276 results on '"Mantovani W"'
Search Results
102. Low incidence of proteinuria in RA after gold thiosulfate treatment
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Carlo Salvarani, Macchioni, P., Zizzi, F., Rossi, F., Baricchi, R., Mantovani, W., Ghirelli, L., Capozzoli, N., Frizziero, L., and Portioli, I.
103. [Cardiovascular screening]
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Pellizzari B, Andrea Siddu, Ferro A, Colonna M, Mantovani W, Valsecchi M, Marensi L, Moro A, Brusaferro S, and Cinquetti S
104. ['Black adenoma' associated with medullary nodular hyperplasia in the ipsilateral adrenal gland. Case report and review of the literature regarding 'mixed' cortico-medullary pathology]
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Bisceglia M, Nirchio V, Attino V, Di Cerbo A, Mantovani W, and Gianandrea Pasquinelli
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Male ,Melanins ,Hyperplasia ,Adrenal Medulla ,Adrenocortical Adenoma ,Adrenal Cortex ,Humans ,Middle Aged ,Cushing Syndrome ,Adrenal Cortex Neoplasms ,Lipofuscin - Abstract
Pigmented or "black" cortical adenoma is a rare variant of the compact or eosinophilic cell type of adrenal gland cortical adenoma. Usually it is non functioning so representing an incidental finding at autopsy, but rare cases producing Cushing's syndrome or hyperaldosteronism have been reported. The simultaneous occurrence of a cortical adenoma and pheochromocytoma in the ipsilateral adrenal gland is an extremely rare event, which has been so far described only seven times with the cortical adenoma always being of the usual yellow or clear cell type. So far no case of "black adenoma" associated with a proliferative condition of the ipsilateral adrenal medulla has ben described.A case of functioning pigmented ("black") cortical adenoma in a male patient affected by Cushing's syndrome associated with asymptomatic medullary nodular hyperplasia in the ipsilateral adrenal gland is described. The results of light microscopy, histochemistry, immunohistochemistry, and electron microscopy studies are presented. It is worthy of note the finding of two types of pigment granules (lipofuscin type, neuromelanin type) observed at elecatron microscopy.The authors underline the difficulty of classifying adrenal medullary nodules and the arbitrarity usually adopted in separating nodular adrenal medullary hyperplasia from early neoplasia (pheochromocytoma). Thus nodular medullary hyperplasia in this case could also be interpreted as an early neoplastic condition. The case herein presented is the first report of a combined cortico-medullary proliferative process in which a "black" adenoma is involved.
105. Prevalence and Characteristics of Coeliac Disease in Type 1 Diabetes Mellitus
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Cacciari, E., primary, Salardi, S., additional, Volta, U., additional, Biasco, G., additional, Partesotti, S., additional, Mantovani, W., additional, Cicognani, A., additional, Tonioli, S., additional, Tassoni, P., additional, Pirazzoli, P., additional, Bianchi, F. B., additional, Barboni, F., additional, and Pisi., E., additional
- Published
- 1987
- Full Text
- View/download PDF
106. A population-based cohort study of chest x-ray screening in smokers: lung cancer detection findings and follow-up
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Dominioni Lorenzo, Rotolo Nicola, Mantovani William, Poli Albino, Pisani Salvatore, Conti Valentina, Paolucci Massimo, Sessa Fausto, Paddeu Antonio, D'Ambrosio Vincenzo, and Imperatori Andrea
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Lung cancer ,Chest x-ray screening ,Population-based ,Cohort study ,volunteer effect ,Survival ,Community ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Case-control studies of mass screening for lung cancer (LC) by chest x-rays (CXR) performed in the 1990s in scarcely defined Japanese target populations indicated significant mortality reductions, but these results are yet to be confirmed in western countries. To ascertain whether CXR screening decreases LC mortality at community level, we studied a clearly defined population-based cohort of smokers invited to screening. We present here the LC detection results and the 10-year survival rates. Methods The cohort of all smokers of > 10 pack-years resident in 50 communities of Varese, screening-eligible (n = 5,815), in July 1997 was invited to nonrandomized CXR screening. Self-selected participants (21% of cohort) underwent screening in addition to usual care; nonparticipants received usual care. The cohort was followed-up until December 2010. Kaplan-Meier LC-specific survival was estimated in participants, in nonparticipants, in the whole cohort, and in an uninvited, unscreened population (control group). Results Over the initial 9.5 years of study, 67 LCs were diagnosed in screening participants (51% were screen-detected) and 178 in nonparticipants. The rates of stage I LC, resectability and 5-year survival were nearly twice as high in participants (32% stage I; 48% resected; 30.5% 5-year survival) as in nonparticipants (17% stage I; 27% resected; 13.5% 5-year survival). There were no bronchioloalveolar carcinomas among screen-detected cancers, and median volume doubling time of incidence screen-detected LCs was 80 days (range, 44-318), suggesting that screening overdiagnosis was minimal. The 10-year LC-specific survival was greater in screening participants than in nonparticipants (log-rank, p = 0.005), and greater in the whole cohort invited to screening than in the control group (log-rank, p = 0.001). This favourable long-term effect was independently related to CXR screening exposure. Conclusion In the setting of CXR screening offered to a population-based cohort of smokers, screening participants who were diagnosed with LC had more frequently early-stage resectable disease and significantly enhanced long-term LC survival. These results translated into enhanced 10-year LC survival, independently related to CXR screening exposure, in the entire population-based cohort. Whether increased long-term LC-specific survival in the cohort corresponds to mortality reduction remains to be evaluated. Trial registration number ISRCTN90639073
- Published
- 2012
- Full Text
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107. Survival and Prognostic Factors at Diagnosis in Non-Functioning Pancreatic Endocrine Tumors: Analysis of 180 Patients.
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Bonisegna, L., Bettini, R., Crippa, S., Mantovani, W., Capelli, P., Bassi, C., Pederzoli, P., Scarpa, A., and Falconi, M.
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- 2007
108. Treefall gap colonization in the Brazilian Atlantic montane rainforest
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Mantovani, W. and Tabarelli, M.
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FORESTS & forestry ,ECOLOGY ,COLONIZATION - Abstract
The occurrence of treefall gaps has been hypothesized to maintain tree species diversity in tropical forests. To analyze this hypothesis for the Brazilian Atlantic montane rainforest, 558 tree and shrub individuals were sampled in 23 natural treefall gaps (29 to 256 m
2 ) in two different sites of the forest. In both sites, the smallgaps were more abundant, occuping the majority of the area with gap disturbance. There was no evidence of regeneration niche partitioningamong species related to gap size; consequently gap size is not the best parameter to predict gap floristic and ecological composition. The gaps were preferentially colonized by typical understory species, which represented 50 to 60.5% of the total species sampled. Accordingto our results, the Atlantic montane forest has a low richness of shade-intolerant species (9.8 to 12.5% of the total sampled), particularly considering the large pioneers. Most of the shade-intolerant species sampled seems to regenerate successfully in other habitats. [ABSTRACT FROM AUTHOR]- Published
- 1998
109. Synovitis in Polymyalgia Rheumatica: An Immunogenetic Study.
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SALVARANI, C., ROSSI, F., MACCHIONI, P., MANTOVANI, W., VENEZIANI, M., BOIARDI, L., LODI, L., and PARTIOLI, I.
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- 1992
110. Management of Atrial Flutter or Fibrillation in a High Volume Emergency Department
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Bonora, A., Dellagiacoma, G., Mantovani, W., Cadamuro, C., Castiglioni, P., Franchina, G., Sanzone, E., Valerio, A., Beltrame, F., and Pistorelli, C.
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- 2006
- Full Text
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111. Resectable Pancreatic Adenocarcinoma: Is the Enhancement Pattern at Contrast-Enhanced Ultrasonography a Pre-Operative Prognostic Factor?
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Mirko D'Onofrio, F Principe, Paola Capelli, William Mantovani, R. Pozzi Mucelli, Niccolò Faccioli, Massimo Falconi, A. Gallotti, Giulia Zamboni, Roberto Malago, D'Onofrio, M, Zamboni, Ga, Malagò, R, Mantovani, W, Principe, F, Gallotti, A, Faccioli, N, Falconi, Massimo, Capelli, P, and Pozzi Mucelli, R.
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Male ,Prognostic factor ,medicine.medical_specialty ,Pathology ,Acoustics and Ultrasonics ,Biophysics ,Contrast Media ,Enhancement pattern ,Adenocarcinoma ,Sensitivity and Specificity ,Pancreatectomy ,Preoperative Care ,Prevalence ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Pancreatic Adenocarcinoma ,Pathological ,Aged ,Ultrasonography ,Radiological and Ultrasound Technology ,business.industry ,Proportional hazards model ,Reproducibility of Results ,Contrast-Enhanced Ultrasonography ,Pre-Operative Imaging ,Middle Aged ,Prognosis ,medicine.disease ,Survival Analysis ,Pre operative ,Pancreatic Neoplasms ,Survival Rate ,Treatment Outcome ,Italy ,Female ,Radiology ,business ,Contrast-enhanced ultrasound - Abstract
The aim of our study was to determine whether the enhancement pattern of pancreatic adenocarcinoma at contrast-enhanced ultrasonography (CEUS) is related to patient prognosis after resection. CEUS of 42 resected adenocarcinomas were retrospectively reviewed. Tumors were divided into two groups: group A=poorly vascularized (presence of avascular areas) or group B=well vascularized (absence of avascular areas). All lesions were resected and underwent pathological examination assessing tumor differentiation as: undifferentiated (poorly differentiated) or differentiated (moderately and well differentiated). Mean vascular density (MVD) was also evaluated. CEUS enhancement and pathology were correlated (Spearman's test). Survival was analyzed with the Kaplan-Meier method. Multivariate analysis was performed with the Cox regression model. There were 30 differentiated and 12 undifferentiated adenocarcinomas at pathology. At CEUS, 10 lesions were poorly vascularized, whereas 32 lesions were well vascularized. Positive correlation was observed between CEUS groups and tumoral differentiation (rs=0.51; p=0.001) and between CEUS and MVD (rs=0.74; p0.0001). Median survival in patients with group A vascularization at CEUS was significantly lower than in group B (p=0.015). Cox proportional hazard model revealed the presence of poorly vascularized tumor at CEUS (p=0.0001) as a predictor of higher mortality. In conclusion, CEUS enables accurate depiction of the vascularization of adenocarcinoma, with positive correlation to histology grade and MVD.
- Published
- 2009
112. Evidence of a Genetic Basis for the Different Geographic Occurrences of Liver/Kidney Microsomal Antibody Type 1 in Hepatitis C
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Fabio Cassani, W. Mantovani, Paolo Muratori, S. Ferri, Marco Lenzi, Francesco B. Bianchi, Albert J. Czaja, G. Pappas, Alessandro Granito, M. Guidi, Umberto Volta, Luigi Muratori, Muratori P, Czaja AJ, Muratori L, Granito A, Guidi M, Ferri S, Volta U, Mantovani W, Pappas G, Cassani F, Lenzi M, and Bianchi FB.
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Adult ,Male ,medicine.medical_specialty ,Physiology ,HLA-DR7 Antigen ,Human leukocyte antigen ,White People ,law.invention ,Antigen ,law ,Internal medicine ,medicine ,Humans ,Polymerase chain reaction ,Aged ,Autoantibodies ,biology ,Haplotype ,Gastroenterology ,HLA-DR Antigens ,Hepatitis C ,Hepatitis C, Chronic ,Middle Aged ,Hepatology ,medicine.disease ,Hepatitis, Autoimmune ,Italy ,North America ,Immunology ,Microsomes, Liver ,biology.protein ,Female ,Viral disease ,Antibody - Abstract
Antibodies to liver/kidney microsome type 1 occur in Italian patients with hepatitis C, but rarely develop in North American patients. Our goals were to compare the frequencies of the HLA markers associated with autoimmune expression in Italian and North American patients with chronic hepatitis C and to determine genetic bases for regional differences in antibody production. HLA B8, DR3, DR4, DR7, DR11, DR13, DQ2, and the B8-DR3-DQ2 haplotype were determined by microlymphocytotoxicity and polymerase chain reaction in 105 Italian patients (50 with microsomal antibodies), 100 North American patients (none with microsomal antibodies), and Italian and North American healthy control subjects. Italian patients with microsomal antibodies differed from North American patients without these antibodies by having a higher frequency of HLA DR7 (54% vs. 27%, P=0.002). HLA DR7 occurred more frequently in seropositive Italian patients than in seronegative counterparts (54% vs. 11% P < 0.0001), Italian healthy control subjects (54% vs. 29%, P=0.0009), and North American healthy control subjects (54% vs. 19%, P < 0.0001). The frequency of HLA DR7 was similar in North American patients and controls (27% vs. 19%, P=0.2), but it was lower than in Italian controls (19% vs. 29%, P=0.059). Seropositive Italian patients had a lower frequency of HLA DR11 than seronegative Italian patients and Italian controls (18% vs. 34%, P=0.07, and 18% vs. 35%, P=0.02, respectively). In contrast to seropositive Italian patients, North American patients had HLA DR4 (30% vs. 12%, P=0.02), HLA DR13 (29% vs. 10%, P=0.01), and the B8-DR3-DQ2 haplotype (23% vs. 6%, P=0.01) more often. Similarly, HLA DR4 and the B8-DR3-DQ2 phenotype were more frequent in North American patients than in Italian controls (30% vs. 16%, P=0.005, and 23% vs. 7%, P=0.00002, respectively). HLA DR7 is associated with the development of microsomal antibodies in Italian patients with chronic hepatitis C. The lower frequency of HLA DR7 in North America could contribute to the rarity of these antibodies in this region. HLA DR11 may be protective against the development of microsomal antibodies in Italian patients, whereas HLA DR4, HLA DR13, and the B8-DR3-DQ2 haplotype may be protective in North American patients.
- Published
- 2006
113. Role of unlabelled somatostatin analogues in the prevention of complications after elective pancreatic and peripancreatic surgery: a critical review
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Claudio Bassi, Roberto Salvia, Giuseppe Mascetta, Paolo Pederzoli, Massimo Falconi, William Mantovani, Giovanni Butturini, Nora Sartori, Falconi, Massimo, Salvia, R, Mascetta, G, Mantovani, W, Sartori, N, Butturini, G, Bassi, C, and Pederzoli, P.
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medicine.medical_specialty ,Complications ,Pancreatic surgery ,Population ,Somatostatin analogues ,Resection ,Double blind ,Postoperative Complications ,Double-Blind Method ,medicine ,Humans ,Prospective Studies ,education ,Medical expenses ,Randomized Controlled Trials as Topic ,education.field_of_study ,Hepatology ,business.industry ,Gastroenterology ,Neoplastic disease ,medicine.disease ,Surgery ,Pancreatic Neoplasms ,Somatostatin ,Elective Surgical Procedures ,Pancreatic fistula ,business - Abstract
Although studies on the use of the somatostatin analogues in the elective pancreatic surgery are mostly prospective, double blind and randomised, the results are contradictory and not univocally interpretable. Through the examination of all randomised perspective works published on this subject, a critical interpretation is attempted which may give relevant suggestions for further studies. A new clinical, randomised, double blind and multicentric prospective trial should take into proper consideration even the changes which have occurred in the care of the patients. Over the years a significant decrease of postoperative hospital stay and a deeper awareness of the medical expenses have been observed. Moreover, since the drug has a potential advantage on specific pancreatic complications, only these must be considered among the end points of the study and the population studied will be limited exclusively to patients who underwent resection of the pancreatic head or of the periampullar region because of neoplastic disease. Finally, the selection of the centres that enrol the patients must be considered, since the expertise of each operator or of the team, affects, as an independent variable, both morbidity and mortality.
- Published
- 2004
114. Carcinoma of pancreatic body and tail: are there improvements in diagnosis and treatment modalities over the past decade?
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Rossella Bettini, Giorgio Talamini, Cristina Oliani, Paolo Pederzoli, William Mantovani, Stefano Cascinu, Claudio Bassi, Massimo Falconi, Falconi, Massimo, Mantovani, W., Bettini, R., Talamini, G., Bassi, C., Cascinu, S., Oliani, C., and Pederzoli, P.
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Oncology ,medicine.medical_specialty ,Pancreatic body ,medicine.medical_treatment ,Internal medicine ,Pancreatic cancer ,Chemotherapy ,5-FU ,Gemcitabine ,medicine ,Carcinoma ,Humans ,Survival analysis ,Hepatology ,business.industry ,Carcinoma, Ductal, Breast ,Gastroenterology ,Ductal carcinoma ,Prognosis ,medicine.disease ,Pancreatic Neoplasms ,Survival Rate ,Treatment modality ,business ,medicine.drug - Abstract
The aim of the present study is to assess whether or not there has been improvement in the therapeutic strategy for body-tail pancreatic carcinoma over the past decade.A total of 215 patients suffering from cytologically and histologically documented ductal carcinoma in the pancreatic body-tail, observed from 1990 to 1999, were analysed. Changes in tumour stage at diagnosis, in the percentage of patients treated surgically, in resectability rates and in the use of anticancer therapies over the years were sought. Survival curves were evaluated in relation to the treatments adopted.Over the 10-year period, no significant differences were observed with respect to the stage at diagnosis, resectability or type of surgery adopted. There was a significant increase in the percentage of unoperated patients (p < 0.0001) and, as expected, in the percentages of patients submitted to chemo- and/or radiotherapy (p < 0.0001). With the sole exception of tumour stage in the case of patients undergoing radiotherapy, a comparison between groups revealed no element of patient selection bias other than time. The survival of patients undergoing chemotherapy is significantly better, also at multivariate analysis, than that of patients not undergoing such therapy (13 vs. 5.8 months; p < 0.0001).There has been no change over the years in the direction of earlier diagnosis and the prognosis remains distinctly poor. More extensive use of anticancer therapies, however, has led to a significant increase in median survival. Radical resection, when possible, assures the longest survival.
- Published
- 2003
115. Perfusion CT can predict tumoral grading of pancreatic adenocarcinoma
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Stefano Crosara, Mirko D'Onofrio, Anna Ventriglia, R. Pozzi Mucelli, William Mantovani, Giulia Zamboni, Erminia Manfrin, Massimo Falconi, Riccardo Manfredi, A. Gallotti, D'Onofrio, M, Gallotti, A, Mantovani, W, Crosara, S, Manfrin, E, Falconi, Massimo, Ventriglia, A, Zamboni, Ga, Manfredi, R, and Pozzi Mucelli, R.
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Adult ,Male ,medicine.medical_specialty ,Perfusion Imaging ,Perfusion scanning ,Perfusion CT, Pancreatic adenocarcinoma, Abdominal radiology, Tumor grading ,Adenocarcinoma ,Sensitivity and Specificity ,Biopsy ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Grading (tumors) ,Aged ,Aged, 80 and over ,Neoplasm Grading ,Perfusion CT ,Receiver operating characteristic ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,General Medicine ,Middle Aged ,medicine.disease ,Abdominal radiology ,Tumor grading ,Pancreatic Neoplasms ,medicine.anatomical_structure ,Mann–Whitney U test ,Radiographic Image Interpretation, Computer-Assisted ,Female ,Radiology ,Tomography, X-Ray Computed ,Pancreas ,business ,Pancreatic adenocarcinoma ,Algorithms - Abstract
Objectives To describe perfusion CT features of locally advanced pancreatic ductal adenocarcinoma and to evaluate correlation with tumor grading. Methods Thirty-two patients with locally advanced pancreatic adenocarcinoma were included in this study. Lesions were evaluated by P-CT and biopsy after patient's informed consent. P-CT parameters have been assessed on a large single and on 6 small intratumoral ROIs. Values obtained have been compared and related to the tumor grading using Mann–Whitney U test. Sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy in predicting tumor grading have been calculated for cut-off values chosen by using ROC curves. Results Out of 32 lesions, 12 were classified as low grade and 20 as high grade. A statistically significant difference between high and low grade neoplasms were demonstrated for PEI and BV parameters. PEI and BV cut-off values were respectively 17.8 HU and 14.8 ml/100 g. PEI identified high grade neoplasms with a 65% sensitivity, 92% specificity, 93% PPV, 61% NPV and 75% accuracy. BV identified high grade neoplasms with a 80% sensitivity, 75% specificity, 84% PPV, 69% NPV, 78% accuracy. Considering both PEI and BV, P-CT identified high grade lesions with a 60% sensitivity, 100% specificity, 100% PPV, 60% NPV and 75% accuracy. Conclusions PEI and BV perfusion CT parameters proved their efficiency in identifying high grade pancreatic adenocarcinoma.
- Published
- 2013
116. Invasive Intraductal Papillary Mucinous Carcinomas of the Pancreas: Predictors of Survival and the Role of Lymph Node Ratio
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William Mantovani, Stefano Crippa, Claudio Bassi, Andrew L. Warshaw, Cristina R. Ferrone, Massimo Falconi, Paolo Pederzoli, Stefano Partelli, Roberto Salvia, Sarah P. Thayer, Carlos Fernandez-del Castillo, Partelli, S., Fernandez-Del Castillo, C., Bassi, C., Mantovani, W., Thayer, S. P., Crippa, S., Ferrone, C. R., Falconi, M., Pederzoli, P., Warshaw, A. L., and Salvia, R.
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Male ,Pathology ,medicine.medical_specialty ,cystic neoplasms ,gastric-cancer ,Article ,experience ,cancer regardless ,cancer regardle ,cystic neoplasm ,medicine ,Carcinoma ,Mucinous carcinoma ,independent prognostic-factor ,clinicopathological features ,ductal adenocarcinoma ,resection ,number ,classification ,Humans ,Neoplasm Invasiveness ,Lymph node ,Survival rate ,Aged ,Retrospective Studies ,business.industry ,Cancer ,clinicopathological feature ,Ductal carcinoma ,Middle Aged ,medicine.disease ,Prognosis ,Adenocarcinoma, Mucinous ,Pancreatic Neoplasms ,Survival Rate ,medicine.anatomical_structure ,Lymphatic Metastasis ,Adenocarcinoma ,Surgery ,Female ,Pancreas ,business ,Carcinoma, Pancreatic Ductal - Abstract
Introduction: Intraductal papillary mucinous neoplasms (IPMNs) are being increasingly recognized, and often harbor cancer. Lymph node metastases are an important prognostic factor for patients with invasive intraductal papillary carcinoma (I-IPMC), but the role of lymph node ratio (LNR) in predicting survival after surgery for I-IPMC is unknown.Methods: The combined databases from the Surgical Department of Massachusetts General Hospital of Boston and the University of Verona were queried. We retrospectively reviewed clinical and pathologic data of all patients with resected, pathologically confirmed, I-IPMC between 1990 and 2007. Univariate and multivariate analysis were performed.Results: I-IPMCs were diagnosed in 104 patients (55 males and 49 females), median age was 69 years. Recurrent disease was identified in 49 patients (47.1%) and the median 5-year disease specific survival (DSS) was 60.1%. The median number of resected/ evaluated nodes was 15 (range, 5-60). There were 60 (57.7%) patients who had negative lymph nodes (N0), whereas 44 (42.3%) had lymph node metastases (N1). Patients with lymph node metastases had a shorter 5-year DSS (28.9%) compared with patients with negative lymph nodes (80.3%; P < 0.05) As the LNR increased, 5-year DSS decreased (LNR = 0, 86.5%; LNR >0 to 0.2, 34.4%; LNR >0.2, 11.1%; P < 0.05). On multivariate analysis, LNR, the presence of a family history of pancreatic cancer and a preoperative value of Ca 19.9 > 37 U/L were significant predictors of survival (P < 0.05).Conclusions: Lymph node ratio is a strong predictor of survival after resection for invasive intraductal papillary mucinous carcinoma.
- Published
- 2010
117. Pancreatic endocrine tumors: improved TNM staging and histopathological grading permit a clinically efficient prognostic stratification of patients
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Rossella Bettini, William Mantovani, Letizia Boninsegna, Francesco Panzuto, Massimo Falconi, Stefania Beghelli, Paola Capelli, Paolo Pederzoli, Gianfranco Delle Fave, Aldo Scarpa, Scarpa, A., Mantovani, W., Capelli, P., Beghelli, S., Boninsegna, L., Bettini, R., Panzuto, F., Pederzoli, P., Delle Fave, G., and Falconi, Massimo
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Adult ,Male ,tumors ,Pathology ,medicine.medical_specialty ,Time Factors ,endocrine ,Kaplan-Meier Estimate ,Neuroendocrine tumors ,World Health Organization ,Risk Assessment ,TNM ,Pathology and Forensic Medicine ,Predictive Value of Tests ,Risk Factors ,pancreas ,staging ,grading ,prognosis ,Humans ,Medicine ,Prospective Studies ,Stage (cooking) ,Prospective cohort study ,Grading (tumors) ,Survival analysis ,Aged ,Cell Proliferation ,Neoplasm Staging ,Proportional Hazards Models ,Chi-Square Distribution ,Proportional hazards model ,business.industry ,Carcinoma ,Cell Differentiation ,Middle Aged ,medicine.disease ,Immunohistochemistry ,Pancreatic Neoplasms ,Ki-67 Antigen ,medicine.anatomical_structure ,Italy ,Lymphatic Metastasis ,Predictive value of tests ,Female ,business ,Pancreas - Abstract
Pancreatic endocrine tumors are rare diseases and devising a clinically effective prognostic stratification of patients is a major clinical challenge. This study aimed at assessing whether the tumor-node-metastasis (TNM)-based staging and proliferative activity-based grading recently proposed by the European NeuroEndocrine Tumors Society (ENETS) have clinical value. TNM was applied to 274 patients with histologically diagnosed pancreatic endocrine tumors operated from 1991 to 2005, with last follow-up at December 2007. According to World Health Organization (WHO) classification, 246 were well-differentiated neoplasms (51 benign, 56 uncertain behavior, 139 carcinomas) and 28 poorly differentiated carcinomas. Grading was based on Ki67 immunohistochemistry. Survival analysis not only ascertained the prognostic value of the TNM system but also highlighted that in the absence of nodal and distant metastasis, infiltration and tumor dimensions over 4 cm had prognostic significance. T parameters were then appropriately modified to reflect this weakness. The 5-year survival for modified TNM stages I, II, III and IV were 100, 93, 65 and 35%, respectively. Multivariate analysis identified TNM stages as independent predictors of death, in which stages II, III and IV showed a risk of death of 7, 29 and 58 times higher than stage I tumors (P
- Published
- 2010
118. Long-term results of Frey's procedure for chronic pancreatitis: a longitudinal prospective study on 40 patients
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Luca Frulloni, Claudio Bassi, Massimo Falconi, Giuseppe Mascetta, Paolo Pederzoli, Luca Casetti, William Mantovani, Nora Sartori, Falconi, Massimo, Bassi, C, Casetti, L, Mantovani, W, Mascetta, G, Sartori, N, Frulloni, L, and Pederzoli, P.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pancreatic pseudocyst ,medicine.medical_treatment ,Anastomosis ,Body Mass Index ,Cohort Studies ,Frey's procedure ,Pancreatectomy ,Postoperative Complications ,Pancreaticojejunostomy ,Pancreatic Pseudocyst ,medicine ,Diabetes Mellitus ,Humans ,Longitudinal Studies ,Prospective Studies ,Prospective cohort study ,Aged ,Pain Measurement ,business.industry ,Gastroenterology ,Pancreatic Ducts ,Anastomosis, Roux-en-Y ,Middle Aged ,medicine.disease ,Roux-en-Y anastomosis ,Surgery ,Pain, Intractable ,Chronic pancreatitis - pancreaticojejunostomy - Frey’s procedure ,Stenosis ,Treatment Outcome ,Pancreatitis ,Chronic Disease ,Quality of Life ,Female ,business ,Follow-Up Studies - Abstract
Only limited prospective data are available regarding the long-term outcome of local resection of the pancreatic head in combination with longitudinal pancreaticojejunostomy in patients with chronic pancreatitis. From 1997 to 2001, 40 patients affected by chronic pancreatitis were subjected to the Frey’s procedure. Preoperative selection criteria included confirmed diagnosis of chronic pancreatitis, dilation of Wirsung’s duct to a diameter greater than 6 mm, and the absence of obstructive chronic pancreatitis secondary to fibrotic stenosis at the pancreatic body or tail. Preoperative pain was present in 38 cases (95%), and follow-up was performed in all patients at least once Yearly up to 2003 (median 60 months, inter percentile range 20.1-79.6). Postoperative morbidity occurred in three cases (7.5%). The percentage of pain-free patients was 94.7%, 93.7%, 87.5%, and 90% at 1, 2, 3, and 4/5 Years after surgical operation, respectively. After surgery, three patients developed diabetes. Both the body mass index and quality of life showed statistically significant improvements at all follow-up intervals. Whenever surgery is indicated, the short-term and long-term outcomes confirm that Frey’s procedure is an appropriate means of management for patients with chronic pancreatitis in the absence of doubts of neoplasia and/or distal ductal obstruction.
- Published
- 2005
119. Main-duct intraductal papillary mucinous neoplasms of the pancreas: clinical predictors of malignancy and long-term survival following resection
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Carlos Fernandez-del Castillo, Roberto Salvia, Sarah P. Thayer, Claudio Bassi, Andrew L. Warshaw, Paolo Pederzoli, William Mantovani, Massimo Falconi, Salvia, R., FERNANDEZ DEL CASTILLO, C., Bassi, C., Thayer, S. P., Falconi, Massimo, Mantovani, W., Pederzoli, P., and Warshaw, A. L.
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Male ,tumors ,medicine.medical_specialty ,intraductal papillary mucinous tumor ,pancreatic cancer ,predictors of malignancy ,surgical-management ,prognosis ,features ,endocrine system diseases ,Malignancy ,Main duct ,Gastroenterology ,Resection ,Postoperative Complications ,Internal medicine ,Pancreatic cancer ,Carcinoma ,medicine ,Humans ,Aged ,Pancreatic duct ,Intraductal papillary mucinous neoplasm ,business.industry ,Middle Aged ,medicine.disease ,Carcinoma, Papillary ,Pancreatic Neoplasms ,medicine.anatomical_structure ,Lymphatic Metastasis ,Surgery ,Female ,Pancreas ,business ,Carcinoma, Pancreatic Ductal - Abstract
To describe clinical characteristics and outcomes of a large cohort of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas affecting the main pancreatic duct.IPMNs are being diagnosed with increasing frequency. Preoperative determination of malignancy remains problematic, and reported results of long-term survival following resection are conflicting.The combined databases from the Massachusetts General Hospital and the Pancreatic Unit of the University of Verona were analyzed. To avoid confusing overlap with mucinous cystic neoplasms, only patients with tumors of the main pancreatic duct (with or without side branch involvement) were included. A total of 140 tumors consecutively resected between 1990 and 2002 were classified as either benign (adenoma and borderline tumors) or malignant (carcinoma in situ or invasive cancer) to compare their characteristics and survival.Men and women were equally affected (mean age 65 years). Seven patients (12%) had adenomas, 40 (28%) borderline tumors, 25 (18%) carcinoma in situ, and 58 (42%) invasive carcinoma. The median age of patients with benign IPMN was 6.4 years younger than those with malignant tumors (P = 0.04). The principal symptoms were abdominal pain (65%), weight loss (44%), acute pancreatitis (23%), jaundice (17%), and onset or worsening of diabetes (12%); 27% of patients were asymptomatic. Jaundice and diabetes were significantly associated with malignant tumors. Five- and 10-year cancer-specific survival for patients with noninvasive tumors was 100%, and comparable survival of the 58 patients with invasive carcinoma was 60% and 50%.Cancer is found in 60% of patients with main-duct IPMNs. Patients with malignant tumors are 6 years older than their benign counterparts and have a higher likelihood of presenting with jaundice or new onset diabetes. No patients with benign tumors or carcinoma in situ died of their disease following resection, and those with invasive cancer had a markedly better survival (60% at 5 years) than pancreatic ductal adenocarcinoma. These findings support both the concept of progression of benign IPMNs to invasive cancer and an aggressive policy of resection at diagnosis.
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- 2004
120. High recurrence rate after atypical resection for pancreatic metastases from renal cell carcinoma
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Claudio Bassi, Massimo Falconi, William Mantovani, Manuela Sargenti, Paolo Pederzoli, Giovanni Butturini, Bassi, C, Butturini, G, Falconi, Massimo, Sargenti, M, Mantovani, W, and Pederzoli, P.
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Adult ,Male ,medicine.medical_specialty ,Pancreatic disease ,medicine.medical_treatment ,Nephrectomy ,Disease-Free Survival ,Pancreaticoduodenectomy ,Pancreatectomy ,Renal cell carcinoma ,medicine ,Carcinoma ,Humans ,RNA, Messenger ,Carcinoma, Renal Cell ,Aged ,business.industry ,Postoperative complication ,Middle Aged ,medicine.disease ,Kidney Neoplasms ,Surgery ,Resection of pancreatic metastases from renal cell carcinoma ,Pancreatic Neoplasms ,medicine.anatomical_structure ,Female ,Neoplasm Recurrence, Local ,Pancreas ,business ,Tomography, X-Ray Computed ,Kidney disease ,Follow-Up Studies - Abstract
Background Pancreatic metastases from renal cell carcinoma are rare but highly resectable. The aim of this study was to review a series of patients with this condition. Methods The study involved 22 consecutive patients with histologically proven pancreatic metastases from renal cell cancer. Results Seventeen of the 22 patients had surgery. No patient died but eight of the 17 patients had a postoperative complication. Median follow-up was 33 (range 1–96) months. The 24- and 60-month survival probabilities were 0·84 and 0·53 respectively. Five patients who did not undergo surgery had 24- and 60-month survival probabilities of 0·53 and 0·26 respectively. The difference between the two groups was significant (P = 0·040). Conclusion Despite the slow development of these secondaries and their well encapsulated morphology, the high rate of recurrence after limited resection suggests that radical resection should be recommended.
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- 2003
121. Duct-to-mucosa versus end-to-side pancreaticojejunostomy reconstruction after pancreaticoduodenectomy: Results of a prospective randomized trial
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Enrico Molinari, Andrew A. Gumbs, William Mantovani, Roberto Salvia, Claudio Bassi, Paolo Pederzoli, Massimo Falconi, Giovanni Butturini, Bassi, C., Falconi, Massimo, Molinari, E., Mantovani, W., Butturini, G., Gumbs, A. A., Salvia, R., and Pederzoli, P.
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Anastomosis ,Group B ,law.invention ,Pancreaticoduodenectomy ,Surgical anastomosis ,Postoperative Complications ,Randomized controlled trial ,law ,Pancreaticojejunostomy ,medicine ,Humans ,Prospective Studies ,Intestinal Mucosa ,Aged ,business.industry ,Anastomosis, Surgical ,Pancreatic Ducts ,Length of Stay ,Middle Aged ,Surgery ,medicine.anatomical_structure ,Pancreatectomy ,Duodenum ,Female ,business ,Complication - Abstract
Background Anastomotic failure is still a significant problem that affects the outcome of pancreaticoduodenectomy. There have been many techniques proposed for the reconstruction of pancreatic digestive continuity, but there have been few prospective and randomized studies that compare their efficacy. Methods In the current work, 144 patients who underwent a pancreaticoduodenectomy with soft residual tissue were assigned randomly to receive either a duct-to-mucosa anastomosis (group A) or a 1-layer end-to-side pancreaticojejunostomy (group B). Results The 2 treatment groups were found not to have any differences in regards to vital statistics, underlying disease, or operative techniques. The postoperative course was complicated in 54% of the 144 patients, with a comprehensive incidence of abdominal complications in 36% (group A, 35%; group B, 38%; P = not significant). The principal complication was pancreatic fistulas, which occurred in 14% of patients (group A, 13%; group B, 15%; P = not significant). Two patients (2%) required reoperation; the postoperative mortality rate was 1%. Conclusion The 2 methods that were studied revealed no significant difference the rate of complications.
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- 2003
122. Genome search in celiac disease
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S. Percopo, Alessandro Ventura, Giuseppe Iacono, Fiorella Balli, Salvatore Musumeci, Ettore Cardi, Giuliano Torre, Gino Roberto Corazza, Carlo Catassi, Wilma Mantavoni, Rosanna Gatti, Françoise Clerget-Darpoux, J.L. Serre, Roberto Tosi, Francesco Cataldo, Jean François Eliaou, Stefano De Virgiliis, Umberto Volta, F. Clot, Colette Dib, Francesco Perri, R. Lazzari, Gianluigi De Angelis, Roberto Ferrari, Marie Claude Fulchignoni-Lataud, Luigi Greco, Riccardo Troncone, Patrizia Zavattari, F. Bouguerra, Giuseppe Magazzù, Annamaria Giunta, Marie Claude Babron, Maria Teresa Bardella, Greco, L, Corazza, G, Babron, Mc, Clot, F, Fulchignonilataud, Mc, Percopo, S, Zavattari, P, Bouguerra, F, Dib, C, Tosi, R, Troncone, R, Ventura, Alessandro, Mantavoni, W, Magazzu, G, Gatti, R, Lazzari, R, Giunta, A, Perri, F, Iacono, G, Cardi, E, DE VIRGILIIS, S, Cataldo, F, DE ANGELIS, G, Musumeci, S, Clergetdarpoux, F., Greco, Luigi, Fulchignoni Lataud, Mc, Troncone, Riccardo, Ventura, A, Mantovani, W, Magazzù, G, de Virgiliis, S, De Angelis, G, Ferrari, R, Balli, F, Bardella, Mt, Volta, U, Catassi, C, Torre, G, Eliaou, Jf, Serre, Jl, and Clerget Darpoux, F.
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Genotype ,Genetic Linkage ,Human leukocyte antigen ,Biology ,Coeliac disease ,Genetic determinism ,Genome screening ,Gene mapping ,Genetic linkage ,Genetics ,Genetic predisposition ,medicine ,Humans ,Genetics(clinical) ,Genetic Testing ,Risk factor ,Genetics (clinical) ,Genetic testing ,medicine.diagnostic_test ,Linkage ,Genome, Human ,medicine.disease ,HLA ,Celiac Disease ,Research Article - Abstract
SummaryCeliac disease (CD), a malabsorption disorder of the small intestine, results from ingestion of gluten. The HLA risk factors involved in CD are well known but do not explain the entire genetic susceptibility. To determine the localization of other genetic risk factors, a systematic screening of the genome has been undertaken. The typing information of 281 markers on 110 affected sib pairs and their parents was used to test linkage. Systematic linkage analysis was first performed on 39 pairs in which both sibs had a symptomatic form of CD. Replication of the regions of interest was then carried out on 71 pairs in which one sib had a symptomatic form and the other a silent form of CD. In addition to the HLA loci, our study suggests that a risk factor in 5qter is involved in both forms of CD (symptomatic and silent). Furthermore, a factor on 11qter possibly differentiates the two forms. In contrast, none of the regions recently published was confirmed by the present screening.
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- 1998
123. 817 PAIN ASSESSMENT FROM 664 CONSECUTIVE PATIENTS THAT UNDERWENT A FIRST SET OF TRANSPERINEAL PROSTATE BIOPSY USING A COAXIAL NEEDLE FOR PROSTATE CANCER SUSPICION
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Cerruto, M.A., Novella, G., Ficarra, V., Mantovani, W., Cardarelli, S., Gigli, F., Ruggera, L., Beltrami, P., Baldassarre, R., and Zattoni, F.
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- 2008
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124. 297 THE EFFECT OF ANKLE INCLINATION IN SUPINE AND STANDING POSITION ON THE ELECTROMYIGRAPHIC ACTIVITY OF ABDOMINAL AND PELVIC FLOOR MUSCLES IN WOMEN WITH AND WITHOUT STRESS URINARY INCONTINENCE: PRELIMINARY RESULTS FROM A PILOT STUDY
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Cerruto, M., Vedovi, E., Rossi, S., Mantovani, W., Pozzo, A., Cangemi, A., Sbarbati, A., Ruggera, L., Fiaschi, A., and Zattoni, Z.
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- 2008
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125. Patients with cancer who will be cured and projections of complete prevalence in Italy from 2018 to 2030.
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Guzzinati S, Toffolutti F, Francisci S, De Paoli A, Giudici F, De Angelis R, Demuru E, Botta L, Tavilla A, Gatta G, Capocaccia R, Zorzi M, Caldarella A, Bidoli E, Falcini F, Bruni R, Migliore E, Puppo A, Ferrante M, Gasparotti C, Gambino ML, Carrozzi G, Bianconi F, Musolino A, Cavallo R, Mazzucco W, Fusco M, Ballotari P, Sampietro G, Ferretti S, Mangone L, Mantovani W, Mian M, Cascone G, Manzoni F, Galasso R, Piras D, Pesce MT, Bella F, Seghini P, Fanetti AC, Pinna P, Serraino D, Rossi S, and Dal Maso L
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- Humans, Italy epidemiology, Female, Male, Prevalence, Aged, Middle Aged, Adult, Adolescent, Young Adult, Child, Aged, 80 and over, Registries, Cancer Survivors statistics & numerical data, Child, Preschool, Infant, Forecasting, Infant, Newborn, Neoplasms epidemiology, Neoplasms therapy
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Background: The number and projections of cancer survivors are necessary to meet the healthcare needs of patients, while data on cure prevalence, that is, the percentage of patients who will not die of cancer by time since diagnosis, are lacking., Materials and Methods: Data from Italian cancer registries (duration of registration ranged from 9 to 40 years, with a median of 22 years) covering 47% of the population were used to calculate the limited-duration prevalence, the complete prevalence in 2018, projections to 2030, and cure prevalence, by cancer type, sex, age, and time since diagnosis., Results: A total of 3 347 809 people were alive in Italy in 2018 after a cancer diagnosis, corresponding to 5.6% of the resident population. They will increase by 1.5% per year to 4 012 376 in 2030, corresponding to 6.9% of the resident population, 7.6% of women and ∼22% after age 75 years. In 2030, more than one-half of all prevalent cases (2 million) will have been diagnosed by ≥10 years. Those with breast (1.05 million), prostate (0.56 million), or colorectal cancers (0.47 million) will be 52% of all prevalent patients. Cure prevalence was 86% for all patients alive in 2018 (87% for patients with breast cancer and 99% for patients with thyroid or testicular cancer), increasing with time since diagnosis to 93% for patients alive after 5 years and 96% after 10 years. Among patients who survived at least 5 years, the excess risk of death (1 - cure prevalence) was <5% for patients with most cancer types except for those with cancers of the breast (8.3%), lung (11.1%), kidney (13.2%), and bladder (15.5%)., Conclusions: Study findings encourage the implementation of evidence-based policies aimed at improving long-term clinical follow-up and rehabilitation of people living after cancer diagnosis throughout the course of the disease. Updated estimates of complete prevalence are important to enhance data-driven cancer control planning., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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126. About cancer screenings and saving lives: measuring the effects of cancer screening programs through meta-analyses-A comment to the meta-analysis "Estimated Lifetime Gained With Cancer Screening Tests" by Bretthauer et al. (2023).
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Stracci F, Martinelli D, Anedda FM, Caminiti M, Mantovani W, Pettinicchio V, Sinopoli A, Vitale F, Siliquini R, and Mazzucco W
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- Humans, Mass Screening statistics & numerical data, Neoplasms diagnosis, Early Detection of Cancer, Meta-Analysis as Topic
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Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.
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- 2024
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127. The COVID-19 vaccination in 4,772 pregnant women in the province of Trento (North-East Italy). Characteristics of vaccinated women.
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Pertile R, Battistella C, De Nisi M, Zuccali MG, Mantovani W, and Moretti F
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- Female, Pregnancy, Humans, COVID-19 Vaccines, Italy epidemiology, SARS-CoV-2, Vaccination, Pregnant Women, COVID-19 epidemiology, COVID-19 prevention & control
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Objectives: to investigate vaccine uptake among pregnant women during the 2nd and 3rd trimester of pregnancy. To describe the factors influencing vaccine uptake during pregnancy, comparing sociodemographic and clinical characteristics of pregnant women who were vaccinated during the 2nd or 3rd trimester with those who were not vaccinated, despite having the indication for vaccination., Design: observational study with a cross-sectional approach and prevalence estimation in the population of women who gave birth in the study period, through record linkages between the ministry information flow Birth assistance certificate, the Regional vaccination register and the Italian flow for SARS-CoV-2 infections., Setting and Participants: the study included all the 4,772 pregnant women living in Trentino (north-east Italy), who were in the 2nd or 3rd trimester of pregnancy between the 5th May 2021 and the 28th February 2022 and who delivered in Trentino., Main Outcome Measures: vaccine uptake among pregnant women during the 2nd and 3rd trimester of pregnancy. Results: 33.3% of pregnant women got vaccinated with at least one dose of vaccine during the 2nd or 3rd trimester of pregnancy. Independent factors associated with vaccine uptake in the 2nd or 3rd trimester were the mother's citizenship, educational level, occupational status and age., Conclusions: the proportion of women who received at least one dose of COVID-19 vaccine during pregnancy was low. The results are important to start efficient actions to promote vaccination in pregnant women, particularly in the most vulnerable ones (unemployed, foreigners and with a low educational level), who appear to be less vaccinated frequently.
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- 2023
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128. Hepatitis C virus burden: Treating and educating people without prejudice.
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Merola E, Menotti E, Branz G, Michielan A, Seligmann S, Ratti A, Agugiaro F, Moser L, Vettori G, Franceschini A, Mantovani W, Pertile R, de Pretis G, and Pravadelli C
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Background: Hepatitis C virus (HCV) infection has a worldwide incidence of 1.1%. In Italy, 60% of people who inject drugs (PWIDs) and are receiving assistance for substance use disorder are infected with HCV. However, this subset of patients has extremely limited access to care due to multiple factors, including alcohol abuse, psychological comorbidities, and homeless status., Aim: To describe the impact of our HCV-dedicated service for substance use disorder (SSUD) service on PWIDs receiving anti-HCV therapy., Methods: A dedicated, multidisciplinary team was set up at the SSUD of Trento in October 2020 to provide antiviral treatment to HCV RiboNucleic Acid-positive patients with an active or previous history of substance abuse. The treatment was followed by a health education program. Patients were treated with Direct-Acting Antivirals (DAAs). Data were retrospectively analyzed to assess the efficacy of our dedicated program in terms of therapy completion, HCV eradication, and compliance (primary endpoint). The rate of HCV reinfection and DAA-related toxicity were also assessed (secondary endpoints)., Results: A total of 40 patients were enrolled in the study: 28 (70.0%) were treated with Sofosbuvir/Velpatasvir, while 12 (30.0%) received Glecaprevir/Pibrentasvir. At the time of inclusion in the study, 36 patients were receiving opioid agonist maintenance therapy, whilst another 4 had just finished the treatment. 37.5% had a history of alcoholism and 42.5% received concomitant psychiatric treatment. All 40 patients (100.0%) completed the therapy cycle and 92.5% of patients adhered to the program. All patients tested negative for viral load at the end of the treatment. There were no significant drug interactions with common psychiatric treatments and no side effects were observed. The sustained virological response was achieved in 92.5% of cases with good tolerability, although two patients discontinued treatment temporarily. After HCV eradication, one patient died from an overdose, another from complications of cirrhosis, and one reinfection occurred., Conclusion: Very high adherence to therapy and good tolerability was observed in our series of HCV patients treated at the SSUD, regardless of the substance abuse condition. Further validation in a larger population is required., Competing Interests: Conflict-of-interest statement: All authors declare that they have no conflict of interest., (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)
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- 2022
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129. A comprehensive assessment of the impact of a colorectal cancer screening program in a northern Italian area.
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Pancheri S, Pertile R, Armelao F, Rizzello RV, Piffer S, Zorzi M, Guzzinati S, Ferro A, Mantovani W, and de Pretis G
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- Aged, Colorectal Neoplasms mortality, Female, Humans, Incidence, Italy epidemiology, Male, Middle Aged, Prognosis, Program Evaluation, Retrospective Studies, Time Factors, Colorectal Neoplasms diagnosis, Early Detection of Cancer statistics & numerical data, Occult Blood
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Background: The impact of a faecal immunochemical test-based colorectal cancer (CRC) screening program in terms of patient prognosis could be affected by lead-time bias, which artificially increases the survival of screen-detected patients due to the early diagnosis., Aims: To provide a description of the impact of the CRC screening program in the Trentino Region (Italy), including the Cure Fraction (CF), a prognostic indicator not affected by lead-time bias., Methods: The program started in 2008, inviting the resident population aged 50-69 years. In this retrospective cohort study, 1,697 CRC diagnosed between 2003 and 2014 in patients aged 50-69 years were classified as pre-screening (PS), screen-detected (SD), interval cancers (IC) and not-screen-detected (NSD). We compared groups by stage at diagnosis and CF. Trends in CRC mortality were reported., Results: The proportion of stage I among SD cases was 51%, higher than PS (19%; OR 4.66, 95%CI 3.50-6.20), NSD (20.6%; OR 3.96, 95%CI 2.95-5.32) and IC (33.3%; OR 2.11, 95%CI 1.10-4.04). The CF of PS, NSD and SD cases was respectively 57% (95%CI 54-60%), 60% (95%CI 58-63%) and 93% (95%CI 89-96%). CRC mortality dropped from 40.7 to 25.6\100,000., Conclusion: The program significantly improved the prognosis of patients, decreasing CRC mortality and incidence of advanced CRCs., Competing Interests: Declaration of Competing Interest None., (Copyright © 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
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- 2022
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130. Identification of bone marrow edema of the knee: diagnostic accuracy of dual-energy CT in comparison with MRI.
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Foti G, Mantovani W, Faccioli N, Crivellari G, Romano L, Zorzi C, and Carbognin G
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- Absorptiometry, Photon, Adult, Aged, Area Under Curve, Female, Humans, Magnetic Resonance Imaging standards, Male, Middle Aged, Observer Variation, Prospective Studies, ROC Curve, Reference Standards, Sensitivity and Specificity, Bone Marrow Diseases diagnostic imaging, Edema diagnostic imaging, Knee Joint diagnostic imaging, Magnetic Resonance Imaging methods, Tomography, X-Ray Computed methods
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Background: To assess the diagnostic accuracy of dual-energy computed tomography (DECT) in diagnosing bone marrow edema (BME) of the knee in traumatic and non-traumatic patients., Methods: This prospective IRB approved study included 33 consecutive patients (20 males, 13 females; mean age of 52.2 years) evaluated with DECT (80 and 150 kV) and MRI within 6 days. Two experienced radiologists qualitatively and quantitatively evaluated DECT images. The accuracy values were calculated by using receiver operator curves (ROC) and area under the curve (AUC), using MRI as the reference standard. Inter-observer and intra-observer agreement were calculated with k-statistics. A p < 0.05 was considered statistically significant., Results: MRI depicted BME in 25/33 patients (75.7%). The sensitivity, specificity, PPV, NPV, and accuracy of per-partition qualitative analysis were 92.9, 92.9, 78.2, 97.9, and 92.9%, for reader 1, and 88.2, 93.9, 79.8, 96.6, and 92.6%, for reader 2, respectively. The inter-observer agreement was substantial (k = 0.793) and the intra-observer agreement was near-perfect (k = 0.844). At the quantitative analysis, a significant difference (p < 0.001) was depicted between the density values of positive (mean 3.6 ± 25.3 HU) and negative cases (mean - 72.2 ± 45.1 HU). By using - 15 HU cutoff to identify BME, sensitivity, specificity, PPV, NPV, and accuracy of DECT were 84.7, 93.6, 78.2, 95.7, and 91.6%, respectively., Conclusion: DECT can accurately identify BME of the knee.
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- 2021
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131. [Reorganization and public health management by the Department of Prevention during the COVID-19 emergency. An experience of integration between prevention and primary care in the proactive management of possible cases].
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Mantovani W, Franchini S, Mazzurana M, Zuccali MG, Pizzo F, Zanin A, and Ferro A
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- Adult, Child, Contact Tracing, Disease Management, Female, General Practice, Humans, Interdisciplinary Communication, Italy, Male, Pediatrics, COVID-19 prevention & control, Communicable Disease Control organization & administration, Intersectoral Collaboration, Pandemics, Primary Health Care organization & administration, Public Health Administration, SARS-CoV-2
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Objectives: to describe the organisation and the role of the Department of Prevention of the Local Health Unit (APSS) of Trento (Trentino-Alto Adige Region, Northern Italy) against the spread of COVID-19 in the population, in the management of possible cases (with only clinical criteria of influenza-like illness, ILI, without diagnostic swab) reported by General practitioners (GPs) and by Family paediatricians (FPs) during the initial phase of the pandemic COVID-19 in Trentino-Alto Adige Region., Design: descriptive study., Setting and Participants: this study analysed the reports of patients with ILI sent to the Healthcare company from 17 March to 17 April 2020 by their GPs or FP and subsequently classified into: redundant reports (people already known to the healthcare company as confirmed or probable case COVID-19); reports inconsistent with ILI criteria (patients not known to APSS as probable/confirmed case; without ILI criteria); appropriate reports (patients not known to APSS as probable/confirmed case; with ILI criteria)., Main Outcome Measures: proportion of GPs and FPs who participated to report system reporting at least one patient, out of the total number of GPs and FPs; frequency of patients reported as ILI; time (in days) to manage reported patients. The cumulative weekly rate of "non-redundant" (not already known to APSS as probable/confirmed case) reports per thousand inhabitants was also calculated., Results: over 80% of GPs and FPs voluntary participated into the reporting system of patients with COVID-19 clinical criteria. Overall, 4,270 patients were reported; of these, 2,865 (67%) were not known to APSS as probable/confirmed case. Response time in days decrease progressively during the period of activity (from a mean of 6 days to 0.4 days during the 12th and 16th week of 2020, respectively). The cumulative weekly rate of client reports which were not already known as probable or confirmed cases (per 1,000 population) ranges from 3.54 to 6.84 cases in the 12th and 16th week, respectively. Among the 4,270 reports, 1,471 patients considered possible COVID-19 cases were identified due to the presence of ILI symptoms, even in the absence of a swab or a positive history for close contact with COVID-19 case. From the epidemiological investigation into the 1,471 possible cases, 2,514 close contacts were identified and quarantined at home. Of the 2,514 close contacts, 127 (5.05%) people developed symptoms during quarantine., Conclusions: the integration among primary care, GPs and FPS, and the Department of Prevention could be an element of success in the management of the COVID-19 emergency and in the return to a normal phase. However, further assessments are required on the effectiveness and impact of the adopted model, especially in relation to the exit from phase 1 and phase 2 of the pandemic emergency.
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- 2020
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132. Evaluation of glenoid labral tears: comparison between dual-energy CT arthrography and MR arthrography of the shoulder.
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Foti G, Mantovani W, Catania M, Avanzi P, Caia S, Zorzi C, and Carbognin G
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- Adult, Area Under Curve, Female, Humans, Male, Middle Aged, Observer Variation, Prospective Studies, Rotator Cuff Injuries surgery, Sensitivity and Specificity, Arthrography methods, Magnetic Resonance Imaging methods, Rotator Cuff Injuries diagnostic imaging, Tomography, X-Ray Computed methods
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Objective: To compare the diagnostic accuracy of dual-energy computed tomography arthrography (DE-CTA) and magnetic resonance arthrography (MRA) of the shoulder in depicting glenoid labral tears., Methods: This prospective institutional review board-approved study included 47 consecutive patients (28 males, 19 females; mean age of 34.2 years) studied between January 2017 and October 2018. All patients underwent DE-CTA and MRA the same day. Two radiologists (25 and 11 years of experience, respectively), blinded to clinical data, evaluated the presence labral tears on virtual-blended 120 kV standard CTA and on DE-CTA images. A third radiologist (18 years of experience) evaluated the MRA images. Diagnostic accuracy values were calculated by using surgery as standard of reference. Inter-observer and intra-observer agreements were calculated with k statistics. A value of p < 0.05 was considered statistically significant., Results: Surgery revealed the presence of labral tears in 38/47 patients (80.9%). Sensitivity and specificity values in diagnosing labral tears were 84.2% and 77.8% for MRA (Reader 3), 84.2% and 77.8% for CTA (Reader 1), 84.2% and 88.9% for CTA (Reader 2), 89.5% and 88.9% for DE-CTA (Reader 1), and 92.1% and 88.9% for DE-CTA (Reader 2). A nonsignificant increase in AUC values with respect to MRA was obtained by reading the CTA (p = 0.470) and DE-CTA dataset (p = 0.217), respectively. Inter-observer agreements were near perfect for CTA (k = 0.84) and substantial for DE-CTA reading (k = 0.76). Intra-observer agreements were near perfect both for CTA (k = 0.88) and for DE-CTA reading (k = 0.82)., Conclusion: DE-CTA and MRA were not different in terms of diagnostic performance.
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- 2020
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133. ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest.
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Ramos FN, Mortara SR, Monalisa-Francisco N, Elias JPC, Neto LM, Freitas L, Kersten R, Amorim AM, Matos FB, Nunes-Freitas AF, Alcantara S, Alexandre MHN, de Almeida-Scabbia RJ, de Almeida OJG, Alves FE, de Oliveira Alves RM, Alvim FS, de Andrade ACS, de Andrade S, Aona LYS, Araujo AC, de Araújo KCT, Ariati V, Assis JC, de Azevedo CO, Barbosa BF, Barbosa DEF, Barbosa FDR, de Barros F, Basilio GA, Bataghin FA, Bered F, Bianchi JS, Blum CT, Boelter CR, Bonnet A, Brancalion PHS, Breier TB, Brion CT, Buzatto CR, Cabral A, Cadorin TJ, Caglioni E, Canêz L, Cardoso PH, de Carvalho FS, Carvalho RG, Catharino ELM, Ceballos SJ, Cerezini MT, César RG, Cestari C, Chaves CJN, Citadini-Zanette V, Coelho LFM, Coffani-Nunes JV, Colares R, Colletta GD, Corrêa NM, da Costa AF, da Costa GM, Costa LMS, Costa NGS, Couto DR, Cristofolini C, da Cruz ACR, Del Neri LA, di Pasquo M, Dos Santos Dias A, Dias LDCD, Dislich R, Duarte MC, Fabricante JR, Farache FHA, de Faria APG, Faxina C, Ferreira MTM, Fischer E, Fonseca CR, Fontoura T, Francisco TM, Furtado SG, Galetti M, Garbin ML, de Gasper AL, Goetze M, Gomes-da-Silva J, Gonçalves MFA, Gonzaga DR, Silva ACGE, Guaraldo AC, Guarino ESG, Guislon AV, Hudson LB, Jardim JG, Jungbluth P, Kaeser SDS, Kessous IM, Koch NM, Kuniyoshi YS, Labiak PH, Lapate ME, Santos ACL, Leal RLB, Leite FS, Leitman P, Liboni AP, Liebsch D, Lingner DV, Lombardi JA, Lucas E, Luzzi JDR, Mai P, Mania LF, Mantovani W, Maragni AG, Marques MCM, Marquez G, Martins C, Martins LDN, Martins PLSS, Mazziero FFF, Melo CA, de Melo MMF, Mendes AF, Mesacasa L, Morellato LPC, Moreno VS, Muller A, Murakami MMDS, Cecconello E, Nardy C, Nervo MH, Neves B, Nogueira MGC, Nonato FR, de Oliveira-Filho AT, de Oliveira CPL, Overbeck GE, Marcusso GM, Paciencia MLB, Padilha P, Padilha PT, Pereira ACA, Pereira LC, Pereira RAS, Pincheira-Ulbrich J, Pires JSR, Pizo MA, Pôrto KC, Rattis L, Reis JRM, Reis SGD, da Rocha-Pessôa TC, Rocha CFD, Rocha FS, Rodrigues ARP, Rodrigues RR, Rogalski JM, Rosanelli RL, Rossado A, Rossatto DR, Rother DC, Ruiz-Miranda CR, Saiter FZ, Sampaio MB, Santana LD, Santos JSD, Sartorello R, Sazima M, Schmitt JL, Schneider G, Schroeder BG, Sevegnani L, Júnior VOS, da Silva FR, da Silva MJ, Silva MPP, Silva RG, Silva SM, Singer RB, Siqueira G, Soares LE, de Sousa HC, Spielmann A, Tonetti VR, Toniato MTZ, Ulguim PSB, van den Berg C, van den Berg E, Varassin IG, da Silva IBV, Vibrans AC, Waechter JL, Weissenberg EW, Windisch PG, Wolowski M, Yañez A, Yoshikawa VN, Zandoná LR, Zanella CM, Zanin EM, Zappi DC, Zipparro VB, Zorzanelli JPF, and Ribeiro MC
- Abstract
Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events., (© 2019 The Authors. Ecology © 2019 The Ecological Society of America.)
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- 2019
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134. Retropubic, Laparoscopic, and Robot-Assisted Radical Prostatectomy: A Comparative Analysis of the Surgical Outcomes in a Single Regional Center.
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Luciani LG, Mattevi D, Mantovani W, Cai T, Chiodini S, Vattovani V, Puglisi M, Tiscione D, Anceschi U, and Malossini G
- Abstract
Background: To compare the surgical outcomes of radical prostatectomy (RP) performed via 3 different approaches: retropubic (RRP), laparoscopic-assisted (LRP), and robot-assisted (RARP), in a single non-academic regional center by a single surgeon., Materials and Methods: The data of patients undergoing RP from 2005 to 2014 were reviewed. The standard approach changed through the years: RRP (n = 380, years 2005 to 2008), LRP (n = 240, years 2009 to 2011), and RARP (n = 262, years 2012 to 2014). Our analysis included the last consecutive 100 RP for each surgical technique by a single surgeon. A logistic regression model adjusted for pre-and postoperative variables was done to evaluate whether transfusion, conversion, and post-operative complication rates were influenced by the approach., Results: RARP was associated with significantly lower blood loss (400 vs. 600 and 600 ml, respectively), transfusion (6 vs. 21 and 21%, respectively), and shorter hospital stay (6 vs. 7 and 8 days, respectively), compared to LRP and RRP, and a lower conversion rate (1 vs. 12%) compared to LRP. Multivariate analysis adjusted for confounders confirmed that the risk of transfusion and conversion was significantly lower in the RARP group compared to the LRP and RRP groups. The RARP group was also associated with a significantly lower risk of complications compared to the RRP group and with a trend in favor of the RARP group compared to the LRP group. The 1-year continence rate was significantly higher in the RARP group compared to the RRP and LRP groups (80 vs. 72 and 68%, respectively)., Conclusion: The surgical approach affected the operative outcomes in a regional setting. The advantages of RARP over RRP (complications, transfusion, conversion, hospital stay, 1-year continence) were over LRP as well, with the only exception being complications.
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- 2017
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135. Robotic-assisted partial nephrectomy provides better operative outcomes as compared to the laparoscopic and open approaches: results from a prospective cohort study.
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Luciani LG, Chiodini S, Mattevi D, Cai T, Puglisi M, Mantovani W, and Malossini G
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- Aged, Blood Loss, Surgical, Carcinoma, Renal Cell pathology, Feasibility Studies, Female, Humans, Kidney Neoplasms pathology, Length of Stay statistics & numerical data, Male, Middle Aged, Postoperative Complications etiology, Postoperative Complications pathology, Prospective Studies, Treatment Outcome, Tumor Burden, Carcinoma, Renal Cell surgery, Kidney Neoplasms surgery, Laparoscopy methods, Nephrectomy methods, Robotic Surgical Procedures methods
- Abstract
The objective of this is to compare the surgical outcomes of partial nephrectomy (PN), performed via three different approaches: robot-assisted (RAPN), laparoscopic (LPN), and open (OPN), in a single non-academic regional center. The data of patients undergoing PN at our Department from 2005 to 2016 were prospectively collected. A logistic regression model adjusted for preoperative variables (age, tumor size, creatinine and hemoglobin, ASA and Padua scores) was performed to evaluate whether transfusion, conversion, and postoperative complication rate were influenced by the surgical approach. Overall 270 patients underwent PN: analysis included 253 cases (RAPN = 110, LPN = 70, OPN = 73). Preoperative variables did not differ significantly among the three groups. Shorter operative (130 vs 180 and 200') and ischaemia (12 vs 23 and 22') times and longer hospital stay (8 vs 7 and 6 days) were found in the OPN group as compared to LPN and RAPN, respectively. The RAPN group included a higher rate of pT1b (31.8 vs 14.2 and 15%) and malignant histotype (90 vs 82.9 and 68.5%) as compared to LPN and OPN, respectively. Clavien Grade III-IV complications were lower in the RAPN (7.2%) as compared to OPN (12.3%) and LPN (17.1%) groups. Multivariate analysis showed a lower risk for conversion, transfusion and overall complications in the RAPN group versus LPN and OPN. The surgical approach affects the perioperative outcomes in a regional setting. The advantages of RAPN over OPN (lower risk of conversion, transfusion, and overall complications) are extended over LPN as well, although OPN offered faster operative and ischemia times at the expense of greater blood loss and hospital stay.
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- 2017
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136. MR arthrography of the shoulder: evaluation of isotropic 3D intermediate-weighted FSE and hybrid GRE T1-weighted sequences.
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Foti G, Avanzi P, Mantovani W, Dal Corso F, Demozzi E, Zorzi C, and Carbognin G
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- Adolescent, Adult, Female, Humans, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Young Adult, Arthrography methods, Imaging, Three-Dimensional, Magnetic Resonance Imaging methods, Shoulder Injuries, Shoulder Joint diagnostic imaging
- Abstract
Purpose: To compare the diagnostic accuracy of three-dimensional (3D) fast spin echo (FSE) intermediate-weighed (IW-3D) and 3D hybrid double-echo steady-state T1-weighted sequences (Hy-3D) and two-dimensional (FSE) images (2D) at shoulder MR arthrography (MRA)., Materials and Methods: Institutional review board approval was obtained and informed consent was waived for this retrospective study. From September 2011 to October 2014, 102 patients who had undergone 1.5 Tesla MRA of the shoulder, including conventional 2D-FSE and IW-3D and Hy-3D images were included in our study. The mean interval between MRA and surgery was 21 days (range 2-70 days). MR images were retrospectively and independently reviewed by two experienced radiologists blinded to the clinical and surgical data. Supraspinatus tendon (SST), infraspinatus tendon (IST) and subscapularis tendon (SCT) tears, as well as antero-inferior, superior and posterior labral lesions were assessed, using surgery as the reference standard. Each reader's performance in assessing rotator cuff and labrum abnormalities was evaluated using the area under the receiver operating characteristic curve (AUC) and 95% confidence intervals (CIs). The difference was evaluated using a univariate z test. The sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) and accuracy (Acc) for all types of rotator cuff tears and labral lesions were calculated. A value of p < 0.05 was considered statistically significant. Inter-observer agreement was calculated using kappa statistics., Results: The difference of diagnostic accuracy achieved was not significant (p > 0.05). In particular, differences in AUC values ranged from 0.002 (p = 0.98) to 0.014 (p = 0.82) as regards the comparison between 2D and IW-3D images, from 0.002 (p = 0.98) to 0.034 (p = 0.08) concerning the comparison between 2D and Hy-3D images and from 0.010 (p = 0.82) to 0.032 (p = 0.09) when comparing Hy-3D to IW-3D images. Accuracy values in evaluating RC lesions and labral lesions were 95.1, 92.1, 91.2, 93.1, 93.1 and 94.1% by reading 2D, Hy-3D and IW-3D images, respectively. The difference of diagnostic accuracy achieved using the datasets analyzed was not significant (p > 0.05). Inter-observer agreement was very good for each of the datasets that were evaluated, with near-perfect agreement for 2D dataset (k = 0.86), Hy-3D (k = 0.81) and IW-3D (k = 0.83)., Conclusions: The accuracy of IW-3D and Hy-3D images was not significantly higher than the 2D sequences in evaluating RC and labral lesions.
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- 2017
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137. Exposure of tropical ecosystems to artificial light at night: Brazil as a case study.
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Freitas JR, Bennie J, Mantovani W, and Gaston KJ
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- Brazil, Spatio-Temporal Analysis, Ecosystem, Environmental Exposure adverse effects, Lighting adverse effects, Tropical Climate
- Abstract
Artificial nighttime lighting from streetlights and other sources has a broad range of biological effects. Understanding the spatial and temporal levels and patterns of this lighting is a key step in determining the severity of adverse effects on different ecosystems, vegetation, and habitat types. Few such analyses have been conducted, particularly for regions with high biodiversity, including the tropics. We used an intercalibrated version of the Defense Meteorological Satellite Program's Operational Linescan System (DMSP/OLS) images of stable nighttime lights to determine what proportion of original and current Brazilian vegetation types are experiencing measurable levels of artificial light and how this has changed in recent years. The percentage area affected by both detectable light and increases in brightness ranged between 0 and 35% for native vegetation types, and between 0 and 25% for current vegetation (i.e. including agriculture). The most heavily affected areas encompassed terrestrial coastal vegetation types (restingas and mangroves), Semideciduous Seasonal Forest, and Mixed Ombrophilous Forest. The existing small remnants of Lowland Deciduous and Semideciduous Seasonal Forests and of Campinarana had the lowest exposure levels to artificial light. Light pollution has not often been investigated in developing countries but our data show that it is an environmental concern., Competing Interests: The authors have declared that no competing interests exist.
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- 2017
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138. Is chest X-ray screening for lung cancer in smokers cost-effective? Evidence from a population-based study in Italy.
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Pertile P, Poli A, Dominioni L, Rotolo N, Nardecchia E, Castiglioni M, Paolucci M, Mantovani W, and Imperatori A
- Abstract
Background: After implementation of the PREDICA annual chest X-ray (CXR) screening program in smokers in the general practice setting of Varese-Italy a significant reduction in lung cancer-specific mortality (18 %) was observed. The objective of this study covering July 1997 through December 2006 was to estimate the cost-effectiveness of this intervention., Methods: We examined detailed information on lung cancer (LC) cases that occurred among smokers invited to be screened in the PREDICA study (Invitation-to-screening Group, n = 5815 subjects) to estimate costs and quality-adjusted life-years (QALYs) from LC diagnosis until death. The control group consisted of 156 screening-eligible smokers from the same area, uninvited and unscreened, who developed LC and were treated by usual care. We calculated the incremental net monetary benefit (INMB) by comparing LC management in screening participants (n = 1244 subjects) and in the Invitation-to-screening group versus control group., Results: The average number of QALYs since LC diagnosis was 1.7, 1.49 and 1.07, respectively, in screening participants, the invitation-to-screening group, and the control group. The average total cost (screening + management) per LC case was higher in screening participants (€17,516) and the Invitation-to-screening Group (€16,167) than in the control group (€15,503). Assuming a maximum willingness to pay of €30,000/QALY, we found that the intervention was cost-effective with high probability: 79 % for screening participation (screening participants vs. control group) and 95 % for invitation-to-screening (invitation-to-screening group vs. control group)., Conclusions: Based on the PREDICA study, annual CXR screening of high-risk smokers in a general practice setting has high probability of being cost-effective with a maximum willingness to pay of €30,000/QALY.
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- 2015
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139. Mucinous cystic neoplasms and serous cystadenomas arising in the body-tail of the pancreas: MR imaging characterization.
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Manfredi R, Ventriglia A, Mantovani W, Mehrabi S, Boninsegna E, Zamboni G, Salvia R, and Pozzi Mucelli R
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- Adolescent, Adult, Aged, Carcinoma in Situ, Contrast Media, Diagnosis, Differential, Female, Humans, Image Enhancement, Male, Middle Aged, Pancreas pathology, Retrospective Studies, Young Adult, Cholangiopancreatography, Magnetic Resonance, Cystadenoma, Mucinous diagnosis, Cystadenoma, Serous diagnosis, Pancreatic Neoplasms diagnosis
- Abstract
Purpose: To identify magnetic resonance (MR)/MR cholangiopancreatography (MRCP) imaging signs helpful in the differential diagnosis between serous cystadenomas (SCAs) and mucinous cystic neoplasms (MCNs), arising from the body/tail of the pancreas., Material and Methods: This retrospective study had institutional review board approval and informed consent was waived. Fifty-three patients with non-communicating cystic pancreatic neoplasm of the body/tail, undergoing MR/MRCP, were included. Qualitative image analysis assessed the macroscopic pattern, number of cysts, presence of central scar, contrast enhancement of peripheral wall, and mural nodules. Quantitative analysis assessed the maximum diameter of the neoplasm, thickness of the peripheral wall, and calibre of the upstream main pancreatic duct., Results: Histopathology results revealed that 27/53 (51 %) were SCAs, 26/53 (49 %) were MCNs. Microcystic pattern was observed in 88.2 % of SCAs and 11.8 % of MCNs; macrocystic pattern was observed in 90.5 % of MCNs and 9.5 % of SCAs (p < 0.0001). Central scar was detected in 29.6 % of SCAs and no MCNs (p = 0.003). Contrast enhancement of the peripheral wall was evident in 99.5 % of MCNs and 11.5 % of SCAs (p < 0.0001); mural nodules were depicted in 94.1 % of MCNs and 5.9 % of SCAs (p < 0.0001). Median maximum diameter was 54 mm for MCNs, 32 mm for SCAs (p = 0.001); median wall thickness was 4 mm for MCNs, 2 mm for SCAs (p < 0.0001)., Conclusions: Macrocystic pattern, enhancement of a peripheral wall and mural nodules are suggestive of MCNs; whereas microcystic pattern, lack of peripheral wall and central scar are suggestive of SCAs., Key Points: • MCNs have macrocystic patterns, contrast enhancement of the peripheral wall and mural nodules • Microcystic pattern and central scar are suggestive of SCA • Mural nodules detected in MCNs correlate with epithelial dysplasia • Chronic obstructive pancreatitis is equally depicted in patients with MCNs and SCAs.
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- 2015
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140. [Cardiovascular screening].
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Pellizzari B, Siddu A, Ferro A, Colonna M, Mantovani W, Valsecchi M, Marensi L, Moro A, Brusaferro S, and Cinquetti S
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- Asymptomatic Diseases, Body Mass Index, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Counseling, Diabetes Mellitus epidemiology, Fasting blood, Female, Humans, Hyperglycemia diagnosis, Hyperglycemia epidemiology, Hypertension diagnosis, Hypertension epidemiology, Italy epidemiology, Male, Middle Aged, Obesity epidemiology, Postprandial Period, Program Evaluation, Risk Factors, Sedentary Behavior, Smoking epidemiology, Surveys and Questionnaires, Waist Circumference, Cardiovascular Diseases prevention & control, Life Style, Mass Screening organization & administration
- Abstract
Objective: To evaluate, through active call, lifestyles of an asymptomatic population in order to identify hyperglycaemic subjects and/or high-blood pressure sufferers to dispatch to their GP to perform suitable checking, and subjects to invite to a cardiovascular disease prevention programme because of their lifestyles., Setting and Participants: Between April 2011 and March 2013, all healthy residents in 6 Local Health Authorities of Regione Veneto aged 45-59 years were invited to join a cardiovascular disease prevention programme., Design: All participants were evaluated through an administered lifestyle questionnaire. Parameters such as blood pressure (BP), glycemia, waist circumference and body mass index were collected and recorded. Participants also received counseling, informational materials on lifestyle and were invited to individual or group health promotion initiatives in relation to personal risk factors., Results: Among the invited, 60.84%(10,346/17,004) adhered. Subjects without risks factors were 23.95%. Subjects with lifestyle risk factors but normal BP and glycemia were 56.59%, while those with altered values for BP and glycemia were 13.9%. The 5.55% of the respondents was not eligible for the study., Conclusions: The results confirmthat a preventive programme based on the citizens active call by the Department of prevention could be an effective tool to identify asymptomatic individuals with unknown hypertension and/or hyperglycaemia and to offer lifestyle interventions to lower the risk of cardiovascular diseases. Since the results were positive, the the Regional Veneto Centre for Disease Prevention and Control (CCMR - Veneto) presented a similar project to the Ministry of Health, involving 12 Italian Regions.
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- 2014
141. Time-to-peak values can estimate hepatic functional reserve in patients undergoing surgical resection: a comparison between perfusion CT and indocyanine green retention test.
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D'Onofrio M, De Robertis R, Ruzzenente A, Mantovani W, Puntel G, Crosara S, Canestrini S, Guglielmi A, and Mucelli RP
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- Adult, Aged, Aged, 80 and over, Female, Hepatectomy, Humans, Liver Neoplasms surgery, Male, Middle Aged, Reproducibility of Results, Sensitivity and Specificity, Image Interpretation, Computer-Assisted methods, Indocyanine Green analysis, Liver Function Tests methods, Liver Neoplasms blood, Liver Neoplasms diagnosis, Perfusion Imaging methods, Tomography, X-Ray Computed methods
- Abstract
Objective: To evaluate the potential usefulness of perfusion computed tomography (CT) for the estimation of hepatic functional reserve in patients scheduled for surgical resection and to compare the results with those of the indocyanine green retention test results., Methods: Thirty-one patients with hepatobiliary malignancies were included. Perfusion CT and indocyanine green retention test were performed on the same day, and their results were compared using Pearson correlation test., Results: A strong correlation was found between perfusion CT time-to-peak values and indocyanine green retention rate at 15 minutes and indocyanine green plasma disappearance rate values (R, 0.789 and -0.790; R, 0.832 and -0.823, respectively; P < 0.0001)., Conclusions: Perfusion CT may be useful for the preoperative noninvasive estimation of hepatic functional reserve for patients undergoing liver resection.
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- 2014
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142. Nonalcoholic fatty liver disease is independently associated with an increased incidence of chronic kidney disease in patients with type 1 diabetes.
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Targher G, Mantovani A, Pichiri I, Mingolla L, Cavalieri V, Mantovani W, Pancheri S, Trombetta M, Zoppini G, Chonchol M, Byrne CD, and Bonora E
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- Adult, Albuminuria epidemiology, Albuminuria etiology, Albuminuria pathology, Diabetes Complications etiology, Diabetes Complications pathology, Female, Follow-Up Studies, Humans, Incidence, Italy epidemiology, Longitudinal Studies, Male, Middle Aged, Renal Insufficiency, Chronic etiology, Renal Insufficiency, Chronic pathology, Retrospective Studies, Risk Factors, Diabetes Complications epidemiology, Diabetes Mellitus, Type 1 complications, Non-alcoholic Fatty Liver Disease physiopathology, Renal Insufficiency, Chronic epidemiology
- Abstract
Objective: There is no information about the role of nonalcoholic fatty liver disease (NAFLD) in predicting the development of chronic kidney disease (CKD) in type 1 diabetes., Research Design and Methods: We studied 261 type 1 diabetic adults with preserved kidney function and with no macroalbuminuria at baseline, who were followed for a mean period of 5.2 years for the occurrence of incident CKD (defined as estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2 and/or macroalbuminuria). NAFLD was diagnosed by ultrasonography., Results: At baseline, patients had a mean eGFR of 92 ± 23 mL/min/1.73 m2; 234 (89.7%) of them had normoalbuminuria and 27 (10.3%) microalbuminuria. NAFLD was present in 131 (50.2%) patients. During follow-up, 61 subjects developed incident CKD. NAFLD was associated with an increased risk of incident CKD (hazard ratio [HR] 2.85 [95% CI 1.59-5.10]; P < 0.001). Adjustments for age, sex, duration of diabetes, hypertension, A1C, and baseline eGFR did not appreciably attenuate this association (adjusted HR 2.03 [1.10-3.77], P < 0.01). Results remained unchanged after excluding those who had microalbuminuria at baseline (adjusted HR 1.85 [1.03-3.27]; P < 0.05). Addition of NAFLD to traditional risk factors for CKD significantly improved the discriminatory capability of the regression models for predicting CKD (e.g., with NAFLD c statistic 0.79 [95% CI 0.73-0.86] vs. 0.76 [0.71-0.84] without NAFLD, P = 0.002)., Conclusions: This is the first study to demonstrate that NAFLD is strongly associated with an increased incidence of CKD. Measurement of NAFLD improves risk prediction for CKD, independently of traditional cardio-renal risk factors, in patients with type 1 diabetes., (© 2014 by the American Diabetes Association.)
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- 2014
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143. Non-hyperfunctioning neuroendocrine tumours of the pancreas: MR imaging appearance and correlation with their biological behaviour.
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Manfredi R, Bonatti M, Mantovani W, Graziani R, Segala D, Capelli P, Butturini G, and Mucelli RP
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- Adult, Aged, Contrast Media, Diagnosis, Differential, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neuroendocrine Tumors surgery, Pancreas surgery, Pancreatectomy, Pancreatic Neoplasms surgery, Reproducibility of Results, Retrospective Studies, Magnetic Resonance Imaging methods, Neuroendocrine Tumors diagnosis, Pancreas pathology, Pancreatic Neoplasms diagnosis
- Abstract
Objective: To describe MR imaging features of non-hyperfunctioning neuroendocrine pancreatic tumours by comparing them to histopathology and to determine the accuracy of MR imaging in predicting biological behaviour., Materials and Methods: After institutional review board approval, we retrospectively reviewed 45 patients with pathologically proven NF-NET of the pancreas and ≥1 preoperative MR/MRCP examinations. Of the NF-NETS, 29/45 (64.4 %) were G1 and 16/45 (35.5 %) were G2. Image analysis included the lesion maximum diameter, vascular encasement, extrapancreatic spread, signal intensity on T1- and T2-weighted, contrast enhancement features, and presence of metastases. Tumour vessel density was calculated on the histological specimen using a grid., Results: The median maximum diameter of NF-NETs was 20 mm (range 5-200 mm). Eighty per cent of the NF-NETs were hypointense on T1-weighted images, 82.2 % were hyperintense on T2-weighted images, and 75.6 % were hypervascular. Overall MRI accuracy showed a mean AUC of 0.86 compared to pathology. Lesions with a maximum diameter of 30 mm irregular margins, absence of a cleavage plane with the main pancreatic duct, vascular encasement, extrapancreatic spread and abdominal metastases were significantly associated with malignant NF-NETs. No correlation was found between the tumour vessel density and contrast-enhanced MR imaging pattern., Conclusions: Hyperintensity on T2-weighted images and iso-/hypervascularity occurred in 27/45 (60.0 %) of NF-NETs. MRI identifies malignant NF-NETs with a sensitivity of 93.3 % and a specificity of 76.9 % (AUC = 0.85)., Key Points: • Non-hyperfunctioning neuroendocrine pancreatic tumours (NF-NET) pose a difficult diagnostic challenge. • On T2-weighted MRI, 82.2 % of neuroendocrine tumours appeared hyperintense. • MR imaging showed 0.94 sensitivity and 0.77 specificity in predicting biological behaviour. • The hyper-/isointensity during dynamic MRI did not correlate with vessel density at pathology.
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- 2013
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144. Predictive factors for the diagnosis of severe acute cholecystitis in an emergency setting.
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Borzellino G, Steccanella F, Mantovani W, and Genna M
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- Aged, Cholecystitis, Acute pathology, Comorbidity, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Retrospective Studies, Sensitivity and Specificity, Severity of Illness Index, Cholecystitis, Acute diagnosis
- Abstract
Background: The aim of this study was to assess predictive factors for the diagnosis of severe acute cholecystitis., Methods: The medical records of 295 patients with pathologically confirmed acute cholecystitis were reviewed. Patients were divided, based on pathology findings, into a group with nonsevere acute cholecystitis and a group with severe acute cholecystitis. Preoperative data were compared by univariate and multivariate analyses. Therefore, diagnostic values were assessed based on the statistically significant predictive factors. The same approach was attempted for differential diagnosis between gangrenous and phlegmonous cholecystitis., Results: Among ten variables found to be significantly different at univariate analysis, four were found to be independent predictive factors of severe acute cholecystitis: fever, distension of the gallbladder, wall edema, and preoperative adverse events. Common bile duct stones were confirmed as a protective factor. Leukocyte count, cardiovascular diseases, age, gender, and diabetes were not found to be significant predictive factors of severe acute cholecystitis. No differences were found in any of the preoperative data by comparing phlegmonous and gangrenous cholecystitis., Conclusion: Severe acute cholecystitis may be differentiated preoperatively from nonsevere acute cholecystitis based on clinical and US data, and predictive diagnostic values may be estimated according to the number of observed predictive factors. No differences were found when comparing phlegmonous and gangrenous cholecystitis.
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- 2013
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145. Cost of a population-based programme of chest x-ray screening for lung cancer.
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Dominioni L, Rotolo N, Poli A, Castiglioni M, Mangini M, Spagnoletti M, Paolucci M, Paddeu A, Mantovani W, Zanini A, and Imperatori A
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- Adult, Costs and Cost Analysis, Follow-Up Studies, Humans, Italy epidemiology, Lung Neoplasms epidemiology, Mass Screening methods, Morbidity trends, Retrospective Studies, Lung Neoplasms diagnostic imaging, Mass Screening economics, Radiography, Thoracic economics
- Abstract
Background: After the implementation of a population-based programme of chest x-ray (CXR) screening on smokers in Varese, Italy, lung cancer (LC) mortality was significantly reduced. Analysis of the incremental costs due to this type of screening programme is needed to evaluate its economic impact on the healthcare system., Methods: In July 1997 a population-based cohort, consisting of all high-risk smokers (n=5,815) identified among 60,000 adult residents from the Varese province, was invited to a LC screening programme (an annual CXR for five years) in a general practice setting, and was observed through 2006. Invitees received National Health Service (NHS) usual care, with the addition of CXRs in screening participants. At the end of observation, among the 245 LCs diagnosed in the entire screening-invited cohort the observed LC deaths were 38 fewer than expected. To estimate the incremental direct cost due to screening in the invited cohort for the period July 1997-2006, we compared the direct cost of screening administration, CXR screens and LC management in the invited cohort and in the uninvited and unscreened controls in NHS usual care setting., Results: Over the 9.5 years, the total incremental direct healthcare costs (including screening organization/administration, CXR screens, additional procedures prompted by false-positive tests, overdiagnosed LCs) were estimated to range from euro 607,440 to euro 618,370 (in euros as of 2012), equating to between euro 15,985- euro 16,273 per patient out of the 38 LC deaths averted., Conclusions: In a general practice setting, the incremental cost for a CXR screening programme targeted at all high-risk smokers in a population of 60,000 adults was estimated to be about euro 65,000 per annum, approx. euro 16,000 for each LC death averted.
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- 2013
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146. Assessment of lung cancer mortality reduction after chest X-ray screening in smokers: a population-based cohort study in Varese, Italy.
- Author
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Dominioni L, Poli A, Mantovani W, Pisani S, Rotolo N, Paolucci M, Sessa F, Conti V, D'Ambrosio V, Paddeu A, and Imperatori A
- Subjects
- Aged, Cohort Studies, Female, Humans, Italy epidemiology, Lung pathology, Lung Neoplasms mortality, Male, Middle Aged, Population Surveillance methods, Risk Factors, Survival Rate trends, Lung diagnostic imaging, Lung Neoplasms diagnosis, Mass Chest X-Ray methods, Smoking
- Abstract
Background: The effectiveness of screening for lung cancer (LC) in smokers on a population level, as distinct from the special circumstances that may apply in a randomized trial of selected volunteers, has not been thoroughly investigated. Here we evaluate by the standardized mortality ratio (SMR) indicator the impact of a chest X-ray (CXR) screening programme carried out at community level on LC mortality in smokers., Methods: All smokers of >10 pack-years, of both genders, ages 45-75 years, resident in 50 communities of the Province of Varese, Italy, screening-eligible, in 1997 were invited by their National Health Service (NHS) general practitioner physicians to a nonrandomized programme of five annual CXR screenings. The entire invitation-to-screen cohort (n=5815 subjects) received NHS usual care, with the addition of CXR exams in volunteer participants (21% of invitees), and was observed through December 2006. To overcome participants' selection bias of LC mortality assessment, for the entire invitation-to-screen cohort we estimated the LC-specific SMR, based on the local reference population receiving the NHS usual care., Results: Over the 8-year period 1999-2006, a total of 172 cumulative LC deaths were observed in the invitation-to-screen cohort; 210 were expected based on the reference population. Each year in the invited cohort the observed LC deaths were fewer than expected. The cumulative LC SMR was 0.82 (95% CI, 0.67-0.99; p=0.048), suggesting that LC mortality was reduced by 18% with CXR screening., Conclusion: Implementation of a CXR screening programme at community level was associated with a significant reduction of LC mortality in smokers., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)
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- 2013
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147. Perfusion CT can predict tumoral grading of pancreatic adenocarcinoma.
- Author
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D'Onofrio M, Gallotti A, Mantovani W, Crosara S, Manfrin E, Falconi M, Ventriglia A, Zamboni GA, Manfredi R, and Pozzi Mucelli R
- Subjects
- Adenocarcinoma diagnostic imaging, Adult, Aged, Aged, 80 and over, Algorithms, Female, Humans, Male, Middle Aged, Neoplasm Grading, Pancreatic Neoplasms diagnostic imaging, Reproducibility of Results, Sensitivity and Specificity, Adenocarcinoma pathology, Pancreatic Neoplasms pathology, Perfusion Imaging methods, Radiographic Image Interpretation, Computer-Assisted methods, Tomography, X-Ray Computed methods
- Abstract
Objectives: To describe perfusion CT features of locally advanced pancreatic ductal adenocarcinoma and to evaluate correlation with tumor grading., Methods: Thirty-two patients with locally advanced pancreatic adenocarcinoma were included in this study. Lesions were evaluated by P-CT and biopsy after patient's informed consent. P-CT parameters have been assessed on a large single and on 6 small intratumoral ROIs. Values obtained have been compared and related to the tumor grading using Mann-Whitney U test. Sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy in predicting tumor grading have been calculated for cut-off values chosen by using ROC curves., Results: Out of 32 lesions, 12 were classified as low grade and 20 as high grade. A statistically significant difference between high and low grade neoplasms were demonstrated for PEI and BV parameters. PEI and BV cut-off values were respectively 17.8 HU and 14.8 ml/100g. PEI identified high grade neoplasms with a 65% sensitivity, 92% specificity, 93% PPV, 61% NPV and 75% accuracy. BV identified high grade neoplasms with a 80% sensitivity, 75% specificity, 84% PPV, 69% NPV, 78% accuracy. Considering both PEI and BV, P-CT identified high grade lesions with a 60% sensitivity, 100% specificity, 100% PPV, 60% NPV and 75% accuracy., Conclusions: PEI and BV perfusion CT parameters proved their efficiency in identifying high grade pancreatic adenocarcinoma., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)
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- 2013
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148. Non-alcoholic fatty liver disease is associated with an increased incidence of atrial fibrillation in patients with type 2 diabetes.
- Author
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Targher G, Valbusa F, Bonapace S, Bertolini L, Zenari L, Rodella S, Zoppini G, Mantovani W, Barbieri E, and Byrne CD
- Subjects
- Aged, Fatty Liver diagnostic imaging, Female, Humans, Incidence, Incidental Findings, Male, Middle Aged, Non-alcoholic Fatty Liver Disease, Prospective Studies, Ultrasonography, Atrial Fibrillation complications, Diabetes Mellitus, Type 2 complications, Fatty Liver complications
- Abstract
Background: The relationship between non-alcoholic fatty liver disease (NAFLD) and atrial fibrillation (AF) in type 2 diabetes is currently unknown. We examined the relationship between NAFLD and risk of incident AF in people with type 2 diabetes., Methods and Results: We prospectively followed for 10 years a random sample of 400 patients with type 2 diabetes, who were free from AF at baseline. A standard 12-lead electrocardiogram was undertaken annually and a diagnosis of incident AF was confirmed in affected participants by a single cardiologist. At baseline, NAFLD was defined by ultrasonographic detection of hepatic steatosis in the absence of other liver diseases. During the 10 years of follow-up, there were 42 (10.5%) incident AF cases. NAFLD was associated with an increased risk of incident AF (odds ratio [OR] 4.49, 95% CI 1.6-12.9, p<0.005). Adjustments for age, sex, hypertension and electrocardiographic features (left ventricular hypertrophy and PR interval) did not attenuate the association between NAFLD and incident AF (adjusted-OR 6.38, 95% CI 1.7-24.2, p = 0.005). Further adjustment for variables that were included in the 10-year Framingham Heart Study-derived AF risk score did not appreciably weaken this association. Other independent predictors of AF were older age, longer PR interval and left ventricular hypertrophy., Conclusions: Our results indicate that ultrasound-diagnosed NAFLD is strongly associated with an increased incidence of AF in patients with type 2 diabetes even after adjustment for important clinical risk factors for AF.
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- 2013
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149. Effects of ankle position on pelvic floor muscle electromyographic activity in female stress urinary incontinence: preliminary results from a pilot study.
- Author
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Cerruto MA, Vedovi E, Mantovani W, D'Elia C, and Artibani W
- Subjects
- Adult, Electromyography, Female, Humans, Middle Aged, Pilot Projects, Ankle, Pelvic Floor physiopathology, Posture, Urinary Incontinence, Stress physiopathology
- Abstract
Objectives: A standing posture including various ankle positions might effectively facilitate pelvic floor muscle activity (PFMa) in incontinent women, and an ankle dorsiflexion (DS) at 15 degrees was identified as the best position able to increase PFMa. Nevertheless, this ankle inclination is very uncomfortable. We carried out this study aiming at identifying smaller ankle inclinations able to significantly affect PFMa in incontinent women reducing patient discomfort., Methods: Twenty women, not yet entered menopause and with mild-moderate uncomnplicated stress urinary incontinence, were enrolled. An electromyographic (EMG) biofeedback instrument using surface electrodes was employed to measure changes in PFMa while each patient assumed the following different ankle inclinations in upright position: horizontal standing (HS); DS at degrees (5DS), 10 degrees (10DS) and 15 degrees (15DS); and ankle plantar flexion (PS) at 5 degrees (5PS), 10 degrees (10PS) and 15 degrees (15PS)., Results: No EMG differences were found between HS and PS. PFM tension in DS, at whatever angle, was significantly greater than in both HS (P < 0.020) and PS (P < 0.040). No differences were found between IODS and 15DS in terms of resting PFMa. Concerning maximal PFMa, it was higher in 10DS than in 15DS (P = 0.010), and in 5PS than in both 5DS (P = 0.006) and 15DS (P = 0.010); no EMG differences were found between 5PS and 10DS., Conclusions: These preliminary results showed that 10DS in upright standing had comparable effects on resting PFMa than 15DS with same effectiveness and less patient's discomfort, facilitating a better maximal contraction. Moreover a slight PS might effectively facilitate maximal PFMa.
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- 2012
150. Comparison of two creatinine-based estimating equations in predicting all-cause and cardiovascular mortality in patients with type 2 diabetes.
- Author
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Targher G, Zoppini G, Mantovani W, Chonchol M, Negri C, Stoico V, Mantovani A, De Santi F, and Bonora E
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Glomerular Filtration Rate physiology, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Cardiovascular Diseases metabolism, Cardiovascular Diseases mortality, Creatinine metabolism, Diabetes Mellitus, Type 2 metabolism, Diabetes Mellitus, Type 2 mortality
- Abstract
Objective: To compare the performance of two glomerular filtration rate (GFR)-estimating equations in predicting the risk of all-cause and cardiovascular mortality in type 2 diabetic patients., Research Design and Methods: We followed 2,823 type 2 diabetic outpatients for a period of 6 years for the occurrence of all-cause and cardiovascular mortality. GFR was estimated using the four-variable Modification of Diet in Renal Disease (MDRD) study equation and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation., Results: At baseline, an estimated GFR (eGFR) <60 mL/min/1.73 m(2) was present in 22.0 and 20.2% of patients using the MDRD study equation and the CKD-EPI equation, respectively. A total of 309 patients died during the follow-up (152 patients from cardiovascular causes). Both creatinine-based equations were associated with an increased risk of all-cause and cardiovascular mortality. However, the CKD-EPI equation provided a more accurate risk prediction of mortality than the MDRD study equation. Receiving operating characteristic curves showed that the areas under the curve (AUCs) for all-cause mortality (AUC 0.712 [95% CI 0.682-0.741]) and cardiovascular mortality (0.771 [0.734-0.808]) using eGFR(CKD-EPI) were significantly greater (P < 0.0001 by the z statistic) than those obtained by using eGFR(MDRD) (0.679 [0.647-0.711] for all-cause mortality and 0.739 [0.698-0.783] for cardiovascular mortality)., Conclusions: Our findings suggest that the estimation of GFR using the CKD-EPI equation more appropriately stratifies patients with type 2 diabetes according to the risk of all-cause and cardiovascular mortality compared with the MDRD study equation.
- Published
- 2012
- Full Text
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