A Bolognese

The American University of Rome, Roma, Latium, Italy

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Publications (69)58.54 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Colonic diverticulosis has continuously increased, noticeably left-sided disease. Colovesical fistula is an uncommon complication of diverticulitis, and its most common cause is diverticular disease. Pneumaturia and fecaluria are commonly related symptoms. We present the case of a 79-year-old woman complaining pneumaturia and fecaluria. Abdominal CT showed a colovesical fistula due to sigmoid diverticulitis. After surgical adhesiolysis between the sigmoid colon and the bladder, the defect of the bladder wall was repaired by simple closure. The colonic defect was treated by segmental resection including the rectosigmoid junction. Following the operation the patient continuously improved at months 6, 12 and 18 without evidence of recurrences. Colonic diverticulitis, Intestinal Fistula, Sigmoid colon.
    Annali italiani di chirurgia. 01/2013; 84:477-81.
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    ABSTRACT: Purpose. To evaluate the treatment tolerance and clinical outcomes in patients aged 70 and older with locally advanced rectal carcinoma treated with multimodality approach. Methods and Materials. We retrospectively analysed 20 consecutive elderly patients, with histologically proven rectal adenocarcinoma, staged T3-4, and/or node-positive tumour, who received chemoradiotherapy and proceeded to surgical approach. Performance status score and adult comorbidity evaluation-27 score were calculated, and their influence on treatment tolerance and clinical outcomes was analysed. Results. All patients completed programmed chemoradiotherapy treatment. Gastrointestinal toxicity was the most common acute side effects: proctitis in 70% of patients and diarrhoea in 55%, classified as Grade 3 in 3 patients only. Radiation dermatitis was reported in 7 patients (35%) and it was graded G3 in one patient. There was no haematological toxicity. Eighteen patients out of 20 underwent surgery. Sphincter preservation was assured in 13 patients. Comorbidity index was related to higher severe acute toxicity (P = 0.015) but no influenced treatment outcomes. Conclusion. Treatment tolerance with combined modality is good in elderly patients. Due to age, no dose reduction for radiation therapy and chemotherapy should be considered.
    BioMed research international. 01/2013; 2013:610786.
  • European Journal of Surgical Oncology (EJSO). 10/2012; 38(10):982–983.
  • European Journal of Surgical Oncology (EJSO). 10/2012; 38(10):992.
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    ABSTRACT: The IGF system has recently been shown to play an important role in the regulation of breast tumor cell proliferation. However, also breast density is currently considered as the strongest breast cancer risk factor. It is not yet clear whether these factors are interrelated and if and how they are influenced by menopausal status. The purpose of this study was to examine the possible effects of IGF-1 and IGFBP-3 and IGF-1/IGFBP-3 molar ratio on mammographic density stratified by menopausal status. A group of 341 Italian women were interviewed to collect the following data: family history of breast cancer, reproductive and menstrual factors, breast biopsies, previous administration of hormonal contraceptive therapy, hormone replacement therapy (HRT) in menopause and lifestyle information. A blood sample was drawn for determination of IGF-1, IGFBP-3 levels. IGF-1/ IGFBP-3 molar ratio was then calculated. On the basis of recent mammograms the women were divided into two groups: dense breast (DB) and non-dense breast (NDB). Student's t-test was employed to assess the association between breast density and plasma level of IGF-1, IGFBP-3 and molar ratio. To assess if this relationship was similar in subgroups of pre- and postmenopausal women, the study population was stratified by menopausal status and Student's t-test was performed. Finally, multivariate analysis was employed to evaluate if there were confounding factors that might influence the relationship between growth factors and breast density. The analysis of the relationship between mammographic density and plasma level of IGF-1, IGFBP-3 and IGF-1/ IGFBP-3 molar ratio showed that IGF-1 levels and molar ratio varied in the two groups resulting in higher mean values in the DB group (IGF-1: 109.6 versus 96.6 ng/ml; p= 0.001 and molar ratio 29.4 versus 25.5 ng/ml; p= 0.001) whereas IGFBP-3 showed similar values in both groups (DB and NDB). Analysis of plasma level of IGF-1, IGFBP-3 and IGF-1/IGFBP-3 molar ratio compared to breast density after stratification of the study population by menopausal status (premenopausal and postmenopausal) showed that there was no association between the plasma of growth factors and breast density, neither in premenopausal nor in postmenopausal patients. Multivariate analysis showed that only nulliparity, premenopausal status and body mass index (BMI) are determinants of breast density. Our study provides a strong evidence of a crude association between breast density and plasma levels of IGF-1 and molar ratio. On the basis of our results, it is reasonable to assume that the role of IGF-1 and molar ratio in the pathogenesis of breast cancer might be mediated through mammographic density. IGF-1 and molar ratio might thus increase the risk of cancer by increasing mammographic density.
    Il Giornale di chirurgia 05/2012; 33(5):153-62.
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    ABSTRACT: To analyze clinical and laboratory findings in order to find variables predictive of severity of Biliary Peritonitis (BP). Patients and methods. Physical findings, course of illness, imaging and laboratory data were evaluated in 42 patients with BP, and statistically analysed to assess their prognostic significance. Serious illness and worse outcome were associated with: age ≥ 60 years (P=0.034), long time between onset of symptoms and treatment (P=0.025), fever > 38°C (P=0.009), WBC count > 17,000 cell/mm³ (P=0.043), diffuse abdominal pain (P=0.034), and infected bile (P=0.048). Most patients become severely ill due to supervening infection, while early bile drainage avoids serious complications. In addition, abdominal pain, fever and WBC count are also predictive of severity of BP.
    Il Giornale di chirurgia 05/2012; 33(5):168-71.
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    ABSTRACT: A case of Primary Testicular Plasmocytoma (PTP) in an 81-year-old man with a painless nodule in the left testis is reported. All possible pre-operative investigations were carried out, but the diagnosis of PTP was possible only after microscopic examination of the resected testis.
    Annali italiani di chirurgia 01/2011; 82(1):65-7. · 0.29 Impact Factor
  • The Breast Journal 11/2010; 16(6):656-8. · 1.83 Impact Factor
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    ABSTRACT: Prostate apoptosis response-4 (Par-4) is a tumor suppressor protein that sensitizes cells to apoptosis; therefore, Par-4 modulation has therapeutic potential. No data currently exist on Par-4 expression in cholangiocarcinoma (CCA). We evaluated the expression of Par-4 in normal and neoplastic cholangiocytes and the effects of its pharmacological or genetic modulation. The study was performed in human and rat liver, CCA patient biopsies, and two CCA cell lines. PAR-4 was expressed in normal rat and human cholangiocytes, but its expression levels decreased in both human CCA and CCA cell lines. In both intrahepatic and extrahepatic CCA, Par-4 expression (as shown by immunohistochemistry) was inversely correlated with markers of proliferation (eg, proliferating cellular nuclear antigen) and directly correlated with apoptotic markers (eg, Bax and Bax/BCL2 ratio). Par-4 expression was decreased during CCA cell proliferation but was enhanced after apoptosis induction. Pharmacological induction of Par-4 expression in CCA cell lines by diindolymethane or withaferin A promoted activation of apoptosis and inhibition of proliferation. In contrast, specific Par-4 silencing by small-interfering RNA determined activation of CCA cell line proliferation. Par-4 is expressed in rat and human cholangiocytes and is down-regulated in both human CCA and CCA cell lines. Par-4 protein levels decrease during cell proliferation but increase during apoptosis. Pharmacological or genetic induction of Par-4 determines apoptosis of CCA cells, suggesting Par-4 targeting as a CCA treatment strategy.
    American Journal Of Pathology 10/2010; 177(4):1779-90. · 4.60 Impact Factor
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    ABSTRACT: Phlegmons of the neck originate from infectious diseases of head and neck. Odontogeneous inflammation of the oral cavity is most frquently primary lesion, followed by sinusitis, otitis, as well as radiation therapy and surgical procedures. Phlegmons of head and neck can drain into the spaces among the muscles, aponevrosis, organs inside the neck like sublingual space, lateral pharyngeal space, retro-pharyngeal space or pre-vertebral space. We hereby report our experience with 7 patients treated from 2001 to 2005.
    Il Giornale di chirurgia 04/2010; 31(4):171-4.
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    ABSTRACT: Sphincter-saving surgery for the treatment of middle and low rectal cancer has spread considerably when total mesorectal excision became standard treatment. In order to reduce leakage-related complications, surgeons often perform a derivative stoma, a loop ileostomy (LI), or a loop colostomy (LC), but to date, there is no evidence on which is the better technique to adopt. We performed a systematic review and meta-analysis of all randomized controlled trials until 2007 and observational studies comparing temporary LI and LC for temporary decompression of colorectal and/or coloanal anastomoses. Clinically relevant events were grouped into four study outcomes: general outcome measures: dehydratation and wound infection GOM construction of the stoma outcome measures: parastomal hernia, stenosis, sepsis, prolapse, retraction, necrosis, and hemorrhage closure of the stoma outcome measures: anastomotic leak or fistula, wound infection COM, occlusion and hernia functioning of the stoma outcome measures: occlusion and skin irritation. Twelve comparative studies were included in this analysis, five randomized controlled trials and seven observational studies. Overall, the included studies reported on 1,529 patients, 894 (58.5%) undergoing defunctioning LI. LI reduced the risk of construction of the stoma outcome measure (odds ratio, OR = 0.47). Specifically, patients undergoing LI had a lower risk of prolapse (OR = 0.21) and sepsis (OR = 0.54). LI was associated with an excess risk of occlusion after stoma closure (OR = 2.13) and dehydratation (OR = 4.61). No other significant difference was found for outcomes. Our overview shows that LI is associated with a lower risk of construction of the stoma outcome measures.
    International Journal of Colorectal Disease 03/2009; 24(5):479-88. · 2.24 Impact Factor
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    BMC Geriatrics 01/2009; · 2.34 Impact Factor
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    ABSTRACT: We report the case of a 29-year-old woman with severe drug-resistant hypertension, caused by a big left adrenal gland pheochromocitoma. She had familiar history of hypercholesterolemia and early hypertension, too. The benign tumor was detected by 64-slice abdominal CT and then it was well defined by 131I metaiodobenzylguanidine scintigraphy. Some days after the eradication of the tumor, the blood pressure gradually normalized. We would like to show the importance of an accurate diagnosis of secondary hypertension in young people. Sometimes, these kind of abdominal tumors are difficult to detect, even if they have big dimensions. In fact the young patients often have vague symptoms but, after long time, the refractory high blood pressure can cause severe cardiovascular complications. So, it is important to perform a suitable examination to establish the right diagnosis.
    European Journal of Radiology Extra. 01/2009;
  • Alberto Gulino, Antonio Bolognese, Luciano Izzo
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    ABSTRACT: The concept that cancer is a multi-step process caused by genetically- and epigenetically-determined abnormal gene function is now well established. Gain-of-function or loss-of-function changes affect a number of genes that control cellular processes such as cell cycle, apoptosis and differentiation and that consequently behave as oncogenes or tumor suppressors, respectively. It is also well established that several genetic hits are required to trigger cell transformation and malignant progression of cancer, in which the altered functions of each oncogene or tumor suppressor contribute, in a coordinated way, to compose the complex network of the cancer phenotypic traits [1, 2]. Elucidating how such gene function diversity is generated during the tumorigenic events is an unanswered question. Although tremendous advances in knowledge have occurred in recent years, there is still no clear understanding in this field.
    12/2008: pages 27-36;
  • Antonio Bolognese, Dominique Elias, Luciano Izzo
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    ABSTRACT: Surgery is the fundamental treatment option in most solid tumors, but it is no longer the sole therapeutic weapon available. Instead it needs to be integrated in a considerably more complex multidisciplinary strategy, with two main aims: — To guarantee recovery and increase the duration of survival through the control of the disease, not only at the local-regional level, but also in general — To guarantee good quality of life by means of the most conservative possible treatment which maintains organ function and a good image of the organism.
    12/2008: pages 5-16;
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    ABSTRACT: Gastric cancer is the second most common cancer world-wide, with a frequency that varies greatly across different geographic locations [1]. Its incidence is higher in southern and Eastern Europe; in Italy there are 22.1 new cases/100,000 males and 11.2 cases/100,000 females annually. Gastric cancer is rare before the age of 40, and its incidence peaks in the seventh decade of life. In recent decades the survival rate for gastric cancer has improved in countries such as Japan [2], but in Western countries in patients resected with curative intent the recurrence rate is 40 to 65% [3] and the overall 5-year survival rate is 30% [4, 5]. Differences in the incidence and overall survival of gastric cancer suggest ethnic origin as a possible risk factor [2], but environmental, dietary and behavioral factors may be more relevant than ethnicity with the generation of carcinogenic N-nitroso compounds, while the influence of smoking and alcohol consumption has not been completely clarified [6]. An important development in the epidemiology of gastric carcinoma has been the recognition of the association with Helicobacter pylori infection: early infection induces changes in the gastric mucosa with progression to gastric atrophy and intestinal metaplasia predisposing the patient to the development of carcinoma and reducing the risk of duodenal ulcer due to the decreased acid production associated with gastritis. In patients with late Helicobacter pylori infection, atrophic gastritis is less frequently observed and therefore the risk of gastric cancer is lower [7], while, in patients with long-lasting reflux disease, antisecretory drugs and eradication of Helicobacter pylori infection [8] could increase the incidence of cancer of the gastric cardia [9].
    12/2008: pages 79-87;
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    ABSTRACT: The diagnosis, treatment and follow up of oncologic patients require multidisciplinary working groups made up of a dedicated team of physicians. Over the last decade the multidisciplinary treatment of oncologic diseases has become increasingly integrated and decreasingly sequential. The aim of cooperation is to provide quality treatment and produce new knowledge through both basic and clinical research and medical education.
    12/2008: pages 17-25;
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    ABSTRACT: The liver is the most common site of metastasis from colorectal cancer: about 50% of patients affected by colorectal cancer develop liver metastases during the course of their disease [1]; of these, 25% present with synchronous liver metastases, whereas an additional 25% develop metachronous hepatic metastases. Approximately 148,800 cases of colorectal cancer are estimated for 2008 in the United States, with more than 60,000 cases of liver metastases [2]. Patients with untreated metastatic colorectal cancer have a poor prognosis with a median survival of 6 to 12 months [3]. Surgical therapy for colorectal liver metastases remains the only potentially curative treatment. Despite recent advances in systemic chemotherapy, the median survival for unresected patients ranges from 12 to 24 months with uncommon long-term survival, while the 5-year survival rate after surgery ranges from 25 to 58%. These results are expected to improve with better patient selection and multimodal approaches. Therefore, when indicated, resection of colorectal metastases to the liver should always be considered.
    12/2008: pages 71-78;
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    ABSTRACT: Until recent years a diagnosis of peritoneal carcinomatosis (PC) from intra-abdominal solid tumors carried a uniformly fatal prognosis, often within weeks or months. Since the 1980s, following the intuition of an American surgeon, Paul Sugarbaker, combined treatment modalities of PC have developed considerably. Since the first pioneering approaches on the treatment of “pseudomyxoma peritonei”
    12/2008: pages 111-131;
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    ABSTRACT: The optimal management of pancreatic ductal carcinoma remains poorly defined. Radical resection is possible in about 20–30% of patients, with an overall 5-year survival rate of only 20% [1]. In recent years, perioperative morbidity and mortality have significantly decreased, and different clinical trials have suggested an important role for adjuvant therapy [2].
    12/2008: pages 89-100;

Publication Stats

309 Citations
58.54 Total Impact Points

Institutions

  • 2012
    • The American University of Rome
      Roma, Latium, Italy
  • 1987–2012
    • Sapienza University of Rome
      • Department of Surgery "Pietro Valdoni"
      Roma, Latium, Italy
  • 2009
    • Umberto I Policlinico di Roma
      Roma, Latium, Italy
  • 2008
    • Sant´Andrea Hospital
      Roma, Latium, Italy
  • 1996
    • Università degli Studi Europea di Roma
      Roma, Latium, Italy