Maria Giusa

University of Messina

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Francesco Tomasello

University of Palermo

Alfredo Conti

Istituto delle Scienze Neurologiche di Bologna

Salvatore Cardali

University of Messina

Filippo Flavio Angileri

University of Messina

Domenico Gerardo Iacopino

University of Palermo

Antonino Germanò

University of Messina

Rosaria Abbritti

Hôpital Lariboisière

Giovanni Raffa

University of Messina

Domenico La Torre

Magna Graecia University

Alfredo Campennì

University of Messina

Cooperative Institutions

University of Messina

Azienda Ospedaliera Universitaria Policlinico "G. Martino"

Morpho (United States)

Neurological Surgery

University of Palermo

Hospital Israelita Albert Einstein

University of Bologna

University of Catania

Sunnybrook Health Science Centre

Health Sciences Centre

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Endometrial Thickness Measurement for Detecting Endometrial Cancer in Women With Postmenopausal Bleeding

Obstetrics and Gynecology (2010)

Anne Timmermans Brent C. Opmeer Khalid S. Khan Lucas M. Bachmann E. Epstein

To estimate the accuracy of endometrial thickness measurement in the detection of endometrial cancer among women with postmenopausal bleeding with individual patient data using different meta-analytic strategies.Original data sets of studies detected after reviewing the included studies of three previous reviews on this subject. An additional literature search of published articles using MEDLINE databases was preformed from January 2000 to December 2006 to identify articles reporting on endometrial carcinoma and sonographic endometrial thickness measurement in women with postmenopausal bleeding.We identified 90 studies reporting on endometrial thickness measurements and endometrial carcinoma in women with postmenopausal bleeding.We contacted 79 primary investigators to obtain the individual patient data of their reported studies, of which 13 could provide data. Data on 2,896 patients, of which 259 had carcinoma, were included. Several approaches were used in the analyses of the acquired data. First, we performed receiver operator characteristics (ROC) analysis per study, resulting in a summary area under the ROC curve (AUC) calculated as a weighted mean of AUCs from original studies. Second, individual patient data were pooled and analyzed with ROC analyses irrespective of study with standardization of distributional differences across studies using multiples of the median and by random effects logistic regression. Finally, we also used a two-stage procedure, calculating sensitivities and specificities for each study and using the bivariate random effects model to estimate summary estimates for diagnostic accuracy. This resulted in rather comparable ROC curves with AUCs varying between 0.82 and 0.84 and summary estimates for sensitivity and specificity located along these curves. These curves indicated a lower AUC than previously reported meta-analyses using conventional techniques.Previous meta-analyses on endometrial thickness measurement probably have overestimated its diagnostic accuracy in the detection of endometrial carcinoma. We advise the use of cutoff level of 3 mm for exclusion of endometrial carcinoma in women with postmenopausal bleeding.

POSTMENOPAUSAL BLEEDING

10.1097/aog.0b013e3181e3e7e8

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Citations (285)

Fully Endoscopic Freehand Evacuation of Spontaneous Supratentorial Intraparenchymal Hemorrhage

World Neurosurgery (2016)

Filippo Flavio Angileri Felice Esposito Stefano M. Priola Giovanni Raffa Daniele Marino

Intraparenchymal hemorrhage

10.1016/j.wneu.2016.07.015

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Citations (21)

“Long Term” follow-up clinico e con angio-RMN del wrapping di aneurismi intracranici rotti con muscolo autologo

Giuseppe Sciarrone A. S. C. C. Germano Salvatore Cardali Lisa J. Merlo Alberto G. Conti

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Transcranial Doppler Ultrasonography in the Assessment of Cerebral Circulation Arrest: Improving Sensitivity by Trancervical and Transorbital Carotid Insonation and Serial Examinations

Neurocritical Care (2009)

Alfredo Conti Domenico Gerardo Iacopino A. Spada Salvatore Cardali Maria Giusa

Transcranial Doppler

Cerebrovascular Circulation

10.1007/s12028-009-9199-7

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Citations (37)

Initial Experience With 1⁸F-FDG PET/MRI In Gynecological Malignant Neoplasms

International Journal of Gynecological Cancer (2025)

Maria Giusa Ricardo Quartim Fonseca Vanessa Alvarenga‐Bezerra Juliana Tabner Raphaël Haddad

10.1016/j.ijgc.2024.100631

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Assistance of intraoperative microvascular Doppler in the surgical obliteration of spinal dural arteriovenous fistula: cases description and technical considerations

Acta Neurochirurgica (2003)

Domenico Gerardo Iacopino Alfredo Conti Maria Giusa Salvatore Cardali Francesco Tomasello

Arteriovenous malformation

10.1007/s00701-002-1039-x

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Intraoperative microvascular Doppler monitoring of blood flow within a spinal dural arteriovenous fistula: a precious surgical tool

Neurosurgical FOCUS (2001)

Domenico Gerardo Iacopino Maria Giusa Alfredo Conti Salvatore Cardali Francesco Tomasello

The authors describe a case of spinal arteriovenous fistula (AVF) treated by a microvauscular Doppler–assisted surgical interruption of the arterialized vein. Microvascular Doppler monitoring represents a valid, widely available, non-invasive tool that enables identification, through flow spectrum analysis, of components of this type of vascular malformation. In this case because the location of the fistula was identified prior to opening the dura only minimally invasive surgery was required. Direct recordings of the arterialized draining vein and the nidus of the fistula demonstrated a pathological spectrum caused by the arterial supply and the disturbed venous outflow in which a high-resistance flow pattern and low diastolic flow resembling an arterial-like flow velocity were observed. The fistula was obliterated by interruption of the draining vein, and Doppler measurements provided information on flow velocity changes in the medullary veins from an arterial to a venous pattern. The absence of any residual flow in the AVF confirmed successful hemodynamic treatment. Intraoperative microvascular Doppler recording during surgical closure of spinal AVF is a widely available and reliable monitoring modality that helps to produce excellent clinical results.

Arteriovenous malformation

10.3171/foc.2001.10.2.6

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Anterior Skull Base Reconstruction With a Galeal-Pericranial Flap

Journal of Craniofacial Surgery (2007)

Enrico Nastro Siniscalchi Filippo Flavio Angileri Paola Mastellone Luciano Catalfamo Maria Giusa

Excision of neoplasm and trauma involving the anterior cranial base may often result in communication between the intracranial and extracranial compartments. Many techniques have been proposed to obtain a watertight separation. We report our 5 years of experience in the management of anterior skull base defects using a galeal-pericranial flap. Between January 2001 and April 2006, 22 patients were treated for a cranial base reconstruction at the University of Messina. Five of them presented with persistent cerebrospinal fluid (CSF) leak after previous craniofacial trauma. Ten underwent a combined maxillofacial-neurosurgical approach for the removal of a benign tumor involving the anterior skull base. Seven had severe craniofacial trauma, which required an intervention of reconstruction of the anterior skull base. In the whole series, a galeal-pericranial flap was used to separate intra- and extracranial compartments. No patients developed postoperative brain contusions or subdural-epidural blood collections. Throughout the follow-up period, there was no evidence of flap failure. In all but one patient, no postoperative CSF leak was evident. In one patient, a mild transient postoperative CSF leakage was present. There has been no recurrent CSF leak or meningitis. The follow up average of 23 months shows no incidence of infection. Even if our series does not comprise malignancies and previously irradiated patients, our data confirm the validity of the galeal- pericranial flap for the surgical management of minimal and moderately sized defects of anterior cranial base.

Intracranial infection

Cerebrospinal fluid leak

Anterior cranial fossa

10.1097/scs.0b013e318052ff6c

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Citations (28)

Potential clinical role of telomere length in human glioblastoma.

PubMed (2011)

Domenico La Torre M’hammed Aguennouz Alfredo Conti Maria Giusa Giovanni Raffa

Glioblastoma Multiforme (GBM) is the most common and lethal of human primary central nervous system (CNS) tumors. Due to the tumour's intrinsic clinical and molecular heterogeneity, choice of initial treatment, prediction of survival, stratification of patients, prediction and monitoring of response to therapy, represent some of the greatest challenges in the management of GBM patients. Patients, despite optimal surgery, radiation and chemotherapy, still have a median survival of 14-16 months. A reason for this dismal prognosis is because of the relative inaccuracy of current prognostic markers, so far based on clinical or pathological variables. Molecular markers that effectively predict response to therapy and survival outcomes are limited. Consequently, there is a strong need to develop novel and independent markers of prognosis. Ideal biomarkers for solid tumors would serve one or more important functions. Telomeres, guanine-rich tandem DNA repeats of the chromosomal end, provide chromosomal stability, regulates important cellular processes, and seem to be implicated in human carcinogenesis. Recently, telomeres have been shown either to be associated with clinical markers of disease progression or to be independent markers of cancer prognosis in solid tumours, including GBM. Nevertheless, a corresponding comprehensive discussion of these promising developments in brain tumours has not yet been available in the literature. Therefore, here we reviewed studies focused on the assessment of telomeric length in brain tumours with the aim to emphasized those findings indicating a potential clinical role of telomeres in GBM. With the aim to enhance the awareness of the potential clinical role of telomeres' length information in GBM, using a southern blot analysis, telomeric length in excised tumour samples was analyzed. Moreover, an attempt to correlated telomere length with patients' overall survival, was also performed. The findings here reviewed shows some contradictory results, due to different tissues used as controls, but mainly to cellular and molecular heterogeneity in GBMs that drive molecular mechanisms controlling telomere length, included telomerase and Alternative Lengthening of Telomeres (ALT), through multiple mechanisms. However, overall these studies, including our own, are consistent with the hypothesis that GBMs' telomeres were always shorter when compared with Normal Brain Tissue (NBT), and together with higher telomerase activity seem to be associated with malignancy and poor outcome; while tumours with ALT phenotype have longer telomeres, "less malignant" behaviour and better prognosis. We conclude that, although not entirely consistent in the type of telomere alteration, i.e., attrition vs. elongation, and unclear on the underlying mechanisms, multiple studies in brain tumours have shown that telomere dysfunctions are associated with parameters of clinical outcome in patients with GBMs and therefore will be part of novel risk assessment and prognostic modalities for patients with these still dismal disease.

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Microsurgical excision of a primary isolated hypothalamic eosinophilic granuloma

Journal of neurosurgery (1997)

Domenico D’Avella Maria Giusa Alfredo Blandino Filippo Flavio Angileri G. La Rosa

✓ Solitary focal eosinophilic granuloma (EG) is one element in the spectrum of diseases associated with Langerhans' cell histiocytosis (LCH). This report documents the occurrence of a primary isolated hypothalamic EG in a man who presented with diabetes insipidus and panhypopituitarism. His treatment consisted of complete microsurgical excision of the lesion. After a 13-month follow-up period, no residual tumor was evident on magnetic resonance imaging and no other lesions were present in peripheral tissues. This case is unique in several respects: 1) it is the third documented case of a primary isolated hypothalamic LCH granuloma diagnosed in a living patient; 2) it is the only known example of complete microsurgical excision of such a lesion in the hypothalamic region; and 3) it demonstrates the efficacy of direct surgery in this scenario, as compared with other treatment modalities such as biopsy and irradiation, suggesting that complete surgical excision may represent the treatment of choice for isolated intracerebral LCH granulomas, being curative in most instances. Also, the literature is reviewed for information about the diagnosis and treatment of this particular type of unifocal brain lesion.

Eosinophilic granuloma

Langerhans Cell Histiocytosis

10.3171/jns.1997.87.5.0768

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Citations (15)