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155. Usefulness of symphysis-fundal height in predicting fetal weight in healthy term pregnant women

Author

Indraccolo, U., Chiocci, L., Rosenberg, P., Nappi, L., and Pantaleo GRECO

Subjects
Fetal Growth Retardation, Symphysis-fundal height (SFH), Pregnancy Trimester, Third, Uterus, Fetal birth weight, Diagnosis, Ultrasonography, Prenatal, NO, Fetal Development, Predictive Value of Tests, Pregnancy, Birth Weight, Humans, Female, Prospective Studies
Abstract

There are some works reporting that the measurement of the symphysis-fundal height (SFH) of a full-term uterus is a simple method for estimating the fetal weight.Evaluating the goodness of distance between the symphysis and uterine fundus in predicting both low-weight fetuses and high-weight fetuses, comparing it with the third quarter ultrasound estimation of fetal weight and then assessing the clinical effectivity of symphysis-fundal measurement associated with third quarter echography in predicting birth weight.A prospective study was carried out on 96 single physiologically full-term pregnancies. The diagnostic accuracy of the SFH, echographic fetal growth estimated between the 32nd and the 35th week (expressed in percentiles), and of both was expressed as sensitivity, specificity, predictive positive and negative value, likelihood ratios and compared.There was a correlation between the SFH and fetal birth weight. A SFH below 33 cm is predictive of a fetus whose weight is less than 3,100 g whereas a SFH above 34 cm is predictive of a fetus whose weight is more than or equal to 4,000 g. The diagnostic effectiveness of the SFH was not significantly higher than the ultrasound scanning evaluation of fetal weight in the third quarter and could be slightly improved if it is taken into account along with the ultrasound scanning data.The measurement of the SFH at term may be helpful in foretelling the fetal birth weight and may improve the diagnostic accuracy of the third quarter echographic estimation of birth weight.

156. Environmental pollution effects on reproductive health - clinical-epidemiological study in southern Italy

Author

Ml, Marra, Fulvio Zullo, De Felice B, Nappi L, Guida M, Trifuoggi M, Nappi C, Di Spiezio Sardo A, Zizolfi B, Capece G, Visconti F, Troisi J, and Ciccone C

Subjects
Research Paper
Abstract

This study aims to address the clinical, statistical and Epidemiological Relationship Between Birth Defects and Environmental Pollution, in the Campania Region and in Salerno. Objectives: We examined four groups of subjects as follows: a sample of pregnant women living in Salerno, a sample of pregnant women living in highly polluted areas, a sample of controls, pregnant women and residents out of the Campania Region, considered in unpolluted areas (Foggia) and in the Salerno area. Methodologies: a toxicological and genetic analysis was conducted on patients examined. Conclusions: there is an epidemiological link between environmental pollution and reproductive health in the Salerno area. Experimentally there are the first evidences of endocrine disruptors by the PCB. It has been inferred an overexpression of the mir-191 as a marker of pollution by dioxin-like compounds. Socially, correct information of populations at risk is necessary and a possible preventive and ongoing medical care must be ensured.

157. Malignant mixed müllerian tumor of the fallopian tube coincident with a primary serous carcinoma of the ovary. Case report

Author

Nappi, L., Indraccolo, U., Matteo, M., Rosenberg, P., and Pantaleo GRECO

Subjects
Ovarian Neoplasms, Malignant mixed müllerian tumor, Serous ovarian cancer, Therapy, Fallopian Tube Neoplasms, Humans, Mixed Tumor, Mullerian, Female, NO, Aged
Abstract

Malignant mixed müllerian tumors are very rare neoplasms of the fallopian tube, and treatment is not well defined. A case of malignant mixed müllerian tumor of the tube concomitant with a primary serous carcinoma of the ovary is reported. It was unclear if there were two distinct neoplasms in the same patient, or if it was a single tumor with a sarcomatous fallopian conversion of the serous component, as described for some recurrent ovarian carcinomas. Chemotherapy for ovarian carcinoma with intraperitoneal metastasis was performed, with about a three-year interval-free period of disease, as could be expected for ovarian carcinomas at the same stage. Such coexistence of these two tumors does not afford adequate staging of the malignancy. Therapy for the very rare cases similar to the one reported here needs to be improved.

158. Sunitinib in a MEN-1 Patient with Small Cell Neuroendocrine Tumor of the Thymus.

Author

Palmieri, G., Buonerba, C., Formisano, L., Damiano, V., Nappi, L., Federico, P., Colao, A., Matano, E., Faggiano, A., and De Placido, S.

Subjects
ONCOGENES, CANCER genes, MENIN, HYPERPARATHYROIDISM, ISLET cell tumor, CANCER treatment
Abstract

Introduction: MEN-1 is an autosomal dominant disease caused by mutation of the oncosuppressor gene menin. MEN-1 is typically associated with hyperparathyroidism, islet cell tumors and pituitary adenomas, but it can also be associated with other neoplasms, such as thymic carcinoids. Aim(s): In January 2009, a 49-year old patient diagnosed with a small cell neuroendocrine tumor of the thymus, considered inoperable. From March 2009 to March 2011, she received several systemic anti-neoplastic therapy consisting of carboplatin-etoposide, capecitabine-gemcitabine, somatostatin analogues and Everolimus. In March 2011, the patient presented progressive radiographic disease with worsening of the mediastinal syndrome. In April 2011, she was started on Sunitinib as reported in a large phase III trial on neuroendocrine tumors of the pancreas. She quickly achieved symptomatic improvement. Stable disease was detected on PET-CT scan in July 2011, which was confirmed in December 2011 by PET-CT scan. Materials and methods: Sunitinib 50 mg/daily, 4/2 w. Results: Thymic carcinoids are described in about 8% of pts with MEN-1, while 25% of patients with thymic carcinoids have MEN-1. Prophylactic thymectomy is a reasonable approach for patients with MEN-1. Recently, both Everolimus and Sunitinib have proved to be effective in two randomized controlled trials in PNET, with a considerable extension of PFS. Conclusion: This is the first reported case of a patient with a small cell neuroendocrine tumor of the thymus treated with Sunitinib. [ABSTRACT FROM AUTHOR]

Published
2012

159. Natural pregnancy in hypothyroid woman complicated by spontaneous ovarian hyperstimulation syndrome.

Author

Nappi, Raffaele G., Di Naro, Edoardo, D'Aries, Anna Pia, Nappi, Luigi, Nappi, R G, Di Naro, E, D'Aries, A P, and Nappi, L

Subjects
HYPOTHYROIDISM, PREGNANCY
Abstract

A unique case of life-threatening spontaneous ovarian hyperstimulation syndrome, resulting from severe untreated hypothyroidism, was observed in a woman who conceived spontaneously and gave birth to a normal viable infant. [ABSTRACT FROM AUTHOR]

Published
1998
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161. Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19

Author

Eran Hadar, Chiara Benedetto, Agnese Maria Chiara Rapisarda, Renato Augusto Moreira de Sá, Deena Elkafrawi, Daniela Luvero, Noa A Brzezinski Sinai, Alicia Martínez-Varea, Antonio Schiattarella, Anna Nunzia Della Gatta, Giovanni Scambia, Albert Lila, Luciano Di Tizio, Andrea Carosso, Giovanni Nazzaro, G. Schera, Giuseppe Rizzo, Giuseppe Maria Maruotti, Giusella D'Urso, Albaro José Nieto-Calvache, Ilenia Mappa, Ozlem Uyaniklar, Fabio Barra, Gilles Faron, Luigi Nappi, Jacopo Ferrari, Giulio Sozzi, Simone Ferrero, Mirjam Druškovič, Tanja Premru-Srsen, Leonardo Borrello, Fabiana Cecchini D, George Daskalakis, Giuliano Petriglia, Caroline Kadji, Felipe Mercado-Olivares, Zeliha Atak, Aylin Pelin Cil, Claudio Gustavino, Axelle Pintiaux, Pantaleo Greco, Rita Figueiredo, Stefano Cosma, Ludovica Puri, Valentina Esposito, Anupam Parange, Simone Garzon, Alessandra Gatti, Ioannis Kyvernitakis, Roberto Brunelli, Maddalena Morlando, Attilio Di Spiezio Sardo, Ignacio Cueto Hernández, Giuseppe Zoccali, Brian Rodriguez, Antonio Mollo, Flaminia Vena, Cihat Sen, Ciuhodaru Madalina, Felice Sorrentino, Francesca Di Sebastiano, Gennady T. Sukhikh, Ilma Floriana Carbone, Andrea Villasco, Blanka Zlatohlavkova, Gabriele Saccone, Erasmo Huertas, Marcel Malan, Leonardo Gucciardo, Eutalia Esposito, Otto Henrique May Feuerschuette, Sarah Dollinger, María de Los Angeles Anaya Baz, Jun Yoshimatsu, Sifa Turan, Vincente Diago, Alicia Yeliz Aykanat, Ignacio Herraiz, Javier Alfonso Schvartzman, Diego Gazzolo, Natalina Buono, Milan Stanojević, Erich Cosmi, Valentina De Robertis, Elena Costa, Angelo Cagnacci, Eleonora Valori, Nicoletta Biglia, Şerife Özlem Genç, Vincenzo Berghella, Francesco Maria Colaleo, Esther Vanessa Aguilar Galán, Gabriela Loscalzo, Marco Palumbo, Fabrizio Sandri, Irmeli Nupponen, Antonio Lanzone, Juan Antonio De León Luis, Amos Grunebaum, Giuseppe Bifulco, Marinella Lenzi, Serena Xodo, Fulvio Zullo, Ozhan Turan, Josefine Königbauer, Anna Luengo Piqueras, Nicola Volpe, Holger Maul, Chiara Taccaliti, Juan Manuel Burgos-Luna, Giovanni Sisti, Rosanna Esposito, Alfredo Ercoli, Panos Antsaklis, Dolores Esteban Oliva, Aly Youssef, Pedro Viana Pinto, Alberto Galindo, Asim Kurjak, Erhan Okuyan, Roberto Angioli, Maria Luisa Gonzalez-Duran, Ana Concheiro Guisan, Massimo Franchi, Maria Carmela Di Dedda, Giovanni Gerosolima, Francesco D'Antonio, Caroline Daelemans, Quintino Cesare Ianniciello, Pasquale De Franciscis, Maurizio Guida, Maria Cristina Rovellotti, Liana Ples, Frank A. Chervenak, Nicola Colacurci, Lilijana Kornhauser Cerar, Zulfiya Khodjaeva, Valentina Longo, Francesca Stollagli, Daniele Di Mascio, Mariavittoria Locci, Amadeo Sanchez, Angelo Sirico, Stefania Fieni, Rebeca Garrote Molpeceres, Pierluigi Benedetti Panici, Vito Chiantera, Esra Tustas Haberal, Liviu Cojocaru, Maria Elena Flacco, Antonella Cromi, Roberta Granese, Antonio Simone Laganà, Maria Giulia Lombana Marino, Silvia Visentin, Beatrice Bianchi, Roberta Venturella, Federica Laraud, Amanda Bermejo, Reyhan Gündüz, Marina Moucho, Zita Maria Gambacorti-Passerini, Danila Morano, Pedro Arango, Francesca Della Sala, Gaetana Di Donna, Jesús S Jimenez Lopez, Mariano Catello Di Donna, Giuliana Simonazzi, Snezana Zdjelar, Vedran Stefanovic, Cecilia Villalain, Antonio Coviello, Lars Hellmeyer, Antonella Giancotti, Elisa Bevilacqua, Igor Samardjiski, Riccardo Buscemi, Arianna Ramone, Marco Cerbone, Lorenza Driul, Danilo Buca, Tiziana Frusca, Elisa Done, Marco Liberati, José Morales Roselló, Fabio Ghezzi, Lorenzo Vasciaveo, Bernd Froessler, Alejandro Pittaro, Yolanda Cuñarro López, Andrew Carlin, Sakine Rahimli Ocakouglu, Giorgia Gattei, I. Cataneo, María José Suárez, Giada Ameli, Lamberto Manzoli, Kaisa Nelskylä, Ludovico Muzii, Peter Palm, Olus Api, Elisa Cueto, Martina Leombroni, Ksenia A. Gorina, HUS Gynecology and Obstetrics, Department of Obstetrics and Gynecology, Children's Hospital, HUS Children and Adolescents, HUS Perioperative, Intensive Care and Pain Medicine, Anestesiologian yksikkö, Department of Diagnostics and Therapeutics, Dicle Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kadın Hastalıkları ve Doğum Ana Bilim Dalı, Gündüz, Reyhan, Di Mascio D., Sen C., Saccone G., Galindo A., Grunebaum A., Yoshimatsu J., Stanojevic M., Kurjak A., Chervenak F., Suarez M.J.R., Gambacorti-Passerini Z.M., De Los Angeles Anaya Baz M., Galan E.V.A., Lopez Y.C., De Leon Luis J.A., Hernandez I.C., Herraiz I., Villalain C., Venturella R., Rizzo G., Mappa I., Gerosolima G., Hellmeyer L., Konigbauer J., Ameli G., Frusca T., Volpe N., Schera G.B.L., Fieni S., Esposito E., Simonazzi G., Di Donna G., Youssef A., Della Gatta A.N., Di Donna M.C., Chiantera V., Buono N., Sozzi G., Greco P., Morano D., Bianchi B., Marino M.G.L., Laraud F., Ramone A., Cagnacci A., Barra F., Gustavino C., Ferrero S., Ghezzi F., Cromi A., Lagana A.S., Longo V.L., Stollagli F., Sirico A., Lanzone A., Driul L., Fabiana Cecchini D., Xodo S., Rodriguez B., Mercado-Olivares F., Elkafrawi D., Sisti G., Esposito R., Coviello A., Cerbone M., Morlando M., Schiattarella A., Colacurci N., De Franciscis P., Cataneo I., Lenzi M., Sandri F., Buscemi R., Gattei G., Della Sala F., Valori E., Rovellotti M.C., Done E., Faron G., Gucciardo L., Esposito V., Vena F., Giancotti A., Brunelli R., Muzii L., Nappi L., Sorrentino F., Vasciaveo L., Liberati M., Buca D., Leombroni M., Di Sebastiano F., Di Tizio L., Gazzolo D., Franchi M., Ianniciello Q.C., Garzon S., Petriglia G., Borrello L., Nieto-Calvache A.J., Burgos-Luna J.M., Kadji C., Carlin A., Bevilacqua E., Moucho M., Pinto P.V., Figueiredo R., Rosello J.M., Loscalzo G., Martinez-Varea A., Diago V., Lopez J.S.J., Aykanat A.Y., Cosma S., Carosso A., Benedetto C., Bermejo A., Feuerschuette O.H.M., Uyaniklar O., Ocakouglu S.R., Atak Z., Gunduz R., Haberal E.T., Froessler B., Parange A., Palm P., Samardjiski I., Taccaliti C., Okuyan E., Daskalakis G., De Sa R.A.M., Pittaro A., Gonzalez-Duran M.L., Guisan A.C., Genc S.O., Zlatohlavkova B., Piqueras A.L., Oliva D.E., Cil A.P., Api O., Antsaklis P., Ples L., Kyvernitakis I., Maul H., Malan M., Lila A., Granese R., Ercoli A., Zoccali G., Villasco A., Biglia N., Madalina C., Costa E., Daelemans C., Pintiaux A., Cueto E., Hadar E., Dollinger S., Sinai N.A.B., Huertas E., Arango P., Sanchez A., Schvartzman J.A., Cojocaru L., Turan S., Turan O., Di Dedda M.C., Molpeceres R.G., Zdjelar S., Premru-Srsen T., Cerar L.K., Druskovie M., De Robertis V., Stefanovic V., Nupponen I., Nelskyla K., Khodjaeva Z., Gorina K.A., Sukhikh G.T., Maruotti G.M., Visentin S., Cosmi E., Ferrari J., Gatti A., Luvero D., Angioli R., Puri L., Palumbo M., D'Urso G., Colaleo F., Rapisarda A.M.C., Carbone I.F., Mollo A., Nazzaro G., Locci M., Guida M., Di Spiezio Sardo A., Panici P.B., Berghella V., Flacco M.E., Manzoli L., Bifulco G., Scambia G., Zullo F., D'Antonio F., Di Mascio D, Sen C, Saccone G, Galindo A, Grünebaum A, Yoshimatsu J, Stanojevic M, Kurjak A, Chervenak F, Rodríguez Suárez MJ, Gambacorti-Passerini ZM, Baz MLAA, Aguilar Galán EV, López YC, De León Luis JA, Hernández IC, Herraiz I, Villalain C, Venturella R, Rizzo G, Mappa I, Gerosolima G, Hellmeyer L, Königbauer J, Ameli G, Frusca T, Volpe N, Luca Schera GB, Fieni S, Esposito E, Simonazzi G, Di Donna G, Youssef A, Della Gatta AN, Di Donna MC, Chiantera V, Buono N, Sozzi G, Greco P, Morano D, Bianchi B, Lombana Marino MG, Laraud F, Ramone A, Cagnacci A, Barra F, Gustavino C, Ferrero S, Ghezzi F, Cromi A, Laganà AS, Laurita Longo V, Stollagli F, Sirico A, Lanzone A, Driul L, Cecchini D F, Xodo S, Rodriguez B, Mercado-Olivares F, Elkafrawi D, Sisti G, Esposito R, Coviello A, Cerbone M, Morlando M, Schiattarella A, Colacurci N, De Franciscis P, Cataneo I, Lenzi M, Sandri F, Buscemi R, Gattei G, Sala FD, Valori E, Rovellotti MC, Done E, Faron G, Gucciardo L, Esposito V, Vena F, Giancotti A, Brunelli R, Muzii L, Nappi L, Sorrentino F, Vasciaveo L, Liberati M, Buca D, Leombroni M, Di Sebastiano F, Di Tizio L, Gazzolo D, Franchi M, Ianniciello QC, Garzon S, Petriglia G, Borrello L, Nieto-Calvache AJ, Burgos-Luna JM, Kadji C, Carlin A, Bevilacqua E, Moucho M, Pinto PV, Figueiredo R, Roselló JM, Loscalzo G, Martinez-Varea A, Diago V, Jimenez Lopez JS, Aykanat AY, Cosma S, Carosso A, Benedetto C, Bermejo A, May Feuerschuette OH, Uyaniklar O, Ocakouglu SR, Atak Z, Gündüz R, Haberal ET, Froessler B, Parange A, Palm P, Samardjiski I, Taccaliti C, Okuyan E, Daskalakis G, Moreira de Sa RA, Pittaro A, Gonzalez-Duran ML, Guisan AC, Genç ŞÖ, Zlatohlávková B, Piqueras AL, Oliva DE, Cil AP, Api O, Antsaklis P, Ples L, Kyvernitakis I, Maul H, Malan M, Lila A, Granese R, Ercoli A, Zoccali G, Villasco A, Biglia N, Madalina C, Costa E, Daelemans C, Pintiaux A, Cueto E, Hadar E, Dollinger S, Brzezinski Sinai NA, Huertas E, Arango P, Sanchez A, Schvartzman JA, Cojocaru L, Turan S, Turan O, Di Dedda MC, Molpeceres RG, Zdjelar S, Premru-Srsen T, Cerar LK, Druškovič M, De Robertis V, Stefanovic V, Nupponen I, Nelskylä K, Khodjaeva Z, Gorina KA, Sukhikh GT, Maruotti GM, Visentin S, Cosmi E, Ferrari J, Gatti A, Luvero D, Angioli R, Puri L, Palumbo M, D'Urso G, Colaleo F, Chiara Rapisarda AM, Carbone IF, Mollo A, Nazzaro G, Locci M, Guida M, Di Spiezio Sardo A, Panici PB, Berghella V, Flacco ME, Manzoli L, Bifulco G, Scambia G, Zullo F, D'Antonio F, Di Mascio, D., Sen, C., Saccone, G., Galindo, A., Grunebaum, A., Yoshimatsu, J., Stanojevic, M., Kurjak, A., Chervenak, F., Suarez, M. J. R., Gambacorti-Passerini, Z. M., De Los Angeles Anaya Baz, M., Galan, E. V. A., Lopez, Y. C., De Leon Luis, J. A., Hernandez, I. C., Herraiz, I., Villalain, C., Venturella, R., Rizzo, G., Mappa, I., Gerosolima, G., Hellmeyer, L., Konigbauer, J., Ameli, G., Frusca, T., Volpe, N., Schera, G. B. L., Fieni, S., Esposito, E., Simonazzi, G., Di Donna, G., Youssef, A., Della Gatta, A. N., Di Donna, M. C., Chiantera, V., Buono, N., Sozzi, G., Greco, P., Morano, D., Bianchi, B., Marino, M. G. L., Laraud, F., Ramone, A., Cagnacci, A., Barra, F., Gustavino, C., Ferrero, S., Ghezzi, F., Cromi, A., Lagana, A. S., Longo, V. L., Stollagli, F., Sirico, A., Lanzone, A., Driul, L., Fabiana Cecchini, D., Xodo, S., Rodriguez, B., Mercado-Olivares, F., Elkafrawi, D., Sisti, G., Esposito, R., Coviello, A., Cerbone, M., Morlando, M., Schiattarella, A., Colacurci, N., De Franciscis, P., Cataneo, I., Lenzi, M., Sandri, F., Buscemi, R., Gattei, G., Della Sala, F., Valori, E., Rovellotti, M. C., Done, E., Faron, G., Gucciardo, L., Esposito, V., Vena, F., Giancotti, A., Brunelli, R., Muzii, L., Nappi, L., Sorrentino, F., Vasciaveo, L., Liberati, M., Buca, D., Leombroni, M., Di Sebastiano, F., Di Tizio, L., Gazzolo, D., Franchi, M., Ianniciello, Q. C., Garzon, S., Petriglia, G., Borrello, L., Nieto-Calvache, A. J., Burgos-Luna, J. M., Kadji, C., Carlin, A., Bevilacqua, E., Moucho, M., Pinto, P. V., Figueiredo, R., Rosello, J. M., Loscalzo, G., Martinez-Varea, A., Diago, V., Lopez, J. S. J., Aykanat, A. Y., Cosma, S., Carosso, A., Benedetto, C., Bermejo, A., Feuerschuette, O. H. M., Uyaniklar, O., Ocakouglu, S. R., Atak, Z., Gunduz, R., Haberal, E. T., Froessler, B., Parange, A., Palm, P., Samardjiski, I., Taccaliti, C., Okuyan, E., Daskalakis, G., De Sa, R. A. M., Pittaro, A., Gonzalez-Duran, M. L., Guisan, A. C., Genc, S. O., Zlatohlavkova, B., Piqueras, A. L., Oliva, D. E., Cil, A. P., Api, O., Antsaklis, P., Ples, L., Kyvernitakis, I., Maul, H., Malan, M., Lila, A., Granese, R., Ercoli, A., Zoccali, G., Villasco, A., Biglia, N., Madalina, C., Costa, E., Daelemans, C., Pintiaux, A., Cueto, E., Hadar, E., Dollinger, S., Sinai, N. A. B., Huertas, E., Arango, P., Sanchez, A., Schvartzman, J. A., Cojocaru, L., Turan, S., Turan, O., Di Dedda, M. C., Molpeceres, R. G., Zdjelar, S., Premru-Srsen, T., Cerar, L. K., Druskovie, M., De Robertis, V., Stefanovic, V., Nupponen, I., Nelskyla, K., Khodjaeva, Z., Gorina, K. A., Sukhikh, G. T., Maruotti, G. M., Visentin, S., Cosmi, E., Ferrari, J., Gatti, A., Luvero, D., Angioli, R., Puri, L., Palumbo, M., D'Urso, G., Colaleo, F., Rapisarda, A. M. C., Carbone, I. F., Mollo, A., Nazzaro, G., Locci, M., Guida, M., Di Spiezio Sardo, A., Panici, P. B., Berghella, V., Flacco, M. E., Manzoli, L., Bifulco, G., Scambia, G., Zullo, F., D'Antonio, F., Di Mascio, Daniele, Sen, Cihat, Saccone, Gabriele, Galindo, Alberto, Grünebaum, Amo, Yoshimatsu, Jun, Stanojevic, Milan, Kurjak, Asım, Chervenak, Frank, Rodríguez Suárez, María José, Gambacorti-Passerini, Zita Maria, Baz, María de Los Angeles Anaya, Aguilar Galán, Esther Vanessa, López, Yolanda Cuñarro, De León Luis, Juan Antonio, Hernández, Ignacio Cueto, Herraiz, Ignacio, Villalain, Cecilia, Venturella, Roberta, Rizzo, Giuseppe, Mappa, Ilenia, Gerosolima, Giovanni, Hellmeyer, Lar, Königbauer, Josefine, Ameli, Giada, Frusca, Tiziana, Volpe, Nicola, Luca Schera, Giovanni Battista, Fieni, Stefania, Esposito, Eutalia, Simonazzi, Giuliana, Di Donna, Gaetana, Youssef, Aly, Della Gatta, Anna Nunzia, Di Donna, Mariano Catello, Chiantera, Vito, Buono, Natalina, Sozzi, Giulio, Greco, Pantaleo, Morano, Danila, Bianchi, Beatrice, Lombana Marino, Maria Giulia, Laraud, Federica, Ramone, Arianna, Cagnacci, Angelo, Barra, Fabio, Gustavino, Claudio, Ferrero, Simone, Ghezzi, Fabio, Cromi, Antonella, Laganà, Antonio Simone, Longo, Valentina Laurita, Stollagli, Francesca, Sirico, Angelo, Lanzone, Antonio, Driul, Lorenza, Cecchini D, Fabiana, Xodo, Serena, Rodriguez, Brian, Mercado-Olivares, Felipe, Elkafrawi, Deena, Sisti, Giovanni, Esposito, Rosanna, Coviello, Antonio, Cerbone, Marco, Morlando, Maddalena, Schiattarella, Antonio, Colacurci, Nicola, De Franciscis, Pasquale, Cataneo, Ilaria, Lenzi, Marinella, Sandri, Fabrizio, Buscemi, Riccardo, Gattei, Giorgia, Sala, Francesca Della, Valori, Eleonora, Rovellotti, Maria Cristina, Done, Elisa, Faron, Gille, Gucciardo, Leonardo, Esposito, Valentina, Vena, Flaminia, Giancotti, Antonella, Brunelli, Roberto, Muzii, Ludovico, Nappi, Luigi, Sorrentino, Felice, Vasciaveo, Lorenzo, Liberati, Marco, Buca, Danilo, Leombroni, Martina, Di Sebastiano, Francesca, Di Tizio, Luciano, Gazzolo, Diego, Franchi, Massimo, Ianniciello, Quintino Cesare, Garzon, Simone, Petriglia, Giuliano, Borrello, Leonardo, Nieto-Calvache, Albaro Josè, Burgos-Luna, Juan Manuel, Kadji, Caroline, Carlin, Andrew, Bevilacqua, Elisa, Moucho, Marina, Pinto, Pedro Viana, Figueiredo, Rita, Roselló, José Morale, Loscalzo, Gabriela, Martinez-Varea, Alicia, Diago, Vincente, Jimenez Lopez, Jesús S, Aykanat, Alicia Yeliz, Cosma, Stefano, Carosso, Andrea, Benedetto, Chiara, Bermejo, Amanda, May Feuerschuette, Otto Henrique, Uyaniklar, Ozlem, Ocakouglu, Sakine Rahimli, Atak, Zeliha, Haberal, Esra Tusta, Froessler, Bernd, Parange, Anupam, Palm, Peter, Samardjiski, Igor, Taccaliti, Chiara, Okuyan, Erhan, Daskalakis, George, Moreira de Sa, Renato Augusto, Pittaro, Alejandro, Gonzalez-Duran, Maria Luisa, Guisan, Ana Concheiro, Genç, Şerife Özlem, Zlatohlávková, Blanka, Piqueras, Anna Luengo, Oliva, Dolores Esteban, Cil, Aylin Pelin, Api, Olu, Antsaklis, Pano, Ples, Liana, Kyvernitakis, Ioanni, Maul, Holger, Malan, Marcel, Lila, Albert, Granese, Roberta, Ercoli, Alfredo, Zoccali, Giuseppe, Villasco, Andrea, Biglia, Nicoletta, Madalina, Ciuhodaru, Costa, Elena, Daelemans, Caroline, Pintiaux, Axelle, Yapar Eyi, Elif Gül, Cueto, Elisa, Hadar, Eran, Dollinger, Sarah, Brzezinski Sinai, Noa A, Huertas, Erasmo, Arango, Pedro, Sanchez, Amadeo, Schvartzman, Javier Alfonso, Cojocaru, Liviu, Turan, Sifa, Turan, Ozhan, Di Dedda, Maria Carmela, Molpeceres, Rebeca Garrote, Zdjelar, Snezana, Premru-Srsen, Tanja, Cerar, Lilijana Kornhauser, Druškovič, Mirjam, De Robertis, Valentina, Stefanovic, Vedran, Nupponen, Irmeli, Nelskylä, Kaisa, Khodjaeva, Zulfiya, Gorina, Ksenia A, Sukhikh, Gennady T, Maruotti, Giuseppe Maria, Visentin, Silvia, Cosmi, Erich, Ferrari, Jacopo, Gatti, Alessandra, Luvero, Daniela, Angioli, Roberto, Puri, Ludovica, Palumbo, Marco, D'Urso, Giusella, Colaleo, Francesco, Chiara Rapisarda, Agnese Maria, Carbone, Ilma Floriana, Mollo, Antonio, Nazzaro, Giovanni, Locci, Mariavittoria, Guida, Maurizio, Di Spiezio Sardo, Attilio, Panici, Pierluigi Benedetti, Berghella, Vincenzo, Flacco, Maria Elena, Manzoli, Lamberto, Bifulco, Giuseppe, Scambia, Giovanni, Zullo, Fulvio, and D'Antonio, Francesco

Subjects
COVID-19 Vaccine, Infectious Disease Transmission, Perinatal Death, Abortion, Clinical Laboratory Technique, Miscarriage, Cohort Studies, 0302 clinical medicine, COVID-19 Testing, Pregnancy, Risk Factors, 3123 Gynaecology and paediatrics, Secondary analysis, Perinatal medicine, Abortion, Spontaneou, Medicine, Vertical, 030212 general & internal medicine, Viral, Pregnancy Complications, Infectious, coronavirus, perinatal morbidity, perinatal mortality, covid-19, Coronavirus, Abortion, Spontaneous, COVID-19, COVID-19 Vaccines, Clinical Laboratory Techniques, Coronavirus Infections, Female, Gestational Age, Humans, Infant, Newborn, Infant, Premature, Infectious Disease Transmission, Vertical, Pandemics, Pneumonia, Viral, Pregnancy Outcome, Reverse Transcriptase Polymerase Chain Reaction, SARS-CoV-2, Betacoronavirus, Fetal Death, 030219 obstetrics & reproductive medicine, Obstetrics, Infectious, Gestational age, Obstetrics and Gynecology, 3. Good health, Settore MED/40, Gestation, Human, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Coronaviru, Socio-culturale, Intrauterine device, 03 medical and health sciences, PARVOVIRUS B19 INFECTION, Coronavirus, perinatal morbidity, perinatal mortality, Adverse effect, Premature, Fetus, Betacoronaviru, Pandemic, Coronavirus Infection, business.industry, Risk Factor, Spontaneous, MORTALITY, Infant, Odds ratio, Pneumonia, medicine.disease, Newborn, Pregnancy Complications, Pediatrics, Perinatology and Child Health, Pregnancy Complications, Infectiou, Cohort Studie, business
Abstract

Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI). Results Mean gestational age at diagnosis was 30.6±9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8–0.9 per week increase; p Conclusions Early gestational age at infection, maternal ventilatory supports and low birthweight are the main determinants of adverse perinatal outcomes in fetuses with maternal COVID-19 infection. Conversely, the risk of vertical transmission seems negligible.

Published
2021

162. Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection

Author

Di Mascio Daniele, Gabriele, Saccone, Cihat, Sen, Daniele Di Mascio, Alberto, Galindo, Amos, Grünebaum, Jun, Yoshimatsu, Milan, Stanojevic, Asım, Kurjak, Frank, Chervenak, María José Rodríguez Suárez, Zita Maria Gambacorti-Passerini, María de Los Angeles Anaya Baz, Esther Vanessa Aguilar Galán, Yolanda Cuñarro López, Juan Antonio De León Luis, Ignacio Cueto Hernández, Ignacio, Herraiz, Cecilia, Villalain, Roberta, Venturella, Rizzo, GIUSEPPE DAVIDE, Ilenia, Mappa, Giovanni, Gerosolima, Lars, Hellmeyer, Josefine, Königbauer, Giada, Ameli, Tiziana, Frusca, Nicola, Volpe, Giovanni Battista Luca Schera, Stefania, Fieni, Eutalia, Esposito, Giuliana, Simonazzi, Gaetana Di Donna, Aly, Youssef, Anna Nunzia Della Gatta, Mariano Catello Di Donna, Vito, Chiantera, Natalina, Buono, Giulio, Sozzi, Pantaleo, Greco, Danila, Morano, Beatrice, Bianchi, Maria Giulia Lombana Marino, Federica, Laraud, Arianna, Ramone, Angelo, Cagnacci, Fabio, Barra, Claudio, Gustavino, Ferrero, Simone, Fabio, Ghezzi, Antonella, Cromi, Antonio Simone Laganà, Valentina Laurita Longo, Francesca, Stollagli, Angelo, Sirico, Antonio, Lanzone, Lorenza, Driul, Fabiana, Cecchini, Serena, Xodo, Brian, Rodriguez, Felipe, Mercado-Olivares, Deena, Elkafrawi, Giovanni, Sisti, Rosanna, Esposito, Antonio, Coviello, Marco, Cerbone, Maddalena, Morlando, Antonio, Schiattarella, Nicola, Colacurci, Pasquale De Franciscis, Ilaria, Cataneo, Marinella, Lenzi, Fabrizio, Sandri, Riccardo, Buscemi, Giorgia, Gattei, Francesca Della Sala, Eleonora, Valori, Maria Cristina Rovellotti, Elisa, Done, Gilles, Faron, Leonardo, Gucciardo, Esposito, Valentina, Flaminia, Vena, Antonella, Giancotti, Roberto, Brunelli, Ludovico, Muzii, Luigi, Nappi, Felice, Sorrentino, Marco, Liberati, Danilo, Buca, Martina, Leombroni, Francesca Di Sebastiano, Massimo, Franchi, Quintino Cesare Ianniciello, Simone, Garzon, Giuliano, Petriglia, Leonardo, Borrello, Albaro Josè Nieto-Calvache, Juan Manuel Burgos-Luna, Caroline, Kadji, Andrew, Carlin, Elisa, Bevilacqua, Marina, Moucho, Pedro, Viana, Rita, Figueiredo, José Morales Roselló, Gabriela, Loscalzo, Alicia, Martinez-Varea, Vincente, Diago, Jesús, S Jimenez Lopez, Alicia Yeliz Aykanat, Cosma, Stefano Domenico, Carosso, ANDREA ROBERTO, Benedetto, Chiara, Amanda, Bermejo, Otto Henrique May Feuerschuette, Ozlem, Uyaniklar, Sakine Rahimli Ocakouglu, Zeliha, Atak, Reyhan, Gündüz, Esra Tustas Haberal, Bernd, Froessler, Anupam, Parange, Peter, Palm, Igor, Samardjiski, Chiara, Taccaliti, Erhan, Okuyan, George, Daskalakis, Renato Augusto Moreira de Sa, Alejandro, Pittaro, Maria Luisa Gonzalez-Duran, Ana Concheiro Guisan, Şerife Özlem Genç, Blanka, Zlatohlávková, Anna Luengo Piqueras, Dolores Esteban Oliva, Aylin Pelin Cil, Olus, Api, Panos, Antsaklis, Liana, Ples, Ioannis, Kyvernitakis, Holger, Maul, Marcel, Malan, Albert, Lila, Roberta, Granese, Alfredo, Ercoli, Giuseppe, Zoccali, Villasco, Andrea, Biglia, Nicoletta, Ciuhodaru, Madalina, Costa, Elena, Caroline, Daelemans, Axelle, Pintiaux, Elif Gül Yapar Eyi, Elisa, Cueto, Eran, Hadar, Sarah, Dollinger, Noa, A Brzezinski-Sinai, Erasmo, Huertas, Pedro, Arango, Amadeo, Sanchez, Javier Alfonso Schvartzman, Liviu, Cojocaru, Sifa, Turan, Ozhan, Turan, Maria Carmela Di Dedda, Rebeca Garrote Molpeceres, Snezana, Zdjelar, Tanja, Premru-Srsen, Lilijana, Kornhauser-Cerar, Mirjam, Druškovič, Valentina De Robertis, Vedran, Stefanovic, Irmeli, Nupponen, Kaisa, Nelskylä, Zulfiya, Khodjaeva, Ksenia, A Gorina, Gennady, T Sukhikh, Giuseppe Maria Maruotti, Silvia, Visentin, Erich, Cosmi, Jacopo, Ferrari, Alessandra, Gatti, Daniela, Luvero, Roberto, Angioli, Ludovica, Puri, Marco, Palumbo, Giusella, D'Urso, Francesco, Colaleo, Agnese Maria Chiara Rapisarda, Ilma Floriana Carbone, Manzoli, Lamberto, Maria Elena Flacco, Giovanni, Nazzaro, Mariavittoria, Locci, Maurizio, Guida, Attilio Di Spiezio Sardo, Pierluigi Benedetti Panici, Asma, Khalil, Vincenzo, Berghella, Giuseppe, Bifulco, Giovanni, Scambia, Fulvio, Zullo, Francesco, D'Antonio, Saccone, Gabriele, Sen, Cihat, Di Mascio, Daniele, Galindo, Alberto, Grünebaum, Amo, Yoshimatsu, Jun, Stanojevic, Milan, Kurjak, Asım, Chervenak, Frank, Suárez, María José Rodríguez, Gambacorti‐Passerini, Zita Maria, de los Angeles Anaya Baz, María, Galán, Esther Vanessa Aguilar, López, Yolanda Cuñarro, Luis, Juan Antonio De León, Hernández, Ignacio Cueto, Herraiz, Ignacio, Villalain, Cecilia, Venturella, Roberta, Rizzo, Giuseppe, Mappa, Ilenia, Gerosolima, Giovanni, Hellmeyer, Lar, Königbauer, Josefine, Ameli, Giada, Frusca, Tiziana, Volpe, Nicola, Schera, Giovanni Battista Luca, Fieni, Stefania, Esposito, Eutalia, Simonazzi, Giuliana, Di Donna, Gaetana, Youssef, Aly, Gatta, Anna Nunzia Della, Di Donna, Mariano Catello, Chiantera, Vito, Buono, Natalina, Sozzi, Giulio, Greco, Pantaleo, Morano, Danila, Bianchi, Beatrice, Marino, Maria Giulia Lombana, Laraud, Federica, Ramone, Arianna, Cagnacci, Angelo, Barra, Fabio, Gustavino, Claudio, Ferrero, Simone, Ghezzi, Fabio, Cromi, Antonella, Laganà, Antonio Simone, Longo, Valentina Laurita, Stollagli, Francesca, Sirico, Angelo, Lanzone, Antonio, Driul, Lorenza, Cecchini, Fabiana, Xodo, Serena, Rodriguez, Brian, Mercado‐Olivares, Felipe, Elkafrawi, Deena, Sisti, Giovanni, Esposito, Rosanna, Coviello, Antonio, Cerbone, Marco, Morlando, Maddalena, Schiattarella, Antonio, Colacurci, Nicola, De Franciscis, Pasquale, Cataneo, Ilaria, Lenzi, Marinella, Sandri, Fabrizio, Buscemi, Riccardo, Gattei, Giorgia, Sala, Francesca Della, Valori, Eleonora, Rovellotti, Maria Cristina, Done, Elisa, Faron, Gille, Gucciardo, Leonardo, Esposito, Valentina, Vena, Flaminia, Giancotti, Antonella, Brunelli, Roberto, Muzii, Ludovico, Nappi, Luigi, Sorrentino, Felice, Liberati, Marco, Buca, Danilo, Leombroni, Martina, Di Sebastiano, Francesca, Franchi, Massimo, Ianniciello, Quintino Cesare, Garzon, Simone, Petriglia, Giuliano, Borrello, Leonardo, Nieto‐Calvache, Albaro Josè, Burgos‐Luna, Juan Manuel, Kadji, Caroline, Carlin, Andrew, Bevilacqua, Elisa, Moucho, Marina, Viana Pinto, Pedro, Figueiredo, Rita, Morales Roselló, José, Loscalzo, Gabriela, Martinez‐Varea, Alicia, Diago, Vincente, Jimenez Lopez, Jesús S, Aykanat, Alicia Yeliz, Cosma, Stefano, Carosso, Andrea, Benedetto, Chiara, Bermejo, Amanda, Feuerschuette, Otto Henrique May, Uyaniklar, Ozlem, Ocakouglu, Sakine Rahimli, Atak, Zeliha, Gündüz, Reyhan, Haberal, Esra Tusta, Froessler, Bernd, Parange, Anupam, Palm, Peter, Samardjiski, Igor, Taccaliti, Chiara, Okuyan, Erhan, Daskalakis, George, de Sa, Renato Augusto Moreira, Pittaro, Alejandro, Gonzalez‐Duran, Maria Luisa, Guisan, Ana Concheiro, Genç, Şerife Özlem, Zlatohlávková, Blanka, Piqueras, Anna Luengo, Oliva, Dolores Esteban, Cil, Aylin Pelin, Api, Olu, Antsaklis, Pano, Ples, Liana, Kyvernitakis, Ioanni, Maul, Holger, Malan, Marcel, Lila, Albert, Granese, Roberta, Ercoli, Alfredo, Zoccali, Giuseppe, Villasco, Andrea, Biglia, Nicoletta, Madalina, Ciuhodaru, Costa, Elena, Daelemans, Caroline, Pintiaux, Axelle, Eyi, Elif Gül Yapar, Cueto, Elisa, Hadar, Eran, Dollinger, Sarah, Brzezinski‐Sinai, Noa A., Huertas, Erasmo, Arango, Pedro, Sanchez, Amadeo, Schvartzman, Javier Alfonso, Cojocaru, Liviu, Turan, Sifa, Turan, Ozhan, Di Dedda, Maria Carmela, Molpeceres, Rebeca Garrote, Zdjelar, Snezana, Premru‐Srsen, Tanja, Kornhauser‐Cerar, Lilijana, Druškovič, Mirjam, De Robertis, Valentina, Stefanovic, Vedran, Nupponen, Irmeli, Nelskylä, Kaisa, Khodjaeva, Zulfiya, Gorina, Ksenia A., Sukhikh, Gennady T., Maruotti, Giuseppe Maria, Visentin, Silvia, Cosmi, Erich, Ferrari, Jacopo, Gatti, Alessandra, Luvero, Daniela, Angioli, Roberto, Puri, Ludovica, Palumbo, Marco, D'Urso, Giusella, Colaleo, Francesco, Rapisarda, Agnese Maria Chiara, Carbone, Ilma Floriana, Manzoli, Lamberto, Flacco, Maria Elena, Nazzaro, Giovanni, Locci, Mariavittoria, Guida, Maurizio, Sardo, Attilio Di Spiezio, Panici, Pierluigi Benedetti, Khalil, Asma, Berghella, Vincenzo, Bifulco, Giuseppe, Scambia, Giovanni, Zullo, Fulvio, D'Antonio, Francesco, Dicle Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kadın Hastalıkları ve DoğumAna Bilim Dalı, University of Helsinki, Department of Obstetrics and Gynecology, HUS Gynecology and Obstetrics, HUS Children and Adolescents, Children's Hospital, HUS Perioperative, Intensive Care and Pain Medicine, Anestesiologian yksikkö, Department of Diagnostics and Therapeutics, Saccone, G., Sen, C., Di Mascio, D., Galindo, A., Grunebaum, A., Yoshimatsu, J., Stanojevic, M., Kurjak, A., Chervenak, F., Suarez, M. J. R., Gambacorti-Passerini, Z. M., de los Angeles Anaya Baz, M., Galan, E. V. A., Lopez, Y. C., Luis, J. A. D. L., Hernandez, I. C., Herraiz, I., Villalain, C., Venturella, R., Rizzo, G., Mappa, I., Gerosolima, G., Hellmeyer, L., Konigbauer, J., Ameli, G., Frusca, T., Volpe, N., Schera, G. B. L., Fieni, S., Esposito, E., Simonazzi, G., Di Donna, G., Youssef, A., Gatta, A. N. D., Di Donna, M. C., Chiantera, V., Buono, N., Sozzi, G., Greco, P., Morano, D., Bianchi, B., Marino, M. G. L., Laraud, F., Ramone, A., Cagnacci, A., Barra, F., Gustavino, C., Ferrero, S., Ghezzi, F., Cromi, A., Lagana, A. S., Longo, V. L., Stollagli, F., Sirico, A., Lanzone, A., Driul, L., Cecchini, F., Xodo, S., Rodriguez, B., Mercado-Olivares, F., Elkafrawi, D., Sisti, G., Esposito, R., Coviello, A., Cerbone, M., Morlando, M., Schiattarella, A., Colacurci, N., De Franciscis, P., Cataneo, I., Lenzi, M., Sandri, F., Buscemi, R., Gattei, G., Sala, F. D., Valori, E., Rovellotti, M. C., Done, E., Faron, G., Gucciardo, L., Esposito, V., Vena, F., Giancotti, A., Brunelli, R., Muzii, L., Nappi, L., Sorrentino, F., Liberati, M., Buca, D., Leombroni, M., Di Sebastiano, F., Franchi, M., Ianniciello, Q. C., Garzon, S., Petriglia, G., Borrello, L., Nieto-Calvache, A. J., Burgos-Luna, J. M., Kadji, C., Carlin, A., Bevilacqua, E., Moucho, M., Viana Pinto, P., Figueiredo, R., Morales Rosello, J., Loscalzo, G., Martinez-Varea, A., Diago, V., Jimenez Lopez, J. S., Aykanat, A. Y., Cosma, S., Carosso, A., Benedetto, C., Bermejo, A., Feuerschuette, O. H. M., Uyaniklar, O., Ocakouglu, S. R., Atak, Z., Gunduz, R., Haberal, E. T., Froessler, B., Parange, A., Palm, P., Samardjiski, I., Taccaliti, C., Okuyan, E., Daskalakis, G., de Sa, R. A. M., Pittaro, A., Gonzalez-Duran, M. L., Guisan, A. C., Genc, S. O., Zlatohlavkova, B., Piqueras, A. L., Oliva, D. E., Cil, A. P., Api, O., Antsaklis, P., Ples, L., Kyvernitakis, I., Maul, H., Malan, M., Lila, A., Granese, R., Ercoli, A., Zoccali, G., Villasco, A., Biglia, N., Madalina, C., Costa, E., Daelemans, C., Pintiaux, A., Cueto, E., Hadar, E., Dollinger, S., Brzezinski-Sinai, N. A., Huertas, E., Arango, P., Sanchez, A., Schvartzman, J. A., Cojocaru, L., Turan, S., Turan, O., Di Dedda, M. C., Molpeceres, R. G., Zdjelar, S., Premru-Srsen, T., Kornhauser-Cerar, L., Druskovic, M., De Robertis, V., Stefanovic, V., Nupponen, I., Nelskyla, K., Khodjaeva, Z., Gorina, K. A., Sukhikh, G. T., Maruotti, G. M., Visentin, S., Cosmi, E., Ferrari, J., Gatti, A., Luvero, D., Angioli, R., Puri, L., Palumbo, M., D'Urso, G., Colaleo, F., Rapisarda, A. M. C., Carbone, I. F., Manzoli, L., Flacco, M. E., Nazzaro, G., Locci, M., Guida, M., Sardo, A. D. S., Panici, P. B., Khalil, A., Berghella, V., Bifulco, G., Scambia, G., Zullo, F., D'Antonio, F., José Rodríguez Suárez, María, Maria Gambacorti-Passerini, Zita, de Los Angeles Anaya Baz, María, Vanessa Aguilar Galán, Esther, Cuñarro López, Yolanda, Antonio De León Luis, Juan, Cueto Hernández, Ignacio, Battista Luca Schera, Giovanni, Nunzia Della Gatta, Anna, Catello Di Donna, Mariano, Giulia Lombana Marino, Maria, Simone Laganà, Antonio, Laurita Longo, Valentina, Mercado-Olivares, Felipe, Della Sala, Francesca, Cristina Rovellotti, Maria, Cesare Ianniciello, Quintino, Josè Nieto-Calvache, Albaro, Manuel Burgos-Luna, Juan, Viana, Pedro, Martinez-Varea, Alicia, S Jimenez Lopez, Jesú, Yeliz Aykanat, Alicia, DI BENEDETTO, Chiara, Henrique May Feuerschuette, Otto, Rahimli Ocakouglu, Sakine, Tustas Haberal, Esra, Augusto Moreira de Sa, Renato, Luisa Gonzalez-Duran, Maria, Concheiro Guisan, Ana, Özlem Genç, Şerife, Luengo Piqueras, Anna, Esteban Oliva, Dolore, Pelin Cil, Aylin, Gül Yapar Eyi, Elif, A Brzezinski-Sinai, Noa, Alfonso Schvartzman, Javier, Carmela Di Dedda, Maria, Garrote Molpeceres, Rebeca, Premru-Srsen, Tanja, Kornhauser-Cerar, Lilijana, A Gorina, Ksenia, T Sukhikh, Gennady, Maruotti, GIUSEPPE MARIA, Maria Chiara Rapisarda, Agnese, Floriana Carbone, Ilma, Elena Flacco, Maria, DI SPIEZIO SARDO, Attilio, Benedetti Panici, Pierluigi, Saccone G., Sen C., Di Mascio D., Galindo A., Grunebaum A., Yoshimatsu J., Stanojevic M., Kurjak A., Chervenak F., Suarez M.J.R., Gambacorti-Passerini Z.M., de los Angeles Anaya Baz M., Galan E.V.A., Lopez Y.C., Luis J.A.D.L., Hernandez I.C., Herraiz I., Villalain C., Venturella R., Rizzo G., Mappa I., Gerosolima G., Hellmeyer L., Konigbauer J., Ameli G., Frusca T., Volpe N., Schera G.B.L., Fieni S., Esposito E., Simonazzi G., Di Donna G., Youssef A., Gatta A.N.D., Di Donna M.C., Chiantera V., Buono N., Sozzi G., Greco P., Morano D., Bianchi B., Marino M.G.L., Laraud F., Ramone A., Cagnacci A., Barra F., Gustavino C., Ferrero S., Ghezzi F., Cromi A., Lagana A.S., Longo V.L., Stollagli F., Sirico A., Lanzone A., Driul L., Cecchini F., Xodo S., Rodriguez B., Mercado-Olivares F., Elkafrawi D., Sisti G., Esposito R., Coviello A., Cerbone M., Morlando M., Schiattarella A., Colacurci N., De Franciscis P., Cataneo I., Lenzi M., Sandri F., Buscemi R., Gattei G., Sala F.D., Valori E., Rovellotti M.C., Done E., Faron G., Gucciardo L., Esposito V., Vena F., Giancotti A., Brunelli R., Muzii L., Nappi L., Sorrentino F., Liberati M., Buca D., Leombroni M., Di Sebastiano F., Franchi M., Ianniciello Q.C., Garzon S., Petriglia G., Borrello L., Nieto-Calvache A.J., Burgos-Luna J.M., Kadji C., Carlin A., Bevilacqua E., Moucho M., Viana Pinto P., Figueiredo R., Morales Rosello J., Loscalzo G., Martinez-Varea A., Diago V., Jimenez Lopez J.S., Aykanat A.Y., Cosma S., Carosso A., Benedetto C., Bermejo A., Feuerschuette O.H.M., Uyaniklar O., Ocakouglu S.R., Atak Z., Gunduz R., Haberal E.T., Froessler B., Parange A., Palm P., Samardjiski I., Taccaliti C., Okuyan E., Daskalakis G., de Sa R.A.M., Pittaro A., Gonzalez-Duran M.L., Guisan A.C., Genc S.O., Zlatohlavkova B., Piqueras A.L., Oliva D.E., Cil A.P., Api O., Antsaklis P., Ples L., Kyvernitakis I., Maul H., Malan M., Lila A., Granese R., Ercoli A., Zoccali G., Villasco A., Biglia N., Madalina C., Costa E., Daelemans C., Pintiaux A., Cueto E., Hadar E., Dollinger S., Brzezinski-Sinai N.A., Huertas E., Arango P., Sanchez A., Schvartzman J.A., Cojocaru L., Turan S., Turan O., Di Dedda M.C., Molpeceres R.G., Zdjelar S., Premru-Srsen T., Kornhauser-Cerar L., Druskovic M., De Robertis V., Stefanovic V., Nupponen I., Nelskyla K., Khodjaeva Z., Gorina K.A., Sukhikh G.T., Maruotti G.M., Visentin S., Cosmi E., Ferrari J., Gatti A., Luvero D., Angioli R., Puri L., Palumbo M., D'Urso G., Colaleo F., Rapisarda A.M.C., Carbone I.F., Manzoli L., Flacco M.E., Nazzaro G., Locci M., Guida M., Sardo A.D.S., Panici P.B., Khalil A., Berghella V., Bifulco G., Scambia G., Zullo F., D'Antonio F., Mother and Child, Surgical clinical sciences, Obstetrics, and Clinical sciences

Subjects
COVID19, medicine.medical_treatment, coronavirus, COVID-19, infection, pregnancy, SARS-CoV-2, Abortion, infectious diseases, law.invention, Cohort Studies, 0302 clinical medicine, law, 3123 Gynaecology and paediatrics, Pregnancy, Obstetrics and Gynaecology, 030212 general & internal medicine, Pregnancy Complications, Infectious, 030219 obstetrics & reproductive medicine, Radiological and Ultrasound Technology, Transmission (medicine), Obstetrics, Pregnancy Outcome, Obstetrics and Gynecology, Coronavirus, SARS-COV-2, General Medicine, Disease 2019 Covid-19, Intensive care unit, 3. Good health, Hospitalization, Intensive Care Units, Maternal Mortality, Settore MED/40, Radiology Nuclear Medicine and imaging, Gestation, Female, coronavirus, Pandemics, Pregnancy, Pregnancy Complications, Infectious, Pregnancy Outcome, Respiration, Artificial, Retrospective Studies, SARS-CoV-2, COVID-19, Infant, Newborn, Intensive Care Units,Maternal Mortality, Infection, Cohort study, Adult, medicine.medical_specialty, NO, 03 medical and health sciences, medicine, Humans, Radiology, Nuclear Medicine and imaging, Pandemics, Retrospective Studies, Mechanical ventilation, business.industry, Infant, Newborn, Infant, Retrospective cohort study, medicine.disease, Respiration, Artificial, coronaviru, Reproductive Medicine, business
Abstract

WOS:000613461600006 PubMed ID: 32926494 Objectives To evaluate the maternal and perinatal outcomes of pregnancies affected by SARS-CoV-2 infection. Methods This was a multinational retrospective cohort study including women with a singleton pregnancy and laboratory-confirmed SARS-CoV-2 infection, conducted in 72 centers in 22 different countries in Europe, the USA, South America, Asia and Australia, between 1 February 2020 and 30 April 2020. Confirmed SARS-CoV-2 infection was defined as a positive result on real-time reverse-transcription polymerase chain reaction (RT-PCR) assay of nasopharyngeal swab specimens. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit (ICU), use of mechanical ventilation and death. Results In total, 388 women with a singleton pregnancy tested positive for SARS-CoV-2 on RT-PCR of a nasopharyngeal swab and were included in the study. Composite adverse maternal outcome was observed in 47/388 (12.1%) women; 43 (11.1%) women were admitted to the ICU, 36 (9.3%) required mechanical ventilation and three (0.8%) died. Of the 388 women included in the study, 122 (31.4%) were still pregnant at the time of data analysis. Among the other 266 women, six (19.4% of the 31 women with first-trimester infection) had miscarriage, three (1.1%) had termination of pregnancy, six (2.3%) had stillbirth and 251 (94.4%) delivered a liveborn infant. The rate of preterm birth before 37 weeks' gestation was 26.3% (70/266). Of the 251 liveborn infants, 69/251(27.5%) were admitted to the neonatal ICU, and there were five (2.0%) neonatal deaths. The overall rate of perinatal death was 4.1% (11/266). Only one (1/251, 0.4%) infant, born to a mother who tested positive during the third trimester, was found to be positive for SARS-CoV-2 on RT-PCR. Conclusions SARS-CoV-2 infection in pregnant women is associated with a 0.8% rate of maternal mortality, but an 11.1% rate of admission to the ICU. The risk of vertical transmission seems to be negligible. (C) 2020 International Society of Ultrasound in Obstetrics and Gynecology.

Published
2021

163. Selective catalytic reduction of NO<f>x</f> by methane over Co-H-MFI and Co-H-FER zeolite catalysts: characterisation and catalytic activity

Author

Resini, C., Montanari, T., Nappi, L., Bagnasco, G., Turco, M., Busca, G., Bregani, F., Notaro, M., and Rocchini, G.

Subjects
*CATALYSIS, *SURFACE chemistry
Abstract

Co-H-MFI and Co-H-FER were studied as catalysts for NO reduction with methane, under diluted conditions. Catalyst bulk and surface structure was characterised by chemical analysis, XRD, TG-DTA, SEM micrographs, IR studies, UV–vis spectroscopy, ammonia TPD, and TPR. Only the features due to zeolitic frameworks were observed. The UV–vis spectra showed that, after outgassing, Co ions are mainly present as Co2+. FT-IR detected residual bridging hydroxyl and silanol groups in spite of the apparent over-exchange, deduced from the chemical analysis. Co ions gave rise to Lewis acid sites of medium strength, evidenced through in situ analysis of the adsorption of a basic probe molecule. NH3-TPD measurements fully confirmed these results. TPR measurements detected easily reducible and oxidizable Co species, possibly related to nanosized Co oxide phases, together with hardly reducible Co2+ ions. Catalytic tests highlighted the Co-H-FER and Co-H-MFI activity, both in NO-selective catalytic reduction by methane and in NO oxidation to NO2, the latter being the predominant reaction at low temperatures. Some mechanistic features of the CH4-SCR reaction are discussed. [Copyright &y& Elsevier]

Published
2003
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165. Clinical Outcomes of Perioperative Chemotherapy in Patients With Locally Advanced Penile Squamous-Cell Carcinoma: Results of a Multicenter Analysis

Author

Rosa S. Djajadiningrat, Sabino De Placido, Sarah R. Ottenhof, Chris Protzel, Roberto Salvioni, B.J. Eigl, Friederike Haidl, Patrizia Giannatempo, Oliver W. Hakenberg, Kazumasa Matsumoto, Vincent Khoo, Mario Catanzaro, Guru Sonpavde, Lucia Nappi, Matthew I. Milowsky, Evanguelos Xylinas, Desiree Louise Draeger, Nicola Nicolai, Gregory R. Pond, Andrea Necchi, Simon Horenblas, Axel Heidenreich, Mirko Preto, Ulka N. Vaishampayan, Giuseppe Di Lorenzo, Daniel M. Geynisman, Michael Woods, Daniele Raggi, Necchi, A, Pond, Gr, Raggi, D, Ottenhof, Sr, Djajadiningrat, R, Horenblas, S, Khoo, V, Hakenberg, Ow, Draeger, D, Protzel, C, Heidenreich, A, Haidl, F, Eigl, Bj, Nappi, L, Matsumoto, K, Vaishampayan, U, Woods, Me, Salvioni, R, Nicolai, N, Catanzaro, M, Giannatempo, P, Geynisman, Dm, Preto, M, Xylinas, E, Milowsky, Mi, De Placido, S, Di Lorenzo, G, Sonpavde, G, Necchi, A., Pond, G. R., Raggi, D., Ottenhof, S. R., Djajadiningrat, R. S., Horenblas, S., Khoo, V., Hakenberg, O. W., Draeger, D., Protzel, C., Heidenreich, A., Haidl, F., Eigl, B. J., Nappi, L., Matsumoto, K., Vaishampayan, U., Woods, M. E., Salvioni, R., Nicolai, N., Catanzaro, M., Giannatempo, P., Geynisman, D. M., Preto, M., Xylinas, E., Milowsky, M. I., De Placido, S., Di Lorenzo, G., and Sonpavde, G.

Subjects
Adult, Male, Oncology, medicine.medical_specialty, Survival, Prognosi, Urology, medicine.medical_treatment, 030232 urology & nephrology, Article, 03 medical and health sciences, 0302 clinical medicine, Squamous cell carcinoma, Internal medicine, medicine, Carcinoma, Humans, Penile cancer, Prospective Studies, Perioperative Period, Prospective cohort study, Penile Neoplasms, Neoadjuvant therapy, Survival analysis, Aged, Aged, 80 and over, business.industry, Regional lymph node, Retrospective cohort study, Chemoradiotherapy, Perioperative, Middle Aged, Prognosis, medicine.disease, Survival Analysis, Neoadjuvant Therapy, Prospective Studie, Treatment Outcome, Penile Neoplasm, Chemotherapy, Adjuvant, Preoperative chemotherapy, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Survival Analysi, business, Human
Abstract

Patients with locally advanced penile squamous-cell carcinoma have a poor prognosis. No difference in survival was noted when using chemotherapy before or after surgery. Uncertainties persist regarding the optimal management of these patients, and new treatments are urgently required, particularly for patients at highest risk, with bilateral and/or pelvic lymph node involvement. BACKGROUND: The prognosis of patients with locally advanced penile squamous-cell carcinoma is primarily related to the extent of lymph node metastases. Surgery alone yields suboptimal results, and there is a paucity of data on these patients’ outcomes. PATIENTS AND METHODS: This retrospective study evaluated patients who received neoadjuvant or adjuvant chemotherapy from 1990 onward at 12 centers. Cox models were used to investigate prognostic factors for relapse-free survival and overall survival (OS). RESULTS: Among the 201 included patients, 39 (19.4%) had disease of T3-4 and N0 clinical stage; the remaining patients had clinical lymph node involvement (cN+). Ninety-four patients received neoadjuvant chemotherapy (group 1), 78 received adjuvant chemotherapy (group 2), and 21 received both (group 3). Eight patients for whom the timing of perioperative chemotherapy administration was unavailable were included in the Cox analyses. Forty-three patients (21.4%) received chemoradiation. Multivariate analysis for OS (n = 172) revealed bilateral disease (P = .035) as a negative prognostic factor, while pelvic cN+ tended to be nonsignificantly associated with decreased OS (P = .076). One-year relapse-free survival was 35.6%, 60.6%, and 45.1% in the 3 groups, respectively. One-year OS was 61.3%, 82.2%, and 75%, respectively. No significant differences were seen on univariable analyses for OS between the groups (P = .45). Platinum type of chemotherapy and chemoradiation were not significantly associated with any outcome analyzed. CONCLUSION: Benchmark survival estimates for patients receiving perioperative chemotherapy for locally advanced penile squamous-cell carcinoma have been provided, with no substantial differences observed between neoadjuvant and adjuvant administration. This analysis may result in improved patient information, although prospective studies are warranted.

Published
2017

166. Inhibition of Hedgehog signalling by NVP-LDE225 (Erismodegib) interferes with growth and invasion of human renal cell carcinoma cells

Author

Lucia Raimondo, Valentina D’Amato, Luigi Formisano, Franco Fulciniti, Lucia Nappi, R. Rosa, Roberto Bianco, S. De Placido, Cesar A. Bianco, Alberto Servetto, C. D'Amato, A Cipolletta, R. Marciano, Fortunato Ciardiello, Bianca Maria Veneziani, C. Di Mauro, D'Amato, C., Rosa, R., Marciano, R., D'Amato, V., Formisano, L., Nappi, L., Raimondo, L., Di Mauro, C., Servetto, A., Fulciniti, F., Cipolletta, A., Bianco, C., Ciardiello, F., Veneziani, BIANCA MARIA, DE PLACIDO, Sabino, Bianco, Roberto, D'Amato, C, Rosa, R, Marciano, R, D'Amato, V, Formisano, L, Nappi, L, Raimondo, L, Di Mauro, C, Servetto, A, Fulciniti, F, Cipolletta, A, Bianco, C, Ciardiello, Fortunato, Veneziani, Bm, De Placido, S, and Bianco, R.

Subjects
Cancer Research, Indoles, Lung Neoplasms, Pyridines, urologic and male genital diseases, Receptors, G-Protein-Coupled, Mice, sunitinib resistance, Cell Movement, immune system diseases, Antineoplastic Combined Chemotherapy Protocols, Sunitinib, Mice, Inbred BALB C, Nuclear Proteins, Ribosomal Protein S6 Kinases, 70-kDa, virus diseases, Drug Synergism, RCC, Smoothened Receptor, female genital diseases and pregnancy complications, Kidney Neoplasms, Tumor Burden, Biphenyl compound, Actin Cytoskeleton, Oncology, Neoplasm Micrometastasis, Mitogen-Activated Protein Kinases, Signal transduction, Signal Transduction, medicine.medical_specialty, Kruppel-Like Transcription Factors, NVP-LDE225, Mice, Nude, Zinc Finger Protein Gli2, Biology, Zinc Finger Protein GLI1, Inhibitory Concentration 50, Cell Line, Tumor, Internal medicine, Carcinoma, medicine, Animals, Humans, Hedgehog Proteins, Pyrroles, Everolimus, Carcinoma, Renal Cell, Hedgehog, Cell Proliferation, Sirolimus, Cell growth, Biphenyl Compounds, medicine.disease, Actin cytoskeleton, Xenograft Model Antitumor Assays, Actins, Endocrinology, Cell culture, Cancer research, Hedgehog, RCC, NVP-LDE225, sunitinib resistance, Paxillin, Translational Therapeutics, Proto-Oncogene Proteins c-akt, Transcription Factors
Abstract

Background: Multiple lines of evidence support that the Hedgehog (Hh) signalling has a role in the maintenance and progression of different human cancers. Therefore, inhibition of the Hh pathway represents a valid anticancer therapeutic approach for renal cell carcinoma (RCC) patients. NVP-LDE225 is a Smoothened (Smo) antagonist that induces dose-related inhibition of Hh and Smo-dependent tumour growth. Methods: We assayed the effects of NVP-LDE225 alone or in combination with everolimus or sunitinib on the growth and invasion of human RCC models both in vitro and in vivo. To this aim, we used a panel of human RCC models, comprising cells with acquired resistance to sunitinib - a multiple tyrosine kinase inhibitor approved as a first-line treatment for RCC. Results: NVP-LDE225 cooperated with either everolimus or sunitinib to inhibit proliferation, migration, and invasion of RCC cells even in sunitinib-resistant (SuR) cells. Some major transducers involved in tumour cell motility, including paxillin, were also efficiently inhibited by the combination therapy, as demonstrated by western blot and confocal microscopy assays. Moreover, these combined treatments inhibited tumour growth and increased animal survival in nude mice xenografted with SuR RCC cells. Finally, lung micrometastasis formation was reduced when mice were treated with NVP-LDE225 plus everolimus or sunitinib, as evidenced by artificial metastatic assays. Conclusions: Hedgehog inhibition by NVP-LDE225 plus sunitinib or everolimus bolsters antitumour activity by interfering with tumour growth and metastatic spread, even in SuR cells. Thus, this new evidence puts forward a new promising therapeutic approach for RCC patients.

Published
2014

167. Office operative hysteroscopy: an update of the evidence (2002-2009)

Author

A. Di Spiezio Sardo, F. Sorrentino, Stefano Bettocchi, Marco Guida, Luigi Nappi, M. Spinelli, Carmela Nappi, Di Spiezio Sardo A, Bettocchi S, Spinelli M, Guida M, Sorrentino F, Nappi L, Nappi C., DI SPIEZIO SARDO, Attilio, Bettocchi, S, Spinelli, M, Guida, M, Sorrentino, F, Nappi, L, and Nappi, Carmine

Subjects
medicine.medical_specialty, business.industry, medicine, Obstetrics and Gynecology, Operative hysteroscopy, business, Surgery
Published
2009

168. Umbilical Cord Knots: Is the Number Related to Fetal Risk?

Author

Guglielmo Stabile, Stefania Carlucci, Lucia De Bonis, Felice Sorrentino, Luigi Nappi, Giuseppe Ricci, Stabile, G., Carlucci, S., De Bonis, L., Sorrentino, F., Nappi, L., and Ricci, G.

Subjects
true knot, double knot, fetal risk, umbilical cord knot, General Medicine
Abstract

True knots of the umbilical cord (UC) are a rare occurrence and are reported in 0.4–1.2% of deliveries. The compression of true knot of the UC can cause obstruction of the fetal circulation, leading to intra-uterine growth retardation or fetal death. Predisposing factors for the genesis of the true UC knot are numerous and include all the conditions, which lead to a relatively large uterine volume. This situation may predispose to free and excessive fetal movements. Although not all true knots lead to perinatal complications, they have been associated with adverse pregnancy outcomes, including fetal distress, fetal hypoxia, intra-uterine growth restriction (IUGR), long-term neurological damage, caesarean delivery and stillbirth. We present a rare case of operative delivery with vacuum in a multiparous woman at term of pregnancy with a double true knot of the UC. As in most cases, the diagnosis was made after delivery, as there were no fetal symptoms during pregnancy. Some authors assume that 3D power sonography may be useful in the diagnosis of true UC knots. However, 3D power Doppler cannot be considered as a definitive method. There are no specific prenatal indications to induce the physician to look for ultrasound signs suggestive of umbilical true knot. Some studies argue that cases of fetal death and fetal risk are directly related to the number of knots. We also support this thesis, even if further observational and retrospective studies are needed to demonstrate it.

Published
2022

169. Postcoital Vaginal Perforation and Evisceration in Women with No Prior Pelvic Surgery: Laparoscopic Management and Systematic Review of the Literature

Author

Guglielmo Stabile, Giuseppe Ricci, Nicolò de Manzini, Felice Sorrentino, Luigi Nappi, Federico Romano, Francesco Paolo Mangino, Stefania Carlucci, Denise Mordeglia, Stabile, G., Mordeglia, D., Romano, F., Carlucci, S., Mangino, F. P., Nappi, L., Sorrentino, F., De Manzini, N., and Ricci, G.

Subjects
medicine.medical_specialty, Health, Toxicology and Mutagenesis, medicine.medical_treatment, Vaginal Diseases, vaginal perforation, MEDLINE, laparoscopy, Review, Disease, Sexual intercourse, Evisceration, Vaginal perforation, medicine, Humans, Postcoital, Surgical emergency, Laparoscopy, Evisceration (ophthalmology), Rupture, medicine.diagnostic_test, business.industry, General surgery, Vaginal rupture, evisceration, Coitus, Public Health, Environmental and Occupational Health, sexual intercourse, postcoital, medicine.anatomical_structure, Vaginal fornix, vaginal rupture, Medicine, Female, business
Abstract

Objective: to evaluate risk factors, causes, management and surgical therapy of postcoital vaginal perforation and evisceration in women with no prior pelvic surgery. Data sources: We used MEDLINE (PubMed), Scopus, Embase and Web of Science for our research. Our review includes all reports from 1980 to November 2020. The research strategy adopted included different combinations of the following terms: (intercourse) AND (coitus) AND (vaginal perforation). Methods of study selection: we report a case of vaginal evisceration after consensual intercourse in a young and healthy woman. In addition, we performed a systematic review of vaginal perforations with or without evisceration in women without prior surgery or any other predisposing disease. All studies identified were listed by citation, title, authors and abstract. Duplicates were identified by an independent manual screening, performed by one researcher and then removed. For the eligibility process, two authors independently screened the title and abstracts of all non-duplicated papers and excluded those not pertinent to the topic. Tabulation, integration and results: We have followed the PRISMA guidelines. Five manuscripts were detected through the references of the works that had been identified with the research on MEDLINE (PubMed), Scopus, Embase and Web of Science. We found 16 cases between 1980 and 2020. The young age and the virginal status represent the principal risk factors and all the lacerations occurred in the posterior vaginal fornix. The most common surgical technique was the laparotomic approach and, in the remaining cases, the laparoscopic and vaginal route was performed. Conclusions: Post-coital vaginal perforation and evisceration in women with no prior pelvic surgery is a rare condition in the clinical practice and, when it is associated with evisceration it is a surgical emergency. Usually, these injuries are not life-threatening conditions but, a delay in diagnosis, can lead to severe complications. In consideration of the high heterogeneity of the data in the literature, it is essential to define a diagnostic–therapeutic management for the patients with vaginal perforation. With our review, we try to identify the associated risk factors, the best and fastest diagnosis, and the best surgical approach. We believe that a combined vaginal and laparoscopic approach can be the best surgical treatment, useful to diagnose injuries of the abdominal organs and to improve postoperative outcome.

Published
2021

170. Three-dimensional echocardiographic evaluation of the right ventricle in patients with uncomplicated systemic lupus erythematosus

Author

Maurizio Galderisi, Regina Sorrentino, A Buonauro, Roberta Esposito, Liliana Nappi, Francesca Wanda Rossi, Bianca Liccardo, A de Paulis, V Sellitto, Antonella Tufano, Antonio Lobasso, Felice Rivellese, Ciro Santoro, Buonauro, A., Sorrentino, R., Esposito, R., Nappi, L., Lobasso, A., Santoro, C., Rivellese, F., Sellitto, V., Rossi, F. W., Liccardo, Bianca, Tufano, A., Galderisi, M., and Paulis, A de

Subjects
Adult, Male, medicine.medical_specialty, Longitudinal strain, Heart Ventricles, Hypertension, Pulmonary, Ventricular Dysfunction, Right, Echocardiography, Three-Dimensional, Blood Pressure, Systemic lupus erythematosu, right ventricle, White People, Body Mass Index, Rheumatology, Internal medicine, three-dimensional echocardiography, medicine, Humans, Lupus Erythematosus, Systemic, In patient, Subclinical infection, business.industry, Stroke Volume, Three dimensional echocardiography, Middle Aged, Echocardiography, Doppler, Right ventricular dysfunction, medicine.anatomical_structure, Ventricle, Case-Control Studies, Ventricular Function, Right, Cardiology, Regression Analysis, right ventricular dysfunction, Female, business, longitudinal strain
Abstract

Our aim was to identify subclinical right ventricular (RV) alterations in systemic lupus erythematosus (SLE) by combining standard and three-dimensional echocardiography (3DE). Fifty SLE patients without concomitant cardiac disease and 50 healthy controls, matched for age and gender, were enrolled. Disease damage was evaluated by inflammatory markers and SLE damage index. All patients underwent an echo-Doppler examination with 3DE assessment of RV function, RV septal and lateral longitudinal strain. The two groups had comparable body mass index and blood pressure. RV transversal middle diameter and pulmonary arterial pressure were significantly higher in SLE compared to controls. By 3DE, RV end-systolic volume ( p = 0.037) was greater, whereas stroke volume ( p = 0.023), ejection fraction ( p

Published
2019

171. Cesarean Scar Pregnancy Treated by Artery Embolization Combined with Diode Laser: A Novel Approach for a Rare Disease

Author

Felice Sorrentino, Raffaele Tinelli, Vincenzo De Feo, Guglielmo Stabile, Giuseppe Ricci, Luigi Nappi, Stefano Angioni, Maurizio Nicola D'Alterio, Sorrentino, F., De Feo, V., Stabile, G., Tinelli, R., D'Alterio, M. N., Ricci, G., Angioni, S., and Nappi, L.

Subjects
Laser surgery, Medicine (General), medicine.medical_treatment, Case Report, Dilation and curettage, 0302 clinical medicine, Uterine artery embolization, Pregnancy, Retrospective Studie, Medicine, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, Ectopic pregnancy, Arteries, Semiconductor, General Medicine, Ectopic, Curettage, Pregnancy, Ectopic, uterine artery embolization (UAE), Treatment Outcome, Hysteroscopy, 030220 oncology & carcinogenesis, Female, Lasers, Semiconductor, Human, medicine.drug, Adult, medicine.medical_specialty, Arterie, Laser, Cicatrix, 03 medical and health sciences, Rare Diseases, R5-920, Rare Disease, Scar pregnancy, Uterine artery embolization (UAE), Humans, Methotrexate, Retrospective Studies, Cesarean Section, hysteroscopy, business.industry, Lasers, scar pregnancy, medicine.disease, Surgery, laser, business, Rare disease
Abstract

Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy which represents a consequence of a previous cesarean section. It is associated with major maternal morbidity and mortality and has potential implications on future fertility. Because of possible serious complications, CSP should be swiftly diagnosed and treated. There is no management protocol for this rare, life-threatening condition, and each patient should be evaluated individually. Several types of conservative treatment have been used to treat cesarean scar pregnancy: dilation and curettage (D&C), excision of trophoblastic tissues, local or systemic administration of methotrexate, bilateral hypogastric artery ligation, and selective uterine artery embolization with curettage and/or methotrexate administration. In our study we present a cesarean scar pregnancy of a 40-year-old woman who was treated with angiographic uterine artery embolization (UAE) followed by hysteroscopic diode laser resection. Our combined UAE–hysteroscopic laser surgery appears to offer an effective, safe, and minimally invasive surgical treatment.

Published
2021

172. Case Report: Bowel Occlusion Following the Use of Barbed Sutures in Abdominal Surgery. A Single-Center Experience and Literature Review

Author

Guglielmo Stabile, Federico Romano, Davide De Santo, Felice Sorrentino, Luigi Nappi, Francesco Cracco, Giuseppe Ricci, Stabile, G., Romano, F., De Santo, D., Sorrentino, F., Nappi, L., Cracco, F., and Ricci, G.

Subjects
medicine.medical_specialty, RD1-811, laparoscopy, Case Report, bowel occlusion, macromolecular substances, Single Center, 03 medical and health sciences, 0302 clinical medicine, Suture (anatomy), Occlusion, medicine, Hernia, Laparoscopy, myomectomy, Surgical repair, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, hernia surgical repair, medicine.disease, Surgery, barbed suture, Barbed suture, 030220 oncology & carcinogenesis, business, Abdominal surgery
Abstract

Introduction: A high level of surgical ability is required to perform endoscopic knot tying. Barbed sutures help in avoiding this procedure, thus reducing intraoperative time and lowering blood loss and hospitalization time when compared to traditional sutures. Some cases of bowel occlusion following the use of barbed sutures have been described in literature. All of them are characterized by the entanglement of an intestinal loop in wire barbs with bowel occlusion symptoms.Case Presentation: We report two more cases which occurred in our Institute in 2020 and review those which have been reported in the literature by searching on Pubmed, Scopus, and Embase. We used the search terms: “Barbed,” ”Suture,” “Bowel,” and ”Obstruction.” We examined in the literature the surgical procedures, the type of complications, the time to onset of the complications, and the type of barbed suture.Discussion: Twenty-two cases in total were reported in the literature from 2011 to 2020, and bowel complications were largely subsequent to interventions such as hernia surgical repair and myomectomy. In order to take advantage of barbed sutures while minimizing the risk of adverse events, such as intestinal occlusion, some precautions may be considered, such as the shortening of thread tails and use of antiadhesive barriers. Moreover, performing a few stitches backwards when ending the suture might be a useful suggestion. Further studies in this field may be useful in order to assess whether it might be better avoiding barbed suture application on serosal tissues to prevent bowel damage.

Published
2021

173. Role of prenatal magnetic resonance imaging in fetuses with isolated severe ventriculomegaly at neurosonography: A multicenter study

Author

Paolo Volpe, Sara Tinari, Vincenzo Berghella, Francesca Ormitti, Francesco Toni, Olav Bennike Bjørn Petersen, Erich Cosmi, Ludovica Oronzi, Alberto Galindo, Marco De Santis, José Morales-Roselló, Lucia Manganaro, Marcella Pellegrino, Gabriela Loscalzo, Giada Ercolani, Lorenzo Pinelli, Giovanni Scambia, Asma Khalil, Flora Murru, Federico Prefumo, Puk Sandager, Daniele Di Mascio, Tamara Stampalija, F. Forlani, Giuseppe Rizzo, Ignacio Herraiz, Cecilia Parazzini, A. Lanzone, Giulia Masini, Gabriele Saccone, Luigi Carbone, Ilaria Giangiordano, Danilo Buca, Marco Liberati, Gianluigi Pilu, Ilenia Mappa, Elena Trincia, Tiziana Frusca, Silvia Visentin, Tullio Ghi, Luigi Nappi, Mariano Lanna, Francesco D'Antonio, Claudiana Olivieri, Christoph Lees, Sandra Ciulla, Ilaria Fantasia, Cecilia Acuti Martellucci, Maria Elena Flacco, Valentina D'Ambrosio, Giuseppe Maria Maruotti, Andrea Dall'Asta, Marco Di Maurizio, Massimo Caulo, Fulvio Zullo, Lamberto Manzoli, Cecilia Villalain, Olivia Mendez Quintero, Ludovico Muzii, Filomena Giulia Sileo, Raquel Garcia, Antonella Giancotti, Lucia Pasquini, Gabriella Bracalente, Roberto Brunelli, Amanda Antonelli, Alice D'Amico, Lisa Neerup, Ginevra Salsi, Di Mascio, D., Khalil, A., Pilu, G., Rizzo, G., Caulo, M., Liberati, M., Giancotti, A., Lees, C., Volpe, P., Buca, D., Oronzi, L., D'Amico, A., Tinari, S., Stampalija, T., Fantasia, I., Pasquini, L., Masini, G., Brunelli, R., D'Ambrosio, V., Muzii, L., Manganaro, L., Antonelli, A., Ercolani, G., Ciulla, S., Saccone, G., Maruotti, G. M., Carbone, L., Zullo, F., Olivieri, C., Ghi, T., Frusca, T., Dall'Asta, A., Visentin, S., Cosmi, E., Forlani, F., Galindo, A., Villalain, C., Herraiz, I., Sileo, F. G., Mendez Quintero, O., Salsi, G., Bracalente, G., Morales-Rosello, J., Loscalzo, G., Pellegrino, M., De Santis, M., Lanzone, A., Parazzini, C., Lanna, M., Ormitti, F., Toni, F., Murru, F., Di Maurizio, M., Trincia, E., Garcia, R., Bennike Bjorn Petersen, O., Neerup, L., Sandager, P., Prefumo, F., Pinelli, L., Mappa, I., Acuti Martellucci, C., Flacco, M. E., Manzoli, L., Giangiordano, I., Nappi, L., Scambia, G., Berghella, V., D'Antonio, F., Di Mascio, Daniele, Khalil, Asma, Pilu, Gianluigi, Rizzo, Giuseppe, Caulo, Massimo, Liberati, Marco, Giancotti, Antonella, Lees, Christoph, Volpe, Paolo, Buca, Danilo, Oronzi, Ludovica, D'Amico, Alice, Tinari, Sara, Stampalija, Tamara, Fantasia, Ilaria, Pasquini, Lucia, Masini, Giulia, Brunelli, Roberto, D'Ambrosio, Valentina, Muzii, Ludovico, Manganaro, Lucia, Antonelli, Amanda, Ercolani, Giada, Ciulla, Sandra, Saccone, Gabriele, Maruotti, Giuseppe Maria, Carbone, Luigi, Zullo, Fulvio, Olivieri, Claudiana, Ghi, Tullio, Frusca, Tiziana, Dall'Asta, Andrea, Visentin, Silvia, Cosmi, Erich, Forlani, Francesco, Galindo, Alberto, Villalain, Cecilia, Herraiz, Ignacio, Sileo, Filomena Giulia, Quintero, Olivia Mendez, Salsi, Ginevra, Bracalente, Gabriella, Morales-Roselló, José, Loscalzo, Gabriela, Pellegrino, Marcella, De Santis, Marco, Lanzone, Antonio, Parazzini, Cecilia, Lanna, Mariano, Ormitti, Francesca, Toni, Francesco, Murru, Flora, Di Maurizio, Marco, Trincia, Elena, Garcia, Raquel, Petersen, Olav Bennike Bjørn, Neerup, Lisa, Sandager, Puk, Prefumo, Federico, Pinelli, Lorenzo, Mappa, Ilenia, Martellucci, Cecilia Acuti, Flacco, Maria Elena, Manzoli, Lamberto, Giangiordano, Ilaria, Nappi, Luigi, Scambia, Giovanni, Berghella, Vincenzo, and D'Antonio, Francesco

Subjects
medicine.medical_specialty, Central nervous system, Fetal magnetic resonance imaging, Fetal ultrasound, MRI, Neurosonography, Prenatal diagnosis, Ventriculomegaly, Prenatal diagnosi, central nervous system, fetal magnetic resonance imaging, fetal ultrasound, neurosonography, prenatal diagnosis, ventriculomegaly, Ultrasonography, Prenatal, NO, Cohort Studies, Lesion, Central nervous system, Fetal magnetic resonance imaging, Fetal ultrasound, MRI, Neurosonography, Prenatal diagnosis, Ventriculomegaly, Fetus, Pregnancy, Humans, Medicine, ventriculomegaly, central nervous system, fetal magnetic resonance imaging, MRI, fetal ultrasound, neurosonography, prenatal diagnosis, Retrospective Studies, medicine.diagnostic_test, business.industry, Ultrasound, Obstetrics and Gynecology, Gestational age, Magnetic resonance imaging, medicine.disease, Magnetic Resonance Imaging, Reproductive Medicine, Settore MED/40, Gestation, Female, Radiology, medicine.symptom, business, Hydrocephalus
Abstract

Objective: The aim of this study was to report the rate of additional anomalies detected exclusively at prenatal magnetic resonance imaging (MRI) in fetuses with isolated severe ventriculomegaly undergoing neurosonography. Method: Multicenter, retrospective, cohort study involving 20 referral fetal medicine centers in Italy, United Kingdom, Spain and Denmark. Inclusion criteria were fetuses affected by isolated severe ventriculomegaly (≥15 mm), defined as ventriculomegaly with normal karyotype and no other additional central nervous system (CNS) and extra-CNS anomalies on ultrasound. In all cases, a multiplanar assessment of fetal brain as suggested by ISUOG guidelines on fetal neurosonography had been performed. The primary outcome was the rate of additional CNS anomalies detected exclusively at fetal MRI within two weeks from neurosonography. Subgroup analyses according to gestational age at MRI (

Published
2021

174. Impact of COVID-19 outbreak on cancer immunotherapy in Italy: A survey of young oncologists

Author

Sara Parola, Diletta Cavallero, Pietro De Placido, Rossella Di Franco, Francesca Zacchi, Giacomo Cartenì, Sabino De Placido, Claudia von Arx, Alice Rossi, Fernanda Picozzi, Pasquale Rescigno, Laura Attademo, Giovannella Palmieri, Carminia Maria Della Corte, Fabiana Vitiello, Anna Russo, Lucia Nappi, Michele Aieta, Alessia Mennitto, Fabiana Napolitano, Marco Messina, Giuseppe Buono, Valeria Merz, Marco De Felice, Stefano De Falco, Immacolata Paciolla, Irene De Santo, Dario Trapani, Antonio M. Grimaldi, Paolo Tarantino, Alessandro Morabito, Tortora Vincenzo, Stefano Pepe, Giuseppe Palmieri, Antonietta Fabbrocini, Diana Giannarelli, Alfonso De Stefano, Sabrina Vari, Cesare Gridelli, Vittorio Riccio, Angelica Petrillo, Martina Pagliuca, Giuseppe Calderoni, Margaret Ottaviano, Vincenza Conteduca, Michela Lia, Giuseppe Santabarbara, Ester Simeone, Valentina Borzillo, Francesca Caputo, Mario Rosanova, Marcello Curvietto, Pasquale Assalone, Brigitta Mucci, Raffaele Conca, Vito Vanella, Francovito Piantedosi, Vincenzo Montesarchio, Erica Pietroluongo, Lucia Festino, Federica Tomei, Vincenzo Di Lauro, Bruno Daniele, Caterina Vivaldi, Andrea Zivi, Veronica Prati, Pasqualina Giordano, Luisa Piccin, Francesco Bloise, Massimiliano Spada, Jole Ventriglia, Davide Bosso, Alessandro Marco Minisini, Massimiliano Salati, Monica Milano, Carlo Messina, Valentina Massa, Mario Giuliano, Claudia Trojanello, Antonella Lucia Marretta, Fortunato Ciardiello, Antonio Avallone, Marianna Tortora, Ilaria Zampiva, Alessia Cavo, Floriana Morgillo, Andrea Sbrana, Piera Federico, Maria Grazia Vitale, Sandro Pignata, Antonia Silvestri, Paola Taveggia, Sara Merler, Paolo A. Ascierto, Michelino De Laurentiis, Ottaviano, Margaret, Curvietto, Marcello, Rescigno, Pasquale, Tortora, Marianna, Palmieri, Giovannella, Giannarelli, Diana, Aieta, Michele, Assalone, Pasquale, Attademo, Laura, Avallone, Antonio, Bloise, Francesco, Bosso, Davide, Borzillo, Valentina, Buono, Giuseppe, Calderoni, Giuseppe, Caputo, Francesca, Cartenì, Giacomo, Cavallero, Diletta, Cavo, Alessia, Ciardiello, Fortunato, Conca, Raffaele, Conteduca, Vincenza, De Falco, Stefano, De Felice, Marco, De Laurentiis, Michelino, De Placido, Pietro, De Placido, Sabino, De Santo, Irene, De Stefano, Alfonso, Della Corte, Carminia Maria, Di Franco, Rossella, Di Lauro, Vincenzo, Fabbrocini, Antonietta, Federico, Piera, Festino, Lucia, Giordano, Pasqualina, Giuliano, Mario, Gridelli, Cesare, Grimaldi, Antonio Maria, Lia, Michela, Marretta, Antonella Lucia, Massa, Valentina, Mennitto, Alessia, Merler, Sara, Merz, Valeria, Messina, Carlo, Messina, Marco, Milano, Monica, Minisini, Alessandro Marco, Montesarchio, Vincenzo, Morabito, Alessandro, Morgillo, Floriana, Mucci, Brigitta, Nappi, Lucia, Napolitano, Fabiana, Paciolla, Immacolata, Pagliuca, Martina, Palmieri, Giuseppe, Parola, Sara, Pepe, Stefano, Petrillo, Angelica, Piantedosi, Francovito, Piccin, Luisa, Picozzi, Fernanda, Pietroluongo, Erica, Pignata, Sandro, Prati, Veronica, Riccio, Vittorio, Rosanova, Mario, Rossi, Alice, Russo, Anna, Salati, Massimiliano, Santabarbara, Giuseppe, Sbrana, Andrea, Simeone, Ester, Silvestri, Antonia, Spada, Massimiliano, Tarantino, Paolo, Taveggia, Paola, Tomei, Federica, Vincenzo, Tortora, Trapani, Dario, Trojanello, Claudia, Vanella, Vito, Vari, Sabrina, Ventriglia, Jole, Vitale, Maria Grazia, Vitiello, Fabiana, Vivaldi, Caterina, von Arx, Claudia, Zacchi, Francesca, Zampiva, Ilaria, Zivi, Andrea, Daniele, Bruno, Ascierto, Paolo Antonio, Ottaviano, M., Curvietto, M., Rescigno, P., Tortora, M., Palmieri, G., Giannarelli, D., Aieta, M., Assalone, P., Attademo, L., Avallone, A., Bloise, F., Bosso, D., Borzillo, V., Buono, G., Calderoni, G., Caputo, F., Carteni, G., Cavallero, D., Cavo, A., Ciardiello, F., Conca, R., Conteduca, V., De Falco, S., De Felice, M., De Laurentiis, M., De Placido, P., De Placido, S., De Santo, I., De Stefano, A., Della Corte, C. M., Di Franco, R., Di Lauro, V., Fabbrocini, A., Federico, P., Festino, L., Giordano, P., Giuliano, M., Gridelli, C., Grimaldi, A. M., Lia, M., Marretta, A. L., Massa, V., Mennitto, A., Merler, S., Merz, V., Messina, C., Messina, M., Milano, M., Minisini, A. M., Montesarchio, V., Morabito, A., Morgillo, F., Mucci, B., Nappi, L., Napolitano, F., Paciolla, I., Pagliuca, M., Parola, S., Pepe, S., Petrillo, A., Piantedosi, F., Piccin, L., Picozzi, F., Pietroluongo, E., Pignata, S., Prati, V., Riccio, V., Rosanova, M., Rossi, A., Russo, A., Salati, M., Santabarbara, G., Sbrana, A., Simeone, E., Silvestri, A., Spada, M., Tarantino, P., Taveggia, P., Tomei, F., Vincenzo, T., Trapani, D., Trojanello, C., Vanella, V., Vari, S., Ventriglia, J., Vitale, M. G., Vitiello, F., Vivaldi, C., Von Arx, C., Zacchi, F., Zampiva, I., Zivi, A., Daniele, B., and Ascierto, P. A.

Subjects
Male, Cancer Research, Immune checkpoint inhibitors, Programmed Cell Death 1 Receptor, Practice Patterns, Medical Oncology, B7-H1 Antigen, Antineoplastic Agents, Immunological, 0302 clinical medicine, Drug Prescription, Neoplasms, Surveys and Questionnaires, Pandemic, Prevalence, Surveys and Questionnaire, Infection control, Immunology and Allergy, CTLA-4 Antigen, 030212 general & internal medicine, Viral, Practice Patterns, Physicians', RC254-282, Clinical/Translational Cancer Immunotherapy, Oncologists, Geography, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, antineoplastic protocols, Immunological, Oncology, Italy, 030220 oncology & carcinogenesis, Molecular Medicine, Female, immunotherapy, Coronavirus Infections, Human, healthcare economics and organizations, Adult, Telemedicine, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Immunology, Antineoplastic Agents, lung neoplasms, Drug Prescriptions, Time-to-Treatment, 03 medical and health sciences, Betacoronavirus, medicine, melanoma, COVID-19, Humans, Infection Control, Pandemics, SARS-CoV-2, Medical prescription, Pharmacology, Physicians', Betacoronaviru, Coronavirus Infection, Cancer, Outbreak, Pneumonia, medicine.disease, lung neoplasm, antineoplastic protocol, Family medicine, healthcare economics and organization, Oncologist, Neoplasm
Abstract

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has overwhelmed the health systems worldwide. Data regarding the impact of COVID-19 on cancer patients (CPs) undergoing or candidate for immune checkpoint inhibitors (ICIs) are lacking. We depicted the practice and adaptations in the management of patients with solid tumors eligible or receiving ICIs during the COVID-19 pandemic, with a special focus on Campania region.MethodsThis survey (25 questions), promoted by the young section of SCITO (Società Campana di ImmunoTerapia Oncologica) Group, was circulated among Italian young oncologists practicing in regions variously affected by the pandemic: high (group 1), medium (group 2) and low (group 3) prevalence of SARS-CoV-2–positive patients. For Campania region, the physician responders were split into those working in cancer centers (CC), university hospitals (UH) and general hospitals (GH). Percentages of agreement, among High (H) versus Medium (M) and versus Low (L) group for Italy and among CC, UH and GH for Campania region, were compared by using Fisher’s exact tests for dichotomous answers and χ2 test for trends relative to the questions with 3 or more options.ResultsThis is the first Italian study to investigate the COVID-19 impact on cancer immunotherapy, unique in its type and very clear in the results. The COVID-19 pandemic seemed not to affect the standard practice in the prescription and delivery of ICIs in Italy. Telemedicine was widely used. There was high consensus to interrupt immunotherapy in SARS-CoV-2–positive patients and to adopt ICIs with longer schedule interval. The majority of the responders tended not to delay the start of ICIs; there were no changes in supportive treatments, but some of the physicians opted for delaying surgeries (if part of patients’ planned treatment approach). The results from responders in Campania did not differ significantly from the national ones.ConclusionOur study highlights the efforts of Italian oncologists to maintain high standards of care for CPs treated with ICIs, regardless the regional prevalence of COVID-19, suggesting the adoption of similar solutions. Research on patients treated with ICIs and experiencing COVID-19 will clarify the safety profile to continue the treatments, thus informing on the most appropriate clinical conducts.

Published
2020

175. Diagnostic accuracy of Doppler ultrasound in predicting perinatal outcome in pregnancies at term: A prospective longitudinal study

Author

Danilo Buca, Sarah Gustapane, Giorgio Pagani, Maria Elena Flacco, Cecilia Acuti Martellucci, Giuseppe Rizzo, Francesco D'Antonio, Luigi Nappi, Lamberto Manzoli, Alexander Makatsariya, Marco Liberati, D'Antonio F., Rizzo G., Gustapane S., Buca D., Flacco M. E., Martellucci C., Manzoli L., Makatsariya A., Nappi L., Pagani G., and Liberati M.

Subjects
Middle Cerebral Artery, Doppler, cerebroplacental ratio, middle cerebral artery, outcome pregnancies at term, perinatal outcome, umbilical artery, Logistic regression, Umbilical Arteries, Pregnancy, Prenatal, Longitudinal Studies, Prospective Studies, Prospective cohort study, Ultrasonography, Obstetrics, Pregnancy Outcome, Obstetrics and Gynecology, Gestational age, General Medicine, Uterine Artery, Pulsatile Flow, Middle cerebral artery, Gestation, Female, Pregnancy Trimester, Adult, medicine.medical_specialty, Pregnancy Trimester, Third, Socio-culturale, Humans, Infant, Newborn, Predictive Value of Tests, Ultrasonography, Doppler, Ultrasonography, Prenatal, NO, medicine.artery, medicine, Third, business.industry, Infant, Umbilical artery, Odds ratio, Newborn, medicine.disease, Settore MED/40 - Ginecologia e Ostetricia, business
Abstract

Introduction: To explore the strength of association and the diagnostic accuracy of umbilical (UA), middle cerebral (MCA), uterine arteries pulsatility index (PI) and the cerebroplacental ratio in predicting an adverse outcome when applied to singleton pregnancies at term. Material and methods: Prospective study carried out in a dedicated research ultrasound clinic. Attended clinicians were blinded to Doppler findings. Inclusion criteria were consecutive singleton pregnancies between 36+0 and 37+6weeks of gestation. The primary outcome was a composite score of adverse perinatal outcome. Logistic regression and ROC curve analyses were used to analyze the data. Results: In all, 600 consecutive singleton pregnancies from 36weeks of gestation were included in the study. Mean MCA PI (1.1± 0.2 vs 1.5± 0.4, P&nbsp

Published
2020

176. Adverse intrapartum outcome in pregnancies complicated by small for gestational age and late fetal growth restriction undergoing induction of labor with Dinoprostone, Misoprostol or mechanical methods: A systematic review and meta-analysis

Author

Alessandra Familiari, Patrizia Vergani, Vincenzo Berghella, Marco Liberati, Franz Bahlmann, E. V. Cosmi, Chinedu Nwabuobi, Francesco D'Antonio, Federico Mecacci, Anthony Odibo, Maria Elena Flacco, Carlotta Iacovella, Asma Khalil, Giuseppe Rizzo, Cecilia Acuti Martellucci, L Manzoli, Karen Melchiorre, Luigi Nappi, Alice D'Amico, Silvia Visentin, Danilo Buca, Giovanni Scambia, Nobuhiro Hidaka, Daniele Di Mascio, Serena Simeone, Familiari, Alessandra, Khalil, Asma, Rizzo, Giuseppe, Odibo, Anthony, Vergani, Patrizia, Buca, Danilo, Hidaka, Nobuhiro, Di Mascio, Daniele, Nwabuobi, Chinedu, Simeone, Serena, Mecacci, Federico, Visentin, Silvia, Cosmi, Eric, Liberati, Marco, D’Amico, Alice, Flacco, Maria Elena, Martellucci, Cecilia Acuti, Manzoli, Lamberto, Nappi, Luigi, Iacovella, Carlotta, Bahlmann, Franz, Melchiorre, Karen, Scambia, Giovanni, Berghella, Vincenzo, D’Antonio, Francesco, Familiari, A, Khalil, A, Rizzo, G, Odibo, A, Vergani, P, Buca, D, Hidaka, N, Di Mascio, D, Nwabuobi, C, Simeone, S, Mecacci, F, Visentin, S, Cosmi, E, Liberati, M, D'Amico, A, Flacco, M, Martellucci, C, Manzoli, L, Nappi, L, Iacovella, C, Bahlmann, F, Melchiorre, K, Scambia, G, Berghella, V, and D'Antonio, F

Subjects
medicine.medical_specialty, Foley balloon catheter, Population, Socio-culturale, Gestational Age, Dinoprostone, Ultrasonography, Prenatal, Pregnancy, Prenatal, Humans, Medicine, IOL, Labor, Induced, education, Misoprostol, Induction of labor, SGA, FGR, Ultrasonography, education.field_of_study, Fetus, Fetal Growth Retardation, Cesarean Section, business.industry, Obstetrics, Cook balloon catheter, Induced, Infant, Newborn, Infant, Obstetrics and Gynecology, Newborn, medicine.disease, Labor, Reproductive Medicine, Settore MED/40, Meta-analysis, Infant, Small for Gestational Age, Small for Gestational Age, Small for gestational age, Female, business, Uterine tachysystole, medicine.drug
Abstract

Objective: To investigate the outcome of pregnancies with small baby, including both small for gestational age (SGA) and late fetal growth restriction (FGR) fetuses, undergoing induction of labor (IOL) with Dinoprostone, Misoprostol or mechanical methods. Study design: Medline, Embase and Cochrane databases were searched. Inclusion criteria were non-anomalous singleton pregnancies complicated by the presence of a small fetus, defined as a fetus with estimated fetal weight (EFW) or abdominal circumference (AC) 3rd centile with normal cerebroplacental Dopplers). Quality assessment of each included study was performed using the Risk of Bias in Non-randomized Studies-of Interventions tool (ROBINS-I), while the GRADE methodology was used to assess the quality of the body of retrieved evidence. Meta-analyses of proportions and individual data random-effect logistic regression were used to analyze the data. Results: 12 studies (1711 pregnancies) were included. In the overall population of small fetuses, composite adverse intra-partum outcome occurred in 21.2 % (95 % CI 10.0−34.9) of pregnancies induced with Dinoprostone, 18.0 % (95 % CI 6.9−32.5) of those with Misoprostol and 11.6 % (95 % CI 5.5−19.3) of those undergoing IOL with mechanical methods. Cesarean section (CS) for non-reassuring fetal status (NRFS) was required in 18.1 % (95 % CI 9.9−28.3) of pregnancies induced with Dinoprostone, 9.4 % (95 % CI 1.4−22.0) of those with Misoprostol and 8.1 % (95 % CI 5.0−11.6) of those undergoing mechanical induction. Likewise, uterine tachysystole, was recorded on CTG in 13.8 % (95 % CI 6.9−22.3) of cases induced with Dinoprostone, 7.5 % (95 % CI 2.1−15.4) of those with Misoprostol and 3.8 % (95 % CI 0–4.4) of those induced with mechanical methods. Composite adverse perinatal outcome following delivery complicated 2.9 % (95 % CI 0.5−6.7) newborns after IOL with Dinoprostone, 0.6 % (95 % CI 0–2.5) with Misoprostol and 0.7 % (95 % CI 0–7.1) with mechanical methods. In pregnancies complicated by late FGR, adverse intrapartum outcome occurred in 25.3 % (95 % CI 18.8−32.5) of women undergoing IOL with Dinoprostone, compared to 7.4 % (95 % CI 3.9−11.7) of those with mechanical methods, while CS for NRFS was performed in 23.8 % (95 % CI 17.3−30.9) and 6.2 % (95 % CI 2.8−10.5) of the cases, respectively. Finally, in SGA fetuses, composite adverse intrapartum outcome complicated 8.4 % (95 % CI 4.6−13.0) of pregnancies induced with Dinoprostone, 18.6 % (95 % CI 13.1−25.2) of those with Misoprostol and 8.7 (95 % CI 2.5−17.5) of those undergoing mechanical IOL, while CS for NRF was performed in 8.4 % (95 % CI 4.6−13.0) of women induced with Dinoprostone, 18.6 % (95 % CI 13.1−25.2) of those with Misoprostol and 8.7 % (95 % CI 2.5−17.5) of those undergoing mechanical induction. Overall, the quality of the included studies was low and was downgraded due to considerable clinical and statistical heterogeneity. Conclusions: There is limited evidence on the optimal type of IOL in pregnancies with small fetuses. Mechanical methods seem to be associated with a lower occurrence of adverse intrapartum outcomes, but a direct comparison between different techniques could not be performed.

Published
2020

177. Role of prenatal magnetic resonance imaging in fetuses with isolated mild or moderate ventriculomegaly in the era of neurosonography: international multicenter study

Author

Vincenzo Berghella, Giuseppe Maria Maruotti, Francesco Toni, Gabriella Bracalente, José Morales-Roselló, Ilaria Fantasia, Karen Melchiorre, Ginevra Salsi, Giovanni Scambia, Gabriella Meccariello, Lucia Manganaro, Marco Di Maurizio, Federico Prefumo, Pierluigi Benedetti Panici, Tamara Stampalija, Christoph Lees, Giuseppe Rizzo, Giada Ercolani, Gianluigi Pilu, Paolo Volpe, Francesco D'Antonio, Basky Thilaganathan, Asma Khalil, Tullio Ghi, Alessandra Familiari, Luisa D'Oria, Luigi Nappi, Roberto Brunelli, Claudio Celentano, Marco De Santis, Ilaria Giangiordano, Danilo Buca, S. Buongiorno, Francesca Ormitti, Tiziana Frusca, Giulia Masini, Fulvio Zullo, Nicola Volpe, Luciana Mastricci, Laura Sarno, Lorenzo Vasciaveo, Massimo Caulo, Lucia Pasquini, Valentina D'Ambrosio, Maria Elena Flacco, Giulia Luise, Lamberto Manzoli, Gabriele Saccone, Antonio Lanzone, Filomena Giulia Sileo, Emma Bertucci, Antonella Giancotti, Amanda Antonelli, Gabriela Loscalzo, Luigi Carbone, Massimo Gregori, Daniele Di Mascio, Claudiana Olivieri, Marco Liberati, Andrea Dall'Asta, Lorenzo Pinelli, Di Mascio D., Khalil A., Thilaganathan B., Rizzo G., Buca D., Liberati M., Celentano C., Melchiorre K., Caulo M., Pilu G., Salsi G., Toni F., Stampalija T., Fantasia I., Luise G., Gregori M., Volpe P., Olivieri C., Giancotti A., D'Ambrosio V., Brunelli R., Panici P.B., Manganaro L., Antonelli A., Ercolani G., Pasquini L., Masini G., Di Maurizio M., Lees C., Bracalente G., Morales-Rosello J., Loscalzo G., Saccone G., Carbone L., Sarno L., Maruotti G.M., Zullo F., Ghi T., Frusca T., Dall'Asta A., Volpe N., Ormitti F., Buongiorno S., De Santis M., D'Oria L., Lanzone A., Prefumo F., Pinelli L., Bertucci E., Sileo F.G., Flacco M.E., Manzoli L., Giangiordano I., Mastricci L., Meccariello G., Vasciaveo L., Nappi L., Familiari A., Scambia G., Berghella V., D'Antonio F., Di Mascio, Daniele, Khalil, Asma, Thilaganathan, Basky, Rizzo, Giuseppe, Buca, Danilo, Liberati, Marco, Celentano, Claudio, Melchiorre, Karen, Caulo, Massimo, Pilu, Gianluigi, Salsi, Ginevra, Toni, Francesco, Stampalija, Tamara, Fantasia, Ilaria, Luise, Giulia, Gregori, Massimo, Volpe, Paolo, Olivieri, Claudiana, Giancotti, Antonella, D'Ambrosio, Valentina, Brunelli, Roberto, Benedetti Panici, Pierluigi, Manganaro, Lucia, Antonelli, Amanda, Ercolani, Giada, Pasquini, Lucia, Masini, Giulia, Di Maurizio, Marco, Lees, Christoph, Bracalente, Gabriella, Morales‐roselló, José, Loscalzo, Gabriela, Saccone, Gabriele, Carbone, Luigi, Sarno, Laura, Maruotti, GIUSEPPE MARIA, Zullo, Fulvio, Ghi, Tullio, Frusca, Tiziana, Dall'Asta, Andrea, Volpe, Nicola, Ormitti, Francesca, Buongiorno, Silvia, De Santis, Marco, D'Oria, Luisa, Lanzone, Antonio, Prefumo, Federico, Pinelli, Lorenzo, Bertucci, Emma, Giulia Sileo, Filomena, Elena Flacco, Maria, Manzoli, Lamberto, Giangiordano, Ilaria, Mastricci, Luciana, Meccariello, Gabriella, Vasciaveo, Lorenzo, Nappi, Luigi, Familiari, Alessandra, Scambia, Giovanni, Berghella, Vincenzo, D'Antonio, Francesco, Mascio, Daniele Di, Panici, Pierluigi Benedetti, Maruotti, Giuseppe Maria, Sileo, Filomena Giulia, and Flacco, Maria Elena

Subjects
Fetal magnetic resonance imaging, central nervous system, fetal magnetic resonance imaging, fetal ultrasound, MRI, neurosonography, prenatal diagnosis, ventriculomegaly, Adult, Cohort Studies, Europe, Female, Gestational Age, Humans, Hydrocephalus, Predictive Value of Tests, Pregnancy, Retrospective Studies, Magnetic Resonance Imaging, Prenatal Diagnosis, medicine.medical_specialty, Socio-culturale, Fetal brain, 03 medical and health sciences, 0302 clinical medicine, medicine, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Fetus, prenatal diagnosi, 030219 obstetrics & reproductive medicine, Radiological and Ultrasound Technology, medicine.diagnostic_test, business.industry, Ultrasound, Obstetrics and Gynecology, Magnetic resonance imaging, General Medicine, medicine.disease, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Reproductive Medicine, Multicenter study, embryonic structures, Radiology, business, Ventriculomegaly
Abstract

Objectives: To assess the role of fetal magnetic resonance imaging (MRI) in detecting associated anomalies in fetuses presenting with mild or moderate isolated ventriculomegaly (VM) undergoing multiplanar ultrasound evaluation of the fetal brain. Methods: This was a multicenter, retrospective, cohort study involving 15 referral fetal medicine centers in Italy, the UK and Spain. Inclusion criteria were fetuses affected by isolated mild (ventricular atrial diameter, 10.0–11.9 mm) or moderate (ventricular atrial diameter, 12.0–14.9 mm) VM on ultrasound, defined as VM with normal karyotype and no other additional central nervous system (CNS) or extra-CNS anomalies on ultrasound, undergoing detailed assessment of the fetal brain using a multiplanar approach as suggested by the International Society of Ultrasound in Obstetrics and Gynecology guidelines for the fetal neurosonogram, followed by fetal MRI. The primary outcome of the study was to report the incidence of additional CNS anomalies detected exclusively on prenatal MRI and missed on ultrasound, while the secondary aim was to estimate the incidence of additional anomalies detected exclusively after birth and missed on prenatal imaging (ultrasound and MRI). Subgroup analysis according to gestational age at MRI (< 24 vs ≥ 24 weeks), laterality of VM (unilateral vs bilateral) and severity of dilatation (mild vs moderate VM) were also performed. Results: Five hundred and fifty-six fetuses with a prenatal diagnosis of isolated mild or moderate VM on ultrasound were included in the analysis. Additional structural anomalies were detected on prenatal MRI and missed on ultrasound in 5.4% (95% CI, 3.8–7.6%) of cases. When considering the type of anomaly, supratentorial intracranial hemorrhage was detected on MRI in 26.7% of fetuses, while polymicrogyria and lissencephaly were detected in 20.0% and 13.3% of cases, respectively. Hypoplasia of the corpus callosum was detected on MRI in 6.7% of cases, while dysgenesis was detected in 3.3%. Fetuses with an associated anomaly detected only on MRI were more likely to have moderate than mild VM (60.0% vs 17.7%; P < 0.001), while there was no significant difference in the proportion of cases with bilateral VM between the two groups (P = 0.2). Logistic regression analysis showed that lower maternal body mass index (adjusted odds ratio (aOR), 0.85 (95% CI, 0.7–0.99); P = 0.030), the presence of moderate VM (aOR, 5.8 (95% CI, 2.6–13.4); P < 0.001) and gestational age at MRI ≥ 24 weeks (aOR, 4.1 (95% CI, 1.1–15.3); P = 0.038) were associated independently with the probability of detecting an associated anomaly on MRI. Associated anomalies were detected exclusively at birth and missed on prenatal imaging in 3.8% of cases. Conclusions: The incidence of an associated fetal anomaly missed on ultrasound and detected only on fetal MRI in fetuses with isolated mild or moderate VM undergoing neurosonography is lower than that reported previously. The large majority of these anomalies are difficult to detect on ultrasound. The findings from this study support the practice of MRI assessment in every fetus with a prenatal diagnosis of VM, although parents can be reassured of the low risk of an associated anomaly when VM is isolated on neurosonography. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.

Published
2020

178. Long term deficiency of vitamin D in germ cell testicular cancer survivors

Author

Giovannella Palmieri, Lucia Nappi, Martin E. Gleave, Sabino De Placido, Margaret Ottaviano, Pasquale Rescigno, Vincenzo Damiano, Ladan Fazli, Nappi, L., Ottaviano, M., Rescigno, P., Fazli, L., Gleave, M. E., Damiano, V., De Placido, S., and Palmieri, G.

Subjects
Quality of life, medicine.medical_specialty, long term side effects, medicine.medical_treatment, Long term side effect, testicular cancer survivors, 030209 endocrinology & metabolism, Calcitriol receptor, Gastroenterology, Targeted therapy, 03 medical and health sciences, 0302 clinical medicine, Testicular cancer, Testicular cancer survivor, Internal medicine, Vitamin D and neurology, Medicine, Vitamin D, Testosterone, Chemotherapy, business.industry, Seminoma, medicine.disease, Oncology, 030220 oncology & carcinogenesis, Germ cell tumors, business, Research Paper
Abstract

// Lucia Nappi 1 , Margaret Ottaviano 2 , Pasquale Rescigno 2, 3 , Ladan Fazli 1 , Martin E. Gleave 1 , Vincenzo Damiano 2 , Sabino De Placido 4 and Giovannella Palmieri 2 1 Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada 2 Department of Medicine and Surgery, Division of Medical Oncology, Centro di Riferimento Tumori Rari Regione Campania, University of Naples “Federico II”, Napoli, Italy 3 The Institute of Cancer Research, Prostate Targeted Therapy Group, Sutton, UK 4 Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy Correspondence to: Giovannella Palmieri, email: giovpalm@unina.it Keywords: testicular cancer; vitamin D; testicular cancer survivors; long term side effects; quality of life Received: August 06, 2017 Accepted: December 05, 2017 Published: April 20, 2018 ABSTRACT Background: Cisplatin-based chemotherapy significantly improved the survival of patients with germ cell testicular cancer. However, long term side effects of chemotherapy have non-negligible impact on the quality of life of these young patients, who have a long life expectancy after being successfully treated. Materials and Methods: 25-OH vitamin D, testosterone, FSH and LH of patients with testicular cancer were retrospectively evaluated and for each patient clinical information were collected. The tissue of 52 patients with germ cell tumors was analyzed for VDR expression by immunohistochemistry. The serum 25-OH vitamin D and VDR expression were correlated to the patients ‘clinical characteristics. Results: 25-OH vitamin D was analyzed in 82 patients. Insufficient (< 30 ng/ml) levels were detected in 65%–85%, mild deficient (< 20 ng/ml) in 25%–36% and severe deficient (< 10 ng/ml) in 6%–18% of the patients over a median follow-up of 48 months. No difference in serum 25-OH vitamin D was detected over the follow-up time points. No correlation with histology, stage and type of treatment was found. The 25-OH vitamin D levels were not correlated to testosterone, FSH and LH levels. Interestingly, the expression of VDR was much higher in non seminoma than in seminoma tissue. Conclusions: Patients with testicular cancer have reduced vitamin D levels after the treatment of the primary cancer. Since long term hypovitaminosis D leads to high risk of fractures, infertility and cardiovascular diseases, we envision that vitamin D should be regularly checked in patients with testicular cancer and replaced if needed.

Published
2018

179. Lack of Effectiveness of Postchemotherapy Lymphadenectomy in Bladder Cancer Patients with Clinical Evidence of Metastatic Pelvic or Retroperitoneal Lymph Nodes Only: A Propensity Score-based Analysis

Author

Vadim S. Koshkin, Joaquim Bellmunt, Matthew D. Galsky, Sylvain Ladoire, B.J. Eigl, Bas W.G. van Rhijn, Andrea Necchi, Johnathan E. Rosenberg, Guenter Niegisch, Kees Hendricksen, Salvatore Lo Vullo, Daniel W. Bowles, Sandy Srinivas, Aristotelis Bamias, Ali Reza Golshayan, Evan Y. Yu, Florian Roghmann, Michael Woods, Matthew I. Milowsky, Jakub Dobruch, Petros Grivas, Evanguelos Xylinas, Dominik D. Berthold, Yu-Ning Wong, Neeraj Agarwal, Srikala S. Sridhar, Jack Baniel, Lucia Nappi, Federica Recine, Ulka N. Vaishampayan, Lauren C. Harshman, Ugo De Giorgi, Simon J. Crabb, Luigi Mariani, Carsten Ohlmann, Ajjaj Alva, Sumanta K. Pal, Thomas Powles, Christine Theodore, Cora N. Sternberg, Necchi, A, Mariani, L, Lo Vullo, S, Yu, Ey, Woods, Me, Wong, Yn, Harshman, Lc, Alva, A, Sternberg, Cn, Bamias, A, Grivas, P, Koshkin, V, Roghmann, F, Dobruch, J, Eigl, Bj, Nappi, L, Milowsky, Mi, Niegisch, G, Pal, Sk, De Giorgi, U, Recine, F, Vaishampayan, U, Berthold, Dd, Bowles, Dw, Baniel, J, Theodore, C, Ladoire, S, Srinivas, S, Agarwal, N, Crabb, S, Sridhar, S, Golshayan, Ar, Ohlmann, C, Xylinas, E, Powles, T, Rosenberg, Je, Bellmunt, J, van Rhijn, B, Galsky, Md, and Hendricksen, K

Subjects
medicine.medical_specialty, Urology, medicine.medical_treatment, Retroperitoneal Lymph Node, 030232 urology & nephrology, Cystectomy, Article, Pelvis, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Retroperitoneal Space, Propensity Score, Lymph node, Aged, Neoplasm Staging, Retrospective Studies, Carcinoma, Transitional Cell, Bladder cancer, business.industry, Hazard ratio, Middle Aged, medicine.disease, Primary tumor, Progression-Free Survival, 3. Good health, Surgery, Treatment Outcome, medicine.anatomical_structure, Urinary Bladder Neoplasms, Chemotherapy, Adjuvant, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Propensity score matching, Lymph Node Excision, Lymphadenectomy, Lymph Nodes, business
Abstract

Background: Limited data is available on the role, and extent of, postchemotherapy lymphadenectomy (PC-LND) in patients with clinical evidence of pelvic (cN1-3) or retroperitoneal (RP) lymph node spread from urothelial bladder carcinoma. Objective: To compare the outcomes of operated versus nonoperated patients after first-line chemotherapy. Design, setting, and participants: Data from 34 centers was collected, totaling 522 patients, treated between January 2000 and June 2015. Criteria for patient selection were the following: bladder primary tumor, lymph node metastases (pelvic. ±. RP) only, first-line platinum-based chemotherapy given. Intervention: LND (with cystectomy) versus observation after first-line chemotherapy for metastatic urothelial bladder carcinoma. Outcome measures and statistical analysis: Overall survival (OS) was the primary endpoint. Multiple propensity score techniques were adopted, including 1:1 propensity score matching and inverse probability of treatment weighting. Additionally, the inverse probability of treatment weighting analysis was performed with the inclusion of the covariates, that is, with doubly robust estimation. Results and limitations: Overall, 242 (46.4%) patients received PC-LND and 280 (53.6%) observation after chemotherapy. There were 177 (33.9%) and 345 (66.1%) patients with either RP or pelvic LND only, respectively. Doubly robust estimation-adjusted comparison was not significant for improved OS for PC-LND (hazard ratio [HR]: 0.86, 95% confidence interval [CI]: 0.56-1.31, p = 0.479), confirmed by matched analysis (HR: 0.91, 95% CI: 0.60-1.36, p = 0.628). This was also observed in the RP subgroup (HR: 1.12, 95% CI: 0.68-1.84). The retrospective nature of the data and the heterogeneous patient population were the major limitations. Conclusions: Although there were substantial differences between the two groups, after accounting for major confounders we report a nonsignificant OS difference with PC-LND compared with observation only. These findings may be hypothesis-generating for future prospective trials. Patient summary: We found no differences in survival by adding postchemotherapy lymphadenectomy in patients with pelvic or retroperitoneal lymph node metastatic bladder cancer. The indication to perform postchemotherapy lymphadenectomy in the most suitable patients requires additional studies. In contemporary cohorts of patients with metastatic pelvic or retroperitoneal lymph nodes from bladder cancer, we found no survival benefit from postchemotherapy surgery versus observation in a retrospective study. Performing postchemotherapy lymphadenectomy remains investigational in patients with metastatic bladder cancer.

Published
2019

180. Clinical features and psychological aspects of the decision-making process in stage I testicular germ cell tumors

Author

Pasquale Rescigno, Sabino De Placido, Marianna Tortora, Margaret Ottaviano, Caterina Condello, Giovannella Palmieri, Lucia Nappi, Condello, C., Rescigno, P., Ottaviano, M., Nappi, L., Tortora, M., De Placido, S., and Palmieri, G.

Subjects
Male, endocrine system, Cancer Research, medicine.medical_specialty, Cure rate, Decision Making, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Testicular Neoplasms, law, medicine, Multiple treatments, Humans, 030212 general & internal medicine, Decision-making, Intensive care medicine, Testicular Neoplasm, shared decision treatment, business.industry, Treatment options, compliance with treatment, General Medicine, Neoplasms, Germ Cell and Embryonal, Testicular germ cell, Oncology, 030220 oncology & carcinogenesis, surveillance, stage I germ cell tumor, Psychological aspects, business, Orchiectomy, late sequelae, Human
Abstract

Testicular germ cell tumors (TGCTs) are the most prevalent malignancies in young Caucasian men. Clinical stage I (CSI) TGCTs present the highest cure rate and treatment options after orchiectomy depend on histology and risk factors. Nevertheless, the management of CSI TGCTs is controversial due to the availability of multiple treatments and the lack of randomized trials. An integrated multidisciplinary approach that includes clinicians (surgeons, radiotherapists and oncologists) and psychologists is crucial to maximize the patients’ compliance and must be acknowledged with appropriate tools. The aim of our work is to review the oncological and psychological aspects of the decision-making process, discussing the fundamental role of the patient involvement in the personalized management of CSI TGCTs.

Published
2018

181. Severe Hypothyroidism due to the Loss of Therapeutic Efficacy of l-Thyroxine in a Patient with Esophageal Complication Associated with Systemic Sclerosis

Author

Amato de Paulis, Antonio Lobasso, Francesca Wanda Rossi, Letizia Barbieri, Liliana Nappi, Bernadette Biondi, Serena Ippolito, Debora Arpaia, Carmela Peirce, Lobasso, A, Nappi, L, Barbieri, L, Peirce, C, Ippolito, S, Arpaia, D, Rossi, Fw, de Paulis, A, and Biondi, B.

Subjects
medicine.medical_specialty, Pathology, endocrine system, Malabsorption, endocrine system diseases, systemic sclerosis, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Case Report, Gastroenterology, Asymptomatic, Pericardial effusion, lcsh:Diseases of the endocrine glands. Clinical endocrinology, Thyroiditis, hypothyrodism, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, L-Thyroxine, systemic sclerosis , poor absorption, Internal medicine, medicine, Adverse effect, skin and connective tissue diseases, lcsh:RC648-665, integumentary system, business.industry, autoimmunity, sclerosis systemic, medicine.disease, Anti-thyroid autoantibodies, 030220 oncology & carcinogenesis, medicine.symptom, Thyroid function, Complication, business, hashomoto thyroiditis, l-thyroxine liquid formulation
Abstract

Background: Thyroid function abnormalities and thyroid autoantibodies have been frequently described in patients with systemic autoimmune diseases as Systemic Sclerosis (SSc). Serum TSH levels are higher in SSc patients with more severe skin diseases and a worse modified Rodnan skin score (mRSS). Asymptomatic esophageal involvement due to SSc has never been described as a cause of severe hypothyroidism due to L-T4 malabsorption in patients with HT and SSc. Case report: Here we report a case of a 56-year-old female affected by both SSc and Hashimoto's thyroiditis (HT) who developed severe hypothyroidism due to the loss of therapeutic efficacy of L-thyroxine (L-T4). Therapeutic failure resulted from the altered L-T4 absorption because of SSc esophageal complications. Clinical findings improved after the administration of oral liquid L-T4. Thyroid function completely normalized with a full clinical recovery, the disappearance of the pericardial effusion and the improvement of the pulmonary pressure. Conclusion: A recognition of a poor absorption is crucial in patients with hypothyroidism and SSc to reduce the risk of the subsequent adverse events. This case suggests the importance of clinical and laboratory surveillance in patients with SSc and HT because the systemic complications of these dysfunctions may worsen the prognosis of hypothyroid SSc/HT patients.

Published
2017

182. The dual PI3K/mTOR inhibitor PKI-587 enhances sensitivity to cetuximab in EGFR-resistant human head and neck cancer models

Author

C. Di Mauro, Lucia Raimondo, Lucia Nappi, R. Marciano, Bianca Maria Veneziani, C Fusciello, Valentina D’Amato, C. D'Amato, Roberto Bianco, R. Rosa, S. De Placido, Alberto Servetto, Luigi Formisano, D'Amato, V, Rosa, R, D'Amato, C, Formisano, L, Marciano, R, Nappi, L, Raimondo, L, Di Mauro, C, Servetto, A, Fusciello, C, Veneziani, BIANCA MARIA, DE PLACIDO, Sabino, and Bianco, Roberto

Subjects
Cancer Research, Pathology, Cetuximab, Apoptosis, HNSCC, Mice, Antineoplastic Combined Chemotherapy Protocols, Neoplasm, Phosphoinositide-3 Kinase Inhibitors, Mice, Inbred BALB C, Caspase 3, Triazines, TOR Serine-Threonine Kinases, Cetuximab resistance, ErbB Receptors, Oncology, Head and Neck Neoplasms, Monoclonal, Carcinoma, Squamous Cell, medicine.drug, medicine.medical_specialty, Morpholines, PI3K-mTOR inhibitors, Mice, Nude, Antineoplastic Agents, Biology, Antibodies, Monoclonal, Humanized, Cell Line, Tumor, Autophagy, medicine, Carcinoma, Animals, Humans, neoplasms, PI3K/AKT/mTOR pathway, Cell Proliferation, cetuximab resistance, Squamous Cell Carcinoma of Head and Neck, target therapy, Cell growth, Cancer, medicine.disease, Xenograft Model Antitumor Assays, digestive system diseases, Drug Resistance, Neoplasm, PI3K7mTOR inhibitors, Cancer research, Translational Therapeutics
Abstract

Background:Cetuximab is the only targeted agent approved for the treatment of head and neck squamous cell carcinomas (HNSCC), but low response rates and disease progression are frequently reported. As the phosphoinositide 3-kinase (PI3K) and the mammalian target of rapamycin (mTOR) pathways have an important role in the pathogenesis of HNSCC, we investigated their involvement in cetuximab resistance.Methods:Different human squamous cancer cell lines sensitive or resistant to cetuximab were tested for the dual PI3K/mTOR inhibitor PF-05212384 (PKI-587), alone and in combination, both in vitro and in vivo.Results:Treatment with PKI-587 enhances sensitivity to cetuximab in vitro, even in the condition of epidermal growth factor receptor (EGFR) resistance. The combination of the two drugs inhibits cells survival, impairs the activation of signalling pathways and induces apoptosis. Interestingly, although significant inhibition of proliferation is observed in all cell lines treated with PKI-587 in combination with cetuximab, activation of apoptosis is evident in sensitive but not in resistant cell lines, in which autophagy is pre-eminent. In nude mice xenografted with resistant Kyse30 cells, the combined treatment significantly reduces tumour growth and prolongs mice survival.Conclusions:Phosphoinositide 3-kinase/mammalian target of rapamycin inhibition has an important role in the rescue of cetuximab resistance. Different mechanisms of cell death are induced by combined treatment depending on basal anti-EGFR responsiveness. © 2014 Cancer Research UK.

Published
2014

183. A Multicenter, Double-Blind, Randomized, Placebo-Controlled Study to Assess Whether Antibiotic Administration Should Be Recommended During Office Operative Hysteroscopy

Author

Attilio Di Spiezio Sardo, Marialuigia Spinelli, Pasquale Florio, Carmine Nappi, Maurizio Guida, Luigi Nappi, Luca Mencaglia, Marco Filippeschi, Pantaleo Greco, Nappi, L, DI SPIEZIO SARDO, Attilio, Spinelli, M, Guida, M, Mencaglia, L, Greco, P, Nappi, Carmine, Filippeschi, M, and Florio, P.

Subjects
Adult, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Antibiotics, Reproductive medicine, Placebo-controlled study, Cefazolin, Hysteroscopy, NO, Double-Blind Method, medicine, Humans, Surgical Wound Infection, Prospective Studies, medicine.diagnostic_test, business.industry, Incidence (epidemiology), Obstetrics and Gynecology, Operative hysteroscopy, Polypectomy, Anti-Bacterial Agents, Surgery, Ambulatory Surgical Procedures, Practice Guidelines as Topic, Female, business, medicine.drug
Abstract

We did a double-blind, randomized, placebo-controlled study to assess the incidence of infectious complications and the protective effect of antibiotic administration during operative hysteroscopic procedures in an office setting. A total of 1046 consecutively enrolled women with intrauterine lesions were randomly allocated to the reference group (523 patients administered with 1 g of cefazolin intramuscularly) and the study group (523 patients administered with 10 mL of isotonic sodium chloride solution), and treated in office setting by operative hysteroscopy for endometrial polypectomy, uterine septa, submucosal myomas, and intrauterine adhesions. The primary outcome measure was the computation of difference between groups in postsurgical infectious complications occurring in the 5 days after the procedures. The time spent in performing the various procedures did not differ significantly (P > .05) between the groups. With respect to the overall rate of postsurgical infection, we found that 12 (1.15%) of 1046 patients referred with symptoms related to infective complications, 7 (1.3% of 523 women) in the study--untreated--group and 5 (1.0% of 523 women) in the reference group. Such incidences did not differ significantly between the groups (P > .05). Antibiotics were prescribed in all cases of postsurgical infection and the infective process resolved in few days. None of these patients developed serious infections with adnexal involvement, as confirmed by clinical and ultrasounds evaluation. The results of the current study would support the American College of Obstetricians and Gynecologists recommendation not to prescribe routine antibiotic administration in the case of hysteroscopic surgery.

Published
2013

184. BRAF mutation and RASSF1A expression in thyroid carcinoma of southern Italy

Author

Arianna Francesconi, Marina Di Domenico, Maria Antonia Carosi, Antonia Feola, Renato Franco, Luigi Nappi, Gaetano De Rosa, Pantaleo Bufo, Giuseppe Russo, Edoardo Pescarmona, Giuseppe Pannone, Gabriella Aquino, Simona Losito, Angela Santoro, Angela, Santoro, Giuseppe, Pannone, Maria Antonia, Carosi, Arianna, Francesconi, Edoardo, Pescarmona, Giuseppe Maria, Russo, Antonia, Feola, Simona, Losito, Franco, Renato, Luigi, Nappi, Gabriella, Aquino, Gaetano De, Rosa, DI DOMENICO, Marina, Pantaleo, Bufo, Santoro, A, Pannone, G, Carosi, Ma, Francesconi, A, Pescarmona, E, Russo, Gm, Feola, A, Losito, S, Franco, R, Nappi, L, Aquino, G, DE ROSA, Gaetano, Di Domenico, M, and Bufo, P.

Subjects
Adult, Male, Proto-Oncogene Proteins B-raf, endocrine system, medicine.medical_specialty, endocrine system diseases, Thyroid Gland, Biology, Nucleic Acid Denaturation, Models, Biological, Biochemistry, Thyroid carcinoma, Internal medicine, medicine, Carcinoma, Humans, Thyroid Neoplasms, Promoter Regions, Genetic, Molecular Biology, Aged, Demography, Neoplasm Staging, Aged, 80 and over, Regulation of gene expression, Tumor Suppressor Proteins, Thyroid, Cell Biology, Methylation, DNA Methylation, Middle Aged, medicine.disease, Immunohistochemistry, Carcinoma, Papillary, Gene Expression Regulation, Neoplastic, Endocrinology, medicine.anatomical_structure, Italy, Mutation, DNA methylation, Cancer research, Female, V600E
Abstract

Aim of this work is to provide a detailed comparison of clinical-pathologic features between well-differentiated and poorly differentiated tumors according to their BRAF and RASSF1A status. We analyzed RASSF1A methylation by MSP and BRAF mutation by LCRT-PCR with LightMix® kit BRAF V600E in neoplastic thyroid tissues. Immunohistochemical evaluation of RASSF1A expression was also performed by standard automated LSAB-HRP technique. An overall higher degree of RASSF1A over-expression than normal thyroid parenchyma surrounding tumors (P

Published
2013

185. Prognostic and predictive factors in patients with advanced penile cancer receiving salvage (2nd or later line) systemic treatment: A retrospective, multi-center study

Author

Fernando Quevedo, Bernhard J. Eigl, Lance C. Pagliaro, Giacomo Cartenì, Sabino De Placido, Guru Sonpavde, Sarah Scagliarini, Giuseppe Di Lorenzo, Carlo Buonerba, Mariano Galdiero, Gaetano Lanzetta, Lucia Nappi, Gurudatta Naik, Antonio Rozzi, Gregory R. Pond, Matteo Ferro, Tanya B. Dorff, Buonerba, C., Di Lorenzo, G., Pond, G., Carteni, G., Scagliarini, S., Rozzi, A., Quevedo, F. J., Dorff, T., Nappi, L., Lanzetta, G., Pagliaro, L., Eigl, B. J., Naik, G., Ferro, M., Galdiero, M., De Placido, S., and Sonpavde, G.

Subjects
medicine.medical_specialty, Prognosi, 030232 urology & nephrology, Context (language use), chemotherapy, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Squamous cell carcinoma, Internal medicine, cetuximab, medicine, Penile cancer, Pharmacology (medical), Risk factor, Penile Neoplasms, Original Research, Pharmacology, Cetuximab, business.industry, lcsh:RM1-950, Retrospective cohort study, Odds ratio, medicine.disease, Classification, Confidence interval, Surgery, Penile squamous cell carcinoma, lcsh:Therapeutics. Pharmacology, Prognostic biomarkers, 030220 oncology & carcinogenesis, Salvage, prognosis, business, medicine.drug
Abstract

Introduction and objectives: Metastatic penile squamous cell carcinoma (PSCC) is associated with dismal outcomes with median overall survival (OS) of 6–12 months in the first-line and

Published
2016

186. Review of New Office-Based Hysteroscopic Procedures 2003–2009

Author

Marialuigia Spinelli, Maurizio Guida, Attilio Di Spiezio Sardo, Loredana Maria Sosa Fernandez, Stefano Angioni, Carmine Nappi, Stefano Bettocchi, Luigi Nappi, DI SPIEZIO SARDO, Attilio, Bettocchi, S., Spinelli, M., Guida, M., Nappi, L., Angioni, S., SOSA FERNANDEZ, L. M., and Nappi, Carmine

Subjects
Hematometra, medicine.medical_specialty, medicine.diagnostic_test, Metroplasty, business.industry, Cervical dilation, Obstetrics and Gynecology, Hysteroscopy, Ambulatory Surgical Procedure, medicine.disease, Surgery, Gynecologic Surgical Procedures, Systematic review, Ambulatory Surgical Procedures, medicine, Hysteroscopes, Humans, Female, business, Genital Diseases, Female, Endometrial biopsy
Abstract

Office operative hysteroscopy is a recent technique that enables treatment of uterine pathologic disorders in the ambulatory setting using miniaturized hysteroscopes with mechanical or electric instruments. The available international literature from 1990 to 2002 has clearly demonstrated that such technique enables performance of hysteroscopically directed endometrial biopsy and treatment of uterine adhesions, anatomic disorders, polyps, and small myomas safely and successfully without cervical dilation and the need for anesthesia. This review provides a comprehensive survey of further advancements of office operative hysteroscopy in the treatment of other gynecologic pathologic conditions that have not been included in the schema of treatment indications for office procedures proposed in 2002. A search of MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews identified articles published from 2003 to 2009. Eighteen articles were identified: 9 on hysteroscopic sterilization; 1 on office-based metroplasty, 8 on office-based treatment of some uncommon gynecologic pathologic conditions (e.g., hematometra, diagnosis and treatment of vaginal lesions, treatment of uterine cystic neoformations, bleeding from the cervical stump, diagnosis and treatment of endocervical ossification, and removal of uterovaginal packing). All performed procedures were carried out safely and successfully in the office setting, with high patient tolerance and minimal discomfort. The success of the procedures has been confirmed by resolution of symptoms and at follow-up ultrasonographic and hysteroscopic examinations. Currently, as a result of technologic advancements and increased operator experience, an increasing number of gynecologic pathologic conditions traditionally treated in the operating room may be treated safely and effectively using office operative hysteroscopy.

Published
2010

187. Epidermal growth factor-receptor activation modulates Src-dependent resistance to lapatinib in breast cancer models

Author

Valentina D’Amato, Sarah J. Parsons, Giancarlo Troncone, Sabino De Placido, Vincenzo Damiano, Lucia Raimondo, Bianca Maria Veneziani, Roberto Bianco, Lucia Nappi, Francesca Iommelli, C. D'Amato, Roberta Marciano, Luigi Formisano, Roberta De Rosa, Antonella Scorziello, Formisano, L, Nappi, L, Rosa, R, Marciano, R, D., Amato C, D., Amato V, Damiano, V, Raimondo, L, Iommelli, F, Scorziello, Antonella, Troncone, Giancarlo, Veneziani, BIANCA MARIA, Parsons, Sj, DE PLACIDO, Sabino, and Bianco, Roberto

Subjects
Lung Neoplasms, Receptor, ErbB-2, Metastasis, Mice, Cell Movement, cetuximab, Antineoplastic Combined Chemotherapy Protocols, Epidermal growth factor receptor, Enzyme Inhibitors, RNA, Small Interfering, skin and connective tissue diseases, Medicine(all), Mice, Inbred BALB C, biology, Drug Synergism, ErbB Receptors, src-Family Kinases, Female, RNA Interference, Signal transduction, Tyrosine kinase, Research Article, Signal Transduction, Proto-oncogene tyrosine-protein kinase Src, medicine.drug, Cell Survival, Transplantation, Heterologous, Mice, Nude, Antineoplastic Agents, Breast Neoplasms, Lapatinib, Cell Line, Tumor, medicine, Animals, Humans, Neoplasm Invasiveness, Benzodioxoles, Protein Kinase Inhibitors, Cell Proliferation, Epidermal Growth Factor, Cell growth, Cancer, medicine.disease, Enzyme Activation, Drug Resistance, Neoplasm, Quinazolines, Cancer research, biology.protein, saracatinib, Neoplasm Transplantation
Abstract

Introduction: Src tyrosine kinase overactivation has been correlated with a poor response to human epidermal growth factor receptor 2 (HER2) inhibitors in breast cancer. To identify the mechanism by which Src overexpression sustains this resistance, we tested a panel of breast cancer cell lines either sensitive or resistant to lapatinib.Methods: To determine the role of Src in lapatinib resistance, we evaluated the effects of Src inhibition/silencing in vitro on survival, migration, and invasion of lapatinib-resistant cells. In vivo experiments were performed in JIMT-1 lapatinib-resistant cells orthotopically implanted in nude mice. We used artificial metastasis assays to evaluate the effect of Src inhibition on the invasiveness of lapatinib-resistant cells. Src-dependent signal transduction was investigated with Western blot and ELISA analyses.Results: Src activation was higher in lapatinib-resistant than in lapatinib-sensitive cells. The selective small-molecule Src inhibitor saracatinib combined with lapatinib synergistically inhibited the proliferation, migration, and invasion of lapatinib-resistant cells. Saracatinib combined with lapatinib significantly prolonged survival of JIMT-1-xenografted mice compared with saracatinib alone, and impaired the formation of lung metastases. Unexpectedly, in lapatinib-resistant cells, Src preferentially interacted with epidermal growth factor receptor (EGFR) rather than with HER2. Moreover, EGFR targeting and lapatinib synergistically inhibited survival, migration, and invasion of resistant cells, thereby counteracting Src-mediated resistance. These findings demonstrate that Src activation in lapatinib-resistant cells depends on EGFR-dependent rather than on HER2-dependent signaling.Conclusions: Complete pharmacologic EGFR/HER2 inhibition is required to reverse Src-dependent resistance to lapatinib in breast cancer. © 2014 Formisano et al.; licensee BioMed Central Ltd.

Published
2014

188. P0081 Src inhibitors act through different mechanisms to cooperate with EGFR or MEK inhibitors in NSCLC models sensitive or resistant to erlotinib

Author

B.M. Veneziani, Roberta Marciano, C. Di Mauro, Luigi Formisano, Valentina D’Amato, S. De Placido, R. Rosa, Lucia Nappi, Lucia Raimondo, Vincenzo Damiano, Alberto Servetto, C. D'Amato, Roberto Bianco, Raimondo, L., Formisano, L., Rosa, R., D?amato, C., D?amato, V., Nappi, L., Marciano, R., Di Mauro, C., Servetto, A., Damiano, V., Veneziani, BIANCA MARIA, DE PLACIDO, Sabino, and Bianco, Roberto

Subjects
Cancer Research, NSCLC cell lines, Chemistry, Pharmacology, respiratory tract diseases, Dasatinib, Gefitinib, Oncology, Cancer research, medicine, Selumetinib, Src inhibitor, Erlotinib, neoplasms, Bosutinib, Tyrosine kinase, Proto-oncogene tyrosine-protein kinase Src, medicine.drug, EGFR inhibitors
Abstract

Background The EGFR tyrosine kinase inhibitors gefitinib and erlotinib are first-line therapy for NSCLCs harbouring EGFR-activating mutations. The intrinsic and acquired resistance to these agents is a relevant clinical issue. Although Src tyrosine kinase has been involved in such resistance in preclinical models, clinical development of these agents has been so far limited. Methods We used a panel of human NSCLC cell lines: PC9 and HCC827 (EGFR-activating mutation; highly sensitive to erlotinib), Calu3 (EGFR/Ras wild-type, wt; moderately sensitive), Calu3-ER (with acquired resistance), H1299 and A549 (Ras mutant; resistant), H1975 (EGFR T790M mutant; resistant). In these models, we tested three different Src inhibitors (saracatinib, dasatinib, and bosutinib), both in vitro and in vivo. Findings NSCLC cell lines showed different activation of EGFR-dependent and Src-dependent pathways and variable sensitivity to Src inhibitors. A kinase assay demonstrated that all the compounds are able to directly inhibit EGFR tyrosine kinase variants. In cell lysates only saracatinib and bosutinib efficiently reduced EGFR activation, while dasatinib was the more effective agent in inhibiting Src tyrosine kinase. Consistently, in EGFR-activating mutant, erlotinib sensitive cells, saracatinib and bosutinib showed anti-proliferative effects related to simultaneous EGFR/Src inhibition. In EGFR wt/Ras mutant cells Src inhibition by dasatinib interfered with cell proliferation and signal transduction. Since Src inhibitors had only moderate effects as single agents we tested the combination of saracatinib with EGFR inhibitors (erlotinib or cetuximab) in EGFR-addicted cells, and of dasatanib with MEK inhibitors (selumetinib) in Ras mutant, erlotinib resistant models. These combinations were effective both in vitro and in nude mice, inhibiting tumour growth, prolonging mice survival, and interfering with signal transduction. Importantly, the combination of saracatanib and cetuximab was effective also in the erlotinib resistant, EGFR T790M mutant model. Interpretation Src inhibitors may act with different mechanisms in NSCLC cell lines, depending on EGFR/Ras mutational profile. Integration of anti-Src agents with EGFR or MEK inhibitors could represent effective therapeutic options for different cohorts of NSCLC patients.

Published
2014

189. Tumor-to-tumor metastasis: breast cancer metastatic to thymic epithelial tumor

Author

Margaret Ottaviano, Giovannella Palmieri, Lucia Nappi, Elide Matano, Pasquale Rescigno, Chiara Alessandra Cella, Vincenzo Damiano, Roberto Moretto, Lucia Raimondo, Luigi Formisano, Filomena Calabrese, Carlo Buonerba, Giuseppe Di Lorenzo, Moretto, R, Cella, Ca, Raimondo, L, Formisano, L, Nappi, L, Rescigno, P, Buonerba, C, Calabrese, F, Ottaviano, M, Di Lorenzo, G, Matano, E, Damiano, V, and Palmieri, G.

Subjects
CA15-3, Oncology, Adult, Cancer Research, medicine.medical_specialty, CA 15-3, Breast Neoplasms, Metastasis, Breast cancer, Neoplasms, Internal medicine, Medicine, Humans, Pharmacology (medical), Neoplasms, Glandular and Epithelial, Lung cancer, Pharmacology, Tumor to tumor metastasis, business.industry, Glandular and Epithelial, Female, Thymus Neoplasms, medicine.disease, Thymic epithelial tumor, Cancer research, business
Abstract

Tumor-to-tumor metastasis is a rare phenomenon, with around 150 cases being reported in the literature. Breast cancer is the second most commonly reported donor tumor after lung cancer, but thymic epithelial tumors have never been reported as recipient tumors. Furthermore, the thymus is rarely affected by metastases. To our knowledge, the present report is the first case of breast cancer metastatic to thymic epithelial tumor.

Published
2013

190. Endometrial polypectomy: outpatient versus inpatient treatment

Author

M. Spinelli, Stefano Bettocchi, A. Di Spiezio Sardo, Pantaleo Greco, Luigi Nappi, L. Mastricci, L. Nappi, A. Di Spiezio Sardo, M. Spinelli, L. Mastricci, S. Bettocchi, P. Greco, Nappi, L., DI SPIEZIO SARDO, Attilio, Spinelli, M., Mastricci, L., Bettocchi, S., and Greco, P.

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, General surgery, medicine, Obstetrics and Gynecology, business, Polypectomy
Published
2009

191. A new hysteroscopic technique for the preparation of partially intramural myomas in office setting (OPPIuM technique): A pilot study

Author

Elena Greco, Anna Lina Camporiale, Attilio Di Spiezio Sardo, Oronzo Ceci, Luigi Nappi, Stefano Bettocchi, Carmine Nappi, L. Pinto, Maurizio Guida, Bettocchi, S., DI SPIEZIO SARDO, Attilio, Ceci, O., Nappi, L., Guida, M., Greco, E., Pinto, L., Camporiale, A. L., and Nappi, Carmine

Subjects
Adult, medicine.medical_specialty, media_common.quotation_subject, Pilot Projects, Hysteroscopy, Daily practice, medicine, Humans, Menstrual cycle, media_common, Mean diameter, medicine.diagnostic_test, business.industry, Obstetrics and Gynecology, Myoma, Middle Aged, medicine.disease, Surgery, medicine.anatomical_structure, Ambulatory Surgical Procedures, Uterine Neoplasms, Total removal, Female, Uterine cavity, business
Abstract

Objective To assess the safety and the effectiveness of a novel hysteroscopic technique for the Office Preparation of Partially Intramural Myomas (OPPIuM), to facilitate the subsequent, already scheduled, resectoscopic myomectomy. Design Pilot study. Setting University of Bari, Naples and Foggia. Patients Fifty-nine fertile women (age 27-48 years) diagnosed at office hysteroscopy as having symptomatic submucous myomas > 1.5 cm with intramural development (G1 and G2), scheduled for resectoscopic surgery. Interventions The OPPIuM technique consisted of an incision of the endometrial mucosa covering the myoma by means of Fr scissors or bipolar Versapoint Twizzle electrode, along its reflection line on the uterine wall, up to the precise identification of the cleavage surface between the myoma and its pseudo-capsule. Such procedure was aimed at triggering the protrusion of the intramural portion of the myoma into the uterine cavity during the following menstrual cycles, thus facilitating the subsequent total removal of the lesion via resectoscopic surgery. All patients underwent follow-up in-patient hysteroscopy after 2 menstrual cycles before resectoscopic surgery were performed. Measurements and Main Results The OPPIuM technique was successfully performed in all cases. The mean diameter of successfully prepared myomas was 2.9 ± 0.8 cm. At follow-up hysteroscopy, the conversion of partially intramural myomas into totally or prevalently intracavitary ones was observed in 93.2% (55/59) of cases. In 2 of 3 cases of failure, the myomas' size was > 4 cm. One patient was excluded from the study because of the occurrence of total spontaneous expulsion of the myoma at the subsequent menstrual cycle. Conclusions Our preliminary findings seem to support the safety and the effectiveness of the OPPIuM procedure by reporting the conversion of myomas with intramural development > 1.5 cm into totally or prevalently intracavitary ones in nearly 93% of cases. Such technique may allow surgeons to perform resectoscopic surgery more safely and quickly as dealing with prevalently intracavitary lesions. However, further studies are mandatory to validate its use in daily practice.

Published
2009

192. P0081 Src inhibitors act through different mechanisms to cooperate with EGFR or MEK inhibitors in NSCLC models sensitive or resistant to erlotinib.

Author

Raimondo, L., Formisano, L., Rosa, R., D'Amato, C., D'Amato, V., Nappi, L., Marciano, R., Di Mauro, C., Servetto, A., Damiano, V., Veneziani, B. M., De Placido, S., and Bianco, R.

Subjects
*ERLOTINIB, *BIOPHYSICS, *CELL lines, *CONFERENCES & conventions, *DRUG resistance, *EPIDERMAL growth factor, *LUNG cancer, *RESEARCH methodology, *GENETIC mutation, *IN vitro studies, *CHEMICAL inhibitors, *THERAPEUTICS
Abstract

Background: The EGFR tyrosine kinase inhibitors gefitinib and erlotinib are first-line therapy for NSCLCs harbouring EGFR-activating mutations. The intrinsic and acquired resistance to these agents is a relevant clinical issue. Although Src tyrosine kinase has been involved in such resistance in preclinical models, clinical development of these agents has been so far limited. Methods: We used a panel of human NSCLC cell lines: PC9 and HCC827 (EGFR-activating mutation; highly sensitive to erlotinib), Calu3 (EGFR/Ras wild-type, wt; moderately sensitive), Calu3-ER (with acquired resistance), H1299 and A549 (Ras mutant; resistant), H1975 (EGFR T790M mutant; resistant). In these models, we tested three different Src inhibitors (saracatinib, dasatinib, and bosutinib), both in vitro and in vivo. Findings: NSCLC cell lines showed different activation of EGFR-dependent and Src-dependent pathways and variable sensitivity to Src inhibitors. A kinase assay demonstrated that all the compounds are able to directly inhibit EGFR tyrosine kinase variants. In cell lysates only saracatinib and bosutinib efficiently reduced EGFR activation, while dasatinib was the more effective agent in inhibiting Src tyrosine kinase. Consistently, in EGFR-activating mutant, erlotinib sensitive cells, saracatinib and bosutinib showed anti-proliferative effects related to simultaneous EGFR/Src inhibition. In EGFR wt/Ras mutant cells Src inhibition by dasatinib interfered with cell proliferation and signal transduction. Since Src inhibitors had only moderate effects as single agents we tested the combination of saracatinib with EGFR inhibitors (erlotinib or cetuximab) in EGFR-addicted cells, and of dasatanib with MEK inhibitors (selumetinib) in Ras mutant, erlotinib resistant models. These combinations were effective both in vitro and in nude mice, inhibiting tumour growth, prolonging mice survival, and interfering with signal transduction. Importantly, the combination of saracatanib and cetuximab was effective also in the erlotinib resistant, EGFR T790M mutant model. Interpretation: Src inhibitors may act with different mechanisms in NSCLC cell lines, depending on EGFR/Ras mutational profile. Integration of anti-Src agents with EGFR or MEK inhibitors could represent effective therapeutic options for different cohorts of NSCLC patients. [ABSTRACT FROM AUTHOR]

Published
2014
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193. Combination of a Toll-like receptor 9 agonist with everolimus interferes with the growth and angiogenic activity of renal cell carcinoma

Author

Roberta Marciano, Bianca Maria Veneziani, Roberta De Rosa, Vincenzo Damiano, Roberto Bianco, Sabino De Placido, Luigi Formisano, Lucia Nappi, Rosa, R., Damiano, V., Formisano, L., Nappi, L., Marciano, R., Veneziani, BIANCA MARIA, DE PLACIDO, Sabino, and Bianco, Roberto

Subjects
Agonist, renal cell carcinoma, medicine.drug_class, Immunology, Pharmacology, urologic and male genital diseases, TLR9, Renal cell carcinoma, medicine, Immunology and Allergy, Receptor, Author's View, PI3K/AKT/mTOR pathway, Everolimus, business.industry, everolimu, everolimus, medicine.disease, microenvironment, female genital diseases and pregnancy complications, Toll-Like Receptor 9, Clinical trial, Oncology, mTOR, business, medicine.drug
Abstract

The mTOR inhibitor everolimus is currently approved for the treatment of renal cell carcinoma (RCC) and several Toll-like receptor 9 (TLR9) agonists, including immunomodulatory oligonucleotides (IMOs), have been tested for their therapeutic potential against advanced RCC. However, no clinical trials investigating the combination of mTOR inhibitors with TLR9 agonists in RCC patients have been performed to date. Our results may pave the way to translate this combinatorial approach to the clinical setting.

Published
2013

194. The Impact of Prophylactic Antibiotics on Infectious Complications in Outpatient Office Operative Hysteroscopy: A Prospective Randomized Study

Author

Stefano Bettocchi, A. Di Spiezio Sardo, Pantaleo Greco, M. Spinelli, L. Mastricci, Luigi Nappi, L. Nappi, A. Di Spiezio Sardo, M. Spinelli, L. Mastricci, S. Bettocchi, P. Greco., Nappi, L., DI SPIEZIO SARDO, Attilio, Spinelli, M., Mastricci, L., Bettocchi, S., and Greco, P.

Subjects
medicine.medical_specialty, medicine.drug_class, business.industry, Antibiotics, medicine, Obstetrics and Gynecology, Operative hysteroscopy, Prospective randomized study, business, Surgery
Published
2009

195. Evaluation of Ovarian Reserve and Recurrence Rate After DWLS Diode Laser Ovarian Endometrioma Vaporization (OMAlaser): A Prospective, Single-arm, Multicenter, Clinical Trial.

Author

D'Alterio MN, Nappi L, Vitale SG, Agus M, Fanni D, Malzoni M, Falcone F, Sorrentino F, D'Agate MG, Scibilia G, Mereu L, Scollo P, and Angioni S

Abstract

Study Objective: To evaluate the effectiveness of the Dual Wavelength Laser System (DWLS) diode laser on the treatment of ovarian endometrioma (OMA), with ablation and vaporization of the cystic capsule without performing the stripping technique, in terms of ovarian reserve and recurrence rate., Design: Prospective, Single-arm, Multicenter, Clinical Trial SETTING: Multicenter University Hospital., Patients: Seventy patients with symptomatic OMA., Interventions: Patients underwent surgery for primary unilateral or bilateral symptomatic OMA treated with DWLS diode laser vaporization. Following surgical intervention, patients were enrolled in a 12 months surveillance protocol featuring regular clinical assessments aimed at detecting ovarian reserve, pregnancy rate and any recurrence of the cyst and/or symptomatic relapse., Measurements and Main Results: Antimullerian hormone (AMH) levels at the 3-month follow-up exhibited a significant difference from the baseline (p=0.034), demonstrating a return to nearly presurgical values in the subsequent months. Antral follicle count (AFC) of the operated ovary showed a significant increase after treatment at the 6-month and 12-month follow-up (p=0.005 and p=0.002, respectively). Pregnancies were documented in 48.3% (14/29) of infertile patients who underwent treatment. OMA recurrence was observed in 4 patients (5.7%) at 12 months. No patient exhibited a significant relapse of the analyzed symptoms compared to baseline values., Conclusion: The findings of this study propose that DWLS diode laser presents a good option for treating OMA, demonstrating minimal impact on the surrounding healthy ovarian tissue, favorable pregnancy rate, coupled with low recurrence rates., Competing Interests: Declaration of competing interest S.A. received honoraria for lectures by the following companies: AG Pharma, Italfarmaco, Gedeon Richter, Exeltis., (Copyright © 2024 AAGL. Published by Elsevier Inc. All rights reserved.)

Published
2024
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197. NT >99th centile and cystic hygroma: Which diagnosis, which management and outcome.

Author

Vasciaveo L, Mastricci AL, De Lucia G, Zanzarelli E, De Feo V, Giansiracusa E, Di Biase S, and Nappi L

Subjects
Humans, Female, Pregnancy, Adult, Pregnancy Outcome, Hydrops Fetalis diagnostic imaging, Hydrops Fetalis diagnosis, Ultrasonography, Prenatal methods, Retrospective Studies, Prognosis, Lymphangioma, Cystic diagnostic imaging, Lymphangioma, Cystic diagnosis, Nuchal Translucency Measurement, Pregnancy Trimester, First
Abstract

Objectives: To evaluate the prevalence of chromosomal anomalies in fetuses affected by increased nuchal translucency(iNT >99Th centile), cystic hygroma (CH) and cases progressing to fetal hydrops (NIHF) in order to correlate this result to prognosis and perinatal fetal outcomes, improving patient's counseling., Methods: From January 2020 to December 2023, first trimester screening according to FMF criteria were performed in "Maternal fetal medicine Unit" of Foggia's hospital. We studied and collected clinical data of fetuses affected by nuchal translucency >99th centile (iNT), CH and cases progressing to Fetal Hydrops (non-immune fetal hydrop, NIFH). In these selected cases, we evaluated fetal Karyotype to demonstrate the presence of chromosomal abnormalities, associated to fetal structural anomalies and different pregnancy outcome., Results: We have evaluated 45 cases of iNT, CH, and NIFH, identified by ultrasound during first trimester screening. Of these 45 pregnant women, four were lost to follow-up. Of the 41 pregnancies, 20 cases (48.8%) delivered at our division with newborns discharged in good health. Of the 21 patients (51.2%) who miscarried, only two miscarried spontaneously; the other 19 decided on a medical termination of pregnancy (MTP). The 19 patients who decided for MTP showed genetic abnormalities and/or malformation. The 20 cases of fetuses discharged as healthy newborns were enrolled with the following diagnoses: 5 had a diagnosis of CH (20% of cases), 1 case of NIFH (5% of cases), and 14 of iNT (75% of cases). All these fetuses had a normal karyotype and no major malformations., Conclusions: Isolated CH diagnosis is more frequent than described in Literature (5 cases out of 12: 41.7%) and their prognosis are better than previously described, with the same outcomes of fetuses with iNT without associated anomalies. The possibility of early diagnosis of chromosomal anomalies, associated malformations or the evolution into hydrops is essential for a complete consultation., (© 2024 Wiley Periodicals LLC.)

Published
2024
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198. Primary Malignant Melanoma of The Endocervix Uteri and Outpatient Hysteroscopy as a Diagnostic Tool: Case Report and Literature Overview.

Author

Dealberti D, Bosoni D, Spissu F, Pisani C, Pizio C, Nappi L, Sorrentino F, Carlucci S, and Stabile G

Abstract

Mucosal malignant melanoma has a low incidence and only 2% are diagnosed in the gynecological tract. Diagnosis of primary cervical malignant melanoma is often challenging. The clinical presentation mimics other malignant cervical tumors, usually with abnormal bleeding or discharge. Cervical screening tests, such as cytology, often fail to detect malignant melanomas because of the rarity of the disorder, and histological evaluation of lesions is of paramount importance. The treatment is often based on regimens used for cutaneous malignant melanoma. We present the first case in the literature of primary malignant melanoma of the endocervix diagnosed by outpatient hysteroscopy and we have performed a narrative review of the literature on PubMed, Scopus and Web of Science from 1980 to December 2023, identifying 137 cases. The most common initial symptom was vaginal bleeding in 82.8% of cases, and 84.8% of patients were menopausal at the time of diagnosis. The first diagnostic modality was biopsy in 67.7%; 90% of patients underwent surgery and 64.5% of the deaths occurred within the first 12 months after diagnosis. Primary malignant melanoma of the cervix is extremely rare and difficult to diagnose at an early stage which is due to the aggressiveness of the disease and the non-specificity of the symptoms. To improve survival, early diagnosis is essential and hysteroscopy could be a useful tool in achieving it. It is crucial to increase the attention of gynecologists on primary malignant melanoma of the cervix to also perform a diagnostic hysteroscopy in case of doubtful symptoms.

Published
2024
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199. Circulating microRNA-155-3p levels predicts response to first line immunotherapy in patients with metastatic renal cell carcinoma.

Author

Soleimani M, Thi M, Janfaza S, Ozcan G, Mazurek S, Ozgun G, Maurice-Dror C, Eigl B, Chi K, Kollmannsberger C, and Nappi L

Subjects
Humans, Immunotherapy, Biomarkers, Tumor Microenvironment genetics, Carcinoma, Renal Cell genetics, Carcinoma, Renal Cell therapy, Circulating MicroRNA, Kidney Neoplasms genetics, Kidney Neoplasms therapy, MicroRNAs genetics
Abstract

Predictive biomarkers of response to immune checkpoint-based therapies (ICI) remain a critically unmet need in the management of advanced renal cell carcinoma (RCC). The complex interplay of the tumour microenvironment (TME) and the circulating immune response has proven to be challenging to decipher. MicroRNAs have gained increasing attention for their role in post-transcriptional gene expression regulation, particularly because they can have immunomodulatory properties. We evaluated the presence of immune-specific extracellular vesicle (EV) microRNAs in the plasma of patients with metastatic RCC (mRCC) prior to initiation of ICI. We found significantly lower levels of microRNA155-3p (miR155) in responders to ICI, when compared to non-responders. This microRNA has unique immunomodulatory properties, thus providing potential biological rationale for our findings. Our results support further work in exploring microRNAs as potential biomarkers of response to immunotherapy., (© 2024. The Author(s).)

Published
2024
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200. Exploring the Relationship between Neuroticism and Perinatal Depressive Symptoms: Findings from a 2-Year, Multicenter Study in Italy.

Author

Severo M, Petito A, Ventriglio A, Iuso S, Ianzano G, Marconcini A, Giannaccari E, Palma GL, Altamura M, Sorrentino F, Maruotti G, Nappi L, Caroli A, and Bellomo A

Abstract

Neuroticism is a personality trait associated with the risk of affective disorders and perinatal depression. We investigated the relationship between different levels of neuroticism, psychological characteristics, and depressive symptoms in a sample of pregnant women (N = 2631) who accessed the gynecology departments in the Puglia Region (Italy) from July 2020 to November 2022. Women were assessed for depressive symptoms and associated risk factors in their third trimester of pregnancy (T0) and after childbirth (T1), and followed-up at 6 months and 1 year after delivery if presenting signs of depression (T2-T3). The Edinburgh Postnatal Depression Scale (EPDS) was used to screen depressive symptoms, and neuroticism was assessed through the subscales of the NEO Five Factor Inventory. Standardized measures of resilience, coping strategies, partner attachment, and quality of life were also employed. Higher levels of neuroticism were significantly associated with: (a) higher scores on the EPDS; (b) higher anxiety in the experience of close relationships; (c) lower psychological wellbeing; (d) lower levels of resilience; (e) lower levels of active coping; and (f) higher levels of self-blame. Our findings may suggest that neuroticism is a specific associated factor of perinatal depression and should be routinely assessed in the clinical screening of pregnant women in order to promote an early referral to psychological or psychiatric support services.

Published
2024
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