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Marconi M, Pagano MT, Ristori J, Bonadonna S, Pivonello R, Meriggiola MC, Motta G, Lombardo F, Mosconi M, Oppo A, Cocchetti C, Romani A, Federici S, Bruno L, Verde N, Lami A, Crespi CM, Marinelli L, Giordani L, Matarrese P, Ruocco A, Santangelo C, Contoli B, Masocco M, Minardi V, Chiarotti F, Fisher AD, Pierdominici M. Sociodemographic profile, health-related behaviours and experiences of healthcare access in Italian transgender and gender diverse adult population. J Endocrinol Invest 2024:10.1007/s40618-024-02362-x. [PMID: 38733428 DOI: 10.1007/s40618-024-02362-x] [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: 12/20/2023] [Accepted: 03/09/2024] [Indexed: 05/13/2024]
Abstract
PURPOSE Information on the general health of transgender and gender diverse (TGD) individuals continues to be lacking. To bridge this gap, the National Institute of Health in Italy together with the National Office against Racial Discriminations, clinical centres, and TGD organizations carried out a cross-sectional study to define the sociodemographic profile, health-related behaviours, and experiences of healthcare access in Italian TGD adult population. METHODS A national survey was conducted by Computer-Assisted Web Interviewing (CAWI) technique. Collected data were compared within the TGD subgroups and between TGD people and the Italian general population (IGP). RESULTS TGD respondents were 959: 65% assigned female at birth (AFAB) and 35% assigned male at birth (AMAB). 91.8% and 8.2% were binary and non-binary TGD respondents, respectively. More than 20% of the TGD population reported to be unemployed with the highest rate detectable in AMAB and non-binary people. Cigarette smoking and binge drinking were higher in the TGD population compared with IGP (p < 0.05), affecting TGD subgroups differently. A significant lower percentage of AFAB TGD people reported having had screening for cervical and breast cancer in comparison with AFAB IGP (p < 0.0001, in both cases). Over 40% was the percentage of AFAB and non-binary TGD people accessing healthcare who felt discriminated against because of their gender identity. CONCLUSIONS Our results are a first step towards a better understanding of the health needs of TGD people in Italy in order to plan the best policy choices for a more inclusive public health.
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Affiliation(s)
- M Marconi
- Reference Centre for Gender Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - M T Pagano
- Reference Centre for Gender Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - J Ristori
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, Florence, Italy
| | - S Bonadonna
- Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - R Pivonello
- Dipartimento Di Medicina Clinica E Chirurgia, Sezione di Endocrinologia, University Federico II, Naples, Italy
| | - M C Meriggiola
- Division of Gynecology and Physiopathology of Human Reproduction, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - G Motta
- Division of Endocrinology, Diabetology and Metabolism, Azienda Ospedaliero-Universitaria Città Della Salute E Della Scienza di Torino, University of Turin, Turin, Italy
| | - F Lombardo
- Laboratory of Semiology, Department of Experimental Medicine, Sperm Bank "Loredana Gandini", Sapienza University of Rome, Rome, Italy
| | - M Mosconi
- Gender Identity Development Service, Hospital S. Camillo-Forlanini, Rome, Italy
| | - A Oppo
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - C Cocchetti
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, Florence, Italy
| | - A Romani
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, Florence, Italy
| | - S Federici
- Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - L Bruno
- Dipartimento Di Medicina Clinica E Chirurgia, Sezione di Endocrinologia, University Federico II, Naples, Italy
| | - N Verde
- Dipartimento Di Medicina Clinica E Chirurgia, Sezione di Endocrinologia, University Federico II, Naples, Italy
| | - A Lami
- Division of Gynecology and Physiopathology of Human Reproduction, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - C M Crespi
- Division of Endocrinology, Diabetology and Metabolism, Azienda Ospedaliero-Universitaria Città Della Salute E Della Scienza di Torino, University of Turin, Turin, Italy
| | - L Marinelli
- Division of Endocrinology, Diabetology and Metabolism, Azienda Ospedaliero-Universitaria Città Della Salute E Della Scienza di Torino, University of Turin, Turin, Italy
| | - L Giordani
- Reference Centre for Gender Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - P Matarrese
- Reference Centre for Gender Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - A Ruocco
- Reference Centre for Gender Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - C Santangelo
- Reference Centre for Gender Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - B Contoli
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità, Rome, Italy
| | - M Masocco
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità, Rome, Italy
| | - V Minardi
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità, Rome, Italy
| | - F Chiarotti
- Reference Centre for Behavioral Sciences and Mental Health, Istituto Superiore Di Sanità, Rome, Italy
| | - A D Fisher
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, Florence, Italy
| | - M Pierdominici
- Reference Centre for Gender Medicine, Istituto Superiore di Sanità, Rome, Italy.
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Santi D, Spaggiari G, Marinelli L, Cacciani M, Scipio S, Bichiri A, Profeta A, Granata ARM, Simoni M, Lanfranco F, Manieri C, Ghigo E, Motta G. Gender-affirming hormone treatment: friend or foe? Long-term follow-up of 755 transgender people. J Endocrinol Invest 2024; 47:1091-1100. [PMID: 37889433 DOI: 10.1007/s40618-023-02220-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 10/07/2023] [Indexed: 10/28/2023]
Abstract
PURPOSE Gender-affirming hormone treatment (GAHT) is one of the main demands of transgender and gender diverse (TGD) people, who are usually categorised as transgender assigned-male-at birth (AMAB) and assigned-female-at birth (AFAB). The aim of the study is to investigate the long-term therapeutic management of GAHT, considering hormonal targets, treatment adjustments and GAHT safety. METHODS A retrospective, longitudinal, observational, multicentre clinical study was carried out. Transgender people, both AMAB and AFAB, were recruited from two Endocrinology Units in Italy (Turin and Modena) between 2005 and 2022. Each subject was managed with specific and personalized follow-up depending on the clinical practice of the Centre. All clinical data routinely collected were extracted, including anthropometric and biochemical parameters, lifestyle habits, GAHT regime, and cardiovascular events. RESULTS Three-hundred and two transgender AFAB and 453 transgender AMAB were included. Similar follow-up duration (p = 0.974) and visits' number (p = 0.384) were detected between groups. The transgender AFAB group reached therapeutic goals in less time (p = 0.002), fewer visits (p = 0.006) and fewer adjustments of GAHT scheme (p = 0.024). Accordingly, transgender AFAB showed a higher adherence to medical prescriptions compared to transgender AMAB people (p < 0.001). No significantly increased rate of cardiovascular events was detected in both groups. CONCLUSION Our real-world clinical study shows that transgender AFAB achieve hormone target earlier and more frequently in comparison to transgender AMAB individuals. Therefore, transgender AMAB people may require more frequent check-ups in order to tailor feminizing GAHT and increase therapeutic adherence.
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Affiliation(s)
- D Santi
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy.
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
- Unit of Andrology and Sexual Medicine of the Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy.
| | - G Spaggiari
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
- Unit of Andrology and Sexual Medicine of the Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - L Marinelli
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - M Cacciani
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - S Scipio
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - A Bichiri
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - A Profeta
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - A R M Granata
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
- Unit of Andrology and Sexual Medicine of the Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - M Simoni
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Unit of Andrology and Sexual Medicine of the Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - F Lanfranco
- Division of Endocrinology, Andrology and Metabolism, Department of Medical Sciences, Humanitas Gradenigo, University of Turin, Turin, Italy
| | - C Manieri
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - E Ghigo
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - G Motta
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
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Marinelli L, Bichiri A, Cagnina S, Castella L, Ghigo E, Motta G. Efficacy of topical minoxidil in enhancing beard growth in a group of transgender assigned female at birth individuals on gender affirming hormone therapy. J Endocrinol Invest 2024:10.1007/s40618-024-02373-8. [PMID: 38644453 DOI: 10.1007/s40618-024-02373-8] [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: 01/05/2024] [Accepted: 04/09/2024] [Indexed: 04/23/2024]
Abstract
PURPOSE Testosterone therapy represents the cornerstone of gender affirming hormone therapy (GAHT) among t-AFAB (transgender Assigned Female At Birth) people. Minoxidil is a vasodilator drug approved for topical use for the treatment of androgenetic alopecia. The aim of the present study was to evaluate the efficacy of topical minoxidil in enhancing beard growth in a group of t-AFAB people on GAHT. METHODS Sixteen t-AFAB individuals with an incomplete beard development, on GAHT for at least 6 months, were enrolled. Topical minoxidil was applied to the interested facial areas. Before starting (T0), after 3 (T3) and 6 (T6) months, we evaluated facial hair growth using the Ferriman-Gallwey modified score (FGm). RESULTS Subjects were 26 (2.7) years old and on GAHT for 18.5 [15-54] months; using a paired match evaluation, a statistically significant facial hair growth was observed over time, in particular at T6 (median upper lip FGm 3.5 [3-4] vs 2 [1-2] at T0 and chin FGm 4 [3.25-4] vs 1 [1-2] at T0; p ≤ 0.002). Comparing the minoxidil group with a control group (n = 16) matched for age and BMI who developed a full-grown beard only with GAHT, a logistic multivariable analysis identified hirsutism before GAHT was independently positively associated with the development of a full beard [OR 15.22 (95% CI 1.46-158.82); p = 0.023]. CONCLUSIONS This is the first study demonstrating the efficacy of topical minoxidil in enhancing facial hair growth among t-AFAB people on GAHT. Further studies will be necessary to assess whether the obtained improvements will persist after discontinuing the medication.
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Affiliation(s)
- L Marinelli
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126, Turin, Italy.
| | - A Bichiri
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126, Turin, Italy
| | - S Cagnina
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126, Turin, Italy
| | - L Castella
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126, Turin, Italy
| | - E Ghigo
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126, Turin, Italy
| | - G Motta
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, 10126, Turin, Italy
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Ristori J, Motta G, Meriggiola MC, Bettocchi C, Crespi C, Falcone M, Lombardo F, Maggi M, Morelli G, Colao AM, Isidori AM, Fisher AD. A comment from SIGIS, SIE and SIAMS: "Puberty blockers in transgender adolescents-a matter of growing evidence and not of ideology". J Endocrinol Invest 2024; 47:479-481. [PMID: 37695460 DOI: 10.1007/s40618-023-02173-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/02/2023] [Indexed: 09/12/2023]
Affiliation(s)
- J Ristori
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, Careggi University Hospital, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
| | - G Motta
- Endocrinology, Diabetology and Metabolism Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - M C Meriggiola
- Division of Gynecology and Human Reproduction Physiopathology, IRCSS Azienda Ospedaliero Universitaria di Bologna, University of Bologna, Bologna, Italy
| | - C Bettocchi
- Department of Urology, University of Foggia, Foggia, Italy
| | - C Crespi
- Endocrinology, Diabetology and Metabolism Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - M Falcone
- Department of Urology, A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, Turin, Italy
| | - F Lombardo
- Department of Experimental Medicine, University of Rome "La Sapienza", Rome, Italy
| | - M Maggi
- Endocrinology Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - G Morelli
- Urology Department, University of Pisa, Pisa, Italy
| | - A M Colao
- Cattedra Unesco "Educazione alla Salute e allo Sviluppo Sostenibile", University "Federico II", Naples, Italy
- UNESCO Chair on Health Education and Sustainable Development, Federico II University, Naples, Italy
| | - A M Isidori
- Department of Experimental Medicine, University of Rome "La Sapienza", Rome, Italy
| | - A D Fisher
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, Careggi University Hospital, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy.
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Bos MK, Lam SW, Motta G, Helmijr JCA, Beaufort CM, de Jonge E, Martens JWM, Boven E, Jansen MPHM, Jager A, Sleijfer S. Plasma ESR1 mutations and outcome to first-line paclitaxel and bevacizumab in patients with advanced ER-positive/HER2-negative breast cancer. Breast Cancer Res Treat 2023:10.1007/s10549-023-06965-5. [PMID: 37226020 DOI: 10.1007/s10549-023-06965-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/02/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND ESR1 mutations have been identified as mechanism for endocrine resistance and are also associated with a decreased overall survival. We assessed ESR1 mutations in circulating tumor DNA (ctDNA) for impact on outcome to taxane-based chemotherapy in advanced breast cancer patients. METHODS ESR1 mutations were determined in archived plasma samples from patients treated with paclitaxel and bevacizumab (AT arm, N = 91) in the randomized phase II ATX study. Samples collected at baseline (n = 51) and at cycle 2 (n = 13, C2) were analyzed using a breast cancer next-generation sequencing panel. This study was powered to detect a benefit in progression-free survival (PFS) at six months for patients treated with paclitaxel/bevacizumab compared to historical trials with fulvestrant. PFS, overall survival (OS), and ctDNA dynamics were exploratory analyses. RESULTS PFS at six months was 86% (18/21) in patients with an ESR1 mutation detected and 85% (23/27) in wildtype ESR1 patients. In our exploratory analysis, median progression-free survival (PFS) was 8.2 months [95% CI, 7.6-8.8] for ESR1 mutant patients versus 8.7 months [95% confidence interval (CI), 8.3-9.2] for ESR1 wildtype patients [p = 0.47]. The median overall survival (OS) was 20.7 months [95% CI, 6.6-33.7] for ESR1 mutant patients versus 28.1 months [95% confidence interval (CI), 19.3-36.9] for ESR1 wildtype patients [p = 0.27]. Patients with ≥ two ESR1 mutations had a significantly worse OS, but not PFS, compared to those who did not [p = 0.003]. Change in ctDNA level at C2 was not different between ESR1 and other mutations. CONCLUSIONS Presence of ESR1 mutations in baseline ctDNA might not be associated with inferior PFS and OS in advanced breast cancer patients treated with paclitaxel/bevacizumab.
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Affiliation(s)
- M K Bos
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands.
| | - S W Lam
- Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit Amsterdam/Cancer Center Amsterdam, De Boelelaan 1117, 1081 , HV, Amsterdam, The Netherlands
- Department of Radiology, The Netherlands, Cancer Institute/Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066, CX, Amsterdam, The Netherlands
| | - G Motta
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands
- IOM (Mediterranean Institute of Oncology) Research, Viagrande, Catania, Italy
- Department of Clinical and Experimental Medicine, A.O.U. Policlinico-Vittorio Emanuele, Center of Experimental Oncology and Hematology, University of Catania, Catania, Italy
| | - J C A Helmijr
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands
| | - C M Beaufort
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands
| | - E de Jonge
- Department of Clinical Chemistry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J W M Martens
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands
| | - E Boven
- Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit Amsterdam/Cancer Center Amsterdam, De Boelelaan 1117, 1081 , HV, Amsterdam, The Netherlands
| | - M P H M Jansen
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands
| | - A Jager
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands
| | - S Sleijfer
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands
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Alberti-Violetti S, Del Corvo M, Melle F, Motta G, Sapienza MR, Venegoni L, Cerroni L, Cota C, Pileri A, Pileri S, Berti E. A 9-gene prognostic signature for predicting survival outcome in mycosis fungoides. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00565-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Castralli H, Tronco G, Salatino L, Motta G, Zancan M. Determinants of female orgasm in medical students from southern Brazil. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tronco G, Castralli H, Salatino L, Motta G, Zancan M. Association between physical activity and sexual dysfunctions in medical students from southern Brazil. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.488] [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: 10/18/2022]
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Fisher AD, Senofonte G, Cocchetti C, Guercio G, Lingiardi V, Meriggiola MC, Mosconi M, Motta G, Ristori J, Speranza AM, Pierdominici M, Maggi M, Corona G, Lombardo F. SIGIS-SIAMS-SIE position statement of gender affirming hormonal treatment in transgender and non-binary people. J Endocrinol Invest 2022; 45:657-673. [PMID: 34677807 DOI: 10.1007/s40618-021-01694-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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: 07/29/2021] [Accepted: 10/10/2021] [Indexed: 01/29/2023]
Abstract
PURPOSE Gender Incongruence (GI) is a marked and persistent incongruence between an individual's experienced and the assigned gender at birth. In the recent years, there has been a considerable evolution and change in attitude as regards to gender nonconforming people. METHODS According to the Italian Society of Gender, Identity and Health (SIGIS), the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Endocrinology (SIE) rules, a team of experts on the topic has been nominated by a SIGIS-SIAMS-SIE Guideline Board on the basis of their recognized clinical and research expertise in the field, and coordinated by a senior author, has prepared this Position statement. Later on, the present manuscript has been submitted to the Journal of Endocrinological Investigation for the normal process of international peer reviewing after a first internal revision process made by the SIGIS-SIAMS-SIE Guideline Board. RESULTS In the present document by the SIGIS-SIAMS-SIE group, we propose experts opinions concerning the psychological functioning, gender affirming hormonal treatment, safety concerns, emerging issues in transgender healthcare (sexual health, fertility issues, elderly trans people), and an Italian law overview aimed to improve gender non-conforming people care. CONCLUSION In this Position statement, we propose experts opinions concerning the psychological functioning of transgender people, the gender-affirming hormonal treatment (full/partial masculinization in assigned female at birth trans people, full/partial feminization and de-masculinization in assigned male at birth trans people), the emerging issues in transgender health care aimed to improve patient care. We have also included an overview of Italian law about gender affirming surgery and registry rectification.
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Affiliation(s)
- A D Fisher
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, Viale Pieraccini 6, 50139, Florence, Italy
| | - G Senofonte
- Laboratory of Seminology, Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza University of Rome, 00185, Rome, Italy
| | - C Cocchetti
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, Viale Pieraccini 6, 50139, Florence, Italy
| | - G Guercio
- Studio Legale Avv. Giovanni Guercio, Via Antonio Mordini, 14, 00195, Rome, Italy
| | - V Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185, Roma, Italy
| | - M C Meriggiola
- Gynecology and Physiopathology of Human Reproduction, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy
| | - M Mosconi
- Gender Identity Development Service, Hospital S. Camillo-Forlanini, Rome, Italy
| | - G Motta
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - J Ristori
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, Viale Pieraccini 6, 50139, Florence, Italy
| | - A M Speranza
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185, Roma, Italy
| | - M Pierdominici
- Center for Gender Specific Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - M Maggi
- Department of Experimental, Clinical and Biomedical Sciences, Careggi University Hospital, Viale Pieraccini 6, 50139, Florence, Italy
| | - G Corona
- Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Azienda-Usl, Bologna, Italy
| | - F Lombardo
- Laboratory of Seminology, Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza University of Rome, 00185, Rome, Italy.
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Massimilla E, Nunziata M, Cimmino E, Magaldi M, Motta G, Donadio A, Castaldo G, Testa D, Motta G. Ossiculoplasty in incudostapedial joint defects: audiologic outcomes of three type of partial ossicular prostheses in retrospective clinical study 1995-2015. Am J Otolaryngol 2022; 43:103370. [PMID: 35074738 DOI: 10.1016/j.amjoto.2021.103370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 12/19/2021] [Indexed: 11/01/2022]
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11
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Cussino M, Crespi C, Mineccia V, Molo M, Motta G, Veglia F. State of mind of attachment and reflective function in an Italian transsexual sample. European Journal of Trauma & Dissociation 2021. [DOI: 10.1016/j.ejtd.2019.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Pasero D, Berton AM, Motta G, Raffaldi R, Fornaro G, Costamagna A, Toscano A, Filippini C, Mengozzi G, Prencipe N, Zavattaro M, Settanni F, Ghigo E, Brazzi L, Benso AS. Neuroendocrine predictors of vasoplegia after cardiopulmonary bypass. J Endocrinol Invest 2021; 44:1533-1541. [PMID: 33247422 PMCID: PMC8195887 DOI: 10.1007/s40618-020-01465-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 11/09/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE Vasoplegia often complicates on-pump cardiac surgery. Systemic inflammatory response induced by extracorporeal circulation represents the major determinant, but adrenal insufficiency and postoperative vasopressin deficiency may have a role. Pathophysiological meaning of perioperative changes in endocrine markers of hydro-electrolyte balance has not still fully elucidated. Objectives of the present research study were to estimate the incidence of vasoplegia in a homogeneous cohort of not severe cardiopathic patients, to define the role of presurgical adrenal insufficiency, to evaluate copeptin and NT-proBNP trends in the perioperative. METHODS We conducted a prospective cohort study in the cardiac intensive care unit of a tertiary referral center. We evaluated 350 consecutive patients scheduled for cardiac surgery; 55 subjects completed the study. Both standard and low-dose corticotropin stimulation tests were performed in the preoperative; copeptin and NT-proBNP were evaluated in the preoperative (T0), on day 1 (T1) and day 7 (T2) after surgery. RESULTS Nine subjects (16.3%) developed vasoplegic syndrome with longer bypass and clamping time (p < 0.001). Reduced response to low-dose ACTH test was not associated to vasoplegia. Preoperative copeptin > 16.9 pmol/L accurately predicted the syndrome (AUC 0.86, 95% CI 0.73-0.94; OR 1.17, 95% CI 1.04-1.32). An evident correlation was observed at 7 days postoperative between NT-proBNP and copeptin (r 0.88, 95% CI 0.8-0.93; p < 0.001). CONCLUSION Preoperative impaired response to low-dose ACTH stimulation test is not a risk factor for post-cardiotomic vasoplegia; conversely, higher preoperative copeptin predicts the complication. On-pump cardiac surgery could be an interesting model of rapid heart failure progression.
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Affiliation(s)
- D Pasero
- Anaesthesia and Critical Care Medicine, Department of Medical, Surgical and Experimental Science, University Hospital, University of Sassari, Sassari, Italy.
| | - A M Berton
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy
| | - G Motta
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy
| | - R Raffaldi
- Department of Surgical Science, University of Turin, Turin, Italy
| | - G Fornaro
- Department of Anesthesiology, Critical Care and Emergency Medicine, Cardiac Intensive Care Unit, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy
| | - A Costamagna
- Department of Anesthesiology, Critical Care and Emergency Medicine, Cardiac Intensive Care Unit, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy
| | - A Toscano
- Department of Anesthesiology, Critical Care and Emergency Medicine, Cardiac Intensive Care Unit, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy
| | - C Filippini
- Department of Surgical Science, University of Turin, Turin, Italy
| | - G Mengozzi
- Clinical Biochemistry Laboratory, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy
| | - N Prencipe
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy
| | - M Zavattaro
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy
| | - F Settanni
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy
| | - E Ghigo
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy
| | - L Brazzi
- Department of Surgical Science, University of Turin, Turin, Italy
- Department of Anesthesiology, Critical Care and Emergency Medicine, Cardiac Intensive Care Unit, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy
| | - A S Benso
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy
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Lorenzano F, Santuccio G, Caruso L, Chiarenza A, Figuera A, Motta G, Di Raimondo F, Romano A. THE CONTRIBUTION OF MONOCYTE‐TO‐PLATELET RATIO TO PREDICT OVERALL SURVIVAL IN MANTLE CELL LYMPHOMA: A SINGLE‐CENTER SURVEY. Hematol Oncol 2021. [DOI: 10.1002/hon.29_2881] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- F Lorenzano
- University of Catania, Dipartimento di Chirurgia e Specialità Medico‐Chirurgiche Catania Italy
| | - G Santuccio
- University of Catania, Dipartimento di Chirurgia e Specialità Medico‐Chirurgiche Catania Italy
| | - L Caruso
- AOU Policlinico Rodolico San Marco, Divisione di Ematologia Catania Italy
| | - A Chiarenza
- AOU Policlinico Rodolico San Marco, Divisione di Ematologia Catania Italy
| | - A Figuera
- AOU Policlinico Rodolico San Marco, Divisione di Ematologia Catania Italy
| | - G Motta
- AOU Policlinico Rodolico San Marco, Divisione di Ematologia Catania Italy
| | - F Di Raimondo
- University of Catania, Dipartimento di Chirurgia e Specialità Medico‐Chirurgiche Catania Italy
| | - A Romano
- University of Catania, Dipartimento di Chirurgia e Specialità Medico‐Chirurgiche Catania Italy
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Abstract
Laryngopharyngeal reflux (LPR) is a common disease caused by the leaking beck of gastric material out of the esophagus. The main symptoms are dysphonia, dysphagia, and cough. There is an established use of proton pump inhibitors (PPI) in patients with suspected LPR in common practice. This habit is translated by the standard strategy to use PPI in treating patients with gastroesophageal reflux. However, PPI can not wholly inhibit all types of reflux and are burden by adverse effects. Alginate, a derivative from algae, is devoid of side effects and effectively counteracts gastric material reflux forming a foaming gel in the stomach. The current study enrolled 100 outpatients with LPR. Alginate treatment was administered for two months. Patients underwent four visits (at baseline and 15, 30, and 60 days after treatment). A visual analog scale assessed the perception of dysphonia, dysphagia, and cough. Alginate significantly (p<0.0001) reduced all parameters. Therefore, the current study demonstrated that magnesium alginate was effective and safe in LPR treatment.
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Affiliation(s)
- G Ciprandi
- Consultant allergist, Casa di Cura Villa Montallegro, Genoa, Italy
| | - V Damiani
- Medical Department, D.M.G. Italia, Pomezia, Italy
| | - F M Passali
- Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, Rome, Italy
| | - A Crisanti
- Clinical Medicine Department, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy
| | - G Motta
- ENT Clinic, University Vanvitelli, Naples, Italy
| | - D Passali
- International Federation ORL Societies (IFOS) Executive Board members Rome Italy
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15
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Cocuzza S, Maniaci A, Di Luca M, La Mantia I, Grillo C, Spinato G, Motta G, Testa D, Ferlito S. Long-term results of nasal surgery: comparison of mini-invasive turbinoplasty. J BIOL REG HOMEOS AG 2020; 34:1203-1208. [PMID: 32640780 DOI: 10.23812/19-522-l-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- S Cocuzza
- Otorhinolaryngology Clinic, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section, University of Catania, Italy
| | - A Maniaci
- Otorhinolaryngology Clinic, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section, University of Catania, Italy
| | - M Di Luca
- Otorhinolaryngology Clinic, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section, University of Catania, Italy
| | - I La Mantia
- Otorhinolaryngology Clinic, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section, University of Catania, Italy
| | - C Grillo
- Otorhinolaryngology Clinic, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section, University of Catania, Italy
| | - G Spinato
- Department of Neurosciences, Section of Otolaryngology and Regional Centre for Head and Neck Cancer, University of Padua, Treviso, Italy.,Department of Surgery, Oncology and Gastroenterology, Section of Oncology and Immunology, University of Padua, Padua, Italy
| | - G Motta
- Otorhinolaryngology, Head and Neck Surgery Unit, Department of Mental and Physical Health and Preventive Medicine, 'Luigi Vanvitelli' University of Campania, Naples, Italy
| | - D Testa
- Otorhinolaryngology, Head and Neck Surgery Unit, Department of Mental and Physical Health and Preventive Medicine, 'Luigi Vanvitelli' University of Campania, Naples, Italy
| | - S Ferlito
- Otorhinolaryngology Clinic, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section, University of Catania, Italy
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16
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Passali D, Motta G, Passali FM, Nunziata M, Ciprandi G. Oral quail egg homogenate in the treatment of allergic rhinitis: a first experience in clinical practice. J BIOL REG HOMEOS AG 2020; 34:1593-1596. [PMID: 32933233 DOI: 10.23812/20-235-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
| | - G Motta
- ENT Clinic, University of Campania L. Vanvitelli, Naples, Italy
| | - F M Passali
- ENT Clinic, Uni¬versity Tor Vergata ENT, Rome, Italy
| | - M Nunziata
- ENT Clinic, University of Campania L. Vanvitelli, Naples, Italy
| | - G Ciprandi
- Allergy Clinic, Casa di Cura Villa Montallegro, Genoa, Italy
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17
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Illiano E, Natale F, Motta G, Rubilotta E, Balzarro M, Costantini E. Are there differences in the urodynamic findings after laparoscopic sacrocolpopexy and Trocarless Transvaginal Mesh System for symptomatic pelvic organ prolapse? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33681-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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18
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Illiano E, Natale F, Marchesi A, Zucchi A, Motta G, Costantini E. Total versus subtotal hysterectomy associated with laparoscopic colposacropexy: A prospective randomized controlled trial. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33672-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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19
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Berne PM, Fancello T, Viola G, Carboni V, Mula G, Ortu S, Lorenzoni G, Merella P, Motta G, Casu G. 851Predictors and causes of inappropriate shocks by subcutaneous defibrillators (S-ICD) in a cohort of sardinian Brugada syndrome patients. Europace 2020. [DOI: 10.1093/europace/euaa162.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Project Code CRP- 6175. Regione Autonoma della Sardegna
Background
The subcutaneous defibrillator (S-ICD) is an attractive option for patients with Brugada syndrome (BrS) at high risk, as it is highly effective to prevent arrhythmic sudden cardiac death (SCD) while avoiding some of the complications associated to transvenous devices. However, S-ICD are not free from complications, one of the most common being inappropriate shocks.
Objective
To assess the causes and predictors of inappropriate shocks by subcutaneous defibrillators (S-ICD) in a cohort of sardinian BrS patients
Methods
From February 2013 to September 2019, 373 patients were diagnosed as BrS patients. Sixty-five patients were considered to be at high risk of SCD, and implanted with an ICD. Of them, 36 were implanted with an S-ICD. Patients went through regular follow-up visits (physical examination, 12-lead ECG, device interrogation, occurrence of symptoms). Appropriate and inappropriate shocks were analyzed to establish their cause.
Results
Thirty-six BrS patients were implanted with an S-ICD (9.7% of the total BrS group, 55% of ICD implants). Twenty-four patients (67%) were male, mean age at diagnosis was 45± 14 y.o., and 31 (86%) were probands. Seventeen patients (47%) had a family history of SCD. Ten patients (28%) had a spontaneous type 1 ECG at diagnosis and 14 (19%) had an spontaneous type 1 ECG at least once since the diagnosis , 2 patients (5.7%) had a type 1 ECG during fever, and 11 (31%) presented an S wave ≥40 msec in lead DI. Twelve patients (33%) underwent EP study, and 8 (67%) were inducible for ventricular fibrillation.
During a mean follow-up of 46 ± 67 months, 2 patients (6%) had appropriate shocks, while 5 (14%) had inappropriate shocks. The rate between inappropriate and appropriate shock was 2.5. The causes of inappropriate shock were T-wave oversensing (4 patients, 80%) and air entrapment (1 patient, 20%).
Gender, proband status, sport practice, family history of SCD, type 1 ECG during fever, S wave ≥40 msec in lead DI, VF inducibility EP study, or the presence of symptoms during the follow-up (vaso-vagal syncope, arrhythmic syncope, nocturnal enuresis, ventricular fibrillation, atrial fibrillation) did not associated with inappropriate shock; neither did the technique of screening for S-ICD (manual or automated tool) nor the selected vector of sensing of the S-ICD.
A spontaneous type 1 ECG at diagnosis (4 (80%) versus 6 (21%), p = 0.009), or at any time from diagnosis during follow-up (4 (80%) versus 10 (33%), p = 0.0049) and having a high-pass filter programmed OFF/not available [3 (75% versus 7 (25%), p = 0.044], were significantly associated with inappropriate shock of S-ICD in these population.
Conclusions
Brugada syndrome patients implanted with S-ICD present a higher rate of inappropriate shock compared to appropriate shock (2.5 times). Patients with spontaneous type 1 ECG are at higher risk to receive inappropriate shock from S-ICDs, while programming a high-pass filter ON may prevent some of these episodes.
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Affiliation(s)
- P M Berne
- San Francesco Hospital, Department of Cardiology, Nuoro, Italy
| | - T Fancello
- San Francesco Hospital, Department of Cardiology, Nuoro, Italy
| | - G Viola
- San Francesco Hospital, Department of Cardiology, Nuoro, Italy
| | - V Carboni
- San Francesco Hospital, Department of Cardiology, Nuoro, Italy
| | - G Mula
- San Francesco Hospital, Department of Cardiology, Nuoro, Italy
| | - S Ortu
- San Francesco Hospital, Department of Cardiology, Nuoro, Italy
| | - G Lorenzoni
- San Francesco Hospital, Department of Cardiology, Nuoro, Italy
| | - P Merella
- San Francesco Hospital, Department of Cardiology, Nuoro, Italy
| | - G Motta
- San Francesco Hospital, Department of Cardiology, Nuoro, Italy
| | - G Casu
- San Francesco Hospital, Department of Cardiology, Nuoro, Italy
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20
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Ciavarella S, Vegliante MC, Fabbri M, De Summa S, Melle F, Motta G, De Iuliis V, Opinto G, Enjuanes A, Rega S, Gulino A, Agostinelli C, Scattone A, Tommasi S, Mangia A, Mele F, Simone G, Zito AF, Ingravallo G, Vitolo U, Chiappella A, Tarella C, Gianni AM, Rambaldi A, Zinzani PL, Casadei B, Derenzini E, Loseto G, Pileri A, Tabanelli V, Fiori S, Rivas-Delgado A, López-Guillermo A, Venesio T, Sapino A, Campo E, Tripodo C, Guarini A, Pileri SA. Dissection of DLBCL microenvironment provides a gene expression-based predictor of survival applicable to formalin-fixed paraffin-embedded tissue. Ann Oncol 2019; 30:2015. [PMID: 31539020 PMCID: PMC6938597 DOI: 10.1093/annonc/mdz386] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Ciavarella
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - M C Vegliante
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - M Fabbri
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan
| | - S De Summa
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - F Melle
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan
| | - G Motta
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan
| | - V De Iuliis
- Post-graduated Medical School of Clinical Pathology, "Gabriele D'Annunzio", University of Chieti, Chieti
| | - G Opinto
- Functional Biomorphology Laboratory, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - A Enjuanes
- Unitat de Genòmica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona; CIBERONC, Barcelona, Spain
| | - S Rega
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - A Gulino
- Tumor Immunology Unit, Dipartimento per la Promozione della Salute e Materno Infantile "G. D'Alessandro", University of Palermo, Palermo
| | - C Agostinelli
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna
| | - A Scattone
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - S Tommasi
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - A Mangia
- Functional Biomorphology Laboratory, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - F Mele
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - G Simone
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - A F Zito
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - G Ingravallo
- Pathology Section, Department of Emergency and Organ Transplantation (DETO), University of Bari "Aldo Moro", Bari
| | - U Vitolo
- Department of Hematology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino
| | - A Chiappella
- Department of Hematology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino
| | - C Tarella
- Onco-Hematology Unit, European Institute of Oncology, IRCCS, Milan
| | - A M Gianni
- Onco-Hematology Unit, European Institute of Oncology, IRCCS, Milan
| | - A Rambaldi
- Department of Hematology and Oncology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo; School of Medicine, University of Milan, Milan, Italy
| | - P L Zinzani
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna
| | - B Casadei
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna
| | - E Derenzini
- Onco-Hematology Unit, European Institute of Oncology, IRCCS, Milan
| | - G Loseto
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - A Pileri
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna
| | - V Tabanelli
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan
| | - S Fiori
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan
| | - A Rivas-Delgado
- CIBERONC, Barcelona, Spain; Hematology Department, Hospital Clínic, Barcelona; IDIBAPS, Barcelona, Spain
| | - A López-Guillermo
- CIBERONC, Barcelona, Spain; Hematology Department, Hospital Clínic, Barcelona; IDIBAPS, Barcelona, Spain
| | - T Venesio
- Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - A Sapino
- Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy; Department of Medical Sciences, University of Torino, Turin, Italy
| | - E Campo
- CIBERONC, Barcelona, Spain; Haematopathology Unit, Pathology Department, Hospital Clínic, Barcelona; University of Barcelona, Barcelona, Spain
| | - C Tripodo
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - A Guarini
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - S A Pileri
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan
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21
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Ciavarella S, Vegliante MC, Fabbri M, De Summa S, Melle F, Motta G, De Iuliis V, Opinto G, Enjuanes A, Rega S, Gulino A, Agostinelli C, Scattone A, Tommasi S, Mangia A, Mele F, Simone G, Zito AF, Ingravallo G, Vitolo U, Chiappella A, Tarella C, Gianni AM, Rambaldi A, Zinzani PL, Casadei B, Derenzini E, Loseto G, Pileri A, Tabanelli V, Fiori S, Rivas-Delgado A, López-Guillermo A, Venesio T, Sapino A, Campo E, Tripodo C, Guarini A, Pileri SA. Dissection of DLBCL microenvironment provides a gene expression-based predictor of survival applicable to formalin-fixed paraffin-embedded tissue. Ann Oncol 2019; 29:2363-2370. [PMID: 30307529 PMCID: PMC6311951 DOI: 10.1093/annonc/mdy450] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Gene expression profiling (GEP) studies recognized a prognostic role for tumor microenvironment (TME) in diffuse large B-cell lymphoma (DLBCL), but the routinely adoption of prognostic stromal signatures remains limited. Patients and methods Here, we applied the computational method CIBERSORT to generate a 1028-gene matrix incorporating signatures of 17 immune and stromal cytotypes. Then, we carried out a deconvolution on publicly available GEP data of 482 untreated DLBCLs to reveal associations between clinical outcomes and proportions of putative tumor-infiltrating cell types. Forty-five genes related to peculiar prognostic cytotypes were selected and their expression digitally quantified by NanoString technology on a validation set of 175 formalin-fixed, paraffin-embedded DLBCLs from two randomized trials. Data from an unsupervised clustering analysis were used to build a model of clustering assignment, whose prognostic value was also assessed on an independent cohort of 40 cases. All tissue samples consisted of pretreatment biopsies of advanced-stage DLBCLs treated by comparable R-CHOP/R-CHOP-like regimens. Results In silico analysis demonstrated that higher proportion of myofibroblasts (MFs), dendritic cells, and CD4+ T cells correlated with better outcomes and the expression of genes in our panel is associated with a risk of overall and progression-free survival. In a multivariate Cox model, the microenvironment genes retained high prognostic performance independently of the cell-of-origin (COO), and integration of the two prognosticators (COO + TME) improved survival prediction in both validation set and independent cohort. Moreover, the major contribution of MF-related genes to the panel and Gene Set Enrichment Analysis suggested a strong influence of extracellular matrix determinants in DLBCL biology. Conclusions Our study identified new prognostic categories of DLBCL, providing an easy-to-apply gene panel that powerfully predicts patients’ survival. Moreover, owing to its relationship with specific stromal and immune components, the panel may acquire a predictive relevance in clinical trials exploring new drugs with known impact on TME.
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Affiliation(s)
- S Ciavarella
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - M C Vegliante
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - M Fabbri
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - S De Summa
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - F Melle
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - G Motta
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - V De Iuliis
- Post-graduated Medical School of Clinical Pathology, "Gabriele D'Annunzio", University of Chieti, Chieti, Italy
| | - G Opinto
- Functional Biomorphology Laboratory, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - A Enjuanes
- Unitat de Genòmica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBERONC, Barcelona, Spain
| | - S Rega
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - A Gulino
- Tumor Immunology Unit, Dipartimento per la Promozione della Salute e Materno Infantile "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - C Agostinelli
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna, Italy
| | - A Scattone
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - S Tommasi
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - A Mangia
- Functional Biomorphology Laboratory, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - F Mele
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - G Simone
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - A F Zito
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - G Ingravallo
- Pathology Section, Department of Emergency and Organ Transplantation (DETO), University of Bari "Aldo Moro", Bari, Italy
| | - U Vitolo
- Department of Hematology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - A Chiappella
- Department of Hematology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - C Tarella
- Onco-Hematology Unit, European Institute of Oncology, IRCCS, Milan, Italy
| | - A M Gianni
- Onco-Hematology Unit, European Institute of Oncology, IRCCS, Milan, Italy
| | - A Rambaldi
- Department of Hematology and Oncology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy; School of Medicine, University of Milan, Milan, Italy
| | - P L Zinzani
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna, Italy
| | - B Casadei
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna, Italy
| | - E Derenzini
- Onco-Hematology Unit, European Institute of Oncology, IRCCS, Milan, Italy
| | - G Loseto
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - A Pileri
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna, Italy
| | - V Tabanelli
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - S Fiori
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - A Rivas-Delgado
- CIBERONC, Barcelona, Spain; Hematology Department, Hospital Clínic, Barcelona, Spain; IDIBAPS, Barcelona, Spain
| | - A López-Guillermo
- CIBERONC, Barcelona, Spain; Hematology Department, Hospital Clínic, Barcelona, Spain; IDIBAPS, Barcelona, Spain
| | - T Venesio
- Pathology Department, Candiolo Cancer Institute, Turin, Italy
| | - A Sapino
- Pathology Department, Candiolo Cancer Institute, Turin, Italy
| | - E Campo
- CIBERONC, Barcelona, Spain; Haematopathology Unit, Pathology Department, Hospital Clínic, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - C Tripodo
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - A Guarini
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - S A Pileri
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan, Italy.
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22
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Pileri S, Mazzara S, Derenzini E, Melle F, Motta G, Tabanelli V, Vitolo U, Chiappella A, Fabbri M, Agostinelli C, Tarella C, Rambaldi A, Guarini A, Opinto G, Vegliante M, De Summa S, Ciavarella S. INTEGRATING TUMOR- AND MICROENVIRONMENT-REFLECTING GENES IN A UNIQUE AND ROUTINE-APPLICABLE ASSAY FOR ACCURATE RISK PREDICTION IN DLBCL. Hematol Oncol 2019. [DOI: 10.1002/hon.98_2629] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- S.A. Pileri
- Unit of Diagnostic Hematopathology; European Institute of Oncology, IRCCS; Milan Italy
| | - S. Mazzara
- Unit of Diagnostic Hematopathology; European Institute of Oncology, IRCCS; Milan Italy
| | - E. Derenzini
- Onco-Hematology Unit; European Institute of Oncology, IRCCS; Milan Italy
| | - F. Melle
- Unit of Diagnostic Hematopathology; European Institute of Oncology, IRCCS; Milan Italy
| | - G. Motta
- Unit of Diagnostic Hematopathology; European Institute of Oncology, IRCCS; Milan Italy
| | - V. Tabanelli
- Unit of Diagnostic Hematopathology; European Institute of Oncology, IRCCS; Milan Italy
| | - U. Vitolo
- Department of Hematology; Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino; Torino Italy
| | - A. Chiappella
- Department of Hematology; Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino; Torino Italy
| | - M. Fabbri
- Unit of Diagnostic Hematopathology; European Institute of Oncology, IRCCS; Milan Italy
| | - C. Agostinelli
- Department of Experimental; Diagnostic and Specialty Medicine (DIMES), Bologna University School of Medicine; Bologna Italy
| | - C. Tarella
- Onco-Hematology Unit; European Institute of Oncology, IRCCS; Milan Italy
| | - A. Rambaldi
- Department of Hematology and Oncology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII; Bergamo and University of Milan, School of Medicine; Milan Italy
| | - A. Guarini
- Hematology and Cell Therapy Unit; IRCCS-Istituto Tumori 'Giovanni Paolo II'; Bari Italy
| | - G. Opinto
- Hematology and Cell Therapy Unit; IRCCS-Istituto Tumori 'Giovanni Paolo II'; Bari Italy
| | | | - S. De Summa
- Hematology and Cell Therapy Unit; IRCCS-Istituto Tumori 'Giovanni Paolo II'; Bari Italy
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23
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Ricciardiello F, Oliva F, Mesolella M, Sequino G, Motta G, Petruzzi G, Cantone E. Effect of silver vitellinate, hyaluronic acid and sodium benzoate nasal spray after septoplasty. J BIOL REG HOMEOS AG 2019; 33:303-308. [PMID: 30696533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- F Ricciardiello
- Ear, Nose and Throat Unit, AORN 'Antonio Cardarelli', Naples, Italy
| | - F Oliva
- Ear, Nose and Throat Unit, AORN 'Antonio Cardarelli', Naples, Italy
| | - M Mesolella
- Department of Neurosciences, "Federico II" University, ENT Section, Naples, Italy
| | - G Sequino
- Ear, Nose and Throat Unit, AORN 'Antonio Cardarelli', Naples, Italy
| | - G Motta
- Departments of Precision Medicine, University of Campania 'L. Vanvitelli', Naples, Italy
| | - G Petruzzi
- Department of Neurosciences, "Federico II" University, ENT Section, Naples, Italy
| | - E Cantone
- Department of Neurosciences, "Federico II" University, ENT Section, Naples, Italy
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24
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Zavattaro M, Ceruti C, Motta G, Allasia S, Marinelli L, Di Bisceglie C, Tagliabue MP, Sibona M, Rolle L, Lanfranco F. Treating varicocele in 2018: current knowledge and treatment options. J Endocrinol Invest 2018; 41:1365-1375. [PMID: 30284221 DOI: 10.1007/s40618-018-0952-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 05/18/2018] [Accepted: 09/11/2018] [Indexed: 01/20/2023]
Abstract
PURPOSE Varicocele is defined as a state of varicosity and tortuosity of the pampiniform plexus around the testis caused by retrograde blood flow through the internal spermatic vein. The prevalence of clinically relevant varicocele ranges from 5 to 20% in the male population and is often associated with infertility and reduction of sperm quality. In this review, the pathophysiology and clinical aspects of varicocele are reviewed along with therapeutic options and treatment effects on sperm parameters and fertility both in adult and in pediatric/adolescent subjects. METHODS We conducted a Medline and a PubMed search from 1965 to 2018 to identify publications related to varicocele clinical aspects, treatment procedures and treatment outcomes. Keywords used for the search were: "varicocele", "varicocelectomy", "sclerotherapy", "male infertility", "subfertility", and "semen abnormalities". RESULTS Data from a large number of studies in adolescent and adult males indicate that varicocele correction improves semen parameters in the majority of patients, reducing oxidative stress and improving sperm nuclear DNA integrity either with surgical or percutaneous approach. CONCLUSIONS Varicocele repair seems to represent a cost-effective therapeutic option for all males (both adolescent and adults) with a clinical varicocele in the presence of testicular hypotrophy, worsening sperm alterations or infertility. On the other hand, some investigators questioned the role of varicocelectomy in the era of assisted reproduction. Thus, a better understanding of the pathophysiology of varicocele-associated male subfertility is of paramount importance to elucidating the deleterious effects of varicocele on spermatogenesis and possibly formulating new treatment strategies.
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Affiliation(s)
- M Zavattaro
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - C Ceruti
- Division of Urology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - G Motta
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - S Allasia
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - L Marinelli
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - C Di Bisceglie
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - M P Tagliabue
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - M Sibona
- Division of Urology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - L Rolle
- Division of Urology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - F Lanfranco
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy.
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25
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Cavaliere M, Di Lullo AM, Cantone E, Scala G, Elefante A, Russo C, Brunetti L, Motta G, Iengo M. Cholesteatoma vs granulation tissue: a differential diagnosis by DWI-MRI apparent diffusion coefficient. Eur Arch Otorhinolaryngol 2018; 275:2237-2243. [PMID: 30088076 DOI: 10.1007/s00405-018-5082-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/31/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE To diagnose cholesteatoma when it is not visible through tympanic perforation, imaging techniques are necessary. Recently, the combination of computed tomography and magnetic resonance imaging has proven effective to diagnose middle ear cholesteatoma. In particular, diffusion weighted images have integrated the conventional imaging for the qualitative assessment of cholesteatoma. Accordingly, the aim of this study was to obtain a quantitative analysis of cholesteatoma calculating the apparent diffusion coefficient value. So, we investigated whether it could differentiate cholesteatoma from other inflammatory tissues both in a preoperative and in a postoperative study. METHODS This study included 109 patients with clinical suspicion of primary or residual/recurrent cholesteatoma. All patients underwent preoperative computed tomography and magnetic resonance imaging with diffusion sequences before primary or second-look surgery to calculate the apparent diffusion coefficient value. RESULTS We found that the apparent diffusion coefficient values of cholesteatoma were significantly lower than those of non cholesteatoma. In particular, the apparent diffusion coefficient median value of the cholesteatoma group (0.84 × 10- 3 mm2/s) differed from the inflammatory granulation tissue (2.21 × 10- 3 mm2/s) group (p < 2.2 × 10- 16). Furthermore, we modeled the probability of cholesteatoma by means of a logistic regression and we determined an optimal cut-off probability value of ~ 0.86 (specificity = 1.0, sensitivity = 0.97), corresponding to an apparent diffusion coefficient cut-off value of 1.37 × 10- 3 mm2/s. CONCLUSIONS Our study has demonstrated that apparent diffusion coefficient values constitute a valuable quantitative parameter for preoperative differentiation of cholesteatomas from other middle ear inflammatory diseases and for postoperative diagnosis of recurrent/residual cholesteatomas.
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Affiliation(s)
- M Cavaliere
- Department of Neuroscience, Reproductive and Odontostomatologic Sciences, ENT Unit, University of Naples "Federico II", Pansini Street no. 5, 80131, Naples, Italy
| | - Antonella Miriam Di Lullo
- Department of Neuroscience, Reproductive and Odontostomatologic Sciences, ENT Unit, University of Naples "Federico II", Pansini Street no. 5, 80131, Naples, Italy.
| | - E Cantone
- Department of Neuroscience, Reproductive and Odontostomatologic Sciences, ENT Unit, University of Naples "Federico II", Pansini Street no. 5, 80131, Naples, Italy
| | - G Scala
- Institute of Biotechnology, University of Helsinki, Helsinki, Finland
| | - A Elefante
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Pansini Street no. 5, 80131, Naples, Italy
| | - C Russo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Pansini Street no. 5, 80131, Naples, Italy
| | - L Brunetti
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Pansini Street no. 5, 80131, Naples, Italy
| | - G Motta
- Department of Neuroscience, Reproductive and Odontostomatologic Sciences, ENT Unit, University of Naples "Federico II", Pansini Street no. 5, 80131, Naples, Italy
| | - M Iengo
- Department of Neuroscience, Reproductive and Odontostomatologic Sciences, ENT Unit, University of Naples "Federico II", Pansini Street no. 5, 80131, Naples, Italy
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Abstract
Two hundred and nine cases of primary gastric cancer were treated surgically from January 1968 to December 1983 and analyzed retrospectively. All patients were followed up for a minimum of 5 years. There were 25 SI cases (12 %), 22 SII (10.5%), 55 SIII (26.3%) and 107 SIV (51.2%). Tumor grade according to Broders classification showed 50 cases of G1 lesions (23.9%), 44 G2 (21.1 %) and 115 G3 (55%). Patients with well differentiated G1 lesion, compared to G2-G3 patients, presented a greater incidence of T1-T2 tumors and decreased incidence of T4 tumors (p < 0.05). The lymph node involvement rate significantly increased with variation of T (p < 0.001) but not with tumor grade. Survival results correlated with tumor stage (p < 0.01) but not with tumor grade or histological type.
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Affiliation(s)
- G B Secco
- Cattedra di Semeiotica Chirurgica B, Genova, Italy
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Abstract
The clinical and pathological data of a single case of carcinosarcoma of the lung observed in the period from 1978 to 1998 were reviewed. The diagnosis was based on immunohistochemical examination of the surgical specimen after a lower left lobectomy. The patient was given adjuvant chemotherapy. The local recurrence showed only sarcomatous features. The characteristics of this rare tumor are discussed in this case report.
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Affiliation(s)
- T Testa
- Department of General and Thoracic Surgery, University of Genoa, Italy
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28
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Minetto MA, Motta G, Gorji NE, Lucini D, Biolo G, Pigozzi F, Portincasa P, Maffiuletti NA. Reproducibility and validity of the Italian version of the International Physical Activity Questionnaire in obese and diabetic patients. J Endocrinol Invest 2018; 41:343-349. [PMID: 28825210 DOI: 10.1007/s40618-017-0746-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 07/03/2017] [Accepted: 08/11/2017] [Indexed: 01/22/2023]
Abstract
PURPOSE Aims of this study were to evaluate the agreement between the short and long versions of the International Physical Activity Questionnaire (IPAQ: Italian versions), their reproducibility (agreement and reliability) and construct validity (relative to pedometry) in a clinical population. METHODS Ninety patients affected by obesity (N = 39), type 2 diabetes mellitus (N = 26) or both (N = 25) were recruited. They were asked to maintain their usual physical activity habits during two consecutive weeks and to fill the questionnaires twice (at the end of each week). They were also asked to wear a pedometer for 7 consecutive days after the first administration of the questionnaires. RESULTS We found acceptable agreement between the IPAQ short and long versions (ICC2,1 values were 0.81 and 0.77 for the 1st and 2nd administration), uncertain reproducibility (acceptable reliability but poor agreement) and inadequate validity relative to pedometry (the correlation coefficients between all IPAQ scores and daily steps were <0.50) for both IPAQ short and IPAQ long. CONCLUSIONS The IPAQ use may be justified in daily clinical practice and in clinical research (e.g., in cross-sectional studies) for a simple and rapid evaluation of the physical activity level for discriminative purposes. However, the use of these questionnaires does not appear suitable for prospective interventional studies in which the level of physical activity of the recruited patients has to be assessed over time.
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Affiliation(s)
- M A Minetto
- Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy.
- Division of Endocrinology, Diabetology and Metabolism, University of Turin, Turin, Italy.
| | - G Motta
- Division of Endocrinology, Diabetology and Metabolism, University of Turin, Turin, Italy
| | - N E Gorji
- Division of Endocrinology, Diabetology and Metabolism, University of Turin, Turin, Italy
| | - D Lucini
- Biometra Department, University of Milan, Milan, Italy
| | - G Biolo
- Clinica Medica ASUITs, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - F Pigozzi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - P Portincasa
- Department of Biomedical Sciences and Human Oncology, University "Aldo Moro" of Bari Medical School, Bari, Italy
| | - N A Maffiuletti
- Human Performance Laboratory, Schultess Clinic, Zurich, Switzerland
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Shariat-Madar Z, Mahdi F, Sampaio CAM, Schmaier AH, Motta G. Assembly of High Molecular Weight Kininogen and Activation of Prekallikrein on Cell Matrix. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1616141] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryInvestigations determined if extracellular matrix of endothelial cells (EC) is a platform for HK assembly and PK activation. In buffers containing bovine serum albumin, biotin-HK binding to ECV304 cells or their matrix requires ≥ 50 µM added Zn 2+. Ortho-phenanthroline or a HK domain 5 peptide blocks HK binding. Binding to umbilical vein EC or matrix, but not ECV304 cells or matrix, is mediated by cytokeratin 1. Biotin-HK binds to ECV304 cells or matrix with a Kd
of 15.8 or 9.0 nM and a Bmax
of 2.6 107 or 2.4 107 sites/cell, respectively. PK activation on ECV304 cells or matrix is blocked by antipain or SBTI and corn trypsin inhibitor partially inhibits kallikrein formation. PK activation occurs on ECV304 cells or matrix prepared without serum or in human factor XII deficient serum, indicating that the PK activator is not factor XIIa. EC matrix promotes plasminogen activation after the assembly of HK, PK and pro-urokinase. These studies indicate that matrix of various EC has the ability to assemble HK allowing for PK activation and subsequent activities.Abbreviations: EC: endothelial cells, FXII: factor XII, HK: high molecular weight kininogen, HKa: bradykinin-free HK, PK: plasma prekallikrein, Pro-UK: pro-urokinase, uPAR: urokinase plasminogen activator receptor, tcuPA: twochain urokinase, CK1: cytokeratin 1, SBTI: soybean trypsin inhibitor, HUVEC: human umbilical vein endothelial cell, SDS-PAGE: sodium dodecyl sulfatepolyacrylamide gel electrophoresis, CTI: corn trypsin inhibitor, p-APMSF: p-amidinophenylmethylsulfonylfluoride, EBSS: Earle’s Balanced Salt Solution
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30
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Motta L, Motta G, Banna G, Martorana F, Longhitano C, Inzerilli N, Restuccia N, Aiello M, Soto Parra H, Vigneri P. EGFR mutational status in determining choice of TKIs or standard chemotherapy for patients with advanced non-small cell lung cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx426.030] [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: 11/12/2022] Open
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31
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Chiappella A, Agostinelli C, Martelli M, Evangelista A, Fabbri M, Melle F, Motta G, Righi S, Novero D, Balzarotti M, Cabras M, Carella A, Gotti M, Pavone V, Tucci A, Ladetto M, Gaidano G, Vitolo U, Pileri S. BIODLCL04: THE PROGNOSTIC ROLE OF CELL OF ORIGIN PROFILE, MYC, BCL2, AND TP53 IN UNTREATED POOR-RISK DIFFUSE LARGE B-CELL LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A. Chiappella
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - C. Agostinelli
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - M. Martelli
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - A. Evangelista
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - M. Fabbri
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - F. Melle
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - G. Motta
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - S. Righi
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - D. Novero
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - M. Balzarotti
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - M.G. Cabras
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - A.M. Carella
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - M. Gotti
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - V. Pavone
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - A. Tucci
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - M. Ladetto
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - G. Gaidano
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - U. Vitolo
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - S.A. Pileri
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
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32
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Pasero D, Greci MC, Raffaldi R, di Vita E, Motta G, Penso A, Ghigo E, Brazzi L. Post-cardiotomy vasoplegic syndrome: role of Copeptine. J Cardiothorac Vasc Anesth 2017. [DOI: 10.1053/j.jvca.2017.02.076] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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33
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Motta G, Ratto G, Sacco A, Ogata T, Masuda H, Kikuchi K, Takagi K, Tanaka S, Yoshizu H, Senoo A. Healing and Long-Term Viability of Grafts in the Venae Cavae Reconstruction. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/153857448702100504] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The need for superior vena cava (SVC) or inferior vena cava (IVC) recon struction is not uncommon: lung cancer, mediastinal tumors, or retroperitoneal neoplasms are the most frequent indications for caval replacement. Since auto genous veins, which represent the most satisfactory venous substitute, have not been applicable to caval replacement, because of the lack of suitable length and caliber, many types of materials have been tested in the venous system. The present study was planned to compare the potential of expanded polytetrafluoroethylene (e-PTFE) and glutaraldehyde-tanned human umbilical vein (HUV) grafts as caval substitutes. Patch (4 x 5 cm) reconstruction of the SVC was carried out in 10 dogs, tubu lar (3 x 10 mm) reconstruction of the SVC in 5 dogs, and patch (1 x 2 cm) recon struction of the IVC in 8 dogs. In the patch reconstruction groups, HUV grafts were used in half of the cases and 30 μm pore sizes e-PTFE grafts in the other half, while in the tubular SVC replacement group, only e-PTFE grafts were employed. The grafts were removed fifteen to thirty days after IVC patch re construction, thirty to two hundred seventy days after SVC patch reconstruc tion, and thirty-three to forty-one months after SVC tubular replacement. In every instance, specimens were obtained for light microscopy (LM) and scan ning electron microscopy (SEM). HUV patches implanted in the SVC showed hemorrhagic foci at their central portion and marked constriction at the anastomotic regions. On the contrary, the inner surface of e-PTFE patch grafts was covered with a uniform and glis tening neointima. By LM, e-PTFE patches showed a smooth and regular lumi nal surface, while the inner surface of HUV patches was irregular, with hemorrhagic areas in the underlying layers. By SEM, e-PTFE patches revealed a more rapid and orderly endothelialization of their inner surface than HUV patches did. Tubular SVC reconstruction showed the good long-term viability of the e-PTFE neointima (as long as forty-one months after grafting). Only spotty areas revealed neointima alterations, such as fibrinoid degeneration, fo cal necrosis, or minor thrombotic foci. In the IVC patch reconstruction model, HUV grafts showed an exuberant fibrin deposition on their inner surface and delayed endothelialization patterns, as compared with e-PTFE grafts. Since rapid healing with rapid endothelialization is accepted as the most important factor providing the graft luminal surface with the best antithrombotic proper ties, the present study demonstrated that e-PTFE is a more suitable material than HUV for SVC and IVC reconstruction.
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Affiliation(s)
- G. Motta
- Department of Semeiotica Chirurgica, University of Genoa, Genoa, Italy
| | - G.B. Ratto
- Department of Semeiotica Chirurgica, University of Genoa, Genoa, Italy
| | - A. Sacco
- Department of Semeiotica Chirurgica, University of Genoa, Genoa, Italy
| | - T. Ogata
- From the Second Department of Surgery, National Defence Medical College, Tokorozawa, Saitama, Japan
| | - H. Masuda
- From the Second Department of Surgery, National Defence Medical College, Tokorozawa, Saitama, Japan
| | - K. Kikuchi
- From the Second Department of Surgery, National Defence Medical College, Tokorozawa, Saitama, Japan
| | - K. Takagi
- From the Second Department of Surgery, National Defence Medical College, Tokorozawa, Saitama, Japan
| | - S. Tanaka
- From the Second Department of Surgery, National Defence Medical College, Tokorozawa, Saitama, Japan
| | - H. Yoshizu
- From the Second Department of Surgery, National Defence Medical College, Tokorozawa, Saitama, Japan
| | - A. Senoo
- From the Second Department of Surgery, National Defence Medical College, Tokorozawa, Saitama, Japan
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Abstract
Carbon has been used to improve the thromboresistance of synthetic vascular prostheses, and for this pur pose, dacron grafts have been coated with carbon. Owing to the contradic tory results reported in the literature, a new kind of vascular conduit, ex clusively textured from carbon fi bers, has been developed. The pres ent research study was undertaken to compare carbon and expanded poly tetrafluoroethylene (e-PTFE) grafts when used as vascular substitutes. Fifty-six experimental animals were divided into four equal groups and underwent substitution of segments of infrarenal aorta or inferior vena cava (IVC), through use of either carbon or e-PTFE grafts. Prosthetic segments were removed fifteen sec onds, or sixty minutes, or seven, fif teen, thirty, sixty, or one hundred twenty days after implantation. Spec imens were examined by light and scanning electron microscopy. Cumu lative patency rates, calculated by the life-table method at 120 days after surgery, were 72% for aortic carbon grafts, 41 % for aortic e-PTFE grafts, and 0% for both carbon and e-PTFE grafts implanted on the IVC. Carbon conduits performed significantly bet ter than e-PTFE conduits when used as small-caliber arterial substitutes (p < 0.05). Fifteen seconds after blood contact, the inner surface of carbon prostheses, regardless of the implantation site, was covered with a thin proteinaceous layer, whereas e- PTFE grafts appeared almost com pletely free from hematic deposits. One hour after implantation, a red thrombus was found to overlay the luminal surface of both carbon and e- PTFE prostheses. This layer ap peared to be thicker on the e-PTFE grafts than on the carbon grafts and thicker on the venous grafts than on the arterial. The endothelialization process of the blood-prosthesis inter face seemed to be slightly more rapid on the carbon than on the e-PTFE aortic grafts. In conclusion, this new carbon graft would appear to possess promising specifications, making it suitable for small-caliber arterial (but not venous) replacement.
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Affiliation(s)
- Giovanni B. Ratto
- Cattedra di Semeiotica Chirurgica I Università di Genova Genova, Italy
| | - R. Di Primio
- From the Istituto di Anatomia Umana Normale (Head: D. Zaccheo), University of Genova, Genova, Italy
| | - P. Romano
- From the Istituto di Anatomia Umana Normale (Head: D. Zaccheo), University of Genova, Genova, Italy
| | - M. Truini
- Cattedra di Anatomia Patologica (Head: A. Badini) University of Genova, Genova, Italy
| | - A. Badini
- Cattedra di Anatomia Patologica (Head: A. Badini) University of Genova, Genova, Italy
| | - D. Zaccheo
- Istituto di Anatomia Umana Normale (Head: D. Zaccheo), University of Genova, Genova, Italy
| | - G. Motta
- Cattedra di Semeiotica Chirurgica I (Head: G. Motta), University of Genova, Genova, Italy
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Abstract
Since 1977, 61 arterial reconstruc tions using glutaraldehyde-tanned human umbilical vein (HUV) grafts were carried out in 56 patients (51 males, 5 females) with unsuitable au togenous saphenous vein. Their mean age was 69 ± 14 years. Limb salvage was the primary indication for sur gery. HUV grafts were used to perform 44 femoropopliteal, 4 composite aor topopliteal (with a direct end-to-end anastomosis between an aortofe moral Dacron graft and a femoropo pliteal HUV graft), 5 femorotibial, and 6 axillofemoral bypasses, and 1 femorofemoral and 1 iliopopliteal by pass. Ten-year cumulative patency rates were 31 % for all HUV recon structions, 36% for femoropopliteal bypasses, and 32% for femoropopli teal bypasses carried out for limb sal vage only. Four of the 5 femorotibial reconstructions failed during the first month following surgery. Two of the 6 axillofemoral and 3 of the 4 com posite aortopopliteal bypasses throm bosed within one and three years after surgery respectively. In conclu sion, the study evidenced long-term durability of HUV grafts, supporting their use for femorodistal reconstruc tions in patients with limb-threaten ing ischemia and inadequate autoge nous saphenous vein.
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Affiliation(s)
- G. Motta
- Cattedra di Semeiotica Chirurgica 1a University of Genoa, Genoa, Italy
| | - G.B. Ratto
- Cattedra di Semeiotica Chirurgica la University of Genoa, Genoa, Italy
| | - A. Sacco
- Cattedra di Semeiotica Chirurgica la University of Genoa, Genoa, Italy
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Rastrelli G, Giovannini L, Calogero AE, Gianfrilli D, Serra E, Pizzocaro A, Giagulli VA, Motta G, Vancieri G, Sperandio A, Andò S, Selice R, Luca G, Cocchiara F, Canale D, Maggi M. Predictors and clinical consequences of starting androgen therapy in men with low testosterone: results from the SIAMO-NOI registry. J Endocrinol Invest 2016; 39:695-708. [PMID: 27037688 DOI: 10.1007/s40618-016-0461-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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] [Received: 02/04/2016] [Accepted: 03/15/2016] [Indexed: 01/26/2023]
Abstract
PURPOSE Management of late onset hypogonadism (LOH) is not homogenous. The aim of the study is to observe the management of patients with low testosterone (T) in highly specialized Italian centres. METHODS The SIAMO-NOI is an observational longitudinal disease registry for the evaluation of the clinical management of patients with low T levels (total T < 12 nmol/L, calculated free T < 225 pmol/l or already in treatment) in 15 Italian centers members of the Italian Society for Andrology and Sexual Medicine (SIAMS). Clinical and biochemical data were collected for four visits during 12 months of observation. RESULTS 432 patients (mean age 50.9 ± 14.9 years) were enrolled. Of them, 247 men were receiving androgen therapy, whereas 145 were naive. After the first visit (V0), 80 men started androgen therapy, whereas 55 remained untreated during the entire observation. Younger age [odds ratio (OR) 0.57 (0.35-0.92)], total T < 8 nmol/l [OR 4.69 (1.59-13.81)], complaining at least one sexual symptom [OR 11.55 (2.01-66.35)] and reporting more severe lower urinary tract symptoms [OR 1.27 (1.01-1.60)] predicted starting an androgen therapy. Sixty-four men started therapy immediately after V0 and maintained it until the observation end. When compared to V0, they reported an increase in all the domains of the International Index of Erectile Function-15 (IIEF-15), in the sexual and physical subdomains of the Aging Male Scale as well as in the International Prostate Symptom Score. Conversely, the untreated group reported a significant improvement, although lower than the treated group, only in the erectile function domain of the IIEF-15. CONCLUSIONS Management of LOH in SIAMS centres is in line with the international guidelines and the newest knowledge about the role of T on prostate health. Androgen therapy is associated with an improvement in all the aspects of sexual life and in the perception of physical strength.
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Affiliation(s)
- G Rastrelli
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
| | - L Giovannini
- Endocrinology Unit, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - A E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - D Gianfrilli
- Department of Experimental Medicine, La Sapienza University of Rome, Rome, Italy
| | - E Serra
- Department of Internal Medical Sciences, Endocrinology and Metabolic Diseases Unit, Cagliari, Italy
| | - A Pizzocaro
- Endocrinology Unit, IRCCS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - V A Giagulli
- Outpatient Clinic for Endocrinology and Metabolic Diseases, Conversano Hospital, Conversano, Bari, Italy
| | - G Motta
- Department of Medical Sciences, Division of Endocrinology, Diabetology and Metabolism, University of Turin, Turin, Italy
| | - G Vancieri
- Section of Reproductive Endocrinology and Andrology, Hospital San Giovanni Calibita Fatebenefratelli Isola Tiberina, University of Rome TorVergata, Rome, Italy
| | - A Sperandio
- Andrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - S Andò
- Department of Pharmacy, Health and Nutrition Sciences, University of Calabria, Rende, Italy
| | - R Selice
- Department of Molecular Medicine, Section of Clinical Pathology and Center for Human Reproduction Pathology, University of Padova, Via Gabelli 63, 35121, Padua, Italy
| | - G Luca
- Department of Experimental Medicine and Biochemical Sciences, University of Perugia, Perugia, Italy
| | - F Cocchiara
- Department of Endocrinological and Medical Sciences, University of Genova, Genoa, Italy
| | - D Canale
- Endocrine Unit, University of Pisa Medical School and Hospitals, Ospedale di Cisanello, Pisa, Italy
| | - M Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy.
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Castellano E, Crespi C, Dell'Aquila C, Rosato R, Catalano C, Mineccia V, Motta G, Botto E, Manieri C. Quality of life and hormones after sex reassignment surgery. J Endocrinol Invest 2015; 38:1373-81. [PMID: 26486135 DOI: 10.1007/s40618-015-0398-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 10/07/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Transpeople often look for sex reassignment surgery (SRS) to improve their quality of life (QoL). The hormonal therapy has many positive effects before and after SRS. There are no studies about correlation between hormonal status and QoL after SRS. AIM To gather information on QoL, quality of sexual life and body image in transpeople at least 2 years after SRS,to compare these results with a control group and to evaluate the relations between the chosen items and hormonal status. SUBJECTS AND METHODS Data from 60 transsexuals and from 60 healthy matched controls were collected. Testosterone,estradiol, LH and World Health Organization Quality of Life (WHOQOL-100) self-reported questionnaire were evaluated. Student’s t test was applied to compare transsexuals and controls. Multiple regression model was applied to evaluate WHOQOL’s chosen items and LH. RESULTS The QoL and the quality of body image scores intranspeople were not statistically different from the matched control groups’ ones. In the sexual life subscale,transwomen’s scores were similar to biological women’s ones, whereas transmen’s scores were statistically lower than biological men’s ones (P = 0.003). The quality of sexual life scored statistically lower in transmen than intranswomen (P = 0.048). A significant inverse relationship between LH and body image and between LH and quality of sexual life was found. CONCLUSIONS This study highlights general satisfaction after SRS. In particular, transpeople’s QoL turns out to be similar to Italian matched controls. LH resulted inversely correlated to body image and sexual life scores.
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Fajardo M, Mattiauda D, Motta G, Genro T, Meikle A, Carriquiry M, Chilibroste P. Use of mixed rations with different access time to pastureland on productive responses of early lactation Holstein cows. Livest Sci 2015. [DOI: 10.1016/j.livsci.2015.09.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Testa D, Castaldo G, De Santis C, Trusio A, Motta G. Treatment of horizontal canal benign paroxysmal positional vertigo: a new rehabilitation technique. ScientificWorldJournal 2012; 2012:160475. [PMID: 22619605 PMCID: PMC3349106 DOI: 10.1100/2012/160475] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 11/19/2011] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to evaluate the effectiveness of a new technical variant applied to the Gufoni's manoeuvre, in the treatment of horizontal canal benign paroxysmal positional vertigo (HSC-BPPV). 87 patients with BPPV of HSC (55 women and 32 men), aged between 21 and 80 years, were randomized either to modified Gufoni's manoeuvre or to the Gufoni's manoeuvre. 93% of patients treated with modified Gufoni's manoeuvre was cured after the first treatment session, of which only 2% had a conversion into PSC-BPPV, while the Gufoni's manoeuvre led to a symptoms resolution in 88% of cases, of which 16% had a conversion into PSC-BPPV. Therefore, the modified Gufoni's manoeuvre shows the same effectiveness in the resolution of symptoms of Gufoni's manoeuvre, but it appears more effective than the latter to reduce the percentage of conversion of the HSC-BPPV into PSC-BPPV (χ(2) = 6.13, P = 0.047).
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Affiliation(s)
- D Testa
- Department of Otorhinolaryngology-ENT Surgery, Second University of Naples, Italy
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Einaudi S, Napolitano E, Restivo F, Motta G, Baldi M, Tuli G, Grosso E, Migone N, Menegatti E, Manieri C. Genotype, phenotype and hormonal levels correlation in non-classical congenital adrenal hyperplasia. J Endocrinol Invest 2011; 34:660-4. [PMID: 21169730 DOI: 10.3275/7410] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 11/17/2022]
Abstract
Non-classical congenital adrenal hyperplasia (NCAH) is a morbid condition sustained by the reduced function of one of the enzymes involved in the adrenal steroid biosynthesis pathway, mainly the 21-hydroxylase. Different degrees of enzyme activity impairment determine different clinical pictures, with childhood or post-pubertal onset. The aim of this study was to evaluate the relationship between genotype, phenotype, and adrenal hormonal levels in a group of 66 patients affected by NCAH attending outpatient pediatric or endocrinological Clinics. Our findings show that age at pubarche/menarche was significantly younger, height SD score) and Δ bone age-chronological age were significantly higher in patients with a more severe enzyme activity impairment, while cutaneous androgenization and menstrual irregularities in post-pubertal girls were not related to the grading of genotype.
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Affiliation(s)
- S Einaudi
- Division of Pediatric Endocrinology and Diabetology, University of Turin, Turin, Italy
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Abstract
Steroid myopathy is a non-inflammatory toxic myopathy that occurs as side effect of exogenous and endogenous glucocorticoid excess. The purpose of this review is to examine issues that limit our understanding of this myopathy with respect to nosology, etiopathogenesis, conditioning factors, and muscle fiber selectivity. We suggest that if more data were available on these issues, the understanding of steroid myopathy would be enhanced substantially, thus allowing an early detection of its occurrence (before the appearance of clinical or laboratory signs) and a proper treatment of the patients.
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Affiliation(s)
- M A Minetto
- Division of Endocrinology, Diabetology and Metabolism, Department of Internal Medicine, University of Turin, Turin, Italy.
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Motta G, Cea M, Carbone F, Augusti V, Moran E, Patrone F, Nencioni A. Current standards and future strategies in immunochemotherapy of non-Hodgkin's lymphoma. J BUON 2011; 16:9-15. [PMID: 21674844] [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: 05/30/2023]
Abstract
The therapeutic options for B-cell non-Hodgkin's lymphoma (NHL) have dramatically expanded with the advent of immune-based treatments. The monoclonal antibody anti- CD20 rituximab represents the best example of these advances and has quickly become incorporated into the therapeutic armamentarium for this hematological disease. In addition, other antibodies are eventually becoming part of treatment approaches to NHL. Furthermore, the role of therapeutic vaccines continues to be an important ongoing research question. Despite this success, several questions on how to optimize the use of monoclonal antibodies in NHL remain open since the best administration schedules, as well as the optimal duration of immunotherapy still have to be determined. Finally the development of resistance to treatment remains the main limit of this innovative approach, necessitating the development of strategies to circumvent resistance itself. This review will summarize the state of the art of antibody-based immunotherapy of NHL and discuss prospective approaches to improve the benefit of these treatments in patients.
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Affiliation(s)
- G Motta
- Department of Internal Medicine, University of Genoa, Genoa, Italy
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Oliveira C, Navarro-Xavier RA, Anjos-Vallota EA, Martins JO, Silveira VLF, Gonçalves LRC, Araújo MS, Motta G, Sannomiya P, Oliva MLV. Effect of plant neutrophil elastase inhibitor on leucocyte migration, adhesion and cytokine release in inflammatory conditions. Br J Pharmacol 2010; 161:899-910. [PMID: 20860667 DOI: 10.1111/j.1476-5381.2010.00924.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND AND PURPOSE The serine and cysteine peptidase inhibitor, BbCI, isolated from Bauhinia bauhinioides seeds, is similar to the classical plant Kunitz inhibitor, STI, but lacks disulphide bridges and methionine residues. BbCI blocks activity of the serine peptidases, elastase (K(iapp) 5.3 nM) and cathepsin G (K(iapp) 160.0 nM), and the cysteine peptidase cathepsin L (K(iapp) 0.2 nM). These three peptidases play important roles in the inflammatory process. EXPERIMENTAL APPROACH We measured the effects of BbCI on paw oedema and on leucocyte accumulation in pleurisy, both induced by carrageenan. Leucocyte-endothelial cell interactions in scrotal microvasculature in Wistar rats were investigated using intravital microscopy. Cytokine levels in pleural exudate and serum were measured by elisa. KEY RESULTS Pretreatment of the animals with BbCI (2.5 mg·kg(-1)), 30 min before carrageenan-induced inflammation, effectively reduced paw oedema and bradykinin release, neutrophil migration into the pleural cavity. The number of rolling, adhered and migrated leucocytes at the spermatic fascia microcirculation following carrageenan injection into the scrotum were reduced by BbCI pretreatment. Furthermore, levels of the rat chemokine cytokine-induced neutrophil chemo-attractant-1 were significantly reduced in both pleural exudates and serum from animals pretreated with BbCI. Levels of interleukin-1β or tumour necrosis factor-α, however, did not change. CONCLUSIONS AND IMPLICATIONS Taken together, our data suggest that the anti-inflammatory properties of BbCI may be useful in investigations of other pathological processes in which human neutrophil elastase, cathepsin G and cathepsin L play important roles.
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Affiliation(s)
- C Oliveira
- Department of Biochemistry, Universidade Federal de São Paulo, Rua Três de Maio, São Paulo, Brazil
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Abstract
Obstructive sleep apnea syndrome (OSAS) is a serious, prevalent condition that has significant mortality and morbidity when untreated. It is strongly associated with obesity and is characterized by changes in the serum levels or secretory patterns of several hormones. In particular, obese patients with OSAS show a peculiar reduction of both spontaneous and stimulated GH secretion coupled with reduced IGF-I concentrations and impaired peripheral sensitivity to GH. These endocrine abnormalities are more marked than those observed in non-apneic obese subjects, and are likely to be due to the effects of hypoxia and sleep fragmentation on hormone secretory pattern. The GH/IGF-I axis activity disruption can be responsible, at least in part, for metabolic alterations, which are common in OSAS and increase the risk of cardiovascular events as well as mortality. Effective assessment and management of OSAS may correct endocrine changes, improve quality of life, and prevent associated morbidity or death.
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Affiliation(s)
- F Lanfranco
- Division of Endocrinology, Diabetology and Metabolism, Department of Internal Medicine, University of Turin, 10126 Turin, Italy.
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Federici D, Brambilla T, Lacelli B, Arcaini L, Motta G, Agarossi A, Muggiasca L, Conti M. Pain relief after combined medical and laparoscopic conservative treatment of stage III–IV endometriosis: A comparison with medical therapy. MINIM INVASIV THER 2009. [DOI: 10.3109/13645709609152702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Galey FR, Rosenblatt S, Motta G, Linthicum FH. Morphometric Analysis of the Human Endolymphatic Sac: Section 3. Computer-aided Three-dimensional Reconstruction of the Sac of One Meniere's Disease Case and the Sac of One Normal Case. Acta Otolaryngol 2009. [DOI: 10.3109/00016488809098979] [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: 11/13/2022]
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Motta G, Casolino D, Cassiano B, Conticello S, Esposito E, Galletti F, Galli V, Larotonda G, Laudadio P, Mansi N, Mevio E, Mira E, Motta G, Ceroni AR, Tarantino V, Tavormina P, Vicini C, Motta S, Aversa S, Canani FB, Cappello V, Carra P, Cifarelli D, Cinquegrana G, Consolo E, Ondolo C, Ripa G, Romano G. Adeno-tonsillar surgery in Italy. Acta Otorhinolaryngol Ital 2008; 28:1-6. [PMID: 18533547 PMCID: PMC2640065] [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] [Subscribe] [Scholar Register] [Received: 10/31/2007] [Accepted: 11/19/2007] [Indexed: 05/26/2023]
Abstract
Indications to surgery for adeno-tonsillar inflammatory disorders and analysis of the effectiveness of surgical treatment, compared with watchful waiting strategy, continue to be the subject of scientific debate. The present investigation focuses on the surgical activity of 14 Italian Otorhinolaryngological Units between 1999 and 2004. Surgical interventions (adeno-tonsillectomy, adenoidectomy, tonsillectomy) on 26915 children (age range: 2-11 years) were considered. Data on adeno-tonsillar interventions were analysed in relation to other interventions of ENT interest, performed in the same units and in the same period. Adeno-tonsillar interventions accounted for 35.4% of all operations of ENT interest. Adeno-tonsillectomy accounted for 56.6% of overall adeno-tonsillar operations, adenoidectomy 31.6%, tonsillectomy 11.8%. The percentage for the three interventions was homogeneous in the period of the study and in the recruited units. The percentage of children who underwent adeno-tonsillar surgery in paediatric units was higher as compared to general units, as far as concerns the overall number of operations performed. In southern Italy, the number of adeno-tonsillar interventions, in general, and of adeno-tonsillectomy, in particular, was higher compared to that in northern Italy. Results of the present study suggest that environmental factors, cultural issues and local health demands, may influence indications and, therefore, the different incidence of the operations under consideration in the units taking part in the investigation.
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Affiliation(s)
- G Motta
- Otorhinolaryngology Unit, Cesena, Italy.
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48
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Motta G, Esposito E, Motta S, Mansi N, Cappello V, Cassiano B, Motta G. [The treatment of acute recurrent pharyngotonsillitis]. Acta Otorhinolaryngol Ital 2006; 26:5-29. [PMID: 17465377] [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: 05/15/2023]
Abstract
AIM OF THE STUDY In paediatric patients, recurrent febrile pharyngo-tonsillitis is usually due to chronic inflammation of the tonsils and/or adenoids: these episodes are often associated with other clinical manifestations (respiratory obstruction of naso-pharyngeal origin; auricular inflammation, especially effusive otitis media and acute otitis media; streptococcal beta-haemolytic Group A (SBEGA) infection, causing a distant disorder of varying severity and which may, therefore, give rise to serious pathological conditions). A retrospective multicentric investigation has, therefore, been carried out in order not only to further elaborate findings emerging from earlier studies, performed in other countries, in which random methods were used, but also to focus on: 1. the possible association of these clinical manifestations with recurrent febrile pharyngo-tonsillar inflammation in relation to frequency of the condition; 2. results obtained with adenoidectomy or with adeno-tonsillectomy, referring to the overall clinical outcome of the pathological condition, bearing in mind data emerging from the control groups, submitted to strict follow-up, associated with any medical treatment deemed necessary. MATERIAL AND METHODS The study population comprised 692 patients (394 male, 298 female), age range 2-11 years and with a minimum follow-up of 2 years. Considering the clinical manifestations emerging from the case history, the following two investigations were carried out: 1. the first, on 501 patients, all previously submitted to adeno-tonsillectomy in whom the recurrent febrile pharyngo-tonsillar inflammation had occurred, respectively > 4 or < or = 4 episodes during the last 12 months; 2. the second, on 455 patients in whom recurrent febrile pharyngo-tonsillar inflammation, in the 12 months prior to the beginning of the study, had been < or = 4 episodes: in 264 cases, adeno-tonsillectomy was carried out; in 144, adenoidectomy; 47 children were studied as controls and, therefore, submitted to watchful waiting. The results obtained were statistically analysed by chi2 and Fisher test: a "p" value of < 0.05 was considered statistically significant. RESULTS The first investigation showed that all symptomatological manifestations considered were resolved following adeno-tonsillectomy, in a significantly high percentage of cases (recurrent febrile pharyngo-tonsillar in flammation: 91.8%; naso-pharyngeal respiratory obstruction: 92.2%; pathological ASO titre: 69.8%; distant disorders probably due to SBEGA: 76%; effusive otitis media: 76%; acute recurrent otitis media: 87.5%). The most interesting clinical findings obtained can be summarized as follows: naso-pharyngeal respiratory obstruction is a frequent finding; the incidence is statistically higher in cases in which recurrent febrile pharyngo-tonsillar inflammation is less frequent (p < 0.05): in these patients, this is an important pathological manifestation indicating the need for surgery; the higher incidence is associated with at significant finding of pathological auricular processes; the percentages of recovery for naso-pharyngeal respiratory obstruction are statistically greater in the group of patients in whom the recurrent febrile pharyngo-tonsillar inflammation is more frequent: an identical result is found in patients with the effusive form of otitis media and in those with recurrent acute otitis media; a pathological ASO titre is more frequently found, the difference being statistically significant (p < 0.05), in the group of patients with more frequent recurrent febrile pharyngo-tonsillar inflammation, albeit this factor does not affect the percentage of recovery; also the favourable evolution and recovery of clinical distant manifestations, related to streptococcal beta-haemolytic Group A infection, are correlated with the return to normal of the ASO titre. The second investigation demonstrated the efficacy of surgical treatment, adeno-tonsillectomy and adenoidectomy, in all the clinical manifestations studied, the possibility of achieving resolution of recurrent febrile pharyngo-tonsillar inflammation even in the control subjects submitted to medical treatment, but also the lack of success, in the latter, as far as concerns naso-pharygeal respiratory obstruction, the pathological ASO titre and the inflammatory auricular processes. CONCLUSIONS The present investigations confirm previous observations emerging from randomized clinical studies, regarding the possibility to achieve valid prevention of recurrent febrile pharyngo-tonsillar inflammation, also in a large percentage of control patients submitted to watchful waiting; these investigations, however, also demonstrated that, in the control group, the percentage of subjects in whom recovery of other symptoms was achieved was very low compared to that in the groups submitted to surgery. In other words, clearly emerges as far as concerns the overall symptomatological picture of the patients, the efficacy of the surgical treatment, but also the lack of success of the medical treatments in all clinical manifestations associated with recurrent febrile inflammations. Therefore, it is necessary to select and advise the most suitable treatment strategy, not in relation to the Guidelines elaborated on the basis of results emerging from statistical research, that, due to the intrinsic methodology limits cannot be applied to all cases in an acritical fashion, but in relationship to the specific clinical picture of each individual patient.
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Affiliation(s)
- G Motta
- Dipartimento di Otorinolaringoiatria dell'Azienda Universitaria "Federico II" di Napoli, FR.
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Motta G, Esposito E, Motta S, Mansi N, Cappello V, Cassiano B, Motta G. [Acute recurrent pharyngotonsillitis and otitis media]. Acta Otorhinolaryngol Ital 2006; 26:30-55. [PMID: 17465378] [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: 05/15/2023]
Abstract
BACKGROUND In the more recent randomized clinical studies, the surgical procedures adopted (adenoidectomy and adeno-tonsillectomy) for the treatment of the effusive and the acute recurrent forms of otitis media have generally shown a relatively modest and not persistent efficacy. It should be pointed out, however, that the cases studied displayed no clinical elements suggesting the existence of any aetio-pathogenic relationship between the auricular inflammation and a possible pathological disorder localized in the tonsils and/or adenoids. AIM OF THE STUDY The present investigation aimed to establish: a) the frequency with which the two forms of tympanic inflammation, under study, were detected in children with recurrent febrile pharyngo-tonsillar inflammation, also considering the possible presence of naso-pharyngeal respiratory obstruction and the severity of these two pathological manifestations; b) in relationship to these parameters, what might be the outcome with respect to the pathological auricular processes following surgical treatment of the pharyngeal disorder (adeno-tonsillectomy or adenoidectomy) vs. watchful waiting, c) the possible advantages offered by ventilation tube, inserted during surgical treatment, in the prevention of the two forms of otitis media studied. MATERIAL AND METHODS This retrospective multi-centre investigation involved 678 subjects (388 male, 290 female), age range 2 - 11 years: all subjects were followed-up for a minimum period of 2 years. Patients in this study population were submitted to 3 groups of investigations: a) in the first (487 children submitted to adeno-tonsillectomy), the study population was subdivided into 2 groups according to the frequency of the complaints of febrile pharyngo-tonsillar inflammation reported during the previous 12 months (> 4 or < or = 4); b) in the second (443 children with recurrent febrile pharyngo-tonsillar inflammation during the previous 12 months < or = 4), three groups of cases were compared; in the 1st (252 cases), patients were submitted to adeno-tonsillectomy; in the 2nd (144 subjects), adenoidectomy was carried out; in the 3rd (47 cases), the watchful waiting approach was adopted; c) in the third (193 cases, with both pathological auricular manifestations), patients were submitted to adeno-tonsillectomy (119 cases) or to adenoidectomy 74 cases); during surgery, ventilation tube was applied bilaterally in 61 cases, while 132 patients formed the control group. The results obtained were statistically analysed by chi2 and Fisher test: a "p" value of < 0.05 was considered statistically significant. RESULTS The first investigation showed: a) the incidence of cases with auricular disorders was greater in the group presenting recurrent febrile pharyngo-tonsillar inflammation < or = 4 (effusive otitis media: p < 0.05); in this group, the presence of cases with naso-pharyngeal respiratory obstruction was statistically greater (p < 0.05); b) the number of cases in which the pathological auricular process was resolved following adeno-tonsillectomy, appeared high (effusive otitis media: 136/179 = 76%; acute recurrent otitis media: 189/216 = 87.5%), not unlike the percentage of patients with positive results on recurrent febrile pharyngo-tonsillar inflammation and on naso-pharyngeal respiratory obstruction (91.6% and 92.4%, respectively); c) the percentages of recovery, for auricular disorders, were significantly higher in the group presenting more frequent recurrent febrile pharyngo-tonsillar inflammation, i.e. > 4 (p < 0.05); in this group, also the incidence of cases, in which the naso-pharyngeal respiratory obstruction was resolved, was greater. The second investigation demonstrated, in the groups in which surgical treatment was carried out, compared to controls: a) a significantly greater percentage of cases achieving recovery, for both parameters (p < 0.05); as far as concerns the effusive form of otitis media, a total of 72 (67.3%) subjects were cured following adeno-tonsillectomy; 67 (81.7%), following adenoidectomy; in acute recurrent otitis media, the subjects achieving recovery were; for adeno-tonsillectomy, 97 (82.2%); for adenoidectomy; 85 (81.7%); b) in the subjects in whom, following surgical treatment, the inflammatory auricular disorder was resolved, it was generally found that recovery had been achieved not only for the recurrent febrile pharyngo-tonsillar inflammation but also for the naso-pharyngeal respiratory obstruction; c) in the controls, the results appeared to be significantly less satisfactory (< 0.001); together with the lack of success in the watchful waiting approach, as far as concerns auricular disorders, we found, likewise, a significant lack of efficacy (p < 0.001) of this treatment in the management of naso-pharyngeal respiratory obstruction (5/35 cases cured: 14.3%). The third investigation showed that the application of the ventilation tube during adeno-tonsillectomy or adenoidectomy did not lead to any improvement in the results; indeed, the percent recovery of the pathological tympanic processes was significantly greater (p < 0.05) in those subjects in whom transtympanic drainage had not been adopted. CONCLUSIONS The results of these investigations reveal a clear relationship between the naso-pharyngeal respiratory obstruction and the pathological auricular processes in subjects with episodes of recurrent febrile pharyngo-tonsillar inflammation. These results also demonstrate that adeno-tonsillectomy and/or adenoidectomy are able to resolve the auricular inflammatory manifestations in a very large percentage of cases. These data are apparently in contrast with those described in recent reports related to randomised investigations. In effect, the two groups of investigations had different aims: the studies carried out according to a randomised approach were performed on study populations in which the findings of pathological auricular manifestations were not linked by the demonstration of a correlation with possible adenoid or adeno-tonsillar inflammation; the present study, on the other hand, was performed on patients in whom the auricular disorder was part of the clinical picture of recurrent febrile pharyngo-tonsillar inflammation. Therefore we believe that each of these study methods has precise possibilities, but also limitations; thus, one should not exclude the other, but rather be integrated.
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Affiliation(s)
- G Motta
- Dipartimento di Otorinolaringoiatria dell'Azienda Universitaria "Federico II" di Napoli, FR.
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Donzelli R, Maiuri F, Peca C, Cavallo L, Motta G, de Divitiis E. Microsurgical repair of the facial nerve. Neurochirurgie 2006. [DOI: 10.1016/s0028-3770(06)71181-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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