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Poscente M, Tolomeo D, Arshadi A, Agostini A, L'Abbate A, Solimando AG, Palumbo O, Carella M, Palumbo P, González T, Hernández-Rivas JM, Bassi L, Isidori R, Dell'Aquila M, Trapè G, Latagliata R, Pessina G, Natoni F, Storlazzi CT. Aggressive systemic mastocytosis with the co-occurrence of PRKG2::PDGFRB, KAT6A::NCOA2, and RXRA::NOTCH1 fusion transcripts and a heterozygous RUNX1 frameshift mutation. Cancer Genet 2024; 284-285:5-11. [PMID: 38471404 DOI: 10.1016/j.cancergen.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 01/05/2024] [Accepted: 03/05/2024] [Indexed: 03/14/2024]
Abstract
Systemic mastocytosis (SM) is a myeloproliferative neoplasm displaying abnormal mast cell proliferation. It is subdivided into different forms, including aggressive systemic mastocytosis (ASM) and systemic mastocytosis with an associated hematologic neoplasm (SM-AHN). Oncogenic genetic alterations include point mutations, mainly the KIT D816V, conferring poor prognosis and therapy resistance, and fusion genes, with those involving PDGFRA/PDGFRB as the most recurrent events. We here describe an ASM case negative to the KIT D816V and JAK2 V617F alterations but showing a RUNX1 frameshift heterozygous mutation and the co-occurrence of three fusion transcripts. The first one, PRKG2::PDGFRB, was generated by a balanced t(4;5)(q24;q32) translocation as the sole abnormality. Other two novel chimeras, KAT6A::NCOA2 and RXRA::NOTCH1, originated from cryptic intra-chromosomal abnormalities. The patient rapidly evolved towards SM-AHN, characterized by the persistence of the PRKG2::PDGFRB chimera, due to the presence of an extra copy of the der(5)t(4;5)(q24;q34) chromosome and an increase in the RUNX1 mutation allelic frequency. The results indicated that the transcriptional landscape and the mutational profile of SM deserve attention to predict the evolution and prognosis of this complex disease, whose classification criteria are still a matter of debate.
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Affiliation(s)
- M Poscente
- UOSD Laboratorio di Genetica Medica, Ospedale Belcolle, Viterbo, Italy
| | - D Tolomeo
- Department of Biosciences, Biotechnology and Environment, University of Bari Aldo Moro, Bari, Italy
| | - A Arshadi
- Department of Biosciences, Biotechnology and Environment, University of Bari Aldo Moro, Bari, Italy
| | - A Agostini
- Department of Precision and Regenerative Medicine and Ionian Area, Unit of Internal Medicine and Clinical Oncology, University of Bari Aldo Moro, Bari, Italy
| | - A L'Abbate
- Istituto di Biomembrane, Bioenergetica e Biotecnologie Molecolari (IBIOM), Consiglio Nazionale delle Ricerche, Bari, Italy
| | - A G Solimando
- Department of Precision and Regenerative Medicine and Ionian Area, Unit of Internal Medicine and Clinical Oncology, University of Bari Aldo Moro, Bari, Italy; IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - O Palumbo
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo Foggia, Italy
| | - M Carella
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo Foggia, Italy
| | - P Palumbo
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo Foggia, Italy
| | - T González
- Department of Medicine, Universidad de Salamanca, Department of Hematology, Hospital Universitario de Salamanca, IBSAL, IBMCC-Centro de Investigación del Cáncer (USAL-CSIC), Salamanca, Spain
| | - J M Hernández-Rivas
- Department of Medicine, Universidad de Salamanca, Department of Hematology, Hospital Universitario de Salamanca, IBSAL, IBMCC-Centro de Investigación del Cáncer (USAL-CSIC), Salamanca, Spain
| | - L Bassi
- UOSD Laboratorio di Genetica Medica, Ospedale Belcolle, Viterbo, Italy
| | - R Isidori
- UOSD Laboratorio di Genetica Medica, Ospedale Belcolle, Viterbo, Italy
| | - M Dell'Aquila
- UOC Anatomia Patologica, Ospedale Belcolle, Viterbo, Italy
| | - G Trapè
- UOC Ematologia, Ospedale Belcolle, Viterbo, Italy
| | - R Latagliata
- UOC Ematologia, Ospedale Belcolle, Viterbo, Italy
| | - G Pessina
- UOSD Laboratorio di Genetica Medica, Ospedale Belcolle, Viterbo, Italy
| | - F Natoni
- UOSD Laboratorio di Genetica Medica, Ospedale Belcolle, Viterbo, Italy
| | - C T Storlazzi
- Department of Biosciences, Biotechnology and Environment, University of Bari Aldo Moro, Bari, Italy.
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2
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Dotto E, Deshapriya JDP, Gai I, Hasselmann PH, Mazzotta Epifani E, Poggiali G, Rossi A, Zanotti G, Zinzi A, Bertini I, Brucato JR, Dall'Ora M, Della Corte V, Ivanovski SL, Lucchetti A, Pajola M, Amoroso M, Barnouin O, Campo Bagatin A, Capannolo A, Caporali S, Ceresoli M, Chabot NL, Cheng AF, Cremonese G, Fahnestock EG, Farnham TL, Ferrari F, Gomez Casajus L, Gramigna E, Hirabayashi M, Ieva S, Impresario G, Jutzi M, Lasagni Manghi R, Lavagna M, Li JY, Lombardo M, Modenini D, Palumbo P, Perna D, Pirrotta S, Raducan SD, Richardson DC, Rivkin AS, Stickle AM, Sunshine JM, Tortora P, Tusberti F, Zannoni M. The Dimorphos ejecta plume properties revealed by LICIACube. Nature 2024; 627:505-509. [PMID: 38418881 PMCID: PMC10954540 DOI: 10.1038/s41586-023-06998-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 12/18/2023] [Indexed: 03/02/2024]
Abstract
The Double Asteroid Redirection Test (DART) had an impact with Dimorphos (a satellite of the asteroid Didymos) on 26 September 20221. Ground-based observations showed that the Didymos system brightened by a factor of 8.3 after the impact because of ejecta, returning to the pre-impact brightness 23.7 days afterwards2. Hubble Space Telescope observations made from 15 minutes after impact to 18.5 days after, with a spatial resolution of 2.1 kilometres per pixel, showed a complex evolution of the ejecta3, consistent with other asteroid impact events. The momentum enhancement factor, determined using the measured binary period change4, ranges between 2.2 and 4.9, depending on the assumptions about the mass and density of Dimorphos5. Here we report observations from the LUKE and LEIA instruments on the LICIACube cube satellite, which was deployed 15 days in advance of the impact of DART. Data were taken from 71 seconds before the impact until 320 seconds afterwards. The ejecta plume was a cone with an aperture angle of 140 ± 4 degrees. The inner region of the plume was blue, becoming redder with increasing distance from Dimorphos. The ejecta plume exhibited a complex and inhomogeneous structure, characterized by filaments, dust grains and single or clustered boulders. The ejecta velocities ranged from a few tens of metres per second to about 500 metres per second.
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Affiliation(s)
- E Dotto
- Osservatorio Astronomico di Roma, INAF, Rome, Italy.
| | | | - I Gai
- Dipartimento di Ingegneria Industriale, Alma Mater Studiorum, Università di Bologna, Forlì, Italy
| | | | | | - G Poggiali
- Osservatorio Astrofisico di Arcetri, INAF, Florence, Italy
- Observatoire de Paris, LESIA, Paris, France
| | - A Rossi
- Istituto di Fisica Applicata 'Nello Carrara', CNR, Florence, Italy
| | | | - A Zinzi
- Space Science Data Center, ASI, Rome, Italy
- Agenzia Spaziale Italiana, Rome, Italy
| | - I Bertini
- Università degli Studi di Napoli 'Parthenope', Naples, Italy
| | - J R Brucato
- Osservatorio Astrofisico di Arcetri, INAF, Florence, Italy
| | - M Dall'Ora
- Osservatorio Astronomico di Capodimonte, INAF, Naples, Italy
| | - V Della Corte
- Osservatorio Astronomico di Capodimonte, INAF, Naples, Italy
| | - S L Ivanovski
- Osservatorio Astronomico di Trieste, INAF, Trieste, Italy
| | - A Lucchetti
- Osservatorio Astronomico di Padova, INAF, Padova, Italy
| | - M Pajola
- Osservatorio Astronomico di Padova, INAF, Padova, Italy
| | - M Amoroso
- Agenzia Spaziale Italiana, Rome, Italy
| | - O Barnouin
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | | | | | - S Caporali
- Osservatorio Astrofisico di Arcetri, INAF, Florence, Italy
| | | | - N L Chabot
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - A F Cheng
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - G Cremonese
- Osservatorio Astronomico di Padova, INAF, Padova, Italy
| | - E G Fahnestock
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - T L Farnham
- Department of Astronomy, University of Maryland, College Park, MD, USA
| | | | - L Gomez Casajus
- Centro Interdipartimentale di Ricerca Industriale Aerospaziale, Alma Mater Studiorum, Università di Bologna, Forlì, Italy
| | - E Gramigna
- Dipartimento di Ingegneria Industriale, Alma Mater Studiorum, Università di Bologna, Forlì, Italy
| | | | - S Ieva
- Osservatorio Astronomico di Roma, INAF, Rome, Italy
| | | | - M Jutzi
- Space Research and Planetary Sciences, Physikalisches Institut, University of Bern, Bern, Switzerland
| | - R Lasagni Manghi
- Dipartimento di Ingegneria Industriale, Alma Mater Studiorum, Università di Bologna, Forlì, Italy
| | | | - J-Y Li
- Planetary Science Institute, Tucson, AZ, USA
| | - M Lombardo
- Dipartimento di Ingegneria Industriale, Alma Mater Studiorum, Università di Bologna, Forlì, Italy
| | - D Modenini
- Dipartimento di Ingegneria Industriale, Alma Mater Studiorum, Università di Bologna, Forlì, Italy
- Centro Interdipartimentale di Ricerca Industriale Aerospaziale, Alma Mater Studiorum, Università di Bologna, Forlì, Italy
| | - P Palumbo
- Istituto di Astrofisica e Planetologia Spaziali, INAF, Rome, Italy
| | - D Perna
- Osservatorio Astronomico di Roma, INAF, Rome, Italy
| | | | - S D Raducan
- Space Research and Planetary Sciences, Physikalisches Institut, University of Bern, Bern, Switzerland
| | - D C Richardson
- Department of Astronomy, University of Maryland, College Park, MD, USA
| | - A S Rivkin
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - A M Stickle
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - J M Sunshine
- Department of Astronomy, University of Maryland, College Park, MD, USA
| | - P Tortora
- Dipartimento di Ingegneria Industriale, Alma Mater Studiorum, Università di Bologna, Forlì, Italy
- Centro Interdipartimentale di Ricerca Industriale Aerospaziale, Alma Mater Studiorum, Università di Bologna, Forlì, Italy
| | - F Tusberti
- Osservatorio Astronomico di Padova, INAF, Padova, Italy
| | - M Zannoni
- Dipartimento di Ingegneria Industriale, Alma Mater Studiorum, Università di Bologna, Forlì, Italy
- Centro Interdipartimentale di Ricerca Industriale Aerospaziale, Alma Mater Studiorum, Università di Bologna, Forlì, Italy
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Baldini E, Lori E, Morini C, Palla L, Coletta D, De Luca GM, Giraudo G, Intini SG, Perotti B, Sorge A, Sozio G, Arganini M, Beltrami E, Pironi D, Ranalli M, Saviano C, Patriti A, Usai S, Vernaccini N, Vittore F, D’Andrea V, Nardi P, Sorrenti S, Palumbo P. Sutureless Repair for Open Treatment of Inguinal Hernia: Three Techniques in Comparison. J Clin Med 2024; 13:589. [PMID: 38276095 PMCID: PMC10816828 DOI: 10.3390/jcm13020589] [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: 01/03/2024] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Currently, groin hernia repair is mostly performed with application of mesh prostheses fixed with or without suture. However, views on safety and efficacy of different surgical approaches are still partly discordant. In this multicentre retrospective study, three sutureless procedures, i.e., mesh fixation with glue, application of self-gripping mesh, and Trabucco's technique, were compared in 1034 patients with primary unilateral non-complicated inguinal hernia subjected to open anterior surgery. Patient-related features, comorbidities, and drugs potentially affecting the intervention outcomes were also examined. The incidence of postoperative complications, acute and chronic pain, and time until discharge were assessed. A multivariate logistic regression was used to compare the odds ratio of the surgical techniques adjusting for other risk factors. The application of standard/heavy mesh, performed in the Trabucco's technique, was found to significantly increase the odds ratio of hematomas (p = 0.014) and, most notably, of acute postoperative pain (p < 0.001). Among the clinical parameters, antithrombotic therapy and large hernia size were independent risk factors for hematomas and longer hospital stay, whilst small hernias were an independent predictor of pain. Overall, our findings suggest that the Trabucco's technique should not be preferred in patients with a large hernia and on antithrombotic therapy.
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Affiliation(s)
- Enke Baldini
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Eleonora Lori
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Carola Morini
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Luigi Palla
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, 00161 Rome, Italy;
| | - Diego Coletta
- United Hospitals of Northern Marche (AOORMN)—Pesaro, 61121 Pesaro, Italy; (D.C.); (A.P.)
| | - Giuseppe M. De Luca
- Unit of Academic General Surgery “V. Bonomo”, University of Bari, 70124 Bari, Italy; (G.M.D.L.); (F.V.)
| | - Giorgio Giraudo
- Department of Surgery, Santa Croce e Carle Hospital (ASO) of Cuneo, 12100 Cuneo, Italy; (G.G.); (E.B.)
| | - Sergio G. Intini
- Department of Surgery, S. Maria Della Misericordia Hospital, ASUFC of Udine, 33100 Udine, Italy; (S.G.I.); (N.V.)
| | - Bruno Perotti
- Department of Surgery, Versilia Hospital of Viareggio, 55049 Camaiore, Italy; (B.P.); (M.A.)
| | - Angelo Sorge
- Day Surgery P.O.S. Giovanni Bosco, 80144 Naples, Italy; (A.S.); (C.S.)
| | - Giampaolo Sozio
- Department of Surgery, Alta Val D’Elsa Hospital of Poggibonsi—Siena, 53036 Poggibonsi, Italy; (G.S.); (M.R.)
| | - Marco Arganini
- Department of Surgery, Versilia Hospital of Viareggio, 55049 Camaiore, Italy; (B.P.); (M.A.)
| | - Elsa Beltrami
- Department of Surgery, Santa Croce e Carle Hospital (ASO) of Cuneo, 12100 Cuneo, Italy; (G.G.); (E.B.)
| | - Daniele Pironi
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Massimo Ranalli
- Department of Surgery, Alta Val D’Elsa Hospital of Poggibonsi—Siena, 53036 Poggibonsi, Italy; (G.S.); (M.R.)
| | - Cecilia Saviano
- Day Surgery P.O.S. Giovanni Bosco, 80144 Naples, Italy; (A.S.); (C.S.)
| | - Alberto Patriti
- United Hospitals of Northern Marche (AOORMN)—Pesaro, 61121 Pesaro, Italy; (D.C.); (A.P.)
| | - Sofia Usai
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Nicola Vernaccini
- Department of Surgery, S. Maria Della Misericordia Hospital, ASUFC of Udine, 33100 Udine, Italy; (S.G.I.); (N.V.)
| | - Francesco Vittore
- Unit of Academic General Surgery “V. Bonomo”, University of Bari, 70124 Bari, Italy; (G.M.D.L.); (F.V.)
| | - Vito D’Andrea
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Priscilla Nardi
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Salvatore Sorrenti
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Piergaspare Palumbo
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
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4
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Baldini E, Cardarelli S, Campese AF, Lori E, Fallahi P, Virili C, Forte F, Pironi D, Di Matteo FM, Palumbo P, Costanzo ML, D’Andrea V, Centanni M, Sorrenti S, Antonelli A, Ulisse S. Evaluation of the Therapeutic Effects of Harmine on Anaplastic Thyroid Cancer Cells. Int J Mol Sci 2024; 25:1121. [PMID: 38256193 PMCID: PMC10816100 DOI: 10.3390/ijms25021121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Anaplastic thyroid carcinoma (ATC) is an extremely difficult disease to tackle, with an overall patient survival of only a few months. The currently used therapeutic drugs, such as kinase inhibitors or immune checkpoint inhibitors, can prolong patient survival but fail to eradicate the tumor. In addition, the onset of drug resistance and adverse side-effects over time drastically reduce the chances of treatment. We recently showed that Twist1, a transcription factor involved in the epithelial mesenchymal transition (EMT), was strongly upregulated in ATC, and we wondered whether it might represent a therapeutic target in ATC patients. To investigate this hypothesis, the effects of harmine, a β-carboline alkaloid shown to induce degradation of the Twist1 protein and to possess antitumoral activity in different cancer types, were evaluated on two ATC-derived cell lines, BHT-101 and CAL-62. The results obtained demonstrated that, in both cell lines, harmine reduced the level of Twist1 protein and reverted the EMT, as suggested by the augmentation of E-cadherin and decrease in fibronectin expression. The drug also inhibited cell proliferation and migration in a dose-dependent manner and significantly reduced the anchorage-independent growth of both ATC cell lines. Harmine was also capable of inducing apoptosis in BHT-101 cells, but not in CAL-62 ones. Finally, the activation of PI3K/Akt signaling, but not that of the MAPK, was drastically reduced in treated cells. Overall, these in vitro data suggest that harmine could represent a new therapeutic option for ATC treatment.
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Affiliation(s)
- Enke Baldini
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (S.C.); (E.L.); (D.P.); (F.M.D.M.); (P.P.); (M.L.C.); (V.D.); (S.S.)
| | - Silvia Cardarelli
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (S.C.); (E.L.); (D.P.); (F.M.D.M.); (P.P.); (M.L.C.); (V.D.); (S.S.)
| | | | - Eleonora Lori
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (S.C.); (E.L.); (D.P.); (F.M.D.M.); (P.P.); (M.L.C.); (V.D.); (S.S.)
| | - Poupak Fallahi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Camilla Virili
- Department of Medico-Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, 04100 Latina, Italy; (C.V.); (M.C.)
| | - Flavio Forte
- Department of Urology, M.G. Vannini Hospital, 00177 Rome, Italy;
| | - Daniele Pironi
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (S.C.); (E.L.); (D.P.); (F.M.D.M.); (P.P.); (M.L.C.); (V.D.); (S.S.)
| | - Filippo Maria Di Matteo
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (S.C.); (E.L.); (D.P.); (F.M.D.M.); (P.P.); (M.L.C.); (V.D.); (S.S.)
| | - Piergaspare Palumbo
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (S.C.); (E.L.); (D.P.); (F.M.D.M.); (P.P.); (M.L.C.); (V.D.); (S.S.)
| | - Maria Ludovica Costanzo
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (S.C.); (E.L.); (D.P.); (F.M.D.M.); (P.P.); (M.L.C.); (V.D.); (S.S.)
| | - Vito D’Andrea
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (S.C.); (E.L.); (D.P.); (F.M.D.M.); (P.P.); (M.L.C.); (V.D.); (S.S.)
| | - Marco Centanni
- Department of Medico-Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, 04100 Latina, Italy; (C.V.); (M.C.)
| | - Salvatore Sorrenti
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (S.C.); (E.L.); (D.P.); (F.M.D.M.); (P.P.); (M.L.C.); (V.D.); (S.S.)
| | - Alessandro Antonelli
- Department of Surgical, Medical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy;
| | - Salvatore Ulisse
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (S.C.); (E.L.); (D.P.); (F.M.D.M.); (P.P.); (M.L.C.); (V.D.); (S.S.)
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5
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Borgheresi A, Agostini A, Pierpaoli L, Zannotti A, Capodagli-Colarizi S, Gabelloni M, De Muzio F, Brunese MC, Bruno F, Palumbo P, Grassi F, Fusco R, Granata V, Gandolfo N, Miele V, Barile A, Giovagnoni A. Diagnostic approach to focal liver lesions at cross-sectional imaging: a primer for beginners. Eur Rev Med Pharmacol Sci 2023; 27:7201-7225. [PMID: 37606131 DOI: 10.26355/eurrev_202308_33293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
Liver imaging encompasses a broad spectrum of diseases in different clinical backgrounds. The available literature is vast and reported data often lacks standardization. Because of all these issues, the differential diagnosis and the characterization of liver lesions can be challenging for the beginner. The aim of this narrative review is to provide the basics for an algorithm approach to liver lesions on cross-sectional imaging. First, some tips for the optimization of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) protocols will be provided. Liver Imaging Reporting and Data System (LI-RADS, version 2018) working group is proposing the adoption of their standardized lexicon beyond the original target population of LI-RADS (i.e., liver cirrhosis). Thus, the main imaging findings will be defined following the LI-RADS lexicon. Since the contrast study is the most important for lesion characterization, this narrative review separates the lesions into avascular, hypovascular, and hypervascular, with a focus on chronic liver disease (CLD) and hepatocellular carcinoma (HCC).
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Affiliation(s)
- A Borgheresi
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Department of Radiological Sciences, University Hospital "Azienda Ospedaliero Universitaria delle Marche", Ancona, Italy.
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6
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Agostini A, Borgheresi A, Granata V, Bruno F, Palumbo P, De Muzio F, Bicci E, Grazzini G, Grassi F, Fusco R, Barile A, Miele V, Giovagnoni A. Technological advances in body CT: a primer for beginners. Eur Rev Med Pharmacol Sci 2022; 26:7918-7937. [PMID: 36394741 DOI: 10.26355/eurrev_202211_30144] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Many technological advances have entered the clinical routine of Computed Tomography (CT) imaging. The new CT scanners have specific solutions in gantry design to bear the mechanical solicitations. The X-ray tubes have been improved for faster acquisitions at low radiation exposure, while the innovations in CT detectors provide a better image quality. The optimization of image quality and contrast, and the reduction of radiation dose, cannot be achieved without the implementation of adequate reconstruction software, such as Iterative Reconstructions (IR) and Artificial Intelligence (AI). In recent years, dual-energy (DECT) technology has expanded the indications of CT. In this narrative review, a panoramic overview of the technological novelties in CT imaging will be provided for optimal utilization of CT technology.
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Affiliation(s)
- A Agostini
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Department of Radiology, University Hospital "Ospedali Riuniti Umberto I - G.M. Lancisi - G. Salesi, Ancona, Italy.
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7
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Monti R, Martinese A, Bonadonna G, Rocco MP, Simonetti I, Arrigoni F, Palumbo P, Bruno F, Granata V, Fusco R, Splendiani A, Di Cesare E, Giovagnoni A, Grassi R, Miele V, Masciocchi C, Barile A. Degenerative and inflammatory musculoskeletal disorders: updates and hot topics in diagnostic and interventional imaging. Eur Rev Med Pharmacol Sci 2022; 26:6958-6971. [PMID: 36263576 DOI: 10.26355/eurrev_202210_29877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The purpose of this review is to present the latest innovations and current topics in musculoskeletal diagnosis and interventional imaging, with a focus on degenerative and inflammatory diseases. MATERIALS AND METHODS In this study, the search was conducted through the online databases PubMed and Google Scholar, including articles published in English in the past 15 years, in order to find existing studies, clinical cases, and reviews on the latest innovations and current topics in degenerative and inflammatory musculoskeletal pathologies. RESULTS Imaging plays a pivotal role in the diagnosis and treatment of MSK degenerative and inflammatory disease. In the last few years continuous innovations and technological advances have allowed new clinical applications in the management of MSK disorder. Advanced magnetic resonance techniques, the introduction of fusion imaging techniques and new approaches to infiltrative medicine are revolutionizing the clinical and therapeutic approach to degenerative and inflammatory pathologies. Artificial intelligence also increasingly seeks to be applied in all fields of medicine and radiology with increasingly promising results. CONCLUSIONS Imaging modalities undergo continuous innovations and revolutions due to technological advances, with direct repercussions on clinical applications and new therapeutic potential through interventional radiology techniques. In recent years, there have been particular innovations in the context of musculoskeletal imaging of degenerative and inflammatory diseases, both for diagnosis and intervention.
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Affiliation(s)
- R Monti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
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8
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Palumbo P, Massimi F, Lucchese S, Grimaldi S, Vernaccini N, Cirocchi R, Sorrenti S, Usai S, Intini SG. Open Surgery for Sportsman’s Hernia a Retrospective Study. Front Surg 2022; 9:893390. [PMID: 35784930 PMCID: PMC9243487 DOI: 10.3389/fsurg.2022.893390] [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: 03/10/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022] Open
Abstract
Sportsman’s hernia is a painful syndrome in the inguinal area occurring in patients who play sports at an amatorial or professional level. Pain arises during sport, and sometimes persists after activity, representing an obstacle to sport resumption. A laparoscopic/endoscopic approach is proposed by many authors for treatment of the inguinal wall defect. Aim of this study is to assess the open technique in terms of safety and effectiveness, in order to obtain the benefit of an open treatment in an outpatient management. From October 2017 to July 2019, 34 patients underwent surgery for groin pain syndrome. All cases exhibited a bulging of the inguinal posterior wall. 14 patients were treated with Lichtenstein technique with transversalis fascia plication and placement of a polypropylene mesh fixed with fibrin glue. In 20 cases, a polypropylene mesh was placed in the preperitoneal space. The procedure was performed in day surgery facilities. Early or late postoperative complications did not occur in both groups. All patients returned to sport, in 32 cases with complete pain relief, whereas 2 patients experienced mild residual pain. The average value of return to sport was 34.11 ± 8.44 days. The average value of return to play was 53.82 ± 11.69 days. With regard to postoperative pain, no substantial differences between the two techniques were detected, and good results in terms of the resumption of sport were ensured in both groups. Surgical treatment for sportsman’s hernia should be considered only after the failure of conservative treatment. The open technique is safe and allows a rapid postoperative recovery.
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Affiliation(s)
- Piergaspare Palumbo
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
- Correspondence: Piergaspare Palumbo
| | - Fanny Massimi
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Sara Lucchese
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Serena Grimaldi
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Roberto Cirocchi
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - Salvatore Sorrenti
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Sofia Usai
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
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Illuminati G, Prezioso G, Nardi P, Pratico M, Lori E, Ferent I, Sorrenti S, Pironi D, Palumbo P, Calio FJ, Lauro A. Pseudoaneurysm of the cystic artery after acute necrotizing pancreatitis. Ann Ital Chir 2022; 11:S2239253X22038026. [PMID: 36065811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A 35-year-old woman, chronic alcoholic, was admitted for an attack of acute, necrotizing pancreatitis. Antibiotics and percutaneous drainage failed to control the septic status and the pancreatic collection. Open surgery allowed a successful necrosectomy and drainage. However, a control CT scan before removal of drains showed a 1 cm diameter pseudoaneurysm of the cystic artery, not present at previous abdominal imaging. A redo laparotomy was performed followed by cholecystectomy with en bloc resection of the pseudoaneurysm and a second look of the peripancreatic area. The patient made an uneventful recovery and was discharged on postoperative day 5. Pseudoaneurysms of the cystic artery after acute necrotizing pancreatitis are very rare. Percutaneous embolization is effective in controlling the pseudoaneurysm, but requires subsequent cholecystectomy within a short delay, due to the risk of gangrene of the gallbladder requiring a further, emergency surgical treatment. Open resection of the pseudoaneurysm en bloc with cholecystectomy appears, therefore, an appropriate treatment of this rare condition. KEY WORDS: Cystic artery, Pancreatitis, Pseudoaneurysm.
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Bicci E, Grazzini G, Cozzi D, Danti G, Pradella S, Palumbo P, Bruno F, Grassi F, Dell' Aversana F, De Muzio F, Brunese MC, Cutolo C, Fusco R, Granata V, Giovagnoni A, Miele V. Non-traumatic non-cardiovascular thoracic emergencies: role of imaging. Eur Rev Med Pharmacol Sci 2022; 26:3249-3260. [PMID: 35587076 DOI: 10.26355/eurrev_202205_28743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Patients presenting to the emergency with thoracic symptoms could have a wide variety of causes, even if the traumatic and vascular causes are excluded. Therefore, the diagnosis is often a challenge for emergency physicians. Anamnesis, physical examination and laboratory testing need to be integrated with imaging to get a rapid diagnosis and to distinguish among the potential causes. This review discusses the role of diagnostic imaging studies in the emergency setting in patients with non-traumatic non-cardiovascular thoracic symptoms. The use of chest x-ray, bedside lung Ultrasound and Computed Tomography in the diagnosis and care of these patients have been reviewed as well as the common findings on imaging.
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Affiliation(s)
- E Bicci
- Department of Emergency Radiology, Careggi University Hospital, Florence, Italy.
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11
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Palumbo P, Cannizzaro E, Bracci A, Bruno F, Arrigoni F, Splendiani A, Danti G, Cozzi D, Pradella S, Grassi F, Grassi R, Dell'Aversana F, Brunese MC, Cutolo C, Ravo L, Fusco R, Galdiero R, Granata V, Masciocchi C, Di Cesare E. Thoracic non-traumatic cardiovascular diseases: current perspective and multi-detectors Computed Tomography protocols optimization in the emergency setting. Eur Rev Med Pharmacol Sci 2022; 26:3621-3641. [PMID: 35647844 DOI: 10.26355/eurrev_202205_28858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Cardiovascular diseases (CVDs) are among the most common causes of access to the Emergency Department and among the leading causes of death worldwide. Accurate diagnostic algorithms are mandatory to ensure a rapid life-saving treatment. However, non-specific clinical presentation and unnecessary referrals to other subspecialties may lead to misinterpretation of the diagnosis and delays. In recent years, the development of imaging technologies has allowed Computed Tomography (CT) to play a prominent role in the concepts of CVD rule-in and rule-out. An optimization strategy for CT protocols is needed to reduce variability and improve image quality. A correct diagnostic suspicion is crucial, as different districts (i.e., heart, aorta and pulmonary circulation) may require different investigation techniques. Additionally, the CVD pre-test probability assessment is highly correlated with CT accuracy. The purpose of this narrative review is to analyze the current role of CT in the approach to the CVDs in the ED, and to analyze the main strategies of CT optimization.
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Affiliation(s)
- P Palumbo
- Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health Unit 1, L'Aquila, Italy.
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12
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Flammia F, Chiti G, Trinci M, Danti G, Cozzi D, Grassi R, Palumbo P, Bruno F, Agostini A, Fusco R, Granata V, Giovagnoni A, Miele V. Optimization of CT protocol in polytrauma patients: an update. Eur Rev Med Pharmacol Sci 2022; 26:2543-2555. [PMID: 35442469 DOI: 10.26355/eurrev_202204_28491] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Radiologists play a key role in the management of trauma patients. With the improvement of computed tomography (CT), radiologist makes an important contribution to the timely diagnosis of trauma-related findings and the choice of the most suitable treatment, improving patient outcomes. It is important to select the most appropriate imaging technique, which in the trauma patient is CT, and especially the most appropriate CT protocol, to correctly characterize trauma injuries. Currently, there is no agreement on what the optimal protocol is, acquisition times and number of contrast enhanced phases are not standardized. This is a review of the most recent literature on optimizing the CT protocol in polytrauma, with the intent of giving a useful tool for radiologists in the management of trauma patients.
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Affiliation(s)
- F Flammia
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
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13
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Cirocchi R, Burini G, Avenia S, Tebala G, Palumbo P, Cianci MC, Morabito A, Bruzzone P. Asymptomatic inguinal hernia: does it need surgical repair? A systematic review and meta-analysis. ANZ J Surg 2022; 92:2433-2441. [PMID: 35338686 DOI: 10.1111/ans.17594] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/25/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The aim of this review is to compare the outcomes of surgical repair versus watchful waiting in asymptomatic or minimally symptomatic inguinal hernias. METHODS Preferred reporting items for systematic reviews and meta-analyses guidelines were employed. We analysed primary outcomes: pain, quality of life, pain during daily activities and visual analogue scale (VAS that measures pain at rest and on movement) and secondary outcomes: postoperative complications and recurrence. RESULTS Pain and quality of life were not comparable due to differences in the parameters used in different articles. Pain interfering with normal daily activity was evaluated in one study and appears more favourable in the post-repair group respect to the watchful waiting (WW) group (5.1% versus 2.2%). VAS, measured in one study, at 6 months was more favourable in the surgery group (37% versus 44%). After 12 months the outcome was better in the control group than in the repair group (28% versus 30%). Conversion rate of the patient cohorts from watchful waiting to elective surgery was between 35.03% and 57.8%. The meta-analysis did not find significant statistical differences in the two groups examined for postoperative complications [RR = 0.95, 95% CI (0.50, 1.80), P = 0.88], as for hernia recurrence [RR = 1.01, 95% CI (0.50, 2.02), P = 0.98]. CONCLUSION WW seems to be an acceptable option for the patient with asymptomatic or minimally symptomatic inguinal hernias. Delaying surgical repair until symptoms appear is safe. Acute hernia incarcerations are not particularly frequent. The incidence of chronic pain after the repair is high. Physicians must select patients carefully and explain to them the risks and benefits of surgery.
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Affiliation(s)
- Roberto Cirocchi
- Department of Medicine and Surgery, S. Maria Hospital, University of Perugia, Terni, Italy
| | - Gloria Burini
- Deparment of General and Emergency Surgery, General and Emergency Surgical Clinic of Ancona, Ancona, Italy
| | - Stefano Avenia
- Department of Medicine and Surgery, S. Maria Hospital, University of Perugia, Terni, Italy
| | - Giovanni Tebala
- Surgical Emergency Unit, John Radcliffe Hospital, Oxford University NHS Foundation Trust, Oxford, UK
| | - Piergaspare Palumbo
- Department of Surgical Sciences, "Sapienza" University of Rome, Azienda Policlinico Umberto I Viale del Policlinico, Rome, Italy
| | - Maria Chiara Cianci
- Department of Pediatric Surgery, Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Antonino Morabito
- Department of Pediatric Surgery, Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Paolo Bruzzone
- Department of General and Specialist Surgery "Paride Stefanini", Sapienza University, Azienda Policlinico Umberto I Viale del Policlinico, Rome, Italy
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14
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Gagliardi F, Lauro A, Tripodi D, Amabile MI, Palumbo P, Di Matteo FM, Palazzini G, Forte F, Frattaroli S, Khouzam S, Marino IR, D'Andrea V, Sorrenti S, Pironi D. Mesenteric Cyst with GI Symptoms: A Fluid Approach to Treatment-Case Report and Literature Review. Dig Dis Sci 2022; 67:786-798. [PMID: 35059952 DOI: 10.1007/s10620-021-07352-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 12/09/2022]
Abstract
Mesenteric cysts are defined as a heterogeneous group of intra-abdominal cystic lesions of the mesentery or omentum that may be found in any portion of the gastrointestinal tract from the duodenum to the rectum. The clinical condition is entirely asymptomatic in many patients, particularly with small cysts. The diagnosis is typically incidental and secondary to imaging performed for other purposes. In symptomatic patients, the clinical picture is characterized by nonspecific gastrointestinal signs and symptoms. Treatment may be surgical or via interventional radiology. We report the case of a 55-year-old female patient complaining of left-sided abdominal discomfort and constipation lasting three months. An abdominal ultrasound showed the presence of a 10 × 14 × 16 cm anechoic cystic mass filling the whole anterior and left abdominal cavity, confirmed by CT and MRI. The cyst, removed laparoscopically, was histologically a simple mesothelial cyst. We reviewed the international literature over the last 10 years of all cases with mesenteric cysts > 10 cm in evaluating gastrointestinal symptoms at diagnosis, histology, performed treatment, and outcome.
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Affiliation(s)
- Federica Gagliardi
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Augusto Lauro
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Domenico Tripodi
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Maria Ida Amabile
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Piergaspare Palumbo
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Filippo Maria Di Matteo
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Giorgio Palazzini
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Flavio Forte
- Urology Department, M.G. Vannini Hospital, Rome, Italy
| | - Stefano Frattaroli
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Simone Khouzam
- Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ignazio R Marino
- Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Vito D'Andrea
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Salvatore Sorrenti
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Daniele Pironi
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
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15
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Ambrosio MR, Perotti B, Battini A, Fattorini C, Cavazzana A, Pasqua R, Palumbo P, Gia L, Arganini M. Surgeon-Pathologist Team Approach Dramatically Affects Lymph Nodes Detection and Improves Patients' Short-Term Outcome. Cancers (Basel) 2022; 14:cancers14041034. [PMID: 35205783 PMCID: PMC8870551 DOI: 10.3390/cancers14041034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/07/2022] [Accepted: 02/11/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Appropriate lymph node harvesting for patients with gastric cancer is fundamental for a correct staging and is strongly related to survival. In this study, we present a new protocol for on-site macroscopic evaluation and sampling of lymph nodes for gastric cancer patients. With the joint collaboration of surgeons and pathologists, our method aims to provide the largest possible number of analyzed lymph nodes per patient, allowing for a better staging. We are convinced that this approach is routinely feasible, and our preliminary results seem to confirm better patient stratification compared to other lymph node dissection methods. Abstract The downstaging of gastric cancer has recently gained particular attention in the field of gastric cancer surgery. The phenomenon is mainly due to an inappropriate sampling of lymph nodes during standard lymphadenectomy. Hence, collection of the maximum number of lymph nodes is a critical factor affecting the outcome of patients. None of the techniques proposed so far have demonstrated a real efficiency in increasing the number of identified lymph nodes. To harvest the maximum number of lymph nodes, we designed a protocol for on-site macroscopic evaluation and sampling of lymph nodes according to the Japanese Gastric Cancer Association protocol. The procedure was carried out by a surgeon/pathologist team in the operating room. We enrolled one hundred patients, 50 of whom belonged to the study group and 50 to a control group. The study group included patients who underwent lymph node dissection following the proposed protocol; the control group encompassed patients undergoing standard procedures for sampling. We compared the number and maximum diameter of lymph nodes collected in both groups, as well as some postoperative variables, the 30-day mortality and the overall survival. In the study group, the mean number of lymph nodes harvested was higher than the control one (p = 0.001). Moreover, by applying the proposed technique, we sampled lymph nodes with a very small diameter, some of which were metastatic. Noticeably, no difference in terms of postoperative course was identified between the two groups, again supporting the feasibility of an extended lymphadenectomy. By comparing the prognosis of patients, a better overall survival (p = 0.03) was detected in the study group; however, to date, no long-term follow-up is available. Interestingly, patients with metastasis in node stations number 8, 9, 11 or with skip metastasis, experienced a worse outcome and died. Based on our preliminary results, the pathologist/surgeon team approach seems to be a reliable option, despite of a slight increase in sfaff workload and technical cost. It allows for the harvesting of a larger number of lymph nodes and improves the outcome of the patients thanks to more precise staging and therapy. Nevertheless, since a higher number of patients are necessary to confirm our findings and assess the impact of this technique on oncological outcome, our study could serve as a proof-of-concept for a larger, multicentric collaboration.
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Affiliation(s)
- Maria Raffaella Ambrosio
- Pathology Unit, Azienda Sanitaria Toscana Nord-Ovest, Via Cocchi 1, 56121 Pisa, Italy; (C.F.); (A.C.)
- Correspondence:
| | - Bruno Perotti
- Surgery Unit, Ospedale Unico Versilia and Nuovo Ospedale Apuane, Azienda Sanitaria Toscana Nord Ovest, 56121 Pisa, Italy; (B.P.); (A.B.); (L.G.); (M.A.)
| | - Alda Battini
- Surgery Unit, Ospedale Unico Versilia and Nuovo Ospedale Apuane, Azienda Sanitaria Toscana Nord Ovest, 56121 Pisa, Italy; (B.P.); (A.B.); (L.G.); (M.A.)
| | - Caterina Fattorini
- Pathology Unit, Azienda Sanitaria Toscana Nord-Ovest, Via Cocchi 1, 56121 Pisa, Italy; (C.F.); (A.C.)
| | - Andrea Cavazzana
- Pathology Unit, Azienda Sanitaria Toscana Nord-Ovest, Via Cocchi 1, 56121 Pisa, Italy; (C.F.); (A.C.)
| | - Rocco Pasqua
- Department of Surgical Sciencies, University “La Sapienza”, 00100 Roma, Italy; (R.P.); (P.P.)
| | - Piergaspare Palumbo
- Department of Surgical Sciencies, University “La Sapienza”, 00100 Roma, Italy; (R.P.); (P.P.)
| | - Liano Gia
- Surgery Unit, Ospedale Unico Versilia and Nuovo Ospedale Apuane, Azienda Sanitaria Toscana Nord Ovest, 56121 Pisa, Italy; (B.P.); (A.B.); (L.G.); (M.A.)
| | - Marco Arganini
- Surgery Unit, Ospedale Unico Versilia and Nuovo Ospedale Apuane, Azienda Sanitaria Toscana Nord Ovest, 56121 Pisa, Italy; (B.P.); (A.B.); (L.G.); (M.A.)
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16
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Tripodi D, Cannistra' C, Gagliardi F, Casella G, Lauro A, De Luca A, Amabile MI, Palumbo P, Pironi D, Mascagni D, D'Andrea V, Vergine M, Sorrenti S. Coincidental or Causal? Concurrence of Colorectal Carcinoma with Primary Breast Cancer. Dig Dis Sci 2022; 67:437-444. [PMID: 34731362 DOI: 10.1007/s10620-021-07296-5] [Citation(s) in RCA: 1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2021] [Indexed: 12/12/2022]
Abstract
Multiple primary malignant neoplasms (MPMN) represent the occurrence of a second malignancy in the same patient within 6 months after the detection of first primary (synchronous) tumor, or > 6 months after primary detection (metachronous). We present a case of a patient treated for carcinoma of the breast who developed a metachronous primary malignancy in the colorectal tract. These tumors were histologically different with distinct immune-histochemical parameters. The association between breast and colon cancer is well documented in the literature with several studies reporting the coexistence of common extrinsic and genetic predisposing factors. Although rare, MPMN are becoming more common due to the increased number of elderly cancer survivors, improved diagnosis and enhanced awareness. The association between colorectal and breast cancer should not be dismissed merely as metastasis since there is good precedent for the co-occurrence of these primary tumors.
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Affiliation(s)
- Domenico Tripodi
- Department of Surgical Sciences, Sapienza University, Rome, Italy.
| | - Claudio Cannistra'
- Department of General Surgery, Bichat C. B. University Hospital, Paris, France
| | | | - Giovanni Casella
- Department of Surgical Sciences, Sapienza University, Rome, Italy
| | - Augusto Lauro
- Department of Surgical Sciences, Sapienza University, Rome, Italy
| | | | | | | | - Daniele Pironi
- Department of Surgical Sciences, Sapienza University, Rome, Italy
| | | | - Vito D'Andrea
- Department of Surgical Sciences, Sapienza University, Rome, Italy
| | - Massimo Vergine
- Department of Surgical Sciences, Sapienza University, Rome, Italy
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17
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De Muzio F, Cutolo C, Granata V, Fusco R, Ravo L, Maggialetti N, Brunese MC, Grassi R, Grassi F, Bruno F, Palumbo P, Palatresi D, Cozzi D, Danti G. CT study protocol optimization in acute non-traumatic abdominal settings. Eur Rev Med Pharmacol Sci 2022; 26:860-878. [PMID: 35179752 DOI: 10.26355/eurrev_202202_27995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Abdominal acute pain is a manifestation of heterogeneous medical conditions, with difficult clinical-laboratory assessment. Multi-detector CT (MDCT) is the gold standard imaging technique for evaluating adult patients with acute abdominal pain. Due to its fast execution and the high spatial resolution, CT is fundamental in the diagnostic and therapeutic work-up of patients with time-dependent pathology that could require surgical treatment, reducing mortality and morbidity. However, the radiological risk connected to the ionizing radiation use should not be underestimated, especially in young patients. The aim of this study is to identify optimized CT protocols to apply in the management of non-traumatic acute abdomen. In particular, this review is focused on the main emergency settings: acute pancreatitis, small bowel obstruction, acute appendicitis and acute diverticulitis. This survey would not be complete without mentioning Dual-Energy CT (DECT) technique, one of the last frontiers in CT, achieving encouraging results also in acute abdominal conditions.
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Affiliation(s)
- F De Muzio
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy.
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Menozzi R, Valoriani F, Prampolini F, Banchelli F, Boldrini E, Martelli F, Galetti S, Fari' R, Gabriele S, Palumbo P, Forni D, Pantaleoni M, D'Amico R, Pecchi AR. Impact of sarcopenia in SARS-CoV-2 patients during two different epidemic waves. Clin Nutr ESPEN 2022; 47:252-259. [PMID: 35063210 PMCID: PMC8648616 DOI: 10.1016/j.clnesp.2021.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 01/11/2023]
Abstract
Background Sarcopenia was reported to be associated with poor clinical outcome, higher incidence of community-acquired pneumonia, increased risk of infections and reduced survival in different clinical settings. The aim of our work is to evaluate the prognostic role of sarcopenia in patients with the 2019 novel coronavirus disease (COVID-19). Materials and methods 272 COVID-19 patients admitted to the University Hospital of Modena (Italy) from February 2020 to January 2021 were retrospectively studied. All included patients underwent a chest computed tomography (CT) scan to assess pneumonia during their hospitalization and showed a positive SARS-CoV-2 molecular test. Sarcopenia was defined by skeletal muscle area (SMA) evaluation at the 12th thoracic vertebra (T12). Clinical, laboratory data and adverse clinical outcome (admission to Intensive Care Unit and death) were collected for all patients. Results Prevalence of sarcopenia was high (41.5%) but significantly different in each pandemic wave (57.9% vs 21.6% p < 0.0000). At the multivariate analysis, sarcopenia during the first wave (Hazard Ratio 2.29, 95% confidence intervals 1.17 to 4.49 p = 0.0162) was the only independent prognostic factor for adverse clinical outcome. There were no significant differences in comorbidities and COVID19 severity in terms of pulmonary involvement at lung CT comparing during the first and second wave. Mixed pattern with peripheral and central involvement was found to be dominant in both groups. Conclusion We highlight the prognostic impact of sarcopenia in COVID-19 patients hospitalized during the first wave. T12 SMA could represent a potential tool to identify sarcopenic patients in particular settings. Further studies are needed to better understand the association between sarcopenia and COVID-19.
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Affiliation(s)
- R Menozzi
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy.
| | - F Valoriani
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - F Prampolini
- Department of Radiology, University Hospital of Modena, Modena, Italy
| | - F Banchelli
- Unit of Clinical Statistics, University Hospital of Modena, Modena, Italy
| | - E Boldrini
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - F Martelli
- Department of Radiology, University Hospital of Modena, Modena, Italy
| | - S Galetti
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - R Fari'
- Department of Radiology, University Hospital of Modena, Modena, Italy
| | - S Gabriele
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - P Palumbo
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - D Forni
- Department of Radiology, University Hospital of Modena, Modena, Italy
| | - M Pantaleoni
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - R D'Amico
- Unit of Clinical Statistics, University Hospital of Modena, Modena, Italy
| | - A R Pecchi
- Department of Radiology, University Hospital of Modena, Modena, Italy
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19
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Sorrenti S, Baldini E, Pironi D, Lauro A, D’Orazi V, Tartaglia F, Tripodi D, Lori E, Gagliardi F, Praticò M, Illuminati G, D’Andrea V, Palumbo P, Ulisse S. Iodine: Its Role in Thyroid Hormone Biosynthesis and Beyond. Nutrients 2021; 13:nu13124469. [PMID: 34960019 PMCID: PMC8709459 DOI: 10.3390/nu13124469] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 11/16/2022] Open
Abstract
The present review deals with the functional roles of iodine and its metabolism. The main biological function of iodine concerns its role in the biosynthesis of thyroid hormones (THs) by the thyroid gland. In addition, however, further biological roles of iodine have emerged. Precisely, due to its significant action as scavenger of reactive oxygen species (ROS), iodine is thought to represent one of the oldest antioxidants in living organisms. Moreover, iodine oxidation to hypoiodite (IO−) has been shown to possess strong bactericidal as well as antiviral and antifungal activity. Finally, and importantly, iodine has been demonstrated to exert antineoplastic effects in human cancer cell lines. Thus, iodine, through the action of different tissue-specific peroxidases, may serve different evolutionarily conserved physiological functions that, beyond TH biosynthesis, encompass antioxidant activity and defense against pathogens and cancer progression.
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20
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Granata V, Fusco R, Bicchierai G, Cozzi D, Grazzini G, Danti G, De Muzio F, Maggialetti N, Smorchkova O, D'Elia M, Brunese MC, Grassi R, Giacobbe G, Bruno F, Palumbo P, Lacasella GV, Brunese L, Grassi R, Miele V, Barile A. Diagnostic protocols in oncology: workup and treatment planning. Part 1: the optimitation of CT protocol. Eur Rev Med Pharmacol Sci 2021; 25:6972-6994. [PMID: 34859859 DOI: 10.26355/eurrev_202111_27246] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The increase in oncology knowledge and the possibility of creating personalized medicine by selecting a more suitable therapy related to tumor subtypes, as well as the patient's management with cancer within a multidisciplinary team has improved the clinical outcomes. Early detection of cancer through screening-based imaging is probably the major contributor to a reduction in mortality for certain cancers. Nowadays, imaging can also characterize several lesions and predict their histopathological features and can predict tumor behaviour and prognosis. CT is the main diagnostic tool in oncologic imaging and is widely used for the tumors detection, staging, and follow-up. Moreover, since CT accounts for 49-66% of overall patient radiation exposure, the constant reduction, optimization, dose inter- and intraindividual consistency are major goals in radiological field. In the recent years, numerous dose reduction techniques have been established and created voltage modulation keeping a satisfactory image quality. The introduction of CT dual-layer detector technology enabled the acquisition of spectral data without additional CT x-ray tube or additional acquisitions. In addition, since MRI does not expose the body to radiation, it has become a mainstay of non-invasive diagnostic radiology modality since the 1980s.
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Affiliation(s)
- V Granata
- Division of Radiology, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy.
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21
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Palumbo P, Massimi F, Biondi A, Cirocchi R, De Luca GM, Giraudo G, Intini SG, Monzani R, Sozio G, Usai S. Recommendations for outpatient activity in COVID-19 pandemic. Open Med (Wars) 2021; 16:1696-1704. [PMID: 34805532 PMCID: PMC8578809 DOI: 10.1515/med-2021-0378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/23/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022] Open
Abstract
The spread of the COVID-19 disease substantially influenced the International Healthcare system, and the national governments worldwide had before long to decide how to manage the available resources, giving priority to the treatment of the COVID-infected patients. Then, in many countries, it was decided to limit the elective procedures to surgical oncology and emergency procedures. In fact, most of the routine, middle-low complexity surgical interventions were reduced, and the day surgery (DS) activities were almost totally interrupted. As a result of this approach, the waiting list of these patients has significantly increased. In the current phase, with a significant decrease in the incidence of COVID-19 cases, the surgical daily activity can be safely and effectively restarted. Adjustments are mandatory to resume the DS activity. The whole separation of pathways with respect to the long-stay and emergency surgery, an accurate preoperative protocol of patient management, with a proper selection and screening of all-day cases, careful scheduling of surgical organization in the operating room, and planning of the postoperative pathway are the goals for a feasible, safe, and effective resumption of DS activity.
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Affiliation(s)
- Piergaspare Palumbo
- Department of Surgical Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Fanny Massimi
- Department of Surgical Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Antonio Biondi
- Department of General Surgery and Surgical Specialities, University of Catania, Catania, Italy
| | - Roberto Cirocchi
- Deparment of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | | | - Giorgio Giraudo
- Department of Surgery, Santa Croce e Carle Hospital, Cuneo, Italy
| | | | - Roberta Monzani
- Department of Anesthesia and Intensive Care, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Giampaolo Sozio
- Department of General Surgery and Emergency, Alta Val D’Elsa Hospital, Poggibonsi (SI), Italy
| | - Sofia Usai
- Department of Surgical Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
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22
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Granata V, Bicchierai G, Fusco R, Cozzi D, Grazzini G, Danti G, De Muzio F, Maggialetti N, Smorchkova O, D'Elia M, Brunese MC, Grassi R, Giacobbe G, Bruno F, Palumbo P, Grassi F, Brunese L, Grassi R, Miele V, Barile A. Diagnostic protocols in oncology: workup and treatment planning. Part 2: Abbreviated MR protocol. Eur Rev Med Pharmacol Sci 2021; 25:6499-6528. [PMID: 34787854 DOI: 10.26355/eurrev_202111_27094] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Magnetic resonance imaging (MRI) is a non-invasive imaging technique (non-ionizing radiation) with superior soft tissue contrasts and potential morphological and functional applications. However, long examination and interpretation times, as well as higher costs, still represent barriers to MRI use in clinical routine. Abbreviated MRI protocols have emerged as an alternative to standard MRI protocols. Abbreviated MRI protocols eliminate redundant sequences that negatively affect cost, acquisition time, patient comfort. However, the diagnostic information is generally not compromised. Abbreviated MRI protocols have already been utilized for hepatocellular carcinoma, for prostate cancer detection, and for nonalcoholic fatty liver disease screening.
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Affiliation(s)
- V Granata
- Division of Radiology, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy.
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23
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Baldini E, Tuccilli C, Pironi D, Catania A, Tartaglia F, Di Matteo FM, Palumbo P, Arcieri S, Mascagni D, Palazzini G, Tripodi D, Maturo A, Vergine M, Tarroni D, Lori E, Ferent IC, De Vito C, Fallahi P, Antonelli A, Censi S, D’Armiento M, Barollo S, Mian C, Morrone A, D’Andrea V, Sorrenti S, Ulisse S. Expression and Clinical Utility of Transcription Factors Involved in Epithelial-Mesenchymal Transition during Thyroid Cancer Progression. J Clin Med 2021; 10:jcm10184076. [PMID: 34575184 PMCID: PMC8469282 DOI: 10.3390/jcm10184076] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 07/14/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 12/12/2022] Open
Abstract
The transcription factors involved in epithelial–mesenchymal transition (EMT-TFs) silence the genes expressed in epithelial cells (e.g., E-cadherin) while inducing those typical of mesenchymal cells (e.g., vimentin). The core set of EMT-TFs comprises Zeb1, Zeb2, Snail1, Snail2, and Twist1. To date, information concerning their expression profile and clinical utility during thyroid cancer (TC) progression is still incomplete. We evaluated the EMT-TF, E-cadherin, and vimentin mRNA levels in 95 papillary TC (PTC) and 12 anaplastic TC (ATC) tissues and correlated them with patients’ clinicopathological parameters. Afterwards, we corroborated our findings by analyzing the data provided by a case study of the TGCA network. Compared with normal tissues, the expression of E-cadherin was found reduced in PTC and more strongly in ATC, while the vimentin expression did not vary. Among the EMT-TFs analyzed, Twist1 seems to exert a prominent role in EMT, being significantly associated with a number of PTC high-risk clinicopathological features and upregulated in ATC. Nonetheless, in the multivariate analysis, none of the EMT-TFs displayed a prognostic value. These data suggest that TC progression is characterized by an incomplete EMT and that Twist1 may represent a valuable therapeutic target warranting further investigation for the treatment of more aggressive thyroid cancers.
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Affiliation(s)
- Enke Baldini
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Chiara Tuccilli
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Daniele Pironi
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Antonio Catania
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Francesco Tartaglia
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Filippo Maria Di Matteo
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Piergaspare Palumbo
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Stefano Arcieri
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Domenico Mascagni
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Giorgio Palazzini
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Domenico Tripodi
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Alessandro Maturo
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Massimo Vergine
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Danilo Tarroni
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Eleonora Lori
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Iulia Catalina Ferent
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00161 Rome, Italy;
| | - Poupak Fallahi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (P.F.); (A.A.)
| | - Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (P.F.); (A.A.)
| | - Simona Censi
- Department of Medicine, University of Padua, 35128 Padua, Italy; (S.C.); (S.B.); (C.M.)
| | - Matteo D’Armiento
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, 00144 Rome, Italy; (M.D.); (A.M.)
| | - Susy Barollo
- Department of Medicine, University of Padua, 35128 Padua, Italy; (S.C.); (S.B.); (C.M.)
| | - Caterina Mian
- Department of Medicine, University of Padua, 35128 Padua, Italy; (S.C.); (S.B.); (C.M.)
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, 00144 Rome, Italy; (M.D.); (A.M.)
| | - Vito D’Andrea
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Salvatore Sorrenti
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
| | - Salvatore Ulisse
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (E.B.); (C.T.); (D.P.); (A.C.); (F.T.); (F.M.D.M.); (P.P.); (S.A.); (D.M.); (G.P.); (D.T.); (A.M.); (M.V.); (D.T.); (E.L.); (I.C.F.); (V.D.); (S.S.)
- Correspondence:
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24
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Affiliation(s)
| | - Fanny Massimi
- Department of Surgical Sciences, 9311Sapienza University of Rome, Italy
| | - Sofia Usai
- Department of Surgical Sciences, 9311Sapienza University of Rome, Italy
| | - Antonio Biondi
- Department of General Surgery and Surgical Specialities, University of Catania, Sicilia, Italy
| | - Roberta Monzani
- Department of Anesthesia and Intensive Care, 9268Humanitas Research Hospital, Italy
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25
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Cirocchi R, Mercurio I, Nazzaro C, De Sol A, Boselli C, Rettagliata G, Vanacore N, Santoro A, Mascagni D, Renzi C, Lancia M, Suadoni F, Zanghì G, Palumbo P, Bruzzone P, Tellan G, Fedeli P, Marsilio F, D'Andrea V. Dermatome Mapping Test in the analysis of anatomo-clinical correlations after inguinal hernia repair. BMC Surg 2020; 20:319. [PMID: 33287793 PMCID: PMC7720581 DOI: 10.1186/s12893-020-00988-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 11/26/2020] [Indexed: 12/22/2022] Open
Abstract
Background Nerve identification is recommended in inguinal hernia repair to reduce or avoid postoperative pain. The aim of this prospective observational study was to identify nerve prevalence and find a correlation between neuroanatomy and chronic neuropathic postoperative inguinal pain (CPIP) after 6 months. Material A total of 115 patients, who underwent inguinal hernia mesh repair (Lichtenstein tension-free mesh repair) between July 2018 and January 2019, were included in this prospective observational study. The mean age and BMI respectively resulted 64 years and 25.8 with minimal inverse distribution of BMI with respect to age. Most of the hernias were direct (59.1%) and of medium dimension (47.8%). Furthermore, these patients were undergoing Dermatome Mapping Test in preoperatively and postoperatively 6 months evaluation. Results Identification rates of the iliohypogastric (IH), ilioinguinal (II) and genitofemoral (GF) nerves were 72.2%, 82.6% and 48.7% respectively. In the analysis of nerve prevalence according to BMI, the IH was statistically significant higher in patients with BMI < 25 than BMI ≥ 25 P (< 0.05). After inguinal hernia mesh repair, 8 patients (6.9%) had chronic postoperative neuropathic inguinal pain after 6 months. The CPIP prevailed at II/GF dermatome. The relation between the identification/neurectomy of the II nerve and chronic postoperative inguinal pain after 6 months was not significant (P = 0.542). Conclusion The anatomy of inguinal nerve is very heterogeneous and for this reason an accurate knowledge of these variations is needed during the open mesh repair of inguinal hernias. The new results of our analysis is the statistically significant higher IH nerve prevalence in patients with BMI < 25; probably the identification of inguinal nerve is more complex in obese patients. In the chronic postoperative inguinal pain, the II nerve may have a predominant role in determining postoperative long-term symptoms. Dermatome Mapping Test in an easy and safe method for preoperative and postoperative 6 months evaluation of groin pain. The most important evidence of our analysis is that the prevalence of chronic pain is higher when the nerves were not identified.
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Affiliation(s)
- Roberto Cirocchi
- Department of Surgical Science, University of Perugia, Piazza dell' Università 1, 06100, Perugia, Italy.,Inguinal NerveWorking Group, Terni, Italy
| | - Isabella Mercurio
- Department of Surgical Science, University of Perugia, Piazza dell' Università 1, 06100, Perugia, Italy. .,Inguinal NerveWorking Group, Terni, Italy.
| | - Claudio Nazzaro
- Inguinal NerveWorking Group, Terni, Italy.,General Surgery and Day Surgery, Azienda Ospedaliera Santa Maria Terni, Via Tristano Di Joannuccio, 05100, Terni, Italy
| | - Angelo De Sol
- Inguinal NerveWorking Group, Terni, Italy.,General Surgery and Day Surgery, Azienda Ospedaliera Santa Maria Terni, Via Tristano Di Joannuccio, 05100, Terni, Italy
| | - Carlo Boselli
- Department of Surgical Science, University of Perugia, Piazza dell' Università 1, 06100, Perugia, Italy.,Inguinal NerveWorking Group, Terni, Italy
| | | | | | - Alberto Santoro
- Inguinal NerveWorking Group, Terni, Italy.,Department of Surgical Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Domenico Mascagni
- Inguinal NerveWorking Group, Terni, Italy.,Department of Surgical Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Claudio Renzi
- Department of Surgical Science, University of Perugia, Piazza dell' Università 1, 06100, Perugia, Italy.,Inguinal NerveWorking Group, Terni, Italy
| | - Massimo Lancia
- Department of Surgical Science, University of Perugia, Piazza dell' Università 1, 06100, Perugia, Italy.,Inguinal NerveWorking Group, Terni, Italy
| | - Fabio Suadoni
- Department of Surgical Science, University of Perugia, Piazza dell' Università 1, 06100, Perugia, Italy.,Inguinal NerveWorking Group, Terni, Italy
| | - Guido Zanghì
- Inguinal NerveWorking Group, Terni, Italy.,Department of Surgery, Policlinico Vittorio Emanuele University Hospital-General Surgery and Oncology Unit, University of Catania, Catania, Sicily, Italy
| | - Piergaspare Palumbo
- Inguinal NerveWorking Group, Terni, Italy.,Department of Surgical Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Paolo Bruzzone
- Inguinal NerveWorking Group, Terni, Italy.,Dipartimento Di Chirurgia Generale E Specialistica "Paride Stefanini", Viale del Policlinico, 155, 00186, Rome, Italy
| | - Guglielmo Tellan
- Inguinal NerveWorking Group, Terni, Italy.,Department of Emergency and Acceptance, Critical Areas and Trauma, "Umberto I" University Hospital, Sapienza University of Rome, 00161, Rome, Italy
| | - Piergiorgio Fedeli
- Inguinal NerveWorking Group, Terni, Italy.,Legal Medicine, School of Law, University of Camerino, Camerino, Italy
| | - Francucci Marsilio
- Inguinal NerveWorking Group, Terni, Italy.,General Surgery and Day Surgery, Azienda Ospedaliera Santa Maria Terni, Via Tristano Di Joannuccio, 05100, Terni, Italy
| | - Vito D'Andrea
- Inguinal NerveWorking Group, Terni, Italy.,Department of Surgical Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
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Palumbo P, Usai S, Amatucci C, Cerasari S, Perotti B, Ruggeri L, Cirocchi R, Tellan G. Tailored Surgery in Inguinal Hernia Repair. The Role of Subarachnoid Anesthesia: A Retrospective Study. Open Med (Wars) 2019; 14:639-646. [PMID: 31667353 PMCID: PMC6818077 DOI: 10.1515/med-2019-0070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/16/2019] [Indexed: 01/16/2023] Open
Abstract
Safety and effectiveness evaluation of subarachnoid anesthesia implemented with hyperbaric Prilocaine in reduced dose (30mg) in combination with Fentanyl (20mcg), for the purpose of ensuring an optimal analgesia in open inguinal hernia repair. Although the local anesthesia is the first line treatment for open inguinal hernia repair, a minority of patients is not eligible because of obesity or big groin hernia, requiring a high dose of local anesthetic. Subarachnoid anesthesia implemented with hyperbaric Prilocaine in reduced dose in combination with Fentanyl may be a good alternative. Thirty patients were treated with intrathecal association of Prilocaine 30 mg and Fentanyl 20 mcg (group PF); they were compared to a group of fifty three ones, previously treated with a classic procedure with intrathecal Prilocaine 60 mg (group P). The sensitive blockage remained within an higher limit at T12 level in the patients of PF group, and a lower limit at S1 level 50 minutes after the anesthesia, while in the P group the anesthetic tended to migrate (p<0.0001). In PF group 70 minutes after the anesthesia 21 patients had a Bromage score equal to 0 and 9 patients equal to 9 (in P group, 19 patients had a score equal to 3, 8 to 2 and 3 to 1, p<0.0001). Subarachnoid anesthesia using Prilocaine 30 mg + Fentanyl 20 mcg could be stated as a viable alternative to local anesthesia in selected patients.
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Affiliation(s)
| | - Sofia Usai
- Department of Surgical Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Chiara Amatucci
- Department of Surgical Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Saverio Cerasari
- Department of Surgical Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Bruno Perotti
- Department of Surgical Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Luca Ruggeri
- Department of Emergency, Anesthesia and Critical Care, “Sapienza” University of Rome, Rome, Italy
| | - Roberto Cirocchi
- Department of Surgical Sciences, University of Perugia, Perugia, Italy
| | - Guglielmo Tellan
- Department of Emergency, Anesthesia and Critical Care, “Sapienza” University of Rome, Rome, Italy
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Gioia S, Lancia M, Cirocchi R, Suadoni F, Franceschetto L, Santoro A, Palumbo P, Boselli C, Barberini F, Covarelli P, Renzi C, Carlini L. Retained sponges in abdomen: an analysis of the judgments of the Italian Supreme Court. G Chir 2019; 40:290-297. [PMID: 32011979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The administration of justice in Italy includes first, second and third instance. The first and second instances are represented by the Court of First Instance and the Court of Appeal: these are judgment of Romamerit. The court of last appeal for both the civil and the criminal jurisdiction is the Court of Cassation, the Italian Supreme Court. It is a court of legitimacy that should provide for a consistent and uniform interpretation of the law and that only on points of law, not on factual evidence. The Court of Cassation can confirm the sentence of second instance, can dismiss it without referral, can deciding and closing the trial definitively, or dismiss it referring the case to the judge of merit that must decide according to the principles set out in the legitimacy. The aim of this study is to analyze the Supreme Cassation Court's judgments on the legal proceedings about retained sponges in abdomen.
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Cirocchi R, Henry BM, Mercurio I, Tomaszewski KA, Palumbo P, Stabile A, Lancia M, Randolph J. Is it possible to identify the inguinal nerves during hernioplasty? A systematic review of the literature and meta-analysis of cadaveric and surgical studies. Hernia 2018; 23:569-581. [PMID: 30570686 PMCID: PMC6586705 DOI: 10.1007/s10029-018-1857-2] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 11/08/2018] [Indexed: 11/27/2022]
Abstract
Purpose Patients who undergo inguinal hernioplasty may suffer from persistent postoperative pain due to inguinal nerve injuries. The aim of this systematic review and meta-analysis was to provide comprehensive data on the prevalence (identification rates), anatomical characteristics, and ethnic variations of the ilioinguinal (IIN), the iliohypogastric (IHN) and the genital branch of the genitofemoral (GNF) nerves. Methods The systematic literature search was conducted using the PubMed, Scopus and Web of Science databases. Results A total of 26 articles (5265 half-body examinations) were included in this study. The identification rate of the IIN was 94.4% (95% CI 89.5–97.9) using a random-effects model. Unweighted multiple regression analysis showed that study sample size (β = − 0.74, p = .036) was the only statistically significant predictor of lower prevalence. The identification rates of the IHN and GNF was 86.7% (95% CI 78.3%–93.3%) and 69.1% (95% CI 53.1%–83.0%) using a random-effects model, respectively. For those outcomes, a visual analysis of funnel and Doi plots indicated irregularity and provided evidence that larger studies tended to have lower identification rates. In terms of the synthesis of anatomical reference points, there was a large and statistically significant amount of heterogeneity for most outcomes. Conclusions The identification rates of the inguinal nerves in our study were lower than reported in literature. The lowest was found for GNF, suggesting that this nerve was the most difficult to identify. Knowledge regarding the anatomy of the inguinal nerves can facilitate their proper identification and reduce the risk of iatrogenic injury and postoperative pain.
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Affiliation(s)
- R Cirocchi
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - B M Henry
- Department of Anatomy, Jagiellonian University Medical College, 12 Kopernika Street, 31-034, Kraków, Poland.
| | - I Mercurio
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - K A Tomaszewski
- Department of Anatomy, Jagiellonian University Medical College, 12 Kopernika Street, 31-034, Kraków, Poland
| | - P Palumbo
- Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - A Stabile
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - M Lancia
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - J Randolph
- Tift College of Education, Mercer University, Atlanta, GA, USA
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Illuminati G, Pizzardi G, Pasqua R, Frezzotti F, Palumbo P, Macrina F, Calio' F. Hybrid treatment of tandem, common carotid/innominate artery and ipsilateral carotid bifurcation stenoses by simultaneous, retrograde proximal stenting and eversion carotid endarterectomy: Preliminary results of a case series. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.02.062] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Palumbo P, Usai S, Amatucci C, Perotti B, Ruggeri L, Illuminati G, Tellan G. Inguinal hernia repair in day surgery: the role of MAC (Monitored Anesthesia Care) with remifentanil. G Chir 2018; 38:273-279. [PMID: 29442057 DOI: 10.11138/gchir/2017.38.6.273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The extension of indications for procedures in a Day Surgery (DS) setting has led to changes in the anesthetic and surgical treatment of Inguinal Hernias (IH). According to the recommendations of the European Hernia Society, the treatment of IH in DS units should be performed under Monitored Anesthesia Care (MAC). PATIENTS AND METHODS 960 patients underwent IH repairs over a period of 24 months. The patients were randomly divided into two groups: R (remifentanil) and F (fentanyl); the group F was considered as a control group. The exclusion criteria in both group were: morbid obesity (BMI>40 or BMI>35 in association with high blood pressure or diabetes); coagulopathy; OSAS (obstructive sleep apnea syndrome) with AHI >10; cardiovascular, respiratory, renal, hepatic or metabolic disease; history of substances abuse; GERD-related esophagitis (gastro-esophageal reflux disease); chronic analgesic use; allergy to local anesthetic and ASA>III. Patients reported their level of pain on a verbal numeric scale (VNS), with scores ranging from 0 to 10. For each patient systolic and diastolic blood pressure (SBP and DBP), mean arterial pressure (MAP), heart rate (HR) and peripheral oxygen saturation (SpO2) were recorded. The results are presented as the mean value ± standard deviations; statistical analysis was performed using Student's t-test. RESULTS Amongst the 960 procedures, complications or side effects related to the anesthetic techniques didn't occur; no procedure-related complications requiring mechanical ventilation support were reported. Our research focused on evaluating remifentanil effectiveness in pain control and its impact on hemodynamic stability and respiratory function. There was a significant difference between the two groups with regard to the VNS. CONCLUSIONS Remifentanil, is an excellent drug for pain control during intra-operative procedures, that allows an optimal hemodynamic stability for IH repairs in a DS setting, due to its pharmacokinetic and pharmacodynamic properties and few adverse effects.
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Palmerini L, Chiari L, Palumbo P. A Probabilistic Model to Investigate the Properties of Prognostic Tools for Falls. Methods Inf Med 2018; 54:189-97. [DOI: 10.3414/me13-01-0127] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 06/25/2014] [Indexed: 11/09/2022]
Abstract
SummaryBackground: Falls are a prevalent and burdensome problem in the elderly. Tools for the assessment of fall risk are fundamental for fall prevention. Clinical studies for the development and evaluation of prognostic tools for falls show high heterogeneity in the settings and in the reported results. Newly developed tools are susceptible to over- optimism.Objectives: This study proposes a probabilistic model to address critical issues about fall prediction through the analysis of the properties of an ideal prognostic tool for falls.Methods: The model assumes that falls occur within a population according to the Greenwood and Yule scheme for accident-proneness. Parameters for the fall rate distribution are estimated from counts of falls of four different epidemiological studies.Results: We obtained analytic formulas and quantitative estimates for the predictive and discriminative properties of the ideal prognostic tool. The area under the receiver operating characteristic curve (AUC) ranges between about 0.80 and 0.89 when prediction on any fall is made within a follow-up of one year. Predicting on multiple falls results in higher AUC.Conclusions: The discriminative ability of current validated prognostic tools for falls is sensibly lower than what the proposed ideal perfect tool achieves. A sensitivity analysis of the predictive and discriminative properties of the tool with respect to study settings and fall rate distribution identifies major factors that can account for the high heterogeneity of results observed in the literature.
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Palumbo P, Usai S, Amatucci C, Pulli VT, Illuminati G, Vietri F, Tellan G. Postoperative nausea and vomiting (PONV) in outpatient repair of inguinal hernia. Ann Ital Chir 2018; 89:75-80. [PMID: 29629886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE Nausea and vomiting are among the most frequent complications following anesthesia and surgery. Due to anesthesia seems to be primarily responsible for post operative nausea and vomiting (PONV) in Day Surgery facilities, the aim of the study is to evaluate how different methods of anesthesia could modify the onset of postoperative nausea and vomiting in a population of patients undergoing inguinal hernia repair. METHODS Ninehundredten patients, aged between 18 and 87 years, underwent open inguinal hernia repair. The PONV risk has been assessed according to Apfel Score. Local anesthetic infiltration, performed by the surgeon in any cases, has been supported by and analgo-sedation with Remifentanil in 740 patients; Fentanyl was used in 96 cases and the last 74 underwent deep sedation with Propofol . RESULTS Among the 910 patients who underwent inguinal hernia repair, PONV occurred in 68 patients (7.5%). Among patients presenting PONV, 29 received Remifentanil, whereas 39 received Fentanyl. In the group of patients receiving Propofol, no one presented PONV. This difference is statistically significant (p < .01). Moreover, only 50 patients of the total sample received antiemetic prophylaxis, and amongst these, PONV occurred in 3 subjects. CONCLUSIONS Compared to Remifentanil, Fentanyl has a major influence in causing PONV. Nonetheless, an appropriate antiemetic prophylaxis can significantly reduce this undesirable complication. Key words: Day Surgery, Fentanyl, Inguinal, Hernia repair, Nausea, Vomiting.
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Illuminati G, Calio' FG, Pizzardi G, Pasqua R, Masci F, Frezzotti F, Palumbo P, Vietri F. Results of Infrageniculate Bypasses Using the Profunda Femoris Artery as Inflow Source. Ann Vasc Surg 2017; 47:188-194. [PMID: 28943485 DOI: 10.1016/j.avsg.2017.09.010] [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: 07/18/2017] [Revised: 09/14/2017] [Accepted: 09/14/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND When the common femoral artery is not accessible for infrainguinal bypass grafting, the profunda femoris artery (PFA) can be a valuable alternative inflow source for distal arterial revascularization. The purpose of this retrospective study was to evaluate the results of infrageniculate bypass grafting via the PFA as inflow source for critical limb ischemia. METHODS Between 1994 and 2016, 68 patients, 51 men of a mean age of 74 years, underwent an infrageniculate arterial bypass grafting for critical limb ischemia, using the PFA as inflow site. PFA was exposed at the Scarpa's triangle in 38 patients (56%) and at its medio-crural segment in 30 patients (44%). The distal anastomosis was performed on the infragenicular popliteal artery in 33 patients (48%), the peroneal artery in 14 patients (20%), the tibioperoneal trunk in 8 patients (12%), the posterior tibial artery in 8 patients (12%), and the dorsalis pedis artery in 5 patients (8%). The graft material consisted of a reversed great saphenous vein (GSV) in 62 patients (91%) and a 6-mm polytetrafluoroethylene graft in 6 patients (9%). The median duration of follow-up was 51 months (range, 6-72 months). As main results, postoperative mortality and morbidity, overall late patients' survival, primary grafts' patency, and limb salvage rate were considered. RESULTS Operative mortality and morbidity were 3% and 4%, respectively. Overall patients' survival, primary patency and limb salvage rate, at 36 and 60 months were, respectively, 62% and 53%, 66% and 59%, and 92% and 77%. CONCLUSIONS The PFA, both exposed at the Scarpa's triangle and at mid-thigh, is an excellent inflow source for infrageniculate revascularizations. It should remain an important part of the technical armamentarium of vascular surgeons, even in the endovascular era.
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Affiliation(s)
- Giulio Illuminati
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy.
| | | | - Giulia Pizzardi
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - Rocco Pasqua
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - Federica Masci
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - Francesca Frezzotti
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - Piergaspare Palumbo
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - Francesco Vietri
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
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Illuminati G, Pizzardi G, Pasqua R, Palumbo P, Vietri F. Schwannoma of the descending loop of the hypoglossal nerve: Case report. Int J Surg Case Rep 2017; 34:20-22. [PMID: 28324801 PMCID: PMC5358956 DOI: 10.1016/j.ijscr.2017.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 02/21/2017] [Revised: 02/27/2017] [Accepted: 03/04/2017] [Indexed: 10/29/2022] Open
Abstract
INTRODUCTION Schwannomas of the descending loop of the hypoglossal nerve are very rare. They are slow-growing tumors that may masquerade a carotid body tumor. PRESENTATION OF CASE A 60-year-old female was referred for a latero-cervical mass appearing as a chemodectoma at CT-scan. At operation, a 2cm mass arising from the descending loop of the hypoglossal nerve was resected en bloc with the loop itself and a functional lymphadenectomy was associated. Post-operative course was uneventful and the patient is free from disease recurrence at one year follow-up. DISCUSSION En bloc resection remains the real curative treatment of Schwannomas, ensuring unlimited freedom from disease, although causing functional impairment which may be significant. Nonetheless recurrence should be prevented as, beside requiring reintervention, it may harbor a malignant evolution towards sarcoma. CONCLUSION Schwannomas of the descending lop of the hypoglossal nerve may masquerade a chemodectoma of the carotid bifurcation and can be curatively resected without any functional impairment.
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Affiliation(s)
- Giulio Illuminati
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy.
| | - Giulia Pizzardi
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - Rocco Pasqua
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - Piergaspare Palumbo
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - Francesco Vietri
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
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Angelici AM, Perotti B, Dezzi C, Amatucci C, Mancuso G, Caronna R, Palumbo P. Measurement of intra-abdominal pressure in large incisional hernia repair to prevent abdominal compartmental syndrome. G Chir 2017; 37:31-6. [PMID: 27142823 DOI: 10.11138/gchir/2016.37.1.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The repair of large incisional hernias may occasionally lead to a substantial increase in intra-abdominal pressure (IAP), and rarely to abdominal compartmental syndrome (ACS) with subsequent respiratory, vascular, and visceral complications. Measurement of the IAP has recently become a common practice in monitoring critical patients, even though such measurements were obtained in the early 1900s. PATIENTS AND METHODS A prospective study involving 54 patients undergoing elective abdominal wall gap repair (mean length, 17.4 cm) with a tension-free technique after incisional hernia was conducted. The purpose of the study was to determine whether or not urinary pressure for indirect IAP measurement is a reliable method for the early identification of patients with a higher risk of developing ACS. IAP measurements were performed using a Foley catheter connected to a HOLTECH® medical manometer. IAP values were determined preoperatively, after anesthetic induction, upon patient awakening, upon patient arrival in the ward after surgery, and 24 h after surgery before removing the catheter. All patients were treated by the same surgical team using a prosthetic composite mesh (PARIETEX®). RESULTS Incisional hernia repair caused an increase in the mean IAP score of 2.68 mmHg in 47 of 54 patients (87.04%); the IAP was decreased in two patients (3.7%) and remained equal in five patients before and 24 h after surgery (9.26%). FEV-1, measured 24 h after surgery, increased in 50 patients (92.6%), remained stable in two patients (3.7%), and decreased in two patients (3.7%). The mean increase in FEV-1 was 0.0676 L (maximum increase = 0.42 L and minimum increase = 0.01 L) in any patient who developed ACS. CONCLUSIONS Measurement of urinary bladder pressure has been shown to be easy to perform and free of complications. Measurement of urinary bladder pressure can also be a useful tool to identify patients with a higher risk of developing ACS.
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Illuminati G, Calio' FG, Pizzardi G, Amatucci C, Masci F, Palumbo P. Fondaparinux for intra and perioperative anticoagulation in patients with heparin-induced thrombocytopenia candidates for peripheral vascular surgery: Report of 4 cases. Int J Surg Case Rep 2016; 28:251-254. [PMID: 27750177 PMCID: PMC5067092 DOI: 10.1016/j.ijscr.2016.10.013] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/05/2016] [Accepted: 10/05/2016] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Intra and perioperative anticoagulation in patients with heparin induced thrombocytopenia (HIT), candidates for peripheral vascular surgery remains a challenge, as the best alternative to heparin has not yet been established. We evaluated the off-label use of fondaparinux in four patients with HIT, undergoing peripheral vascular surgery procedures. PRESENTATION OF CASES Four patients of whom 3 men of a mean age of 66 years, with proven heparin induced thrombocytopenia (HIT) underwent two axillo-femoral bypasses, one femoro-popliteal bypass and one resection of a splenic artery aneurysm under fondaparinux. No intra or perioperative bleeding or thrombosis of new onset was observed. DISCUSSION In the absence of a valid alternative to heparin for intra and perioperative anticoagulation in HIT, several other anticoagulants can be used in an off-label setting. However, no general consensus exist on which should be the one of choice. In this small series fondaparinux appeared to be both safe and effective. CONCLUSIONS These preliminary results seem to justify the off-label use of fondaparinux for intra and perioperative anticoagulation in patients with HIT, candidates for peripheral vascular surgery interventions.
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Affiliation(s)
- Giulio Illuminati
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy.
| | - Francesco G Calio'
- The Department of Vascular Surgery, Sant'Anna Hospital, Catanzaro, Italy
| | - Giulia Pizzardi
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - Chiara Amatucci
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - Federica Masci
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - Piergaspare Palumbo
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
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Illuminati G, Carboni F, Ceccanei G, Pacilè M, Pizzardi G, Palumbo P, Vietri1 F. Long-term Evaluation of a Modified Double Staple Technique for Low Anterior Resection. Acta Chir Belg 2016. [DOI: 10.1080/00015458.2014.11681038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- G. Illuminati
- The “F. Durante” Department of Surgery, the University of Rome “La Sapienza”; Italy
| | - F. Carboni
- Department of Digestive Surgery, Regina Elena Cancer Institute, Rome, Italy
| | - G. Ceccanei
- The “F. Durante” Department of Surgery, the University of Rome “La Sapienza”; Italy
| | - M.A. Pacilè
- The “F. Durante” Department of Surgery, the University of Rome “La Sapienza”; Italy
| | - G. Pizzardi
- The “F. Durante” Department of Surgery, the University of Rome “La Sapienza”; Italy
| | - P. Palumbo
- The “F. Durante” Department of Surgery, the University of Rome “La Sapienza”; Italy
| | - F. Vietri1
- The “F. Durante” Department of Surgery, the University of Rome “La Sapienza”; Italy
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Palumbo P, Perotti B, Amatucci C, Pangrazi MP, Leuzzi B, Vietri F, Illuminati G. Perceived quality in Day Surgery Units Proposal of an enquiry postoperative questionnaire. Ann Ital Chir 2016; 87:172-176. [PMID: 27179308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Assessing patient satisfaction could be particularly useful in Day Surgery Units, as it helps maintaining and increasing medical care demand. Moreover, it provides feedback that turns out useful for improving quality in departments, and for assessing competence and skill of the whole staff. Background and aim - The purpose of this study was to evaluate the quality perceived in a day surgery unit through a questionnaire, covering the 10 main aspects of the care pathway. MATERIALS AND METHODS The results of a questionnaire filled by patients undergoing Day Surgery between January 2007 and December 2012 were retrospectively reviewed. Patients undergoing surgery between 2007 and 2009 filled up the questionnaire at the time of the discharge, whereas those operated on between 2009 and 2012 filled up the same questionnaire 30 days after discharge. RESULTS The results were good in terms of number of returned questionnaires, underlining its comprehensibility and suitability to be filled out. The questionnaires' scores were good in both groups, although quality perceived by the group that completed it in 30 days after surgery were lightly better than the other group's. CONCLUSIONS The advantages of the questionnaire consisted of an overall improvement of the quality of care, whereas limitations consisted of the difficulty in setting up the questionnaire accurately, interpreting patients' answers correctly, and dispensing the questionnaire in a timely fashion, in order to evaluate the quality perceived by the patients without any bias related to delay, pain and anxiety. KEY WORDS Day Surgery, Nursing, Questionnaire, Quality.
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Fulle M, Corte VD, Rotundi A, Weissman P, Juhasz A, Szego K, Sordini R, Ferrari M, Ivanovski S, Lucarelli F, Accolla M, Merouane S, Zakharov V, Epifani EM, Moreno JJL, Rodríguez J, Colangeli L, Palumbo P, Grün E, Hilchenbach M, Bussoletti E, Esposito F, Green SF, Lamy PL, McDonnell JAM, Mennella V, Molina A, Morales R, Moreno F, Ortiz JL, Palomba E, Rodrigo R, Zarnecki JC, Cosi M, Giovane F, Gustafson B, Herranz ML, Jerónimo JM, Leese MR, Jiménez ACL, Altobelli N. DENSITY AND CHARGE OF PRISTINE FLUFFY PARTICLES FROM COMET 67P/CHURYUMOV–GERASIMENKO. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/2041-8205/802/1/l12] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Capaccioni F, Coradini A, Filacchione G, Erard S, Arnold G, Drossart P, De Sanctis MC, Bockelee-Morvan D, Capria MT, Tosi F, Leyrat C, Schmitt B, Quirico E, Cerroni P, Mennella V, Raponi A, Ciarniello M, McCord T, Moroz L, Palomba E, Ammannito E, Barucci MA, Bellucci G, Benkhoff J, Bibring JP, Blanco A, Blecka M, Carlson R, Carsenty U, Colangeli L, Combes M, Combi M, Crovisier J, Encrenaz T, Federico C, Fink U, Fonti S, Ip WH, Irwin P, Jaumann R, Kuehrt E, Langevin Y, Magni G, Mottola S, Orofino V, Palumbo P, Piccioni G, Schade U, Taylor F, Tiphene D, Tozzi GP, Beck P, Biver N, Bonal L, Combe JP, Despan D, Flamini E, Fornasier S, Frigeri A, Grassi D, Gudipati M, Longobardo A, Markus K, Merlin F, Orosei R, Rinaldi G, Stephan K, Cartacci M, Cicchetti A, Giuppi S, Hello Y, Henry F, Jacquinod S, Noschese R, Peter G, Politi R, Reess JM, Semery A. Cometary science. The organic-rich surface of comet 67P/Churyumov-Gerasimenko as seen by VIRTIS/Rosetta. Science 2015; 347:aaa0628. [PMID: 25613895 DOI: 10.1126/science.aaa0628] [Citation(s) in RCA: 266] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The VIRTIS (Visible, Infrared and Thermal Imaging Spectrometer) instrument on board the Rosetta spacecraft has provided evidence of carbon-bearing compounds on the nucleus of the comet 67P/Churyumov-Gerasimenko. The very low reflectance of the nucleus (normal albedo of 0.060 ± 0.003 at 0.55 micrometers), the spectral slopes in visible and infrared ranges (5 to 25 and 1.5 to 5% kÅ(-1)), and the broad absorption feature in the 2.9-to-3.6-micrometer range present across the entire illuminated surface are compatible with opaque minerals associated with nonvolatile organic macromolecular materials: a complex mixture of various types of carbon-hydrogen and/or oxygen-hydrogen chemical groups, with little contribution of nitrogen-hydrogen groups. In active areas, the changes in spectral slope and absorption feature width may suggest small amounts of water-ice. However, no ice-rich patches are observed, indicating a generally dehydrated nature for the surface currently illuminated by the Sun.
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Affiliation(s)
- F Capaccioni
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy.
| | - A Coradini
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - G Filacchione
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - S Erard
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - G Arnold
- Institute for Planetary Research, Deutsches Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany
| | - P Drossart
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - M C De Sanctis
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - D Bockelee-Morvan
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - M T Capria
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - F Tosi
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - C Leyrat
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - B Schmitt
- Université Grenoble Alpes, CNRS, Institut de Planétologie et d'Astrophysique de Grenoble, Grenoble, France
| | - E Quirico
- Université Grenoble Alpes, CNRS, Institut de Planétologie et d'Astrophysique de Grenoble, Grenoble, France
| | - P Cerroni
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - V Mennella
- Osservatorio di Capodimonte, INAF, Napoli, Italy
| | - A Raponi
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - M Ciarniello
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - T McCord
- Bear Fight Institute, Winthrop, WA 98862, USA
| | - L Moroz
- Institute for Planetary Research, Deutsches Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany
| | - E Palomba
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - E Ammannito
- University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - M A Barucci
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - G Bellucci
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - J Benkhoff
- European Space Agency (ESA), European Space Research and Technology Centre (ESTEC), Noordwijk, Netherlands
| | - J P Bibring
- Institut d'Astrophysique Spatial, CNRS, Orsay, France
| | - A Blanco
- Dipartimento di Matematica e Fisica "Ennio De Giorgi," Università del Salento, Italy
| | - M Blecka
- Space Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | - R Carlson
- NASA Jet Propulsion Laboratory, Pasadena, CA 91109, USA
| | - U Carsenty
- Institute for Planetary Research, Deutsches Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany
| | - L Colangeli
- European Space Agency (ESA), European Space Research and Technology Centre (ESTEC), Noordwijk, Netherlands
| | - M Combes
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - M Combi
- Space Physics Research Laboratory, The University of Michigan, Ann Arbor, MI 48109, USA
| | - J Crovisier
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - T Encrenaz
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | | | - U Fink
- Lunar Planetary Laboratory, University of Arizona, Tucson, AZ 85721, USA
| | - S Fonti
- Dipartimento di Matematica e Fisica "Ennio De Giorgi," Università del Salento, Italy
| | - W H Ip
- National Central University, Taipei, Taiwan
| | - P Irwin
- Departement of Physics, Oxford University, Oxford, UK
| | - R Jaumann
- Institute for Planetary Research, Deutsches Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany. Free University of Berlin, Institute of Geosciences, Malteserstraße 74-100, Building Haus A, 12249 Berlin, Germany
| | - E Kuehrt
- Institute for Planetary Research, Deutsches Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany
| | - Y Langevin
- Institut d'Astrophysique Spatial, CNRS, Orsay, France
| | - G Magni
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - S Mottola
- Institute for Planetary Research, Deutsches Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany
| | - V Orofino
- Dipartimento di Matematica e Fisica "Ennio De Giorgi," Università del Salento, Italy
| | - P Palumbo
- Università "Parthenope," Napoli, Italy
| | - G Piccioni
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - U Schade
- Helmholtz-Zentrum Berlin für Materialien und Energie, Berlin, Germany
| | - F Taylor
- Departement of Physics, Oxford University, Oxford, UK
| | - D Tiphene
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - G P Tozzi
- Osservatorio Astrofisico di Arcetri, INAF, Firenze, Italy
| | - P Beck
- Université Grenoble Alpes, CNRS, Institut de Planétologie et d'Astrophysique de Grenoble, Grenoble, France
| | - N Biver
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - L Bonal
- Université Grenoble Alpes, CNRS, Institut de Planétologie et d'Astrophysique de Grenoble, Grenoble, France
| | - J-Ph Combe
- Bear Fight Institute, Winthrop, WA 98862, USA
| | - D Despan
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - E Flamini
- Agenzia Spaziale Italiana, Rome, Italy
| | - S Fornasier
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - A Frigeri
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - D Grassi
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - M Gudipati
- NASA Jet Propulsion Laboratory, Pasadena, CA 91109, USA. Institute for Physical Science and Technology, University of Maryland, College Park, MD 20742, USA
| | - A Longobardo
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - K Markus
- Institute for Planetary Research, Deutsches Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany
| | - F Merlin
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - R Orosei
- Istituto di Radioastronomia, INAF, Bologna, Italy
| | - G Rinaldi
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - K Stephan
- Institute for Planetary Research, Deutsches Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany
| | - M Cartacci
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - A Cicchetti
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - S Giuppi
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - Y Hello
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - F Henry
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - S Jacquinod
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - R Noschese
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - G Peter
- Institut für Optische Sensorsysteme, DLR, Berlin, Germany
| | - R Politi
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Rome, Italy
| | - J M Reess
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
| | - A Semery
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris/CNRS/Université Pierre et Marie Curie[acute accent over last letter in "Université"]/Université Paris-Diderot, Meudon, France
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Illuminati G, Pizzardi G, Calio F, Pacilè MA, Carboni F, Palumbo P, Vietri F. Hemangiopericytoma of the spleen. Int J Surg 2015; 15:6-10. [PMID: 25638732 DOI: 10.1016/j.ijsu.2015.01.018] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 01/15/2015] [Accepted: 01/21/2015] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Hemangiopericytoma of the spleen is a very rare tumor, with 14 isolated reports. It was our aim to review our experience and compare it with all the reported cases in an attempt to standardize surgical treatment, adjuvant treatment and follow-up protocol of this infrequent condition. METHODS A consecutive case series study, with a mean follow-up of 44 months. Five patients (mean age, 49 years) underwent simple splenectomy for hemangiopericytoma limited to the spleen followed by adriamycin-based chemotherapy in one patient. RESULTS All the patients are alive and free from disease. CONCLUSIONS For tumors confined to the spleen, simple splenectomy can be considered curative, without any need for further adjuvant treatment. On review of the medical literature, cure can still be achieved with complete resection of recurrences, when feasible, with adjuvant chemotherapy being also indicated. The slow-growing pattern of the tumor suggests a 10-year follow-up.
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Affiliation(s)
- Giulio Illuminati
- The "F. Durante" Department of Surgical Sciences, University "La Sapienza", Rome, Italy.
| | - Giulia Pizzardi
- The "F. Durante" Department of Surgical Sciences, University "La Sapienza", Rome, Italy
| | - Francesco Calio
- The Department of Surgery, Sant'Anna Hospital, Catanzaro, Italy
| | - Maria A Pacilè
- The "F. Durante" Department of Surgical Sciences, University "La Sapienza", Rome, Italy
| | - Fabio Carboni
- The Department of Surgery, "Regina Elena" Cancer Institute, Rome, Italy
| | - Piergaspare Palumbo
- The "F. Durante" Department of Surgical Sciences, University "La Sapienza", Rome, Italy
| | - Francesco Vietri
- The "F. Durante" Department of Surgical Sciences, University "La Sapienza", Rome, Italy
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Palumbo P, Pizzichelli G, Panunzi S, Pepe P, De Gaetano A. Model-based control of plasma glycemia: Tests on populations of virtual patients. Math Biosci 2014; 257:2-10. [PMID: 25223234 DOI: 10.1016/j.mbs.2014.09.003] [Citation(s) in RCA: 20] [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: 02/28/2014] [Revised: 06/26/2014] [Accepted: 09/01/2014] [Indexed: 11/27/2022]
Abstract
Closed-loop devices delivering medical treatments in an automatic fashion clearly require a thorough preliminary phase according to which the proposed control law is tested and validated as realistically as possible, before arranging in vivo experiments in a clinical setting. The present note develops a virtual environment aiming to validate a recently proposed model-based glucose control law on a solid simulation framework. From a theoretical viewpoint, the artificial pancreas has been designed by suitably exploiting a minimal set of delay differential equations modeling the glucose-insulin regulatory system; on the other hand, the validation platform makes use of a different, multi-compartmental model to build up a population of virtual patients. Simulations are carried out by properly addressing the available technological limits and the unavoidable uncertainties in real-time continuous glucose sensors as well as possible malfunctioning on the insulin delivery devices. The results show the robustness of the proposed control law that turns out to be efficient and extremely safe on a heterogenous population of virtual patients.
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Affiliation(s)
- P Palumbo
- Istituto di Analisi dei Sistemi ed Informatica "A. Ruberti", Consiglio Nazionale delle Ricerche (IASI-CNR), BioMatLab - UCSC - Largo A. Gemelli 8, 00168 Roma, Italy.
| | - G Pizzichelli
- Istituto Italiano di Tecnologia, Center for Micro-BioRobotics@SSSA, Viale R. Piaggio 34, 56025 Pontedera, Italy; Scuola Superiore Sant'Anna, The BioRobotics Institute, Viale R. Piaggio 34, 56025 Pontedera, Italy
| | - S Panunzi
- Istituto di Analisi dei Sistemi ed Informatica "A. Ruberti", Consiglio Nazionale delle Ricerche (IASI-CNR), BioMatLab - UCSC - Largo A. Gemelli 8, 00168 Roma, Italy
| | - P Pepe
- Università degli Studi dellAquila, 67040 Poggio di Roio, L'Aquila, Italy
| | - A De Gaetano
- Istituto di Analisi dei Sistemi ed Informatica "A. Ruberti", Consiglio Nazionale delle Ricerche (IASI-CNR), BioMatLab - UCSC - Largo A. Gemelli 8, 00168 Roma, Italy
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Illuminati G, Carboni F, Ceccanei G, Pacilè MA, Pizzardi G, Palumbo P, Vietri F. Long-term Evaluation of a Modified Double Staple Technique for Low Anterior Resection. Acta Chir Belg 2014; 114:338-343. [PMID: 26021539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND When performing low anterior resection for rectal cancer with the double staple technique, -closing the rectum with a linear stapler in the abdomen can be challenging, especially when dealing with a narrow pelvis. For such instances we proposed to modify this technique by pulling the rectal stump through the anus, doing an extra-anal resection of the tumor and linear suture of the rectal stump, before performing a standard, stapled colorectal anastomosis. The purpose of this study was to assess the adequacy of this modification of the double staple technique. METHODS Retrospective review of 108 patients undergoing a stapled, low colorectal or coloanal anastomosis, after -eversion, extra-anal resection of the tumor and linear closure of the rectal stump for colorectal cancer, from January 1990 to December 2012. RESULTS Operative mortality was 0.9%. Fourteen patients (13%) presented early, surgery-related complications -consisting of 7 anastomotic leaks, 5 wound infections, 1 ureteral lesion, and 1 peristomal abscess. Late complications related to surgery included 5 incisional hernias (4.6%), 4 anastomotic strictures (3.7%), 4 neurogenic bladders (3.7%) and 2 fecal incontinences (1.8%). The incidence of local disease recurrence was 10%. CONCLUSIONS Surgical and oncological results validate the proposed modification of the double staple technique, when facing difficulties in suturing the rectum from the abdomen.
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Affiliation(s)
- G Illuminati
- The "F. Durante" Department of Surgery, the University of Rome "La Sapienza", Rome, Italy
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Marini S, Caruso A, Falcini M, Palumbo P, Pantoni L. Listeria monocytogenes brainstem infection (rhombencephalitis) mimicking ischemic stroke. J Clin Neurosci 2014; 21:2006-8. [PMID: 24961733 DOI: 10.1016/j.jocn.2014.03.021] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 03/10/2014] [Indexed: 11/25/2022]
Abstract
The frequency of Listeria monocytogenes (Lm) infection of the central nervous system is increasing. We report a patient recently treated with chemotherapeutic drugs for pulmonary adenocarcinoma who suddenly developed hemiparesis, was initially diagnosed with stroke, and was then found to be affected by Lm rhombencephalitis accompanied by a brain abscess. Lm meningoencephalitis mimicking ischemic stroke is rare but must be considered, especially in specific patients.
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Affiliation(s)
- S Marini
- Neuroscience Section, NeuroFARBA Department, University of Florence, Florence, Italy
| | - A Caruso
- Unità operativa degenza cerebrovascolare, Nuovo Ospedale di Prato, Italy
| | - M Falcini
- Unità operativa degenza cerebrovascolare, Nuovo Ospedale di Prato, Italy
| | - P Palumbo
- Unità operativa degenza cerebrovascolare, Nuovo Ospedale di Prato, Italy
| | - L Pantoni
- Stroke Unit and Neurology, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, Florence 50134, Italy.
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Palumbo O, Mattina T, Palumbo P, Carella M, Perrotta CS. A de novo 11p13 Microduplication in a Patient with Some Features Invoking Silver-Russell Syndrome. Mol Syndromol 2013; 5:11-8. [PMID: 24550760 DOI: 10.1159/000356459] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2013] [Indexed: 01/10/2023] Open
Abstract
Patients with Silver-Russell syndrome (SRS) show an intrauterine and postnatal growth restriction associated with a variable spectrum of additional features. Genetic or epigenetic alterations on chromosomes 7 and 11 can be detected in several SRS patients; however, a large fraction of cases remains with unknown genetic etiology. Here, we describe the clinical and molecular findings of a patient with a phenotype invoking SRS showing intrauterine and postnatal growth retardation, psychomotor retardation, relative macrocephaly, slightly triangular face with pointed chin, clinodactyly, and a slight body asymmetry, in whom single-nucleotide polymorphism oligonucleotide array analysis led to the identification of a de novo 11p13 duplication containing many genes that could be functionally related with the observed clinical features. Many deletions of chromosome 11p13, resulting in WAGR (Wilms tumor, aniridia, genital anomalies, mental retardation) syndrome, have been described, while only few duplications spanning the same region have been reported so far. To our knowledge, this is the first reported case presenting a SRS carrier of an 11p13 duplication. We propose candidate genes for the observed traits, and in particular, we discuss the possible role of the involvement of 2 noncoding RNAs in the etiology of the phenotype.
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Affiliation(s)
- O Palumbo
- Medical Genetics Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - T Mattina
- Department of Pediatrics, Medical Genetics University of Catania, Catania, Italy
| | - P Palumbo
- Medical Genetics Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy ; Department of Biology, University of Bari, Bari, Italy
| | - M Carella
- Medical Genetics Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - C S Perrotta
- Medical Genetics Unit, P.O. Vittorio Emanuele III, Gela, Italy
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Palumbo P, Tellan G, Perotti B, Pacilè MA, Vietri F, Illuminati G. Modified PADSS (Post Anaesthetic Discharge Scoring System) for monitoring outpatients discharge. Ann Ital Chir 2013; 84:661-665. [PMID: 23165318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The decision to discharge a patient undergoing day surgery is a major step in the hospitalization pathway, because it must be achieved without compromising the quality of care, thus ensuring the same assistance and wellbeing as for a long-term stay. Therefore, the use of an objective assessment for the management of a fair and safe discharge is essential. The authors propose the Post Anaesthetic Discharge Scoring System (PADSS), which considers six criteria: vital signs, ambulation, nausea/vomiting, pain, bleeding and voiding. Each criterion is given a score ranging from 0 to 2. Only patients who achieve a score of 9 or more are considered ready for discharge. Furthermore, PADSS has been modified to ensure a higher level of safety, thus the "vital signs" criteria must never score lower than 2, and none of the other five criteria must ever be equal to 0, even if the total score reaches 9. The effectiveness of PADSS was analyzed on 2432 patients, by recording the incidence of postoperative complications and the readmission to hospital. So far PADDS has proved to be an efficient system that guarantees safe discharge.
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Illuminati G, Ceccanei G, Pacilè MA, Pizzardi G, Palumbo P, Vietri F. Colorectal cancer associated with abdominal aortic aneurysm: results of EVAR followed by colectomy. Ann Ital Chir 2013; 84:579-582. [PMID: 23151840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The association of colorectal cancer and abdominal aortic aneurysm (AAA) is infrequent but poses special problems of priority of treatment under elective circumstances. The purpose of this study was to retrospectively evaluate the outcome of 16 consecutive patients undergoing endovascular aneurysm repair (EVAR) followed by colectomy. Operative mortality was nil. Operative morbidity included two transient rise of serum creatinine level and one extraperitoneal anastomotic leakage which evolved favourably with conservative treatment. EVAR allowed a very short delay of treatment of colorectal cancer after aneurysm repair, minimizing operative complications.
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Illuminati G, Pacilè MA, Palumbo P, Salvatori FM, Vietri F. Endovascular treatment of false-aneurysm ten years after dacron patch aortoplasty for coarctation of the aortic isthmus. Report of a case. Ann Ital Chir 2013; 84:463-466. [PMID: 23080212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
False aneurysm degeneration is a known complication of patch aortoplasty for coarctation of the aortic isthmus. Open surgical treatment consists of prosthetic graft repair of the involved aorta, often requires circulatory arrest to achieve a safe proximal aortic control and perform proximal anastomosis, and finally is associated with substantial perioperative morbidity. Endografting of the diseased aorta is a valuable alternative to open repair, when feasible, with good short and long term results. We now report one more case of false aneurysm ten years after Dacron patch aortoplasty for isthmic coarctation in a 26-year-old woman, successfully treated by endovascular repair via the left common iliac artery, and a complete exclusion of the aneurysm at two year follow-up.
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Illuminati G, Ceccanei G, Pacilè MA, Pizzardi G, Palumbo P, Vietri F. Dual antiplatelet treatment in patients candidates for abdominal surgery. Ann Ital Chir 2013; 84:291-294. [PMID: 23103787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED With the increasing diffusion of percutaneous interventions (PCI), surgeons are often faced with the problem of operating on patients under dual antiplatelet treatment. Replacing dual antiplatelet regiment with low molecular weight heparin may expose to the abrupt thrombosis of coronary stent and massive myocardial infarction. The purpose of this study was to test the hypothesis that abdominal operations can be safely performed under dual antiplatelet treatment. Eleven patients underwent 5 colectomies, 3 nefrectomies, 2 gastrectomies and 1 hysterectomy under aspirin and plavix without any significant perioperative hemorrhage. These preliminary results show that abdominal operations can be safely performed under dual antiplatelet regimen. KEY WORDS Abdominal surgery, Dual antiplatelet treatment.
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Affiliation(s)
- Giulio Illuminati
- Francesco Durante Dept. of Surgery, University of Rome La Sapienza, Rome, Italy.
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Palumbo P, Amatucci C, Perotti B, Dezzi C, Girolami M, Illuminati G, Angelici AM. The Lynch syndrome: a management dilemma. Anticancer Res 2013; 33:2147-2152. [PMID: 23645768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The case of a familial Lynch syndrome is reported. The criteria for early diagnosis, management and surveillance are briefly reviewed. A germline mutation of genes responsible for mismatch repair is at the basis of the Lynch syndrome. Carriers are predisposed to colorectal cancer and other tumors. Two members of the presently reported family developed colorectal cancer, whereas two others developed other neoplasms. The syndrome was confirmed in members of the same family with appropriate genetic workup. Clinical examination and endoscopy were consequently scheduled once-a-year. Given the high risk of neoplastic disease, such yearly controls can be proposed as the standard follow-up of this condition.
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Affiliation(s)
- Piergaspare Palumbo
- "R. Paolucci" Department of Surgery, The University of Rome "La Sapienza", Viale del Policlinico 155, 00161 Rome, Italy.
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