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6 results on '"Guastella, C."'

2. Pituitary apoplexy : considerations on a single center experience and review of the literature

Author

Giammattei, L, Mantovani, G, Carrabba, G, Ferrero, S, Di Cristofori, A, Verrua, E, Guastella, C, Pignataro, L, Rampini, P, Minichiello, M, Locatelli, M, L. Giammattei, G. Mantovani, G. Carrabba, S. Ferrero, A. Di Cristofori, E. Verrua, C. Guastella, L. Pignataro, P. Rampini, M. Minichiello, M. Locatelli, Giammattei, L, Mantovani, G, Carrabba, G, Ferrero, S, Di Cristofori, A, Verrua, E, Guastella, C, Pignataro, L, Rampini, P, Minichiello, M, Locatelli, M, L. Giammattei, G. Mantovani, G. Carrabba, S. Ferrero, A. Di Cristofori, E. Verrua, C. Guastella, L. Pignataro, P. Rampini, M. Minichiello, and M. Locatelli

Abstract

Purpose: To present a single-center experience on pituitary tumor apoplexy and a review of literature focusing on predisposing and precipitating factors. Methods: Clinical presentation of our series of cases. Contemporary published literature is also reviewed. Results: The definition of this syndrome has not been consistent although now the majority of authors agree to definite it as an acute condition caused by hemorrhage or infarction of a pre-existing pituitary adenoma. Different predisposing and precipitating factors have been described in literature; among these antithrombotic and anticoagulant drugs, seem to play relevant roles. The clinical cases observed in our clinic confirm these data and suggest a probable association between elderly patients taking anticoagulant therapy and pituitary apoplexy adenoma. Conclusion: Pituitary tumor apoplexy remains a challenging disease in relation to difficulties in correct diagnosis and thus in appropriate treatment. Antithrombotic/anticoagulant therapy may have an important role as precipitating factor. When a pituitary disorder is known, great care should be taken in the prescription of anticoagulant therapy.

Published
2016

5. Rituximab Induces Distinct Intraorbital and Intrathyroidal Effects in One Patient Satisfactorily Treated for Graves’ Ophthalmopathy.

Author

Bonara, P., Vannucchi, G., Campi, I., Rossi, S., Cantoni, F., Frugoni, C., Sbrozzi, F., Guastella, C., Avignone, S., Beck-Peccoz, P., and Salvi, M.

Abstract

Hyperthyroid Graves’ disease (GD) is a B-cell-mediated disease caused by antibodies stimulating the thyroid stimulating hormone (TSH) receptor (TRAb). A proportion of patients (40–60%) present with an associated ophthalmopathy (TAO), a progressive inflammatory autoimmune disease of the retroorbital tissue. We thought that the anti-CD20 monoclonal antibody rituximab (RTX), by inducing transient B-cell depletion, may potentially modify the active inflammatory phase of TAO. One patient with GD and TAO in its active phase and unresponsive to steroid, was treated with RTX. Whereas the ophthalmopathy responded to RTX therapy and a decrease in the clinical activity score from 5 to 2 was observed during the B-cell depletion, serum antithyroid antibodies, and in particular serum TRAb, were not affected by therapy. When the patient underwent total thyroidectomy, we found B-cells in the thyroid tissue specimens. The eye disease remained stable (clinical activity score = 2) and the patient subsequently underwent orbital decompression to correct proptosis of the eye. At that time we did not find lymphocytes in any of the orbital tissue specimens. We believe that RTX therapy in GD may cause amelioration of ophthalmopathy by depleting total lymphocyte population in the orbit, but not lymphocyte depletion in thyroid tissue with consequent unchanged serum TRAb levels. [ABSTRACT FROM AUTHOR]

Published
2008
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6. Anterior cranial base reconstruction following a complicated nasal septoplasty

Author

Sergio M. Gaini, Giorgio Carrabba, Diego Spagnoli, Claudio Guastella, Carrabba, G, Guastella, C, Gaini, S, and Spagnoli, D

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Oculomotor Nerve Injuries, Anterior cranial, Nasal septoplasty, Vision, Low, Occlusive Dressings, Surgical Flaps, Postoperative Complications, Foreign-Body Migration, Oculomotor Nerve, otorhinolaryngologic diseases, medicine, Humans, Endoscopic endonasal approach, Orbital Fractures, Nasal Septum, Neuroradiology, Cranial Fossa, Anterior, Ophthalmoplegia, medicine.diagnostic_test, Septoplasty, business.industry, Anterior cranial base reconstruction, Pericranial flap, Endoscopy, Interventional radiology, Anatomy, Plastic Surgery Procedures, Rhinoplasty, Frontal Lobe, Otorhinolaryngologic Surgical Procedures, Surgery, Treatment Outcome, Intracranial complication, Neurology (clinical), Neurosurgery, Tomography, X-Ray Computed, business, Complication, Nasal packing
Abstract

We present a 29 year old man who had unilateral visual loss and 3rd cranial nerve palsy after a nasal septoplasty. Nasal packing was extending from the right nasal cavity into the right frontal lobe passing through the right orbit. A combined trans-cranial and endoscopic endonasal approach was performed to safely remove the nasal packing and to achieve a leak-proof sealing of the anterior cranial base. This surgical technique proved successful in the management of this unique complication and should be considered in the surgical management of foreign body removal from the anterior cranial base.

Published
2009

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