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26 results on '"Caporali, C."'

1. Robotic liver resection versus percutaneous ablation for early hcc: Short-and long-term results

Author

Magistri, P, Catellani, B, Frassoni, S, Guidetti, C, Olivieri, T, Assirati, G, Caporali, C, Pecchi, A, Serra, V, Ballarin, R, Guerrini, G, Bagnardi, V, Di Sandro, S, Di Benedetto, F, Magistri P., Catellani B., Frassoni S., Guidetti C., Olivieri T., Assirati G., Caporali C., Pecchi A., Serra V., Ballarin R., Guerrini G. P., Bagnardi V., Di Sandro S., Di Benedetto F., Magistri, P, Catellani, B, Frassoni, S, Guidetti, C, Olivieri, T, Assirati, G, Caporali, C, Pecchi, A, Serra, V, Ballarin, R, Guerrini, G, Bagnardi, V, Di Sandro, S, Di Benedetto, F, Magistri P., Catellani B., Frassoni S., Guidetti C., Olivieri T., Assirati G., Caporali C., Pecchi A., Serra V., Ballarin R., Guerrini G. P., Bagnardi V., Di Sandro S., and Di Benedetto F.

Abstract

Background: The correct approach for early hepatocellular carcinoma (HCC) is debatable, since multiple options are currently available. Percutaneous ablation (PA) is associated in some series to reduced morbidity compared to liver resection (LR); therefore, minimally invasive surgery may play a significant role in this setting. Methods: All consecutive patients treated by robotic liver resection (RLR) or PA between January 2014 and October 2019 for a newly diagnosed single HCC, less than 3 cm in size (very early/early stages according to the Barcelona Clinic Liver Cancer (BCLC)) on chronic liver disease or liver cirrhosis, were enrolled in this retrospective study. The aim of this study was to compare short-and long-term outcomes to define the best approach in this specific cohort. Results: 60 patients fulfilled the inclusion criteria: 24 RLR and 36 PA. The two populations were homogeneous in terms of baseline characteristics. There were no statistically significant differences regarding the incidence of postoperative morbidity (RLR 38% vs. PA 19%, p = 0.15). The cumulative incidence of recurrence (CIR) was significantly higher in patients who underwent PA, with the one, two, and three years of CIR being 42%, 69%, and 73% in the PA group and 17%, 27%, and 27% in the RLR group, respectively. Conclusions: RLR provides a significantly higher potential of cure and tumor-related free survival in cases of newly diagnosed single HCCs smaller than 3 cm. Therefore, it can be considered as a first-line approach for the treatment of patients with those characteristics in high-volume centers with extensive experience in the field of hepatobiliary surgery and minimally invasive approaches.

Published
2020

2. Robotic Liver Resection Versus Percutaneous Ablation for Early HCC: Short- and Long-Term Results

Author

Magistri, P., Catellani, B., Frassoni, S., Guidetti, C., Olivieri, T., Assirati, G., Caporali, C., Pecchi, A., Serra, V., Ballarin, R., Guerrini, G. P., Bagnardi, V., Di Sandro, S., Di Benedetto, F., Magistri, P, Catellani, B, Frassoni, S, Guidetti, C, Olivieri, T, Assirati, G, Caporali, C, Pecchi, A, Serra, V, Ballarin, R, Guerrini, G, Bagnardi, V, Di Sandro, S, and Di Benedetto, F

Subjects
RFA, recurrence, robotic surgery, minimally invasive, hepatocellular carcinoma, Hepatocellular carcinoma, Minimally invasive, Recurrence, Robotic surgery, Survival, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, survival, lcsh:RC254-282, Article, digestive system diseases
Abstract

Background: The correct approach for early hepatocellular carcinoma (HCC) is debatable, since multiple options are currently available. Percutaneous ablation (PA) is associated in some series to reduced morbidity compared to liver resection (LR), therefore, minimally invasive surgery may play a significant role in this setting. Methods: All consecutive patients treated by robotic liver resection (RLR) or PA between January 2014 and October 2019 for a newly diagnosed single HCC, less than 3 cm in size (very early/early stages according to the Barcelona Clinic Liver Cancer (BCLC)) on chronic liver disease or liver cirrhosis, were enrolled in this retrospective study. The aim of this study was to compare short- and long-term outcomes to define the best approach in this specific cohort. Results: 60 patients fulfilled the inclusion criteria: 24 RLR and 36 PA. The two populations were homogeneous in terms of baseline characteristics. There were no statistically significant differences regarding the incidence of postoperative morbidity (RLR 38% vs. PA 19%, p = 0.15). The cumulative incidence of recurrence (CIR) was significantly higher in patients who underwent PA, with the one, two, and three years of CIR being 42%, 69%, and 73% in the PA group and 17%, 27%, and 27% in the RLR group, respectively. Conclusions: RLR provides a significantly higher potential of cure and tumor-related free survival in cases of newly diagnosed single HCCs smaller than 3 cm. Therefore, it can be considered as a first-line approach for the treatment of patients with those characteristics in high-volume centers with extensive experience in the field of hepatobiliary surgery and minimally invasive approaches.

Published
2020

3. Under-dilated TIPS Associate With Efficacy and Reduced Encephalopathy in a Prospective, Non-randomized Study of Patients With Cirrhosis

Author

Schepis, F, Vizzutti, F, Garcia-Tsao, G, Marzocchi, G, Rega, L, De Maria, N, Di Maira, T, Gitto, S, Caporali, C, Colopi, S, De Santis, M, Arena, U, Rampoldi, A, Airoldi, A, Cannavale, A, Fanelli, F, Mosconi, C, Renzulli, M, Agazzi, R, Nani, R, Quaretti, P, Fiorina, I, Moramarco, L, Miraglia, R, Luca, A, Bruno, R, Fagiuoli, S, Golfieri, R, Torricelli, P, Di Benedetto, F, Belli, L, Banchelli, F, Laffi, G, Marra, F, Villa, E, Schepis F., Vizzutti F., Garcia-Tsao G., Marzocchi G., Rega L., De Maria N., Di Maira T., Gitto S., Caporali C., Colopi S., De Santis M., Arena U., Rampoldi A., Airoldi A., Cannavale A., Fanelli F., Mosconi C., Renzulli M., Agazzi R., Nani R., Quaretti P., Fiorina I., Moramarco L., Miraglia R., Luca A., Bruno R., Fagiuoli S., Golfieri R., Torricelli P., Di Benedetto F., Belli L. S., Banchelli F., Laffi G., Marra F., Villa E., Schepis, F, Vizzutti, F, Garcia-Tsao, G, Marzocchi, G, Rega, L, De Maria, N, Di Maira, T, Gitto, S, Caporali, C, Colopi, S, De Santis, M, Arena, U, Rampoldi, A, Airoldi, A, Cannavale, A, Fanelli, F, Mosconi, C, Renzulli, M, Agazzi, R, Nani, R, Quaretti, P, Fiorina, I, Moramarco, L, Miraglia, R, Luca, A, Bruno, R, Fagiuoli, S, Golfieri, R, Torricelli, P, Di Benedetto, F, Belli, L, Banchelli, F, Laffi, G, Marra, F, Villa, E, Schepis F., Vizzutti F., Garcia-Tsao G., Marzocchi G., Rega L., De Maria N., Di Maira T., Gitto S., Caporali C., Colopi S., De Santis M., Arena U., Rampoldi A., Airoldi A., Cannavale A., Fanelli F., Mosconi C., Renzulli M., Agazzi R., Nani R., Quaretti P., Fiorina I., Moramarco L., Miraglia R., Luca A., Bruno R., Fagiuoli S., Golfieri R., Torricelli P., Di Benedetto F., Belli L. S., Banchelli F., Laffi G., Marra F., and Villa E.

Abstract

Background & Aims: Portosystemic encephalopathy (PSE) is a major complication of trans-jugular intrahepatic porto-systemic shunt (TIPS) placement. Most devices are self-expandable polytetrafluoroethylene-covered stent grafts (PTFE-SGs) that are dilated to their nominal diameter (8 or 10 mm). We investigated whether PTFE-SGs dilated to a smaller caliber (under-dilated TIPS) reduce PSE yet maintain clinical and hemodynamic efficacy. We also studied whether under-dilated TIPS self-expand to nominal diameter over time. Methods: We performed a prospective, non-randomized study of 42 unselected patients with cirrhosis who received under-dilated TIPS (7 and 6 mm) and 53 patients who received PTFE-SGs of 8 mm or more (controls) at referral centers in Italy. After completion of this study, dilation to 6 mm became the standard and 47 patients were included in a validation study. All patients were followed for 6 months; Doppler ultrasonography was performed 2 weeks and 3 months after TIPS placement and every 6 months thereafter. Stability of PTFE-SG diameter was evaluated by computed tomography analysis of 226 patients with cirrhosis whose stent grafts increased to 6, 7, 8, 9, or 10 mm. The primary outcomes were incidence of at least 1 episode of PSE grade 2 or higher during follow up, incidence of recurrent variceal hemorrhage or ascites, incidence of shunt dysfunction requiring TIPS recanalization, and reduction in porto-caval pressure gradient. Results: PSE developed in a significantly lower proportion of patients with under-dilated TIPS (27%) than controls (54%) during the first year after the procedure (P =.015), but the proportions of patients with recurrent variceal hemorrhage or ascites did not differ significantly between groups. No TIPS occlusions were observed. These results were confirmed in the validation cohort. In an analysis of self-expansion of stent grafts, during a mean follow-up period of 252 days after placement, none of the PTFE-SGs self-expanded to t

Published
2018

4. Monte Carlo calculation of correction factors for dosimetry in radiotherapy using the correlated sampling method

Author

Maria Pimpinella, Caporali, C., Stravato, A., Guerra, A. S., D Arienzo, M., D'Arienzo, M., Guerra, A. S., Stravato, A., Caporali, C., and Pimpinella, M.

Subjects
Diamond detector, Small fields, Graphite calorimeter, Correlated sampling
Abstract

In the present work, the correlated sampling technique in Monte Carlo calculations related to diamond dosimetry and graphite calorimetry will be described. The egs_chamber and DOSRZnrc user-codes included in the EGSnrc package are used. Egs_chamber is already provided with routines enabling the use of correlated sampling while an in-house implementation of this technique was made in the original version of DOSRZnrc. Both codes have been used for calculating perturbation factors needed for absorbed dose measurements in radiotherapy dosimetry. Correlated sampling turned out to be a reliable method, allowing to determine, in reasonable times, accurate correction factors, even in unfavourable conditions as when absorbed dose is scored in very small volumes.

Published
2014

6. Parenteral and enteral feeding in hospitals in Italy: a national survey

Author

Braga, M, Bozzetti, F, Dionigi, P, Radrizzani, D, Iapichino, G, Salis, C, Scroccaro, G, Gelio, S, Messori, A, Tognoni, G, Zanello, M, Ferrara, F, Corti, A, Fanchini, P, Vernero, S, Congedo, R, Decicco, M, Morelli, M, Carrata, R, Laddaga, L, Lattarulo, M, Marchesi, G, Sequenza, S, Stivala, B, Lanzone, L, Sozzi, P, Raitano, A, Fiacchi, M, Pierangeli, A, Russito, G, Caporali, C, Bittasi, P, Sanna, P, Savona, G, Usai, C, Accogli, P, Selli, L, Pusceddu, P, Iasiello, G, Fazio, S, Badoino, C, Burlon, N, Lombardi, M, Bertana, P, Bartazzi, D, Paolucci, R, Tella, G, Callegari, R, Toffoletto, F, Torreggiani, L, Campo, S, Micheletti, I, Lidestri, G, Zanin, P, Giuliano, G, Chioldi, G, Perlasca, F, Grande, W, Pincelli, D, Paccagnella, A, Francesconi, R, Domeniconi, D, Bertotti, G, Campi, A, Vivarelli, R, Donati, D, Sibilla, C, Cervi, R, Vannucci, A, Tonelli, F, Bravo, M, Fusi, D, Pagani, M, Desalvo, L, Amalfitano, M, Zunino, Vanliut, M, Pirola, V, Campestrini, G, Agostini, S, Galdieri, M, Severino, A, Casula, C, Agus, G, Franceschini, L, Sarni, A, Vendrame, G, Frattini, F, Nardi, L, Valente, F, Rambelli, G, Rusconi, A, Taddei, G, Barbuscia, M, Cozzaglio, L, Regalia, E, Giudici, D, Gianotti, L, Baccari, P, Dalcin, S, Molene, V, Biffi, R, Gallitelli, L, Bianchi, G, Vecchi, G, Villa, E, Barzan, D, Mazzato, M, Pietromaggiori, F, Campisi, M, Palozzo, A, Inzalaco, M, Ricci, G, Castellucci, M, Maggiore, E, Salvadore, C, Grusovin, M, Mezzasalma, N, Maso, G, Pecorelli, O, Finco, C, Sartori, F, Buffano, G, Iacovelli, W, Ferri, T, Zermani, R, Rovati, P, Cebrelli, T, Pallavicini, F, Albertario, F, Bosco, A, Olivi, P, Paolini, P, Dalcanto, L, Marconcini, F, Lazzarini, R, Malacrida, A, Amboldi, A, Bonelli, S, Florianello, F, Borin, F, Vaghi, G, Fanelli, F, Mancini, S, Giusti, D, Nanni, G, Sannella, F, Sganga, G, Fellegara, P, Mosconi, F, Signorelli, I, Orban, D, Ceccherini, E, Orsini, A, Giuliano, P, Rosa, F, Zanella, A, Croatto, T, Toffanin, D, Binotto, F, Marcato, P, Menardo, G, Faucci, L, Spoldi, L, Marsetti, M, Dicosmo, L, Fornasetti, A, Manetti, A, Salvatore, A, Rossi, C, Rinaldi, S, Deangelis, C, Azzola, M, Conte, F, Rizzo, V, Bona, Mazzego, M, Leggieri, A, Canino, V, Pastore, V, Bosco, R, Debernardi, Disalvatore, A, Degrazia, R, Mazzon, D, Papadia, G, Toigo, G, Iscra, F, Nemez, M, Drobinz, F, Mesgez, D, Troncon, M, Bacco, A, Cattaruzzi, C, Cinque, A, Pasquetto, A, Cartei, G, Dibello, B, Miani, P, Chizzola, A, Baldassarre, M, Borga, P, Borgato, F, Scattolini, C, Laveggio, L, Franceschini, F, Turturo, F, Porretto, V, Coati, M, Nesi, L, Carner, M, Zampieri, P, Gabrielli, G, Todeschini, G, Falconi, M, Fratucello, G, Delgrossi, S, Citterio, R, Villa, C, Rivolta, A, Minuto, D, Orcalli, F, Ferrera, G, BRAGA M, BOZZETTI F, DIONIGI P, RADRIZZANI D, IAPICHINO G, SALIS C, SCROCCARO G, GELIO S, MESSORI A, TOGNONI G, ZANELLO M, FERRARA F, CORTI A, FANCHINI P, VERNERO S, CONGEDO RM, DECICCO M, MORELLI M, CARRATA R, LADDAGA L, LATTARULO M, MARCHESI G, SEQUENZA S, STIVALA B, LANZONE L, SOZZI P, RAITANO A, FIACCHI M, PIERANGELI A, RUSSITO G, CAPORALI C, BITTASI P, SANNA P, SAVONA G, USAI C, ACCOGLI P, SELLI L, PUSCEDDU P, IASIELLO G, FAZIO S, BADOINO C, BURLON N, LOMBARDI M, BERTANA P, BARTAZZI D, PAOLUCCI R, TELLA GC, CALLEGARI R, TOFFOLETTO F, TORREGGIANI L, CAMPO S, MICHELETTI I, LIDESTRI G, ZANIN P, GIULIANO G, CHIOLDI G, PERLASCA F, GRANDE W, PINCELLI D, PACCAGNELLA A, FRANCESCONI R, DOMENICONI D, BERTOTTI G, CAMPI A, VIVARELLI R, DONATI D, SIBILLA C, CERVI R, VANNUCCI A, TONELLI F, BRAVO MT, FUSI D, PAGANI M, DESALVO L, AMALFITANO ME, ZUNINO, VANLIUT MT, PIROLA V, CAMPESTRINI G, AGOSTINI S, GALDIERI MT, SEVERINO A, CASULA C, AGUS G, FRANCESCHINI L, SARNI A, VENDRAME G, FRATTINI F, NARDI L, VALENTE F, RAMBELLI G, RUSCONI A, TADDEI G, BARBUSCIA M, COZZAGLIO L, REGALIA E, GIUDICI D, GIANOTTI L, BACCARI P, DALCIN S, MOLENE V, BIFFI R, GALLITELLI L, BIANCHI G, VECCHI G, VILLA E, BARZAN D, MAZZATO M, PIETROMAGGIORI F, CAMPISI M, PALOZZO A, INZALACO M, RICCI G, CASTELLUCCI MG, MAGGIORE E, SALVADORE C, GRUSOVIN MT, MEZZASALMA N, MASO G, PECORELLI O, FINCO C, SARTORI F, BUFFANO G, IACOVELLI W, FERRI T, ZERMANI R, ROVATI P, CEBRELLI T, PALLAVICINI FB, ALBERTARIO F, BOSCO A, OLIVI P, PAOLINI P, DALCANTO L, MARCONCINI F, LAZZARINI R, MALACRIDA A, AMBOLDI A, BONELLI S, FLORIANELLO F, BORIN F, VAGHI GM, FANELLI FR, MANCINI S, GIUSTI D, NANNI G, SANNELLA F, SGANGA G, FELLEGARA P, MOSCONI F, SIGNORELLI I, ORBAN D, CECCHERINI E, ORSINI A, GIULIANO P, ROSA F, ZANELLA A, CROATTO T, TOFFANIN D, BINOTTO F, MARCATO P, MENARDO G, FAUCCI L, SPOLDI L, MARSETTI M, DICOSMO L, FORNASETTI A, MANETTI A, SALVATORE A, ROSSI C, RINALDI S, DEANGELIS C, AZZOLA M, CONTE F, RIZZO V, BONA, MAZZEGO M, LEGGIERI A, CANINO V, PASTORE V, BOSCO R, DEBERNARDI, DISALVATORE A, DEGRAZIA R, MAZZON D, PAPADIA G, TOIGO G, ISCRA F, NEMEZ M, DROBINZ F, MESGEZ D, TRONCON MG, BACCO A, CATTARUZZI C, CINQUE A, PASQUETTO A, CARTEI G, DIBELLO B, MIANI P, CHIZZOLA A, BALDASSARRE M, BORGA P, BORGATO F, SCATTOLINI C, LAVEGGIO L, FRANCESCHINI F, TURTURO F, PORRETTO V, COATI M, NESI L, CARNER M, ZAMPIERI P, GABRIELLI G, TODESCHINI G, FALCONI M, FRATUCELLO G, DELGROSSI S, CITTERIO R, VILLA C, RIVOLTA A, MINUTO D, ORCALLI F, FERRERA G, Braga, M, Bozzetti, F, Dionigi, P, Radrizzani, D, Iapichino, G, Salis, C, Scroccaro, G, Gelio, S, Messori, A, Tognoni, G, Zanello, M, Ferrara, F, Corti, A, Fanchini, P, Vernero, S, Congedo, R, Decicco, M, Morelli, M, Carrata, R, Laddaga, L, Lattarulo, M, Marchesi, G, Sequenza, S, Stivala, B, Lanzone, L, Sozzi, P, Raitano, A, Fiacchi, M, Pierangeli, A, Russito, G, Caporali, C, Bittasi, P, Sanna, P, Savona, G, Usai, C, Accogli, P, Selli, L, Pusceddu, P, Iasiello, G, Fazio, S, Badoino, C, Burlon, N, Lombardi, M, Bertana, P, Bartazzi, D, Paolucci, R, Tella, G, Callegari, R, Toffoletto, F, Torreggiani, L, Campo, S, Micheletti, I, Lidestri, G, Zanin, P, Giuliano, G, Chioldi, G, Perlasca, F, Grande, W, Pincelli, D, Paccagnella, A, Francesconi, R, Domeniconi, D, Bertotti, G, Campi, A, Vivarelli, R, Donati, D, Sibilla, C, Cervi, R, Vannucci, A, Tonelli, F, Bravo, M, Fusi, D, Pagani, M, Desalvo, L, Amalfitano, M, Zunino, Vanliut, M, Pirola, V, Campestrini, G, Agostini, S, Galdieri, M, Severino, A, Casula, C, Agus, G, Franceschini, L, Sarni, A, Vendrame, G, Frattini, F, Nardi, L, Valente, F, Rambelli, G, Rusconi, A, Taddei, G, Barbuscia, M, Cozzaglio, L, Regalia, E, Giudici, D, Gianotti, L, Baccari, P, Dalcin, S, Molene, V, Biffi, R, Gallitelli, L, Bianchi, G, Vecchi, G, Villa, E, Barzan, D, Mazzato, M, Pietromaggiori, F, Campisi, M, Palozzo, A, Inzalaco, M, Ricci, G, Castellucci, M, Maggiore, E, Salvadore, C, Grusovin, M, Mezzasalma, N, Maso, G, Pecorelli, O, Finco, C, Sartori, F, Buffano, G, Iacovelli, W, Ferri, T, Zermani, R, Rovati, P, Cebrelli, T, Pallavicini, F, Albertario, F, Bosco, A, Olivi, P, Paolini, P, Dalcanto, L, Marconcini, F, Lazzarini, R, Malacrida, A, Amboldi, A, Bonelli, S, Florianello, F, Borin, F, Vaghi, G, Fanelli, F, Mancini, S, Giusti, D, Nanni, G, Sannella, F, Sganga, G, Fellegara, P, Mosconi, F, Signorelli, I, Orban, D, Ceccherini, E, Orsini, A, Giuliano, P, Rosa, F, Zanella, A, Croatto, T, Toffanin, D, Binotto, F, Marcato, P, Menardo, G, Faucci, L, Spoldi, L, Marsetti, M, Dicosmo, L, Fornasetti, A, Manetti, A, Salvatore, A, Rossi, C, Rinaldi, S, Deangelis, C, Azzola, M, Conte, F, Rizzo, V, Bona, Mazzego, M, Leggieri, A, Canino, V, Pastore, V, Bosco, R, Debernardi, Disalvatore, A, Degrazia, R, Mazzon, D, Papadia, G, Toigo, G, Iscra, F, Nemez, M, Drobinz, F, Mesgez, D, Troncon, M, Bacco, A, Cattaruzzi, C, Cinque, A, Pasquetto, A, Cartei, G, Dibello, B, Miani, P, Chizzola, A, Baldassarre, M, Borga, P, Borgato, F, Scattolini, C, Laveggio, L, Franceschini, F, Turturo, F, Porretto, V, Coati, M, Nesi, L, Carner, M, Zampieri, P, Gabrielli, G, Todeschini, G, Falconi, M, Fratucello, G, Delgrossi, S, Citterio, R, Villa, C, Rivolta, A, Minuto, D, Orcalli, F, Ferrera, G, BRAGA M, BOZZETTI F, DIONIGI P, RADRIZZANI D, IAPICHINO G, SALIS C, SCROCCARO G, GELIO S, MESSORI A, TOGNONI G, ZANELLO M, FERRARA F, CORTI A, FANCHINI P, VERNERO S, CONGEDO RM, DECICCO M, MORELLI M, CARRATA R, LADDAGA L, LATTARULO M, MARCHESI G, SEQUENZA S, STIVALA B, LANZONE L, SOZZI P, RAITANO A, FIACCHI M, PIERANGELI A, RUSSITO G, CAPORALI C, BITTASI P, SANNA P, SAVONA G, USAI C, ACCOGLI P, SELLI L, PUSCEDDU P, IASIELLO G, FAZIO S, BADOINO C, BURLON N, LOMBARDI M, BERTANA P, BARTAZZI D, PAOLUCCI R, TELLA GC, CALLEGARI R, TOFFOLETTO F, TORREGGIANI L, CAMPO S, MICHELETTI I, LIDESTRI G, ZANIN P, GIULIANO G, CHIOLDI G, PERLASCA F, GRANDE W, PINCELLI D, PACCAGNELLA A, FRANCESCONI R, DOMENICONI D, BERTOTTI G, CAMPI A, VIVARELLI R, DONATI D, SIBILLA C, CERVI R, VANNUCCI A, TONELLI F, BRAVO MT, FUSI D, PAGANI M, DESALVO L, AMALFITANO ME, ZUNINO, VANLIUT MT, PIROLA V, CAMPESTRINI G, AGOSTINI S, GALDIERI MT, SEVERINO A, CASULA C, AGUS G, FRANCESCHINI L, SARNI A, VENDRAME G, FRATTINI F, NARDI L, VALENTE F, RAMBELLI G, RUSCONI A, TADDEI G, BARBUSCIA M, COZZAGLIO L, REGALIA E, GIUDICI D, GIANOTTI L, BACCARI P, DALCIN S, MOLENE V, BIFFI R, GALLITELLI L, BIANCHI G, VECCHI G, VILLA E, BARZAN D, MAZZATO M, PIETROMAGGIORI F, CAMPISI M, PALOZZO A, INZALACO M, RICCI G, CASTELLUCCI MG, MAGGIORE E, SALVADORE C, GRUSOVIN MT, MEZZASALMA N, MASO G, PECORELLI O, FINCO C, SARTORI F, BUFFANO G, IACOVELLI W, FERRI T, ZERMANI R, ROVATI P, CEBRELLI T, PALLAVICINI FB, ALBERTARIO F, BOSCO A, OLIVI P, PAOLINI P, DALCANTO L, MARCONCINI F, LAZZARINI R, MALACRIDA A, AMBOLDI A, BONELLI S, FLORIANELLO F, BORIN F, VAGHI GM, FANELLI FR, MANCINI S, GIUSTI D, NANNI G, SANNELLA F, SGANGA G, FELLEGARA P, MOSCONI F, SIGNORELLI I, ORBAN D, CECCHERINI E, ORSINI A, GIULIANO P, ROSA F, ZANELLA A, CROATTO T, TOFFANIN D, BINOTTO F, MARCATO P, MENARDO G, FAUCCI L, SPOLDI L, MARSETTI M, DICOSMO L, FORNASETTI A, MANETTI A, SALVATORE A, ROSSI C, RINALDI S, DEANGELIS C, AZZOLA M, CONTE F, RIZZO V, BONA, MAZZEGO M, LEGGIERI A, CANINO V, PASTORE V, BOSCO R, DEBERNARDI, DISALVATORE A, DEGRAZIA R, MAZZON D, PAPADIA G, TOIGO G, ISCRA F, NEMEZ M, DROBINZ F, MESGEZ D, TRONCON MG, BACCO A, CATTARUZZI C, CINQUE A, PASQUETTO A, CARTEI G, DIBELLO B, MIANI P, CHIZZOLA A, BALDASSARRE M, BORGA P, BORGATO F, SCATTOLINI C, LAVEGGIO L, FRANCESCHINI F, TURTURO F, PORRETTO V, COATI M, NESI L, CARNER M, ZAMPIERI P, GABRIELLI G, TODESCHINI G, FALCONI M, FRATUCELLO G, DELGROSSI S, CITTERIO R, VILLA C, RIVOLTA A, MINUTO D, ORCALLI F, and FERRERA G

Abstract

A multicentre prospective survey on the use of artificial nutrition (AN) and its complications has been carried out on 1657 hospitalised patients including 7.8% in surgical departments, 7.1% in medical departments and 59.9% in intensive care units. Gastrointestinal diseases and cancer were the most frequent pathologies among patients requiring AN. Parenteral nutrition (PN) alone was employed in 1103 (66.5%) patients. In 267 (16.1%) PN was associated with enteral nutrition (EN). 287 (17.3%) patients were fed by the enteral route alone. The average daily energy intake was 35 kcal/kg for central PN, 26 kcal/kg for peripheral PN and 33 kcal/kg for EN. The mean daily nitrogen intake was 0.19 g/kg for central PN, 0.17 g/kg for peripheral PN and 0.20 g/kg for EN. In 10% of patients PN was electrolyte free and in only 50% all the main electrolytes were added. Trace elements were added in 48% of formulations, mainly as multiple combination. Insulin was added in 61% of PN patients, while albumin was given with PN in 20% of patients. Adverse reactions were observed in 10.9% of PN patients and in 11.5% of EN patients. The most frequent complications occurring in parenterally fed patients were infections of the central venous catheter and metabolic alterations (severe electrolyte abnormalities, liver or renal dysfunction, hypo or persistent hyperglycemia). In enterally fed patients the frequent complications were abdominal distension, cramps and diarrhoea. Adverse reactions were responsible for discontinuation of AN in 2.2% of parenterally supported patients and in 5.7% of enterally fed patients.

Published
1994

7. PARENTERAL AND ENTERAL FEEDING IN HOSPITALS IN ITALY - A NATIONAL SURVEY

Author

BRAGA , MARCO, BOZZETTI F, DIONIGI P, RADRIZZANI D, IAPICHINO G, SALIS C, SCROCCARO G, GELIO S, MESSORI A, TOGNONI G, ZANELLO M, FERRARA F, CORTI A, FANCHINI P, VERNERO S, CONGEDO RM, DECICCO M, MORELLI M, CARRATA R, LADDAGA L, LATTARULO M, MARCHESI G, SEQUENZA S, STIVALA B, LANZONE L, SOZZI P, RAITANO A, FIACCHI M, PIERANGELI A, RUSSITO G, CAPORALI C, BITTASI P, SANNA P, SAVONA G, USAI C, ACCOGLI P, SELLI L, PUSCEDDU P, IASIELLO G, FAZIO S, BADOINO C, BURLON N, LOMBARDI M, BERTANA P, BARTAZZI D, PAOLUCCI R, TELLA GC, CALLEGARI R, TOFFOLETTO F, TORREGGIANI L, CAMPO S, MICHELETTI I, LIDESTRI G, ZANIN P, GIULIANO G, CHIOLDI G, PERLASCA F, GRANDE W, PINCELLI D, PACCAGNELLA A, FRANCESCONI R, DOMENICONI D, BERTOTTI G, CAMPI A, VIVARELLI R, DONATI D, SIBILLA C, CERVI R, VANNUCCI A, TONELLI F, BRAVO MT, FUSI D, PAGANI M, DESALVO L, AMALFITANO ME, ZUNINO, VANLIUT MT, PIROLA V, CAMPESTRINI G, AGOSTINI S, GALDIERI MT, SEVERINO A, CASULA C, AGUS G, FRANCESCHINI L, SARNI A, VENDRAME G, FRATTINI F, NARDI L, VALENTE F, RAMBELLI G, RUSCONI A, TADDEI G, BARBUSCIA M, COZZAGLIO L, REGALIA E, GIUDICI D, GIANOTTI L, BACCARI P, DALCIN S, MOLENE V, BIFFI R, GALLITELLI L, BIANCHI G, VECCHI G, VILLA E, BARZAN D, MAZZATO M, PIETROMAGGIORI F, CAMPISI M, PALOZZO A, INZALACO M, RICCI G, CASTELLUCCI MG, MAGGIORE E, SALVADORE C, GRUSOVIN MT, MEZZASALMA N, MASO G, PECORELLI O, FINCO C, SARTORI F, BUFFANO G, IACOVELLI W, FERRI T, ZERMANI R, ROVATI P, CEBRELLI T, PALLAVICINI FB, ALBERTARIO F, BOSCO A, OLIVI P, PAOLINI P, DALCANTO L, MARCONCINI F, LAZZARINI R, MALACRIDA A, AMBOLDI A, BONELLI S, FLORIANELLO F, BORIN F, VAGHI GM, FANELLI FR, MANCINI S, GIUSTI D, NANNI G, SANNELLA F, SGANGA G, FELLEGARA P, MOSCONI F, SIGNORELLI I, ORBAN D, CECCHERINI E, ORSINI A, GIULIANO P, ROSA F, ZANELLA A, CROATTO T, TOFFANIN D, BINOTTO F, MARCATO P, MENARDO G, FAUCCI L, SPOLDI L, MARSETTI M, DICOSMO L, FORNASETTI A, MANETTI A, SALVATORE A, ROSSI C, RINALDI S, DEANGELIS C, AZZOLA M, CONTE F, RIZZO V, BONA, MAZZEGO M, LEGGIERI A, CANINO V, PASTORE V, BOSCO R, DEBERNARDI, DISALVATORE A, DEGRAZIA R, MAZZON D, PAPADIA G, TOIGO G, ISCRA F, NEMEZ M, DROBINZ F, MESGEZ D, TRONCON MG, BACCO A, CATTARUZZI C, CINQUE A, PASQUETTO A, CARTEI G, DIBELLO B, MIANI P, CHIZZOLA A, BALDASSARRE M, BORGA P, BORGATO F, SCATTOLINI C, LAVEGGIO L, FRANCESCHINI F, TURTURO F, PORRETTO V, COATI M, NESI L, CARNER M, ZAMPIERI P, GABRIELLI G, TODESCHINI G, FALCONI, MASSIMO, FRATUCELLO G, DELGROSSI S, CITTERIO R, VILLA C, RIVOLTA A, MINUTO D, ORCALLI F, FERRERA G., Braga, Marco, Bozzetti, F, Dionigi, P, Radrizzani, D, Iapichino, G, Salis, C, Scroccaro, G, Gelio, S, Messori, A, Tognoni, G, Zanello, M, Ferrara, F, Corti, A, Fanchini, P, Vernero, S, Congedo, Rm, Decicco, M, Morelli, M, Carrata, R, Laddaga, L, Lattarulo, M, Marchesi, G, Sequenza, S, Stivala, B, Lanzone, L, Sozzi, P, Raitano, A, Fiacchi, M, Pierangeli, A, Russito, G, Caporali, C, Bittasi, P, Sanna, P, Savona, G, Usai, C, Accogli, P, Selli, L, Pusceddu, P, Iasiello, G, Fazio, S, Badoino, C, Burlon, N, Lombardi, M, Bertana, P, Bartazzi, D, Paolucci, R, Tella, Gc, Callegari, R, Toffoletto, F, Torreggiani, L, Campo, S, Micheletti, I, Lidestri, G, Zanin, P, Giuliano, G, Chioldi, G, Perlasca, F, Grande, W, Pincelli, D, Paccagnella, A, Francesconi, R, Domeniconi, D, Bertotti, G, Campi, A, Vivarelli, R, Donati, D, Sibilla, C, Cervi, R, Vannucci, A, Tonelli, F, Bravo, Mt, Fusi, D, Pagani, M, Desalvo, L, Amalfitano, Me, Zunino, Vanliut, Mt, Pirola, V, Campestrini, G, Agostini, S, Galdieri, Mt, Severino, A, Casula, C, Agus, G, Franceschini, L, Sarni, A, Vendrame, G, Frattini, F, Nardi, L, Valente, F, Rambelli, G, Rusconi, A, Taddei, G, Barbuscia, M, Cozzaglio, L, Regalia, E, Giudici, D, Gianotti, L, Baccari, P, Dalcin, S, Molene, V, Biffi, R, Gallitelli, L, Bianchi, G, Vecchi, G, Villa, E, Barzan, D, Mazzato, M, Pietromaggiori, F, Campisi, M, Palozzo, A, Inzalaco, M, Ricci, G, Castellucci, Mg, Maggiore, E, Salvadore, C, Grusovin, Mt, Mezzasalma, N, Maso, G, Pecorelli, O, Finco, C, Sartori, F, Buffano, G, Iacovelli, W, Ferri, T, Zermani, R, Rovati, P, Cebrelli, T, Pallavicini, Fb, Albertario, F, Bosco, A, Olivi, P, Paolini, P, Dalcanto, L, Marconcini, F, Lazzarini, R, Malacrida, A, Amboldi, A, Bonelli, S, Florianello, F, Borin, F, Vaghi, Gm, Fanelli, Fr, Mancini, S, Giusti, D, Nanni, G, Sannella, F, Sganga, G, Fellegara, P, Mosconi, F, Signorelli, I, Orban, D, Ceccherini, E, Orsini, A, Giuliano, P, Rosa, F, Zanella, A, Croatto, T, Toffanin, D, Binotto, F, Marcato, P, Menardo, G, Faucci, L, Spoldi, L, Marsetti, M, Dicosmo, L, Fornasetti, A, Manetti, A, Salvatore, A, Rossi, C, Rinaldi, S, Deangelis, C, Azzola, M, Conte, F, Rizzo, V, Bona, Mazzego, M, Leggieri, A, Canino, V, Pastore, V, Bosco, R, Debernardi, Disalvatore, A, Degrazia, R, Mazzon, D, Papadia, G, Toigo, G, Iscra, F, Nemez, M, Drobinz, F, Mesgez, D, Troncon, Mg, Bacco, A, Cattaruzzi, C, Cinque, A, Pasquetto, A, Cartei, G, Dibello, B, Miani, P, Chizzola, A, Baldassarre, M, Borga, P, Borgato, F, Scattolini, C, Laveggio, L, Franceschini, F, Turturo, F, Porretto, V, Coati, M, Nesi, L, Carner, M, Zampieri, P, Gabrielli, G, Todeschini, G, Falconi, Massimo, Fratucello, G, Delgrossi, S, Citterio, R, Villa, C, Rivolta, A, Minuto, D, Orcalli, F, Ferrera, G., Braga, M, Congedo, R, Tella, G, Bravo, M, Amalfitano, M, Vanliut, M, Galdieri, M, Castellucci, M, Grusovin, M, Pallavicini, F, Vaghi, G, Fanelli, F, Troncon, M, Falconi, M, and Ferrera, G

Subjects
Pediatrics, medicine.medical_specialty, Nutrition and Dietetics, business.industry, medicine.medical_treatment, Insulin, Abdominal distension, Critical Care and Intensive Care Medicine, Enteral administration, Gastroenterology, Discontinuation, Parenteral nutrition, Internal medicine, Intensive care, Medicine, enteral feeding, medicine.symptom, business, Complication, Central venous catheter
Abstract

A multicentre prospective survey on the use of artificial nutrition (AN) and its complications has been carried out on 1657 hospitalised patients including 7.8% in surgical departments, 7.1% in medical departments and 59.9% in intensive care units. Gastrointestinal diseases and cancer were the most frequent pathologies among patients requiring AN. Parenteral nutrition (PN) alone was employed in 1103 (66.5%) patients. In 267 (16.1%) PN was associated with enteral nutrition (EN). 287 (17.3%) patients were fed by the enteral route alone. The average daily energy intake was 35 kcal/kg for central PN, 26 kcal/kg for peripheral PN and 33 kcal/kg for EN. The mean daily nitrogen intake was 0.19 g/kg for central PN, 0.17 g/kg for peripheral PN and 0.20 g/kg for EN. In 10% of patients PN was electrolyte free and in only 50% all the main electrolytes were added. Trace elements were added in 48% of formulations, mainly as multiple combination. Insulin was added in 61% of PN patients, while albumin was given with PN in 20% of patients. Adverse reactions were observed in 10.9% of PN patients and in 11.5% of EN patients. The most frequent complications occurring in parenterally fed patients were infections of the central venous catheter and metabolic alterations (severe electrolyte abnormalities, liver or renal dysfunction, hypo or persistent hyperglycemia). In enterally fed patients the frequent complications were abdominal distension, cramps and diarrhoea. Adverse reactions were responsible for discontinuation of AN in 2.2% of parenterally supported patients and in 5.7% of enterally fed patients.

Published
1994

8. Contributo alla conoscenza della Flora del Monte Paganuccio (Monti del Furlo, Pesaro)

Author

Angiolini, C, Baiocco, M, BRILLI CATTARINI, A, Caporali, C, Capotorti, Giulia, Casavecchia, S, Cerroni, M, Corazzi, G, Fratini, S, Frondoni, Raffaella, Galli, P, Gallo, A. M., Gallozzi, M. R., Gubellini, L, Lattanzi, Edda, Marrocchi, D, Mazzerioli, M, Milanese, A, Ortolani, S, Pacini, A, Papini, A, Paradisi, L, Pignatelli, S, Pinzi, M, Presti, G, Raponi, M, Recucci, C, Scarici, E, Scoppola, A, Silvi, B, Stagnari, M, and Tanfulli, M.

Published
1999

9. Investigation about the thermal features of the ovens used for thermoluminescence

Author

Scarpa, G, Caporali, C, and Moscati, M

Subjects
Health Physics and Radiation Effects
Abstract

The present paper reports the results of an investigation carried out by the PAS-FIBI-DOSIBIO laboratory (ENEA, Casaccia, Roma) about the thermal features of the ovens used for annealing treatments of TL dosemeters. A total number of 45 commercial ovens and muffle furnaces were studied. belonging to 24 Italian Health Physics laboratories. The investigation has shown that the majority of the ovens do not possess a degree of accuracy, stability, uniformity and reproducibility suitable for their use in the field of thermoluminescence dosimetry. Practical suggestions are also given in order to reduce the effects of some of the negative characteristics found in most ovens.

Published
1991

10. Feasibility of using a dose-area product ratio as beam quality specifier for photon beams with small field sizes

Author

Maria Pimpinella, A. Ostrowsky, F. Delaunay, J. Daures, Maïwenn Le Roy, J. Gouriou, L. Silvi, S. Dufreneix, Didier Vermesse, Claudio Caporali, Assunta Petrucci, Vanessa De Coste, Line Sommier, A.S. Guerra, Jean-Marc Bordy, B. Rapp, Istituto Nazionale di Metrologia delle Radiazioni Ionizzanti (ENEA-INMRI), Azienda Ospedaliera San Filippo Neri, Laboratoire National Henri Becquerel (LNHB), Département Métrologie Instrumentation & Information (DM2I), Laboratoire d'Intégration des Systèmes et des Technologies (LIST), Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Laboratoire d'Intégration des Systèmes et des Technologies (LIST), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, European Project: EMRP-HLT09,MetrExtRT, Laboratoire d'Intégration des Systèmes et des Technologies (LIST (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Laboratoire d'Intégration des Systèmes et des Technologies (LIST (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Département d'instrumentation Numérique (DIN (CEA-LIST)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), De Coste, V., Silvi, L., Guerra, A. S., Caporali, C., and Pimpinella, M.

Subjects
Monte Carlo method, General Physics and Astronomy, DIODE, 7. Clean energy, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, MONTE-CARLO, ionization chamber, Ionization, Cobalt Radioisotopes, [STAT.AP]Statistics [stat]/Applications [stat.AP], DAP ratio, Dose-area product, Beam quality, Small photon beams, Air, Uncertainty, Radiotherapy Dosage, General Medicine, DOSIMETRY, simulation, 030220 oncology & carcinogenesis, Absorbed dose, DIAMOND DETECTORS, Laser beam quality, ionizing radiation, Monte Carlo Method, SYNTHETIC MICRODIAMOND DETECTORS, RADIOSURGERY, Materials science, Field (physics), Biophysics, DIAMOND, [PHYS.NEXP]Physics [physics]/Nuclear Experiment [nucl-ex], 03 medical and health sciences, SCINTILLATOR, Optics, MONTE CARLO, Dosimetry, Radiology, Nuclear Medicine and imaging, Computer Simulation, IMRT, Radiometry, DETECTOR, radiotherapy, Photons, business.industry, Water, [INFO.INFO-MO]Computer Science [cs]/Modeling and Simulation, Dose area product, MV, [SPI.OPTI]Engineering Sciences [physics]/Optics / Photonic, Particle Accelerators, business, Beam (structure), SYSTEM
Abstract

Purpose: To investigate the feasibility of using the ratio of dose-area product at 20 cm and 10 cm water depths (DAPR20,10) as a beam quality specifier for radiotherapy photon beams with field diameter below 2 cm. Methods: Dose-area product was determined as the integral of absorbed dose to water (Dw) over a surface larger than the beam size. 6 MV and 10 MV photon beams with field diameters from 0.75 cm to 2 cm were considered. Monte Carlo (MC) simulations were performed to calculate energy-dependent dosimetric parameters and to study the DAPR20,10 properties. Aspects relevant to DAPR20,10 measurement were explored using large-area plane-parallel ionization chambers with different diameters. Results: DAPR20,10 was nearly independent of field size in line with the small differences among the corresponding mean beam energies. Both MC and experimental results showed a dependence of DAPR20,10 on the measurement setup and the surface over which Dw is integrated. For a given setup, DAPR20,10 values obtained using ionization chambers with different air-cavity diameters agreed with one another within 0.4%, after the application of MC correction factors accounting for effects due to the chamber size. DAPR20,10 differences among the small field sizes were within 1% and sensitivity to the beam energy resulted similar to that of established beam quality specifiers based on the point measurement of Dw. Conclusions: For a specific measurement setup and integration area, DAPR20,10 proved suitable to specify the beam quality of small photon beams for the selection of energy-dependent dosimetric parameters. © 2017 Associazione Italiana di Fisica Medica

Published
2018

11. Neoangiogenesis-related genes are hallmarks of fast-growing hepatocellular carcinomas and worst survival. Results from a prospective study

Author

Mariagrazia Del Buono, Paola Loria, Teresa Pollicino, Stefano Colopi, Elena Bertolini, Guido Marzocchi, Stefano Ballestri, Cristian Caporali, Calogero Cammà, Barbara Lei, Aimilia Karampatou, Gianluigi Giannelli, Fabiola Milosa, Erica Villa, Giuseppe Cabibbo, Marco Enea, Elena Turola, Rosina Maria Critelli, Umberto Cillo, Giorgio Enrico Gerunda, Patrizia Pontisso, Nicola De Maria, María L. Martínez-Chantar, Paola Todesca, Luisa Losi, Livia Maccio, Filippo Schepis, Villa E., Critelli R., Lei B., Marzocchi G., Camma C., Giannelli G., Pontisso P., Cabibbo G., Enea M., Colopi S., Caporali C., Pollicino T., Milosa F., Karampatou A., Todesca P., Bertolini E., Maccio L., Martinez-Chantar M.L., Turola E., Dal Buono M., De Maria N., Ballestri S., Schepis F., Loria P., Gerunda G.E., Losi L., and Cillo U.

Subjects
Adult, Male, 0301 basic medicine, medicine.medical_specialty, Time Factors, Carcinoma, Hepatocellular, Time Factor, Microarray, Hepatocellular carcinoma, molecular carcinogenesis, Gastroenterology, liver imaging, HEPATOCELLULAR CARCINOMA, LIVER IMAGING, MOLECULAR CARCINOGENESIS, MOLECULAR ONCOLOGY, Aged, Aged, 80 and over, Disease Progression, Female, Humans, Liver Neoplasms, Middle Aged, Neovascularization, Pathologic, Prospective Studies, Survival Rate, Tumor Burden, Medicine (all), 03 medical and health sciences, molecular oncology, 0302 clinical medicine, Hepatocellular carcinoma, liver imaging, molecular carcinogenesis, molecular oncology, Internal medicine, medicine, Carcinoma, Doubling time, Prospective cohort study, Survival rate, business.industry, Proportional hazards model, medicine.disease, Prospective Studie, 030104 developmental biology, Quartile, Liver Neoplasm, 030220 oncology & carcinogenesis, business, Human
Abstract

Objective The biological heterogeneity of hepatocellular carcinoma (HCC) makes prognosis difficult. We translate the results of a genome-wide high-throughput analysis into a tool that accurately predicts at presentation tumour growth and survival of patients with HCC.Design Ultrasound surveillance identified HCC in 78 (training set) and 54 (validation set) consecutive patients with cirrhosis. Patients underwent two CT scans 6 weeks apart (no treatment in-between) to determine tumour volumes (V-0 and V-1) and calculate HCC doubling time. Baseline-paired HCC and surrounding tissue biopsies for microarray study (Agilent Whole Human Genome Oligo Microarrays) were also obtained. Predictors of survival were assessed by multivariate Cox model.Results Calculated tumour doubling times ranged from 30 to 621 days (mean, 107 +/- 91 days; median, 83 days) and were divided into quartiles: = 111 days (n= 19). Median survival according to doubling time was significantly lower for the first quartile versus the others (11 vs 41 months, 42, and 47 months, respectively) (p< 0.0001). A five-gene transcriptomic hepatic signature including angiopoietin-2 (ANGPT2), delta-like ligand 4 (DLL4), neuropilin (NRP)/tolloid (TLL)-like 2 (NETO2), endothelial cell-specific molecule-1 (ESM1), and nuclear receptor subfamily 4, group A, member 1 (NR4A1) was found to accurately identify rapidly growing HCCs of the first quartile (ROC AUC: 0.961; 95% CI 0.919 to 1.000; p< 0.0001) and to be an independent factor for mortality (HR: 3.987; 95% CI 1.941 to 8.193, p< 0.0001).Conclusions The hepatic five-gene signature was able to predict HCC growth in individual patient and the consequent risk of death. This implies a role of this molecular tool in the future therapeutic management of patients with HCC.

Published
2015

12. Under-dilated TIPS Associate With Efficacy and Reduced Encephalopathy in a Prospective, Non-randomized Study of Patients With Cirrhosis

Author

Tommaso Di Maira, Stefano Fagiuoli, Rita Golfieri, Umberto Arena, Fabio Marra, Stefano Gitto, Stefano Colopi, Alessandro Cannavale, Filippo Schepis, Pietro Torricelli, Luca S. Belli, Pietro Quaretti, Giacomo Laffi, Angelo Luca, Cristian Caporali, Roberto Agazzi, Roberto Miraglia, Federico Banchelli, Nicola De Maria, Guido Marzocchi, Ilaria Fiorina, Roberto Nani, Antonio Rampoldi, Erica Villa, Mario De Santis, Raffaele Bruno, Lorenzo Paolo Moramarco, Guadalupe Garcia-Tsao, Aldo Airoldi, Francesco Vizzutti, Fabrizio Fanelli, L. Rega, Matteo Renzulli, Cristina Mosconi, Fabrizio Di Benedetto, Schepis, F, Vizzutti, F, Garcia-Tsao, G, Marzocchi, G, Rega, L, De Maria, N, Di Maira, T, Gitto, S, Caporali, C, Colopi, S, De Santis, M, Arena, U, Rampoldi, A, Airoldi, A, Cannavale, A, Fanelli, F, Mosconi, C, Renzulli, M, Agazzi, R, Nani, R, Quaretti, P, Fiorina, I, Moramarco, L, Miraglia, R, Luca, A, Bruno, R, Fagiuoli, S, Golfieri, R, Torricelli, P, Di Benedetto, F, Belli, L, Banchelli, F, Laffi, G, Marra, F, Villa, E, Schepis, Filippo, Vizzutti, Francesco, Garcia-Tsao, Guadalupe, Marzocchi, Guido, Rega, Luigi, De Maria, Nicola, Di Maira, Tommaso, Gitto, Stefano, Caporali, Cristian, Colopi, Stefano, De Santis, Mario, Arena, Umberto, Rampoldi, Antonio, Airoldi, Aldo, Cannavale, Alessandro, Fanelli, Fabrizio, Mosconi, Cristina, Renzulli, Matteo, Agazzi, Roberto, Nani, Roberto, Quaretti, Pietro, Fiorina, Ilaria, Moramarco, Lorenzo, Miraglia, Roberto, Luca, Angelo, Bruno, Raffaele, Fagiuoli, Stefano, Golfieri, Rita, Torricelli, Pietro, Di Benedetto, Fabrizio, Belli, Luca Saverio, Banchelli, Federico, Laffi, Giacomo, Marra, Fabio, and Villa, Erica

Subjects
Male, medicine.medical_specialty, Cirrhosis, medicine.medical_treatment, Liver, liver, portal hypertensive bleeding, portal hypertensive complications, treatment, vascular disease, Hemodynamics, Inferior vena cava, 03 medical and health sciences, 0302 clinical medicine, Model for End-Stage Liver Disease, Vascular Disease, Ascites, medicine, Humans, Prospective Studies, Aged, Hepatology, Vascular disease, business.industry, Incidence, Gastroenterology, Stent, Middle Aged, medicine.disease, Fibrosis, Surgery, Treatment, Treatment Outcome, Italy, Portal Hypertensive Bleeding, medicine.vein, Hepatic Encephalopathy, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Portasystemic Shunt, Transjugular Intrahepatic, medicine.symptom, business, Transjugular intrahepatic portosystemic shunt
Abstract

Background & Aims: Portosystemic encephalopathy (PSE) is a major complication of trans-jugular intrahepatic porto-systemic shunt (TIPS) placement. Most devices are self-expandable polytetrafluoroethylene-covered stent grafts (PTFE-SGs) that are dilated to their nominal diameter (8 or 10 mm). We investigated whether PTFE-SGs dilated to a smaller caliber (under-dilated TIPS) reduce PSE yet maintain clinical and hemodynamic efficacy. We also studied whether under-dilated TIPS self-expand to nominal diameter over time. Methods: We performed a prospective, non-randomized study of 42 unselected patients with cirrhosis who received under-dilated TIPS (7 and 6 mm) and 53 patients who received PTFE-SGs of 8 mm or more (controls) at referral centers in Italy. After completion of this study, dilation to 6 mm became the standard and 47 patients were included in a validation study. All patients were followed for 6 months; Doppler ultrasonography was performed 2 weeks and 3 months after TIPS placement and every 6 months thereafter. Stability of PTFE-SG diameter was evaluated by computed tomography analysis of 226 patients with cirrhosis whose stent grafts increased to 6, 7, 8, 9, or 10 mm. The primary outcomes were incidence of at least 1 episode of PSE grade 2 or higher during follow up, incidence of recurrent variceal hemorrhage or ascites, incidence of shunt dysfunction requiring TIPS recanalization, and reduction in porto-caval pressure gradient. Results: PSE developed in a significantly lower proportion of patients with under-dilated TIPS (27%) than controls (54%) during the first year after the procedure (P =.015), but the proportions of patients with recurrent variceal hemorrhage or ascites did not differ significantly between groups. No TIPS occlusions were observed. These results were confirmed in the validation cohort. In an analysis of self-expansion of stent grafts, during a mean follow-up period of 252 days after placement, none of the PTFE-SGs self-expanded to the nominal diameter in hemodynamically relevant sites (such as portal and hepatic vein vascular walls). Conclusions: In prospective, non-randomized study of patients with cirrhosis, we found under-dilation of PTFE-SGs during TIPS placement to be feasible, associated with lower rates of PSE, and effective.

Published
2018

13. Regressing Multiple Viral Plaques and Skin Fragility Syndrome in a Cat Coinfected with FcaPV2 and FcaPV3

Author

Chiara Caporali, Laura Gallina, Alessandra Scagliarini, Francesca Abramo, Federica Savini, Gessica Tore, Alberto Alberti, Alberti A., Tore G., Scagliarini A., Gallina L., Savini F., Caporali C., and Abramo F.

Subjects
N.A, Mild Dysplasia, medicine.medical_specialty, Pathology, CATS, lcsh:Veterinary medicine, General Veterinary, integumentary system, business.industry, Spontaneous remission, medicine.disease, Koilocyte, Immunology, medicine, lcsh:SF600-1100, Histopathology, business, Skin fragility syndrome, Stomatitis, Glucocorticoid, medicine.drug
Abstract

Feline viral plaques are uncommon skin lesions clinically characterized by multiple, often pigmented, and slightly raised lesions. Numerous reports suggest thatpapillomaviruses(PVs) are involved in their development. Immunosuppressed and immunocompetent cats are both affected, the biological behavior is variable, and the regression is possible but rarely documented. Here we report a case of a FIV-positive cat with skin fragility syndrome and regressing multiple viral plaques in which the contemporary presence of two PV types (FcaPV2 and FcaPV3) was demonstrated by combining a quantitative molecular approach to histopathology. The cat, under glucocorticoid therapy for stomatitis and pruritus, developed skin fragility and numerous grouped slightly raised nonulcerated pigmented macules and plaques with histological features of epidermal thickness, mild dysplasia, and presence of koilocytes. Absolute quantification of the viral DNA copies (4555 copies/microliter of FcaPV2 and 8655 copies/microliter of FcaPV3) was obtained. Eighteen months after discontinuation of glucocorticoid therapy skin fragility and viral plaques had resolved. The role of the two viruses cannot be established and it remains undetermined how each of the viruses has contributed to the onset of VP; the spontaneous remission of skin lesions might have been induced by FIV status change over time due to glucocorticoid withdraw and by glucocorticoids withdraw itself.

Published
2015

14. Study of a CVD diamond detector for absorbed dose measurement in photon beams with small field sizes

Author

R F Laitano, Gennaro Conte, Maria Pimpinella, A.S. Guerra, C. Caporali, Dössel O., Schlegel W.C., Caporali, C., Conte, G., Guerra, A. S., Laitano, R. F., and Pimpinella, M.

Subjects
Reproducibility, Materials science, Optics, business.industry, CVD diamond detector, single crystal diamonds, radiation detector, radiotherapy, Monte Carlo simulation, Absorbed dose, Detector, Monte Carlo method, Laser beam quality, Chemical vapor deposition, business, Single crystal, Particle detector
Abstract

A new diamond detector to perform absorbed-dose- to-water measurement in radiotherapy photon beams with small field sizes is being developed in the framework of the EURAMET/EC FP7 project “External Beam Cancer Therapy”. An objective of the project is to obtain detectors capable of ensuring traceability of absorbed dose measurements in radiotherapy photon beams with field size down to 1 cm x 1 cm. To this end the CVD diamond detectors up to now developed were found not adequate. The present project requires detectors with high spatial resolution, good stability and low energy dependence. Diamond detectors were chosen for their high spatial resolution and good tissue equivalence (Z = 6). The detector studied in this work is based on a single crystal CVD diamond with dimensions 3 mm x 3 mm x 0.5 mm on which 0.2 μm electrodes were thermally evaporated. Particular care was addressed to ensure the tissue-equivalence of the detector by using appropriate materials. A thorough analysis of the priming procedure, stability and signal reproducibility was carried out in a Co-60 gamma beam at dose rates in the range from 0.3 Gy min− 1 to 1.38 Gy min− 1. Moreover the detector response was studied by Monte Carlo calculations as a function both of the beam quality, from Co-60 to 10 MV photon beams, and field size, from 10 cm x 10 cm to 1 cm x 1 cm. The perturbation due to the non-water equivalence of electrodes was also determined by Monte Carlo simulations.

Published
2009

15. Enoxaparin Prevents Portal Vein Thrombosis and Liver Decompensation in Patients With Advanced Cirrhosis

Author

Cristian Caporali, Cristina Tata, Monica Luongo, Ramona Zecchini, Aimilia Karampatou, Elena Turola, Barbara Lei, Stefano Gitto, Mariagrazia Del Buono, Beatrice Zambotto, Salvatore Petta, Ranka Vukotic, Marco Marietta, Anna Ferrari, Rosina Maria Critelli, Giovanni Fornaciari, Filippo Schepis, Stefano Colopi, Veronica Bernabucci, Calogero Cammà, Dominique Valla, Luisa Simoni, Erica Villa, Nicola De Maria, Susanna Schianchi, Villa, E, Camma', C, Marietta, M, Luongo, M, Critelli, R, Colopi, S, Tata, C, Zecchini, R, Gitto, S, Petta, S, Lei, B, Bernabucci, V, Vukotic, R, De Maria, N, Schepis, F, Karampatou, A, Caporali, C, Simoni, L, Del Buono, M, Zambotto, B, Turola, E, Fornaciari, G, Schianchi, S, Ferrari, A, and Valla, D

Subjects
medicine.medical_specialty, Cirrhosis, Intention-to-treat analysis, Hepatology, business.industry, cirrhosis, Gastroenterology, Portal vein trombosis, Enoxaparin, enoxaparin, cirrhosis, portal thrombosis, medicine.disease, Surgery, Portal vein thrombosis, law.invention, Spontaneous bacterial peritonitis, Model for End-Stage Liver Disease, Randomized controlled trial, law, Hepatocellular carcinoma, Medicine, Portal hypertension, business
Abstract

BACKGROUND & AIMS: We performed a randomized controlled trial to evaluate the safety and efficacy of enoxaparin, a low-molecular-weight heparin, in preventing portal vein thrombosis (PVT) in patients with advanced cirrhosis. METHODS: In a nonblinded, single-center study, 70 outpatients with cirrhosis (Child-Pugh classes B7-C10) with demonstrated patent portal veins and without hepatocellular carcinoma were assigned randomly to groups that were given enoxaparin (4000 IU/day, subcutaneously for 48 weeks; n = 34) or no treatment (controls, n = 36). Ultrasonography (every 3 months) and computed tomography (every 6 months) were performed to check the portal vein axis. The primary outcome was prevention of PVT. Radiologists and hepatologists that assessed outcomes were blinded to group assignments. Analysis was by intention to treat. RESULTS: At 48 weeks, none of the patients in the enoxaparin group had developed PVT, compared with 6 of 36 (16.6%) controls (P = .025). At 96 weeks, no patient developed PVT in the enoxaparin group, compared with 10 of 36 (27.7%) controls (P = .001). At the end of the follow-up period, 8.8% of patients in the enoxaparin group and 27.7% of controls developed PVT (P = .048). The actuarial probability of PVT was lower in the enoxaparin group (P = .006). Liver decompensation was less frequent among patients given enoxaparin (11.7%) than controls (59.4%) (P < .0001); overall values were 38.2% vs 83.0%, respectively (P < .0001). The actuarial probability of liver decompensation was lower in the enoxaparin group (P < .0001). Eight patients in the enoxaparin group and 13 controls died. The actuarial probability of survival was higher in the enoxaparin group (P = .020). No relevant side effects or hemorrhagic events were reported. CONCLUSIONS: In a small randomized controlled trial, a 12-month course of enoxaparin was safe and effective in preventing PVT in patients with cirrhosis and a Child-Pugh score of 7-10. Enoxaparin appeared to delay the occurrence of hepatic decompensation and to improve survival.

Published
2012

16. The Neoangiogenic Transcriptomic Signature Impacts Hepatocellular Carcinoma Prognosis and Can Be Triggered by Transarterial Chemoembolization Treatment.

Author

Critelli RM, Casari F, Borghi A, Serino G, Caporali C, Magistri P, Pecchi A, Shahini E, Milosa F, Di Marco L, Pivetti A, Lasagni S, Schepis F, De Maria N, Dituri F, Martínez-Chantar ML, Di Benedetto F, Giannelli G, and Villa E

Abstract

Background/Objectives : We evaluated the relationship between the neoangiogenic transcriptomic signature (nTS) and clinical symptoms, treatment outcomes, and survival in hepatocellular carcinoma (HCC) patients. Methods : This study prospectively followed 328 patients in the derivation and 256 in the validation cohort (with a median follow-up of 31 and 22 months, respectively). The nTS was associated with disease presentation, treatments administered, and overall survival rates. Additionally, this study investigated how multiple treatments influenced changes in nTS status and alterations in microRNA expression. Results : The nTS was identified in 27.4% of patients, linked to aggressive features like multifocality and elevated alpha-fetoprotein (AFP), a pattern consistent with that of the validation cohort. Most patients in both cohorts received treatment for HCC. nTS+ patients had limited access to, and benefited less from, liver transplantation or radiofrequency ablation (RFA) compared to nTS- patients. By the end, 78.9% had died, with nTS- patients showing better median survival and response to treatments than their nTS+ counterparts, who had lower survival across all treatment types. Among those who received transarterial chemoembolization (TACE), 31.2% (21/80 patients after the initial treatment and another four following a second TACE) transitioned from an nTS- to an nTS+ status. This shift was associated with lower survival and alterations in microRNA expressions related to oncogenic pathways. Conclusions : The nTS markedly influences treatment eligibility and survival in patients with HCC. Notably, the nTS can develop after repeated TACE procedures, significantly impacting patient survival and altering oncogenic microRNA expression patterns. These findings highlight the critical role of the nTS in guiding treatment decisions and prognostication in HCC management.

Published
2024
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17. Transjugular Intrahepatic Portosystemic Shunt: Devices Evolution, Technical Tips and Future Perspectives.

Author

Saltini D, Indulti F, Guasconi T, Bianchini M, Cuffari B, Caporali C, Casari F, Prampolini F, Senzolo M, Colecchia A, and Schepis F

Abstract

Portal hypertension (PH) constitutes a pivotal factor in the progression of cirrhosis, giving rise to severe complications and a diminished survival rate. The transjugular intrahepatic portosystemic shunt (TIPS) procedure has undergone significant evolution, with advancements in stent technology assuming a central role in managing PH-related complications. This review aims to outline the progression of TIPS and emphasizes the significant influence of stent advancement on its effectiveness. Initially, the use of bare metal stents (BMSs) was limited due to frequent dysfunction. However, the advent of expanding polytetrafluoroethylene-covered stent grafts (ePTFE-SGs) heralded a transformative era, greatly enhancing patency rates. Further innovation culminated in the creation of ePTFE-SGs with controlled expansion, enabling precise adjustment of TIPS diameters. Comparative analyses demonstrated the superiority of ePTFE-SGs over BMSs, resulting in improved patency, fewer complications, and higher survival rates. Additional technical findings highlight the importance of central stent placement and adequate stent length, as well as the use of smaller calibers to reduce the risk of shunt-related complications. However, improving TIPS through technical means alone is inadequate for optimizing patient outcomes. An extensive understanding of hemodynamic, cardiac, and systemic factors is required to predict outcomes and tailor a personalized approach. Looking forward, the ongoing progress in SG technology, paired with the control of clinical factors that can impact outcomes, holds the promise of reshaping the management of PH-related complications in cirrhosis.

Published
2023
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18. Neurodevelopmental outcome of Italian preterm ELBW infants: an eleven years single center cohort.

Author

Caporali C, Longo S, Tritto G, Perotti G, Pisoni C, Naboni C, Gardella B, Spinillo A, Manzoni F, Ghirardello S, Borgatti R, and Orcesi S

Subjects
Birth Weight, Humans, Infant, Infant, Extremely Low Birth Weight, Infant, Newborn, Infant, Premature, Language, Bronchopulmonary Dysplasia complications, Cerebral Palsy epidemiology
Abstract

Background: Preterm extremely low birth weight infants (ELBWi) are known to be at greater risk of developing neuropsychiatric diseases. Identifying early predictors of outcome is essential to refer patients for early intervention. Few studies have investigated neurodevelopmental outcomes in Italian ELBWi. This study aims to describe neurodevelopmental outcome at 24 months of corrected age in an eleven-year single-center cohort of Italian ELBWi and to identify early risk factors for adverse neurodevelopmental outcomes., Methods: All infants born with birth weight < 1000 g and admitted to the Neonatal Intensive Care Unit of the "Fondazione IRCCS Policlinico San Matteo" hospital in Pavia, Italy, from Jan 1, 2005 to Dec 31, 2015 were eligible for inclusion. At 24 months, Griffiths' Mental Developmental Scales Extended Revised (GMDS-ER) were administered. Neurodevelopmental outcome was classified as: normal, minor sequelae (minor neurological signs, General Quotient between 76 and 87), major sequelae (cerebral palsy; General Quotient ≤ 75; severe sensory impairment). Univariate and multivariate multinomial logistic regression models were performed to analyze the correlation between neonatal variables and neurodevelopmental outcome., Results: 176 ELBWi were enrolled (mean gestational age 26.52 weeks sd2.23; mean birthweight 777.45 g sd142.89). 67% showed a normal outcome at 24 months, 17% minor sequelae and 16% major sequelae (4.6% cerebral palsy on overall sample). The most frequent major sequela was cognitive impairment (8.52%). In the entire sample the median score on the Hearing-Speech subscale was lower than the median scores recorded on the other subscales and showed a significantly weaker correlation to each of the other subscales of the GMDS-ER. Severely abnormal cUS findings (RRR 10.22 p 0.043) and bronchopulmonary dysplasia (RRR 4.36 p 0.008) were independent risk factors for major sequelae and bronchopulmonary dysplasia for minor sequelae (RRR 3.00 p 0.018) on multivariate multinomial logistic regression., Conclusions: This study showed an improvement in ELBWI survival rate without neurodevelopmental impairment at 24 months compared to previously reported international cohorts. Cognitive impairment was the most frequent major sequela. Median scores on GMDS-ER showed a peculiar developmental profile characterized by a selective deficit in the language domain. Severely abnormal cUS findings and bronchopulmonary dysplasia were confirmed as independent risk factors for major sequelae., (© 2022. The Author(s).)

Published
2022
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19. Neurodevelopmental outcome of preterm very low birth weight infants admitted to an Italian tertiary center over an 11-year period.

Author

Longo S, Caporali C, Pisoni C, Borghesi A, Perotti G, Tritto G, Olivieri I, La Piana R, Tonduti D, Decio A, Ariaudo G, Spairani S, Naboni C, Gardella B, Spinillo A, Manzoni F, Tinelli C, Stronati M, and Orcesi S

Subjects
Adult, Cerebral Palsy physiopathology, Cohort Studies, Female, Gestational Age, Humans, Infant, Premature physiology, Italy, Longitudinal Studies, Male, Neurologic Examination methods, Tertiary Care Centers, Developmental Disabilities physiopathology, Infant, Very Low Birth Weight physiology, Neurodevelopmental Disorders physiopathology
Abstract

Preterm very low birth weight infants (VLBWi) are known to be at greater risk of adverse neurodevelopmental outcome. Identifying early factors associated with outcome is essential in order to refer patients for early intervention. Few studies have investigated neurodevelopmental outcome in Italian VLBWi. The aim of our longitudinal study is to describe neurodevelopmental outcome at 24 months of corrected age in an eleven-year cohort of 502 Italian preterm VLBWi and to identify associations with outcome. At 24 months, Griffiths' Mental Developmental Scales were administered. Neurodevelopmental outcome was classified as: normal, minor sequelae (minor neurological signs, General Quotient between 76 and 87), major sequelae (cerebral palsy; General Quotient ≤ 75; severe sensory impairment). 75.3% showed a normal outcome, 13.9% minor sequelae and 10.8% major sequelae (3.8% cerebral palsy). Male gender, bronchopulmonary dysplasia, abnormal neonatal neurological assessment and severe brain ultrasound abnormalities were independently associated with poor outcome on multivariate ordered logistic regression. Rates of major sequelae are in line with international studies, as is the prevalence of developmental delay over cerebral palsy. Analysis of perinatal complications and the combination of close cUS monitoring and neurological assessment are still essential for early identification of infants with adverse outcome., (© 2021. The Author(s).)

Published
2021
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20. Relevance of Spontaneous Portosystemic Shunts Detected with CT in Patients with Cirrhosis.

Author

Nardelli S, Riggio O, Turco L, Gioia S, Puzzono M, Bianchini M, Ridola L, Aprile F, Gitto S, Pelle G, Di Martino M, Marzocchi G, Caporali C, Spagnoli A, Di Rocco A, and Schepis F

Subjects
Female, Humans, Italy, Male, Middle Aged, Retrospective Studies, Venous Thrombosis complications, Hypertension, Portal etiology, Hypertension, Portal therapy, Liver Cirrhosis complications, Portasystemic Shunt, Surgical adverse effects, Tomography, X-Ray Computed
Abstract

Background Cirrhosis leads to portal hypertension and to the consequent formation of spontaneous portosystemic shunts (SPSSs), leading to complications related to the diversion of portal blood into the systemic circulation, which is called portosystemic shunt syndrome. Purpose To investigate the characteristics of patients with cirrhosis and an SPSS and secondarily to assess the prognostic impact of SPSSs on portal hypertension-related complications and transplant-free survival. Materials and Methods A retrospective database review of patients with cirrhosis (observed from March 2015 to July 2019) was performed to identify patients with CT imaging and outcomes data. For each patient, clinical and biochemical data were collected, and the presence, types, and sizes of SPSSs were investigated with CT. Patients were followed for a mean of 27.5 months ± 22.8. Multivariable logistic analysis was used to identify the clinical characteristics associated with the presence of SPSSs (any size) and presence of SPSSs 1 cm or larger. Competitive risk analysis (Fine and Gray model) was used to identify the association between SPSSs and complications and mortality. Results Two hundred twenty-two patients with cirrhosis (157 male, 65 female; mean age, 62 years ± 12 [standard deviation]) were evaluated. An SPSS was found in 141 of 222 patients (63.5%), and 40 of 222 (18%) had a shunt diameter of at least 1 cm. At presentation, variables independently associated with the presence of SPSSs (any size) were portal vein thrombosis (odds ratio, 5.5; P = .008) and Child-Pugh class C (odds ratio, 3.0; P = .03). Previous hepatic encephalopathy (odds ratio, 4.4; P = .001) and portal vein thrombosis (odds ratio, 5.3; P = .001) were the only variables associated with SPSSs larger than 1 cm. Patients with SPSSs of any size had higher mortality (subdistribution hazard ratio, 1.9; P < .001) and higher frequency of hepatic encephalopathy (subdistribution hazard ratio, 2.3; P = .023), gastrointestinal bleeding (subdistribution hazard ratio, 2.9; P = .039), and portal vein thrombosis (subdistribution hazard ratio, 7.6; P = .005). Conclusion The presence of spontaneous portosystemic shunts on CT images in patients with cirrhosis was associated with higher mortality and complications, including portal vein thrombosis, hepatic encephalopathy, and gastrointestinal bleeding. © RSNA, 2021 See also the editorial by Reeder in this issue.

Published
2021
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21. Oral melatonin as a new tool for neuroprotection in preterm newborns: study protocol for a randomized controlled trial.

Author

Garofoli F, Longo S, Pisoni C, Accorsi P, Angelini M, Aversa S, Caporali C, Cociglio S, De Silvestri A, Fazzi E, Rizzo V, Tzialla C, Zecca M, and Orcesi S

Subjects
Female, Humans, Infant, Infant, Newborn, Infant, Premature, Multicenter Studies as Topic, Neuroprotection, Pregnancy, Prospective Studies, Randomized Controlled Trials as Topic, Melatonin adverse effects, Premature Birth
Abstract

Background: Prevention of neurodevelopmental impairment due to preterm birth is a major health challenge. Despite advanced obstetric and neonatal care, to date there are few neuroprotective molecules available. Melatonin has been shown to have anti-oxidant/anti-inflammatory effects and to reduce brain damage, mainly after hypoxic ischemic encephalopathy. The planned study will be the first aiming to evaluate the capacity of melatonin to mitigate brain impairment due to premature birth., Method: In our planned prospective, multicenter, double-blind, randomized vs placebo study, we will recruit, within 96 h of birth, 60 preterm newborns with a gestational age ≤ 29 weeks + 6 days; these infants will be randomly allocated to oral melatonin, 3 mg/kg/day, or placebo for 15 days. After the administration period, we will measure plasma levels of malondialdehyde, a lipid peroxidation product considered an early biological marker of melatonin treatment efficacy (primary outcome). At term-equivalent age, we will evaluate neurological status (through cerebral ultrasound, cerebral magnetic resonance imaging, vision and hearing evaluations, clinical neurological assessment, and screening for retinopathy of prematurity) as well as the incidence of bronchodysplasia and sepsis. We will also monitor neurodevelopmental outcome during the first 24 months of corrected age (using the modified Fagan Test of Infant Intelligence at 4-6 months and standardized neurological and developmental assessments at 24 months)., Discussion: Preterm birth survivors often present long-term neurodevelopmental sequelae, such as motor, learning, social-behavioral, and communication problems. We aim to assess the role of melatonin as a neuroprotectant during the first weeks of extrauterine life, when preterm infants are unable to produce it spontaneously. This approach is based on the supposition that its anti-oxidant mechanism could be useful in preventing neurodevelopmental impairment. Considering the short- and long-term morbidities related to preterm birth, and the financial and social costs of the care of preterm infants, both at birth and over time, we suggest that melatonin administration could lead to considerable saving of resources. This would be the first study addressing the role of melatonin in very low birth weight preterm newborns, and it could provide a basis for further studies on melatonin as a neuroprotection strategy in this vulnerable population., Trial Registration: ClinicalTrials.gov NCT04235673 . Prospectively registered on 22 January 2020.

Published
2021
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22. New insights into the phenotypic spectrum of 14q22q23 deletions: a case report and literature review.

Author

Pichiecchio A, Vitale G, Caporali C, Parazzini C, Milani D, Recalcati MP, D'Amico L, Signorini S, Balottin U, and Bastianello S

Subjects
Anophthalmos genetics, Blepharophimosis diagnosis, Blepharophimosis genetics, Brain diagnostic imaging, Echocardiography, Gene Deletion, Humans, Infant, Intellectual Disability diagnosis, Intellectual Disability genetics, Magnetic Resonance Imaging, Male, Microphthalmos genetics, Otx Transcription Factors genetics, Phenotype, Anophthalmos diagnosis, Chromosomes, Human, Pair 14, Microphthalmos diagnosis
Abstract

Background: Mutations occurring in the orthodenticle homeobox 2 gene (OTX2) are responsible for a rare genetic syndrome, characterized mainly by microphthalmia/anophthalmia associated with extra-ocular defects such as brain malformations, pituitary abnormalities, short stature and intellectual disability. To date, the spectrum of radiological features observed in patients with OTX2 mutations has never been summarized., Case Presentation: In this report, we describe a case of large microdeletion encompassing OTX2 but not BMP4 presenting with a syndromic anophthalmia with corpus callosum hypoplasia, pituitary gland hypoplasia and vermian hypoplasia., Conclusion: Our case report provides an illustration of the neuroradiological spectrum in a case of OTX2-related syndrome and the first radiological evidence of 14q22.2q23.1 deletion associated posterior cranial fossa anomalies.

Published
2018
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23. Under-dilated TIPS Associate With Efficacy and Reduced Encephalopathy in a Prospective, Non-randomized Study of Patients With Cirrhosis.

Author

Schepis F, Vizzutti F, Garcia-Tsao G, Marzocchi G, Rega L, De Maria N, Di Maira T, Gitto S, Caporali C, Colopi S, De Santis M, Arena U, Rampoldi A, Airoldi A, Cannavale A, Fanelli F, Mosconi C, Renzulli M, Agazzi R, Nani R, Quaretti P, Fiorina I, Moramarco L, Miraglia R, Luca A, Bruno R, Fagiuoli S, Golfieri R, Torricelli P, Di Benedetto F, Belli LS, Banchelli F, Laffi G, Marra F, and Villa E

Subjects
Aged, Fibrosis surgery, Humans, Incidence, Italy epidemiology, Male, Middle Aged, Prospective Studies, Treatment Outcome, Fibrosis complications, Hepatic Encephalopathy epidemiology, Hepatic Encephalopathy prevention & control, Portasystemic Shunt, Transjugular Intrahepatic adverse effects, Portasystemic Shunt, Transjugular Intrahepatic methods
Abstract

Background & Aims: Portosystemic encephalopathy (PSE) is a major complication of trans-jugular intrahepatic porto-systemic shunt (TIPS) placement. Most devices are self-expandable polytetrafluoroethylene-covered stent grafts (PTFE-SGs) that are dilated to their nominal diameter (8 or 10 mm). We investigated whether PTFE-SGs dilated to a smaller caliber (under-dilated TIPS) reduce PSE yet maintain clinical and hemodynamic efficacy. We also studied whether under-dilated TIPS self-expand to nominal diameter over time., Methods: We performed a prospective, non-randomized study of 42 unselected patients with cirrhosis who received under-dilated TIPS (7 and 6 mm) and 53 patients who received PTFE-SGs of 8 mm or more (controls) at referral centers in Italy. After completion of this study, dilation to 6 mm became the standard and 47 patients were included in a validation study. All patients were followed for 6 months; Doppler ultrasonography was performed 2 weeks and 3 months after TIPS placement and every 6 months thereafter. Stability of PTFE-SG diameter was evaluated by computed tomography analysis of 226 patients with cirrhosis whose stent grafts increased to 6, 7, 8, 9, or 10 mm. The primary outcomes were incidence of at least 1 episode of PSE grade 2 or higher during follow up, incidence of recurrent variceal hemorrhage or ascites, incidence of shunt dysfunction requiring TIPS recanalization, and reduction in porto-caval pressure gradient., Results: PSE developed in a significantly lower proportion of patients with under-dilated TIPS (27%) than controls (54%) during the first year after the procedure (P = .015), but the proportions of patients with recurrent variceal hemorrhage or ascites did not differ significantly between groups. No TIPS occlusions were observed. These results were confirmed in the validation cohort. In an analysis of self-expansion of stent grafts, during a mean follow-up period of 252 days after placement, none of the PTFE-SGs self-expanded to the nominal diameter in hemodynamically relevant sites (such as portal and hepatic vein vascular walls)., Conclusions: In prospective, non-randomized study of patients with cirrhosis, we found under-dilation of PTFE-SGs during TIPS placement to be feasible, associated with lower rates of PSE, and effective., (Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Published
2018
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24. Pathology in Practice.

Author

Caporali C, Albanese F, Vicari N, Dawidowicz J, Mancianti F, and Abramo F

Subjects
Animals, Cat Diseases pathology, Cats, Diagnosis, Differential, Male, Toxoplasmosis, Animal pathology, Cat Diseases diagnosis, Toxoplasmosis, Animal diagnosis
Published
2018
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25. Microenvironment inflammatory infiltrate drives growth speed and outcome of hepatocellular carcinoma: a prospective clinical study.

Author

Critelli R, Milosa F, Faillaci F, Condello R, Turola E, Marzi L, Lei B, Dituri F, Andreani S, Sighinolfi P, Manni P, Maiorana A, Caporali C, di Benedetto F, Del Buono M, De Maria N, Schepis F, Martinez-Chantar ML, Giannelli G, and Villa E

Subjects
Carcinoma, Hepatocellular mortality, Carcinoma, Hepatocellular pathology, Cell Line, Tumor, Female, Humans, Liver Neoplasms mortality, Liver Neoplasms pathology, Male, Prospective Studies, Signal Transduction, Survival Analysis, Tumor Microenvironment, Carcinoma, Hepatocellular genetics, Liver Neoplasms genetics
Abstract

In HCC, tumor microenvironment, heavily influenced by the underlying chronic liver disease, etiology and stage of the tissue damage, affects tumor progression and determines the high heterogeneity of the tumor. Aim of this study was to identify the circulating and tissue components of the microenvironment immune-mediated response affecting the aggressiveness and the ensuing clinical outcome. We analyzed the baseline paired HCC and the surrounding tissue biopsies from a prospective cohort of 132 patients at the first diagnosis of HCC for immunolocalization of PD-1/PD-L1, FoxP3, E-cadherin, CLEC2 and for a panel of 82 microRNA associated with regulation of angiogenesis, cell proliferation, cell signaling, immune control and autophagy. Original microarray data were also explored. Serum samples were analyzed for a panel of 19 cytokines. Data were associated with biochemical data, histopathology and survival. Patients with a more aggressive disease and shorter survival, who we named fast-growing accordingly to the tumor doubling time, at presentation had significantly higher AFP levels, TGF-β1 and Cyphra 21-1 levels. Transcriptomic analysis evidenced a significant downregulation of CLEC2 and upregulation of several metalloproteinases. A marked local upregulation of both PD-1 and PD-L1, a concomitant FoxP3-positive lymphocytic infiltrate, a loss of E-cadherin, gain of epithelial-mesenchymal transition (EMT) phenotype and extreme poor differentiation at histology were also present. Upregulated microRNA in fast-growing HCCs are associated with TGF-β signaling, angiogenesis and inflammation. Our data show that fast HCCs are characterized not only by redundant neo-angiogenesis but also by unique features of distinctively immunosuppressed microenvironment, prominent EMT, and clear-cut activation of TGFβ1 signaling in a general background of long-standing and permanent inflammatory state.

Published
2017
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26. Enoxaparin prevents portal vein thrombosis and liver decompensation in patients with advanced cirrhosis.

Author

Villa E, Cammà C, Marietta M, Luongo M, Critelli R, Colopi S, Tata C, Zecchini R, Gitto S, Petta S, Lei B, Bernabucci V, Vukotic R, De Maria N, Schepis F, Karampatou A, Caporali C, Simoni L, Del Buono M, Zambotto B, Turola E, Fornaciari G, Schianchi S, Ferrari A, and Valla D

Subjects
Anticoagulants adverse effects, Bacterial Infections blood, Bacterial Translocation, Biomarkers blood, Enoxaparin adverse effects, Fatty Acid-Binding Proteins blood, Female, Humans, Interleukin-6 blood, Kaplan-Meier Estimate, Lipopolysaccharide Receptors blood, Liver Failure etiology, Male, Middle Aged, Proportional Hazards Models, Statistics, Nonparametric, Thrombosis complications, Anticoagulants therapeutic use, DNA, Bacterial blood, Enoxaparin therapeutic use, Liver Cirrhosis complications, Liver Failure prevention & control, Renal Veins, Thrombosis prevention & control
Abstract

Background & Aims: We performed a randomized controlled trial to evaluate the safety and efficacy of enoxaparin, a low-molecular-weight heparin, in preventing portal vein thrombosis (PVT) in patients with advanced cirrhosis., Methods: In a nonblinded, single-center study, 70 outpatients with cirrhosis (Child-Pugh classes B7-C10) with demonstrated patent portal veins and without hepatocellular carcinoma were assigned randomly to groups that were given enoxaparin (4000 IU/day, subcutaneously for 48 weeks; n = 34) or no treatment (controls, n = 36). Ultrasonography (every 3 months) and computed tomography (every 6 months) were performed to check the portal vein axis. The primary outcome was prevention of PVT. Radiologists and hepatologists that assessed outcomes were blinded to group assignments. Analysis was by intention to treat., Results: At 48 weeks, none of the patients in the enoxaparin group had developed PVT, compared with 6 of 36 (16.6%) controls (P = .025). At 96 weeks, no patient developed PVT in the enoxaparin group, compared with 10 of 36 (27.7%) controls (P = .001). At the end of the follow-up period, 8.8% of patients in the enoxaparin group and 27.7% of controls developed PVT (P = .048). The actuarial probability of PVT was lower in the enoxaparin group (P = .006). Liver decompensation was less frequent among patients given enoxaparin (11.7%) than controls (59.4%) (P < .0001); overall values were 38.2% vs 83.0%, respectively (P < .0001). The actuarial probability of liver decompensation was lower in the enoxaparin group (P < .0001). Eight patients in the enoxaparin group and 13 controls died. The actuarial probability of survival was higher in the enoxaparin group (P = .020). No relevant side effects or hemorrhagic events were reported., Conclusions: In a small randomized controlled trial, a 12-month course of enoxaparin was safe and effective in preventing PVT in patients with cirrhosis and a Child-Pugh score of 7-10. Enoxaparin appeared to delay the occurrence of hepatic decompensation and to improve survival., (Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Published
2012
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