Publications by authors named "Fabrizio Romano"

In candidates for hepatectomy, different techniques to induce liver hypertrophy and modulate the future liver remnant are available. However, their use in specific clinical scenarios is highly heterogeneous and there is no consensus about minimal safety standards needed to incorporate these strategies into routine clinical practice. The aim of this position paper was to summarize newly available evidence in the field and compare medical practice among different hepatobiliary surgical units to evaluate the transformative potential of liver hypertrophy techniques in surgical oncology.

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Background & Aims: For patients with single small (≤3 cm) hepatocellular carcinoma ablation is the first-line treatment, although a high rate of recurrence has been reported. The aim was to compare videolaparoscopic liver resection (laparoscopic resection group) percutaneous thermoablation (ablation group) in terms of overall survival, recurrence-free survival and early recurrence in a real-life national scenario.

Methods: The study is a retrospective collection with subsequent survival analysis.

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Background: Liver resection classifications have traditionally been based on the number of segments resected. However, with advancements in techniques and the diffusion of minimally invasive surgery (MiLS), these classifications may no longer adequately represent the complexities of modern liver surgery. This study evaluates five liver resection classifications using a multicenter Italian database of hepatocellular carcinoma resections with the main focus of catching surgical outcomes, rather than technical complexity.

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It has been 10-years since the publication of Rhinosinusitis: evidence and experience, and since then a lot has changed in our understanding of the disease. Advances in pathophysiology, endotyping and new treatments such as biologics brought a new era in the management of our patients. This new guideline, developed jointly by ABR and ABORL-CCF, with the help of ASBAI presents an updated, evidence-based approach to the different forms of rhinosinusitis that aims to improve the diagnosis and treatment of this complex disease.

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Background: Enhanced Recovery Protocol (ERP) has the purpose of minimising postoperative hospitalisation and expediting the restoration of preoperative patient conditions. This study seeks to investigate the correlation between early non-compliance to postoperative items within ERP and complications in liver surgery.

Methods: From January 2019 to December 2022 the ERP was proposed to all consecutive patients undergoing liver surgery.

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Background: Recent papers report significant survival gain after liver resection in BCLC-B and -C HCC patients. The results of minimally invasive liver surgery (MILS) in such patients have not been widely investigated so far.

Methods: Data regarding patients undergoing MILS or open liver resection (OLR) for HCC staged BCLC -B and -C were extracted from the HERCOLES database.

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Objective: Blood-biomarkers have the potential to aid clinicians in pediatric emergency departments (PED) in managing children with mild traumatic brain injury (mTBI) acutely. However, studies focusing on pediatric populations remain limited. We aim to assess the performances of two routinely used biomarkers in other fields: the neurofilament light chain protein (NfL), and the N-terminal prohormone of brain natriuretic peptide (NTproBNP), to safely discharge children without intracranial injuries (ICIs).

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Background: Minimal access liver surgery (MALS) is considered superior to open liver resection (OLR) in reducing the perioperative risk in patients affected by hepatocellular carcinoma (HCC). No national-level comparisons exist based on procedure complexity. This study aims to compare postoperative complications, postoperative ascites (POA), and major complications (MC) between MALS and OLR.

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Introduction: No instruments are available to predict preoperatively the risk of posthepatectomy liver failure (PHLF) in HCC patients. The aim was to predict the occurrence of PHLF preoperatively by radiomics and clinical data through machine-learning algorithms.

Materials And Methods: Clinical data and 3-phases CT scans were retrospectively collected among 13 Italian centres between 2008 and 2022.

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Article Synopsis
  • The "V Brazilian Consensus on Rhinitis" is a significant update aimed at improving the understanding and management of rhinitis, focusing on evidence-based practices.
  • * It includes detailed information on rhinitis phenotypes, diagnostic criteria, treatment customization based on symptoms and comorbidities, and the importance of thorough clinical evaluation.
  • * The guideline also emphasizes patient education and addresses specific populations such as children, pregnant women, and the elderly to enhance overall quality of life for those affected by rhinitis.
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  • Breast cancer is prevalent among women, with 20-30% of patients developing metastases, primarily affecting the liver. Patients with liver metastases have a wide range of survival rates, influenced by various factors.
  • This study aimed to assess the long-term survival and disease-free outcomes for patients who had surgery for liver metastases stemming from breast cancer.
  • Results indicated that surgery can enhance long-term survival, with specific patient characteristics (like health status, hormone receptor positivity, and prior treatments) linked to improved outcomes.
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  • This study evaluated the effectiveness of the FLIS (Functional Liver Imaging Score) in predicting post-hepatectomy liver failure (PHLF) and death in patients who had liver surgery for cancer.
  • It involved 150 patients, with a high reliability in assessment results between radiologists, indicating solid agreement in the evaluation processes used.
  • The findings suggest that FLIS, along with factors like blood transfusions and major resections, may help identify patients at risk for adverse outcomes after surgery.
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Purpose: Single large hepatocellular carcinoma >5cm (SLHCC) traditionally requires a major liver resection. Minor resections are often performed with the goal to reduce morbidity and mortality. Aim of the study was to establish if a major resection should be considered the best treatment for SLHCC or a more limited resection should be preferred.

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This study aims to provide a national overview of procedural sedation and analgesia practices within Pediatric Emergency Departments in Switzerland, focusing on the availability of pharmacologic agents, the presence of safety protocols, the utilization of non-pharmacological interventions, and to identify specific local limitations. We conducted a detailed subgroup analysis of Swiss data from a European cross-sectional survey on emergency department pediatric Procedural Sedation and Analgesia (PSA) practice, isolating data from Swiss sites. The survey, conducted between November 2019 and March 2020, covered various aspects of procedural sedation and analgesia practices.

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Objectives: To determine the inflammatory profile of CRSwNP in Brazil and characterize the subgroups of CRSwNP patients in this population through cluster analysis.

Study Design: Multicenter cross-sectional study involving 15 centers representing different regions of Brazil.

Subjects And Methods: Clinical data of 166 patients and 80 controls, aged 18 to 70 years old, number of surgeries for CRS, history of asthma and aspirin sensitivity, and Lund-Mackay scores on CT scans.

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Introduction: The anterior approach (AA), whether or not associated with the liver hanging maneuver (LHM), has been advocated to improve survival and postoperative outcomes in HCC patients undergoing major liver resection. This systematic review and meta-analysis of randomized controlled trials aims to explore intra/perioperative and long-term survival outcomes of AA ± LHM compared to CA regardless of tumor histology.

Methods: The study was conducted according to the Cochrane recommendations searching the PubMed, Scopus, and EMBASE databases until January 27, 2024 (PROSPERO ID: CRD42024507060).

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Article Synopsis
  • - This national survey aimed to assess the use of liver hypertrophy techniques in Italy, focusing on trends and differences among various medical centers.
  • - In December 2022, 46 centers completed a detailed online questionnaire, revealing that hypertrophy techniques were used in 6.2% of liver resections, with PVE and ALPPS being the most common techniques employed.
  • - The findings indicated that while these techniques play a crucial role in increasing resectability, there is substantial inconsistency in how centers define the need for them and the protocols used for patient allocation.
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Children are highly vulnerable to mild traumatic brain injury (mTBI). Blood biomarkers can help in their management. This study evaluated the performances of biomarkers, in discriminating between children with mTBI who had intracranial injuries (ICIs) on computed tomography (CT+) and (1) patients without ICI (CT-) or (2) both CT- and in-hospital-observation without CT patients.

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  • This study looks at blood markers that can help doctors tell how serious a mild brain injury (mTBI) is in kids.
  • Researchers checked levels of certain markers (IL6, IL8, IL10) in 285 children with mTBI and found that IL6 is particularly helpful for figuring out which kids need further tests.
  • The results show that IL6 is a good indicator for children with mTBI, helping doctors make better decisions about their care, especially for those who haven’t had a CT scan.
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Objective: There is preliminary evidence that children after traumatic brain injury (TBI) have accelerated long-term forgetting (ALF), i.e., an adequate learning and memory performance in standardized memory tests, but an excessive rate of forgetting over delays of days or weeks.

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Objective: Following mild traumatic brain injury (mTBI), children show reduced processing speed (PS). Evidence suggests that slowed PS after TBI is associated with working memory deficits. Our aim was to investigate several forms of PS and to examine its impact on working and episodic memory performance in children after mTBI.

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  • The 2022 Barcelona Clinic Liver Cancer algorithm advises against liver resection for patients with multiple small tumors (2 or 3 nodules, each ≤3 cm) in hepatocellular carcinoma.
  • This study retrospectively analyzed data from over 12,000 patients to compare survival outcomes among those undergoing liver resection (LR), percutaneous radiofrequency ablation (PRFA), and transarterial chemoembolization (TACE).
  • Results showed that LR had the highest survival rates at 1, 3, and 5 years (89.11%, 70.98%, 56.44% respectively) compared to PRFA and TACE, indicating that LR may offer better long-term outcomes in treating early multin
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Purpose: The aim of this study was to investigate the trajectory of parent-rated post-concussive symptoms (PCS), attentional performance and participation within 6 months in children after mild traumatic brain injury (mTBI).

Methods: For this prospective longitudinal study, we included data on 64 children after mTBI and 57 healthy control children (age 8-16 years). Parents rated PCS using the Post-Concussion Symptom Inventory (PCSI) immediately (T0), 1 week (T1), and 3-6 months after injury (T2).

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Introduction: Microvascular invasion (MVI) is the main risk factor for overall mortality and recurrence after surgery for hepatocellular carcinoma (HCC).The aim was to train machine-learning models to predict MVI on preoperative CT scan.

Methods: 3-phases CT scans were retrospectively collected among 4 Italian centers.

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