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Sant'Ambrogio di Torino, Italy

Cistaro A.,Positron | Palandri S.,Umberto i Mauriziano Hospital | Balsamo V.,Operative Unit of Nuclear Medicine | Migliaretti G.,University of Turin | And 6 more authors.
Journal of Nuclear Medicine Technology | Year: 2011

Because image fusion using 18F-FDG PET/CT allows a better localization of the pathologic uptake, this modality has a greater sensitivity than PET alone in examining the head-neck region. However, examination of this area is particularly critical because the head and neck are close to other anatomic structures and because of the high physiologic uptake of the radiocompound. The purpose of this study was to evaluate the utility of a new imaging protocol in the staging of oral carcinoma. Methods: Thirty-four consecutive patients (21 women and 13 men; age range, 20-84y) with untreated biopsy-proven oral squamous cell carcinomas were examined using whole-body 18F-FDG PET/CT fusion imaging. All patients observed strict regulations before undergoing the PET/CT examination. At the end of the whole-body acquisition, another open-mouth scan was obtained. To compare the open-and closed-mouth methods, we analyzed features such as the feasibility of an accurate topographic localization of the tumor, evaluation of tumor extent, detection of tumor involvement with adjacent structures, and involvement of lymph nodes to which we assigned a score from 1 to 5. Results: No cases of 18F-FDG physiologic uptake in the tongue or muscles were observed. The open-mouth scan obtained a better score than did the closed-mouth scan when considering the tumor localization, tumor extent, and evaluation of adjacent anatomic structures near the clinically evident tumor. For lymph node involvement, the 2 methods showed similar results. Conclusion: The open-mouth scan improved the anatomic tumor localization and extent and detection of tumor involvement in adjacent anatomic structures achieved by the standard PET/CT procedure. In addition, time of the examination (mid morning), relaxation of muscles before the compound was administered, and an upright position while the patient waited caused a reduction of the frequent equivocal physiologic uptake in the head and neck region. The open-mouth method does not influence the nodal staging. © 2011 by the Society of Nuclear Medicine, Inc. Source


Orzan F.,University of Turin | Liboni W.,Gradenigo Hospital | Bonzano A.,Umberto i Mauriziano Hospital | Molinari F.,Polytechnic University of Turin | And 4 more authors.
Acta Neurologica Scandinavica | Year: 2010

Objectives - Transesophageal echocardiography (TEE) is usually recommended in the evaluation of the patent foramen ovale (PFO). Our goal is to confirm the efficacy of contrast-enhanced transcranial Doppler (ce-TCD) in detecting residual significant right-to-left shunts (RLS) after PFO percutaneous closure. Materials and methods - Sixty-eight patients with a previous transient ischemic attack, stroke and a large PFO were investigated for residual RLS after percutaneous closure. Results - Assuming TEE as the gold standard, the sensitivity and negative predictive value of ce-TCD was 100%, whereas the specificity was 75.8% and the positive predictive value was 28%. Conclusions - ce-TCD appears to be the preferable technique to identify subjects with significant residual shunts after percutaneous closure of a PFO. In follow-up, if ce-TCD is negative, no further examination may be necessary; whereas if ce-TCD shows a residual shunt, it is advisable to perform a TEE investigation. © 2009 Blackwell Munksgaard. Source


Biglia N.,University of Turin | Peano E.,University of Turin | Sgandurra P.,University of Turin | Moggio G.,University of Turin | And 5 more authors.
Gynecological Endocrinology | Year: 2010

The study aim is to evaluate the efficacy and safety of two low-dose vaginal estrogen treatments (ETs) and of a non-hormonal vaginal moisturizer in postmenopausal breast cancer survivors with urogenital atrophy. Eighteen patients receiving estriol cream 0.25mg (n=10) or estradiol tablets 12.5μg (n=8) twice/week for 12 weeks were evaluated and compared with eight patients treated with polycarbophil-based moisturizer 2.5g twice/week. Severity of vaginal atrophy was assessed using subjective [Vaginal Symptoms Score (VSS), Profile of Female Sexual Function (PFSF)] and objective [Vaginal Health Index (VHI), Karyopycnotic Index (KI)] evaluations, while safety by measuring endometrial thickness and serum sex hormones levels. After 4 weeks, VSS and VHI were significantly improved by both vaginal ETs, with further improvement after 12 weeks. PFSF improved significantly only in estriol group (p=0.02). Safety measurements did not significantly change. Vaginal moisturizer improved VSS at week 4 (p=0.01), but score returned to pre-treatment values at week 12; no significant modification of VHI, KI, PFSF was recorded. Both low-dose vaginal ET are effective for relieving urogenital atrophy, while non-hormonal moisturizer only provides transient benefit. The increase of serum estrogens levels during treatment with vaginal estrogen at these dosages is minimal. © 2010 Informa UK Ltd. Source


Russolillo N.,Umberto i Mauriziano Hospital | Ferrero A.,Umberto i Mauriziano Hospital | Vigano' L.,Umberto i Mauriziano Hospital | Langella S.,Umberto i Mauriziano Hospital | And 4 more authors.
Updates in Surgery | Year: 2014

This study aimed at evaluating whether the administration of symbiotic therapy in jaundiced patients could reduce their postoperative infectious complications. The study was conducted between November 2008 and February 2011. Jaundiced patients scheduled for elective extrahepatic bile duct resection without liver cirrhosis, intestinal malabsorption or intolerance to symbiotic therapy were randomly assigned to receive [Group A] or not [Group B] symbiotics perioperatively. The primary endpoint was the infectious morbidity rate. Forty patients were included in the analysis (20 in each group). The patients in Group B presented a higher overall morbidity (70 vs 50 %) and infectious morbidity rate (50 vs 25 %), but the differences were not significant. Eleven patients in Group A (Group ndA) and 13 in Group B (Group ndB) did not receive preoperative biliary drainage. The results of the two groups were comparable. Infectious complications were higher in Group B [5 (34 %) vs 0, p = 0.030], while the prevalence of natural killer (NK) cells was higher in Group ndA the day before surgery (17 % ± 5.1 vs 10 % ± 5.3, p < 0.01) and on post-operative day (POD) 7 (13.1 % ± 4.1 vs 7.7 % ± 3.4, p < 0.01). The rates of lymph node colonization were similar. The symbiotic therapy failed to reduce the rate of infectious morbidity in jaundiced patients. Further studies investigating the place of symbiotic in no-drainage patients are required. © 2014 Springer-Verlag Italia. Source


Langella S.,Umberto i Mauriziano Hospital | Russolillo N.,Umberto i Mauriziano Hospital | D'Eletto M.,Umberto i Mauriziano Hospital | Forchino F.,Umberto i Mauriziano Hospital | And 2 more authors.
Updates in Surgery | Year: 2015

Laparoscopic liver surgery has gained widespread acceptance and nowadays it is suggested even for malignant disease. Although the benefits on short-term outcomes have been proven, data on oncological safety are still lacking. The aim of this study is to assess oncologic results after ultrasound-guided laparoscopic liver resection (LLR) or open liver resection (OLR) for colorectal metastases. 37 consecutive patients undergoing LLR between 01/2004 and 03/2014 were matched at a ratio of 1:1 with 37 OLR. Matching criteria were male sex, number and diameter of liver metastases, segment location, synchronous presentation, site and stage of primary tumor, positive lymph nodes of the primary, and concomitant extrahepatic disease. Demographic characteristics were similar among groups. Parenchymal transection time was longer in the LLR group (68 ± 38.2 SD vs 40 ± 33.7 SD, p = 0.01). Mortality was nil in LLR and OLR. Overall morbidity was significantly lower in LLR (13.5 vs 37.8 %, p = 0.02), although severe complications were similar among the two groups. Patients undergoing LLR were discharged earlier (5 ± 2.3 SD vs 8 ± 6.6 SD days, p < 0.001). The median margin width was 5 (0–40) mm in LLR vs 8 (0–25) mm in OLR, p = 0.897. R1 resection was recorded in four LLR and three OLR (p = 1). Overall recurrences were similar among groups. Eight patients with hepatic or extrahepatic recurrence among LLR underwent surgery vs four of OLR (p = 0.03). After a median follow-up of 35.7 months in LLR and 47.9 months in OLR, 3-year overall survival was 91.8 % LLR and 74.8 % OLR (p = 0.14). 3-year disease-free survival was 69.1 % LLR and 65.9 % OLR (p = 0.53). Multivariate analysis showed that postoperative complications [HR 3.42 (95 % CI 1.32–8.89)] and multiple metastases [HR 3.84 (95 % CI 1.34–10.83)] were independent predictors of worse survival (p = 0.01). Ultrasound-LLR for colorectal hepatic metastases is safe, ensuring oncologic outcomes comparable to OLR. © 2015, Italian Society of Surgery (SIC). Source

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