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1. The Feasibility of Long-Segment Fluoroscopy-guided Percutaneous Thoracic Spine Pedicle Screw Fixation, and the Outcome at Two-year Follow-up

Author

Tamburrelli FC, Perna A, Proietti L, Zirio G, Santagada DA, and Genitiempo M

Subjects
percutaneous, minimally invasive surgery, thoracic spine fractures, metastasis and infection, neuro-navigation, Orthopedic surgery, RD701-811
Abstract

INTRODUCTION: Posterior percutaneous instrumentation may represent a challenge when multiple levels need to be instrumentated, especially when including the upper thoracic spine. The aim of the present study was to evaluate the technical feasibility and the long-term outcome of such long constructs in different surgical conditions. MATERIALS AND METHODS: This investigation was a retrospective cohort study which included patients who underwent thoraco-lumbar percutaneous fixations. We collected clinical, surgical and radiological data, with a minimum follow-up of 24 months. Health-related quality-oflife, residual pain, instrumentation placement, and complications were studied. RESULTS: A total of 18 procedures were enrolled, in which 182 screws were implanted, (170 positioned in thoracic and 12 in lumbar pedicles, respectively). No surgical complications or hardware failure occurred in our series, 6 out of 182 (3,2%) screws had a partial pedicle breach, without neurological impairment or need for surgical revision. CONCLUSION: According to our results, a fully posterior percutaneous approach for long thoraco-lumbar spine instrumentation can be considered safe and reproducible, although an adequate training is strictly required.

Published
2019
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6. Trisomy 22 mosaicism from prenatal to postnatal findings: a case series and systematic review of the literature

Author

Trevisan, Valentina, Meroni, Anna, Leoni, Chiara, Sirchia, F, Politano, D, Fiandrino, G, Giorgio, Valentina, Rigante, Donato, Limongelli, Domenico, Perri, L, Sforza, Elisabetta, Leonardi, Fabio, Viscogliosi, Germana, Contaldo, Ilaria, Orteschi, D, Proietti, Luca, Zampino, Giuseppe, Onesimo, Roberta, Trevisan V, Meroni A, Leoni C, Giorgio V, Rigante D (ORCID:0000-0001-7032-7779), Limongelli D, Sforza E, Leonardi F, Viscogliosi G, Contaldo I, Proietti L (ORCID:0000-0003-2919-0381), Zampino G (ORCID:0000-0003-3865-3253), Onesimo R, Trevisan, Valentina, Meroni, Anna, Leoni, Chiara, Sirchia, F, Politano, D, Fiandrino, G, Giorgio, Valentina, Rigante, Donato, Limongelli, Domenico, Perri, L, Sforza, Elisabetta, Leonardi, Fabio, Viscogliosi, Germana, Contaldo, Ilaria, Orteschi, D, Proietti, Luca, Zampino, Giuseppe, Onesimo, Roberta, Trevisan V, Meroni A, Leoni C, Giorgio V, Rigante D (ORCID:0000-0001-7032-7779), Limongelli D, Sforza E, Leonardi F, Viscogliosi G, Contaldo I, Proietti L (ORCID:0000-0003-2919-0381), Zampino G (ORCID:0000-0003-3865-3253), and Onesimo R

Abstract

Background: Among aneuploidies compatible with life, trisomy 22 mosaicism is extremely rare, and only about 25 postnatal and 18 prenatal cases have been described in the literature so far. The condition is mainly characterized by facial and body asymmetry, cardiac heart defects, facial dysmorphisms, growth failure, delayed puberty, and variable degrees of neurodevelopmental delay. Problem: The scattered information regarding the condition and the dearth of data on its natural history and developmental outcomes restrict genetic counseling, particularly in prenatal settings. Moreover, a prompt diagnosis is frequently delayed by the negative selection of trisomic cells in blood, with mosaicism percentage varying among tissues, which often entails the need for further testing. Purpose/topic: The aim of our work is to provide assistance in prenatal and postnatal genetic counseling by systematically delineating the current knowledge of the condition. This entails defining the prenatal and postnatal characteristics of the condition and presenting novel data from three cases, both prenatally and postnatally. Additionally, we report the developmental outcomes observed in two new patients.

Published
2024

14. Oxidative stress and anabolic hormones in back pain: Current concept and preliminary analysis in male cohort

Author

Vergani, E., Bruno, C., Silvestrini, A., Meucci, E., Proietti, L., Perna, A., Tamburrelli, F. C., Mancini, A., Vergani E., Bruno C., Silvestrini A. (ORCID:0000-0002-2005-3746), Meucci E. (ORCID:0000-0002-8821-8041), Proietti L. (ORCID:0000-0003-2919-0381), Tamburrelli F. C. (ORCID:0000-0002-3140-5700), Mancini A. (ORCID:0000-0002-7707-4564), Vergani, E., Bruno, C., Silvestrini, A., Meucci, E., Proietti, L., Perna, A., Tamburrelli, F. C., Mancini, A., Vergani E., Bruno C., Silvestrini A. (ORCID:0000-0002-2005-3746), Meucci E. (ORCID:0000-0002-8821-8041), Proietti L. (ORCID:0000-0003-2919-0381), Tamburrelli F. C. (ORCID:0000-0002-3140-5700), and Mancini A. (ORCID:0000-0002-7707-4564)

Abstract

Back Pain (BP) is a common medical problem; anabolic hormones, through the modulation of oxidative stress (OS), could influence fracture risk. We evaluated the prevalence of anabolic hormonal deficiencies and their relationship with OS in males with BP, associated or not to nontraumatic fractures. 49 males with BP, from 36 to 80 years, were divided in two groups according to radiological evidence of nontraumatic fractures; group A (n=25): non-fractured; group B (n=24): fractured. A different prevalence of hormonal deficits was observed: 24% of hypotestosteronemia in A, 0% in B; 16% of GHD in A, 29% in B; Total Antioxidant Capacity (TAC) showed a trend toward higher levels in B. In A, despite lower TAC, a significant inverse correlation was present between TAC and IGF-1. A greater prevalence of GHD in patients with vertebral fractures was seen and, in a subgroup, OS could mediate the deleterious effects of hyposecretory GH state.

Published
2020

15. A Journey Into the Unknown: PhD Students in a European Training Network on Age-related Changes in Hematopoiesis Conduct Their Project During a Global Pandemic

Author

Pitsillidou, C, Alonso-Rubido, S, Ávila-Ávila, A, Romero-Mulero, M, Labedz, A, Oikonomou, A, Proietti, L, Psychoyiou, M, Tellez-Quijorna, C, Hillary, M, Fasouli, E, Fernández-Rodríguez, G, Giner-Laguarda, N, Skinder, N, Taroni, C, Strouboulis, J, Katsantoni, E, Ronchi, A, Pitsillidou, Christina, Alonso-Rubido, Sandra, Ávila-Ávila, Andrea, Romero-Mulero, Mari Carmen, Labedz, Agata, Oikonomou, Athanasios, Proietti, Ludovica, Psychoyiou, Maria Eleni, Tellez-Quijorna, Clara, Hillary, Maniriho, Fasouli, Eirini Sofia, Fernández-Rodríguez, Guillermo, Giner-Laguarda, Natalia, Skinder, Natalia, Taroni, Chiara, Strouboulis, John, Katsantoni, Eleni, Ronchi, Antonella Ellena, Pitsillidou, C, Alonso-Rubido, S, Ávila-Ávila, A, Romero-Mulero, M, Labedz, A, Oikonomou, A, Proietti, L, Psychoyiou, M, Tellez-Quijorna, C, Hillary, M, Fasouli, E, Fernández-Rodríguez, G, Giner-Laguarda, N, Skinder, N, Taroni, C, Strouboulis, J, Katsantoni, E, Ronchi, A, Pitsillidou, Christina, Alonso-Rubido, Sandra, Ávila-Ávila, Andrea, Romero-Mulero, Mari Carmen, Labedz, Agata, Oikonomou, Athanasios, Proietti, Ludovica, Psychoyiou, Maria Eleni, Tellez-Quijorna, Clara, Hillary, Maniriho, Fasouli, Eirini Sofia, Fernández-Rodríguez, Guillermo, Giner-Laguarda, Natalia, Skinder, Natalia, Taroni, Chiara, Strouboulis, John, Katsantoni, Eleni, and Ronchi, Antonella Ellena

Abstract

The age-related changes in hematopoiesis (ARCH) project is part of the Innovative Training Network (ITN) of the Marie-Sklodowska Curie Actions (MSCA) program, which provides doctorate training of excellence based on the exchange of ideas and competencies from the academic and private sectors.1 The ARCH project intends to outline hematopoietic stem cell (HSC) alterations with aging, how hematopoietic cell individuality is controlled at the transcriptional and epigenetic levels in normal hematopoiesis and in leukemias, and understand the crosstalk between intrinsic and extrinsic indications that support the proliferation of preleukemic and leukemic cells within the hematopoietic niche. We are 15 PhD students funded by this network, based around Europe, and our common aim is to understand functional changes in the hematopoietic system with age, how these changes link to the development of age-associated diseases and in parallel work towards the development of new treatments.2 Our projects kicked off just when the severe acute respiratory coronavirus-2 (SARS-CoV-2) emerged. Two and a half years later, SARS-CoV-2 continues to infect millions of people and has taken the lives of at least 6 million people worldwide.3 The COVID-19 outbreak brought along social isolation and feelings of uncertainty to everyone around the world, including doctorate students.4,5 Ironically, our projects have been more relevant than ever, as the pandemic has highlighted the important relationship between age-related changes in hematopoiesis and disease severity. Below, we aim to discuss the timeline of the ARCH project throughout the pandemic and how we managed to courageously pull through the hardships of doing research during a global pandemic within different settings (academia/institutes and industry). We provide recommendations to future PhD students on how to manage their PhD projects during global emergencies.

Published
2022

16. Could serum procalcitonin play a role in an emergency setting for patients with pyogenic spondylodiscitis?

Author

Santagada, Domenico Alessandro, Perna, Alessandro, Tullo, Gianluca, Proietti, Luca, Vitiello, Raffaele, Ferraro, S, Giovannini, Silvia, Gasbarrini, Antonio, Franceschi, Francesco, Maccauro, Giulio, Tamburrelli, Francesco Ciro, Covino, Marcello, Santagada, D A, Perna, A, Tullo, G, Proietti, L (ORCID:0000-0003-2919-0381), Vitiello, R, Giovannini, S (ORCID:0000-0001-9125-752X), Gasbarrini, A (ORCID:0000-0002-7278-4823), Franceschi, F (ORCID:0000-0001-6266-445X), Maccauro, G (ORCID:0000-0002-7359-268X), Tamburrelli, F C (ORCID:0000-0002-3140-5700), Covino, M (ORCID:0000-0002-6709-2531), Santagada, Domenico Alessandro, Perna, Alessandro, Tullo, Gianluca, Proietti, Luca, Vitiello, Raffaele, Ferraro, S, Giovannini, Silvia, Gasbarrini, Antonio, Franceschi, Francesco, Maccauro, Giulio, Tamburrelli, Francesco Ciro, Covino, Marcello, Santagada, D A, Perna, A, Tullo, G, Proietti, L (ORCID:0000-0003-2919-0381), Vitiello, R, Giovannini, S (ORCID:0000-0001-9125-752X), Gasbarrini, A (ORCID:0000-0002-7278-4823), Franceschi, F (ORCID:0000-0001-6266-445X), Maccauro, G (ORCID:0000-0002-7359-268X), Tamburrelli, F C (ORCID:0000-0002-3140-5700), and Covino, M (ORCID:0000-0002-6709-2531)

Abstract

OBJECTIVE: Spinal infections, represent quite rare but often severe conditions. However, due to symptoms' non-specificity and the lack of specific laboratory tests, diagnosis is often delayed with serious consequences for the patient's outcomes. The present investigation aimed at evaluating the role of procalcitonin (PCT) and other clinical features on the risk stratification and the clinical outcomes in spondylodiscitis patients treated in our Emergency Department. PATIENTS AND METHODS: The present investigation represents a single-center retrospective study. Clinical records of consecutive patients admitted to our Emergency Department from 1 January 2015 to 31 March 2021 were evaluated and patients with spondylodiscitis diagnosis in this period were recruited. Our primary outcome was the degree of autonomy of patients following the acute event. Our secondary outcome was the resolution of the infection. RESULTS: In the study period, a total of 345 patients were evaluated. Among these, 165 met the inclusion criteria, and constituted the study cohort. Concerning the primary outcome, we observed that the most significant predictive factors for being non-autonomous were elevated serum creatinine (> 1.05 mg/dl), Blood Urea Nitrogen ( BUN) > 23 mg/dl, Lactate dehydrogenase > 228 U/L, PCT > 0.11 ng/mL. Patients with higher PCT (PCT > 0.11 ng/mL) and higher BUN ( BUN > 23 mg/dl) had higher odds of infection persistence (the Odd Ratio, OR, were respectively 3.78 for PCT and 3.14 for BUN). CONCLUSIONS: PCT assay may play a role in diagnosing spondylodiscitis in an emergency setting. A PCT value > 0.11 ng/mL should be considered as a red flag, a predictor of worse clinical outcomes and persistence of infection.

Published
2022

17. The use of Carbon-Peek volar plate after distal radius osteotomy for Kienbock’s Disease in a volleyball athlete: a case report

Author

Guzzini, M., Princi, G., Proietti, L., and Ferretti, A.

Subjects
Adult, carbon-peek plate, core decompression, kienbock, radius osteotomy, volleyball, adult, biocompatible materials, carbon fiber, female, humans, ketones, osteonecrosis, polyethylene glycols, prosthesis design, radius, bone plates, osteotomy, Polymers, Osteonecrosis, Kienbock, Case Report, Biocompatible Materials, Ketones, Prosthesis Design, Osteotomy, Polyethylene Glycols, Benzophenones, Radius, Carbon-Peek plate, Carbon Fiber, Humans, Female, Bone Plates
Abstract

Kienbock’s Disease, or lunatomalacia, has uncertain etiopathogenesis, it is more common in male from 20 to 45-year-old. The Lichtman’s classification is the most used by authors and it divides Kienbock’s Disease in 4 stages according to radiographic parameters. In early stages could be performed a conservative treatment, but failure rate is high; various surgical techniques are available in case of failure or higher stages. We report a case of a 26-year-old female volleyball player affected by stage I Kienbock’s Disease who underwent distal radius osteotomy core decompression synthesized with Carbon-Peek plate fixation. Follow-up was performed with clinical evaluation (ROM analysis, VAS score, Quick Dash Score), wrist radiographs and wrist MRI. (www.actabiomedica.it)

Published
2020

18. FUSE-ML: development and external validation of a clinical prediction model for mid-term outcomes after lumbar spinal fusion for degenerative disease

Author

Staartjes, V.E., Stumpo, V., Ricciardi, L., Maldaner, N., Eversdijk, H.A.J., Vieli, M., Ciobanu-Caraus, O., Raco, A., Miscusi, M., Perna, A., Proietti, L., Lofrese, G., Dughiero, M., Cultrera, F., Nicassio, N., An, S.B., Ha, Y., Amelot, A., Alcobendas, I., Viñuela-Prieto, J.M., Gandía-González, M.L., Girod, P.-P., Lener, S., Kögl, N., Abramovic, A., Safa, N.A., Laux, C.J., Farshad, M., O'Riordan, D., Loibl, M., Mannion, A.F., Scerrati, A., Molliqaj, G., Tessitore, E., Schröder, M.L., Vandertop, W.P., Stienen, M.N., Regli, L., and Serra, C.

Published
2022
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22. Surgical Decision-Making in Spinal Instability in Facioscapulohumeral Muscular Dystrophy Related with a Spinal Muscle Atrophy

Author

Fumo, C., Armocida, D., Perna, Alessia, Pesce, A., Ricci, Enzo, Tamburrelli, Francesco Ciro, Frati, A., Santoro, Antonio, Proietti, Luca, Perna A., Ricci E. (ORCID:0000-0003-3092-3597), Tamburrelli F. C. (ORCID:0000-0002-3140-5700), Santoro A., Proietti L. (ORCID:0000-0003-2919-0381), Fumo, C., Armocida, D., Perna, Alessia, Pesce, A., Ricci, Enzo, Tamburrelli, Francesco Ciro, Frati, A., Santoro, Antonio, Proietti, Luca, Perna A., Ricci E. (ORCID:0000-0003-3092-3597), Tamburrelli F. C. (ORCID:0000-0002-3140-5700), Santoro A., and Proietti L. (ORCID:0000-0003-2919-0381)

Abstract

PMCID: PMC8064827 DOI: 10.1055/s-0041-1722816

Published
2021

23. Long-term Radiologic and Clinical Outcomes after Three-level Contiguous Anterior Cervical Diskectomy and Fusion without Plating: A Multicentric Retrospective Study

Author

Ricciardi, L., Scerrati, A., Bonis, P. D., Miscusi, M., Trungu, S., Visocchi, Massimiliano, Papacci, Fabio, Raco, A., Proietti, Luca, Pompucci, Angelo, Olivi, Alessandro, Montano, Nicola, Visocchi M. (ORCID:0000-0003-1087-0491), Papacci F. (ORCID:0000-0001-8742-2713), Proietti L. (ORCID:0000-0003-2919-0381), Pompucci A. (ORCID:0000-0002-5427-9719), Olivi A. (ORCID:0000-0002-4489-7564), Montano N. (ORCID:0000-0002-4965-1950), Ricciardi, L., Scerrati, A., Bonis, P. D., Miscusi, M., Trungu, S., Visocchi, Massimiliano, Papacci, Fabio, Raco, A., Proietti, Luca, Pompucci, Angelo, Olivi, Alessandro, Montano, Nicola, Visocchi M. (ORCID:0000-0003-1087-0491), Papacci F. (ORCID:0000-0001-8742-2713), Proietti L. (ORCID:0000-0003-2919-0381), Pompucci A. (ORCID:0000-0002-5427-9719), Olivi A. (ORCID:0000-0002-4489-7564), and Montano N. (ORCID:0000-0002-4965-1950)

Abstract

Background Anterior cervical diskectomy and fusion (ACDF) has been providing good surgical, clinical, and radiologic outcomes in patients suffering from cervical degenerative disk disease (DDD). However, the role of anterior plating is still debated, especially in three-level procedures. This study aimed to investigate long-term clinical and radiologic outcomes and complications after three-level contiguous ACDF without plating for cervical DDD. Methods Two institutional databases were retrieved (January 2009-December 2014) for patients treated with three-level contiguous ACDF without plating. Minimum follow-up (FU) was 5 years. Demographical data, smoking status, implant types, Neck Disability Index (NDI), visual analog scale (VAS) for neck pain, complications, fusion rate, adjacent segment degeneration (ASD), cervical lordosis (CL), and residual segmental mobility were evaluated. Results We enrolled 21 patients. Tantalum and carbon fiber cages were implanted, respectively, in 13 and 8 patients. The mean FU length was 5.76 ± 0.87 years. Mean NDI score was 78.29 ± 9.98% preoperatively and 8.29 ± 1.67% at last FU (p < 0.01), whereas mean VAS score decreased from 7.43 ± 1.14 preoperatively to 0.95 ± 0.95 at last FU (p < 0.01). Complications were one postoperative hematoma, one superficial wound infection, and five cases of postoperative dysphagia (recovered within 3 days). The fusion rate was 90% and ASD was reported in three (14%) cases. The mean CL was 6.33 ± 2.70 degrees preoperatively, 8.19 ± 1.97 degrees 3 months after surgery (p = 0.02), and 7.62 ± 1.96 degrees at latest FU. There was no residual mobility on every operated segment at last FU. The smoking status was an independent risk factor for nonfusion in this case series (p = 0.02). Conclusions Three-level contiguous ACDF without plating seems to be an effective treatment for cervical DDD. Properly designed comparative clinical trials are needed to further investigate this topic.

Published
2021

26. Traumatic experiences and type 2 diabetes mellitus

Author

Saya, A, Proietti, L, Lisi, G, Ribolsi, M, Uccioli, L, Niolu, C, and Siracusano, A

Subjects
Male, Adult Survivors of Child Abuse, Resilience, Psychological, Checklist, Logistic Models, Settore MED/25, Adult Survivors of Child Adverse Events, Diabetes Mellitus, Type 2, Case-Control Studies, Surveys and Questionnaires, Humans, Female, Life Style, Stress, Psychological, Aged
Abstract

Type 2 diabetes mellitus (T2DM) is a complex and demanding chronic condition resulting from the body's inability to adequately produce and or effectively utilize insulin. A wide variety of lifestyle factors are of great importance to the development of T2DM, such as sedentary lifestyle, obesity, physical inactivity, smoking and alcohol consumption. An emerging body of literature suggests that stress and traumatic experiences have a role in the aetiology of T2DM.We recruited a sample of 52 patients with a diagnosis of T2DM and a control group of 48 subjects. Using the Traumatic Experience Checklist (TEC), the Childhood Experience of Care and Abuse Questionnaire (CECA-Q), and the Connor-Davidson Resilience Scale (CD-RISC 25), we investigated the presence of history of traumatic experiences and of childhood experience of neglect and abuse.We found that patients with a diagnosis of T2DM have a higher number of traumatic experiences in their personal history, when compared to the control group.Traumatic experiences or sustained stress exposure may contribute to the onset of T2DM. Neuro-inflammatory and psychoanalytic factors will be discussed to explain such association.We conclude that factors that determine high levels of resiliency can have a protective effect against the development of T2DM while stress and the consequent inflammation can contribute to the development of depression and T2DM. These biological features are analyzed in the psychoanalytical context of theories from Freud, Mahler, and Kohut.

Published
2020

32. Contributor contact details

Author

Ambrosio, L., primary, Tanner, K.E., additional, Raucci, M.G., additional, Gloria, A., additional, De Santis, R., additional, Ambrosio, L., additional, Alcock, Ben, additional, Quaye, Michael, additional, Harvey, Jason, additional, Wilke, H.-J., additional, Rohlmann, A., additional, Noailly, Jérôme, additional, Lacroix, Damien, additional, Mohan, Vivek, additional, Gupta, Munish C., additional, Logroscino, Giandomenico, additional, Proietti, L., additional, Pola, E., additional, Revell, Peter A., additional, Baxter, Major David, additional, Yeh, John, additional, Bauer, Thomas W., additional, Persson, Cecilia, additional, Engqvist, Håkan, additional, Maclaine, S.E., additional, Bennett, A.J., additional, Niinomi, Mitsuo, additional, Miot, Sylvie, additional, Marsano, Anna, additional, Martin, Ivan, additional, Tsaryk, Roman, additional, Dohle, Eva, additional, Unger, Ronald E., additional, Kirkpatrick, C. James, additional, Santin, Matteo, additional, Loughran, Michael J., additional, Hunt, John A., additional, Russo, T., additional, Smit, Theo H., additional, and Helder, Marco N., additional

Published
2012
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36. Adult spinal deformity: effectiveness of interbody lordotic cages to restore disc angle and spino-pelvic parameters through completely mini-invasive trans-psoas and hybrid approach

Author

Barone, G., Scaramuzzo, L., Zagra, A., Giudici, F., Perna, A., Proietti, L., Barone G., Giudici F., Proietti L. (ORCID:0000-0003-2919-0381), Barone, G., Scaramuzzo, L., Zagra, A., Giudici, F., Perna, A., Proietti, L., Barone G., Giudici F., and Proietti L. (ORCID:0000-0003-2919-0381)

Abstract

Purpose: The aim of the study is to assess and quantify the effectiveness of interbody lordotic cages applied by trans-psoas approach to improve radiographic parameters, showing the differences between completely mini-invasive and hybrid approach. Methods: We collected data of 65 patients affected by degenerative lumbar deformity/diseases and underwent mini-invasive lateral interbody fusion followed by percutaneous (group A, completely mini-invasive) or open (group B, hybrid) posterior instrumentation. A subgroup underwent anterior column realignment (ACR). We assessed statistical differences in preoperative and postoperative (at least 6-month) coronal and sagittal parameters, and disc angle (DA) at each level of cage application. Results: 107 lordotic cages were implanted. Group B had the most significant mean changes, especially in coronal Cobb angle, sagittal vertical axis, lumbar lordosis (LL), pelvic incidence-LL mismatch and DA. Concerning DA, at each level of lordotic cage application, in group A changed from −2.9° preop to −6.5° postop (p = 0.01); in group B, DA changed from −2.6° to −9.5° (p = 0.002) and from +1° to −13.2° in patients underwent ACR. Conclusions: Minimally invasive lateral lumbar interbody fusion is an effective technique in improving sagittal parameters. When combined with posterior open approach and/or application of ACR procedure greater corrections are possible.

Published
2017

37. Liner dissociation in total hip arthroplasty: a systematic review.

Author

CIOLLI, G., SILVA, R., GIOVANNETTI DE SANCTIS, E., PROIETTI, L., MOCINI, F., CORONA, K., MAZZOLENI, M. G., ROMANINI, E., MARESCALCHI, M., BRANCACCIO, V., MACCAURO, G., and CERCIELLO, S.

Abstract

OBJECTIVE: Liner dissociation (LD) is a rare catastrophic mechanical failure of total hip arthroplasty (THA). The study aims at reviewing the available literature regarding liner dissociations to point out their prevalence, describing any possible association and highlighting the surgical management at the time of revision. MATERIALS AND METHODS: A systematic review of the literature was conducted from January 2002, until February 2022, according to the PRISMA guidelines. The main keywords were: "dissociation" AND "liner" OR "hip arthroplasty" OR "THA" and their MeSH terms in any possible combination. Cases of liner dissociation with all levels of evidence of any age published in indexed journals were included. The study quality of all included studies was evaluated using the MINORS criteria. The kappa (k) value was used to assess the consensus between reviewers in the selection of articles and methodological quality assessment. Finally, a sub-analysis was performed specifically concerning the elderly population. RESULTS: Thirty-one manuscripts met the inclusion criteria of the systematic review (21 case reports and 10 case series). 124 LD in 123 patients, (53% females and 47% males) were evaluated. The overall prevalence of LD was 0.15%. The mean age at surgery was of 56.5 years (range 31-75 years). LD occurred in a primary surgery setting in 86% of the cases, at a mean time of presentation of 45.8 months after replacement surgery. 39.5% of the cups and 8.8% of the stems required revision. The mean follow-up after the revision was 18.4 months. Complications after revision occurred in 19.6% of cases, including 3 cases of re-dissociations. Re-revision was required in 13.6% of the revisions. The sub-analysis of the elderly population included 28 cases of LD identified in 10 manuscripts, with an average age of 73.5 years. CONCLUSIONS: LD is a rare but catastrophic mechanical complication of modular THA that requires implant revision. The LD is not related to a specific prosthetic implant, liner material or design, acetabular positioning within the safe zone or age group. [ABSTRACT FROM AUTHOR]

Published
2022

38. Could serum procalcitonin play a role in an emergency setting for patients with pyogenic spondylodiscitis?

Author

SANTAGADA, D. A., PERNA, A., TULLO, G., PROIETTI, L., VITIELLO, R., FERRARO, S., GIOVANNINI, S., GASBARRINI, A., FRANCESCHI, F., MACCAURO, G., TAMBURRELLI, F. C., and COVINO, M.

Abstract

OBJECTIVE: Spinal infections, represent quite rare but often severe conditions. However, due to symptoms' non-specificity and the lack of specific laboratory tests, diagnosis is often delayed with serious consequences for the patient's outcomes. The present investigation aimed at evaluating the role of procalcitonin (PCT) and other clinical features on the risk stratification and the clinical outcomes in spondylodiscitis patients treated in our Emergency Department. PATIENTS AND METHODS: The present investigation represents a single-center retrospective study. Clinical records of consecutive patients admitted to our Emergency Department from 1 January 2015 to 31 March 2021 were evaluated and patients with spondylodiscitis diagnosis in this period were recruited. Our primary outcome was the degree of autonomy of patients following the acute event. Our secondary outcome was the resolution of the infection. RESULTS: In the study period, a total of 345 patients were evaluated. Among these, 165 met the inclusion criteria, and constituted the study cohort. Concerning the primary outcome, we observed that the most significant predictive factors for being non-autonomous were elevated serum creatinine (> 1.05 mg/dl), Blood Urea Nitrogen (BUN) > 23 mg/dl, Lactate dehydrogenase > 228 U/L, PCT > 0.11 ng/mL. Patients with higher PCT (PCT > 0.11 ng/mL) and higher BUN (BUN > 23 mg/dl) had higher odds of infection persistence (the Odd Ratio, OR, were respectively 3.78 for PCT and 3.14 for BUN). CONCLUSIONS: PCT assay may play a role in diagnosing spondylodiscitis in an emergency setting. A PCT value > 0.11 ng/mL should be considered as a red flag, a predictor of worse clinical outcomes and persistence of infection. [ABSTRACT FROM AUTHOR]

Published
2022

39. Conservative management of Anderson Type II odontoid fractures in octogenarians: is radiological union what we are searching for?

Author

CANDURA, D., PERNA, A., VELLUTO, C., PROIETTI, L., MAZZELLA, G. G., BORRUTO, M. I., TAMBURRELLI, F. C., ZIRIO, G., GENITIEMPO, M., and SANTAGADA, D. A.

Abstract

OBJECTIVE: The C2 odontoid fractures represent one of the most common cervical spine injuries. Stabilization and immobility are required for a correct treatment. However, in some cases surgical treatment is recommended. There are still no guidelines for Type II odontoid fractures management. The present study aims at determining how non-union could impact on mortality, functional and clinical outcomes in octogenarian patients conservatively treated. PATIENTS AND METHODS: The present investigation is a retrospective case series. All patients with diagnosis of Type II odontoid fractures, over 80 years and conservatively treated in our institution between January 2016 to April 2020 were potentially eligible for the study. The primary outcome was the bony fusion of the fracture after 3 months of conservative treatment. The secondary outcomes were clinical, functional outcomes and mortality. RESULTS: Sixty-four patients were eligible for the study according to inclusion and exclusion criteria. Computer Tomography (CT) evaluation performed 3 months after trauma showed complete fracture healing in 31 patients (48.4%, Fused), while 33 patients (51.6%) were evaluated as non-fused. Among these, 6 months after the CT evaluation, 14 patients were classified as stable, while 19 were classified as unstable. There were no statistically significant changes in clinical and functional outcomes reported in our patient series between patients with complete radiological healing and patients who reported stable fibrous non-union. CONCLUSIONS: In a selected group of elderly patients with a high risk for surgery, the conservative treatment of odontoid Type II fractures can be considered a viable management strategy. The achievement of a stable non-union allows for clinical and functional results comparable to complete fracture healing. [ABSTRACT FROM AUTHOR]

Published
2022

40. The role of vascularized flaps in the treatment of proximal pole avascular necrosis in scaphoid non-unions

Author

Guzzini, M., Lanzetti, R. M., Proietti, L., Lupariello, D., Iorio, R., and Ferretti, A.

Subjects
Adult, Male, Scaphoid Bone, Osteonecrosis, microsurgery, fractures, ununited, Surgical Flaps, corticoperiosteal flap, Treatment Outcome, microsurger, scaphoid nonunion, adult, female, follow-up studies, fracture fixation, fractures, ununited, humans, male, osteonecrosis, retrospective studies, scaphoid bone, surgical flaps, treatment outcome, Fracture Fixation, Fractures, Ununited, Humans, Female, Original Article, Follow-Up Studies, Retrospective Studies
Abstract

Objectives: The purpose of this study is to evaluate the clinical and radiological outcomes of scaphoid non unions surgically treated with bone graft versus medial condyle corticoperiosteal free flaps. Materials and Methods: 32 patients were divided in 2 groups. Group A (17 patients 12male, 5 females, mean age 35 years old) treated with bone grafts; Group B (15patients 11 male, 4 females, mean age 33 years old) treated with medial condyle cortico periosteal free flap. A radiological follow up was performed about every 30 days after surgery until the complete healing and at 12-month follow-up. The clinical follow up was performed at 6 and 12 months from surgery. Functional assessment was provided by Mayo wrist score and Visual Analogic Scale (VAS). Results: The average length of follow up was 12.52 months ± 1.36. In group A 60% of patients healed in 4.4 ± 1months with a reduction of 28.4% of healing times in group B (p

Published
2019

42. Patient-Oriented Aesthetic Outcome After Lumbar Spine Surgery: A 1-Year Follow-Up Prospective Observational Study Comparing Minimally Invasive and Standard Open Procedures

Author

Ricciardi, L., Sturiale, Carmelo Lucio, Pucci, R., Reale, G., Stifano, Vito, Izzo, A., Perna, A., Proietti, Luca, Forcato, S., Rivera Perla, K. M., El Boustany, S., Olivi, Alessandro, Polli, Filippo Maria, Sturiale C. L. (ORCID:0000-0002-4080-2492), Stifano V., Proietti L. (ORCID:0000-0003-2919-0381), Olivi A. (ORCID:0000-0002-4489-7564), Polli F. M., Ricciardi, L., Sturiale, Carmelo Lucio, Pucci, R., Reale, G., Stifano, Vito, Izzo, A., Perna, A., Proietti, Luca, Forcato, S., Rivera Perla, K. M., El Boustany, S., Olivi, Alessandro, Polli, Filippo Maria, Sturiale C. L. (ORCID:0000-0002-4080-2492), Stifano V., Proietti L. (ORCID:0000-0003-2919-0381), Olivi A. (ORCID:0000-0002-4489-7564), and Polli F. M.

Abstract

Background: Despite recent treatment developments, back pain and related disabilities still represent a challenge for practitioners. Among the available surgical techniques, many different features and outcomes have been investigated; however, aesthetic result was missing among them. The present investigation was designed to prospectively compare patient-oriented aesthetic results after minimally invasive surgery (MIS) and standard open surgery (SOS) for the lumbar spine. Methods: This was a prospective observational study with 1-year follow-up. Patients who underwent SOS were assigned to group 1 and MIS to group 2. Patient-oriented aesthetic result evaluation was collected using a dedicated visual aesthetic analogue scale. The Vancouver Scar Scale was used to exclude objective underlying influencing factors. The Oswestry Disability Index and a 10-point itemized visual analogue scale for back pain were administered to assess the clinical and functional status. Follow-up data were collected before discharge at 1, 6, and 12 months. Statistical analysis was conducted, and P < 0.05 was considered as significant. Results: We enrolled 74 patients, 44 in group 1 and 30 in group 2. The 2 groups were homogeneous for demographic and clinical data. No clinical or functional differences were measured at the end of follow-up. Visual aesthetic analogue scale reported greater mean values in group 1 at every follow-up time. Conclusions: Patients seem to prefer the aesthetic result from a single midline incision after SOS compared with MIS. The use of specific techniques could be considered if there is scientific evidence reporting greater aesthetic outcome, having similar clinical and functional ones.

Published
2019

43. Response to the letter by Sen Yang, Weimin Jiang

Author

Proietti, Luca, Scaramuzzo, L, Sessa, S, Schiro, Gr, Logroscino, Ca, Proietti, L (ORCID:0000-0003-2919-0381), Proietti, Luca, Scaramuzzo, L, Sessa, S, Schiro, Gr, Logroscino, Ca, and Proietti, L (ORCID:0000-0003-2919-0381)

Abstract

N/a

Published
2019

48. Platelet count does not predict bleeding in cirrhotic patients: Results from the PRO-LIVER Study

Author

Basili, S. a, Raparelli, V. b., Napoleone, L. b., Talerico, G. a., Corazza, G. R. c., Perticone, F. d., Sacerdoti, D. e., Andriulli, A. f., Licata, A. g., Pietrangelo, A., Picardi, A. i., Raimondo, G. j., Violi, F., Palasciano, G., D’Alitto, F., Palmieri, V. O., Santovito, D., Michele, Di, Croce, D., Brocco, G., Fasolato, S., Cecchetto, S., Bombonato, L., Bertoni, G., Restuccia, M., Andreozzi, T., Liguori, P., Caroleo, M. L., Perticone, B., Staltari, M., Manfredini, O., Giorgi, De, Averna, A., Giammanco, M., Granito, A., Pettinari, A., Marinelli, I., Bolondi, S., Falsetti, L., Salvi, L., Durante-Mangoni, A., Cesaro, E., Farinaro, F., Ragone, V., Morana, E., Ippolito, I., Iacobellis, A., Niro, A., Merla, G., Maimone, A., Cacciola, S., Varvara, I., Drenaggi, D., Staffolani, D., Vespasiani-Gentilucci, S., Galati, U., Gallo, G., Davì, P., Schiavone, G., Santilli, C., Tana, F., Soresi, C., Bianchi, Giovanni, Carderi, B., Pinto, I., Tuttolomondo, A., Ferrari, A., Gresele, G., Fierro, P., Morelli, T., Laffi, O., Romanelli, G., Arena, R. G., Stasi, U., Gasbarrini, A., Garcovich, M., Zocco, M. A., Riccardi, L., Ainora, M. E., Capeci, W., Martino, Giuseppe, Nobili, P., Cavallo, L., Frugiuele, M., Greco, P., Ventura, P., Cuoghi, C., Marcacci, M., Serviddio, G., Vendemiale, G., Villani, R., Gargano, R., Vidili, G., Cesare, Di, Masala, V., Delitala, M., Invernizzi, G., Vincenzo, P., Minno, Di, Tufano, G., Purrello, A., Privitera, F., Forgione, G., Curigliano, A., Senzolo, V., Rodríguez-Castro, M., Giannelli, K. I., Serra, G., Neri, C., Pignataro, S., Rizzetto, P., Debernardi, M., Svegliati, V. W., Bergamaschi, B. G., Masotti, G., Costanzo, M., Antonio, F., Angelico, F., Del, Ben, Polimeni, M., Proietti, L., Cangemi, M., Romiti, R., Toriello, G. F., Sperduti, F., Santangelo, N., Visioli, G., Todisco, G., Vestri, Anna, Farcomeni, R., Corrao, A., Gobbi, S., Corradini, E., Costantino, G., Tripepi, G., Angelico, M., Bolondi, L., D’Amico, G., Franchis, De, Gatta, R., Tassone, A., Anzaldi, E. J., Barone, M., Bazzini, M., Bianchi, C., Boari, P. I., Bracco, B., Buonauro, C., Buttà, A., Buzzetti, E., Calabria, S., Caradio, F., Carleo, P., Carrabba, Maria, Castorani, D., Cecchetto, L., Cicco, L., Cimini, S., Colombo, C., B. M., Vuono, De, Denegri, S., Del, Corso, Giosia, Di, Donnarumma, P., Giorgini, E., Grassi, P., Grembiale, D., Hijazi, A., Iamele, D., Lorusso, L., Marchese, G., Marra, Alberto, Masala, M., Miceli, M., Montebianco, G., Murgia, A. L., Naccarato, G., Padula, P., Pattoneri, D., Perego, P., Pesce, F., Petramala, P., Piano, L., Pinto, S., Pinna, D., Pignataro, M., Pretti, F. S., Pucci, V., Salinaro, G., Salzano, F., Santarossa, A., Scarpini, C., Scicali, F., Sirico, R., Suppressa, D., Talia, P., Torres, M., Traversa, D., Vazzana, M., Vecchio, Claudia, Vettore, R., Vitale, E., Basili, S., Raparelli, V., Napoleone, L., Talerico, G., Corazza, G.R., Perticone, F., Sacerdoti, D., Andriulli, A., Licata, A., Pietrangelo, A., Picardi, A., Raimondo, G., Violi, F., Palasciano, Giuseppe, D’Alitto, Felicia, Palmieri, Vincenzo Ostilio, Santovito, Daniela, Di Michele, Dario, Croce, Giuseppe, Brocco, Silvia, Fasolato, Silvano, Cecchetto, Lara, Bombonato, Giancarlo, Bertoni, Michele, Restuccia, Tea, Andreozzi, Paola, Liguori, Maria Livia, Caroleo, Benedetto, Perticone, Maria, Staltari, Orietta, Manfredini, Roberto, De Giorgi, Alfredo, Averna, Maurizio, Giammanco, Antonina, Granito, Alessandro, Pettinari, Irene, Marinelli, Sara, Bolondi, Luigi, Falsetti, Lorenzo, Salvi, Aldo, Durante-Mangoni, Emanuele, Cesaro, Flavio, Farinaro, Vincenza, Ragone, Enrico, Morana, Ignazio, Ippolito, Antonio, Iacobellis, Angelo, Niro, Grazia, Merla, Antonio, Maimone, Sergio, Cacciola, Irene, Varvara, Doriana, Drenaggi, Davide, Staffolani, Silvia, Vespasiani-Gentilucci, Umberto, Galati, Giovanni, Gallo, Paolo, Davì, Giovanni, Schiavone, Cosima, Santilli, Francesca, Tana, Claudio, Soresi, Maurizio, Bianchi Giovanni, Battista, Carderi, Isabella, Pinto, Antonio, Tuttolomondo, Antonino, Ferrari, Giovanni, Gresele, Paolo, Fierro, Tiziana, Morelli, Olivia, Laffi, Giacomo, Romanelli, Roberto Giulio, Arena, Umberto, Stasi, Cristina, Gasbarrini, Antonio, Garcovich, Matteo, Zocco, Maria Assunta, Riccardi, Laura, Ainora, Maria Elena, Capeci, William, Martino Giuseppe, Pio, Nobili, Lorenzo, Cavallo, Maurizio, Frugiuele, Pierluigi, Greco, Antonio, Ventura, Paolo, Cuoghi, Chiara, Marcacci, Matteo, Serviddio, Gaetano, Vendemiale, Gianluigi, Villani, Rosanna, Gargano, Ruggiero, Vidili, Gianpaolo, Di Cesare, Valentina, Masala, Maristella, Delitala, Giuseppe, Invernizzi, Pietro, Vincenzo, Ronca, Di Minno, Giovanni, Tufano, Antonella, Purrello, Francesco, Privitera, Graziella, Forgione, Alessandra, Curigliano, Valentina, Senzolo, Marco, Rodríguez-Castro, Kryssia Isabel, Giannelli, Gianluigi, Serra, Carla, Neri, Sergio, Pignataro, Pietro, Rizzetto, Mario, Debernardi, Venon Wilma, Svegliati, Baroni Gianluca, Bergamaschi, Gaetano, Masotti, Michela, Costanzo, Filippo, Antonio, Figliomeni, Angelico, Francesco, Del Ben, Maria, Polimeni, Licia, Proietti, Marco, Cangemi, Roberto, Romiti Giulio, Francesco, Toriello, Filippo, Sperduti, Nicolò, Santangelo, Giuseppe, Visioli, Giacomo, Todisco, Tommaso, Vestri Anna, Rita, Farcomeni, Alessio, Corrao, Salvatore, Gobbi, Paolo, Corradini, Elena, Costantino, Giorgio, Tripepi, Giovanni, Angelico, Mario, D’Amico, Gennaro, De Franchis, Roberto, Gatta, Angelo, Tassone, Eliezer Joseph, Anzaldi, Massimiliano, Barone, Milena, Bazzini, Cristina, Bianchi, Paola Ilaria, Boari, Benedetta, Bracco, Christian, Buonauro, Agostino, Buttà, Carmelo, Buzzetti, Elena, Calabria, Stefano, Caradio, Federica, Carleo, Pietro, Carrabba Maria, Domenica, Castorani, Luigi, Cicco, Sebastiano, Cimini, Claudia, Colombo, Barbara Maria, De Vuono, Stefano, Denegri, Andrea, Del Corso, Lisette, Di Giosia, Paolo, Donnarumma, Emilia, Giorgini, Paolo, Grassi, Davide, Grembiale, Alessandro, Hijazi, Daniel, Iamele, Luigi, Lorusso, Giusi, Marchese, Alessandra, Marra Alberto, Maria, Miceli, Giuseppe, Montebianco, Abenavoli Ludovico, Murgia, Giuseppe, Naccarato, Paola, Padula, Donatella, Pattoneri, Paolo, Perego, Francesca, Pesce, Paola, Petramala, Luigi, Piano, Salvatore, Pinto, Daniela, Pinna, Miriam, Pignataro, Francesca Serena, Pretti, Vincenzo, Pucci, Giacomo, Salinaro, Francesco, Salzano, Andrea, Santarossa, Claudia, Scarpini, Francesca, Scicali, Roberto, Sirico, Domenico, Suppressa, Patrizia, Talia, Michela, Torres, Daniele, Traversa, Matteo, Vazzana, Natale, Vecchio Claudia, Rita, Vettore, Elia, Vitale, Francesco, Basili, S, Raparelli, V, Napoleone, L, Talerico, G, Corazza, G, Perticone, F, Sacerdoti, D, Andriulli, A, Licata, A, Pietrangelo, A, Picardi, A, Raimondo, G, Violi, F, Palasciano, G, D'Alitto, F, Palmieri, V, Santovito, D, Di Michele, D, Croce, G, Brocco, S, Fasolato, S, Cecchetto, L, Bombonato, G, Bertoni, M, Restuccia, T, Andreozzi, P, Liguori, M, Caroleo, B, Perticone, M, Staltari, O, Manfredini, R, De Giorgi, A, Averna, M, Giammanco, A, Granito, A, Pettinari, I, Marinelli, S, Bolondi, L, Falsetti, L, Salvi, A, Durante-Mangoni, E, Cesaro, F, Farinaro, V, Ragone, E, Morana, I, Ippolito, A, Iacobellis, A, Niro, G, Merla, A, Maimone, S, Cacciola, I, Varvara, D, Drenaggi, D, Staffolani, S, Vespasiani-Gentilucci, U, Galati, G, Gallo, P, Davi, G, Schiavone, C, Santilli, F, Tana, C, Soresi, M, Bianchi Giovanni, B, Carderi, I, Pinto, A, Tuttolomondo, A, Ferrari, G, Gresele, P, Fierro, T, Morelli, O, Laffi, G, Romanelli, R, Arena, U, Stasi, C, Gasbarrini, A, Garcovich, M, Zocco, M, Riccardi, L, Ainora, M, Capeci, W, Martino Giuseppe, P, Nobili, L, Cavallo, M, Frugiuele, P, Greco, A, Ventura, P, Cuoghi, C, Marcacci, M, Serviddio, G, Vendemiale, G, Villani, R, Gargano, R, Vidili, G, Di Cesare, V, Masala, M, Delitala, G, Invernizzi, P, Vincenzo, R, Di Minno, G, Tufano, A, Purrello, F, Privitera, G, Forgione, A, Curigliano, V, Senzolo, M, Rodriguez-Castro, K, Giannelli, G, Serra, C, Neri, S, Pignataro, P, Rizzetto, M, Debernardi, V, Svegliati, B, Bergamaschi, G, Masotti, M, Costanzo, F, Antonio, F, Angelico, F, Del Ben, M, Polimeni, L, Proietti, M, Cangemi, R, Romiti, G, Toriello, F, Sperduti, N, Santangelo, G, Visioli, G, Todisco, T, Vestri Anna, R, Farcomeni, A, Corrao, S, Gobbi, P, Corradini, E, Costantino, G, Tripepi, G, Angelico, M, D'Amico, G, De Franchis, R, Gatta, A, Tassone, E, Anzaldi, M, Barone, M, Bazzini, C, Bianchi, P, Boari, B, Bracco, C, Buonauro, A, Butta, C, Buzzetti, E, Calabria, S, Caradio, F, Carleo, P, Carrabba Maria, D, Castorani, L, Cicco, S, Cimini, C, Colombo, B, De Vuono, S, Denegri, A, Del Corso, L, Di Giosia, P, Donnarumma, E, Giorgini, P, Grassi, D, Grembiale, A, Hijazi, D, Iamele, L, Lorusso, G, Marchese, A, Marra, A, Miceli, G, Montebianco, A, Murgia, G, Naccarato, P, Padula, D, Pattoneri, P, Perego, F, Pesce, P, Petramala, L, Piano, S, Pinto, D, Pinna, M, Pignataro, F, Pretti, V, Pucci, G, Salinaro, F, Salzano, A, Santarossa, C, Scarpini, F, Scicali, R, Sirico, D, Suppressa, P, Talia, M, Torres, D, Traversa, M, Vazzana, N, Vecchio Claudia, R, Vettore, E, Vitale, F, S Basili, V Raparelli, L Napoleone, G Talerico, G Corazza, F Perticone, D Sacerdoti, A Andriulli, A Licata, A Pietrangelo, A Picardi, G Raimondo, F Violi, MD on behalf of PRO-LIVER Collaborator, Palasciano Giuseppe, D’Alitto Felicia, Palmieri Vincenzo Ostilio, Santovito Daniela, Di Michele Dario, Croce Giuseppe, Brocco Silvia, Fasolato Silvano, Cecchetto Lara, Bombonato Giancarlo, Bertoni Michele, Restuccia Tea, Andreozzi Paola, Liguori Maria Livia, Caroleo Benedetto, Perticone Maria, Staltari Orietta, Manfredini Roberto, De Giorgi Alfredo, Averna Maurizio, Giammanco Antonina, Granito Alessandro, Pettinari Irene, Marinelli Sara, Bolondi Luigi, Falsetti Lorenzo, Salvi Aldo, Durante-Mangoni Emanuele, Cesaro Flavio, Farinaro Vincenza, Ragone Enrico, Morana Ignazio, Ippolito Antonio, Iacobellis Angelo, Niro Grazia, Merla Antonio, Maimone Sergio, Cacciola Irene, Varvara Doriana, Drenaggi Davide, Staffolani Silvia, Vespasiani-Gentilucci Umberto, Galati Giovanni, Gallo Paolo, Davi Giovanni, Schiavone Cosima, Santilli Francesca, Tana Claudio, Soresi Maurizio, Bianchi Giovanni Battista, Carderi Isabella, Pinto Antonio, Tuttolomondo Antonino, Ferrari Giovanni, Gresele Paolo, Fierro Tiziana, Morelli Olivia, Laffi Giacomo, Romanelli Roberto Giulio, Arena Umberto, Stasi Cristina, Gasbarrini Antonio, Garcovich Matteo, Zocco Maria Assunta, Riccardi Laura, Ainora Maria Elena, Capeci William, Martino Giuseppe Pio, Nobili Lorenzo, Cavallo Maurizio, Frugiuele Pierluigi, Greco Antonio, Ventura Paolo, Cuoghi Chiara, Marcacci Matteo, Serviddio Gaetano, Vendemiale Gianluigi, Villani Rosanna, Gargano Ruggiero, Vidili Gianpaolo, Di Cesare Valentina, Masala Maristella, Delitala Giuseppe, Invernizzi Pietro, Vincenzo Ronca, Di Minno Giovanni, Tufano Antonella, Purrello Francesco, Privitera Graziella, Forgione Alessandra, Curigliano Valentina, Senzolo Marco, Rodríguez-Castro Kryssia Isabel, Giannelli Gianluigi, Serra Carla, Neri Sergio, Pignataro Pietro, Rizzetto Mario, Debernardi Venon Wilma, Svegliati Baroni Gianluca, Bergamaschi Gaetano, Masotti Michela, Costanzo Filippo, Antonio Figliomeni, Angelico Francesco, Del Ben Maria, Polimeni Licia, Proietti Marco, Cangemi Roberto, Romiti Giulio Francesco, Toriello Filippo, Sperduti Nicolò, Santangelo Giuseppe, Visioli Giacomo, Todisco Tommaso, Vestri Anna Rita, Farcomeni Alessio, Corrao Salvatore, Gobbi Paolo, Corradini Elena, Costantino Giorgio, Tripepi Giovanni, Angelico Mario, D’Amico Gennaro, de Franchis Roberto, Gatta Angelo, Tassone Eliezer Joseph, Anzaldi Massimiliano, Barone Milena, Bazzini Cristina, Bianchi Paola Ilaria, Boari Benedetta, Bracco Christian, Buonauro Agostino, Buttà Carmelo, Buzzetti Elena, Calabria Stefano, Caradio Federica, Carleo Pietro, Carrabba Maria Domenica, Castorani Luigi, Cicco Sebastiano, Cimini Claudia, Colombo Barbara Maria, De Vuono Stefano, Denegri Andrea, Del Corso Lisette, Di Giosia Paolo, Donnarumma Emilia, Giorgini Paolo, Grassi Davide, Grembiale Alessandro, Hijazi Daniel, Iamele Luigi, Lorusso Giusi, Marchese Alessandra, Marra Alberto Maria, Miceli Giuseppe, Montebianco Abenavoli Ludovico, Murgia Giuseppe, Naccarato Paola, Padula Donatella, Pattoneri Paolo, Perego Francesca, Pesce Paola, Petramala Luigi, Piano Salvatore, Pinto Daniela, Pinna Miriam, Pignataro Francesca Serena, Pretti Vincenzo, Pucci Giacomo, Salinaro Francesco, Salzano Andrea, Santarossa Claudia, Scarpini Francesca, Scicali Roberto, Sirico Domenico, Suppressa Patrizia, Talia Michela, Torres Daniele, Traversa Matteo, Vazzana Natale, Vecchio Claudia Rita, Vettore Elia, Vitale Francesco, Corazza, G. R., Guidacci, Raimondo, Palasciano, G., D'Alitto, F., Palmieri, V. O., Santovito, D., Di Michele, D., Croce, G., Brocco, S., Fasolato, S., Cecchetto, L., Bombonato, G., Bertoni, M., Restuccia, T., Andreozzi, P., Liguori, M. L., Caroleo, B., Perticone, M., Staltari, O., Manfredini, R., De Giorgi, A., Averna, M., Giammanco, A., Granito, A., Pettinari, I., Marinelli, S., Bolondi, L., Falsetti, L., Salvi, A., Durante-Mangoni, E., Cesaro, F., Farinaro, V., Ragone, E., Morana, I., Ippolito, A., Iacobellis, A., Niro, G., Merla, A., Maimone, S., Cacciola, I., Varvara, D., Drenaggi, D., Staffolani, S., Vespasiani-Gentilucci, U., Galati, G., Gallo, P., Davi, G., Schiavone, C., Santilli, F., Tana, C., Soresi, M., Bianchi Giovanni, B., Carderi, I., Pinto, A., Tuttolomondo, A., Ferrari, G., Gresele, P., Fierro, T., Morelli, O., Laffi, G., Romanelli, R. G., Arena, U., Stasi, C., Gasbarrini, A., Garcovich, M., Zocco, M. A., Riccardi, L., Ainora, M. E., Capeci, W., Martino Giuseppe, P., Nobili, L., Cavallo, M., Frugiuele, P., Greco, A., Ventura, P., Cuoghi, C., Marcacci, M., Serviddio, G., Vendemiale, G., Villani, R., Gargano, R., Vidili, G., Di Cesare, V., Masala, M., Delitala, G., Invernizzi, P., Vincenzo, R., Di Minno, G., Tufano, A., Purrello, F., Privitera, G., Forgione, A., Curigliano, V., Senzolo, M., Rodriguez-Castro, K. I., Giannelli, G., Serra, C., Neri, S., Pignataro, P., Rizzetto, M., Debernardi, V. W., Svegliati, B. G., Bergamaschi, G., Masotti, M., Costanzo, F., Antonio, F., Angelico, F., Del Ben, M., Polimeni, L., Proietti, M., Cangemi, R., Romiti, G. F., Toriello, F., Sperduti, N., Santangelo, G., Visioli, G., Todisco, T., Vestri Anna, R., Farcomeni, A., Corrao, S., Gobbi, P., Corradini, E., Costantino, G., Tripepi, G., Angelico, M., D'Amico, G., De Franchis, R., Gatta, A., Tassone, E. J., Anzaldi, M., Barone, M., Bazzini, C., Bianchi, P. I., Boari, B., Bracco, C., Buonauro, A., Butta, C., Buzzetti, E., Calabria, S., Caradio, F., Carleo, P., Carrabba Maria, D., Castorani, L., Cicco, S., Cimini, C., Colombo, B. M., De Vuono, S., Denegri, A., Del Corso, L., Di Giosia, P., Donnarumma, E., Giorgini, P., Grassi, D., Grembiale, A., Hijazi, D., Iamele, L., Lorusso, G., Marchese, A., Marra, A. M., Miceli, G., Montebianco, A. L., Murgia, G., Naccarato, P., Padula, D., Pattoneri, P., Perego, F., Pesce, P., Petramala, L., Piano, S., Pinto, D., Pinna, M., Pignataro, F. S., Pretti, V., Pucci, G., Salinaro, F., Salzano, A., Santarossa, C., Scarpini, F., Scicali, R., Sirico, D., Suppressa, P., Talia, M., Torres, D., Traversa, M., Vazzana, N., Vecchio Claudia, R., Vettore, E., and Vitale, F.

Subjects
Liver Cirrhosis, Male, Settore MED/09 - Medicina Interna, 030204 cardiovascular system & hematology, Gastroenterology, Severity of Illness Index, cjirrhosis, ACTIVATION, 0302 clinical medicine, Risk Factors, Medicine, Platelet, Prospective Studies, Prospective cohort study, RISK, Aged, 80 and over, medicine.diagnostic_test, PRO-LIVER, Platelet, cirrhosis, gastrointestinal bleeding, ASSOCIATION, Middle Aged, Prognosis, Italy, 030211 gastroenterology & hepatology, Female, Gastrointestinal Hemorrhage, Human, Adult, Platelets, medicine.medical_specialty, Prognosi, Liver Cirrhosi, MEDLINE, COAGULATION, gastrointestinal bleeding, Socio-culturale, Hemorrhage, Hepatology, Follow-Up Studie, 03 medical and health sciences, Text mining, Internal medicine, Severity of illness, ENDOTOXEMIA, Pro-Liver Study, Humans, HEMOSTASIS, International Normalized Ratio, Aged, Proportional Hazards Models, Prothrombin time, Cirrhosi, Platelet Count, Bleeding, Liver Cirrhosis, business.industry, Proportional hazards model, Platelet Count, Risk Factor, cirrhosis, bleeding, Thrombocytopenia, Prospective Studie, THROMBOSIS, Platelets, cjirrhosis, bleeding, PRO-LIVER, Proportional Hazards Model, Prothrombin Time, business, DECOMPENSATED CIRRHOSIS, Follow-Up Studies
Abstract

OBJECTIVES: Thrombocytopenia is a hallmark for patients with cirrhosis and it is perceived as a risk factor for bleeding events. However, the relationship between platelet count and bleeding is still unclear. METHODS: We investigated the relationship between platelet count and major or clinical relevant nonmajor bleedings during a follow-up of ∼4 years. RESULTS: A total of 280 cirrhotic patients with different degrees of liver disease (67% males; age 64±37 years; 47% Child–Pugh B and C) were followed up for a median of 1,129 (interquartile range: 800–1,498) days yielding 953.12 patient-year of observation. The annual rate of any significant bleeding was 5.45%/year (3.57%/year and 1.89%/year for major and minor bleeding, respectively). Fifty-two (18.6%) patients experienced a major (n=34) or minor (n=18) bleeding event, predominantly from gastrointestinal origin. Platelet counts progressively decreased with the worsening of liver disease and were similar in patients with or without major or minor bleeding: a platelet count ≤50×103/μl was detected in 3 (6%) patients with and in 20 (9%) patients without any bleeding event. Conversely, prothrombin time-international normalized ratio was slightly higher in patients with overall or major bleeding. On Cox proportional hazard analysis, only a previous gastrointestinal bleeding (hazard ratio (HR): 1.96; 95% confidence interval: 1.11–3.47; P=0.020) and encephalopathy (HR: 2.05; 95% confidence interval: 1.16–3.62; P=0.013) independently predicted overall bleeding events. CONCLUSIONS: Platelet count does not predict unprovoked major or minor bleeding in cirrhotic patients.

Published
2018

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