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  1. Article ; Online: Does the distal ureteral diameter ratio (UDR) matter in the surgical management of vesicoureteral reflux in children?

    Carlucci, Marcello / Damasio, Maria B / Parodi, Stefano / Anfigeno, Lorenzo / Caprioli, Simone / Ottolenghi, Sara / Piaggio, Giorgio / Fiorenza, Venusia / Mattioli, Girolamo

    Pediatric surgery international

    2023  Volume 39, Issue 1, Page(s) 249

    Abstract: Purpose: To evaluate UDR reliability, sensitivity, specificity and to identify the best treatment basing on UDR among single or double endoscopic injections and ureteral reimplantation.: Methods: Data of patients affected by primary VUR and treated ... ...

    Abstract Purpose: To evaluate UDR reliability, sensitivity, specificity and to identify the best treatment basing on UDR among single or double endoscopic injections and ureteral reimplantation.
    Methods: Data of patients affected by primary VUR and treated by endoscopic injection over a 10 years period were retrospectively analyzed. Two radiologist attributed reflux grade and UDR on voiding cystourethrogram twice and blinded. Follow-up focused on resolution after 1 or 2 endoscopic injections. Relation between UDR, reflux grade and outcomes were analyzed.
    Results: Patient enrolled were 198. Low grade VUR was present in 24.8%, grade 3 in 41.6%, grade 4-5 in 33.6%. Resolution after one injection was obtained in 88 patients; among 110 not resolved 104 cases had a second injection. Success after 2 injections was reported in 138 cases. UDR showed a higher reliability compared with reflux grade both in intra than inter-reader measurement (ICC > 90%). Success after 1 or 2 injections was reported for UDR < 0.33 and UDR < 0.47 respectively.
    Conclusion: UDR shows to be a more reliable measurement that allows for an objective estimation of VUR severity and prognosis. It represents a quantitative parameter that might be useful to identify patients who may benefit endoscopic or surgical treatment, avoiding unnecessary under or over-treatment.
    MeSH term(s) Humans ; Child ; Vesico-Ureteral Reflux/diagnostic imaging ; Vesico-Ureteral Reflux/surgery ; Reproducibility of Results ; Retrospective Studies ; Ureter/diagnostic imaging ; Ureter/surgery ; Replantation
    Language English
    Publishing date 2023-08-17
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 632773-4
    ISSN 1437-9813 ; 0179-0358
    ISSN (online) 1437-9813
    ISSN 0179-0358
    DOI 10.1007/s00383-023-05535-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Complicated appendicitis due to diagnosis delay during lockdown period in Italy.

    Bellini, Tommaso / Rotulo, Gioacchino Andrea / Carlucci, Marcello / Fiorenza, Venusia / Piccotti, Emanuela / Mattioli, Girolamo

    Acta paediatrica (Oslo, Norway : 1992)

    2021  Volume 110, Issue 6, Page(s) 1959–1960

    MeSH term(s) Acute Disease ; Appendicitis/diagnosis ; Appendicitis/surgery ; Delayed Diagnosis ; Humans ; Italy ; Length of Stay
    Language English
    Publishing date 2021-02-03
    Publishing country Norway
    Document type Journal Article
    ZDB-ID 203487-6
    ISSN 1651-2227 ; 0365-1436 ; 0803-5253
    ISSN (online) 1651-2227
    ISSN 0365-1436 ; 0803-5253
    DOI 10.1111/apa.15756
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Dextranomer Endoscopic Injections for the Treatment of Urinary Incontinence in Bladder Exstrophy-epispadias Complex.

    Fiorenza, Venusia / Hukkinen, Maria / Alova, Ilona / Clermidi, Pauline / Broch, Aline / Botto, Nathalie / Blanc, Thomas / Lottmann, Henri B

    The Journal of urology

    2022  Volume 209, Issue 3, Page(s) 591–599

    Abstract: Purpose: Since bladder neck dextranomer/hyaluronic acid copolymer (Deflux) injections can improve urinary incontinence of various etiologies, we hypothesized that incontinent children with bladder exstrophy-epispadias complex would benefit from ... ...

    Abstract Purpose: Since bladder neck dextranomer/hyaluronic acid copolymer (Deflux) injections can improve urinary incontinence of various etiologies, we hypothesized that incontinent children with bladder exstrophy-epispadias complex would benefit from dextranomer/hyaluronic acid copolymer. We aimed to analyze dextranomer/hyaluronic acid copolymer efficacy and predictors of treatment success in bladder exstrophy-epispadias complex.
    Materials and methods: Incontinent bladder exstrophy-epispadias complex children aged >4 years undergoing dextranomer/hyaluronic acid copolymer injections in our hospital between October 1997 and January 2021 were included. Medical history, continence, and bladder capacity before injections were recorded. Postoperatively, patients were categorized as "dry," "significantly improved," or "failure." Postoperative complications, bladder emptying mode, and bladder capacity were reported. Failure-free survival was estimated by Kaplan-Meier models.
    Results: Altogether, 58 patients (27 male epispadias, 9 female epispadias, 22 bladder exstrophy) underwent 105 injections at median age of 8.5 (interquartile range 5.8-12) years. Previous bladder neck reconstruction had been performed in 38 (66%) and 33 (57%) received multiple injections. Complications occurred in 9%. Five-year failure-free survival was 70% (standard error 9.1) in males epispadias compared to 45% (9.0) in females and exstrophy patients (
    Conclusions: Dextranomer/hyaluronic acid copolymer injections provided satisfactory and lasting continence in over half of bladder exstrophy-epispadias complex patients. While injections were successful in male epispadias regardless of bladder neck reconstruction timing, results were better in bladder exstrophy and female epispadias after previous bladder neck reconstruction.
    MeSH term(s) Child ; Humans ; Male ; Female ; Child, Preschool ; Urinary Bladder/surgery ; Bladder Exstrophy/complications ; Bladder Exstrophy/surgery ; Epispadias/complications ; Epispadias/surgery ; Hyaluronic Acid ; Urinary Incontinence/therapy ; Urinary Incontinence/surgery
    Chemical Substances dextranomer (30KXI0TVD3) ; Hyaluronic Acid (9004-61-9)
    Language English
    Publishing date 2022-11-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3176-8
    ISSN 1527-3792 ; 0022-5347
    ISSN (online) 1527-3792
    ISSN 0022-5347
    DOI 10.1097/JU.0000000000003086
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  4. Article ; Online: Esophageal Stricture as a Complication After Scald Injury in Children.

    Boscarelli, Alessandro / Fiorenza, Venusia / Chiaro, Andrea / Incerti, Filippo / Mattioli, Girolamo / Gandullia, Paolo

    Journal of burn care & research : official publication of the American Burn Association

    2020  Volume 41, Issue 3, Page(s) 734–736

    Abstract: Burn injuries are distressful and shocking events, which can lead to noteworthy sequelae on metabolic markers and organs. Such traumatic accidents do occur every so often in both adult and pediatric populations, requiring prompt and adequate treatments. ... ...

    Abstract Burn injuries are distressful and shocking events, which can lead to noteworthy sequelae on metabolic markers and organs. Such traumatic accidents do occur every so often in both adult and pediatric populations, requiring prompt and adequate treatments. Notably, scald injuries occur due to direct contact with hot liquids and these are the most common cause of burns in early childhood. Herein, we report on an 18-month-old boy admitted to our pediatric surgery unit for an extensive scald injury, who has experienced an unusual esophageal stricture following the traumatic event.
    MeSH term(s) Burns/complications ; Burns/therapy ; Esophageal Stenosis/diagnostic imaging ; Esophageal Stenosis/etiology ; Esophageal Stenosis/surgery ; Humans ; Infant ; Male
    Language English
    Publishing date 2020-02-20
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2224246-6
    ISSN 1559-0488 ; 1559-047X
    ISSN (online) 1559-0488
    ISSN 1559-047X
    DOI 10.1093/jbcr/iraa027
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Surgical validation of functional magnetic resonance urography in the study of ureteral anomalies distal to the uretero-pelvic junction in a pediatric cohort.

    Sertorio, Fiammetta / Delfino, Lorenza / Wong, Michela Cy / Palo, Federico / Carlucci, Marcello / Fiorenza, Venusia / Basso, Luca / Anfigeno, Lorenzo / Piaggio, Giorgio / Damasio, Maria B / Mattioli, Girolamo

    Minerva pediatrics

    2022  

    Abstract: Background: Ureteral anomalies distal to the Uretero-Pelvic Junction (UPJ) belong to the wide spectrum of congenital anomalies of the kidney and urinary tract (CAKUT). They can cause severe obstruction requiring a detailed anatomical depiction to define ...

    Abstract Background: Ureteral anomalies distal to the Uretero-Pelvic Junction (UPJ) belong to the wide spectrum of congenital anomalies of the kidney and urinary tract (CAKUT). They can cause severe obstruction requiring a detailed anatomical depiction to define the surgical approach. Up to date, ultrasonography, voiding cystourethrography and scintigraphy are considered the gold-standard diagnostic tools to study obstructive anomalies of the urinary tract, however, they do not provide accurate ureteral anatomical details. The aim of our study was to evaluate the concordance between functional magnetic resonance urography (fMRU) and intraoperative findings to define ureteral anomalies distal to UPJ.
    Methods: Pediatric patients with ureteral anomalies distal to the UPJ who underwent surgery after performing fMRU were retrospectively collected. Surgical data were compared with radiological results. The concordance was assessed considering both pathological and non-pathological urinary tracts and was calculated by means of the Cohen's kappa coefficient. fMRU diagnostic accuracy was defined by sensitivity, specificity, and binomial exact confidence intervals.
    Results: We included 46 patients. The sensitivity and specificity of fMRU were 98.0% and 83,3%; positive predictive value 90,4%, negative predictive value 96.2%. The concordance between surgical findings and fMRU was 92,3%, with a k Cohen's coefficient of 0.83 (excellent).
    Conclusions: Our study demonstrates the excellent agreement between fMRU and surgical findings in the definition of ureteral anomalies distal to the UPJ in children. Thus, it could be considered a valid imaging technique in the preoperative planning as it provides the surgeon with important information regarding the etiology and site of the obstruction.
    Language English
    Publishing date 2022-01-26
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 3062664-X
    ISSN 2724-5780
    ISSN (online) 2724-5780
    DOI 10.23736/S2724-5276.22.06462-X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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