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Pampanini V.,University of Rome Tor Vergata | Boiani A.,Bambino Gesu Childrens Hospital | De Marchis C.,Bambino Gesu Childrens Hospital | Giacomozzi C.,Belcolle Hospital | And 6 more authors.
European Journal of Pediatrics

Extrauterine growth retardation (EUGR) seriously affects premature newborns and is related to the impairment of growth during childhood. There are very limited data available concerning the growth outcome of EUGR children. Our aim was to assess the growth outcome in a cohort of children born before 34 weeks of gestation with severe EUGR. This was a retrospective multicenter study, performed in outpatient endocrinology clinic. A total of 103 premature children with weight and/or length below −2 standard deviation score (SDS) of “intrauterine” growth expectation at the time of discharge from hospital (within 42 weeks of postmenstrual age) were included in the study. The study participants underwent a thorough anthropometric assessment at a mean age of 3.9 years±1.7 SD. Of the EUGR children, 12.6 % showed a height below −2 SDS and 7.7 % even below−2.5 SDS. Growth impairment was more common in males than in females (17 vs. 8 %). The prevalence of subnormal weight (below −2 SDS) was 13.6 %, being higher in males than in females (17 vs. 10 %). BMI values below −2 SDS were found in 18.4 % of our study population (22.7 % in males and 12 % in females). The 19.6 % of EUGR children did not catch up in head circumference during early childhood. Length at term was the major predictor of height in childhood (P<0.001). Conclusion: A significant proportion of children born prematurely with severe EUGR show growth retardation in childhood thus suggesting the need for a close clinical follow-up to determine their growth potential and implement effective intervention strategies. © 2014, Springer-Verlag Berlin Heidelberg. Source

Mangili G.,San Raffaele Scientific Institute | Ottolina J.,San Raffaele Scientific Institute | Gadducci A.,University of Pisa | Giorda G.,Italian National Cancer Institute | And 9 more authors.
British Journal of Cancer

Objective:The aim of this study is to evaluate the long-term outcome of granulosa cell tumour (GCT) of the ovary in a large series of patients treated in MITO centres (Multicentre Italian Trials in Ovarian Cancer) and to define prognostic parameters for relapse and survival.Methods:A retrospective multi-institutional review of patients with GCTs of the ovary treated or referred to MITO centres was conducted. Surgical outcome, intraoperative and pathological findings and follow-up data were analysed. Kaplan-Meier and Cox proportional hazards analyses were used to determine the predictors for survival and recurrence.Results:A total of 97 patients with primary GCT of the ovary were identified. The median follow-up period was 88 months (range 6-498). Of these, 33 patients had at least one episode of disease recurrence, with a median time to recurrence of 53 months (range 9-332). Also, 47% of recurrences occurred after 5 years from initial diagnosis. At multivariate analysis, age and stage were independent poor prognostic indicators for survival; surgical treatment outside MITO centres and incomplete surgical staging retained significant predictive value for recurrence in both univariate and multivariate analyses.Conclusions:This study confirms the generally favourable prognosis of GCTs of the ovary, with 5-year overall survival approaching 97%. Nevertheless, prognosis after 20 years was significantly poorer, with 20-year survival rate of 66.8% and a global mortality of 30-35. These findings support the need for lifelong follow-up even in early-stage GCT. © 2013 Cancer Research UK. All rights reserved. Source

Di Pietro M.,University of Rome La Sapienza | Schiavoni G.,University of Rome La Sapienza | Sessa V.,San Giovanni Calibita Fatebenefratelli Hospital | Pallotta F.,San Camillo Forlanini Hospital | And 2 more authors.
Osteoporosis International

We found an association between the presence of Chlamydia pneumoniae DNA both in osteoporotic bone tissue and peripheral blood mononuclear cells (PBMCs) and the increase in circulating resorptive cytokines. Introduction: Our study was designed to determine whether C. pneumoniae infection may be involved in osteoporosis-associated bone loss. Methods: The study included 59 women undergoing hip joint replacement surgery for femoral neck fracture: 32 with osteoporosis and 27 with osteoarthritis. A total of 118 tissue specimens (59 bone tissues, 59 PBMCs) were examined for C. pneumoniae DNA by real-time polymerase chain reaction (PCR). Serum levels of soluble receptor activator of nuclear factor kappa B ligand (sRANKL), osteoprotegerin (OPG), interleukin (IL)-1β, tumor necrosis factor-α, and IL-6 were also measured. Results: C. pneumoniae DNA was detected in osteoporotic bone tissue whereas it was not found in non-osteoporotic bone tissue (p < 0.05). A significantly higher rate of C. pneumoniae DNA (p < 0.05) was found in PBMCs of osteoporotic patients than in those of osteoarthritis patients. Among osteoporotic patients, serum sRANKL, IL-1, and IL-6 concentrations as well as sRANKL/OPG ratio significantly differ between patients with bone tissue and PBMCs positive to C. pneumoniae and C. pneumoniae-negative patients. Conclusion: The association between the presence of C. pneumoniae DNA, both in bone tissue and PBMCs, and the increase in sRANKL/OPG ratio as well as in IL-1β and IL-6 levels observed in osteoporotic patients suggests C. pneumoniae infection as a new risk factor for osteoporosis. © 2012 International Osteoporosis Foundation and National Osteoporosis Foundation. Source

Pagnotta G.,Hospital Bambin Gesu | Boccanera F.,Hospital Bambin Gesu | Rizzo G.,San Giovanni Calibita | Agostino R.,San Giovanni Calibita Fatebenefratelli Hospital | And 2 more authors.
Journal of Foot and Ankle Surgery

The etiology of congenital idiopathic talipes equinovarus deformity is unclear. Studies on populations, families, and twins have suggested a genetic component. However, the mode of inheritance does not fit classic patterns. The intrauterine posture and environmental and developmental causative factors have also been associated with the deformity. Neurologic, muscular, bony, connective tissue, and vascular structures can be affected. We present the case of monochorionic triplets with bilateral congenital idiopathic talipes equinovarus deformities. To the best of our knowledge, such a presentation has not been previously described and supports a genetic etiology of congenital idiopathic talipes equinovarus deformity. © 2011 American College of Foot and Ankle Surgeons. Source

Ottolina J.,San Raffaele Scientific Institute | Ferrandina G.,Catholic University of the Sacred Heart | Gadducci A.,University of Pisa | Scollo P.,Obstetrics and Gynecology | And 7 more authors.
Gynecologic Oncology

Objective. Granulosa cell tumors (GCTs) are the most common estrogen-secreting ovarian tumors; perhaps due to the persistent hyperestrogenism, a wide spectrum of associated endometrial pathologies ranging from endometrial hyperplasia to carcinoma has been documented in patients with GCTs. The aim of this study is to evaluate the incidence of endometrial pathologies in a large series of GCT patients treated in MITO centers. Methods. A retrospective multi-institutional review of patients with granulosa cell tumors of the ovary treated or referred to MITO centers was conducted. Descriptive statistics were used to characterize the patient population and to assess the association of GCT and endometrial abnormalities at the time of diagnosis; multivariate regression analysis was also performed to identify independent predictors of endometrial abnormalities. Results. A total of 150 patients with primary adult GCT was identified. During the preoperative assessment, endometrial pathology was found in 35.9% of symptomatic patients and in 90.9% of asymptomatic women with endometrial thickening at transvaginal ultrasound. At the time of surgery, hyperplasia was documented in 29.2% of patients, whereas endometrial cancer occurred in 7.5% of patients. Almost all of the patients (97.6%) with endometrial hyperplasia were older than 40 years. All patients with endometrial cancer were older than 40 years and postmenopausal. Conclusions. Endometrial carcinoma/atypical hyperplasia were commonly observed in GCT patients > 40 years; based on these data, endometrial sampling should be performed in symptomatic women at least 40 years of age. In asymptomatic women < 40 years, endometrial sampling is of low yield. © 2014 Elsevier Inc. All rights reserved. Source

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