108 results on '"Noviello, Carmine"'
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2. Unusual position of pilonidal sinus in children may explain its malformative etiology: Case report and review of the literature
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Noviello, Carmine, primary, Romano, Mercedes, additional, Marzuillo, Pierluigi, additional, Ronchi, Andrea, additional, and Papparella, Alfonso, additional
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- 2024
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3. Transanal protrusion of intussusception can be sign of Waugh syndrome
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Noviello Carmine, Cascone Salvatore, Romano Mercedes, Nobile Stefano, and Papparella Alfonso
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Intussusception ,Waugh syndrome ,Anal prolapse ,Pediatrics ,RJ1-570 ,Surgery ,RD1-811 - Abstract
Intussusception rarely occurs with transanal prolapse of intussusception (TAPI), this presentation may be a sign of Waugh's syndrome (WS), an association between intestinal malrotation and intussusception. The authors present the case of infant with an episode of TAPI, resolved with air enema, who required later diagnostic tests that showed the presence of WS, for which surgery was required after the resolution of the intussusception. At now we found only 72 cases reported of WS and some of them clinically presented with TAPI. In our opinion, patients with this type of presentation require a thorough radiological study of the intestine to rule out intestinal malrotations.
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- 2022
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4. Functional constipation or redundancy of the colon?
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Noviello, Carmine, Nobile, Stefano, Romano, Mercedes, Mazzarini, Alessandra, Papparella, Alfonso, and Cobellis, Giovanni
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- 2020
- Full Text
- View/download PDF
5. Are the complications after laparo-assisted endo-rectal pull-through for Hirschsprung disease related to the change of the anal tone?
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Noviello, Carmine, Romano, Mercedes, Trotta, Letizia, Umano, Giuseppina Rosaria, and Papparella, Alfonso
- Abstract
The main advantage of the laparo-assisted transanal endorectal pull-through technique (LA - TERPT) for Hirschsprung Disease (HD) is the respect to the rectal-anal anatomy. Postoperative complications have been observed recently. The present study aims to determine how often these postoperative complications occur in these patients. From January 2009 to December 2018, a retrospective analysis was conducted on 36 children (25 males) with HD who underwent LA-TERPT. Data were collected on the age of diagnosis and surgery, sex, the presence of other pathologies, and cases of enterocolitis. In all cases, anorectal manometry (ARM) was performed to evaluate the anal tone. The median age at diagnosis was 2 months and the mean age at surgery was 5 months. Nine related pathologies were identified: five cases of Down syndrome, one case of hypertrophic stenosis of the pylorus, atresia of the esophagus, polydactyly, and anorectal malformation. A patient with total colonic aganglionosis was identified through laparoscopic serum-muscular biopsies. Enterocolitis was diagnosed in 7 cases before and 6 after surgery. At follow-up, the complications recorded were: 5 cases of constipation (treated with fecal softeners), one case of anal stenosis (patient with anorectal malformation), 16 cases of soiling (treated with enemas) and 1 child with fecal incontinence (treated with a transanal irrigation system). The ARM was performed in all 36 cases and showed normal anal tone, except for one case with anal hypotonia. LA-TERPT is an important surgical technique for HD. According to the literature, soiling is the most main complication after HD surgery, probably due to "pseudo-incontinence" with normal anal sphincter tone. [ABSTRACT FROM AUTHOR]
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- 2024
- Full Text
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6. Retroperitoneoscopic Varicocelectomy in Adolescents: Long-term Follow-up in Two Italian Centres
- Author
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Molinaro Francesco, Cobellis Giovanni, Cerchia Elisa, Ferrara Francesco, Tallarico Rosella, Sica Marina, Noviello Carmine, Martino Ascanio, Angotti Rossella, and Messina Mario
- Subjects
Adolescents ,infertility ,retroperitoneoscopy ,varicocele ,Pediatrics ,RJ1-570 ,Surgery ,RD1-811 - Abstract
Background: The varicocele is the most commonly diagnosed pre-pubertal andrological condition with an incidence of 10%–15% between adolescents. The aim of this study was to evaluate the efficacy of retroperitoneoscopic varicocelectomy (RV) in two Italian centres with particular attention to post-operative testicular volume and semen analysis after 18 years of life. Materials and Methods: From 1999 to 2010, 286 adolescents underwent retroperitoneoscopic left varicocelectomy. Of these patients, 67 were evaluated by clinical examination, ultrasound and semen analysis, allowing an adequate long-term follow-up. Results: Surgery was performed at a mean age of 13 years (range 10–17) without intraoperative complications. There were two recurrences (3%), two left testis hypotrophy (3%) and four hydroceles (6%), not yet undergone surgery because asymptomatic or without tension. Currently, 44 patients accepted to perform semen analysis which showed a reduction in sperm motility in 12 cases, with associated morphological alterations in 3 and reducing number of spermatozoa in one case. Conclusions: In consideration of morphological and biomolecular spermatic alterations reported in adolescent varicocele that could interfere with cellular migration, differentiation and nutrition, it is fundamental to consider the correction of varicocele, not only for the classical indications, but also as a choice for arresting the progressive damage that inevitably acts for several years on the adolescent testis. The RV in adolescents is a safe and feasible procedure for experienced paediatric laparoscopic surgeons with early good clinical outcomes, but more studies occur to understand the real impact of adolescent varicocelectomy on testicular function.
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- 2017
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- View/download PDF
7. Author’s reply to comment on article: Redundant colon and refractory constipation in children
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Noviello, Carmine, Nobile, Stefano, Romano, Mercedes, Cobellis, Giovanni, and Papparella, Alfonso
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- 2020
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8. Treatment of post-traumatic parotid gland fistula in children
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Noviello, Carmine, primary, Romano, Mercedes, additional, Delehaye, Giulia, additional, and Papparella, Alfonso, additional
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- 2022
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9. In Which Patients and Why Is Laparoscopy Helpful for the Impalpable Testis?
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Papparella, Alfonso, primary, Umano, Giuseppina Rosaria, additional, Romano, Mercedes, additional, Delehaye, Giulia, additional, Cascone, Salvatore, additional, Trotta, Letizia, additional, and Noviello, Carmine, additional
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- 2022
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10. Can Infant Dyschezia Be a Suspect of Rectosigmoid Redundancy?
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Noviello, Carmine, primary, Nobile, Stefano, additional, Romano, Mercedes, additional, Trotta, Letizia, additional, and Papparella, Alfonso, additional
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- 2022
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11. Can Infant Dyschezia Be a Suspect of Rectosigmoid Redundancy?
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Noviello, Carmine, Nobile, Stefano, Romano, Mercede,  , Trotta, Letizia, Papparella, Alfonso, Stefano Nobile (ORCID:0000-0002-5304-1485), Noviello, Carmine, Nobile, Stefano, Romano, Mercede,  , Trotta, Letizia, Papparella, Alfonso, and Stefano Nobile (ORCID:0000-0002-5304-1485)
- Abstract
nfant dyschezia is a functional gastrointestinal disorder that occurs in children less than nine months of age. This disorder causes much anxiety among parents who consult different physicians when suspecting major intestinal problems. The aim of this study is to verify whether infant dyschezia involves an anatomic abnormality (redundancy) of the colon. In this retrospective study (48 months) we analyzed all the children younger than 9 months who came to our attention through the suspicion of gastrointestinal abnormality (Hirschsprung's disease, anorectal malformations, colonic disorders or constipation). They all had a complete medical history, clinical examination and diagnostic tests, such as blood samples, suction rectal biopsy, a study of stool characteristics and, finally, a contrast enema. In cases with infant dyschezia, different colonic sizes and rectosigmoid length were measured, which created a ratio with the diameter of the second lumbar vertebra. These values were compared with those reported in the literature as normal for the age of one year. Of the 24 patients evaluated (mean age 4 months), 9 were excluded for different diagnoses (aganglionic megacolon, hypothyroidism, constipation). The comparison of the ratios obtained in the remaining 15 cases showed a significantly higher rectosigmoid length (redundancy) in children with dyschezia, 18.47 vs. 9.75 (p < 0.001). The rectosigmoid redundancy, a congenital anomaly already reported as a cause of refractory constipation, may be present in children with infant dyschezia.
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- 2022
12. Esophageal impedance baseline in infants with bronchopulmonary dysplasia: A pilot study
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Nobile, Stefano,  , Marchionni, Paolo, Meneghin, Fabio, Salvatore, Silvia, Noviello, Carmine, Margiotta, Gaia, Giorgio, Valentina, Vento, Giovanni, Stefano Nobile (ORCID:0000-0002-5304-1485), Gaia Margiotta, Valentina Giorgio, Giovanni Vento (ORCID:0000-0002-8132-5127), Nobile, Stefano,  , Marchionni, Paolo, Meneghin, Fabio, Salvatore, Silvia, Noviello, Carmine, Margiotta, Gaia, Giorgio, Valentina, Vento, Giovanni, Stefano Nobile (ORCID:0000-0002-5304-1485), Gaia Margiotta, Valentina Giorgio, and Giovanni Vento (ORCID:0000-0002-8132-5127)
- Abstract
Background: Bronchopulmonary dysplasia (BPD) may induce gastroesophageal reflux (GER). Esophageal impedance baseline values (BI) reflect mucosal inflammation. Our aim was to evaluate BI levels in preterm infants with BPD compared with those without BPD and to identify BI predictors. Methods: This is a retrospective pilot study including infants born <32 weeks' gestational age (GA) who underwent esophageal multichannel intraluminal impedance (MII)-pH. Univariate/multivariate analysis were performed to compare data between BPD and non-BPD infants and to identify BI predictors. A subgroup analysis was performed in infants born <29 weeks' GA, at highest risk for BPD. Results: Ninety-seven patients (median GA 285/7 weeks, mean postnatal age 49 days, 29 with BPD), were studied. BPD infants had significantly lower birth weight compared with non-BPD infants (750 vs. 1275 g), were more immature (274/7 vs. 290/7 weeks GA), were older at MII-pH (79 vs. 38 days) and received less fluids during MII-pH (147 vs. 161 ml/kg/day). The same findings were found in the group of 53 infants born <29 weeks. BPD versus non-BPD infants had significantly lower BI (2050 vs. 2574 ohm, p = 0.007) (<1000 ohm in five BPD infants vs. one non-BPD) whereas the other MII-pH parameters were not significantly different. Multiple regression analysis found that increasing chronological age was positively associated with BI (B = 9.3, p = 0.013) whereas BPD was associated with lower BI (B = −793.4, p < 0.001). Conclusions: BPD versus non-BPD infants had significantly lower BI despite similar MII-pH data. BPD and chronological age predicted BI, whereas only BPD predicted BI in the most immature infants.
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- 2022
13. Thoracoscopic excision of pediatric thymic cysts
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Nino, Fabiano, Fusi, Giulia, Bindi, Edoardo, Ilari, Michele, Noviello, Carmine, Torino, Giovanni, and Cobellis, Giovanni
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- 2021
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14. A Simple Technique for Investigating Stromatal Formation in the Sclerotiniaceae
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Noviello, Carmine and Korf, Richard P.
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- 1961
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15. What Is the Correct Way to Manage Children Requiring Gastrostomy? Single Center Experience
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Noviello, Carmine, primary, Romano, Mercedes, additional, Bindi, Edoardo, additional, Cobellis, Giovanni, additional, Nobile, Stefano, additional, and Papparella, Alfonso, additional
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- 2021
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16. Thoracoscopic excision of asymptomatic antenatally diagnosed mediastinal bronchogenic cysts: A case report
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Cerchia, Elisa, primary, Noviello, Carmine, additional, Torino, Giovanni, additional, Bindi, Edoardo, additional, Mariscoli, Francesca, additional, and Cobellis, Giovanni, additional
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- 2021
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17. The “Dark Side” of Pneumoperitoneum and Laparoscopy
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Umano, Giuseppina Rosaria, primary, Delehaye, Giulia, additional, Noviello, Carmine, additional, and Papparella, Alfonso, additional
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- 2021
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18. New Surgical Frontiers for Nutrition in Children
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Noviello, Carmine, primary
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- 2021
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19. What Is the Correct Way to Manage Children Requiring Gastrostomy? Single Center Experience
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Noviello, Carmine, Romano, Mercede, Bindi, Edoardo, Cobellis, Giovanni, Nobile, Stefano, Papparella, Alfonso, Stefano Nobile (ORCID:0000-0002-5304-1485), Noviello, Carmine, Romano, Mercede, Bindi, Edoardo, Cobellis, Giovanni, Nobile, Stefano, Papparella, Alfonso, and Stefano Nobile (ORCID:0000-0002-5304-1485)
- Abstract
Children with complex medical issues often present different comorbidities that cause feeding difficulties. Gastrostomy is often helpful, and should be performed when nutritional supplementation is necessary for longer than 6 weeks. Recently, different techniques have been used for gastrostomy in children. The authors report on their experiences regarding the diagnostic and therapeutic management of children requiring gastrostomy. All patients managed in the last 10 years were reviewed, retrospectively. Everyone underwent investigation to exclude gastroesophageal reflux disease (GERD). A total of 148 patients: 111 cases (75%) were neurologically impaired patients, 18 (12%) had complex heart disease, 10 (6%) had metabolic diseases, 4 (3%) had fibrosis cystic, 4 (3%) had muscle disease, and one had chromosomopathy. After investigation, 49 patients had GERD. PEG was performed in 101 cases (68%), laparo-assisted gastrostomy was performed in 44 cases (29.7%), open gastrostomy was performed in three cases. At follow-up, all patients reported weight gain, but 13 cases had major complications. Currently, the surgeon has the possibility of choosing between several safe techniques for gastrostomy. In our experience, PEG is the most useful technique for patients without GERD, while a laparo-assisted technique is better for patients who require laparoscopic fundoplication.
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- 2021
20. COVID-19 Can Cause Severe Intussusception in Infants: Case Report and Literature Review
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Noviello, Carmine, Bollettini, Taisia, Mercedes, Romano, Papparella, Alfonso, Nobile, Stefano, Cobellis, Giovanni, Stefano Nobile (ORCID:0000-0002-5304-1485), Noviello, Carmine, Bollettini, Taisia, Mercedes, Romano, Papparella, Alfonso, Nobile, Stefano, Cobellis, Giovanni, and Stefano Nobile (ORCID:0000-0002-5304-1485)
- Abstract
COVID-19 may cause intussusception in infants. We report on a case of severe ileo-colic intussusception in an infant with COVID-19 who required an ileo-colic resection. A literature review revealed 9 other cases with COVID-19 and intussusception. In this article, we will discuss the management and treatment of the first reported case of intussusception associated with COVID-19 in Italy.
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- 2021
21. Laparoscopic Fowler-Stephens orchidopexy for intra-abdominal cryptorchid testis: a single institution experience
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Papparella, Alfonso, primary, De Rosa, Laura, additional, and Noviello, Carmine, additional
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- 2021
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22. Pneumoperitoneum Modifies Serum and Tissue CCL2-CCL5 Expression in Mice
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Papparella, Alfonso, primary, Noviello, Carmine, additional, Ranucci, Sara, additional, Paciello, Orlando, additional, Papparella, Serenella, additional, De Biase, Davide, additional, Cirillo, Grazia, additional, and Umano, Giuseppina Rosaria, additional
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- 2020
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23. How replace the gastrostomy tube in children with extremely compromised general conditions
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Noviello, Carmine, primary, Romano, Marcedes, additional, Rossi, Lorenzo, additional, Cobellis, Giovanni, additional, and Martino, Ascanio, additional
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- 2019
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24. The isolated tubal torsion: an insidious pediatric and adolescent pelvic urgency
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Noviello, Carmine, primary, Romano, Mercedes, additional, Papparella, Alfonso, additional, Ciavattini, Andrea, additional, Martino, Ascanio, additional, and Cobellis, Giovanni, additional
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- 2018
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25. Delayed diagnosis of hirschsprungs disease after esophageal atresia repair
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Noviello, Carmine, R Romano, Mario, Nino, Fabiano, Rossi, M., Nobile, Stefano, Mariscoli, Francesca, Martino, Ascanio, Cobellis, G., Stefano Nobile (ORCID:0000-0002-5304-1485), Noviello, Carmine, R Romano, Mario, Nino, Fabiano, Rossi, M., Nobile, Stefano, Mariscoli, Francesca, Martino, Ascanio, Cobellis, G., and Stefano Nobile (ORCID:0000-0002-5304-1485)
- Abstract
N/A
- Published
- 2018
26. Retroperitoneoscopic Varicocelectomy in Adolescents: Long-term Follow-up in Two Italian Centres
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Messina Mario, Noviello Carmine, Ferrara Francesco, Martino Ascanio, Sica Marina, Cobellis Giovanni, Molinaro Francesco, Tallarico Rosella, Cerchia Elisa, Angotti Rossella, Francesco, M., Giovanni, C., Elisa, C., Francesco, F., Rosella, T., Marina, S., Noviello, C., Ascanio, M., Angotti, R., and Mario, M.
- Subjects
Infertility ,varicocele ,Male ,medicine.medical_specialty ,Adolescent ,Varicocele ,lcsh:Surgery ,Physical examination ,Semen analysis ,Adolescents ,Asymptomatic ,Pediatrics ,Spermatic cord ,Follow-Up Studie ,retroperitoneoscopy ,medicine ,Humans ,Semen Analysi ,Laparoscopy ,Child ,Spermatic Cord ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,lcsh:RJ1-570 ,lcsh:Pediatrics ,lcsh:RD1-811 ,Perinatology and Child Health ,medicine.disease ,Spermatozoa ,Surgery ,Semen Analysis ,medicine.anatomical_structure ,Italy ,infertility ,Follow-Up Studies ,Pediatrics, Perinatology and Child Health ,Original Article ,medicine.symptom ,business ,Human - Abstract
Background: The varicocele is the most commonly diagnosed pre-pubertal andrological condition with an incidence of 10%–15% between adolescents. The aim of this study was to evaluate the efficacy of retroperitoneoscopic varicocelectomy (RV) in two Italian centres with particular attention to post-operative testicular volume and semen analysis after 18 years of life. Materials and Methods: From 1999 to 2010, 286 adolescents underwent retroperitoneoscopic left varicocelectomy. Of these patients, 67 were evaluated by clinical examination, ultrasound and semen analysis, allowing an adequate long-term follow-up. Results: Surgery was performed at a mean age of 13 years (range 10–17) without intraoperative complications. There were two recurrences (3%), two left testis hypotrophy (3%) and four hydroceles (6%), not yet undergone surgery because asymptomatic or without tension. Currently, 44 patients accepted to perform semen analysis which showed a reduction in sperm motility in 12 cases, with associated morphological alterations in 3 and reducing number of spermatozoa in one case. Conclusions: In consideration of morphological and biomolecular spermatic alterations reported in adolescent varicocele that could interfere with cellular migration, differentiation and nutrition, it is fundamental to consider the correction of varicocele, not only for the classical indications, but also as a choice for arresting the progressive damage that inevitably acts for several years on the adolescent testis. The RV in adolescents is a safe and feasible procedure for experienced paediatric laparoscopic surgeons with early good clinical outcomes, but more studies occur to understand the real impact of adolescent varicocelectomy on testicular function.
- Published
- 2017
27. Laparoscopic Fowler-Stephens orchidopexy for intra-abdominal cryptorchid testis: a single institution experience.
- Author
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Papparella, Alfonso, De Rosa, Laura, and Noviello, Carmine
- Abstract
Fowler-Stephens Laparoscopic Orchiopexy (FSLO) permits the mobilization of Intra-Abdominal Testis (IAT) to the scrotal position after spermatic vessel ligation. We reported our experience of FSLO for IAT. The charts of all boys who underwent a FSLO were retrospectively reviewed. Data were analysed for demographic data, procedure, complications and follow-up results. From January 2008 to June 2016, 160 laparoscopies for Non Palpable Testis (NPT) were performed at a mean age of 3,2 years. 61% of patients had a right NPT, while 6% were bilateral. In 64 cases, an IAT was found: 20 were managed by FSLO with a two-stage procedure in 11 patients. There were no differences in hospitalisations; one patient had a prolonged ileus. Follow-up ranged from 1 to 8 years. Of the 20 patients who underwent FSLO, testicular atrophy developed in three; the remaining testes were in the scrotal position, with normal consistency. FSLO was applied in 31% of IAT. The overall success rate of the technique was 85 %. The percentage of atrophy associated after spermatic vessels interruption appears to provide a good chance of testicular survival. [ABSTRACT FROM AUTHOR]
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- 2020
- Full Text
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28. Transscrotal orchidopexy for palpable cryptorchid testis: follow-up and outcomes
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Papparella, Alfonso, primary, Cobellis, Giovanni, additional, De Rosa, Laura, additional, and Noviello, Carmine, additional
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- 2018
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29. Risk Factors of Cholelithiasis Unrelated to Hematological Disorders in Pediatric Patients Undergoing Cholecystectomy
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Noviello, Carmine, primary, Papparella, Alfonso, additional, Romano, Mercedes, additional, and Cobellis, Giovanni, additional
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- 2018
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30. Prove di lotta contro Sclerotium rolfsii Sacc. sulla Canapa / Tests on the control of Sclerotium rolfsii Sacc. on Hemp
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Ferri, Floriano and Noviello, Carmine
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- 1963
31. Persistent Nonbilious Vomiting in a Child: Possible Duodenal Webbing
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Angotti, Rossella, primary, Molinaro, Francesco, additional, Cobellis, Giovanni, additional, Noviello, Carmine, additional, Bocchi, Caterina, additional, Ferrara, Francesco, additional, Bindi, Edoardo, additional, and Messina, Mario, additional
- Published
- 2017
- Full Text
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32. Gastric transposition as a valid surgical option for esophageal replacement in pediatric patients: experience from three Italian medical centers
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Angotti, Rossella, primary, Molinaro, Francesco, additional, Noviello, Carmine, additional, Cobellis, Giovanni, additional, Martino, Ascanio, additional, Del Rossi, Carmine, additional, Bianchi, Adrian, additional, and Messina, Mario, additional
- Published
- 2016
- Full Text
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33. Are Infants with Bronchopulmonary Dysplasia Prone to Gastroesophageal Reflux? A Prospective Observational Study with Esophageal pH-Impedance Monitoring
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Nobile, Stefano, Noviello, Carmine, Cobellis, Giovanni, Paolo Carnielli, Virgilio, Stefano Nobile (ORCID:0000-0002-5304-1485), Nobile, Stefano, Noviello, Carmine, Cobellis, Giovanni, Paolo Carnielli, Virgilio, and Stefano Nobile (ORCID:0000-0002-5304-1485)
- Abstract
Objective To perform an observational cohort study with esophageal pH-multichannel intraluminal impedance (pH-MII) monitoring in symptomatic preterm infants with and without bronchopulmonary dysplasia (BPD). Study design We prospectively studied 46 infants born ≤32 weeks gestational age: 12 infants with BPD and 34 infants without BPD. Each patient had symptoms consistent with gastroesophageal reflux and had 24-hour pH-MII, which were compared between BPD and non-BPD by univariate analysis and quantile regression analysis. Results Demographic and clinical characteristics were similar between infants with and without BPD, except for fluid administration (145 vs 163 mL/kg/d, P =.003), length of stay (92 vs 69 days, P =.019), and time to achieve complete oral feeding (76 vs 51 days, P =.013). The analysis of 1104 hours of pH-MII tracings demonstrated that infants with BPD compared with infants without BPD had increased numbers of pH-only events (median number 21 vs 9) and a higher symptom sensitivity index for pH-only events (9% vs 4.9%); the number and characteristics of acid, weakly acid, nonacid and gas gastroesophageal reflux events, acid exposure, esophageal clearance, and recorded symptoms did not significantly differ between the 2 groups. Conclusions The increased number of (and sensitivity for) pH-only events among infants with BPD may be explained by several factors, including lower milk intake, impaired esophageal motility, and a peculiar autonomic nervous system response pattern.
- Published
- 2015
34. Transumbilical Laparoscopic-Assisted Appendectomy in the Treatment of Acute Uncomplicated Appendicitis in Children
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Noviello, Carmine, primary, Romano, Mercedes, additional, Martino, Ascanio, additional, and Cobellis, Giovanni, additional
- Published
- 2015
- Full Text
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35. Morbo di Hirschsprung: approccio diagnostico differenziato
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Noviello, Carmine
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Costiveness ,MED/38 ,Megacolon ,Hirschsprung ,Constipation - Abstract
La diagnosi del morbo di Hirschsprung (MH) si esegue con esami per immagini (clisma opaco), tests funzionali come la Manometria Ano-Rettale (MAR) e studi immunoistochimici su biopsie rettali per suzione (BRS). L’approccio diagnostico più appropriato è ancora discusso dato che tutti i tests producono falsi positivi e falsi negativi ed ognuno presenta vantaggi e svantaggi. Lo scopo di questo lavoro è quello di valutare l’efficacia di un approccio diagnostico differenziato in base all’età per i pazienti con sospetto di MH. Materiali e Metodi: da Gennaio 2005 a Giugno 2007 sono stati esaminati tutti i pazienti giunti all’osservazione chirurgica per sospetto di MH. I pazienti sono stati divisi in due gruppi: A (età inferiore ad 1 anno) e B (età superiore ad 1 anno). I pazienti del gruppo A sono stati sottoposti a BRS e clisma opaco (CO), mentre quelli del gruppo B sono stati sottoposti a MAR per lo studio del tono dello sfintere anale interno e per la ricerca del Riflesso Inibitore Retto-Anale (RIRA), poi in base all’esito della MAR sono stati divisi in 5 sottogruppi ed hanno ricevuto un iter diagnostico-terapeutico diverso: B1, tono normale e RIRA presente (pulizia intestinale con soluzione a base di polietilenglicole (PEG) ad alto peso molecolare poi lassativi orali e clisteri settimanali per 2 mesi); B2, ipertono dello sfintere anale interno e RIRA presente (anestetico locale per 8 settimane associato al lassativo orale e clisteri settimanali per 2 mesi); B3, pazienti non collaboranti (sottoposti a BRS); B4, RIRA assente/dubbio (sottoposti a BRS e CO); B5, RIRA presente, ma scarsi risultati dopo terapia medica al follow up di 6 mesi (sottoposti a BRS e CO). I pazienti con BRS positive (aumentata attività dell’Acetilcolinesterasi associata ad assenza dei gangli) sono stati sottoposti ad intervento chirurgico di Pull-Through ano-rettale per via laparoscopica sec. Georgeson. Tutti i pazienti hanno seguito un follow up a 2 mesi (positivo se evacuazioni settimanali > 5 in corso di trattamento), poi a 6 mesi (positivo se evacuazioni settimanali > 3, senza trattamento). Risultati: I pazienti arruolati per questo studio sono stati 100 (55 maschi, 45 femmine), di cui 14 (età media 2 mesi) sono stati inseriti nel gruppo A, gli altri 86 (età media 6 anni) nel gruppo B. Il CO nei pazienti del gruppo A ha mostrato dilatazione del colon con cono di transizione in due casi, mentre le biopsie rettali per suzione hanno evidenziato assenza di cellule gangliari ed aumento delle fibre colinergiche nel 50% dei pazienti. Nel gruppo B1 sono stati inclusi 40 pazienti, 24 nel gruppo B2, i non collaboranti sono stati 4, mentre 18 sono stati inclusi nel gruppo B4 ed uno solo nel B5. Nel gruppo B sono stati eseguiti 19 CO (gruppi B4 e B5) e BRS in 23 pazienti (gruppi B3, B4 e B5). Al CO sono stati evidenziati dolicolon e megaretto nel 89% dei casi, mentre le BRS hanno evidenziato assenza di gangli ed aumento delle fibre colinergiche in 3 bambini (13%). L’intervento chirurgico è stato eseguito in 6 bambini del gruppo A e 2 del gruppo B, gli altri sono stati trattati altrove. Conclusioni: La MAR è un esame semplice e poco invasivo per studiare il meccanismo della defecazione nei bambini di età superiore ad un anno. L’approccio diagnostico differenziato in base all’età permette di selezionare i casi da sottoporre alle BRS e CO, esami invasivi che possono presentare complicanze. L’esecuzione delle BRS in casi selezionati permette di avere alti valori di positività (50% e 13%) evitando di estendere la procedura a tutti i pazienti con sospetto di MH.
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- 2008
36. Spermatogenesis and Cryptorchidism
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Cobellis, Giovanni, primary, Noviello, Carmine, additional, Nino, Fabiano, additional, Romano, Mercedes, additional, Mariscoli, Francesca, additional, Martino, Ascanio, additional, Parmeggiani, Pio, additional, and Papparella, Alfonso, additional
- Published
- 2014
- Full Text
- View/download PDF
37. The “Dark Side” of Pneumoperitoneum and Laparoscopy
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Rosaria Umano, Giuseppina, Delehaye, Giulia, Noviello, Carmine, and Papparella, Alfonso
- Abstract
Laparoscopic surgery has been one of the most common procedures for abdominal surgery at pediatric age during the last few decades as it has several advantages compared to laparotomy, such as shorter hospital stays, less pain, and better cosmetic results. However, it is associated with both local and systemic modifications. Recent evidence demonstrated that carbon dioxide pneumoperitoneum might be modulated in terms of pressure, duration, temperature, and humidity to mitigate and modulate these changes. The aim of this study is to review the current knowledge about animal and human models investigating pneumoperitoneum-related biological and histological impairment. In particular, pneumoperitoneum is associated with local and systemic inflammation, acidosis, oxidative stress, mesothelium lining abnormalities, and adhesion development. Animal studies reported that an increase in pressure and time and a decrease in humidity and temperature might enhance the rate of comorbidities. However, to date, few studies were conducted on humans; therefore, this research field should be further investigated to confirm in experimental models and humans how to improve laparoscopic procedures in the spirit of minimally invasive surgeries.
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- 2021
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38. What Is the Correct Way to Manage Children Requiring Gastrostomy? Single Center Experience
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M. Romano, Alfonso Papparella, Edoardo Bindi, Carmine Noviello, Stefano Nobile, Giovanni Cobellis, Noviello, Carmine, Romano, Mercede, Bindi, Edoardo, Cobellis, Giovanni, Nobile, Stefano, and Papparella, Alfonso
- Subjects
Pediatrics ,medicine.medical_specialty ,Nutritional Supplementation ,Heart disease ,medicine.medical_treatment ,gastroesophageal reflux ,RC799-869 ,Disease ,Single Center ,03 medical and health sciences ,0302 clinical medicine ,children ,030225 pediatrics ,Medicine ,Hepatology ,business.industry ,Gastroenterology ,Reflux ,Diseases of the digestive system. Gastroenterology ,medicine.disease ,Gastrostomy ,neurological impairment patient ,Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA ,gastrostomy ,GERD ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Weight gain - Abstract
Children with complex medical issues often present different comorbidities that cause feeding difficulties. Gastrostomy is often helpful, and should be performed when nutritional supplementation is necessary for longer than 6 weeks. Recently, different techniques have been used for gastrostomy in children. The authors report on their experiences regarding the diagnostic and therapeutic management of children requiring gastrostomy. All patients managed in the last 10 years were reviewed, retrospectively. Everyone underwent investigation to exclude gastroesophageal reflux disease (GERD). A total of 148 patients: 111 cases (75%) were neurologically impaired patients, 18 (12%) had complex heart disease, 10 (6%) had metabolic diseases, 4 (3%) had fibrosis cystic, 4 (3%) had muscle disease, and one had chromosomopathy. After investigation, 49 patients had GERD. PEG was performed in 101 cases (68%), laparo-assisted gastrostomy was performed in 44 cases (29.7%), open gastrostomy was performed in three cases. At follow-up, all patients reported weight gain, but 13 cases had major complications. Currently, the surgeon has the possibility of choosing between several safe techniques for gastrostomy. In our experience, PEG is the most useful technique for patients without GERD, while a laparo-assisted technique is better for patients who require laparoscopic fundoplication.
- Published
- 2021
39. Can Infant Dyschezia Be a Suspect of Rectosigmoid Redundancy?
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Carmine, Noviello, Nobile, Stefano, Mercedes, Romano, nbsp, Letizia, Trotta, undefined, Alfonso, Papparella, Noviello, Carmine, Nobile, Stefano, Romano, Mercede, and Papparella, Alfonso
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Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA ,redundancy ,Pediatrics, Perinatology and Child Health ,infant dyschezia ,constipation - Abstract
Infant dyschezia is a functional gastrointestinal disorder that occurs in children less than nine months of age. This disorder causes much anxiety among parents who consult different physicians when suspecting major intestinal problems. The aim of this study is to verify whether infant dyschezia involves an anatomic abnormality (redundancy) of the colon. In this retrospective study (48 months) we analyzed all the children younger than 9 months who came to our attention through the suspicion of gastrointestinal abnormality (Hirschsprung’s disease, anorectal malformations, colonic disorders or constipation). They all had a complete medical history, clinical examination and diagnostic tests, such as blood samples, suction rectal biopsy, a study of stool characteristics and, finally, a contrast enema. In cases with infant dyschezia, different colonic sizes and rectosigmoid length were measured, which created a ratio with the diameter of the second lumbar vertebra. These values were compared with those reported in the literature as normal for the age of one year. Of the 24 patients evaluated (mean age 4 months), 9 were excluded for different diagnoses (aganglionic megacolon, hypothyroidism, constipation). The comparison of the ratios obtained in the remaining 15 cases showed a significantly higher rectosigmoid length (redundancy) in children with dyschezia, 18.47 vs. 9.75 (p < 0.001). The rectosigmoid redundancy, a congenital anomaly already reported as a cause of refractory constipation, may be present in children with infant dyschezia.
- Published
- 2022
40. In Which Patients and Why Is Laparoscopy Helpful for the Impalpable Testis?
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Alfonso Papparella, Giuseppina Rosaria Umano, Mercedes Romano, Giulia Delehaye, Salvatore Cascone, Letizia Trotta, Carmine Noviello, Papparella, Alfonso, Umano, Giuseppina Rosaria, Romano, Mercede, Delehaye, Giulia, Cascone, Salvatore, Trotta, Letizia, and Noviello, Carmine
- Subjects
Article Subject ,Surgery ,Non palpable testis, laparoscopy, cryptorchidism - Abstract
Since laparoscopy has been proposed in the management of the nonpalpable testis (NPT), this technique has been widely diffused among pediatric surgeons and urologists, but its application is still debated. We conducted a retrospective review to highlight how diagnostic and surgical indications for laparoscopy are selective and should be targeted to individual patients. From 2015 to 2019, 135 patients with NPT were admitted to our surgical division. Of these, 35 were palpable on clinical examination under anesthesia and 95 underwent laparoscopy. The main laparoscopic findings considered were: intra-abdominal testis (IAT), cord structures that are blind-ending, completely absent, or entering the abdominal ring. The patients’ mean age was 22 months. In 48 cases, an IAT was found, and 42 of these underwent primary orchidopexy while 6 had the Fowler–Stephens (FS) laparoscopic procedure. Of the first group one patient experienced a testicular atrophy while two a reascent of the testis. In the FS orchidopexy group, one patient had testicular atrophy. Cord structures entering the internal inguinal ring were observed in 35 children, and all were surgically open explored. In 3 cases of these, a hypotrophic testis was revealed and an open orchidopexy was executed. In the remaining the histological examination revealed viable testicular cells in four patients and fibrosis, calcifications, and hemosiderin deposits in the others. Eleven patients presented with intrabdominal blind-ending vessels and one a testicular agenesia. A careful clinical examination is important to select patients to submit to laparoscopy. Diagnostic laparoscopy, and therefore, the anatomical observation of the testis and cord structures are strictly related to develop a treatment plan. In IAT, many surgical strategies can be applied with good results. Laparoscopy offers a concrete benefit to the patient.
- Published
- 2022
- Full Text
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41. New Surgical Frontiers for Nutrition in Children
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Carmine Noviello and Noviello, Carmine
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medicine.medical_specialty ,business.industry ,fungi ,food and beverages ,Pediatric age ,Pediatrics ,RJ1-570 ,03 medical and health sciences ,Editorial ,0302 clinical medicine ,n/a ,030225 pediatrics ,Family medicine ,Pediatrics, Perinatology and Child Health ,Medicine ,030212 general & internal medicine ,business - Abstract
Nutrition in pediatric age, if properly adapted to the various developmental phases, can be considered the first prevention tool for the most common pathologies of this age [...]
- Published
- 2021
42. COVID-19 Can Cause Severe Intussusception in Infants: Case Report and Literature Review
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Romano Mercedes, Giovanni Cobellis, Carmine Noviello, Alfonso Papparella, Taisia Bollettini, Stefano Nobile, Noviello, Carmine, Bollettini, Taisia, and Papparella, Alfonso
- Subjects
Microbiology (medical) ,Male ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,MEDLINE ,Resection ,Instructive Cases ,Intussusception (medical disorder) ,medicine ,pediatric surgery ,Humans ,intussusception ,business.industry ,SARS-CoV-2 ,infants ,General surgery ,Disease Management ,Infant ,COVID-19 ,medicine.disease ,Combined Modality Therapy ,Infectious Diseases ,Treatment Outcome ,Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA ,Pediatrics, Perinatology and Child Health ,Female ,Disease Susceptibility ,Symptom Assessment ,business - Abstract
COVID-19 may cause intussusception in infants. We report on a case of severe ileo-colic intussusception in an infant with COVID-19 who required an ileo-colic resection. A literature review revealed 9 other cases with COVID-19 and intussusception. In this article, we will discuss the management and treatment of the first reported case of intussusception associated with COVID-19 in Italy.
- Published
- 2021
43. The isolated tubal torsion: an insidious pediatric and adolescent pelvic urgency
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Alfonso Papparella, Ascanio Martino, Carmine Noviello, Giovanni Cobellis, M. Romano, Andrea Ciavattini, Noviello, Carmine, Romano, Mercede, Papparella, Alfonso, Ciavattini, Andrea, Martino, Ascanio, and Cobellis, Giovanni
- Subjects
0301 basic medicine ,Abdominal pain ,Delayed Diagnosis ,0302 clinical medicine ,Retrospective Studie ,Medicine ,Child ,Laparoscopy ,Ultrasonography ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,Delayed Diagnosi ,lcsh:RJ1-570 ,Nausea ,Fallopian Tube Diseases ,medicine.anatomical_structure ,Acute abdomen ,Vomiting ,Fallopian Tube ,Female ,medicine.symptom ,Human ,Torsion Abnormality ,medicine.medical_specialty ,Adolescent ,lcsh:Surgery ,Fallopian Tube Disease ,Asymptomatic ,Follow-Up Studie ,Diagnosis, Differential ,Salpingectomy ,03 medical and health sciences ,Laproscopy ,Humans ,Isolated tubal torsion ,Fallopian Tubes ,Retrospective Studies ,Ovarian cyst ,business.industry ,lcsh:Pediatrics ,lcsh:RD1-811 ,medicine.disease ,Abdominal Pain ,Surgery ,Pediatrics, Perinatology and Child Health ,030101 anatomy & morphology ,Differential diagnosis ,business ,Follow-Up Studies ,Fallopian tube - Abstract
Isolated tubal torsion (ITT) is a rare cause of acute abdominal pain. Preoperative diagnosis is difficult because of a lack of specific signs. Surgery is recommended to preserve the integrity of the tube. Seven patients of median age of 13 years (range 9 to 15) came to our observation for worsening abdominal pain, nausea and vomiting. On admission, all girls had blood tests and ultrasound. Laparoscopy was performed for diagnosis in all cases. The girls had one-month and one-year ultrasound and clinic follow up. In all cases diagnosis was delayed, median 66 hours after the onset of symptoms and laparoscopy showed necrosis of the Fallopian tube. In five girls a laparoscopic salpingectomy was performed. In the other two, an open salpingectomy was necessary because of pelvic adhesions. Histology showed a hemorrhagic infarction of the Fallopian tubes. At follow up all patients were asymptomatic with normal ovaries, but one ovarian cyst. In the differential diagnosis of acute abdominal pain in children or female adolescents the possibility of ITT should be considered for a conservative treatment. Laparoscopy allows for definitive diagnosis and treatment. Isolated tubal torsion (ITT) is a rare cause of acute abdominal pain. Preoperative diagnosis is difficult because of a lack of specific signs. Surgery is recommended to preserve the integrity of the tube. Seven patients of median age of 13 years (range 9 to 15) came to our observation for worsening abdominal pain, nausea and vomiting. On admission, all girls had blood tests and ultrasound. Laparoscopy was performed for diagnosis in all cases. The girls had one-month and one-year ultrasound and clinic follow up. In all cases diagnosis was delayed, median 66 hours after the onset of symptoms and laparoscopy showed necrosis of the Fallopian tube. In five girls a laparoscopic salpingectomy was performed. In the other two, an open salpingectomy was necessary because of pelvic adhesions. Histology showed a hemorrhagic infarction of the Fallopian tubes. At follow up all patients were asymptomatic with normal ovaries, but one ovarian cyst. In the differential diagnosis of acute abdominal pain in children or female adolescents the possibility of ITT should be considered for a conservative treatment. Laparoscopy allows for definitive diagnosis and treatment.
- Published
- 2018
44. Risk Factors of Cholelithiasis Unrelated to Hematological Disorders in Pediatric Patients Undergoing Cholecystectomy
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M. Romano, Giovanni Cobellis, Carmine Noviello, Alfonso Papparella, Noviello, Carmine, Papparella, Alfonso, Romano, Mercede, and Cobellis, Giovanni
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Abdominal pain ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Gold standard ,030204 cardiovascular system & hematology ,medicine.disease ,Asymptomatic ,Cholecistectomy ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Parenteral nutrition ,Biliary tract ,Cholelithiasis ,030225 pediatrics ,Cholecystitis ,medicine ,Cholecystectomy ,Original Article ,medicine.symptom ,business ,Body mass index ,Children - Abstract
Background: Pediatric cholelithiasis unrelated to hematological disorders is an increasing disease. We analyzed our experience in the surgical treatment of these cases to evaluate risk factors, clinical presentation, intervention and follow-up. Methods: From January 2010 to December 2016, we retrospectively recorded all data (hematological study, familiarity, use of lithogenic drugs and parenteral nutrition) of cholecystectomies for cholelithiasis not related to hematological diseases. The body mass index (BMI) was calculated (obesity if > 25), medical treatment, surgery and follow-up were evaluated. All patients underwent ultrasound for diagnosis and major biliary tract assessment prior to surgery. All patients had a 1-year follow-up. Results: There were twenty-four cases (eight males), with a median age of 11.2 years. Predisposing factors were familiarity in 19, use of lithogenic drugs in 5 and total parental nutrition (TPN) in 3. Median BMI was 19.8 kg/m2, with BMI > 25 kg/m2 in eight cases. Regarding the clinical presentation, 14 had acute pain in the right upper quadrant, 5 had cholecystitis and 5 had non-specific abdominal pain. The medical treatment lasted 6 months in all, except for five (three operated after 2 months and two after 12 months). Preoperative ultrasound did not show stones in the biliary tract. MRI was performed in three cases for suspected malformation of the biliary tract (negative). Laparoscopic cholecystectomy was performed in all cases: mean intervention time was 95 min. A case of postcolecystectomy syndrome was found. At follow-up, all were asymptomatic, except two (recurrent abdominal pain). Conclusion: Main predisposing factors are familiarity and obesity. Preoperative ultrasound in our series replaced the intraoperative study of the biliary tract. Laparoscopic cholecystectomy is the gold standard.
- Published
- 2018
45. Transscrotal orchidopexy for palpable cryptorchid testis: follow-up and outcomes
- Author
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Alfonso Papparella, Laura De Rosa, Giovanni Cobellis, Carmine Noviello, Papparella, Alfonso, Cobellis, Giovanni, Laura, Derosa, and Noviello, Carmine
- Subjects
Male ,medicine.medical_specialty ,Under anaesthesia ,030232 urology & nephrology ,lcsh:Surgery ,palpable testi ,Postoperative recovery ,Testicle ,03 medical and health sciences ,orchidopexy ,Postoperative Complications ,0302 clinical medicine ,030225 pediatrics ,Cryptorchidism ,Scrotum ,medicine ,Humans ,Child ,Retrospective Studies ,Testicular atrophy ,business.industry ,Palpable testis ,lcsh:RJ1-570 ,Infant ,Retrospective cohort study ,Mean age ,lcsh:Pediatrics ,lcsh:RD1-811 ,High scrotal orchidopexy ,medicine.disease ,Inguinal canal ,Surgery ,undescendede testis ,Treatment Outcome ,medicine.anatomical_structure ,Child, Preschool ,Orchiopexy ,Undescended testis ,Pediatrics, Perinatology and Child Health ,transscrotal orchidopexy ,business ,Follow-Up Studies - Abstract
We retrospectively reviewed the results of transscrotal orchidopexy in the surgical management of palpable testis. From January 2014 to June 2017, 130 male children with a total of 140 palpable undescended testes (UDT) underwent transscrotal orchidopexy. The charts were retrospectively reviewed for demographic data, preoperative position and mobility of the testis, patency of the peritoneal vaginal duct (PVD), and post-operative complications. The resting position of the testis and its traction towards the scrotum were assessed before surgery and under anaesthesia. The mean age of the patients was 4.6 years. The position of the testis assessed at surgery was in most cases at the external inguinal ring (62.8%), at the neck of the scrotum (15.7%), in the inguinal canal (12.8%), or in an ectopic position (8,5%). A PVD was found in 66 testes (47.1%). Two surgical cases required an inguinal incision. In each patient, the postoperative course was unremarkable. The testicle at 1-year follow-up was in a scrotal position in 134 cases, but 6 patients required a second surgical intervention for re-ascent of the testis. No testicular atrophy or inguinal hernias were observed. Transscrotal orchidopexy is a simple and effective procedure for the treatment of palpable UDT. The incidence of complications is low and manageable, with rapid postoperative recovery and early resumption of normal activities.
- Published
- 2018
46. Morphologic changes due to human chorionic gonadotropin in the rat testis: Role of vascular endothelial growth factor
- Author
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Serenella Papparella, Orlando Paciello, F. Nino, M. Romano, Alfonso Papparella, Antonio Agostino Sinisi, Carmine Noviello, Papparella, Alfonso, Fabiano, Nino1, Noviello, Carmine, Mercedes, Romano2, Serenella, Papparella3, Orlando, Paciello3, and Antonio Agostino, Sinisi4
- Subjects
medicine.medical_specialty ,endocrine system ,Leydig cell ,urogenital system ,Angiogenesis ,Biology ,Sertoli cell ,Human chorionic gonadotropin ,Vascular endothelial growth factor ,chemistry.chemical_compound ,Endocrinology ,medicine.anatomical_structure ,Blood serum ,chemistry ,Internal medicine ,medicine ,Immunostaining ,Testosterone - Abstract
Introduction: Human chorionic gonadotropin (hCG) has an important role in the regulation of reproduc- tive system and a high capacity to stimulate angio- genesis by secretion of vascular endothelial growth factor (VEGF). It could be also used for medical treatment of cryptorchidism, as it stimulates Leydig cells to produce testosterone, but its use has been discussed. Aim of the study was to evaluate the tes- ticular morphological changes due to cyclic admini- stration of hCG possibly related to VEGF effect. Methods: 80 pre-puberal male Sprague-Dawley rats were randomly divided in two groups hCG (50 U/I/ Kg) (n = 55/S) and placebo (n = 25/C) treated. The animals were sacrificed respectively after one (S1 n = 10; C1 n = 5), two (S2 n = 10; C2 n = 5) and three weeks of hCG or placebo treatment (S3 n = 35; C3 n = 15); a blood serum was obtained for evaluation of plasmatic testosterone. The testis, prostates, epidi- dymides and seminal vesicles were drawn and weight- ed. Specimens were fixed in formalin and coloured by hematoxylin-eosin. Morphometric analysis of Leydig cell number, nuclear area and perimeter was carried out. Immunoistochemistry for VEGF has been per- formed with the avidin-biotin peroxidase technique. Statistical differences between groups, each of differ- ent age, were calculating using Student’s T-test. Re- sults: After the first week of hCG treatment it has been observed an increased testicular weight and volume (+/−6%) in experimental respect to control group. This result was not observed after the second and third week of treatment. Significant variations were also observed in the mean prostate weight, whereas mean seminal vesicles weight was significant in the S2 and S3 groups respect to control. In the hCG treated rats it has been observed a poor differ- entiation of the seminiferous epithelium, with high Leydig cell evidence and increased intertubular eosi- nophilic material. An interstitial edema was demon- strated without inflammatory cell changes. Morpho- metric analysis confirmed an increased number of Leydig cells that were always strongly immunostained for VEGF. Low-medium reactivity was present in spermatogonial, peritubular, endothelial and Sertoli cells. Testosterone plasmatic values showed a statisti- cally significant and progressive increase. Conclu- sions: hCG treatment clutters the germinative line and modifies VEGF testicular expression, suggesting its role in male reproductive system. The increased number of Leydig cells and the immunostaining for VEGF suggests an intense interstitial and metabolic arrangement. The morphologic modifications induced by hCG treatment and its influence on testis function raise the question about its use in the medical treat- ment of cryptorchidism.
- Published
- 2013
47. Endopolygalacturonase from Rhizoctonia fragariae. Purification and charcterization of two isoenzymes
- Author
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Marcello G. Cacace, Magda Foresti, Carmine Noviello, Aniello Scala, Felice Cervone, F., Cervone, Scala, Aniello, Foresti, Magda, M., Cacace, and Noviello, Carmine
- Subjects
Glycoside Hydrolases ,Sodium ,Size-exclusion chromatography ,chemistry.chemical_element ,Rhizoctonia ,Isozyme ,isoelectric focusing ,chemistry.chemical_classification ,Sephadex gel filtration ,Chromatography ,biology ,General Medicine ,biology.organism_classification ,Isoenzymes ,Molecular Weight ,endo-polygalacturonase ,Polygalacturonase ,Isoelectric point ,Enzyme ,chemistry ,Biochemistry ,Homogeneous ,Sephadex ,Rhizoctonia fragariae ,Mitosporic Fungi - Abstract
An electrophoretically homogeneous preparation of endo-polygalacturonase (poly(1,4-α- d -galacturonide)glycanohydrolase, EC 3.2.1.15) from culture filtrates of Rhizoctonia fragariae, a pathogenic agent in strawberry plants, was resolved into two isoenzymes when subjected to isoelectrofocusing in a narrow pH range. The isoelectric points of the two isoenzymes were 6.76 ± 0.03 and 7.08 ± 0.05 . The two polygalacturonases exhibited similar substrate specificity, pH optimum and pattern of degradation of sodium polypectate. The two enzymes consisted of a sigle polypeptide chain which had an apparent molecular weight of 36 000 as determined by gel filtration on Sephadex G-100.
- Published
- 1977
48. Satisfaction and results of the subareolar incision as treatment for gynecomastia in adolescents: experience of two centers.
- Author
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Zangari A, Noviello C, Todesco C, Romano M, Trotta L, Botta C, Cascone I, Scommegna S, Vasta G, Briganti V, and Papparella A
- Subjects
- Humans, Male, Adolescent, Treatment Outcome, Postoperative Complications epidemiology, Mammaplasty methods, Child, Gynecomastia surgery, Patient Satisfaction
- Abstract
Gynecomastia is a benign glandular proliferation that can affect adolescents causing significant psychological discomfort. Generally, it is idiopathic but underlying endocrinological conditions must be excluded. Different surgical techniques are available, the surgical correction with subareolar incision achieves the goal of satisfactory aesthetic result for patients. We studied all patients treated for gynecomastia in two centers of pediatric surgery. After collection of a detailed family history, we evaluated the presence of early onset of puberty, congenital abnormalities of the external genitalia, use of drugs, eating habits and the presence of genetic disorders. Laboratory tests and ultrasound were made to exclude endocrinological disorders. The surgical treatment was performed by a subareolar incision with gland and adipose tissue excision. A Body - Q chest module to evaluate patient satisfaction has been proposed to everyone before and after surgery. 47 adolescents with median age of 15 years were surgically treated. Three presented endocrinological disorders. Grade of gynecomastia for surgery was: III in 40 patients and IIb in 7 patients. Postoperative complications occurred in 5 patients. The Body - Q chest module was completed by 42 patients and showed good results for all points analyzed, except for social feelings. Gynecomastia in adolescents can be surgically treated with subareolar incision, reporting good aesthetic results and low incidence of complications. Specific tests are useful to assess patient satisfaction.
- Published
- 2024
- Full Text
- View/download PDF
49. Are the complications after laparo-assisted endo-rectal pull-through for Hirschsprung disease related to the change of the anal tone?
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Noviello C, Romano M, Trotta L, Umano GR, and Papparella A
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- Humans, Male, Female, Retrospective Studies, Infant, Laparoscopy methods, Laparoscopy adverse effects, Enterocolitis etiology, Enterocolitis diagnosis, Rectum surgery, Hirschsprung Disease surgery, Anal Canal surgery, Postoperative Complications etiology, Manometry methods
- Abstract
The main advantage of the laparo-assisted transanal endorectal pull-through technique (LA - TERPT) for Hirschsprung Disease (HD) is the respect to the rectal-anal anatomy. Postoperative complications have been observed recently. The present study aims to determine how often these postoperative complications occur in these patients. From January 2009 to December 2018, a retrospective analysis was conducted on 36 children (25 males) with HD who underwent LA-TERPT. Data were collected on the age of diagnosis and surgery, sex, the presence of other pathologies, and cases of enterocolitis. In all cases, anorectal manometry (ARM) was performed to evaluate the anal tone. The median age at diagnosis was 2 months and the mean age at surgery was 5 months. Nine related pathologies were identified: five cases of Down syndrome, one case of hypertrophic stenosis of the pylorus, atresia of the esophagus, polydactyly, and anorectal malformation. A patient with total colonic aganglionosis was identified through laparoscopic serummuscular biopsies. Enterocolitis was diagnosed in 7 cases before and 6 after surgery. At follow-up, the complications recorded were: 5 cases of constipation (treated with fecal softeners), one case of anal stenosis (patient with anorectal malformation), 16 cases of soiling (treated with enemas) and 1 child with fecal incontinence (treated with a transanal irrigation system). The ARM was performed in all 36 cases and showed normal anal tone, except for one case with anal hypotonia. LA-TERPT is an important surgical technique for HD. According to the literature, soiling is the most main complication after HD surgery, probably due to "pseudo-incontinence" with normal anal sphincter tone.
- Published
- 2024
- Full Text
- View/download PDF
50. Gastric transposition as a valid surgical option for esophageal replacement in pediatric patients: experience from three Italian medical centers.
- Author
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Angotti R, Molinaro F, Noviello C, Cobellis G, Martino A, Del Rossi C, Bianchi A, and Messina M
- Abstract
Background: Esophageal replacement in children is an option that is confined to very few situations including long-gap esophageal atresia and esophageal strictures unresponsive to other therapies (peptic or caustic ingestion). The purpose of our work was to describe the experience of gastric transposition in three Italian centers., Methods: This is a retrospective study. The data were extrapolated from a prospective database. We included all patients who had undergone gastric transposition in the last 15 years., Results: In the 15-year period, eight infants and children (3 males and 5 females) underwent gastric transposition for esophageal replacement. Six patients had long-gap esophageal atresia, and two had caustic esophageal stenosis. There were no deaths in the series. Three patients had an early postoperative complication: two had a self-limited salivary fistula at three weeks, and one (a patient with jejunostomy) had a jejunal perforation treated surgically. One late complication, anastomotic stricture, was recorded that required two endoscopic dilatations. The median follow-up was 60 months (range: 18-144 months). At final clinical follow-up, six patients had no eating problems, and two patients had some difficulties with eating (jejunostomy in situ), but they underwent logopedic therapy with improved outcomes. All patients had an increase in body weight and height postoperatively., Conclusion: Our small study reports the clinical experience of three Italian centers in which gastric transposition was performed with excellent results, both in terms of surgical technique (simplicity, reproducibility, complication rate) and clinical follow-up (good oral feeding of young patients, normal social life and regular growth curves)., (© The Author(s) 2016. Published by Oxford University Press and Sixth Affiliated Hospital of Sun Yat-Sen University.)
- Published
- 2017
- Full Text
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