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Article ; Online: Like a Perfect Swiss Clock: Interactive and Multimodal Strategies to Improve Quality and Outcomes of Bariatric Surgery.

Frattini, Francesco / Carrano, Francesco Maria / Bertoli, Simona / Dionigi, Gianlorenzo

2022 Volume 32, Issue 8, Page(s) 2797–2798

MeSH term(s)	Bariatric Surgery ; Humans ; Obesity, Morbid/surgery ; Treatment Outcome
Language	English
Publishing date	2022-06-07
Publishing country	United States
Document type	Letter
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-022-06138-1
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Article ; Online: Clinical Relevance and Interplay between miRNAs in Influencing Glioblastoma Multiforme Prognosis.

Epistolio, Samantha / Dazio, Giulia / Zaed, Ismail / Sahnane, Nora / Cipriani, Debora / Polinelli, Francesco / Barizzi, Jessica / Spina, Paolo / Stefanini, Federico Mattia / Cerati, Michele / Balbi, Sergio / Mazzucchelli, Luca / Sessa, Fausto / Pesce, Gianfranco Angelo / Reinert, Michael / Cardia, Andrea / Marchi, Francesco / Frattini, Milo

Cells

2024 Volume 13, Issue 3

Abstract: Glioblastoma multiforme (GBM) is usually treated with surgery followed by adjuvant partial radiotherapy combined with temozolomide (TMZ) chemotherapy. Recent studies demonstrated a better survival and good response to TMZ in methylguanine-DNA ... ...

Abstract	Glioblastoma multiforme (GBM) is usually treated with surgery followed by adjuvant partial radiotherapy combined with temozolomide (TMZ) chemotherapy. Recent studies demonstrated a better survival and good response to TMZ in methylguanine-DNA methyltransferase (
MeSH term(s)	Humans ; Glioblastoma/metabolism ; MicroRNAs/metabolism ; Dacarbazine/therapeutic use ; Clinical Relevance ; Temozolomide/pharmacology ; Temozolomide/therapeutic use
Chemical Substances	MicroRNAs ; Dacarbazine (7GR28W0FJI) ; Temozolomide (YF1K15M17Y)
Language	English
Publishing date	2024-02-02
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2661518-6
ISSN	2073-4409 ; 2073-4409
ISSN (online)	2073-4409
ISSN	2073-4409
DOI	10.3390/cells13030276
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Article ; Online: Noticeable effect of lower baseline amplitude on the predictive accuracy of intraoperative amplitude changes for postoperative vocal cord palsy: a prospective cohort study.

Kou, Jiedong / Zhao, Yishen / Han, Yujia / Li, Fang / Du, Rui / Dionigi, Gianlorenzo / Frattini, Francesco / Li, Jingting / Liang, Nan / Sun, Hui

International journal of surgery (London, England)

2024

Abstract: Background: To explore the effect of lower baseline amplitude on its predictive accuracy of postoperative vocal cord paralysis (VCP) in monitored thyroid surgery.: Materials and methods: Clinical and electrophysiological data were collected during ... ...

Abstract	Background: To explore the effect of lower baseline amplitude on its predictive accuracy of postoperative vocal cord paralysis (VCP) in monitored thyroid surgery. Materials and methods: Clinical and electrophysiological data were collected during thyroid surgeries performed between November and December 2021 at XXX. Univariate/multivariate regression analysis were applied to these data to examine a possible correlation. A receiver operating characteristic (ROC) curve was used to evaluate predictive efficacy. Results: A total of 631 nerves-at-risk (NAR) were identified in 460 patients who were divided into two groups according to postoperative development of VCP. The VCP group included a higher percentage of NAR with V1<1000 (68.2% vs. 40.7%, respectively; P=0.014) and NAR with R1<1400 (77.3% vs. 47.0%, respectively; P=0.005) compared with the non-VCP group. Multivariate regression analysis further identified V1<1000 (odds ratio (OR)=2.688, P=0.038), R1<1400 (OR=3.484, P=0.018) as independent risk factors for postoperative temporary VCP. The ROC curve showed the AUC value of V signal decline for predicting VCP was 0.87. The diagnostic efficiency of R signal decline reached as high as 0.973. A multivariate logistic regression analysis identified independent risk factors for V1<1000 and these included: higher body mass index (BMI) (OR=1.072, P=0.013), hypertension (OR=1.816, P=0.015), smoking (OR=1.814, P=0.031), and male gender (OR=2.016, P=0.027). Conclusion: In our cohort, lower baseline amplitude was an independent risk factor for developing transient postoperative VCP. It also affected the predictive efficacy of intraoperative amplitude changes on VCP. Higher BMI, hypertension, smoking, and male gender may also be closely associated with lower initial amplitude. Thus, maintaining a higher initial amplitude is critical for patient safety during thyroid surgery.
Language	English
Publishing date	2024-02-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1097/JS9.0000000000001203
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Article ; Online: The risk factors for postoperative temporary vocal cord paralysis after thyroid cancer surgery: an observational retrospective cohort study.

Han, Yujia / Zhao, Yishen / Kou, Jiedong / Li, Jingting / Li, Fang / Du, Rui / Dionigi, Gianlorenzo / Frattini, Francesco / Liang, Nan / Sun, Hui

International journal of surgery (London, England)

2024

Abstract: Objective: To analyze the potential factors influencing new-onset postoperative transient vocal cord paralysis (VCP) in thyroid cancer patients.: Methods: Case information of 8,340 thyroid cancer patients hospitalized at XX from January 2018 to ... ...

Abstract	Objective: To analyze the potential factors influencing new-onset postoperative transient vocal cord paralysis (VCP) in thyroid cancer patients. Methods: Case information of 8,340 thyroid cancer patients hospitalized at XX from January 2018 to December 2020 was collected retrospectively and analyzed. The possible influencing factors were analyzed using a chi-square test, rank-sum test, and multiple logistic regression analysis. A nomogram was used to construct the clinical prediction model that was validated in the validation set by ROC, calibration curves, and DCA. Results: The STROCSS guideline was followed to conduct a retrospective cohort study. A total of 8,340 patients, including 1,817 (21.8%) men and 6,523 (78.2%) women, were enrolled in this study. The rate of temporary VCP was 3.6% (308/8,340). Based on the results of postoperative laryngoscopy, the patients were divided into VCP group and non-VCP group. Comparative analysis between the groups revealed that potential factors associated with postoperative transient VCP were tumor location on the dorsal side of the gland (P = 0.042), ultrasound showing a maximum nodal diameter > 1 cm (P = 0.002), multifocal carcinoma (P < 0.001), invasion of surrounding tissue (P = 0.005), lymph node metastases in the central compartment (P = 0.034), lateral cervical lymph node metastasis (P < 0.001), and prolonged operation (P < 0.001). A multiple logistic regression analysis showed that the independent risk factors in postoperative transient VCP were T stage (OR = 1.411, P = 0.013, 95% CI: 1.075-1.853), multifocal carcinoma (OR = 1.532, P = 0.013, 95% CI: 1.095-2.144), and duration of surgery (OR = 1.009, P < 0.001, 95% CI: 1.006-1.012). Finally, a clinical prediction model was established via a nomogram and was validated in the validation set, although its diagnostic efficacy needs to be improved further. Conclusion: High T stage, multifocal carcinoma, and prolonged operation time may be independent risk factors for the occurrence of postoperative transient VCP in patients undergoing initial surgery for thyroid cancer.
Language	English
Publishing date	2024-04-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1097/JS9.0000000000001471
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Article: A Novel Family with Demyelinating Charcot-Marie-Tooth Disease Caused by a Mutation in the PMP2 Gene: A Case Series of Nine Patients and a Brief Review of the Literature.

Baga, Margherita / Rizzi, Susanna / Spagnoli, Carlotta / Frattini, Daniele / Pisani, Francesco / Fusco, Carlo

Children (Basel, Switzerland)

2023 Volume 10, Issue 5

Abstract: Introduction: Charcot-Marie-Tooth (CMT) is a group of inherited peripheral neuropathies characterized by wide genotypic and phenotypic variability. The onset is typically in childhood, and the most frequent clinical manifestations are predominantly ... ...

Abstract	Introduction: Charcot-Marie-Tooth (CMT) is a group of inherited peripheral neuropathies characterized by wide genotypic and phenotypic variability. The onset is typically in childhood, and the most frequent clinical manifestations are predominantly distal muscle weakness, hypoesthesia, foot deformity (pes cavus) and areflexia. In the long term, complications such as muscle-tendon retractions, extremity deformities, muscle atrophy and pain may occur. Among CMT1, demyelinating and autosomal dominant forms, CMT1G is determined by mutations in the PMP2 myelin protein. Results: Starting from the index case, we performed a clinical, electrophysiological, neuroradiological and genetic evaluation of all family members for three generations; we identified p.Ile50del in PMP2 in all the nine affected members. They presented a typical clinical phenotype, with childhood-onset variable severity between generations and a chronic demyelinating sensory-motor polyneuropathy on the electrophysiologic examination; the progression was slow to very slow and predominant in the lower limbs. Our study reports a relatively large sample of patients, members of the same family, with CMT1G by PMP2, which is a rare form of demyelinating CMT, highlighting the genetic variability of the CMT family instead of the overlapping clinical phenotypes within demyelinating forms. To date, only supportive and preventive measures for the most severe complications are available; therefore, we believe that early diagnosis (clinical, electrophysiological and genetic) allows access to specialist follow-up and therapies, thereby improving the quality of life of patients.
Language	English
Publishing date	2023-05-19
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children10050901
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Article: Endoscopic Gastric Plication: A Flexible and Tailored Alternative to Bariatric Surgery.

Frattini, Francesco / Gambetti, Andrea / Cordaro, Giuseppe / Spisani, Jerry / Lianos, Georgios / Simona, Bertoli / Dionigi, Gianlorenzo

Surgical technology international

2023 Volume 43

Abstract: Introduction: Endoscopic procedures are expanding and have been evolving in recent years, increasing their volume along with the development of new devices. This is due to the low morbidity and complication rate, the reversibility of the procedures, and ...

Abstract	Introduction: Endoscopic procedures are expanding and have been evolving in recent years, increasing their volume along with the development of new devices. This is due to the low morbidity and complication rate, the reversibility of the procedures, and the positive impact on patients. Among the endoscopic procedures gaining interest is sleeve gastroplasty. It emerged as a feasible and safe alternative to traditional bariatric surgery. There are no guidelines available on the indications and use of endoscopic gastroplasty. The aim of this study is to present preliminary results of a case series of endoscopic gastric plication procedures performed for different options: as a primary endoscopic sleeve, as revision for sleeve gastrectomy, and as revision for gastric bypass. Materials and methods: A retrospective analysis was performed on a prospective database collecting data on all patients with obesity treated with endoscopic gastroplasty with the Overstitch™ (Apollo Endosurgery, Inc., Austin, Texas) device from 2022 to 2023 in the bariatric surgery unit. Results: Twenty-three patients were treated from May 2022 to July 2023 with endoscopic gastric plication. Ten patients (43%) were submitted to primary endoscopic sleeve gastroplasty, three patients to revision of sleeve gastrectomy, one patient to revision of one anastomosis gastric bypass, and eight patients received a revision of Roux-en-Y gastric bypass. The body mass index (BMI) of patients submitted to primary ESG ranged from 33 to 42kg/m2, with a mean BMI of 37kg/m2. The age of the patients ranged from 22 to 70 years, with a mean age of 45. In one case, we registered a Clavien-Dindo 2 complication-an inflammatory perigastric reaction without a collection occurred 15 days after a primary ESG. Conclusion: Endoscopic gastric plication is emerging as a safe, mini-invasive, and effective procedure alternative to sleeve gastrectomy in patients with I or II class obesity or for those unfit for bariatric surgery. The endoscopic suturing device can be used both as a primary procedure or as a revisional option after failure of the primary surgery, thus proving to be a versatile option to provide to bariatric patients.
Language	English
Publishing date	2023-12-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	1225512-9
ISSN	1090-3941
ISSN	1090-3941
DOI	10.52198/23.STI.43.GS1745
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Article ; Online: Clinical Features in Aromatic L-Amino Acid Decarboxylase (AADC) Deficiency: A Systematic Review.

Rizzi, Susanna / Spagnoli, Carlotta / Frattini, Daniele / Pisani, Francesco / Fusco, Carlo

Behavioural neurology

2022 Volume 2022, Page(s) 2210555

Abstract: Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare congenital autosomal recessive metabolic disorder caused by pathogenic homozygous or compound heterozygous variants in the dopa decarboxylase (DDC) gene. Adeno-associated viral vector- ... ...

Abstract	Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare congenital autosomal recessive metabolic disorder caused by pathogenic homozygous or compound heterozygous variants in the dopa decarboxylase (DDC) gene. Adeno-associated viral vector-mediated gene transfer of the human AADC gene into the putamina has become available. This systematic review on PubMed, Scopus databases, and other sources is aimed at describing the AADC whole phenotypic spectrum in order to facilitate its early diagnosis. Literature reviews, original articles, retrospective and comparative studies, large case series, case reports, and short communications were considered. A database was set up using Microsoft Excel to collect clinical, molecular, biochemical, and therapeutic data. By analysing 261 patients from 41 papers with molecular and/or biochemical diagnosis of AADC deficiency for which individuality could be determined with certainty, we found symptom onset to occur in the first 6 months of life in 93% of cases. Hypotonia and developmental delay are cardinal signs, reported as present in 73.9% and 72% of cases, respectively. Oculogyric crises were seen in 67% of patients while hypokinesia in 42% and ptosis in 26%. Dysautonomic features have been revealed in 53% and gastrointestinal symptoms in 19% of cases. With 37% and 30% of patients reported being affected by sleep and behavioural disorders, it seems to be commoner than previously acknowledged. Although reporting bias cannot be excluded, there is still a need for comprehensive clinical descriptions of symptoms at onset and during follow-up. In fact, our review suggests that most of the neurological and extraneurological symptoms and signs reported, although quite frequent in this condition, are not pathognomonic, and therefore, ADCC deficiency can remain an underdiscovered disorder.
MeSH term(s)	Humans ; Dopa Decarboxylase/genetics ; Dopa Decarboxylase/therapeutic use ; Retrospective Studies ; Amino Acid Metabolism, Inborn Errors/genetics ; Amino Acid Metabolism, Inborn Errors/diagnosis ; Amino Acid Metabolism, Inborn Errors/drug therapy ; Amino Acids/therapeutic use
Chemical Substances	Dopa Decarboxylase (EC 4.1.1.-) ; Amino Acids
Language	English
Publishing date	2022-10-11
Publishing country	Netherlands
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	1001896-7
ISSN	1875-8584 ; 0953-4180
ISSN (online)	1875-8584
ISSN	0953-4180
DOI	10.1155/2022/2210555
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Article ; Online: Safety profile of treatment with greenlight versus Thulium Laser for benign prostatic hyperplasia.

Campobasso, Davide / Barbieri, Antonio / Bocchialini, Tommaso / Pozzoli, Gian Luigi / Dinale, Francesco / Facchini, Francesco / Grande, Marco Serafino / Kwe, Jean Emmanuel / Larosa, Michelangelo / Guarino, Giulio / Mezzogori, Davide / Simonetti, Elisa / Ziglioli, Francesco / Frattini, Antonio / Maestroni, Umberto Vittorio

Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica

2023 Volume 95, Issue 1, Page(s) 11101

Abstract: Objective: The major strengths of surgical treatment of benign prostatic hyperplasia with laser are reduced morbidity compared to endoscopic resection. No studies analysed the different risk of intra/peri-operative events between patients undergoing ... ...

Abstract	Objective: The major strengths of surgical treatment of benign prostatic hyperplasia with laser are reduced morbidity compared to endoscopic resection. No studies analysed the different risk of intra/peri-operative events between patients undergoing Thulium and GreenLight procedures. Materials and methods: We retrospectively reviewed 100 consecutive cases undergoing GreenLight vaporization and Thulium procedures performed during the learning curve of two expert endoscopic surgeons. Pre-operative data, intra and post-operative events at 90 days were analysed. Results: Patients on antiplatelet/anticoagulant therapy were pre-dominant in the Green group (p < 0.0001). Rates of blood transfusion (p < 0.0038), use of resectoscope (p < 0.0086), and transient stress urinary incontinence were statistically higher in the Thulium group. On the contrary conversions to TURP (p < 0.023) were more frequent in GreenLight patients. Readmissions were more frequently necessary in GreenLight group (24%) vs. Thulium group (26.6%). The overall complication rate in GreenLight and Thulium groups were 31% and 53% respectively; Clavien 3b complications were 13% in Thulium patients versus 1% in GreenLight patients. Conclusions: GreenLight and Thulium treatments show similar safety profiles. Randomized controlled trial are needed to better clarify the rate of major complications in Thulium group, and the incidence of post-operative storage symptoms in these patients' populations.
MeSH term(s)	Male ; Humans ; Prostatic Hyperplasia/complications ; Thulium/therapeutic use ; Retrospective Studies ; Treatment Outcome ; Lasers ; Transurethral Resection of Prostate/adverse effects ; Transurethral Resection of Prostate/methods ; Laser Therapy/adverse effects ; Laser Therapy/methods
Chemical Substances	Thulium (8RKC5ATI4P)
Language	English
Publishing date	2023-02-22
Publishing country	Italy
Document type	Journal Article
ZDB-ID	1153526-x
ISSN	2282-4197 ; 1120-8538 ; 1124-3562
ISSN (online)	2282-4197
ISSN	1120-8538 ; 1124-3562
DOI	10.4081/aiua.2023.11101
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Article ; Online: Extra-nuclear TERT counteracts oxidative stress and promotes progression in papillary thyroid carcinoma.

Muzza, Marina / Pogliaghi, Gabriele / Colombo, Carla / Grassi, Elisa Stellaria / Carbone, Erika / Palazzo, Sonia / Frattini, Francesco / Gazzano, Giacomo / Persani, Luca / Fugazzola, Laura

Translational research : the journal of laboratory and clinical medicine

2024 Volume 271, Page(s) 1–12

Abstract: The reactivation of TERT is associated with poor outcome in papillary thyroid cancer (PTC). Extra-telomeric functions of TERT were reported, with a protective role against oxidative stress (OS). The aim of the present study was to explore the extra- ... ...

Abstract	The reactivation of TERT is associated with poor outcome in papillary thyroid cancer (PTC). Extra-telomeric functions of TERT were reported, with a protective role against oxidative stress (OS). The aim of the present study was to explore the extra-nuclear TERT localization in PTC and its role in cancer progression. TERT nuclear export under OS were analyzed in K1 PTC cell line. We investigated the role of different TERT localizations using specific TERT constructs that limit its localization to the nucleus or to the mitochondria. The effect of SRC kinase inhibitor PP2, which reduces TERT nuclear export, was investigated as well. Moreover, TERT localization was analyzed in 39 PTC tissues and correlated with the genetic profile and the level of OS, DNA damage and apoptosis in the tumors and with the clinical characteristics of the patients. We demonstrated that TERT is exported from the nucleus in response to OS induced either from H2O2 or the BRAF inhibitor PLX4720. We proved that extra-nuclear TERT reduces mitochondrial OS and induces mitochondrial fragmentation. Moreover, limiting mitochondrial TERT localization reduced proliferation, migration, AKT phosphorylation and glycolysis and increased DNA damage and p21 expression. Finally, in PTC tissues the fraction of mitochondrial/nuclear TERT resulted inversely correlated with OS and p21 expression and associated with tumor persistence. In conclusion, our data indicate that extra-nuclear TERT is involved in reducing the effect of excessive OS, thus promoting cancer cell survival. Extra-nuclear TERT may thus represent a marker of cancer progression and a possible therapeutic target in PTC.
Language	English
Publishing date	2024-04-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2246684-8
ISSN	1878-1810 ; 1532-6543 ; 1931-5244
ISSN (online)	1878-1810 ; 1532-6543
ISSN	1931-5244
DOI	10.1016/j.trsl.2024.04.004
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Article ; Online: A Feasible Technique for Transoral Endoscopic Thyroidectomy Through Vestibular Access Using a Single-port Technique: A Video Vignette in Cadaver Dissection.

Karimov, Ziya / Turk, Yigit / Ozdemir, Murat / Celik, Servet / Bilge, Okan / Frattini, Francesco / Dionigi, Gianlorenzo / Makay, Ozer

Surgical laparoscopy, endoscopy & percutaneous techniques

2023 Volume 33, Issue 1, Page(s) 84–88

Abstract: Background: The aim of this study was to evaluate the safety and feasibility of a single-port system for transoral endoscopic thyroidectomy with vestibular access (TOETVA).: Materials and methods: Two embalmed human cadavers were used to test the ... ...

Abstract	Background: The aim of this study was to evaluate the safety and feasibility of a single-port system for transoral endoscopic thyroidectomy with vestibular access (TOETVA). Materials and methods: Two embalmed human cadavers were used to test the single-port technique. After positioning, a median vestibular incision was made. Adipose tissue was dissected through the mentum with a Kelly clamp to reach the subplatysmal level. The Keyport Single Port System (Richard Wolf) was then inserted. After port placement, flexible endoscopic dissectors and a 5-mm endoscope were advanced. After removing the dissectors, we inserted the ArtiSential laparoscopic instruments. We also used a 3-port TOETVA on another human cadaver to compare the results with those of the single-port surgery. Results: In the first cadaver, skin tension was observed during trocar insertion and dissection. Trocar insertion resulted in skin perforation in the submental area. In the second cadaver, the single-port trocar was successfully inserted despite the significant skin tension. However, the trocar did not allow the necessary surgical maneuvers to proceed with subsequent surgical steps and create a working space. Postprocedural anatomic dissection revealed that the distal branches of the mental nerve were related to the trocar passage. Conclusions: Our cadaver study demonstrated that single-port TOETVA is unsafe and not feasible with the current technology of the Keyport single-port system. This approach needs to be improved to perform this technique without injury to distal branches of the mental nerve, skin perforation, and other complications.
MeSH term(s)	Humans ; Thyroidectomy/methods ; Dissection ; Neck Dissection/methods ; Laparoscopy ; Cadaver ; Natural Orifice Endoscopic Surgery/methods
Language	English
Publishing date	2023-02-01
Publishing country	United States
Document type	Video-Audio Media ; Journal Article
ZDB-ID	1475108-2
ISSN	1534-4908 ; 1530-4515 ; 1051-7200
ISSN (online)	1534-4908
ISSN	1530-4515 ; 1051-7200
DOI	10.1097/SLE.0000000000001124
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