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  1. Article ; Online: Artist's Statement: We Are at War.

    Gennai, Stéphane

    Academic medicine : journal of the Association of American Medical Colleges

    2022  Volume 97, Issue 2, Page(s) 199

    Language English
    Publishing date 2022-01-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 96192-9
    ISSN 1938-808X ; 1040-2446
    ISSN (online) 1938-808X
    ISSN 1040-2446
    DOI 10.1097/ACM.0000000000004488
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  2. Article: The Reliability of Ultrasonographic Assessment of Depth of Invasion: A Systematic Review with Meta-Analysis.

    Nisi, Marco / Gennai, Stefano / Graziani, Filippo / Izzetti, Rossana

    Diagnostics (Basel, Switzerland)

    2023  Volume 13, Issue 17

    Abstract: Depth of invasion (DOI) has been recognized to be a strong prognosticator for oral squamous cell carcinoma (OSCC). Several diagnostic techniques can be employed for DOI assessment, however intraoral ultrasonography has been increasingly applied for the ... ...

    Abstract Depth of invasion (DOI) has been recognized to be a strong prognosticator for oral squamous cell carcinoma (OSCC). Several diagnostic techniques can be employed for DOI assessment, however intraoral ultrasonography has been increasingly applied for the intraoral evaluation of OSCCs. The aim of the present study is to review the evidence on the application of intraoral ultrasonography to the assessment of DOI in patients affected by OSCC. A systematic electronic and manual literature search was performed, and data from eligible studies were reviewed, selected, and extracted. The studies had to report the correlation between DOI estimated with ultrasonography versus histopathology. A meta-analysis was conducted on the quantitative data available. Sixteen articles were included in the review following the screening of the initial 228 studies retrieved from the literature. The meta-analysis showed a significant correlation between ultrasonographic and histopathologic measurements (
    Language English
    Publishing date 2023-09-01
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics13172833
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  3. Article ; Online: Anatomical Feasibility of an Off-the-shelf Single-Renal Scalloped Stent-Graft for Hostile Neck Abdominal Aortic Aneurysm: A Preclinical Study.

    Gennai, Stefano / Leone, Nicola / Andreoli, Francesco / Migliari, Mattia / Silingardi, Roberto

    Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists

    2023  , Page(s) 15266028231169164

    Abstract: Objectives: To evaluate the feasibility of a standardized single-renal scallop stent-graft.: Design: Preclinical, single-center, real-world, all-comers, retrospective cohort study.: Methods: A total of 1347 abdominal aortic aneurysm (AAA) repairs ( ...

    Abstract Objectives: To evaluate the feasibility of a standardized single-renal scallop stent-graft.
    Design: Preclinical, single-center, real-world, all-comers, retrospective cohort study.
    Methods: A total of 1347 abdominal aortic aneurysm (AAA) repairs (endovascular and open) performed between 2010 and 2020 were screened for elective treatment and retrievable preoperative high-quality computed tomography angiography (CTA) performed <6 months of the surgical procedure. Six hundred of the included CTAs involved prespecified measurements and a morphological assessment protocol (NCT05150873). The proximal sealing zones suitable for standard stent-graft implantations were further analyzed (N=547). The primary outcome assessed the feasibility of 2 single-renal scallop designs (10×10 mm and 15×10 mm, height × width). The feasibility was the inter-renal length ≥10 mm and ≥15 mm for prototypes #10 and #15, respectively. The secondary outcome quantified hypothetical length and surface improvements comparing those suitable for investigational devices implantation (study group) versus those not (control group).
    Results: Of the total, 24.7% (n=135) was feasible with prototype #10. The study versus control group sealing zones were shorter (p=0.008), with a smaller surface (p=0.009) and a higher alpha angle (p=0.039). The length and surface area increased by about 25% and 23%, respectively, (both p<0.001) within the study group and became significantly better versus the control group (standard stent-graft; both p<0.001). Of the total, 7.1% (n=39) was suitable for prototype #15. The study versus control group sealing zones were shorter (p=0.148), with a smaller surface (p=0.077) and a higher alpha angle (p=0.027). The length and surface area increased by about 34% and 31%, respectively, (both p<0.001) within the study group and became significantly higher versus the control group (standard stent-graft; both p<0.001).
    Conclusions: The use of single-renal scalloped stent-graft might be feasible in a considerable number of AAA patients. The breakthrough stands in treating hostile AAAs presenting in mismatched renal arteries, keeping the complexity of the repair as similar as possible to standard endovascular repair with a remarkable improvement in sealing.
    Clinical impact: The anatomic feasibility of a single renal stent graft for the treatment of "hostile" abdominal aortic aneurysm (AAA) with mismatched renal arteries was evaluated. The experimental device could be feasible in a considerable number of patients with AAA, approaching 25%, and demonstrate significant improvements in sealing. As far as we know, this is the first paper to report the prevalence of mismatched renal arteries in a large cohort of AAA patients in the real world, while proposing a dedicated device. The breakthrough is to keep the complexity of the repair as close as possible to standard endovascular repair.
    Language English
    Publishing date 2023-04-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2006618-1
    ISSN 1545-1550 ; 1526-6028
    ISSN (online) 1545-1550
    ISSN 1526-6028
    DOI 10.1177/15266028231169164
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  4. Article ; Online: Endovascular occlusion of an aortic coarctation after thoracic endovascular aortic repair of an anastomotic aneurysm.

    Covic, Tea / Leone, Nicola / Gennai, Stefano / Silingardi, Roberto

    Diagnostic and interventional radiology (Ankara, Turkey)

    2021  Volume 27, Issue 4, Page(s) 567–569

    Abstract: A 58-year-old man with a history of aortic and mitral mechanical valve replacement was referred to our hospital for symptomatic chronic heart failure. In 1988, he had undergone open surgical correction of an isthmic aortic coarctation (CoA), with the ... ...

    Abstract A 58-year-old man with a history of aortic and mitral mechanical valve replacement was referred to our hospital for symptomatic chronic heart failure. In 1988, he had undergone open surgical correction of an isthmic aortic coarctation (CoA), with the creation of an extra-anatomic bypass from the left subclavian artery to the descending thoracic aorta. The following findings were found: severe mitral valve failure with perivalvular leakage, severe aortic valve stenosis, pulmonary hypertension, distal anastomotic aneurysm with the apparent occlusion of the CoA. A thoracic endovascular aneurysm repair was performed. A postoperative high-pressure leak with no evident signs of ineffective sealing was observed. Computed tomography angiography (CTA) 3D reconstruction demonstrated the recanalization of the CoA. A second procedure was planned. The CoA was anterogradely cannulated. Three coils were deployed into the aneurysmal sac, followed by a vascular plug, positioned on the coarctation conduit, but it failed to anchor and dislocated into the sac. A second plug was deployed, but it also partially dislocated. Finally, a patent foramen ovale occluder device was deployed to occlude the communication. The final angiogram showed the complete occlusion of the coarctation and correction of the leak, which was confirmed by a 6-month post-operative CTA.
    MeSH term(s) Aorta, Thoracic/surgery ; Aortic Aneurysm, Abdominal ; Aortic Aneurysm, Thoracic/diagnostic imaging ; Aortic Aneurysm, Thoracic/surgery ; Aortic Coarctation/diagnostic imaging ; Aortic Coarctation/surgery ; Blood Vessel Prosthesis Implantation ; Endovascular Procedures ; Humans ; Male ; Middle Aged ; Treatment Outcome
    Language English
    Publishing date 2021-08-13
    Publishing country Turkey
    Document type Case Reports ; Journal Article
    ZDB-ID 2184145-7
    ISSN 1305-3612 ; 1305-3612
    ISSN (online) 1305-3612
    ISSN 1305-3612
    DOI 10.5152/dir.2021.20385
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Reliability of OMERACT Scoring System in Ultra-High Frequency Ultrasonography of Minor Salivary Glands: Inter-Rater Agreement Study.

    Izzetti, Rossana / Fulvio, Giovanni / Nisi, Marco / Gennai, Stefano / Graziani, Filippo

    Journal of imaging

    2022  Volume 8, Issue 4

    Abstract: Minor salivary gland ultra-high frequency ultrasonography (UHFUS) has recently been introduced for the evaluation of patients with suspected primary Sjögren’s Syndrome (pSS). At present, ultrasonographic assessment of major salivary glands is performed ... ...

    Abstract Minor salivary gland ultra-high frequency ultrasonography (UHFUS) has recently been introduced for the evaluation of patients with suspected primary Sjögren’s Syndrome (pSS). At present, ultrasonographic assessment of major salivary glands is performed using the Outcome Measures in Rheumatology (OMERACT) scoring system. Previous reports have explored the possibility of applying the OMERACT scoring system to minor salivary glands UHFUS, with promising results. The aim of this study was to test the inter-reader concordance in the assignment of the OMERACT score to minor salivary gland UHFUS. The study was conducted on 170 minor salivary glands UHFUS scans of patients with suspected pSS. Three independent readers performed UHFUS image evaluation. Intraclass correlation coefficient (ICC) was employed to assess inter-reader reliability. Bland and Altman analysis was employed to test the agreement with a gold standard examiner. ICC values > 0.9 were found for scores 0 and 1, while score 2 and score 3 presented ICCs of 0.873 and 0.785, respectively. The measurements performed by the three examiners were in agreement with the gold standard examiner. According to these results, UHFUS interpretation showed good inter-observer reliability, suggesting that OMERACT score can be effectively used for the evaluation of glandular alterations, even for minor salivary glands.
    Language English
    Publishing date 2022-04-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2824270-1
    ISSN 2313-433X ; 2313-433X
    ISSN (online) 2313-433X
    ISSN 2313-433X
    DOI 10.3390/jimaging8040111
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  6. Article ; Online: Treatment of gingivitis is associated with reduction of systemic inflammation and improvement of oral health-related quality of life: A randomized clinical trial.

    Perić, Marina / Marhl, Urska / Gennai, Stefano / Marruganti, Crystal / Graziani, Filippo

    Journal of clinical periodontology

    2022  Volume 49, Issue 9, Page(s) 899–910

    Abstract: Aim: To compare the level of inflammatory markers, oral health-related quality of life (OHRQoL), and gingival parameters 1 month after introduction of electric toothbrush and intensive oral hygiene manoeuvre adaptation (OHI) versus routine habits (no- ... ...

    Abstract Aim: To compare the level of inflammatory markers, oral health-related quality of life (OHRQoL), and gingival parameters 1 month after introduction of electric toothbrush and intensive oral hygiene manoeuvre adaptation (OHI) versus routine habits (no-OHI) in patients affected by generalized gingivitis.
    Materials and methods: One hundred forty subjects with generalized gingivitis were randomized to receive either OHI or no-OHI. Full-mouth plaque/bleeding scores (FMPS/FMBS), serum high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and an oral health impact profile-14 questionnaire were collected at baseline and at 1-month follow-up visit.
    Results: In the OHI, a significant FMPS and FMBS reduction (p < .01), a significant intra-group decrease in hs-CRP and IL-6 (p < .01), and a significant improvement of OHRQoL (p < .01) were noted at 1-month follow-up visit. In the no-OHI, lower-magnitude differences were noted only for oral parameters. Resolution of gingivitis varied between OHI and no-OHI (89% vs. 7%, respectively, p < .01). A logistic multivariate regression suggested that FMBS ≤8% was associated with the odds ratio of 13, having both CRP and IL-6 below the selected threshold for healthy young adults (p = .04).
    Conclusions: Gingivitis resolution determined important reductions of gingival inflammation and plaque levels, as well as systemic inflammatory markers and an improvement of quality of life (NCT03848351).
    MeSH term(s) C-Reactive Protein ; Dental Plaque/prevention & control ; Dental Plaque Index ; Gingivitis/prevention & control ; Humans ; Inflammation ; Interleukin-6 ; Quality of Life ; Single-Blind Method ; Toothbrushing ; Young Adult
    Chemical Substances Interleukin-6 ; C-Reactive Protein (9007-41-4)
    Language English
    Publishing date 2022-07-17
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 188647-2
    ISSN 1600-051X ; 0303-6979
    ISSN (online) 1600-051X
    ISSN 0303-6979
    DOI 10.1111/jcpe.13690
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  7. Article ; Online: Systematic Review and Meta-Analysis of Cerebro-Spinal Fluid Drain-Related Mortality and Morbidity After Fenestrated-Branched Endovascular Aortic Repair.

    Leone, Nicola / D'Oria, Mario / Mani, Kevin / Oderich, Gustavo / Maleti, Gianmarco / Bartolotti, Luigi Am / Silingardi, Roberto / Lepidi, Sandro / Gennai, Stefano

    Journal of vascular surgery

    2024  

    Abstract: Objective: This study aimed to investigate the incidence of cerebrospinal fluid drainage (CSFD)-related complications specifically in patients undergoing fenestrated and branched endovascular aortic repair (F/B-EVAR). This objective was chosen ... ...

    Abstract Objective: This study aimed to investigate the incidence of cerebrospinal fluid drainage (CSFD)-related complications specifically in patients undergoing fenestrated and branched endovascular aortic repair (F/B-EVAR). This objective was chosen considering the limitations and uncertainties surrounding its efficacy in preventing spinal cord injury (SCI).
    Methods: A systematic review following Cochrane Handbook and PRISMA guidelines was conducted (PROSPERO; #CRD42022359223). Literature searches of MEDLINE, Embase, and Scopus were performed until May 1, 2023, focusing on studies published after January 1, 2000. The inclusion criteria encompassed studies reporting on F/B-EVAR, CSFD, and drain-related complications. Data extraction and quality assessment using the Newcastle-Ottawa scale (NOS) were performed by multiple reviewers to ensure accuracy and reliability. A proportion meta-analysis was conducted to calculate the pooled rate and 95% confidence interval (CI). The primary and secondary outcomes were CSFD-related mortality and morbidity, respectively.
    Results: Six retrospective, observational, single-center studies were included, totaling 1 079 patients and 730 CSFD placements (all prophylactic except for one). NOS showed a high to moderate risk of bias. The analysis revealed a CSFD-related mortality rate of 1.4% (95%CI 0.0-4.8; I
    Conclusion: F/B-EVAR patients showed a notable incidence of CSFD-related death and substantial morbidity. This study highlights the limitations of the available data, the high prevalence of complications associated with CSFD, and the need for further research to better understand the risks and benefits of CSFD in F/B-EVAR. This calls for careful consideration regarding the routine use of prophylactic drainage due to the accumulating evidence of the risks associated with CSFD without proven benefit in this specific contex.
    Language English
    Publishing date 2024-04-16
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 605700-7
    ISSN 1097-6809 ; 0741-5214
    ISSN (online) 1097-6809
    ISSN 0741-5214
    DOI 10.1016/j.jvs.2024.04.038
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  8. Article ; Online: Balloon Inducted Re-Lamination and False Lumen Thrombosis in Chronic Type B Aortic Dissection: Technique and Long-Term Results.

    Gennai, Stefano / Andreoli, Francesco / Leone, Nicola / Bartolotti, Luigi Alberto Maria / Covic, Tea / Silingardi, Roberto

    Annals of vascular surgery

    2023  Volume 92, Page(s) 211–221

    Abstract: Background: To evaluate the safety, feasibility, and effectiveness of the BAlloon Inducted re-Lamination and false lUmen Thrombosis (BAILOUT) as a simple technique to address the retrograde false lumen (FL) perfusion and subsequent aneurysmatic ... ...

    Abstract Background: To evaluate the safety, feasibility, and effectiveness of the BAlloon Inducted re-Lamination and false lUmen Thrombosis (BAILOUT) as a simple technique to address the retrograde false lumen (FL) perfusion and subsequent aneurysmatic degeneration of the thoracic aorta due to a stent-graft crimped in a small true lumen in chronic Type B dissections.
    Methods: An observational, retrospective, single-center study analyzing a nonconsecutive cohort of 8 patients affected by chronic type B aortic dissections already treated with thoracic endovascular repair and with an FL lumen backflow corrected with BAILOUT between 2006 and 2020. After a standard distal extension of the previously implanted graft, the distal end of the graft area was ballooned to completely rupture the dissection lamella to relaminate the aorta hindering the FL backflow. Computed tomography was routinely performed within the first postoperative week before discharge and then at 3 months, at 6 months, and yearly thereafter. The technical and clinical success rates were analyzed. Primary outcomes were safety and feasibility of the technique, secondary ones included FL thrombosis evaluation, and total aortic diameter analysis at the above-defined levels during the follow-up. Safety was defined if clinical success was reached. Feasibility was intended as technical success obtention.
    Results: The technical and clinical success achieved was 100% with the complete interruption of FL backflow stating the safety and feasibility of the BAILOUT technique. No early procedure reinterventions were recorded and during a median follow-up of 62.5 months [interquartile range 43.2-94.1], only 1 death unrelated to the procedure was recorded. Freedom from aortic-related adverse events at 1 month, 3 months, 1 year, 5, and 7 years was 87.5%, 62.5%, 62.5%, 62.5%, and 62.5%, respectively. During the follow-up, no one increment of the diameter of the thoracic aorta was documented and all the patients at 3 years of computed tomography angiography showed a complete FL thrombosis.
    Conclusions: The BAILOUT technique demonstrates to be safe and feasible in this small cohort of patients as a simple and quick way to overcome the issue of FL backflow in chronic type B dissection. Small cohort and retrospective designs were limitations of the study.
    MeSH term(s) Humans ; Aortic Aneurysm, Thoracic/diagnostic imaging ; Aortic Aneurysm, Thoracic/surgery ; Aortic Aneurysm, Thoracic/etiology ; Blood Vessel Prosthesis Implantation/adverse effects ; Blood Vessel Prosthesis Implantation/methods ; Retrospective Studies ; Treatment Outcome ; Aortic Dissection/diagnostic imaging ; Aortic Dissection/surgery ; Stents ; Thrombosis/diagnostic imaging ; Thrombosis/etiology ; Thrombosis/surgery ; Endovascular Procedures/adverse effects ; Endovascular Procedures/methods
    Language English
    Publishing date 2023-01-13
    Publishing country Netherlands
    Document type Observational Study ; Journal Article
    ZDB-ID 1027366-9
    ISSN 1615-5947 ; 0890-5096
    ISSN (online) 1615-5947
    ISSN 0890-5096
    DOI 10.1016/j.avsg.2022.12.091
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  9. Article ; Online: Anatomical suitability for branched endovascular aortic arch repair and balloon-expandable bridging stent grafts in a cohort of patients previously treated with a hybrid approach.

    Leone, Nicola / Bartolotti, Luigi Alberto Maria / Baresi, Giovanni Francesco / Silingardi, Roberto / Resch, Timothy Andrew / Gennai, Stefano

    Journal of vascular surgery

    2023  Volume 79, Issue 2, Page(s) 198–206.e15

    Abstract: Objective: We assessed the suitability of two triple branch arch devices (aBranch) (Terumo aortic and Cook Medical) and a balloon-expandable covered stent (VBX, W. L. Gore & Associates, Johnson & Johnson) to incorporate the brachiocephalic trunk (BCT) ... ...

    Abstract Objective: We assessed the suitability of two triple branch arch devices (aBranch) (Terumo aortic and Cook Medical) and a balloon-expandable covered stent (VBX, W. L. Gore & Associates, Johnson & Johnson) to incorporate the brachiocephalic trunk (BCT) in a cohort previously treated with hybrid thoracic endovascular repair (TEVAR).
    Methods: This is a single-center, retrospective, all-comers, preclinical suitability study. We conducted an analysis of preoperative computed tomography scans in surgical patients between 1999 and 2022 in a single vascular surgery unit. The primary outcome was the aortic suitability of aBranch devices and VBX as mating stent for BCT in previous hybrid TEVAR. Hybrid repair of the aortic arch included TEVAR, fenestrated or branched TEVAR associated with any surgical debranching of the supra-aortic trunks and chimney TEVAR with proximal landing in zones 0 to 2. Secondary outcomes included (i) suitability assessment when excluding minor instruction for use (IFU) criteria, (ii) a comparison of suitable and nonsuitable patients, (iii) risk factors analysis for nonsuitability, and (iv) a description of the exclusion causes.
    Results: During the study period, 120 patients were treated. Among elective patients (n = 73), the suitability of any aBranch was 82.2% (60/73) and VBX was suitable in 64.4% of BCTs (47/73). The aBranch suitable patients had a significantly longer sinotubular-BCT length (P = .017) and smaller distal ascending aorta (P = .043) as compared with nonsuitable ones. The suitability of Terumo Aortic and Cook Medical devices was 52.1% (38/73) and 46.6% (34/73), respectively. When minor IFU criteria were ignored, suitability increased to 82.2% (60/73) and 63.0% (46/73), respectively. Left common carotid artery diameter and sinotubular-BCT length were significant nonsuitability risk factors for Terumo Aortic aBranch in multivariable analysis. No associations were found for Cook Medical device. The outcomes were tested in the entire cohort demonstrating a global suitability of 82.9%, increasing to 86.3% when ignoring minor IFUs. VBX was anatomically suitable to use in BCT in 73.2% of patient BCTs.
    Conclusions: aBranch devices are anatomically suitable in a vast majority of patients (86%) undergoing hybrid TEVAR. The innominate artery seems eligible for incorporation with VBX in almost two-thirds of patients. This mating stent may help to overcome some minor IFU restrictions.
    MeSH term(s) Humans ; Blood Vessel Prosthesis ; Aorta, Thoracic/diagnostic imaging ; Aorta, Thoracic/surgery ; Endovascular Aneurysm Repair ; Blood Vessel Prosthesis Implantation/adverse effects ; Aortic Aneurysm, Thoracic/diagnostic imaging ; Aortic Aneurysm, Thoracic/surgery ; Aortic Aneurysm, Thoracic/etiology ; Retrospective Studies ; Endovascular Procedures/adverse effects ; Prosthesis Design ; Stents ; Treatment Outcome
    Language English
    Publishing date 2023-11-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605700-7
    ISSN 1097-6809 ; 0741-5214
    ISSN (online) 1097-6809
    ISSN 0741-5214
    DOI 10.1016/j.jvs.2023.11.011
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  10. Article ; Online: An emergency department organizational assessment questionnaire: a Delphi study to create standardized comparators for emergency department directors.

    Abensur Vuillaume, Laure / Gennai, Stéphane / Casalino, Enrique / Tazarourte, Karim / Bilbault, Pascal

    European journal of emergency medicine : official journal of the European Society for Emergency Medicine

    2023  Volume 30, Issue 3, Page(s) 209–210

    MeSH term(s) Humans ; Delphi Technique ; Emergency Service, Hospital ; Emergency Medicine ; Surveys and Questionnaires
    Language English
    Publishing date 2023-04-24
    Publishing country England
    Document type Letter
    ZDB-ID 1233544-7
    ISSN 1473-5695 ; 0969-9546
    ISSN (online) 1473-5695
    ISSN 0969-9546
    DOI 10.1097/MEJ.0000000000001003
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