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Article ; Online: Prostatic Neoplasia in the Intact and Castrated Dog

Magdalena Schrank / Stefano Romagnoli

Animals, Vol 10, Iss 1, p

How Dangerous is Castration?

2020 Volume 85

Abstract: Elective gonadectomy in the dog is a topic of interest for clinicians, pet-owners, and society. Although canine prostatic neoplasia (CPN) has a low incidence (0.35%), reports of an increased risk for castrated dogs attract attention and cause concern in ... ...

Abstract	Elective gonadectomy in the dog is a topic of interest for clinicians, pet-owners, and society. Although canine prostatic neoplasia (CPN) has a low incidence (0.35%), reports of an increased risk for castrated dogs attract attention and cause concern in pet-owners. Our aim is to provide professionals and non-professionals with a detailed description of this possible side effect of gonadectomy in the dog. The mean age at diagnosis of CPN ranges from 8.5 to 11.2 years. Medium to large size breeds are more frequently affected. Symptoms and findings of non-invasive examinations are not pathognomonic, therefore, cytological or histological examinations are needed for diagnosis. Overall, the incidence of metastasis reaches up to 80%, yet lung metastasis reportedly has no negative impact on median survival time (MST). It has been reported that castrated males have a significantly higher MST than intact males. Differences in inclusion criteria for studied populations make a comparison of studies difficult. Citation of odds ratios without consideration of the context of the reference may result in premature conclusions. We conclude that elective gonadectomy of adult male dogs under six years of age cannot be excluded from the veterinary practice due to concern of causing CPN until clear and strong evidence is available.
Keywords	dog ; castration ; gonadectomy ; prostatic neoplasms ; prostate cancer ; Veterinary medicine ; SF600-1100 ; Zoology ; QL1-991
Subject code	630
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Chronic Use of Deslorelin in Dogs

Stefano Romagnoli / Alice Diana / Lluis Ferré-Dolcet / Christelle Fontaine / Chiara Milani

Animals, Vol 13, Iss 265, p

Six Cases (2005–2022)

2023 Volume 265

Abstract: Deslorelin is currently registered for the induction of temporary infertility in male dogs, male cats, male ferrets, and also prepubertal female dogs, but research has shown its usefulness for other conditions requiring chronic treatment. This paper ... ...

Abstract	Deslorelin is currently registered for the induction of temporary infertility in male dogs, male cats, male ferrets, and also prepubertal female dogs, but research has shown its usefulness for other conditions requiring chronic treatment. This paper presents six cases of dogs chronically treated with deslorelin for indications such as benign prostatic hyperplasia, control of fertility, abnormal reproductive behavior and urinary incontinence. All animals were in good health during treatment. Treatment duration was 2–9 years. No short-term side effects were observed except for flare-up reactions, which were observed only in 1/4 intact males. Two dogs developed a neoplasia: a spayed bitch treated for urinary incontinence developed a pituitary carcinoma, and an intact male dog implanted for control of fertility developed a bladder carcinoma. While the pituitary carcinoma seems unlikely to be related to deslorelin, the bladder carcinoma could be due to the neutered condition of the dog (which was treated for 9 years) as urinary tract neoplasia is more common in dogs following gonadectomy. Chronic treatment with deslorelin is regarded as safe when an animal is being treated for life. The possibility that a pause in the treatment might be helpful for the animal should be investigated.
Keywords	benign prostatic hyperplasia ; chronic treatment ; control of reproductive behavior ; deslorelin ; dog ; urinary incontinence ; Veterinary medicine ; SF600-1100 ; Zoology ; QL1-991
Subject code	630
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The new SUMPOT to predict postoperative complications using an Artificial Neural Network

Cosimo Chelazzi / Gianluca Villa / Andrea Manno / Viola Ranfagni / Eleonora Gemmi / Stefano Romagnoli

Scientific Reports, Vol 11, Iss 1, Pp 1-

2021 Volume 12

Abstract: Abstract An accurate assessment of preoperative risk may improve use of hospital resources and reduce morbidity and mortality in high-risk surgical patients. This study aims at implementing an automated surgical risk calculator based on Artificial Neural ...

Abstract	Abstract An accurate assessment of preoperative risk may improve use of hospital resources and reduce morbidity and mortality in high-risk surgical patients. This study aims at implementing an automated surgical risk calculator based on Artificial Neural Network technology to identify patients at risk for postoperative complications. We developed the new SUMPOT based on risk factors previously used in other scoring systems and tested it in a cohort of 560 surgical patients undergoing elective or emergency procedures and subsequently admitted to intensive care units, high-dependency units or standard wards. The whole dataset was divided into a training set, to train the predictive model, and a testing set, to assess generalization performance. The effectiveness of the Artificial Neural Network is a measure of the accuracy in detecting those patients who will develop postoperative complications. A total of 560 surgical patients entered the analysis. Among them, 77 patients (13.7%) suffered from one or more postoperative complications (PoCs), while 483 patients (86.3%) did not. The trained Artificial Neural Network returned an average classification accuracy of 90% in the testing set. Specifically, classification accuracy was 90.2% in the control group (46 patients out of 51 were correctly classified) and 88.9% in the PoC group (8 patients out of 9 were correctly classified). The Artificial Neural Network showed good performance in predicting presence/absence of postoperative complications, suggesting its potential value for perioperative management of surgical patients. Further clinical studies are required to confirm its applicability in routine clinical practice.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Potential therapeutic role of pharmacological sympathectomy in Martorell ulcer

Mirko Baglivo / Manuela Baronio / Nina Arnelle Dieumo Ngongan / Stefano Romagnoli / Raffaele De Gaudio / Matteo Bertelli

Advances in Dermatology and Allergology, Vol 38, Iss 6, Pp 1112-

2022 Volume 1114

Abstract: Martorell ulcer (MU) is a rare complication of arterial hypertension. It was first described in 1945 by the Spanish cardiologist Fernando Martorell, who reported 4 clinical cases [1]. A few cases of MU have been treated with pharmacological sympathectomy ...

Abstract	Martorell ulcer (MU) is a rare complication of arterial hypertension. It was first described in 1945 by the Spanish cardiologist Fernando Martorell, who reported 4 clinical cases [1]. A few cases of MU have been treated with pharmacological sympathectomy [2]. Here we report another small group of cases of MU treated in this manner. Sixteen patients with MU, aged 69 to 92 years, were selected. A precise diagnosis of MU was made by checking the Martorell diagnostic inclusion criteria: anterolateral site in the lower third of the leg, diastolic hypertension in the lower third of the leg, hyperpulsation of the arteries of the leg, absence of arterial calcification and other causes of the ulcer, possible presence of symmetrical lesions and stronger pain in the horizontal position [1].
Keywords	Dermatology ; RL1-803 ; Internal medicine ; RC31-1245
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Termedia Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Interval between Removal of a 4.7 mg Deslorelin Implant after a 3-, 6-, and 9-Month Treatment and Restoration of Testicular Function in Tomcats

Lluis Ferré-Dolcet / Lisa Carniello / Silvia Ferro / Andrea Cattai / Stefano Romagnoli / Antonio Mollo

Animals, Vol 10, Iss 1559, p

2020 Volume 1559

Abstract: Deslorelin implants have been used to produce a reversible sterilization in several species. In cats, the prolonged duration (12–15 months in tomcats and 18–22 months in queen) is often too much for cat breeders who request early implant removal. The ... ...

Abstract	Deslorelin implants have been used to produce a reversible sterilization in several species. In cats, the prolonged duration (12–15 months in tomcats and 18–22 months in queen) is often too much for cat breeders who request early implant removal. The interval between implant removal and resumption of reproductive function in cats has never been investigated. Eighteen tomcats received a 4.7 mg deslorelin implant placed in the periumbilical area and surgically removed during all seasons of the year after 3, 6, or 9 months (n = 6, 6, and 6 cats, respectively). Following implant removal, all cats received a clinical exam every two weeks, including testicular ultrasonographic measurement, observation of penile spikes, and blood collection for serum testosterone assay. Restoration of serum testosterone secretion occurred after 23 ± 6, 23 ± 6, and 22 ± 7 days in the 3-, 6-, and 9-month groups, respectively. Restoration of testicular function was confirmed by histology in 13/15 cats undergoing orchiectomy at the end of the study while the owners of the remaining two cats opted to maintain their animals intact. Removal of a 4.7 mg deslorelin implant after 3, 6, or 9 months is followed by resumption of serum testosterone secretion after about 3 weeks independent of age or season.
Keywords	deslorelin ; testosterone ; reproductive function restoration ; breeding ; Veterinary medicine ; SF600-1100 ; Zoology ; QL1-991
Subject code	630
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: How to measure blood pressure using an arterial catheter

Bernd Saugel / Karim Kouz / Agnes S. Meidert / Leonie Schulte-Uentrop / Stefano Romagnoli

Critical Care, Vol 24, Iss 1, Pp 1-

a systematic 5-step approach

2020 Volume 10

Abstract: Abstract Arterial blood pressure (BP) is a fundamental cardiovascular variable, is routinely measured in perioperative and intensive care medicine, and has a significant impact on patient management. The clinical reference method for BP monitoring in ... ...

Abstract	Abstract Arterial blood pressure (BP) is a fundamental cardiovascular variable, is routinely measured in perioperative and intensive care medicine, and has a significant impact on patient management. The clinical reference method for BP monitoring in high-risk surgical patients and critically ill patients is continuous invasive BP measurement using an arterial catheter. A key prerequisite for correct invasive BP monitoring using an arterial catheter is an in-depth understanding of the measurement principle, of BP waveform quality criteria, and of common pitfalls that can falsify BP readings. Here, we describe how to place an arterial catheter, correctly measure BP, and identify and solve common pitfalls. We focus on 5 important steps, namely (1) how to choose the catheter insertion site, (2) how to choose the type of arterial catheter, (3) how to place the arterial catheter, (4) how to level and zero the transducer, and (5) how to check the quality of the BP waveform.
Keywords	Cardiovascular dynamics ; Hemodynamic monitoring ; Patient monitoring ; Critical care ; Intensive care medicine ; Anesthesia ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9
Language	English
Publishing date	2020-04-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The criteria of “inoperability”

Stefano Romagnoli / Laura Paparella / Paolo Boninsegni

Monaldi Archives for Chest Disease, Vol 87, Iss

2017 Volume 2

Abstract: In the literature, the term “inoperable” mainly refers to two specific clinical aspects: cancer staging and technical difficulty/impossibility in performing. In light of this clarification, the statement “the patient cannot be anesthetized” has no ... ...

Abstract	In the literature, the term “inoperable” mainly refers to two specific clinical aspects: cancer staging and technical difficulty/impossibility in performing. In light of this clarification, the statement “the patient cannot be anesthetized” has no medical foundation. On the contrary, the physicians have to carefully stratify the perioperative risk and optimize the patients’ preoperative clinical status. In order to perform a precise risk stratification, the European Society of Cardiology and the European Society of Anaesthesiology have joined and published the guidelines for the perioperative cardiovascular management of patients scheduled to undergo non-cardiac surgery. The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) represents the most complete and accurate prediction tool so far. It includes 21 preoperative factors relating to demographics, comorbidities and procedures able to predict outcomes based on preoperative risk factors such as death, cardiac complications, pneumonia, and acute kidney injury. The present article will address aspects related to common aspects concerning modifiable and non-modifiable that should be addressed in every patient to whom elective surgery has been scheduled.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2017-07-01T00:00:00Z
Publisher	PAGEPress Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Renal Replacement Therapy [version 1; referees

Zaccaria Ricci / Stefano Romagnoli / Claudio Ronco

F1000Research, Vol

4 approved]

2016 Volume 5

Abstract: During the last few years, due to medical and surgical evolution, patients with increasingly severe diseases causing multiorgan dysfunction are frequently admitted to intensive care units. Therapeutic options, when organ failure occurs, are frequently ... ...

Abstract	During the last few years, due to medical and surgical evolution, patients with increasingly severe diseases causing multiorgan dysfunction are frequently admitted to intensive care units. Therapeutic options, when organ failure occurs, are frequently nonspecific and mostly directed towards supporting vital function. In these scenarios, the kidneys are almost always involved and, therefore, renal replacement therapies have become a common routine practice in critically ill patients with acute kidney injury. Recent technological improvement has led to the production of safe, versatile and efficient dialysis machines. In addition, emerging evidence may allow better individualization of treatment with tailored prescription depending on the patients’ clinical picture (e.g. sepsis, fluid overload, pediatric). The aim of the present review is to give a general overview of current practice in renal replacement therapies for critically ill patients. The main clinical aspects, including dose prescription, modality of dialysis delivery, anticoagulation strategies and timing will be addressed. In addition, some technical issues on physical principles governing blood purification, filters characteristics, and vascular access, will be covered. Finally, a section on current standard nomenclature of renal replacement therapy is devoted to clarify the “Tower of Babel” of critical care nephrology.
Keywords	Dialysis & Renal Transplantation ; Renal & Gastrointestinal Problems in Critical Care ; Sepsis & Multiple Organ Failure in Critical Care ; Medicine ; R ; Science ; Q
Subject code	616
Language	English
Publishing date	2016-01-01T00:00:00Z
Publisher	F1000 Research Ltd
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Regional Citrate Anticoagulation and Systemic Anticoagulation during Pediatric Continuous Renal Replacement Therapy

Emanuele Buccione / Stefano Bambi / Laura Rasero / Lorenzo Tofani / Tessa Piazzini / Carlo Della Pelle / Khadija El Aoufy / Zaccaria Ricci / Stefano Romagnoli / Gianluca Villa

Journal of Clinical Medicine, Vol 11, Iss 3121, p

A Systematic Literature Review

2022 Volume 3121

Abstract: Background: Clotting is a major drawback of continuous renal replacement therapy (CRRT) performed on critically ill pediatric patients. Although anticoagulation is recommended to prevent clotting, limited results are available on the effect of each ... ...

Abstract	Background: Clotting is a major drawback of continuous renal replacement therapy (CRRT) performed on critically ill pediatric patients. Although anticoagulation is recommended to prevent clotting, limited results are available on the effect of each pharmacological strategy in reducing filter clotting in pediatric CRRT. This study defines which anticoagulation strategy, between regional citrate anticoagulation (RCA) and systemic anticoagulation with heparin, is safer and more efficient in reducing clotting, patient mortality, and treatment complications during pediatric CRRT. Methods: A systematic literature review was run considering papers published in English until December 2021 and describing patients’ and treatments’ complications in CRRT performed with heparin and RCA on patients aged less than 18 years. Results: Eleven studies were considered, cumulatively comprising 1.706 CRRT sessions (62% with systemic anticoagulation and 38% with RCA). Studies have consistently identified RCA’s superiority over systemic anticoagulation with heparin in prolonging circuit life. The pooled estimate (95% CI) of filter clotting risk showed that RCA is a protective factor for clotting risk (RR = 0.204). Conclusions: RCA has a potential role in prolonging circuit life and seems superior to systemic anticoagulation with heparin in decreasing the risk of circuit clotting during CRRT performed in critically ill pediatric patients.
Keywords	continuous renal replacement therapy ; pediatric intensive care unit ; anticoagulation methods ; systemic anticoagulation ; regional anticoagulation ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Management of Acute Kidney Injury and Extracorporeal Blood Purification Therapies During the COVID-19 Pandemic

Silvia De Rosa / Marita Marengo / Stefano Romagnoli / Marco Fiorentino / Vito Fanelli / Enrico Fiaccadori / Nicola Brienza / Santo Morabito / Vincenzo Pota / Fabrizio Valente / Giacomo Grasselli / Piergiorgio Messa / Antonino Giarratano / Vincenzo Cantaluppi

Frontiers in Medicine, Vol

The Italian SIN–SIAARTI Joint Survey (and Recommendations for Clinical Practice)

2022 Volume 9

Abstract: Background and AimThe novel coronavirus disease 2019 remains challenging. A large number of hospitalized patients are at a high risk of developing AKI. For this reason, we conducted a nationwide survey to assess the incidence and management of AKI in ... ...

Abstract	Background and AimThe novel coronavirus disease 2019 remains challenging. A large number of hospitalized patients are at a high risk of developing AKI. For this reason, we conducted a nationwide survey to assess the incidence and management of AKI in critically ill patients affected by the SARS-CoV-2 infection.MethodsThis is a multicenter, observational, nationwide online survey, involving the Italian Society of Nephrology and the critical care units in Italy, developed in partnership between the scientific societies such as SIN and SIAARTI. Invitations to participate were distributed through emails and social networks. Data were collected for a period of 1 week during the COVID-19 pandemic.ResultsA total of 141 responses were collected in the SIN–SIAARTI survey: 54.6% from intensivists and 44.6% from nephrologists. About 19,000 cases of COVID-19 infection have been recorded in hospitalized patients; among these cases, 7.3% had a confirmed acute kidney injury (AKI), of which 82.2% were managed in ICUs. Only 43% of clinicians routinely used the international KDIGO criteria. Renal replacement therapy (RRT) was performed in 628 patients with continuous techniques used most frequently, and oliguria was the most common indication (74.05%). Early initiation was preferred, and RRT was contraindicated in the case of therapeutic withdrawal or in the presence of severe comorbidities or hemodynamic instability. Regional anticoagulation with citrate was the most common choice. About 41.04% of the interviewed physicians never used extracorporeal blood purification therapies (EBPTs) for inflammatory cytokine or endotoxin removal. Moreover, 4.33% of interviewed clinicians used these techniques only in the presence of AKI, whereas 24.63% adopted them even in the absence of AKI. Nephrologists made more use of EBPT, especially in the presence of AKI. HVHF was never used in 58.54% of respondents, but HCO membranes and adsorbents were used in more than 50% of cases.ConclusionThis joint SIN–SIAARTI survey at the Italian Society of ...
Keywords	acute kidney injury ; COVID-19 ; critical care ; renal replacement therapy ; blood purification ; surveys and questionnaires ; Medicine (General) ; R5-920
Subject code	610 ; 616
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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