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  1. Article ; Online: An unusual case of genital filariasis of the testicular tunics in an Italian patient.

    Fassari, Alessia / Polistena, Andrea / De Toma, Giorgio / Fiori, Enrico

    Annals of Saudi medicine

    2021  Volume 41, Issue 3, Page(s) 186–189

    Abstract: At least 27 million men present with urogenital manifestations of genital filariasis (GF). Although there is a large burden of GF in residents in endemic regions, infection in short-term travellers and in non-endemic areas is rare. We report the case of ... ...

    Abstract At least 27 million men present with urogenital manifestations of genital filariasis (GF). Although there is a large burden of GF in residents in endemic regions, infection in short-term travellers and in non-endemic areas is rare. We report the case of a 75-year-old Italian man referred to our institution for a testicular discomfort. Clinical examination and ultrasound detected a mass of 40×18 mm in the scrotum without signs of varicocele, hydrocele and testicular or epididymal abnormalities. After ineffective medical treatment, the patient underwent surgical excision. Histology demonstrated filarial granuloma with thick cuticles pathognomonic of an adult worm in the testicular tunics. Surgery has a fundamental role in localized cases of GF to remove nematodes from the fibrotic nodules. The present manuscript describes a singular case of GF observed in Italy in a non-immigrant patient with evidence of remnants of an adult worm in the testicular tunics. SIMILAR CASES PUBLISHED: 11.
    MeSH term(s) Aged ; Filariasis/diagnosis ; Genitalia ; Humans ; Italy ; Male ; Scrotum/diagnostic imaging ; Ultrasonography
    Language English
    Publishing date 2021-06-01
    Publishing country Saudi Arabia
    Document type Case Reports ; Journal Article
    ZDB-ID 639014-6
    ISSN 0975-4466 ; 0256-4947
    ISSN (online) 0975-4466
    ISSN 0256-4947
    DOI 10.5144/0256-4947.2021.186
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  2. Article ; Online: Lorenzo Capussotti (1947-2014).

    De Toma, Giorgio

    Updates in surgery

    2014  Volume 66, Issue 3, Page(s) 171

    MeSH term(s) General Surgery/history ; History, 20th Century ; History, 21st Century ; Italy
    Language English
    Publishing date 2014-09
    Publishing country Italy
    Document type Biography ; Historical Article ; Journal Article
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-014-0263-2
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  3. Article ; Online: Italian Society of Surgery and Association of Stoma Care Nurses Joint Position Statement on Preoperative Stoma Siting.

    Roveron, Gabriele / De Toma, Giorgio / Barbierato, Maria

    Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society

    2016  Volume 43, Issue 2, Page(s) 165–169

    Abstract: Drawing on the existing position statements approved by the Wound, Ostomy and Continence Nursing Society in collaboration with the American Society of Colon & Rectal Surgeons and the American Urological Association, the Italian Association of Stoma care ... ...

    Abstract Drawing on the existing position statements approved by the Wound, Ostomy and Continence Nursing Society in collaboration with the American Society of Colon & Rectal Surgeons and the American Urological Association, the Italian Association of Stoma care Nurses and the Italian Society of Surgery jointly developed and approved this document on July 27, 2013. Its purpose was to provide a formal recommendation for preoperative stoma siting and associated counseling for all patients undergoing enterostomy or urostomy surgery, with the goals of preventing complications, enhancing health-related quality of life, improving care, achieving better health outcomes, and reducing health care costs.
    MeSH term(s) Directive Counseling ; Humans ; Italy ; Organizational Policy ; Ostomy ; Practice Guidelines as Topic ; Preoperative Care ; Societies, Medical ; Societies, Nursing ; Surgical Stomas
    Language English
    Publishing date 2016-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1188388-1
    ISSN 1528-3976 ; 1071-5754
    ISSN (online) 1528-3976
    ISSN 1071-5754
    DOI 10.1097/WON.0000000000000204
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  4. Article: Analysis of the miRNA expression from the adipose tissue surrounding the adrenal neoplasia.

    Concistrè, Antonio / Petramala, Luigi / Circosta, Francesco / Romagnoli, Priscilla / Soldini, Maurizio / Bucci, Marco / De Cesare, Domenico / Cavallaro, Giuseppe / De Toma, Giorgio / Cipollone, Francesco / Letizia, Claudio

    Frontiers in cardiovascular medicine

    2022  Volume 9, Page(s) 930959

    Abstract: Background: Primary aldosteronism (PA) is characterized by several metabolic changes such as insulin resistance, metabolic syndrome, and adipose tissue (AT) inflammation. Mi(cro)RNAs (miRNAs) are a class of non-coding small RNA molecules known to be ... ...

    Abstract Background: Primary aldosteronism (PA) is characterized by several metabolic changes such as insulin resistance, metabolic syndrome, and adipose tissue (AT) inflammation. Mi(cro)RNAs (miRNAs) are a class of non-coding small RNA molecules known to be critical regulators in several cellular processes associated with AT dysfunction. The aim of this study was to evaluate the expression of some miRNAs in visceral and subcutaneous AT in patients undergoing adrenalectomy for aldosterone-secreting adrenal adenoma (APA) compared to the samples of AT obtained in patients undergoing adrenalectomy for non-functioning adrenal mass (NFA).
    Methods: The quantitative expression of selected miRNA using real-time PCR was analyzed in surrounding adrenal neoplasia, peri-renal, and subcutaneous AT samples of 16 patients with adrenalectomy (11 patients with APA and 5 patients with NFA).
    Results: Real-time PCR cycles for miRNA-132, miRNA-143, and miRNA-221 in fat surrounding adrenal neoplasia and in peri-adrenal AT were significantly higher in APA than in patients with NFA. Unlike patients with NFA, miRNA-132, miRNA-143, miRNA-221, and miRNA-26b were less expressed in surrounding adrenal neoplasia AT compared to subcutaneous AT in patients with APA.
    Conclusion: This study, conducted on tissue expression of miRNAs, highlights the possible pathophysiological role of some miRNAs in determining the metabolic alterations in patients with PA.
    Language English
    Publishing date 2022-07-28
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2781496-8
    ISSN 2297-055X
    ISSN 2297-055X
    DOI 10.3389/fcvm.2022.930959
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  5. Article ; Online: Mapping complications in thyroid surgery: statistical data are useful for medico-legal management of a recurrent safety issue.

    Padovano, Martina / Scopetti, Matteo / Tomassi, Raoul / Manetti, Federico / D'Errico, Stefano / Santurro, Alessandro / De Toma, Giorgio / Frati, Paola / Miccoli, Paolo / Fineschi, Vittorio

    Updates in surgery

    2022  Volume 74, Issue 5, Page(s) 1725–1732

    Abstract: Quality of care assessment is a crucial tool for patient safety implementation. Litigation relating to thyroid surgery is one of the most represented sectors also due to the continuous increase in the number of thyroid interventions. Given the incidence ... ...

    Abstract Quality of care assessment is a crucial tool for patient safety implementation. Litigation relating to thyroid surgery is one of the most represented sectors also due to the continuous increase in the number of thyroid interventions. Given the incidence of the problem, the present study aims to outline an operational methodology for risk mapping and litigation management in thyroid surgery. The study was conducted through the analysis of data collected at Umberto I General Hospital in Rome from 2007 to 2018. All thyroid surgery claims were included and, subsequently, a descriptive statistical analysis of the categorical variables was performed with the representation of frequencies in absolute terms and as a percentage. The results obtained show that in 94% of cases (44 cases) the reported event consists of incorrect treatment. The most frequent adverse events were identified in unilateral or bilateral recurrent nerve lesions (31; 70%); incomplete removal of the thyroid gland (6; 14%), post-surgical hypoparathyroidism (4; 9%), aesthetic damage secondary to surgical scars (2; 5%), dental avulsion during intubation maneuvers (1; 2%). The experience derived from the risk mapping through management of thyroid claims proved it to be a reactive tool of considerable importance in clinical governance. The promotion of measures aimed at improving the satisfaction of some critical parameters identified in the litigation management activity such as adherence to the indications for surgery, the preoperative diagnostic path, and the adequacy of the surgical report allows to further implement the quality of care in the surgical treatment of thyroid pathology.
    MeSH term(s) Humans ; Patient Safety ; Thyroid Gland/surgery ; Thyroidectomy/adverse effects ; Thyroidectomy/methods
    Language English
    Publishing date 2022-08-27
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-022-01357-8
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  6. Article ; Online: Intensified Total Neoadjuvant Therapy

    DE Felice, Francesca / Musio, Daniela / Iafrate, Franco / Caponnetto, Salvatore / Picone, Vincenzo / D'Ambrosio, Giancarlo / Magliocca, Fabio Massimo / Tozzi, Francesca / DE Toma, Giorgio / Tombolini, Vincenzo / Cortesi, Enrico

    Anticancer research

    2022  Volume 42, Issue 2, Page(s) 991–1000

    Abstract: Background/aim: To compare clinical outcomes following intensified total neoadjuvant therapy (TNT) and intensified neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC).: Patients and methods: Of the 79 patients ... ...

    Abstract Background/aim: To compare clinical outcomes following intensified total neoadjuvant therapy (TNT) and intensified neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC).
    Patients and methods: Of the 79 patients with LARC admitted to our department, 51 received intensified neoadjuvant CRT (CRT group) and 28 received intensified TNT (TNT group). Intensified TNT was defined as multi-agent chemotherapy, including FOLFOXIRI regimen plus bevacizumab (mutated Ras-BRAF) or panitumumab/cetuximab (wild-type Ras-BRAF) followed by oxaliplatin-5-fluorouracil-based CRT and surgery. Kaplan-Meier and Log rank test were used for survival analysis. Survival rates of the two groups were compared using propensity score matching.
    Results: Data from 28 TNT patients and 28 CRT patients were analyzed after a 1:1 propensity matching with replacement. Kaplan-Meier curve showed that overall survival (OS), disease-free survival (DFS) and distant metastasis-free survival (DMFS) rates with TNT were comparable to those with CRT. The 5-year DMFS rates for TNT and CRT were 61.5% versus 63.0% (p=0.82), respectively. In the TNT group, 32.1% patients (n=9) achieved pathological complete response (pCR), whereas 21.4% patients (n=6) achieved pCR with CRT (p=0.37).
    Conclusion: Intensified TNT and CRT resulted in similar survival outcomes, while intensified TNT led to higher pCR, albeit not statistically significant.
    MeSH term(s) Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/therapy ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Chemoradiotherapy/methods ; Disease Progression ; Dose-Response Relationship, Drug ; Female ; Follow-Up Studies ; Humans ; Italy/epidemiology ; Male ; Matched-Pair Analysis ; Middle Aged ; Neoadjuvant Therapy/methods ; Neoplasm Invasiveness ; Propensity Score ; Rectal Neoplasms/mortality ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy ; Survival Analysis ; Young Adult
    Language English
    Publishing date 2022-01-29
    Publishing country Greece
    Document type Comparative Study ; Journal Article
    ZDB-ID 604549-2
    ISSN 1791-7530 ; 0250-7005
    ISSN (online) 1791-7530
    ISSN 0250-7005
    DOI 10.21873/anticanres.15559
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  7. Article ; Online: Ultrasound-guided Transversus Abdominis Plane Block is Effective as Laparoscopic Trocar site infiltration in Postoperative Pain Management in Patients Undergoing Adrenal Surgery.

    Cavallaro, Giuseppe / Gazzanelli, Sergio / Iossa, Angelo / De Angelis, Francesco / Fassari, Alessia / Micalizzi, Alessandra / Petramala, Luigi / Crocetti, Daniele / Circosta, Francesco / Concistrè, Antonio / Letizia, Claudio / De Toma, Giorgio / Polistena, Andrea

    The American surgeon

    2022  Volume 89, Issue 11, Page(s) 4401–4405

    Abstract: Background: Pain management in patients undergoing laparoscopy is still a matter of debate as several techniques have been proposed to reduce postoperative analgesic consumption and improve recovery. Among these, transversus abdominis plane (TAP) block ... ...

    Abstract Background: Pain management in patients undergoing laparoscopy is still a matter of debate as several techniques have been proposed to reduce postoperative analgesic consumption and improve recovery. Among these, transversus abdominis plane (TAP) block is considered as safe, effective, and easy to perform under ultrasound guidance; even so, recently laparoscopically guided trocar site anesthetic infiltration has been proposed as a "surgeon-dependent alternative to TAP block." The aim of this evaluation is to compare these analgesic techniques in the setting of laparoscopic adrenalectomy.
    Methods: This is a retrospective evaluation of a prospectively maintained database. Patients were divided into two groups: Group A patients received laparoscopic-assisted trocar site infiltration of ropivacaine; Group B patients received bilateral ultrasound-guided TAP block with ropivacaine. All patients received 24 h infusion of 20 mg morphine postoperatively; pain was checked at 6, 24 and 48 h after surgery. A rescue analgesia was given if numerical rating scale (NRS) score was > 4 or on patient request.
    Results: One hundred and three patients were enrolled in the evaluation (57 in group A and 46 in group B). There were no differences in operative time, complications and postoperative stay, and no complications related to trocar site infiltration. There were no differences in NRS at 6, 24, and 48 hours as well as in patients requiring further analgesic administration.
    Conclusions: Laparoscopic-guided trocar site ropivacaine infiltration has similar pain outcomes compared to ultrasound-guided TAP block in the management of postoperative pain in patients undergoing laparoscopic adrenalectomy. Since there is no difference among these techniques, the decision can be based on surgeon or anesthesiologist preference.
    MeSH term(s) Humans ; Ropivacaine ; Anesthetics, Local ; Retrospective Studies ; Pain, Postoperative/prevention & control ; Pain, Postoperative/etiology ; Laparoscopy/adverse effects ; Analgesics ; Surgical Instruments/adverse effects ; Ultrasonography, Interventional ; Abdominal Muscles ; Analgesics, Opioid
    Chemical Substances Ropivacaine (7IO5LYA57N) ; Anesthetics, Local ; Analgesics ; Analgesics, Opioid
    Language English
    Publishing date 2022-07-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
    DOI 10.1177/00031348221114035
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  8. Article ; Online: Locally Advanced Rectal Cancer: Treatment Approach in Elderly Patients.

    De Felice, Francesca / Crocetti, Daniele / Maiuri, Veronica / Parisi, Martina / Marampon, Francesco / Izzo, Luciano / De Toma, Giorgio / Musio, Daniela / Tombolini, Vincenzo

    Current treatment options in oncology

    2020  Volume 21, Issue 1, Page(s) 1

    Abstract: Independently of age, evidence-based guidelines recommend a multidisciplinary treatment approach in patients with locally advanced rectal cancer (LARC). But actually, elderly patients are grossly underrepresented in clinical trials, accounting < 10% of ... ...

    Abstract Independently of age, evidence-based guidelines recommend a multidisciplinary treatment approach in patients with locally advanced rectal cancer (LARC). But actually, elderly patients are grossly underrepresented in clinical trials, accounting < 10% of enrolled cases. Therefore, LARC management in elderly patients remains a crucial issue in daily practice, especially due to their frailty. Multiple clinical factors, including general health status, cognitive status, co-morbidity, disability, and life expectancy should be considered to understand the complexities of geriatric assessment and then define therapy. We use a patient-centered approach in order to tailor the optimal treatment strategy. We treat fit elderly patients as younger patients, including neoadjuvant chemoradiotherapy (CRT), surgery, and adjuvant chemotherapy. Whereas, in vulnerable and frail patients, we propose standard CRT (vulnerable patients) or radiotherapy alone (frail patients).
    MeSH term(s) Age Factors ; Aged ; Algorithms ; Clinical Decision-Making ; Combined Modality Therapy ; Comorbidity ; Disease Management ; Female ; Humans ; Male ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Rectal Neoplasms/diagnosis ; Rectal Neoplasms/etiology ; Rectal Neoplasms/mortality ; Rectal Neoplasms/therapy ; Treatment Outcome
    Language English
    Publishing date 2020-01-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057351-0
    ISSN 1534-6277 ; 1527-2729
    ISSN (online) 1534-6277
    ISSN 1527-2729
    DOI 10.1007/s11864-019-0692-8
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  9. Article ; Online: Francesco Durante (1844-1934).

    Sterpetti, Antonio V / De Toma, Giorgio / Cavallaro, Antonino

    Journal of neurology

    2014  Volume 261, Issue 12, Page(s) 2469–2470

    MeSH term(s) Brain Neoplasms/history ; Brain Neoplasms/surgery ; History, 19th Century ; Humans ; Surgeons/history
    Language English
    Publishing date 2014-03-07
    Publishing country Germany
    Document type Biography ; Historical Article ; Journal Article ; Portrait
    ZDB-ID 187050-6
    ISSN 1432-1459 ; 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
    ISSN (online) 1432-1459
    ISSN 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
    DOI 10.1007/s00415-014-7296-9
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  10. Article ; Online: Pneumothorax: a rare complication of colonoscopy. A systematic review of literature.

    Crocetti, Daniele / Fiori, Enrico / Costi, Umberto / Tarallo, Mariarita / De Gori, Antonietta / Cavallaro, Giuseppe / De Toma, Giorgio

    Annali italiani di chirurgia

    2019  Volume 90, Page(s) 201–207

    Abstract: Aim: The purpose of this study is to determine the anatomica! aspects, mechanisms, risk factors and appropriate management of development of pneumothorax during a routine colonoscopy.: Material of study: The review has been carried out according to ... ...

    Abstract Aim: The purpose of this study is to determine the anatomica! aspects, mechanisms, risk factors and appropriate management of development of pneumothorax during a routine colonoscopy.
    Material of study: The review has been carried out according to PRISMA statement. The literature search included PubMed and Scopus database. The search string was "pneumothorax AND colonscopy".
    Results: A total of 36 papers met the inclusion criteria out of 57 non duplicate citations. Papers describing the clinical course of 36 patients with pneumothorax alter colonoscopy plus one case (our personal report), achieving a total of 37 patients available for analysis have been investigated. The review revealed a female predominance. 16 procedures were just diagnostic without biopsies, whereas in 21 cases procedures were performed with interventional maneuvers. The most common clinical feature of extraperitoneal colonic perforation was dyspnea in 31 patients (84%). Treatment included unilateral or bilateral chest drain, chest drain and laparotomy, only laparotomy or laparoscopìc approach, endoscopic treatment and conservative management was also reported.
    Discussion: Rarely, colonic perforation during colonoscopy can occur into the extraperitoneal space, thus leading to the passage and diffusion of air along the fasciai planes and large vessels, possibly causing pneumoretroperitoneum, pneumomediastinum, pneumopericardium, pneumothorax, and subcutaneous emphysema. The combination of intraperitoneal and extraperitoneal perforation has also been reported.
    Conclusion: Pneumothorax and tension pneumothorax following a colonoscopy is an extremely rare but severe and often lifethreatening complication. If the patient develops dyspnea and pneumoderma during or alter this procedure, a chest radiogram or thoracoabdominal CT should be taken for diagnostic purposes. Urgent treatment, starting with chest tube insertion(s) and laparotomy or laparoscopy could be lifesaving.
    Key words: Colonic perforation, Colonoscopy, Pneumothorax.
    MeSH term(s) Colonoscopy/adverse effects ; Female ; Humans ; Middle Aged ; Pneumothorax/etiology ; Postoperative Complications/etiology ; Risk Factors
    Language English
    Publishing date 2019-07-28
    Publishing country Italy
    Document type Case Reports ; Journal Article ; Systematic Review
    ZDB-ID 418927-9
    ISSN 2239-253X ; 0003-469X
    ISSN (online) 2239-253X
    ISSN 0003-469X
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