, Ruggiero M, Bocchi L. Morphological analysis of neurons: Automatic identification of elongations. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2015:8131-8134. [PMID: 26738181 DOI: 10.1109/embc.2015.7320281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Our study is focused on the development of a new method for the automatic analysis of cell images. We focused on neurons (cells line SH-SY5Y) treated/untreated with ultrasound and stained with Haematoxylin-Eosin. The aim of the algorithm is the automatic detection of the cell body as well as the determination of the number and the length of neuron elongations. Starting point of the algorithm was the convolution of an image with a bank of rotating Gaussian kernels and the construction of a module map. Then several strategies were implemented to detect cell bodies and to detect and extract data about cell elongations. We have also realized a graphical user interface allowing the loading, saving and processing of images. Results show that this method is able to properly and efficiently detect cell contours and elongations. The automated evaluation is in strong agreement with manual evaluation performed by an expert operator, with an average error of 11% with most parameter combinations. This tool constitutes an important support in biological research activities, where operators need to analyze a large number of images to investigate about cell morphology before and after a treatment.
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Beltramello A, Casartelli Liviero M, Bernardi B, Causin F, Di Paola F, Muto M, Ruggiero M, Procaccio F. Computed tomography angiography: a double step methodology in brain death confirmation. Minerva Anestesiol 2014; 80:862-863. [PMID: 24463944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- A Beltramello
- Dipartimento di Neuroradiologia, AOUI Verona, Verona, Italia -
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Carlesimo B, Lo Torto F, Rossi A, Marcasciano M, Ruggiero M. Long-term result of bilateral pectoralis major muscle advancement flap in median sternotomy wound infections. Eur Rev Med Pharmacol Sci 2014; 18:3767-3772. [PMID: 25555865] [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: 06/04/2023]
Abstract
OBJECTIVE Deep sternal wound infection (DSWI) is an uncommon but serious complication of open heart surgery being characterized by a high mortality rate and a considerable economic weight. Repair of sternal defects, compromised with infection, can be achieved in several ways. The aim of our study is to report our case load in the management of sternal wound infection. PATIENTS AND METHODS In this study, we will report our twelve-year case load with bilateral pectoralis major advancement flap as the sole treatment modality for deep sternal wound infection. RESULTS This surgical approach has given excellent results in terms of resolution of the infection of the sternum, with few complications and a good cosmetic result. CONCLUSIONS We propose bilateral pectoralis major advancement flap as the first choice treatment for deep sternal wound infection.
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Affiliation(s)
- B Carlesimo
- Department of Plastic and Reconstructive and Aesthetic Surgery, Sapienza University of Rome, Rome, Italy.
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Cotroneo A, Ruggiero M. Sala Gran Sasso - 17.20–18.08 Comunicazioni. Neuroradiol J 2013. [DOI: 10.1177/19714009130260s119] [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: 11/16/2022] Open
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Artini PG, Di Berardino OM, Papini F, Genazzani AD, Simi G, Ruggiero M, Cela V. Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study. Gynecol Endocrinol 2013; 29:375-9. [PMID: 23336594 DOI: 10.3109/09513590.2012.743020] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To evaluate the effects the administration of myo-inositol (MYO) on hormonal parameters in a group of polycystic ovary syndrome (PCOS) patients. DESIGN Controlled clinical study. SETTING PCOS patients in a clinical research environment. PATIENTS 50 overweight PCOS patients were enrolled after informed consent. INTERVENTIONS All patients underwent hormonal evaluations and an oral glucose tolerance test (OGTT) before and after 12 weeks of therapy (Group A (n¼10): MYO 2 g plus folic acid 200 mg every day; Group B (n¼10): folic acid 200 mg every day). Ultrasound examinations and Ferriman-Gallwey score were also performed. MAIN OUTCOME MEASURES Plasma LH, FSH, PRL, E2, 17OHP, A, T, glucose, insulin, C peptide concentrations, BMI, HOMA index and glucose-to-insulin ratio. RESULTS After 12 weeks of MYO administration plasma LH, PRL, T, insulin levels and LH/FSH resulted significantly reduced. Insulin sensitivity, expressed as glucose-to-insulin ratio and HOMA index resulted significantly improved after 12 weeks of treatment. Menstrual cyclicity was restored in all amenorrheic and oligomenorrheic subjects. No changes occurred in the patients treated with folic acid. CONCLUSIONS MYO administration improves reproductive axis functioning in PCOS patients reducing the hyperinsulinemic state that affects LH secretion.
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Affiliation(s)
- P G Artini
- Department of Reproductive Medicine and Child Development, Division of Obstetrics and Gynecology, University of Pisa, Pisa, Italy.
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Chiummariello S, Monarca C, Rizzo MI, Ruggiero M, Gangemi EN, Scuderi N, Alfano C. ["Step technique" in the treatment of the loss of substance of the lower lip]. G Chir 2010; 31:549-551. [PMID: 21232202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The most frequent pathology of the lower lip is the neoplastic pathology and squamous cell carcinoma is the most clinically diagnosed. Wide excision is the correct surgical approach but it may cause severe morpho-functional and aesthetic damages. At the Plastic and Reconstructive Department of Policlinico Umberto I, " Sapienza" University of Rome, from 2005 to 2008 36 patients were treated, 19 only by surgical excision (Group I) and 17 by Johanson's technique (Group II). Follow-up was at 6 and 12 months to evaluate the morpho-functional outcome, the asymmetry and the healing. Moreover a questionnaire of 9 items was proposed to patients to evaluate functional and aesthetic results. Data showed that Johansons' s flap achieves the same results of the complete surgical excision but with better morpho-functional and aesthetic outcomes, greater satisfaction and same staying in hospital for patients.
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Artini PG, Di Berardino OM, Simi G, Papini F, Ruggiero M, Monteleone P, Cela V. Best methods for identification and treatment of PCOS. Minerva Ginecol 2010; 62:33-48. [PMID: 20186113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The polycystic ovarian syndrome (PCOS) includes a wide spectrum of clinical symptoms and signs. Three different diagnostic classifications have been proposed to define this disease. The first one, published in 1990, known as the "NIH criteria" requires the simultaneous presence of hyperandrogenism and menstrual dysfunction in order to diagnose PCOS. Later on, in 2003, an expert panel met in Rotterdam and added to the previous criteria the presence of polycystic ovarian morphology detected by transvaginal ultrasonography. The later classification broadened the spectrum of PCOS and also included women with oligomenorrhea and PCO without hyperandrogenism or hyperandrogenism and PCO without menstrual dysfunction. Finally, the Androgen Excess Society, published in 2006 new diagnostic criteria which required the presence of clinical or biochemical hyperandrogenism, with either PCO or menstrual dysfunction to diagnose PCOS. This review focuses on the diagnostic techniques and methods of treatment for PCOS patients. Special attention is given to the role of insulin resistance and the potential utility of insulin sensitizers in management of the syndrome. The benefit and utmost importance of lifestyle modification for the long-term health of these women is stressed as well. It is hoped that some clarity in this regard will allow more women to not only be diagnosed and managed properly for their presenting symptoms (hirsutism, irregular menses, etc.), but also to be educated and managed for the continuing health risk of insulin resistance throughout their lives.
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Affiliation(s)
- P G Artini
- Department of Reproductive Medicine and Child Development, Division of Obstetric and Gynecology, "S. Chiara" Hospital, University of Pisa, Pisa, Italy.
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Chiummariello S, De Gado F, Monarca C, Ruggiero M, Carlesimo B, Scuderi N, Alfano C. [Multicentric study on a topical compound with lymph-draining action in the treatment of the phlebostatic ulcer of the inferior limbs]. G Chir 2009; 30:497-501. [PMID: 20109380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Phlebostatic sore of the lower limbs is a typical chronic venous insufficiency complication and is still a widely controversial issue in its treatment. The common therapies, in fact, are not yet standardized and they not show complete efficacy. Since 2005 to 2007 a multicentric clinical trial was conducted at the Plastic and Reconstructive Surgery of "Sapienza" University of Rome and at the Plastic and Reconstructive Surgery Department, University of Perugia, in order to evaluate the efficacy of the Idrastin lymph-draining cream in patients with phlebostatic sores of the lower limbs. This study enrolled on 80 patients, split into 2 homogeneous groups of 40 patients: group A was treated by only elastocompressive therapy, group B by elastocompressive therapy and Idrastin. Multicentric analysis has considered the following parameters: local pain, perilesional flogosis , granulation tissue, perilesional tissue tropism healing time. In the group B results highlighted: reduction of the local pain, stopped in 72 hours; flogosis decrease disappeared in one week; tissue granulation growth in one week; lesion healing in 4 weeks. These results pointed out statistically significance of the variables considered. In our opinion Idrastin compounds such as phytoessence of hops and Hedera helix, had contributed to analgesia; Aesculus hippocastanum, and Vitis vinifera and Ruscus aculeatus phytoessence showed anti-flogistic action; allantoin and Centella asiatica and jaluronic acid aided to sore healing. Idrastin gives an effective support to the treatment of the phlebostatic sores warrants a faster and more effective healing process, than to the wounds treated by only the elastocompressive therapy.
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Affiliation(s)
- S Chiummariello
- Università degli Studi di Perugia, Cattedra di Chirurgia Plastica e Ricostruttiva
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Carlesimo B, Tempesta M, Fioramonti P, Bistoni G, Ruggiero M, Marchetti F. [Breast cancer metastasis in distal phalanx of the big toe. Case report]. G Chir 2009; 30:487-489. [PMID: 20109377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Breast cancer represents the most prevalent malignancies in women and bone is the first site of metastasis in 26-50% of cases. Usually metastasis involve limbs in 16%. We present a rare case of 47-year-old woman, who underwent to monolateral mastectomy for lobular cancer. After 8 years from surgery, she presented pain, swelling and functional limitations, gradually increasing, to the left big toe. X-rays and MRI showed a lucent area of bone destruction on the shaft of the distal phalanx of the left big toe. Surgical biopsy on the excised bone assessed for breast cancer metastasis.
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MESH Headings
- Antineoplastic Agents, Hormonal/therapeutic use
- Bone Neoplasms/diagnosis
- Bone Neoplasms/secondary
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Lobular/diagnosis
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/surgery
- Chemotherapy, Adjuvant
- Combined Modality Therapy
- Diagnostic Errors
- Estrogens
- Female
- Humans
- Lung Neoplasms/diagnostic imaging
- Lung Neoplasms/secondary
- Mastectomy, Radical
- Middle Aged
- Neoplasms, Hormone-Dependent/diagnosis
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/secondary
- Neoplasms, Hormone-Dependent/surgery
- Osteomyelitis/diagnosis
- Radiography
- Tamoxifen/therapeutic use
- Toe Phalanges/pathology
- Toe Phalanges/surgery
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Affiliation(s)
- B Carlesimo
- "Sapienza" Università di Roma, Policlinico Umberto l di Roma, Cattedra Chirurgia Plastica Ricostruttiva ed Estetica
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Ruggiero M, Galletti MP, Pacini S, Punzi T, Morucci G, Gulisano M. WITHDRAWN: Aids denialism at the ministry of health. Med Hypotheses 2009:S0306-9877(09)00415-0. [PMID: 19586724 DOI: 10.1016/j.mehy.2009.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Revised: 06/03/2009] [Accepted: 06/03/2009] [Indexed: 11/27/2022]
Abstract
This Article-in-Press has been permanently withdrawn. The editorial policy of Medical Hypotheses makes it clear that the journal considers "radical, speculative, and non-mainstream scientific ideas", and articles will only be acceptable if they are "coherent and clearly expressed." However, we received serious expressions of concern about the quality of this article. Given these important signals of concern, we commissioned an external expert panel to investigate the circumstances in which this article came to be published online. The panel recommended that the article should be externally peer-reviewed. Following a peer-review process managed by The Lancet editorial team, all five external reviewers recommended rejection, as a result of which the expert panel recommended permanent withdrawal. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
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Affiliation(s)
- M Ruggiero
- Department of Experimental Pathology and Oncology, University of Firenze, V. le Morgagni 50, 50134 Firenze, Italy
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Giannoni MF, Ciatti R, Capoccia L, Ruggiero M, Dauri M, Mariani PP. Total knee replacement: prevention of deep-vein thrombosis using pharmacological (low-molecular-weight heparin) and mechanical (intermittent foot sole pump system) combined prophylaxis. Preliminary results. INT ANGIOL 2006; 25:316-21. [PMID: 16878083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
AIM The aim of this study was to determine the role of combined mechanical and pharmacological prophylaxis in the prevention of deep venous thrombosis (DVT) after total knee replacement (TKR). DESIGN prospective case series study. METHODS Between October 2002 and June 2003, 38 total knee procedures were carried out on 34 patients (4 patients had bilateral TKR). To exclude the presence of a concomitant DVT echo-color-flow of the legs was performed between 2 and 1 week prior to surgery, in the postoperative period (before discharging) and 30 days after surgery. Patients received one daily subcutaneous injection of nadroparin calcium (dosage adapted to body-weight). An intermittent foot sole pump (IFSP) was applied in the recovery room postoperatively, in both feet for about 5 h a day and all night long, and continued at home until the 15(th) day. RESULTS No major perioperative or rehabilitation phase-related complications were observed (2 patients required manual drainage of blood clots from the wound). The incidence of DVT was 7.9% (3 cases). In one of these cases we observed a previous DVT so it was classified as rethrombosis. All were successfully treated with therapeutic introduced low molecular weight heparin (LMWH) therapy. No pulmonary embolism or deaths associated with the use of LMWH or IFSP were observed. CONCLUSIONS In our experience the combined prophylaxis with nadroparin calcium and IFSP significantly reduced the incidence of DVT.
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Affiliation(s)
- M F Giannoni
- Department of Vascular Surgery, La Sapienza University of Rome, Rome, Italy.
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Piotin M, Spelle L, Mounayer C, Lazzarotti G, Ruggiero M, Kadziolka K, De Paula Lucas C, Moret J. CO-63 - Remplissage anévrismal, coils à formes complexes et stabilité du résultat angiographique des anévrismes traités avec des coils nus. J Neuroradiol 2006. [DOI: 10.1016/s0150-9861(06)77182-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ruggiero M, Piotin M, Mounayer C, Spelle L, Moret J. P-37 - Disparition d’acouphènes pulsatiles après angioplastie d’une sténose carotidienne intracrânienne. J Neuroradiol 2006. [DOI: 10.1016/s0150-9861(06)77220-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Suski L, Kołacz J, Mordarski G, Ruggiero M. Determination of open-circuit potentials at gas/electrode/YSZ boundary versus molten carbonate reference electrode at medium temperatures. Electrochim Acta 2005. [DOI: 10.1016/j.electacta.2004.11.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Mordarski G, Suski L, Ruggiero M, Kołacz J, Wyrwa J. Open-circuit-potentials of gas/electrode/YSZ boundary versus molten carbonate reference electrode at medium temperatures. Electrochim Acta 2005. [DOI: 10.1016/j.electacta.2004.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sbarigia E, Speziale F, Ducasse E, Giannoni MF, Ruggiero M, Palmieri A, Fiorani P. What is the best management for abdominal aortic aneurysm in patients at high surgical risk? A single-center review. INT ANGIOL 2005; 24:70-4. [PMID: 15877002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
AIM To determine the best treatment for high-risk patients with abdominal aortic aneurysms (AAA). METHODS We reviewed a prospective database of all patients who underwent conventional (OPEN) or endovascular aneurysm repair (EVAR) between January 1998 and December 2002. Patients were preoperatively classified according to the American Society of Anesthesiology (ASA). Comorbidities and medical risk factors were categorized according to the Ad Hoc Committee on Reporting Standards. Perioperative mortality and morbidity rates were analyzed according to the type of surgical procedure (OPEN vs EVAR) and ASA class. Patients in ASA classes I and II were excluded. Continuous data were expressed as mean +/- standard deviation. All data were calculated using the cumulated actuarial method of event outcome probability. Kaplan-Meier curves were constructed and the log-rank statistic and chi squared test were used for comparative data. P values less than 0.05 were considered to indicate statistical significance. RESULTS Of the total 375 patients who underwent AAA repair, 168 (45%) belonged in ASA classes III and IV (85 submitted OPEN and 83 EVAR to repair). Among general risk factors only coronary artery disease differed significantly between the 4 groups (P = 0.04). The Bonferroni correction identified a statistically significant difference between ASA classes III and IV for the OPEN technique and for EVAR (P = 0.007 and P = 0.012). Neither 30-day morbidity or mortality differed significantly according to ASA class and surgical technique. The median follow-up was 19 months (range 5-60 months). The overall survival was 78% at 60 months. Survival rates during follow-up differed significantly in the 2 risk classes (ASA III 5/123, 4% vs ASA IV 9/38, 24%), (P = 0.0001). The deaths in the ASA class 4 patients (12/14; 86%) were caused by preexisting medical comorbidities (in 9 patients cardiovascular, in 1 cancer and in 2 cirrhosis). CONCLUSIONS Except patients with small aneurysms (< 6 cm), in whom the risk of death at 1-year due to comorbidities exceeds the risk of a ruptured aneurysm, all patients at high surgical risk (ASA class IV) benefit from AAA repair. Patients with small aneurysms must undergo strict surveillance to assess growth and aneurysmal wall changes to prevent unexpected rupture.
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Affiliation(s)
- E Sbarigia
- Department of Vascular Surgery, Umberto I Polyclinic, La Sapienza University of Rome, Rome, Italy.
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Ruggiero M, Gulisano M, Peruzzi B, Giomi B, Caproni M, Fabbri P, Pacini S. Vitamin D receptor gene polymorphism is not associated with psoriasis in the Italian Caucasian population. J Dermatol Sci 2004; 35:68-70. [PMID: 15194150 DOI: 10.1016/j.jdermsci.2004.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2003] [Indexed: 11/18/2022]
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Capelli G, Baldelli R, Ferroglio E, Genchi C, Gradoni L, Gramiccia M, Maroli M, Mortarino M, Pietrobelli M, Rossi L, Ruggiero M. [Monitoring of canine leishmaniasis in northern Italy: an update from a scientific network]. Parassitologia 2004; 46:193-7. [PMID: 15305715] [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: 04/30/2023]
Abstract
Canine leishmaniasis (CanL) due to Leishmania infantum is a disease of great veterinary importance and a serious public health problem. In humans, L. infantum causes visceral (VL) and cutaneous leishmaniasis (CL) and the distribution of VL overlaps that of CanL. Currently, VL is considered by WHO as an emerging zoonosis in southern Europe. The dog is the only domestic reservoir of the infection and phlebotomine sandflies are the only proven vectors of leishmaniasis for dogs and humans. CanL is endemic in Italy, particularly in central and southern regions, including islands. Until 1983, all regions of northern Italy but Liguria and some territories of Emilia Romagna were considered free from CanL. From early '90s new stable foci of CanL have appeared, most of them located within classical endemic areas including territories of Emilia Romagna, Tuscany, Umbria, Marche, and Abruzzi regions. But the most relevant aspect, from an epidemiological point of view, has been the appearance of stable CanL foci in northern Italy, namely in Veneto and Piedmont regions. In these two foci, entomological surveys showed the presence of P. perniciosus and of a second phlebotomine vector, P. neglectus, which may have played a role in the CanL diffusion in some parts of northern Italy. Furthermore, in these areas, autochthonous human VL cases have occurred. There is therefore a realistic risk that CanL infection could rapidly spread through northern latitudes and a surveillance activity is strongly needed. For this reason, in October 2002, thanks to the collaboration and support of Intervet Italia, the network "LeishMap" was created, with the main purpose of monitoring the spread of CanL and vectors in northern Italy. LeishMap consists of scientific and sanitary institutions with proven experience both in field surveys and diagnostic methodologies on CanL and phlebotomine vector. It is organised in 4 Operational Units (OU), represented by researchers of the Veterinary Faculties of the University of Bologna, Padua, Milan and Turin, under the scientific coordination of the MIPI Department, ISS of Rome and with the collaboration of private and public veterinarians operating in the regions under study. During the first year of activity, each OU was involved in the serological and entomological surveillance of several territories in the respective regions, where recent autochthonous CanL cases were registered. The studies have involved five regions, namely Valle D'Aosta, Piedmont, Lombardia, Veneto, Trentino-Alto Adige and Emilia Romagna. In the Symposium 6 of this Congress we report detailed results of a retrospective analysis of data concerning CanL and vectors in northern Italy till 2002 and the preliminary results of 2003 on the seroprevalence rates observed in foci studied and on the entomological surveys carried out. In summary, the results outlined that already known foci of CanL are expanding from the original sites. Several new foci have been identified and many others are at high risk of evolving toward a stable endemicity. P. perniciosus has been found in all but one the suspected new foci. In Emilia Romagna region P. perfiliewi was identified in 2 areas and in one was the only species present. The occurrence of P. neglectus was confirmed in three regions, Veneto, Lombardia and Piedmont. In conclusion, from the 2002-2003 LeishMap activities it appears that further monitoring activities are necessary to identify new endemic foci of CanL, this representing the prerequisite for the implementation of programs for leishmaniasis control in northern Italy.
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Contini M, Pacini S, Ibba-Manneschi L, Boddi V, Ruggiero M, Liguri G, Gulisano M, Catini C. Modification of plasma glycosaminoglycans in long distance runners. Br J Sports Med 2004; 38:134-7; discussion 137. [PMID: 15039246 PMCID: PMC1724789 DOI: 10.1136/bjsm.2002.001388] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND It is well documented that exercise reduces the risk of thromboembolic disease, possibly by increasing the plasma concentration of anticoagulant-antithrombotic compounds. OBJECTIVES As plasma glycosaminoglycans (GAGs) play a role in the anticoagulant-antithrombotic potential of plasma, to examine the concentration and profile of these compounds in well trained, long distance runners and sedentary subjects. METHODS Plasma GAGs were measured in 10 male, long distance runners and 10 sedentary counterparts before and after ergometric tests. GAGs were extracted, purified, and identified by electrophoretic and enzymatic methods, and measured as hexosamine. RESULTS Plasma GAGs found in sedentary subjects were slow migrating heparan sulphates I and II, keratan sulphate I, and chondroitin 4-6-sulphate. Those found in trained athletes were slow migrating heparan sulphate I, chondroitin 4-6-sulphate (or keratan sulphate I), and fast migrating heparan sulphate. Total plasma concentrations of GAGs were higher in athletes than in sedentary subjects at rest. In sedentary subjects, plasma GAGs did not change after cycle ergometric exercise at 80% of their anaerobic threshold. However, the appearance of a novel band of heparan sulphate migrating faster than fast migrating heparan sulphate was observed in athletes after exercise. CONCLUSIONS Exercise changes the amount and profile of plasma GAGs; these changes may play a role in protecting subjects who practise aerobic sports against developing cardiovascular disease.
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Affiliation(s)
- M Contini
- Department of Anatomy, Histology and Forensic Medicine, University of Firenze, Florence, Italy
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Messori A, Di Bella P, Herber N, Logullo F, Ruggiero M, Salvolini U. The importance of suspecting superficial siderosis of the central nervous system in clinical practice. J Neurol Neurosurg Psychiatry 2004; 75:188-90. [PMID: 14742584 PMCID: PMC1738929 DOI: 10.1136/jnnp.2003.023648] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Once the central nervous system surface is greatly encrusted with haemosiderin, even removing the source of bleeding will have little effect on the progression of clinical deterioration. Superficial siderosis of the central nervous system is rare and insidious, but magnetic resonance imaging has turned a previously late, mainly autoptical diagnosis into an easy, specific, in vivo, and possibly early one. Avoiding long diagnostic delay will be very important in those cases susceptible of causal treatment.
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Affiliation(s)
- A Messori
- Department of Neuroradiology, Umberto I Hospital and University of Ancona, Torrette, Ancona, Italy
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Pacini S, Ruggiero M, Cammarota N, Protopapa C, Gulisano M. Bio-Alcamid, a novel prosthetic polymer, does not interfere with morphological and functional characteristics of human skin fibroblasts. Plast Reconstr Surg 2003; 111:489-91. [PMID: 12496626 DOI: 10.1097/00006534-200301000-00092] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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