Cesareo R.,Sm Goretti Hospital |
Pasqualini V.,Sm Goretti Hospital |
Sacchi M.,Sm Goretti Hospital |
Saralli E.,Sm Goretti Hospital |
And 2 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2015
Context: Ultrasound-guided radiofrequency ablation (RFA) of solid thyroid nodules (TNs) is a minimally invasive procedure that may induce a volume reduction of symptomatic solid benign TNs. Objective: The aim of the study was to evaluate the effectiveness and safety of RFA in debulking benign TNs. Design and Patients: Eighty-four consecutive patients with symptomatic and cytologically benign solid nodules were randomly assigned to either a single RFA session (group A; n = 42) or follow-up (group B; n = 42) at our center. Entry criteria were a solid thyroid nodule or predominantly solid (with a fluid component ≤ 30% of the volume), normal thyroid function, no autoimmunity, and no previous thyroid gland treatment. Three subgroups were formed according to the baseline volume of nodules: small (≤12 mL), medium (from 12 to 30 mL), or large (>30 mL). Methods: In group A RFA was performed in a single session with the moving-shot technique. Volume and local symptom changes were evaluated 1 and 6 months after RFA. Results: In group A, the volume decreased from 24.5.5 ± 19.6 to 8.6 ± 9.5 6 months after RFA (P = .001). The greatest volume reduction was in small nodules. The pressure symptom score improved only in medium and large nodules (P < .001), whereas the cosmetic score improved in all treated patients (P< .001). The rate of thyroid volumetric reduction was not statistically different between solid and predominantly solid nodules. Only one patient experienced permanent right paramedian vocal cord palsy with inspiratory stridor without dysphonia. In group B, nodule volume remained unchanged, whereas the symptom score was worse at the 6-month evaluation (P = .01). Conclusions: RFA is effective in reducing thyroid nodule volume. The best reduction rate was observed in small TNs. The thyroid volumetric reduction does not change according to the sonographic features. The mean treatment duration was longer in larger TNs. Copyright © 2015 by the Endocrine Society.
PubMed | Italian National Cancer Institute, San Camillo Forlanini Hospital, Sm Goretti Hospital, National Institute For Infectious Disease L Spallanzani and 2 more.
Type: Journal Article | Journal: World journal of surgery | Year: 2016
Liver transplantation (LT) is a well-established procedure for hepatocellular carcinoma (HCC) within the Milan criteria. Yttrium-90 microspheres radioembolization (Y90-RE) has shown to be an effective and safe treatment of primary liver tumors. We retrospectively evaluate the efficacy of the Y90-RE in patients with HCC prior to LT.From January 2002 to December 2015, 365 patients were transplanted at the San Camillo Hospital Center. One hundred forty-three patients were transplanted for HCC, and in 22 cases the patients were treated with Y90-RE before LT.Three patients were treated with Y90-RE within the Milan criteria, and 19 patients were out of criteria before Y90-RE. Four patients had an increasing MELD score between Y90-RE and LT. On the other hand, alpha-fetoprotein decreases after Y90-RE treatment in all cases. No patient death was observed in Y90-RE procedure or at LT. In 78.9% of cases, a successful downstaging was observed, and in 100% of cases bridging was achieved. From Y90-RE treatment overall survival was 43.9months. From LT, overall mean survival was 30.2months with a free survival of 29.6months. The overall survival after LT analysis between the patients treated with Y90-RE and patients without was not significant (p=0.113). Free survival analysis was not significant (p=0.897) between the two populations.We successfully performed LT in patients after Y90-RE treatment both as bridging and downstaging for HCC and obtained a similar overall and free survival of LT for HCC within Milan criteria. Y90-RE becomes a real option to provide curative therapy for patients who traditionally are not considered eligible for surgery.
Verboschi F.,A Fiorini Hospital |
Verboschi F.,University of Rome La Sapienza |
Domanico D.,Sm Goretti Hospital |
Nebbioso M.,University of Rome La Sapienza |
And 4 more authors.
Functional Neurology | Year: 2014
The aim of this study was to evaluate the efficacy of visual rehabilitation with MP-1 microperimeter biofeedback in advanced optic neural dysfunction due to glaucoma, and to precisely characterize fixation stability and location in affected patients. Ten patients (18 eyes) with advanced glaucoma were submitted to a rehabilitation protocol that consisted of: a 25-item questionnaire (National Eye Institute Visual Functioning Que stionnaire); measurement of visual acuity; a reading speed test; microperimetry with fixation study, retinal sensitivity and the bivariate contour ellipse area (BCEA). The rehabilitation program consisted of 10 training sessions of 10 minutes per eye performed over a period of one week and was repeated at four months, eight months, and one year. Statistical analysis was performed using the Student's t-test and Spearman correlation; p values less than 0.05 were considered statistically significant. In 13 eyes fixation changed from unstable to relatively unstable while its location changed from predominantly eccentric to predominantly central. In five eyes, fixation changed from relatively unstable to stable with a change of location from poor central fixation to predominantly central fixation. Mean retinal sensitivity changed from 7.43±8.28 dB to 8.33±9.04 dB (p<0.05); the mean best corrected visual acuity was 0.98±0.66 logMAR at the baseline assessment, and 0.75±0.6 logMAR at the end of rehabilitation (p>0.05); reading speed improved from a mean value of 31.4±4.3 words/minute to 55.6±3.2 words/minute at the end of the training (p<0.05). The BCEA changed from 0.94±0.39 deg2 to 0.86±0.46 deg2 (p=0.76). Rehabilitation with MP-1 biofeedback in patients with advanced glaucoma is a useful means of improving these patients' fixation stability, reading speed and quality of life. © CIC Edizioni InternazionaliProcessed by We Batch PDF Unlocker.
PubMed | Advanced Orthopedic Technologies, Rizzoli Orthopaedic Institute, CNR Institute of Structure of Matter, Romana Film Sottili and 5 more.
Type: Journal Article | Journal: Materials science & engineering. C, Materials for biological applications | Year: 2016
Titanium implants coated with a 500nm nanostructured layer, deposited by the Ion Plating Plasma Assisted (IPPA) technology, composed of 60% graphitic carbon, 25% titanium oxides and 15% titanium carbide were implanted into rabbit femurs whilst into the controlateral femurs uncoated titanium implants were inserted as control. At four time points the animals were injected with calcein green, xylenol orange, oxytetracycline and alizarin. After 2, 4 and 8weeks femurs were removed and processed for histology and static and dynamic histomorphometry for undecalcified bone processing into methylmethacrylate, sectioned, thinned, polished and stained with Toluidine blue and Fast green. The overall bone-implant contacts rate (percentage of bone-implant contacts/weeks) of the TiC coated implant was 1.6 fold than that of the uncoated titanium implant. The histomorphometric analyses confirmed the histological evaluations. More precisely, higher Mineral Apposition Rate (MAR, m/day) (p<0.005) and Bone Formation Rate (BFR, m
Zullo A.,Nuovo Regina Margherita Hospital |
Hassan C.,Nuovo Regina Margherita Hospital |
De Francesco V.,Riuniti Hospital |
Repici A.,IRCCS Instituto Clinico Humanitas |
And 5 more authors.
World Journal of Gastroenterology | Year: 2014
Patients with Helicobacter pylori (H. pylori) infection may complain of dyspeptic symptoms without presence of macroscopic lesions on gastroduodenal mucosa. Such a condition is usually recognized as functional dyspepsia, and different pathogenetic mechanisms are involved. The role of H. pylori in these patients is controversial. Several trials assessed the potential role of H. pylori eradication in improving dyspeptic symptoms, and data of some meta-analyses demonstrated that cure of infection is associated with a small (10%), but significant therapeutic gain as compared to placebo. The reason for which dyspeptic symptoms regress in some patients following bacterial eradication, but persist in others remains unclear. Regrettably, trials included in the meta-analyses are somewhat different for study design, definition of symptoms, assessment of symptoms changes, and some may be flawed by potential pitfalls. Consequently, the information could be not consistent. We critically reviewed the main available trials, attempting to address future research in this field © 2014 Baishideng Publishing Group Inc. All rights reserved.
Cesareo R.,Sm Goretti Hospital |
Napolitano C.,Sm Goretti Hospital |
Iozzino M.,Sm Goretti Hospital
International Journal of Women's Health | Year: 2010
Osteoporosis is a progressive and debilitating disease characterized by a massive bone loss with a deterioration of bone tissues, and a propensity for a fragility fracture. Strontium ranelate is the first antiosteoporotic treatment that has dual mode of action and simultaneously increases bone formation, while decreasing bone resorption, thus rebalancing bone turnover formation. Strontium ranelate rebalances bone turnover in favor of improved bone geometry, cortical thickness, trabecular bone morphology and intrinsic bone tissue quality, which translates into enhanced bone strength. This review describes the mechanism of the strontium ranelate action and its effects on bone mineral density, bone turnover, and osteoporotic fractures. The efficacy of strontium ranelate in postmenopausal osteoporosis treatment to reduce the risk of vertebral and hip fractures has been highlighted in several randomized, controlled trials. Treatment efficacy with strontium ranelate has been documented across a wide range of patient profiles: age, number of prevalent vertebral fractures, body mass index, and a family history of osteoporosis. Because strontium ranelate has a large spectrum of efficacy, it can be used to treat different subgroups of patients with postmenopausal osteoporosis. Strontium ranelate was shown to be relatively well tolerated and the safety aspects were good. Strontium ranelate should be considered as a first-line treatment for postmenopausal osteoporotic patients. © 2010 Cesareo et al, publisher and licensee Dove Medical Press Ltd.
Rago A.,University of Rome La Sapienza |
Lichtner M.,University of Rome La Sapienza |
Mecarocci S.,University of Rome La Sapienza |
Marocco R.,University of Rome La Sapienza |
And 5 more authors.
Antiviral Therapy | Year: 2010
Entecavir and tenofovir disoproxil fumarate are potent and effective antiviral drugs that now represent recommended treatment options for chronic HBV infection. However, no or very limited clinical evidence is currently available on these drugs for the management of HBV reactivation in patients with haematological malignancies. Herein, we report a case of HBV reactivation in a patient with non-Hodgkin's lymphoma following a rituximab-based regimen, and who was successfully treated with a combination antiviral treatment including entecavir and tenofovir disoproxil fumarate. ©2010 International Medical Press.
Rago R.,Sm Goretti Hospital |
Salacone P.,Sm Goretti Hospital |
Caponecchia L.,Sm Goretti Hospital |
Marcucci I.,Sm Goretti Hospital |
And 2 more authors.
Journal of Endocrinological Investigation | Year: 2012
Background: Severeal in vivo and in vitro studies have been carried out in order to evaluate the efficacy of long-term treatment with phosphodiesterase type-5 (PDE5) inhibitors (PDE5i) on spermatogenesis, but the results are still controversial. Aim: To evaluate the effects of vardenafil on seminal parameters of infertile men after a short-term treatment. Materials/subjects and methods: A total of 205 male subjects were randomized to receive a single dose of vardenafil 10 mg (73 men, group B), a single dose of vardenafil 10 mg every other day for 15 days (67 men, group C), and no treatment (65 men, group A). Semen parameters were evaluated before and after the end of the treatment in each of group A, B, and C, respectively. Additionally, an IIEF-5 questionnaire was administered to all patients with erectile dysfunction (ED) before and after each treatment period. Results: The semen parameters in groups B and C has shown a significant increase in percentage forward motility after vardenafil administration as compared with baseline (p<0.001). In group C, we observed an increase in the mean semen volume and an improvement in the mean total sperm concentration (p<0.001) as compared with baseline. Conclusions: We showed the efficacy of vardenafil in the treatment of ED and, on a large series of infertile patients, the positive effect on sperm motility after a single-dose administration. It also showed that after 15 days of treatment on alternate days is also achieved an improvement in sperm concentration. ©2012, Editrice Kurtis.
Biscetti F.,melli University Hospital |
Pecorini G.,melli University Hospital |
Straface G.,Sm Goretti Hospital |
Arena V.,Catholic University |
And 6 more authors.
International Journal of Cardiology | Year: 2013
Background/objectives: Cilostazol has been found to be effective for the treatment of intermittent claudication (IC). This compound has several beneficial effects on platelet aggregation, serum lipids and endothelial cells, but how these might relate to improvements in walking is not entirely understood. The aim of this work was to investigate the effects of cilostazol on angiogenic response in a murine model of peripheral ischemia and to clarify the underlying molecular mechanisms of that response. Methods: We studied ischemia-induced neovascularization in the ischemic hindlimb of cilostazol-treated and untreated control mice. Results: We found that the perfusion recovery was significantly improved in treated compared with control mice. Interestingly, there was a higher level of circulating endothelial progenitor cells (EPCs) in mice treated with cilostazol than in untreated mice. Furthermore, cilostazol administration resulted in upregulation of granulocyte colony-stimulating factor (G-CSF) and vascular endothelial growth factor (VEGF) in the ischemic muscle of treated mice. Finally, inhibiting VEGF activity significantly reduced cilostazol-induced angiogenesis. Conclusions: The results of this study show that cilostazol administration enhances collateral blood flow in the ischemic hindlimbs of mice through a VEGF-dependent mechanism. These data may help to explain the beneficial effects that this drug has on patients with peripheral arterial disease (PAD) and IC. © 2012 Elsevier Ireland Ltd.
Maneschi F.,Sm Goretti Hospital |
Nale R.,University of Rome La Sapienza |
Tozzi R.,Sm Goretti Hospital |
Biccire D.,University of Rome La Sapienza |
And 2 more authors.
International Journal of Gynecological Cancer | Year: 2014
Objective: The aim of this study was to report the incidence, severity, and factors associated with femoral nerve injury during gynecologic cancer surgery. Methods: All patients who underwent abdominal surgery for gynecologic cancer entered the study. A retrospective reviewof the medical records was carried out for patients operated on from 2003 to April 2011. After this analysis, the use of the Bookwalter retractor was modified and the data were prospectively recorded. Results: In the first period, femoral nerve injury was observed in 11 (2.7%) of 406 patients, occurringwith a significantly higher frequencywhen the Bookwalter retractorwas used (5.1% vs0%, P < 0.01) andwhen pelvic lymphadenectomywas performed (5.1%vs 0.9%, P < 0.01). The analysis of the 212 patients (52.2%) in the Bookwalter group showed higher frequency of nerve injury in the patients undergoing pelvic lymphadenectomy (7.8%vs 2.0%, P = 0.05). In the second period, femoral nerve injury was observed in 1 (0.7%) of 132 patients operated on and in 1 (2.3%)of 43 patients (32.6%) in theBookwalter group.When comparing the 2 periods, the lesser use of the Bookwalter retractor and the reduced time of maximal traction of the pelvic blades decreased the nerve injury rate from2.7%to 0.7%and, in the Bookwalter group, from 5.1% to 2.3%. These results, although not statistically significant, are clinically relevant. Conclusions: Femoral nerve injury during gynecologic cancer surgery was associated with the Bookwalter retractor. The pelvic blades of the retractor may exert a compression on the nerve. The weakened muscles suggest that the nerve compression occurred intrapelvically over the iliacus muscle. Shortening the time of maximal traction of the pelvic blades reduced the incidence of femoral nerve injury. When performing gynecologic surgery with the use of the Bookwalter retractor, care must taken with the placement of the pelvic blades. ©2014 by IGCS and ESGO.