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1. Effectiveness of cardiac resynchronization therapy in heart failure patients with valvular heart disease: comparison with patients affected by ischaemic heart disease or dilated cardiomyopathy. The InSync/InSync ICD Italian Registry

Author

Boriani, G, Gasparini, M, Landolina, M, Lunati, M, Biffi, M, Santini, M, Padeletti, L, Molon, G, Botto, G, De Santo, T, Valsecchi, S, Galimberti, P, Regoli, F, Ceriotti, C, Cattafi, G, Magenta, G, Paolucci, M, Vecchi, R, Ricci, R, Gaita, F, Bocchiardo, M, Didonna, P, Caponi, D, Tavazzi, L, Rordorf, R, Petracci, B, Vicentini, A, Savastano, S, Matteo, Ps, Pieragnoli, P, Vincenti, A, Deceglia, S, Ciró, A, Gerardo Dei Tintori, S, Curnis, A, Mascioli, G, Puglisi, A, Bianchi, S, Peraldo, C, Sassara, M, Achilli, A, Turreni, F, Rossi, P, Perego, Gb, Ravazzi, Pa, Diotallevi, P, Antonio, e Biagio SS, Tritto, M, Carboni, A, Ardissino, D, Gonzi, G, Serra, V, Vergara, G, Maria Del Carmine, S, Martignani, C, Frabetti, L, Orsola-Mailpighi, S, Luzzi, G, Laurenzi, F, Camillo, S, Pistis, G, Cesario, A, Grassi, Gb, Zanotto, G, Orazi, S, Ometto, R, Bonanno, C, Bortolo, S, Barbieri, E, Cuore, S, Raviele, A, Gasparini, G, Luzi, M, Sagone, A, Anna, S, Vado, A, Croce, S, Montenero, A, Giovanni, Ss, Inama, G, Sassone, B, Briedda, M, Zardo, F, Maria, S, Bertaglia, E, Proclemer, A, Zanon, F, Disertori, M, Gramegna, L, Delgreco, M, Dallafior, D, Chiara, S, Tomasi, C, Maresta, A, Piancastelli, M, Maria Croci, S, Bridda, A, Martino, S, Mantovan, R, Fusco, A, Baraldi, P, Agostino, S, Lonardi, G, Rahue, W, Maurizio, S, Delise, P, Menozzi, C, Marianuova, S, Babudri, P, Marconi, R, Defabrizio, G, Alfano, F, Moscati, G, Barbato, G, Gelmini, P, Disabato, Leopoldo, S, Ricci, S, Aulerio, Md, Biagio, S, Morgagni, Gl, Latini, R, Bardelli, G, Paulichl, R, Tappeiner Merano, F, Bernasconi, M, Marzegalli, M, Carlo, S, Neri, G, Occhetta, E, Bocconcelli, P, Salvatore, S, Capucci, A, Campana, A, Giovanni, S, Dibelardino, N, Vaglio, A, Boriani G, Gasparini M, Landolina M, Lunati M, Biffi M, Santini M, Padeletti L, Molon G, Botto G, De Santo T, and Valsecchi S

Subjects
Cardiomyopathy, Dilated, Male, medicine.medical_specialty, Pacemaker, Artificial, medicine.medical_treatment, Cardiac resynchronization therapy, Cardiomyopathy, Heart Valve Diseases, Myocardial Ischemia, Socio-culturale, Heart failure, Aged, Atrial Fibrillation, Defibrillators, Implantable, Female, Heart Failure, Humans, Middle Aged, Registries, Treatment Outcome, Ventricular Remodeling, Cardiac Pacing, Artificial, Clinical Research, Internal medicine, medicine, cardiovascular diseases, Remodelling, Valvular heart disease, Heart transplantation, Ejection fraction, business.industry, valvular heart disease, Atrial fibrillation, Dilated cardiomyopathy, medicine.disease, Cardiology, cardiovascular system, Cardiology and Cardiovascular Medicine, business
Abstract

Aims To analyse the effectiveness of cardiac resynchronization therapy (CRT) in patients with valvular heart disease (a subset not specifically investigated in randomized controlled trials) in comparison with ischaemic heart disease or dilated cardiomyopathy patients. Methods and results Patients enrolled in a national registry were evaluated during a median follow-up of 16 months after CRT implant. Patients with valvular heart disease treated with CRT ( n = 108) in comparison with ischaemic heart disease ( n = 737) and dilated cardiomyopathy ( n = 635) patients presented: (i) a higher prevalence of chronic atrial fibrillation, with atrioventricular node ablation performed in around half of the cases; (ii) a similar clinical and echocardiographic profile at baseline; (iii) a similar improvement of LVEF and a similar reduction in ventricular volumes at 6–12 months; (iv) a favourable clinical response at 12 months with an improvement of the clinical composite score similar to that occurring in patients with dilated cardiomyopathy and more pronounced than that observed in patients with ischaemic heart disease; (v) a long-term outcome, in term of freedom from death or heart transplantation, similar to patients affected by ischaemic heart disease and basically more severe than that of patients affected by dilated cardiomyopathy. Conclusion In ‘real world’ clinical practice, CRT appears to be effective also in patients with valvular heart disease. However, in this group of patients the outcome after CRT does not precisely overlap any of the two other groups of patients, for which much more data are currently available.

Published
2009

3. The SIC-GIRCG 2013 Consensus Conference on Gastric Cancer

Author

Andrea Rinnovati, Franco Roviello, Carlo Staudacher, Riccardo Rosati, Paolo Innocenti, Natale Di Martino, Angelo Filippini, Giovanni Sgroi, Gualtiero Mazzocconi, Gianni Pantuso, Mario Morino, Lorenzo Capussotti, Carlo Vallicelli, Gian Luca Baiocchi, Antonio Martino, Umberto Bracale, Diego Piazza, Giorgio Maria Verdecchia, Maurizio De Giuli, Stefano Maria Giulini, Nicola Palasciano, Gianfranco Francioni, Patrizio Capelli, Severino Montemurro, Nereo Vettoretto, Giovanni Battista Grassi, Roberto Petri, Lorenzo Mazzola, Marco Frascio, S. Berti, Heinrich Pernthaler, Daniele Marrelli, Paolo Morgagni, Domenico D'Ugo, Annibale Donini, Donato Nitti, Alfredo Garofalo, Massimo Framarini, Alberto Marchet, Costantino Zingaretti, Michele Testa, Rosario Sacco, Rosaldo Allieta, Giovanni de Manzoni, Angelo Cavicchi, De Manzoni, G, Baiocchi, Gl, Framarini, M, De Giuli, M, D'Ugo, D, Marchet, A, Nitti, D, Marrelli, D, Morgagni, P, Rinnovati, A, Rosati, R, Roviello, F, Allieta, R, Berti, S, Bracale, Umberto, Capelli, P, Cavicchi, A, Di Martino, N, Donini, A, Filippini, A, Francioni, G, Frascio, M, Garofalo, A, Giulini, Sm, Grassi, Gb, Innocenti, P, Martino, A, Mazzocconi, G, Mazzola, L, Montemurro, S, Palasciano, N, Pantuso, G, Pernthaler, H, Petri, R, Piazza, D, Sacco, R, Sgroi, G, Staudacher, C, Testa, M, Vallicelli, C, Vettoretto, N, Zingaretti, C, Capussotti, L, Morino, M, Verdecchia, Gm, De Manzoni, G., Baiocchi, G., Framarini, M., De Giuli, M., D'Ugo, D., Marchet, A., Nitti, D., Marrelli, D., Morgagni, P., Rinnovati, A., Rosati, R., Roviello, F., Allieta, R., Berti, S., Bracale, U., Capelli, P., Cavicchi, A., Di Martino, N., Donini, A., Filippini, A., Francioni, G., Frascio, M., Garofalo, A., Giulini, S., Grassi, G., Innocenti, P., Martino, A., Mazzocconi, G., Mazzola, L., Montemurro, S., Palasciano, N., Pantuso, G., Pernthaler, H., Petri, R., Piazza, D., Sacco, R., Sgroi, G., Staudacher, C., Testa, M., Vallicelli, C., Vettoretto, N., Zingaretti, C., Capussotti, L., Morino, M., Verdecchia, G, De Manzoni, G1, Bracale, U, DI MARTINO, Natale, and Verdecchia, G. M.

Subjects
Male, medicine.medical_specialty, Gastric cancer, Surgery, Chemotherapy, Staging, Endoscopy, Laparoscopy, Staging, Delphi Technique, MEDLINE, Delphi method, chemotherapy, Endosonography, Female, Humans, Italy, Lymph Node Excision, Neoplasm Staging, Societies, Medical, Stomach Neoplasms, Stomach Neoplasm, Medical, medicine, lapaoscopy, guidelines, gastric cancer, staging endoscopy, Settore MED/06 - ONCOLOGIA MEDICA, treatment, business.industry, Consensus conference, Cancer, Endoscopy, medicine.disease, Plenary session, Surgery, Settore MED/18 - Chirurgia Generale, Gastric Cancer, Neoplasm staging, Laparoscopy, business, Societies, Human
Abstract

The topic chosen by the Board of the Italian Society of Surgery for the 2013 annual Consensus Conference was gastric cancer. With this purpose, under the direction of 2 chairmen, 36 experts nominated by the Regional Societies of Surgery and by the Italian Research Group for Gastric Cancer (GIRCG) participated in an experts consensus exercise, preceded by a questionnaire and mainly held by telematic vote, in accordance with the rules of the Delphi method. The results of this Consensus Conference, presented to the 115th National Congress of the Italian Society of Surgery, and approved in plenary session, are reported in the present paper.

Published
2014

4. Antibiotic prophylaxis in elective laparoscopic cholecystectomy. Lack of need or lack of evidence?

Author

Pierpaolo Sileri, Giovanni Battista Grassi, Stefano Mancini, C. Camplone, Marco Catarci, Paolo Gentileschi, Catarci, M, Mancini, S, Gentileschi, P, Camplone, C, Sileri, P, and Grassi, Gb

Subjects
Antibiotic prophylaxis, Cholecystectomy, Laparoscopy, Meta-analysis, Randomized controlled trials, law.invention, Randomized controlled trial, law, Odds Ratio, Medicine, Prospective Studies, Bibliographic, Antibacterial agent, Randomized Controlled Trials as Topic, Evidence-Based Medicine, adult, Incidence, placebo, aged, antibiotic prophylaxis, article, cholecystectomy, clinical trial, controlled clinical trial, controlled study, elective surgery, female, gallstone, human, infection rate, infectious complication, laparoscopic surgery, major clinical study, male, meta analysis, outcomes research, postoperative infection, practice guideline, priority journal, randomized controlled trial, sampling, surgical infection, wound infection, Antibiotic Prophylaxis, Cholecystectomy, Laparoscopic, Confidence Intervals, Databases, Bibliographic, Humans, Randomized Controlled Trials, Surgical Wound Infection, Treatment Outcome, Chemoprophylaxis, medicine.medical_specialty, Placebo, Databases, Laparoscopic, Internal medicine, business.industry, Perioperative, Odds ratio, Surgery, Settore MED/18 - Chirurgia Generale, business
Abstract

Background: The need to administer antibiotic prophylaxis (ABP) during laparoscopic cholecystectomy (LC) is still a matter of significant controversy. The purpose of this study was to resolve this issue by performing a meta-analysis of the available randomized controlled trials (RCT) on this topic. Methods: Papers identified via a systematic literature search were evaluated according to standard criteria. Data regarding the patient sample, study methods, and outcomes were abstracted and summarized across studies. The outcome measures were the rates of all perioperative infections, the rates of surgical site infections, and the rates of infections at other sites. Results were examined for 974 patients randomized to ABP or placebo prior to LC in six RCT published from 1997 to 2001. Results: The cumulative rates of all infections were 2.8% in the ABP group and 4.4% in the placebo group. The pooled odds ratio (OR) (95% confidence interval [CI]) was 0.69 (0.34–1.43; p = 0.32). The cumulative rates of surgical site infections were 2.1% in the ABP group and 2.9% in the placebo group. The pooled OR (95% CI) was 0.82 (0.36–1.86; p = 0.63). The cumulative rates of infections at other sites were 0.7% in the ABP group and 1.5% in the placebo group. Pooled OR (95% CI) was 0.82 (0.18–1.90; p = 0.37). No significant heterogeneity was found in any data pooling. Conclusions: Based on the available evidence, there appears to be no need to administer routine ABP to low-risk patients during LC. However, the number of patients enrolled to date into RCT is insufficient to avoid a type II error. A large and well-designed trial is urgently needed to find a conclusive answer to this question.

Published
2003

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