567 results on '"Stabile, G."'
Search Results
202. Role of pulmonary veins isolation in persistent atrial fibrillation ablation: the pulmonary vein isolation in persistent atrial fibrillation (PIPA) study.
- Author
-
Stabile G, Bertaglia E, Turco P, Zoppo F, Iuliano A, Zerbo F, La Rocca V, and De Simone A
- Abstract
Background: The role of pulmonary veins (PV) isolation in patients with persistent atrial fibrillation (AF) is still debated. The aim of this study was to evaluate the adjunctive role of PV isolation in patients with persistent AF who underwent circumferential PV ablation (anatomical approach). Methods: We treated 97 consecutive patients presenting with drug-refractory persistent AF by an anatomical approach (group A, n = 36, mean age = 60 ± 8 years, 29 males) or an integrated approach (group B, n = 61, mean age 59 ± 10 years, 48 males). In all patients, radiofrequency (RF) ablation was performed by means of a nonfluoroscopic navigation system, in order to anatomically create circumferential lines around the PV. In group B, the persistence of PV potentials was ascertained with a multipolar circular catheter. If PV potentials persisted, RF energy targeting the electrophysiological breakthroughs was delivered to disconnect the PV. Past a 2-month period of observation, success was defined as absence of any atrial tachyarrhythmia recurrence lasting >30 seconds. Results: Total procedure duration (220 ± 62 minutes vs 140 ± 43 minutes, P < 0.001), fluoroscopy time (35 ± 15 minutes vs 17 ± 9 minutes, P < 0.001), and RF delivery time (48 ± 22 minutes vs 27 ± 9 minutes, P < 0.001) were significantly longer in group B than in group A. One cardiac perforation occurred in group A. After 15 ± 9.1 months, 21 patients in group A (58%) and 34 patients in group B (56%) were free of atrial tachyarrhythmia recurrence (P = 0.9). Conclusions: In patients with persistent AF, who underwent an anatomical approach, electrophysiological confirmation of PV disconnection significantly increased the fluoroscopy and procedural times, without effect on the long-term outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
203. Left ventricular functional recovery during cardiac resynchronization therapy: predictive role of asynchrony measured by strain rate analysis.
- Author
-
Capasso F, Giunta A, Stabile G, Turco P, La Rocca V, Grimaldi G, and De Simone A
- Abstract
Cardiac resynchronization therapy (CRT) improves myocardial performance in patients with heart failure (HF) and left bundle-branch block (LBBB). Tissue Doppler echocardiography (TDE) has already been used to guide the selection of candidates for CRT. The objective of this study is to correlate the effects of CRT on left ventricular (LV) systolic function with wall motion synchrony assessed by TDE. High frame TDE data were obtained in 15 patients (mean age = 68.9 years, 11 men) with LBBB (QRS = 163 +/- 13 ms) to derive temporal intraventricular horizontal asynchrony indexes, expressed as the time difference at the onset of shortening between the septum and the lateral (S-L) and antero-inferior (A-I) walls, and measure the amount of delayed longitudinal contraction (DLC) within the LV. All measurements were made at baseline, 24 hours after implantation, and at 1 year of follow-up. The results show that LV ejection fraction (EF) increased from 25 +/- 6.2% at baseline to 36.9 +/- 7.9% at 1 year, and was strongly related to DLC, expressed either by time duration (DLCd, r =-0.51; P < 0.0001) or percent of the basal segments (%DLC, r =-0.50; P < 0.001). New York Heart Association functional class, which decreased from 3.6 +/- 0.5 to 2.3 +/- 0.8, was correlated with %DLC (r = 0.50) and DLCd (r = 0.48, P < 0.001). Weaker correlations were found between LVEF and S-Li (r =-0.40) and between NYHA and S-Li (r = 0.40). It is concluded that DLC was the best among intraventricular asynchrony indexes in predicting increases in LVEF after CRT. DLC may be useful to identify responders to CRT. [ABSTRACT FROM AUTHOR]
- Published
- 2005
- Full Text
- View/download PDF
204. Response to flecainide infusion predicts long-term success of inferior vena cava-tricuspid annulus ablation in patients with atrial fibrillation.
- Author
-
Stabile, G., De Simone, A., Turco, P., La Rocca, V., Vitale, D. F., Astarita, C., Maresca, F., De Matteis, C., and Di Napoli, T.
- Published
- 2000
205. Verapamil improves secondary cardioversion in patients with early atrial fibrillation recurrence after electrical cardioversion.
- Author
-
De Simone, A., Stabile, G., Turco, P., Nocerino, P., La Rocca, V., Vitale, D. F., Astarita, C., Maresca, F., De Matteis, C., and Di Napoli, T.
- Published
- 2000
206. Musculoskeletal manifestations of childhood cancer and differential diagnosis with juvenile idiopathic arthritis (ONCOREUM): a multicentre, cross-sectional study
- Author
-
Giovanna Russo, Valentino Conter, M Caniglia, A Garaventa, Giulia Stabile, MF Gicchino, Elisa Rossi, Annalisa Arlotta, S Ladogana, C Atzeni, Rita Consolini, Luciana Vinti, Daniela Onofrillo, Roberto Rondelli, Nicola Santoro, Loredana Lepore, F Locatelli, Elisa Coassin, Monica Ficara, Micol Romano, S Martino, Roberta Burnelli, I Fontanili, Francesca Soscia, Eleonora Prete, Francesca Santarelli, Romina Gallizzi, Patrizia Barone, MG Cefalo, E Cortis, Giovanni Filocamo, M Amatruda, Angela Miniaci, Anna Maria Caroleo, Massimo Eraldo Abate, Maria Cristina Maggio, M Mascarin, Simone Cesaro, E Fabbri, F De Benedetti, Angelo Ravelli, Alma Nunzia Olivieri, C Micalizzi, A Magnolato, B Bigucci, Francesca Ricci, Elisa Tirtei, Antonella Colombini, Luciana Breda, Tamara Belotti, Raffaela De Santis, Roberta Pericoli, Serena Pastore, Silvia Magni-Manzoni, Rosa Anna Podda, Chiara Mainardi, Donato Rigante, Federico Verzegnassi, C Messina, Adele Civino, Cristina Pizzato, M Marsili, Chiara Gorio, Rossella Mura, M Cattalini, Andrea Pession, M Cappella, A Di Cataldo, Francesco La Torre, Assunta Tornesello, Andrea Roncadori, F Porta, Maria Antonietta Pelagatti, F Fagioli, P Bertolini, Ilaria Capolsini, C Rizzari, M Cellini, Bianca Lattanzi, Alessandro De Fanti, S Davì, Carmela De Fusco, Giovanni Alighieri, Andrea Biondi, Civino, Adele, Alighieri, Giovanni, Prete, Eleonora, Maria Caroleo, Anna, SilviaMagni-Manzoni, Vinti, Luciana, Romano, Micol, Santoro, Nicola, Filocamo, Giovanni, Belotti, Tamara, Santarelli, Francesca, Gorio, Chiara, Ricci, Francesca, Colombini, Antonella, Pastore, Serena, Cesaro, Simone, Barone, Patrizia, Verzegnassi, Federico, Olivieri, Alma Nunzia, Ficara, Monica, Miniaci, Angela, Russo, Giovanna, Gallizzi, Romina, Pericoli, Roberta, Breda, Luciana, Mura, Rossella, Annapodda, Rosa, Onofrillo, Daniela, Lattanzi, Bianca, Elisatirtei, Cristina Maggio, Maria, De Santis, Raffaela, Ritaconsolini, Arlotta, Annalisa, La Torre, Francesco, Mainardi, Chiara, Antonietta Pelagatti, Maria, Coassin, Elisa, Capolsini, Ilaria, Burnelli, Roberta, Tornesello, Assunta, Soscia, Francesca, De Fanti, Alessandro, Donatorigante, Pizzato, Cristina, De Fusco, Carmela, Eraldo Abate, Massimo, Roncadori, Andrea, Rossi, Elisa, Stabile, Giulia, Biondi, Andrea, Lepore, Loredana, Conter, Valentino, Rondelli, Roberto, Pession, Andrea, Ravelli, Angelo, Association of Paediatric Haematology and Oncology†and the Italian Paediatric Rheumatology Study Group†, Italian, Amatruda, M, Atzeni, C, Pbertolini, Bigucci, B, Caniglia, M, Cappella, M, Cattalini, M, Cefalo, Mg, Cellini, M, Cortis, E, Davì, S, De Benedetti, F, Di Cataldo, A, Fabbri, E, Fagioli, F, Fontanili, I, Garaventa, A, Gicchino, MARIA FRANCESCA, Ladogana, S, Locatelli, F, Magnolato, A, Marsili, M, Martino, S, Mascarin, M, Messina, C, Micalizzi, C, Porta, F, Rizzari, C, Civino A., Alighieri G., Prete E., Caroleo A.M., Magni-Manzoni S., Vinti L., Romano M., Santoro N., Filocamo G., Belotti T., Santarelli F., Gorio C., Ricci F., Colombini A., Pastore S., Cesaro S., Barone P., Verzegnassi F., Olivieri A.N., Ficara M., Miniaci A., Russo G., Gallizzi R., Pericoli R., Breda L., Mura R., Podda R.A., Onofrillo D., Lattanzi B., Tirtei E., Maggio M.C., De Santis R., Consolini R., Arlotta A., La Torre F., Mainardi C., Pelagatti M.A., Coassin E., Capolsini I., Burnelli R., Tornesello A., Soscia F., De Fanti A., Rigante D., Pizzato C., De Fusco C., Abate M.E., Roncadori A., Rossi E., Stabile G., Biondi A., Lepore L., Conter V., Rondelli R., Pession A., Ravelli A., Amatruda M., Atzeni C., Bertolini P., Bigucci B., Caniglia M., Cappella M., Cattalini M., Cefalo M.G., Cellini M., Cortis E., Davi S., De Benedetti F., Di Cataldo A., Fabbri E., Fagioli F., Fontanili I., Garaventa A., Gicchino M.F., Ladogana S., Locatelli F., Magnolato A., Marsili M., Martino S., Mascarin M., Messina C., Micalizzi C., Porta F., Rizzari C., Civino, A, Alighieri, G, Prete, E, Caroleo, A, Magni-Manzoni, S, Vinti, L, Romano, M, Santoro, N, Filocamo, G, Belotti, T, Santarelli, F, Gorio, C, Ricci, F, Colombini, A, Pastore, S, Cesaro, S, Barone, P, Verzegnassi, F, Olivieri, A, Ficara, M, Miniaci, A, Russo, G, Gallizzi, R, Pericoli, R, Breda, L, Mura, R, Podda, R, Onofrillo, D, Lattanzi, B, Tirtei, E, Maggio, M, De Santis, R, Consolini, R, Arlotta, A, La Torre, F, Mainardi, C, Pelagatti, M, Coassin, E, Capolsini, I, Burnelli, R, Tornesello, A, Soscia, F, De Fanti, A, Rigante, D, Pizzato, C, De Fusco, C, Abate, M, Roncadori, A, Rossi, E, Stabile, G, Biondi, A, Lepore, L, Conter, V, Rondelli, R, Pession, A, Ravelli, A, Bertolini, P, Cefalo, M, Davi, S, and Gicchino, M
- Subjects
medicine.medical_specialty ,business.industry ,Immunology ,Arthritis ,Cancer ,Odds ratio ,Musculoskeletal manifestation ,Juvenile idiopathic arthritis ,medicine.disease ,Histiocytosis ,Rheumatology ,Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA ,Prednisone ,Internal medicine ,Joint pain ,Arthropathy ,Musculoskeletal manifestations, childhood cancer, juvenile idiopathic arthritis ,medicine ,childhood cancer ,Immunology and Allergy ,Differential diagnosis ,medicine.symptom ,business ,medicine.drug - Abstract
Summary Background Presenting symptoms of childhood cancers might mimic those of rheumatic diseases. However, the evidence available to guide differential diagnosis remains scarce. Preventing wrong or delayed diagnosis is therefore important to avoid incorrect administration of glucocorticoid or immunosuppressive therapy and worsening of prognosis. As such, we aimed to assess the prevalence and characteristics of presenting musculoskeletal manifestations in patients at cancer onset and to identify the factors that differentiate childhood malignancies with arthropathy from juvenile idiopathic arthritis. Methods We did a multicentre, cross-sectional study at 25 paediatric haemato-oncology centres and 22 paediatric rheumatology centres in Italy. We prospectively recruited patients who were younger than 16 years that were newly diagnosed with cancer or juvenile idiopathic arthritis. We excluded patients with glucocorticoid pre-treatment (>1 mg/kg per day of oral prednisone or equivalent for ≥2 consecutive weeks). We collected data for patients with a new diagnosis of cancer or juvenile idiopathic arthritis using an electronic case report form on a web-based platform powered by the Cineca Interuniversity Consortium. The primary outcome was to describe the frequency and characteristics of musculoskeletal manifestations at cancer onset; and the secondary outcome was to identify factors that could discriminate malignancies presenting with arthropathy, with or without other musculoskeletal symptoms, from juvenile idiopathic arthritis using multivariable logistic regression analysis. Findings Between May 1, 2015, and May 31, 2018, 1957 patients were eligible, of which 1277 (65%) had cancer and 680 (35%) had juvenile idiopathic arthritis. Musculoskeletal symptoms occurred in 324 (25% [95% CI 23·0–27·8]) of 1277 patients with cancer, of whom 207 had arthropathy. Patients with malignant bone tumours had the highest frequency of musculoskeletal symptoms (53 [80%] of 66), followed by patients with Langerhans histiocytosis (16 [47%] of 34), leukaemia (189 [32%] of 582), soft-tissue sarcomas (16 [24%] of 68), and neuroblastoma (21 [19%] of 109). In the 324 patients with cancer and musculoskeletal symptoms, the most common complaints were joint pain (199 [61%]), followed by limb bone pain (112 [35%]). Joint involvement had a prevalent monoarticular pattern (100 [48%] of 207) and oligoarticular pattern (86 [42%] had 2–4 joints involved and 20 [10%] had >4 joints involved), with the most frequently involved joints being the hip (88 [43%] of 207) and knee (81 [39%]). On multivariable analysis, limb bone pain was the independent variable most strongly associated with cancer (odds ratio [OR] 87·80 [95% CI 18·89–408·12]), followed by weight loss (59·88 [6·34–565·53]), thrombocytopenia (12·67 [2·40–66·92]), monoarticular involvement (11·30 [4·09–31·19]), hip involvement (3·30 [1·13–9·61]), and male sex (2·40 [1·03–5·58]). Factors independently associated with juvenile idiopathic arthritis were morning stiffness (OR 0·04 [95% CI 0·01–0·20]), joint swelling (0·03 [0·01–0·09]), and involvement of the small hand joints (0·02 [0–1·05]). Interpretation Our study provides detailed information about presenting musculoskeletal manifestations of childhood cancers and highlights the clinical and laboratory features that are most helpful in the differential diagnosis with juvenile idiopathic arthritis. Funding Associazione Lorenzo Risolo.
- Published
- 2021
207. Rational development and evaluation of novel formulations for urinary health
- Author
-
Francesco De Seta, Zoe Johnson, Guglielmo Stabile, Audrey Martin, Bryan Larsen, De Seta, F., Johnson, Z., Stabile, G., Martin, A., Larsen, B., De Seta, Francesco, Johnson, Zoe, Stabile, Guglielmo, Martin, Audrey, and Larsen, Bryan
- Subjects
Urinary tract infection ,Prebiotic ,Obstetrics and Gynecology ,Citric acid ,D-mannose ,Therapy ,Urinary tract infections ,Anti-Bacterial Agents ,Enterococcus faecalis ,Female ,Humans ,Proteus mirabilis ,Escherichia coli ,Urinary Tract Infections ,Proteus mirabili ,Reproductive Medicine ,Anti-Bacterial Agent ,Enterococcus faecali ,Human - Abstract
Objective: Urinary tract infections (UTI) among women form a substantial part of medical practice and both patients and medical professionals have an interest in non-antibiotic treatments and preventative measures. This research provides preliminary data on a multi-functional composition, DAPAD, which explored several biologic activities of relevance to UTI. Study Design: This formulation included D-mannose, citric acid, three prebiotic compounds, and extracts of dandelion and astragalus. Studies performed employed 4 bacterial strains that have relevance to UTI including E. coli, Proteus mirabilis, Streptococcus agalactiae and Enterococcus faecalis. Results: Key findings from in vitro studies included: DAPAD at full- and half-strength inhibited growth of all UTI bacteria. Evidence for D-mannose agglutination of E. coli was demonstrated. D-mannose also showed unexpected effects on bacterial membrane integrity with vital staining and modest growth restriction. We did not demonstrate growth inhibition by dandelion or astragalus extracts but the latter showed diminished cytokine elaboration by bladder epithelial cells. Conclusion: DAPAD is a multifunctional composition that may warrant further development as a UTI treatment or preventive if supported by clinical evaluation.
- Published
- 2022
208. Characteristics of Submucous Myomas and the Risk of Anemia
- Author
-
Giuseppe Ricci, Federica Scrimin, Andrea Sartore, Massimo Borelli, Gabriella Zito, Federico Romano, Guglielmo Stabile, Ricci, G., Scrimin, F., Sartore, A., Borelli, M., Zito, G., Romano, F., and Stabile, G.
- Subjects
Leiomyoma ,anemia ,hemoglobin ,metrorrhagia ,myoma grade ,myomas ,Anemia ,General Medicine ,Myoma ,Humans ,Female ,Menorrhagia ,Retrospective Studies - Abstract
Background and Objectives: Uterine fibroids still represent the most common indication for hysterectomy for benign pathologies. In the United States, more than 479,000 hysterectomies are performed annually, 46.6% for myomas and 47.7% in women aged from 18 to 44 years. By applying appropriateness criteria to this procedure, it has been estimated that overuse ranges from 16 to 70%. One of the main reasons that induce patients and gynecologists to consider hysterectomy is represented by severe anemia. Materials and Methods: This is a retrospective cohort study of 202 patients with uterine fibroids diagnosed by transvaginal ultrasound who underwent a hysteroscopic procedure. Myoma grade, size, location, and number were assessed by transvaginal scan and office hysteroscopy and correlated to the pre-treatment hemoglobin level. Results: Univariate analysis showed that anemia does not have a statistically significant association with myoma number and with age considered as a numerical predictor. In the patients with myoma type 0, there is a possibility of 81% having anemia regardless of menorrhagia. On the contrary, in patients with myoma type 1 or type 2, the possibility of having anemia varies according to the presence or absence of menorrhagia. If there is menorrhagia, the risk of moderate anemia is only present for myomas >60 mm. Conclusions: The results of this study may contribute to defining objective criteria for the management of submucous myomas and anemia. Our data suggest that submucosal myomas type 0 >10 mm should always be treated, putting patients at risk for anemia. Myomas type 2 and 3 should be treated for the risk of anemia in the presence of menorrhagia episodes or if > of 60 mm. Adequate management of anemia and myomas could reduce the rate of unnecessary hysterectomies.
- Published
- 2022
209. Pelvic mass, ascites, hydrothorax: a malignant or benign condition? Meigs syndrome with high levels of CA 125
- Author
-
Chiara Dal Pozzolo, Antonio Simone Laganà, Federico Romano, Guglielmo Stabile, Giuseppe Ricci, Giulia Zinicola, Stabile, G., Zinicola, G., Romano, F., Lagana, A. S., Dal Pozzolo, C., and Ricci, G.
- Subjects
medicine.medical_specialty ,Abdominal pain ,Pleural effusion ,Endocrinology, Diabetes and Metabolism ,Hydrothorax ,Case Report ,pelvic mass ,Ovarian tumor ,ascites ,Ovarian cancer ,Ascites ,medicine ,Meigs syndrome ,fibrothecoma ,Meigs' syndrome ,Tumor marker ,hydrothorax ,CA 125 ,Fibrothecoma ,Pelvic mass ,business.industry ,Obstetrics and Gynecology ,ovarian cancer ,medicine.disease ,Ascite ,Medicine ,Radiology ,medicine.symptom ,business - Abstract
Introduction Abdominal-pelvic mass, ascites and pleural effusion are suggestive of malignant metastatic ovarian cancer. This triad is also present in a rare benign condition called Meigs syndrome. Rarely this condition is associated with an increased CA 125 level. Case report A 62-year-old woman with a history of abdominal pain underwent an ultrasound (US) examination and a chest X-ray. The imaging revealed the presence of a large pelvic mass and ascites with a monolateral pleural effusion and a high level of the tumor marker CA 125. The patient underwent a total abdominal hysterectomy, salpingoophorectomy, removal of the pelvic mass, pelvic lymphadenectomy and peritoneal biopsies. The histology showed an ovarian fibrothecoma. Discussion The US analysis according to international ovarian tumor analysis simple rules revealed "inconclusive results"; the logistic regression model LR2 and Adnex suggested a high risk of malignancy. The presence of ascites and the size of the lesion associated with a high level of CA 125 affected the correct assessment of the risk of malignancy, exposing the patient to overtreatment. Conclusions Meigs syndrome is characterized by the resolution of symptoms after surgical removal of the pelvic mass. However, it mimics the clinical picture of a malignant metastatic ovarian cancer. Clinicians have to exclude ovarian cancer and recognize the syndrome to reduce inappropriate procedures.
- Published
- 2021
210. 'Nerve-sparing' laparoscopic treatment of parametrial ectopic pregnancy
- Author
-
Guglielmo Stabile, Stefano Facchin, Giuseppe Ricci, Giuseppe Mirenda, Federico Romano, Giovanni Di Lorenzo, F. Buonomo, Francesco Cracco, Di Lorenzo, G., Romano, F., Mirenda, G., Cracco, F., Buonomo, F., Stabile, G., Facchin, S., and Ricci, G.
- Subjects
medicine.medical_specialty ,Pregnancy ,Abdominal pregnancy ,laparoscopy ,nerve-sparing ,parametrial pregnancy ,Ectopic pregnancy ,business.industry ,Parametrial ,Gestational sac ,Obstetrics and Gynecology ,Ureterolysis ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Reproductive Medicine ,Parametrium ,medicine ,Maternal death ,business - Abstract
Objective: To demonstrate laparoscopic surgical management of parametrial ectopic pregnancy. Design: Video presentation of laparoscopic nerve-sparing treatment of parametrial pregnancy. Setting: Tertiary university center. Patient(s): A 33-year-old patient, nullipara at 8 weeks of gestation, with no comorbidity and no previous surgery, was admitted to a spoke hospital for acute abdominal pain. During hospitalization, a transvaginal gynecologic ultrasound revealed pregnancy with ectopic localization. Free pelvic fluid was detected, and a subsequent diagnostic laparoscopy was performed because of worsening symptoms. During the procedure, hemoperitoneum drainage was instituted and American Society of Reproductive Medicine stage III pelvic endometriosis was diagnosed. A round formation approximately 3 cm in diameter was found at the left posterior parametrium (Fig. 1). Due to the pregnancy position and β-human chorionic gonadotropic (β-hCG; 820 mUI /mL) values, conservative treatment was chosen. Thus, methotrexate at 50 mg/m2 body surface area was administered. A second dose of methotrexate was administered seven days after the first one, and the β-hCG increased to 1068 mUI. On day 14 after treatment, the β-hCG was 1053 mUI/mL. Therefore, surgical treatment was chosen, and the patient was transferred to our center. An ultrasound assessment confirmed the ectopic pregnancy with a live fetus in the left posterior parametrium. Intervention(s): The patient underwent operative laparoscopy to remove the ectopic pregnancy. Surgery was performed using a 3-dimensional optical system (TIPCAM 1, S D3-LINK; Karl Storz SE & Co., Tuttlingen, Germany). After drainage of the hemoperitoneum, the gestational sac was identified in the left posterior parametrium. The uterus, tubes, and ovaries showed normal morphology. Pelvic endometriosis was confirmed. After accessing the left pelvic retroperitoneum with the medial and lateral pararectal spaces’ opening and development, ipsilateral ureterolysis was necessary to isolate the parametrial pregnancy in close contact with it. Coagulation and sectioning of the deep uterine veins were essential to control hemostasis. Identification of the left hypogastric nerve, which was partially infiltrated by the chorionic villi, and the pelvic splanchnic nerves, was required to safeguard them (Fig. 2). Subsequently, the surgeon decided to place a ureteral stent to prevent urologic complications. Main Outcome Measure(s): The laparoscopic approach proved to be safe and feasible to manage parametrial pregnancy. Result(s): The pregnancy was removed entirely. The patient was discharged 72 hours after the procedure with an uneventful postoperative course. The histologic report confirmed the diagnosis of parametrial pregnancy on decidualized endometriotic tissue. The β-hCG serum level became negative in 20 days. Conclusion(s): Extrauterine pregnancies represent one of the leading causes of maternal death in the first trimester and constitute approximately 1%–2% of total pregnancies. Of these percentages, only 5%–8.3% are nontubal. Cases of abdominal pregnancy are even rarer, estimated at
- Published
- 2021
211. Impact of ablation index settings on pulmonary vein reconnection
- Author
-
Mark M Gallagher, S Abbey, Matteo Anselmino, M. Rillo, Frederic Sebag, Francesco Solimene, Ennio Pisano, Graziana Viola, Domenico Pecora, F. Lamberti, Giuseppe Sgarito, Marco Scaglione, A. Lepillier, A. De Simone, E. De Ruvo, Emanuele Bertaglia, A. Pani, Teresa Strisciuglio, Giulio Zucchelli, Giuseppe Stabile, Lepillier, A., Strisciuglio, T., De Ruvo, E., Scaglione, M., Anselmino, M., Sebag, F. A., Pecora, D., Gallagher, M. M., Rillo, M., Viola, G., Pisano, E., Abbey, S., Lamberti, F., Pani, A., Zucchelli, G., Sgarito, G., De Simone, A., Bertaglia, E., Solimene, F., and Stabile, G.
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Catheter ablation ,030204 cardiovascular system & hematology ,Pulmonary vein ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Fluoroscopy ,030212 general & internal medicine ,Pulmonary vein reconnection ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Ablation index ,Atrial fibrillation ,Ablation ,medicine.disease ,eye diseases ,Catheter ,Treatment Outcome ,Pulmonary Veins ,Cardiology ,Population study ,Cardiology and Cardiovascular Medicine ,business - Abstract
Purpose: Ablation index (AI) is a radiofrequency lesion quality marker. The AI value that allows effective and safe pulmonary vein isolation (PVI) is still debated. We evaluated the incidence of acute and late PV reconnection (PVR) with different AI settings and its predictors. Methods: The Ablation Index Registry is a multicenter study that included patients with paroxysmal/persistent atrial fibrillation (AF) who underwent first-time ablation. Each operator performed the ablation using his preferred ablation catheter (ThermoCool® SmartTouch or Surround Flow) and AI setting (380 posterior-500 anterior and 330 posterior-450 anterior). We divided the study population into two groups according to the AI setting used: group 1 (330–450) and group 2 (380–500). Incidence of acute PVR was validated within 30 min after PVI, whereas the incidence of late PVR was evaluated at repeat procedure. Results: Overall, 490 patients were divided into groups 1 (258) and 2 (232). There was no significant difference in the procedural time, fluoroscopy time, and rate of the first-pass PVI between the two study groups. Acute PVR was observed in 5.6% PVs. The rate of acute PVR was slightly higher in group 2 (64/943, 6.8%, PVs) than in group 1 (48/1045, 4.6% PVs, p = 0.04). Thirty patients (6%) underwent a repeat procedure and late PVR was observed in 57/116 (49%) PVs (number of reconnected PV per patient of 1.9 ± 1.6). A similar rate of late PVR was found in the two study groups. No predictors of acute and late PVR were found. Conclusion: Ablation with a lower range of AI is highly effective and is not associated with a higher rate of acute and late PVR. No predictors of PV reconnection were found.
- Published
- 2022
212. A Systematic Review of the Guidelines on Venous Thromboembolism Prophylaxis in Gynecologic Oncology
- Author
-
Federico Romano, Giovanni Di Lorenzo, Guglielmo Stabile, Mariateresa Mirandola, Stefano Restaino, Patrizia Ianniello, Giuseppe Mirenda, Giuseppe Ricci, Romano, F., Di Lorenzo, G., Stabile, G., Mirandola, M., Restaino, S., Ianniello, P., Mirenda, G., and Ricci, G.
- Subjects
Cancer Research ,deep vein thrombosis ,gynecological cancer ,pulmonary embolism ,thromboprophylaxis ,venous thromboembolism prevention ,Oncology ,thromboprophylaxi ,deep vein thrombosi - Abstract
(1) Background: This review aimed to summarize the indications for venous thromboembolic (VTE) events’ prophylaxis in a gynecological cancer population, according to the most recent guidelines. (2) Methods: A systematic review of the guidelines in PubMed, SCOPUS, Web of Science, EMBASE, and CINHAL regarding VTE prevention in gynecological cancer patients was conducted according to PRISMA criteria. We compared the recommendations given by oncological and hematological societies regarding VTE prevention in gynecological cancer patients published from January 2010 through March 2021. We searched for the following keywords: “venous thromboembolism prevention”, “cancer”, and “guidelines”. The AGREE II checklist was used to critically analyze the guidelines’ quality. (3) Results: There were 1003 documents available; 14 met the inclusion criteria, 5 were excluded and, eventually, the guidelines of 10 societies were evaluated. (4) Conclusions: The guidelines agree that low-molecular-weight heparin (LMWH) and fondaparinux achieve better results in VTE prevention in gynecological cancer patients. Direct oral anticoagulants (DOACs) can be used to prevent VTE in outpatients and high-risk medical patients after discharge. VTE risk scores should be applied to all oncological patients to identify those who would benefit from a prevention program. More attention should be paid to mechanical prophylactic methods due to the high bleeding risk of gynecological cancer patients.
- Published
- 2022
213. 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
214. Spondylodiscitis After Surgery for Pelvic Organ Prolapse: Description of a Rare Complication and Systematic Review of the Literature
- Author
-
Guglielmo Stabile, Federico Romano, Ghergana A. Topouzova, Francesco Paolo Mangino, Giovanni Di Lorenzo, Antonio Simone Laganà, Nicolò De Manzini, Giuseppe Ricci, Stabile, G., Romano, F., Topouzova, G. A., Mangino, F. P., Di Lorenzo, G., Lagana, A. S., De Manzini, N., and Ricci, G.
- Subjects
Spondylodiscitis ,medicine.medical_specialty ,RD1-811 ,medicine.medical_treatment ,MEDLINE ,sacrocolpopexy ,Lumbar ,medicine.ligament ,mesh ,prolapse ,rectopexy ,spondylodiscitis ,medicine ,Gynecological surgery ,business.industry ,Pelvic pain ,Sacrospinous ligament ,medicine.disease ,Sacrum ,Surgery ,Systematic Review ,medicine.symptom ,Complication ,business - Abstract
Background: Spondylodiscitis can be a rare complication of gynecological surgery, typically of procedures involving the sacrum and the sacrospinous ligament. This report presents a case of spondylodiscitis arising after a laparoscopic sacrocolpopexy with a mesh. We also review the literature finding 52 cases of spondylodiscitis following sacrocolpopexy and (or) rectopexy with or without a mesh.Methods: We performed a comprehensive search from the electronic databases MEDLINE (Pubmed), Scopus, Web of Science, Embase, CINAHL, and Google Scholar from 1990 to February 2021 in order to identify case reports or case series reporting on spondylodiscitis after rectopexy or sacrocolpopexy.Results: We identified 52 total postoperative spondylodiscitis. We examined the mean age of patients, the surgical history, the time from initial surgery to spondylodiscitis, the presenting symptoms, the diagnostic tools, the medical and surgical treatment, the type of mesh used, the surgical access, and the possible causes of spondylodiscitis.Conclusions: Diagnosis of spondylodiscitis may be challenging. From our review emerges that recurrent pelvic pain and lumbosciatalgia may be signals of lumbar spondylodiscitis. Magnetic resonance is the gold standard examination for spondylodiscitis. Surgical practice needs to be improved further in order to establish the best procedure to minimize the incidence of this complication. Awareness of symptoms, timely diagnosis, and treatment are fundamental to prevent irreversible complications.
- Published
- 2021
215. Interstitial Ectopic Pregnancy: The Role of Mifepristone in the Medical Treatment
- Author
-
Ghergana Alexandrova Topouzova, Federico Romano, Giovanni Di Lorenzo, Guglielmo Stabile, Francesco Paolo Mangino, Giuseppe Ricci, Giulia Zinicola, Stabile, G., Romano, F., Zinicola, G., Topouzova, G. A., Lorenzo, G. D., Mangino, F. P., and Ricci, G.
- Subjects
medicine.medical_specialty ,Medical therapy ,Ectopic pregnancy ,Health, Toxicology and Mutagenesis ,mifepristone ,Gestational sac ,Fertility sparing ,conservative treatment ,Article ,methotrexate ,Folinic acid ,Pregnancy ,interstitial pregnancy ,medicine ,Humans ,business.industry ,Obstetrics ,Public Health, Environmental and Occupational Health ,Mifepristone ,medicine.disease ,fertility sparing ,medical therapy ,medicine.anatomical_structure ,Methotrexate ,Fertility ,Pregnancy, Interstitial ,Myometrium ,Medicine ,ectopic pregnancy ,Interstitial pregnancy ,Female ,business ,Conservative treatment ,Fallopian tube ,medicine.drug - Abstract
Interstitial pregnancy is defined as the presence of a gestational sac in the most proximal section of the fallopian tube. Management of interstitial pregnancy remains a debated topic. Depending on hemodynamic stability, size of pregnancy, depth of surrounding myometrium, and desires for future fertility, interstitial pregnancy can be managed medically or surgically. We reviewed the literature in December 2020 using keywords “interstitial pregnancy”, “medical treatment”, “methotrexate”, and “mifepristone”. Articles published from January 1991 until 2020 were obtained from databases EMBASE, SCOPUS, and PUBMED. We describe the case of a patient with an interstitial pregnancy that was managed with a total medical approach in August 2020 at Burlo Garofolo Hospital. The patient was asymptomatic and hemodynamically stable, with a high level of serum β-hCG (22,272 mUi/mL). We used the combination of methotrexate (MTX) and mifepristone. Medical therapy was effective leading to interstitial pregnancy resolution in 51 days without collateral effects for the patient. We found seven previous cases reported in the literature. Our purpose is to underline the efficacy of medical therapy with systemic multidose MTX associated with a single oral dose of mifepristone and also folinic acid when is present a viable fetus and a high serum β-hCG level.
- Published
- 2021
- Full Text
- View/download PDF
216. 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
217. Induced Dryness Stress on Human Vaginal Epithelium: The Efficacy of a New Vaginal Gel
- Author
-
Guglielmo Stabile, Giuseppe Ricci, Francesco De Seta, Maria Sole Scalia, Stabile, G., Ricci, G., Scalia, M. S., and De Seta, F.
- Subjects
Genitourinary syndrome ,Polymers and Plastics ,Science ,medicine.medical_treatment ,menopause ,General. Including alchemy ,Bioengineering ,Article ,Biomaterials ,Andrology ,Extracellular matrix ,chemistry.chemical_compound ,vulvovaginal atrophy ,QD1-65 ,Hyaluronic acid ,medicine ,genitourinary syndrome ,Dryness ,Menopause ,Vaginal gel ,Vulvovaginal atrophy ,QD1-999 ,Saline ,QD146-197 ,biology ,Chemistry ,Organic Chemistry ,CD44 ,medicine.disease ,humanities ,Epithelium ,stomatognathic diseases ,medicine.anatomical_structure ,biology.protein ,Immunohistochemistry ,Dryne ,medicine.symptom ,Inorganic chemistry ,vaginal gel ,dryness - Abstract
An experimental model of dryness on vaginal mucosa is proposed to assess the efficacy of a new vaginal gel (Respecta® Hydragel Ref 17031). The dryness model was induced on reconstituted human vaginal epithelium (HVE) by incubating the tissues in modified environmental conditions (R.H. <, 50% and T = 40 °C) for 48 h. The products were applied on the ‘Dry’ HVE models for 24 h (series 48 h + 24 h) in standard culture conditions (37 °C 5% CO2). Their efficacy in counteracting vaginal dryness was assessed and compared to tissues treated with saline solution and cultured in standard culture conditions (negative control) and to untreated tissues incubated in dryness conditions for 48 h and then recovered after 24 h in standard culture conditions (positive control). The products’ efficacy was quantified by measuring the following parameters: (1) water flux and direct moisturization by AQP3 immunohistochemical staining, and (2) maintenance of moisturization and elasticity of the mucosa by hyaluronic acid (CD44) immunofluorescence staining. Respecta® Hydragel demonstrated efficacy in regulating the water flux by inducing AQP3 expression thus determining a positive water balance within the vaginal epithelium. It induced a remodelling of the epithelium morphology with restored trophism compared to the dry HVE control. Furthermore, it demonstrated a significant increase of the expression of CD44, related to hyaluronic acid (HA) distribution in the extracellular matrix. HA has the ability to act on the cellular matrix composition and its renewal compared to the dry HVE control. Through these mechanisms it induces a deep hydration and elasticity of the vaginal mucosa.
- Published
- 2021
218. 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
219. 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
220. A new therapy for uncomplicated vulvovaginal candidiasis and its impact on vaginal flora
- Author
-
Roberta Marie Gentile, Francesco De Seta, Guglielmo Stabile, Stefania Carlucci, Stefano Restaino, Stabile, G., Gentile, R. M., Carlucci, S., Restaino, S., and De Seta, F.
- Subjects
medicine.medical_specialty ,Leadership and Management ,Azole resistance ,Health Informatics ,Context (language use) ,Probiotic ,clotrimazole ,Health Information Management ,Internal medicine ,Medicine ,Clotrimazole ,chemistry.chemical_classification ,Vaginal flora ,therapy ,treatment ,business.industry ,Probiotics ,Therapy ,Treatment ,Vulvovaginal candidiasis ,Communication ,Health Policy ,vaginal flora ,probiotics ,chemistry ,Vulvovaginal Candidiasis ,Toxicity ,vulvovaginal candidiasis ,Azole ,High incidence ,business ,medicine.drug - Abstract
Background: An estimated 75% of women will have one episode of vulvovaginal candidiasis (VCC) during their lifetime, and 40–50% of these will experience further episodes. The high incidence of vulvovaginal candidiasis, combined with the problems of azole resistance and toxicity, highlights the necessity for new strategies for the treatment of this condition. In this context, natural compounds represent promising alternatives. Methods: We enrolled, between January 2020 and April 2021, forty women affected by uncomplicated vulvovaginal candidiasis. Women were divided into two groups. In the first group, we treated 20 women with clotrimazole daily administration for six days. In the second group, 20 women were treated with clotrimazole associated with Unilen® Microbio+, a new product containing Saccharomyces cerevisiae, melatonin, and GLA-14. Women underwent a check at days 15, 30, and 90. A clinical and cultural examination were performed to establish the effect of the treatments on vaginal flora. Results: In the group treated with Unilen® Microbio+, clinical and microbiological cure at 15 and 30 days was observed in 18 women (90%), compared with 16 women (80%) in the group treated only with clotrimazole. The efficacy of the association between clotrimazole and Unilen® Microbio+ in these uncomplicated forms was therefore not inferior to the azole treatment alone. Only four women (20%) in the Unilen® Microbio+ group presented symptomatic recurrences within the 3 months, compared with eight women (40%) in the clotrimazole-only group. Microscopic wet mount analysis at 1 and 3 months demonstrated a significant increase in lactobacillus count and a reduction in the polymorphonucleate cells in the Unilen® Microbio+ group. Conclusions: Unilen® Microbio+ supplementation was demonstrated to cure uncomplicated vulvovaginal candidiasis with clotrimazole, reducing recurrence and improving vaginal flora better than clotrimazole treatment alone.
- Published
- 2021
221. CD133 expression in placenta chorioangioma presenting as a giant asymptomatic mass
- Author
-
Guglielmo Stabile, Giuseppe Ricci, Gianluca Di Di Massa, Tiziana Salviato, Andrea Balduit, Federico Romano, Pina Canu, Beatrice Belmonte, Alessandro Mangogna, Emma Bertucci, Massa, G. D., Stabile, G., Romano, F., Balduit, A., Mangogna, A., Belmonte, B., Canu, P., Bertucci, E., Ricci, G., Salviato, T., Di Massa, Gianluca, Stabile, Guglielmo, Romano, Federico, Balduit, Andrea, Mangogna, Alessandro, Belmonte, Beatrice, Canu, Pina, Bertucci, Emma, Ricci, Giuseppe, and Salviato, Tiziana
- Subjects
CD31 ,Adult ,medicine.medical_specialty ,Medicine (General) ,Placenta Diseases ,giant asymptomatic ma ,Placenta ,Case Report ,giant asymptomatic mass ,R5-920 ,Pregnancy ,medicine ,Childbirth ,CD133 expression ,Giant asymptomatic mass ,Placental chorioangioma ,Cesarean Section ,Endothelial Cells ,Female ,Humans ,Infant, Newborn ,Hemangioma ,Pregnancy Complications, Neoplastic ,Clinical significance ,Cardiotocography ,Fetus ,Neoplastic ,placental chorioangioma ,medicine.diagnostic_test ,Obstetrics ,business.industry ,Infant ,General Medicine ,medicine.disease ,Newborn ,Pregnancy Complications ,medicine.anatomical_structure ,embryonic structures ,Gestation ,Giant asymptomatic ma ,business - Abstract
Background: Placental chorioangioma is the most common benign non-trophoblastic neoplasm of the placenta. Its clinical relevance lies in the size of the tumor since larger masses cause pregnancy complications, including an unfavorable neonatal outcome. Case presentation: We report the case of a 34-year-old second gravida and nullipara at the 35th week of gestation, admitted to the gynecological department for antibiotic-resistant fever. The cardiotocography performed during hospitalization showed an abnormal fetal pattern. A 2250 g newborn was delivered by cesarean section. No complications were observed during childbirth and postpartum was insignificant. On gross inspection a white fleshy intraparenchymal mass blooming on the maternal surface was noted; routinely stained sections revealed features consistent with chorioangioma with vascular channels lined by inconspicuous endothelial cells immunoreactive for CD31 and CD133. Focal expression of CD133 was also observed in placental villi. Discussion: CD133 expression indicated the presence of stem cells in chorioangioma, suggesting their possible role in the development of mesenchymal lesions including chorioangioma.
- Published
- 2021
222. The rare, unexpected condition of a twisted leiomyoma in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: Etiopathogenesis, diagnosis and management. Our experience and narrative review of the literature
- Author
-
A. Romano, Francesco Paolo Mangino, Stefania Carlucci, Giuseppe Mirenda, Mariateresa Mirandola, Federico Romano, Guglielmo Stabile, Giuseppe Ricci, Romano, F., Carlucci, S., Stabile, G., Mirenda, G., Mirandola, M., Mangino, F. P., Romano, A., and Ricci, G.
- Subjects
Torsion ,Mayer rokitansky kuster hauser ,Abdominal pain ,medicine.medical_specialty ,MRKH Syndrome ,46, XX Disorders of Sex Development ,Health, Toxicology and Mutagenesis ,Pelvic mass ,pelvic mass ,Review ,Disease ,Congenital Abnormalities ,Mullerian Duct ,03 medical and health sciences ,Rare Diseases ,0302 clinical medicine ,XX Disorders of Sex Development ,Rare Disease ,leiomyoma ,Humans ,Medicine ,Mullerian Ducts ,030219 obstetrics & reproductive medicine ,Uterine leiomyoma ,Leiomyoma ,business.industry ,General surgery ,Mayer-Rokitansky-Küster-Hauser ,Public Health, Environmental and Occupational Health ,torsion ,Abdominal Pain ,Female ,Middle Aged ,medicine.disease ,Pelvic ma ,Congenital Abnormalitie ,030220 oncology & carcinogenesis ,Narrative review ,medicine.symptom ,business ,Human - Abstract
Uterine leiomyomas are a common finding in medical practice, but their frequency changes drastically when contextualized in a syndrome, as in the following case. A 50-year-old woman with a known Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome presented at our clinic with abdominal pain located in the lower quadrants and scarcely responsive to analgesic therapy. A twisted gynecological pelvic mass was diagnosed, and management for prompt resolution was adopted. Histologically the mass was described as a leiomyoma. The aim of the present study is to share our experience and to review the literature to compare different manifestation of the disease and different approach used in the various centers. The additional novelty of the paper is the immunohistochemical study we carried out on the leiomyoma that is contrasted with the current etiopathogenetic theories.
- Published
- 2021
223. Incidence and Predictors of Infections and All-Cause Death in Patients with Cardiac Implantable Electronic Devices: The Italian Nationwide RI-AIAC Registry
- Author
-
Giuseppe Boriani, Marco Proietti, Matteo Bertini, Igor Diemberger, Pietro Palmisano, Stefano Baccarini, Francesco Biscione, Nicola Bottoni, Antonio Ciccaglioni, Alessandro Dal Monte, Franco Alberto Ferrari, Saverio Iacopino, Marcello Piacenti, Daniele Porcelli, Stefano Sangiorgio, Luca Santini, Michele Malagù, Giuseppe Stabile, Jacopo Francesco Imberti, Davide Caruso, Massimo Zoni-Berisso, Roberto De Ponti, Renato Pietro Ricci, on behalf of RI-AIAC Registry Investigators, Boriani G., Proietti M., Bertini M., Diemberger I., Palmisano P., Baccarini S., Biscione F., Bottoni N., Ciccaglioni A., Monte A.D., Ferrari F.A., Iacopino S., Piacenti M., Porcelli D., Sangiorgio S., Santini L., Malagu M., Stabile G., Imberti J.F., Caruso D., Zoni-Berisso M., De Ponti R., and Ricci R.P.
- Subjects
Pacemaker ,cardiac implantable electronic device ,implantable defibrillator ,pacemaker ,infection ,outcome ,Cardiac implantable electronic device ,Socio-culturale ,Medicine ,Medicine (miscellaneous) ,Implantable defibrillator ,Infection ,Article ,Outcome - Abstract
Background: The incidence of infections associated with cardiac implantable electronic devices (CIEDs) and patient outcomes are not fully known. Aim: To provide a contemporary assessment of the risk of CIEDs infection and associated clinical outcomes. Methods: In Italy, 18 centres enrolled all consecutive patients undergoing a CIED procedure and entered a 12-months follow-up. CIED infections, as well as a composite clinical event of infection or all-cause death were recorded. Results: A total of 2675 patients (64.3% male, age 78 (70–84)) were enrolled. During follow up 28 (1.1%) CIED infections and 132 (5%) deaths, with 152 (5.7%) composite clinical events were observed. At a multivariate analysis, the type of procedure (revision/upgrading/reimplantation) (OR: 4.08, 95% CI: 1.38–12.08) and diabetes (OR: 2.22, 95% CI: 1.02–4.84) were found as main clinical factors associated to CIED infection. Both the PADIT score and the RI-AIAC Infection score were significantly associated with CIED infections, with the RI-AIAC infection score showing the strongest association (OR: 2.38, 95% CI: 1.60–3.55 for each point), with a c-index = 0.64 (0.52–0.75), p = 0.015. Regarding the occurrence of composite clinical events, the Kolek score, the Shariff score and the RI-AIAC Event score all predicted the outcome, with an AUC for the RI-AIAC Event score equal to 0.67 (0.63−0.71) p < 0.001. Conclusions: In this Italian nationwide cohort of patients, while the incidence of CIED infections was substantially low, the rate of the composite clinical outcome of infection or all-cause death was quite high and associated with several clinical factors depicting a more impaired clinical status.
- Published
- 2022
224. Reproducibility of pulmonary vein isolation guided by the ablation index: 1-year outcome of the AIR registry
- Author
-
Mariano Rillo, Nicolas Badenco, Mark M Gallagher, Marco Scaglione, Ermenegildo De Ruvo, Giuseppe Sgarito, Maurizio Del Greco, Daniela Dugo, Frederic Sebag, Antonio De Simone, Francesco Solimene, A. Pani, A. Castro, Maurizio Landolina, A. Lepillier, Giuseppe Stabile, Filippo Lamberti, Teresa Strisciuglio, Valerio De Santis, Massimo Grimaldi, Luca Rossi, Giulio Zucchelli, Salim Abbey, Emanuele Bertaglia, Ennio Pisano, Graziana Viola, Domenico Pecora, Matteo Anselmino, Stabile, G., Lepillier, A., De Ruvo, E., Scaglione, M., Anselmino, M., Sebag, F., Pecora, D., Gallagher, M., Rillo, M., Viola, G., Rossi, L., De Santis, V., Landolina, M., Castro, A., Grimaldi, M., Badenco, N., Del Greco, M., De Simone, A., Pisano, E., Abbey, S., Lamberti, F., Pani, A., Zucchelli, G., Sgarito, G., Dugo, D., Bertaglia, E., Strisciuglio, T., and Solimene, F.
- Subjects
Registrie ,medicine.medical_specialty ,medicine.medical_treatment ,Anterior wall ,Reproducibility of Result ,Catheter ablation ,030204 cardiovascular system & hematology ,Pulmonary vein ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Physiology (medical) ,Atrial Fibrillation ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Registries ,reproducibility ,Reproducibility ,ablation index ,atrial fibrillation ,catheter ablation ,business.industry ,Reproducibility of Results ,Atrial fibrillation ,Ablation ,medicine.disease ,Surgery ,Prospective Studie ,Catheter ,Treatment Outcome ,Pulmonary Veins ,Catheter Ablation ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Human - Abstract
Background Ablation index (AI) is a new lesion quality marker that has been demonstrated to allow a high single-procedure arrhythmia-free survival in single-center studies. This prospective, multi-center study was designed to evaluate the reproducibility of pulmonary vein (PV) isolation guided by the AI. Methods A total of 490 consecutive patients with paroxysmal (80.4%) and persistent AF underwent first time PV isolation and were divided in four study groups according to operator's preference in choosing the ablation catheter (a contact force (ST) or contact force surround flow (STSF) catheter) and the AI setting (330-450 or 380-500 at anterior wall or posterior wall, respectively). Results At 12 months a high rate of freedom from AF recurrences was observed in patients with both paroxysmal and persistent AF (91% vs 83.3%; P = .039). There was no difference in the rate of AF recurrence among the four study groups (4.5% in group ST330-450, 12.2% in group ST 380-500, 14.9% in group STSF330-450, 9.4% in group STSF380-500; P = .083). Recurrence was also similar between patients treated with a ST (8%) or STSF catheter (12.1%; P = .2), and within patients targeting an AI settings of 330 to 450 (10.9%) or 380 to 500 (10.3%; P = .64). In patients with paroxysmal AF, there was no difference (P = .12) in the 1-year freedom from AF recurrence among 14 operators that performed ≥10 ablation procedure. Conclusions An ablation protocol respecting strict criteria for contiguity and quality lesion resulted in high rate of 1-year freedom from AF recurrence, irrespective of the ablation catheters, AI settings, and operator.
- Published
- 2020
225. Atrial fibrillation ablation long-term ESC-EHRA EORP AFA LT registry: in-hospital and 1-year follow-up findings in Italy
- Author
-
Massimo Tritto, Giuseppe Stabile, Matteo Anselmino, Fiorenzo Gaita, Maria Grazia Bongiorni, Roberto De Ponti, Gaetano M. De Ferrari, Carlo Pappone, Pietro Agricola, Leonardo Calò, Paolo Della Bella, Andrea Saglietto, Carina Blomström-Lundqvist, Massimo Grimaldi, Andrea Ballatore, Anselmino, M., Ballatore, A., Saglietto, A., Stabile, G., De Ponti, R., Grimaldi, M., Agricola, P. M. G., Della Bella, P., Tritto, M., Pappone, C., Calo, L., Bongiorni, M. G., Blomstrom-Lundqvist, C., Gaita, F., and De Ferrari, G. M.
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Paroxysmal atrial fibrillation ,medicine.medical_treatment ,Operative Time ,Catheter ablation ,1 year follow up ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Recurrence ,Internal medicine ,Atrial Fibrillation ,Prevalence ,Humans ,Medicine ,Registries ,030212 general & internal medicine ,Adverse effect ,Aged ,business.industry ,Atrial fibrillation ,General Medicine ,Middle Aged ,Radiation Exposure ,Ablation ,medicine.disease ,Treatment Outcome ,Italy ,Catheter Ablation ,Lower prevalence ,Procedure Duration ,Female ,Cardiology and Cardiovascular Medicine ,business ,Anti-Arrhythmia Agents ,Follow-Up Studies - Abstract
AIM: To report the Italian data deriving from the European Society of Cardiology-EURObservational Research Program atrial fibrillation ablation long-term registry. METHODS AND RESULTS: Ten Italian centers enrolled up to 50 consecutive patients undergoing atrial fibrillation ablation. Of the 318 patients included, 5 (1.6%) did not undergo catheter ablation, 1 had ablation partially done and 62 were lost at 1-year follow-up. Women were less represented (23.6%) and the median age was 60.0 years. A total of 195 patients (62.3%) suffered paroxysmal atrial fibrillation, whereas only 9 (2.9%) had long-standing persistent atrial fibrillation. Most Italian patients (92.3%) were symptomatic but suffering fewer symptomatic events than patients enrolled in other countries (median of two events in the month preceding the ablation vs. three, respectively; P
- Published
- 2020
226. Ectopic cervical pregnancy: Treatment route
- Author
-
Guglielmo Stabile, Giuseppe Ricci, Giulia Zinicola, Federico Romano, Francesco Paolo Mangino, Stabile, G., Mangino, F. P., Romano, F., Zinicola, G., and Ricci, G.
- Subjects
Adult ,medicine.medical_specialty ,Medicine (General) ,Ectopic pregnancy ,Cervical pregnancy ,Hysteroscopy ,Article ,methotrexate ,R5-920 ,Pregnancy ,medicine ,Humans ,Vaginal bleeding ,Prospective Studies ,Prospective cohort study ,Misoprostol ,Fertility-sparing treatment ,Methotrexate ,Retrospective Studies ,Abortifacient Agents, Nonsteroidal ,hysteroscopy ,medicine.diagnostic_test ,business.industry ,cervical pregnancy ,fertility-sparing treatment ,General Medicine ,Mifepristone ,medicine.disease ,Surgery ,Pregnancy, Ectopic ,Fertility ,Treatment Outcome ,Italy ,ectopic pregnancy ,Female ,medicine.symptom ,business ,medicine.drug - Abstract
Background and objectives: Cervical pregnancy (CP) is a rare form of ectopic pregnancy (EP) in which the embryo implants and grows inside the endocervical canal. Early diagnosis is essential in order to allow conservative medical and surgical treatments. Although many treatment approaches are disponible, the most effective is still unclear. The aim of this study is to evaluate the efficacy of hysteroscopic management in early CP in order to preserve future fertility. Materials and Methods: This is a retrospective observational case series. Five patients with a diagnosis of CP, hemodynamically stables and managed conservatively between 2014 and 2019 at the Institute of Child and Maternal Health Burlo Garofolo in Trieste, Italy, were included. Four patients, with &beta, hCG levels >, 5000 mUi/mL were managed by hysteroscopy, with or without a previous systemic Methotrexate (MTX). One case with &beta, hCG levels <, 5000 mUi/mL was treated using MTX combined to Mifepristone and Misoprostol. Results: In one patient treated by hysteroscopy alone it occurred a profuse vaginal bleeding with necessity for blood transfusion. Haemorrhage was controlled by a second hysteroscopic procedure. No complications, such as vaginal bleeding, were recorded in the other cases. Serum &beta, hCG levels become undetectable in a range of 15&ndash, 40 days after hysteroscopic management, after medical treatment it become undetectable after 35 days. Serum &beta, hCG levels had a faster drop the day after hysteroscopy than post medical management. The onset of a spontaneous pregnancy at the normal implantation site occurred after five months in one case treated by hysteroscopy. Conclusions: Many therapeutic approaches are effective for CP treatment. Hysteroscopy, alone or in combination with MTX, may provide a greater effect on the descent of &beta, hCG, leading to a reduction of the hospitalization stay, decreasing costs and period for attempt pregnancy. Further prospective studies on larger samples are needed to define therapeutic protocols for CP management
- Published
- 2020
227. Conservative Treatment of Interstitial Ectopic Pregnancy with the Combination of Mifepristone and Methotrexate: Our Experience and Review of the Literature
- Author
-
Guglielmo Stabile, Giuseppe Ricci, F. Buonomo, Federico Romano, Giulia Zinicola, Stabile, G., Romano, F., Buonomo, F., Zinicola, G., and Ricci, G.
- Subjects
Adult ,medicine.medical_specialty ,endocrine system ,Article Subject ,Conservative Treatment ,Asymptomatic ,Interstitial Pregnancy ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,medicine ,Humans ,Chorionic Gonadotropin, beta Subunit, Human ,Ectopic Pregnancy ,Methotrexate ,Mifepristone ,030219 obstetrics & reproductive medicine ,General Immunology and Microbiology ,Ectopic pregnancy ,business.industry ,Gestational age ,General Medicine ,medicine.disease ,Surgery ,Regimen ,medicine.anatomical_structure ,Pregnancy, Interstitial ,030220 oncology & carcinogenesis ,Medicine ,Interstitial pregnancy ,Female ,medicine.symptom ,business ,Fallopian tube ,medicine.drug ,Research Article - Abstract
Introduction. Interstitial pregnancy (IP) is an ectopic pregnancy (EP) located in the portion of the fallopian tube that penetrates the uterine muscular layer. Incidence increased in the last two decades with the widespread use of the assisted reproductive techniques. It is estimated in 1-6% of all the EPs, with a maternal mortality rate of 2.0-2.5%. Clinical presentation, gestational age at diagnosis, beta-human chorionic gonadotropin (β-hCG) levels, ultrasound features, and patient preference, should be considered to determine the best management: surgical, medical treatment, or close observation. We report two cases of IP successfully managed with systemic MTX and Mifepristone: in one case β-hCG was >10.000 mIU/mL and a vital embryo was present. Materials and Methods. A literature search was carried out on MEDLINE, EMBASE, and PUBMED. We identified two cases of IP referred to the Institute for Maternal and Child Burlo Garofolo, Trieste. Data related to clinical presentation, β-hCG, and ultrasound scan at the moment of the diagnosis were recorded. In one of the cases, the β-hCG level was >10.000 mIU/mL, and a vital embryo was testified at an ultrasound scan. The patient was asymptomatic and she was treated using multidose systemic Methotrexate (MTX) combined with Mifepristone. In the second case, in the presence of a clinically stable patient with β−hCG>10.000 mIU/mL, it was chosen that the administration of Mifepristone combined with a double dose of MTX. β-hCG levels and ultrasound examinations were performed weekly until a complete resolution of the IP. Results. In the first case, β-hCG dropped down in 5 days and became undetachable in 30 days. In the second case, β-hCG became undetectable in 47 days. The first-line therapy in asymptomatic women could be addressed to a combined protocol, consisting of a systemic multidose MTX regimen with a single oral dose of Mifepristone. Conclusions. Clinical management of IP remains a debated topic. In selected cases, a systemic multidose MTX regimen combined with a single oral dose of Mifepristone could be considered also in the presence of high serum β-hCG.
- Published
- 2020
- Full Text
- View/download PDF
228. Laparoscopic and laparotomic guided ureteral stenting during gynecological surgery without use of imaging: Safety and feasibility in a single institutional case series
- Author
-
Michele Rizzo, Carlo Trombetta, Giovanni Di Lorenzo, Guglielmo Stabile, Giuseppe Ricci, Giovanni Liguori, Federico Romano, Romano, F., Rizzo, M., Stabile, G., Di Lorenzo, G., Liguori, G., Trombetta, C., and Ricci, G.
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,urologic and male genital diseases ,Single Center ,03 medical and health sciences ,Gynecologic Surgical Procedures ,0302 clinical medicine ,Ureter ,medicine ,Stent ,Humans ,Fluoroscopy ,030212 general & internal medicine ,Child ,Laparoscopy ,Gynecological surgery ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,urogenital system ,business.industry ,Obstetrics and Gynecology ,Cystoscopes ,Cystoscopies ,female genital diseases and pregnancy complications ,Surgery ,surgical procedures, operative ,medicine.anatomical_structure ,Italy ,Reproductive Medicine ,Feasibility Studies ,Female ,Stents ,business - Abstract
Objectives Aim of this study is to refer a single center experience of laparoscopic or laparotomic assisted ureteral stenting without the use of imaging guidance. Study design We recruited 19 patients in the Institute for Maternal and Child Health in Trieste (Italy) who underwent ureteral stenting between June 2017 and December 2018 for suspicious ureteral injury during gynecological surgery. Ureteral stents insertions were performed in all cases using rigid cystoscopes, hybrid guidewire with a hydrophilic coating, and double loop ureteral stents; the ureters were skeletonized during surgery and stents were used to permit better visualization of the ureteral whole and to prevent complications connected with the ureteral devascularization and minor not recognized ureteral injuries. All the procedures were performed under a laparoscopic or laparotomic guide. Results No sign of acute kidney failure was reported during the post-operative kidney functions evaluation. The right position of the stents was confirmed in the first postoperative day by ultrasonographic imaging. No major complications related to the urinary tract have been detected. Ten patients stated stent related symptoms well controlled by analgesic therapies. All stents were removed by office cystoscopies one month later without reporting any complication. Conclusions Introducing fluoroscopy or ultrasonographic imaging into the operative field could be difficult and time-consuming. Instead, the laparoscopic and laparotomic guided ureteral stenting without the use of imaging currently used in the standard clinical practice of many institutions even without an official standardization in order to treat or prevent ureteral injuries after the surgery, seems to be safe and feasible.
- Published
- 2020
229. Spontaneous Bladder Rupture after Normal Vaginal Delivery: Description of a Rare Complication and Systematic Review of the Literature
- Author
-
Nicolò de Manzini, Guglielmo Stabile, Giuseppe Ricci, Serena Scomersi, Giulia Zinicola, Federico Romano, Francesco Cracco, Davide De Santo, Stabile, G., Cracco, F., De Santo, D., Zinicola, G., Romano, F., De Manzini, N., Scomersi, S., and Ricci, G.
- Subjects
Medicine (General) ,medicine.medical_specialty ,Abdominal pain ,medicine.diagnostic_test ,Spontaneous Bladder Rupture ,Bladder rupture ,Laparoscopy ,Spontaneous ,Systematic review ,Vaginal delivery ,business.industry ,Urinary system ,Clinical Biochemistry ,Spontaneou ,Surgery ,Cystography ,R5-920 ,Oliguria ,Vomiting ,Medicine ,medicine.symptom ,business ,Complication - Abstract
Objective: To identify the possible causes of spontaneous bladder rupture after normal vaginal delivery and to propose a diagnostic and therapeutic algorithm. Material and Methods: MEDLINE (PubMed), Web of Science and Scopus databases were searched up to August 2020. Manuscripts considered were published from 1990 and only English articles were included. The research strategy adopted included the following terms: (bladder rupture) AND (spontaneous) AND (delivery). 103 studies were identified. Duplicates were found through an independent manual screening. Subsequently, two authors independently screened the full text of articles and excluded those not pertinent to the topic. Discrepancies were resolved by consensus. Finally, thirteen studies were included. Results: PRISMA guidelines were followed. For each study, fetal weight, catheterization during labor, parity, maternal age, occurrence time, previous abdominal or pelvic surgery, symptoms complained of, diagnostic methods, and treatment were considered. Median age was 26.0 (range 20–34 years); median presentation time was 3.0 days after delivery (range 1–20 days); and median newborn weight was 3227.0 g (range 2685–3600 g). Catheterization during labor was reported only in four of the thirteen cases (30.8%) identified. The symptoms most frequently complained of were abdominal pain and distension, fever, oliguria, haematuria and vomiting. Instrumental diagnosis was performed using X-rays in five cases and computerized tomography in six cases. Ultrasound was chosen in five cases as a first diagnostic tool. In two cases, cystography was performed. Treatment was always laparotomic repair of the visceral defect. Conclusion: Abdominal pain, increased creatinine and other signs of kidney failure on blood tests should lead to suspicion of this complication. Cystourethrography is regarded as a procedure of choice, but a first ultrasound approach is recommended. The main factor for the therapeutic choice is the intraperitoneal or extraperitoneal rupture of the bladder. Classical management for intraperitoneal rupture of the bladder is surgical repair and urinary rest.
- Published
- 2021
230. Proteins involved in oxidative stress in leiomyoma tissues treated with ulipristal acetate
- Author
-
Federica Scrimin, Michelangelo Aloisio, Lorenzo Monasta, Giorgio Arrigoni, Emmanouil Athanasakis, Danilo Licastro, Blendi Ura, Cinzia Franchin, Stefania Biffi, Yeraldin Chiquinquira Castillo De Spelorzi, Bartolomea Gaita, Federico Romano, Giovanni Di Lorenzo, Guglielmo Stabile, Giuseppe Ricci, Ura, B., Monasta, L., de Spelorzi, Y. C. C., Arrigoni, G., Franchin, C., Biffi, S., Aloisio, M., Gaita, B., Licastro, D., Athanasakis, E., Scrimin, F., Stabile, G., Romano, F., Di Lorenzo, G., and Ricci, G.
- Subjects
Adult ,Proteomics ,0301 basic medicine ,Cancer Research ,Norpregnadienes ,Ulipristal acetate ,medicine.disease_cause ,Biochemistry ,Andrology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Genetics ,medicine ,Humans ,Gene Regulatory Networks ,Protein Interaction Maps ,Molecular Biology ,chemistry.chemical_classification ,Gel electrophoresis ,Reactive oxygen species ,Uterine leiomyoma ,Leiomyoma ,Mass spectrometry ,Two‑dimensional electrophoresis ,Proteomic ,Hydrogen Peroxide ,medicine.disease ,Gene Expression Regulation, Neoplastic ,Blot ,Two‑dimensional electrophoresi ,Oxidative Stress ,030104 developmental biology ,Oncology ,chemistry ,030220 oncology & carcinogenesis ,Uterine Neoplasms ,Proteome ,Molecular Medicine ,Female ,Reactive Oxygen Species ,Oxidative stress - Abstract
Uterine leiomyoma presents the highest incidence among benign tumors of the female reproductive tract. The present study compared the proteome of leiomyoma treated with ulipristal acetate with that of untreated leiomyoma to investigate protein expression patterns in relation to oxidative stress. Paired tissue samples from seven treated and untreated leiomyomas were collected and the proteome was analyzed by two‑dimensional gel electrophoresis (2‑DE). Western blotting was used to validate the results of 2‑DE, and mass spectrom‑ etry was used to identify proteins. The tissue expression of 30 proteins was markedly affected by treatment with ulipristal acetate. Bioinformatics analysis revealed that several of the differentially expressed proteins were involved in the degrada‑ tion of hydrogen peroxide and the synthesis of reactive oxygen species. The present study suggested the involvement of oxida‑ tive stress as a novel mechanism of action of ulipristal acetate. These findings require further investigations to understand the role of ulipristal acetate in the treatment of the leiomyoma.
- Published
- 2020
231. Management of Non-Tubal Ectopic Pregnancies: A Single Center Experience
- Author
-
F. Buonomo, Francesco Paolo Mangino, Guglielmo Stabile, Giuseppe Ricci, Giulia Zinicola, Federico Romano, Stabile, G., Zinicola, G., Romano, F., Buonomo, F., Mangino, F. P., and Ricci, G.
- Subjects
medicine.medical_specialty ,animal structures ,Ectopic non-tubal pregnancy ,Fertility sparing ,Hysteroscopy ,Laparoscopy ,medicine.medical_treatment ,Clinical Biochemistry ,laparoscopy ,Cervical pregnancy ,Article ,03 medical and health sciences ,0302 clinical medicine ,medicine ,030212 general & internal medicine ,lcsh:R5-920 ,hysteroscopy ,Pregnancy ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,Ectopic pregnancy ,business.industry ,Obstetrics ,Retrospective cohort study ,medicine.disease ,fertility sparing ,female genital diseases and pregnancy complications ,Curettage ,ectopic non-tubal pregnancy ,Interstitial pregnancy ,lcsh:Medicine (General) ,business - Abstract
Non-tubal ectopic pregnancies (NT-EPs) are rare but potentially life-threatening conditions. The incidence ranges are between 5&ndash, 8.3% of all ectopic pregnancies. For this retrospective observational study, 16 patients with NT-EP and treated from January 2014 to May 2020 were recruited. Demographic details, symptoms, Beta human chorionic gonadotrophin (&beta, hCG) levels, ultrasound findings, management and treatment outcomes were presented. In hemodynamically stable patients, diagnosis was made using ultrasounds and &beta, hCG levels. Laparoscopy was essential to identify and remove the ectopic pregnancy in clinical unstable patients. A radical laparoscopic approach was chosen in one case of cervical pregnancy diagnosed late in the first trimester. Medical treatment and minimally invasive procedure, alone or combined, resulted in effective strategies in asymptomatic women with an early diagnosis of NT-EP. We report cases of cervical pregnancies successfully treated by hysteroscopy alone or combined with medical treatment, the first case of scar pregnancy treated by mini-reseptoscope and curettage and the fifth case of interstitial pregnancy treated with Methotrexate and Mifepristone. In this manuscript we report a single center experience in the management of NT-EPs with the aim of outlining the importance of the early diagnosis for a minimally invasive treatment in order to reduce maternal morbidity and mortality and preserve future fertility.
- Published
- 2020
232. Low incidence of permanent complications during catheter ablation for atrial fibrillation using open-irrigated catheters: A multicentre registry
- Author
-
Giuseppe Stabile, Sakis Themistoclakis, Antonio De Simone, Matteo Anselmino, Leonardo Corò, Vittorio Calzolari, Luca Rebellato, Andrea Avella, Alessia Pappone, Giuseppe Arena, Maurizio Del Greco, Carlo Pappone, Emanuele Bertaglia, Nicola Bottoni, Claudio Tondo, Stabile, G., Bertaglia, E., Pappone, A., Themistoclakis, S., Tondo, C., Calzolari, V., Bottoni, N., Arena, G., Rebellato, L., Del Greco, M., De Simone, A., Coro, L., Avella, A., Anselmino, M., and Pappone, C.
- Subjects
Male ,Registrie ,Time Factors ,medicine.medical_treatment ,Pericardial effusion ,Cardiac Catheters ,Postoperative Complications ,Risk Factors ,Cardiac tamponade ,Atrial Fibrillation ,Odds Ratio ,Medicine ,Prospective Studies ,Registries ,Multivariate Analysi ,Incidence ,Atrial fibrillation ,Equipment Design ,Middle Aged ,Hemothorax ,Catheter ,Treatment Outcome ,Italy ,Catheter Ablation ,Female ,Cardiology and Cardiovascular Medicine ,Human ,medicine.medical_specialty ,Logistic Model ,Time Factor ,Catheter ablation ,Pericarditis ,Permanent complication ,Physiology (medical) ,Humans ,Therapeutic Irrigation ,Aged ,Chi-Square Distribution ,business.industry ,Risk Factor ,Odds ratio ,medicine.disease ,Surgery ,Prospective Studie ,Logistic Models ,Multivariate Analysis ,Postoperative Complication ,business - Abstract
Aims Despite catheter ablation (CA) has become an accepted treatment option for symptomatic, drug-resistant atrial fibrillation (AF), the safety of this procedure continues to be cause for concern. The aim of the present study was to assess the incidence of complications with permanent sequelae of CA for AF using open-irrigated catheters in a contemporary, unselected population of consecutive patients. Methods and results From 1 January 2011 to 31 December 2011, data from 2167 consecutive patients who underwent CA for AF using an open-irrigated catheter in 29 Italian centres were collected. All the complications occurring to the patient from admission to the 30th post-procedural day were recorded. No procedure-related death was observed. Complications occurred in 81 patients (3.7%): 46 patients (2.1%) suffered vascular access complications; 13 patients (0.6%) cardiac tamponade, successfully drained in all the cases; six patients (0.3%) arterial thromboembolism (four transient ischaemic attack and two ischaemic strokes); five (0.2%) patients conservatively treated pericardial effusion; three patients (0.1%) phrenic nerve paralysis; three patients (0.1%) pericarditis; three patients (0.1%) haemothorax, and two patients (0.1%) other isolated adverse events. At multivariate analysis, only female sex [odds ratio (OR) 2.5, confidence interval (CI): 1.5-3.7, P < 001] and the operator experience (OR 0.5, CI: 0.4-0.7, P < 001) related to the complications. Only five (0.2%) patients developed permanent sequelae from their complications. Conclusion Catheter ablation for AF with the use of open-irrigated catheters is currently affected by a very low rate of complications leading to permanent sequelae. © 2014 Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014.
- Published
- 2014
233. Feasibility and safety of a cardiologist-only approach to sedation for DFT testing
- Author
-
Eugenio Stabile, Maria Teresa Librera, Francesco Solimene, Vincenzo La Rocca, Antonio De Simone, Giuseppe Stabile, Assunta Iuliano, Giovanni Napolitano, Iuliano, A, Librera, Mt, De Simone, A, La Rocca, V, Solimene, F, Napolitano, G, Stabile, Eugenio, and Stabile, G.
- Subjects
Male ,medicine.medical_specialty ,business.industry ,Midazolam ,Sedation ,Cardiology ,Conscious Sedation ,Electric Countershock ,Middle Aged ,Defibrillators, Implantable ,Emergency medicine ,medicine ,Feasibility Studies ,Humans ,Female ,medicine.symptom ,Physician's Role ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,business ,Anesthetics, Intravenous ,Aged ,medicine.drug - Published
- 2015
234. Role of catheter-induced mechanical trauma in localization of target sites of radiofrequency ablation in automatic atrial tachycardia
- Author
-
Nicola Spampinato, Antonio De Simone, Massimo Chiariello, Carlo Pappone, Domenico Iorio, Michele Damiano, Giuseppe Stabile, Pietro Turco, Gaetano Senatore, Pappone, C, Stabile, G, De Simone, A, Senatore, G, Turco, P, Damiano, M, Iorio, D, Spampinato, N, and Chiariello, M
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Radiofrequency ablation ,medicine.medical_treatment ,Catheter ablation ,Automatic atrial tachycardia ,law.invention ,Electrocardiography ,law ,Predictive Value of Tests ,Internal medicine ,Tachycardia, Supraventricular ,Medicine ,Humans ,cardiovascular diseases ,Child ,Atrial tachycardia ,medicine.diagnostic_test ,business.industry ,Middle Aged ,Ablation ,Catheter ,Predictive value of tests ,Anesthesia ,Cardiology ,cardiovascular system ,Catheter Ablation ,Female ,medicine.symptom ,business ,Cardiology and Cardiovascular Medicine - Abstract
Objectives.We compared the efficacy of two different mapping techniques in identifying the ablation site for atrial tachycardia. Moreover, we evaluated the additive positive predictive value of mechanical interruption of atrial tachycardia to reduce the number of ineffective radiofrequency applications.Background.Radiofrequency catheter ablation has been suggested as a highly effective technique to treat drug-resistant atrial tachycardia. However, irrespective of the mapping technique utilized, success was most often achieved with a large number of radiofrequency applications.Methods.Forty-five patients with atrial tachycardia underwent radiofrequency catheter ablation. Mapping techniques included identification of earliest atrial activation and pace-mapping concordant sequence.Results.Atrial tachycardia was successfully treated in 42 (93.3%) of 45 patients with a mean of 3.9 radiofrequency pulses/ patient. An interval between the onset of the intracavitary atrial deflection and the onset of the P wave during atrial tachycardia (AP interval) ≥30 ms (p < 0.001) and pace-mapping concordant sequence (p = 0.01) were all significant predictors of outcome. An AP interval ≥30 ms and a pace-mapping concordant sequence were highly sensitive (92.8%, 95% confidence interval [CI] 80.5% to 98.5%; 85.7%, 95% CI 71.5% to 94.6%, respectively) but less specific (47.8%, 95% CI 37.9% to 58.2%; 36.8%, 95% CI 27.6% to 47.2%, respectively) in identifying the site of ablation. By using atrial tachycardia mechanical interruption combined with the AP interval >30 ms or the pace-mapping concordant sequence, we obtained a specificity of 76.5% (95% CI 66.4% to 84.0%) and 73.5% (95% CI 63.2% to 81.4%), respectively, and a positive predictive value of 49.2% and 44.6%, respectively.Conclusions.An AP interval ≥30 ms and a pace-mapping concordant sequence were reliable mapping features for predicting the outcome of the ablation procedure. Mechanical interruption of atrial tachycardia improved the specificity and positive predictive value of these two mapping techniques.
- Published
- 1996
- Full Text
- View/download PDF
235. Techniques and Technologies for Atrial Fibrillation Catheter ablation
- Author
-
Robert A. Schweikert, Hiroshi Nakagawa, Vivek Y. Reddy, David Keane, Pedro Adragão, David Burkhardt, Pierre Jaïs, Karl H. Kuck, Jasbir Sra, Pappone, C., Hindricks, G., Antz, M., Jais, P., Nademanee, K., Carlos Pachon, J., Schweikert, R., and Stabile, G.
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Atrial fibrillation ,Computed tomography ,Catheter ablation ,Pulmonary veins ,medicine.disease ,Internal medicine ,medicine ,Cardiology ,Radiology ,Anatomy ,business - Published
- 2008
236. Is pulmonary vein isolation necessary for curing atrial fibrillation?
- Author
-
Antonio De Simone, Giuseppe Stabile, Eugenio Stabile, Vincenzo La Rocca, Pietro Turco, Pasquale Nocerino, Stabile, G, Turco, P, La Rocca, V, Nocerino, P, Stabile, Eugenio, and De Simone, A.
- Subjects
Male ,medicine.medical_specialty ,Radiofrequency ablation ,medicine.medical_treatment ,Left atrium ,Disease-Free Survival ,law.invention ,Pulmonary vein ,Electrical isolation ,Electrocardiography ,law ,Heart Conduction System ,Recurrence ,Physiology (medical) ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,business.industry ,Significant difference ,Body Surface Potential Mapping ,Atrial fibrillation ,Atrial arrhythmias ,Middle Aged ,medicine.disease ,Ablation ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Pulmonary Veins ,cardiovascular system ,Cardiology ,Catheter Ablation ,Female ,Cardiology and Cardiovascular Medicine ,business ,Anti-Arrhythmia Agents - Abstract
Background— Pulmonary veins (PVs) play a pivotal role in initiating and perpetuating atrial fibrillation (AF). We investigated if PV electrical isolation from the left atrium is required for curing AF. Methods and Result— Fifty-one patients with paroxysmal or persistent AF underwent circumferential radiofrequency ablation of PV ostia performed with an anatomic approach. The end point of the ablation procedure was the recording of low peak-to-peak bipolar potentials ( Conclusions— Our findings show that with the use of a pure anatomic approach, it is possible to prevent AF in >80% of patients undergoing catheter ablation. Moreover, the isolation of PVs is not crucial for curing AF.
- Published
- 2003
237. Effect of verapamil on secondary cardioversion in patients with early atrial fibrillation recurrence after electrical cardioversion
- Author
-
Carmine De Matteis, Vincenzo La Rocca, Eugenio Stabile, Vincenzo Messina, Gianfranco Iaconelli, Costantino Astarita, Raffaele Rotunno, Pasquale Nocerino, Luciano Greco, Pietro Turco, Antonio De Simone, Giuseppe Stabile, De Simone, A, Turco, P, De Matteis, C, La Rocca, V, Nocerino, P, Greco, Luigi, Astarita, C, Messina, V, Rotunno, R, Iaconelli, G, Stabile, Eugenio, and Stabile, G.
- Subjects
Male ,Reoperation ,medicine.medical_specialty ,Time Factors ,Heart disease ,Defibrillation ,medicine.medical_treatment ,Electric Countershock ,Administration, Oral ,Antiarrhythmic agent ,Cardioversion ,Internal medicine ,Atrial Fibrillation ,Preoperative Care ,medicine ,Secondary Prevention ,Humans ,In patient ,Prospective Studies ,business.industry ,Atrial fibrillation ,Middle Aged ,medicine.disease ,Electrical cardioversion ,Treatment Outcome ,Verapamil ,Anesthesia ,Cardiology ,Drug Therapy, Combination ,Female ,Cardiology and Cardiovascular Medicine ,business ,Anti-Arrhythmia Agents ,medicine.drug ,Follow-Up Studies - Published
- 2002
238. Response to flecainide infusion predicts long-term success of hybrid pharmacologic and ablation therapy in patients with atrial fibrillation
- Author
-
Vincenzo La Rocca, Pietro Turco, Tommaso Di Napoli, Costantino Astarita, Pasquale Nocerino, Dino Franco Vitale, Antonio De Simone, Carmine De Matteis, Giuseppe Stabile, Eugenio Stabile, Francesco Saverio Maresca, Stabile, G, De Simone, A, Turco, P, La Rocca, V, Nocerino, P, Astarita, C, Maresca, F, De Matteis, C, Di Napoli, T, Stabile, Eugenio, and Vitale, Df
- Subjects
Male ,Heart disease ,medicine.medical_treatment ,Administration, Oral ,Catheter ablation ,Antiarrhythmic agent ,Disease-Free Survival ,Electrocardiography ,Predictive Value of Tests ,Recurrence ,Atrial Fibrillation ,medicine ,Humans ,cardiovascular diseases ,Infusions, Intravenous ,Flecainide ,Aged ,Proportional Hazards Models ,Chemotherapy ,Analysis of Variance ,medicine.diagnostic_test ,business.industry ,Patient Selection ,Atrial fibrillation ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Treatment Outcome ,Atrial Flutter ,Anesthesia ,Chronic Disease ,cardiovascular system ,Catheter Ablation ,Female ,Cardiology and Cardiovascular Medicine ,business ,Anti-Arrhythmia Agents ,Atrial flutter ,medicine.drug ,Follow-Up Studies - Abstract
OBJECTIVESWe tested the hypothesis that the response to flecainide infusion can identify patients with atrial fibrillation (AF) in whom the hybrid pharmacologic and ablation therapy reduces the recurrences of AF.BACKGROUNDInfusion of class IC anti-arrhythmic drugs may promote transformation of AF into atrial flutter. Catheter ablation of atrial flutter has been demonstrated to be highly effective in preventing recurrences of atrial flutter.METHODSSeventy-one consecutive patients with paroxysmal or chronic AF, in whom flecainide infusion (2 mg/kg body weight, intravenously) determined the transformation of AF into common atrial flutter (positive response), were randomized to receive one of the following treatments: oral pharmacologic treatment with flecainide (group A, n = 23); the hybrid treatment (catheter ablation of the inferior vena cava-tricuspid annulus isthmus, plus oral flecainide) (group B, n = 24); or catheter ablation of the isthmus only (group C, n = 24). Thirty-seven patients with a negative response to flecainide, who chose to be submitted to the hybrid treatment, were selected as the control group (group D).RESULTSDuring a mean follow-up period of 24 ± 7.2 months, the recurrences of AF and atrial flutter in group B (42%) were significantly lower than those in group A (78%, p < 0.001), group C (92%, p < 0.001) and group D (92%, p < 0.001).CONCLUSIONSThe creation of a complete bi-directional conduction block at the inferior vena cava-tricuspid annulus isthmus, plus flecainide administration, reduces the recurrences of both AF and atrial flutter in patients with class IC atrial flutter. Moreover, the early response to flecainide is safe and reliable in identifying patients who may benefit from this therapy.
- Published
- 2001
239. Inappropriate sinus tachycardia after radiofrequency ablation of para-Hisian accessory pathways
- Author
-
Sergio Chierchia, Antonio De Simone, Patrizio Mazzone, Carlo Pappone, Mariano Rillo, Giuseppe Stabile, Giuseppe Oreto, Riccardo Cappato, Pappone, C, Stabile, G, Oreto, G, De Simone, A, Rillo, M, Mazzone, P, Cappato, R, and Chierchia, S
- Subjects
Tachycardia ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Radiofrequency ablation ,medicine.medical_treatment ,Catheter ablation ,law.invention ,law ,Physiology (medical) ,Internal medicine ,medicine ,Heart rate variability ,Humans ,Sinus (anatomy) ,business.industry ,Ablation ,medicine.disease ,Inappropriate sinus tachycardia ,Tachycardia, Sinus ,medicine.anatomical_structure ,Cardiology ,Atrioventricular Node ,Catheter Ablation ,Female ,Wolff-Parkinson-White Syndrome ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Complication - Abstract
Inappropriate Sinus Tachycardia After Catheter Ablation. Introduction: Inappropriate sinus tachycardia (IST) has been observed following radiofrequency ablation (RFA) of the AV nodal fast pathway. This study was aimed to prospectively analyze the incidence and clinical significance of IST following RFA of para-Hisian accessory pathways (APs). Methods and Results: Twenty-eight patients (pts) with para-Hisian APs underwent RFA. An AP was defined as para-Hisian whenever its atrial and ventricular insertions were associated with a His-bundle potential ≥ 0.1 mV. RF current was always delivered at the atrial aspect of the tricuspid annulus. to a site where the His-bundle potential was < 0.15 mV. Time- and frequency-domain analysis of heart rate variability was performed in 22 patients, before and after RFA. Abolition of AP conduction was obtained in all pts, and no AV conduction alteration occurred. Six pts (21.4%) presented with IST 45 to 240 minutes after the ablation procedure. In 5 of them, IST disappeared spontaneously within 72 hours, whereas in 1 pt β-blockers were required for 2 months. The atrial potential amplitude (1.217 ± 0.264 mV vs 0.882 ± 0.173 mV, P = 0.009) and A/V potential amplitude ratio (2.633 vs 1.686, P = 0.05) were significantly higher in pts who developed IST than in those who did not. A marked decrease in heart rate variability was observed only in pts who developed IST. Conclusion: IST is a relatively frequent complication after RFA of para-Hisian APs: it is generally short-lasting and usually does not require any treatment. IST after catheter ablation is likely to depend upon transient parasympathetic denervation of the sinus node.
- Published
- 1997
240. Probiotics in the add-on treatment of otitis media in clinical practice
- Author
-
Gelardi, M., La Mantia, I., Drago, L., Meroni, G., Salvatore Emanuele Aragona, Cupido, G., Vicini, C., Berardi, C., Ciprandi, G., Albanese, G., Anni, A., Antoniacomi, G., Artoni, S., Asprella, G., Azzaro, R., Azzolin, A., Balduzzi, A., Barbarino, I., Bertetto, B. I., Bianchi, A., Bianco, N., Bonanno, A., Bordonaro, C., Brindisi, A. M., Bucolo, S., Bulzomì, A. G., Caligo, G., Capaccio, P., Capelli, M., Capone, A., Carboni, S., Carluccio, G., Casaula, M., Cassano, M., Cavaliere, M., Ciabattoni, A., Conti, A., Cordier, A., Cortellessa, F., Costanzo, M., Cupido, F., D’ascanio, L., Danza, C., D’auria, C., Ciccio, M., Luca, C., D’emila, M., Dessi, R., Di Lullo, A., D’urso, M., Falcetti, S., Falciglia, R., Fera, G., Ferrari, G., Ferraro, S. M., Fini, O., Fiorella, M., Floriddia, A., Asprea, F., Fusco, C., Fuson, R., Gallo, A., Gambardella, T., Gambardella, G., Giangregorio, F., Gramellini, G., Ierace, M., Ingria, F., La Paglia, A., Lanza, L., Lauletta, R., Lavazza, P., Leone, M., Lovotti, P., Luperto, P., Maniscalco, F., Marincolo, I., Martone, R., Melis, A., Messina, A., Milone, V., Mirra, N., Montanaro, S. C., Muià, F., Nacci, A., Nardello, E., Paderno, L., Padovani, D., Palma, A., Paoletti, M., Pedrotti, I., Petrillo, F., Piccolo, M., Pinto, P., Policarpo, M., Raguso, M., Ranieri, A., Romano, G., Rondinelli, M., Russo, C., Di Santillo, L. S., Sequino, G., Serraino, E. M., Spahiu, I., Spanò, G., Stabile, C., Stagni, G., Stellin, M., Tassi, S., Tomacelli, G., Tombolini, A., Valenzise, V., Zirone, A., Gelardi, M., Mantia, La, Drago, I., Meroni, L., Aragona, G., Cupido, S. E., Vicini, G., Berardi, C., Ciprandi, C., Albanese, G., Anni, G., Antoniacomi, A., Artoni, G., Asprella, S., Azzaro, G., Azzolin, R., Balduzzi, A., Barbarino, A., Berardi, I., Bertetto, C., Bianchi, B. I., Bianco, A., Bonanno, N., Bordonaro, A., Brindisi, C., Bucolo, A. M., Bulzomì, S., Caligo, A. G., Capaccio, G., Capelli, P., Capone, M., Carboni, A., Carluccio, S., Casaula, G., Cassano, M., Cavaliere, M., Ciabattoni, M., Conti, A., Cordier, A., Cortellessa, A., Costanzo, F., Cupido, M., D’Ascanio, F., Danza, L., D’Auria, C., Ciccio, De, Luca, De, D’Emila, C., Dessi, M., Lullo, Di, D’Urso, A., Falcetti, M., Falciglia, S., Fera, R., Ferrari, G., Ferraro, G., Fini, S. M., Fiorella, O., Floriddia, M., Asprea, A., Fusco, F., Fuson, C., Gallo, R., Gambardella, A., Gambardella, T., Giangregorio, G., Gramellini, F., Ierace, G., Ingria, M., Paglia, La, Lanza, A., Lauletta, L., Lavazza, R., Leone, P., Lovotti, M., Luperto, P., Maniscalco, P., Marincolo, F., Martone, I., Melis, R., Messina, A., Milone, A., Mirra, V., Montanaro, N., Muià, S. C., Nacci, F., Nardello, A., Paderno, E., Padovani, L., Palma, D., Paoletti, A., Pedrotti, M., Petrillo, I., Piccolo, F., Pinto, M., Policarpo, P., Raguso, M., Ranieri, M., Romano, A., Rondinelli, G., Russo, M., Santillo, Di, Sequino, L. S., Serraino, G., Spahiu, E. M., Spanò, I., Stabile, G., Stagni, C., Stellin, G., Tassi, M., Tomacelli, S., Tombolini, G., Valenzise, A., and Zirone, V.
- Subjects
chronic ,Lactobacillu ,Otitis Media ,dysbiosi ,Probiotics ,Anti-Bacterial Agent ,antibiotic therapy ,acute ,probiotic ,Human - Abstract
Otitis media (OM) affects the middle ear and is typically characterized by earache. OM may be classified as acute (AOM) or chronic (COM), based on symptom duration. OM may be clinically suspected, but the diagnosis is usually confirmed by the otoscopy. Antibiotic therapy is frequently used in clinical practice. However, antibiotics often induce intestinal and respiratory dysbiosis associated with some clinical problems. A one-month course of a probiotic mixture (Abincol® containing Lactobacillus plantarum LP01 (1 billion of living cells), Lactobacillus lactis subspecies cremoris LLC02 (800 million living cells), and Lactobacillus delbrueckii LDD01 (200 million living cells), was prescribed in the Group A, and was compared with no addon treatment, such as the Group B. Patients were evaluated at baseline (T0), at the end of antibiotic treatment (T1), at the end of probiotic course (T2), and at the end of 3-month follow-up (T3).
241. Pure Magnetic Control for Attitude Slew Maneuvers
- Author
-
C. Stabile, G. Avanzini, F. Giulietti, E. L. de Angelis, and C. Stabile, G. Avanzini, F. Giulietti, E.L. de Angelis
- Subjects
Magnetic Control, Satellite, Nonlinear control
242. On the comparison of LES data-driven reduced order approaches for hydroacoustic analysis
- Author
-
Marco Tezzele, Andrea Mola, Mahmoud Gadalla, Giovanni Stabile, Marta Cianferra, Gianluigi Rozza, Gadalla, M., Cianferra, M., Tezzele, M., Stabile, G., Mola, A., and Rozza, G.
- Subjects
General Computer Science ,Rank (linear algebra) ,Truncation ,Ffowcs Williams and Hawking ,01 natural sciences ,010305 fluids & plasmas ,Settore MAT/08 - Analisi Numerica ,Dynamic mode decomposition ,0103 physical sciences ,Linear regression ,FOS: Mathematics ,Sensitivity (control systems) ,Mathematics - Numerical Analysis ,0101 mathematics ,Hydroacoustic ,Mathematics ,Ffowcs Williams and Hawkings ,Hydroacoustics ,Large eddy simulation ,Model reduction ,Proper orthogonal decomposition ,General Engineering ,Numerical Analysis (math.NA) ,010101 applied mathematics ,Noise ,Algorithm ,Interpolation - Abstract
In this work, Dynamic Mode Decomposition (DMD) and Proper Orthogonal Decomposition (POD) methodologies are applied to hydroacoustic dataset computed using Large Eddy Simulation (LES) coupled with Ffowcs Williams and Hawkings (FWH) analogy. First, a low-dimensional description of the flow fields is presented with modal decomposition analysis. Sensitivity towards the DMD and POD bases truncation rank is discussed, and extensive dataset is provided to demonstrate the ability of both algorithms to reconstruct the flow fields with all the spatial and temporal frequencies necessary to support accurate noise evaluation. Results show that while DMD is capable to capture finer coherent structures in the wake region for the same amount of employed modes, reconstructed flow fields using POD exhibit smaller magnitudes of global spatiotemporal errors compared with DMD counterparts. Second, a separate set of DMD and POD modes generated using half the snapshots is employed into two data-driven reduced models respectively, based on DMD mid cast and POD with Interpolation (PODI). In that regard, results confirm that the predictive character of both reduced approaches on the flow fields is sufficiently accurate, with a relative superiority of PODI results over DMD ones. This infers that, discrepancies induced due to interpolation errors in PODI is relatively low compared with errors induced by integration and linear regression operations in DMD, for the present setup. Finally, a post processing analysis on the evaluation of FWH acoustic signals utilizing reduced fluid dynamic fields as input demonstrates that both DMD and PODI data-driven reduced models are efficient and sufficiently accurate in predicting acoustic noises.
- Full Text
- View/download PDF
243. Primary Cutaneous Spindle Cell B-Cell Follicle Center Lymphoma Presenting as Long-Standing Plaque of Cicatricial Alopecia: A Case Report With a Comprehensive Review of the Literature.
- Author
-
Bigotto GD, Brunetti AP, Guida S, Stabile G, Rizzo N, and Rongioletti F
- Abstract
Abstract: Primary cutaneous spindle B-cell lymphoma is an uncommon subtype of cutaneous lymphoma characterized by a distinct spindled cytology of neoplastic B cells. Despite sharing clinical, histopathological, and phenotypical similarities with primary cutaneous follicle center lymphoma, an indolent form of B-cell lymphoma, it also exhibits certain features akin to primary cutaneous diffuse large B-cell lymphoma. Notably, in rare instances, a more aggressive clinical course has been observed. This report details a rare case of primary cutaneous spindle cell B-cell follicle center lymphoma, manifested as a prolonged solitary plaque of cicatricial alopecia. In addition, we provide a comprehensive review of existing cases documented in the literature., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
244. A reduced order model formulation for left atrium flow: an atrial fibrillation case.
- Author
-
Balzotti C, Siena P, Girfoglio M, Stabile G, Dueñas-Pamplona J, Sierra-Pallares J, Amat-Santos I, and Rozza G
- Subjects
- Humans, Hemodynamics, Computer Simulation, Blood Flow Velocity, Atrial Fibrillation physiopathology, Models, Cardiovascular, Heart Atria physiopathology
- Abstract
A data-driven reduced order model (ROM) based on a proper orthogonal decomposition-radial basis function (POD-RBF) approach is adopted in this paper for the analysis of blood flow dynamics in a patient-specific case of atrial fibrillation (AF). The full order model (FOM) is represented by incompressible Navier-Stokes equations, discretized with a finite volume (FV) approach. Both the Newtonian and the Casson's constitutive laws are employed. The aim is to build a computational tool able to efficiently and accurately reconstruct the patterns of relevant hemodynamics indices related to the stasis of the blood in a physical parametrization framework including the cardiac output in the Newtonian case and also the plasma viscosity and the hematocrit in the non-Newtonian one. Many FOM-ROM comparisons are shown to analyze the performance of our approach as regards errors and computational speed-up., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
245. Melasma and reflectance confocal microscopy: from baseline to treatment monitoring.
- Author
-
Guida S, Longo C, Ronga R, Stabile G, Podo Brunetti A, Bigotto GD, Conforti C, Ciardo S, Cantisani C, Paolino G, Mercuri SR, Nisticò SP, Zerbinati N, Rongioletti F, and Pellacani G
- Subjects
- Humans, Epidermis pathology, Epidermis diagnostic imaging, Laser Therapy methods, Melanosis diagnostic imaging, Melanosis therapy, Melanosis pathology, Microscopy, Confocal methods
- Abstract
Melasma is a frequent condition worldwide, and it represents one of the most challenging disorders to treat in cosmetic dermatology. One of the critical factors for treatment prognosis is the assessment of the depth and distribution of pigment within the hyperpigmented area. Nowadays, non-invasive skin imaging techniques, such as reflectance confocal microscopy (RCM), have been used to estimate pigment distribution and depth within different skin layers. This article aims to provide a systematic review of RCM applications in melasma, providing terminology and investigating characteristics of melasma at baseline and after medical and laser treatment. Our results support the recognition of two main types of melasma, epidermal and mixed type, thanks to the role of RCM in highlighting the precise pigment depth location in the skin non-invasively. RCM treatment monitoring enables the objectification of pigment variations after treatment and the identification of prognostic factors for different treatment modalities. After the era of the application of RCM as a technique applied strictly to skin cancers, additional cosmetic applications are emerging, such as the application of melasma treatment monitoring., (© 2024 the International Society of Dermatology.)
- Published
- 2024
- Full Text
- View/download PDF
246. Acquired elastotic hemangioma: a benign vascular lesion associated with sun exposure.
- Author
-
Stabile G, Brunetti AP, Bigotto G, Guida S, and Rongioletti F
- Published
- 2024
- Full Text
- View/download PDF
247. The Role of Combined Muscle Ultrasound and Bioimpedentiometry Parameters for Sarcopenia Diagnosis in a Population of Hospitalized Older Adults.
- Author
-
Zanotelli A, Rossi AP, Del Monte L, Vantini G, Stabile G, Urbani S, Giani A, Zoico E, Babbanini A, Fantin F, Zamboni M, and Mazzali G
- Subjects
- Humans, Male, Female, Aged, Aged, 80 and over, Hospitalization, Quadriceps Muscle diagnostic imaging, Body Composition, Sarcopenia diagnostic imaging, Sarcopenia diagnosis, Ultrasonography methods, Electric Impedance, Muscle, Skeletal diagnostic imaging
- Abstract
Background: For the study of quantitative and qualitative muscle parameters, ultrasound and bioelectric impedance analysis are reliable, non-invasive, and reproducible. The aim of this study was to test the combined role of those techniques for the diagnosis of sarcopenia in a population of hospitalized older males and females., Methods: A total of 70 subjects were recruited, including 10 healthy adults and 60 hospitalized elderly patients with a good level of independence and cooperation, with and without sarcopenia. The rectus femoris cross-sectional area (CSA), thickness, echogenicity, and compressibility were measured with ultrasound echography. The phase angles (PhAs) and skeletal muscle mass were calculated by bioimpedence analysis. The muscle quality index (MQI) was calculated as the product of CSA and PhA., Results: Muscle compressibility was greater and PhA was lower in sarcopenic when compared with non-sarcopenic subjects. The threshold values for sarcopenia diagnosis in both sexes of CSA, of PhA, and of the MQI were identified. The obtained CSA values showed an AUC of 0.852 for women and 0.867 for men, PhA of 0.792 in women and 0.898 in men, while MQI was 0.900 for women and 0.969 for men., Conclusions: The newly calculated cut-off values of CSA, PhA, and MQI predicted the presence of sarcopenia with good sensitivity and specificity values. The use of the MQI proved to be more promising than the separate use of CSA and PhA in both male and female subjects.
- Published
- 2024
- Full Text
- View/download PDF
248. A case of widespread furuncular cutaneous myiasis in a man returning from Senegal.
- Author
-
DE Rosa C, Podo Brunetti A, Guida S, Bigotto GD, Stabile G, and Rongioletti F
- Published
- 2024
- Full Text
- View/download PDF
249. Contact-force local impedance algorithm to guide effective pulmonary vein isolation in AF patients: 1-year outcome from an international multicenter clinical setting.
- Author
-
Solimene F, Maggio R, De Sanctis V, Escande W, Malacrida M, Stabile G, Zakine C, Champ-Rigot L, Anselmino M, Ferraro A, Mantica M, Zucchelli G, Dell'Era G, Mascia G, Ricci Maga R, Pandozi C, Rossi P, Scaglione M, Zingarini G, Garnier F, Loricchio ML, Pelargonio G, and Lepillier A
- Abstract
Background: The combination of highly localized impedance (LI) and contact force (CF) may improve tissue characterization and lesion prediction during radiofrequency (RF) pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF)., Objective: We report the outcomes of our acute and long-term clinical evaluation of CF-LI-guided PVI in consecutive AF ablation cases from an international multicenter clinical setting., Methods: Three hundred twenty-four consecutive patients from 20 European centers undergoing RF catheter ablation with the Stablepoint™ catheter were enrolled in the CHARISMA registry. Of these, 275 had a minimum follow-up of 1 year and were included in the primary analysis., Results: The mean procedure duration was 115 ± 47 min, and the mean fluoroscopy time was 9.9 ± 6 min. At the end of the procedures, all PVs had been successfully isolated in all study patients. Minor complications were reported in 12 patients (4.4%). At 1 year, 36 (13.1%) patients had had an AF recurrence, and freedom from antiarrhythmic drugs and AF recurrence was achieved in 228 (82.9%) patients. The recurrence rate was higher in patients with persistent AF (21/116, 18.1%) than in those with paroxysmal AF (15/159, 9.4%; p = 0.0459). On multivariate logistic analysis adjusted for baseline confounders, only time > 6 months from first diagnosis of AF to ablation (HR = 2.93, 95%CI 1.03 to 8.36, p = 0.0459) was independently associated with recurrences., Conclusion: An ablation strategy for PVI guided by CF-LI technology proved safe and effective and resulted in a low recurrence rate of AF over 1-year follow-up, irrespective of the underlying AF type., Clinical Trial Registration: Catheter Ablation of Arrhythmias with a High-Density Mapping System in Real-World Practice. (CHARISMA). URL: http://clinicaltrials.gov/ Identifier: NCT03793998., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2024
- Full Text
- View/download PDF
250. Impact of surgery on reproductive outcomes in women with deep endometriosis and proven presurgical infertility: Facts and controversies.
- Author
-
Etrusco A, Chiantera V, Serra P, Stabile G, Margioula-Siarkou C, Della Corte L, Giampaolino P, Török P, Baldini GM, Ghezzi F, D'Amato A, and Laganà AS
- Abstract
In women with proven infertility and deep endometriosis (DE), optimal management is controversial. To date, there is no clear evidence on the association between infertility and different stages of rASRM, nor is there clear guidance from leading scientific societies for surgical treatment of DE patients. A comprehensive literature search was conducted on the main databases for English-language trials describing the effectiveness of surgery for DE in patients with proven infertility; 16 studies were deemed eligible for inclusion in this systematic review (CRD42024498888). Quantitative analysis was not possible because of the heterogeneity of the data. A descriptive summary of the results according to location of pathology, surgical technique used, and whether assisted reproductive technology (ART) was needed or not was provided. A total of 947 infertile women were identified, 486 of whom became pregnant, with an average pregnancy rate of 51.3%. Our review suggests that surgery can be of valuable help in improving reproductive outcomes by improving the results of ART. It has not been possible to reach robust conclusions on the outcomes of surgery based on the location of DE because of the heterogeneity of evidence available to date. Overall, although some data encourage first-line surgical management, further investigation is needed to determine its effective application before or after ART failure., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.