Borgo Trento Hospital

Verona, Italy

Borgo Trento Hospital

Verona, Italy
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PubMed | University of Verona, Borgo Trento Hospital, Esine Hospital, Morgagni Pierantoni Hospital and 5 more.
Type: Journal Article | Journal: Oncotarget | Year: 2016

Barretts esophagus (BE) is the only well-known precursor lesion of esophageal adenocarcinoma (EA). The exact estimates of the annual progression rate from BE to EA vary from 0.07% to 3.6%. The identification of BE patients at higher risk to progress to EA is hence mandatory, although difficult to accomplish. In search of novel BE biomarkers we analyzed the efficacy of hERG1 potassium channels in predicting BE progression to EA. Once tested by immunohistochemistry (IHC) on bioptic samples, hERG1 was expressed in BE, and its expression levels increased during progression from BE to esophageal dysplasia (ED) and EA. hERG1 was also over-expressed in the metaplastic cells arising in BE lesions obtained in different BE mouse models, induced either surgically or chemically. Furthermore, transgenic mice which over express hERG1 in the whole gastrointestinal tract, developed BE lesions after an esophago-jejunal anastomosis more frequently, compared to controls. A case-control study was performed on 104 bioptic samples from newly diagnosed BE patients further followed up for at least 10 years. It emerged a statistically significant association between hERG1 expression status and risk of progression to EA. Finally, a novel fluorophore- conjugated recombinant single chain variable fragment antibody (scFv-hERG1-Alexa488) was tested on freshly collected live BE biopsies: it could recognize hERG1 positive samples, perfectly matching IHC data.Overall, hERG1 can be considered a novel BE biomarker to be exploited for a novel endoscopic surveillance protocol, either in biopsies or through endoscopy, to identify those BE patients with higher risk to progress to EA.


PubMed | Nuovo S Giovanni Of Dio Hospital, University of Ferrara, S Maria Annunziata Hospital, The Second University of Naples and 8 more.
Type: | Journal: European heart journal cardiovascular Imaging | Year: 2016

The determinants of discrepancies among two-dimensional echocardiographic (2D-E) methods for left atrial volume (LAV) assessment are poorly investigated.Maximal LAV was measured in 613 individuals (282 healthy subjects,180 athletes, and 151 hypertensives; age 45 20 years, 62% male) using the ellipsoid model (LAVLA geometry is the main determinant of inconsistencies between 2D-E methods for measuring maximal LAV. Body mass index is the strongest determinant of differences between single-plane and biplane approaches. Different 2D-E methods cannot be used interchangeably for diagnosis and follow-up. The biplane area-length method should be preferred, particularly in overweight-obese subjects.


Zoico E.,University of Verona | Rossi A.,University of Verona | Di Francesco V.,University of Verona | Sepe A.,University of Verona | And 7 more authors.
Journals of Gerontology - Series A Biological Sciences and Medical Sciences | Year: 2010

BackgroundAssociation between inflammatory markers and intermuscular adipose tissue (IMAT) has been reported. We hypothesized that subclinical inflammation of adipose tissue surrounding and infiltrating muscle could be related to the metabolic and functional abnormalities of the "aging muscle."MethodsIn 20 healthy elderly men undergoing elective vertebral surgery, IMAT within erector spinae was evaluated by magnetic resonance imaging and body composition by dual-energy X-ray absorptiometry. Fasting glucose, insulin, high-sensitive C-reactive protein (hs-CRP), leptin, adiponectin, and interleukin 6 (IL-6) were measured, and insulin resistance was estimated by homeostasis model assessment (HOMA) index. In subcutaneous adipose tissue (SAT) biopsies near the erector spinae, quantification of gene expression was performed.ResultsIMAT showed a significant association with body mass index and total and regional body fat, even after adjustment for age. Insulin, HOMA, and leptin were significantly correlated with IMAT, whereas hs-CRP presented an association of borderline significance. IL-6 expression in SAT was significantly associated with IMAT; IL-6 messenger RNA (mRNA) was negatively associated with adiponectin and peroxisome proliferator-activated receptor gamma expression. In multivariate regression analysis, 68% of IMAT variance was explained by fat mass and age, independent of waist circumference, leptin, HOMA, and IL-6 mRNA.ConclusionIMAT was primarily related to age and total body adiposity; subclinical inflammation in fat significantly contributes to IMAT. © The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.


PubMed | San Filippo Neri Hospital, Unit of Pathology, University of Verona, Circolo e Fondazione Macchi Hospital and 7 more.
Type: Journal Article | Journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology | Year: 2016

Gastric gastrointestinal stromal tumors (GISTs) represent a subgroup of GISTs with a better prognosis than those located in other areas. In this retrospective study we performed a molecular characterization of a large series of patients with gastric GISTs in relation to clinical-pathological characteristics and prognosis.DNA was extracted from paraffin-embedded sections from 221 gastric GIST patients submitted to surgery. Exons 9, 11, 13 and 17 of KIT, exons 12 and 18 of PDGFRA and exons 11 and 15 of BRAF were analyzed by direct sequencing. Cox regression analysis adjusted for clinical-pathological factors was performed to evaluate KIT and PDGFRA mutations in relation to the composite endpoint of relapse or death.KIT and PDGFRA mutations were observed in 119 (53.8%) and 56 (25.3%) patients, respectively, whereas 46 (20.8%) patients had wild type (wt) disease. Univariable analyses showed that a high Miettinen risk category and the presence of ulceration and KIT deletions were associated with increased risk of relapse or death (p<0.001; p=0.0389 and p=0.002, respectively). After adjusting for Miettinen risk score, KIT deletions remained an independent prognostic factor (HRadj=2.65, 95% CI [1.15-6.13], p=0.023). Moreover, KIT deletions in exon 11 codons 557, 558 or 559 were associated with a higher risk of relapse or death than wt tumors (HRadj=3.29 95% CI [1.64-6.64], p=0.001).KIT deletions in exon 11, especially those involving codons 557, 558 or 559, were correlated with a more aggressive gastric GIST phenotype and increased risk of relapse or death.


Kagi G.,University College London | Katschnig P.,University College London | Katschnig P.,Medical University of Graz | Fiorio M.,University of Verona | And 5 more authors.
Movement Disorders | Year: 2013

A characteristic feature of primary cervical dystonia is the presence of "sensory tricks" as well as the impairment of temporal and spatial sensory discrimination on formal testing. The aim of the present study was to test whether the amount of improvement of abnormal head deviation due to a sensory trick is associated with different performance of temporal sensory discrimination in patients with cervical dystonia. We recruited 32 patients with cervical dystonia. Dystonia severity was assessed using the Toronto Western Spasmodic Torticollis Rating Scale. Patients were rated according to clinical improvement to a sensory trick and assigned to 1 of the following groups: (1) no improvement (n = 6), (2) partial improvement (n = 17), (3) complete improvement (n = 9). Temporal discrimination thresholds were assessed for visual, tactile, and visuotactile modalities. Disease duration was shorter (P = .026) and dystonia severity lower (P = .033) in the group with complete improvement to sensory tricks compared with the group with partial improvement to sensory tricks. A significant effect for group and modality and a significant interaction between group × modality were found, with lower visuotactile discrimination thresholds in the group with complete improvement to sensory tricks compared with the other groups. In primary cervical dystonia, a complete resolution of dystonia during a sensory trick is associated with better visuotactile discrimination and shorter disease duration compared with patients with less effective sensory tricks, which may reflect progressive loss of adaptive mechanisms to basal ganglia dysfunction. © 2013 Movement Disorder Society.


Deluca C.,University of Verona | Golzar A.,University of Verona | Golzar A.,McGill University | Santandrea E.,University of Verona | And 11 more authors.
Cortex | Year: 2014

Visual perceptual learning is widely assumed to reflect plastic changes occurring along the cerebro-cortical visual pathways, including at the earliest stages of processing, though increasing evidence indicates that higher-level brain areas are also involved. Here we addressed the possibility that the cerebellum plays an important role in visual perceptual learning. Within the realm of motor control, the cerebellum supports learning of new skills and recalibration of motor commands when movement execution is consistently perturbed (adaptation). Growing evidence indicates that the cerebellum is also involved in cognition and mediates forms of cognitive learning. Therefore, the obvious question arises whether the cerebellum might play a similar role in learning and adaptation within the perceptual domain. We explored a possible deficit in visual perceptual learning (and adaptation) in patients with cerebellar damage using variants of a novel motion extrapolation, psychophysical paradigm. Compared to their age- and gender-matched controls, patients with focal damage to the posterior (but not the anterior) cerebellum showed strongly diminished learning, in terms of both rate and amount of improvement over time. Consistent with a double-dissociation pattern, patients with focal damage to the anterior cerebellum instead showed more severe clinical motor deficits, indicative of a distinct role of the anterior cerebellum in the motor domain. The collected evidence demonstrates that a pure form of slow-incremental visual perceptual learning is crucially dependent on the intact cerebellum, bearing the notion that the human cerebellum acts as a learning device for motor, cognitive and perceptual functions. We interpret the deficit in terms of an inability to fine-tune predictive models of the incoming flow of visual perceptual input over time. Moreover, our results suggest a strong dissociation between the role of different portions of the cerebellum in motor versusnon-motor functions, with only the posterior lobe being responsible for learning in the perceptual domain. © 2014.


Catalano F.,Borgo Trento Hospital | Rodella L.,Borgo Trento Hospital | Lombardo F.,Borgo Trento Hospital | Silano M.,Instituto Superiore Of Sanita | And 5 more authors.
Gastric Cancer | Year: 2013

Background: A submucosal tumor (SMT) of the stomach, which is an occasional finding during routine upper gastrointestinal endoscopy, may pose diagnostic and therapeutic challenges. Methods: To assess whether endoscopic submucosal dissection (ESD) is a feasible approach to definitively cure SMTs, the authors performed a retrospective cohort study with two endoscopic italian centers. Results: The study consisted of 20 patients with SMTs who underwent ESD. The patients underwent ESD and were followed up by endoscopy. We analyzed complete resection rate, frequency of complications, and survival. The overall rate of R0 resection was 90 % (18/20), with two endoscopic failures, one for a submucosal tumor and one for a neoplasm deeply infiltrating the proper muscle layer. The median procedure time was 119.1 min (range 40-240 min). The median size of the resected specimens was 29 mm (range 15-60 mm). Perforation occurred in 3 patients; all were treated conservatively. There were no cases of severe bleeding. Based on histopathological findings, 6 cases of ectopic pancreas, 1 of ectopic spleen, 3 of leiomyoma, and 10 of gastrointestinal stromal tumor (GIST) were diagnosed. Complete resection was obtained in all GIST cases. Among the 10 GIST cases treated by ESD, no death occurred: the 5-year disease-specific survival rate was 100 %. Conclusions: The high success rate of 90 % and the low incidence of complications should indicate ESD is the correct diagnostic and definitive treatment in selected patients. © 2012 The International Gastric Cancer Association and The Japanese Gastric Cancer Association.


Nikolac N.,University of Zagreb | Simundic A.-M.,University of Zagreb | Miksa M.,University of Zagreb | Lima-Oliveira G.,University of Verona | And 4 more authors.
Clinica Chimica Acta | Year: 2013

Introduction: Due to the budget limitations, laboratories mostly rely on the manufacturers' information about the influence of interfering substances on laboratory results. However, some manufacturers do not follow the recommended procedures for testing interferences (CLSI standard) and there is a great variability in the presentation of data regarding lipemia interference. Materials and methods: We aimed to verify the manufacturers' specifications for lipemia interference for clinical chemistry reagents provided by Beckman Coulter, Roche and Siemens. Bias was determined using the Intralipid® simulated lipemic samples. Furthermore, we aimed to compare obtained data with the manufacturers' claims and desirable specification for imprecision derived from biological variation. Results: i) Manufacturers' declarations were not confirmed for all three manufacturers; ii) the magnitude and direction of the effect of lipemia on laboratory results differ substantially between the three tested analytical systems; and iii) manufacturers are using arbitrary limits in declaring the expected effect of interference on laboratory results. Conclusions: There is an urgent need to standardize the way manufacturers test and report their data on the lipemia interference. We propose that, instead of arbitrary limits, manufacturers use evidence based quality specifications for assessing the allowable biases. Moreover, laboratories should be aware of the possible lack of replicability of manufacturers' declarations. © 2013 Elsevier B.V.


PubMed | Morgagni Pierantoni Hospital and Borgo Trento Hospital
Type: | Journal: Translational gastroenterology and hepatology | Year: 2017

The role of lymphadenectomy for the treatment of gastric cancer is still very much open to debate. Consequently, Japanese, European and American surgeons perform different typologies of lymphadenectomy because of the absence of randomized clinical trials confirming the superiority of extended lymphadenectomy over less invasive surgery. In Japan, D2 lymphadenectomy has been considered as the gold standard for advanced gastric carcinoma for many years. Although numerous European studies have been conducted in an attempt to find differences between D1 and D2 lymphadenectomy, none has succeeded to date. The decision to wait for results attesting to the fact that D2 guarantees a better outcome than D1 resulted in a long delay in the implementation of D2 as the gold standard treatment in Europe. In the U.S., the study by Macdonald


Verlato G.,University of Verona | Zanoni A.,University of Verona | Tomezzoli A.,Borgo Trento Hospital | Minicozzi A.,University of Verona | And 4 more authors.
British Journal of Surgery | Year: 2010

Background: Tumour regression grade (TRG) is used to evaluate responses to induction therapy in cancer of the oesophagus or cardia. This study aimed to determine whether inclusion of node category could improve the prognostic accuracy provided by TRG, and explore the prognostic value of an alternative classification based on size of residual foci and node category. Methods: Patients with oesophageal or cardia cancer treated with neoadjuvant chemoradiotherapy followed by resection were studied. Treatment-induced response at the primary site was evaluated by TRG and by a method whereby patients were classified as having no residual cancer, minimal residual disease (MRD) or as non-responders. Results: Between 2000 and 2007, 108 patients underwent resection. Disease-related survival decreased with increasing TRG in node-negative (NO) patients (P < 0-001), whereas in node-positive (N+) patients it was poor irrespective of TRG (P = 0-241). For NO disease, 3-year survival in patients with MRD (58 (95 per cent confidence interval 26 to 80) per cent) was intermediate between that in patients with no residual cancer (85 (70 to 93) per cent) and non-responders (28 (4 to 59) per cent). Worst prognosis was for N+ disease (21 (9 to 36) per cent). Conclusion: Node category should be considered when evaluating response to induction therapy in oesophageal or cardia cancer. A new classification based on size of residual foci and node category seems promising. Copyright © 2010 British Journal of Surgery Society Ltd.

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