70 research outputs found
Producción de sentido crítico y Educación en Derechos Humanos: La propuesta del Programa Jóvenes y Memoria y su implementación en las escuelas secundarias de la Provincia de Buenos Aires entre los años 2018-2020
No full textFil: Urricelqui, Federico Ariel. Universidad de Buenos Aires. Facultad de Filosofía y Letras; Argentina
Producción de sentido crítico y Educación en Derechos Humanos: La propuesta del\nPrograma Jóvenes y Memoria y su implementación en las escuelas secundarias de la\nProvincia de Buenos Aires entre los años 2018-2020
No full textFil: Urricelqui, Federico Ariel. Universidad de Buenos Aires. Facultad de Filosofía y Letras
Producción de sentido crítico y Educación en Derechos Humanos: La propuesta del Programa Jóvenes y Memoria y su implementación en las escuelas secundarias de la Provincia de Buenos Aires entre los años 2018-2020
No full textFil: Urricelqui, Federico Ariel. Universidad de Buenos Aires. Facultad de Filosofía y Letras
Prophylactic central lymph node dissection improves disease-free survival in patients with intermediate and high risk differentiated thyroid carcinoma: A retrospective analysis on 399 patients
No full textThe role of prophylactic central lymph node dissection (pCLND) in the treatment of differentiated thyroid cancer (DTC) is controversial and still a matter of debate. The primary outcome of our study was to assess whether pCLND is effective in reducing the incidence of recurrent disease, and the secondary goal was to estimate the incidence of postoperative complications in patients who underwent pCLND and to evaluate the prognostic value of occult node metastases. In this retrospective study, we included patients with preoperative diagnosis of DTC and clinically uninvolved lymph nodes (cN0). The patients were divided into two groups, depending on the surgical approach: total thyroidectomy alone (TT group) or total thyroidectomy and pCLND (pCLND group). Three hundred and ninety-nine patients were included in this study, 320 (80.2%) in the TT group and 79 (19.8%) in the pCLND group. There were no significant differences in morbidity among the two groups. Histopathological evaluation demonstrated a similar distribution of aggressive features, especially regarding multicentricity, extrathyroidal extension, and angioinvasivity between the two groups. Occult lymph node metastases were found in 20 (25.3%) patients in the pCLND group. Prophylactic CLND was effective in improving disease-free survival in patients with intermediate and high risk of disease recurrence (p= 0.0392); occult lymph node metastases resulted as a significant negative prognostic factor (p< 0.001)
Is extensive surgery really necessary in patients with parathyroid carcinoma? Single-centre experience and a brief review of the literature
No full textAim: Parathyroid carcinoma (PC) represents a rare cause of primary hyperparathyroidism (PHPT). In this paper, among patients who underwent surgery for PHPT, we compared those with benign parathyroid disease with those affected by PC in terms of demographic and preoperative biochemical features. Moreover, we singularly described all 10 cases of PC treated at our Institution (including a case that occurred in a patient with tertiary hyperparathyroidism) and a brief review of the literature. Material and methods: Patients undergoing surgery for PHPT in our Unit between 2003 and 2018 were retrospectively analysed. They were divided into two groups: Group A (benign parathyroid disease), Group B (PC). The case of PC that occurred in the patient with tertiary hyperparathyroidism was not included into the two groups. Results: Three hundred and eight patients were included: 299 in Group A and 9 in Group B. The mean preoperative serum PTH value and mean preoperative serum calcium level were significantly higher in Group B than in Group A (P = 0.018, P = 0.027; respectively). Including the case of PC that occurred in the patient with tertiary hyperparathyroidism, 10 patients with PC were treated at our Institution. Among these, 3 underwent a re-exploration. Disease recurrence occurred in 1 (10%) patient, who developed a local recurrence and distant metastases. Conclusions: In the presence of PHPT characterized by particularly high preoperative levels of serum PTH and calcium this malignancy should be suspected. On the basis of our experience, we believe that extensive surgery is not always necessary. Key words: Hyperparathyroidism, Parathyroid carcinoma, Parathyroid surgery
Tall Cell Variant versus Conventional Papillary Thyroid Carcinoma: A Retrospective Analysis in 351 Consecutive Patients
No full textBackground: The aim of this retrospective study was to investigate clinical and pathological characteristics of the tall cell variant of papillary thyroid carcinoma compared to conventional variants. Methods: The clinical records of patients who underwent surgical treatment between 2009 and 2015 were analyzed. The patients were divided into two groups: those with a histopathological diagnosis of tall cell papillary carcinoma were included in Group A, and those with a diagnosis of conventional variants in Group B. Results: A total of 35 patients were included in Group A and 316 in Group B. All patients underwent total thyroidectomy. Central compartment and lateral cervical lymph node dissection were performed more frequently in Group A (42.8% vs. 18%, p = 0.001, and 17.1% vs. 6.9%, p = 0.04). Angiolymphatic invasion, parenchymal invasion, extrathyroidal extension, and lymph node metastases were more frequent in Group A, and the data reached statistical significance. Local recurrence was more frequent in Group A (17.1% vs. 6.3%, p = 0.02), with two patients (5.7%) in Group A showing visceral metastases, whereas no patient in Group B developed metastatic cancer (p = 0.009). Conclusions: Tall cell papillary carcinoma is the most frequent aggressive variant of papillary thyroid cancer. Tall cell histology represents an independent poor prognostic factor compared to conventional variants
Intact parathyroid hormone value on the first postoperative day following total thyroidectomy as a predictor of permanent hypoparathyroidism: a retrospective analysis on 426 consecutive patients
No full textIntroduction: Hypoparathyroidism represents a common complication following total thyroidectomy. To date, there is still no reliable and immediate postoperative parameter to establish which patients with postsurgical hypoparathyroidism will develop permanent hypoparathyroidism.The main purpose of the present study was to assess whether the intact parathyroid hormone (iPTH) value on the first postoperative day is a good predictor of permanent hypoparathyroidism.Material and methods: Patients undergoing thyroidectomy in our unit between March 2018 and January 2020 were analysed. According to the iPTH value on the first postoperative day and on the basis of the detection threshold of the iPTH test used, patients were divided into two groups: Group A (iFTH >= mu g/mL) and Group B (iFIE < 4.6 pg/mL, undetectable).Results: In total 426 patients were included: 364 in Group A and 62 in Group B. Permanent hypoparathyroidism occurred in 3 (0.82%) patients from Group A and in 26 (41.94%) from Group B (p < 0.001). When iPTH levels were < 4.6 pg/mL on the first postoperative day the sensitivity for the prediction of permanent hypoparathyroidism was 89.66%, the specificity was 90.93%, the positive predictive value (PPV) was 41.94%, the negative predictive value (NPV) was 99.18% and the accuracy was 90.85%.Conclusions: An ipTH value < 4.6 pg/mL on the first postoperative day following total thyroidectomy has proven to be a good parameter for early identification of patients at high risk for permanent hypoparathyroidism. Moreover, we want to underline that in our experience no patient with an iPTH level > 65 pg/mL developed this complication
Paralytic Shellfish Poisoning toxins from Mediterranean Alexandrium minutum and A. catenella: toxin profile and sxt gene content
No full textParalytic shellfish poisoning (PSP) toxins are potent water-soluble neurotoxins including the parent compound saxitoxin (STX) and a number of its congeners. They are tetrahydropurine derivatives that can be subdivided into three main groups according to substitution of the side chain: carbamoyl-, N-sulfocarbamoyl-, and decarbamoyl-toxins. The carbamoyl derivatives (STX, NEO and GTX1-4) are reported to be the most potent. Due to their accumulation in filter feeding shellfish, PSP toxins can move through the food chain inducing a toxic syndrome in seafood consumers. Symptoms are neurological with rapid onset (30-60 min from ingestion) and include paraesthesia, vertigo, numbness, tingling of the face, tongue, and lip, ataxia, blocking of respiration and even death.
Due to the high risk posed to human health by PSP toxins, a multidisciplinary integrated approach based on liquid chromatography high resolution mass spectrometry (LC-HRMS and MS2) and qPCR-based assay has been used to depict the PSP toxin scenario in the Mediterranean Sea. As the sxtA and the sxtG genes are known as the starting genes of PSP toxin synthesis in dinoflagellates, different populations of the Mediterranean A. minutum from NW Adriatic, Ionian, Tyrrhenian and Catalan Seas were grown in culture and analyzed by qPCR in order to obtain the quantification of these genes. In parallel, LC-HRMS2 analyses were performed on the A. minutum cultured strains and revealed for all of them a toxin profile consisting of only GTX1 and GTX4. Toxin production was in the fg/cell range. Concomitantly with a massive bloom of A. minutum and A. catenella that occurred in Spring 2014 along the Syracuse coasts (Sicily, Italy), four seawater samples were collected and analyzed by LC-HRMS and MS2. The analyzed extracts were found to contain a variety of PSP toxins, namely STX, NEO, the gonyautoxins GTX1-4, the N-sulfocarbamoyl derivatives C1/C2, B1 and B2 and the decarbamoyl ST
Axillary Treatment Management in Breast Cancer during COVID-19 Pandemic (Association between ACOSOG Z0011 Criteria and OSNA Test)
No full textThe outbreak of the SARS-COVID-2 pandemic (COVID-19) had a significant effect on the organisation of healthcare systems. Surgical units saw a significant reduction in the volume of surgical procedures performed, with lengthening waiting lists as a consequence. We assessed the surgical activity in relation to breast cancer that took place at the University Hospital of Cagliari, Italy, from February 2018 to March 2022. Two phases were identified based on the epidemiological circumstances: Phase 1—February 2018 to February 2020; Phase 2—March 2020 to March 2022. The surgery performed in the two phases was then compared. All the patients in our sample underwent a breast surgical procedure involving a lymph node biopsy using OSNA associated with the ACOSOG Z0011 criteria. In the study period overall at our facility, there were 4214 procedures, 417 of which involved breast surgery. In Phase 2, 91 procedures were performed using the OSNA method and ACOSOG Z0011 criteria, enabling the intraoperative staging of axillary nodes. Axillary treatment in breast cancer using this approach resulted in a significant reduction in the number of reoperations for the radicalisation of metastatic sentinel lymph nodes
The Use of Harmonic Focus and Thunderbeat Open Fine Jaw in Thyroid Surgery: Experience of a High-Volume Center
No full textBackground: In thyroid surgery, achieving accurate haemostasis is fundamental in order to avoid the occurrence of complications. Energy-based devices are currently extensively utilized in this field of surgery. This study aims to compare Harmonic Focus and Thunderbeat Open Fine Jaw with regard to surgical outcomes and complications. Methods: Patients submitted to total thyroidectomy in our center, between January 2017 and June 2020, were retrospectively analysed. Based on the energy-based device utilized, two groups were identified: Group A (Harmonic Focus) and Group B (Thunderbeat Open Fine Jaw). Results: A total of 527 patients were included: 409 in Group A and 118 in Group B. About surgical outcomes, the mean operative time was significantly shorter in Group B than in Group A (p < 0.001), while as regards complications, the occurrence of transient recurrent laryngeal nerve injury was significantly greater in Group B than in Group A (p = 0.019). Conclusions. Both Harmonic Focus and Thunderbeat Open Fine Jaw have proven to be effective devices. Operative times were significantly shorter in thyroidectomies performed with Thunderbeat Open Fine Jaw; however, the occurrence of transient recurrent laryngeal nerve injury was significantly greater in patients operated on with this device
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