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5. De Novo Renal Neoplasia After Kidney Transplantation According to New 2016 WHO Classification of Renal Tumors

Author

Eccher, Albino, primary, Boschiero, Luigino, additional, Delahunt, Brett, additional, Cima, Luca, additional, Fior, Francesca, additional, Nacchia, Francesco, additional, Rostand, Momo, additional, Carraro, Amedeo, additional, Tedeschi, Umberto, additional, Zaza, Gianluigi, additional, Casartelli Liviero, Marilena, additional, Zampicinini, Laura, additional, Chilosi, Marco, additional, Feltrin, Giuseppe, additional, Rago, Claudio, additional, D\'Errico, Antonietta, additional, Ghimenton, Claudio, additional, Martignoni, Guido, additional, and Brunelli, Matteo, additional

Published
2016
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6. Infections in liver and lung transplant recipients. A national prospective cohort

Author

Gagliotti, Carlo, Morsillo, Filomena, Moro, Maria Luisa, Masiero, Lucia, Procaccio, Francesco, Vespasiano, Francesca, Pantosti, Annalisa, Monaco, Monica, Errico, Giulia, Ricci, Andrea, Grossi, Paolo, Nanni Costa, Alessandro, Adorno, D., Ambretti, S., Amoroso, A., Arghittu, M., Berloco, P., Bertani, A., Bonizzoli, M., Cambieri, P., Canzonieri, M., Caprio, M., Carrara, E., Carrinola, R., Cibelli, E., Cillo, U., Colledan, M., Colombo, R., Coluccio, E., Conaldi, P. G., Cusi, M., D’Armini, A. M., da Riva, A., D’Auria, B., de Carlis, L., de Cillia, C., de Gasperi, A., Di Caro, A., Di Ciaccio, P., Dondossola, D., Farina, C., Feltrin, G., Finarelli, A. C., Fossati, L., Gaibani, P., Garcia Fernandez, A., Gesu, G., Giacometti, R., Gona, F., Gridelli, B., Henrici de Angelis, L., Landini, M. P., Maldarelli, F., Mancini, C., Marone, P., Mularoni, A., Paglialunga, G., Paladini, P., Palù, G., Parisi, S., Peris, A., Pinna, A. D., Platto, M., Pugliese, F., Puoti, F., Rago, C., Ravini, M., Rea, F., Rinaldi, M., Rossi, G., Rossi, L., Rossi, M., Salizzoni, M., Sangiorgi, G., Santambrogio, L., Spada, M., Sparacino, V., Stella, F., Torelli, R., Torresani, E., Tosi, D., Vailati, F., Valeri, M., Venuta, F., Vesconi, S., Viale, P., Vismara, C., Gagliotti, C, Morsillo, F, Moro, M, Masiero, L, Procaccio, F, Vespasiano, F, Pantosti, A, Monaco, M, Errico, G, Ricci, A, Grossi, P, Nanni Costa, A, Adorno, D, Ambretti, S, Amoroso, A, Arghittu, M, Berloco, P, Bertani, A, Bonizzoli, M, Cambieri, P, Canzonieri, M, Caprio, M, Carrara, E, Carrinola, R, Cibelli, E, Cillo, U, Colledan, M, Colombo, R, Coluccio, E, Conaldi, P, Cusi, M, D’Armini, A, da Riva, A, D’Auria, B, de Carlis, L, de Cillia, C, de Gasperi, A, Di Caro, A, Di Ciaccio, P, Dondossola, D, Farina, C, Feltrin, G, Finarelli, A, Fossati, L, Gaibani, P, Garcia Fernandez, A, Gesu, G, Giacometti, R, Gona, F, Gridelli, B, Henrici de Angelis, L, Landini, M, Maldarelli, F, Mancini, C, Marone, P, Mularoni, A, Paglialunga, G, Paladini, P, Palù, G, Parisi, S, Peris, A, Pinna, A, Platto, M, Pugliese, F, Puoti, F, Rago, C, Ravini, M, Rea, F, Rinaldi, M, Rossi, G, Rossi, L, Rossi, M, Salizzoni, M, Sangiorgi, G, Santambrogio, L, Spada, M, Sparacino, V, Stella, F, Torelli, R, Torresani, E, Tosi, D, Vailati, F, Valeri, M, Venuta, F, Vesconi, S, Viale, P, Vismara, C, Gagliotti, Carlo, Morsillo, Filomena, Moro, Maria Luisa, Masiero, Lucia, Procaccio, Francesco, Vespasiano, Francesca, Pantosti, Annalisa, Monaco, Monica, Errico, Giulia, Ricci, Andrea, Grossi, Paolo, Costa, Alessandro Nanni, Adorno, Domenico, Ambretti, Simone, Amoroso, Antonio, Arghittu, Milena, Berloco, Pasquale, Bertani, Alessandro, Bonizzoli, Manuela, Cambieri, Patrizia, Canzonieri, Marco, Caprio, Mario, Carrara, Elena, Carrinola, Rosaria, Cibelli, Eva, Cillo, Umberto, Colledan, Michele, Colombo, Rosaria, Coluccio, Elena, Conaldi, Pier Giulio, Cusi, Mariagrazia, D’Armini, Andrea Maria, Da Riva, Adelaide, D'Auria, Bianca, De Carlis, Luciano, De Cillia, Carlo, De Gasperi, Andrea, Di Caro, Antonino, Di Ciaccio, Paola, Dondossola, Daniele, Farina, Claudio, Feltrin, Giuseppe, Finarelli, Alba Carola, Fossati, Lucina, Gaibani, Paolo, Fernandez, Aurora Garcia, Gesu, Giovanni, Giacometti, Raffaella, Gona, Floriana, Gridelli, Bruno, De Angelis, Lucia Henrici, Landini, Maria Paola, Maldarelli, Federica, Mancini, Carlo, Marone, Piero, Mularoni, Alessandra, Paglialunga, Giulia, Paladini, Piero, Palù, Giorgio, Parisi, Saverio, Peris, Adriano, Pinna, Antonio Daniele, Platto, Marco, Pugliese, Francesco, Puoti, Francesca, Rago, Claudio, Ravini, Mario, Rea, Federico, Rinaldi, Mauro, Rossi, Giorgio, Rossi, Lucia, Rossi, Massimo, Salizzoni, Mauro, Sangiorgi, Gabriela, Santambrogio, Luigi, Spada, Marco, Sparacino, Vito, Stella, Franco, Torelli, Rosanna, Torresani, Erminio, Tosi, Davide, Vailati, Francesca, Valeri, Maurizio, Venuta, Federico, Vesconi, Sergio, Viale, Pierluigi, and Vismara, Chiara

Subjects
Microbiology (medical), Infectious Diseases, Male, 0301 basic medicine, medicine.medical_treatment, Drug Resistance, Transplant Recipient, 030230 surgery, Liver transplantation, Postoperative Complications, 0302 clinical medicine, Drug Resistance, Multiple, Bacterial, Medicine, Cumulative incidence, Prospective Studies, Prospective cohort study, Incidence, Incidence (epidemiology), Mortality rate, Bacterial, Bacterial Infections, General Medicine, Middle Aged, lung transplant, Anti-Bacterial Agents, infectious, Italy, Female, Multiple, Adult, Bacteria, Humans, Transplant Recipients, Liver Transplantation, Lung Transplantation, Human, medicine.medical_specialty, 030106 microbiology, Bacterial Infection, Infectious Diseases, transplantation, 03 medical and health sciences, Internal medicine, Anti-Bacterial Agent, Lung transplantation, business.industry, lung transplant, liver transplant, infectious, Transplantation, Prospective Studie, liver transplant, Etiology, Postoperative Complication, business, transplantation
Abstract

Infections are a major complication of solid organ transplants (SOTs). This study aimed to describe recipients’ characteristics, and the frequency and etiology of infections and transplant outcome in liver and lung SOTs, and to investigate exposures associated to infection and death in liver transplant recipients. The study population included recipients of SOTs performed in Italy during a 1-year period in ten Italian lung transplant units and eight liver transplant units. Data on comorbidities, infections, retransplantation, and death were prospectively collected using a web-based system, with a 6-month follow-up. The cumulative incidence of infection was 31.7% and 47.8% in liver and lung transplants, respectively, with most infections occurring within the first month after transplantation. Gram-negatives, which were primarily multidrug-resistant, were the most frequent cause of infection. Death rates were 0.42 per 1000 recipient-days in liver transplants and 1.41 per 1000 recipient-days in lung transplants. Infection after SOT in adult liver recipients is associated to an increased risk of death (OR = 13.25; p-value < 0.001). Given the frequency of infection caused by multidrug-resistant microorganisms in SOT recipients in Italy and the heavy impact of infections on the transplant outcome, the reinforcement of surveillance and control activities to prevent the transmission of multidrug-resistant microorganisms in SOT recipients represents a priority. The implementation of the study protocol in liver and lung transplant units and the sharing of results have increased the awareness about the threat due to antimicrobial resistance in the country.

Published
2018

7. Alteration of the Death Scene After Self-stabbing: A Case of Sharp Force Suicide Disguised by the Victim as a Homicide?

Author

Claudio Rago, Guido Pelletti, Sindi Visentin, Giovanni Cecchetto, Massimo Montisci, Pelletti, Guido, Visentin, Sindi, Rago, Claudio, Cecchetto, Giovanni, and Montisci, Massimo

Subjects
medicine.medical_specialty, atypical sharp force suicide, forensic science, Physical activity, Criminology, 01 natural sciences, Pathology and Forensic Medicine, 03 medical and health sciences, 0302 clinical medicine, Homicide, medicine, Sharp force, Genetics, 030216 legal & forensic medicine, Forensic examination, Stab wound, bloodstain pattern analysis, bloodstain pattern analysi, disguised suicide, Unusual case, death scene investigation, forensic pathology, 010401 analytical chemistry, medicine.disease, 0104 chemical sciences, Surgery, Psychology, Bloodstain pattern analysis, Bedroom
Abstract

This paper reports a case of a 72-year-old woman who was found dead in her bedroom with a 4 cm vertical stab wound in the abdomen. A bloodstained knife was found in the top drawer of her bedside table. The clothes worn by the victim showed no damage. A bloodstained vest and a sweater with frontal incisions were found far from the victim, in the bathroom and in the bedroom respectively. Several bloodstains were found in every room of the apartment. The evidence found during the forensic examination and, in particular, the Bloodstain Pattern Analysis, led the investigators to determine the manner of death, being consistent with a suicide with a long-lasting physical activity after self-stabbing. This report describes an unusual case of “disguised suicide,” in which the victim tried to cover-up the suicide by changing her clothes and concealing the weapon, in the last minutes of her life.

Published
2017

8. De Novo Renal Neoplasia After Kidney Transplantation According to New 2016 WHO Classification of Renal Tumors

Author

Amedeo Carraro, Antonietta D'Errico, Claudio Rago, Marco Chilosi, Brett Delahunt, Francesca Fior, Luigino Boschiero, Claudio Ghimenton, Albino Eccher, Momo Rostand, Guido Martignoni, Francesco Nacchia, Luca Cima, Umberto Tedeschi, Matteo Brunelli, Giuseppe Feltrin, Laura Zampicinini, Gianluigi Zaza, Marilena Casartelli Liviero, Eccher, Albino, Boschiero, Luigino, Delahunt, Brett, Cima, Luca, Fior, Francesca, Nacchia, Francesco, Rostand, Momo, Carraro, Amedeo, Tedeschi, Umberto, Zaza, Gianluigi, Casartelli Liviero, Marilena, Zampicinini, Laura, Chilosi, Marco, Feltrin, Giuseppe, Rago, Claudio, D'Errico, Antonietta, Ghimenton, Claudio, Martignoni, Guido, and Brunelli, Matteo

Subjects
Adult, Male, medicine.medical_specialty, Urology, 030204 cardiovascular system & hematology, Artificial kidney, World Health Organization, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, medicine, Carcinoma, Biomarkers, Tumor, Humans, Stage (cooking), Carcinoma, Renal Cell, Kidney transplantation, Aged, Neoplasm Staging, Retrospective Studies, Transplantation, Kidney, business.industry, Renal Cell, Kidney Neoplasm, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Kidney Transplantation, Kidney Neoplasms, medicine.anatomical_structure, Carcinoma, Renal Cell, Kidney Neoplasms, Kidney Transplantation, World Health Organization, 030211 gastroenterology & hepatology, Female, Postoperative Complication, business, Clear cell, Human
Abstract

BACKGROUND De novo renal neoplasia developing after kidney transplantation at Verona Kidney Transplant Center were reviewed according to new 2016 WHO Renal Tumor Classification. MATERIAL AND METHODS Primary renal tumors developed in native or transplanted kidneys de novo following renal transplantation were retrieved and histologically reviewed by three expert uropathologists. Immunoexpression of the diagnostic antigens CD13, CD10, CK7, CK34bE12, AMACR, CAIX, AE1/AE3, CK14, GATA-3, HMB-45, cathepsin-k, S100A1, and parvalbumin was assessed. Predictive antigens ph-mTOR and ph-p70S6k were also tested. RESULTS Two thousands and sixteen kidney transplantations have been carried out from 1968-2015. Follow-up was available per 1,646 patients (mean 8.4 years). We observed 16 cases of de novo renal neoplasia arising in patients 16 to 286 months post-transplantation. Nine clear cell, two papillary RCCs and a single case of the new WHO entity denominated "acquired cystic disease-associated RCC" were identified in native kidneys. Another new WHO tumor entity called "clear cell papillary RCC" was diagnosed and a new variant of papillary RCC with diffuse clear cytoplasm was also identified. The majority of tumors were low stage and low grade according to the new ISUP grading system. Seven patients were additionally treated with mTOR inhibitors. Post-cancer follow-up ranged from 62 to 281 months. One patient showed a recurrence (a lung metastases) and died. Of the remaining patients, three died of non-cancer-related causes. CONCLUSIONS The application of the new WHO 2016 classification has importance as it identifies new (18% of tumors) morphotypes that are likely to behave in a less aggressive fashion.

Published
2016

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