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Hamel R, Peruzzotti-Jametti L, Ridley K, Testa V, Yu B, Rowitch D, Marioni JC, Pluchino S. Time-resolved single-cell RNAseq profiling identifies a novel Fabp5+ subpopulation of inflammatory myeloid cells with delayed cytotoxic profile in chronic spinal cord injury. Heliyon 2023; 9:e18339. [PMID: 37636454 PMCID: PMC10450865 DOI: 10.1016/j.heliyon.2023.e18339] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 07/09/2023] [Accepted: 07/13/2023] [Indexed: 08/29/2023] Open
Abstract
Traumatic spinal cord injuries (SCI) are a group of highly debilitating pathologies affecting thousands annually, and adversely affecting quality of life. Currently, no fully restorative therapies exist, and SCI still results in significant personal, societal and financial burdens. Inflammation plays a major role in the evolution of SCI, with myeloid cells, including bone marrow derived macrophages (BMDMs) and microglia (MG) being primary drivers of both early secondary pathogenesis and delayed wound healing events. The precise role of myeloid cell subsets is unclear as upon crossing the blood-spinal cord barrier, infiltrating bone marrow derived macrophages (BMDMs) may take on the morphology of resident microglia, and upregulate canonical microglia markers, thus making the two populations difficult to distinguish. Here, we used time-resolved scRNAseq and transgenic fate-mapping to chart the transcriptional profiles of tissue-resident and -infiltrating myeloid cells in a mouse model of thoracic contusion SCI. Our work identifies a novel subpopulation of foam cell-like inflammatory myeloid cells with increased expression of Fatty Acid Binding Protein 5 (Fabp5) and comprise both tissue-resident and -infiltrating cells. Fabp5+ inflammatory myeloid cells display a delayed cytotoxic profile that is predominant at the lesion epicentre and extends into the chronic phase of SCI.
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Affiliation(s)
- Regan Hamel
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Luca Peruzzotti-Jametti
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | | | - Veronica Testa
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Bryan Yu
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - David Rowitch
- Cambridge Stem Cell Institute, University of Cambridge, UK
| | - John C. Marioni
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, UK
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK
| | - Stefano Pluchino
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
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Zanfardino A, Piscopo A, Gizzone P, Vitulano C, Di Gennaro F, Buccella G, Fabozzi I, Mainolfi G, Marongiu MB, Rollato AS, Testa V, Chianese A, Miraglia Del Giudice E, Troncone A, Iafusco D. Adolescents with type 1 diabetes vs. hybrid closed loop systems: a case series of patients' behaviour that challenges the algorithm. J Pediatr Endocrinol Metab 2023; 36:216-222. [PMID: 36511758 DOI: 10.1515/jpem-2022-0411] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/17/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Hybrid closed loop systems (HCL) improve the management of type 1 diabetes (T1DM). T1DM adolescent patients represent a risk category also if they are in an automated insulin infusion delivery therapy. CASE PRESENTATION We describe a series of four cases in which adolescent patients have adopted incorrect behaviours in the managing of HCL systems, challenging the algorithm skills. Two patients performed fabricated sensor calibrations. The other two did not perform pre-prandial insulin boluses correctly. Despite these behaviours, the algorithm corrected the glucose values in three out of four patients. Only in one case, where fabricated calibrations were too frequent, the automatic system failed to restore the glycemic balance. CONCLUSIONS Fabricated calibrations seem to be more important than uncorrected insulin boluses to challenge the HCL systems.
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Affiliation(s)
- Angela Zanfardino
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Alessia Piscopo
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Pietro Gizzone
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Caterina Vitulano
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Federica Di Gennaro
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Giulia Buccella
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Irma Fabozzi
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Gabriella Mainolfi
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Mariagrazia Bathilde Marongiu
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Assunta S Rollato
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Veronica Testa
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Antonietta Chianese
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Emanuele Miraglia Del Giudice
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Alda Troncone
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Dario Iafusco
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
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Zanfardino A, Piscopo A, Curto S, Schiaffini R, Rollato AS, Testa V, Miraglia Del Giudice E, Barbetti F, Iafusco D. Very low birth weight newborn with diabetes mellitus due to pancreas agenesis managed with insulin pump reservoir filled with undiluted insulin: 16-month follow-up. Diabetes Metab Syndr 2022; 16:102561. [PMID: 35809554 DOI: 10.1016/j.dsx.2022.102561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/27/2022] [Accepted: 06/27/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND When very low doses of insulin are used insulin dilution, a procedure prone to errors, is recommended. CASE PRESENTATION We managed a neonate with pancreas agenesis with insulin pump therapy from the first days of life to 16 months of age without insulin dilution. Predictive low glucose suspend mode first and then closed loop control were used. No episodes of severe hypoglycemia were observed. CONCLUSIONS Though limited to a single patient with pancreas agenesis we believe that the use of pump should be warranted in patients with permanent neonatal diabetes mellitus and intestinal malabsorption, even with undiluted insulin.
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Affiliation(s)
- Angela Zanfardino
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of the Study of Campania, via Sant'Andrea delle Dame,4, Naples, 80138, Italy.
| | - Alessia Piscopo
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of the Study of Campania, via Sant'Andrea delle Dame,4, Naples, 80138, Italy
| | - Stefano Curto
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of the Study of Campania, via Sant'Andrea delle Dame,4, Naples, 80138, Italy
| | | | - Assunta S Rollato
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of the Study of Campania, via Sant'Andrea delle Dame,4, Naples, 80138, Italy
| | - Veronica Testa
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of the Study of Campania, via Sant'Andrea delle Dame,4, Naples, 80138, Italy
| | - Emanuele Miraglia Del Giudice
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of the Study of Campania, via Sant'Andrea delle Dame,4, Naples, 80138, Italy
| | - Fabrizio Barbetti
- Department of Experimental Medicine, Tor Vergata University, Rome, 00133, Italy; Clinical Laboratory Unit, Bambino Gesù Children's Hospital, Rome, 00163, Italy
| | - Dario Iafusco
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of the Study of Campania, via Sant'Andrea delle Dame,4, Naples, 80138, Italy
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Viola P, Testa V, Ferro Desideri L, Di Cello L, Rutigliani C, Vagge A, Nicolò M, Cian R, Traverso CE. Aflibercept, ranibizumab and bevacizumab upcoming biosimilars: a general overview. Drugs Today (Barc) 2021; 57:689-697. [PMID: 34821882 DOI: 10.1358/dot.2021.57.11.3331006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Anti-vascular endothelial growth factors currently are the first-line treatment option for neovascular age-related macular degeneration (nAMD) and other retinal vascular disorders, and their clinical use is associated with high financial burden. Biosimilars are a type of biological product highly similar to referral biologic drugs; they are increasing competition among biologics and have the potential to reduce the overall expenditures on biologics. In this comprehensive literature review, the current investigational biosimilars acting on retinal diseases are discussed. The authors review the results of clinical studies and highlight ongoing trials. Several biosimilar candidates are under evaluation and the pipeline will rapidly change in the future, as soon as each patent expires. Clinicians have to know these new therapeutic agents, which might come in the mainstream clinical practice as a more cost-efficient option.
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Affiliation(s)
- P Viola
- Ospedale San Bortolo, Vicenza, Italy
| | - V Testa
- Ospedale San Bortolo, Vicenza, Italy
| | - L Ferro Desideri
- Eye Clinic, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,University Eye Clinic of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - L Di Cello
- Eye Clinic, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,University Eye Clinic of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - C Rutigliani
- IRCCS Ospedale San Raffaele, University Vita-Salute, Milan, Italy
| | - A Vagge
- Eye Clinic, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,University Eye Clinic of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - M Nicolò
- Eye Clinic, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,University Eye Clinic of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - R Cian
- Ospedale San Bortolo, Vicenza, Italy
| | - C E Traverso
- Eye Clinic, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,University Eye Clinic of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Troncone A, Chianese A, Zanfardino A, Cascella C, Piscopo A, Borriello A, Rollato S, Casaburo F, Testa V, Iafusco D. Disordered eating behaviors in youths with type 1 diabetes during COVID-19 lockdown: an exploratory study. J Eat Disord 2020; 8:76. [PMID: 33292623 PMCID: PMC7708884 DOI: 10.1186/s40337-020-00353-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/20/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Recent research indicates that patients with type 1 diabetes (T1D) are at higher risk for disordered eating behaviors (DEBs) than their peers without diabetes. The present study aimed to explore the prevalence of DEBs in a sample of Italian children and adolescents with T1D and in matched-pair healthy controls during the COVID-19 lockdown. METHODS In a cross-sectional study, 138 children and adolescents with T1D (aged 8.01-19.11 years, 65 boys) attending a Southern Italian diabetic service and 276 age- and gender-matched healthy peers voluntarily completed an online survey about eating behaviors (ChEAT and EAT-26), anthropometric characteristics, and clinical characteristics. RESULTS 8.69% (N = 12) of participants with T1D and 13.4% (N = 37) of controls had ChEAT/EAT-26 scores indicating presence of DEBs, with no differences between patients-whether children (total ChEAT score F(1, 157) = .104, p = .748) or adolescents (total EAT-26 score F(1, 255) = .135, p = .731)-and healthy peers. zBMI values were lower than those measured in the latest diabetes visit (p < .0001), while HbA1c values remained unchanged (p = .110). In both groups, adolescents had lower Oral Control scores than children (T1D: F(1, 138) = 20.411, p < .0001, η2 = .132, controls: F(1, 276) = 18.271, p < .0001, η2 = .063); additionally, gender (female) and age were found to be significant predictors of several ChEAT/EAT-26 scores. CONCLUSIONS This exploratory study suggested that children and adolescents with T1D did not experience more DEB symptoms during the COVID-19 lockdown compared to healthy controls. Results revealed DEBs as more of a female adolescent developmental issue rather than a result of the challenges of living with a chronic illness under quarantine measures. Possible effects of parental pressure on their children's eating behaviors in the context of home confinement and of using a non-diabetes-specific measure to assess DEBs are discussed.
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Affiliation(s)
- Alda Troncone
- University of Campania "Luigi Vanvitelli", Caserta, Italy.
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy.
| | - Antonietta Chianese
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy
| | - Angela Zanfardino
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
| | - Crescenzo Cascella
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy
| | - Alessia Piscopo
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
| | - Anna Borriello
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy
| | - Serena Rollato
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
| | - Francesca Casaburo
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
| | - Veronica Testa
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
| | - Dario Iafusco
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
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6
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Ferrio Desideri L, Vagge A, Testa V, Nicolò M, Traverso C. Risuteganib. Broad-spectrum integrin inhibitor, Treatment of diabetic macular edema, Treatment of dry age-related macular degeneration. DRUG FUTURE 2020. [DOI: 10.1358/dof.2020.45.9.3161236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Testa V, Ferro Desideri L, Della Giustina P, Traverso C, Iester M. An update on ripasudil for the treatment of glaucoma and ocular hypertension. Drugs Today (Barc) 2020; 56:599-608. [DOI: 10.1358/dot.2020.56.9.3178110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Zanfardino A, Confetto S, Curto S, Cocca A, Rollato AS, Zanfardino F, Troise AD, Testa V, Bologna O, Stanco M, Piscopo A, Cohen O, Miraglia Del Giudice E, Vitaglione P, Iafusco D. Demystifying the Pizza Bolus: The Effect of Dough Fermentation on Glycemic Response-A Sensor-Augmented Pump Intervention Trial in Children with Type 1 Diabetes Mellitus. Diabetes Technol Ther 2019; 21:721-726. [PMID: 31335171 DOI: 10.1089/dia.2019.0191] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Glycemia following pizza consumption is typically managed with a dual-wave insulin bolus. This study evaluated the effect of a simple bolus on glycemia following consumption of traditionally prepared pizzas with long (24 h) or short (8 h) dough fermentation periods. Research Design and Methods: On two separate evenings, children with type 1 diabetes (n = 38) receiving sensor-integrated pump therapy consumed traditionally prepared pizza with either short (pizza A) or long (pizza B) dough fermentation, and blood glucose was monitored over 11 h. A simple insulin bolus was administered 15 min preprandially. The carbohydrate and amino acid contents of the two types of pizza were analyzed by liquid chromatography and high-resolution mass spectrometry (LC-HRMS). Results: The mean (±standard deviation) time in range 3.9-10.0 mmol/L was 73.2% ± 23.2%, and 50.8% ± 26.7% of glucose measurements were within the range 3.9-7.8 mmol/L. However, during the 2 h after bolus administration, the mean time in range 3.9-7.8 mmol/L was significantly greater with pizza B than with pizza A (73.3% ± 31.5% vs. 51.8% ± 37.4%, respectively, P = 0.009), and the time in hyperglycemia (>10 mmol/L) was significantly shorter (mean percentage 6.1% ± 19.0% vs. 17.7% ± 29.8%, respectively, P = 0.019). LC-HRMS analysis showed that long fermentation was associated with a lower carbohydrate content in the pizza, and a higher amino acid content. Conclusions: Glycemia following consumption of traditionally prepared pizza can be managed using a simple bolus 15 min before eating. Glycemic control can be further improved by increasing the dough fermentation time. Study registration: NCT03748251, Clinicaltrials.gov.
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Affiliation(s)
- Angela Zanfardino
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Santino Confetto
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Stefano Curto
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Alessandra Cocca
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Assunta Serena Rollato
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Francesco Zanfardino
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Antonio Dario Troise
- Department of Agricultural Sciences, University of Naples "Federico II," Portici, Italy
| | - Veronica Testa
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Oriana Bologna
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Michela Stanco
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Alessia Piscopo
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Ohad Cohen
- Institute of Endocrinology, Ch. Sheba Medical Center, Tel Aviv University Sackler School of Medicine, Tel Aviv, Israel
| | - Emanuele Miraglia Del Giudice
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Paola Vitaglione
- Department of Agricultural Sciences, University of Naples "Federico II," Portici, Italy
| | - Dario Iafusco
- Regional Center for Pediatric Diabetes, Department of Pediatrics, University of Campania "Luigi Vanvitelli," Naples, Italy
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Maffulli N, Oliva F, Frizziero A, Nanni G, Barazzuol M, Giai Via A, Ramponi C, Brancaccio P, Lisitano G, Rizzo D, Freschi M, Galletti S, Melegati G, Pasta G, Testa V, Valent A, Del Buono A. ISMuLT skeletal muscles injuries Guidelines. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.04.2013.02] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- N. Maffulli
- Head of Department of Physical and Rehabilitation Medicine, University of Salerno, Azienda Ospedaliera San Giovanni Di Dio e Ruggi d’Aragona, Salerno, Italy Centre for Sports and Exercise Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Mile End Hospital, London, UK
| | - F. Oliva
- Department of Orthopaedics and Traumatology, University of Rome ‘Tor Vergata’ School of Medicine, Rome, Italy
| | - A. Frizziero
- Department of Orthopaedic Rehabilitation, University of Padova School of Medicine, Italy
| | - G. Nanni
- Isokinetic Medical Group, Head of the Medical Staff of Bologna Football Club 1909, Bologna, Italy
| | - M. Barazzuol
- Department of Orthopaedic Rehabilitation, University of Padova School of Medicine, Italy
| | - A. Giai Via
- Department of Orthopaedics and Traumatology, University of Rome ‘Tor Vergata’ School of Medicine, Rome, Italy
| | - C. Ramponi
- Sport Physical Therapist, Kinè Physiotherapic Center, Conegliano, Italy
| | - P. Brancaccio
- Sports Medicine Unit, II University of Naples, Italy
| | - G. Lisitano
- Head of Kinecenter Rehabilitation Center, Messina, Italy
| | - D. Rizzo
- Isokinetic Medical Group, Medical Staff of Bologna Football Club 1909 Youth Department, Bologna, Italy
| | - M. Freschi
- Isokinetic Medical Group, Medical Staff of AC Milan, Italy
| | - S. Galletti
- Muscoloskeletal Interventional Sonographic Unit, Casa di Cura Toniolo, Bologna, Italy
| | - G. Melegati
- Rehabilitation I Unit, Center for Sports Rehabilitation, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
| | - G. Pasta
- Head of Radiology Unit Parma Football Club, Italy
| | - V. Testa
- Olympic Center, Sports Medicine Unit, Angri, Salerno, Italy
| | - A. Valent
- Head of the Rehabilitation Unit “Riacef Clinic” Spezzano, Modena, Italy
| | - A. Del Buono
- Department of Orthopaedic and Trauma Surgery Hospital Antonio Cardarelli, Campobasso, Italy
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Parisi S, Aragno V, Testa V, Scarati M, Priora M, Machetta F, Peroni C, D'Antico S, Fusaro E, Caporali R, Montecucco C. SAT0326 Efficacy and Safety of Autologous Platelet Lysate Eye Drops in Sjögren's Syndrome: A New Approach. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Landoni G, Pieri M, Testa V, Silvetti S, Zambon M, Borghi G, Azzolini M, Di Prima AL, Nobile L, Lembo R, Zangrillo A. Intrathecal lactate to predict spinal cord ischemia in major abdominal surgery. Crit Care 2014. [PMCID: PMC4069986 DOI: 10.1186/cc13639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Maffulli N, Del Buono A, Testa V, Capasso G, Oliva F, Denaro V. Safety and outcome of surgical debridement of insertional Achilles tendinopathy using a transverse (Cincinnati) incision. J Bone Joint Surg Br 2012. [PMID: 22058302 DOI: 10.1302/0301-620x.93b10.27379] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This is a prospective analysis on 30 physically active individuals with a mean age of 48.9 years (35 to 64) with chronic insertional tendinopathy of the tendo Achillis. Using a transverse incision, the tendon was debrided and an osteotomy of the posterosuperior corner of the calcaneus was performed in all patients. At a minimum post-operative follow-up of three years, the Victorian Institute of Sports Assessment scale-Achilles tendon scores were significantly improved compared to the baseline status. In two patients a superficial infection of the wound developed which resolved on antibiotics. There were no other wound complications, no nerve related complications, and no secondary avulsions of the tendo Achillis. In all, 26 patients had returned to their pre-injury level of activity and the remaining four modified their sporting activity. At the last appointment, the mean pain threshold and the mean post-operative tenderness were also significantly improved from the baseline (p < 0.001). In patients with insertional tendo Achillis a transverse incision allows a wide exposure and adequate debridement of the tendo Achillis insertion, less soft-tissue injury from aggressive retraction and a safe osteotomy of the posterosuperior corner of the calcaneum.
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Affiliation(s)
- N Maffulli
- Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK.
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13
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Maffulli N, Del Buono A, Testa V, Capasso G, Oliva F, Denaro V. Safety and outcome of surgical debridement of insertional Achilles tendinopathy using a transverse (Cincinnati) incision. ACTA ACUST UNITED AC 2011; 93:1503-7. [DOI: 10.1302/0301-620x.93b11.27379] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This is a prospective analysis on 30 physically active individuals with a mean age of 48.9 years (35 to 64) with chronic insertional tendinopathy of the tendo Achillis. Using a transverse incision, the tendon was debrided and an osteotomy of the posterosuperior corner of the calcaneus was performed in all patients. At a minimum post-operative follow-up of three years, the Victorian Institute of Sports Assessment scale – Achilles tendon scores were significantly improved compared to the baseline status. In two patients a superficial infection of the wound developed which resolved on antibiotics. There were no other wound complications, no nerve related complications, and no secondary avulsions of the tendo Achillis. In all, 26 patients had returned to their pre-injury level of activity and the remaining four modified their sporting activity. At the last appointment, the mean pain threshold and the mean post-operative tenderness were also significantly improved from the baseline (p < 0.001). In patients with insertional tendo Achillis a transverse incision allows a wide exposure and adequate debridement of the tendo Achillis insertion, less soft-tissue injury from aggressive retraction and a safe osteotomy of the posterosuperior corner of the calcaneum.
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Affiliation(s)
- N. Maffulli
- Centre for Sports and Exercise Medicine,
Mile End Hospital, 275 Bancroft Road, London
E1 4DG, UK
| | - A. Del Buono
- Department of Orthopaedic and Trauma Surgery,
Campus Biomedico University of Rome, Via
Alvaro del Portillo 200, 00128 Rome, Italy
| | - V. Testa
- Department of Sports Traumatology, Olympic
Centre, Via dei Goti, 1-84012
Angri, Italy
| | - G. Capasso
- Department of Orthopaedics and Traumatology, Second
University of Napoli, Via Luigi De Crecchio, 4-80138
Napoli, Italy
| | - F. Oliva
- Department of Orthopaedic and Trauma Surgery,
University of Rome, Tor Vergata 1, 00155
Rome, Italy
| | - V. Denaro
- Department of Orthopaedic and Trauma Surgery,
Campus Biomedico University of Rome, Via
Alvaro del Portillo 200, 00128 Rome, Italy
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Salvaterra R, Valle MD, Campana S, Chincarini G, Covino S, D’Avanzo P, Fernández-Soto A, Guidorzi C, Mannucci F, Margutti R, Thöne CC, Antonelli LA, Barthelmy SD, De Pasquale M, D’Elia V, Fiore F, Fugazza D, Hunt LK, Maiorano E, Marinoni S, Marshall FE, Molinari E, Nousek J, Pian E, Racusin JL, Stella L, Amati L, Andreuzzi G, Cusumano G, Fenimore EE, Ferrero P, Giommi P, Guetta D, Holland ST, Hurley K, Israel GL, Mao J, Markwardt CB, Masetti N, Pagani C, Palazzi E, Palmer DM, Piranomonte S, Tagliaferri G, Testa V. GRB 090423 at a redshift of z ≈ 8.1. Nature 2009; 461:1258-60. [PMID: 19865166 DOI: 10.1038/nature08445] [Citation(s) in RCA: 358] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Accepted: 08/19/2009] [Indexed: 11/09/2022]
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15
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Racusin JL, Karpov SV, Sokolowski M, Granot J, Wu XF, Pal’shin V, Covino S, van der Horst AJ, Oates SR, Schady P, Smith RJ, Cummings J, Starling RLC, Piotrowski LW, Zhang B, Evans PA, Holland ST, Malek K, Page MT, Vetere L, Margutti R, Guidorzi C, Kamble AP, Curran PA, Beardmore A, Kouveliotou C, Mankiewicz L, Melandri A, O’Brien PT, Page KL, Piran T, Tanvir NR, Wrochna G, Aptekar RL, Barthelmy S, Bartolini C, Beskin GM, Bondar S, Bremer M, Campana S, Castro-Tirado A, Cucchiara A, Cwiok M, D’Avanzo P, D’Elia V, Valle MD, de Ugarte Postigo A, Dominik W, Falcone A, Fiore F, Fox DB, Frederiks DD, Fruchter AS, Fugazza D, Garrett MA, Gehrels N, Golenetskii S, Gomboc A, Gorosabel J, Greco G, Guarnieri A, Immler S, Jelinek M, Kasprowicz G, La Parola V, Levan AJ, Mangano V, Mazets EP, Molinari E, Moretti A, Nawrocki K, Oleynik PP, Osborne JP, Pagani C, Pandey SB, Paragi Z, Perri M, Piccioni A, Ramirez-Ruiz E, Roming PWA, Steele IA, Strom RG, Testa V, Tosti G, Ulanov MV, Wiersema K, Wijers RAMJ, Winters JM, Zarnecki AF, Zerbi F, Mészáros P, Chincarini G, Burrows DN. Broadband observations of the naked-eye γ-ray burst GRB 080319B. Nature 2008; 455:183-8. [DOI: 10.1038/nature07270] [Citation(s) in RCA: 376] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2008] [Accepted: 07/11/2008] [Indexed: 11/09/2022]
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16
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Della Valle M, Chincarini G, Panagia N, Tagliaferri G, Malesani D, Testa V, Fugazza D, Campana S, Covino S, Mangano V, Antonelli LA, D'Avanzo P, Hurley K, Mirabel IF, Pellizza LJ, Piranomonte S, Stella L. An enigmatic long-lasting γ-ray burst not accompanied by a bright supernova. Nature 2006; 444:1050-2. [PMID: 17183317 DOI: 10.1038/nature05374] [Citation(s) in RCA: 299] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2006] [Accepted: 10/25/2006] [Indexed: 11/09/2022]
Abstract
Gamma-ray bursts (GRBs) are short, intense flashes of soft gamma-rays coming from the distant Universe. Long-duration GRBs (those lasting more than approximately 2 s) are believed to originate from the deaths of massive stars, mainly on the basis of a handful of solid associations between GRBs and supernovae. GRB 060614, one of the closest GRBs discovered, consisted of a 5-s hard spike followed by softer, brighter emission that lasted for approximately 100 s (refs 8, 9). Here we report deep optical observations of GRB 060614 showing no emerging supernova with absolute visual magnitude brighter than M(V) = -13.7. Any supernova associated with GRB 060614 was therefore at least 100 times fainter, at optical wavelengths, than the other supernovae associated with GRBs. This demonstrates that some long-lasting GRBs can either be associated with a very faint supernova or produced by different phenomena.
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Affiliation(s)
- M Della Valle
- INAF, Osservatorio Astrofisico di Arcetri, largo E. Fermi 5, I-50125 Firenze, Italy.
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Sullo A, Maffulli N, Capasso G, Testa V. The effects of prolonged peritendinous administration of PGE1 to the rat Achilles tendon: a possible animal model of chronic Achilles tendinopathy. J Orthop Sci 2002; 6:349-57. [PMID: 11479765 DOI: 10.1007/s007760100031] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2000] [Accepted: 03/24/2001] [Indexed: 11/28/2022]
Abstract
We studied the effects of peritendinous Achilles tendon injections of prostaglandin E1 (PGE1) on the Achilles tendon of rats. Five groups of Sprague-Dawley rats (n = 24 each) were studied. Groups 1 to 4 received weekly peritendinous injections. In group 1, one side was injected with 800 ng of PGE1 in 0.5 ml of 0.9% NaCl and the contralateral side was injected with 0.5 ml of 0.9% NaCl. In group 2, one side was injected with 800 ng of PGE1. In group 3, one side was injected with 0.5 ml of 0.9% NaCl. In group 4, a syringe needle was inserted in the peritenon unilaterally, but no substances were administered. In groups 2, 3, and 4, the contralateral tendon was used as the control. In group 5, treatment was not administered. Eight rats in each group were killed at each time point, after 7, 21, and 35 days of treatment. On day 7, values for average water content and average wet weight of the tendons treated with PGE1 were significantly higher than those in the control tendons (analysis of variance [ANOVA]; P = 0.02), with a histological picture of acute inflammation. On day 21, approximately half of the PGE1-treated tendons showed fibrosis of the paratenon, with adhesions and intra-tendinous degeneration, with the other half still showing a picture of acute inflammation. On day 35, all of the PGE1-treated tendons showed fibrosis of the paratenon, with adhesions and intra-tendinous degeneration. At all time points, there was no evidence of pathology in the tendons that had not received PGE1. Sham peritendinous injections and injections of normal saline did not produce inflammation in the Achilles tendons. Initially, local administration of PGE1 produced acute inflammation of the tendon and its surrounding tissues. Prolonged PGE1 administration produced peri- and intra-tendinous degeneration, providing a cheap, reproducible model of Achilles tendinopathy, which would allow studies of the effects of conservative and surgical management of the condition.
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Affiliation(s)
- A Sullo
- Department of Sports Physiopathology, University of Napoli, Napoli, Italy
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Mavilio N, Pisani R, Rivano C, Testa V, Spaziante R, Rosa M. Recovery of third nerve palsy after endovascular packing of internal carotid-posterior communicating artery aneurysms. Interv Neuroradiol 2001; 6:203-9. [PMID: 20667199 DOI: 10.1177/159101990000600305] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2000] [Accepted: 08/31/2000] [Indexed: 02/02/2023] Open
Abstract
SUMMARY Endovascular packing of intracranial aneurysm with preservation of the parent vessel has become in many cases a valid alternative to surgical clipping. Regression of oculomotor disorders after clipping of internal carotid-posterior communicating artery (ICA-PCoA) aneurysms has been well assessed. This report focuses on the reversal of third nerve palsy after endovascular packing of ICA-PCoA aneurysms. To this end, clinical appearances, neuroradiological features, and endovascular interventional procedures of six treated patient are reported and discussed in the light of the very few previous case observations found in the literature. Results indicate that endovascular packing of ICA-PCoA aneurysms may produce effective recovery of correlated third nerve dysfunction.
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Affiliation(s)
- N Mavilio
- Department of Neuroradiology, San Martino Hospital; Genoa, Italy
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19
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Abstract
Thirty-eight athletes with unilateral patellar tendinopathy (17 with a tendinopathy of the main body of the tendon, and 21 with an insertional tendinopathy) underwent ultrasound-guided multiple percutaneous longitudinal tenotomy under local anaesthetic infiltration after failure of conservative management. Thirty-four patients were reviewed at least 24 months after the operation. Sixteen patients were rated excellent, nine good, eight fair, and five poor. Nine of the 13 patients with a fair or poor result had an insertional tendinopathy, and eight of them underwent a formal exploration of the patellar tendon. Before the operation, there were some areas of altered echogenicity at and around the site of involvement. These were still visible 6 wk after surgery in 70% of the patients. At the latest follow-up, in the patients with an excellent or good result, the tendon was generally isoechogenic but slightly thicker (P = 0.06) than the normal contralateral. In the patients with a fair or poor result, the tendon was significantly thicker than the contralateral (P = 0.03), and showed some areas of mixed echogenicity. In the patients in whom the procedure was successful, the thicker operated tendon did not interfere with physical training. Bilateral isokinetic peak torque (Nm), average work (Joules), and average power (Watts) were tested at 90 degrees x s(-1). Immediately before the operation, there was no significant difference in peak torque, but total work and average power were significantly lower in the limb to be operated (0.01 < P < 0.05). By the end of the study, although peak torque was, on average, within 7% of the unoperated limb, total work and average power were still significantly lower than in the unoperated limb (0.01 < P < 0.04). Percutaneous longitudinal internal tenotomy is simple, can be performed on an outpatient basis, requires minimal follow-up care, does not hinder further surgery should it be unsuccessful, and, in our experience, has produced no significant complications. In our hands, it has become the first line operative intervention in the treatment of chronic patellar tendinopathy after failure of conservative management. However, patients should be advised that, if they suffer from an tendinopathy at the attachment of the patellar tendon at the lower pole of the patella, a formal surgical exploration with stripping of the paratenon is preferable.
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Affiliation(s)
- V Testa
- Scuola di Specializzazione in Ortopedia, Istituto di Clinica Ortopedica, II Università di Napoli, Italy
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20
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Capasso G, Maffulli N, Testa V. AUTHORS REPLY. International Orthopaedics SICOT 1999. [PMCID: PMC3619800 DOI: 10.1007/pl00022766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- G. Capasso
- Via V. Emanuelle III, 50 I-80027 Frattamaggiore, Italy, , , , IT
| | - N. Maffulli
- Via V. Emanuelle III, 50 I-80027 Frattamaggiore, Italy, , , , IT
| | - V. Testa
- Via V. Emanuelle III, 50 I-80027 Frattamaggiore, Italy, , , , IT
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Abstract
A girl aged 11 years was referred to us with a medial upper right tibial exostosis. As the lesion was asymptomatic, surgery was not undertaken. The patient defaulted from follow up, and, when reviewed 32 months later, there was no clinical or radiographic evidence of the exostosis. Spontaneous involution of an exostosis may occasionally occur in childhood.
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Affiliation(s)
- G Capasso
- Instituto di Clinica Ortopedica, Seconda Università degli Studi Napoli, Italy
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22
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Affiliation(s)
- G Capasso
- Scuola di Specializzazione in Medicina dello Sport, Seconda Università degli Studi di Napoli, Italy
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23
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De Cicco M, Matovic M, Balestreri L, Fracasso A, Morassut S, Testa V. Single-needle celiac plexus block: is needle tip position critical in patients with no regional anatomic distortions? Anesthesiology 1997; 87:1301-8. [PMID: 9416713 DOI: 10.1097/00000542-199712000-00007] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The "single-needle" celiac plexus block is becoming a popular technique. Despite different approaches and methods used to place the needle, the success of the block depends on adequate spread of the injectate in the celiac area. In the present retrospective study, the influence of needle tip position in relation to the celiac artery on injectate spread was evaluated. METHODS Among 138 cancer patients subjected, via an anterior approach, to computed tomography (CT)-guided single-needle neurolytic celiac plexus block, a radiologist, blinded to the aim of the study, retrospectively selected 53 cases with normal anatomy of the celiac area as judged by CT. The decision was based on images obtained before the block. Patients were then classified into either group A (29 patients), in whom the needle tip was caudad to the celiac artery, and group B (24 patients), in whom it was cephalad. To evaluate CT patterns of neurolytic (mixed with contrast) spread, the celiac area was divided on the frontal plane into four quadrants: upper right and left and lower right and left, as related to the celiac artery. Patient assessments by visual analog scale were reviewed to evaluate the degree of pain relief. Pain relief 30 days after block was judged as long-lasting. The patterns of contrast spread in relation to the needle position and pain relief according to the number of quadrants with contrast were analyzed. RESULTS The percentage of cases with four quadrants with contrast was higher when the needle tip was cephalad (58%, group B) than when it was caudad (14%, group A) to the celiac artery (P < 0.01). The percentage of patients with four and three quadrants with contrast was also higher in group B at 79% than in group A at 38% (P < 0.01). A significant difference in long-lasting pain relief was observed between patients with four quadrants with contrast (18 of 18, 100%; 95% confidence interval [CI], 81-100%) and patients with three quadrants with contrast (5 of 12, 42%; 95% CI, 15-72%) (P < 0.01). No patients showing two or one quadrant with contrast had long-lasting pain relief. CONCLUSIONS These findings suggest that, when the celiac area is free from anatomic distortions, and the single-needle neurolytic celiac plexus block technique is used, the needle tip should be positioned cephalad to the celiac artery to achieve a wider neurolytic spread. It also appears that only a complete (four quadrants) neurolytic spread in the celiac area can guarantee long-lasting analgesia.
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Affiliation(s)
- M De Cicco
- Centro di Riferimento Oncologico, Istituto Nazionale Tumori Centroeuropeo, Aviano, Italy.
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Maffulli N, Testa V, Capasso G, Bifulco G, Binfield PM. Results of percutaneous longitudinal tenotomy for Achilles tendinopathy in middle- and long-distance runners. Am J Sports Med 1997; 25:835-40. [PMID: 9397274 DOI: 10.1177/036354659702500618] [Citation(s) in RCA: 163] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
From August 1989 to January 1995 we performed multiple percutaneous longitudinal tenotomies under local anesthetic on 52 middle- and long-distance runners with unilateral Achilles tendinitis or peritendinitis that had failed conservative treatment. Forty-eight patients were reviewed at an average of 22.1 months (SD, 6.5) after surgery. Results were rated as excellent in 25 patients, good in 12, fair in 7, and poor in 4. Four patients developed subcutaneous hematomas. One patient developed a superficial infection at one of the incision sites, which was managed by oral antibiotics with full recovery. Three patients complained of over-sensitivity to the incisions; this was resolved by rubbing hand cream over the incisions several times a day. One patient developed hypertrophic painful scars on three of the five incisions, but corticosteroid injections yielded good functional and cosmetic results. Isometric strength and endurance of the gastrocsoleus complex was measured just before the procedure, and at 6 weeks and 6 months later. Both were within 10% of the normal contralateral limb by the 6th postoperative month. Percutaneous longitudinal tenotomy is simple, can be performed on an outpatient basis, requires minimal follow-up care, and, in our experience, has produced no significant complications. We use this procedure as the operative treatment of choice for cases of chronic tendinitis that have failed conservative treatment.
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Affiliation(s)
- N Maffulli
- Department of Orthopaedic Surgery, University of Aberdeen Medical School, Scotland
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25
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Facchini U, Sesana L, Agostoni G, Testa V. [The radon risk in Lombardy]. Radiol Med 1997; 94:376-84. [PMID: 9465246] [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: 02/06/2023]
Abstract
We investigated the geographical distribution of lung cancer mortality rates in some Italian regions, Lombardy and Emilia-Romagna in particular, where the investigation was mainly focused on the risk related to the presence of radon inside dwelling-houses. We referred to the death certificates provided by the Central Institute of Statistics (ISTAT) relative to the years 1980-1988 to calculate the relevant mortality rates. Mortality rates appear higher in some northern than in southern regions and in the islands and also (> a factor of 10) in the male than in the female population; the mortality rates in the male population exhibit a linear correlation with past cigarette smoking. The death rates in the male population (age range: 35-64 years) in northern Italy average 100 events/100,000 inhabitants, but several local health centers in Lombardy at the foot of the Alpine range, north of the Po River, have mortality rates over 50% higher than estimated rates. We considered radon exposure in Lombardy dwelling-houses. The Alps are rich in granite rocks, with 50-150 Bq/kg uranium concentrations, which produce the sediments, sands and gravels making the ground of the Lombardy plain. A recent survey of indoor radon exposure levels showed average values around 100 Bq/m3. The National Academy of Sciences (Washington, DC) has presented a formula to calculate the relative risk of lung cancer related to radon exposure during a lifetime. When this model was applied to excess events in Lombardy, acceptable agreement was found with the assumption that excess deaths are ascribable to higher radon exposure levels. We also compared Lombardy with Emilia-Romagna where the sediments and soil in the plain come from the Apennine range where calcareous rocks have low uranium content. Radon exposure levels in Emilia-Romagna were around 50 Bq/m3 and the radon risk factor in this region is therefore not particularly significant.
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Affiliation(s)
- U Facchini
- Istituto di Fisica Generale Applicata, Università degli Studi di Milano.
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De Cicco M, Matovic M, Balestreri L, Panarello G, Fantin D, Morassut S, Testa V. Central venous thrombosis: an early and frequent complication in cancer patients bearing long-term silastic catheter. A prospective study. Thromb Res 1997; 86:101-13. [PMID: 9175232 DOI: 10.1016/s0049-3848(97)00054-6] [Citation(s) in RCA: 138] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Studies on catheter-related central venous thrombosis (CRCVT) have been focused mainly on clinically evident CRCVT due to occlusive thrombi, underestimating therefore the actual thrombosis prevalence. This prospective study was aimed at evaluating prevalence, timing and evolution of thrombosis, and identifying involved veins and risk factors in cancer patients (pts) undergoing percutaneous subclavian central venous catheterization (CVC) for chemotherapy, parenteral nutrition or both. We enrolled 127 consecutive pts requiring partially or totally implanted central venous silastic catheters. The study protocol included peripheral phlebography (P) at day 8, 30 and every two months following CVC and/or when clinically indicated, along with peripheral and pullout P on catheter withdrawal. A quantitative scale was developed to evaluate thrombus grading in subclavian, innominate and cava veins. Age, sex, coagulation profile tumor histotype, metastases, therapy, catheter type, and catheter insertion side were also investigated. Only pts who underwent at least two P were evaluated, and chi 2 test was adopted for statistical analysis. Altogether, 95 pts were evaluable. CRCVT was observed in 63/95 (66%) pts. At day 8, 30 and 105 (representing the median days in which first, second and last P were performed) CRCVT was evidenced in 64%, 65% and 66% of the pts, respectively. Thrombus grading did not differ among first, second and last P. CRCVT was symptomatic in 4/63 (6%) pts. Thrombosis prevalence was higher in subclavian (97%) with respect to innominate (60%) or cava (13%) veins (p < 0.001). Thrombosis was higher in left subclavian catheters (14/16; 87.5%) than in right ones (49/79; 62%), p < 0.01. No associations were established between CRCVT and other investigated parameters. Our data show a very high actual frequency of CRCVT in cancer pts, and emphasize that first days following CVC are at the highest risk for CRCVT development. Based on our results, a study on short-term antithrombotic prophylaxis in cancer pts requiring CVC is warranted. Finally, our data indicate that left subclavian vein catheterization represents a risk factor for CRCVT.
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Affiliation(s)
- M De Cicco
- Department of Anesthesiology, CRO-Istituto Nazionale Tumori Centroeuropeo, I.N.R.C.C.S., Aviano, Italy
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27
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Capasso G, Testa V, Maffulli N. Variability in Cobb angle measurements. J Bone Joint Surg Br 1996; 78:339. [PMID: 8666658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Gangemi M, Maiuri F, Donati PA, Sigona L, Testa V. Giant spinal cord ependymoma in a child. Case report. J Neurosurg Sci 1996; 40:71-5. [PMID: 8913964] [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: 02/03/2023]
Abstract
Ependymomas of the spinal cord extending to more than ten vertebral segments are rare. A case of a 14-month-old child is described and the other 13 reported cases are reviewed. The finding of a very extensive tumor (from T5 to L5) after only 14 months of life suggests that in our case the tumor was present since birth. Magnetic resonance well shows the real extent of the tumor in height and its different components. Complete removal is often possible even in very extensive ependymomas and results in clinical improvement. Postoperative radiotherapy is necessary only for incompletely removed or malignant ependymomas.
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Affiliation(s)
- M Gangemi
- Institute of Neurosurgery, School of Medicine, University Federico II, Naples, Italy
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Testa V, Maffulli N, Capasso G, Bifulco G. Percutaneous longitudinal tenotomy in chronic Achilles tendonitis. Bull Hosp Jt Dis 1996; 54:241-244. [PMID: 8731418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
In the period from August 1989 through December 1992, 42 track and field athletes with unilateral Achilles tendonitis and/or peritendinitis were operated using multiple percutaneous longitudinal tenotomy under local anesthesia following failure of conservative treatment. Patients were reviewed in a special clinic over three consecutive days at an average of 19.2 (9.4) months from the operation. Of the 42 patients operated, 36 (86%) attended. On this occasion, only subjective assessment was carried out. Of the other six patients, four were interviewed by telephone using the same questionnaire; two were lost to follow-up. The results in 25 patients (59.5) were rated as excellent, 11 (28.2%) as good, 4 (9.5%) as fair, and 2 (4.8%) as poor.
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Affiliation(s)
- V Testa
- First Institute of Orthopaedics, Second University of Naples Medical School
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30
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Valentini M, Cannizzaro R, Poletti M, Bortolussi R, Fracasso A, Testa V, Sozzi M, Fornasarig M, Bortoluzzi F, Grazioli I. Nonsteroidal antiinflammatory drugs for cancer pain: comparison between misoprostol and ranitidine in prevention of upper gastrointestinal damage. J Clin Oncol 1995; 13:2637-42. [PMID: 7595718 DOI: 10.1200/jco.1995.13.10.2637] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
PURPOSE The prophylactic strategy of nonsteroidal antiinflammatory drug (NSAID)-induced upper gastrointestinal (UGI) damage has largely been studied in arthritic patients, but not in cancer patients. The efficacy of misoprostol and ranitidine in the prevention of gastroduodenal damage in patients taking diclofenac for their cancer pain has been compared in this study. PATIENTS AND METHODS Patients who needed high-dose (200 to 300 mg/d) diclofenac for cancer pain and without mucosal lesions at baseline gastroduodenal endoscopy were randomized to receive misoprostol (200 micrograms twice daily; M group) or ranitidine (150 mg twice daily; R group). UGI endoscopy was repeated after 4 weeks. RESULTS Twenty-three patients treated with misoprostol and 26 treated with ranitidine concluded the study. The M group showed a significantly (P < .02) lower incidence of gastroduodenal lesions (two patients; 8.7%) than the R group (10 patients; 38.5%). Gastric ulcers occurred in one (4%) misoprostol-treated patient and in six (23%) ranitidine-treated patients. Six of seven patients with ulcers were asymptomatic. Seventy-one percent and 86% of ulcers occurred in patients older than 60 years and in those who received greater than 3.1 mg/kg of diclofenac, respectively. CONCLUSION Misoprostol was significantly more effective than ranitidine in the prevention of gastroduodenal lesions in cancer patients receiving diclofenac.
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Affiliation(s)
- M Valentini
- Department of Gastroenterology, CRO-Istituto Nazionale Tumori Centroeuropeo, Aviano, Italy
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De Cicco M, Matovic M, Balestreri L, Panarello G, Fantin D, Morassut S, Testa V. P.27 Central vein thrombosis in cancer patientsbearing long-term silastic catheter. A prospective study. Clin Nutr 1995. [DOI: 10.1016/s0261-5614(95)80176-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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De Cicco M, Matovic M, Balestreri L, De Angelis V, Fracasso A, Morassut S, Coran F, Babare R, Buonadonna A, Testa V. Antithrombin III deficiency as a risk factor for catheter-related central vein thrombosis in cancer patients. Thromb Res 1995; 78:127-37. [PMID: 7482430 DOI: 10.1016/0049-3848(95)00041-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The fibrin sleeve of venous catheters (VC) and parietal thrombi represent frequent and dangerous side-effects of central venous catheterization (CVC), due to the risk of embolism. Reduced levels of coagulation clotting factors inhibitors (such as Antithrombin III) are known to be associated with increased thrombogenic risk. The aim of this study was to evaluate the role of Antithrombin III (AT III) deficiency as a risk factor for thrombosis in cancer patients undergoing CVC. The study groups included patients with a reduced AT III activity (< 70%, 20 consecutive patients) and with normal AT III values (> 70%, 20 randomly selected patients), requiring a VC for chemotherapy and/or total parenteral nutrition. The study protocol included evaluation of Hb, PLTs, PT (INR), aPTT, Fibrinogen and AT III at days 0, 1, 3 and 8 after CVC and upon VC removal. Peripheral and pullout phlebographies were performed in all patients on catheter withdrawal. A quantitative scale was developed to evaluate both VC and parietal thrombus degree in each catheter-containing venous segment (subclavian, innominate, superior vena cava); the sum of the mean values was defined as overall thrombus. The average VC dwelling time was similar in both groups. There were no significant differences in Hb, PLTs, PT (INR), aPTT, Fibrinogen and in the remaining parameters of the study between the two groups. The group with AT III deficiency presented a higher degree of both parietal (p < 0.05) and overall thrombus (p < 0.02). Data showed a higher severity of CVC-related thrombosis in patients with AT III deficiency than in the control group. Further studies are needed to evaluate whether the therapeutically-induced normalization of AT III levels can reduce the thrombosis degree.
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Affiliation(s)
- M De Cicco
- Department of Anesthesiology and Resuscitation, Centro di Riferimento Oncologico, I.N.R.C.C.S., Aviano, Italy
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De Cicco M, Matovic M, Castellani GT, Basaglia G, Santini G, Del Pup C, Fantin D, Testa V. Time-dependent efficacy of bacterial filters and infection risk in long-term epidural catheterization. Anesthesiology 1995; 82:765-71. [PMID: 7533485 DOI: 10.1097/00000542-199503000-00019] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Epidural infection represents a serious albeit infrequent complication of long-term epidural catheterization. The catheter hub is regarded as the main point of entry for microorganisms among the three possible routes (hematogenous, insertion site, hub) of microbial colonization of the inserted catheter. The current study was aimed at evaluating whether frequent changing of antimicrobial filters carries an increased risk of catheter hub contamination and the time-dependent efficacy of commonly used antimicrobial filters after prolonged use. METHODS In the first part of the study, a microbiologic survey (skin, filter, hub, and catheter tip) was performed weekly in a group of 47 patients with cancer bearing subcutaneously tunneled catheters managed at home. Subsequently, the time-dependent efficacy of 96 micropore filters (32 Portex, 32 Sterifix-Braun, 32 Encapsulon TFX-Medical) differing in surface areas and/or composition of the filtering membrane was evaluated in a laboratory study. Filters were perfused, under the usual conditions of clinical use (flow resistance, injection pressure, temperature), every 8 h up to 60 days, with 5 ml of two different analgesic solutions, either sterile or containing 1.5 x 10(5)/ml of Streptococcus milleri I. Eight filters of each type subsequently were flushed with a S. milleri suspension (0.5 McFarland) after 7, 14, 28, and 60 days of continuous perfusion, and the resulting filtrates were cultured. RESULTS In 16 of 19 positive hub cultures, the same microorganisms (species, biotype, antibiotype) were cultured from skin and filters. A statistically significant positive trend was found between the number of filter changes and the rate of positive hub cultures (chi 1(2) trend 5.11; P = 0.02). A high correlation coefficient was found between number of positive skin cultures and number of positive filtrates (r = 0.88; P = 0.01) and between number of positive filtrates and number of positive hub cultures (r = 0.93; P = 0.003). Cultures obtained from Portex and Sterifix-Braun filters yielded no bacterial growth (64/64) throughout the study period. Cultures from Encapsulon TFX-Medical filters showed bacterial growth 2/8 at seventh day, 7/8 at the 14th day, and 16/16 from the 28th day onward. CONCLUSIONS Our data indicate significant correlation between the incidence of catheter hub colonization and the filter-change frequency, when the skin close to the filter-hub connection is contaminated. Our results also show that Portex and Sterifix-Braun bacterial filters, when perfused with reduced volumes at low injection pressures, maintain an unmodified antimicrobial function for at least 60 days. Based on these data, it appears clinically feasible to reduce the frequency of filter changes during long-term epidural catheterization, with a consequent possible decrease of epidural catheter colonization.
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Affiliation(s)
- M De Cicco
- Department of Anesthesiology and Pain Therapy, Centro di Riferimento Oncologico, INRCCS, Aviano, Italy
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Capasso G, Testa V, Maffulli N, Barletta L. Molded arthroplasty and transfer of the extensor hallucis brevis tendon. A modification of the Keller-Lelievre operation. Clin Orthop Relat Res 1994:43-9. [PMID: 7955699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The Keller-Lelievre technique for hallux valgus correction was modified by detaching the extensor hallucis brevis tendon from the proximal phalanx, and reattaching it on the medial sesamoid. Thirty-five consecutive patients were assigned randomly to 1 of 2 groups. Patients in Group 1 received the modified operation, and the original Keller-Lelievre technique was used for the control group. The only significant radiographic difference at 6 months was the distance between the first and the fifth metatarsal heads. There were only slightly significant differences in function and in pain relief between the 2 groups at the 6th postoperative month. At 3 years, these differences were greater, with the group treated by the modification described herein, retaining significant correction and showing better functional results.
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Affiliation(s)
- G Capasso
- 2nd University of Napoli Medical School, 1st Institute of Orthopaedics, Italy
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35
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Testa V, Capasso G, Maffulli N, Sgambato A, Ames PR. Proteases and antiproteases in cartilage homeostasis. A brief review. Clin Orthop Relat Res 1994:79-84. [PMID: 7955705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Among other factors, articular cartilage degeneration is caused by proteolytic enzymes. Different cell types of the synovial fluid and/or the synovial membrane and cartilage release specific proteases. Normally, these are finely tuned with their inhibitors. When this balance is altered, the proteolytic action may prevail, producing tissue damage, cartilage disruption, and ultimately a full osteoarthritic picture. The protease antiprotease mechanism opens new perspectives in the diagnosis and pharmacologic management of osteoarthritis. Early diagnosis and improved monitoring of the evolution of the disease are made possible, and a more rational therapy against cartilage disruption becomes feasible.
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Affiliation(s)
- V Testa
- University of Napoli, Medical School, Residency Programme in Orthopaedics, Italy
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36
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Maffulli N, Testa V, Capasso G. Anaerobic threshold determination in master endurance runners. J Sports Med Phys Fitness 1994; 34:242-9. [PMID: 7830387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Twenty middle aged endurance runners underwent physiological testing to determine their maximal oxygen uptake (VO2max), lactate threshold, ventilatory threshold, the slope variation point (SVP) of the linear relationship between running speed (RS) and heart rate (HR) both on the treadmill and during a field test, and the onset of blood lactate accumulation point. The RS, HR, VO2 and blood lactate concentration at which the different thresholds occurred were highly correlated (0.70 < r < 0.95; p < 0.01). The various indices of aerobic-anaerobic transition in the master athletes examined were shown to occur at a comparable percentage of their VO2max as compared to their younger counterparts. The tests developed for, and commonly used in adult athletes, are equally valid in this age group.
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Affiliation(s)
- N Maffulli
- University of London, Institute of Child Health, England
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37
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Bortolussi R, Fabiani F, Savron F, Testa V, Lazzarini R, Sorio R, De Conno F, Caraceni A. Acute morphine intoxication during high-dose recombinant interleukin-2 treatment for metastatic renal cell cancer. Eur J Cancer 1994; 30A:1905-7. [PMID: 7880626 DOI: 10.1016/0959-8049(94)00257-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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38
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Maffulli N, Testa V, Capasso G. Post-viral fatigue syndrome. A longitudinal assessment in varsity athletes. J Sports Med Phys Fitness 1993; 33:392-9. [PMID: 8035588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Maximal oxygen uptake, anaerobic threshold (AT), isometric strength of the elbow flexor and knee extensor muscles, isometric strength endurance exhaustion time (prolonged contraction at 66% of maximal isometric strength), uphill sprinting exhaustion time were longitudinally studied in eight varsity endurance runners with post-viral fatigue syndrome (PVFS). Prolonged impairment of exercise performance is evident during the course of PVFS. Although maximal oxygen uptake (VO2max) had returned to pre-infection values 13 months after the viral illness (4.160 vs 4.0 L.min-1), AT was still significantly reduced [52 ml.kg-1.min-1, 18.6 km.hr-1, 176 bpm, and 82% of VO2max vs. 49.1 ml.kg-1.min-1 (p < 0.05), 175 bpm (NS), 17.2 km.hr-1 (p < 0.01) and 79% of VO2max (NS)]. Maximal isometric contraction strength of the upper limb remained constant (282 N vs. 274 N), while knee extensor muscles strength decreased significantly (730 N vs. 701 N, p < 0.05). Strength endurance was still significantly reduced by the end of the study (arm average pre-infection: 46.2 sec; end of study: 29.3 sec, p < 0.001; leg average pre-infection: 66.4 sec; end of study: 49.1 sec, p < 0.01). Up hill sprinting time was similarly reduced by the end of the study period (29.3 sec vs. 16.2 sec, p < 0.01). Both aerobic and anaerobic exercise variables are seriously affected by post-viral fatigue syndrome, and one year may not be sufficient to fully recover.
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Affiliation(s)
- N Maffulli
- Department of Orthopaedic Surgery, University of Aberdeen Medical School, Scotland
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39
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De Cicco M, Panarello G, Fantin D, Veronesi A, Pinto A, Zagonel V, Monfardini S, Testa V. Parenteral nutrition in cancer patients receiving chemotherapy: effects on toxicity and nutritional status. JPEN J Parenter Enteral Nutr 1993; 17:513-8. [PMID: 8301803 DOI: 10.1177/0148607193017006513] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The role of total parenteral nutrition (TPN) in reducing toxicity related to cancer chemotherapy (CT) is presently a controversial issue. To evaluate the effectiveness of TPN in reducing CT-associated toxicity and correcting and preventing CT-related impairments of nutritional status, a prospective crossover controlled study was performed in 43 cancer patients (19 normally nourished and 24 malnourished) randomly divided into two groups (A and B). Group A patients received TPN concomitantly with the first course of chemotherapy, and the second course was administered 21 to 28 days later without TPN support; group B patients were treated in the opposite sequence. The rates of myelotoxicities and gastrointestinal toxicities after CT courses with or without TPN were essentially similar in normally nourished and malnourished patients. No changes in nutritional indexes were detected in normally nourished subjects after each course. Conversely, in undernourished subjects, prealbumin, retinol-binding protein, and nitrogen balance increased in CT+TPN courses (p < .02). In CT-only courses, undernourished subjects showed a decrease in prealbumin and nitrogen balance. Significant changes of nitrogen balance in CT vs CT+TPN courses were detected in malnourished subjects. TPN appears to be unable to reduce CT-associated toxicity. CT administration does not result in any impairment of the nutritional status in normally nourished cancer patients. From our study, it appears that TPN should be limited to severely malnourished neoplastic patients undergoing CT, because of its ability to prevent further impairment of nutritional status and to improve the nitrogen balance and the levels of fast-turnover visceral proteins.
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Affiliation(s)
- M De Cicco
- Anaesthesia, Resuscitation and Clinical Nutrition Unit, Istituto Nazionale di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
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40
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Maffulli N, Testa V, Capasso G. Mediopatellar synovial plica of the knee in athletes: results of arthroscopic treatment. Med Sci Sports Exerc 1993; 25:985-8. [PMID: 8231782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The long-term results (9-87 months) of the arthroscopic treatment of unilateral mediopatellar synovial plica of the knee in 102 athletes are reported. In all patients a large and/or fibrotic inflamed mediopatellar plica impinging on the femoral condyle on knee flexion was identified and trimmed. Chondromalacia patellae was detected in 38 patients. The impingement lesion was seen in 13 knees. In one patient, a minor tear of the lateral meniscus was trimmed, and one patient was found to suffer from a clinically asymptomatic partial tear of the anterior cruciate ligament. Isometric strength testing of the quadriceps revealed marked decrease at the second postoperative week, with subsequent gradual recovery. The results obtained justify arthroscopic treatment in a young, extremely active population.
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Affiliation(s)
- N Maffulli
- First Institute of Orthopaedics, University of Naples, First Medical School, Italy
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Abstract
A prospective, randomized trial was undertaken to determine the rate of complications after the use of a tourniquet during open reduction and internal fixation of simple, closed fractures of the distal part of the fibula. Forty patients were operated on with use of a tourniquet (Group 1) and forty patients, without use of a tourniquet (Group 2). The average duration of the operation was significantly different between the two groups (41 +/- 9 minutes for Group 1 compared with 53 +/- 12 minutes for Group 2 [p = 0.026]). There were more complications in the patients in Group 1, two of whom had an isolated deep-vein thrombosis of the calf. The wound was possibly infected in eleven patients (seven in Group 1 and four in Group 2 [p < 0.05]) and frankly infected in three patients, all in Group 1 (p < 0.05). The plaster-of-Paris cast needed to be changed in three patients from Group 1. The patients in Group 1 returned to work an average of one week later than those in Group 2. The mean duration of follow-up was eighteen months (range, nine to thirty-two months). Given the lower prevalence of postoperative complications and the shorter time to recovery for the patients in Group 2, we believe that it is justified not to use a tourniquet in the operative treatment of simple, isolated fibular fractures.
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Affiliation(s)
- N Maffulli
- First Institute of Orthopaedics, University of Naples, First Medical School, Italy
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Abstract
The histochemical composition of the triceps surae muscle was investigated in 13 previously unoperated children (age 9-24 months) with unilateral idiopathic clubfoot. On both the normal and the affected side, the percentage of type I fibers was significantly higher than that of the other fiber types. The muscle biopsies from the clubfoot side showed an increase in their connective tissue content. The affected side showed a nonsignificant higher percentage of type I fibers, whereas the average capillary density and capillary to fiber ratio were significantly lower.
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Affiliation(s)
- N Maffulli
- Department of Orthopaedics, Hospital for Sick Children, London, England
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Abstract
A survey of glove perforation in 100 consecutive hand surgery operations was undertaken. A total of 397 pairs of gloves were tested for punctures after the operation. Evidence of perforation was found in 19% of the gloves used, and only in 12 cases did the surgeons actually realize that a perforation had occurred. With a perforation rate of 43%, the surgeons were significantly more at risk of glove perforation than the other members of the operating team.
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Affiliation(s)
- N Maffulli
- Institute of Child Health, Hospital for Sick Children, London, United Kingdom
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Maffulli N, Testa V, Capasso G. Achilles tendon rupture in athletes: histochemistry of the triceps surae muscle. J Foot Surg 1991; 30:529-33. [PMID: 1770203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Bilateral percutaneous muscle biopsies of the triceps surae were analyzed in 12 athletes who had sustained a one-sided subcutaneous rupture of the Achilles tendon while practicing their main sport. No necrosis, atrophy, or significant fiber grouping or regeneration was evident. The soleus muscle in these athletes was composed of approximately 70% of type I fibers in both the noninjured and injured sides, and no significant differences were detected in their histochemical composition. Fiber areas were within described values and not significantly different between the two sides. The noninjured side revealed an insignificant trend to greater average capillary density and average capillary/fiber ratio. Muscle abnormalities do not appear to be a significant factor in determining Achilles tendon rupture in healthy athletes.
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Affiliation(s)
- N Maffulli
- Newham General Hospital, Department of Orthopaedics, Plaistow, London, England
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Maffulli N, Capasso G, Testa V. Spinal anaesthesia for day case surgery in sportspersons and sedentary patients. Can J Sport Sci 1991; 16:200-3. [PMID: 1655194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The effects of spinal anaesthesia were investigated in 67 sportspersons and in 128 sedentary patients (average age 31.8 +/- 6.2 yrs). The most frequent complaint in both groups was mild low back pain (27 cases vs. 58). Postspinal headache was severe and disabling, with an incidence of 13.4% in the sportspersons and 21.1% in the sedentary group. The sedentary group also showed a higher incidence of other postanaesthetic problems. Given the high rate of side effects, the young age of the subjects, and their desire to resume work as soon as possible after the operation, spinal anaesthesia is not the best anaesthetic procedure for this age group.
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Affiliation(s)
- N Maffulli
- Institute of Child Health, University of London, U.K
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46
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Maffulli N, Testa V, Lancia A, Capasso G, Lombardi S. Indices of sustained aerobic power in young middle distance runners. Med Sci Sports Exerc 1991; 23:1090-6. [PMID: 1943631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Sixteen young endurance athletes underwent physiological testing to determine their maximal oxygen uptake (VO2max), lactate threshold (lacAT), ventilatory threshold, and the slope variation point (SVP) of the linear relationship between running speed (RS) and heart rate (HR) both on the treadmill and during a field test, and the onset of blood lactate accumulation point. The RS, HR, VO2, and blood lactate concentration at which the different thresholds occurred were highly correlated, with r ranging from 0.82 to 0.90. The highest correlation was shown by RS at lacAT and RS at SVP during the field test. Various indices of sustained aerobic power in athletic children examined were shown to occur at a percentage of their VO2max similar to adult endurance runners. The tests developed for older athletes can be used in this age group as well.
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Affiliation(s)
- N Maffulli
- University of London, Institute of Child Health, United Kingdom
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47
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Capasso G, Testa V, Bonavolontá A. The Doppler stress test for the vertebral arteries. Ital J Orthop Traumatol 1991; 17:141-4. [PMID: 1894511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The authors propose a new method of dépistage and thorough diagnostic examination of temporary vertigo caused by extrinsic compression of the vertebral arteries. This method is easy to execute, noninvasive, reliable, and relatively inexpensive. Its purpose is to confirm diagnosis by documenting criteria that are visible and reproducible.
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Affiliation(s)
- G Capasso
- I Facoltà di Medicina e Chirurgia, Università di Napoli
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48
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Abstract
A total of 391 pairs of gloves were tested for punctures after 100 consecutive foot surgery operations to assess the rate, site, procedure, and maneuver during which glove puncture accidents took place. Evidence of perforation was found in 23% of the gloves used. The surgeons are significantly more at risk of glove perforation than the other members of the operating team.
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Affiliation(s)
- N Maffulli
- Università Di Napoli, First Institute of Orthopaedics and Traumatology, Italy
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49
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De Cicco M, Fracasso A, Magri D, Barzan L, Testa V. [Morphine in the inferior cerebellar cisterna for oncologic pain in the ORL area]. Minerva Anestesiol 1990; 56:1401-8. [PMID: 2084588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The study aimed to assess whether the infusion of microdoses of morphine in the cisterna magna, close to the sensitive nuclei of the cranial nerves (V-VII-IX-X) involved in painful syndromes of the head and neck, is able to control severe oncological pain in this region which does not respond to traditional pain killing treatment or neurolesive practices. Cisternal catheters were inserted in eight patients with cancer of the head and neck. The intensity of pain was assessed using VAS and the quality of analgesia obtained using cisternal morphine was judged to be: excellent, good, inadequate or null. Treatment lasted a mean of 121 days. Good or excellent analgesia was achieved in 7 patients using a mean daily dose of 1.5 mg morphine during the initial stage and 4.8 mg during the final stage; in one patient with a large component of "deafferent pain", good pain relief was obtained by associating cisternal morphine with chlorimipramin per os. The side-effects observed were almost always short-term and easily resolved. Morphine treatment was begun in the hospital and in all cases continued at home. This efficacious pain killing method should be given adequate attention in the global strategies used to treat oncological pain in the head and neck region.
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Affiliation(s)
- M De Cicco
- Servizio di Anestesia, Rianimazione e Terapia Antalgica, Centro Regionale di Riferimento Oncologico, Aviano, Pordenone
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50
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Abstract
The traumatic dislocation of the lateral sesamoid of the flexor hallucis brevis tendon in a soccer player is reported. It was treated surgically by open reduction and ligamentoplasty of the ruptured intersesamoid ligament. Fourteen months after the injury, the patient is fully asymptomatic, and has returned to full activity.
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Affiliation(s)
- G Capasso
- Università di Napoli, First Medical School, First Institute of Orthopaedics, Italia
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