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1. Organization and regional distribution of centers for the management of children and adolescents with diabetes in Italy

Author

Giorgetti C., Ferrito L., Zallocco F., Iannilli A., Cherubini V., Maghnie M., Rabbone I., Lera R., De Luna L., Kienberger B., Gualtieri A., Zecchino C., Piccino E., Ortolani F., Zucchini S., Maltoni G., Pasquino B., Reinstadler P., Prandi E., Zattoni V., Gallo F., Morganti G., Guerraggio L., Ripoli C., Frongia M., Pusceddu P., La Loggia A., Scanu P., Cardinale G., Ponzi G., Tomaselli L. G., Rapisarda V., Citriniti F., Soprani T., Tumini S., Lazzaro N., De Donno V., Banin P., Toni S., Lenzi L., Mainetti B., Coccioli M. S., D'Annunzio G., Minuto N., Montani E., Maccioni R., Marongiu U., Beccaria L., Bruzzese M., Mammi F., Pardi D., Lombardo F., Ventrici C., Scaramazza A., Ferrari M., Bonfanti R., Rigamonti A., Iughetti L., Predieri B., Iafusco D., Confetto S., Zanfardino A., Prisco F., Francese A., De Nitto E., Cadario F., Milia A., Piredda G., Mereu L., Soro M., Correddu A., Pipia A., Monciotti C., Cardella F., De Berardinis F., Santoro G., Chiari G., Berioli M. G., Federico G., Zanette G., Marsciani A., Pedini A., Patera I. P., Schiaffini R., Bitti M., Lidano R., Pietrosanti S., Delvecchio M., Trada M., Marinaro A., Meloni G., Galero A., Fichera G., Bulciolu P., Ignaccolo G., Cauvin V., Franceschi R., Faleschini E., Tornese G., Salvatoni A., Cardani R., Maffeis C., Marigliano M., Sabbion A., Arnaldi C., Giorgetti, Chiara, Ferrito, Lucia, Zallocco, Federica, Iannilli, Antonio, Cherubini, Valentino, Maghnie, Mohamad, Rabbone, Ivana, Lera, R., De Luna, L., Kienberger, B., Gualtieri, A., Zecchino, C., Piccino, E., Ortolani, F., Zucchini, S., Maltoni, G., Pasquino, B., Reinstadler, P., Prandi, E., Zattoni, V., Gallo, F., Morganti, G., Guerraggio, L., Ripoli, C., Frongia, M., Pusceddu, P., La Loggia, A., Scanu, P., Cardinale, G., Ponzi, G., Tomaselli, L. G., Rapisarda, V., Citriniti, F., Soprani, T., Tumini, S., Lazzaro, N., De Donno, V., Banin, P., Toni, S., Lenzi, L., Mainetti, B., Coccioli, M. S., D’Annunzio, G., Minuto, N., Montani, E., Maccioni, R., Marongiu, U., Beccaria, L., Bruzzese, M., Mammì, F., Pardi, D., Lombardo, F., Ventrici, C., Scaramazza, A., Ferrari, M., Bonfanti, R., Rigamonti, A., Iughetti, L., Predieri, B., Iafusco, Dario, Confetto, S., Zanfardino, A., Prisco, Francesco, Francese, A., De Nitto, E., Cadario, F., Milia, A., Piredda, G., Mereu, L., Soro, M., Correddu, A., Pipia, A., Monciotti, C., Cardella, F., De Berardinis, F., Santoro, G., Chiari, G., Berioli, M. G., Federico, G., Zanette, G., Marsciani, A., Pedini, A., Patera, I. P., Schiaffini, R., Bitti, M., Lidano, R., Pietrosanti, S., Delvecchio, M., Trada, M., Marinaro, A., Meloni, G., Galero, A., Fichera, G., Bulciolu, P., Rabbone, I., Ignaccolo, G., Cauvin, V., Franceschi, R., Faleschini, E., Tornese, G., Salvatoni, A., Cardani, R., Maffeis, C., Marigliano, M., Sabbion, A., Arnaldi, C., Study Group for Diabetes of, Isped, Tornese, Gianluca, Giorgetti, C., Ferrito, L., Zallocco, F., Iannilli, A., Cherubini, V., Maghnie, M., D'Annunzio, G., Mammi, F., Iafusco, D., and Prisco, F.

Subjects
Male, medicine.medical_specialty, Type 1 diabete, Adolescent, MEDLINE, Staffing, Distribution (economics), Legislation, diabetes, children, T1D, Italy, Pediatrics, Regional Medical Program, Prevalence, Surveys and Questionnaire, Medicine, Regional legislation, Practice Patterns, Physicians', Disease management (health), Child, Organization of care, Pediatric diabetes centers, Type 1 diabetes, Pediatrics, Perinatology and Child Health, business.industry, Incidence, Incidence (epidemiology), Research, Disease Management, Perinatology and Child Health, medicine.disease, Diabetes Mellitus, Type 1, diabete, Family medicine, Female, Organizational structure, Pediatric diabetes center, business, Delivery of Health Care, Human
Abstract

Background: The incidence of type 1 diabetes in childhood is increasing by 3 % per year, placing growing demands on healthcare professionals and medical expenditures. Aim of this study wars to assess the organization of care to children with diabetes in Italy. Methods: During 2012 a structured questionnaire was sent to all of the members of Italian Society of Paediatric Endocrinology and Diabetology (ISPED). Questions examined organizational structure of Centers, personnel dedicated to the care of children with diabetes, number of subjects followed, local legal legislation supporting centres. Results: A total of 68 centers taking care to 15,563 children and adolescents with diabetes under 18 years of age were identified with a prevalence of 1.4 per 1,000 people. A wide variation in the organizational background was also reported. Fourty-four centers were organized as outpatient departments, 17 as simple units, 5 as complex units and 2 as simple departmental structures. Most centers had a multidisciplinary team. Ten out of twenty Italian regions had introduced supportive regional legislation, but it was fully applied only in six of them. Conclusion: Great differences between regions were found in organizational structures, staffing levels and supportive legislation. The national legislation on diabetes was broadly implemented throughout the country regions. Further efforts are needed to improve standards and consistency of pediatric diabetes care in Italy.

Published
2015

2. Are there any relations among transplant centre volume, surgical technique and anatomy for donor graft selection? Ten-year multicentric Italian experience on mini-invasive living donor nephrectomy

Author

Ravaioli, M, Capocasale, E, Furian, L, De Pace, V, Iaria, M, Spagnoletti, G, Salerno, M, Giacomoni, A, De Carlis, L, Di Bella, C, Rostand, N, Boschiero, L, Pasquale, G, Bosio, A, Collini, A, Carmellini, M, Airoldi, A, Bondonno, G, Ditonno, P, Impedovo, S, Beretta, C, Giussani, A, Socci, C, Parolini, D, Abelli, M, Ticozzelli, E, Baccarani, U, Adani, G, Caputo, F, Buscemi, B, Frongia, M, Solinas, A, Gruttadauria, S, Spada, M, Pinna, A, Romagnoli, J, Salerno, MP, Rostand, NM, Impedovo, SV, Parolini, DC, Adani, GL, Pinna, AD, Ravaioli, M, Capocasale, E, Furian, L, De Pace, V, Iaria, M, Spagnoletti, G, Salerno, M, Giacomoni, A, De Carlis, L, Di Bella, C, Rostand, N, Boschiero, L, Pasquale, G, Bosio, A, Collini, A, Carmellini, M, Airoldi, A, Bondonno, G, Ditonno, P, Impedovo, S, Beretta, C, Giussani, A, Socci, C, Parolini, D, Abelli, M, Ticozzelli, E, Baccarani, U, Adani, G, Caputo, F, Buscemi, B, Frongia, M, Solinas, A, Gruttadauria, S, Spada, M, Pinna, A, Romagnoli, J, Salerno, MP, Rostand, NM, Impedovo, SV, Parolini, DC, Adani, GL, and Pinna, AD

Abstract

Background. Selection of the right or left living donor kidney for transplantation is influenced by many variables. In the present multi centric study including 21 Italian transplant centres, we evaluated whether centre volume or surgical technique may influence the selection process. Methods. Intra- and perioperative donor data, donor kidney function, and recipient and graft survival were collected among 693 mini-invasive living donor nephrectomies performed from 2002 to 2014. Centre volume (LOW, 1-50 cases; HIGH,>50 cases) and surgical technique (FULL-LAP, full laparoscopic and robotic; HA-LAP, hand-assisted laparoscopy; MINI-OPEN, mini-lumbotomy) were correlated with selection of right or left donor kidney and with donor and recipient outcome. Results. HIGH-volume centres retrieved a higher rate of donor right kidneys (29.3% versus 17.6%, P<0.01) with single artery (83.1% versus 76.4%, P<0.05) compared with LOW-volume centres. Surgical technique correlated significantly with rate of donor right kidney and presence of multiple arteries: MINIOPEN (53% and 13%) versus HA-LAP (29% and 22%) versus FULL-LAP (11% and 23%), P<0.001 and P<0.05, respectively. All donors had an uneventful outcome; donor bleeding was more frequent in LOW-volume centres (4% versus 0.9%, P<0.05). Conclusions. Centre volume and surgical technique influenced donor kidney side selection. Donor nephrectomy in LOWvolume centres was associated with higher risk of donor bleeding.

Published
2017

3. Are there any relations among transplant centre volume, surgical technique and anatomy for donor graft selection? Ten-year multicentric Italian experience on mini-invasive living donor nephrectomy

Author

Ravaioli, M., Capocasale, E., Furian, L., De Pace, V., Iaria, M., Spagnoletti, Gionata, Salerno, Maria Paola, Giacomoni, A., De Carlis, L., Di Bella, C., Rostand, N. M., Boschiero, L., Pasquale, G., Bosio, A., Collini, A., Carmellini, M., Airoldi, A., Bondonno, G., Ditonno, P., Impedovo, S. V., Beretta, C., Giussani, A., Socci, C., Parolini, D. C., Abelli, M., Ticozzelli, E., Baccarani, U., Adani, G. L., Caputo, F., Buscemi, B., Frongia, M., Solinas, A., Gruttadauria, S., Spada, M., Pinna, A. D., Romagnoli, Jacopo, Spagnoletti G. (ORCID:0000-0003-2626-8147), Salerno M. P., Romagnoli J. (ORCID:0000-0002-7153-0346), Ravaioli, M., Capocasale, E., Furian, L., De Pace, V., Iaria, M., Spagnoletti, Gionata, Salerno, Maria Paola, Giacomoni, A., De Carlis, L., Di Bella, C., Rostand, N. M., Boschiero, L., Pasquale, G., Bosio, A., Collini, A., Carmellini, M., Airoldi, A., Bondonno, G., Ditonno, P., Impedovo, S. V., Beretta, C., Giussani, A., Socci, C., Parolini, D. C., Abelli, M., Ticozzelli, E., Baccarani, U., Adani, G. L., Caputo, F., Buscemi, B., Frongia, M., Solinas, A., Gruttadauria, S., Spada, M., Pinna, A. D., Romagnoli, Jacopo, Spagnoletti G. (ORCID:0000-0003-2626-8147), Salerno M. P., and Romagnoli J. (ORCID:0000-0002-7153-0346)

Abstract

Background. Selection of the right or left living donor kidney for transplantation is influenced by many variables. In the present multi centric study including 21 Italian transplant centres, we evaluated whether centre volume or surgical technique may influence the selection process. Methods. Intra- and perioperative donor data, donor kidney function, and recipient and graft survival were collected among 693 mini-invasive living donor nephrectomies performed from 2002 to 2014. Centre volume (LOW, 1-50 cases; HIGH,>50 cases) and surgical technique (FULL-LAP, full laparoscopic and robotic; HA-LAP, hand-assisted laparoscopy; MINI-OPEN, mini-lumbotomy) were correlated with selection of right or left donor kidney and with donor and recipient outcome. Results. HIGH-volume centres retrieved a higher rate of donor right kidneys (29.3% versus 17.6%, P<0.01) with single artery (83.1% versus 76.4%, P<0.05) compared with LOW-volume centres. Surgical technique correlated significantly with rate of donor right kidney and presence of multiple arteries: MINIOPEN (53% and 13%) versus HA-LAP (29% and 22%) versus FULL-LAP (11% and 23%), P<0.001 and P<0.05, respectively. All donors had an uneventful outcome; donor bleeding was more frequent in LOW-volume centres (4% versus 0.9%, P<0.05). Conclusions. Centre volume and surgical technique influenced donor kidney side selection. Donor nephrectomy in LOWvolume centres was associated with higher risk of donor bleeding.

Published
2017

4. Epidemiologia della chetoacidosi diabetica in Italia

Author

Cherubini, Valentino, Gesuita, R., Sternardi, S., Ferrito, L., Lenzi, L., Iannilli, A., Piccini, B., Skrami, E., Nicolucci, A., Pintaudi, B., Toni, S., Lera, R., De Luna, L., Kienberger, B., Gualtieri, A., Zecchino, C., Piccino, E., Ortolani, F., Zucchini, S., Maltoni, G., Pasquino, B., Reinstadler, P., Prandi, E., Zattoni, V., Gallo, F., Morganti, G., Guerraggio, L., Ripoli, C., Frongia, M., Pusceddu, P., La Loggia, A., Scanu, P., Cardinale, G., Ponzi, G., Tomaselli, L. G., Rapisarda, V., Citriniti, F., Soprani, T., Tumini, S., Lazzaro, N., De Donno, V., Banin, P., Mainetti, B., Coccioli, M. S., D'Annunzio, G., Minuto, N., Montani, E., Maccioni, R., Marongiu, U., Beccaria, L., Bruzzese, M., Mammì, F., Pardi, D., Lombardo, F., Ventrici, C., Scaramazza, A., Ferrari, M., Bonfanti, R., Rigamonti, A., Iughetti, Lorenzo, Predieri, Barbara, Iafusco, D., Confetto, S., Zanfardino, A., Prisco, F., Franzese, A., De Nitto, E., Cadario, F., Milia, A., Piredda, G., Mereu, L., Soro, M., Correddu, A., Pipia, A., Monciotti, C., Cardella, F., De Berardinis, F., Santoro, G., Chiari, G., Berioli, M. G., Federico, G., Zanette, G., Marsciani, A., Pedini, A., Patera, I. P., Schiaffini, R., Bitti, M., Lidano, R., Pietrosanti, S., Delvecchio, M., Trada, M., Marinaro, A., Meloni, G., Galero, A., Fichera, G., Bulciolu, P., Rabbone, I., Ignaccolo, G., Cauvin, V., Franceschi, R., Faleschini, E., Tornese, G., Salvatoni, A., Cardani, R., Maffeis, C., Marigliano, M., Sabbion, A., Arnaldi, C., Cherubini, Valentino, Gesuita, R., Sternardi, S., Ferrito, L., Lenzi, L., Iannilli, A., Piccini, B., Skrami, E., Nicolucci, A., Pintaudi, B., Toni, S., Lera, R., De Luna, L., Kienberger, B., Gualtieri, A., Zecchino, C., Piccino, E., Ortolani, F., Zucchini, S., Maltoni, G., Pasquino, B., Reinstadler, P., Prandi, E., Zattoni, V., Gallo, F., Morganti, G., Guerraggio, L., Ripoli, C., Frongia, M., Pusceddu, P., La Loggia, A., Scanu, P., Cardinale, G., Ponzi, G., Tomaselli, L. G., Rapisarda, V., Citriniti, F., Soprani, T., Tumini, S., Lazzaro, N., De Donno, V., Banin, P., Mainetti, B., Coccioli, M. S., D'Annunzio, G., Minuto, N., Montani, E., Maccioni, R., Marongiu, U., Beccaria, L., Bruzzese, M., Mammì, F., Pardi, D., Lombardo, F., Ventrici, C., Scaramazza, A., Ferrari, M., Bonfanti, R., Rigamonti, A., Iughetti, L., Predieri, B., Iafusco, Dario, Confetto, S., Zanfardino, A., Prisco, F., Franzese, A., De Nitto, E., Cadario, F., Milia, A., Piredda, G., Mereu, L., Soro, M., Correddu, A., Pipia, A., Monciotti, C., Cardella, F., De Berardinis, F., Santoro, G., Chiari, G., Berioli, M. G., Federico, G., Zanette, G., Marsciani, A., Pedini, A., Patera, I. P., Schiaffini, R., Bitti, M., Lidano, R., Pietrosanti, S., Delvecchio, M., Trada, M., Marinaro, A., Meloni, G., Galero, A., Fichera, G., Bulciolu, P., Rabbone, I., Ignaccolo, G., Cauvin, V., Franceschi, R., Faleschini, E., Tornese, G., Salvatoni, A., Cardani, R., Maffeis, C., Marigliano, M., Sabbion, A., and Arnaldi, C.

Subjects
endocrine system diseases, Type 1 diabete, Endocrinology, Diabetes and Metabolism, nutritional and metabolic diseases, Risk of complication, Diabetes and Metabolism, Type 1 diabetes, Nation-wide retrospective observational study, Endocrinology, Risk factors, Diabetic ketoacidosis, Children, Internal Medicine, Diabetic ketoacidosi, Risk factor
Abstract

Ketoacidosis is a potentially life-threatening complication in patients with type 1 diabetes mellitus (T1DM), particularly children. If diabetic ketoacidosis (DKA) is diagnosed late, the child risks cerebral edema, permanent neurological damage or even death. There have been only few studies of DKA in Italy.From January-May 2014 a nation-wide observational, retrospective study of DKA at diabetes onset was done by the Pediatric Diabetology Study Group (PDSG) of the Italian Society of Pediatric Endocrinology and Diabetes (ISPED), involving 76 Italian centers. DKA was defined using ISPAD criteria; 7457 new cases of T1DM were recruited from mainland Italy and the island of Sicily and 770 from Sardinia, in the period 2004-2013. On the mainland and in Sicily, DKA at diabetes onset was about 32.9% (95% CI 31.8-34.0%), and there was 6.6% (95% CI 6.02-7.20%) of the severe form. Mild and severe DKA risk was significantly higher in children aged 0-4 years; no significant temporal trend was found in the study period. Patients living in Sardinia or having a firstdegree relative with T1DM were at significantly lower risk of DKA at diabetes onset. In the ten-year study period three children died of DKA at onset and four suffered permanent neurological lesions. From November 2011-April 2012 the PDSG conducted a retrospective study based on a sample of 2025 patients with T1DM, aged 0-18 years, involving 29 national centers for pediatric diabetes. The incidence of DKA was 2.4% (IC 95% 1.8-3.1), with children older than ten years at significantly higher risk, probably due to shortages of insulin. Multiple analysis showed a higher risk of DKA in those using a rapid-acting insulin analog and in those with high HbA1c. Young mothers and low levels of education were also associated with DKA.In conclusion, although a wide network of specialized home pediatricians and pediatric diabetes centers is spread across the country, the incidence of DKA at diabetes onset is still high. Further social and health-system efforts are needed to boost awareness of this risk and to reduce damages and costs related to the complication.

Published
2014

5. Impatto dei recettori KIR e dei suoi ligandi HLA sull’esito del trapianto di rene

Author

Littera, R., Argiolas, D., Gongeddu, E, Ragatzu, P., Loi, V., Serra, M., Maddi, R., Alba, F., Valentini, D., Porcella, R., Cappai, I., Lai, S., Orrù, S., Piredda, G., Pani, A., Frongia, M., Trucas, M., Piras, F., Cusano, R., and Carcassi, C.

Subjects
nk, patogenesi, immunity, kir, immunology, rigetto, rene, irc, graft, trapianto, cad, killer, engraftment, natural, rc
Published
2016

6. Erratum: Organization and regional distribution of centers for the management of children and adolescents with diabetes in Italy (Ital J Pediatr (2015) 41 (74) DOI:10.1186/s13052-015-0179-6)

Author

Giorgetti, C., Ferrito, L., Zallocco, F., Iannilli, A., Cherubini, V., Maghnie, M., Rabbone, I., Lera, R., De Luna, L., Kienberger, B., Gualtieri, A., Zecchino, C., Piccino, E., Ortolani, F., Zucchini, S., Maltoni, G., Pasquino, B., Reinstadler, P., Prandi, E., Zattoni, V., Gallo, F., Morganti, G., Guerraggio, L., Ripoli, C., Frongia, M., Pusceddu, P., La Loggia, A., Scanu, P., Cardinale, G., Ponzi, G., Tomaselli, L. G., Rapisarda, V., Citriniti, F., Soprani, T., Tumini, S., Lazzaro, N., De Donno, V., Banin, P., Toni, S., Lenzi, L., Mainetti, B., Coccioli, M. S., D(')Annunzio, G., Minuto, N., Montani, E., Maccioni, R., Marongiu, U., Beccaria, L., Bruzzese, M., Mamm(`i), F., Pardi, D., Lombardo, F., Ventrici, C., Scaramazza, A., Ferrari, M., Bonfanti, R., Rigamonti, A., Iughetti, L., Predieri, B., Iafusco, D., Confetto, S., Zanfardino, A., Prisco, F., Francese, A., De Nitto, E., Cadario, F., Milia, A., Piredda, G., Mereu, L., Soro, M., Correddu, A., Pipia, A., Monciotti, C., Cardella, F., De Berardinis, F., Santoro, G., Chiari, G., Berioli, M. G., Federico, G., Zanette, G., Marsciani, A., Pedini, A., Patera, I. P., Schiaffini, R., Bitti, M., Lidano, R., Pietrosanti, S., Delvecchio, M., Trada, M., Marinaro, A., Meloni, G., Gaiero, A., Fichera, G., Bulciolu, P., Ignaccolo, G., Cauvin, V., Franceschi, R., Faleschini, E., Tornese, G., Salvatoni, A., Cardani, R., Maffeis, C., Marigliano, M., Sabbion, A., and Arnaldi, C.

Subjects
children, type 1 diabetes, children, adolescents, adolescents
Published
2016

7. Epidemiology of diabetic ketoacidosis in Italy

Author

Cherubini, V, Gesuita, R, Sternardi, S, Ferrito, L, Lenzi, L, Iannilli, A, Piccini, B, Skrami, E, Nicolucci, A, Pintaudi, B, Toni, S, Lera, R, De Luna, L, Kienberger, B, Gualtieri, A, Zecchino, C, Piccino, E, Ortolani, F, Zucchini, S, Maltoni, G, Pasquino, B, Reinstadler, P, Prandi, E, Zattoni, V, Gallo, F, Morganti, G, Guerraggio, L, Ripoli, C, Frongia, M, Pusceddu, P, La Loggia, A, Scanu, P, Cardinale, G, Ponzi, G, Tomaselli, L, G, Rapisarda, V, Citriniti, F, Soprani, T, Tumini, S, Lazzaro, N, De Donno, V, Banin, P, Mainetti, B, Coccioli, Ms, D'Annunzio, G, Minuto, N, Montani, E, Maccioni, R, Marongiu, U, Beccaria, L, Bruzzese, M, Mammì, F, Pardi, D, Lombardo, F, Ventrici, C, Scaramazza, A, Ferrari, M, Bonfanti, R, Rigamonti, A, Iughetti, L, Predieri, B, Iafusco, D, Confetto, S, Zanfardino, A, Prisco, F, Franzese, A, De Nitto, E, Cadario, F, Milia, A, Piredda, G, Mereu, L, Soro, M, Correddu, A, Pipia, A, Monciotti, C, Cardella, F, De Berardinis, F, Santoro, G, Chiari, G, Berioli, M, Federico, G, Zanette, G, Marsciani, A, Pedini, A, Patera, I, P, Schiaffini, R, Bitti, M, Lidano, R, Pietrosanti, S, Delvecchio, M, Trada, M, Marinaro, A, Meloni, G, Galero, A, Fichera, G, Bulciolu, P, Rabbone, I, Ignaccolo, G, Cauvin, V, Franceschi, R, Faleschini, E, Tornese, G, Salvatoni, Alessandro, Cardani, R, Maffeis, C, Marigliano, M, Sabbion, A, and Arnaldi, C.

Published
2014

8. IL DIABETE MELLITO TIPO 2 (T2DM) IN ETÀ PEDIATRICA: LA CASISTICA DEL GRUPPO DI STUDIO DIABETOLOGIA S.I.E.D.P

Author

Cerutti1, F., Banin, P., Barbetti, F., Boccato, S., Bonfanti, R., Buono, P., Calcaterra, V., Cardella, F., Cardin, G. M., Cavallo, L., D’Annunzio, G., DE LUCA, Filippo, DEL VECCHIO, M., DE MARCO, R., Francese, A., Frongia, M. P., Iafusco, D., Lombardo, Fortunato, Lorini, R., Meschi, F., Monciotti, C., Prisco, F., Rabbone, I., Toni, S., and S. ZUCCHINI E. IL GRUPPO DI STUDIO DIABETOLOGIA S. I. E. D. P.

Published
2009

11. Eswl for Ureteral Calculi

Author

Ayyoub, M., primary, Usai, M., additional, Malloci, S., additional, Solinas, A., additional, Atzori, G., additional, and Frongia, M., additional

Published
2005
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12. 3-Month Formulation of Goserelin Acetate (‘Zoladex’ 10.8-mg Depot) in Advanced Prostate Cancer: Results from an Italian, Open, Multicenter Trial

Author

Fontana, D., primary, Mari, M., additional, Martinelli, A., additional, Boccafoschi, C., additional, Magno, C., additional, Turriziani, M., additional, Maymone, S.S., additional, Cunico, S. Cosciani, additional, Zanollo, A., additional, Montagna, G., additional, Frongia, M., additional, and Jacobellis, U., additional

Published
2003
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13. Epidemiology of diabetic ketoacidosis in Italy,Epidemiologia della chetoacidosi diabetica in Italia

Author

Cherubini, V., Gesuita, R., Sternardi, S., Ferrito, L., Lenzi, L., Iannilli, A., Piccini, B., Skrami, E., Nicolucci, A., Pintaudi, B., Toni, S., Lera, R., Luna, L., Kienberger, B., Gualtieri, A., Zecchino, C., Piccino, E., Ortolani, F., Zucchini, S., Maltoni, G., Pasquino, B., Reinstadler, P., Prandi, E., Zattoni, V., Gallo, F., Morganti, G., Guerraggio, L., Ripoli, C., Frongia, M., Pusceddu, P., La Loggia, A., Scanu, P., Cardinale, G., Ponzi, G., Tomaselli, L. G., Rapisarda, V., Citriniti, F., Soprani, T., Tumini, S., Lazzaro, N., Donno, V., Banin, P., Mainetti, B., Coccioli, M. S., Giuseppe d'Annunzio, Minuto, N., Montani, E., Maccioni, R., Marongiu, U., Beccaria, L., Bruzzese, M., Mammì, F., Pardi, D., Lombardo, F., Ventrici, C., Scaramazza, A., Ferrari, M., Bonfanti, R., Rigamonti, A., Iughetti, L., Predieri, B., Iafusco, D., Confetto, S., Zanfardino, A., Prisco, F., Franzese, A., Nitto, E., Cadario, F., Milia, A., Piredda, G., Mereu, L., Soro, M., Correddu, A., Pipia, A., Monciotti, C., Cardella, F., Berardinis, F., Santoro, G., Chiari, G., Berioli, M. G., Federico, G., Zanette, G., Marsciani, A., Pedini, A., Patera, I. P., Schiaffini, R., Bitti, M., Lidano, R., Pietrosanti, S., Delvecchio, M., Trada, M., Marinaro, A., Meloni, G., Galero, A., Fichera, G., Bulciolu, P., Rabbone, I., Ignaccolo, G., Cauvin, V., Franceschi, R., Faleschini, E., Tornese, G., Salvatoni, A., Cardani, R., Maffeis, C., Marigliano, M., Sabbion, A., and Arnaldi, C.

Subjects
diabetic ketoacidosis, children, type 1 diabetes, risk factors, nation-wide retrospective observational study, risk of complication

14. Epidemiology of diabetic ketoacidosis in Italy | Epidemiologia della chetoacidosi diabetica in Italia

Author

valentino cherubini, Gesuita, R., Sternardi, S., Ferrito, L., Lenzi, L., Iannilli, A., Piccini, B., Skrami, E., Nicolucci, A., Pintaudi, B., Toni, S., Lera, R., Luna, L., Kienberger, B., Gualtieri, A., Zecchino, C., Piccino, E., Ortolani, F., Zucchini, S., Maltoni, G., Pasquino, B., Reinstadler, P., Prandi, E., Zattoni, V., Gallo, F., Morganti, G., Guerraggio, L., Ripoli, C., Frongia, M., Pusceddu, P., La Loggia, A., Scanu, P., Cardinale, G., Ponzi, G., Tomaselli, L. G., Rapisarda, V., Citriniti, F., Soprani, T., Tumini, S., Lazzaro, N., Donno, V., Banin, P., Mainetti, B., Coccioli, M. S., D Annunzio, G., Minuto, N., Montani, E., Maccioni, R., Marongiu, U., Beccaria, L., Bruzzese, M., Mammì, F., Pardi, D., Lombardo, F., Ventrici, C., Scaramazza, A., Ferrari, M., Bonfanti, R., Rigamonti, A., Iughetti, L., Predieri, B., Iafusco, D., Confetto, S., Zanfardino, A., Prisco, F., Franzese, A., Nitto, E., Cadario, F., Milia, A., Piredda, G., Mereu, L., Soro, M., Correddu, A., Pipia, A., Monciotti, C., Cardella, F., Berardinis, F., Santoro, G., Chiari, G., Berioli, M. G., Federico, G., Zanette, G., Marsciani, A., Pedini, A., Patera, I. P., Schiaffini, R., Bitti, M., Lidano, R., Pietrosanti, S., Delvecchio, M., Trada, M., Marinaro, A., Meloni, G., Galero, A., Fichera, G., Bulciolu, P., Rabbone, I., Ignaccolo, G., Cauvin, V., Franceschi, R., Faleschini, E., Tornese, G., Salvatoni, A., Cardani, R., Maffeis, C., Marigliano, M., Sabbion, A., and Arnaldi, C.

15. Is there a way to conserve the wellbeing of nurses working in children's critical care areas?

Author

Colelli, D. and Frongia, M.

Subjects
PSYCHOLOGICAL burnout, INTENSIVE care nursing, INTENSIVE care units, JOB stress, RESEARCH methodology, PEDIATRIC nursing, PEDIATRICS, QUESTIONNAIRES, DESCRIPTIVE statistics
Abstract

An abstract of the article "Is There a Way to Conserve the Wellbeing of Nurses Working in Children's Critical Care Areas?," by D. Colelli is presented.

Published
2013

16. Are there any relations among transplant centre volume, surgical technique and anatomy for donor graft selection? Ten-year multicentric Italian experience on mini-invasive living donor nephrectomy

Author

Pasquale Ditonno, Mauro Frongia, A. Collini, Massimo Abelli, Salvatore Gruttadauria, Caterina Di Bella, Danilo Carlo Parolini, Elena Ticozzelli, Mario Carmellini, Gionata Spagnoletti, Flavia Caputo, Andrea Airoldi, Maria Paola Salerno, Vanessa De Pace, Barbara Buscemi, Umberto Baccarani, Enzo Capocasale, Alessandro Giacomoni, Nguefouet Momo Rostand, Andrea Solinas, Antenore Giussani, Gianmarco Bondonno, Gian Luigi Adani, Antonio Daniele Pinna, Maurizio Iaria, Andrea Bosio, Luciano De Carlis, Luigino Boschiero, Carlo Socci, Stefano Vittorio Impedovo, Giovanni Pasquale, Matteo Ravaioli, Claudio Beretta, Jacopo Romagnoli, Lucrezia Furian, Marco Spada, Ravaioli, M, Capocasale, E, Furian, L, De Pace, V, Iaria, M, Spagnoletti, G, Salerno, M, Giacomoni, A, De Carlis, L, Di Bella, C, Rostand, N, Boschiero, L, Pasquale, G, Bosio, A, Collini, A, Carmellini, M, Airoldi, A, Bondonno, G, Ditonno, P, Impedovo, S, Beretta, C, Giussani, A, Socci, C, Parolini, D, Abelli, M, Ticozzelli, E, Baccarani, U, Adani, G, Caputo, F, Buscemi, B, Frongia, M, Solinas, A, Gruttadauria, S, Spada, M, Pinna, A, and Romagnoli, J

Subjects
Nephrology, Male, Time Factors, volume transplant centre, medicine.medical_treatment, Settore MED/18 - CHIRURGIA GENERALE, 030232 urology & nephrology, mini-invasive surgical approach, 030230 surgery, Kidney, Nephrectomy, delayed graft function, donor outcome, living donor transplant, 0302 clinical medicine, Living Donors, Medicine, Laparoscopy, Kidney transplantation, medicine.diagnostic_test, Graft Survival, Middle Aged, Hospitals, medicine.anatomical_structure, Tissue and Organ Harvesting, Female, Artery, medicine.medical_specialty, Hospitals, Low-Volume, Donor Selection, High-Volume, 03 medical and health sciences, Internal medicine, Low-Volume, Humans, Transplantation, business.industry, Donor selection, Perioperative, medicine.disease, Kidney Transplantation, Surgery, Hospitals, High-Volume, business
Abstract

Background Selection of the right or left living donor kidney for transplantation is influenced by many variables. In the present multi centric study including 21 Italian transplant centres, we evaluated whether centre volume or surgical technique may influence the selection process. Methods Intra- and perioperative donor data, donor kidney function, and recipient and graft survival were collected among 693 mini-invasive living donor nephrectomies performed from 2002 to 2014. Centre volume (LOW, 1-50 cases; HIGH, >50 cases) and surgical technique (FULL-LAP, full laparoscopic and robotic; HA-LAP, hand-assisted laparoscopy; MINI-OPEN, mini-lumbotomy) were correlated with selection of right or left donor kidney and with donor and recipient outcome. Results HIGH-volume centres retrieved a higher rate of donor right kidneys (29.3% versus 17.6%, P

Published
2017

18. Are there any relations among transplant centre volume, surgical technique and anatomy for donor graft selection? Ten-year multicentric Italian experience on mini-invasive living donor nephrectomy.

Author

Ravaioli M, Capocasale E, Furian L, De Pace V, Iaria M, Spagnoletti G, Salerno MP, Giacomoni A, De Carlis L, Di Bella C, Rostand NM, Boschiero L, Pasquale G, Bosio A, Collini A, Carmellini M, Airoldi A, Bondonno G, Ditonno P, Impedovo SV, Beretta C, Giussani A, Socci C, Parolini DC, Abelli M, Ticozzelli E, Baccarani U, Adani GL, Caputo F, Buscemi B, Frongia M, Solinas A, Gruttadauria S, Spada M, Pinna AD, and Romagnoli J

Subjects
Female, Graft Survival, Humans, Kidney blood supply, Kidney surgery, Male, Middle Aged, Time Factors, Donor Selection, Hospitals, High-Volume statistics & numerical data, Hospitals, Low-Volume statistics & numerical data, Kidney anatomy & histology, Kidney Transplantation methods, Living Donors, Nephrectomy methods, Tissue and Organ Harvesting methods
Abstract

Background: Selection of the right or left living donor kidney for transplantation is influenced by many variables. In the present multi centric study including 21 Italian transplant centres, we evaluated whether centre volume or surgical technique may influence the selection process., Methods: Intra- and perioperative donor data, donor kidney function, and recipient and graft survival were collected among 693 mini-invasive living donor nephrectomies performed from 2002 to 2014. Centre volume (LOW, 1-50 cases; HIGH, >50 cases) and surgical technique (FULL-LAP, full laparoscopic and robotic; HA-LAP, hand-assisted laparoscopy; MINI-OPEN, mini-lumbotomy) were correlated with selection of right or left donor kidney and with donor and recipient outcome., Results: HIGH-volume centres retrieved a higher rate of donor right kidneys (29.3% versus 17.6%, P < 0.01) with single artery (83.1% versus 76.4%, P < 0.05) compared with LOW-volume centres. Surgical technique correlated significantly with rate of donor right kidney and presence of multiple arteries: MINI-OPEN (53% and 13%) versus HA-LAP (29% and 22%) versus FULL-LAP (11% and 23%), P < 0.001 and P < 0.05, respectively. All donors had an uneventful outcome; donor bleeding was more frequent in LOW-volume centres (4% versus 0.9%, P < 0.05)., Conclusions: Centre volume and surgical technique influenced donor kidney side selection. Donor nephrectomy in LOW-volume centres was associated with higher risk of donor bleeding., (© The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)

Published
2017
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19. KIR and their HLA Class I ligands: Two more pieces towards completing the puzzle of chronic rejection and graft loss in kidney transplantation.

Author

Littera R, Piredda G, Argiolas D, Lai S, Congeddu E, Ragatzu P, Melis M, Carta E, Michittu MB, Valentini D, Cappai L, Porcella R, Alba F, Serra M, Loi V, Maddi R, Orrù S, La Nasa G, Caocci G, Cusano R, Arras M, Frongia M, Pani A, and Carcassi C

Subjects
Adult, Cadaver, Case-Control Studies, Female, Gene Expression, Glomerular Filtration Rate, Graft Rejection immunology, Graft Rejection pathology, Graft Survival genetics, HLA-B Antigens genetics, HLA-C Antigens genetics, Histocompatibility, Humans, Kidney Failure, Chronic immunology, Kidney Failure, Chronic pathology, Kidney Failure, Chronic surgery, Killer Cells, Natural immunology, Killer Cells, Natural pathology, Ligands, Male, Middle Aged, Receptors, KIR2DL1 genetics, Receptors, KIR3DL1 genetics, Transplantation, Homologous, Unrelated Donors, Graft Rejection genetics, HLA-B Antigens immunology, HLA-C Antigens immunology, Kidney Transplantation, Receptors, KIR2DL1 immunology, Receptors, KIR3DL1 immunology
Abstract

Background: Kidney transplantation is a life-saving treatment for patients with end-stage renal disease. However, despite progress in surgical techniques and patient management, immunological rejection continues to have a negative impact on graft function and overall survival. Incompatibility between donors and recipients for human leukocyte antigens (HLA) of the major histocompatibility complex (MHC) generates a series of complex cellular and humoral immune response mechanisms that are largely responsible for rejection and loss of graft function. Within this context, a growing amount of evidence shows that alloreactive natural killer (NK) cells play a critical role in the immune response mechanisms elicited by the allograft. Killer immunoglobulin-like receptors (KIRs) are prominent mediators of NK cell alloreactivity., Methods and Findings: A cohort of 174 first cadaveric kidney allograft recipients and their donors were selected from a total cohort of 657 transplanted patients for retrospective immunogenetic analyses. Patients with HLA Class II mismatches were excluded. HLA Class I allele frequencies were compared among patients with chronic rejection, patients with stable graft function and a group of 2388 healthy controls. Activating and inhibitory KIR gene frequencies, KIR haplotypes, KIR-HLA ligand matches/mismatches and combinations of recipient KIRs and donor HLA Class I ligands were compared among patients with and without chronic rejection and a group of 221 healthy controls. Patients transplanted from donors homozygous for HLA-C1 antigens had a significantly higher risk for chronic rejection than patients transplanted from donors homozygous or heterozygous for HLA-C2 antigens or with epitopes belonging to the HLA-Bw4 ligand group. The Kaplan-Meier curves obtained by dividing the patients into 3 groups according to the presence or absence of one or both of the combinations of recipient KIRs and donor HLA ligands (rKIR2DL1/dHLA-C2 and rKIR3DL1/dHLA-Bw4) showed a significantly higher cumulative incidence of chronic rejection in the group of patients completely lacking these functional units. These patients showed a progressively stronger decline in modification of diet in renal disease-estimated glomerular filtration rate., Conclusions: KIR genotyping should be performed at the time of enrolment of patients on the waiting list for organ transplantation. In our study, a significantly higher risk of chronic rejection after kidney transplantation was observed when recipient (r) and donor (d) pairs completely lacked the two functional rKIR-dHLA ligand combinations rKIR2DL1/dHLA-C2 and rKIR3DL1/dHLA-Bw4. This immunogenetic profile corresponds to low levels of NK cell inhibition. Therefore, patients with this high risk profile could benefit from immunosuppressive therapy aimed at reducing NK-cell cytotoxicity.

Published
2017
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20. First Robotic-Assisted Dual Kidney Transplant: Surgical Technique and Report of a Case With 24-month Follow-up.

Author

Frongia M, Cadoni R, and Solinas A

Abstract

Background: Open surgery is the gold standard procedure for kidney transplantation. There is a strong rationale for using minimally invasive surgery in patients with end-stage renal disease. A robotic-assisted dual kidney transplant was performed for the first time at our institution., Methods: In August 2013, a 63-year-old man with end-stage renal disease and diabetes mellitus under pharmacological control received both kidneys from a 70-year-old marginal donor. Pretransplant donor biopsy demonstrated a bilateral Karpinski score greater than 5. The organs did not exhibit malformations and each had an artery and a vein. The procedure was carried out by a 7-port intraperitoneal approach using the da Vinci surgical system. The procedure was identical for the 2 kidneys except that mobilization of the sigmoid colon was required to introduce the left graft. The renal vessels were anastomosed to the left external iliac vessels. The novel aspect of the technique was the introduction of both grafts through a single, 7-cm upper midline incision., Results: Total operative time was 400 minutes and blood loss was 120 mL. Both grafts immediately began functioning. There were no intraoperative or postoperative complications. The patient was discharged on the seventh postoperative day with normal renal function. At 24 months, he is well and does not require hemodialysis., Conclusions: Minimally invasive robotic-assisted technology is a promising technique that provides exceptional patient outcomes by reducing operative morbidity, immobilization, and time to recovery, while affording better esthetic results. Selected patients with multiple comorbidities benefit most. Grafts from marginal donors are an extremely valuable resource.

Published
2015
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21. Role of human leukocyte antigen-G 14-base pair polymorphism in kidney transplantation outcomes.

Author

Littera R, Piredda G, Pani A, Frongia M, Onano B, Michittu MB, Murgia MG, Lai S, Alba F, Valentini MD, Loi V, Caocci G, Orrù S, La Nasa G, and Carcassi C

Subjects
Adult, Aged, Female, Genetic Markers, HLA-G Antigens immunology, Homozygote, Humans, Male, Middle Aged, Retrospective Studies, Young Adult, 3' Untranslated Regions physiology, Gene Deletion, Graft Rejection genetics, HLA-G Antigens genetics, HLA-G Antigens metabolism, Kidney Transplantation, Polymorphism, Genetic
Abstract

Background: Both the membrane-bound and soluble forms of human leukocyte antigen-G (HLA-G) molecules exhibit a multitude of immunomodulatory properties that can potentially obviate or delay graft rejection. The 14-base pair (14-bp) polymorphism in the 3'-untranslated region of the HLA-G gene is thought to have a role in soluble HLA-G (sHLA-G) expression., Methods: In this study, we retrospectively investigated a large cohort of 418 kidney transplant recipients with the aim of establishing whether the HLA-G 14-bp insertion/deletion polymorphism could serve as an effective genetic risk marker for acute and/or chronic deterioration of transplanted kidney function., Results: A statistically significant higher incidence of chronic kidney dysfunction leading to allograft loss was observed in transplant recipients homozygous for the HLA-G 14-bp deletion polymorphism. This difference increased over time and was confirmed by progressive decline in the glomerular filtration rate., Conclusions: These results suggest that alongside other factors previously consolidated in clinical practice, recipient HLA-G 14-bp genotype may serve as an adjuvant independent predictor of long-term outcome of kidney transplantation.

Published
2013
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22. Fibromuscular dysplasia causing renal artery aneurysm and renovascular hypertension: a case report.

Author

Solinas A, Cadoni R, Usai M, and Frongia M

Subjects
Adult, Female, Fibromuscular Dysplasia complications, Humans, Aneurysm etiology, Hypertension, Renovascular etiology, Renal Artery
Abstract

Objective: Renal artery aneurysm is a rare disease and usually is due to fibromuscular dysplasia. We describe a case in a woman who had renovascular hypertension due to aneurysm of fibromuscular dysplasia-associated renal artery., Material and Methods: The clinical presentation, renal function, radiologic data, complications and treatment were studied., Results: To report a case of 37-year-old female with a history of hypertension in the last year in pharmacological therapy and in absence of other clinical symptoms. A Doppler ultrasound and a spiral tomography revealed the presence of a right renal artery aneurysm with a hypoplastic kidney. Controlateral kidney was normal. We carried out total nephrectomy to resolve high blood pression and the risk of rupture. The patient was discharged home in 5th post operative day. Serum creatinine level remained normal as it was before. Her blood pressure normalized over a period of several months using a single antihypertensive medication., Conclusion: We suggested that in presence of renovascular hypertension in young adult fibromuscular dysplasia-related renal artery aneurysm will be suspected. When possible aneurysmectomy and angioplastic renal artery closure or segmental renal artery reimplantation and renal artery bypass are the gold standard while nephrectomy will be reserved for unreconstructable renal arteries or advanced parenchymal disease.

Published
2010

23. Primary obstructive megaureter in adults: management strategy in a young woman.

Author

Solinas A, Pau A, Ayyoub M, and Frongia M

Subjects
Adult, Female, Humans, Radiography, Ureteral Calculi diagnostic imaging, Ureteral Calculi etiology, Ureteral Calculi surgery, Ureteral Obstruction complications, Ureteral Obstruction diagnostic imaging, Ureteral Obstruction surgery
Abstract

Objective: Primary obstructive megaureter is an uncommon disease in adults. We describe a case in a thirty years old woman affected by monolateral megaureter complicated by ureteric calculi., Material and Method: The clinical presentation, renal function, radiologic data, complications and treatment were studied., Results: The patient, with a history of recurrent right flank pain in the last ten years, had a right primary obstructive megaureter radiologically revealed complicated by ureteric calculi. Omolateral kidney result malrotate. Extensive ureteral tailoring with an extravesical ureteral reimplantation was performed. The calculi were removed at the time of ureteroneocystostomy., Conclusion: Adult and adolescent primary obstructive megaureter is a congenital abnormality that do not regress. Complications such us stone formation and altered function of the affected kidney are common and when associated to recurrent urinary tract infections require surgical intervention. Conservative management probably has a role only in the uncomplicated primary megaureter patients with normal creatinine clearance and who have possibility of a regular lifelong follow-up.

Published
2010

24. Ablation of non functioning renal allograft by embolization: a valid alternative to graft nephrectomy?

Author

Solinas A, De Giorgi F, and Frongia M

Subjects
Adult, Embolization, Therapeutic instrumentation, Feasibility Studies, Female, Humans, Male, Middle Aged, Polyvinyl Alcohol administration & dosage, Retrospective Studies, Stainless Steel, Transplantation, Homologous, Embolization, Therapeutic methods, Graft Rejection therapy, Kidney Transplantation, Nephrectomy methods
Abstract

Objective: Removal of transplant for the treatment of graft intolerance syndrome (GIS) is an invasive procedure with high risk, often performed in patients with poor general conditions. Renal allograft embolization is a recent alternative treatment to surgical nephrectomy. The aim of this study was to evaluate the efficacy and safety of allograft embolization in a series of patients with GIS., Patients and Methods: The study included 12 patients (9 males and 3 females) with irreversible renal graft rejection and GIS. All patients were in hemodialysis and they have not responded to medical treatment. Infection was ruled out by blood and urine cultures. The embolization was performed using polyvinyl alcohol particles and steel coils. Vascular access was obtained via femoral artery puncture in all the patients. Before starting embolization at the puncture site local anaesthesia was performed., Results: Eleven of the twelve procedures were technically successful, but in one patient a second treatment was necessary, after a month, for the presence of collateral perirenal circulation caused hematuria. There were no major complications and the mean hospital stay was 5 days., Conclusion: The graft embolization is a simple, safe and effective technique that permits non-surgical ablation of a non-functioning renal allograft in a significant number of patients.

Published
2005

25. Embolization of a hypoplastic kidney with a vaginal ectopic ureter in a case of pseudo-incontinence.

Author

Solinas A, De Giorgi F, and Frongia M

Subjects
Adolescent, Female, Humans, Urinary Incontinence therapy, Abnormalities, Multiple, Embolization, Therapeutic, Kidney abnormalities, Ureter abnormalities, Urinary Incontinence etiology, Vagina abnormalities
Abstract

Ureteral ectopy into the vagina is a cause of pseudo-incontinence. When the corresponding kidney has a good function, the treatment of choice is the ureter reimplantation, otherwise the alternative is partial or total nephrectomy. To report a case of 18-year-old girl presented with urinary leakage occurring between normal voids that at 11-year-old was found to have, at cistoscopy and vaginoscopy, an left ureteral ectopy into the vagina with a non demonstrable corresponding kidney at conventional intravenous urography, dimercaptosuccinic acid scintigraphy and ultrasonography. Moreover the right kidney was found enlarged but normally located. Her parents refused the explorative laparotomy to localize and to remove the left kidney. We completed the examination with computed tomography that revealed a small hypoplastic and ectopic left kidney located at L4 level. Because the contribution of the hypoplastic kidney to the total renal function was insignificant, we decided to eliminate it. A selective embolization of the left renal artery was performed using polyvinyl alcohol foam. The pseudo-incontinence stopped immediately after The patient was discharged home in II postoperative day and has been free from any leakage for 3 years. Serum creatinine levels and blood pressure returned to their normal values.

Published
2004

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