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Belli P, Palma S, Costantini M. Diagnostics and Therapeutics in Early Stage Breast Cancer Receiving Neoadjuvant Systemic Therapy. Cancers (Basel) 2023; 15:4874. [PMID: 37835568 PMCID: PMC10571562 DOI: 10.3390/cancers15194874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
Breast cancer (BC) remains a major challenge for oncology today, impacting the lives of countless individuals worldwide [...].
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Affiliation(s)
- Paolo Belli
- Department of Bioimaging, Radiation Oncology and Hematology, UOC of Radiologia, Fondazione Policlinico Universitario A. Gemelli IRCSS, Largo A. Gemelli 8, 00168 Rome, Italy; (S.P.); (M.C.)
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2
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Pagliara D, Schiavone L, Garganese G, Bove S, Montella RA, Costantini M, Rinaldi PM, Bottosso S, Grieco F, Rubino C, Salgarello M, Ribuffo D. Predicting Mastectomy Skin Flap Necrosis: A Systematic Review of Preoperative and Intraoperative Assessment Techniques. Clin Breast Cancer 2023; 23:249-254. [PMID: 36725477 DOI: 10.1016/j.clbc.2022.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 12/31/2022] [Accepted: 12/31/2022] [Indexed: 01/06/2023]
Abstract
Mastectomy skin-flap necrosis (MSFN) is one of the most feared complications of immediate implant-based breast reconstruction (IIBR). Traditionally, mastectomy skin-flap viability was based only on surgeons' clinical experience. Even though numerous studies have already addressed the patients' risk factors for MSFN, few works have focused on assessing quality of breast envelope. This review investigates mastectomy's flap viability-assessment methods, both preoperative (PMFA) and intraoperative (IMFA), to predict MSFN and its sequalae. Between June and November 2022, we conducted a systematic review of Pubmed/MEDLINE and Cochrane electronic databases. Only English studies regarding PMFA and IMFA applied to IIBR were selected. The use of digital mammography, ultrasound, magnetic resonance imaging, and a combination of several methods before surgery was shown to be advantageous by several authors. Indocyanine performed better than other IMFA, however both thermal imaging and spectroscopy demonstrated novel and promising results. Anyway, the best prediction comes when preoperative and intraoperative values are combined. Particularly in prepectoral reconstruction, when mastectomy flaps are essential to determine a successful breast reconstruction, surgeons' clinical judgment is insufficient in assessing the risk of MSFN. Preoperative and intraoperative assessment techniques play an emerging key role in MSFN prediction. However, although there are several approaches to back up the surgeon's processing choice, there is still a dearth of pertinent literature on the subject, and more research is required.
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Affiliation(s)
- Domenico Pagliara
- Gynecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy.
| | - Laurenza Schiavone
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Sapienza University of Rome, Roma, Italy
| | - Giorgia Garganese
- Gynecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy
| | - Sonia Bove
- Gynecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy
| | - Rino Aldo Montella
- Radiology Unit, Mater Olbia Hospital, Mater Olbia Hospital, Olbia, Italy
| | - Melania Costantini
- Radiology Unit, Mater Olbia Hospital, Mater Olbia Hospital, Olbia, Italy
| | | | - Stefano Bottosso
- Department of Medical, Surgical and Health Sciences, Plastic Surgery Unit, University of Trieste, Ospedale di Cattinara, ASUGI, Trieste, Italy
| | - Federica Grieco
- Department of Medical, Surgical and Experimental Sciences, Plastic Surgery Unit, University of Sassari, Sassari University Hospital Trust, Sassari, Italy
| | - Corrado Rubino
- Department of Medical, Surgical and Experimental Sciences, Plastic Surgery Unit, University of Sassari, Sassari University Hospital Trust, Sassari, Italy
| | - Marzia Salgarello
- Department of Woman and Child Health and Public Health, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Diego Ribuffo
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Sapienza University of Rome, Roma, Italy
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3
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Tuderti G, Mastroianni R, Mari A, Saidian A, Narasimhan R, Anceschi U, Brassetti A, Ferriero M, Bove A, Misuraca L, Costantini M, Guaglianone S, Autorino R, Derweesh I, Minervini A, Gallucci M, Simone G. Assessing the trade-off between safety and effectiveness of off-clamp robotic partial nephrectomy in patients with high RENAL score: A propensity score-matched comparison of perioperative and functional outcomes in a multicenter analysis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01059-x] [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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4
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Pagliara D, Montella RA, Garganese G, Bove S, Costantini M, Rinaldi PM, Pino V, Grieco F, Rubino C, Salgarello M. Improving Decision-making in Prepectoral Direct-to-implant Reconstruction After Nipple Sparing Mastectomy: The Key Role of Flap Thickness Ratio. Clin Breast Cancer 2023; 23:e37-e44. [PMID: 36610826 DOI: 10.1016/j.clbc.2022.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 11/23/2022] [Indexed: 11/28/2022]
Abstract
We report our experience in direct-to-implant breast reconstruction with prepectoral polyurethane implants, with a focus on intraoperative mastectomy flap thickness compared to preoperative data (flap thickness ratio) as a reliable predictive variable of ischemic complications and reconstructive outcomes (satisfaction with breast). BACKGROUND The optimization of nipple sparing mastectomy and implant-based reconstruction techniques led to an increase in the popularity of prepectoral reconstruction. The aim of this study is to explore the ratio between the intraoperative and preoperative breast tissue coverage assessment as reliable tool in order to predict the risk of ischemic complications in prepectoral reconstruction. METHODS We analyzed 124 preoperative digital mammograms of 100 patients who underwent prepectoral implant-based reconstruction. We applied a Rancati modified score for breast tissue coverage classification, adding 4 measurements on the craniocaudal view. The intraoperative mastectomy flap thickness was measured using an intraoperative ultrasound assessment. We investigated the differences between the groups with and without ischemic complications related to the preoperative, intraoperative, and flap thickness ratio data. RESULTS The flap thickness ratio was lower in ischemic complication group compared to no ischemic complication group (0.4 vs. 0.8) with statistically significant differences for all ischemic complication subgroups: major mastectomy flap necrosis (P = .000), minor mastectomy flap necrosis (P = .005), partial nipple areola complex necrosis (P = .007), and implant exposure (P = .001).
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Affiliation(s)
- Domenico Pagliara
- Gynecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy.
| | - Rino Aldo Montella
- Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Olbia, Italy
| | - Giorgia Garganese
- Gynecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy
| | - Sonia Bove
- Gynecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy
| | - Melania Costantini
- Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Olbia, Italy
| | - Pierluigi Maria Rinaldi
- Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Olbia, Italy
| | - Valentina Pino
- Department of Woman and Child Health and Public Health, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Federica Grieco
- Department of Medical, Surgical and Experimental Sciences, Plastic Surgery Unit, University of Sassari, Sassari University Hospital Trust, Sassari, Italy
| | - Corrado Rubino
- Department of Medical, Surgical and Experimental Sciences, Plastic Surgery Unit, University of Sassari, Sassari University Hospital Trust, Sassari, Italy
| | - Marzia Salgarello
- Department of Woman and Child Health and Public Health, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
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Brassetti A, Anceschi U, Bove A, Cartolano S, Costantini M, Ferriero M, Mastroianni R, Misuraca L, Tuderti G, Simone G. Partial vs. radical nephrectomy to treat pT3a renal cancers: Propensity score matched analysis of a single center series. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00512-2] [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: 02/12/2023]
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6
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Costantini M, Filianoti A, Bove A, Anceschi U, Brassetti A, Ferriero M, Mastroianni R, Misuraca L, Tuderti G, D’Annunzio S, Ciliberto G, Simone G. Volatilome analysis in renal cancer by electronic nose: A pilot monocentric study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01090-4] [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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7
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Brassetti A, Mari A, Saidian A, Derweesh I, Anceschi U, Bove A, Costantini M, Ferriero M, Guaglianone S, Mastroianni R, Misuraca L, Tuderti G, Minervini A, Gallucci M, Simone G. Outcomes of on-clamp vs. off-clamp robot-assisted partial nephrectomy for large highly complex renal tumors: A multicenter study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01061-8] [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: 02/12/2023]
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8
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Ferriero M, Costantini M, Mastroianni R, Tuderti G, Misuraca L, Anceschi U, Bove A, Brassetti A, Guaglianone S, Gallucci M, Simone G. Perioperative and functional outcomes of off-clamp robotic partial nephrectomy for “purely hilar” versus “abutting the hilum” and “central” tumors. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01297-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Costantini M, Montella RA, Fadda MP, Tondolo V, Franceschini G, Bove S, Garganese G, Rinaldi PM. Diagnostic Challenge of Invasive Lobular Carcinoma of the Breast: What Is the News? Breast Magnetic Resonance Imaging and Emerging Role of Contrast-Enhanced Spectral Mammography. J Pers Med 2022; 12:jpm12060867. [PMID: 35743654 PMCID: PMC9224821 DOI: 10.3390/jpm12060867] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/10/2022] [Accepted: 05/19/2022] [Indexed: 02/01/2023] Open
Abstract
Invasive lobular carcinoma is the second most common histologic form of breast cancer, representing 5% to 15% of all invasive breast cancers. Due to an insidious proliferative pattern, invasive lobular carcinoma remains clinically and radiologically elusive in many cases. Breast magnetic resonance imaging (MR) is considered the most accurate imaging modality in detecting and staging invasive lobular carcinoma and it is strongly recommended in pre-operative planning for all ILC. Contrast-enhanced spectral mammography (CESM) is a new diagnostic method that enables the accurate detection of malignant breast lesions similar to that of breast MR. CESM is also a promising breast imaging method for planning surgeries. In this study, we compare the ability of contrast-enhanced spectral mammography (CESM) with breast MR in the preoperative assessment of the extent of invasive lobular carcinoma. All patients with proven invasive lobular carcinoma treated in our breast cancer center underwent preoperative breast MRI and CESM. Images were reviewed by two dedicated breast radiologists and results were compared to the reference standard histopathology. CESM was similar and in some cases more accurate than breast MR in assessing the extent of disease in invasive lobular cancers. Further evaluation in larger prospective randomized trials is needed to validate our preliminary results.
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Affiliation(s)
- Melania Costantini
- Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Strada Statale 125 Orientale Sarda, 07026 Olbia, Italy; (M.C.); (M.P.F.); (P.M.R.)
- Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Area Diagnostica per Immagini, 00168 Rome, Italy
| | - Rino Aldo Montella
- Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Strada Statale 125 Orientale Sarda, 07026 Olbia, Italy; (M.C.); (M.P.F.); (P.M.R.)
- Correspondence: ; Tel.: +39-078-9189-9901
| | - Maria Paola Fadda
- Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Strada Statale 125 Orientale Sarda, 07026 Olbia, Italy; (M.C.); (M.P.F.); (P.M.R.)
| | - Vincenzo Tondolo
- General Surgery Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Strada Statale 125 Orientale Sarda, 07026 Olbia, Italy;
| | - Gianluca Franceschini
- Multidisciplinary Breast Center, Dipartimento Scienze Della Salute Della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
- Istituto di Semeiotica Chirurgica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Sonia Bove
- Gynecology and Breast Care Center, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Strada Statale 125 Orientale Sarda, 07026 Olbia, Italy; (S.B.); (G.G.)
| | - Giorgia Garganese
- Gynecology and Breast Care Center, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Strada Statale 125 Orientale Sarda, 07026 Olbia, Italy; (S.B.); (G.G.)
- Dipartimento Scienze Della Vita e Sanità Pubblica, Sezione Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Pierluigi Maria Rinaldi
- Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Strada Statale 125 Orientale Sarda, 07026 Olbia, Italy; (M.C.); (M.P.F.); (P.M.R.)
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Guzowski J, Buda RJ, Costantini M, Ćwiklińska M, Garstecki P, Stone HA. From dynamic self-organization to avalanching instabilities in soft-granular threads. Soft Matter 2022; 18:1801-1818. [PMID: 35166293 PMCID: PMC8889560 DOI: 10.1039/d1sm01350e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
We study the dynamics of threads of monodisperse droplets, including droplet chains and multi-chains, in which the droplets are interconnected by capillary bridges of another immiscible liquid phase. This system represents wet soft-granular matter - a class of granular materials in which the grains are soft and wetted by thin fluid films-with other examples including wet granular hydrogels or foams. In contrast to wet granular matter with rigid grains (e.g., wet sand), studied previously, the deformability of the grains raises the number of available metastable states and facilitates rearrangements which allow for reorganization and self-assembly of the system under external drive, e.g., applied via viscous forces. We use a co-flow configuration to generate a variety of unique low-dimensional regular granular patterns, intermediate between 1D and 2D, ranging from linear chains and chains with periodically occurring folds to multi-chains and segmented structures including chains of finite length. In particular, we observe that the partially folded chains self-organize via limit cycle of displacements and rearrangements occurring at a frequency self-adapted to the rate of build-up of compressive strain in the chain induced by the viscous forces. Upon weakening of the capillary arrest of the droplets, we observe spontaneous fluidization of the quasi-solid structures and avalanches of rearrangements. We identify two types of fluidization-induced instabilities and rationalize them in terms of a competition between advection and propagation. While we use aqueous droplets as the grains we demonstrate that the reported mechanisms of adaptive self-assembly apply to other types of soft granular systems including foams and microgels. We discuss possible application of the reported quasi-1D compartmentalized structures in tissue engineering, bioprinting and materials science.
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Affiliation(s)
- J Guzowski
- Institute of Physical Chemistry, Polish Academy of Sciences, ul. Kasprzaka 44/52, 01-224 Warsaw, Poland.
| | - R J Buda
- Institute of Physical Chemistry, Polish Academy of Sciences, ul. Kasprzaka 44/52, 01-224 Warsaw, Poland.
| | - M Costantini
- Institute of Physical Chemistry, Polish Academy of Sciences, ul. Kasprzaka 44/52, 01-224 Warsaw, Poland.
| | - M Ćwiklińska
- Institute of Physical Chemistry, Polish Academy of Sciences, ul. Kasprzaka 44/52, 01-224 Warsaw, Poland.
| | - P Garstecki
- Institute of Physical Chemistry, Polish Academy of Sciences, ul. Kasprzaka 44/52, 01-224 Warsaw, Poland.
| | - H A Stone
- Department of Mechanical and Aerospace Engineering, Princeton University, Princeton, 08544 NJ, USA
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Costantini M, Sentinelli S, Torregrossa L, Alì G, Munari E, Jeronimo C, Henrique R, Petronilho S, Capitanio U, Lucianò R, Suardi N, Landi M, Anceschi U, Bove A, Brassetti A, Ferriero M, Mastroianni R, Misuraca L, Tuderti G, Fazio V, Gallucci M, Simone G, Poeta M. Assessment of HER2 protein overexpression and gene amplification in renal collecting duct carcinoma: Therapeutic implication. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01202-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Tuderti G, Autorino R, Mastroianni R, Mari A, Carbonara U, Misuraca L, Anceschi U, Brassetti A, Ferriero M, Bove A, Costantini M, Porpiglia F, Kaouk J, Lau C, Derweesh I, Rha K, Schiavina R, Mottrie A, Gallucci M, Simone G. Nephrometry scores predicting value of Trifecta achievement in a multicenter analysis (ROSULA database) of Robotic Partial Nephrectomy for totally endophytic “deep” renal masses. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00146-4] [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: 11/29/2022]
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Brassetti A, Anceschi U, Bove A, Costantini M, Ferriero M, Guaglianone S, Mastroianni R, Misuraca L, Tuderti G, Simone G. Avoiding renorraphy at the end of off-clamp robotic partial nephrectomy does not jeopardize surgical and functional outcomes: A single center analysis. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00428-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Ferriero M, Mastroianni R, Tuderti G, Costantini M, Anceschi U, Misuraca L, Brassetti A, Guaglianone S, Bove A, Gallucci M, Simone G. Long term oncologic outcomes of partial nephrectomy for cystic renal tumors: a propensity score matched-pair comparison of cystic versus clear cell carcinoma from a single center experience. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00749-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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15
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Plessi C, Sica M, Molinaro F, Fusi G, Rossi F, Costantini M, Roviello F, Marano L, D'ignazio A, Spinelli C, Angotti R. Diagnosis and treatment of primary hypertrophic pyloric stenosis (HPS) in older children. Journal of Pediatric Surgery Case Reports 2021. [DOI: 10.1016/j.epsc.2021.101860] [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: 12/15/2022] Open
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Tuderti G, Mastroianni R, Anceschi U, D’Annunzio S, Misuraca L, Ferriero M, Bove A, Brassetti A, Costantini M, Guaglianone S, Gallucci M, Simone G. Purely off-clamp robot-assisted partial nephrectomy for totally endophytic renal tumors: Surgical technique and mid-term outcomes of a single center series. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01634-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Filianoti A, Costantini M, Anceschi U, Bove A, Brassetti A, Ferriero M, Mastroianni R, Misuraca L, Tuderti G, Ciliberto G, Simone G. Human volatilome analysis of patients with prostate cancer: prospective, two-arm non-randomized monocentric study. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01260-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Anceschi U, Brassetti A, Tuderti G, Guaglianone S, Ferriero M, Misuraca L, Bove A, Mastroianni R, Costantini M, Gallucci M, Simone G. Robot-assisted radical nephrectomy and inferior vena cava level I-III thrombectomy: An update on perioperative and mid-term oncologic outcomes from a tertiary-referral centre. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01002-2] [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: 11/26/2022]
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Brassetti A, Anceschi U, Bove A, Costantini M, Ferriero M, Guaglianone S, Mastroianni R, Tuderti G, Gallucci M, Simone G. Sutureless purely off-clamp robotic partial nephrectomy: Surgical technique and outcomes. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01633-x] [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: 12/01/2022]
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Tuderti G, Mastroianni R, Anceschi U, D’Annunzio S, Misuraca L, Ferriero M, Bove A, Brassetti A, Costantini M, Guaglianone S, Gallucci M, Simone G. Trans-arterial ICG delivery before purely off-clamp robot-assisted partial nephrectomy for totally endophytic renal tumors: Mid-term outcomes. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00970-2] [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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Costantini M, Montella RA, Fadda MP, Garganese G, Di Leone A, Sanchez AM, Franceschini G, Rinaldi PM. Axillary Nodal Metastases from Carcinoma of Unknown Primary (CUPAx): Role of Contrast-Enhanced Spectral Mammography (CESM) in Detecting Occult Breast Cancer. J Pers Med 2021; 11:jpm11060465. [PMID: 34070278 PMCID: PMC8225076 DOI: 10.3390/jpm11060465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/21/2021] [Accepted: 05/21/2021] [Indexed: 12/14/2022] Open
Abstract
Axillary lymph node metastases of occult breast cancer (CUPAx) is an unusual condition that represents both a diagnostic and therapeutic challenge. The first steps in the diagnostic work-up of patients with CUPAx are the histological analysis of the lymph node metastasis and the execution of basic breast diagnostic imaging (mammography and ultrasound). In the case of occult breast cancer, breast Magnetic Resonance (MR) must be performed. Breast MR identifies a suspicious lesion in many patients and second-look ultrasound detects a corresponding ultrasound alteration in about half of cases, allowing the performance of a US-guided biopsy. In the case of an MR-only lesion, MR-guided biopsy is mandatory. We present a case of CUPAx in which contrast-enhanced spectral mammography (CESM) is used to help the detection of occult breast cancer and to guide stereotactic vacuum breast biopsy (VABB). CESM is a new breast imaging technique that is proving to have good performance in breast cancer detection and that is showing potential in the identification of occult breast cancer in a CUPAx setting. The use of an innovative and personalized breast imaging approach in breast cancer patients improves diagnostic possibilities and promises to become the focus in decision strategies.
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Affiliation(s)
- Melania Costantini
- Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), 07026 Olbia, Italy; (M.C.); (M.P.F.); (P.M.R.)
- Area Diagnostica per Immagini, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
| | - Rino Aldo Montella
- Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), 07026 Olbia, Italy; (M.C.); (M.P.F.); (P.M.R.)
- Correspondence: ; Tel.: +39-0789-1899901
| | - Maria Paola Fadda
- Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), 07026 Olbia, Italy; (M.C.); (M.P.F.); (P.M.R.)
| | - Giorgia Garganese
- Gynecology and Breast Care Center, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), 07026 Olbia, Italy;
- Dipartimento Scienze della Vita e Sanità Pubblica, Sezione Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Alba Di Leone
- Multidisciplinary Breast Center, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy; (A.D.L.); (A.M.S.); (G.F.)
| | - Alejandro Martin Sanchez
- Multidisciplinary Breast Center, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy; (A.D.L.); (A.M.S.); (G.F.)
| | - Gianluca Franceschini
- Multidisciplinary Breast Center, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy; (A.D.L.); (A.M.S.); (G.F.)
- Istituto di Semeiotica Chirurgica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Pierluigi Maria Rinaldi
- Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), 07026 Olbia, Italy; (M.C.); (M.P.F.); (P.M.R.)
- Area Diagnostica per Immagini, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
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Albarano L, Lofrano G, Costantini M, Zupo V, Carraturo F, Guida M, Libralato G. Comparison of in situ sediment remediation amendments: Risk perspectives from species sensitivity distribution. Environ Pollut 2021; 272:115995. [PMID: 33187838 DOI: 10.1016/j.envpol.2020.115995] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/27/2020] [Accepted: 11/02/2020] [Indexed: 06/11/2023]
Abstract
Contaminated sediment is a major issue for aquatic environments, but attention must be kept even during remediation activities that can negatively affect resident biota especially when applied in situ. For the first time, the species sensitivity distribution (SSD) approach was applied to amendments used for in situ sediment remediation considering 39 papers including both freshwater (F) and saltwater (S) effect data (i.e. n = 17 only F, n = 19 only S, and n = 3 both F and S). Toxicity data related to the application of activated carbon (AC), nano-Zero-Valent-Iron (nZVI), apatite (A), organoclay (OC) and zeolite (Z) were collected and analyzed. SSD curves were constructed by lognormal model providing comprehensive comparisons of the sensitivities of different species to the relative testing methods. Results indicated that Bacteria were the most sensitive group of testing organisms, while Crustaceans were the less sensitive. The hazardous concentration for 5% of the affected species (HC5) were derived to determine the concentration protecting 95% of the species. OC, A and Z presented both acute and chronic toxicity. The HC5 values in descending order are: AC (4.79 g/L) > nZVI (0.02 g/L) > OC, A and Z (1.77E-04 g/L). AC and nZVI can be considered safer than OC, A and Z in sediment remediation activities, even if in situ long-term effects remained still underexplored.
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Affiliation(s)
- L Albarano
- Department of Biology, University of Naples Federico II, Complesso Universitario di Monte Sant'Angelo, Via Cinthia 21, 80126, Naples, Italy; Department of Marine Biotechnology, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121, Napoli, Italy
| | - G Lofrano
- Centro Servizi Metrologici e Tecnologici Avanzati (CeSMA), Complesso Universitario di Monte Sant'Angelo, Via Cinthia 21, 80126, Naples, Italy
| | - M Costantini
- Department of Marine Biotechnology, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121, Napoli, Italy
| | - V Zupo
- Department of Marine Biotechnology, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121, Napoli, Italy
| | - F Carraturo
- Department of Biology, University of Naples Federico II, Complesso Universitario di Monte Sant'Angelo, Via Cinthia 21, 80126, Naples, Italy
| | - M Guida
- Department of Biology, University of Naples Federico II, Complesso Universitario di Monte Sant'Angelo, Via Cinthia 21, 80126, Naples, Italy; Centro Servizi Metrologici e Tecnologici Avanzati (CeSMA), Complesso Universitario di Monte Sant'Angelo, Via Cinthia 21, 80126, Naples, Italy
| | - G Libralato
- Department of Biology, University of Naples Federico II, Complesso Universitario di Monte Sant'Angelo, Via Cinthia 21, 80126, Naples, Italy.
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23
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Tanzi S, De Panfilis L, Costantini M, Artioli G, Alquati S, Di Leo S. Development and preliminary evaluation of a communication skills training programme for hospital physicians by a specialized palliative care service: the 'Teach to Talk' programme. BMC Med Educ 2020; 20:363. [PMID: 33059642 PMCID: PMC7560022 DOI: 10.1186/s12909-020-02275-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 10/01/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND There is widespread agreement about the importance of communication skills training (CST) for healthcare professionals caring for cancer patients. Communication can be effectively learned and improved through specific CST. Existing CSTs have some limitations with regard to transferring the learning to the workplace. The aim of the study is developing, piloting, and preliminarily assessing a CST programme for hospital physicians caring for advanced cancer patients to improve communication competences. METHODS This is a Phase 0-I study that follows the Medical Research Council framework; this paper describes the following sections: a literature review on CST, the development of the Teach to Talk training programme (TtT), the development of a procedure for assessing the quality of the implementation process and assessing the feasibility of the implementation process, and the pilot programme. The study was performed at a 900-bed public hospital. The programme was implemented by the Specialized Palliative Care Service. The programme was proposed to 19 physicians from 2 departments. RESULTS The different components of the training course were identified, and a set of quality indicators was developed. The TtT programme was implemented; all the physicians attended the lesson, videos, and role-playing sessions. Only 25% of the physicians participated in the bedside training. It was more challenging to involve Haematology physicians in the programme. CONCLUSIONS The programme was completed as established for one of the two departments in which it was piloted. Thus, in spite of the good feedback from the trainees, a re-piloting of a different training program will be developed, considering in particular the bed side component. The program should be tailored on specific communication attitude and believes, probably different between different specialties.
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Affiliation(s)
- S Tanzi
- Palliative Care Unit, Azienda USL- IRCCS Reggio Emilia, Reggio Emilia, Italy.
- Clinical and Experimental Medicine PhD Programme, University of Modena and Reggio Emilia, Modena, Italy.
| | - L De Panfilis
- Unit of Bioethics, Azienda USL- IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - M Costantini
- Scientific Directorate, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - G Artioli
- Palliative Care Unit, Azienda USL- IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - S Alquati
- Palliative Care Unit, Azienda USL- IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - S Di Leo
- Psycho-oncology Unit, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
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24
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Quarona D, Raffuzzi M, Costantini M, Sinigaglia C. Preventing action slows down performance in perceptual judgment. Exp Brain Res 2020; 238:2857-2864. [PMID: 33048197 PMCID: PMC7644466 DOI: 10.1007/s00221-020-05948-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 10/06/2020] [Indexed: 11/28/2022]
Abstract
Action and vision are known to be tightly coupled with each other. In a previous study, we found that repeatedly grasping an object without any visual feedback might result in a perceptual aftereffect when the object was visually presented in the context of a perceptual judgement task. In this study, we explored whether and how such an effect could be modulated by presenting the object behind a transparent barrier. Our conjecture was that if perceptual judgment relies, in part at least, on the same processes and representations as those involved in action, then one should expect to find a slowdown in judgment performance when the target object looks to be out of reach. And this was what we actually found. This indicates that not only acting upon an object but also being prevented from acting upon it can affect how the object is perceptually judged.
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Affiliation(s)
- D Quarona
- Department of Philosophy, University of Milan, Milan, Italy.,Cognition in Action (CIA) Unit, PHILAB, University of Milan, Milan, Italy
| | - M Raffuzzi
- Cognition in Action (CIA) Unit, PHILAB, University of Milan, Milan, Italy
| | - M Costantini
- Department of Psychological, Health, and Territorial Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Institute for Advanced Biomedical Technologies-ITAB, University "G. D'Annunzio", Chieti, Italy
| | - C Sinigaglia
- Department of Philosophy, University of Milan, Milan, Italy. .,Cognition in Action (CIA) Unit, PHILAB, University of Milan, Milan, Italy.
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25
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Anceschi U, Bertolo R, Brassetti A, Tuderti G, Costantini M, Flammia R, Mastroianni R, Ferriero M, Bove A, Guaglianone S, Gallucci M, Kaouk J, Simone G. On-Clamp versus purely Off-Clamp robotic partial nephrectomy in solitary kidneys: comparison of chronic kidney disease progression at two high-volume centers. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35522-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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26
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Anceschi U, Brassetti A, Tuderti G, Costantini M, Mastroianni R, Bove A, Ferriero M, Zappalà O, Carrara A, Motter M, Fiori C, De Concilio B, Porpiglia F, Tirone G, Celia A, Gallucci M, Simone G. Combined assessment of main outcomes of partial or total adrenalectomy for functioning adrenal masses: a novel trifecta. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35510-5] [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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27
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Brassetti A, Anceschi U, Bove A, Costantini M, Ferriero M, Mastroianni R, Misuraca L, Tuderti G, Guaglianone S, Gallucci M, Simone G. 15 years outcomes of laparoscopic partial nephrectomy: single center experience. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35518-x] [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] Open
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28
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Brassetti A, Sforza S, Anceschi U, Bove A, Costantini M, Ferriero M, Guaglianone S, Mastroianni R, Tuderti G, Minervini A, Gallucci M, Simone G. Minimally invasive surgery for bilateral synchronous renal masses: no advantages from a a two-steps approach. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35521-x] [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] Open
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29
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Anceschi U, Brassetti A, Tuderti G, Bove A, Ferriero M, Costantini M, Mastroianni R, Guaglianone S, Gallucci M, Simone G. Robot-Assisted radical nephrectomy and inferior vena cava level I-III thrombectomy: an update on perioperative and mid-term oncologic outcomes from a tertiary-referral centre. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35527-0] [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: 11/27/2022] Open
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30
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Brassetti A, Benecchi L, Lombardo R, Anceschi U, Bove A, Costantini M, Ferriero M, Mastroianni R, Tuderti G, Gallucci M, Simone G. A nomogram to predict disease-free survival after partial nephrectomy: development and internal validation. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35520-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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31
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Valmasoni M, Pierobon ES, Capovilla G, Piangerelli A, Moletta L, Costantini M, Salvador R, Merigliano S. Providing surgery for cancer during the COVID-19 pandemic: experience of a northern Italian referral centre. Br J Surg 2020; 107:e326-e327. [PMID: 32658329 PMCID: PMC7405134 DOI: 10.1002/bjs.11780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/15/2020] [Indexed: 11/12/2022]
Affiliation(s)
- M Valmasoni
- Padova University Hospital, Center for Esophageal Diseases, Department of Surgical, Oncological and Gastroenterological Sciences, Padova, Italy
| | - E S Pierobon
- Padova University Hospital, Center for Esophageal Diseases, Department of Surgical, Oncological and Gastroenterological Sciences, Padova, Italy
| | - G Capovilla
- Padova University Hospital, Center for Esophageal Diseases, Department of Surgical, Oncological and Gastroenterological Sciences, Padova, Italy
| | - A Piangerelli
- Padova University Hospital, Center for Esophageal Diseases, Department of Surgical, Oncological and Gastroenterological Sciences, Padova, Italy
| | - L Moletta
- Padova University Hospital, Center for Esophageal Diseases, Department of Surgical, Oncological and Gastroenterological Sciences, Padova, Italy
| | - M Costantini
- Padova University Hospital, Center for Esophageal Diseases, Department of Surgical, Oncological and Gastroenterological Sciences, Padova, Italy
| | - R Salvador
- Padova University Hospital, Center for Esophageal Diseases, Department of Surgical, Oncological and Gastroenterological Sciences, Padova, Italy
| | - S Merigliano
- Padova University Hospital, Center for Esophageal Diseases, Department of Surgical, Oncological and Gastroenterological Sciences, Padova, Italy
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32
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Ferriero M, Mastroianni R, Costantini M, Tuderti G, Anceschi U, Bove A, Brassetti A, Guaglianone S, Gallucci M, Simone G. Robot assisted partial nephrectomy for hilar tumors: Technique, perioperative, oncologic and functional outcomes from a single center series. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34184-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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33
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Brassetti A, Tuderti G, Misuraca L, Minisola F, Ferriero M, Mastroianni R, Flammia R, Guaglianone S, Anceschi U, Costantini M, Gallucci M, Simone G. Off-clamp robot-assisted partial nephrectomy for cT2 renal cancers. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34264-6] [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: 10/23/2022] Open
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34
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Tuderti G, Mastroianni R, Anceschi U, D’annunzio S, Ferriero M, Bove A, Brassetti A, Costantini M, Guaglianone S, Gallucci M, Simone G. Transarterial ICG delivery before purely off-clamp robot-assisted partial nephrectomy for totally endophytic renal tumors: Technique and outcomes. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34183-5] [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] Open
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35
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Tuderti G, Mastroianni R, Anceschi U, D’annunzio S, Ferriero M, Bove A, Brassetti A, Costantini M, Guaglianone S, Gallucci M, Simone G. Purely off-clamp robot-assisted partial nephrectomy for totally endophytic renal tumors: Mid-term outcomes from a single-center series. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34186-0] [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: 10/23/2022] Open
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36
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Meccariello G, Montevecchi F, D'Agostino G, Iannella G, Calpona S, Parisi E, Costantini M, Cammaroto G, Gobbi R, Firinu E, Sgarzani R, Nestola D, Bellini C, De Vito A, Amadori E, Vicini C. Trans-oral robotic surgery for the management of oropharyngeal carcinomas: a 9-year institutional experience. ACTA ACUST UNITED AC 2019; 39:75-83. [PMID: 31097824 PMCID: PMC6522856 DOI: 10.14639/0392-100x-2199] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 09/15/2018] [Indexed: 12/11/2022]
Abstract
Trans-oral robotic surgery (TORS) has changed surgical management
of patients with oropharyngeal squamous cell carcinomas (OPSCC). In
this study we present surgical and oncologic outcomes of patients with
oropharyngeal squamous cell carcinomas, treated using TORS, with and
without an adjuvant therapy. Sixty patients with oropharyngeal
squamous cell carcinomas treated with TORS between January 2008 and
December 2017 have been retrospectively evaluated considering
clinicopathologic features, disease characteristics, adjuvant
treatments and oncological outcomes. TORS was performed for OPSCC to
the base of tongue in 41.7%, tonsils in 46.7%, soft palate and
posterior pharyngeal wall in 3.3% and 5%, respectively. Neck
dissection was performed in 43.3% of patients. Management strategies
included surgery alone in 30%, TORS and adjuvant radiotherapy in
33.3%, and TORS plus adjuvant chemotherapy in 36.7%. The 5-year
overall survival of the total group was 77.6%, the 5-year disease-free
survival rate was 85.2%, and the 5-year local recurrence-free survival
rate was 90.6%. Finally, in selected patients TORS appears to yield
similar oncologic outcomes and functional outcomes to traditional
techniques and non-operative treatment with a possible benefit on
long-term quality of life. The future offers exciting opportunities to
combine TORS and radiotherapy in unique ways. However, further
research is urgently needed to clarify the indications for adjuvant
therapy following TORS resections.
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Affiliation(s)
- G Meccariello
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy
| | - F Montevecchi
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy
| | - G D'Agostino
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy
| | - G Iannella
- Department of Organs of Sense, Ear, Nose, and Throat Section, University of Rome "La Sapienza," Italy
| | - S Calpona
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola (FC), Italy
| | - E Parisi
- Radiotherapy Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola (FC), Italy
| | - M Costantini
- Department of Surgical Pathology, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy
| | - G Cammaroto
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy.,Department of Otolaryngology, University of Messina, Italy
| | - R Gobbi
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy
| | - E Firinu
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy
| | - R Sgarzani
- Department of Emergency, Burn Center, Bufalini Hospital, Azienda USL della Romagna, Cesena, Italy
| | - D Nestola
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy
| | - C Bellini
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy
| | - A De Vito
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy
| | - E Amadori
- Radiology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola (FC), Italy
| | - C Vicini
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy
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37
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Zaninotto G, Bennett C, Boeckxstaens G, Costantini M, Ferguson MK, Pandolfino JE, Patti MG, Ribeiro U, Richter J, Swanstrom L, Tack J, Triadafilopoulos G, Markar SR, Salvador R, Faccio L, Andreollo NA, Cecconello I, Costamagna G, da Rocha JRM, Hungness ES, Fisichella PM, Fuchs KH, Gockel I, Gurski R, Gyawali CP, Herbella FAM, Holloway RH, Hongo M, Jobe BA, Kahrilas PJ, Katzka DA, Dua KS, Liu D, Moonen A, Nasi A, Pasricha PJ, Penagini R, Perretta S, Sallum RAA, Sarnelli G, Savarino E, Schlottmann F, Sifrim D, Soper N, Tatum RP, Vaezi MF, van Herwaarden-Lindeboom M, Vanuytsel T, Vela MF, Watson DI, Zerbib F, Gittens S, Pontillo C, Vermigli S, Inama D, Low DE. The 2018 ISDE achalasia guidelines. Dis Esophagus 2018; 31:5087687. [PMID: 30169645 DOI: 10.1093/dote/doy071] [Citation(s) in RCA: 155] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Achalasia is a relatively rare primary motor esophageal disorder, characterized by absence of relaxations of the lower esophageal sphincter and of peristalsis along the esophageal body. As a result, patients typically present with dysphagia, regurgitation and occasionally chest pain, pulmonary complication and malnutrition. New diagnostic methodologies and therapeutic techniques have been recently added to the armamentarium for treating achalasia. With the aim to offer clinicians and patients an up-to-date framework for making informed decisions on the management of this disease, the International Society for Diseases of the Esophagus Guidelines proposed and endorsed the Esophageal Achalasia Guidelines (I-GOAL). The guidelines were prepared according the Appraisal of Guidelines for Research and Evaluation (AGREE-REX) tool, accredited for guideline production by NICE UK. A systematic literature search was performed and the quality of evidence and the strength of recommendations were graded according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Given the relative rarity of this disease and the paucity of high-level evidence in the literature, this process was integrated with a three-step process of anonymous voting on each statement (DELPHI). Only statements with an approval rate >80% were accepted in the guidelines. Fifty-one experts from 11 countries and 3 representatives from patient support associations participated to the preparations of the guidelines. These guidelines deal specifically with the following achalasia issues: Diagnostic workup, Definition of the disease, Severity of presentation, Medical treatment, Botulinum Toxin injection, Pneumatic dilatation, POEM, Other endoscopic treatments, Laparoscopic myotomy, Definition of recurrence, Follow up and risk of cancer, Management of end stage achalasia, Treatment options for failure, Achalasia in children, Achalasia secondary to Chagas' disease.
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Affiliation(s)
- G Zaninotto
- Department of Surgery and Cancer, Imperial College, London, UK
| | - C Bennett
- Office of Research and Innovation, Royal College of Surgeons in Ireland, Ireland
| | - G Boeckxstaens
- Department of Chronic Diseases, Metabolism and Ageing (Chrometa), Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium
| | - M Costantini
- Department of Surgical, Oncological and Gastroenterologica Sciences, University of Padua, Padua, Italy
| | - M K Ferguson
- Department of Surgery, University of Chicago, Chicago, Illinois, USA
| | - J E Pandolfino
- Department of Medicine, Northwestern University, Chicago, Illinois, USA
| | - M G Patti
- Department of Medicine and Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - U Ribeiro
- Department of Gastroenterology, Division of Surgery, University of Sao Paulo, Sao Paulo, Brazil
| | - J Richter
- Department of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - L Swanstrom
- Institute of Image-Guided Surgery, Strasbourg, France; Interventional Endoscopy and Foregut Surgery, Oregon Health Science University, Portland, Oregon, USA
| | - J Tack
- Department of Chronic Diseases, Metabolism and Ageing (Chrometa), Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium
| | - G Triadafilopoulos
- Division of Gastroenterology and Hepatology, Stanford Esophageal Multidisciplinary Program in Innovative Research Excellence (SEMPIRE), Stanford University, Stanford, California, USA
| | - S R Markar
- Department of Surgery and Cancer, Imperial College, London, UK
| | - R Salvador
- Department of Surgical, Oncological and Gastroenterologica Sciences, University of Padua, Padua, Italy
| | - L Faccio
- Division of Surgery, Padova University Hospital, Padova, Italy
| | - N A Andreollo
- Faculty of Medical Science, State University of Campinas, Campinas, São Paulo, Brazil
| | - I Cecconello
- Digestive Surgery Division, University of São Paulo School of Medicine, São Paulo, Brazil
| | - G Costamagna
- Digestive Endoscopy Unit, A. Gemelli Hospital, Catholic University, Rome, Italy
| | - J R M da Rocha
- Department of Gastroenterology, Division of Surgery, University of Sao Paulo, Sao Paulo, Brazil
| | - E S Hungness
- Department of Surgery, Northwestern University, Chicago, Illinois, USA
| | - P M Fisichella
- Department of Surgery, Brigham and Women's Hospital and Boston VA Healthcare System, Harvard Medical School, Boston, Massachusetts, USA
| | - K H Fuchs
- Department of Surgery, AGAPLESION-Markus-Krankenhaus, Frankfurt, Germany
| | - I Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - R Gurski
- Department of Surgery, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - C P Gyawali
- Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA
| | - F A M Herbella
- Department of Surgery, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - R H Holloway
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, The University of Adelaide, Adelaide, Australia
| | - M Hongo
- Department of Medicine, Kurokawa Hospital, Taiwa, Kurokawa, Miyagi, Japan
| | - B A Jobe
- Esophageal and Lung Institute, Allegheny Health Network Cancer Institute, Pittsburgh, Pennsylvania, USA
| | - P J Kahrilas
- Department of Medicine, Northwestern University, Chicago, Illinois, USA
| | - D A Katzka
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - K S Dua
- Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - D Liu
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - A Moonen
- Department of Chronic Diseases, Metabolism and Ageing (Chrometa), Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium
| | - A Nasi
- Digestive Surgery Division, University of São Paulo School of Medicine, São Paulo, Brazil
| | - P J Pasricha
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - R Penagini
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico; Department of Pathophysiology and Transplantation; Università degli Studi, Milan, Italy
| | - S Perretta
- Institute for Image Guided Surgery IHU-Strasbourg, Strasbourg, France
| | - R A A Sallum
- Department of Gastroenterology, Division of Surgery, University of Sao Paulo, Sao Paulo, Brazil
| | - G Sarnelli
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
| | - E Savarino
- Department of Surgical, Oncological and Gastroenterologica Sciences, University of Padua, Padua, Italy
| | - F Schlottmann
- Department of Surgery, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina
| | - D Sifrim
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - N Soper
- Department of Surgery, Northwestern University, Chicago, Illinois, USA
| | - R P Tatum
- Department of Surgery, University of Washington School of Medicine, Seattle, Washington, USA
| | - M F Vaezi
- Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona, USA
| | - M van Herwaarden-Lindeboom
- Department of Pediatric Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - T Vanuytsel
- Department of Chronic Diseases, Metabolism and Ageing (Chrometa), Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium
| | - M F Vela
- Department of Surgery, University of Washington School of Medicine, Seattle, Washington, USA
| | - D I Watson
- Department of Surgery, Flinders University, Adelaide, Australia
| | - F Zerbib
- Department of Gastroenterology, University of Bordeaux, Bordeaux, France
| | - S Gittens
- ECD Solutions, Atlanta, Georgia, USA
| | - C Pontillo
- ALMA (Association of patients with achalasia, ONLUS), Naples, Italy
| | - S Vermigli
- ALMA (Association of patients with achalasia, ONLUS), Naples, Italy
| | - D Inama
- ALMA (Association of patients with achalasia, ONLUS), Naples, Italy
| | - D E Low
- Department of Thoracic Surgery Virginia Mason Medical Center, Seattle, Washington, USA
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Bortesi M, Martino V, Marchetti M, Cavazza A, Gardini G, Zanetti E, Bassi MC, Ghirotto L, Costantini M, Piana S. Pathologist’s assistant (PathA) and his/her role in the surgical pathology department: a systematic review and a narrative synthesis. Virchows Arch 2018; 472:1041-1054. [DOI: 10.1007/s00428-018-2300-x] [Citation(s) in RCA: 4] [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] [Received: 11/10/2017] [Revised: 12/28/2017] [Accepted: 01/15/2018] [Indexed: 12/01/2022]
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Abbruzzese F, Basoli F, Costantini M, Giannitelli SM, Gori M, Mozetic P, Rainer A, Trombetta M. Hyaluronan: an overview. J BIOL REG HOMEOS AG 2017; 31:9-22. [PMID: 29202559] [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: 06/07/2023]
Abstract
Hyaluronic acid (HA) is a polyanionic natural polymer occurring as a linear polysaccharide composed of glucuronic acid and N-acetylglucosamine repeats. Hyaluronic acid has a wide range of applications with its excellent physicochemical properties such as biodegradability, biocompatibility, non-toxicity, non-immunogenicity and serves as an excellent tool in biomedical applications such as osteoarthritis surgery, ocular surgery, plastic surgery, tissue engineering and drug delivery. This work provides an overview on hyaluronic acid, its chemistry and biochemistry and its medical applications.
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Affiliation(s)
- F Abbruzzese
- Università Campus Bio-Medico di Roma, Rome, Italy
| | - F Basoli
- Università Campus Bio-Medico di Roma, Rome, Italy
| | - M Costantini
- Università Campus Bio-Medico di Roma, Rome, Italy
| | | | - M Gori
- Università Campus Bio-Medico di Roma, Rome, Italy
| | - P Mozetic
- Università Campus Bio-Medico di Roma, Rome, Italy
| | - A Rainer
- UniversitàCampus Bio-Medico di Roma, Rome, Italy
| | - M Trombetta
- Università Campus Bio-Medico di Roma, Rome, Italy
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Moonen A, Busch O, Costantini M, Finotti E, Tack J, Salvador R, Boeckxstaens G, Zaninotto G. Economic evaluation of the randomized European Achalasia trial comparing pneumodilation with Laparoscopic Heller myotomy. Neurogastroenterol Motil 2017; 29. [PMID: 28547866 DOI: 10.1111/nmo.13115] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 04/25/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND A recent multicenter randomized trial in achalasia patients has shown that pneumatic dilation resulted in equivalent relief of symptoms compared to laparoscopic Heller myotomy. Additionally, the cost of each treatment should be also taken in consideration. Therefore, the aim of the present study was to perform an economic analysis of the European achalasia trial. METHODS Patients with newly diagnosed achalasia were enrolled from to 2003 to 2008 in 14 centers in five European countries and were randomly assigned to either pneumatic dilation (PD) or laparoscopic Heller (LHM). The economic analysis was performed in the three centers in three different countries where most patients were enrolled (Amsterdam [NL], Leuven, [B] and Padova [I]) and then applied to all patients included in the study. The total raw costs of the two treatments per patient include the initial costs, the costs of complications, and the costs of retreatments. RESULTS Two hundred and one patients, 107 (57 males and 50 females, mean age 46 CI: 43-49 years) were randomized to LHM and 94 (59 males and 34 females, mean age 46 CI 43-50 years) to PD. The total cost of PD per patient was quite comparable in the three different centers; €3397 in Padova, €3259 in Amsterdam and €3792 in Leuven. For LHM, the total costs per patient were highest in Amsterdam: €4488 in Padova, €6720 in Amsterdam, and €5856 in Leuven. CONCLUSION In conclusion, the strategy of treating achalasia starting with PD appears the most economic approach, independent of the health system.
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Affiliation(s)
- A Moonen
- Department of Gastroenterology, Catholic University of Leuven, Leuven, Belgium
| | - O Busch
- Gastrointestinal Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - M Costantini
- Department of Surgical Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy
| | - E Finotti
- Department of Surgery, Policlinico di Abano Terme, Abano, Italy
| | - J Tack
- Department of Gastroenterology, Catholic University of Leuven, Leuven, Belgium
| | - R Salvador
- Department of Surgical Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy
| | - G Boeckxstaens
- Department of Gastroenterology, Catholic University of Leuven, Leuven, Belgium
| | - G Zaninotto
- Department of Academic Surgery, St Mary's Hospital, Imperial College, London, UK
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Capovilla G, Salvador R, Spadotto L, Voltarel G, Pesenti E, Perazzolo A, Nicoletti L, Merigliano S, Costantini M. Long-term wireless pH monitoring of the distal esophagus: prolonging the test beyond 48 hours is unnecessary and may be misleading. Dis Esophagus 2017; 30:1-8. [PMID: 28859392 DOI: 10.1093/dote/dox069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 05/23/2017] [Indexed: 12/11/2022]
Abstract
Wireless pH monitoring of the esophagus has been widely used to detect GERD for more than a decade. It is generally well tolerated and accepted by patients, but it is still unclear whether prolonging a recording beyond the usual 48 hours can improve the test's diagnostic value. The aim of this study is to examine the diagnostic yield of 96-hour pH monitoring vis-à-vis 24- and 48-hour tests, and to ascertain whether any gain in diagnostic terms was of genuine clinical utility. Patients with suspected GERD underwent 4-day PPI-off wireless pH monitoring of the distal esophagus. The capsule was inserted under endoscopic control, 6 cm above the squamocolumnar junction. Average acid exposure time was calculated after 24, 48, and 96 hours of recording. Ninety-nine patients completed the 96 hour test, and formed the study sample. The wireless test method was used in 42 patients (42.4%) unable to tolerate the traditional pH-monitoring catheter, and in 57 (57.6%) with a previous negative pH study despite symptoms suggestive of GERD. On complete analysis, 47 patients (47.5%) had a pathological test result: 19 patients within the first 24 hours (19.2%, 24 hour group); another 16 after 48 hours (+16.2%, 48 hour group), and a further 12 (+12.1%, 96 hour group) only after 96 hours of monitoring. All 47 patients with an abnormal acid exposure were offered and accepted surgery (10 patients) or medical therapy (37 patients). Clinical follow-up was obtained in all patients with a positive Bravo test result after a median 67 months (IQR: 38-98) using a validated symptom questionnaire. A good outcome after fundoplication or medical therapy was achieved in 73.7% of patients in the 24 hour group, in 62.5% of those in the 48 hour group, and in only 25% of those in the 96 hour group, P = 0.02. Long-term wireless pH monitoring enables an increase in the diagnostic yield over traditional 24- and 48-hour pH studies, but prolonging the test may constitute an unwanted bias and prompt the recruitment of more complex patients, in whom the outcome of surgical or medical therapy may prove less than satisfactory. These findings should be taken into account when establishing the guidelines for assessing GERD with such long-term pH monitoring methods.
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Romano G, Costantini M, Sansone C, Lauritano C, Ruocco N, Ianora A. Marine microorganisms as a promising and sustainable source of bioactive molecules. Mar Environ Res 2017; 128:58-69. [PMID: 27160988 DOI: 10.1016/j.marenvres.2016.05.002] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/29/2016] [Accepted: 05/01/2016] [Indexed: 06/05/2023]
Abstract
There is an urgent need to discover new drug entities due to the increased incidence of severe diseases as cancer and neurodegenerative pathologies, and reducing efficacy of existing antibiotics. Recently, there is a renewed interest in exploring the marine habitat for new pharmaceuticals also thanks to the advancement in cultivation technologies and in molecular biology techniques. Microorganisms represent a still poorly explored resource for drug discovery. The possibility of obtaining a continuous source of bioactives from marine microorganisms, more amenable to culturing compared to macro-organisms, may be able to meet the challenging demands of pharmaceutical industries. This would enable a more environmentally-friendly approach to drug discovery and overcome the over-utilization of marine resources and the use of destructive collection practices. The importance of the topic is underlined by the number of EU projects funded aimed at improving the exploitation of marine organisms for drug discovery.
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Affiliation(s)
- G Romano
- Department of Integrative Marine Ecology, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Napoli, Italy.
| | - M Costantini
- Department of Biology and Evolution of Marine Organisms, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Napoli, Italy
| | - C Sansone
- Department of Integrative Marine Ecology, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Napoli, Italy
| | - C Lauritano
- Department of Integrative Marine Ecology, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Napoli, Italy
| | - N Ruocco
- Department of Biology and Evolution of Marine Organisms, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Napoli, Italy; Department of Biology, University of Naples Federico II, Complesso Universitario di Monte Sant'Angelo, Via Cinthia, 80126 Napoli, Italy; Bio-Organic Chemistry Unit, Institute of Biomolecular Chemistry-CNR, Via Campi Flegrei 34, Pozzuoli, Naples 80078, Italy
| | - A Ianora
- Department of Integrative Marine Ecology, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Napoli, Italy
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Corbo M, Di Cosmo G, Ferri F, Salone A, Carlesi D, Centofanti M, Cipollone F, Costantini M, Di Iorio G, Martinotti G, di Giannantonio M. Peripersonal space and schizophrenia: Looking for the self boundaries. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionPeripersonal space has been defined as the area immediately surrounding the body in which interactions with a person or an object can occur. Larger peripersonal space may reflect discomfort in close interpersonal situation or cognitive deficit. Individuals with schizophrenia are more sensitive to social stimulation. The capacity to provide accurate judgments of peripersonal space boundaries depend on the capacity to create an organized and structured mental representation that integrates signals from different sensory modalities and brain regions.ObjectivesWe conducted a study on personal space in patients with schizophrenia using a paradigm that was not affected by emotional and social interference.AimsWe aimed to investigate the characteristics of personal space in patients with schizophrenia.MethodsWe recruited 20 schizophrenic patients according to DSM-V criterion and 20 healthy volunteers, matched by gender and age. Schizophrenic symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Participants performed the peripersonal space (PPS) task. Collected data underwent statistical analyses.ResultsSchizophrenic patients demonstrate a stronger/weaker need for personal space, than the comparison group, depending on the score of negative and positive symptom, as assessed by using the PANSS even without emotional and social interference.ConclusionsInterpersonal interactions between the individual with schizophrenia and people in their immediate environment can lead to increased symptomatology. Social isolation is one of the most primary causes of poor quality of life in mental illnesses. Better understanding of the mechanisms for abnormal interactive behavior could provide significant valid guidelines for innovating intervention programs.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Giannetto M, Costantini M, Mattarozzi M, Careri M. Innovative gold-free carbon nanotube/chitosan-based competitive immunosensor for determination of HIV-related p24 capsid protein in serum. RSC Adv 2017. [DOI: 10.1039/c7ra07245g] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The first competitive immunosensor for the determination of HIV-related p24 capsid protein, realized and validated in undiluted human serum.
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Affiliation(s)
- M. Giannetto
- Dipartimento di Scienze Chimiche
- della Vita e della Sostenibilità Ambientale
- Università degli Studi di Parma
- Parma
- Italy
| | - M. Costantini
- Dipartimento di Scienze Chimiche
- della Vita e della Sostenibilità Ambientale
- Università degli Studi di Parma
- Parma
- Italy
| | - M. Mattarozzi
- Dipartimento di Scienze Chimiche
- della Vita e della Sostenibilità Ambientale
- Università degli Studi di Parma
- Parma
- Italy
| | - M. Careri
- Dipartimento di Scienze Chimiche
- della Vita e della Sostenibilità Ambientale
- Università degli Studi di Parma
- Parma
- Italy
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Savarino EV, Tolone S, Bartolo O, de Cassan C, Caccaro R, Galeazzi F, Nicoletti L, Salvador R, Martinato M, Costantini M, Savarino V. The GerdQ questionnaire and high resolution manometry support the hypothesis that proton pump inhibitor-responsive oesophageal eosinophilia is a GERD-related phenomenon. Aliment Pharmacol Ther 2016; 44:522-30. [PMID: 27373195 DOI: 10.1111/apt.13718] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 01/22/2016] [Accepted: 06/15/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Little is known about the relationship between proton pump inhibitor-responsive oesophageal eosinophilia (PPI-REE), eosinophilic esophagitis (EoE) and gastro-oesophageal reflux disease (GERD). AIM To compare high resolution manometry features and symptom profiles of patients with EoE, PPI-REE and GERD. METHODS Consecutive patients diagnosed with EoE or PPI-REE according to international criteria (presence of at least one typical symptom of oesophageal dysfunction; at least 15 eosinophils per high-power field at mid/proximal oesophagus, persistence or resolution of eosinophils after an 8-week PPI trial), and a group of patients with proven GERD and oesophageal eosinophilia, prospectively completed the GerdQ questionnaire and underwent high resolution manometry. RESULTS Thirty-five patients with EoE, 17 with PPI-REE and 27 with GERD were enrolled. When compared to GERD, both EoE and PPI-REE had higher rates of dysphagia (15% vs. 94% vs. 88%, P < 0.0001), patients with EoE reported heartburn and regurgitation less frequently (26% vs. 85%, and 17% vs. 74%, respectively; P < 0.001 for each and had lower GerdQ score [1 (0-6) vs. 8 (6-12), P < 0.001] than GERD patients. There was no significant difference comparing PPI-REE and GERD patients. Patients with PPI-REE had a higher prevalence of erosive oesophagitis than patients with EoE (35% vs. 9%, P = 0.04), which was similar to that of GERD (48%, P = 0.54). Patients with EoE had a lower frequency of high resolution manometry features associated with GERD than patients with PPI-REE. There was no significant difference between PPI-REE and GERD patients. CONCLUSION GERD, as assessed by GerdQ and high resolution manometry is common in patients with PPI-REE, which may share similar pathogenic mechanisms.
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Affiliation(s)
- E V Savarino
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - S Tolone
- Division of General and Bariatric Surgery, Department of Surgery, Second University of Naples, Naples, Italy
| | - O Bartolo
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - C de Cassan
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - R Caccaro
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - F Galeazzi
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - L Nicoletti
- U.O. Clinica Chirurgica 3, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - R Salvador
- U.O. Clinica Chirurgica 3, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - M Martinato
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - M Costantini
- U.O. Clinica Chirurgica 3, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - V Savarino
- Division of Gastroenterology, Department of Internal Medicine, University of Genoa, Genoa, Italy
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Simone G, Tuderti G, Ferriero M, Papalia R, Misuraca L, Minisola F, Costantini M, Mastroianni R, Sentinelli S, Guaglianone S, Gallucci M. Papillary type 2 versus clear cell renal cell carcinoma: Survival outcomes. Eur J Surg Oncol 2016; 42:1744-1750. [PMID: 27593224 DOI: 10.1016/j.ejso.2016.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 06/02/2016] [Accepted: 08/01/2016] [Indexed: 11/18/2022] Open
Abstract
AIM To compare the cancer specific survival (CSS) between p2-RCC and a Propensity Score Matched (PSM) cohort of cc-RCC patients. METHODS Fifty-five (4.6%) patients with p2-RCC and 920 cc-RCC patients were identified within a prospectively maintained institutional dataset of 1205 histologically proved RCC patients treated with either RN or PN. Univariable and multivariable Cox regression analyses were used to identify predictors of CSS after surgical treatment. A 1:2 PSM analysis based on independent predictors of oncologic outcomes was employed and CSS was compared between PSM selected cc-RCC patients using Kaplan-Meier and Cox regression analysis. RESULTS Overall, 55 (4.6%) p2-RCC and 920 (76.3%) cc-RCC patients were selected from the database; p2-RCC were significantly larger (p = 0.001), more frequently locally advanced (p < 0.001) and node positive (p < 0.001) and had significantly higher Fuhrman grade (p < 0.001) than cc-RCC. On multivariable Cox regression analysis age (p = 0.025), histologic subtype (p = 0.029), pN stage (p = 0.006), size, pT stage, cM stage, sarcomatoid features and Fuhrman grade (all p < 0.001) were independent predictors of CSS. After applying the PSM, 82 cc-RCC selected cases were comparable to 41 p2-RCC for age (p = 0.81), tumor size (p = 0.39), pT (p = 1.00) and pN (p = 0.62) stages, cM stage (p = 0.71) and Fuhrman grade (p = 1). In this PSM cohort, 5 yr CSS was significantly lower in the p2-RCC (63% vs 72.4%; p = 0.047). At multivariable Cox analysis p2 histology was an independent predictor of CSM (HR 2.46, 95% CI 1.04-5.83; p = 0.041). CONCLUSIONS We confirmed the tendency of p2-RCC to present as locally advanced and metastatic disease more frequently than cc-RCC and demonstrated p2-RCC histology as an independent predictor of worse oncologic outcomes.
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Affiliation(s)
- G Simone
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy.
| | - G Tuderti
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - M Ferriero
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - R Papalia
- Department of Urology, "Campus Biomedico" University of Rome, Italy
| | - L Misuraca
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - F Minisola
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - M Costantini
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - R Mastroianni
- Department of Urology, "Campus Biomedico" University of Rome, Italy
| | - S Sentinelli
- Department of Pathology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - S Guaglianone
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - M Gallucci
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
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Franceschini G, Sanchez AM, Di Leone A, Scaldaferri A, Ferrucci M, Mulè A, Costantini M, Masetti R. Penile cancer metastasizing to the breast: a case report. J Med Case Rep 2016; 10:53. [PMID: 26961850 PMCID: PMC4785622 DOI: 10.1186/s13256-016-0829-3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 02/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Penile cancer is a relatively uncommon cancer in developed nations. Metastatic disease is rare, but lymphatic or vascular spreading has been previously reported to the liver, lungs, bones, brain, heart and skin. CASE PRESENTATION We report a case of a 49-year-old white man with a penile squamous cell carcinoma previously treated with partial penectomy and bilateral inguinal lymph node dissection, followed by adjuvant therapy. Three years after treatment, the primitive neoplasm metastasized to the breast, presenting as a painful lump. Differentials of a secondary versus a malignant primary tumor were considered and in view of a diagnostic dilemma the lesion was excised. CONCLUSIONS This case is unusual in its site of metastatic progression as well as in its pattern of clinical presentation. Awareness of such a condition by physicians is mandatory in order to make an early diagnosis and start prompt and correct therapeutic planning.
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Affiliation(s)
- Gianluca Franceschini
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy.
| | - Alejandro Martin Sanchez
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy
| | - Alba Di Leone
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy
| | - Assunta Scaldaferri
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy
| | - Massimo Ferrucci
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy
| | - Antonio Mulè
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy
| | - Melania Costantini
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy
| | - Riccardo Masetti
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy
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Higginson IJ, Rumble C, Shipman C, Koffman J, Sleeman KE, Morgan M, Hopkins P, Noble J, Bernal W, Leonard S, Dampier O, Prentice W, Burman R, Costantini M. The value of uncertainty in critical illness? An ethnographic study of patterns and conflicts in care and decision-making trajectories. BMC Anesthesiol 2016; 16:11. [PMID: 26860461 PMCID: PMC4746769 DOI: 10.1186/s12871-016-0177-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 02/01/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND With increasingly intensive treatments and population ageing, more people face complex treatment and care decisions. We explored patterns of the decision-making processes during critical care, and sources of conflict and resolution. METHODS Ethnographic study in two Intensive Care Units (ICUs) in an inner city hospital comprising: non-participant observation of general care and decisions, followed by case studies where treatment limitation decisions, comfort care and/or end of life discussions were occurring. These involved: semi-structured interviews with consenting families, where possible, patients; direct observations of care; and review of medical records. RESULTS Initial non-participant observation included daytime, evenings, nights and weekends. The cases were 16 patients with varied diagnoses, aged 19-87 years; 19 family members were interviewed, aged 30-73 years. Cases were observed for <1 to 156 days (median 22), depending on length of ICU admission. Decisions were made serially over the whole trajectory, usually several days or weeks. We identified four trajectories with distinct patterns: curative care from admission; oscillating curative and comfort care; shift to comfort care; comfort care from admission. Some families considered decision-making a negative concept and preferred uncertainty. Conflict occurred most commonly in the trajectories with oscillating curative and comfort care. Conflict also occurred inside clinical teams. Families were most often involved in decision-making regarding care outcomes and seemed to find it easier when patients switched definitively from curative to comfort care. We found eight categories of decision-making; three related to the care outcomes (aim, place, response to needs) and five to the care processes (resuscitation, decision support, medications/fluids, monitoring/interventions, other specialty involvement). CONCLUSIONS Decision-making in critical illness involves a web of discussions regarding the potential outcomes and processes of care, across the whole disease trajectory. When measures oscillate between curative and comfort there is greatest conflict. This suggests a need to support early communication, especially around values and preferred care outcomes, from which other decisions follow, including DNAR. Offering further support, possibly with expert palliative care, communication, and discussion of 'trial of treatment' may be beneficial at this time, rather than waiting until the 'end of life'.
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Affiliation(s)
- I J Higginson
- King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, Bessemer Road, Denmark Hill, London, SE5 9PJ, UK.
| | - C Rumble
- King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, Bessemer Road, Denmark Hill, London, SE5 9PJ, UK
| | - C Shipman
- King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, Bessemer Road, Denmark Hill, London, SE5 9PJ, UK
| | - J Koffman
- King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, Bessemer Road, Denmark Hill, London, SE5 9PJ, UK
| | - K E Sleeman
- King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, Bessemer Road, Denmark Hill, London, SE5 9PJ, UK
| | - M Morgan
- King's College London, Department of Primary Care and Public Health Sciences, Capital House, London Bridge, London, UK
| | - P Hopkins
- King's College Hospital, King's Critical Care, Denmark Hill, London, UK
| | - J Noble
- King's College Hospital, King's Critical Care, Denmark Hill, London, UK
| | - W Bernal
- King's College Hospital, King's Critical Care, Denmark Hill, London, UK
| | - S Leonard
- King's College Hospital, King's Critical Care, Denmark Hill, London, UK
| | - O Dampier
- King's College Hospital, King's Critical Care, Denmark Hill, London, UK
| | - W Prentice
- King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, Bessemer Road, Denmark Hill, London, SE5 9PJ, UK
| | - R Burman
- King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, Bessemer Road, Denmark Hill, London, SE5 9PJ, UK
| | - M Costantini
- Palliative Care Unit, IRCCS Arcispedale S. Maria Nuova, Reggio Emilia, Italy
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Costantini M, Belli P, Bufi E, Asunis AM, Ferra E, Bitti GT. Association between sonographic appearances of breast cancers and their histopathologic features and biomarkers. J Clin Ultrasound 2016; 44:26-33. [PMID: 26402438 DOI: 10.1002/jcu.22312] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 08/20/2015] [Accepted: 08/24/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE The purpose of this study was to investigate potential associations between invasive breast cancer sonographic (US) findings and histopathologic patterns and biomarkers. METHODS One hundred consecutive women with invasive breast cancer treated in the Breast Diagnostic Center of Brotzu Hospital in Cagliari, Italy, from January to October 2013, were retrospectively evaluated. Two experienced breast radiologists independently evaluated hard copies of US examinations performed during the US-guided biopsy procedure. Tumor characteristics were assessed by using the BI-RADS US lexicon. For each patient, the results of histopathologic examination, tumor grading, hormone-receptor status, HER2, and Ki67 were considered. US characteristics were compared with histopathologic features and biomarkers. Statistical analysis was performed. RESULTS Low-grade tumors were statistically significantly associated with spiculated margins (p = 0.002) and hyperechoic halos (p < 0.001). High-grade tumors were associated with abrupt interfaces, nonspiculated margins, and absence of posterior acoustic shadowing. Malignant breast masses with spiculated margins were significantly associated with hormone-receptor positivity (p = 0.009). The most frequent tumor grade was G3 in the HER2 + and triple-negative subgroups. Patients with G3 tumors were significantly younger than those with G1 or G2 disease (51.3 ± 9.5 years versus 58.7 ± 12.6 years; p = 0.004). CONCLUSIONS Histopathologic patterns and breast cancer biomarkers determine differences in US imaging that can guide radiologists in better understanding the development of breast cancer and its prognosis.
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Affiliation(s)
- Melania Costantini
- Radiology Department, Brotzu Hospital, Piazzale A. Ricchi 1, 09134, Cagliari, Italy
| | - Paolo Belli
- Radiology Department, Cattolica del Sacro Cuore University, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Enida Bufi
- Radiology Department, Cattolica del Sacro Cuore University, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Anna Maria Asunis
- Pathology Department, Brotzu Hospital, Piazzale A. Ricchi 1, 09134, Cagliari, Italy
| | - Enrico Ferra
- Radiology Department, Brotzu Hospital, Piazzale A. Ricchi 1, 09134, Cagliari, Italy
| | - Grazia Tomasa Bitti
- Radiology Department, Brotzu Hospital, Piazzale A. Ricchi 1, 09134, Cagliari, Italy
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