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Grani G, Cera G, Conzo G, Del Gatto V, di Gioia CRT, Maranghi M, Lucia P, Cantisani V, Metere A, Melcarne R, Borcea MC, Scorziello C, Menditto R, Summa M, Biffoni M, Durante C, Giacomelli L. Preoperative Ultrasonography in the Evaluation of Suspected Familial Non-Medullary Thyroid Cancer: Are We Able to Predict Multifocality and Extrathyroidal Extension? J Clin Med 2021; 10:jcm10225277. [PMID: 34830559 PMCID: PMC8624166 DOI: 10.3390/jcm10225277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 11/26/2022] Open
Abstract
Family history of thyroid cancer increases the risk of harboring thyroid malignancies that end up having extrathyroidal extension (ETE) and multifocality on histology; some authors suggest a more aggressive surgical approach. Their pre-operative identification could allow more conservative surgical procedures if none of these features are suspected. Our aim was to assess if neck ultrasonography could identify or exclude multifocality or ETE in these patients to tailor the extent of surgery. This retrospective study included patients with previous thyroid surgery, ≥1 first-grade relative with thyroid cancer, and who had undergone pre-surgical ultrasound. ETE was suspected in the case of thyroid border interruption or gross invasion of perithyroidal tissues. Multiple suspicious nodules were defined as suspicion of multifocal cancer. The cohort consisted of 45 patients (median age 49 years, 40 with thyroid cancer, 30 females). The positive predictive value of ultrasonography in predicting multifocality and ETE was 57.14% (25.25–84.03) and 41.67% (21.5–65.1%), respectively, while the negative predictive values were 63.2% (56.4–69.4%) and 72.7% (63.3–80.5%). Pre-operative ultrasound examination is unable to reliably identify or exclude multifocal disease or extrathyroidal extension. In patients scheduled for surgery and with a first-degree relative affected by DTC, a “negative” pre-operative US report does not exclude the potential finding of multifocality and ETE at final histopathology.
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Affiliation(s)
- Giorgio Grani
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (G.G.); (G.C.); (V.D.G.); (M.M.); (P.L.)
| | - Gianluca Cera
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (G.G.); (G.C.); (V.D.G.); (M.M.); (P.L.)
| | - Giovanni Conzo
- Department of Cardiothoracic Sciences, University of Campania Luigi Vanvitelli, I-80131 Naples, Italy;
| | - Valeria Del Gatto
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (G.G.); (G.C.); (V.D.G.); (M.M.); (P.L.)
| | - Cira Rosaria Tiziana di Gioia
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (C.R.T.d.G.); (V.C.)
| | - Marianna Maranghi
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (G.G.); (G.C.); (V.D.G.); (M.M.); (P.L.)
| | - Piernatale Lucia
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (G.G.); (G.C.); (V.D.G.); (M.M.); (P.L.)
| | - Vito Cantisani
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (C.R.T.d.G.); (V.C.)
| | - Alessio Metere
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
| | - Rossella Melcarne
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
| | - Maria Carola Borcea
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
| | - Chiara Scorziello
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
| | - Rosa Menditto
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
| | - Marco Summa
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
| | - Marco Biffoni
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
| | - Cosimo Durante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (G.G.); (G.C.); (V.D.G.); (M.M.); (P.L.)
- Correspondence: ; Tel.: +39-0-649-975-130
| | - Laura Giacomelli
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy; (A.M.); (R.M.); (M.C.B.); (C.S.); (R.M.); (M.S.); (M.B.); (L.G.)
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Bellini MI, Biffoni M, Patrone R, Borcea MC, Costanzo ML, Garritano T, Melcarne R, Menditto R, Metere A, Scorziello C, Summa M, Ventrone L, D’Andrea V, Giacomelli L. Poorly Differentiated Thyroid Carcinoma: Single Centre Experience and Review of the Literature. J Clin Med 2021; 10:jcm10225258. [PMID: 34830540 PMCID: PMC8623499 DOI: 10.3390/jcm10225258] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/05/2021] [Accepted: 11/11/2021] [Indexed: 11/21/2022] Open
Abstract
There is controversy in the literature regarding a distinct subset of thyroid carcinoma whose histologically classification falls between well-differentiated and anaplastic carcinomas, previously identified as ‘poorly differentiated thyroid carcinoma’ (PDTC), or ‘insular carcinoma’, in view of the peculiar morphological characteristics of the cell groupings. The correct diagnosis and treatment of this entity have important prognostic and therapeutic significance. In this review, we describe the epidemiology, diagnosis, and management of PDTC and report our single centre experience to add to the limited evidence existing in the literature.
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Affiliation(s)
- Maria Irene Bellini
- Azienda Ospedaliera San Camillo Forlanini, 00152 Rome, Italy
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
- Correspondence:
| | - Marco Biffoni
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Renato Patrone
- ICTUS, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy;
| | - Maria Carola Borcea
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Maria Ludovica Costanzo
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Tiziana Garritano
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Rossella Melcarne
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Rosa Menditto
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Alessio Metere
- General Surgery Department, Ospedale dei Castelli (O.D.C.), Via Nettunense Km 11,5, 00040 Rome, Italy;
| | - Chiara Scorziello
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Marco Summa
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Luca Ventrone
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Vito D’Andrea
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Laura Giacomelli
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
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Abstract
Human noroviruses (HuNoVs) are one of the leading global causes of diarrhoeal diseases and are transmitted mainly from person to person but also through contaminated food, water and fomites. The possible zoonotic nature of NoVs has occasionally been discussed, although the viruses are generally considered to be host-species-specific. We investigated whether wild birds and rodents could serve as carriers of HuNoVs, thereby transmitting the virus to humans directly or indirectly by contaminating foods. All samples, 115 avian and 100 rat faeces collected in springs 2009-2013 from dump sites, and 85 faeces from yellow-necked mice trapped in late autumn 2008 and 2009 after the rodents entered human settlements due to the first night frosts, were screened for HuNoV using real-time reverse transcription PCR. HuNoVs were detected in 31 (27%) faecal samples of wild birds, in two (2%) faecal samples of rats and in no samples of mice. Most (25) of the positive bird samples and both rat samples contained genogroup II, and six positive bird samples contained genogroup I HuNoV. The avian species shedding faeces containing HuNoVs were identified as gulls and crows using DNA barcoding. Our results show that wildlife, birds and rats in particular, is capable of spreading HuNoVs in the environment.
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Affiliation(s)
- M Summa
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - H Henttonen
- Natural Resources Institute Finland, Helsinki, Finland
| | - L Maunula
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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Bonfiglio T, Olivero G, Vergassola M, Di Cesare Mannelli L, Pacini A, Iannuzzi F, Summa M, Bertorelli R, Feligioni M, Ghelardini C, Pittaluga A. Environmental training is beneficial to clinical symptoms and cortical presynaptic defects in mice suffering from experimental autoimmune encephalomyelitis. Neuropharmacology 2018; 145:75-86. [PMID: 29402503 DOI: 10.1016/j.neuropharm.2018.01.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 01/19/2018] [Accepted: 01/20/2018] [Indexed: 01/08/2023]
Abstract
The effect of "prophylactic" environmental stimulation on clinical symptoms and presynaptic defects in mice suffering from the experimental autoimmune encephalomyelitis (EAE) at the acute stage of disease (21 ± 1 days post immunization, d.p.i.) was investigated. In EAE mice raised in an enriched environment (EE), the clinical score was reduced when compared to EAE mice raised in standard environment (SE).Concomitantly, gain of weight and increased spontaneous motor activity and curiosity were observed, suggesting increased well-being in mice. Impaired glutamate exocytosis and cyclic adenosine monophosphate (cAMP) production in cortical terminals of SE-EAE mice were evident at 21 ± 1 d.p.i.. Differently, the 12 mM KCl-evoked glutamate exocytosis from cortical synaptosomes of EE-EAE mice was comparable to that observed in SE and EE-control mice, but significantly higher than that in SE-EAE mice. Similarly, the 12 mM KCl-evoked cAMP production in EE-EAE mice cortical synaptosomes recovered to the level observed in SE and EE-control mice. MUNC-18 and SNAP25 contents, but not Syntaxin-1a and Synaptotagmin 1 levels, were increased in cortical synaptosomes from EE-EAE mice when compared to SE-EAE mice. Circulating IL-1β was increased in the spinal cord, but not in the cortex, of SE-EAE mice, and it did not recover in EE-EAE mice. Inflammatory infiltrates were reduced in the cortex but not in the spinal cord of EE-EAE mice. Demyelination was observed in the spinal cord; EE significantly diminished it. We conclude that "prophylactic" EE is beneficial to synaptic derangements and preserves glutamate transmission in the cortex of EAE mice. This article is part of the Special Issue entitled "Neurobiology of Environmental Enrichment".
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Affiliation(s)
- T Bonfiglio
- Department of Pharmacy, School of Medical and Pharmaceutical Sciences, University of Genoa, Viale Cembrano 4, 16148, Genoa, Italy
| | - G Olivero
- Department of Pharmacy, School of Medical and Pharmaceutical Sciences, University of Genoa, Viale Cembrano 4, 16148, Genoa, Italy
| | - M Vergassola
- Department of Pharmacy, School of Medical and Pharmaceutical Sciences, University of Genoa, Viale Cembrano 4, 16148, Genoa, Italy
| | - L Di Cesare Mannelli
- Department of Neuroscience, Psychology, Drug Research and Child Health, Neurofarba, Pharmacology and Toxicology Section, University of Florence, Italy
| | - A Pacini
- Department of Experimental and Clinical Medicine, DMSC, Section of Anatomy and Histology, University of Florence, Italy
| | - F Iannuzzi
- EBRI-European Brain Research Institute, Rome, Italy
| | - M Summa
- D3. PharmaChemistry Line, Istituto Italiano di Tecnologia, Via Morego 30, 16163, Genoa, Italy
| | - R Bertorelli
- D3. PharmaChemistry Line, Istituto Italiano di Tecnologia, Via Morego 30, 16163, Genoa, Italy
| | - M Feligioni
- EBRI-European Brain Research Institute, Rome, Italy; Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy
| | - C Ghelardini
- Department of Neuroscience, Psychology, Drug Research and Child Health, Neurofarba, Pharmacology and Toxicology Section, University of Florence, Italy
| | - A Pittaluga
- Department of Pharmacy, School of Medical and Pharmaceutical Sciences, University of Genoa, Viale Cembrano 4, 16148, Genoa, Italy; Centre of Excellence for Biomedical Research, University of Genoa, Viale Benedetto XV, 16132, Genoa, Italy.
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Romano I, Summa M, Heredia-Guerrero JA, Spanò R, Ceseracciu L, Pignatelli C, Bertorelli R, Mele E, Athanassiou A. Fumarate-loaded electrospun nanofibers with anti-inflammatory activity for fast recovery of mild skin burns. ACTA ACUST UNITED AC 2016; 11:041001. [PMID: 27481333 DOI: 10.1088/1748-6041/11/4/041001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In the biomedical sector the availability of engineered scaffolds and dressings that control and reduce inflammatory states is highly desired, particularly for the management of burn wounds. In this work, we demonstrate for the first time, to the best of our knowledge, that electrospun fibrous dressings of poly(octyl cyanoacrylate) (POCA) combined with polypropylene fumarate (PPF) possess anti-inflammatory activity and promote the fast and effective healing of mild skin burns in an animal model. The fibers produced had an average diameter of (0.8 ± 0.1) µm and they were able to provide a conformal coverage of the injured tissue. The application of the fibrous mats on the burned tissue effectively reduced around 80% of the levels of pro-inflammatory cytokines in the first 48 h in comparison with un-treated animals, and enhanced skin epithelialization. From histological analysis, the skin thickness of the animals treated with POCA : PPF dressings appeared similar to that of one of the naïve animals: (13.7 ± 1.4) µm and (14.3 ± 2.5) µm for naïve and treated animals, respectively. The density of dermal cells was comparable as well: (1100 ± 112) cells mm(-2) and (1358 ± 255) cells mm(-2) for naïve and treated mice, respectively. The results demonstrate the suitability of the electrospun dressings in accelerating and effectively promoting the burn healing process.
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Affiliation(s)
- I Romano
- Smart Materials, Nanophysics, Istituto Italiano di Tecnologia, Via Morego 30, Genoa 16163, Italy
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van Duppen Z, Summa M, Fuchs T. [Psychopathology and film: a valuable interaction?]. Tijdschr Psychiatr 2015; 57:596-603. [PMID: 26402896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Film or film fragments are often used in psychopathology education. However, so far there have been very few articles that have discussed the benefits and limitations of using films to explain or illustrate psychopathology. Although numerous films involves psychopathology in varying degrees, it is not clear how we can use films for psychopathology education. AIM To examine the advantages, limitations and possible methods of using film as a means of increasing our knowledge and understanding of psychiatric illnesses. METHOD We discuss five examples that illustrate the interaction of film and psychopathology. On the one hand we explain how the psychopathological concepts are used in each film and on the other hand we explain which aspects of each film are valuable aids for teaching psychopathology. RESULTS The use of film makes it possible to introduce the following topics in psychopathological teaching programme: holistic psychiatric reasoning, phenomenology and the subjective experience, the recognition of psychopathological prototypes and the importance of context. CONCLUSION There is undoubtedly an analogy between the method we have chosen for teaching psychopathology with the help of films and the holistic approach of the psychiatrist and his or her team. We believe psychopathology education can benefit from films and we would recommend our colleagues to use it in this way.
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Maunula L, Roivainen M, Keränen M, Mäkela S, Söderberg K, Summa M, von Bonsdorff CH, Lappalainen M, Korhonen T, Kuusi M, Niskanen T. Detection of human norovirus from frozen raspberries in a cluster of gastroenteritis outbreaks. Euro Surveill 2009; 14:19435. [PMID: 20003905] [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] Open
Abstract
We describe a cluster of norovirus outbreaks affecting about 200 people in Southern Finland in September and October 2009. All outbreaks occurred after consumption of imported raspberries from the same batch intended for the catering sector. Human norovirus genotype GI.4 was found in frozen raspberries. The berries were served in toppings of cakes in separate catering settings or mixed in curd cheese as a snack for children in a daycare center. The relative risk for consumption of the berry dish was 3.0 (p <or= 0.05) at the daycare centre. Human norovirus GI.4 was also detected in samples from two patients, and in berries. Both shared identical partial capsid sequences. Based on the results of epidemiological, trace-back and laboratory investigations it was concluded that one particular batch of frozen raspberries was the source of all outbreaks.
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Affiliation(s)
- L Maunula
- Department of Food and Environmental Hygiene, University of Helsinki, Finland.
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Maunula L, Roivainen M, Keränen M, Mäkelä S, Söderberg K, Summa M, von Bonsdorff CH, Lappalainen M, Korhonen T, Kuusi M, Niskanen T. Detection of human norovirus from frozen raspberries in a cluster of gastroenteritis outbreaks. Euro Surveill 2009. [DOI: 10.2807/ese.14.49.19435-en] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We describe a cluster of norovirus outbreaks affecting about 200 people in Southern Finland in September and October 2009. All outbreaks occurred after consumption of imported raspberries from the same batch intended for the catering sector. Human norovirus genotype GI.4 was found in frozen raspberries. The berries were served in toppings of cakes in separate catering settings or mixed in curd cheese as a snack for children in a daycare center. The relative risk for consumption of the berry dish was 3.0 (p ≤ 0.05) at the daycare centre. Human norovirus GI.4 was also detected in samples from two patients, and in berries. Both shared identical partial capsid sequences. Based on the results of epidemiological, trace-back and laboratory investigations it was concluded that one particular batch of frozen raspberries was the source of all outbreaks.
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Affiliation(s)
- L Maunula
- Department of Food and Environmental Hygiene, University of Helsinki, Finland
| | - M Roivainen
- Institute of Health and Welfare, Helsinki. Finland
| | - M Keränen
- Regional Food Inspection Authority, Lahti, Finland
| | - S Mäkelä
- Regional Food Inspection Authority, Social and Health Care Group, Päijät-Häme, Finland
| | - K Söderberg
- Department of Food and Environmental Hygiene, University of Helsinki, Finland
| | - M Summa
- Department of Food and Environmental Hygiene, University of Helsinki, Finland
| | - C H von Bonsdorff
- Department of Food and Environmental Hygiene, University of Helsinki, Finland
| | - M Lappalainen
- Laboratory Division (HUSLAB), Department of Virology, Helsinki University Central Hospital, Helsinki, Finland
| | - T Korhonen
- Institute of Health and Welfare, Helsinki. Finland
| | - M Kuusi
- Institute of Health and Welfare, Helsinki. Finland
| | - T Niskanen
- Finnish Food Safety Authority Evira, Helsinki, Finland
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Abstract
PURPOSE Acute appendicitis is one of the commonest diseases encountered in the field of emergency surgery. If untreated, it can rapidly develop severe complications such as perforation and peritonitis. Surgeons therefore often choose early surgical treatment also when the diagnosis is only probable, facing the risk of performing an elevated amount of unnecessary appendectomies. The aim of this study is to analyse our experience with integrated clinical-ultrasonographic diagnosis in acute appendicitis. MATERIAL AND METHODS From January 1999 to December 2006, 1447 patients underwent clinical examination, leucocyte count, evaluation of C-reactive protein level, and abdominal ultrasonography using graded compression technique and a high frequency probe. RESULTS In 368 patients (25%) ultrasonographic diagnosis was acute appendicitis; 8 patients were operated on the basis of clinical evaluation only. Ultrasonography yielded false positive results in 7 cases. In 1079 patients (75%) diagnosis was negative for acute appendicitis; 173 of these patients (12%) received a different diagnosis. The remaining 906 patients underwent clinical follow-up until the symptoms disappeared; there were no complications. In our study, sensitivity of ultrasonography was 98%, specificity 99%, positive predictive value 98%, and negative predictive value 99%. Overall diagnostic accuracy was 99%. CONCLUSION Integrated diagnosis of acute appendicitis based on clinical evaluation, laboratory tests and ultrasonography is safe and saves resources by preventing unnecessary operations.
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Affiliation(s)
- M Summa
- Section of General Surgery and Surgical Oncology, Department of Surgery, S.S. Antonio and Biagio and C. Arrigo Hospital, Alessandria, Italy
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Cavallero G, Rossi E, Dealessi M, Testa S, Zanardi F, Leinati A, Summa M. [Primary and secondary hyperparathyroidism. Analysis of our results]. MINERVA CHIR 1991; 46:447-9. [PMID: 1886687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The Authors introduce their experience of primary and secondary surgical treatment of hyperparathyroidism, pointing out at first the good confidence of echography, scintigraphy and TAC, in the pre-operating diagnostic of the parathyroid glands localization and then the satisfactory clinical results with a follow-up which, up to date, has not shown any relapse.
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Affiliation(s)
- G Cavallero
- II Divisione di Chirurgia, Ospedale Civile di Alessandria
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Cavallero G, Rossi E, Dealessi M, Leinati A, Perrone F, Quarati R, Summa M. [Perioperative total parenteral nutrition. Our experience]. MINERVA CHIR 1991; 46:455-7. [PMID: 1909426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The Authors analyze the results of 83 cases of TPN in a surgical department after a revision of the literature from which it comes out how such a method has been proposed to reduce the catabolism by surgical trauma of fasting, especially after greater surgical operations.
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Affiliation(s)
- G Cavallero
- II Divisione di Chirurgia, Ospedale Civile di Alessandria
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Serra R, Summa M. [Corynebacterium G-1 infection: description of a case of endocarditis]. G Batteriol Virol Immunol 1991; 84:103-6. [PMID: 1844914] [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: 12/29/2022]
Abstract
Here we report a case of Corynebacterium G1 group endocarditis following acute bpn in non immunodeficient host. The bacterial strain was isolated from the surgically removed heart valve. To our knowledge this is the first report of such an isolate. Recently recurrent peritonitis in CAPD were also ascribed to the same agent.
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Affiliation(s)
- R Serra
- Laboratorio Microbiologia Clinica, Ospedale Molinette USSL VIII, Torino
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14
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Adami GF, Barreca A, Gianetta E, Friedman D, Traverso E, Castagnola M, Vitale B, Summa M, Semino G, Marinari G. Body composition in subjects with surgically obtained stable body weight normalization. Int J Obes (Lond) 1989; 13:55-8. [PMID: 2703293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The body composition of lean control subjects was compared with that of subjects following biliopancreatic diversion for morbid obesity, when their excess weight had been stabilized at under 40 per cent of the ideal body weight value for over two years. Lean body mass, body cell mass and fat were indirectly calculated from total body water and total body sodium, measured by isotope dilution technique. The body composition in the two groups of subjects was essentially normal, as was indicated by the percentage values of the body composition parameters and by the linear correlations between body weight and the lean body compartments size.
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Affiliation(s)
- G F Adami
- Istituto di Patologia chirurgica, Genova, Italy
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Scopinaro N, Gianetta E, Friedman D, Adami GF, Traverso E, Vitale B, Castagnola M, Semino G, Summa M, Bachi V. Surgical revision of biliopancreatic diversion. Gastroenterol Clin North Am 1987; 16:529-31. [PMID: 3436660] [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: 01/05/2023]
Abstract
Biliopancreatic diversion is a very effective method for weight reduction. In some instances it is too effective and needs to be revised.
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Affiliation(s)
- N Scopinaro
- Department of Surgery, University of Genoa School of Medicine, Italy
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Adami GF, Summa M, Gianetta E, Caponnetto A, Friedman D, Scopinaro N. [Automated determination of total nitrogen in urine and feces]. Minerva Med 1986; 77:757-60. [PMID: 3714090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Urine and stool total nitrogen was measured using the Carlo Erba Strumentazione NA 1500 nitrogen analyzer. Determinations were carried out on 10 mcl, 20 mcl and 50 mcl urine samples and on 20-50 mg stool samples. Both urine and stool data distributions were normal, thus indicating the reliability of the method. The NA and the classic Kjeldahl method gave very close results in the same urine specimen; slight and not significant differences were found in stool analysis, most likely caused by the poor homogeneity of the material. Due to the automation, they very short analysis time, the accuracy and the reproducibility of the results, NA 1500 can be used in clinical practice for nitrogen balance studies by direct measurement of losses.
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Adami GF, Gianetta E, Summa M, Castagnola M, Semino G, Scopinaro N. [Total nitrogen concentration in human liver tissue. Correlations between morphological and microanalytical data]. Minerva Med 1986; 77:105-7. [PMID: 3945413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The degree of hepatic steatosis and percentage total nitrogen content were evaluated simultaneously in a group of obese patients and after bypass surgery for obesity. The straight line relationship between sample weight and gas chromatographic response integrals shows that samples had the same water content. The higher concentration of total nitrogen in patients with higher levels of steatosis and the inverse correlation between degree of adipose infiltration and degree of total nitrogen, when water content is the same, suggest that the total liver parenchyma nitrogen concentration closely reflects the structural protein content.
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