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  1. Article ; Online: The learning curve for using intestinal ultrasonography.

    Bezzio, Cristina / Saibeni, Simone / Vernero, Marta / Furfaro, Federica / Monteleone, Michela / Ribaldone, Davide / Fiorino, Gionata / Friedman, Antony B / Armuzzi, Alessandro / Scalvini, Davide / Maconi, Giovanni

    Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

    2024  

    Abstract: Background and aims: Intestinal ultrasonography (IUS) is challenging to learn. This prospective study examined how the accuracy of IUS increases with operator experience ("learning curve") and if prior abdominal ultrasound experience facilitates the ... ...

    Abstract Background and aims: Intestinal ultrasonography (IUS) is challenging to learn. This prospective study examined how the accuracy of IUS increases with operator experience ("learning curve") and if prior abdominal ultrasound experience facilitates the learning process.
    Methods: The study included two trainees with limited abdominal ultrasound experience (< 50 exams) and two with extensive experience (> 500 exams). Each trainee performed 99 examinations and reported four IUS findings. An expert sonographer repeated the exam, and concordance (k) between the expert and trainees was assessed in three consecutive testing periods of 33 exams each.
    Results: A progressive improvement in concordance was observed for all IUS findings from Period 1 to Period 3, overall and for both groups of trainees, although those with experience in abdominal ultrasound had faster learning curves. The minimum number of examinations required to achieve concordance with the expert operator for detecting increased bowel wall thickness was 84 and detecting bowel dilatation was 79. However, a minimum of 97 examinations was necessary to achieve concordance for detecting intra-abdominal complications, considered an advanced IUS competence.
    Conclusion: Basic competence in IUS can be acquired with relatively few examinations, while advanced competence requires more extensive training, particularly for gastroenterologists without abdominal ultrasound experience.
    Language English
    Publishing date 2024-02-05
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1459373-7
    ISSN 1878-3562 ; 1125-8055
    ISSN (online) 1878-3562
    ISSN 1125-8055
    DOI 10.1016/j.dld.2024.01.192
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Late Bowel Iischemia and Colovaginal Fistula after Low Anterior Resection in a COVID-19 Patient.

    Costanzi, Andrea / Monteleone, Michela / Confalonieri, Marco / Colletti, Gaia / Frattaruolo, Colomba / Fingerhut, Abe

    Chirurgia (Bucharest, Romania : 1990)

    2020  Volume 115, Issue 5, Page(s) 677–680

    Abstract: The spread of SARS-CoV-2 in Italy has been rapid, with over 230.000 infections and 33.000 deaths (May 31st, 2020). The full impact of COVID19 on surgery is still unknown, as its effects on healthcare strategy, hospital infrastructure, staff, regional ... ...

    Abstract The spread of SARS-CoV-2 in Italy has been rapid, with over 230.000 infections and 33.000 deaths (May 31st, 2020). The full impact of COVID19 on surgery is still unknown, as its effects on healthcare strategy, hospital infrastructure, staff, regional economy and colorectal disease progression, may not be evident before several months. No systematic reports are available about a higher incidence of COVID19 infections in patients with cancer. However, available data indicate that older people are more vulnerable, particularly when there are underlying health conditions such as chemotherapy or active cancer. Herein, we present the case of a patient with rectal cancer treated with pull-through technique low anterior rectal resection and coloanal anastomosis with protective loop ileostomy, complicated with Sars-CoV-2 infection and late (31st post-operative day) colic ischemia with colo-vaginal fistula. Late intestinal ischemia is a rare complication and can be secondary to several traditional factors, but certainly small vessel thrombosis related to Coronavirus disease must be taken into consideration.
    MeSH term(s) Aged ; Betacoronavirus ; COVID-19 ; Colon/pathology ; Colon/surgery ; Coronavirus Infections/complications ; Female ; Humans ; Ischemia/complications ; Ischemia/surgery ; Italy ; Pandemics ; Pneumonia, Viral/complications ; SARS-CoV-2 ; Treatment Outcome ; Vaginal Fistula/complications ; Vaginal Fistula/surgery
    Keywords covid19
    Language English
    Publishing date 2020-09-17
    Publishing country Romania
    Document type Case Reports ; Journal Article
    ZDB-ID 419244-8
    ISSN 1842-368X ; 1221-9118 ; 0009-4730 ; 0377-5003
    ISSN (online) 1842-368X
    ISSN 1221-9118 ; 0009-4730 ; 0377-5003
    DOI 10.21614/chirurgia.115.5.677
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Postrecurrence Survival After Liver Transplantation for Liver Metastases From Neuroendocrine Tumors.

    Sposito, Carlo / Rossi, Roberta Elisa / Monteleone, Michela / Coppa, Jorgelina / Bongini, Marco / Milione, Massimo / Bhoori, Sherrie / Mazzaferro, Vincenzo

    Transplantation

    2021  Volume 105, Issue 12, Page(s) 2579–2586

    Abstract: Background: Liver metastases from neuroendocrine tumors (NETs) are an accepted indication for liver transplantation (LT). Despite strict patient selection, post-LT recurrence is observed in 30%-50% of cases. Postrecurrence survival is poorly ... ...

    Abstract Background: Liver metastases from neuroendocrine tumors (NETs) are an accepted indication for liver transplantation (LT). Despite strict patient selection, post-LT recurrence is observed in 30%-50% of cases. Postrecurrence survival is poorly investigated as well as factors influencing postrecurrence outcomes.
    Methods: Consecutive patients treated at a single institution for post-LT recurrence of NET between January 1, 2004, and December 31, 2018, were included. Baseline patients' characteristics, data on the primary tumor, pretransplant therapies, posttransplant recurrence and treatments, and long-term outcomes were prospectively collected and retrospectively analyzed.
    Results: Thirty-two patients presented with post-LT NET recurrence occurring 82.9 mo (interquartile range, 29.4-119.1 mo) from LT, and the most common sites were abdominal lymph nodes (59.4%), peritoneum (6.3%), and lungs (6.3%). Fourteen patients (43.8%) underwent surgery with radical intent. Five- and 10-y survival after recurrence were 76.3% and 45.5%, respectively. Only time from LT to recurrence had a significant impact on postrecurrence survival, being 5-y overall survival 89.5% versus 0% for patients recurring >24 mo after LT versus ≤24 mo, respectively (P = 0.001). Moreover, for patients with Ki-67 monoclonal antibody staining >2% at recurrence, 5 y overall survival was 87.5% versus 0% for those undergoing surgery versus locoregional or systemic treatments (P = 0.011).
    Conclusions: The presented results, although based on a retrospective and relatively small series, show that excellent long-term survival is observed after post-LT NET recurrence, particularly in those patients recurring long after LT (>24 mo). An aggressive surgical treatment might result in a new chance of cure for a selected subgroup of patients.
    MeSH term(s) Carcinoma, Hepatocellular ; Humans ; Liver Neoplasms ; Liver Transplantation/adverse effects ; Neoplasm Recurrence, Local/etiology ; Neuroendocrine Tumors/surgery ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2021-04-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 208424-7
    ISSN 1534-6080 ; 0041-1337
    ISSN (online) 1534-6080
    ISSN 0041-1337
    DOI 10.1097/TP.0000000000003802
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: A rare challenge in general surgery: double surgical procedure for large and small bowel obstruction in a patient with Gerstmann- Sträussler-Scheinker syndrome.

    Costanzi, Andrea / Monteleone, Michela / Berardi, Valter / Miranda, Angelo / Mari, Giulio / Maggioni, Dario

    Intractable & rare diseases research

    2019  Volume 10, Issue 1, Page(s) 52–54

    Abstract: Gerstmann-Sträussler-Scheinker syndrome (GSS) is a rare, infectious syndrome related to a mutation in the prion protein gene. Described here are the challenges posed by surgery for a patient with GSS. A 61-yr-old woman with GSS was admitted to this ... ...

    Abstract Gerstmann-Sträussler-Scheinker syndrome (GSS) is a rare, infectious syndrome related to a mutation in the prion protein gene. Described here are the challenges posed by surgery for a patient with GSS. A 61-yr-old woman with GSS was admitted to this department and underwent surgery twice for large and small bowel obstruction. This is the first report of two major surgical procedures in a patient with GSS. Experiences with this case and precautions when using a disposable device during endotracheal intubation and a surgical procedure to manage a patient with GSS are described.
    Language English
    Publishing date 2019-08-30
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 2672570-8
    ISSN 2186-361X ; 2186-3644
    ISSN (online) 2186-361X
    ISSN 2186-3644
    DOI 10.5582/irdr.2020.03116
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: COVID-19 and acute perforated diverticulitis: management and surgical timing.

    Costanzi, Andrea / Monteleone, Michela / Confalonieri, Marco / Colletti, Gaia / Frattaruolo, Colomba / Magni, Carla / Corizia, Lucia / Fingerhut, Abe

    Minerva chirurgica

    2020  Volume 75, Issue 6, Page(s) 468–470

    MeSH term(s) COVID-19/complications ; COVID-19/diagnostic imaging ; Diverticulitis, Colonic/complications ; Diverticulitis, Colonic/diagnostic imaging ; Diverticulitis, Colonic/surgery ; Humans ; Hypertension/drug therapy ; Intestinal Perforation/complications ; Intestinal Perforation/diagnostic imaging ; Intestinal Perforation/surgery ; Male ; Middle Aged ; Respiratory Distress Syndrome/etiology ; SARS-CoV-2 ; Tomography, X-Ray Computed
    Keywords covid19
    Language English
    Publishing date 2020-09-25
    Publishing country Italy
    Document type Case Reports ; Letter
    ZDB-ID 123603-9
    ISSN 1827-1626 ; 0026-4733
    ISSN (online) 1827-1626
    ISSN 0026-4733
    DOI 10.23736/S0026-4733.20.08487-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Adjuvant radiotherapy in urothelial neuroendocrine carcinoma.

    Rossi, Roberta E / Monteleone, Michela / Altomare, Michele / Cattaneo, Laura / Torchio, Martina / Coppa, Jorgelina / Mazzaferro, Vincenzo

    Minerva chirurgica

    2020  Volume 75, Issue 3, Page(s) 210–212

    MeSH term(s) Aged ; Carcinoma, Neuroendocrine/diagnostic imaging ; Carcinoma, Neuroendocrine/drug therapy ; Carcinoma, Neuroendocrine/radiotherapy ; Female ; Humans ; Positron-Emission Tomography ; Radiotherapy, Adjuvant ; Rare Diseases/diagnostic imaging ; Rare Diseases/drug therapy ; Rare Diseases/radiotherapy ; Tomography, X-Ray Computed ; Ureteral Neoplasms/diagnostic imaging ; Ureteral Neoplasms/drug therapy ; Ureteral Neoplasms/radiotherapy
    Language English
    Publishing date 2020-02-20
    Publishing country Italy
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 123603-9
    ISSN 1827-1626 ; 0026-4733
    ISSN (online) 1827-1626
    ISSN 0026-4733
    DOI 10.23736/S0026-4733.20.08259-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Hepatocellular Carcinoma in Abernethy Malformation: A Rare Occurrence of Congenital Complete Portosystemic Shunt.

    Virdis, Matteo / Monteleone, Michela / Sposito, Carlo / Cascella, Tommaso / Pellegrinelli, Alessandro / Mazzaferro, Vincenzo

    Journal of vascular and interventional radiology : JVIR

    2018  Volume 29, Issue 12, Page(s) 1775–1778

    MeSH term(s) Aged ; Angiography, Digital Subtraction ; Biopsy ; Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/etiology ; Carcinoma, Hepatocellular/physiopathology ; Carcinoma, Hepatocellular/radiotherapy ; Computed Tomography Angiography ; Embolization, Therapeutic/methods ; Female ; Humans ; Liver Circulation ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/etiology ; Liver Neoplasms/physiopathology ; Liver Neoplasms/radiotherapy ; Phlebography/methods ; Portal Vein/abnormalities ; Portal Vein/diagnostic imaging ; Portal Vein/physiopathology ; Radiopharmaceuticals/administration & dosage ; Single Photon Emission Computed Tomography Computed Tomography ; Treatment Outcome ; Vascular Malformations/complications ; Vascular Malformations/diagnostic imaging ; Vascular Malformations/physiopathology ; Yttrium Radioisotopes/administration & dosage
    Chemical Substances Radiopharmaceuticals ; Yttrium Radioisotopes ; Yttrium-90 (1K8M7UR6O1)
    Language English
    Publishing date 2018-10-30
    Publishing country United States
    Document type Case Reports ; Letter
    ZDB-ID 1137756-2
    ISSN 1535-7732 ; 1051-0443
    ISSN (online) 1535-7732
    ISSN 1051-0443
    DOI 10.1016/j.jvir.2018.07.014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Late Bowel Iischemia and Colovaginal Fistula after Low Anterior Resection in a COVID-19 Patient

    Costanzi, Andrea / Monteleone, Michela / Confalonieri, Marco / Colletti, Gaia / Frattaruolo, Colomba / Fingerhut, Abe

    Chirurgia (Bucur)

    Abstract: The spread of SARS-CoV-2 in Italy has been rapid, with over 230.000 infections and 33.000 deaths (May 31st, 2020). The full impact of COVID19 on surgery is still unknown, as its effects on healthcare strategy, hospital infrastructure, staff, regional ... ...

    Abstract The spread of SARS-CoV-2 in Italy has been rapid, with over 230.000 infections and 33.000 deaths (May 31st, 2020). The full impact of COVID19 on surgery is still unknown, as its effects on healthcare strategy, hospital infrastructure, staff, regional economy and colorectal disease progression, may not be evident before several months. No systematic reports are available about a higher incidence of COVID19 infections in patients with cancer. However, available data indicate that older people are more vulnerable, particularly when there are underlying health conditions such as chemotherapy or active cancer. Herein, we present the case of a patient with rectal cancer treated with pull-through technique low anterior rectal resection and coloanal anastomosis with protective loop ileostomy, complicated with Sars-CoV-2 infection and late (31st post-operative day) colic ischemia with colo-vaginal fistula. Late intestinal ischemia is a rare complication and can be secondary to several traditional factors, but certainly small vessel thrombosis related to Coronavirus disease must be taken into consideration.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #903188
    Database COVID19

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  9. Article: The potential role of metformin in the treatment of patients with pancreatic neuroendocrine tumors: a review of preclinical to clinical evidence.

    Pusceddu, Sara / Vernieri, Claudio / Prinzi, Natalie / Torchio, Martina / Coppa, Jorgelina / Antista, Maria / Niger, Monica / Milione, Massimo / Giacomelli, Luca / Corti, Francesca / Prisciandaro, Michele / Monteleone, Michela / Colombo, Elena / Di Bartolomeo, Maria / de Braud, Filppo

    Therapeutic advances in gastroenterology

    2020  Volume 13, Page(s) 1756284820927271

    Abstract: The incidence of pancreatic neuroendocrine tumors (panNETs) has increased worldwide in the last two decades. Given the indolent nature of these tumors, several patients are diagnosed with metastatic disease, which partially impairs the long-term efficacy ...

    Abstract The incidence of pancreatic neuroendocrine tumors (panNETs) has increased worldwide in the last two decades. Given the indolent nature of these tumors, several patients are diagnosed with metastatic disease, which partially impairs the long-term efficacy of currently available treatments and reduces survival rates. The search for new therapeutic strategies for cancer patients has pushed towards the retrospective analysis of studies involving patients who concomitantly received other drugs together with standard anticancer agents. In this light, several retrospective analyses have shown that metformin use is associated with improved prognosis in patients with different tumor types treated with standard antitumor agents. Metformin, the cornerstone oral agent for the treatment of type 2 diabetes, plays a role in modulating glucose cell metabolism. Its potential ability to interfere with tumors may derive from the tight relationship between metabolic reprogramming in cancer cells and tumor progression. Indications for metformin use as an anticancer drug result from pre-clinical and clinical observations. In particular, metformin use in diabetic patients with advanced panNETs has been associated with better progression-free survival in patients treated with somatostatin analogues with or without metformin.
    Language English
    Publishing date 2020-07-31
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2440710-0
    ISSN 1756-2848 ; 1756-283X
    ISSN (online) 1756-2848
    ISSN 1756-283X
    DOI 10.1177/1756284820927271
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Preoperative predictors of liver decompensation after mini-invasive liver resection.

    Sposito, Carlo / Monteleone, Michela / Aldrighetti, Luca / Cillo, Umberto / Dalla Valle, Raffaele / Guglielmi, Alfredo / Ettorre, Giuseppe Maria / Ferrero, Alessandro / Di Benedetto, Fabrizio / Rossi, Giorgio Ettore / De Carlis, Luciano / Giuliante, Felice / Mazzaferro, Vincenzo

    Surgical endoscopy

    2020  Volume 35, Issue 2, Page(s) 718–727

    Abstract: Background: Post-hepatectomy liver failure (PHLF) represents the most frequent complication after liver surgery, and the most common cause of morbidity and mortality. Aim of the study is to identify the predictors of PHLF after mini-invasive liver ... ...

    Abstract Background: Post-hepatectomy liver failure (PHLF) represents the most frequent complication after liver surgery, and the most common cause of morbidity and mortality. Aim of the study is to identify the predictors of PHLF after mini-invasive liver surgery in cirrhosis and chronic liver disease, and to develop a model for risk prediction.
    Methods: The present study is a multicentric prospective cohort study on 490 consecutive patients who underwent mini-invasive liver resection from the Italian Registry of Mini-invasive Liver Surgery (I go MILS). Retrospective additional biochemical and clinical data were collected.
    Results: On 490 patients (26.5% females), PHLF occurred in 89 patients (18.2%). The only independent predictors of PHLF were Albumin-Bilirubin (ALBI) score (OR 3.213; 95% CI 1.661-6.215; p < .0.0001) and presence of ascites (OR 3.320; 95% CI 1.468-7.508; p = 0.004). Classification and regression tree (CART) modeling led to the identification of three risk groups: PHLF occurred in 23/217 patients with ALBI grade 1 (10.6%, low risk group), in 54/254 patients with ALBI score 2 or 3 and absence of ascites (21.3%, intermediate risk group) and in 12/19 patients with ALBI score 2 or 3 and evidence of ascites (63.2%, high risk group), p < 0.0001. The three groups showed a corresponding increase in postoperative complications (20.0%, 27.5% and 66.7%), Comprehensive Complication Index (5.1 ± 11.1, 6.0 ± 10.9 and 18.8 ± 18.9) and hospital stay (6.0 ± 4.0, 6.0 ± 6.0 and 8.0 ± 5.0 days).
    Conclusion: The risk of PHLF can be stratified by determining two easily available preoperative factors: ALBI and ascites. This model of risk prediction offers an objective instrument for a correct clinical decision-making.
    MeSH term(s) Aged ; Carcinoma, Hepatocellular/complications ; Carcinoma, Hepatocellular/surgery ; Cohort Studies ; Female ; Hepatectomy/adverse effects ; Humans ; Liver Failure/etiology ; Liver Neoplasms/complications ; Liver Neoplasms/surgery ; Male ; Preoperative Period ; Prospective Studies ; Retrospective Studies ; Risk Factors
    Language English
    Publishing date 2020-03-02
    Publishing country Germany
    Document type Journal Article ; Multicenter Study
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-020-07438-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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