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Treatment of Scaphoid Non-Unions with Custom-Made 3D-Printed Titanium Partial and Total Scaphoid Prostheses and Scaphoid Interosseous Ligament Reconstruction. Healthcare (Basel) 2023; 11:3123. [PMID: 38132013 PMCID: PMC10743063 DOI: 10.3390/healthcare11243123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 12/02/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE Treatment of scaphoid fracture sequelae is still an unsolved problem in hand surgery. Custom-made 3D-printed titanium partial and total scaphoid prosthesis and scaphoid interosseous ligament reconstruction (SLIL) are performed in cases of non-union and isolated aseptic necrosis of the proximal scaphoid pole and when it is impossible to save the scaphoid bone, respectively. This study aims to evaluate the clinical, functional and radiographic results after these two prosthesis implantations. METHODS Between January 2019 and July 2020, nine partial and ten total scaphoid prostheses were implanted using custom-made 3D-printed titanium implants. Evaluation criteria included carpal height ratio (CHR), radioscaphoid angle, wrist extension and flexion, radial deviation and ulnar deviation of the wrist, grip strength and pinch strength, Visual Analogue Scale (VAS), the Disabilities of Arm, Shoulder, and Hand (DASH) score, and the Patient-Rated Wrist Evaluation (PRWE). RESULTS Clinical, functional, and radiographic improvements were found in all outcomes analyzed for both patient groups. The VAS pain scale obtained the most remarkable improvement at the one-year follow-up. The results of the DASH scores and the PRWE were good, with a great rate of patient satisfaction at the end of the follow-up. SLIL reconstruction also provided excellent stability and prevented a mid-carpal bone collapse in the short- and medium-term follow-up. CONCLUSIONS A custom-made 3D-printed titanium partial or total scaphoid prosthesis is a viable solution for patients with scaphoid non-union and necrosis or complete scaphoid destruction in whom previous conservative or surgical treatment has failed.
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Attitudes of Italian Infertile Women Toward Ethical and Regulatory Limits of Medically Assisted Procreation (MAP). LA CLINICA TERAPEUTICA 2023; 174:251-256. [PMID: 37199360 DOI: 10.7417/ct.2023.2530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Objective Outline the views of Italian women, with fertility problems, on Medically Assisted Procreation. Methods We have collected the opinions of 448 infertile women. The items used in the questionnaire were created with a qualitative method based on the Medically Assisted Procreation's most important bioethics issues and on the basis of the limits imposed by Law. The questions of the first part of the questionnaire were open; in the second part was closed ("Yes/No"); for each method they were asked whether they would introduce a legal limit to prohibit it. The tests have been standardized with test-retest method. Results We found that much of the disputes that have, over time, been made to Law 40 of 2004 by Italian Courts, are shared by patients with infertility problems. Italian women do not share the legal limit for Medically Assisted Procreation in over 43 women, heterologous in-semination with seed donation and egg donation. Moreover, our sample show that Italian women do not share legal limit to pre-implantation genetic diagnosis and cryopreservation of embryos. Moreover, it emerges that many Italian infertile patients disagree with the Medically Assisted Procreation for homosexual couples. Conclusion It will be important, in the event of a legislative reform in Italy on the Medically Assisted Procreation, also consider the point of view of women with infertility problems.
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3
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Predicting the risk of biochemical recurrence at five years in patients treated with radical prostatectomy for prostate cancer: The PIPEN categories. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00306-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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4
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Differences in oncological outcomes in patients treated with thermal ablation for T1 renal cell masses: complete ablation vs. partial ablation +/- immediate re-treatment. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01186-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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5
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Thermal ablation for small renal masses: identifying anthropometric predictors of surgical and oncologic outcomes. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01195-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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6
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Sars-CoV-2 Infection After Lung Transplantation: Is There Professional Liability? LA CLINICA TERAPEUTICA 2022; 173:222-223. [PMID: 35612334 DOI: 10.7417/ct.2022.2422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
For the first time in the literature, a case of Sars-Cov-2 infection after lung Transplantation has been described. This case, particularly rare, brought attention on the in-depth screening for Sars-CoV-2 on lung donor. In addition to infectious problems, it is important to focus attention on medico-legal issues related to this case. In fact, from the point of view of professional responsibility, in theory, there could be criteria for identifying professional responsibility. The author analyzes the possible presence of medical liability in this specific case.
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Peri-Implant Distal Radius Fracture: Proposal of a New Classification. J Clin Med 2022; 11:jcm11092628. [PMID: 35566755 PMCID: PMC9105785 DOI: 10.3390/jcm11092628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/28/2022] [Accepted: 05/05/2022] [Indexed: 02/01/2023] Open
Abstract
A peri-implant fracture near the volar plate of the distal radius represents a rarity and can be associated with a mechanical failure of the devices. A literature review was conducted including all fractures that occurred around a volar wrist plate, which could be associated with an ulna fracture. All articles published until December 2021 were considered according to the guidelines presented in the PRISMA Statement. The search was conducted with the PubMed electronic database, Cochrane Database of Systematic Reviews, Medline, Embase, and Google Scholar. Only nine cases of these fractures were reported in the literature. The causes could be due to delayed union/non-union of the old fracture after low energy traumas, high energy trauma in patients with poor bone quality, or hardware mechanical failure. Furthermore, the literature review of peri-implant radius fracture shows different level of radius fracture and types of implant failure. In accordance with these different cases, a new classification of peri-implant fracture of the distal radius is proposed.
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8
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Validation of the recommended size cut-off for thermal ablation in T1 renal cell carcinoma patients, according to the EAU Guidelines. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00302-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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9
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Conditional survival of patients with low-risk prostate cancer: Temporal changes in active surveillance permanence according to risk stratification. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00370-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Development and validation of an Italian version of the PMOS-30 questionnaire at hospital level. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
An important challenge for health systems worldwide is to ensure that health professionals can carry out their mission to treat, rehabilitate and prevent diseases safely. The Patient Measure of Safety (PMOS) questionnaire is an instrument that allows the systematic collection of patients' feedback about their care to understand and assess the level of safety in hospital. The PMOS-30 questionnaire was recently developed as shorter version of the 44-item PMOS. The objectives of this study are to develop and validate an Italian version of the PMOS-30 questionnaire so that this instrument can be utilised in hospital routine for the continuous improvement of patient safety.
Methods
A cross-sectional study was carried out on patients in a hospital in Italy. A confirmatory factor analysis was conducted after the development of an Italian version of the PMOS-30 questionnaire. Maximum Likelihood (ML) estimation was used to perform CFA. The quality of the model fit was evaluated on the basis of the Comparative Fit Index (CFI), Tucker Lewis Index (TLI) and Root Mean Square Error of Approximation (RMSEA).
Results
A total of 435 patients filled in the Italian version of the PMOS-30 questionnaire. The CFI did not achieve the fit value (CFI= 0.802). But RMSEA suggests a reasonably good fit value (RMSEA=0.076). Internal consistency analysis showed that the Cronbach's alpha value was more than 0.6 in all domains except for the domain “organisation and care planning” that had a value of 0.525.
Conclusions
Patients feedback about their safety in hospital is an important source of information for the routine hospital life. Since patient safety is an intrinsic part of patient care, it deserves every possible new approach in the continuous improvement of care. The PMOS-30 questionnaire is a validated instrument for hospital settings and future research in other Italian hospitals may increase the routine use of this instrument to improve patient safety.
Key messages
The use of the Italian version of the PMOS-30 questionnaire can support the identification of vulnerable areas in the hospital through patient feedback and therefore improve patient safety. The PMOS-30 questionnaire offers the opportunity to enable Italian hospital managers to track changes in safety over time through repeated assessments in the wards and avoid future patient incidents.
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11
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Active surveillance for prostate cancer: comparison between incidental tumors vs. tumors diagnosed at prostate biopsies. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00959-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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12
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Association between previous negative biopsies and lower rates of disease progression during active surveillance for prostate cancer. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00957-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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13
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Outcomes of serial multiparametric magnetic resonance imaging in patients managed with Active Surveillance for prostate cancer. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00960-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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14
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Polybutylene succinate artificial scaffold for peripheral nerve regeneration. J Biomed Mater Res B Appl Biomater 2021; 110:125-134. [PMID: 34180135 PMCID: PMC9290626 DOI: 10.1002/jbm.b.34896] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/03/2021] [Accepted: 06/13/2021] [Indexed: 12/15/2022]
Abstract
Regeneration and recovery of nerve tissues are a great challenge for medicine, and positively affect the quality of life of patients. The development of tissue engineering offers a new approach to the problem with the creation of multifunctional artificial scaffolds that act on various levels in the damaged tissue, providing physical and biochemical support for the growth of nerve cells. In this study, the effects of the use of a tubular scaffold made of polybutylene succinate (PBS), surgically positioned at the level of a sciatic nerve injured in rat, between the proximal stump and the distal one, was investigated. Scaffolds characterization was carried out by scanning electron microscopy and X‐ray microcomputed tomography and magnetic resonance imaging, in vivo. The demonstration of the nerve regeneration was based on the evaluation of electroneurography, measuring the weight of gastrocnemius and tibialis anterior muscles, histological examination of regenerated nerves and observing the recovery of the locomotor activity of animals. The PBS tubular scaffold minimized iatrogenic trauma on the nerve, acting as a directional guide for the regenerating fibers by conveying them toward the distal stump. In this context, neurotrophic and neurotropic factors may accumulate and perform their functions, while invasion by macrophages and scar tissue is hampered.
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15
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Active surveillance for prostate cancer: Comparison between incidental tumors vs. tumors diagnosed at prostate biopsies. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01405-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Outcomes of serial multiparametric magnetic resonance imaging in patients managed with active surveillance for prostate cancer. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01416-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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COVID-19 vaccine: Risk of inequality and failure of public health strategies. ACTA ACUST UNITED AC 2021; 17:100653. [PMID: 33758775 PMCID: PMC7972670 DOI: 10.1016/j.jemep.2021.100653] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/14/2021] [Indexed: 10/31/2022]
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18
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COVID-19 Pandemic and Balance of Constitutional Rights. LA CLINICA TERAPEUTICA 2021; 172:119-122. [PMID: 33763685 DOI: 10.7417/ct.2021.2297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
ABSTRACT In 2020 the World Health Organization declared the Covid-19 to be a pandemic. Governments around the world are facing a tough challenge that could jeopardise the national healthcare systems. Safeguarding the rights of Covid patients and all citizens - especially those who are now even more vulnerable than they were before - is part of this challenge. This work aims to examine the issues arising from the current emergency in terms of how individuals' constitutional rights have been balanced and how much people at the highest risk amid this pandemic - the homeless, the inmates in prison, geriatric and psychiatric patients, and doctors on the Covid frontline - have been protected. This analysis focuses mostly on one of the worst-hit countries by the SARS-CoV-2: Italy.
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Mortality Risk Assessment at the Admission in Patient With Proximal Femur Fractures: Electrolytes and Renal Function. Geriatr Orthop Surg Rehabil 2021; 12:2151459321991503. [PMID: 33623723 PMCID: PMC7876745 DOI: 10.1177/2151459321991503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 12/30/2022] Open
Abstract
In patients over 65y.o. who were surgically treated for a hip fracture,
electrolytes have not been specifically studied as predictors of mortality. The
main purpose of this study was to assess whether electrolytes and chronic kidney
disease (CKD) stages, evaluated at admission, could represent a pre-operative
prognostic factor in this population. Moreover, the role of epidemiological and
clinical parameters was analyzed with and without a surgical timing
stratification. This retrospective study included 746 patients. For each
patient, their age, gender, fracture classification, Hb value, comorbidities,
ASA class, chronic kidney disease, creatinine levels, electrolytes and surgical
timing were collected. CKD-epi, MDRD, modified MDRD and BIS1 were used to obtain
eGFR and CKD stages. All parameters were analyzed individually and in relation
to the different surgical timing. Descriptive statistics, Chi-square test and
survivability analysis with Kaplan Meier curve were used. In patients with a hip
fracture non-significant association with increased mortality was shown for the
following variables: Hb value, sodium values, calcium values, CKD stages and
creatinine values. Otherwise altered kalemia was associated with a statistically
significant increase in mortality as well as male gender, two or more comorbid
medical conditions, advanced age (>75 years), higher ASA class. Surgery
performed within 72h resulted in a statistically significant reduction in
mortality at 6 months and, when performed in 24h-48h, a further reduction at 4
years. Age and ASA class statistically significant increased mortality
regardless the surgical timing. Male patients operated after 48h from
hospitalization were associated with a statistically significant increase in
mortality rate. Two or more comorbidities were related to a statistically
significant increased number of deaths when patients were treated after 96h.
Altered kalemia values at hospitalization are associated with a statistically
significant increase in mortality in patients operated after 72h from
admission.
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What's the resolutive surgery for pseudo-ainhum in Vohwinkel syndrome? A case report and review of the literature. Orthop Rev (Pavia) 2021; 12:8868. [PMID: 33633820 PMCID: PMC7883105 DOI: 10.4081/or.2020.8868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/22/2020] [Indexed: 11/22/2022] Open
Abstract
Vohwinkel Syndrome, also known as Keratoderma Hereditarium Mutilans, is an extremely rare dominant autosomal keratosis. It typically presents with “starfish” keratoses on the knuckles, palmoplantar keratoderma (PPK), hearing impairment and mutilating digital constriction bands (pseudoainhum) that cause strangulation, often leading to autoamputation of the affected digit. Both medical and surgical treatment haven’t shown to date consistent results, in the treatment of pseudoainhum. In this study we present the case of a woman with Vohwinkel syndrome who showed constriction bands causing ischemic changes of the 5th digit of the right hand for which she was treated with surgery. We also present a review of the literature for the management of this disease.
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Abstract
A peri-implant fracture near the volar plate of distal radius represent a very rare injury. The main factor of this lesion is high energy trauma on the wrist. We report a case of a 61-year-old woman with a peri-implant fracture located just proximally to the plate and a fracture of the ulnar head that occurred after a simple fall. The patient was surgically treated by plate and screws removal. The fracture was fixed using a longer volar plate for the radial fracture and a plate for the head ulnar fracture. Different factors such as osteoporosis, BMI and screw position could influence the fracture pattern. However, considering growing use of plates for distal radius fracture fixation, the frequency of these kind of fracture will probably increase.
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Isolated osteoblastoma of the cuboid bone: A case report and review of the literature. Foot (Edinb) 2020; 45:101691. [PMID: 33039906 DOI: 10.1016/j.foot.2020.101691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/21/2020] [Accepted: 05/10/2020] [Indexed: 02/04/2023]
Abstract
Osteoblastoma is a relatively rare, benign, bone-forming tumor, commonly observed in the second and third decades of life. Spine and the long tubular bones are the most common sites of involvement. Osteoblastoma is infrequently seen in other sites, including the bones of hand and foot. A rare case of a 35-year-old man that presented an osteoblastoma of the cuboid bone is reported. The patient was treated with surgical resection and grafting. After the intervention, the patient recovered with no clinical and radiological evidence of recurrence after one year of follow-up. Several cases of osteoblastoma-like variant of osteosarcoma of the cuboid have been previously reported, but, to our knowledge, this is the first case of conventional and isolated osteoblastoma involving the cuboid bone reported in the literature.
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Prognostic role of preoperative neutrophil-to-lymphocyte ratio in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35603-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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The decline of COVID-19-related deaths and the risk of underestimating the pandemic. ACTA ACUST UNITED AC 2020; 15:100601. [PMID: 32989423 PMCID: PMC7510418 DOI: 10.1016/j.jemep.2020.100601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 11/27/2022]
Abstract
COVID-19 pandemic has put a strain on the stability of National Health Systems and society itself. The decline in COVID-19-related mortality is positive. However, we do not know the reason for this decline associated with a rise in infection in many countries of the world. For these reasons, this is not the time to lower our guard and excessively reduce preventive strategies against COVID-19.
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[Telemedicine: a Proxemics tool of Primary Care?]. IGIENE E SANITA PUBBLICA 2020; 76:288-294. [PMID: 33724982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The impact of demographic and sociopolitical phenomena such as population aging, economic and social changes derivinf from globalization and the pervasiveness of information technologies, require innovative and efficient responses to new health needs, characterized by the increase o in the numer of healthcare procedures and its complexity. The COVID 19 has had a negative impact on the that context. This paper demonstrates that the telemdicine enables to optimize resources, as well as to ensure the distancing and delivery times of services. The telemedicine in the time of COVID is the new proxemics tool of Primary care.
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Apps for COVID-19 contact-tracing: Too many questions and few answers. ACTA ACUST UNITED AC 2020; 15:100575. [PMID: 32838002 PMCID: PMC7421297 DOI: 10.1016/j.jemep.2020.100575] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/03/2020] [Indexed: 11/17/2022]
Abstract
Recently, for the second phase of prevention of the COVID-19 Pandemic, it is being assumed the use of an app for the prevention of infections COVID-19. The utility of these apps is not yet proven and the apps for COVID-19 contact-tracing probably cannot be used as a preventive tool until the bioethics and legal issues related to their use are resolved.
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Adjuvant Systemic Therapies in Patients with Colorectal Cancer: An Audit on Clinical Practice in Italy. TUMORI JOURNAL 2019; 91:472-6. [PMID: 16457144 DOI: 10.1177/030089160509100605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Background Rarely are conclusions from clinical trials summarized in international consensus conferences and promptly transferred to patient care. The adjuvant therapy for colorectal cancer used in daily clinical practice in Italy is described and compared with the recommendations of the 1990 NIH Consensus Conference. Patients and Methods We audited prescriptions of adjuvant systemic therapies for Italian colorectal cancer patients in 82 centers during a fixed one-week period. Results Among 434 patients receiving adjuvant chemotherapy there were 139 (42.5%) colon cancer patients with N- and 169 (51.7%) with N+ regional nodal involvement. Treatment at academic centers, a young age, T4 and a low total number of lymph nodes removed at surgery were the factors potentially justifying the decision for adjuvant chemotherapy in stage II colon cancer patients. The most common chemotherapy used was a bolus of 5-fluorouracil/folinic acid for 6 months (75.8%). Adjuvant radiotherapy was not administered to 37 (38.5%) of 96 patients with stage II and III rectal cancer. Conclusions The study shows that a substantial proportion of patients on adjuvant treatment at a certain time point in a large enough sample of Italian centers are stage II (potential over-treatment) and that an under-treatment of stage II and III rectal cancer patients (lack of radiotherapy) occurs too often in daily clinical practice in this country.
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Letter to the editor in response to "Is it time for international guidelines on physical restraint in psychiatric patients?". LA CLINICA TERAPEUTICA 2019; 170:e108-e109. [PMID: 30993306 DOI: 10.7417/ct.2019.2119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Mastrogiovanni case was a revolutionary case in the field of Italian forensic psychiatry. A recent judgment of the Court of Cassation has defined what the legal limits of mechanical restraint should be. On the other hand, even today, there is a gap in the scientific community about the presence of guidelines governing mechanical restraint. It is probably time to create specific guidelines to protect the psychiatric patient and the mental health worker.
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Long-Term Outcome of Dasatinib First-Line Treatment in Gastrointestinal Stromal Tumors: a Multicenter Two Stage Phase Ii Trial Sakk 56/07. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu354.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
BACKGROUND There are limited data about the role of chemotherapy in patients with advanced chondrosarcomas. METHODS The medical charts of 180 patients with advanced chondrosarcomas having received chemotherapy in 15 participating institutions between 1988 and 2011 were reviewed. RESULTS Median age was 52 years. Sixty-three percent of patients had conventional chondrosarcoma and 88% had metastatic disease. Combination chemotherapy was delivered in 98 cases (54.5%). One hundred and thirty-one patients (73%) received an anthracycline-containing regimen. Using RECIST, the objective response rate was significantly different according to histological subtype, being 31% for mesenchymal chondrosarcoma, 20.5% for dedifferentiated chondrosarcoma, 11.5% for conventional chondrosarcoma and 0% for clear-cell chondrosarcoma (P = 0.04). Median progression-free survival (PFS) was 4.7 months [95% confidence interval (CI) 3-6.5]. Performance status (PS) ≥2, number of metastatic sites ≥1 and single-agent regimen were independently associated with poor PFS. Median overall survival (OS) was 18 months (95% CI 14.5-21.6). PS, number of metastatic sites and palliative surgery were independently associated with OS. CONCLUSIONS Conventional chemotherapy have very limited efficacy in patients with advanced chondrosarcoma, the highest benefit being observed in mesenchymal and dedifferentiated chondrosarcoma. These data should be used as a reference for response and outcome in the assessment of investigational drugs in advanced chondrosarcoma.
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Vinorelbine is an Active Drug in Desmoid Tumors / Aggressive Fibromatosis: Institut Gustave Roussy Experience. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34048-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Use of piezosurgery device in management of oral surgery complications: clincal case and clinical experience report. MINERVA STOMATOLOGICA 2012; 61:225-231. [PMID: 22576447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The root displacement into the maxillary sinus could be a complication of oral surgery in the upper jaw. In these cases, the root removal is needed in order to avoid the occurrence of sinus pathologies. Piezosurgery techniques could assure a safer management of such complications, because of the clear surgical visibility and the selective ability of cut. The aim of this article is to present a case of oral surgery complication (root displacement in the right maxillary sinus), in which piezosurgery technique helped for a correct and safe clinical management, allowing to reduce the soft tissue damage.
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Advanced well-differentiated/dedifferentiated liposarcomas: role of chemotherapy and survival. Ann Oncol 2011; 23:1601-7. [PMID: 22039081 DOI: 10.1093/annonc/mdr485] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Data regarding the role of systemic therapy in patients with advanced well-differentiated/dedifferentiated liposarcomas (WDLPS/DDLPS) are limited. METHODS From 2000 to 2010, 208 patients with advanced WDLPS/DDLPS received chemotherapy in 11 participating institutions. Clinical and pathological data were collected by reviewing medical records. RESULTS Median age was 63 years (range 32-84). Combination chemotherapy was delivered in 85 cases (41%) and single agent in 123 cases (59%), respectively. One hundred and seventy-one patients (82%) received an anthracycline-containing regimen. Using RECIST, objective response was observed in 21 patients (12%), all treated with anthracyclines. Median progression-free survival (PFS) was 4.6 months [95% confidence interval (CI) 3.3-5.9]. On multivariate analysis, age and performance status (PS) were the sole factors significantly associated with poor PFS. Median overall survival (OS) was 15.2 months (95% CI 11.8 -18.7). On multivariate analysis, grade and PS were the sole factors significantly associated with OS. CONCLUSIONS Chemotherapy was associated with clinical benefit in 46% of patients with advanced WDLPS/DDLPS. OS remains poor, even though visceral metastatic disease is less frequent than in other sarcomas.
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Advanced well-differentiated/dedifferentiated liposarcomas: Role of chemotherapy and survival. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Use of extent surgery via intraperitoneal route to improve iliopsoas sarcoma local control. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e20508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Patterns of care, prognosis, and survival of patients with metastatic gastrointestinal stromal tumors (GIST) refractory to first-line imatinib and second-line sunitinib. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Prognostic factors for progression-free and overall survival in patients with advanced GIST treated with standard-dose imatinib (IM): Results from the BFR14 phase III trial of the French Sarcoma Group. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e20506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Effects of denosumab on pain reduction in giant cell tumor of bone (GCTB): Interim phase II study results. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Study of dynamic contrast-enhanced ultrasound (DCE-US) for the early evaluation of imatinib. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Time to secondary resistance (TSR) after interruption of imatinib (IM) in advanced GIST: Updated results of the prospective French Sarcoma Group randomized phase III trial on long-term survival. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10015] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Overall survival benefit with masitinib mesylate in imatinib-naive, locally advanced, or metastatic gastrointestinal stromal tumor (GIST): 4-years follow-up of the French Sarcoma Group phase II trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.85] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
85 Background: Masitinib is a novel tyrosine kinase inhibitor which, in vitro, has greater activity and selectivity than imatinib (IM) against both wild-type KIT receptor and its mutated form in the juxtamembrane region (IC 50=100 nM versus 200 nM for IM, 3 nM versus 27nM and 40 nM versus 120nM, respectively, for exons 9,11, and 13). This multicenter phase II study evaluated efficacy and safety of masitinib as a first-line treatment of advanced GIST. Methods: IM-naïve patients with inoperable, locally advanced or metastatic GIST received oral masitinib (7.5 mg/kg/day) until progression, refusal or toxicity. Efficacy variables included response rate, best response (RECIST), progression-free survival (PFS) and overall survival (OS). Initial results were previously reported in EJC 2010. We present here the same series with updated PFS and OS (median follow up of 48 months). Results: 30 patients with a median age of 58 years (60% of males) were included from June 2005 to April 2007 in five French institutions. At the cut-off date (31 august 2010), 9 patients are still under treatment with a median treatment duration of 41 months (min=33, max=52). Two additional progressions have been reported for a total of 14 events (13 progressions and 1 death). Updated median PFS is 41 months (95% CI: [17.5; NR]) with PFS rates of 60% [39; 77], 56% [35; 73] and 45% [24; 64] respectively at 2, 3 and 4 years. With 8 patients dead, median OS is not yet reached with OS rates of 90% [72; 97], 87% [68; 95] and 74% [52; 87], respectively, at 2, 3, and 4 years. The main frequent relevant grade 3 toxicities were: rash (10%), neutropenia (7%) and abdominal pain (7%) with one patient presented a grade 4 skin exfoliation. No other relevant long-term toxicities were reported and no more patients discontinued treatment due to suspected toxicity. Conclusions: The long term results observed with masitinib confirm a very interesting activity with prolonged PFS and OS. These results support the head to head comparison with imatinib in the currently ongoing phase III randomized clinical trial in first line locally advanced or metastatic GIST patients. [Table: see text]
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Evaluating Urinary Continence and Preoperative Predictors of Urinary Continence After Robot Assisted Laparoscopic Radical Prostatectomy. J Urol 2010; 184:1028-33. [DOI: 10.1016/j.juro.2010.04.069] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Indexed: 11/30/2022]
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A stratified phase II trial investigating sorafenib (SORA) in patients (pts) with metastatic or locally advanced angiosarcoma (AS). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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A national registry for the off-label use of targeted therapies in patients (pts) with malignant mesenchymal tumors: A retrospective study from the GSF-GETO. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Quality of surgical margins and local recurrence in primary extremity soft tissue sarcoma (STS). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Metronomic oral cyclophosphamide (CPM) and prednisolone in elderly patients (pts) with inoperable or metastatic soft tissue sarcoma (STS). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Antitumor activity of pemetrexed (Pem) in second-line advanced/metastatic osteosarcomas: A multicenter phase II study. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Activity of eribulin mesylate (E7389) in patients with soft tissue sarcoma (STS): Phase II studies of the European Organisation for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group (EORTC 62052). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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