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1. Location of Traumatic Cranial Epidural Hematoma Correlates with the Source of Hemorrhage: A 12-Year Surgical Review

Author

Iman Feiz-Erfan, Adrienne R. Azurdia, Daniel Gridley, Tina W. Wong, Sydney J. Vail, Iris B. Charcos, Salvatore C. Lettieri, Brett Larsen, and Alexzandra K. Hollingworth

Subjects
Adult, Hematoma, Epidural, Cranial, Male, medicine.medical_specialty, Time Factors, Adolescent, Traumatic brain injury, Cranial Epidural Hematoma, Computed tomography, Neurosurgical Procedures, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Epidural hematoma, medicine, Humans, Prospective Studies, Child, Cerebral Hemorrhage, Retrospective Studies, medicine.diagnostic_test, business.industry, Infant, Middle Aged, Bleed, medicine.disease, Single surgeon, Surgery, Current management, Child, Preschool, 030220 oncology & carcinogenesis, Arterial bleed, Female, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

BACKGROUND Epidural hematoma (EDH) can result in a catastrophic outcome of traumatic brain injury. Current management guidelines do not consider the source of hemorrhage in decision making. The purpose of this study was to examine the relationship between EDH location and the source of hemorrhage. METHODS We report retrospectively reviewed, prospectively obtained surgical data of patients with acute traumatic cranial EDH treated between 2007 and 2018. Computed tomography (CT) scans were used to categorize EDH location as lateral or medial. The source of hemorrhage was identified intraoperatively by a single surgeon. RESULTS Overall, of 92 evacuated EDHs (in 87 patients), 71 (77.2%) were in the lateral location. Arterial bleeding was the cause of EDH in 63.4% of the lateral EDHs and 9.2% of the medial EDHs (P < 0.0001). In the cases where surgery was done primarily to treat EDH, 65.3% had an arterial bleed source (P < 0.0001). In those treated for primary reasons other than EDH evacuation, 75% had a venous bleed source (P = 0.002). CONCLUSIONS The location of EDH correlates with the source of hemorrhage. The decision to operate on EDH may be influenced by this factor.

Published
2021
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2. The Medial Femoral Condyle Free Flap for Reconstruction of Recalcitrant Defects in the Head and Neck

Author

Tony Chieh-Ting Huang, Salvatore C. Lettieri, Jesse D. Meaike, Steven L. Moran, Kuldeep Singh, John M. Nathan, Andrew M. Mills, and Kevin Arce

Subjects
medicine.medical_specialty, Debridement, business.industry, Osteoradionecrosis, Medial femoral condyle, medicine.medical_treatment, Mandible, Free flap, medicine.disease, Surgery, medicine.anatomical_structure, Maxilla, medicine, Implant, business, Cancellous bone
Abstract

BACKGROUND Small recalcitrant defects of the mandible and maxilla may be secondary to tumor, trauma, infection, and congenital origin. Vascularized bone grafting has been shown to effectively manage these defects; however, donor sites are limited. The vascularized medial femoral condyle (MFC) provides adequate cortical cancellous bone with the option of a skin island, consistent anatomy, and minimal donor site morbidity. This article outlines the use of the MFC flap for maxillomandibular reconstruction. METHODS A retrospective chart review of patients who required segmental maxillomandibular reconstruction with the MFC flap was conducted. A total of 9 patients (5 men and 5 women) with an average age of 45.3 years were identified. The etiology of the defects, flap sizes, and postoperative outcomes were recorded. RESULTS Three patients had osteoradionecrosis of the neomandible after irradiation of the free fibula reconstruction, 3 patients had defects after cancer extirpation (1 mandible, 2 maxillary), 1 patient had a maxillary defect from trauma, and 2 patients had a residual cleft palate defect. All defects failed initial treatment with nonvascularized bone grafts. The average dimensions of the MFC flaps were 1.2 × 2.5 × 4 cm. Two of 9 flaps included a skin island. Eight flaps survived completely, but 1 patient suffered from flap failure requiring debridement and resulted in an oroantral fistula. Four patients received endosseous dental implants. Average time to union was 6.7 months, and average time to implant was 6.75 months. The average follow-up time was 24.9 months. CONCLUSIONS The MFC flap is useful in the reconstruction of small segmental maxillomandibular defects and for the salvage of a neomandible after osteoradionecrosis. The MFC flap provides a reliable platform for endosseous dental implants and serves as an alternative source of vascularized bone reconstruction in the head and neck.

Published
2021
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3. Pyoderma gangrenosum confined to the irradiated chest wall of the reconstructed breast

Author

Sara L. Struve, Shelley S. Noland, William J. Casey, Erwin A. Kruger, Chad M. Teven, Jacob B. Hammond, Alanna M. Rebecca, Salvatore C. Lettieri, and Lacey R Pflibsen

Subjects
medicine.medical_specialty, Medicine (General), Atypical manifestations, DIEP flap reconstruction, Case Report, Case Reports, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, R5-920, Medicine, skin and connective tissue diseases, business.industry, Surgical debridement, General Medicine, medicine.disease, Diagnosis of exclusion, autologous breast reconstructio, pyoderma gangrenosum in irradiated tissue, 030220 oncology & carcinogenesis, Radiology, business, Pyoderma gangrenosum, pyoderma gangrenosum
Abstract

Pyoderma gangrenosum (PG) is a diagnosis of exclusion worsened by surgical debridement. This report presents two atypical manifestations of PG in the reconstructed breast, whereby the disease is only confined to the irradiated chest wall tissue bed, sparing the abdominal donor sites and the contralateral reconstructed breast.

Published
2021

4. Atlanto-Occipital Transarticular Screw Fixation for the Treatment of Traumatic Occipitocervical Instability in the Pediatric Population

Author

Salvatore C. Lettieri, Ramin Jamshidi, Sydney J. Vail, Mary J. Connell, Iman Feiz-Erfan, Kenneth R. Hassler, and Kote Chundu

Subjects
Joint Instability, Male, medicine.medical_specialty, Adolescent, Bone Screws, Screw fixation, 03 medical and health sciences, Fixation (surgical), 0302 clinical medicine, Chart review, medicine, Humans, Child, Retrospective Studies, business.industry, Occipital condyle, Internal Fixators, Surgery, Atlanto-Occipital Joint, Spinal Fusion, medicine.anatomical_structure, Child, Preschool, Occipital Bone, 030220 oncology & carcinogenesis, Cervical Vertebrae, Female, Neurology (clinical), business, 030217 neurology & neurosurgery, Follow-Up Studies, Pediatric population
Abstract

Background Atlanto-occipital transarticular screw fixation (AOTSF) has rarely been reported for fixation of the craniovertebral junction (CVJ). Methods A retrospective chart review of all pediatric patients (less than 18 years of age) with an attempt of AOTSF for fixation of traumatic CVJ instability was conducted. Results A total of 4 patients (2 boys and 2 girls; ages 2, 3, 5, and 8 years) who suffered from acute traumatic CVJ instability managed during 2007–2018 underwent an attempted AOTSF. In 2 patients, this method was technically successful. In the other 2 instances, we were not able to engage the screw into the occipital condyle. These were converted to standard occipital plate, rod, and screw fixation. All were placed in a halo subsequently for a minimum of 3 months. Three patients were fused at last follow-up (range, 17–48 months). One patient after successful AOTSF did not fuse. There were no surgical complications or revision procedures. Conclusions AOTSF was feasible in half of pediatric patients suffering from traumatic CVJ instability. Therefore, intraoperative salvage options and strategies should be on hand readily. In the pediatric population, where bony anatomy may pose challenges to fixation, this technique may offer a viable first-line option in selected cases, despite the overall modest success rate.

Published
2020
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5. Analyzing 2,589 child neurology telehealth encounters necessitated by the COVID-19 pandemic

Author

Alexander K. Gonzalez, Brenda Banwell, Ingo Helbig, Salvatore C. Rametta, Michael Kaufman, Donna J. Stephenson, Uzma Sharif, Peter D. Galer, Julie Xian, Marissa Malcolm, Susan Melamed, Sudha Kilaru Kessler, Marisa S. Prelack, Nicholas S. Abend, Sara E. Fridinger, and Mark Fitzgerald

Subjects
Male, Telemedicine, Adolescent, Pneumonia, Viral, MEDLINE, Ethnic group, Telehealth, Pediatrics, Article, Job Satisfaction, Cohort Studies, Patient satisfaction, Ambulatory care, Surveys and Questionnaires, Humans, Medicine, Child, Pandemics, Minority Groups, Retrospective Studies, business.industry, COVID-19, Retrospective cohort study, medicine.disease, Caregivers, Neurology, Patient Satisfaction, Child, Preschool, Female, Neurology (clinical), Medical emergency, Coronavirus Infections, business, Cohort study
Abstract

ObjectiveTo assess the rapid implementation of child neurology telehealth outpatient care with the onset of the coronavirus disease 2019 (COVID-19) pandemic in March 2020.MethodsThis was a cohort study with retrospective comparison of 14,780 in-person encounters and 2,589 telehealth encounters, including 2,093 audio-video telemedicine and 496 scheduled telephone encounters, between October 1, 2019 and April 24, 2020. We compared in-person and telehealth encounters for patient demographics and diagnoses. For audio-video telemedicine encounters, we analyzed questionnaire responses addressing provider experience, follow-up plans, technical quality, need for in-person assessment, and parent/caregiver satisfaction. We performed manual reviews of encounters flagged as concerning by providers.ResultsThere were no differences in patient age and major ICD-10 codes before and after transition. Clinicians considered telemedicine satisfactory in 93% (1,200 of 1,286) of encounters and suggested telemedicine as a component for follow-up care in 89% (1,144 of 1,286) of encounters. Technical challenges were reported in 40% (519 of 1,314) of encounters. In-person assessment was considered warranted after 5% (65 of 1,285) of encounters. Patients/caregivers indicated interest in telemedicine for future care in 86% (187 of 217) of encounters. Participation in telemedicine encounters compared to telephone encounters was less frequent among patients in racial or ethnic minority groups.ConclusionsWe effectively converted most of our outpatient care to telehealth encounters, including mostly audio-video telemedicine encounters. Providers rated the vast majority of telemedicine encounters to be satisfactory, and only a small proportion of encounters required short-term in-person follow-up. These findings suggest that telemedicine is feasible and effective for a large proportion of child neurology care. Additional strategies are needed to ensure equitable telemedicine use.

Published
2020
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6. Medial approach to the peroneal vessels as recipients for free flap reconstruction of the leg

Author

Salvatore C. Lettieri, Amar Miglani, and Sarah M. Elswick

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Ischemia, Soft tissue, Dissection (medical), 030230 surgery, medicine.disease, Pilon fracture, Surgery, 03 medical and health sciences, External fixation, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, cardiovascular system, medicine, Internal fixation, Ankle, business, Artery
Abstract

The anatomic variation in the branching pattern of the popliteal vessel has been well-established. Little has been written in the literature regarding recipient vessel selection for microvascular reconstruction in the lower extremity as it pertains to aberrant vascular anatomy. We present the case of a 57-year-old male patient who sustained a closed right lower extremity pilon fracture in a motor vehicle accident. The patient was initially treated with external fixation, which was followed by definitive open reduction and internal fixation 3 weeks later. Over the next 2 weeks, the patient developed skin ischemia of the anterior ankle. A free-tissue transfer was planned. A digital subtraction angiogram revealed absence of the posterior tibial (PT) vessels and an aberrant course of the peroneal (PR) artery. In the operating room, the medial distal leg was explored for the PT vessels, which were severely hypoplastic. Given the close proximity of the PR vessels, the dissection was extended proximally to assess these vessels for microvascular anastomosis. They were found to be suitable. A parascapular flap was harvested and transferred to the right leg wound without any significant stretch on the vessels for soft tissue coverage. The flap demonstrated excellent inflow and outflow, and the leg and foot remained well perfused. The patient's postoperative course was uncomplicated. The technique of exposing the peroneal vessels for microvascular anastomosis via a medial approach is described. This technique is an excellent option to have available when aberrant anatomy precludes the use more commonly utilized vessels.

Published
2020
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7. The Case for Palliative Reconstruction

Author

Salvatore C. Lettieri, Alanna M. Rebecca, and Chad M. Teven

Subjects
Aged, 80 and over, Male, medicine.medical_specialty, business.industry, General surgery, Palliative Care, Sarcoma, Plastic Surgery Procedures, Limb Salvage, Treatment Outcome, Medicine, Humans, Surgery, Knee, business
Published
2021

8. Pediatric Mandibular Central Giant Cell Granuloma: Neoadjuvant Immunotherapy to Minimize Surgical Resection

Author

S. Ryan Hall, Christine Oh, Jason Lin, Salvatore C. Lettieri, and Jeffrey C. Mecham

Subjects
Surgical resection, medicine.medical_specialty, medicine.medical_treatment, Mandible, Lesion, 03 medical and health sciences, 0302 clinical medicine, Granuloma, Giant Cell, medicine, Humans, Mandibular Diseases, Mandibular reconstruction, Child, 030223 otorhinolaryngology, business.industry, 030206 dentistry, General Medicine, Immunotherapy, Plastic Surgery Procedures, medicine.disease, Neoadjuvant Therapy, Surgery, Denosumab, Otorhinolaryngology, Extensive resection, medicine.symptom, business, Central giant-cell granuloma, medicine.drug
Abstract

Central giant cell granuloma (CGCG) is a relatively uncommon benign bony lesion accounting for approximately 7% of all non-neoplastic lesions of the jaw. The clinical behavior of CGCG can vary from a slow-growing, painless lesion to fast-growing and locally destructive. When such a lesion involves the mandible, this can be quite debilitating for the patient, inhibiting oral intake and requiring an extensive resection and bone graft reconstruction. The authors present a case of effectively decreasing the surgical morbidity associated with a large and rapidly growing CGCG of the mandible in a pediatric patient. Neoadjuvant immunotherapy with denosumab (human monoclonal antibody) facilitated treatment of the tumor without the need for a large resection which would have otherwise necessitated a vascularized bony mandibular reconstruction. Consideration of neoadjuvant medical management of CGCG as the primary treatment is advocated.

Published
2020
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9. A Subtle Clinical Finding in Free Tissue Transfer

Author

Lacey R Pflibsen, Alanna M. Rebecca, Salvatore C. Lettieri, and Chad M. Teven

Subjects
Pathology, medicine.medical_specialty, Viewpoint, business.industry, lcsh:Surgery, medicine, Surgery, lcsh:RD1-811, medicine.symptom, business, Blood hammer, Tissue transfer
Published
2020
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11. Traumatic Cranio-Orbital Injury: Reconstruction Using Extraocular Muscles

Author

Salvatore C. Lettieri, Jason Lin, and Christine Oh

Subjects
medicine.medical_specialty, genetic structures, Enucleation, Extraocular muscles, 03 medical and health sciences, 0302 clinical medicine, Eye Injuries, Anophthalmos, medicine, Humans, 030223 otorhinolaryngology, integumentary system, business.industry, 030206 dentistry, General Medicine, Middle Aged, medicine.disease, eye diseases, Surgery, body regions, medicine.anatomical_structure, Otorhinolaryngology, Frontal lobe, Oculomotor Muscles, Enucleation procedure, Female, Wounds, Gunshot, Gunshot wound, business
Abstract

Cranio-orbital trauma is an uncommon yet devastating injury, especially one in the setting of a high-energy gunshot wound. Such injuries were historically reported in the setting of military conflict, and are associated with vision-threatening complications, often resulting in anophthalmos. The authors report a case of a self-inflicted gunshot wound to the eye, which requires orbital enucleation with exposed frontal lobe dura. To address the exposed dura, the extraocular muscles were utilized from the enucleation procedure to cover the defect in the acute setting prior to final staged reconstruction.

Published
2020

12. Natural History of a Patient with Sacral Chordoma: Case Report and Literature Review

Author

Daniel G. Gridley, Brooke Kennamer, Salvatore C. Lettieri, Geetha R. Nair, Laurence D. Rhines, Karole M. Davis, and Iman Feiz-Erfan

Subjects
musculoskeletal diseases, Male, medicine.medical_specialty, Sacrum, Constipation, Urinary system, Conservative Treatment, Treatment Refusal, 03 medical and health sciences, 0302 clinical medicine, Quality of life, medicine, Chordoma, Fecal incontinence, Humans, Pain Management, Rectal Pain, Aged, Spinal Neoplasms, business.industry, medicine.disease, Magnetic Resonance Imaging, Surgery, Natural history, 030220 oncology & carcinogenesis, Disease Progression, Neurology (clinical), medicine.symptom, business, Tomography, X-Ray Computed, 030217 neurology & neurosurgery, Sacral Chordoma
Abstract

Background Chordomas are rare, slow-growing, locally aggressive, malignant tumors of the spine. Chordomas are conventionally treated with surgical resection with or without radiation. There is an absence of literature documenting the natural history of a primary sacral chordoma. Case Description A 65-year-old man presented with rectal pain, constipation, urinary and fecal incontinence, S1 radiculopathy, and a palpable rectal mass. A needle biopsy confirmed the pathologic diagnosis of sacral chordoma. The patient declined to have surgery because of the surgical risks involved. He was managed conservatively with supportive care only. The patient was routinely followed in clinic and had a subjective and objective excellent quality of life with adequate pain management. Meanwhile, his neurologic status did not deteriorate. During follow-up, some posterolateral aspects of the chordoma regressed. However, the bulk of the lesion continued to slowly progress. The patient survived for 7.5 years. He eventually succumbed to urosepsis and new-onset peritoneal metastasis. Conclusions To our knowledge, the patient is the only documented case in the literature of an untreated biopsy-proven sacral chordoma. The patient's tumor was intended for resection, and therefore comparable with data from treated chordomas. The patient's survival is similar to the median survival in treated chordomas. The patient's survival was despite negative prognosticators, such as advanced age of the patient and high sacral location above S2.

Published
2020

13. INNV-11. THE RISK OF HEMORRHAGE ASSOCIATED WITH THROMBOCYTOPENIA IN PATIENTS UNDERGOING OMMAYA RESERVOIR PLACEMENT FOR INTRATHECAL CHEMOTHERAPY: A SINGLE INSTITUTION RETROSPECTIVE ANALYSIS

Author

Iman Feiz-Erfan, Arpan Patel, Daniel Gridley, Surabhi Amar, Salvatore C. Lettieri, and Bikash Bhattarai

Subjects
Cancer Research, medicine.medical_specialty, business.industry, Innovations in Patient Care, Surgery, Platelet transfusion, Oncology, Ommaya reservoir, medicine, Retrospective analysis, Platelet Count measurement, Platelet, In patient, Neurology (clinical), Single institution, Intrathecal chemotherapy, business
Abstract

PURPOSE Ommaya reservoirs are frequently inserted in patients requiring regular delivery of intrathecal medications. The incidence of intracranial hemorrhage following insertion ranges from 1–3% and is typically associated with thrombocytopenia. However, the exact platelet count at which it is considered safe to insert an Ommaya reservoir has not been previously reported. The purpose of this study is to investigate the nature of the relationship between thrombocytopenia and post-operative hemorrhage following insertion of Ommaya reservoirs for intrathecal chemotherapy. METHODS Consecutive patients requiring insertion of an Ommaya reservoir were enrolled in the study with no minimum platelet count as an exclusion criterion. Patients data were retrospectively reviewed with thrombocytopenia defined as platelet count < 100,000. All thrombocytopenic patients received at least one unit of intraoperative platelet transfusion. Post-operative incidence of hemorrhage, determined through CT scan, was compared between the thrombocytopenic group and normal platelet group. RESULTS 53 patients were enrolled within the study with 23 patients determined to be thrombocytopenic at the time of insertion. Thrombocytopenic patients were found to have 18.6 times the odds of post-operative bleeding when compared to patients with normal platelet counts (p< 0.001). However, no patient in the thrombocytopenic group had a clinically significant bleed, defined as being symptomatic or requiring intervention. CONCLUSIONS Although thrombocytopenia increases the risk of post-operative hemorrhage associated with Ommaya reservoir placement, there is no increase in clinically significant bleeding. With concurrent platelet transfusion and use of neuronavigation, Ommaya reservoir may be safely placed in thrombocytopenic patients.

Published
2019

14. The Utility of 5-Aminolevulinic Acid for Microsurgical Resection of Meningiomas

Author

Sarah A. Merrill, Salvatore C. Lettieri, Bernard R. Bendok, Evelyn L. Turcotte, Ryan A. Hess, and Rudy J. Rahme

Subjects
medicine.medical_specialty, Sphenoid wing meningioma, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Magnetic resonance imaging, medicine.disease, Foramen Magnum Meningioma, Microsurgical treatment, Meningioma, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Parenchyma, medicine, Surgery, Neurology (clinical), Radiology, business, 030217 neurology & neurosurgery, Craniotomy, Artery
Abstract

Fluorescence-guided resection of brain tumors using 5-aminolevulinic acid (5-ALA) has been established for high-grade gliomas. Recently, its application for the resection of low grade tumors and benign lesions including meningioma has been suggested in the literature. 1 Achieving a Simpson grade I resection in meningioma surgery is associated with a lower rate of recurrence. 2 , 3 Although meningiomas are mostly benign and well-circumscribed lesions, they can be locally aggressive, invading brain parenchyma and other critical structures. In these cases, 5-ALA–guided resection may help maximize the extent of tumor resection and limit disruption of normal structures. In this video, we present 3 cases demonstrating the use of 5-ALA–induced fluorescence to alleviate 3 specific challenges in meningioma resection: 1) to aid visualization with a minimally invasive approach, 2) to distinguish recurrent tumor from scar tissue from prior treatments, and 3) to ensure that no viable tumor cells remain on the surface of a critical artery. The first patient is a 60-year-old woman who was found to have an incidental left sphenoid wing meningioma on magnetic resonance imaging. We elected for an extended lateral orbital craniotomy through a transpalpebral approach. The second patient is a 72-year-old man with recurrent left occipital parietal meningioma who underwent a parietal craniotomy. The third case was a 62-year-old woman with a foramen magnum meningioma encircling the left vertebral artery. These cases demonstrate the utility of 5-ALA in a variety of challenges associated with resection of meningiomas ( Video 1 ).

Published
2020
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15. The Unfavorable Result in Plastic Surgery

Author

Collier S. Pace, David J. David, John T. Paige, Mark W. Clemens, Pravin K. Patel, Bahman Guyuron, Susan E. Mackinnon, Joseph Upton, Daniel J. Krochmal, Milomir Ninkovic, Kuylhee Kim, James E. Vogel, Foad Nahai, Byron D. Poindexter, Mouchammed Agko, Ron B. Somogyi, Alexandre Marchac, Ivica Ducic, Dennis Hurwitz, Joshua Fosnot, Michael P. Ogilvie, Sanjeev N. Puri, Karen Kim Evans, Charles D. Hwang, David Kenneth Funt, Julius W. Few, J. Rodrigo Diaz-Siso, Holly S. Ryan, Duncan Angus McGrouther, Sheri A. Keitz, Mark S. Granick, Kevin H. Small, Guillermo J. Gallardo, Yu-Te Lin, Onelio Garcia, Chris Alabiad, David J. Reisberg, Karl C. Bruckman, Amir Taghinia, Jason Wong, Geoffrey R. Keyes, Susie Lin, Alyson A. Melin, Wee Sim Khor, M. Bradley Calobrace, Ali Shirafkan, Alan Yan, Andreas D. Weber, Ahmed M. Hashem, Deana Saleh Shenaq, Rizal Lim, Mark S. Nestor, Luis O. Vasconez, Seth R. Thaller, Kenneth W. Goodman, Youssef Tahiri, Françoise Firmin, Mark B. Constantian, Alfonso Barrera, Bruce S. Bauer, Christopher J. Salgado, Albert Losken, Dang T. Pham, Joseph G. McCarthy, David R. 'Chip' Barry, Geoffrey G. Hallock, Henry M. Spinelli, Steven L. Moran, David W. Chang, David E. Morris, Allen L. Van Beek, Nicholas A. Fiore, David H. Song, George W. Weston, Mimis N. Cohen, Daniel Josef Kedar, Edward R. Lee, Dean M. Toriumi, Michael Patipa, Wyndell H. Merritt, Adrian S.H. Ooi, Jürgen Hoffmann, Robert K. Sigal, Marco Rainer Kesting, Peter J. Taub, Riccardo F. Mazzola, David T. Netscher, Lawrence S. Bass, Garry S. Brody, David Gerth, Natalie R. Joumblat, Alessio Baccarani, Mordcai Blau, Mark G. Albert, Mitchell Manway, Ron Hazani, Amy S. Colwell, Dennis P. Orgill, G. Patrick Maxwell, Ashkan Ghavami, Leslie Agatha Grossman, Arin K. Greene, Kenneth C. Shestak, Eduardo D. Rodriguez, Christian Schaudy, Simeon Wall, Alan Matarasso, Jason D. Fowler, Ernest K. Manders, William C. Lineaweaver, Ali Izadpanah, Scott N. Oishi, Aditya Sood, Basel Sharaf, Karol A. Gutowski, David J. Birnbach, Lesley C. Butler, Samir Mardini, Linda G. Phillips, William B. Norbury, Hung Chi Chen, Giorgio De Santis, Ajani Nugent, John Reinisch, Joseph F. Capella, Sabine Lovell, Jonathan S. Friedstat, Gary J. Alter, Luis R. Scheker, J. Abel de la Peña, Ali Totonchi, Joseph E. Losee, Martin Franz Langer, Herbert Valencia, Shannon L. Wong, Joseph M. Serletti, Jason N. Pozner, Neil A. Fine, Brian I. Labow, Todd A. Theman, Sigrid Blome-Eberwein, Joubin S. Gabbay, Michelle Grim, Mitchell Howard Brown, Fernando Molina, Richard E. Kirschner, Kurt Vinzenz, Debra A. Reilly, Darren M. Smith, Zubin J. Panthaki, Michael J. Yaremchuk, Salvatore C. Lettieri, Wei F. Chen, Randal D. Haworth, Cristiano Boneti, Timothy J. Marten, Warren Garner, Arun K. Gosain, Lawrence J. Gottlieb, Fu Chan Wei, Thomas J. Baker, Paige Paparone, Lydia A. Fein, Matthias B. Donelan, Harvey Chim, Prosper Benhaim, Sydney R. Coleman, Raphael C. Lee, David B. Sarwer, John A.I. Grossman, Joseph P. Hunstad, Donald S. Mowlds, Neal R. Reisman, Peter C. Neligan, Timothy B. McDonald, James E. Zins, Bradford W. Lee, Sara R. Dickie, Charles E. Butler, Elizabeth J. Hall-Findlay, James M. Stuzin, Thomas H. Tung, Allen Gabriel, Dennis C. Hammond, Benjamin Levi, Heather M. Polonsky, Vasanth S. Kotamarti, Donald H. Lalonde, Christopher D. Knotts, Stephanie Hoffbauer, Jin Bo Tang, Gustavo A. Rubio, Ronald M. Zuker, Michael W. Neumeister, Val Lambros, David N. Herndon, David W. Person, Enrico Robotti, Jillian M. McLaughlin, Eyal Gur, Joe I. Garri, Francisco del Piñal, Matthew M. Hanasono, Peirong Yu, Christopher L. Nuland, Russell R. Reid, Edward O. Terino, Juan Carlos Lopez Gutierrez, Philip Kuo-Ting Chen, L. Scott Levin, Nidal F. Al Deek, Oksana Jackson, Yan T. Ortiz-Pomales, Tulsi Roy, Robert M. Goldwyn, Andrew E. Price, and Abigail M. Cochran

Subjects
medicine.medical_specialty, Plastic surgery, business.industry, medicine, Adverse effect, business, Surgery
Abstract

The unfavorable result in plastic surgery , The unfavorable result in plastic surgery , کتابخانه مرکزی دانشگاه علوم پزشکی تهران

Published
2018
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16. Closed therapy of thoracic and lumbar vertebral body fractures in trauma patients

Author

Iman Feiz-Erfan, Paola G. Pieri, Poya Hedayati, Jarvis W. Walters, Tammy R. Kopelman, Patrick J. O'Neill, Sydney J. Vail, Salvatore C. Lettieri, and Arpan A. Patel

Subjects
medicine.medical_specialty, thoracic, Population, Computed tomography, Asymptomatic, Spine: Original Article, 03 medical and health sciences, 0302 clinical medicine, Lumbar, vertebral body fracture, Deformity, Medicine, education, lumbar, 030222 orthopedics, education.field_of_study, medicine.diagnostic_test, business.industry, Spinal cord, medicine.disease, Surgery, Lumbar vertebral body, failure, Pseudarthrosis, medicine.anatomical_structure, fracture, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

Background The failure rate for the closed/non-surgical treatment of thoracic and lumbar vertebral body fractures (TLVBF) in trauma patients has not been adequately evaluated utilizing computed tomography (CT) studies. Methods From 2007 to 2008, consecutive trauma patients, who met inclusion criteria, with a CT diagnosis of acute TLVBF undergoing closed treatment were assessed. The failure rates for closed therapy, at 3 months post-trauma, were defined by progressive deformity, vertebral body collapse, or symptomatic/asymptomatic pseudarthrosis. The Arbeitsgemeinschaft fur Osteosynthesefragen (AO) classification was utilized to classify the fractures (groups A1 and non-A1 fractures) and were successively followed with CT studies. Results There were 54 patients with 91 fractures included in the study; 66 were A1 fractures, and 25 were non-A1 fractures. All had rigid bracing applied with flat and upright X-ray films performed to rule out instability. None had sustained spinal cord injuries. Thirteen patients (24%) failed closed therapy [e.g. 13 failed fractures (14%) out of 91 total fractures]. Five failed radiographically only (asymptomatic), and eight failed radiographically and clinically (symptomatic). A1 fractures had a 4.5% failure rate, while non-A1 fractures failed at a rate of 40%. Conclusion Failure of closed therapy for TLVBF in the trauma population is not insignificant. Non-A1 fractures had a much higher failure rate when compared to A1 fractures. We recommend close follow-up particularly of non-A1 fractures treated in closed fashion using successive CT studies.

Published
2017

17. Is poor sleep associated with obesity in older adults? A narrative review of the literature

Author

Paolo Falaschi, Stefano Eleuteri, Fabio Lucidi, Andrea Ballesio, Silvia Cerolini, Maria C. Norton, and Salvatore C Conte

Subjects
Gerontology, Sleep Wake Disorders, Population, Sleep, REM, 030209 endocrinology & metabolism, Affect (psychology), 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Obesity, Disordered eating, education, Association (psychology), older adults, Aged, sleep problems, education.field_of_study, business.industry, medicine.disease, Sleep in non-human animals, Psychiatry and Mental health, Clinical Psychology, Causal inference, obesity, business, Sleep, Developed country, 030217 neurology & neurosurgery
Abstract

To address the worldwide epidemic of obesity, a sizable literature implicates sleep problems in the onset of obesity in younger populations. However, less is known about how this process may operate among older adults, which is of concern, given demographic shifts that have resulted in a much higher proportion of developed nations around the world reaching late life. We offer a current review of the literature studying older adults and examining associations between sleep quality and obesity in this population. We consider both subjective and objectively measured sleep as well as both cross-sectional and longitudinal studies offering stronger causal inference. We discuss seemingly contradictory literature showing that shorter sleep duration as well as longer sleep duration are associated with obesity risk, then review studies that tested for non-linear relationships and reported a U-shape pattern, suggesting that too much or too little sleep is detrimental. Besides sleep duration, we discuss evidence showing that other forms of sleep dysfunction related to night-time awakenings, REM sleep, slow-wave sleep, and daytime sleepiness, which are indicators of sleep quality, are also linked to obesity. Specific psychological and physiological mediators and moderators, suggesting possible mechanisms whereby sleep problems may affect obesity in older adults, are described. We conclude by discussing areas, where additional research could help clarify this association, considering such factors as medical comorbidities common in late life, and health-related behaviors that may stem from poor sleep (such as disordered eating behavior). Such insights will have great value for clinical practice. Level V, narrative review.

Published
2017

18. Management of Panfacial Fracture

Author

Kausar Ali and Salvatore C. Lettieri

Subjects
Facial trauma, 03 medical and health sciences, 0302 clinical medicine, business.industry, Fracture (geology), Dentistry, Medicine, Surgery, 030206 dentistry, 030223 otorhinolaryngology, business, medicine.disease
Abstract

Traumatic panfacial fracture repair is one of the most complex and challenging reconstructive procedures to perform. Several principles permeate throughout literature regarding the repair of panfacial injuries in a stepwise fashion. The primary goal of management in most of these approaches is to restore the occlusal relationship at the beginning of sequential repair so that other structures can fall into alignment. Through proper positioning of the occlusion and the mandibular-maxillary unit with the skull base, the spatial relationships and stability of midface buttresses and pillars can then be re-established. Here, the authors outline the sequencing of panfacial fracture repair for the restoration of anatomical relationships and the optimization of functional and structural outcomes.

Published
2017

19. Cerebral revascularization and carotid artery resection at the skull base for treatment of advanced head and neck malignancies

Author

Salvatore C. Lettieri, Nikolay L. Martirosyan, Iman Feiz-Erfan, Mohammad Yashar S. Kalani, Samuel Kalb, Robert F. Spetzler, and Randall W. Porter

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Fistula, Cerebral Revascularization, Revascularization, medicine.disease, Magnetic resonance angiography, Surgery, Skull, medicine.anatomical_structure, Skull Base Neoplasm, medicine.artery, medicine, Radiology, Sarcoma, Internal carotid artery, business
Abstract

Object Resection of cancer and the involved artery in the neck has been applied with some success, but the indications for such an aggressive approach at the skull base are less well defined. The authors therefore evaluated the outcomes of advanced skull base malignancies in patients who were treated with bypass and resection of the internal carotid artery (ICA). Methods The authors retrospectively reviewed the charts of all patients with advanced head and neck cancers who underwent ICA sacrifice with revascularization in which an extracranial-intracranial bypass was used between 1995 and 2010 at the Barrow Neurological Institute. Results Eighteen patients (11 male and 7 female patients; mean age 46 years, range 7–69 years) were identified. There were 4 sarcomas and 14 carcinomas that involved the ICA at the skull base. All patients underwent ICA sacrifice with revascularization. One patient died of a stroke after revascularization. A second patient died of the effects of a fistula between the oral and cranial cavities (surgery-related mortality rate 11.1%). Eight months after the operation, 1 patient developed occlusion of the bypass and died. Complications associated with the bypass surgery included 1 case of subdural hematoma (SDH) with blindness, 1 case of status epilepticus, and 1 case of asymptomatic bypass occlusion (bypass-related morbidity 16.7%). Complications associated with tumor resection included 3 cases of CSF leakage requiring repair and shunting, 1 case of hydrocephalus requiring shunting, 1 case of SDH, and 1 case of contralateral ICA injury requiring a bypass (tumor resection morbidity rate 33.3%). In 1 patient treated with adjuvant therapy before surgery, the authors identified only a radiation effect and no tumor on resection. In a second patient the bypass was occluded, and her tumor was not resected. The other 16 patients underwent gross-total resection of their tumor. Excluding the surgery-related deaths, the mean and median lengths of survival in this series were 13.2 and 8.3 months, respectively (range 1.5–48 months). Including the surgery-related deaths, the mean and median lengths of survival were 11.8 and 8 months, respectively (range 17 days–48 months). At last follow-up all patients had died of cancer or cancer-related causes. Conclusions Despite maximal surgical intervention, including ICA sacrifice at the skull base with revascularization, patient survival was dismal, and the complication rate was significant. The authors no longer advocate such an aggressive approach in this patient population. On rare occasions, however, such an approach may be considered for low-grade malignancies.

Published
2013
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20. Risk factors for hospital readmission of elderly patients

Author

Franchi, C, Nobili, A, Mari, D, Tettamanti, M, Djade, Cd, Pasina, L, Salerno, F, Corrao, S, Marengoni, A, Iorio, A, Marcucci, M, Mannucci, Pm, Reposi, Investigators, Pier, Mm, Alessandro, N, Salvatore, C, Spirito, V, Noce, D, Bonazzi, J, Lombardo, R, Sparacio, E, Alborghetti, S, De Vittorio, L, Paolisso, G, Rizzo, Mr, Laieta, Mt, Brignone, C, Roberto, T, Persico, Marcello, Salvatore, T, Sasso, Fc, Utili, R, Durante Mangoni, E, Pinto, D, Fenoglio, L, Bracco, C, Gasbarrone, L, Porcari, P, Famularo, G, Sajeva, Mr, Maniscalco, G, Gunelli, M, Tirotta, D, Realdi, G, Baritussio, A, Frassoni, F, Delsignore, R, Baroni, Mc, Zardo, M, Volpato, S, Fotini, S, Manfredini, R, Longhini, C, Molino, C, Incasa, E, Guarnieri, G, Zanetti, M, Spalluti, A, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Tuttolomondo, A, Di Sciacca, R, Antonaci, S, Vella, F, Marseglia, A, Centonze, V, Modeo, Me, Palasciano, G, Pugliese, S, Capobianco, C, Murialdo, G, Bovio, M, Laghi Pasini, F, Capecchi, Pl, Bicchi, M, Nuti, R, Valenti, R, Capodarca, C, Auteri, A, Pasqui, Al, Puccetti, L, Olivieri, O, Stanzial, Am, Agnelli, G, Macura, A, Mannarino, E, Lupattelli, G, Rondelli, P, Serra, Mg, Musca, G, Cuccurullo, O, Cappellini, Md, Fabio, G, Motta, I, Cantoni, F, Fargion, S, Bonara, P, Bulgheroni, M, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Monzani, V, Savojardo, V, Folli, C, Dionigi Rossi, P, Ziglioli, E, Lilleri, Ms, Selmi, C, Meda, F, Cazzaniga, M, Monti, V, Balduini, Cl, Bertolino, G, Dezzani, L, Cavallo, P, Corazza, Gr, Miceli, E, Secchi, Mb, Wu, Sc, Sofia, L, Anastasio, L, Carbone, M, Bertucci, L, De Feudis, L, Traisci, G, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Ronchi, E, Buratti, A, Tognin, T, Bertolini, D, Liberato, Nl, Bernasconi, G, Nardo, B, Venco, A, Guasti, L, Maroni, L, Castiglioni, L, Casella, G, Vanoli, M, Grignani, G, Mancuso, G, Tavella, R, Persico, R, Cicardi, M, Sandrone, G, Magenta, M, Perego, F, Meroni, Mr, Rozzini, R, Falanga, L, Giordano, A, Menardo, G, Bottone, S, Sferrazzo, E, Tassara, R, Melis, D, Rebella, L, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Di Todaro, F, Nielsen, I, Giusto, L, Semplicini, A, Gottardo, L, Delitala, G, Carta, S, Atzori, S, Rosei, Ea, Rizzoni, D, Castoldi, L, Altomare, E, Serviddio, G, Salvatore, S, Fera, G, Di Luca ML, Renna, D, Picardi, A, Mazzarelli, C, Vespasiani Gentilucci, U, De Vincentis, A, Hila, D, Bernardi, M, Li Bassi, S, Santi, L, Masala, C, Mammarella, A, Raparelli, V, Rossi Fanelli, F, Delfino, M, Amoroso, A, Serra, P, Fontana, V, Falcone, M, Violi, F, Basili, S, Perri, L, Silveri, Ng, De Marco, G, Giupponi, B, Landolfi, R, Grieco, A, Gallo, A, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Bonometti, F, Loria, P, Ballestri, S, Becchi, Ma, Bolondi, L, Rasciti, L, Serio, I, Gualandi, S, Romanelli, G, Carulli, N, Rondinella, S, Giannico, I, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Sacco, A, Bonelli, A, Dentamaro, G, Micale, G, Delitalia, G, Deidda, S, Cuccuru, Lm, Benetti, G, Quagliolo, M, Centenaro, Gr, Macchini, L, Perciccante, A, Coralli, A, Realdi, A, Cricco, L, Morabito, C, Fava, R, Fiorentini, A, Tofi, C., Franchi C, Nobili A, Mari D, Tettamanti M, Djade CD, Pasina L, Salerno F, Corrao S, Marengoni A, Iorio A, Marcucci M, Mannucci PM, REPOSI Investigators [.., Bernardi M, Bolondi L, ], Franchi, C, Nobili, A, Mari, D, Tettamanti, M, Djade, CD, Pasina, L, Salerno, F, Corrao, S, Marengoni, A, Iorio, A, Marcucci, M, Mannucci, PM, Tuttolomondo, A, Mansueto, P, Franchi, Carlotta, Nobili, Alessandro, Mari, Daniela, Tettamanti, Mauro, Djade, Codjo D., Pasina, Luca, Salerno, Francesco, Corrao, Salvatore, Marengoni, Alessandra, Iorio, Alfonso, Marcucci, Maura, Mannucci, Pier Mannuccio, Rizzo, Maria Rosaria, Carlotta, Franchi, Alessandro, Nobili, Daniela, Mari, Mauro, Tettamanti, Codjo D., Djade, Luca, Pasina, Francesco, Salerno, Salvatore, Corrao, Alessandra, Marengoni, Alfonso, Iorio, Maura, Marcucci, Pier Mannuccio, Mannucci, and Zanetti, Michela

Subjects
Male, Settore MED/09 - Medicina Interna, Time Factors, Risk factors, internal medicine, Geriatric patient, hospital admission, Logistic regression, Elderly, Hospital readmission, Internal medicine and geriatric wards, 80 and over, Aged, Aged, 80 and over, Female, Geriatrics, Hospital Departments, Humans, Internal Medicine, Patient Readmission, Risk Factors, Medical diagnosis, Aged, Aged, 80 and over, Female, Geriatrics, Hospital Departments, Humans, Internal Medicine, Male, Patient Readmission, statistics /&/ numerical data, Risk Factors, Time Factors, Univariate analysis, vascular disease, Settore MED/45 - Scienze Infermieristiche Generali, Cliniche E Pediatriche, Ageing, readmission, statistics /&/ numerical data, Hospital Department, liver disease, Human, medicine.medical_specialty, Time Factor, MEDLINE, Hospital readmission, Internal medicine and geriatric wards, Risk factors, Elderly, elderly patients, NO, medicine, Registry Politerapie SIMI (REPOSI), Adverse effect, business.industry, Risk Factor, Univariate, medicine.disease, Comorbidity, elderly, hospital readmission, risk factors, internal medicine and geriatric wards, Internal medicine and geriatric ward, Emergency medicine, business, Geriatric
Abstract

Background: The aim of this study was to identify which factors were associated with a risk of hospital readmission within 3 months after discharge of a sample of elderly patients admitted to internal medicine and geriatric wards. Methods: Of the 1178 patients aged 65 years or more and discharged from one of the 66 wards of the 'Registry Politerapie SIMI (REPOSI)' during 2010, 766 were followed up by phone interview 3 months after discharge and were included in this analysis. Univariate and multivariate logistic regression models were used to evaluate the association of several variables with rehospitalization within 3 months from discharge. Results: Nineteen percent of patients were readmitted at least once within 3 months after discharge. By univariate analysis in-hospital clinical adverse events (AEs), a previous hospital admission, number of diagnoses and drugs, comorbidity and severity index (according to Cumulative Illness Rating Scale-CIRS), vascular and liver diseases with a level of impairment at discharge of 3 or more at CIRS were significantly associated with risk of readmission. Multivariate logistic regression analysis showed that only AEs during hospitalization, previous hospital admission, and vascular and liver diseases were significantly associated with the likelihood of readmission. Conclusions: The results demonstrate the need for increased medical attention towards elderly patients discharged from hospital with characteristics such as AEs during the hospitalization, previous admission, vascular and liver diseases. © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Published
2013
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21. Are all people with diabetes and cardiovascular risk factors or microvascular complications at very high risk? Findings from the Risk and Prevention Study

Author

Marzona, I., Avanzini, F., Lucisano, G., Tettamanti, M., Baviera, M., Nicolucci, A., Roncaglioni, M. C., Tombesi, M., Tognoni, G., Massa, E., Marrocco, W., Micalella, M., Caimi, V., Longoni, P., Franzosi, M. G., Monesi, L., Pangrazzi, I., Barlera, S., Milani, V., Nicolis, E., Casola, C., Clerici, F., Palumbo, A., Sgaroni, G., Marchioli, R., Silletta, M. G., Pioggiarella, R., Scarano, M., Marfisi, R. M., Flamminio, A., Macino, L., Ferri, B., Pera, C., Polidoro, A., Abbatino, D., Acquati, M., Addorisio, G., Adinolfi, D., Adreani, L., Agistri, M. R., Agneta, A., Agnolio, M. L., Agostini, N., Agostino, G., Airo, A., Alaimo, N., Albano, M., Albano, N., Alecci, G., Alemanno, S., Alexanian, A., Alfarano, M., Alfe, L., Alonzo, N., Alvino, S., Ancora, A., Andiloro, S., Andreatta, E., Angeli, S., Angiari, F., Angilletti, V., Annicchiarico, C., Anzivino, M., Aprea, R., Aprile, A., Aprile, E., Aprile, I., Aprile, L., Armellani, V., Arnetoli, M., Aronica, A., Autiero, V., Bacca, G., Baccalaro, A. M., Bacci, M., Baglio, G., Bagnani, M., Baiano, A., Baldari, A., Ballarini, L., Banchi, G., Bandera, R., Bandini, F., Baratella, M., Barbieri, A., Barbieri Vita, A., Bardi, M., Barlocchi, M., Baron, P., Bartoli, M., Basile, A., Basile, F., Basile, S., Battaggia, A., Battaglia, A., Bau, A., Beconcini, G., Beggio, R., Belfiore, P. A., Belicchi, M., Bellamoli, S., Bellini, C., Bellomo, M., Benetollo, C., Benetti, R., Beretta, E., Bertalero, P., Bertaso, F. G., Bertolani, U., Bettelli, G., Biagiotti, G., Bianchi, S., Bianco, G., Biccari, F., Bigioli, F., Bindi, M., Bisanti, G., Bitetti, E. M., Blasetti, M. P., Blesi, F., Boato, V., Boga, S., Boidi, E., Boldrin, G., Bollati, A., Bolzan, L., Bolzonella, S., Bonardi, P., Bonato, G. B., Bonci, M., Bonfitto, G., Bonincontro, E., Boninsegna, F., Bonissone, D., Bono, L., Bonollo, E., Borghi, M., Borioli, N., Borsatto, M., Bosco, T., Bosisio Pioltelli, M., Botarelli, C., Botassis, S., Bottini, F., Bottos, C., Bova, G., Bova, V., Bozzani, A., Bozzetto, R. M., Braga, V. T., Braglia, M., Bramati, E., Brazzoli, C., Breglia, G., Brescia, A., Briganti, D., Brigato, G., Brocchi, A., Brosio, F. A., Bruni, E., Buscaglia, E., Bussini, M. D., Bussotti, A., Buzzaccarini, F., Buzzatti, A., Caccamo, G., Cacciavillani, C., Caggiano, G., Calciano, F. P., Calderisi, M., Calienno, S., Caltagirone, P., Calzolari, I., Cammisa, M., Campanaro, M., Campanella, G. B., Campese, F., Canali, G., Candiani, D. E. L., Canepa, R., Canini, D., Canino, A., Cantoro, E. A., Capilupi, V., Capotosto, P., Cappelli, B., Capraro, G., Carafa, F. A., Carano, Q., Carcaterra, V., Carriero, D., Carrozzo, G., Cartanese, M., Casalena, M., Casarola, M., Caso, C., Casotto, M., Castaldi, F., Castegnaro, R., Castellani, G., Castri, S., Catalano, E., Catinello, N., Caturano, G., Cavallaro, R., Cavallo, A. M., Cavallo, G., Cavion, M. T., Cavirani, G., Cazzaniga, F., Cazzetta, D., Cecconi, V., Cefalo, A., Celebrano, M., Celora, A., Centonze, P., Cerati, D., Cesaretti, D., Checchia, G., Checchin, A., Cherubini, M., Chianese, L., Chiappa, A., Chiappa, M. V., Chiariello, G., Chiavini, G., Chicco, M., Chiumeo, F., Ciacciarelli, A., Ciaci, D., Ciancaglini, R., Cicale, C., Cicale, S., Cipolla, A., Ciruolo, A., Citeri, A. L., Citterio, G., Clerici, M., Coazzoli, E., Collecchia, G., Colletta, F., Colombo, I., Colorio, P., Coluccia, S., Comerio, M., Comoretto, P., Compagni, M., Conte, O., Contri, S., Contrisciani, A., Coppetti, T., Corasaniti, F., Corradi, M. T., Corsano, A., Corsini, A., Corti, N., Costantini, G., Costantino, A., Cotroneo, S., Cozzi, D., Cravello, M. G., Cristiano, E., Cucchi, R., Cusmai, L., D'Errico, G. B., D'Agostino, P., Dal Bianco, L., Dal Mutto, U., Dal Pozzo, G., Dallapiccola, P., Dallatorre, G., Dalle Molle, G., Dalloni, E., D'Aloiso, A., D'Amicis, G., Danese, R., Danieli, D., Danisi, G., D'Anna, M. A., Danti, G., D'Ascanio, S., Davidde, G., De Angeli, D., De Bastiani, R., De Battisti, A., De Bellis, A., De Berardinis, G., De Carlo, F., De Giorgi, D., De Gobbi, R., De Lorenzis, E., De Luca, P., De Martini, G., De Marzi, M., De Matteis, D., De Padova, S., De Polo, P., De Sabato, N., De Stefano, T., De Vita, M. T., De Vito, U., De Zolt, V., Debernardi, F., Del Carlo, A., Del Re, G., Del Zotti, F., D'Elia, R., Della Giovanna, P., Dell'Acqua, L., Dell'Orco, R. L., Demaria, G., Di Benedetto, M. G., Di Chiara, G., Di Corcia, V., Di Domizio, O., Di Donato, P., Di Donato, S., Di Fermo, G., Di Franco, M., Di Giovannantonio, G., Di Lascio, G., Di Lecce, G., Di Lorenzo, N., Di Maro, T., Di Mattia, Q., Di Michele, E., Di Modica, R. S., Di Murro, D., Di Noi, M. C., Di Paoli, V., Di Santi, M., Di Sanzo, A., Di Turi, C., Diazzi, A., Dileo, I., D'Ingianna, A. P., Dolci, A., Dona, G., Donato, C., Donato, P., Donini, A., Donna, M. E., Donvito, T. V., Esposito, L., Esposito, N., Evangelista, M., Faita, G., Falco, M., Falcone, D. A., Falorni, F., Fanciullacci, A., Fanton, L., Fasolo, L., Fassina, R., Fassone, A., Fatarella, P., Fedele, F., Fera, I., Fera, L., Ferioli, S., Ferlini, M. G., Ferlino, R., Ferrante, G., Ferrara, F. N., Ferrarese, M. F., Ferrari, G., Ferrari, O., Ferreri, A., Ferroni, M., Fezzi, G., Figaroli, C., Fina, M. G., Fioretta, A., Fiorucci, C., Firrincieli, R., Fischetti, M., Fischietti, G., Fiume, D. C., Flecchia, G., Forastiere, G., Fossati, B., Franceschi, P. L., Franchi, L., Franzoso, F., Frapporti, G., Frasca, G., Frisotti, A., Fumagalli, G., Fusco, D., Gabriele, P., Gabrieli, A., Gagliano, D., Galimberti, G., Galli, A., Gallicchio, N., Gallio, F., Gallipoli, T., Gallo, P., Galopin, T., Gambarelli, L., Garbin, A., Garozzo, G. M., Gasparri, R., Gastaldo, M., Gatti, E., Gazzaniga, P., Gennachi, N., Gentile, R. V., Germani, P., Gesualdi, F., Gherardi, E., Ghezzi, C., Ghidini, M. G., Ghionda, F., Giacci, L., Gialdini, D., Giampaolo, C., Giancane, R., Giannanti, A., Giannese, S., Giannini, L., Giaretta, M., Giaretta, R., Giavardi, L., Giordano, P., Giordano, E., Giordano, B., Gioria, G. M., Giugliano, R., Grassi, E. A., Greco, A., Greco, L., Grilletti, N., Grimaldi, N., Grisetti, G., Groppelli, G., Gualtieri, L., Guarducci, M., Guastella, G., Guerra, M., Guerrini, F., Guglielmini, A., Guido, A., Gulotta, P., Iacono, E., Iadarola, G., Ianiro, G., Iarussi, V., Ieluzzi, M. L., Ierardi, C., Ingaldi, F., Interlandi, S., Iocca, M., Iorno, A., Ioverno, E., Iurato, R., La Pace, L., La Piscopia, C., La Selva, R., Lafratta, M., Lamparelli, M., Lanaro, G., Lancerotto, R., Larcher, M., Lassandro, M., Lattuada, G., Laurino, P., Lefons, C., Legrottaglie, F., Lemma, A., Leone, D., Leone, F., Leso, A., Leuzzi, G., Levato, G., Libardi, L., Libralesso, N., Licini, P. I., Licursi, G., Lidonnici, F., Lillo, C., Liveri, L., Livio, A., Loiero, R. A., Loison, M., Lombardo, G., Lombardo, T., Lomunno, V., Lomuscio, S., Lonedo, A., Longo, E., Lora, L., Lotterio, A., Lucatello, L., Luongo, A., Lupoli, M., Macchia, C., Macri, G., Mafessanti, M., Maggialetti, V., Maggioni, A., Magnani, M., Maiellaro, G., Mancuso, A., Maniglio, A. R., Mannari, G. L., Manni, A., Manocchio, B., Mao, M., Marano, A., Maraone, E., Marascio, D., Marcheselli, P., Marchetto, B., Marchetto, S., Marchi, A., Marchi, G. L., Mariano, C., Marinacci, S., Marinelli, S., Marini, G., Marra, V. C., Marrali, F., Marseglia, C., Martello, G., Martino, C., Martino, G., Martino, M., Marulli, C. F., Maruzzi, G., Marzotti, A., Mascheroni, G., Mascolo, P., Masoch, G., Masone, R., Massa, L., Massafra, M., Massi, M., Massignani, D. M., Matarese, A. M., Matini, G., Mauro, R., Mazzi, M., Mazzillo, A., Mazzocato, E., Mazzoleni, N. S., Mazzone, A., Melacci, A., Mele, E., Meliota, P., Menaspa, S., Meneghello, F., Merola, G., Merone, L., Metrucci, A., Mezzina, V., Micchi, A., Michielon, A., Migliore, N., Minero, G., Minotta, F., Mirandola, C., Mistrorigo, S., Modafferi, L., Moitre, R., Mola, E., Monachese, C., Mongiardini, C., Montagna, F., Montani, M., Montemurno, I., Montolli, R., Montorsi, S., Montresor, M., Monzani, M. G., Morabito, F., Mori, G., Moro, A., Mosca, M. F., Motti, F., Muddolon, L., Mugnai, M., Muscas, F., Naimoli, F., Nanci, G., Nargi, E., Nasorri, R., Nastrini, G., Negossi, M., Negrini, A., Negroni, A., Neola, V., Niccolini, F., Niro, C. M., Nosengo, C., Novella, G., Nuti, C., Obici, F., Olita, C., Oliverio, S. S., Olivieri, I., Oriente, S., Orlando, G., Paci, C., Pagano, G., Pagliara, C., Paita, G., Paladini, G., Paladino, G., Palano, T., Palatella, A., Palermo, P., Palmisano, M., Pando, P., Panessa, P., Panigo, F., Panozzo, G., Panvini, F., Panzieri, F., Panzino, A., Panzitta, F., Paoli, N., Papagna, R., Papaleo, M. G., Papalia, G., Parisi, R., Parotti, N., Parravicini, D., Passarella, P., Pastore, G. A., Patafio, M., Pavone, P., Pedroli, W., Pedroni, M., Pelligra, G., Pellizzari, M., Penati, A., Perlot, M., Perrone, A., Perrone, G., Peruzzi, P., Peselli, C., Petracchini, L., Petrera, L., Petrone, S., Peverelli, C., Pianorsi, F., Piazza, G. P., Piazzolla, G., Picci, A., Pienabarca, G., Pietronigro, T. P., Pignocchino, P., Pilone, R., Pinto, D., Pirovano, E., Pirrotta, D., Pisante, V., Pitotto, P., Pittari, L., Piva, A., Pizzoglio, A., Plantera, O. R., Plebani, W., Plessi, S., Podrecca, D., Poerio, V., Poggiani, F., Pogliani, W., Poli, L., Poloni, F. G., Porcelli, R., Porto, S., Pranzo, L., Prevedello, C., Profeta, C., Profico, D., Punzi, A., Quaglia, G. M., Racano, M., Raccone, A., Radice, F., Raho, C. A., Raimondi, R., Raino, M., Ramponi, R., Ramunni, A., Ramunni, A. L., Ravasio, F., Ravera, M., Re Sarto, G., Rebustello, G., Regazzoli, S., Restelli, C., Rezzonico, M., Ricchiuto, F., Rigo, S., Rigon, G., Rigon, R., Rinaldi, O. V., Rinaldi, M., Risplendente, P. G., Rispoli, M., Riundi, R., Riva, M. G., Rizzi, A. L., Rizzi, D., Rizzo, L. D., Rocchi, L., Rondinone, B., Rosa, B., Rosati, F., Roselli, F., Rossetti, A., Rossetti, C., Rossi, R., Rossi, P. R., Rossi, A., Rossi, C. L., Rossitto, A., Ruffini, R., Ruffo, A., Ruggio, S., Ruo, M., Russo, B., Russo, L., Russo, R., Russo, S., Russo, U., Russo, V., Ruta, G., Sacchi, F., Sacco Botto, F., Saia, A., Salladini, G., Salmoiraghi, S., Saluzzo, F., Salvatore, C., Salvatori, E., Salvio, G., Sandri, P., Sandrini, T., Sangermano, V., Santoni, N., Saracino, A. D., Saracino, A., Sarasin, P., Sardo Infirri, C., Sarri, B., Sartori, G., Sartori, N., Sauro, C., Scaglioni, M., Scalfi, C., Scamardella, A. M., Scandale, G., Scandone, L., Scannavini, G., Scarati, R., Scardi, A., Scarpa, F. M., Scazzi, P., Schifone, A., Schiroso, G., Scigliano, G., Scilla, A., Sciortino, M., Scolaro, G., Scollo, E., Scorretti, G., Sellitti, R., Selmo, A., Selvaggio, G., Sempio, A., Seren, F., Serio, L., Serra, C., Serra, L., Siciliano, D., Sideri, A., Sighele, M., Signore, R., Siliberto, F., Silvestro, M., Simioni, G., Simmini, G., Simonato, L., Sinchetto, F., Sizzano, E., Smajato, G., Smaldone, M., Sola, G., Sordillo, L., Sovran, C. 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Subjects
Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Population, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, Overweight, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Prediction model, Internal medicine, Diabetes mellitus, Internal Medicine, Diabetes Mellitus, Medicine, Humans, Multicenter Studies as Topic, Myocardial infarction, Risk factor, education, Stroke, Aged, Randomized Controlled Trials as Topic, education.field_of_study, Lifestyle habits, business.industry, Major cardiovascular events, Atrial fibrillation, General Medicine, Middle Aged, medicine.disease, Cardiovascular Diseases, Heart failure, Physical therapy, Female, medicine.symptom, business, Diabetic Angiopathies
Abstract

To verify whether it is possible, in people with diabetes mellitus (DM) considered at very high cardiovascular (CV) risk, stratify this risk better and identify significant modifiable risk factor (including lifestyle habits) to help patients and clinicians improve CV prevention. People with DM and microvascular diseases or one or more CV risk factors (hypertension, hyperlipidemia, smoking, poor dietary habits, overweight, physical inactivity) included in the Risk and Prevention study were selected. We considered the combined endpoint of non-fatal acute myocardial infarction and stroke and CV death. A multivariate Cox proportional analysis was carried out to identify relevant predictors. We also used the RECPAM method to identify subgroups of patients at higher risk. In our study, the rate of major CV events was lower than expected (5 % in 5 years). Predictors of CV events were age, male, sex, heart failure, previous atherosclerotic disease, atrial fibrillation, insulin treatment, high HbA1c, heart rate and other CV diseases while being physically active was protective. RECPAM analysis indicated that history of atherosclerotic diseases and a low BMI defined worse prognosis (HR 4.51 95 % CI 3.04–6.69). Among subjects with no previous atherosclerotic disease, men with HbA1c more than 8 % were at higher CV risk (HR 2.77; 95 % CI 1.86–4.14) with respect to women. In this population, the rate of major CV events was lower than expected. This prediction model could help clinicians identify people with DM at higher CV risk and support them in achieving goals of physical activity and HbA1c.

Published
2016

22. Management of temporomandibular joint Coccidioidomycosis

Author

Ziyad S. Hammoudeh and Salvatore C. Lettieri

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Condyle, 03 medical and health sciences, 0302 clinical medicine, Amphotericin B, medicine, Humans, Coccidioides, 030223 otorhinolaryngology, Abscess, Infusions, Intravenous, General Dentistry, Fluconazole, Debridement, Coccidioidomycosis, biology, business.industry, Mandible, Osteomyelitis, 030108 mycology & parasitology, Temporomandibular Joint Disorders, medicine.disease, biology.organism_classification, Long-Term Care, Temporomandibular joint, Surgical access, Surgery, medicine.anatomical_structure, Otorhinolaryngology, Drug Therapy, Combination, business, Tomography, X-Ray Computed, Bony destruction
Abstract

The aim of this report was to present the first known case of coccidioidomycosis involving the temporomandibular joint, review the literature regarding dissemination to the mandible, and to provide treatment recommendations for this challenging condition.Coccidioidomycosis of the mandibular condyle was identified in a 30-year-old Somali male residing in Arizona. Due to the difficulty of surgical access and the anticipated temporomandibular joint morbidity of radical condylar debridement, primary medical management was performed.Marked symptomatic improvement was observed after 10 days of IV antifungal therapy. Resolution of the abscess with residual bony destruction was observed on CT scan. Based on the results of this patient and review of the literature, an algorithm is presented to help guide management of coccidioidomycosis dissemination to the mandible.Prolonged antifungal therapy should be attempted for initial management of a Coccidioides abscess involving the condyle with early surgical intervention reserved for the more easily accessible and less functionally compromising portions of the mandible.

Published
2016

23. Duration of ruptured membranes and vertical transmission of HIV-1: a meta-analysis from 15 prospective cohort studies

Author

Bulterys, M. B., Fowler, M. G., Hanson, I. C., Lemay, M., Mayaux, M. J., Mofenson, L., Newell, M. -L., Peavy, H., Peckham, C., Read, J. S., Rother, C., Simpson, B. J., Van Dyke, R. B., Harris, D. R., Peavy, H. H., Easley, K., Khammy, A., Nugent, R. P., Mitchell, R., Owen, W., Van Dyke, R., Widmayer, S., Bardeguez, A., Hanson, C., Wiznia, A., Luzuriaga, K., Viscarello, R., Ho, D., Koup, R., Chen, I., Krogstad, P., Mullins, J., Wolinsky, S., Korber, B., Walker, B., Ammann, A., Clapp, S., Mcdonald, D., Lapointe, N., Boucher, M., Fauvel, M., Hankins, C., Samson, J., Newell, M. L., Peckham, C. S., Thorne, C. N., Giaquinto, C., Ruga, E., De Rossi, A., Truscia, D., Grosch-Worner, I., Schafer, A., Mok, J., Johnstone, F., Jiminez, J., de Alba, C., Garcia Rodriguez, M. C., Bates, I., de Josee, I., Hawkins, F., Martinez Zapico, R., Pena, J. M., Gonzalez Garcia, J., Arribas Lopez, J. R., Asensi-Botet, F., Otero, M. C., Peerez-Tamarit, D., Moya, A., Galbis, M. 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A., Mancuso S., Villa P., Conti M., Principi N., Muggiasca M., Marchisio P., Zara C., Ravagni F., Vignali M., Rossi G., Selvaggi L., Greco P., Vimercati A., Massi G., Innocenti T., Fiscella A., Sansone M., Benedetto C., Tadrist B., Thevenieau D., Gondry J., Paulard B., Alisy C., Brault D., Tordjeman N., Mamou J., Rozan M., Colombani D., Pincemaille O., Salvetti A., Chabanier C., Hernandorena X., Leroy J., Schaal J., Balde P., Faucher P., Lachassinne E., Benoit S., Douard D., Hocke C., Barjot P., Brouard J., Delattre P., Stien L., Audibert F., Labrune P., Vial M., Mazy F., Sitbon D., Crenn-Hebert C., Floch-Tudal C., Akakpo R., Daveau C., Leblanc A., Cesbron P., Duval-Arnould M., Huraux-Rendu C., Lemerle S., Touboul C., Guerin M., Maingueneau C., Reynaud I., Rousseau T., Ercoil V., Lanza M., Denavit M., Garnier J., Lahsinat K., Pia P., Allouche C., Nardou M., Grall F., May A., Dallot M., Lhuillier P., Cecile W., Mezin R., Bech A., Lobut J., Algava G., Chalvon Dermesay A., Busuttil R., Jacquemot M., Bader-Meunier B., Fridman S., Codaccioni X., Maxingue F., Thomas D., Alain J., De Lumley L., Tabaste J., Bailly Salin P., Seaume H., Guichard A., Kebaill K., Roussouly C., Botto C., De Lanete A., Wipff P., Cravello L., De Boisse P., Leclaire M., Michel G., Crumiere C., Lefevre V., Le Lorier B., Pauly I., Robichez B., Seguy D., Delhinger M., Rideau F., Talon P., Benos P., Huret C., Nicolas J., Heller-Roussin B., Saint-Leger S., Delaporte M., Hubert C., De Sarcus B., Karoubi P., Mechinaud F., Bertcrottiere D., Bongain A., Monpoux F., De Gennes C., Devianne F., Nisand I., Rousset M., Mouchnino G., Muray J., Munzer M., Quereux C., Brossard V., Clavier B., Allemon M., Rotten D., Stephan J., Varlet M., Guyot B., Narcy P., Bardinet F., De Caunes F., Jeny R., Robin M., Raison Boulley A., Savey L., Berrebi A., Tricoire J., Borderon J., Fignon A., Guillot F., Maria B., Broyard A., Chitrit Y., Firtion G., Mandelbrot L., Lafay Pillet M., Parat S., Boissinot C., Garec N., Levine M., Ottenwalter A., Schaller F., Vilmer E., Courpotin C., Brunner C., Ciraru-Vigneron N., Hatem-Gantzer G., Fritel X., Wallet A., Bouille J., Milliez J., Bensaid Mrejen D., Dermer E., Noseda G., Bardou D., Cressaty J., Francoual C., Carlus Moncomble C., Cohen H., Blanche S., Bastion H., Benifla J., Benkhatar F., Berkane N., Hervee F., Ronzier M., Mayaux MJ., de Martino M., Tovo P.-A., Galli L., Gabiano C., Ferraris G., Garetto S., Palomba E., Riva C., Vierucci A., de Luca M., Farina S., Fundaro C., Genovese O., Mereu G., Forni G.L., Casadei A., Zuccotti G.V., Riva E., Cellini M., Baraldi C., Consolini R., Palla G., Ruggeri M., Ciccimarra F., Guarino A., Osimani P., Benaglia G., Romano A., De Mattia D., Caselli D., Boni S., Dell'Erba G., Bassanetti F., Sticca M., Timpano C., Magnani C., Salvatore C., Lipreri R., Tornaghi R., Pinzani R., Cecchi M.T., Bezzi T., Battisti L., Bresciani E., Castelli Gattinara G., Nasi C., Pellegatta A., Mazza A., Baldi F., Altobelli R., Deiana M., Colnaghi C., Tarallo L., Tondo U., Anastasio E., Chiriaco P.G., Ruggeri C., Scott G., Hutto C., O'Sullivan M., Malmsberry A., Willoughby A., Burns D., Goedert J., Landesman S., Minkoff H., Mendez H., Holman S., Rubinstein A., Durako S., Muenz L., Goodwin S., Bryson Y., Dillon M., Nielsen K., Boyer P., Liao D., Keller M., Deveikis A., Nesheim S., Lindsay M., Lee F., Nahmias A., Sawyer M., Vink P., Farley J., Alger L., Abrams E., Bamji M., Lambert G., Schoenbaum E., Thomas P., Weedon J., Palumbo P., Denny T., Oleske J., Bulterys M., Simonds R., Ethier-Ives J., Rogers M., Schluchter M., Kutner M., Kaplan S., Kattan M., Lipshultz S., Mellins R., Shearer W., Sopko G., Sloand E., Wu M., Kind C., Nadal D., Rudin C., Siegrist C.-A., Wyler C.-A., Cheseaux J.-J., Aebi C., Gnehm H., Schubiger G., Klingler J., Hunziker U., Kuchler H., Gianinazzi M., Buhlmann U., Biedermann K., Lauper U., Irion O., Brunelli A., Spoletini G., Schreyer A., Hosli I., Saurenmann E., Drack G., Isenschmid M., Poorbeik M., Schupbach J., Perrin L., Erb P., Joller H., Kovacs A., Stek A., Chan L., Khoury M., Diaz C., Pacheco-Acosta E., Tuomala R., Cooper E., Mesthene D., Pitt J., Higgins A., Moroso G., Rich K., Turpin D., Cooper N., Davenny K., Thompson B., Andiman W., and Simpson J.

Subjects
Time Factors, Epidemiology, Infectious Disease Transmission, Prevention of perinatal transmission, Extraembryonic Membranes, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Cohort Studies, Pregnancy, Risk Factors, INFECTION, Vertical, Immunology and Allergy, HIV Infection, MOTHER-TO-CHILD, Pregnancy Complications, Infectious, Prospective cohort study, prevention of perinatal transmission, vertical transmission, obstetrics/gynaecology, epidemiology, Obstetrics, Transmission (medicine), Infectious, HUMAN-IMMUNODEFICIENCY-VIRUS, MOTHER-TO-CHILD, ZIDOVUDINE PROPHYLAXIS, RISK-FACTORS, TYPE-1, PREGNANCY, INFECTION, TRIAL, PREVENTION, Breast Feeding, Infectious Diseases, Meta-analysis, HUMAN-IMMUNODEFICIENCY-VIRUS, Vertical transmission, Regression Analysis, TRIAL, Female, Delivery, Obstetrics gynaecology, Human, medicine.medical_specialty, Time Factor, Ruptured membranes, Immunology, Regression Analysi, NO, ZIDOVUDINE PROPHYLAXIS, Extraembryonic Membrane, medicine, Humans, TYPE-1, business.industry, Risk Factor, Infant, Newborn, Infant, Obstetric, Delivery, Obstetric, Newborn, PREVENTION, Infectious Disease Transmission, Vertical, Pregnancy Complications, Obstetrics/gynaecology, RISK-FACTORS, Cohort Studie, business
Abstract

Objective: To test the a priori hypothesis that longer duration of ruptured membranes is associated with increased risk of vertical transmission of HIV. Design: The relationship between duration of ruptured membranes and vertical transmission of HIV was evaluated in an individual patient data meta-analysis. Methods: Eligible studies were prospective cohort studies including at least 100 mother-child pairs, from regions where HIV-infected women are counselled not to breastfeed. Analyses were restricted to vaginal deliveries and non-elective Cesarean sections; elective Cesarean section deliveries (those performed before onset of labour and before rupture of membranes) were excluded. Results: The primary analysis included 4721 deliveries with duration of ruptured membranes ≤ 24 h. After adjusting for other factors known to be associated with vertical transmission using logistic regression analysis to assess the strength of the relationship, the risk of vertical HIV transmission increased approximately 2% with an increase of 1 h in the duration of ruptured membranes [adjusted odds ratio, 1.02; 95% confidence interval, 1.01-1.04; for each 1 h increment]. There were no significant interactions of duration of ruptured membranes with study cohort or with any of the covariates, except maternal AIDS. Among women diagnosed with AIDS, the estimated probability of transmission increased from 8% to 31% with duration of ruptured membranes of 2 h and 24 h respectively (P < 0.01). Conclusions: These results support the importance of duration of ruptured membranes as a risk factor for vertical transmission of HIV and suggest that a diagnosis of AIDS in the mother at the time of delivery may potentiate the effect of duration of ruptured membranes. © 2001 Lippincott Williams & Wilkins.

Published
2001
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24. Lower Branches of the Facial Nerve

Author

Salvatore C. Lettieri

Subjects
Facial Nerve Injuries, business.industry, Facial rejuvenation, Dissection, Mandibular Nerve, Anatomy, Facial nerve, Facial Nerve, stomatognathic diseases, Cadaver, Rhytidoplasty, Humans, Medicine, Surgery, Cadaveric spasm, business
Abstract

Various aesthetic procedures have been developed over the past several decades for facial rejuvenation. One of the parallel goals is protection of vital structures such as the facial nerve. In this study, 10 cadaveric hemifacial dissections were performed, and the course of the lower portion of the facial nerve was studied with specific attention addressed toward the three-dimensional location of the nerve as it relates to the usual superficial tissue planes that are dissected during the course of an open facial rejuvenation procedure. The locations of the nerve as it runs within the different planes in addition to some suggestions to avoid injury to the lower branches of the facial nerve are discussed.

Published
2012
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25. Colostomy-Sparing Fecal Diversion in a Child After Extensive Perianal Trauma

Author

Kevin N Foster, Patrick J. O'Neill, Daniel M. Caruso, Salvatore C. Lettieri, Tammy R. Kopelman, Nathaniel E. Uecker, and Marc R. Matthews

Subjects
Male, Reoperation, medicine.medical_specialty, Adolescent, medicine.medical_treatment, MEDLINE, Critical Care and Intensive Care Medicine, Fractures, Bone, Colostomy, Humans, Surgical Wound Infection, Medicine, Therapeutic Irrigation, Digestive System Surgical Procedures, Wound Healing, Debridement, Multiple Trauma, business.industry, Accidents, Traffic, Off-Label Use, Surgery, Thigh, Bone surgery, Back Injuries, Buttocks, business
Published
2010
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26. Proposed Classification for the Transbasal Approach and Its Modifications

Author

Edward F. Joganic, Iman Feiz-Erfan, Robert F. Spetzler, Franco DeMonte, Stephen P. Beals, Randall W. Porter, Eric M. Horn, and Salvatore C. Lettieri

Subjects
business.industry, Medicine, Original Article, Classification scheme, Neurology (clinical), Data mining, Craniofacial, computer.software_genre, business, computer
Abstract

The transbasal approach offers extradural exposure of the anterior midline skull base transcranially. It can be used to treat a variety of conditions, including trauma, craniofacial deformity, and tumors. This approach has been modified to enhance basal access. This article reviews the principle differences among modifications to the transbasal approach and introduces a new classification scheme. The rationale is to offer a uniform nomenclature to facilitate discussion of these approaches, their indications, and related issues.

Published
2008
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28. Management of Enterocutaneous Fistulas Using Negative-Pressure Dressings

Author

L. Scott Levin, Laura A. Gunn, Keith E. Follmar, Salvatore C. Lettieri, Michael S. Wong, and Detlev Erdmann

Subjects
Adult, Male, Enterocutaneous fistula, medicine.medical_specialty, Vacuum, Fistula, Closure rate, Intestinal mucosa, Intestinal Fistula, Pressure, medicine, Humans, Surgical treatment, Digestive System Surgical Procedures, Aged, Aged, 80 and over, business.industry, Negative-Pressure Dressings, Middle Aged, medicine.disease, Bandages, Abdominal wound, Surgery, Plastic surgery, Multivariate Analysis, Female, business
Abstract

Fifteen patients with enterocutaneous fistulas (ECFs) not amenable to surgical treatment were treated with negative-pressure dressings over the abdominal wound and ECF. Closure of the ECF and time to closure were examined. In 11 patients who had no visible intestinal mucosa on examination, the closure rate was 100%, with a mean time to closure of 14 days. In 4 patients who did have grossly visible intestinal mucosa, no closure occurred. This represents an overall closure rate of 73%. Fistula output rate did not have a significant effect on outcome. These results confirm the efficacy of negative-pressure dressings in the closure of ECFs. Presence or absence of visible intestinal mucosa is the single most important clinical factor when considering the use of a negative-pressure dressing in the management of a patient with ECF.

Published
2006
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29. The radical transbasal approach for resection of anterior and midline skull base lesions

Author

Edward F. Joganic, Mauro A. T. Ferreira, Jeffrey D. Klopfenstein, Iman Feiz-Erfan, Robert F. Spetzler, Patrick P. Han, Eric M. Horn, Salvatore C. Lettieri, Stephen P. Beals, and Randall W. Porter

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Osteotomy, Skull Base Neoplasms, Neurosurgical Procedures, Resection, Lesion, Postoperative Complications, medicine, Humans, Craniofacial, Child, Craniotomy, Craniofacial surgery, Aged, Retrospective Studies, Skull Base, business.industry, Middle Aged, Surgery, Skull, Treatment Outcome, medicine.anatomical_structure, Scalp, Female, Nasal Cavity, medicine.symptom, business, Orbit
Abstract

Craniofacial surgery can be performed to treat midline and anterior skull base lesions by creating a bicoronal scalp incision without the need for an additional transfacial procedure. Originally described as the transbasal approach, several modifications for further exposure of the skull base have been described. The authors present data on the application and outcomes of a modified transbasal approach. The radical transbasal approach consists of a bifrontal craniotomy and a frontoorbitonasal osteotomy.Between 1992 and 2002, 41 patients (28 male and 13 female patients with a mean age of 38.3 years [range 7-77 years]) underwent 44 radical transbasal procedures. Twenty-three malignant and 18 benign lesions involving the midline skull base were treated. These cases were reviewed retrospectively. Gross-total resection of 30 lesions was achieved. Seven lesions were resected subtotally and six partially; one lesion was debulked. Complications occurred in 26 (59.1%) of the 44 operations and mostly consisted of cerebrospinal fluid leakage. The surgery-related mortality rate was 6.8% (three patients). Based on their pre- and postoperative Karnofsky Performance Scale scores, 86.4% of patients improved or remained the same.The radical transbasal approach increases the midline craniofacial corridor by allowing the globes to be safely retracted laterally. It also enhances exposure of the maxillary sinus from above. The morbidity and mortality rates associated with this procedure are high but consistent with the known rates for craniofacial surgery. This approach is best suited for the treatment of anterior skull base tumors that extend into the nasal cavity, orbit, ethmoid sinus, nasopharynx, and upper clivus. The approach may allow resection of tumors involving the maxillary sinus area without the need for an additional transfacial approach.

Published
2005
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30. Trans-vastus Intermedius Transfer of the Pedicled Anterolateral Thigh Flap for Posterior Thigh Reconstruction

Author

Niles J. Batdorf, Michel Saint-Cyr, and Salvatore C. Lettieri

Subjects
medicine.medical_specialty, Groin, business.industry, lcsh:Surgery, Anatomy, Free flap, Pedicled Flap, lcsh:RD1-811, Case Reports, Posterior compartment of thigh, Thigh, Lateral circumflex femoral artery, Surgery, body regions, medicine.anatomical_structure, medicine.artery, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Medicine, Femur, business, Anterior compartment of thigh
Abstract

Supplemental Digital Content is available in the text., Summary: Proximal, posterior thigh wounds from oncologic or traumatic defects can be difficult wounds to reconstruct if local flap options have been sacrificed during the trauma or oncologic resection. Free flap options to cover these defects are also difficult because of the lack of convenient recipient vessels in the region. The authors present 2 cases (oncologic and traumatic) wherein a myocutaneous anterolateral thigh (ALT) flap was harvested and tunneled from the anterior muscle compartment to the posterior muscle compartment of the thigh through a medially based transmuscular tunnel, decreasing the required pedicle distance to the wound. This technique of transmuscular tunneling of the ALT flap expands the indications and utility of the ALT flap to cover posterior thigh wounds.

Published
2014

31. The Mode of Delivery and the Risk of Vertical Transmission of Human Immunodeficiency Virus Type 1 — A Meta-Analysis of 15 Prospective Cohort Studies

Author

Andiman, W., Boucher, M., Burns, D., Bryson, Y., Farley, J., Fowler, H., Gabiano, C., Galli, L., Hutto, C., Kind, C., Korber, B., Kovacs, A., Krogstad, P., Landesman, S., Lapointe, N., Lemay, M., Lew, J., Mandelbrot, L., Mayaux, Mj, Mellins, R., Minkoff, H., Mofenson, L., Nielsen, K., Newell, Ml, Pardi, G., Peavy, H., Peckham, C., Read, J., Rother, C., Rudin, C., Scott, G., Semprini, A., Shearer, W., Simonds, R., Simpson, B., Stek, A., Tovo, Pa, Tuomala, R., Dyke, R., Weedon, J., Martino, M., Lindsay, M., Belair, S., Chan, L., Harris, D., Kalish, L., Muenz, L., Nugent, R., Schluchter, M., Durako, S., Goodwin, S., Mitchell, R., Nourjah, P., Owen, W., Widmayer, S., Bardeguez, A., Hanson, C., Wiznia, A., Luzuriaga, K., Viscarello, R., Ho, D., Koup, R., Chen, I., Mullins, J., Wolinsky, S., Walker, B., Ammann, A., Clapp, S., Mcdonald, D., Fauvel, M., Hankins, C., Samson, J., Bailey, A., Giaquinto, C., Ruga, E., Rossi, A., Truscia, D., Grosch-Worner, I., Schafer, A., Mok, J., Johnstone, F., Jiminez, J., Alba, C., Garcia-Rodriguez, M., Bates, I., Jose, I., Hawkins, F., Zapico, Rm, Asensi-Botet, F., Otero, M., Perez-Tamarit, D., Moya, A., Galbis, M., Scherpbier, H., Boer, K., Bohlin, A., Lindgren, S., Ehrnst, A., Anzen, B., Belfrage, E., Levy, J., Alimenti, A., Barlow, P., Ferrazin, A., Maria, A., Gotta, C., Maritati, V., Mur, A., Rovira, M., Paya, A., Coll, O., Fortuny, C., Boguna, J., Caro, Mc, Canet, Y., Ravizza, M., Castagna, C., Fiore, S., Guerra, B., Lanari, M., Bianchi, S., Bovicelli, L., Prati, E., Duse, M., Soresina, A., Scaravelli, G., Santis, M., Muggiasca, M., Vigano, A., Marchisio, P., Iasci, A., Spinillo, A., Bucceri, A., Grossi, E., Rancilio, L., Della Torre, M., Dallacasa, P., Pachi, A., Principi, N., Zara, C., Vignali, M., Rossi, G., Selvaggi, L., Greco, P., Vimercati, A., Massi, G., Innocenti, T., Fiscella, A., Sansone, M., Benedetto, C., Tibaldi, C., Ziarati, N., Tadrist, B., Thevenicau, D., Gondry, J., Paulard, B., Alisy, C., Brault, D., Tordjeman, P., Mamou, J., Rozan, M., Colombani, D., Pincemaille, O., Salvetti, A., Chabanier, C., Hernandorena, X., Leroy, J., Schaal, J., Balde, P., Faucher, P., Lachassinne, E., Benoit, S., Douard, D., Hocke, C., Barjot, P., Brouard, J., Delattre, P., Stien, L., Audibert, F., Labrune, P., Vial, M., Mazy, F., Sitbon, D., Crenn-Hebert, C., Floch-Tudal, C., Akakpo, R., Daveau, C., Leblanc, A., Cesbron, P., Duval-Arnould, H., Huraux-Rendu, C., Lemerle, S., Touboul, C., Guerin, M., Maingueneau, C., Reynaud, I., Rousseau, T., Ercoil, V., Lanza, M., Denavit, M., Garnier, J., Lahsinat, K., Pia, R., Allouche, C., Nardou, M., Grall, F., May, A., Dallot, M., Lhuillier, P., Cecile, W., Mezin, R., Bech, A., Lobut, J., Algava, G., Dermesay, Ac, Busuttil, R., Jacquemot, M., Bader-Meunier, B., Fridman, S., Codaccioni, X., Maxingue, F., Thomas, D., Alain, J., Lumley, L., Tabaste, J., Salin, Pb, Seaume, H., Guichard, A., Kebaili, K., Roussouly, C., Botto, C., Lanete, A., Wipff, P., Cravello, L., Boisse, P., Leclaire, M., Michel, G., Crumiere, C., Lefevre, V., Le Lorier, B., Pauly, I., Robichez, B., Seguy, D., Dehlinger, M., Rideau, F., Talon, P., Benos, P., Huret, C., Nicolas, J., Heller-Roussin, B., Saint-Leger, S., Delaporte, M., Hubert, C., Sarcus, B., Karoubi, P., Mechinaud, F., Bertcrottiere, D., Bongain, A., Monpoux, F., Gennes, C., Devianne, F., Nisand, I., Rousset, M., Mouchnino, G., Muray, J., Munzer, M., Quereux, C., Brossard, V., Clavier, B., Allemon, M., Rotten, D., Stephan, J., Varlet, M., Guyot, B., Narey, P., Bardinet, F., Caunes, F., Jeny, R., Robin, M., Bouley, Ar, Savey, L., Berrebi, A., Tricoire, J., Borderon, J., Fignon, A., Guillot, F., Maria, B., Broyard, A., Chitrit, Y., Firtion, G., Pillet, Ml, Parat, S., Boissinot, C., Garec, N., Levine, M., Ottenwalter, A., Schaller, F., Vilmer, B., Courpotin, C., Brunner, C., Ciraru-Vigneron, N., Hatem-Gantzer, G., Xavier FRITEL, Wallet, A., Bouille, J., Milliez, J., Mrejen, Db, Dermer, E., Noseda, G., Bardou, D., Cressaty, J., Francoual, C., Moncomble, Cc, Cohen, H., Blanche, S., Bastion, H., Benifla, J., Benkhatar, F., Berkane, N., Herve, F., Ronzier, M., Ferraris, G., Rancillo, L., Tulisso, S., Scolfaro, C., Riva, C., Vierucci, A., Luca, M., Farina, S., Fundaro, C., Genovese, O., Mercu, G., Forni, G., Stegagno, M., Falconieri, P., Zuccotti, G., Riva, E., Cellini, M., Baraldi, C., Consolini, R., Palla, G., Ruggeri, M., Pignata, C., Guarino, A., Osimani, P., Metri, A., Antonellini, A., Benaglia, G., Romano, A., Mattia, D., Caselli, D., Boni, S., Erba, G., Bassanetti, F., Sticca, M., Timpano, C., Magnani, C., Salvatore, C., Gambaretto, G., Lipreri, R., Tornaghi, R., Pinzani, R., Cecchi, M., Bezzi, T., Battisti, L., Bresciani, E., Gattinara, G., Berrino, R., Pellegatta, A., Mazza, A., Baldi, F., Micheletti, E., Altobelli, R., Deiana, M., Colnaghi, C., Tarallo, L., Tondo, U., Anastasio, E., Chiriaco, P., Contardi, I., Ruggeri, C., Ibba, P., O Sullivan, M., Malmsberry, A., Willoughby, A., Goedert, J., Mendez, H., Holman, S., Rubinstein, A., Nesheim, S., Clark, S., Lee, F., Nahmias, A., Sawyer, M., Vink, P., Alger, L., Abrams, E., Bamji, M., Lambert, G., Schoenbaum, E., Thea, D., Thomas, P., Palumbo, P., Denny, T., Oleske, J., Orloff, S., Ethier-Ives, J., Rogers, M., Kutner, M., Kaplan, S., Kattan, M., Lipshultz, S., Sopko, G., Sloand, E., Wu, M., Nadal, D., Siegrist, Ca, Wyler, Ca, Cheseaux, Jj, Aebi, C., Gnehm, H., Schubiger, G., Klingler, J., Hunziker, U., Kuchler, H., Gianinazzi, M., Buhlmann, U., Biedermann, K., Lauper, U., Irion, O., Brunelli, A., Spoletini, G., Schreyer, A., Hosli, I., Saurenmann, E., Drack, G., Isenschmid, M., Poorbeik, M., Schupbach, J., Perrin, L., Erb, P., Joller, H., Dillon, M., Nielsen, R., Boyer, P., Liao, D., Keller, M., Deveikis, A., Khoury, M., Diaz, C., Pacheco-Acosta, E., Cooper, E., Mesthene, D., Pitt, J., Higgins, A., Moroso, G., Rich, K., Turpin, D., Cooper, N., Fowler, M., Smeriglio, V., Mckinlay, S., and Ellis, S.

Subjects
Male, medicine.medical_specialty, Multivariate analysis, Anti-HIV Agents, Birth weight, HIV Infections, Cohort Studies, Pregnancy, Risk Factors, medicine, Birth Weight, Humans, Rupture of membranes, Pregnancy Complications, Infectious, Prospective cohort study, Cesarean Section, Obstetrics, business.industry, Infant, Newborn, General Medicine, Odds ratio, Delivery, Obstetric, medicine.disease, Infectious Disease Transmission, Vertical, Confidence interval, Logistic Models, Multivariate Analysis, Immunology, HIV-1, Female, business, Zidovudine, Cohort study
Abstract

Background To evaluate the relation between elective cesarean section and vertical transmission of human immunodeficiency virus type 1 (HIV-1), we performed a meta-analysis using data on individual patients from 15 prospective cohort studies. Methods North American and European studies of at least 100 mother-child pairs were included in the meta-analysis. Uniform definitions of modes of delivery were used. Elective cesarean sections were defined as those performed before onset of labor and rupture of membranes. Multivariate logistic-regression analysis was used to adjust for other factors known to be associated with vertical transmission. Results The primary analysis included data on 8533 mother-child pairs. After adjustment for receipt of antiretroviral therapy, maternal stage of disease, and infant birth weight, the likelihood of vertical transmission of HIV-1 was decreased by approximately 50 percent with elective cesarean section, as compared with other modes of delivery (adjusted odds ratio, 0.43; 95 percent confidence interval, 0.33 to 0.56). The results were similar when the study population was limited to those with rupture of membranes shortly before delivery. The likelihood of transmission was reduced by approximately 87 percent with both elective cesarean section and receipt of antiretroviral therapy during the prenatal, intrapartum, and neonatal periods, as compared with other modes of delivery and the absence of therapy (adjusted odds ratio, 0.13; 95 percent confidence interval, 0.09 to 0.19). Among mother-child pairs receiving antiretroviral therapy during the prenatal, intrapartum, and neonatal periods, rates of vertical transmission were 2.0 percent among the 196 mothers who underwent elective cesarean section and 7.3 percent among the 1255 mothers with other modes of delivery. Conclusions The results of this meta-analysis suggest that elective cesarean section reduces the risk of transmission of HIV-1 from mother to child independently of the effects of treatment with zidovudine.

Published
1999
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32. Circulating Iodide Concentrations during and after Pregnancy1

Author

Charles H. Emerson, Claudio Liberman, Lewis E. Braverman, Salvatore C. Pino, and Shih Lieh Fang

Subjects
chemistry.chemical_classification, medicine.medical_specialty, Pregnancy, business.industry, Endocrinology, Diabetes and Metabolism, Urinary system, fungi, Biochemistry (medical), Clinical Biochemistry, Thyroid, Iodide, Urine, medicine.disease, Third trimester, Biochemistry, Endocrinology, medicine.anatomical_structure, chemistry, Internal medicine, Blood plasma, medicine, Gestation, business
Abstract

Early, indirect studies suggested that an important aspect of thyroid economy during pregnancy was a decline in plasma or serum inorganic iodide (PII) concentrations, but there is little information concerning circulating iodide concentrations as assessed by direct measurement. The present study was undertaken to determine the relationship between gestation and serum iodide concentrations as assessed by direct measurement of PII. PII concentrations, urinary iodide levels, and other parameters of thyroid economy were measured during the first, second, and third trimesters and after delivery in 16 women. Mean serum T4 concentrations were significantly higher in all 3 trimesters than those after delivery. Serum free T4 index concentrations were significantly higher in the first trimester than during later periods of gestation or after delivery, but serum TSH concentrations were not depressed in the first trimester. Serum thyroglobulin concentrations were similar during pregnancy and after delivery. There was wide variability in PII and urinary iodide concentrations during and after pregnancy, but there was no trend for PII concentrations to be depressed during pregnancy. Pregnancy, at least in iodine-sufficient regions, does not have an important influence on circulating concentrations of iodide.

Published
1998
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33. N-3 fatty acids in patients with multiple cardiovascular risk factors

Author

Roncaglioni, Maria Carla, Avanzini, Fausto, Barlera, Simona, Marzona, Irene, Milani, Valentina, Tombesi, Massimo, Caimi, Vittorio, Longoni, Paolo, Silletta, Maria Giuseppina, Tognoni, Gianni, Marchioli, Avanzini F, Roberto., Caimi, V, Longoni, P, Marchioli, R, Roncaglioni, Mc, Silletta, Mg, Tognoni, G, Tombesi, M, Barlera, S, Milani, V, Nicolis, Eb, Casola, C, Marzona, I, Massa, E, Marrocco, W, Micalella, M, Avanzini, F, Franzosi, Mg, Geraci, E, Giansiracusa, N, Rocchetti, L, Decarli, A, Satolli, R, Alli, C, Beghi, E, Bertele', V, Volpi, A, Baviera, M, Monesi, L, Pangrazzi, I, Nicolis, E, Clerici, F, Palumbo, A, Sgaroni, G, Pioggiarella, R, Scarano, M, Marfisi, Rm, Flamminio, A, Macino, L, Ferri, B, Pera, C, Polidoro, A, Abbatino, D, Acquati, M, Addorisio, G, Adinolfi, D, Adreani, L, Agistri, Mr, Agneta, A, Agnolio, Ml, Agostini, N, Agostino, G, Airò, A, Alaimo, N, Albano, M, Albano, N, Alecci, G, Alemanno, S, Alexanian, A, Alfarano, M, Alfè, L, Alonzo, N, Alvino, S, Ancora, A, Andiloro, S, Andreatta, E, Angeli, S, Angiari, F, Angilletti, V, Annicchiarico, C, Anzivino, M, Aprea, R, Aprile, A, Aprile, E, Aprile, I, Aprile, L, Armellani, V, Arnetoli, M, Aronica, A, Autiero, V, Bacca, G, Baccalaro, Am, Bacci, M, Baglio, G, Bagnani, M, Baiano, A, Baldari, A, Ballarini, L, Banchi, G, Bandera, R, Bandini, F, Baratella, M, Barbieri, A, Barbieri Vita, A, Bardi, M, Barlocchi, M, Baron, P, Bartoli, M, Basile, A, Basile, F, Basile, S, Battaggia, A, Battaglia, A, Baù, A, Beconcini, G, Beggio, R, Belfiore, Pa, Belicchi, M, Bellamoli, S, Bellini, C, Bellomo, M, Benetollo, C, Benetti, R, Beretta, E, Bertalero, P, Bertaso, Fg, Bertolani, U, Bettelli, G, Biagiotti, G, Bianchi, S, Bianco, G, Biccari, F, Bigioli, F, Bindi, M, Bisanti, G, Bitetti, Em, Blasetti, Mp, Blesi, F, Boato, V, Boga, S, Boidi, E, Boldrin, G, Bollati, A, Bolzan, L, Bolzonella, S, Bonardi, P, Bonato, Gb, Bonci, M, Bonfitto, G, Bonincontro, E, Boninsegna, F, Bonissone, D, Bono, L, Bonollo, E, Borghi, M, Borioli, N, Borsatto, M, Bosco, T, Bosisio Pioltelli, M, Botarelli, C, Botassis, S, Bottini, F, Bottos, C, Bova, G, Bova, V, Bozzani, A, Bozzetto, Rm, Braga, Vt, Braglia, M, Bramati, E, Brazzoli, C, Breglia, G, Brescia, A, Briganti, D, Brigato, G, Brocchi, A, Brosio, Fa, Bruni, E, Buscaglia, E, Bussini, Md, Bussotti, A, Buzzaccarini, F, Buzzatti, A, Caccamo, G, Cacciavillani, C, Caggiano, G, Calciano, Fp, Calderisi, M, Calienno, S, Caltagirone, P, Calzolari, I, Cammisa, M, Campanaro, M, Campanella, Gb, Campese, F, Canali, G, Candiani, De, Canepa, R, Canini, D, Canino, A, Cantoro, Ea, Capilupi, V, Capotosto, P, Cappelli, B, Capraro, G, Carafa, Fa, Carano, Q, Carcaterra, V, Carriero, D, Carrozzo, G, Cartanese, M, Casalena, M, Casarola, M, Caso, C, Casotto, M, Castaldi, F, Castegnaro, R, Castellani, G, Castri, S, Catalano, E, Catinello, N, Caturano, G, Cavallaro, R, Cavallo, Am, Cavallo, G, Cavion, Mt, Cavirani, G, Cazzaniga, F, Cazzetta, D, Cecconi, V, Cefalo, A, Celebrano, M, Celora, A, Centonze, P, Cerati, D, Cesaretti, D, Checchia, G, Checchin, A, Cherubini, M, Chianese, L, Chiappa, A, Chiappa, Mv, Chiariello, G, Chiavini, G, Chicco, M, Chiumeo, F, Ciacciarelli, A, Ciaci, D, Ciancaglini, R, Cicale, C, Cicale, S, Cipolla, A, Ciruolo, A, Citeri, Al, Citterio, G, Clerici, M, Coazzoli, E, Collecchia, G, Colletta, F, Colombo, I, Colorio, P, Coluccia, S, Comerio, M, Comoretto, P, Compagni, M, Conte, O, Contri, S, Contrisciani, A, Coppetti, T, Corasaniti, F, Corradi, Mt, Corsano, A, Corsini, A, Corti, N, Costantini, G, Costantino, A, Cotroneo, S, Cozzi, D, Cravello, Mg, Cristiano, E, Cucchi, R, Cusmai, L, D' Errico GB, D'Agostino, P, Dal Bianco, L, Dal Mutto, U, Dal Pozzo, G, Dallapiccola, P, Dallatorre, G, Dalle Molle, G, Dalloni, E, D'Aloiso, A, D'Amicis, G, Danese, R, Danieli, D, Danisi, G, D'Anna, Ma, Danti, G, D'Ascanio, S, Davidde, G, De Angeli, D, De Bastiani, R, De Battisti, A, De Bellis, A, De Berardinis, G, De Carlo, F, De Giorgi, D, De Gobbi, R, De Lorenzis, E, De Luca, P, De Martini, G, De Marzi, M, De Matteis, D, De Padova, S, De Polo, P, De Sabato, N, De Stefano, T, De Vita MT, De Vita, U, De Zolt, V, Debernardi, F, Del Carlo, A, Del Re, G, Del Zotti, F, D'Elia, R, Della Giovanna, P, Dell'Acqua, L, Dell'Orco, Rl, Demaria, G, Di Benedetto MG, Di Chiara, G, Di Corcia, V, Di Domizio, O, Di Donato, P, Di Donato, S, Di Fermo, G, Di Franco, M, Di Giovannantonio, G, Di Lascio, G, Di Lecce, G, Di Lorenzo, N, Di Maro, T, Di Mattia, Q, Di Michele, E, Di Modica RS, Di Murro, D, Di Noi MC, Di Paoli, V, Di Santi, M, Di Sanzo, A, Di Turi, C, Diazzi, A, Dileo, I, D'Ingianna, Ap, Dolci, A, Donà, G, Donato, C, Donato, P, Donini, A, Donna, Me, Donvito, Tv, Esposito, L, Esposito, N, Evangelista, M, Faita, G, Falco, M, Falcone, Da, Falorni, F, Fanciullacci, A, Fanton, L, Fasolo, L, Fassina, R, Fassone, A, Fatarella, P, Fedele, F, Fera, I, Fera, L, Ferioli, S, Ferlini, Mg, Ferlino, R, Ferrante, G, Ferrara, Fn, Ferrarese, Mf, Ferrari, G, Ferrari, O, Ferreri, A, Ferroni, M, Fezzi, G, Figaroli, C, Fina, Mg, Fioretta, A, Fiorucci, C, Firrincieli, R, Fischetti, M, Fischietti, G, Fiume, Dc, Flecchia, G, Forastiere, G, Fossati, B, Franceschi, Pl, Franchi, L, Franzoso, F, Frapporti, G, Frasca, G, Frisotti, A, Fumagalli, G, Fusco, D, Gabriele, P, Gabrieli, A, Gagliano, D, Galimberti, G, Galli, A, Gallicchio, N, Gallio, F, Gallipoli, T, Gallo, P, Galopin, T, Gambarelli, L, Garbin, A, Garozzo, Gm, Gasparri, R, Gastaldo, M, Gatti, E, Gazzaniga, P, Gennachi, N, Gentile, Rv, Germani, P, Gesualdi, F, Gherardi, E, Ghezzi, C, Ghidini, Mg, Ghionda, F, Giacci, L, Gialdini, D, Giampaolo, C, Giancane, R, Giannanti, A, Giannese, S, Giannini, L, Giaretta, M, Giaretta, R, Giavardi, L, Giordano, P, Giordano, E, Giordano, B, Gioria, Gm, Giugliano, R, Grassi, Ea, Greco, A, Greco, L, Grilletti, N, Grimaldi, N, Grisetti, G, Groppelli, G, Gualtieri, L, Guarducci, M, Guastella, G, Guerra, M, Guerrini, F, Guglielmini, A, Guido, A, Gulotta, P, Iacono, E, Iadarola, G, Ianiro, G, Iarussi, V, Ieluzzi, Ml, Ierardi, C, Ingaldi, F, Interlandi, S, Iocca, M, Iorno, A, Ioverno, E, Iurato, R, La Pace, L, La Piscopia, C, La Selva, R, Lafratta, M, Lamparelli, M, Lanaro, G, Lancerotto, R, Larcher, M, Lassandro, M, Lattuada, G, Laurino, P, Lefons, C, Legrottaglie, F, Lemma, A, Leone, D, Leone, F, Leso, A, Leuzzi, G, Levato, G, Libardi, L, Libralesso, N, Licini, Pi, Licursi, G, Lidonnici, F, Lillo, C, Liveri, L, Livio, A, Loiero, Ra, Loison, M, Lombardo, G, Lombardo, T, Lomunno, V, Lomuscio, S, Lonedo, A, Longo, E, Lora, L, Lotterio, A, Lucatello, L, Luongo, A, Lupoli, M, Macchia, C, Macri, G, Mafessanti, M, Maggialetti, V, Maggioni, A, Magnani, M, Maiellaro, G, Mancuso, A, Maniglio, Ar, Mannari, Gl, Manni, A, Manocchio, B, Mao, M, Maranò, A, Maraone, E, Marascio, D, Marcheselli, P, Marchetto, B, Marchetto, S, Marchi, A, Marchi, Gl, Mariano, C, Marinacci, S, Marinelli, S, Marini, G, Marra, Vc, Marrali, F, Marseglia, C, Martello, G, Martino, C, Martino, G, Martino, M, Marulli, Cf, Maruzzi, G, Marzotti, A, Mascheroni, G, Mascolo, P, Masoch, G, Masone, R, Massa, L, Massafra, M, Massi, M, Massignani, Dm, Matarese, Am, Matini, G, Mauro, R, Mazzi, M, Mazzillo, A, Mazzocato, E, Mazzoleni, Ns, Mazzone, A, Melacci, A, Mele, E, Meliota, P, Menaspà, S, Meneghello, F, Merola, G, Merone, L, Metrucci, A, Mezzina, V, Micchi, A, Michielon, A, Migliore, N, Minero, G, Minotta, F, Mirandola, C, Mistrorigo, S, Modafferi, L, Moitre, R, Mola, E, Monachese, C, Mongiardini, C, Montagna, F, Montani, M, Montemurno, I, Montolli, R, Montorsi, S, Montresor, M, Monzani, Mg, Morabito, F, Mori, G, Moro, A, Mosca, Mf, Motti, F, Muddolon, L, Mugnai, M, Muscas, F, Naimoli, F, Nanci, G, Nargi, E, Nasorri, R, Nastrini, G, Negossi, M, Negrini, A, Negroni, A, Neola, V, Niccolini, F, Niro, Cm, Nosengo, C, Novella, G, Nuti, C, Obici, F, Olita, C, Oliverio, Ss, Olivieri, I, Oriente, S, Orlando, G, Paci, C, Pagano, G, Pagliara, C, Paita, G, Paladini, G, Paladino, G, Palano, T, Palatella, A, Palermo, P, Palmisano, M, Pando, P, Panessa, P, Panigo, F, Panozzo, G, Panvini, F, Panzieri, F, Panzino, A, Panzitta, F, Paoli, N, Papagna, R, Papaleo, Mg, Papalia, G, Parisi, R, Parotti, N, Parravicini, D, Passarella, P, Pastore, Ga, Patafio, M, Pavone, P, Pedroli, W, Pedroni, M, Pelligra, G, Pellizzari, M, Penati, A, Perlot, M, Perrone, A, Perrone, G, Peruzzi, P, Peselli, C, Petracchini, L, Petrera, L, Petrone, S, Peverelli, C, Pianorsi, F, Piazza, Gp, Piazzolla, G, Picci, A, Pienabarca, G, Pietronigro, Tp, Pignocchino, P, Pilone, R, Pinto, D, Pirovano, E, Pirrotta, D, Pisante, V, Pitotto, P, Pittari, L, Piva, A, Pizzoglio, A, Plantera, Or, Plebani, W, Plessi, S, Podrecca, D, Poerio, V, Poggiani, F, Pogliani, W, Poli, L, Poloni, Fg, Porcelli, R, Porto, S, Pranzo, L, Prevedello, C, Profeta, C, Profico, D, Punzi, A, Quaglia, Gm, Racano, M, Raccone, A, Radice, F, Raho, Ca, Raimondi, R, Rainò, M, Ramponi, R, Ramunni, A, Ramunni, Al, Ravasio, F, Ravera, M, Re Sartò, G, Rebustello, G, Regazzoli, S, Restelli, C, Rezzonico, M, Ricchiuto, F, Rigo, S, Rigon, G, Rigon, R, Rinaldi, Ov, Rinaldi, M, Risplendente, Pg, Rispoli, M, Riundi, R, Riva, Mg, Rizzi, Al, Rizzi, D, Rizzo, Ld, Rocchi, L, Rondinone, B, Rosa, B, Rosati, F, Roselli, F, Rossetti, A, Rossetti, C, Rossi, R, Rossi, Pr, Rossi, A, Rossi, Cl, Rossitto, A, Ruffini, R, Ruffo, A, Ruggio, S, Ruo, M, Russo, B, Russo, L, Russo, R, Russo, S, Russo, U, Russo, V, Ruta, G, Sacchi, F, Sacco Botto, F, Saia, A, Salladini, G, Salmoiraghi, S, Saluzzo, F, Salvatore, C, Salvatori, E, Salvio, G, Sandri, P, Sandrini, T, Sangermano, V, Santoni, N, Saracino, Ad, Saracino, A, Sarasin, P, Sardo Infirri, C, Sarrì, B, Sartori, G, Sartori, N, Sauro, C, Scaglioni, M, Scalfi, C, Scamardella, Am, Scandale, G, Scandone, L, Scannavini, G, Scarati, R, Scardi, A, Scarpa, Fm, Scazzi, P, Schifone, A, Schirosa, G, Scigliano, G, Scilla, A, Sciortino, M, Scolaro, G, Scollo, E, Scorretti, G, Sellitti, R, Selmo, A, Selvaggio, G, Sempio, A, Seren, F, Serio, L, Serra, C, Serra, L, Siciliano, D, Sideri, A, Sighele, M, Signore, R, Siliberto, F, Silvestro, M, Simioni, G, Simmini, G, Simonato, L, Sinchetto, F, Sizzano, E, Smajato, G, Smaldone, M, Sola, G, Sordillo, L, Sovran, Cs, Spagnul, P, Spanò, F, Sproviero, S, Squintani, A, Stella, L, Stilo, V, Stocchiero, B, Stornello, Mc, Stracka, G, Strada, S, Stranieri, G, Stucci, N, Stufano, N, Suppa, A, Susca, Vg, Sutti, M, Taddei, M, Tagliabue, E, Tagliente, G, Talato, F, Talerico, P, Talia, R, Taranto, R, Tartaglia, M, Tauro, N, Tedesco, A, Tieri, P, Tirelli, M, Tocci, L, Todesco, P, Tognolo, M, Tomba, A, Tonello, P, Tonon, R, Toscano, L, Tosi, A, Tosi, G, Toso, S, Travaglio, P, Tremul, L, Tresso, C, Triacchini, P, Triggiano, L, Trigilio, A, Trimeloni, J, Tripicchio, G, Tritto, Gs, Trono, F, Trotta, E, Trotta, G, Tubertini, A, Turri, C, Turri, L, Tuttolani, Mp, Urago, M, Ursini, G, Valcanover, F, Valente, L, Valenti, M, Valentini, F, Vallone, G, Valz, P, Valzano, L, Vanin, V, Vatteroni, M, Vegetti, L, Vendrame, D, Veramonti, I, Veronelli, G, Vesco, A, Vicariotto, G, Vignale, G, Villa, Pl, Vinciguerra, R, Visco, A, Visentin, G, Visonà, E, Vitali, E, Vitali, S, Vitti, F, Volpone, Da, Zambon, N, Zammarrelli, A, Zanaboni, A, Zane, D, Zanetti, B, Zanibellato, R, Zappetti, M, Zappone, P, Zerilli, G, Zirino, V, Zoccali, R, Zuin, F, Altomonte, M, Anelli, N, Angiò, F, Annale, P, Antonacci, S, Anzilotta, R, Bano, F, Basadonna, O, Beduschi, L, Becagli, P, Bellotti, G, Blotta, C, Bruno, G, Cappuccini, A, Caramatti, S, Cariolato, Mp, Castellana, M, Castellani, L, Catania, R, Chielli, A, Chinellato, A, Ciaccia, A, Clerici, E, Cocci, A, Costanzo, G, D'Ercole, F, De Stefano, G, Decè, F, Di Cicco, N, Di Marco, A, Donati Sarti, C, Draghi, E, Dusi, G, Esposito, V, Ferraro, L, Ferretti, A, Ferri, E, Foggetti, L, Foglia, A, Fonzi, E, Frau, G, Fuoco, Mr, Furci, G, Gallo, L, Garra, V, Giannini, A, Gris, A, Iacovino, R, Interrigi, R, Joppi, R, Laner, B, La Fortezza, G, La Padula, A, Lista, Mr, Lupi, G, Maffei, D, Maggioni, G, Magnani, L, Marrazzo, E, Marcon, L, Marinò, V, Maroni, A, Martinelli, C, Mastandrea, E, Mastropierro, F, Meo, At, Mero, P, Minesso, E, Moschetta, V, Mosele, E, Nanni, C, Negretti, A, Nisticò, C, Orsini, A, Osti, M, Pacilli, Mc, Pennestre, C, Picerno, G, Piol, K, Pivano, L, Pizzuti, E, Poggi, L, Poidomani, I, Pozzetto, M, Presti, Ml, Ravani, R, Recalenda, V, Romagnuolo, F, Rossignoli, S, Rossin, E, Sabatella, C, Sacco, F, Sanità, F, Sansone, E, Servadei, F, Sisto, Mt, Sorio, A, Sorrentino, A, Spinelli, E, Spolaor, A, Squillacioti, A, Stella, P, Talerico, A, Todisco, C, Vadino, M, and Zuliani, C.

Subjects
Male, medicine.medical_specialty, General Practice, Kaplan-Meier Estimate, Placebo, Double-Blind Method, Risk Factors, Internal medicine, Fatty Acids, Omega-3, Clinical endpoint, medicine, Humans, Myocardial infarction, Treatment Failure, Aged, Proportional Hazards Models, chemistry.chemical_classification, Omega-3, business.industry, Proportional hazards model, Medicine (all), Hazard ratio, Fatty Acids, General Medicine, Middle Aged, medicine.disease, Hospitalization, Primary Prevention, chemistry, Cardiovascular Diseases, Heart failure, Cohort, Female, business, Polyunsaturated fatty acid
Abstract

Background Trials have shown a beneficial effect of n-3 polyunsaturated fatty acids in patients with a previous myocardial infarction or heart failure. We evaluated the potential benefit of such therapy in patients with multiple cardiovascular risk factors or atherosclerotic vascular disease who had not had a myocardial infarction. Methods In this double-blind, placebo-controlled clinical trial, we enrolled a cohort of patients who were followed by a network of 860 general practitioners in Italy. Eligible patients were men and women with multiple cardiovascular risk factors or atherosclerotic vascular disease but not myocardial infarction. Patients were randomly assigned to n-3 fatty acids (1 g daily) or placebo (olive oil). The initially specified primary end point was the cumulative rate of death, nonfatal myocardial infarction, and nonfatal stroke. At 1 year, after the event rate was found to be lower than anticipated, the primary end point was revised as time to death from cardiovascular causes or admission to the hospital for cardiovascular causes. Results Of the 12,513 patients enrolled, 6244 were randomly assigned to n-3 fatty acids and 6269 to placebo. With a median of 5 years of follow-up, the primary end point occurred in 1478 of 12,505 patients included in the analysis (11.8%), of whom 733 of 6239 (11.7%) had received n-3 fatty acids and 745 of 6266 (11.9%) had received placebo (adjusted hazard ratio with n-3 fatty acids, 0.97; 95% confidence interval, 0.88 to 1.08; P=0.58). The same null results were observed for all the secondary end points. Conclusions In a large general-practice cohort of patients with multiple cardiovascular risk factors, daily treatment with n-3 fatty acids did not reduce cardiovascular mortality and morbidity. (Funded by Societa Prodotti Antibiotici and others; ClinicalTrials.gov number, NCT00317707.).

Published
2013

34. Human immunodeficiency virus-related cancer in children: incidence and treatment outcome--report of the Italian Register

Author

Caselli D, Klersy C, de Martino M, Gabiano C, Galli L, Tovo PA, Aricò M, Giaquinto C. Giacomet V, Castelli Gattinara G, Livadiotti S, Minoli L, Maccabruni A, Fundarò C, Osimani P, De maria A, Rossi G, Dessì C, Viganò A, Plebani A, Riva C, De mattia D, Salvatore C, Mazza A., GUARINO, ALFREDO, Caselli, D, Klersy, C, de Martino, M, Gabiano, C, Galli, L, Tovo, Pa, Aricò, M, Giaquinto C., Giacomet V, Castelli Gattinara, G, Livadiotti, S, Minoli, L, Maccabruni, A, Fundarò, C, Osimani, P, Guarino, Alfredo, De maria, A, Rossi, G, Dessì, C, Viganò, A, Plebani, A, Riva, C, De mattia, D, Salvatore, C, and Mazza, A.

Subjects
Male, Cancer Research, medicine.medical_specialty, Pediatrics, Adolescent, HIV Infections, Acquired immunodeficiency syndrome (AIDS), Pregnancy, Neoplasms, Epidemiology, medicine, Humans, Prospective Studies, Registries, Risk factor, Sida, Child, Lymphoma, AIDS-Related, Acquired Immunodeficiency Syndrome, Perinatal Exposure, biology, business.industry, Incidence (epidemiology), Incidence, Lymphoma, Non-Hodgkin, Infant, Newborn, Infant, biology.organism_classification, medicine.disease, Infectious Disease Transmission, Vertical, Surgery, Treatment Outcome, Oncology, El Niño, Italy, Child, Preschool, Female, Viral disease, business
Abstract

PURPOSE: To outline the incidence, presenting features, treatment response, and outcome of human immunodeficiency virus (HIV)–associated malignancies in infancy and childhood, together with the estimated risk of HIV-associated cancer in children born to mothers infected with HIV. PATIENTS AND METHODS: The Italian Register for HIV Infection in Children collected data by specific registration and follow-up forms. By March 1999, 5,060 children were recruited, including 4,889 with perinatal exposure to HIV-1. Overall, 1,331 infected children were enrolled onto the Register and classified according to current Centers for Disease Control criteria; of them, 1,163 were vertically infected (24% of those with perinatal exposure). Of these 1,163, 569 (49%) were considered to have been prospectively followed-up since they had been registered at birth or within the first 3 months of age. RESULTS: Of the 1,331 children observed for a median time of 6.5 years, 35 developed 36 malignancies, four of which occurred in patients with blood-borne risk. For the 1,163 vertically infected children, the cumulative number of years of observation was 7,178 child-years and the cumulative incidence of HIV-associated tumors was 4.18 per 1,000 children/yr (95% confidence interval [CI], 2.92 to 5.98). When only the 569 vertically infected children prospectively followed up since birth were considered, the cumulative number of years of observation was 2,803 child-years. In this group, 10 tumors were observed, with a cumulative incidence of HIV-associated tumors of 3.57 per 1,000 children per year (95% CI, 1.92 to 6.63). CONCLUSION: The risk of cancer was significantly higher but not restricted to symptomatic and/or immune-compromised children. Cancer-directed treatment should be given promptly to these patients, who have a fair chance to survive their tumor in view of potential highly aggressive antiretroviral therapy–associated improvement in survival and quality of life.

Published
2000

35. Cybersecurity Technology Transition: A Practical Approach

Author

Jason E. Fingerman and Salvatore C. Paladino

Subjects
Government, Engineering, business.industry, Best practice, Homeland security, Law enforcement, Critical infrastructure protection, ComputingMilieux_LEGALASPECTSOFCOMPUTING, Computer security, computer.software_genre, Field (computer science), Critical infrastructure, User interface, business, computer
Abstract

ITT’s CyberScience Laboratory (CSL) has become an effective technology transition agent for the Department of Homeland Security’s Science & Technology (DHS S&T) Directorate as well as other government agencies. By acquiring, evaluating, and transferring cybersecurity technologies to those tasked with protecting critical infrastructure, the CSL has been able to provide operational feedback to technology developers, expose end-users to cutting edge tools, and better match future investments from technology sponsors with cybersecurity requirements. Discussed in this paper are best practices for technology transition as well as considerations for future activity in the field.

Published
2009
Full Text
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36. Frontal branch of the facial nerve: galeal temporal relationship

Author

Salvatore C. Lettieri

Subjects
Dense connective tissue, Temporal Muscle, Dissection (medical), Temporal fascia, Cadaver, Galea, medicine, Humans, Prospective Studies, Fascia, Surgery, Plastic, Zygoma, biology, business.industry, Dissection, General Medicine, Anatomy, biology.organism_classification, medicine.disease, Facial nerve, Facial Nerve, medicine.anatomical_structure, Face, Surgery, Zygomatic arch, business
Abstract

Background: Risks to the frontal branch of the facial nerve, especially at the juncture of the zygomatic arch, have been well studied in connection with aesthetic procedures. The use of bicoronal incisions led to the observation that there is a second area in which injury to the frontal branch of the facial nerve is at risk: the transition plane between the area over the temporalis muscle and the pericranial region. Objective: A study was conducted to map out the frontal branch of the facial nerve as it passes through the dense galeal temporal fascia, because this is a zone of potential injury. Methods: Ten fresh frozen cadaver halves were dissected by use of a standard surgical bicoronal approach with surgical instrumentation and loupe magnification × 2.5. Results: In the area of interest, which included the region overlying the zygomatic arch, as well as the galeal frontalis fusion point, the nerve was found to be deep and within the fusion point. The nerve was cephalad to the sentinel vein in each instance, and the tissue was freely dissected medial and lateral to the fusion point of the galea and the temporal fascia. The fusion plane was dense and in a direct line in the vertical direction with the loose areolar plane on either side. Conclusion: The dense tissue within the galeal temporal region needs to be approached with caution, avoiding electrocautery and using sharp dissection. The cadaver study demonstrates the close proximity of the nerve in the deeper portion of the elevated superficial flap.

Published
2007

38. A New Classification of Transbasal Approaches

Author

Franco DeMonte, Stephen P. Beals, Edward F. Joganic, Salvatore C. Lettieri, Randall W. Porter, Robert F. Spetzler, and Iman Feiz-Erfan

Subjects
business.industry, Medicine, Neurology (clinical), Artificial intelligence, business, Machine learning, computer.software_genre, computer
Published
2007
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39. Sinonasal leiomyosarcoma: review of literature and case report

Author

Edward J Joganic, Christian T Ulrich, Robert F. Spetzler, Peter Nakaji, John Milligan, Stephen W. Coons, Salvatore C. Lettieri, Jeffrey D Isaacs, Jonathan S. Hott, Iman Feiz-Erfan, and John J Kresl

Subjects
Leiomyosarcoma, Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Nose Neoplasms, MEDLINE, Severity of Illness Index, Severity of illness, Paranasal Sinuses, medicine, Humans, Neoplasm Invasiveness, Nose, Etoposide, Chemotherapy, Ifosfamide, business.industry, medicine.disease, Magnetic Resonance Imaging, Surgery, medicine.anatomical_structure, Otorhinolaryngology, Sarcoma, business, medicine.drug
Abstract

Objectives/Hypothesis: To determine prognosis of primary sinonasal leiomyosarcomas after treatment. Study Design: Literature review and case report. Methods: Review of English literature from MEDLINE and independent sources with the addition of our case. Results: Including our case, 63 cases have been reported. Primary treatment includes resection with or without radiation. Chemotherapy has not been reported to be effective. In our case, however, chemotherapy, consisting of etoposide and high-dose ifosfamide, caused the tumor to shrink significantly. On the basis of a review of all reported cases, the overall survival rate at a mean follow-up of 38.24 month is 66%. The minimal overall survival rates at 5 and 10 years are 20% and 6%, respectively. Conclusion: The prognosis for primary sinonasal leiomyosarcomas is poor. However, a 10–year survival has been reported in a few patients. Chemotherapy may be a useful adjunct when managing extensive lesions unamenable to curative resection.

Published
2005

40. Preserving olfactory function in anterior craniofacial surgery through cribriform plate osteotomy applied in selected patients

Author

Edward F. Joganic, Iman Feiz-Erfan, Robert F. Spetzler, Stephen P. Beals, Jeffrey D. Klopfenstein, Randall W. Porter, Patrick P. Han, Louis J. Kim, Eric M. Horn, and Salvatore C. Lettieri

Subjects
Olfactory system, Adult, Male, medicine.medical_specialty, Adolescent, Olfactory Nerve, medicine.medical_treatment, Skull Neoplasms, Cribriform plate, Olfaction, Osteotomy, Facial Bones, Olfaction Disorders, Medicine, Humans, Longitudinal Studies, Craniofacial, Child, Craniofacial surgery, Cranial Nerve Injuries, Aged, Orange juice, business.industry, Infant, Nasopharyngeal Neoplasms, Middle Aged, Nasal bone, Surgery, Ethmoid Bone, Olfactory Nerve Injuries, Treatment Outcome, Child, Preschool, Female, Neurology (clinical), business
Abstract

OBJECTIVE:Olfaction is often sacrificed to gain access to the cranial base in anterior craniofacial surgery. We describe the long-term results of olfactory function in patients who underwent anterior craniofacial surgery and a cribriform plate osteotomy to preserve olfaction.METHODS:Between 1992 and 2004, 28 patients underwent 29 cribriform plate osteotomies in an attempt to preserve olfaction during anterior craniofacial surgery performed through modified extended transbasal approaches. Patients' charts and office notes were reviewed retrospectively. Formal olfactory testing was available in 5 patients, but most data were based on patients' subjective reports of olfaction. Olfactory preservation was defined by the subjective ability to detect fumes such as coffee, chocolate, roses, and orange juice regardless of the intensity of the sensation. Follow-up was based on phone calls to patients.RESULTS:Four patients were lost to follow-up and excluded. Therefore, follow-up was available in 24 patients after 25 procedures. On the basis of patients' subjective reports, olfaction was spared in 22 patients after 23 procedures (92%) and was confirmed objectively in the five patients formally tested. After surgery, only two patients were anosmic.CONCLUSION:Olfaction can be preserved in selected patients undergoing anterior craniofacial surgery. At least 1 cm of nasal mucosa should remain attached to the cribriform plate, which can be achieved by including the nasal bone in the osteotomy of the orbital bar. A medial orbital canthopexy is therefore necessary after these procedures.

Published
2004

41. Reverse sural artery flap: caveats for success

Author

Mark F. Price, Salvatore C. Lettieri, Paul A. Watterson, and Peter J. Capizzi

Subjects
Adult, Male, medicine.medical_specialty, Soft Tissue Injuries, Dissection (medical), Surgical Flaps, Gastrocnemius muscle, Postoperative Complications, medicine, Humans, Ankle Injuries, Child, business.industry, Middle Aged, medicine.disease, Tissue transfer, Surgery, Plastic surgery, medicine.anatomical_structure, Sural artery flap, Female, Ankle, Sural artery fasciocutaneous flap, business, Leg Injuries
Abstract

Complex open wounds of the distal third of the leg and ankle remain a reconstructive challenge for the plastic surgeon. In many cases, these wounds are best addressed with a free tissue transfer. Although this group has performed more than 400 free flaps to the leg during the past 6 years, free tissue transfer can be an arduous operation that requires a team approach and substantial donor site morbidity for the patient. In recent years, the authors have favored the reverse sural artery fasciocutaneous flap in 11 patients for its ease of dissection, limited morbidity, and preservation of major vessels to the limb. Caveats for successful performance of the reverse sural artery flap include Doppler evidence of patent peroneal perforators, placement of a lazy T-shape skin paddle over the distal gastrocnemius muscle bellies, inclusion of the lesser saphenous vein to augment venous drainage, and, lastly, careful dissection to provide a wide adipofascial pedicle.

Published
2002

44. Sulla regionalità letteraria in italia: Pirandello, D'arrigo, Consolo

Author

Salvatore C. Trovato

Subjects
Literature, Linguistics and Language, History, Arts and Humanities (miscellaneous), business.industry, Filter (video), Italian language, Literary language, business, Derived Data, Realism, Linguistics, Spoken language
Abstract

Both in the written and the oral form, the dialects have always been the great reserve of the Italian language, which has never had a spoken " pendant ", being born as a literary language. The only true spoken language was, especially in the past, dialect. Italian writers have always derived data from this huge reserve. Realism and Expressionism have motivated writers to use dialects, even through the filter of the Italian language. According to that, are being examined both works of Pirandello, an author lived between the 19th and the 20th century, and works written by contemporary authors, like D’Arrigo and Consolo. For each of them a representative sample of their " regionality " is given.

Published
2008
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45. Clinicopathological features in patients with isolated C3 mesangial proliferative glomerulonephritis

Author

Francesco Paolo Schena, Carlo Manno, M Di Carlo, Salvatore C, E Laraia, A Tasco, M Giangrande, and A R Proscia

Subjects
Adult, Male, Pathology, medicine.medical_specialty, Adolescent, Glomerulonephritis, Membranoproliferative, Renal function, Fluorescent Antibody Technique, urologic and male genital diseases, medicine, Humans, In patient, Hematuria, Transplantation, Proteinuria, business.industry, Glomerular mesangium, Glomerulonephritis, Complement C3, Middle Aged, medicine.disease, Prognosis, Nephrology, Mesangium, Mesangial proliferative glomerulonephritis, Female, medicine.symptom, business, Nephritis
Abstract

The clinicopathological picture of 'isolated C3 mesangial nephritis' was studied in our case records. Focal and segmental or generalised deposits of C3 in the mesangium were found in 12 of 157 (7.6%) patients with primary glomerulonephritis. The clinical picture, similar to Berger's disease, was characterised by episodes of gross haematuria and/or persistent or recurrent microhaematuria and/or proteinuria. Arterial hypertension and mild renal failure were observed in one case. Light-microscopy showed minor glomerular changes such as focal and segmental increase of mesangial matrix and mesangial hyperplasia. During the short-term follow-up (median 25.5 months) no deterioration of renal function was observed. The clinical course and short-term prognosis suggest that this form of glomerulonephritis is benign.

Published
1990

46. BENZETHACIL (BICILLIN)

Author

Bayne Gm, Gylfe J, Salvatore C. Carfagno, and William P. Boger

Subjects
medicine.drug_class, business.industry, Oral administration, Antibiotics, medicine, General Medicine, Pharmacology, business, Beta lactam antibiotics
Published
1953
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47. Immunological and bacteriological studies in chronic pyelonephritis associated with kidney stones

Author

Francesco Paolo Schena, Lorenzo Bonomo, Fp Selvaggi, S. Barbuti, A. Tallarigo, Salvatore C, and Marzullo F

Subjects
Adult, Male, Pathology, medicine.medical_specialty, Adolescent, Fluorescent Antibody Technique, Urine, Fibrinogen, Kidney, Kidney Calculi, Immune system, Enterobacteriaceae, Medicine, Humans, Child, Antigens, Bacterial, biology, Pyelonephritis, business.industry, General Medicine, Complement System Proteins, Middle Aged, biology.organism_classification, medicine.disease, medicine.anatomical_structure, Nephrology, Chronic Disease, biology.protein, Kidney stones, Female, Antibody, business, Bacteria, medicine.drug
Abstract

Histological and immunofluorescent techniques, urine, stone and renal fragment culture, demonstration of bacteria with fluorescent specific antisera in the renal tissue and determination of circulating antiGBM and antiTBM antibodies in the serum, were studied on the renal biopsies of 46 patients with chronic pyelonephritis (CPN) associated to kidney stones. Results show that the bacteria are often present in renal tissue of CPN with negative urine culture. The presence of C3 and C4 in some cases, and C3 and C3PA in others, at the tubular level associated with bacteria, suggest that the activation of the C system may be through the classic way, i.e., through the bacteriological immune complexes, or the alternate pathway, i.e., through the bacteria or their products. In conclusion, the evolution of the CPN may be related to the activation of the C system and the coagulation mechanism, as shown by frequent fibrinogen deposits.

Published
1979

48. The Patient for Electroconvulsive Therapy

Author

Salvatore C. Scalafani

Subjects
Pediatrics, medicine.medical_specialty, Activities of daily living, Lithium (medication), business.industry, medicine.medical_treatment, medicine.disease, Neuroleptic malignant syndrome, Orthostatic vital signs, Electroconvulsive therapy, Current medication, Trigeminal neuralgia, Medicine, business, Depression (differential diagnoses), medicine.drug
Abstract

A 68-year-old woman with a history of recurrent depression was scheduled for a course of electroconvulsive therapy (ECT), 3 treatments per week for at least 2 weeks, on an outpatient basis. She had received several courses of ECT in the past and her condition had improved significantly for 8–12 months. Her only current medication was lithium. She complained of not being able to attend to her usual daily activities. She had a history of hypertension with poor medication compliance attributed to episodes of orthostatic hypotension.

Published
1989
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49. The serum lipids in lipemia retinalis

Author

Salvatore C. Carfagno and William A. Steiger

Subjects
medicine.medical_specialty, Endocrinology, Retinal Diseases, Lipemia retinalis, business.industry, Internal medicine, medicine, Blood lipids, Hyperlipidemias, General Medicine, business, Lipids, Retina
Published
1951

50. Diabetes insipidus in pregnancy

Author

Salvatore C. Carfagno, Charles R. Shuman, and Thomas M. Durant

Subjects
Pituitary gland, medicine.medical_specialty, Pregnancy, business.industry, Physiology, Disease, medicine.disease, female genital diseases and pregnancy complications, Diabetes Insipidus, Neurogenic, medicine.anatomical_structure, Endocrinology, Posterior pituitary, Internal medicine, Diabetes insipidus, Internal Medicine, medicine, Endocrine system, Humans, Female, business, Diabetes Insipidus, Antidiuretic, Hormone
Abstract

DIABETES insipidus is a rare complication of pregnancy. When this disease does happen to be associated with the pregnant state, however, considerable interest attaches to the combination, since there are implications both from the obstetrical and from the endocrine standpoint. To the obstetrician it is of importance to know whether an insufficient production of oxytocic hormone coincides with the inadequate elaboration of antidiuretic hormone, with the resultant possibility of dystocia. The obstetrician is interested also in the possibility that posterior pituitary extract administration, necessary for the treatment of the diabetes insipidus, might be responsible for the induction of premature labor. From an endocrine standpoint, further information is needed concerning the effect various normal hormonal shifts during pregnancy might have upon the function of the posterior lobe of the pituitary gland. That such shifts might well have an important effect is suggested by the well-known fact that in diabetes insipidus the

Published
1953

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