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Article ; Online: Coronary stent management in elective genitourinary surgery.

Picozzi, Stefano C M / Carmignani, Luca

2012 Volume 109, Issue 6, Page(s) E17–8, author reply E18

MeSH term(s)	Angioplasty, Balloon, Coronary ; Elective Surgical Procedures ; Humans ; Stents ; Urologic Surgical Procedures
Language	English
Publishing date	2012-03
Publishing country	England
Document type	Letter
ZDB-ID	1462191-5
ISSN	1464-410X ; 1464-4096 ; 1358-8672
ISSN (online)	1464-410X
ISSN	1464-4096 ; 1358-8672
DOI	10.1111/j.1464-410X.2012.10983_3.x
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Article ; Online: Re: Giacomo Novara, Vincenzo Ficarra, Simone Mocellin, et al. Systematic review and meta-analysis of studies reporting oncologic outcome after robot-assisted radical prostatectomy. Eur Urol 2012;62:382-404.

Picozzi, Stefano C M / Ricci, Cristian / Carmignani, Luca

European urology

2013 Volume 63, Issue 2, Page(s) e27–8

MeSH term(s)	Humans ; Laparoscopy ; Male ; Prostatectomy/methods ; Prostatic Neoplasms/surgery ; Robotics ; Surgery, Computer-Assisted
Language	English
Publishing date	2013-02
Publishing country	Switzerland
Document type	Comment ; Letter
ZDB-ID	193790-x
ISSN	1873-7560 ; 1421-993X ; 0302-2838
ISSN (online)	1873-7560 ; 1421-993X
ISSN	0302-2838
DOI	10.1016/j.eururo.2012.11.028
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Article ; Online: Pulmonary emphysema and coronary artery calcifications at baseline LDCT and long-term mortality in smokers and former smokers of the ITALUNG screening trial.

Mascalchi, Mario / Romei, Chiara / Marzi, Chiara / Diciotti, Stefano / Picozzi, Giulia / Pistelli, Francesco / Zappa, Marco / Paci, Eugenio / Carozzi, Francesca / Gorini, Giuseppe / Falaschi, Fabio / Deliperi, Anna Lisa / Camiciottoli, Gianna / Carrozzi, Laura / Puliti, Donella

European radiology

2023 Volume 33, Issue 5, Page(s) 3115–3123

Abstract: Objectives: Cardiovascular disease (CVD), lung cancer (LC), and respiratory diseases are main causes of death in smokers and former smokers undergoing low-dose computed tomography (LDCT) for LC screening. We assessed whether quantification of pulmonary ... ...

Abstract	Objectives: Cardiovascular disease (CVD), lung cancer (LC), and respiratory diseases are main causes of death in smokers and former smokers undergoing low-dose computed tomography (LDCT) for LC screening. We assessed whether quantification of pulmonary emphysematous changes at baseline LDCT has a predictive value concerning long-term mortality. Methods: In this longitudinal study, we assessed pulmonary emphysematous changes with densitometry (volume corrected relative area below - 950 Hounsfield units) and coronary artery calcifications (CAC) with a 0-3 visual scale in baseline LDCT of 524 participants in the ITALUNG trial and analyzed their association with mortality after 13.6 years of follow-up using conventional statistics and a machine learning approach. Results: Pulmonary emphysematous changes were present in 32.3% of subjects and were mild (6% ≤ RA950 ≤ 9%) in 14.9% and moderate-severe (RA950 > 9%) in 17.4%. CAC were present in 67% of subjects (mild in 34.7%, moderate-severe in 32.2%). In the follow-up, 81 (15.4%) subjects died (20 of LC, 28 of other cancers, 15 of CVD, 4 of respiratory disease, and 14 of other conditions). After adjusting for age, sex, smoking history, and CAC, moderate-severe emphysema was significantly associated with overall (OR 2.22; 95CI 1.34-3.70) and CVD (OR 3.66; 95CI 1.21-11.04) mortality. Machine learning showed that RA950 was the best single feature predictive of overall and CVD mortality. Conclusions: Moderate-severe pulmonary emphysematous changes are an independent predictor of long-term overall and CVD mortality in subjects participating in LC screening and should be incorporated in the post-test calculation of the individual mortality risk profile. Key points: • Densitometry allows quantification of pulmonary emphysematous changes in low-dose CT examinations for lung cancer screening. • Emphysematous lung density changes are an independent predictor of long-term overall and cardio-vascular disease mortality in smokers and former smokers undergoing screening. • Emphysematous changes quantification should be included in the post-test calculation of the individual mortality risk profile.
MeSH term(s)	Humans ; Pulmonary Emphysema/diagnostic imaging ; Smokers ; Longitudinal Studies ; Early Detection of Cancer ; Lung Neoplasms/diagnostic imaging ; Tomography, X-Ray Computed/methods ; Coronary Artery Disease/diagnostic imaging ; Cardiovascular Diseases ; Emphysema
Language	English
Publishing date	2023-03-01
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1085366-2
ISSN	1432-1084 ; 0938-7994 ; 1613-3749
ISSN (online)	1432-1084
ISSN	0938-7994 ; 1613-3749
DOI	10.1007/s00330-023-09504-4
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Article: Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed.

Mascalchi, Mario / Picozzi, Giulia / Puliti, Donella / Diciotti, Stefano / Deliperi, Annalisa / Romei, Chiara / Falaschi, Fabio / Pistelli, Francesco / Grazzini, Michela / Vannucchi, Letizia / Bisanzi, Simonetta / Zappa, Marco / Gorini, Giuseppe / Carozzi, Francesca Maria / Carrozzi, Laura / Paci, Eugenio

Diagnostics (Basel, Switzerland)

2023 Volume 13, Issue 13

Abstract: The ITALUNG trial started in 2004 and compared lung cancer (LC) and other-causes mortality in 55-69 years-aged smokers and ex-smokers who were randomized to four annual chest low-dose CT (LDCT) or usual care. ITALUNG showed a lower LC and cardiovascular ... ...

Abstract	The ITALUNG trial started in 2004 and compared lung cancer (LC) and other-causes mortality in 55-69 years-aged smokers and ex-smokers who were randomized to four annual chest low-dose CT (LDCT) or usual care. ITALUNG showed a lower LC and cardiovascular mortality in the screened subjects after 13 years of follow-up, especially in women, and produced many ancillary studies. They included recruitment results of a population-based mimicking approach, development of software for computer-aided diagnosis (CAD) and lung nodules volumetry, LDCT assessment of pulmonary emphysema and coronary artery calcifications (CAC) and their relevance to long-term mortality, results of a smoking-cessation intervention, assessment of the radiations dose associated with screening LDCT, and the results of biomarkers assays. Moreover, ITALUNG data indicated that screen-detected LCs are mostly already present at baseline LDCT, can present as lung cancer associated with cystic airspaces, and can be multiple. However, several issues of LC screening are still unaddressed. They include the annual vs. biennial pace of LDCT, choice between opportunistic or population-based recruitment. and between uni or multi-centre screening, implementation of CAD-assisted reading, containment of false positive and negative LDCT results, incorporation of emphysema. and CAC quantification in models of personalized LC and mortality risk, validation of ultra-LDCT acquisitions, optimization of the smoking-cessation intervention. and prospective validation of the biomarkers.
Language	English
Publishing date	2023-06-28
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics13132197
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Article ; Online: Radiosurgery of limited brain metastases from primary solid tumor: results of the randomized phase III trial (NCT02355613) comparing treatments executed with a specialized or a C-arm linac-based platform.

Scorsetti, Marta / Navarria, Pierina / Cozzi, Luca / Clerici, Elena / Bellu, Luisa / Franceschini, Davide / Marzo, Antonio Marco / Franzese, Ciro / Torri, Valter / Reggiori, Giacomo / Lobefalo, Francesca / Raspagliesi, Luca / Attuati, Luca / Pessina, Federico / Franzini, Andrea / Picozzi, Piero / Tomatis, Stefano

Radiation oncology (London, England)

2023 Volume 18, Issue 1, Page(s) 28

Abstract: Background: Comparative prospective data regarding different radiosurgery (SRS) modalities for treating brain metastases (BMs) from solid tumors are not available. To investigate with a single institute phase III randomized trial whether SRS executed ... ...

Abstract	Background: Comparative prospective data regarding different radiosurgery (SRS) modalities for treating brain metastases (BMs) from solid tumors are not available. To investigate with a single institute phase III randomized trial whether SRS executed with linac (Arm-B) is superior to a dedicated multi-source gamma-ray stereotactic platform (Arm-A). Methods: Adults patients with 1-4 BMs from solid tumors up to 30 mm in maximum diameter were randomly assigned to arms A and B. The primary endpoint was cumulative incidence of symptomatic (grade 2-3) radionecrosis (CIRN). Secondary endpoints were local progression cumulative incidence (CILP), distant brain failure, disease-free survival (DFS), and overall survival (OS). Results: A total of 251 patients were randomly assigned to Arm-A (121) or Arm-B (130). The 1-year RN cumulative incidence was 6.7% in whole cohort, 3.8% (95% CI 1.9-7.4%) in Arm-B, and 9.3% (95% CI 6.2-13.8%) in the Arm-A (p = 0.43). CIRN was influenced by target volume irradiated only for the Arm-A (p << 0.001; HR 1.36 [95% CI 1.25-1.48]). Symptomatic RN occurred in 56 cases at a median time of 10.3 months (range 1.15-54.8 months), 27 in the Arm-B at a median time of 15.9 months (range 4.9-54.8 months), and 29 in the Arm-A at a median time of 6.9 months (1.2-32.3 months), without statistically significant differences between the two arms. No statistically significant differences were recorded between the two arms in CILP, BDF, DFS or OS. The mean beam-on time to deliver SRS was 49.0 ± 36.2 min in Arm-A, and 3.1 ± 1.6 min in Arm-B. Conclusions: Given the technical differences between the treatment platforms investigated in this single-institution study, linac-based SRS (Arm-B) did not lead to significantly lower grade 2-3 RN rates versus the multi-source gamma-ray system (Arm-A) in a population of patients with limited brain metastases of small volume. No significant difference in local control was observed between both arms. For Arm-B, the treatment delivery time was significantly lower than for Arm-A. Trial registration: ClinicalTrials.gov Identifier NCT02355613.
MeSH term(s)	Adult ; Humans ; Radiosurgery/methods ; Prospective Studies ; Retrospective Studies ; Brain Neoplasms/secondary ; Progression-Free Survival ; Treatment Outcome
Language	English
Publishing date	2023-02-07
Publishing country	England
Document type	Randomized Controlled Trial ; Clinical Trial, Phase III ; Journal Article
ZDB-ID	2224965-5
ISSN	1748-717X ; 1748-717X
ISSN (online)	1748-717X
ISSN	1748-717X
DOI	10.1186/s13014-023-02216-5
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Article: Extended-spectrum beta-lactamase-positive Escherichia coli causing complicated upper urinary tract infection: Urologist should act in time.

Picozzi, Stefano C M / Casellato, Stefano / Rossini, Mattia / Paola, Gaia / Tejada, Milvana / Costa, Elena / Carmignani, Luca

Urology annals

2014 Volume 6, Issue 2, Page(s) 107–112

Abstract: Objective: Recently, many articles reported increased incidence of urinary tract infection (UTI) due to Extended-Spectrum Beta-Lactamase (ESBL)-producing E. coli. No data are available to date regarding patients presenting with complicated upper ESBL- ... ...

Abstract	Objective: Recently, many articles reported increased incidence of urinary tract infection (UTI) due to Extended-Spectrum Beta-Lactamase (ESBL)-producing E. coli. No data are available to date regarding patients presenting with complicated upper ESBL-positive E. coli UTI and sepsis. We report the clinical presentation, management, and outcomes in seven cases. Materials and methods: This prospective study was carried out between January 2008 and September 2011. Follow-ups varied in patients according to their disease presentation and clinical outcomes. All strains were cultured and identified by the Clinical Microbiology Laboratory and were recovered from blood and urine cultures. In-vitro presence of ESBL was confirmed with Clinical and Laboratory Standard Institute double disc method. Results: In the study period, 49 patients needed hospitalization for upper UTI. Overall, in 25 patients (51%), cultures were negative. In the remaining, seven patients (14.3%) presented positive blood and urine-culture for ESBL + E. coli. Of these, four were female and three were male. Their median age was 73 years (range 66-84). The median hospital stay of these patients was 23 days (range 13 to 45 days). Conclusions: The current situation of multiple bacterial antibiotic resistance has become a worrisome issue in UTI. Multi-drug-resistant E. coli can be readily encountered in hospital settings during daily clinical practice, and urologist should act timely. The management of such infections is extremely important for the future, with particular reference to prevention of new antibiotic resistance patterns.
Language	English
Publishing date	2014-05-03
Publishing country	India
Document type	Journal Article
ISSN	0974-7796
ISSN	0974-7796
DOI	10.4103/0974-7796.130536
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Article ; Online: Low-dose CT for lung cancer screening: position paper from the Italian college of thoracic radiology.

Silva, Mario / Picozzi, Giulia / Sverzellati, Nicola / Anglesio, Sandra / Bartolucci, Maurizio / Cavigli, Edoardo / Deliperi, Annalisa / Falchini, Massimo / Falaschi, Fabio / Ghio, Domenico / Gollini, Paola / Larici, Anna Rita / Marchianò, Alfonso V / Palmucci, Stefano / Preda, Lorenzo / Romei, Chiara / Tessa, Carlo / Rampinelli, Cristiano / Mascalchi, Mario

La Radiologia medica

2022 Volume 127, Issue 5, Page(s) 543–559

Abstract: Smoking is the main risk factor for lung cancer (LC), which is the leading cause of cancer-related death worldwide. Independent randomized controlled trials, governmental and inter-governmental task forces, and meta-analyses established that LC screening ...

Abstract	Smoking is the main risk factor for lung cancer (LC), which is the leading cause of cancer-related death worldwide. Independent randomized controlled trials, governmental and inter-governmental task forces, and meta-analyses established that LC screening (LCS) with chest low dose computed tomography (LDCT) decreases the mortality of LC in smokers and former smokers, compared to no-screening, especially in women. Accordingly, several Italian initiatives are offering LCS by LDCT and smoking cessation to about 10,000 high-risk subjects, supported by Private or Public Health Institutions, envisaging a possible population-based screening program. Because LDCT is the backbone of LCS, Italian radiologists with LCS expertise are presenting this position paper that encompasses recommendations for LDCT scan protocol and its reading. Moreover, fundamentals for classification of lung nodules and other findings at LDCT test are detailed along with international guidelines, from the European Society of Thoracic Imaging, the British Thoracic Society, and the American College of Radiology, for their reporting and management in LCS. The Italian College of Thoracic Radiologists produced this document to provide the basics for radiologists who plan to set up or to be involved in LCS, thus fostering homogenous evidence-based approach to the LDCT test over the Italian territory and warrant comparison and analyses throughout National and International practices.
MeSH term(s)	Early Detection of Cancer/methods ; Female ; Humans ; Lung Neoplasms/diagnostic imaging ; Mass Screening ; Radiography, Thoracic ; Radiology ; Tomography, X-Ray Computed/methods
Language	English
Publishing date	2022-03-20
Publishing country	Italy
Document type	Journal Article
ZDB-ID	205751-7
ISSN	1826-6983 ; 0033-8362
ISSN (online)	1826-6983
ISSN	0033-8362
DOI	10.1007/s11547-022-01471-y
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Article ; Online: Is stone diameter a variable in the decision process of employing a ureteral stent in patients undergoing uncomplicated ureterorenoscopy and associated intracorporeal lithotripsy?

Picozzi, Stefano C M / Ricci, Cristian / Stubinski, Robert / Casellato, Stefano / Ratti, Dario / Macchi, Alberto / Bozzini, Giorgio / Carmignani, Luca

World journal of urology

2013 Volume 31, Issue 6, Page(s) 1617–1625

Abstract: Introduction: A number of randomized trials and meta-analysis in patients who underwent ureteroscopic stone removal investigated the effects of placing a ureteral stent at the end of the procedure on complication rates. However, none of these ... ...

Abstract	Introduction: A number of randomized trials and meta-analysis in patients who underwent ureteroscopic stone removal investigated the effects of placing a ureteral stent at the end of the procedure on complication rates. However, none of these investigates the stone diameter and its possible influence on complication rates and, as such, if it should be considered a possible variable in the decision process of placing or not a ureteral stent. Materials and methods: A bibliographic search covering the period from January 1990 to March 2012 was conducted in PubMed, MEDLINE and EMBASE. This analysis is based on the fifteen remaining studies which fulfilled the predefined inclusion criteria. All statistical evaluations were performed using SAS version 9.2. and by RevMan 5.0. Results: A total of 1,416 patients were included. All the studies were published after 2000. Mean stone diameter ranged between 5.3 and 13.3 mm in the non-stented group and between 6.26 and 13.28 mm in the stented group. Meta-analysis showed that stone diameter was not statistically different for stented or non-stented subgroups, whereas surgical operative time was shorter for the non-stented subgroup. The effect of stone diameter, irrespectively if patients were operated with or without stents were grouped or considered separately, did not influence complications of fever, haematuria, unplanned medical visits after surgery and urinary tract infections. Conclusions: Stone diameter is not a variable in the pre- or intraoperative decision process of placing or not placing a ureteral stent in patients undergoing uncomplicated ureterorenoscopy with intracorporeal lithotripsy.
MeSH term(s)	Decision Making ; Hematuria/epidemiology ; Humans ; Incidence ; Lithotripsy/instrumentation ; Lithotripsy/methods ; Operative Time ; Postoperative Complications/epidemiology ; Stents/adverse effects ; Stents/statistics & numerical data ; Treatment Outcome ; Ureteral Calculi/pathology ; Ureteral Calculi/surgery ; Ureteroscopy/instrumentation ; Ureteroscopy/methods
Language	English
Publishing date	2013-03-05
Publishing country	Germany
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	380333-8
ISSN	1433-8726 ; 0724-4983
ISSN (online)	1433-8726
ISSN	0724-4983
DOI	10.1007/s00345-013-1046-y
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Article ; Online: Extended-spectrum beta-lactamase-positive Escherichia coli causing complicated upper urinary tract infection

Stefano C.M. Picozzi / Stefano Casellato / Mattia Rossini / Gaia Paola / Milvana Tejada / Elena Costa / Luca Carmignani

Urology Annals, Vol 6, Iss 2, Pp 107-

Urologist should act in time

2014 Volume 112

Abstract	Objective: Recently, many articles reported increased incidence of urinary tract infection (UTI) due to Extended-Spectrum Beta-Lactamase (ESBL)-producing E. coli. No data are available to date regarding patients presenting with complicated upper ESBL-positive E. coli UTI and sepsis. We report the clinical presentation, management, and outcomes in seven cases. Materials and Methods: This prospective study was carried out between January 2008 and September 2011. Follow-ups varied in patients according to their disease presentation and clinical outcomes. All strains were cultured and identified by the Clinical Microbiology Laboratory and were recovered from blood and urine cultures. In-vitro presence of ESBL was confirmed with Clinical and Laboratory Standard Institute double disc method. Results: In the study period, 49 patients needed hospitalization for upper UTI. Overall, in 25 patients (51%), cultures were negative. In the remaining, seven patients (14.3%) presented positive blood and urine-culture for ESBL + E. coli . Of these, four were female and three were male. Their median age was 73 years (range 66-84). The median hospital stay of these patients was 23 days (range 13 to 45 days). Conclusions: The current situation of multiple bacterial antibiotic resistance has become a worrisome issue in UTI. Multi-drug-resistant E. coli can be readily encountered in hospital settings during daily clinical practice, and urologist should act timely. The management of such infections is extremely important for the future, with particular reference to prevention of new antibiotic resistance patterns.
Keywords	Extended-spectrum beta-lactamase positive ; Escherichia coli ; hydronephrosis ; infection ; pyonephrosis ; sepsis ; Diseases of the genitourinary system. Urology ; RC870-923 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
Subject code	610
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Medknow Publications
Document type	Article ; Online
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Article ; Online: Management of ureteral calculi and medical expulsive therapy in emergency departments.

Picozzi, Stefano C M / Marenghi, Carlo / Casellato, Stefano / Ricci, Cristian / Gaeta, Maddalena / Carmignani, Luca

Journal of emergencies, trauma, and shock

2009 Volume 4, Issue 1, Page(s) 70–76

Abstract: Introduction: Ureteral stones are a common problem in daily emergency department practice. Patients may be offered medical expulsive therapy (MET1) to facilitate stone expulsion and this should be offered as a treatment for patients with distal ureteral ...

Abstract	Introduction: Ureteral stones are a common problem in daily emergency department practice. Patients may be offered medical expulsive therapy (MET1) to facilitate stone expulsion and this should be offered as a treatment for patients with distal ureteral calculi, who are amenable to waiting management. Emergency department clinicians and family practitioners are often in the front line regarding the diagnosis and treatment of symptomatic nephrolithiasis and this commentary is dedicated to them because their decisions directly influence the outcome of the acute stone episode and appropriate referral patterns. Materials and methods: The aim of this systematic review and meta-analysis was to understand the role of MET in the treatment of obstructing ureteral calculi. A bibliographic search covering the period from January 1980 to March 2010 was conducted in PubMed, MEDLINE and EMBASE. The searches were restricted to publications in English. This analysis is based on the 21 studies that fulfilled the predefined inclusion criteria. Results: A metaregression analysis of expulsion time showed a statistically significant advantage in the experimental group, in which the mean expulsion time was 6.2 days compared to 10.3 days in controls. The treatment effect on expulsion rate (P = 0.53) was partially lost as the size of the stones decreased because of the high spontaneous expulsion rate of small stones and the expulsion time was not influenced by pharmacological treatment (P = 0.76) if the stone size was smaller than 5 mm. Analysis of the tamsulosin database. A total of 1283 participants were included in the 17 studies. These studies showed that compared to standard therapy or placebo, tamsulosin had significant benefits, being associated with both a higher stone expulsion rate (P < 0.001) and reduction of the expulsion time (P = 0.02). Reductions in the need for analgesic therapy, hospitalization and surgery are also shown. Analysis of the nifedipine database. The number of participants in each trial ranged from 25 to 70. Compared to standard therapy, the use of nifedipine significantly improved the spontaneous stone expulsion rate (P < 0.001). The mean expulsion time was slightly, but not statistically significantly, different (P = 0.19) between the treatment and control groups. A possible benefit of nifedipine, in terms of significantly reducing the doses of analgesics required, was reported in three studies. There was no difference between the tamsulosin- and nifedipine-treated groups with regard to expulsion time (P = 0.17) or expulsion rate (P = 0.79). Conclusions: Despite all its advantages, MET is rarely used, representing a failure of the translation of medical science into practice. These data raise concerns not only about the quality of care of patients who could benefit from resolution of stones without anaesthetic and surgical risks but also with regard to potential cost savings. MET should be offered as a treatment for patients with distal ureteral calculi who are amenable to a waiting management.
Language	English
Publishing date	2009-11-14
Publishing country	India
Document type	Journal Article
ZDB-ID	2461111-6
ISSN	0974-519X ; 0974-2700
ISSN (online)	0974-519X
ISSN	0974-2700
DOI	10.4103/0974-2700.76840
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