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4. Techniques of parenchyma-sparing hepatectomy for the treatment of tumors involving the hepatocaval confluence: A reliable way to assure an adequate future liver remnant volume

Author

Francesco Forfori, Chiara Leoni, Piero Colombatto, Maura Castagna, Piero Buccianti, Piero Boraschi, Riccardo Balestri, G Licitra, Gianluca Masi, and Lucio Urbani

Subjects
Male, Neoplasm, Residual, medicine.medical_treatment, Kaplan-Meier Estimate, 030230 surgery, Cohort Studies, 0302 clinical medicine, Suture (anatomy), Major complication, Aged, 80 and over, Portal Vein, Liver Neoplasms, Cirrhotic patient, Middle Aged, Prognosis, Magnetic Resonance Imaging, Tumor Burden, Treatment Outcome, Italy, 030220 oncology & carcinogenesis, Female, Patient Safety, Adult, medicine.medical_specialty, Carcinoma, Hepatocellular, Vena Cava, Inferior, Disease-Free Survival, 03 medical and health sciences, Parenchyma, medicine, Carcinoma, Hepatectomy, Humans, Neoplasm Invasiveness, Parenchymal Tissue, Survival analysis, Aged, Neoplasm Staging, Retrospective Studies, business.industry, Retrospective cohort study, medicine.disease, Survival Analysis, Liver Regeneration, Surgery, Tomography, X-Ray Computed, business, Organ Sparing Treatments
Abstract

Parenchyma-sparing hepatectomy techniques allow a lesser volume resection (3 adjacent segments) for tumors involving the hepatic veins at the hepatocaval confluence, assuring adequate volume of the future liver remnant. We report the ability to perform parenchyma-sparing hepatectomy as planned from the preoperative imaging and the type of vascular intervention used to preserve hepatic outflow.We analyzed 60 consecutive parenchyma-sparing hepatectomies in 54 patients for 7 primary and 53 metastatic tumors (48 colorectal), located in segments I, VII, VIII, or IVa and involving the hepatocaval confluence. Patients had a median of 2 (range: 1-18) lesions with median diameter of 4 cm (range: 1.2-16.5), which were bilateral in 43%.A parenchyma-sparing hepatectomy was performed in all of the 60 cases, only one case required the resection of 3 adjacent segments. In 16 (27%) hepatic veins-resections, the outflow was assured by preservation of the inferior-right-hepatic veins in 3 (5%), of the communicating-veins in 4 (7%), of the middle-hepatic veins in 3 (4%; middle-hepatic veins patch-reconstruction in 2 cases), by polytetrafluoroethylene-grafts in 4 (7%), and by hepatic veins-anastomosis in 2 (3%). In 15 (25%) cases, the hepatic veins were resected tangentially and reconstructed by direct suture venorraphy. In 29 (48%) cases, the hepatic veins were skeletonized from the tumor. Grade IIIb to IV complications occurred in 7%, median hospital-stay was 9 days, and 90-day mortality occurred in one cirrhotic patient. Median overall and disease-free survivals were 72 and 16 months (median follow-up: 34 months).A lesser volume parenchyma-sparing hepatectomy rather than a formal major hepatectomy for tumors involving the hepatocaval confluence can be performed with a low rate of major complications (7%). Parenchyma-sparing hepatectomy should be considered in highly selected patients when evaluating liver resection for tumors involving the hepatocaval confluence based on appropriate and accurate preoperative imaging.

Published
2017
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6. 37th International Symposium on Intensive Care and Emergency Medicine (part 1 of 3)

Author

F. Barbariol, N. Koulouris, Matteo Pozzi, Fengmei Guo, Christian Richard, Gel'fand Br, A. Sergienko, Erica Adrario, G. Narváez, P. Wacharasint, V. Galanti, I. Labbene, M. Barbagallo, R. Hemler, M. Aroca, Z. Pranskuniene, E. Bresadola, D. Niro, N. Tapanwong, Claudia Scorcella, Elisa Damiani, M. W. Donnino, A. H. Horvat, G. Brizzi, Antonella Marino, Gustavo Ferreira, David H. Berger, S. P. Zeferino, A. Asta, M. R. Pinsky, P. Vargas, Anna Lee, V. Parrini, S. Sosio, J. Gimenez, H. Kandil, C. Y. Yeung, D. G. Grimaldi, S. Poels, M. Ferjani, C. Marenghi, E. Vinke, A. Ulici, S. Risk, V. Ricca, Michele Umbrello, P. Castaldi, V. Rajnala, A. Costa, A. Trifi, M. Serna, T. Apurv, M. Chew, Håkon Haugaa, C. Lai, S. Kongsayreepong, M. Stefan, D. Bonacina, Donald Maberry, I. Toumpoulis, M. Kardara, M. Chlabicz, T. Delnoij, G. Di Lascio, M. Lagiou, Vidas Pilvinis, R. Al Hamdan, A. Devigili, E. Karakoc, M. Gotti, Lars W. Andersen, M. Resta, Massimo Cressoni, L. Zerman, J. Chen, M. Bonizzoli, B. Pedron, Ronney B. Panerai, Guido Tavazzi, O. Koltsida, V. Wongsrichanalai, Luciano Gattinoni, M. Ciapetti, A. Bronco, A. Wattanathum, T. G. Robinson, S. Abdellatif, E. Maffezzini, V. Chica-Saez, Sophia Montissol, Xiaowen Liu, T. Ozahata, Alessia Vargiolu, D. Pavelescu, Geert Meyfroidt, C. Spina, M. Gimeno-Raga, P. V. Van Heerden, Paolo Pelaia, Fabio Guarracino, Luis Fernando Lisboa, S. Asar, Parth V. Patel, G. Kanellis, F. Magni, D. L. Lykke Nielsen, Tommaso Mauri, I. Kiudulaite, N.V. Trembach, J. Higuera, Peter Schellongowski, P. Radsel, L. Colinas, Julia Tizue Fukushima, T. Lam, G. Moise, D. Amitrano, S Martini, M. Stites, A. Lertamornpong, J. Arstikyte, J Ribeiro, A. Peris, Stefano Gatti, Jose Mª Vila, M. Brazaitis, M. C. Ferraro, C. Kroupis, J. Mroczka, M.I. Monge García, A. Herner, F. Dias, Giovanni Landoni, Martin Aldasoro, Diana Jansen, Dan Longrois, M. Castañeda Bermudez, C. Mendes, J. Garlicki, D. Trunfio, L. Masciopinto, S. Ollieuz, J. Hoellthaler, M. Bousselmi, Alexandra Beurton, E. Kaya, I. Kuchyn, M. Cozzolino, J. Serrano Simón, L. Videc, P. Lubli, Anders Larsson, Asta Krikscionaitiene, D. Stajer, M. A. Suzer, G. Hernández, T. Serrano, J. Jancik, Marta Lazzeri, Cornelia W. E. Hoedemaekers, Nawal Salahuddin, T. Morley, Mathieu Jozwiak, Jigeeshu V Divatia, P. Nocera, Peter E. Spronk, Laurent Brochard, D. Vannini, A. Carletti, W. Farouk, A. Kyriakoudi, B. Kreymann, Stefania Tondi, K. Kaminski, Annmarie Touborg Lassen, Napplika Kongpolprom, Czarina C. H. Leung, Xavier Monnet, Sheila Nainan Myatra, A. Abdelmohsen, M. Siranovic, A. Tycińska, A. Waldmann, Pablo Mercado, E. Konstantellou, N Rossi, Jean-Louis Teboul, J. Nikhilesh, D. Ippolito, R. Martinelli, R. Pinciroli, Juliano Pinheiro de Almeida, S. Mashayekhi, A. Botero, P. Werner-Moller, E. Näslund, Phillip A Hopkins, F. Marani, C. Gerrard, V. Nn, C. Filippini, G. Cuvelier, B. Ende-Schneider, F. Perlikos, Carlo Alberto Volta, Rafael Kawati, F. Ruiz-Ferron, J. Villalobos Silva, M. Sklar, S. Golemati, L. Mirea, O. Maadarani, G. Michaloudis, T. Bonus, F Galas, G. Vergani, Nicholas Hart, Katharina Riss, Jihad Mallat, O. R. Ranzani, F. Fortuna, M. Taverna, B L De Keulenaer, W. Serednicki, M. Chambaz, Roberta Domizi, L. Ferreira-Santos, N. Abded, L.B. von Kobyletzki, C. Aldasoro, François Dépret, S. Heines, N. A. Rezepov, A. Calini, Antonio Pesenti, T. Goslar, R. Groehs, R. Fumagalli, L. Gottin, S. Pentakota, M. Guanziroli, Paolo Formenti, M Falco, Gerrard F. Rafferty, AI Yaroshetskiy, P. Checharoen, R. Driessen, S. H. Munson, T. Skladzien, B. Kodali, P. Numthavaj, Baljit Singh, T. M. Kuijper, K. Abdel Aziz, G. Eren, M. Kuroki, S. Guerra-Ojeda, Marco Antonio de Carvalho-Filho, Eddy Fan, J. Mendes, K. Sassi, Z. G. Gavranovic, W. Sellami, R. Norgueira, Joseph Rinehart, J. Real, Giacomo Bellani, M. Yahia, C. Schreiber, S. Sardo, Paul J Young, L. Stojcic, G. Giuliano, HK Atalan, Paolo Taccone, Stephanie Itala Rizk, Jukka Takala, David Cabestrero, Manuel Ignacio Monge García, Thomas Staudinger, Antoni Torres, Valentina Girotto, Andrew Rhodes, G Van den Berghe, P. Rastrelli, G. Stocchi, Zhongping Jian, R. Vela-Colmenero, M. Van de Poll, Gaetano Perchiazzi, S. Reidt, A. Franci, Khaled M. Taema, R. Cavazos Schulte, Giacomo Grasselli, S. Johansson, K. Hung, M. R. Lima, I. Smith, C. Day, Xiwen Zhang, L. Hajjar, M. Eriksson, T. Kinsella, I. Vasileiadis, O. Acicbe, Andrius Pranskunas, Silvia Mongodi, Stefan Wolf, Giovanni Mistraletti, L Camara, Neringa Balciuniene, J. Freeman, J. De Los Santos, R. Lo, O. Fochi, A. Pikwer, A. Dijkstra, I. Regeni, N. Nakwan, Annemijn H. Jonkman, A. Papalois, D. N. Novotni, Nicola Jones, G. Cappuccini, F Turani, Miklos Lipcsey, L. Alban, A. Canabal, M. Buise, A. Nestorowicz, O. Hergunsel, G. Mercurio, H. Lopez Ferretis, A. G. Garnero, D. Signori, A. Zanella, A. Ayyildiz, D. Falco, E. Bor-Seng-Shu, Martin Urner, Tomas Tamosuitis, A. Trimmings, Eduardo L. V. Costa, A. M. Dzyadzko, W. Lamm, R Nakamura, Cecilia Turrini, Jonne Doorduin, Valentina Monaldi, S Ben Lakhal, Federico Franchi, K. Al Assas, K. H. Lee, Robert Frithiof, Luigi Vetrugno, F. Daly, T. Tagami, A. Turan, Giorgio Antonio Iotti, H. Latham, S. Livigni, R. Stolk, M. Nacoti, M. Luperto, G. Gavriilidis, H. Gharsallah, L. Bartoletti, I. Kayaalp, E. M. Roldi, Oliver Robak, R. Kalil, Gilles Clermont, N. D’Arrigo, M. Saad, J. Caldas, Laveena Munshi, Davide Chiumello, A. Koutsoukou, Cecilia Canales, Anne V. Grossestreuer, Colin A. Graham, H. Lyons, A. Blandino, D. Escobar, Stephan M. Jakob, F. Ramos, Michael P Casaer, L. Zamidei, I. Sigala, S. Kazune, C. A. Volta, F. Fava, B. Cambiaghi, J. Donaghy, R. Cuena, U. Strauch, Anita Orlando, Tobias Lahmer, S. Gonnella, G. Dua, L. Yang, Alexander Hermann, D. Shook, Lisen Emma Hockings, M. Boddi, Niall D. Ferguson, A. M. Neitenbach, T. Guedj, N. Eronia, Tor Inge Tønnessen, T. Lamas, D. Carter, Soraya L. Valles, T. Thamjamrassri, M. Gordillo-Resina, G. Salati, J Aron, Maurizio Cecconi, S Di Valvasone, A. Jorda, P. Guijo González, A. F. Grootendorst, O. T. Ranzani, A. Kröner, Lorenzo Berra, Rafael Alves Franco, G. Stringari, W. Saasouh, S. Hundeshagen, G. Queiroz de Oliveira, Gabriele Via, F. Socci, M. Malbrain, Jon Gitz Holler, V. Punzi, W. Samoud, Wolfgang Huber, Belaid Bouhemad, Y. Nassar, Uldis Rubins, J. Sels, Lisanne H Roesthuis, S. Y. Chan, H. Krolo, M. Cavana, Giuseppe Citerio, Mark Blunt, P. T. Thorburn, V. Meroni, I. Mandel, L. Sakic, W. Musial, M Mariyaselvam, J. Simkiene, J.G. van der Hoeven, L. Satterwhite, Martin Dres, Abele Donati, M. Cicio, J. Rasmusson, Mathias J Holmberg, E. Polati, M. D. Mauricio, M. Panigada, G. Magni, Thiago M Santos, B. I. Cleffken, K. Trejo García, M. L. Katsin, M. Ceola Graziadei, M. Gagliardone, F. Becherucci, Zouheir Ibrahim Bitar, F. Vetrone, Antonio Belli, C. Guetti, Azam Shafquat, A. Lissoni, V. Karavana, S. Horst, L. Cecci, G. Cogo, A. Mokhtar, J. Jardim, P. Morgan, C. Capoletto, L. Pistidda, Ling Yan Leung, C. Chiurazzi, I. Adamini, S. Batacchi, U. B. Borg, M. Suverein, Maxime Cannesson, Ling Liu, Gisele Queiroz de Oliveira, Dennis C J J Bergmans, E. Sanidas, L. Mu, W. Omar, Andrew D. Shaw, L. C. Chen, J. M. Van den Brule, M. Fister, M. Vd Poll, Chiara Abbruzzese, D. L. Loncar Stojiljkovic, P. Moller, B. Rode, N. Oer-areemitr, E. Bonvecchio, D. Franci, Silvia Pierantozzi, R. Baldassarri, S. Saéz, S. Amella, A. Fijalkowska-Nestorowicz, J.G van der Hoeven, Michael R. Pinsky, M. Elghonemi, M. Flim, Ewan C. Goligher, J. Graf, M. G. Mythen, Patricia Marchio, K. Ben Ismail, A Gil Cano, J. Watcharotayangul, S. C. Park, E. Ozen, M I Ruiz García, Eduardo A Osawa, M. Gilyarov, G. Gonsales, Brian S. Zuckerbraun, B. Benco, M. Bol, Markus Castegren, J. Glapinski, R Nasri, D. Hayashida, A. Moustakas, D. Damanskyte, O. Pengpinij, A. Baisi, S. Jonnada, S. Redaelli, M. Bottiroli, Theodor Kolobow, R. Nogueira, MA Oliveira, T. Delhaas, L. Rey González, A. Bouattour, Dinas Vaitkaitis, R. De Vos, R. Pool, D. Colosimo, I. Grintescu, F. Coelho, C. Di Giambattista, H. Phiphitthanaban, D. Cabestrero Alonso, H. El Azizy, T. Musaeva, D. Hadfield, M. Dogan, Francesco Forfori, S. Gupta, A. Salazar, A. Amatu, O. Kriukelyte, J. Parodo, N. Bussink-van Dijk, Wai T. Wong, E. Corsi, Filippo Binda, Fábio Biscegli Jatene, Michael W. Donnino, G. Licitra, B Yelken, A. Ottaviano, Haibo Qiu, Bethany Penhaligon, M. Elbanna, Ludhmila Abrahão Hajjar, M. Karaman Iliæ, R. De Pablo, G. Della Rocca, A. Mohamed, A. Shilova, Andris Grabovskis, Peter Pickkers, S. Kara, Z. Hajjej, S. Vorona, Miet Schetz, G. Mancino, C Park, D Ragab, S. Ekemen, Roland M. Schmid, Bülent Güçyetmez, Fiona Reid, M. Gracia Romero, Songqiao Liu, A. Sawyer, Ryon M. Bateman, G. Li Bassi, N. Rovina, Leo M. A. Heunks, M. Adlam, L. C. Azevedo, Eleonora Carlesso, J. A. Arnal, P. Terragni, B. Khwannimit, S. Spano, F. Massaro, A. Gopcevic, S. Provenchere, Laura Galarza, L. Pariente Zorrilla, Adrian Regli, C. D. Bengtson, A. Perez Ruiz de Garibay, P. Chuntupama, J. Babel, X. Zhang, Feras Hatib, M Espinoza, C. Gontijo-Coutinho, R. Kazimierczyk, M. Xue, L. Cotes, Hai Bo Qiu, S. Zakynthinos, E. Cappellini, A. Uber, L. Becker, H. Jones, L. Tadini Buoninsegni, A. U. Uber, Andrea Stella, C. Lee, O. Aguilera Olvera, R. Vicho, P. Bertini, E. Bonanomi, S. Kongsareepong, J. Alphonsine, F. Duprez, K. Volceka, P. M. Roekaerts, J. Ramsaite, A. Yafarova, Simone Lindau, J. X. Chen, Hernando Gomez, M. Redondo-Orts, Riccardo Ragazzi, I.B. Zabolotskikh, J. Wordliczek, L. Fadel, Charles D. Gomersall, Stefan Bloechlinger, W. Van Snippenburg, S. J. Heines, A. Monir, A. Vezzani, Samuele Zuccari, B. Noffsinger, Alessandro Galazzi, Joo Heung Yoon, P. Saludes Orduña, S. Böhm, Thomas Scheeren, Feng Mei Guo, Gavin M. Joynt, R. Sungsiri, S. Arrigoni Marocco, A. Nichols, B. Sobkowicz, L. G. Lindberg, A. Vassi, G. Cianchi, K. Bielka, Anja Bojic, Luciana Mascia, Massimo Girardis, P. Wongsripunetit, G. Boscolo, Ari Moskowitz, Yi Yang, Steven Q. Simpson, Vito Marco Ranieri, M. Kox, Airan Liu, C. Lazzeri, L. Brazzi, L. Rey, M. Y. Hurava, Z. Duhailib, Artur Dubrawski, Gaetano Scaramuzzo, Nahit Cakar, Giuseppe Foti, P. Sentenac, R. Knafelj, E. Kostakou, A. Bloch, I. Lund, Wolfgang R. Sperr, Francesco Mojoli, M. E. Kavlak, N. Sanguanwong, J. Wosko, L. Valeanu, V. L. Sala, B. Holzgraefe, G. Strandberg, L. M. Van Loon, F. Gaiotto, R. M. Grounds, S. R. Yeom, D. Weller, V. Chantziara, G. Reychler, S. Mair, Savino Spadaro, Karavana, V, Smith, I, Kanellis, G, Sigala, I, Kinsella, T, Zakynthinos, S, Liu, L, Chen, J, Zhang, X, Liu, A, Guo, F, Liu, S, Yang, Y, Qiu, H, Grimaldi, D, Kaya, E, Acicbe, O, Kayaalp, I, Asar, S, Dogan, M, and Citerio, G

Subjects
03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, Intensive care, Emergency medicine, Medicine, 030208 emergency & critical care medicine, intensive care medicine, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, business
Published
2017
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10. MP208SERUM AND URINARY MARKERS OF ACUTE KIDNEY INJURY AFTER COMPLEX HEPATIC SURGERY

Author

Lucio Urbani, Chiara Leoni, Carlo Donadio, Giovanna Pasquariello, Domenico Giannese, Piero Buccianti, G Licitra, Antonio Lucacchini, Elena Donadio, Elisabetta Giglio, Emanuela Mangione, Laura Bozzoli, Maria Enrica Baronti, Francesco Forfori, and Laura Giusti

Subjects
Transplantation, medicine.medical_specialty, Nephrology, business.industry, Hepatic surgery, Urinary system, Urology, Acute kidney injury, Medicine, business, medicine.disease
Published
2016
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12. Oral administration of gentamicin for prophylaxis of KPC-producing Klebsiella pneumoniae gut colonization in patients treated with a novel parenchymal-sparing liver surgery: the GEN Gut study

Author

Francesco Menichetti, Carlo Tascini, Marco Puccini, Andrea Ripoli, Lucio Urbani, Piero Colombatto, Chiara Leoni, Francesco Sbrana, Simona Fortunato, G Licitra, Antonello Di Paolo, E Rossi, Riccardo Balestri, Francesco Forfori, Alessandro Leonildi, and Piero Buccianti

Subjects
Male, 0301 basic medicine, Pediatrics, medicine.medical_specialty, Klebsiella pneumoniae, 030106 microbiology, Administration, Oral, Pilot Projects, gentamicin, Critical Care and Intensive Care Medicine, Chemoprevention, Gastroenterology, 03 medical and health sciences, Oral administration, Anesthesiology, Internal medicine, Parenchyma, medicine, Humans, In patient, colistin, Digestive System Surgical Procedures, Aged, Gut colonization, biology, business.industry, biology.organism_classification, Anti-Bacterial Agents, Klebsiella Infections, Gastrointestinal Tract, Liver, Colistin, Female, Gentamicin, Gentamicins, business, medicine.drug
Published
2015
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13. The impact of aircraft noise on the health of population living near six Italian airports

Author

T Fabozzi, Maria Angela Vigotti, G Licitra, Giorgio Cattani, Roberto Sozzi, Anconac, S Simonato, Ennio Cadum, Carla Ancona, F. Mataloni, M Ottino, Francesco Forastiere, S Pisani, and D Camerino

Subjects
education.field_of_study, Aircraft noise, Noise pollution, education, Population, Noise, Aeronautics, Environmental health, parasitic diseases, General Earth and Planetary Sciences, Environmental science, Environmental noise, human activities, Health impact assessment, health care economics and organizations, General Environmental Science
Abstract

Background: Aircraft noise has been associated with several health effects. Because of the great success of low cost flights, small airports have been turned into international airports thus exposi...

Published
2013
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14. Environment and Health - Bridging South, North, East and West. Basel, Switzerland 19-23 August 2013

Author

F. Mataloni, T Fabozzi, Ennio Cadum, S Pisani, Francesco Forastiere, Giorgio Cattani, G Licitra, D Camerino, M Ottino, Maria Angela Vigotti, Carla Ancona, Roberto Sozzi, Anconac, and S Simonato

Subjects
education.field_of_study, Aircraft noise, Aeronautics, Noise pollution, Health, Toxicology and Mutagenesis, parasitic diseases, education, Population, Public Health, Environmental and Occupational Health, Environmental science, human activities, health care economics and organizations
Abstract

Background: Aircraft noise has been associated with several health effects. Because of the great success of low cost flights, small airports have been turned into international airports thus exposi...

Published
2013
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15. Public Health physicians and empathy: are we really emphatic? The Jefferson Scale applied to Italian resident doctors in Public Health

Author

C Marcantoni, G Goi, Dario Tedesco, S. Ferioli, P. Camia, M. Martinese, C. Baldini, S. Vallorani, A. Ziglio, R. Furnari, Giorgia Gregoraci, S. Sironi, A. Poscia, P. Pelullo, R. Zucco, A. Montante, R. Guerra, A Rinaldi, E Garavelli, M. Pastori, S. Reggiani, A. Caruana, A. Guaccero, V. Vighi, M. Passaro, C. Nioteni, V Burrai, E. La Rosa, F. Puggelli, Claudia Murru, R. Palladino, T. Marzulli, C. Ravaioli, T. Tanini, D. Boemo, Gb Giraldi, P. Tricarico, G. La Maestra, R. Santoru, F. Napolitano, F. Marra, V. Di Gregori, A. Soumelis, G. Licitra, Francesca Campanella, E. D’Ippolito, A. Conti, E. Azzolini, V. Ciorba, Lorenzo Bandini, G. Silvestrini, F. Zazzara, F Gilardi, Claudio Costantino, Elvira D’Andrea, I. Bernardini, F. Lucaroni, S. Parisi, A. Zoccali, F. Soncini, Soncini, F, Silvestrini, G, Poscia, A, Ciorba, V, Conti, A, Murru, C, Rinaldi, A, Zoccali, A, Azzolini, E, Baldini, C, Bandini, L, Bernardini, I, Boemo, D, Burrai, V, Camia, P, Campanella, F, Caruana, A, Costantino, C, D’Andrea, E, Di Gregori, V, D’Ippolito, E, Ferioli, S, Furnari, R, Garavelli, E, Gilardi, F, Giraldi, G, Goi, G, Gregoraci, G, Guaccero, A, Guerra, R, La Maestra, G, La Rosa, E, Licitra, G, Lucaroni, F, Marcantoni, C, Marra, F, Martinese, M, Marzulli, T, Montante, A, Napolitano, F, Nioteni, C, Palladino, R, Parisi, S, Passaro, M, Pastori, M, Pelullo, P, Puggelli, F, Ravaioli, C, Reggiani, S, Sironi, S, Soumelis, A, Tanini, T, Tedesco, D, Tricarico, P, Vallorani, S, Vighi, V, Zazzara, F, Ziglio, A, and Zucco, R

Subjects
medicine.medical_specialty, business.industry, media_common.quotation_subject, Public health, Public Health, Environmental and Occupational Health, Empathy, Health outcomes, Settore MED/42 - Igiene Generale E Applicata, Nursing, Family medicine, Scale (social sciences), Health care, medicine, Empathy, medical residents, public health, Quality (business), business, Healthcare providers, media_common
Abstract

Large gaps in care quality resulting from ineffective communication between health providers, patients, and other health care organizations have been documented. Research suggests that effective, empathic communication positively influences health outcomes. Many studies focused on the assessment of clinicians empathy, while there is still a lack of evidence on the role and level of empathy for public health medical doctors,especially during their postgraduate education. The aim of this study was to assess empathy level of public health residents, and to investigate differences in empathy scores using a validated questionnaire. The Italian version of the Jefferson scale of Physician Empathy was mailed to all the resident doctors of the Italian Schools in Hygiene and Public Health during the month of April 2013. Individual Empathy Scores (IES) were calculated, as well as descriptive statistics for the items and scale levels. The difference in empathy scores according to physician’s gender, age class, career rank, place of residency, work experiences(medical direction vs research career) were examined trough t test or ANOVA as appropriate. 352 out of 402 resident doctors replied the questionnaire(response rate 87%). The mean of IES was 118.5 (SD 13.4; range = 54-140; median = 120). There were no IES differences between career rank (p = 0.3), age class (p = 0.2), and place of residency (p = 0.07), while females had higher IES than males (120.3 vs 114.9; p < 0.01). Physicians who have had experience in healthcare administration reported higher IES compared to those who only performed research activity (120.4 vs 117.1; p = 0.02). In addition the respondent physicians believe that the development of social skills should be promoted with greater attention during the undergraduate education (78%)and during the postgraduate education in public health (65%). Our results show a good level of IES in the public health residents, with some significant differences according to gender and physicians work experience. Furthermore, considering empathy and cultural competence essential for public health professionals in order to provide and manage high quality patient-centred care, the widespread demand for specific training outlined by this survey should be taken into adequate account.

Published
2013

16. PTFE Graft as a 'Bridge' to Communicating Veins Maturation in the Treatment of an Intrahepatic Cholangiocarcinoma Involving the 3 Hepatic Veins. The Minor-but-Complex Liver Resection

Author

Juri Bernardini, Francesco Arces, Piero Boraschi, G Licitra, Riccardo Balestri, Piero Buccianti, Maura Castagna, Lucio Urbani, Francesco Sidoti, Chiara Leoni, Francesco Forfori, and Piero Colombatto

Subjects
Male, Liver surgery, medicine.medical_specialty, Hepatic Veins, 030230 surgery, Liver resections, Resection, Cholangiocarcinoma, 03 medical and health sciences, 0302 clinical medicine, medicine, Hepatectomy, Humans, Polytetrafluoroethylene, Parenchymal Tissue, Intrahepatic Cholangiocarcinoma, integumentary system, business.industry, Ptfe graft, Middle Aged, Surgery, Bile Ducts, Intrahepatic, Bridge (graph theory), Bile Duct Neoplasms, Oncology, 030220 oncology & carcinogenesis, Hepatic veins, Vascular Grafting, business, Organ Sparing Treatments
Abstract

Parenchyma-sparing liver surgery allows resecting hepatic veins (HV) at the hepatocaval confluence with minor (3 adjacent segments) liver resections. PTFE graft can be used as a bridge to communicating-veins maturation to ensure the correct outflow of the spared liver. We present a video of an intrahepatic cholangiocarcinoma (IC) involving the three HV at the hepatocaval confluence treated with this approach.In a 50-year old obese (BMI 44.8) male a 6-cm IC involving the hepatocaval confluence was identified during the follow-up for a kidney malignancy. At the preoperative CT scan the left HV was not detectable, the middle HV was incorporated within the tumor, and right HV had a 3-cm contact with the tumor. No communicating veins were evident at preoperative imaging.After a J-shape thoracophrenolaparotomy, the resection of segments II-III-IVa was partially extended to segment VIII-VII and I. The right HV was detached from the tumor, and the middle HV was reconstructed with a 7-mm ringed-armed PTFE graft anastomosed to V8. Surgery lasted 20 h and 55 min with an estimated blood loss of 3500 ml, but the postoperative course was uneventful and the patient was discharged on the 14th postoperative day. One month later the CT scan showed a patent PTFE graft with the maturation of communicating-veins. One year later a complete thrombosis of the PTFE graft was observed with normal liver perfusion and function, and the patient was disease-free.PTFE-based parenchyma-sparing liver resection is a new tool to treat tumors located at the hepatocaval confluence exploiting the maturation of intrahepatic communicating-veins between main HV.

Published
2016
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22. Minor-but-Complex Liver Resection

Author

Marco Puccini, Adriana Paolicchi, Chiara Leoni, Francesco Forfori, Maura Castagna, Lucio Urbani, Carlo Tascini, Piero Colombatto, Piero Buccianti, Alessandro Lunardi, G Licitra, Gianluca Masi, A Marioni, Valerio Prosperi, Piero Boraschi, Riccardo Balestri, and Caterina Vivaldi

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Observational Study, Liver resections, Metastasis, Resection, High morbidity, Hepatectomy, Humans, Medicine, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Medicine (all), Liver Neoplasms, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Combined Modality Therapy, Thrombosis, Surgery, Liver, Female, Colorectal Neoplasms, business, Major hepatectomy, Research Article
Abstract

Major hepatectomy (MH) is often considered the only possible approach for colorectal liver metastasis (CRLM) at the hepato-caval confluence (CC), but it is associated with high morbidity and mortality. With the aim to reduce MH, we developed the “minor-but-complex” (MbC) technique, which consists in the resection of less than 3 adjacent liver segments with exposure of the CC and preservation of hepatic outflow until spontaneous maturation of peripheral intrahepatic shunts between main hepatic veins. We have evaluated applicability and outcome of MbC resections for the treatment of CRLM involving the CC. In this retrospective cohort study, all consecutive liver resections (LR) performed for CRLM located in segments 1, 7, 8, or 4a were classified as MINOR – removal of

Published
2015
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26. An overview of the ETSI-BRAN HIPERACCESS physical layer air interface specification

Author

Y.Y. Lebret, J. Klein, K. Fazel, C. Decanis, L. Lindh, and G. Licitra

Subjects
Mobile radio, business.industry, Computer science, Air interface, Transmitter, Physical layer, Core network, Link adaptation, Spectral efficiency, Transmission (telecommunications), Data Link Control, PHY, Baseband, Electronic engineering, business, Computer network
Abstract

The ETSI-BRAN-HIPERACCESS standard is confined to specify the radio subsystem above 11 GHz of a point-to-multi-point (PMP) interoperable system consisting of the physical (PHY) layer and the data link control (DLC)/convergence layer (CL) - which are both core network independent. The paper gives a description of the physical layer, which specifies the transmission scheme in order to allow interoperability between equipment developed by different manufacturers. This is achieved by standardizing all baseband signal processing structures in the transmitter side by using the most technology advanced architecture and components. The system, by employing adaptive coding and modulation (i.e. individual link adaptation) and cell sectorization techniques, offers a high spectral efficiency and a great flexibility for the deployment. Furthermore, the specification includes basic RF aspects and those other parameters necessary for radio regulatory purposes.

Published
2003
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28. [Acute pancreatitis and pregnancy]

Author

P, Scollo and G, Licitra

Subjects
Adult, Pregnancy Complications, Pancreatitis, Pregnancy, Acute Disease, Humans, Female
Abstract

Aetiologic factors (gallstones, hyperlipidemia I-IV, hypertriglyceridaemia) make their occurrence, mainly, in the third trimester of gestation. Two cases of acute pancreatitis in pregnancy are described; in both cases patients referred healthy diet, no habit to smoke and no previous episode of pancreatitis. An obstructive pathology of biliary tract was the aetiologic factor. Vomiting, upper abdominal pain are aspecific symptoms that impose a differential diagnosis with acute appendicitis, cholecystitis and obstructive intestinal pathology. Laboratory data (elevated serum amylase and lipase levels) and ultrasonography carry out an accurate diagnosis. The management of acute pancreatitis is based on the use of symptomatic drugs, a low fat diet alternated to the parenteral nutrition when triglycerides levels are more than 28 mmol/L. Surgical therapy, used only in case of obstructive pathology of biliary tract, is optimally collected in the third trimester or immediately after postpartum. Our patients, treated only medically, delivered respectively at 38th and 40th week of gestation. Tempestivity of diagnosis and appropriate therapy permit to improve prognosis of a pathology that, although really associated with pregnancy, presents high maternal mortality (37%) cause of complications (shock, coagulopathy, acute respiratory insufficiency) and fetal (37.9%) by occurrence of preterm delivery.

Published
1993

32. Risk factors for lung colonization by Candida albicans in a general ICU

Author

S Silvestri, Francesco Giunta, L Toma, Francesco Forfori, and G Licitra

Subjects
medicine.medical_specialty, Pediatrics, Lung, medicine.diagnostic_test, biology, business.industry, Invasive candidiasis, Critical Care and Intensive Care Medicine, medicine.disease, biology.organism_classification, Candida infections, Bronchoalveolar lavage, medicine.anatomical_structure, Parenteral nutrition, Internal medicine, Poster Presentation, Medicine, Colonization, business, Candida albicans, Hospital stay
Abstract

Although a substantial proportion of patients become colonized with Candida sp. during a hospital stay, only few develop severe infection. Invasive candidiasis occurs in only 1–8% of patients admitted to hospitals, but in 10% of patients housed in the ICU where candida infections represent up to 15% of all nosocomial infections [1]. Candida sp. isolates from bronchoalveolar lavage (BAL) cultures in immunocompetent patients are through contaminants rather than pathogens. The objective of this study is to research the most important risk factors for lung colonization by Candida albicans in ICU patients.

Published
2008

33. Therapy with teicoplanin in the ICU: continuous intravenous infusion or intermittent intravenous administration?

Author

M Del Turco, G Licitra, E Nardi, Francesco Forfori, L Marioni, and Francesco Giunta

Subjects
medicine.medical_specialty, Teicoplanin, business.industry, medicine.drug_class, biochemical phenomena, metabolism, and nutrition, Glycopeptide antibiotic, bacterial infections and mycoses, Critical Care and Intensive Care Medicine, carbohydrates (lipids), Pharmacodynamics, Poster Presentation, Emergency medicine, polycyclic compounds, medicine, bacteria, Time dependency, Intensive care medicine, business, medicine.drug
Abstract

Teicoplanin is a glycopeptide antibiotic. The principle pharmacodynamic parameter is time dependency.

Published
2008
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34. Renal protection in the ICU: role of fenoldopam

Author

T Angelini, Pietro Bertini, Francesco Forfori, G Licitra, F Pratesi, and Francesco Giunta

Subjects
Agonist, Pathology, medicine.medical_specialty, Fenoldopam, business.industry, medicine.drug_class, Dopaminergic, Urology, Diuresis, urologic and male genital diseases, Critical Care and Intensive Care Medicine, medicine.disease, Natriuresis, Renal blood flow, Poster Presentation, Medicine, business, Receptor, Acute tubular necrosis, medicine.drug
Abstract

Acute renal failure (ARF) is one of the most common problems of the critical patient, often resulting in acute tubular necrosis following an impairment in renal hemodynamics. Fenoldopam is a selective dopaminergic agonist specific for dopaminergic receptor DA-1 that, provoking an increase in renal blood flow, diuresis and natriuresis, seems to prevent ARF – exerting a nephro-protective effect.

Published
2008
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36. A critical review of Compton imaging

Author

R, Guzzardi and G, Licitra

Subjects
Lung Diseases, Humans, Models, Theoretical, Image Enhancement, Iridium Radioisotopes, Tomography, Emission-Computed
Abstract

This paper reviews the basic aspects, problems, and applications of Compton imaging including those related to nonmedical applications. The physics and technology at the base of this specific methodology are analyzed and the relative differences and merits with respect to other imaging techniques, using ionizing radiations, are reviewed. The basic Compton imaging approaches, i.e., point-by-point, line-by-line, and plane-by-plane, are analyzed. Specifically, physical design and technological aspects are reviewed and discussed. Furthermore, the most important clinical applications of the different methods are presented and discussed. Finally, possibilities and applications of the Compton imaging method to other nonmedical fields, as in the case of the important area of object defects recognition, are analyzed and reviewed.

Published
1987

43. Risk factors associated with delirium in a general ICU: role of S-100 protein

Author

A Rubino, Francesca Foltran, G Licitra, P. Cosimini, Francesco Forfori, and Francesco Giunta

Subjects
Icu patients, medicine.medical_specialty, business.industry, health care facilities, manpower, and services, Incidence (epidemiology), Critical Care and Intensive Care Medicine, behavioral disciplines and activities, Intensive care unit, nervous system diseases, law.invention, law, Poster Presentation, mental disorders, Assessment methods, Emergency medicine, Cohort, Medicine, Delirium, medicine.symptom, business, Complication, Intensive care medicine, Confusion
Abstract

Delirium is an increasing complication of the ICU patient. We estimated the incidence of delirium using the Confusion Assessment Methods for the Intensive Care Unit (CAM-ICU) in a cohort of general ICU patients. We also investigated the value of S-100 protein to reflect this clinical condition.

44. Management parameters from the random regressions testday model to advic farmers on cow nutrition

Author

Caccamo, M., Wageningen University, Johan van Arendonk, Roel Veerkamp, J.D. Ferguson, and G. Licitra

Subjects
dairy cattle nutrition, WIAS, melkveevoeding, dairy cows, Fokkerij en Genomica, Animal Breeding and Genomics, Fokkerij & Genomica, melkkoeien, Animal Breeding & Genomics
Abstract

Accurate monitoring and adequate planning of activities at modern dairy farms are important to improve farm profitability. The aim of this study was to investigate the use of test-day information to support farmers in management of Sicilian dairy herds. To this purpose, a test-day random regression model was developed for the analysis of production data of Sicilian dairy herds. Highest between-herd variation found in the variance components analysis using the test day model showed clear evidence of benefits in using a random regression TD model for management improvement. To identify sources of variation able to explain differences between herds in milk and milk components production herd curves, a field study was conducted in Southern Italy (Ragusa province) where diets and chemical composition of the diet was collected at herd level (every 3 months) and testday milk yield records at individual cow level (every month). Data collection was performed from March 2006 through December 2008 on 40 cooperating farms. Animal breed, feeding system, and total mixed ration chemical composition were identified to influence between-herd variation. At the individual cow level, test day model was further used to investigate the production response to changes in chemical and physical composition of diets in Ragusa province. Starch had the greatest effect on milk, fat, and protein production when crude protein and neutral detergent fiber contents were at a high and low value, respectively. Effects of a nutrition component on production changed when the other nutrients were included in the model, suggesting the confounding response one can have when multiple nutrients are not accounted for.

Published
2012

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