Publications by authors named "Giovanni Romano"

73 Publications

Short stump and high anastomosis pull-through (SHiP) procedure for delayed coloanal anastomosis with no protective stoma for low rectal cancer.

Updates Surg 2021 Apr 16;73(2):495-502. Epub 2021 Mar 16.

San Michele Hospital, Maddaloni, Italy.

Despite advances in coloanal anastomosis techniques, satisfactory procedures completed without complications remain lacking. We investigated the effectiveness of our recently developed 'Short stump and High anastomosis Pull-through' (SHiP) procedure for delayed coloanal anastomosis without a stoma. In this retrospective study, we analysed functional outcomes, morbidity, and mortality rates and local recurrence of 37 patients treated using SHiP procedure, out of the 282 patients affected by rectal cancer treated in our institution between 2012 and 2020. The inclusion criterion was that the rectal cancer be located within 4 cm from the anal margin. One patient died of local and pulmonary recurrence after 6 years, one developed lung and liver metastases after 2 years, and one experienced local recurrence 2.5 years after surgery. No major leak, retraction, or ischaemia of the colonic stump occurred; the perioperative mortality rate was zero. Five patients (13.51%) had early complications. Stenosis of the anastomosis, which occurred in nine patients (24.3%), was the only long-term complication; only three (8.1%) were symptomatic and were treated with endoscopic dilation. The mean Wexner scores at 24 and 36 months were 8.3 and 8.1 points, respectively. At the 36-month check-up, six patients (24%) had major LARS, ten (40%) had minor LARS, and nine (36%) had no LARS. The functional results in terms of LARS were similar to those previously reported after immediate coloanal anastomosis with protective stoma. The SHiP procedure resulted in a drastic reduction in major complications, and none of the patients had a stoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s13304-021-01022-6DOI Listing
April 2021

Gels in Medicine and Surgery: Current Trends and Future Perspectives.

Gels 2020 Dec 3;6(4). Epub 2020 Dec 3.

Department of Biomedical and Biotechnological Sciences (BIOMETEC), Section of Pharmacology, University of Catania, 95124 Catania, Italy.

Gel is a two-phase elastic colloidal material, consisting of a dispersed liquid incorporated in the solid phase [...].
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/gels6040048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768370PMC
December 2020

Cardiopulmonary resuscitation (CPR) during spaceflight - a guideline for CPR in microgravity from the German Society of Aerospace Medicine (DGLRM) and the European Society of Aerospace Medicine Space Medicine Group (ESAM-SMG).

Scand J Trauma Resusc Emerg Med 2020 Nov 2;28(1):108. Epub 2020 Nov 2.

University Department for Anesthesia, Intensive and Emergency Medicine and Pain Management, Hospital Oldenburg, Oldenburg, Germany.

Background: With the "Artemis"-mission mankind will return to the Moon by 2024. Prolonged periods in space will not only present physical and psychological challenges to the astronauts, but also pose risks concerning the medical treatment capabilities of the crew. So far, no guideline exists for the treatment of severe medical emergencies in microgravity. We, as a international group of researchers related to the field of aerospace medicine and critical care, took on the challenge and developed a an evidence-based guideline for the arguably most severe medical emergency - cardiac arrest.

Methods: After the creation of said international group, PICO questions regarding the topic cardiopulmonary resuscitation in microgravity were developed to guide the systematic literature research. Afterwards a precise search strategy was compiled which was then applied to "MEDLINE". Four thousand one hundred sixty-five findings were retrieved and consecutively screened by at least 2 reviewers. This led to 88 original publications that were acquired in full-text version and then critically appraised using the GRADE methodology. Those studies formed to basis for the guideline recommendations that were designed by at least 2 experts on the given field. Afterwards those recommendations were subject to a consensus finding process according to the DELPHI-methodology.

Results: We recommend a differentiated approach to CPR in microgravity with a division into basic life support (BLS) and advanced life support (ALS) similar to the Earth-based guidelines. In immediate BLS, the chest compression method of choice is the Evetts-Russomano method (ER), whereas in an ALS scenario, with the patient being restrained on the Crew Medical Restraint System, the handstand method (HS) should be applied. Airway management should only be performed if at least two rescuers are present and the patient has been restrained. A supraglottic airway device should be used for airway management where crew members untrained in tracheal intubation (TI) are involved.

Discussion: CPR in microgravity is feasible and should be applied according to the Earth-based guidelines of the AHA/ERC in relation to fundamental statements, like urgent recognition and action, focus on high-quality chest compressions, compression depth and compression-ventilation ratio. However, the special circumstances presented by microgravity and spaceflight must be considered concerning central points such as rescuer position and methods for the performance of chest compressions, airway management and defibrillation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13049-020-00793-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607644PMC
November 2020

P2X7 receptor antagonism preserves retinal ganglion cells in glaucomatous mice.

Biochem Pharmacol 2020 10 13;180:114199. Epub 2020 Aug 13.

Biomedical and Biotechnological Sciences Department, University of Catania, Catania, Italy; Center for Research in Ocular Pharmacology - CERFO, University of Catania, Catania, Italy.

To investigate the role of P2X7 receptor to preserve retinal ganglion cells (RGCs) structure and function in a genetic mouse model (DBA/2J mouse) of age-related glaucomatous neurodegeneration. Chronic treatment with P2X7 receptor antagonist eye drops was carried out in order to assess RGCs function and density by pattern electroretinogram (PERG) and RBPMS immunostaining, respectively. Further, microglia activation was assessed in flat-mounted retina by using Iba-1 immunostaining. Untreated glaucomatous eyes displayed significant microglia activation, alteration of PERG signal, and RGCs loss. In the P2X7 receptor antagonist-treated eyes, the PERG signal was significantly (p < 0.05) improved compared to controls, along with a significant (p < 0.05) reduction in terms of retinal microglial activation, and remarkable preservation of RGCs density. Altogether, these findings demonstrated that topical treatment with a P2X7 receptor antagonist has a neuroprotective effect on RGCs in glaucomatous mice, suggesting an appealing pharmacological approach to prevent retinal degenerative damage in optic neuropathy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.bcp.2020.114199DOI Listing
October 2020

Shedding light on the restart.

Phys Med 2020 09 5;77:18-20. Epub 2020 Aug 5.

Medical Physics Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio" Viale G. Pieraccini 6, I-50139 Florence, University of Florence, Italy. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ejmp.2020.07.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7403859PMC
September 2020

Nicotinamide-Rich Diet in DBA/2J Mice Preserves Retinal Ganglion Cell Metabolic Function as Assessed by PERG Adaptation to Flicker.

Nutrients 2020 Jun 27;12(7). Epub 2020 Jun 27.

Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA.

Flickering light increases metabolic demand in the inner retina. Flicker may exacerbate defective mitochondrial function in glaucoma, which will be reflected in the pattern electroretinogram (PERG), a sensitive test of retinal ganglion cell (RGC) function. We tested whether flicker altered the PERG of DBA/2J (D2) glaucomatous mice and whether vitamin B3-rich diet contributed to the flicker effect. D2 mice fed with either standard chow (control, = 10) or chow/water enriched with nicotinamide (NAM, 2000 mg/kg per day) (treated, = 10) were monitored from 3 to 12 months. The PERG was recorded with superimposed flicker (F-PERG) at either 101 Hz (baseline) or 11 Hz (test), and baseline-test amplitude difference (adaptation) evaluated. At endpoint, flat-mounted retinas were immunostained (RBPMS and mito-tracker). F-PERG adaptation was 41% in 3-month-old D2 and decreased with age more in control D2 than in NAM-fed D2 (GEE, < 0.01). At the endpoint, F-PERG adaptation was 0% in control D2 and 17.5% in NAM-fed D2, together with higher RGC density (2.4×), larger RGC soma size (2×), and greater intensity of mitochondrial staining (3.75×). F-PERG adaptation may provide a non-invasive tool to assess RGC autoregulation in response to increased metabolic demand and test the effect of dietary/pharmacological treatments on optic nerve disorders.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/nu12071910DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7401244PMC
June 2020

COVID-19 Surface Persistence: A Recent Data Summary and Its Importance for Medical and Dental Settings.

Int J Environ Res Public Health 2020 04 30;17(9). Epub 2020 Apr 30.

Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Azienda Ospedaliera Universitaria "G. Martino", Via Consolare Valeria, 98100 Messina, Italy.

Recently, due to the coronavirus pandemic, many guidelines and anti-contagion strategies continue to report unclear information about the persistence of coronavirus disease 2019 (COVID-19) in the environment. This certainly generates insecurity and fear in people, with an important psychological component that is not to be underestimated at this stage of the pandemic. The purpose of this article is to highlight all the sources currently present in the literature concerning the persistence of the different coronaviruses in the environment as well as in medical and dental settings. As this was a current study, there are still not many sources in the literature, and scientific strategies are moving towards therapy and diagnosis, rather than knowing the characteristics of the virus. Such an article could be an aid to summarize virus features and formulate new guidelines and anti-spread strategies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph17093132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246498PMC
April 2020

A case of intractable hyperglycemia.

Minerva Anestesiol 2020 Jul 11;86(7):793-794. Epub 2020 Mar 11.

Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.23736/S0375-9393.20.14554-1DOI Listing
July 2020

Retinal biomarkers and pharmacological targets for Hermansky-Pudlak syndrome 7.

Sci Rep 2020 03 4;10(1):3972. Epub 2020 Mar 4.

Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy.

Deletion of dystrobrevin binding protein 1 has been linked to Hermansky-Pudlak syndrome type 7 (HPS-7), a rare disease characterized by oculocutaneous albinism and retinal dysfunction. We studied dysbindin-1 null mutant mice (Dys) to shed light on retinal neurodevelopment defects in HPS-7. We analyzed the expression of a focused set of miRNAs in retina of wild type (WT), Dys and Dys mice. We also investigated the retinal function of these mice through electroretinography (ERG). We found that miR-101-3p, miR-137, miR-186-5p, miR-326, miR-382-5p and miR-876-5p were up-regulated in Dysmice retina. Dys mice showed significant increased b-wave in ERG, compared to WT mice. Bioinformatic analysis highlighted that dysregulated miRNAs target synaptic plasticity and dopaminergic signaling pathways, affecting retinal functions of Dys mice. Overall, the data indicate potential mechanisms in retinal neurodevelopment of Dys mice, which may have translational significance in HSP-7 patients, both in terms of diagnostic/prognostic biomarkers and novel pharmacological targets.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-020-60931-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055265PMC
March 2020

Synergistic effect of photodynamic therapy at 400 nm and doxycycline against .

Future Microbiol 2019 09;14:1199-1205

Department of Experimental & Clinical Medicine, University of Florence, Florence, Italy.

The objective of this study was to investigate the possible synergy between doxycycline and photodynamic therapy against and to evaluate the possible side effects on adenocarcinoma gastric cells with and without protoporphyrin IX. Three strains (ATCC 700392, 43504 and 49503) were grown on solid medium either with, or without, doxycycline at subinhibitory concentrations, and irradiated for 10, 20 and 30 minutes with a 400 nm-peaked light source. The phototoxicity tests on AGS cells were evaluated by MTT assay. The photodynamic therapy and doxycycline combination showed an antibacterial synergistic effect with no significant toxicities. The synergistic treatment could be considered as an interesting therapeutic option.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/fmb-2019-0129DOI Listing
September 2019

Are you sure of the "other tube"? Role of ultrasound in the evaluation of gastric tube positioning in the operating room.

Minerva Anestesiol 2019 11 17;85(11):1149-1150. Epub 2019 Jun 17.

Department of Anesthesia and Intensive Care Unit, Cardarelli Hospital, Naples, Italy.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.23736/S0375-9393.19.13878-3DOI Listing
November 2019

Accuracy and trending ability of hemoglobin measurement by the Pulse CO-Oximeter during vascular surgery.

J Clin Monit Comput 2020 Jun 10;34(3):501-508. Epub 2019 Jun 10.

Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy.

Real time information of Hb concentration can guide a tailored patient blood management. The study investigates the accuracy, precision and trending ability of the Pulse CO-Oximeter (SpHb) and blood gas analyzer in measuring the Hb concentration, compared to hematological analysis, in surgery at high risk of hemorrhage. We performed an observational study, involving 48 patients undergoing abdominal aortic open surgery. The primary endpoints of the study were to compare the accuracy in measuring the Hb concentration using non-invasive method (Masimo rainbow SET Radical 7 Pulse CO-Oximetry™) compared to the values provided by invasive conventional blood gas analyzer and hematological analysis. The secondary endpoint was to compare the differences between the baseline and the final value of the Hb after surgery (Δ-values), as well as the trending ability. Bias (precision) for the SpHb was 1.63 g/dL (± 0.05) with 95% limits of agreement between 0.85 and + 2.4 g/dL, while for the blood gas analyzer was 0.69 g/dL (± 0.04) with 95% limits of agreement between 0.07 and 1.3 g/dL. Δ-values values were not statistically different from the reference values of ΔHb obtained with the hematological analysis. Trending ability was good for both Pulse CO-Oximeter and blood gas analysis. Our results have shown that the SpHb is not precise enough to replace an invasive approach, but the trending ability of SpHb is accurate and may provide important information on the changes in hemoglobin concentration to guide blood management.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10877-019-00337-5DOI Listing
June 2020

Prognostic significance of deregulated microRNAs in uveal melanomas.

Mol Med Rep 2019 Apr 11;19(4):2599-2610. Epub 2019 Feb 11.

Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy.

Uveal melanoma (UM) represents the most frequent primary tumor of the eye. Despite the development of new drugs and screening programs, the prognosis of patients with UM remains poor and no effective prognostic biomarkers are yet able to identify high‑risk patients. Therefore, in the present study, microRNA (miRNA or miR) expression data, contained in the TCGA UM (UVM) database, were analyzed in order to identify a set of miRNAs with prognostic significance to be used as biomarkers in clinical practice. Patients were stratified into 2 groups, including tumor stage (high‑grade vs. low‑grade) and status (deceased vs. alive); differential analyses of miRNA expression among these groups were performed. A total of 20 deregulated miRNAs for each group were identified. In total 7 miRNAs were common between the groups. The majority of common miRNAs belonged to the miR‑506‑514 cluster, known to be involved in UM development. The prognostic value of the 20 selected miRNAs related to tumor stage was assessed. The deregulation of 12 miRNAs (6 upregulated and 6 downregulated) was associated with a worse prognosis of patients with UM. Subsequently, miRCancerdb and microRNA Data Integration Portal bioinformatics tools were used to identify a set of genes associated with the 20 miRNAs and to establish their interaction levels. By this approach, 53 different negatively and positively associated genes were identified. Finally, DIANA‑mirPath prediction pathway and Gene Ontology enrichment analyses were performed on the lists of genes previously generated to establish their functional involvement in biological processes and molecular pathways. All the miRNAs and genes were involved in molecular pathways usually altered in cancer, including the mitogen‑activated protein kinase (MAPK) pathway. Overall, the findings of the presents study demonstrated that the miRNAs of the miR‑506‑514 cluster, hsa‑miR‑592 and hsa‑miR‑199a‑5p were the most deregulated miRNAs in patients with high‑grade disease compared to those with low‑grade disease and were strictly related to the overall survival (OS) of the patients. However, further in vitro and translational approaches are required to validate these preliminary findings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/mmr.2019.9949DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6423615PMC
April 2019

Curcumin prevents high glucose damage in retinal pigment epithelial cells through ERK1/2-mediated activation of the Nrf2/HO-1 pathway.

J Cell Physiol 2019 08 15;234(10):17295-17304. Epub 2019 Feb 15.

Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, University of Catania, Catania, Italy.

To study the effects of curcumin on human retinal pigment epithelial (RPE) cells exposed to high glucose (HG) insult, we performed in vitro studies on RPE cells cultured both in normal and HG conditions to assess the effects of curcumin on the cell viability, nuclear factor erythroid 2-related factor 2 (Nrf2) expression, HO-1 activity, and ERK1/2 expression. RPE cells exposed to HG insult were treated with curcumin. The cell viability, apoptosis, HO-1 activity, ERK, and Nrf2 expression were evaluated. The data indicated that treatment with curcumin caused a significant decrease in terms of apoptosis. Further, curcumin was able to induce HO-1 expression via Nrf2 activation and counteracts the damage elicited by HG. The present study demonstrated that curcumin provides protection against HG-induced damage in RPE cells through the activation of Nrf2/HO-1 signaling that involves the ERK pathway, suggesting that curcumin may have therapeutic value in the treatment of diabetic retinopathy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jcp.28347DOI Listing
August 2019

Effect of check dams on riparian vegetation cover: A multiscale approach based on field measurements and satellite images for Leaf Area Index assessment.

Sci Total Environ 2019 Mar 7;657:827-838. Epub 2018 Dec 7.

University of Bari Aldo Moro, Department of Agricultural and Environmental Sciences, Bari, Italy.

This study aims to detect the variability of riparian vegetation by means of in-situ measurements of the Leaf Area Index (LAI) and its retrieval from Landsat 8 satellite images in a Mediterranean stream ('Cammarota', Puglia region, Southern Italy) characterized by the presence of intact and destroyed check dams. Fifty-three transects were measured using a Plant Canopy Analyzer and a broad range of LAI values (0.26-5.71) was observed. Lower values were found in Cammarota reaches with damaged or destroyed check dams that led to active erosive processes, whereas higher LAI values were detected in the reaches with greater geomorphological stability. These results were confirmed by the analysis of a nearby stream ('Vallone della Madonna') with intact check dams and sound riparian vegetation which produced a higher range (4.08-5.93) of LAI values. The LAI values of riparian vegetation in both streams were compared with those found in more homogeneous types of vegetation (wheat field and deciduous forest) in the surrounding areas, which were used as control plots. Landsat 8 satellite images relating to the same period of field activity were also analyzed, and the performance of three equations for deriving LAI values from the corrected Normalized Difference Vegetation Index (NDVI) was evaluated. The Lambert-Beer equation gave the best statistical performance for predicting LAI within the reaches of the Cammarota stream with a denser vegetation, as well as in the Vallone della Madonna stream and deciduous forest. The significant variability of the observed LAI values in the Cammarota reach subject to initial erosive processes, was not detected by any of the equations applied.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.scitotenv.2018.12.081DOI Listing
March 2019

Unstained cell imaging: Morphological insights from coupled fixation and darkfield microscopy.

Acta Histochem 2019 Feb 24;121(2):248-252. Epub 2018 Nov 24.

Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Viale Pieraccini 6, 50139, Florence, Italy.

Cell staining techniques are well established in cell biology and associated with a broad range of dedicated dyes; however, they are accompanied by non-negligible costs, preparation time and unavoidable alterations of the sample with foreign molecules. In this context, we point out and propose the use of darkfield microscopy (DM) combined with different fixation protocols (to be used anyway) to enhance the different cell structures and districts as a timesaving and inexpensive support to the techniques that need staining or immuno-staining protocols and products. In a first step, we have analysed the effect of different fixation protocols on DM images for various human cellular lines. The presented imaging study shows that cell morphology actually changes with the fixation protocols that enhance, through contrast and luminosity variations, different shapes and patterns and thus structures of the cells. The different chemical action of various fixations, in fact, modifies the local scattering coefficient, thus affecting in a different way the morphology shown by DM images. As a second step we have compared the observed DM morphologies to those of selective fluorescent staining being therefore able to associate them to specific cell districts (e.g. nucleus, membrane or cytoskeleton). The obtained results indicate that this common microscopy technique can give images with particular cellular structures or districts enhanced more than others depending on the choice of fixation protocol. Therefore Darkfield Microscopy can be considered as a simpler, cheaper and faster method to provide morphological indications, respect to staining techniques, even at low and medium magnifications.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.acthis.2018.11.006DOI Listing
February 2019

Assessing response to neo-adjuvant therapy in locally advanced rectal cancer using Intra-voxel Incoherent Motion modelling by DWI data and Standardized Index of Shape from DCE-MRI.

Ther Adv Med Oncol 2018 16;10:1758835918809875. Epub 2018 Nov 16.

Radiotherapy Unit, 'Istituto Nazionale Tumori, IRCCS, Fondazione G Pascale', Naples, Italy.

Background: Our aim was to investigate preoperative chemoradiation therapy (pCRT) response in locally advanced rectal cancer (LARC) comparing standardized index of shape (SIS) obtained from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with intravoxel-incoherent-motion-modelling-derived parameters by diffusion-weighted imaging (DWI).

Materials And Methods: Eighty-eight patients with LARC were subjected to MRI before and after pCRT. Apparent diffusion coefficient (ADC), tissue diffusion (D), pseudodiffusion (D) and perfusion fraction (f) were calculated and percentage changes ∆ADC, ∆D, ∆D, ∆f were computed. SIS was derived comparing DCE-MRI pre- and post-pCRT. Nonparametric tests and receiver operating characteristic (ROC) curves were performed.

Results: A total of 52 patients were classified as responders (tumour regression grade; TRG ⩽ 2) and 36 as not-responders (TRG > 3). Mann-Whitney test showed statistically significant differences in SIS, ∆ADC and ∆D between responders and not-responders and between complete responders (19 patients with TRG = 1) incomplete responders. The best parameters to discriminate responders by nonresponders were SIS and ∆ADC, with an accuracy of 91% and 82% (cutoffs of -5.2% and 18.7%, respectively); the best parameters to detect pathological complete responders were SIS, ∆f and ∆D with an accuracy of 78% (cutoffs of 38.5%, 60.0% and 83.0%, respectively). No increase of performance was observed by combining linearly each possible couple of parameters or combining all parameters.

Conclusion: SIS allows assessment of preoperative treatment response with high accuracy guiding the surgeon more or less conservative treatment. DWI-derived parameters reached less accuracy compared with SIS and combining linearly DCE- and DWI-derived parameters; no increase of accuracy was obtained.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1758835918809875DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6243411PMC
November 2018

Complete Mesocolic Excision With Central Vascular Ligation in Comparison With Conventional Surgery for Patients With Colon Cancer - The Experiences at Two Centers.

Ann Coloproctol 2018 Aug 31;34(4):180-186. Epub 2018 Aug 31.

Division of Surgical Oncology, Department of Abdominal Oncology, ''Istituto Nazionale Tumori Fondazione G. Pascale'' IRCCS, Naples, Italy.

Purpose: Revolutions have occurred over the last 3 decades in the management of patients with colorectal cancer. Most advances were in rectal cancer surgery, especially after the introduction of the total mesorectal excision (TME) by Heald. However, no parallel advances regarding colon cancer surgeries have occurred. In 2009, Hohenberger introduced a new concept trying to translate the survival advantages of TME to patients with colon cancer. This relatively new concept of a complete mesocolic excision (CME) with central vascular ligation (CVL) in the management of patients with colon cancer represents an evolution in operative technique. We performed a comparative study between CME with CVL and conventional surgery for patients with colon cancer at Italian and Egyptian cancer centers, considering surgical quality and clinical outcome.

Methods: Seventy-nine Egyptian patients underwent conventional surgery (non-CME group) while 52 Italian patients underwent CME with sharp dissection between the embryological planes and CVL of the supplying vessels (CME group).

Results: Significantly better results were observed in terms of lymph node yield (CME group: 22.5 vs. non-CME group: 12; P < 0.0001) and lymph node ratio (CME group: 0.03 vs. non-CME group: 0.22; P < 0.0001). Regarding surgical morbidity, no significant difference was noted (CME group: 2 vs. non-CME group: 5; P < 0.702).

Conclusion: CME appears to be a safe procedure when performed by experienced hands through proper embryological planes. It also provides a superior specimen, with a higher lymph node yield, which consequently affects the lymph node ratio. Eventually, CME with CVL should be increasingly adopted and studied more deeply.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3393/ac.2017.08.05DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140369PMC
August 2018

Side effects of intra-gastric photodynamic therapy: an in vitro study.

J Photochem Photobiol B 2018 Sep 12;186:107-115. Epub 2018 Jul 12.

Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Viale Pieraccini 6, I-50139 Florence, University of Florence, Italy.

Since many years it has been acknowledged that some bacterial species, among which H. pylori, P. aeruginosa, P. acnes accumulate endogenous photosensitizers (PS) in the form of porphyrins. This makes antibacterial photodynamic therapy (PDT) easier to perform due to the possible avoidance of external PS. In this study, we focus on gastric infections associated with the presence of Helicobacter pylori (H. pylori), known to accumulate and release both protoporphyrin IX (PPIX) and coproporphyrins. PDT versus H. pylori can be carried out by modified endoscopes or by new ingestible luminous devices under development. In both cases of in vitro and in vivo applications, either for therapy (PDT) or diagnosis, scientific literature lacks studies on the possible side-effects of light treatments on the surrounding tissues. To this aim we evaluated in vitro side-effects due to a possible intrinsic photosensitivity of gastric mucosa or to a photosensitization by the PS released from the bacterium itself. Photo-toxicity studies were conducted on the AGS cell line (ATCC® CRL-1739™), commonly used as a model for the stomach mucosa tissue, considering PPIX as the photosensitizing agent. After first evaluations of PPIX dark toxicity, its uptake and accumulation sites, photo-toxicity tests were conducted using a LED light source peaked at 400 nm, by varying both PPIX concentration (50 nM - 2 μM) and light dose in the range 0.6-13 J/cm, representing different treatment procedures found in literature. The oxidative stress consequent to irradiation was investigated both in terms of ROS production and assessment of the activity of enzymes involved in ROS-related biological mechanisms. A significant phototoxic effect was found only for PPIX concentration > 100 nM for all tested light doses. This indicates that the evaluated photo-treatments do not cause side effects even with the sensitization due to PPIX released by the bacteria.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jphotobiol.2018.07.010DOI Listing
September 2018

Innovative Nanoparticles Enhance -Palmitoylethanolamide Intraocular Delivery.

Front Pharmacol 2018 28;9:285. Epub 2018 Mar 28.

Department of Drug Sciences, University of Catania, Catania, Italy.

Nanostructured lipid carriers (NLCs) loaded with palmitoylethanolamide (PEA) were formulated with the aim to enhance ocular bioavailability of PEA, particularly to the back of the eye. Technological characterization (e.g., size, charge) of NLC loaded with PEA formulation (PEA-NLC) was performed, and NLC morphology was characterized by electron microscopy. Ocular pharmacokinetic study, after topical administration of the formulation, was carried out in rabbit eye. Ultra-high performance liquid chromatography tandem mass spectrometry analysis was carried out to detect PEA levels in ocular tissues. Finally, the ocular tolerability of PEA-NLC formulation was assessed in rabbit eye. The novel formulation significantly increased PEA levels in ocular tissues compared to PEA suspension. Vitreous and retinal levels of PEA were significantly higher in the group treated with PEA-NLC formulation versus PEA suspension (PEA-NLC C 5919 ± 541 pmol/g and 315 ± 70 pmol/g in vitreous and retina, respectively). The PEA-NLC formulation was characterized by high stability and robust ocular bioavailability. Therefore, this innovative formulation may be useful in clinical practice to manage retinal diseases.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fphar.2018.00285DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5882782PMC
March 2018

Anesthetic Preconditioning as Endogenous Neuroprotection in Glaucoma.

Int J Mol Sci 2018 Jan 13;19(1). Epub 2018 Jan 13.

Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, Miami, FL 33136, USA.

Blindness in glaucoma is the result of death of Retinal Ganglion Cells (RGCs) and their axons. RGC death is generally preceded by a stage of reversible dysfunction and structural remodeling. Current treatments aimed at reducing intraocular pressure (IOP) are ineffective or incompletely effective in management of the disease. IOP-independent neuroprotection or neuroprotection as adjuvant to IOP lowering in glaucoma remains a challenge as effective agents without side effects have not been identified yet. We show in DBA/2J mice with spontaneous IOP elevation and glaucoma that the lifespan of functional RGCs can be extended by preconditioning RGCs with retrobulbar lidocaine in one eye at four months of age that temporary blocks RGC axonal transport. The contralateral, PBS-injected eye served as control. Lidocaine-induced impairment of axonal transport to superior colliculi was assessed by intravitreal injection of cholera toxin B. Long-term (nine months) effect of lidocaine were assessed on RGC electrical responsiveness (PERG), IOP, expression of relevant protein (BDNF, TrkB, PSD95, GFAP, Synaptophysin, and GAPDH) and RGC density. While lidocaine treatment did not alter the age-related increase of IOP, TrkB expression was elevated, GFAP expression was decreased, RGC survival was improved by 35%, and PERG function was preserved. Results suggest that the lifespan of functional RGCs in mouse glaucoma can be extended by preconditioning RGCs in early stages of the disease using a minimally invasive treatment with retrobulbar lidocaine, a common ophthalmologic procedure. Lidocaine is inexpensive, safe and is approved by Food and Drug Administration (FDA) to be administered intravenously.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijms19010237DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5796185PMC
January 2018

MR imaging perfusion and diffusion analysis to assess preoperative Short Course Radiotherapy response in locally advanced rectal cancer: Standardized Index of Shape by DCE-MRI and intravoxel incoherent motion-derived parameters by DW-MRI.

Med Oncol 2017 Nov 18;34(12):198. Epub 2017 Nov 18.

Radiotherapy Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Via Mariano Semmola, 80131, Naples, Italy.

Our aim is to assess preoperative Short Course Radiotherapy (SCR) tumor response in locally advanced rectal cancer (LARC) through Standardized Index of Shape (SIS) by DCE-MRI, apparent diffusion coefficient (ADC) and intravoxel incoherent motion-derived parameters by DW-MRI. 35 patients with LARC underwent MR scan before and after SCR followed by delayed surgery, retrospectively, were enrolled. SIS, ADC, tissue diffusion (D ), pseudodiffusion (D ), and perfusion fraction (f) were extracted by MRI for each patient before and after SCR. Tumor regression grade (TRG) was estimated. Receiver operating characteristic curve and linear classification were performed. Sixteen patients were classified as responders (TRG ≤ 2) and 19 as non-responders. Seven patients had TRG1 [pathological complete response (pCR)]. The best parameter to discriminate responders by non-responders was SIS (sensitivity 94%, specificity 84%, accuracy 89%, cutoff value = - 7.8%). SIS obtained the best diagnostic performance also to discriminate pCR (sensitivity 86%, specificity 89%, accuracy 89%, cutoff value = 68.2%). No accuracy increase was obtained combining linearly each possible parameters couple or all functional MR-derived parameters. SIS is a hopeful DCE-MRI angiogenic biomarker to assess preoperative treatment response after SCR with delayed surgery, and it permits to discriminate pCR allowing to direct surgery for tailored and conservative treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12032-017-1059-2DOI Listing
November 2017

A Giant With Clay Feet.

Ann Surg 2017 12;266(6):e110-e111

State University of New York, Stony Brook, New York, NY.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SLA.0000000000001933DOI Listing
December 2017

Modified Pull-Through Technique With A Delayed High Coloanal Anastomosis: No Stoma and Scarless Surgery for Low Rectal Cancer.

Dis Colon Rectum 2017 10;60(10):1113

1 Department of Abdominal Surgery, National Cancer Institute "Fondazione G. Pascale," Naples, Italy 2 Universita degli Studi di Napoli Federico II, Naples, Italy 3 Monterrey Institute of Technology and Higher Education, Monterrey, Mexico.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/DCR.0000000000000897DOI Listing
October 2017

Two-stage Turnbull-Cutait pull-through coloanal anastomosis versus coloanal anastomosis with protective loop ileostomy for low rectal cancer. Protocol for a randomized controlled trial (Turnbull-BCN).

Int J Colorectal Dis 2017 Sep 30;32(9):1357-1362. Epub 2017 Jun 30.

Department of General and Digestive Surgery, Colorectal Unit, Bellvitge University Hospital, University of Barcelona and IDIBELL, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.

Purpose: The aim of this study was to determine whether patients that underwent ultra-low rectal resection for cancer can benefit from the recently reintroduced two-stage Turnbull-Cutait abdominoperineal pull-through procedure.

Methods: Patients with low rectal tumors undergoing radical sphincter-sparing resection are eligible for inclusion in a randomized multicenter study. Whether two-stage Turnbull-Cutait coloanal anastomosis provides significant benefits over hand-sewn coloanal anastomosis and associated lateral ileostomy in terms of postoperative morbidity is the primary endpoint. In addition, the study aims to assess secondary endpoints such as quality of life, fecal incontinence, and locoregional recurrence of the neoplasm. Patients with adenocarcinoma of the lower rectum diagnosed by rigid proctoscopy, with histological confirmation of malignancy, and who are candidates of rectal removal and coloanal anastomosis will be included in a randomized controlled and multicenter trial. Postoperative morbidity is defined as complications that occur within 30 days of the data of the second surgical procedure of the last patient included in the trial. Patients will be followed for a minimum period of 3 years.

Conclusions: The two-stage Turnbull-Cutait coloanal anastomosis may constitute an effective surgical alternative in the current approach to the treatment of low rectal cancer without the need of a temporary loop colostomy, preventing the wide range of complications related to stoma surgery.

Trial Registration: This trial is registered at clinicaltrials.gov (trial number: NCT01766661). This trial is registered in January 10, 2013.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00384-017-2842-4DOI Listing
September 2017

Retinal and Circulating miRNAs in Age-Related Macular Degeneration: An Animal and Human Study.

Front Pharmacol 2017 30;8:168. Epub 2017 Mar 30.

Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of CataniaCatania, Italy.

Age related macular degeneration (AMD) is the leading cause of blindness among people aged 50 and over. Retinal deposition of amyloid-β (Aβ) aggregates in AMD patients has suggested a potential link between AMD and Alzheimer's disease (AD). We have evaluated the differential retinal expression profile of miRNAs in a rat model of AMD elicited by Aβ. A serum profile of miRNAs in AMD patients has been also assessed using single TaqMan assay. Analysis of retina from rats intravitreally injected with Aβ revealed that miR-27a, miR-146a, and miR-155 were up-regulated in comparison to control rats. Seven miRNA (miR-9, miR-23a, miR-27a, miR-34a, miR-126, miR-146a, and miR-155) have been found to be dysregulated in serum of AMD patients in comparison to control group. Analysis of pathways has revealed that dysregulated miRNAs, both in the AMD animal model and in AMD patients, can target genes regulating pathways linked to neurodegeneration and inflammation, reinforcing the hypothesis that AMD is a protein misfolding disease similar to AD. In fact, miR-9, miR-23a, miR-27a, miR-34a, miR-146a, miR-155 have been found to be dysregulated both in AMD and AD. In conclusion, we suggest that miR-9, miR-23a, miR-27a, miR-34a, miR-146a, miR-155 represent potential biomarkers and new pharmacological targets for AMD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fphar.2017.00168DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5371655PMC
March 2017

Nab-Paclitaxel and Gemcitabine in Advanced Pancreatic Cancer: The One-year Experience of the National Cancer Institute of Naples.

Anticancer Res 2017 04;37(4):1975-1978

Department of Abdominal Oncology, Istituto Nazionale, Tumori di Napoli "G. Pascale" IRCCS, National Cancer Institute, Naples, Italy.

Background: Pancreas adenocarcinoma is the sixth cause of cancer-related death worldwide with an increasing mortality in the Western countries. Recently, the association between nab-paclitaxel (nab-P) and gemcitabine (GEM) has significantly improved progression-free and overall survival.

Patients And Methods: Patients affected by metastatic pancreas adenocarcinoma were treated at the Department of Abdominal Oncology of the National Cancer Institute of Naples from July 2015 to July 2016 with nab-P at 125 mg per square meter of body-surface area followed by GEM at 1,000 mg per square meter on days 1, 8 and 15 every 4 weeks. Computed tomography (CT) was performed every three months of therapy. Toxicity was graded with National Cancer Institute-Common Toxicity Criteria (NCI-CTC) v4.0. Objective responses were evaluated with Response Evaluation Criteria in Solid Tumors (RECIST). Analysis of time-to-progression is only descriptive. Pain was evaluated with a visual analogue scale (VAS).

Results: Twenty-three patients were treated. Median age was 67 years (range=45-81); 8 patients were ≥70 years old. Performance status (PS) Eastern Cooperative Oncology Group (ECOG) was 2 in 8 patients, 1 in 10 and 0 in 5. Twelve patients presented with diffuse hepatic metastases, 4 with carcinosis, 7 with more than one organ involvement. Nab-P was reduced at 100 mg per square meter in all patients. The most common G3/G4 adverse events were neutropenia (13.0% G4, 8.6% G3; none was febrile), neuropathy (30.4% G3) and asthenia (G3 17.3%). The disease control rate was 43.4% (partial response+stable disease (PR+SD) 10/23). The median time-to-progression was 7.9 months (95% confidence interval (CI)=5.8-11.2). After three months of therapy the PS improved in 14 patients, as well as pain in 18 patients.

Conclusion: We present an experience with nab-P and GEM association in a series with poor PS and highly metastatic disease relatively to a previous randomized study. The schedule is feasible, with nab-P at 100 mg per square meter achieving a good disease control rate, as well as a clinical benefit.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21873/anticanres.11539DOI Listing
April 2017

Antiangiogenic Therapy in Pancreatic Neuroendocrine Tumors.

Anticancer Res 2016 10;36(10):5025-5030

Department of Abdominal Oncology, Division of Medical Oncology, National Cancer Institute IRCCS "G. Pascale Foundation", Naples, Italy.

In recent years, many progresses have been pursued in the management of advanced pancreatic neuroendocrine tumor (pNET); most of them were prompted by increasing knowledge of biology of these neoplasms, including the identification of promising biological targets for therapy. PNETs belong to a group of rare neoplastic diseases. They originate from neuroendocrine system cells and are very heterogeneous regarding anatomic localization and aggressiveness. Recently, many efforts have been particularly focused on the identification of pathologic pathways and innovative drugs in order to treat patients with unresectable, metastatic disease, in progressive well-differentiated pNETs. Chemotherapy remains the mainstay of treatment of poorly-differentiated pNETs. The positive results obtained by sunitinib, a multi-targeted tyrosine kinase receptor inhibitor of vascular endothelial growth factor receptor (VEGFR) 1-3, platelet-derived growth factor receptor (PDGFR), c-kit, RET, colony stimulating factor-1 receptor (CSF-1R) and Fms-like tyrosine kinase 3 (FLT3), with direct antitumor and antiangiogenic effects, have highlighted the importance of tumor angiogenesis inhibition in controlling these tumors. Angiogenesis is a crucial process during tumor progression and plays a key role in development of metastasis. The role of angiogenesis in the malignant spread of pNET cells is finally supported by in vivo studies conducted on the RIP1-Tag2 mouse model. In this mini-review, we focus on the two pharmaceuticals that have given the most interesting results in clinical trials: bevacizumab and sunitinib. These drugs are changing the management of advanced pNETs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21873/anticanres.11071DOI Listing
October 2016

Ultrasonography during weaning: a support to a comprehensive skilful strategy.

Minerva Anestesiol 2016 11 16;82(11):1132-1134. Epub 2016 Sep 16.

Department of Neurosciences, Reproductive and Odontostomatologic Sciences, University of Naples Federico II, Naples, Italy -

View Article and Find Full Text PDF

Download full-text PDF

Source
November 2016

Experimental investigations on the fluid-mechanics of an electrospun heart valve by means of particle image velocimetry.

J Mech Behav Biomed Mater 2016 12 2;64:229-39. Epub 2016 Aug 2.

Department of Mechanical & Aerospace Engineering, University of Rome La Sapienza, Roma, Italy. Electronic address:

End-stage failing heart valves are currently replaced by mechanical or biological prostheses. Both types positively contribute to restore the physiological function of native valves, but a number of drawbacks limits the expected performances. In order to improve the outcome, tissue engineering can offer an alternative approach to design and fabricate innovative heart valves capable to support the requested function and to promote the formation of a novel, viable and correctly operating physiological structure. This potential result is particularly critical if referred to the aortic valve, being the one mainly exposed to structural and functional degeneration. In this regard, the here proposed study presents the fabrication and in vitro characterization of a bioresorbable electrospun heart valve prosthesis using the particle image velocimetry technique either in physiological and pathological fluid dynamic conditions. The scaffold was designed to reproduce the aortic valve geometry, also mimicking the fibrous structure of the natural extracellular matrix. To evaluate its performances for possible implantation, the flow fields downstream the valve were accurately investigated and compared. The experimental results showed a correct functionality of the device, supported by the formation of vortex structures at the edge of the three cusps, with Reynolds stress values below the threshold for the risk of hemolysis (which can be comprised in the range 400-4000N/m(2) depending on the exposure period), and a good structural resistance to the mechanical loads generated by the driving pressure difference.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jmbbm.2016.07.030DOI Listing
December 2016