68 results on '"Capuano I"'
Search Results
2. Erosion after laparoscopic ventral mesh rectopexy with a biological mesh
- Author
-
Shalaby, M., Matarangolo, A., Capuano, I., Petrella, G., and Sileri, P.
- Published
- 2017
- Full Text
- View/download PDF
3. Oral Sucrosomial® iron versus intravenous iron for recovering iron deficiency anaemia in ND-CKD patients: a cost- minimization analysis
- Author
-
Riccio E, Sabbatini M, Capuano I, Pellegrino AM, Petruzzelli LA, Pisani A., Riccio, E, Sabbatini, M, Capuano, I, Pellegrino, Am, Petruzzelli, La, and Pisani, A.
- Published
- 2020
4. Acellular Dermal Matrix in Prosthetic Breast Reconstructive Surgery with Prepectoral Technique: A Literature Review
- Author
-
Mattei M, Bernardini R, Capuano I, and Dimitrios Varvaras
- Subjects
medicine.medical_specialty ,Reconstructive surgery ,business.industry ,Medicine ,business ,Dermal matrix ,Surgery - Published
- 2020
5. The role of transanal tube drainage to prevent colorectal anastomotic leakage: a case control study
- Author
-
Shalaby M, Capuano I, Saraceno F, Mastrovito S, Mascagni P, Cianfarani A, Muzi MG, Buonomo OC, Petrella G, Sileri P, Shalaby, M, Capuano, I, Saraceno, F, Mastrovito, S, Mascagni, P, Cianfarani, A, Muzi, Mg, Buonomo, Co, Petrella, G, Sileri, P, and Buonomo, Oc
- Published
- 2018
6. Muzi's tension free primary closure technique versus the endoscopic pilonidal sinus treatment: a retrospective study
- Author
-
Giarratano, G, Mascagni, P, Cianfarani, A, Mosconi, C, Saraceno, F, Capuano, I, Mascagni, D, Sileri, P, Muzi, M, Giarratano, G, Mascagni, P, Cianfarani, A, Mosconi, C, Saraceno, F, Capuano, I, Mascagni, D, Sileri, P, and Muzi, Mg
- Subjects
Settore MED/18 - Published
- 2018
7. Nutritional management in renal transplant recipients: A transplant team opportunity to improve graft survival
- Author
-
Sabbatini, M., primary, Ferreri, L., additional, Pisani, A., additional, Capuano, I., additional, Morgillo, M., additional, Memoli, A., additional, Riccio, E., additional, and Guida, B., additional
- Published
- 2019
- Full Text
- View/download PDF
8. Laparoscopic Ventral Bio-Mesh Rectopexy for Internal and External Rectal Prolapse
- Author
-
Sileri P, Shalaby M, Franceschilli L, Missori G, Quaresima S, Capuano I, Sileri, P, Shalaby, M, Franceschilli, L, Missori, G, Quaresima, S, and Capuano, I
- Published
- 2016
9. Transanal Hemorrhoidal Dearterialization vs Ferguson Hemorrhoidectomy in the Treatment of Hemorrhoidal Disease
- Author
-
Stolfi VM, Capuano I, Micossi C, Nigro F, Sileri P, Stolfi, Vm, Capuano, I, Micossi, C, Nigro, F, and Sileri, P
- Published
- 2016
10. Initial Experience With TST STARR PLUS to Treat Obstructed Defecation Syndrome
- Author
-
Franceschilli L, Lacapra D, Capuano I, Giorgi F, Stolfi VM, Gaspari AL, Sileri P, Franceschilli, L, Lacapra, D, Capuano, I, Giorgi, F, Stolfi, Vm, Gaspari, Al, and Sileri, P
- Published
- 2015
11. Omento(Fat)Plasty After Colorectal Anastomosis May Reduce Leakages
- Author
-
Franceschilli L, Di Lorenzo N, Capuano I, De Felice V, Giorgi F, Gaspari AL, Sileri P, Franceschilli, L, Di Lorenzo, N, Capuano, I, De Felice, V, Giorgi, F, Gaspari, Al, and Sileri, P
- Published
- 2015
12. One-stage versus two-stage implant-based breast reconstruction after breast surgery for cancer
- Author
-
Capuano, I., primary, Orsaria, P., additional, Caredda, E., additional, Foglio, F., additional, Saraceno, F., additional, Sileri, P., additional, Petrella, G., additional, and Buonomo, O.C., additional
- Published
- 2018
- Full Text
- View/download PDF
13. Abstract P1-09-10: ICOSL anti-HER2 V-mAbs: Localizing engineered ICOSL costimulatory agonists to HER2+ tumors through trastuzumab
- Author
-
Rickel, E, primary, Evans, L, additional, Swanson, R, additional, Levin, SS, additional, Rixon, M, additional, Wolfson, M, additional, Bhandari, J, additional, MacNeil, S, additional, Hoover, J, additional, Kornacker, M, additional, Capuano, I, additional, and Peng, SL, additional
- Published
- 2018
- Full Text
- View/download PDF
14. 22. New frontiers in neurophysiological instrumental diagnostics in the neonatal intensive care unit: “Smart-EEG”
- Author
-
Capuano, I., primary, Gabbanini, S., additional, Bastianelli, M., additional, Cossu, C., additional, Roma, I., additional, and Lori, S., additional
- Published
- 2017
- Full Text
- View/download PDF
15. 143 (PB-044) - One-stage versus two-stage implant-based breast reconstruction after breast surgery for cancer
- Author
-
Capuano, I., Orsaria, P., Caredda, E., Foglio, F., Saraceno, F., Sileri, P., Petrella, G., and Buonomo, O.C.
- Published
- 2018
- Full Text
- View/download PDF
16. Therapeutic advances in ADPKD: the future awaits
- Author
-
Pasquale Buonanno, Antonio Pisani, Maria Amicone, Eleonora Riccio, Ivana Capuano, Capuano, I., Buonanno, P., Riccio, E., Amicone, M., and Pisani, A.
- Subjects
TRPP Cation Channels ,Molecular pathway ,medicine.medical_treatment ,030232 urology & nephrology ,Autosomal dominant polycystic kidney disease ,Apoptosis ,030204 cardiovascular system & hematology ,Total kidney volume ,urologic and male genital diseases ,Bioinformatics ,End stage renal disease ,Targeted therapy ,Cell therapy ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Animals ,Humans ,Glomerular filtration rate ,education ,education.field_of_study ,PKD1 ,business.industry ,Genetic disorder ,Cell cycle ,Polycystic Kidney, Autosomal Dominant ,medicine.disease ,Polycystin 2 ,Nephrology ,Tolvaptan ,Kidney Failure, Chronic ,Calcium ,business - Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is a heterogeneous genetic disorder included in ciliopathies, representing the fourth cause of end stage renal disease (ESRD), with an estimated prevalence between 1:1000 and 1:2500. It is mainly caused by mutations in the PKD1 and PKD2 genes encoding for polycystin 1 (PC1) and polycystin 2 (PC2), which regulate differentiation, proliferation, survival, apoptosis, and autophagy. The advances in the knowledge of multiple molecular pathways involved in the pathophysiology of ADPKD led to the development of several treatments which are currently under investigation. Recently, the widespread approval of tolvaptan and, in Italy, of long-acting release octreotide (octreotide-LAR), represents but the beginning of the new therapeutic management of ADPKD patients. Encouraging results are expected from ongoing randomized controlled trials (RCTs), which are investigating not only drugs acting on the calcium/cyclic adenosin monoposphate (cAMP) pathway, the most studied target so far, but also molecules targeting specific pathophysiological pathways (e.g. epidermal growth factor (EGF) receptor, AMP-activated protein kinase (AMPK) and KEAP1-Nrf2) and sphingolipids. Moreover, studies on animal models and cultured cells have also provided further promising therapeutic strategies based on the role of intracellular calcium, cell cycle regulation, MAPK pathway, epigenetic DNA, interstitial inflammation, and cell therapy. Thus, in a near future, tailored therapy could be the key to changing the natural history of ADPKD thanks to the vigorous efforts that are being made to implement clinical and preclinical studies in this field. Our review aimed to summarize the spectrum of drugs that are available in the clinical practice and the most promising molecules undergoing clinical, animal, and cultured cell studies. Graphical abstract: [Figure not available: see fulltext.]
- Published
- 2021
17. Stepwise shortening of agalsidase beta infusion duration in Fabry disease: Clinical experience with infusion rate escalation protocol
- Author
-
Maria Amicone, Pasquale Buonanno, Eleonora Riccio, Monica Franzese, Antonio Pisani, Ivana Capuano, Lucia Ferreri, Mario Zanfardino, Riccio, E., Zanfardino, M., Franzese, M., Capuano, I., Buonanno, P., Ferreri, L., Amicone, M., and Pisani, A.
- Subjects
Adult ,Male ,0301 basic medicine ,infusion‐associated reactions ,QH426-470 ,030105 genetics & heredity ,Drug Administration Schedule ,03 medical and health sciences ,Quality of life ,infusion-associated reaction ,Genetics ,Humans ,Medicine ,infusion-associated reactions ,Infusions, Intravenous ,Patient compliance ,Molecular Biology ,Genetics (clinical) ,Aged ,Fabry disease ,business.industry ,Significant difference ,Original Articles ,Enzyme replacement therapy ,Middle Aged ,medicine.disease ,AGALSIDASE BETA ,Isoenzymes ,030104 developmental biology ,Tolerability ,infusion rate escalation protocol ,alpha-Galactosidase ,Anesthesia ,Cohort ,agalsidase beta ,Original Article ,Female ,business ,enzyme replacement therapy - Abstract
Background Although enzyme replacement therapy with agalsidase beta resulted in a variety of clinical benefits, life‐long biweekly intravenous infusion may impact on patients’ quality of life. Moreover, regular infusions are time‐consuming: although a stepwise shortening of infusion duration is allowed up to a minimum of 1.5 hr, in most centers it remains ≥3 hr, and no data exists about the safety and tolerability of agalsidase beta administration at maximum tolerated infusion rate. Methods In this study, we reported our experience with a stepwise infusion rate escalation protocol developed in our center in a cohort of 53 Fabry patients (both already receiving and treatment‐naΪve), and explored factors predictive for the infusion rate increase tolerability. Results Fifty‐two patients (98%) reduced infusion duration ≤3 hr; of these, 38 (72%) even reached a duration ≤2 hr. We found a significant difference between the mean duration reached by already treated and naΪve patients (p, Although enzyme replacement therapy with agalsidase beta resulted in a variety of clinical benefits, life‐long biweekly intravenous infusion may impact on patients’ quality of life because regular infusions are time‐consuming. In this study, we reported our experience with a stepwise infusion rate escalation protocol developed in our center in a cohort of 53 Fabry patients (both already receiving and treatment‐naΪve), and explored factors predictive for the infusion rate increase tolerability. We showed that our infusion rate escalation protocol is safe and could improve patient compliance, satisfaction and quality of life.
- Published
- 2021
18. The effects of somatostatin analogues on liver volume and quality of life in polycystic liver disease: a meta-analysis of randomized controlled trials
- Author
-
Carlo Garofalo, Ivana Capuano, Luigi Pennino, Ilaria De Gregorio, Eleonora Riccio, Michele Provenzano, Felice Crocetto, Pasquale Buonanno, Savio Domenico Pandolfo, Michele Andreucci, Antonio Pisani, Garofalo, Carlo, Capuano, Ivana, Pennino, Luigi, De Gregorio, Ilaria, Riccio, Eleonora, Provenzano, Michele, Crocetto, Felice, Buonanno, Pasquale, Pandolfo, Savio Domenico, Andreucci, Michele, Pisani, Antonio, Garofalo, C., Capuano, I., Pennino, L., De Gregorio, I., Riccio, E., Provenzano, M., Crocetto, F., Buonanno, P., Pandolfo, S. D., Andreucci, M., and Pisani, A.
- Subjects
Multidisciplinary ,Cysts ,Liver Diseases ,Science ,Gastroenterology ,Organ Size ,Middle Aged ,Polycystic Kidney, Autosomal Dominant ,Article ,Liver ,Nephrology ,Quality of Life ,Humans ,Medicine ,Somatostatin ,Randomized Controlled Trials as Topic - Abstract
A clear evidence on the benefits of somatostatin analogues (SA) on liver outcome in patients affected by polycystic liver disease is still lacking. We performed a meta-analysis of RCTs and a trial sequential analysis (TSA) evaluating the effects of SA in adult patients with polycystic liver disease on change in liver volume. As secondary outcome, we evaluated the effects on quality of life as measured by SF36-questionnaire. Six RCTs were selected with an overall sample size of 332 adult patients with polycystic liver disease (mean age: 46 years). Mean liver volume at baseline was 3289 ml in SA group and 3089 ml in placebo group. Overall, unstandardized mean difference in liver volume was − 176 ml (95%CI, − 406, 54; p 2:0%, p p = 0.036). Cumulative Z-curve in TSA did not reach either significance and futility boundaries or required information size. Three RCTs have evaluated Quality of life parameters measured by SF36-QOL questionnaire for a total of 124 patients; no significant difference was found on the effect of SA on QOL parameters when compared with placebo. The present meta-analysis revealed a potential effect of SA on reduction of liver volume and quality of life parameters, but results did not reach a statistical significance. These data could be explained by the need of further studies, as demonstrated through TSA, to reach an adequate sample size to confirm the beneficial outcomes of SAs treatment.
- Published
- 2021
19. Identifying Fabry patients in dialysis population: prevalence of GLA mutations by renal clinic screening, 1995-2019
- Author
-
Ivana Capuano, Eleonora Riccio, Carlo Garofalo, Sandro Feriozzi, Antonio Pisani, Pasquale Buonanno, Teodolinda Di Risi, Michele Pinelli, Capuano, Ivana, Garofalo, Carlo, Buonanno, Pasquale, Pinelli, Michele, Di Risi, Teodolinda, Feriozzi, Sandro, Riccio, Eleonora, Pisani, Antonio, Capuano, I., Garofalo, C., Buonanno, P., Pinelli, M., Di Risi, T., Feriozzi, S., Riccio, E., and Pisani, A.
- Subjects
Nephrology ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Population ,030232 urology & nephrology ,Late onset ,030204 cardiovascular system & hematology ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Renal Dialysis ,Internal medicine ,medicine ,Prevalence ,Humans ,education ,Uncertain significance ,GLA mutation ,Dialysis ,education.field_of_study ,Mutation ,business.industry ,Dialysi ,Genetic disorder ,medicine.disease ,Fabry disease ,alpha-Galactosidase ,Screening ,Fabry Disease ,Female ,business - Abstract
Background: Fabry disease (FD) is a rare X-linked genetic disorder of glycosphingolipid catabolism caused by mutations in the GLA gene. Its heterogeneous presentation, the paucity of specific early markers, and the absence of a genotype–phenotype correlation are associated with a delayed or missed diagnosis. The true prevalence of FD remains so far unknown. Methods: A systematic search of FD screening studies in dialysis patients published from January 1995 until January 2019 was performed to reanalyze the prevalence of GLA mutations in this population after assigning their correct phenotype. Results: Twenty five screening studies involving 39,621 dialysis patients were included. Of them, 116 [91 males (0.23%) and 25 females (0.06%)] were positive to the GLA sequencing analysis. 56 (48.2%) had benign variant, 52 (44.8%) a pathogenic GLA mutation (39 classic and 13 late onset mutations) and 8 (6.9%) a mutation of uncertain significance. The overall prevalence of GLA variants was 0.24% [CI 95%, 0.17–0.32] while the overall prevalence recalculated on basis of only pathogenetic mutations was 0.14% [CI 95%, 0.08–0.20]. This difference was significant (P = 0.048). Conclusions: Although the real prevalence of classic FD is low, the screening in the high-risk renal population remains of primary interest as an early diagnosis is fundamental for a timely specific therapy; moreover, the identification of index cases could allow patients’ relatives to be investigated and promptly treated.
- Published
- 2019
20. Early Biomarkers of Fabry Nephropathy: A Review of the Literature
- Author
-
Eleonora Riccio, Massimo Sabbatini, Antonio Pisani, Ivana Capuano, Riccio, E, Sabbatini, M, Capuano, I, and Pisani, A
- Subjects
Male ,Proteomics ,medicine.medical_specialty ,030232 urology & nephrology ,Renal function ,Disease ,030204 cardiovascular system & hematology ,Urine ,Nephropathy ,Fabry nephropathy ,03 medical and health sciences ,0302 clinical medicine ,Alpha-Globulins ,medicine ,Humans ,Enzyme Replacement Therapy ,Cystatin C ,Intensive care medicine ,Kidney ,Proteinuria ,business.industry ,Cysts ,Trihexosylceramides ,Enzyme replacement therapy ,medicine.disease ,Fabry disease ,Early marker ,medicine.anatomical_structure ,Early Diagnosis ,Albuminuria ,Fabry Disease ,Female ,medicine.symptom ,business ,Biomarkers ,Glomerular Filtration Rate - Abstract
Progressive nephropathy is one of the main features of Fabry disease. Although some clinical signs of Fabry nephropathy are already present in childhood, patients are often diagnosed relatively late in the course of the disease due to the absence of specific clinical markers, while a timely diagnosis and the prompt start of enzyme replacement therapy may be beneficial in stabilizing renal function or slowing its decline. Proteinuria/albuminuria has been accepted as the most important marker for Fabry nephropathy; however, a large proportion of renal impairment occurs in nonalbuminuric state. Therefore, early biomarkers may be useful for early identification of kidney involvement. The aim of this article is to review the current available literature on all biomarkers of Fabry nephropathy, with a comprehensive and critical description of their utilization in early recognition of renal damage.
- Published
- 2019
21. ADPKD and metformin: from bench to bedside
- Author
-
Antonio Pisani, Ivana Capuano, Simona Caccavallo, Eleonora Riccio, Imma De Simone, Capuano, I., Riccio, E., Caccavallo, S., De Simone, I., and Pisani, A.
- Subjects
Nephrology ,medicine.medical_specialty ,endocrine system diseases ,Physiology ,business.industry ,digestive, oral, and skin physiology ,Disease progression ,MEDLINE ,nutritional and metabolic diseases ,adpkd ,urologic and male genital diseases ,Polycystic kidney ,Bench to bedside ,Metformin ,Physiology (medical) ,Internal medicine ,medicine ,business ,Intensive care medicine ,medicine.drug - Abstract
This is the frst record in the literature of the benefcial efect of metformin on ADPKD progression in the same family: during 10 years of follow-up, eGFR decreased in three sisters, but in one of them, it decreased slower after the introduction of metformin and without adverse event . Our results confrm the benefcial efect of metformin in delaying the progression of renal dysfunction in ADPKD patients with moderately impaired eGFR
- Published
- 2019
22. Additional Nodal Disease Prediction in Breast Cancer with Sentinel Lymph Node Metastasis Based on Clinicopathological Features
- Author
-
Alessandra Vittoria Granai, Ilaria Capuano, Ilaria Portarena, Adriano De Majo, Emanuele Caredda, Oreste Claudio Buonomo, Marco Materazzo, Paolo Orsaria, Gianluca Vanni, Giuseppe Petrella, Federica Genova, Pierpaolo Sileri, Leonardo Palombi, Orsaria, P, Caredda, E, Genova, F, Materazzo, M, Capuano, I, Vanni, G, Granai, Av, De Majo, A, Portarena, I, Sileri, P, Petrella, G, Palombi, L, and Buonomo, Oc
- Subjects
Oncology ,Cancer Research ,Lymphovascular invasion ,Receptor, ErbB-2 ,Metastasis ,ErbB-2 ,0302 clinical medicine ,Risk Factors ,Ductal ,80 and over ,Breast ,Prospective cohort study ,Aged, 80 and over ,medicine.diagnostic_test ,Carcinoma, Ductal, Breast ,General Medicine ,Middle Aged ,Prognosis ,medicine.anatomical_structure ,nodal metastasis ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,Breast neoplasms ,sentinel lymph node ,Adult ,Aged ,Axilla ,Breast Neoplasms ,Female ,Humans ,Lymph Node Excision ,Retrospective Studies ,Sentinel Lymph Node ,Sentinel Lymph Node Biopsy ,030211 gastroenterology & hepatology ,Receptor ,medicine.medical_specialty ,Sentinel lymph node ,03 medical and health sciences ,Breast cancer ,Internal medicine ,Biopsy ,medicine ,business.industry ,Carcinoma ,Axillary Lymph Node Dissection ,medicine.disease ,Settore MED/18 - Chirurgia Generale ,business - Abstract
Aim: The standard-of-care in breast cancer (BC) with positive sentinel lymph node (SLN) metastasis includes complete axillary lymph node dissection (ALND); however, almost half of such cases have no further tumor burden. This study aimed to assess the clinicopathological factors that predict non-SLN metastasis to define subgroups of SLN-positive patients in whom the axilla may be staged by SLN biopsy alone, while avoiding unnecessary overtreatment. Patients and Methods: The records of 191 patients with histologically-proven primary BC who underwent a positive (SLN) biopsy between 2005 and 2017 were reviewed. Patients with at least one tumor-involved SLN who underwent completion ALND were enrolled. Demographic and clinicopathological characteristics, including age, primary tumor size and histological grade, lymphovascular invasion, ratio of positive SLNs to the harvested SLNs, SLN metastasis size, and molecular subtype classification according to immunohistochemical biomarker status [estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2)], were evaluated. Data were collected retrospectively and analyzed using the Mann-Whitney and Chi-square tests (statistical significance: p0.67 [odds ratio (OR)=2.55, p=0.032], luminal BC subtype (OR=2.67, p=0.06), HER2 overexpression (OR=0.4, p=0.016), and ER(+)PR(-)HER2(-) profile (OR=2.95, p=0.027). There was a tendency (statistically insignificant; p>0.05) toward higher incidence of non SLN metastasis with increasing age and histological grade, which could be attributed to the small sample size. Conclusion: According to this study, sentinel nodal ratio and BC subtypes as per ER, PR, and HER2 status significantly predicted the likelihood of additional lymphatic involvement. Validation of these parameters in prospective studies is indicated, and may help individualize treatment modalities.
- Published
- 2018
23. Laparoscopic ventral rectopexy using biologic mesh for the treatment of obstructed defaecation syndrome and/or faecal incontinence in patients with internal rectal prolapse: a critical appraisal of the first 100 cases
- Author
-
Federica Giorgi, Luana Franceschilli, C Ciangola, Ilaria Capuano, Pierpaolo Sileri, D. Varvaras, G. Boehm, A.L. Gaspari, Franceschilli, L, Varvaras, D, Capuano, I, Ciangola, Ci, Giorgi, F, Boehm, G, Gaspari, Al, and Sileri, P
- Subjects
Adult ,medicine.medical_specialty ,Operative Time ,Anal Canal ,Biocompatible Materials ,Postoperative Complications ,Recurrence ,medicine ,Humans ,Prospective Studies ,Defecation ,Laparoscopy ,Prospective cohort study ,Digestive System Surgical Procedures ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Rectocele ,Rectum ,Gastroenterology ,Rectal Prolapse ,Length of Stay ,Middle Aged ,Surgical Mesh ,medicine.disease ,Colorectal surgery ,Surgery ,Rectal prolapse ,Critical appraisal ,Treatment Outcome ,Female ,Complication ,business ,Constipation ,Fecal Incontinence ,Intestinal Obstruction ,Follow-Up Studies ,Abdominal surgery - Abstract
Laparoscopic ventral mesh rectopexy (LVR) is gaining wider acceptance as the preferred procedure to correct internal as well as external rectal prolapse associated with obstructed defaecation syndrome and/or faecal incontinence. Very few reports exist on the use of biologic mesh for LVR. The aim of our study was to report the complication and recurrence rate of our first 100 cases of LVR for symptomatic internal rectal prolapse and/or rectocele using a porcine dermal collagen mesh. Prospectively collected data on LVR for internal rectal prolapse were analysed. Surgical complications and functional results in terms of faecal incontinence (measured with the Faecal Incontinence Severity Index = FISI) and constipation (measured with the Wexner Constipation Score = WCS) at 3, 6 and 12 months were analysed. It was considered an improvement if FISI or WCS scores were reduced by at least 25 % and a cure if the FISI score decreased to < 10 and the WCS decreased to < 5. Between April 2009 and April 2013, 100 consecutive female patients (mean age 63 years, range 24-88 years) underwent LVR. All patients had internal rectal prolapse (grade III [n = 25] and grade IV [n = 75] according to the Oxford classification) and rectocele. Mean operative time was 85 +/- A 40 min. Conversion rate to open technique was 1 %. There was no post-operative mortality. Overall 16 patients (16 %) experienced 18 complications, including rectal perforation (n = 1), small bowel obstruction (n = 2), urinary tract infection (n = 8), subcutaneous emphysema (n = 3), wound haematoma (n = 2), long lasting sacral pain (n = 1) and incisional hernia (1). Median post-operative length of stay was 2 days. Ninety-eight out of 100 patients completed follow-up. At the end of follow-up, the mean FISI score improved from 8.4 (+/- 4.0 standard deviation (SD) p = 0.003) to 3.3 +/- 2.3 SD (p = 0.04). Incontinence improved in 37 out of 43 patients (86 %), and 31 patients (72 %) were cured. Similarly, the mean WCS score improved from 18.4 +/- 11.6 SD to 5.4 +/- 4.1 SD (p = 0.04). Constipation improved in 82 out of 89 patients (92 %), and 70 patients (79 %) were cured. No worsening of continence status, constipation or sexual function was observed. Fourteen patients (14 %) experienced persistence or recurrence of prolapse. LVR using biologic mesh is a safe and effective procedure for improving symptoms of obstructed defaecation and faecal incontinence in patients with internal rectal prolapse associated with rectocele.
- Published
- 2015
24. Erosion after laparoscopic ventral mesh rectopexy with a biological mesh
- Author
-
Mostafa Shalaby, A. Matarangolo, Giuseppe Petrella, Pierpaolo Sileri, Ilaria Capuano, Shalaby, M, Matarangolo, A, Capuano, I, Petrella, G, and Sileri, P
- Subjects
medicine.medical_specialty ,Mesh rectopexy ,business.industry ,Gastroenterology ,Colorectal surgery ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Medicine ,030211 gastroenterology & hepatology ,business ,Abdominal surgery - Published
- 2017
25. Small-Bowel Obstruction Secondary to Adhesions After Open or Laparoscopic Colorectal Surgery
- Author
-
Paolo Angelucci G, Luana Franceschilli, Di Lorenzo N, Ilaria Capuano, Silvia Quaresima, Sebastian Smolarek, Pierpaolo Sileri, Mostafa Shalaby, Giulia Missori, Smolarek, S, Shalaby, M, Angelucci, Gp, Missori, G, Capuano, I, Franceschilli, L, Quaresima, S, Di Lorenzo, N, and Sileri, P
- Subjects
Adult ,Male ,Reoperation ,medicine.medical_specialty ,Time Factors ,Adolescent ,Incisional hernia ,030230 surgery ,Scientific Paper ,Young Adult ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,adult ,aged ,aged, 80 and over ,colorectal surgery ,female ,humans ,intestinal obstruction ,laparoscopy ,male ,middle aged ,postoperative complications ,reoperation ,retrospective studies ,risk factors ,time factors ,young adult ,intestine small ,Risk Factors ,Intestine, Small ,80 and over ,medicine ,Humans ,Surgical emergency ,Risk factor ,Laparoscopy ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,Colorectal surgery ,Settore MED/18 ,Surgery ,Bowel obstruction ,030220 oncology & carcinogenesis ,Female ,business ,Colorectal Surgery ,Intestinal Obstruction ,Cohort study ,Abdominal surgery - Abstract
Background and Objectives: Small-bowel obstruction (SBO) is a common surgical emergency that occurs in 9% of patients after abdominal surgery. Up to 73% are caused by peritoneal adhesions. The primary purpose of this study was to compare the rate of SBOs between patients who underwent laparoscopic (LPS) and those who had open (OPS) colorectal surgery. The secondary reasons were to evaluate the rate of adhesive SBO in a cohort of patients who underwent a range of colorectal resections and to assess risk factors for the development of SBO. Method: This was a retrospective observational cohort study. Data were analyzed from a prospectively collected database and cross checked with operating theater records and hospital patient management systems. Results: During the study period, 707 patients underwent colorectal resection, 350 of whom (49.5%) were male. Median follow-up was 48.3 months. Of the patients included, 178 (25.2%) underwent LPS, whereas 529 (74.8%) had OPS. SBO occurred in 72 patients (10.2%): 20 (11.2%) in the LPS group and 52 (9.8%) in the OPS group [P = .16; hazards ratio (HR) 1.4 95% CI 0.82-2.48] within the study period. Conversion to an open procedure was associated with increased risk of SBO (P = .039; HR 2.82; 95% CI 0.78-8.51). Stoma formation was an independent risk factor for development of SBO (P = .049; HR, 0.63; 95% CI 0.39 -1.03). The presence of an incisional hernia in the OPS group was associated with SBO (P = .0003; HR, 2.85; 95% CI 1.44 -5.283). There was no difference in SBO between different types of procedures: right colon, left colon, and rectal surgery. Patients who developed early small-bowel obstruction (ESBO) were more often treated surgically compared to late SBO (P= .0001). Conclusion: The use of laparoscopy does not influence the rate of SBO, but conversion from laparoscopic to open surgery is associated with an increased risk of SBO. Stoma formation is associated with a 2-fold increase in SBO. Development of ESBO is highly associated with a need for further surgical intervention.
- Published
- 2016
26. Does physical exercise ameliorate CKD-related complications? The case of anaemia and CKD-MBD.
- Author
-
Aucella F, Amicone M, Perez Ys ADM, Aucella F, Gatta G, Prencipe MA, Riccio E, Capuano I, Pisani A, and Battaglia Y
- Abstract
Background Physical exercise (PE) can regulate inflammation, cardiovascular health, sarcopenia, anaemia and bone health in the chronic kidney disease (CKD) population. Experimental and clinical studies both help us to better understand the mechanisms that underlie the beneficial effects of the exercise, especially in renal anaemia and CKD-Mineral Bone Disorders (CKD-MBD). Here, we summarize this evidence, exploring the biological pathways involved, locally released substances and crosstalk between tissues, but also the shortcomings of current knowledge. Main findings Anaemia- Both in healthy and CKD subjects PE may mimic hypoxia, inhibiting PHDs; so hydroxylate HIF-α subunits may be translocated into the nucleus, resulting in dimerization of HIF-1α and HIF1β, recruitment of p300 and CBP, and ultimately, binding to HREs at target genes to cause activation. However, in CKD subjects acute PE causes higher levels of lactate, leading to iron restriction by upregulating hepatic hepcidin expression; while chronic PE allows an increased lactate clearance and HIF-α and VEGFα levels, stimulating both erythropoiesis and angiogenesis. CKD-MBD -PE may improve bone health decreasing bone resorption and increasing bone formation throughout at least three main pathways: A) increasing osteoprotegerin and decreasing RANKL system; B) decreasing cytokines levels; and C) stimulating production of miokines and adipokines. Conclusions Future research needs to be defined to develop evidence-based exercise guidance to provide optimal benefit for CKD using exercise interventions as adjuvant therapy for CKD-related complications such as anaemia and CKD-MBD., (The Author(s). Published by S. Karger AG, Basel.)
- Published
- 2024
- Full Text
- View/download PDF
27. In vivo demonstration of globotriaosylceramide brain accumulation in Fabry Disease using MR Relaxometry.
- Author
-
Pontillo G, Tranfa M, Scaravilli A, Monti S, Capuano I, Riccio E, Rizzo M, Brunetti A, Palma G, Pisani A, and Cocozza S
- Subjects
- Humans, Male, Female, Adult, Cross-Sectional Studies, Retrospective Studies, Case-Control Studies, Brain diagnostic imaging, Brain metabolism, Middle Aged, White Matter diagnostic imaging, White Matter metabolism, Fabry Disease diagnostic imaging, Fabry Disease metabolism, Magnetic Resonance Imaging methods, Trihexosylceramides metabolism
- Abstract
Purpose: How to measure brain globotriaosylceramide (Gb3) accumulation in Fabry Disease (FD) patients in-vivo is still an open challenge. The objective of this study is to provide a quantitative, non-invasive demonstration of this phenomenon using quantitative MRI (qMRI)., Methods: In this retrospective, monocentric cross-sectional study conducted from November 2015 to July 2018, FD patients and healthy controls (HC) underwent an MRI scan with a relaxometry protocol to compute longitudinal relaxation rate (R1) maps to evaluate gray (GM) and white matter (WM) lipid accumulation. In a subgroup of 22 FD patients, clinical (FAbry STabilization indEX -FASTEX- score) and biochemical (residual α-galactosidase activity) variables were correlated with MRI data. Quantitative maps were analyzed at both global ("bulk" analysis) and regional ("voxel-wise" analysis) levels., Results: Data were obtained from 42 FD patients (mean age = 42.4 ± 12.9, M/F = 16/26) and 49 HC (mean age = 42.3 ± 16.3, M/F = 28/21). Compared to HC, FD patients showed a widespread increase in R1 values encompassing both GM (p
FWE = 0.02) and WM (pFWE = 0.02) structures. While no correlations were found between increased R1 values and FASTEX score, a significant negative correlation emerged between residual enzymatic activity levels and R1 values in GM (r = -0.57, p = 0.008) and WM (r = -0.49, p = 0.03)., Conclusions: We demonstrated the feasibility and clinical relevance of non-invasively assessing cerebral Gb3 accumulation in FD using MRI. R1 mapping might be used as an in-vivo quantitative neuroimaging biomarker in FD patients., (© 2024. The Author(s).)- Published
- 2024
- Full Text
- View/download PDF
28. Clinical and pathophysiological correlates of basilar artery measurements in Fabry Disease.
- Author
-
Scaravilli A, Capasso S, Ugga L, Capuano I, Risi TD, Pontillo G, Riccio E, Tranfa M, Pisani A, Brunetti A, and Cocozza S
- Abstract
Background and Purpose: Alterations of the Basilar Artery (BA) anatomy have been suggested as a possible Magnetic Resonance Angiography (MRA) feature of Fabry Disease (FD). Nonetheless, no information about their clinical or pathophysiological correlates is available, limiting our comprehension of the real impact of vessel remodeling in FD., Materials and Methods: Brain MRIs of 53 FD subjects (40.7±12.4 years, M/F=23/30) were collected in this single center study. Mean BA diameter and its Tortuosity Index (TI) were calculated on MRA. Possible correlations between these metrics and clinical, laboratory and advanced imaging variables of the posterior circulation were tested. In a subgroup of 20 subjects, a two-year clinical and imaging follow-up was available, with possible longitudinal changes of these metrics and their ability in predicting clinical scores that were also probed., Results: No significant association was found between MRA metrics and any clinical, laboratory or advanced imaging variable (ρ values ranging from -0.006 to 0.32). At the follow-up examination, no changes were observed over time for mean BA diameter (p = 0.84) and TI (p = 0.70). Finally, baseline MRA variables failed to predict the clinical status of FD patients at follow-up (p=0.42 and 0.66, respectively)., Conclusions: Alterations of BA in FD lack of any significant association with clinical, laboratory or advanced imaging findings collected in this study. Furthermore, this lack of correlation seems constant over time, suggesting their stability over time. Taken together, all these results suggest that the role of BA dolichoectasia in FD should be reconsidered., Abbreviations: CNS = Central Nervous System; FASTEX = FAbry STabilization indEX; FD = Fabry Disease; Gb3 = Globotriaosylceramide; LysoGb3 = globotriaosylsphingosine; MSSI = Mainz Severity Score Index., Competing Interests: The authors declare no conflicts of interest related to the content of this article., (© 2024 by American Journal of Neuroradiology.)
- Published
- 2024
- Full Text
- View/download PDF
29. Increased Expression of Orexin-A in Patients Affected by Polycystic Kidney Disease.
- Author
-
Nigro E, D'Arco D, Moscatelli F, Pisani A, Amicone M, Riccio E, Capuano I, Argentino F, Monda M, Messina G, Daniele A, and Polito R
- Subjects
- Humans, Male, Female, Middle Aged, Adult, TRPP Cation Channels genetics, TRPP Cation Channels metabolism, Polycystic Kidney, Autosomal Dominant metabolism, Polycystic Kidney, Autosomal Dominant genetics, Polycystic Kidney, Autosomal Dominant blood, Case-Control Studies, Aged, Blood Pressure, Polycystic Kidney Diseases genetics, Polycystic Kidney Diseases metabolism, Polycystic Kidney Diseases blood, Orexins metabolism, Orexins genetics, Polymorphism, Single Nucleotide, Orexin Receptors metabolism, Orexin Receptors genetics
- Abstract
Orexin-A is a neuropeptide product of the lateral hypothalamus that acts on two receptors, OX1R and OX2R. The orexinergic system is involved in feeding, sleep, and pressure regulation. Recently, orexin-A levels have been found to be negatively correlated with renal function. Here, we analyzed orexin-A levels as well as the incidence of SNPs in the hypocretin neuropeptide precursor (HCRT) and its receptors, HCRTR1 and HCRTR2, in 64 patients affected by autosomal dominant polycystic kidney disease (ADPKD) bearing truncating mutations in the PKD1 or PKD2 genes. Twenty-four healthy volunteers constituted the control group. Serum orexin-A was assessed by ELISA, while the SNPs were investigated through Sanger sequencing. Correlations with the main clinical features of PKD patients were assessed. PKD patients showed impaired renal function (mean eGFR 67.8 ± 34.53) and a statistically higher systolic blood pressure compared with the control group ( p < 0.001). Additionally, orexin-A levels in PKD patients were statistically higher than those in healthy controls (477.07 ± 69.42 pg/mL vs. 321.49 ± 78.01 pg/mL; p < 0.001). Furthermore, orexin-A inversely correlated with blood pressure ( p = 0.0085), while a direct correlation with eGFR in PKD patients was found. None of the analyzed SNPs showed any association with orexin-A levels in PKD. In conclusion, our data highlights the emerging role of orexin-A in renal physiology and its potential relevance to PKD. Further research is essential to elucidate the intricate mechanisms underlying orexin-A signaling in renal function and its therapeutic implications for PKD and associated cardiovascular complications.
- Published
- 2024
- Full Text
- View/download PDF
30. Cardiopulmonary determinants of reduced exercise tolerance in Fabry disease.
- Author
-
De Marco O, Gambardella J, Bianco A, Fiordelisi A, Cerasuolo FA, Buonaiuto A, Avvisato R, Capuano I, Amicone M, Di Risi T, Riccio E, Spinelli L, Pisani A, Iaccarino G, and Sorriento D
- Abstract
Fabry disease (FD), also known as Anderson-Fabry disease, is a hereditary disorder of glycosphingolipid metabolism, caused by a deficiency of the lysosomal alpha-galactosidase A enzyme. This causes a progressive accumulation of glycosphingolipids in tissues and organs which represents the main pathogenetic mechanism of FD. The disease is progressive and multisystemic and is characterized by early symptoms and late complications (renal, cardiac and neurological dysfunction). Fatigue and exercise intolerance are early common symptoms in FD patients but the specific causes are still to be defined. In this narrative review, we deal with the contribution of cardiac and pulmonary dysfunctions in determining fatigue and exercise intolerance in FD patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (© 2024 De Marco, Gambardella, Bianco, Fiordelisi, Cerasuolo, Buonaiuto, Avvisato, Capuano, Amicone, Di Risi, Riccio, Spinelli, Pisani, Iaccarino and Sorriento.)
- Published
- 2024
- Full Text
- View/download PDF
31. Real-world management of chronic and postprandial hyperkalemia in CKD patients treated with patiromer: a single-center retrospective study.
- Author
-
Riccio E, D'Ercole A, Sannino A, Hamzeh S, De Marco O, Capuano I, Buonanno P, Rizzo M, and Pisani A
- Subjects
- Humans, Retrospective Studies, Male, Female, Aged, Middle Aged, Cross-Sectional Studies, Treatment Outcome, Time Factors, Aged, 80 and over, Hyperkalemia blood, Hyperkalemia drug therapy, Hyperkalemia etiology, Postprandial Period, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic blood, Potassium blood, Polymers therapeutic use
- Abstract
Introduction: Hyperkalemia, one of the most important electrolyte abnormalities of chronic kidney disease (CKD), often limits the use of renin-angiotensin-aldosterone system inhibitors and can increase in the postprandial period. In this study we report a real-world experience with the new non-adsorbed potassium binder patiromer in stage 3b-4 CKD patients. Moreover, we performed a cross-sectional analysis to evaluate, for the first time, the efficacy of patiromer in the control of postprandial potassium concentrations., Methods: We retrospectively collected data of 40 patients at the time of patiromer initiation (T0), and after 2 (T2), 6 (T6) and 12 (T12) months of treatment. For cross sectional analysis, a blood sample was collected 2 h after the main meal for the evaluation of postprandial potassium concentrations., Results: Eighty-two point five percent of patients (33/40) reached normal potassium concentrations at T2. Serum potassium significantly decreased at T2 compared to T0 (5.13 ± 0.48 vs 5.77 ± 0.41 mmol/L, respectively; p < 0.001) and the reduction remained significant during the follow-up (5.06 ± 0.36 at T6 and 5.77 ± 0.41 at T12; p < 0.001 vs T0). Renin-angiotensin-aldosterone system inhibitors were continued by 93% of patients (27/29). Adverse events were reported in 27.5% of patients and were all mild-to-moderate. Postprandial potassium concentrations did not significantly change compared to fasting state potassium measured at T12 (4.53 ± 0.33 vs 5.06 ± 0.36 mmol/L; p = 0.15)., Conclusions: In a real-world setting of advanced CKD patients, patiromer is a useful treatment for hyperkalemia, since it significantly reduces serum potassium levels over the long term and is able to maintain potassium concentrations in the normal range even in the post-prandial period., (© 2024. The Author(s) under exclusive licence to Italian Society of Nephrology.)
- Published
- 2024
- Full Text
- View/download PDF
32. Diet and Physical Activity in Fabry Disease: A Narrative Review.
- Author
-
Muscogiuri G, De Marco O, Di Lorenzo T, Amicone M, Capuano I, Riccio E, Iaccarino G, Bianco A, Di Risi T, and Pisani A
- Subjects
- Humans, Quality of Life, Diet, Exercise, Nutritional Status, Fabry Disease therapy
- Abstract
Fabry disease (FD) is caused by mutations in the galactosidase alpha (GLA) gene which lead to the accumulation of globotriaosylceramide (Gb-3). Enzyme replacement therapy (ERT) and oral chaperone therapy are the current pharmacological treatments for this condition. However, in the literature, there is a growing emphasis on exploring non-pharmacological therapeutic strategies to improve the quality of life of patients with FD. In particular, the nutritional approach to FD has been marginally addressed in the scientific literature, although specific dietary interventions may be useful for the management of nephropathy and gastrointestinal complications, which are often present in patients with FD. Especially in cases of confirmed diagnosis of irritable bowel syndrome (IBS), a low-FODMAP diet can represent an effective approach to improving intestinal manifestations. Furthermore, it is known that some food components, such as polyphenols, may be able to modulate some pathogenetic mechanisms underlying the disease, such as inflammation and oxidative stress. Therefore, the use of healthy dietary patterns should be encouraged in this patient group. Sports practice can be useful for patients with multi-organ involvement, particularly in cardiovascular, renal, and neurological aspects. Therefore, the aim of this review is to summarize current knowledge on the role of nutrition and physical activity in FD patients.
- Published
- 2024
- Full Text
- View/download PDF
33. [Type I Hyperprolinemia - What about the Kidney?]
- Author
-
Rizzo M, Amicone M, Sellitti ML, Marino A, Sannino A, Capuano I, and Pisani A
- Subjects
- Humans, Child, Proline Oxidase genetics, Mutation, Proline genetics, Proline metabolism, Kidney metabolism, Amino Acid Metabolism, Inborn Errors genetics, Acidosis
- Abstract
Hyperprolinemia is a rare genetic condition due to mutations in proline metabolic pathway. Type I Hyperprolinemia (HPI) typically causes neuropsychiatric disorders, and diagnosis is usually confirmed in pediatric population with suggestive neuropsychiatric involvement by elevated serum proline levels and elevated urinary proline, hydroxyproline, and glycine levels. The possible coexistence of nephropathy in patients with HPI, often specified as malformative urinary disease, is often mentioned. However, reports of HPI diagnosis due to kidney impairment do not exist in scientific literature yet. Here we present the case of a patient presenting with chronic kidney disease secondary to obstructive nephropathy who received a HPI diagnosis in adulthood. Interestingly, the family study showed the same 22q11.21 deletion and elevated blood proline levels in the father, who had no clinical anomalies. We therefore suggest, in light of the high frequency of mutations involving 22q11 and PRODH in the general population, to consider these rare alterations in patients with congenital urinary malformations, even in the presence of nuanced neurological symptoms and negative family history., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)
- Published
- 2023
34. Pain in Fabry Disease: Could Spinal Cord Stimulation be a Solution?
- Author
-
Buonanno P, Capuano I, Riccio E, and Pisani A
- Abstract
Competing Interests: There are no conflicts of interest.
- Published
- 2023
- Full Text
- View/download PDF
35. Familial polycystic kidneys with no genetic confirmation: Are we sure it is ADPKD?
- Author
-
Rizzo M, Pezone I, Amicone M, Capuano I, Buonanno P, Riccio E, and Pisani A
- Subjects
- Humans, Ultrasonography, Tomography, X-Ray Computed, Magnetic Resonance Imaging, Diagnosis, Differential, Polycystic Kidney, Autosomal Dominant diagnosis
- Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is the most common heritable multifocal cystic disease encountered in clinical practice, and it is usually diagnosed in patients with family history by the evidence of markedly enlarged kidneys with multiple bilateral cysts at ultrasound (U.S.), computed tomography (CT) scan, or magnetic resonance imaging (MRI). In most cases, genetic testing is not required. Though ADPKD diagnosis is often straightforward, misdiagnosis is possible. Here we present a case of ADPKD misdiagnosis, followed by a review of the most important kidney heritable multifocal cystic diseases. Our case report demonstrates that ADPKD can be erroneously diagnosed when other kidney heritable multifocal cystic diseases occur without their distinguishing manifestations and when there is no genetic characterization among the relatives. A proper diagnosis of heritable diseases is crucial, as it allows an appropriate management of family members who carry disease allele, apart from patient management. Therefore, we suggest a careful differential diagnosis with possible molecular genetic analysis in presentations with familial cystic kidneys and suspicious clinical and radiological features.
- Published
- 2023
- Full Text
- View/download PDF
36. Inhaled Bacteriophage Therapy for Multi-Drug Resistant Achromobacter .
- Author
-
Winzig F, Gandhi S, Lee A, Würstle S, Stanley GL, Capuano I, Neuringer I, Koff JL, Turner PE, and Chan BK
- Subjects
- Humans, Anti-Bacterial Agents pharmacology, Bacteriophages, Phage Therapy, Achromobacter, Cystic Fibrosis therapy, Cystic Fibrosis complications
- Abstract
The rise of antimicrobial resistant (AMR) bacteria is a global public health threat. AMR Achromobacter bacteria pose a challenging clinical problem, particularly for those with cystic fibrosis (CF) who are predisposed to chronic bacterial lung infections. Lytic bacteriophages (phages) offer a potential alternative to treat AMR infections, with the possible benefit that phage selection for resistance in target bacteria might coincide with reduced pathogenicity. The result is a genetic "trade-off," such as increased sensitivity to chemical antibiotics, and/or decreased virulence of surviving bacteria that are phage resistant. Here, we show that two newly discovered lytic phages against Achromobacter were associated with stabilization of respiratory status when deployed to treat a chronic pulmonary infection in a CF patient using inhaled (nebulized) phage therapy. The two phages demonstrate traits that could be generally useful in their development as therapeutics, especially the possibility that the phages can select for clinically useful trade-offs if bacteria evolve phage resistance following therapy. We discuss the limitations of the current study and suggest further work that should explore whether the phages could be generally useful in targeting pulmonary or other Achromobacter infections in CF patients., (Copyright ©2022, Yale Journal of Biology and Medicine.)
- Published
- 2022
37. Parapelvic Cysts: An Imaging Marker of Kidney Disease Potentially Leading to the Diagnosis of Treatable Rare Genetic Disorders? A Narrative Review of the Literature.
- Author
-
Capuano I, Buonanno P, Riccio E, Crocetto F, and Pisani A
- Subjects
- Humans, Male, Kidney pathology, Biomarkers, Rare Diseases pathology, Polycystic Kidney, Autosomal Dominant complications, Polycystic Kidney, Autosomal Dominant diagnostic imaging, Polycystic Kidney, Autosomal Dominant genetics, Cysts diagnostic imaging, Cysts therapy, Liver Diseases diagnosis, Liver Diseases pathology, Kidney Neoplasms pathology
- Abstract
Simple renal cysts are a common finding during abdominal imaging assessment. The incidence increases with age and it is higher in male gender. Parapelvic cysts are a subset of simple cysts that arise within the renal parenchyma, adjacent to the renal sinus, characterized by being generally single, larger, and incompletely surrounded by renal parenchyma. Noteworthy, parapelvic cysts are a rare and understudied condition which, although considered clinically insignificant due to the absence of influence on renal function, still have a controversial aetiopathogenesis. On the other hand, urological management and differential diagnosis have been thoroughly investigated. The aim of our review is to provide an overall vision on this rare condition, usually misdiagnosed and underestimated, on the basis of more recent data. An accurate differential diagnosis of parapelvic cysts can lead to the identification of treatable conditions such as Fabry disease, autosomal dominant polycystic kidney disease, polycystic liver disease and tuberous sclerosis complex disease., (© 2022. The Author(s) under exclusive licence to Italian Society of Nephrology.)
- Published
- 2022
- Full Text
- View/download PDF
38. Randomized Controlled Trials on Renin Angiotensin Aldosterone System Inhibitors in Chronic Kidney Disease Stages 3-5: Are They Robust? A Fragility Index Analysis.
- Author
-
Capuano I, Buonanno P, Riccio E, Bianco A, and Pisani A
- Abstract
Inhibition of the renin-angiotensin-aldosterone system (RAAS) is broadly recommended in many nephrological guidelines to prevent chronic kidney disease (CKD) progression. This work aimed to analyze the robustness of randomized controlled trials (RCTs) investigating the renal and cardiovascular outcomes in CKD stages 3-5 patients treated with RAAS inhibitors (RAASi). We searched for RCTs in MEDLINE (PubMed), EMBASE databases, and the Cochrane register. Fragility indexes (FIs) for every primary and secondary outcome were calculated according to Walsh et al., who first described this novel metric, suggesting 8 as the cut-off to consider a study robust. Spearman coefficient was calculated to correlate FI to p value and sample size of statistically significant primary and secondary outcomes. Twenty-two studies met the inclusion criteria, including 80,455 patients. Sample size considerably varied among the studies (median: 1693.5, range: 73-17,276). The median follow-up was 38 months (range 24-58). The overall median of both primary and secondary outcomes was 0 (range 0-117 and range 0-55, respectively). The median of FI for primary and secondary outcomes with a p value lower than 0.05 was 6 (range: 1-117) and 7.5 (range: 1-55), respectively. The medians of the FI for primary outcomes with a p value lower than 0.05 in CKD and no CKD patients were 5.5 (range 1-117) and 22 (range 1-80), respectively. Only a few RCTs have been shown to be robust. Our analysis underlined the need for further research with appropriate sample sizes and study design to explore the real potentialities of RAASi in the progression of CKD.
- Published
- 2022
- Full Text
- View/download PDF
39. [A possible relationship between anti-SARS-CoV-2 vaccination and glomerular diseases: food for thought for the nephrologist].
- Author
-
Rizzo M, Marino A, Sannino A, Urciuoli V, Capuano I, and Pisani A
- Subjects
- COVID-19 Vaccines adverse effects, Female, Humans, Male, Nephrologists, SARS-CoV-2, Vaccination, COVID-19 prevention & control, Glomerulonephritis, IGA, Nephrosis, Lipoid
- Abstract
In order to fight the SARS-CoV-2 pandemic, mass-vaccination programs have been launched globally starting December 2020. The pace of COVID-19 vaccines development was impressive and although data from clinical trials and post-authorization studies showed acceptable safety profile, additional studies and long-term population-level surveillance are needed. A possible link between all type of vaccination and immunological diseases is perhaps one of the hottest topics in literature; correspondingly, there is growing concern over the small but growing number of case reports linking COVID-19 vaccines with the development of glomerular disease. Our group conducted a systematic review of such cases. Results showed that IgA nephropathy (IgAN) and Minimal Change Disease (MCD) are the most frequently associated glomerulopathies. Interestingly, IgAN cases are mostly flares occurring few hours after the second dose of RNA vaccines and have a good clinical outcome, while both de novo and recurring MCD can occur up to 28 days after the first or second dose of vaccines. RNA vaccines are the most common vaccine type to be associated with glomerulopathy. Of course, this may simply reflect the more widespread use of these vaccines. However, compared to traditional vaccines, they do seem produce a higher antibody response and a stronger CD8+ T- and CD4+ T-cell response, including higher production of chemokines and cytokines., (Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.)
- Published
- 2022
40. Tolvaptan vs. somatostatin in the treatment of ADPKD: A review of the literature.
- Author
-
Capuano I, Buonanno P, Riccio E, Rizzo M, and Pisani A
- Subjects
- Antidiuretic Hormone Receptor Antagonists therapeutic use, Glomerular Filtration Rate, Humans, Octreotide therapeutic use, Somatostatin therapeutic use, Tolvaptan therapeutic use, Polycystic Kidney, Autosomal Dominant drug therapy
- Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic disorder with an estimated prevalence between 1 : 1,000 and 1 : 2,500. Until a few decades ago, ADPKD was considered an untreatable disease, relentlessly progressing towards end-stage renal disease because of the lack of specific interventions. In the last decade, some aberrant molecular pathways involved in ADPKD development have been identified, and controlled clinical trials have been conducted to investigate the potential role of active drugs on these pathophysiological mechanisms such somatostatin and tolvaptan. Somatostatin analogues have been shown to be effective not only in ADPKD, but also in polycystic liver disease (PLD) with beneficial effect on cardiac function and a better cost/benefit profile; the only somatostatin analogue currently available for clinical use is octreotide long-acting release (octreotide-LAR), and it is approved only in Italy. On the contrary, tolvaptan is authorized worldwide and has received more attention in the last years, even if its clinical use is widely limited by aquaresis tolerability. The aim of this review is to investigate the advantages and drawbacks of somatostatin analogues and tolvaptan in the treatment of ADPKD.
- Published
- 2022
- Full Text
- View/download PDF
41. Therapeutic advances in ADPKD: the future awaits.
- Author
-
Capuano I, Buonanno P, Riccio E, Amicone M, and Pisani A
- Subjects
- Animals, Apoptosis, Calcium metabolism, Humans, TRPP Cation Channels genetics, Tolvaptan therapeutic use, Kidney Failure, Chronic etiology, Polycystic Kidney, Autosomal Dominant drug therapy, Polycystic Kidney, Autosomal Dominant genetics
- Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is a heterogeneous genetic disorder included in ciliopathies, representing the fourth cause of end stage renal disease (ESRD), with an estimated prevalence between 1:1000 and 1:2500. It is mainly caused by mutations in the PKD1 and PKD2 genes encoding for polycystin 1 (PC1) and polycystin 2 (PC2), which regulate differentiation, proliferation, survival, apoptosis, and autophagy. The advances in the knowledge of multiple molecular pathways involved in the pathophysiology of ADPKD led to the development of several treatments which are currently under investigation. Recently, the widespread approval of tolvaptan and, in Italy, of long-acting release octreotide (octreotide-LAR), represents but the beginning of the new therapeutic management of ADPKD patients. Encouraging results are expected from ongoing randomized controlled trials (RCTs), which are investigating not only drugs acting on the calcium/cyclic adenosin monoposphate (cAMP) pathway, the most studied target so far, but also molecules targeting specific pathophysiological pathways (e.g. epidermal growth factor (EGF) receptor, AMP-activated protein kinase (AMPK) and KEAP1-Nrf2) and sphingolipids. Moreover, studies on animal models and cultured cells have also provided further promising therapeutic strategies based on the role of intracellular calcium, cell cycle regulation, MAPK pathway, epigenetic DNA, interstitial inflammation, and cell therapy. Thus, in a near future, tailored therapy could be the key to changing the natural history of ADPKD thanks to the vigorous efforts that are being made to implement clinical and preclinical studies in this field. Our review aimed to summarize the spectrum of drugs that are available in the clinical practice and the most promising molecules undergoing clinical, animal, and cultured cell studies., (© 2021. Italian Society of Nephrology.)
- Published
- 2022
- Full Text
- View/download PDF
42. RAAS Inhibitor Prescription and Hyperkalemia Event in Patients With Chronic Kidney Disease: A Single-Center Retrospective Study.
- Author
-
Riccio E, Capuano I, Buonanno P, Andreucci M, Provenzano M, Amicone M, Rizzo M, and Pisani A
- Abstract
Hyperkalemia is common in patients treated with renin-angiotensin-aldosterone system inhibitors (RAASis), and it represents the main cause of the large gap reported between guideline recommendations and real-world practice in chronic kidney disease (CKD). We conducted a CKD-population-based restrospective study to determine the prevalence of patients with CKD treated with RAASis, incidence of hyperkalemia in patients with CKD treated with RAASis, and proportion of patients with RAASi medication change after experiencing incident hyperkalemia. Among 809 patients with CKD analyzed, 556 (68.7%) were treated with RAASis, and RAASi prescription was greater in stages 2-4 of CKD. Hyperkalemia occurred in 9.2% of RAASi-treated patients, and the adjusted rate of hyperkalemia among patients with stage 4-5 CKD was 3-fold higher compared with patients with eGFR > 60 ml/min/1.73 m
2 . RAASi treatment was discontinued in 55.3% of the patients after hyperkalemia event (74.2% discontinued therapy, 3.2% received a reduced dose, and 22.6% reduced the number of RAASi drugs). This study shows that the incidence of hyperkalemia is frequently observed in patients with CKD patients with RAASis, and that rates increase with deteriorating levels of kidney function from stages 1 to 3. RAASi medication change following an episode of hyperkalemia occurred in almost half of the patients after experiencing hyperkalemia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Riccio, Capuano, Buonanno, Andreucci, Provenzano, Amicone, Rizzo and Pisani.)- Published
- 2022
- Full Text
- View/download PDF
43. The effects of somatostatin analogues on liver volume and quality of life in polycystic liver disease: a meta-analysis of randomized controlled trials.
- Author
-
Garofalo C, Capuano I, Pennino L, De Gregorio I, Riccio E, Provenzano M, Crocetto F, Buonanno P, Pandolfo SD, Andreucci M, and Pisani A
- Subjects
- Humans, Middle Aged, Polycystic Kidney, Autosomal Dominant drug therapy, Quality of Life, Randomized Controlled Trials as Topic, Cysts drug therapy, Liver drug effects, Liver Diseases drug therapy, Organ Size drug effects, Somatostatin analogs & derivatives, Somatostatin therapeutic use
- Abstract
A clear evidence on the benefits of somatostatin analogues (SA) on liver outcome in patients affected by polycystic liver disease is still lacking. We performed a meta-analysis of RCTs and a trial sequential analysis (TSA) evaluating the effects of SA in adult patients with polycystic liver disease on change in liver volume. As secondary outcome, we evaluated the effects on quality of life as measured by SF36-questionnaire. Six RCTs were selected with an overall sample size of 332 adult patients with polycystic liver disease (mean age: 46 years). Mean liver volume at baseline was 3289 ml in SA group and 3089 ml in placebo group. Overall, unstandardized mean difference in liver volume was - 176 ml (95%CI, - 406, 54; p < 0.133). Heterogeneity was low (I
2 :0%, p < 0.992). However, we performed a moderator analysis and we found that a higher eGFR significantly correlates to a more pronounced effect of SA on liver volume reduction (p = 0.036). Cumulative Z-curve in TSA did not reach either significance and futility boundaries or required information size. Three RCTs have evaluated Quality of life parameters measured by SF36-QOL questionnaire for a total of 124 patients; no significant difference was found on the effect of SA on QOL parameters when compared with placebo. The present meta-analysis revealed a potential effect of SA on reduction of liver volume and quality of life parameters, but results did not reach a statistical significance. These data could be explained by the need of further studies, as demonstrated through TSA, to reach an adequate sample size to confirm the beneficial outcomes of SAs treatment., (© 2021. The Author(s).)- Published
- 2021
- Full Text
- View/download PDF
44. Stepwise shortening of agalsidase beta infusion duration in Fabry disease: Clinical experience with infusion rate escalation protocol.
- Author
-
Riccio E, Zanfardino M, Franzese M, Capuano I, Buonanno P, Ferreri L, Amicone M, and Pisani A
- Subjects
- Adult, Aged, Drug Administration Schedule, Fabry Disease pathology, Female, Humans, Infusions, Intravenous methods, Isoenzymes therapeutic use, Male, Middle Aged, alpha-Galactosidase therapeutic use, Enzyme Replacement Therapy methods, Fabry Disease drug therapy, Isoenzymes administration & dosage, alpha-Galactosidase administration & dosage
- Abstract
Background: Although enzyme replacement therapy with agalsidase beta resulted in a variety of clinical benefits, life-long biweekly intravenous infusion may impact on patients' quality of life. Moreover, regular infusions are time-consuming: although a stepwise shortening of infusion duration is allowed up to a minimum of 1.5 hr, in most centers it remains ≥3 hr, and no data exists about the safety and tolerability of agalsidase beta administration at maximum tolerated infusion rate., Methods: In this study, we reported our experience with a stepwise infusion rate escalation protocol developed in our center in a cohort of 53 Fabry patients (both already receiving and treatment-naΪve), and explored factors predictive for the infusion rate increase tolerability., Results: Fifty-two patients (98%) reduced infusion duration ≤3 hr; of these, 38 (72%) even reached a duration ≤2 hr. We found a significant difference between the mean duration reached by already treated and naΪve patients (p < .01). More severely affected patients (male patients and those with lower enzyme activity) received longer infusions for higher risk of infusion-associated reactions (IARs). A significant correlation between anti-agalsidase antibodies and IARs was found., Conclusion: Our infusion rate escalation protocol is safe and could improve patient compliance, satisfaction and quality of life., (© 2021 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals LLC.)
- Published
- 2021
- Full Text
- View/download PDF
45. Switch from enzyme replacement therapy to oral chaperone migalastat for treating fabry disease: real-life data.
- Author
-
Riccio E, Zanfardino M, Ferreri L, Santoro C, Cocozza S, Capuano I, Imbriaco M, Feriozzi S, and Pisani A
- Subjects
- 1-Deoxynojirimycin administration & dosage, 1-Deoxynojirimycin adverse effects, 1-Deoxynojirimycin therapeutic use, Administration, Oral, Adolescent, Adult, Aged, Drug Administration Schedule, Drug Tolerance, Enzyme Replacement Therapy, Humans, Isoenzymes administration & dosage, Isoenzymes adverse effects, Isoenzymes therapeutic use, Male, Middle Aged, Recombinant Proteins administration & dosage, Recombinant Proteins adverse effects, Recombinant Proteins therapeutic use, alpha-Galactosidase administration & dosage, alpha-Galactosidase adverse effects, alpha-Galactosidase therapeutic use, 1-Deoxynojirimycin analogs & derivatives, Drug-Related Side Effects and Adverse Reactions epidemiology, Fabry Disease drug therapy
- Abstract
The treatment options for Fabry disease (FD) are enzyme replacement therapy (ERT) with agalsidase alfa or beta, and the oral pharmacological chaperone migalastat. Since few data are available on the effects of switching from ERT to migalastat, we performed a single-center observational study on seven male Fabry patients (18-66 years) to assess the effects of the switch on renal, cardiac, and neurologic function, health status, pain, lyso-Gb3, α-Gal A activity and adverse effects. Data were retrospectively collected at time of diagnosis of FD (baseline, T0), and after 12 months of ERT (T1), and prospectively after 1 year of therapy with migalastat (T2). No patient died or reported renal, cardiac, or cerebrovascular events during the study period. The predefined measures for cardiac, renal and neurologic function, and FD-related symptoms and questionnaires were stable between baseline and the switch, and remained unchanged with migalastat. However, a significant improvement was observed in left ventricular mass index from baseline to T2 (p = 0.016), with a significative difference between the treatments (p = 0.028), and in median proteinuria from T2 vs T1 (p = 0.048). Moreover, scores of the BPI improved from baseline to T1, and remained stable with migalastat. Plasma lyso-Gb3 levels significantly decreased from baseline to T1 (P = 0.007) and T2 (P = 0.003), while did not significantly differ between the two treatments. α-Gal A activity increased from T0 to T2 (p < 0.0001). The frequency of adverse effects under migalastat and ERT was comparable (28% for both drugs). In conclusion, switching from ERT to migalastat is valid, safe and well tolerated.
- Published
- 2020
- Full Text
- View/download PDF
46. Identifying Fabry patients in dialysis population: prevalence of GLA mutations by renal clinic screening, 1995-2019.
- Author
-
Capuano I, Garofalo C, Buonanno P, Pinelli M, Di Risi T, Feriozzi S, Riccio E, and Pisani A
- Subjects
- Female, Humans, Male, Mutation, Prevalence, Renal Dialysis, Fabry Disease diagnosis, Fabry Disease epidemiology, Fabry Disease genetics, alpha-Galactosidase genetics
- Abstract
Background: Fabry disease (FD) is a rare X-linked genetic disorder of glycosphingolipid catabolism caused by mutations in the GLA gene. Its heterogeneous presentation, the paucity of specific early markers, and the absence of a genotype-phenotype correlation are associated with a delayed or missed diagnosis. The true prevalence of FD remains so far unknown., Methods: A systematic search of FD screening studies in dialysis patients published from January 1995 until January 2019 was performed to reanalyze the prevalence of GLA mutations in this population after assigning their correct phenotype., Results: Twenty five screening studies involving 39,621 dialysis patients were included. Of them, 116 [91 males (0.23%) and 25 females (0.06%)] were positive to the GLA sequencing analysis. 56 (48.2%) had benign variant, 52 (44.8%) a pathogenic GLA mutation (39 classic and 13 late onset mutations) and 8 (6.9%) a mutation of uncertain significance. The overall prevalence of GLA variants was 0.24% [CI 95%, 0.17-0.32] while the overall prevalence recalculated on basis of only pathogenetic mutations was 0.14% [CI 95%, 0.08-0.20]. This difference was significant (P = 0.048)., Conclusions: Although the real prevalence of classic FD is low, the screening in the high-risk renal population remains of primary interest as an early diagnosis is fundamental for a timely specific therapy; moreover, the identification of index cases could allow patients' relatives to be investigated and promptly treated.
- Published
- 2020
- Full Text
- View/download PDF
47. Acute Kidney Injury in COVID-19 Pandemic.
- Author
-
Capuano I, Buonanno P, Riccio E, and Pisani A
- Subjects
- Betacoronavirus, COVID-19, Humans, Nephrologists, SARS-CoV-2, Acute Kidney Injury, Angiotensins, Coronavirus Infections, Pandemics, Pneumonia, Viral
- Published
- 2020
- Full Text
- View/download PDF
48. ADPKD and metformin: from bench to bedside.
- Author
-
Capuano I, Riccio E, Caccavallo S, De Simone I, and Pisani A
- Subjects
- Adult, Disease Progression, Female, Humans, Middle Aged, Diabetes Mellitus drug therapy, Glomerular Filtration Rate drug effects, Hypoglycemic Agents therapeutic use, Metformin therapeutic use, Polycystic Kidney, Autosomal Dominant physiopathology
- Published
- 2019
- Full Text
- View/download PDF
49. Anastomotic leakage following laparoscopic resection of low and mid rectal cancer.
- Author
-
Shalaby M, Thabet W, Rulli F, Palmieri F, Saraceno F, Capuano I, Buonomo O, Giarratano G, Petrella G, Morshed M, Farid M, and Sileri P
- Subjects
- Digestive System Surgical Procedures methods, Female, Humans, Incidence, Male, Middle Aged, Prospective Studies, Rectal Neoplasms pathology, Anastomotic Leak epidemiology, Laparoscopy, Rectal Neoplasms surgery
- Abstract
Purpose: Anastomotic leakage is considered the commonest major complication after surgery for rectal cancer., Materials and Methods: Patients who underwent laparoscopic LAR or ULAR for rectal cancer were recruited. The primary outcome was the incidence of the AL during 30 days postoperative., Results: Fifty-nine consecutive patients were included in the study. Fifty-three patients underwent LAR with stapled colorectal anastomoses, while the remaining 6 patients underwent ULAR with hand-sewn coloanal anastomoses. The median duration of operation was 195 minutes (range; 120-315). The defunctioning ileostomy was created in 24 (7%) patients. Overall, there was no recorded mortality. Only 10 (17%) patients developed complications. There were only 4 patients who developed AL. Three patients had a subclinical AL as they had defunctioning ileostomy at the time of the initial procedure, the diagnosis was made by CT with rectal contrast. They were treated conservatively with transanal anastomotic drainage under endoscopic guidance. One patient had a clinically significant AL, demonstrated as a peritonitis. This patient required reoperation during which pelvic abscess was drained, resection of the previous anastomosis, and hartmann's colostomy was performed., Conclusion: Standardization of a definition, as well as, criteria for the diagnosis of AL, will help in comparison of the results and the surgical techniques in order to optimize the required care offered to rectal cancer patients. On expert hands, it is feasible to perform a laparoscopic sphincter-saving total mesorectal excision, additionally, it provides the advantages of a clear view of the deep pelvis and facilitates a precise sharp dissection., Key Words: Anastomosis, Anastomotic Leakage, Rectal cancer, Total mesorectal excision.
- Published
- 2019
50. Early Biomarkers of Fabry Nephropathy: A Review of the Literature.
- Author
-
Riccio E, Sabbatini M, Capuano I, and Pisani A
- Subjects
- Alpha-Globulins urine, Biomarkers analysis, Cystatin C blood, Cysts diagnostic imaging, Early Diagnosis, Enzyme Replacement Therapy, Fabry Disease physiopathology, Fabry Disease therapy, Female, Glomerular Filtration Rate, Humans, Male, Proteinuria diagnosis, Proteomics methods, Trihexosylceramides urine, Urine chemistry, Urine cytology, Fabry Disease diagnosis
- Abstract
Progressive nephropathy is one of the main features of Fabry disease. Although some clinical signs of Fabry nephropathy are already present in childhood, patients are often diagnosed relatively late in the course of the disease due to the absence of specific clinical markers, while a timely diagnosis and the prompt start of enzyme replacement therapy may be beneficial in stabilizing renal function or slowing its decline. Proteinuria/albuminuria has been accepted as the most important marker for Fabry nephropathy; however, a large proportion of renal impairment occurs in nonalbuminuric state. Therefore, early biomarkers may be useful for early identification of kidney involvement. The aim of this article is to review the current available literature on all biomarkers of Fabry nephropathy, with a comprehensive and critical description of their utilization in early recognition of renal damage., (© 2019 S. Karger AG, Basel.)
- Published
- 2019
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.