Publications by authors named "Orsini A"
Introduction: The introduction of multiparametric prostate magnetic resonance imaging (mpMRI) has revolutionized prostate cancer (PCa) diagnosis, enhancing the localization of clinically significant prostate cancer (csPCa) and guiding targeted biopsies. However, significant disparities in the execution, interpretation, and reporting of prostate MRI examinations across centers necessitate greater standardization and accuracy. This study compares the diagnostic efficacy of mpMRI from academic and nonacademic centers in detecting csPCa and identifies factors associated with csPCa detection.
View Article and Find Full Text PDFPurpose: To evaluate the predictors of delayed discharge for patients undergoing robot-assisted partial nephrectomy (RAPN) at our Institution since the introduction of the single port (SP) robotic system.
Methods: We performed a retrospective review of our prospectively maintained database of patients undergoing RAPN from September 2020 to August 2024. Patients were categorized by the postoperative day of their discharge: POD1 (single overnight stay) or POD > 1 (more than one night stay).
Robotic-assisted surgery for the treatment of urologic cancers: recent advances.
Expert Rev Med Devices
December 2024
Introduction: Recent advancements in single-port surgery, robotic platforms, 3D models and artificial intelligence have transformed surgical procedures, especially in urology. These innovations enhance precision, safety, and efficacy, reducing invasiveness and recovery times. The review focuses on the latest in robotic-assisted surgery for genitourinary cancers, highlighting the shift toward personalized, minimally invasive treatments.
View Article and Find Full Text PDFArticle Synopsis
- Socioeconomic determinants of health (SDOH) are often overlooked in assessing risks for urological surgeries, which may lead to disparities in patient outcomes, particularly after minimally invasive radical prostatectomy (MIRP).
- A study using data from over 100,000 patients revealed that about 6% reported SDOH, which were linked to a 24% increased risk of complications post-surgery, including higher rates of urinary tract infections and acute kidney injuries.
- The findings highlight the need for healthcare systems to address SDOH to improve patient outcomes and reduce complications after procedures like MIRP.
Purpose: The rise of frail patients in the worldwide population poses a challenge in the prostate cancer surgical care. In this light, we aimed to compare perioperative and early surgical outcomes of Extraperitoneal Single Port (SP)- vs Transperitoneal Multiport (MP) - Robot Assisted Radical Prostatectomy (RALP) in different frailty settings.
Materials And Methods: Clinical and surgical data of all consecutive patients treated with RALP between March 2014 and October 2023 were gathered.
Article Synopsis
- Minimally invasive surgery offers shorter hospital stays, enabling the potential for outpatient (OP) procedures, especially with the introduction of single-port (SP) robotic techniques in urology.
- A literature review analyzed the safety and feasibility of OP robotic urological surgeries, revealing high same-day discharge rates and lower complication risks compared to inpatient procedures.
- Overall, the study concludes that outpatient robotic urological surgery is both feasible and safe for selected patients, with SP-RARP procedures showing even better outcomes than multiport options.
Article Synopsis
- Robotic surgery has shifted urology towards minimally invasive techniques, significantly benefiting procedures like radical prostatectomy.
- A review of literature on robotic platforms reveals that while the DaVinci system is predominant, new alternatives are emerging, but comprehensive comparisons are rare.
- The role of artificial intelligence in robotic surgery is growing, suggesting that more research is needed to fully understand its impact and future developments in urology.
Article Synopsis
- Penile cancer is a rare type of cancer that affects the penis, with an estimated 2,100 new cases and 500 deaths in the U.S. in 2024.
- Surgery has traditionally been used as the main treatment, but new studies suggest that less invasive options may work just as well without requiring major surgeries.
- It's really important to help patients cope with the emotional effects of the disease, as losing part of the penis can impact their mental health and quality of life, so therapies and support are key.
Rationale: Anecdotal reports suggest that psychedelic drugs can improve psychological wellbeing and social engagement in autistic people. However, there are few contemporary studies on this topic.
Objectives: To examine autistic participants' experiences with psychedelic drugs and the extent to which they attributed changes in mental health and social engagement to their most 'impactful' psychedelic experience.
Article Synopsis
- Developmental and epileptic encephalopathies (DEE) are disorders that can be caused by new mutations in a specific gene, leading to different symptoms, from severe conditions to milder ones like autism.
- A case study of a six-year-old boy showed he had a new mutation in that gene, but he did not develop epilepsy and had a normal brain scan over five years.
- This case helps us understand that not everyone with mutations in this gene will have serious problems, which is important for doctors to know when diagnosing developmental delays.
Objective: To analyze the temporal trends and perioperative and long-term outcomes of living donor kidney nephrectomy in the United States.
Methods: The PearlDiverTM Mariner database (Pearl-Diver Technologies, Colorado Springs, CO, USA) was used for our retrospective analysis. The data were identified using ICD-9/10 codes, as well as CPT codes.
Sydenham's chorea (SC), an autoimmune disorder affecting the central nervous system, is a pivotal diagnostic criterion for acute rheumatic fever. Primarily prevalent in childhood, especially in developing countries, SC manifests with involuntary movements and neuropsychiatric symptoms. Predominantly occurring between ages 5 and 15, with a female bias, SC may recur, particularly during pregnancy or estrogen use.
View Article and Find Full Text PDFArticle Synopsis
- Patients with AP-4 deficiency have developmental delays and seizures that start early in life, along with other issues like trouble with speech and movement.
- The study looked at how these seizures happen and how patients respond to treatment, finding various types of seizures and some unique brain wave patterns.
- Overall, while epilepsy can develop at different ages, many patients had a good outlook, and they didn’t seem to be resistant to medications.
Article Synopsis
- Renal cell carcinoma (RCC) consists of various subtypes with unique genetic changes, requiring tailored treatment approaches for each.
- A detailed review was performed of English language articles on the molecular mechanisms of kidney cancer, excluding non-original studies.
- Hereditary kidney cancer accounts for 5-8% of cases, linked to specific syndromes with genetic mutations that lead to tumor development and related symptoms, emphasizing the importance of understanding these mechanisms for early diagnosis and treatment options.
Introduction: Urachal carcinoma (UrC) is a rare, nonurothelial malignancy, comprising less than 1% of all bladder cancers. It usually affects males in their fifth to sixth decade and is often diagnosed at an advanced stage with metastasis. This study examines UrC population characteristics and management.
View Article and Find Full Text PDFArticle Synopsis
- Researchers discovered a recessive syndrome linked to mutations in the DNA ligase 3 (LIG3) gene that causes chronic intestinal pseudo-obstruction and other neurological issues due to impaired mitochondrial DNA maintenance and energy production.
- They performed whole transcriptome analysis on patient fibroblasts, finding deregulated genes related to mitochondrial function and extracellular matrix development, and tested l-glutamine supplementation to address energy impairments.
- Treatment with l-glutamine significantly improved the symptoms of patients with LIG3 mutations, highlighting its potential as a targeted therapy for mitochondrial dysfunction related to this condition.*
Purpose: Minimally invasive radical nephrectomy is often preferred for larger renal tumours not suitable for partial nephrectomy (1). When performed with a multiport robot, the procedure is routinely performed with a transperitoneal approach, with recent studies highlighting important factors for surgical outcomes, including predictive factors (2), segmental artery unclamping techniques (3), and comparisons of robotic techniques (4). This video shows that SP Robot-Assisted Radical Nephrectomy (RARN) via a lower anterior approach is valuable in challenging cases.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates long-term epilepsy outcomes in pediatric patients who experienced acute central nervous system complications during hematopoietic cell transplantation (HCT).
- Data was collected from 94 patients, revealing that common acute complications included posterior reversible encephalopathy syndrome and infections, with a notable incidence of acute symptomatic seizures.
- Findings indicate that 9.6% of patients were diagnosed with long-term epilepsy, especially those who experienced acute symptomatic status epilepticus, highlighting the need for specialized neurological follow-up in these cases.
Purpose: The management of renal masses in the elderly population is particularly challenging, as these patients are often more frail and potentially more susceptible to surgical morbidity. This review aims to provide a comprehensive analysis of the outcomes of partial nephrectomy (PN) for treating renal masses in elderly individuals.
Methods: A systematic electronic literature search was conducted in May 2024 using the Medline (via PubMed) database by searching publications up to April 2024.
Background: Sturge-Weber syndrome (SWS) is a neurocutaneous disorder for which the neurological aspects, particularly headaches, remain poorly understood, despite significantly affecting morbidity. The present study aimed to elucidate the prevalence, characteristics and treatment strategies, as well as explore the pathogenesis of headaches, in SWS.
Methods: Using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, we systematically reviewed observational studies, case reports and series from eight databases (Cochrane Library, EBSCO, Embase, Medline, PubMed, Science Direct, Scopus and Web of Science), published from 1978 to 2023, to investigate the prevalence, characteristics, medication response and pathogenic theories of headaches in SWS.
Behçet's Disease (BD), also recognized as Behçet Syndrome, manifests uniquely in pediatric populations as Pediatric Behçet's Disease (PBD), characterized by multisystemic inflammatory symptoms including recurrent oral and genital aphthae, and diverse ocular, vascular, and neurological involvements. This review elucidates the prevalence, burden, and management strategies of headaches in children with PBD, focusing on both primary headaches, such as migraine and tension-type headaches, and secondary headaches linked to systemic disease manifestations. It explores the pathophysiological underpinnings specific to PBD-related headaches and discusses the intricate relationship between systemic inflammatory processes and neurological symptoms.
View Article and Find Full Text PDFUnlabelled: Familial hyperlysinemia is a rare autosomal recessive disorder due to defects of the AASS (α-aminoadipate δ-semialdehyde synthase) gene, which encodes for a bifunctional enzyme. Two types of hyperlysinemia have been identified namely type 1, due to the deficit of the alfa-ketoglutarate activity, and type 2, due to the deficit of the saccharopine dehydrogenase activity.
Methods: To better characterize the phenotypic spectrum of familial hyperlysinemia type 1, we conducted a systematic review of cases in the literature following PRISMA guidelines.
Background: The primary aims of our cross-sectional observational study were: (i) to determine the prevalence of depressive symptoms in children and adolescents with epilepsy compared to controls and (ii) to explore the difference in depressive symptoms in patients with epilepsy only and those with epilepsy and primary headache as a comorbidity. The secondary objective was to explore parental stress levels.
Methods: 68 pediatric patients aged 6-18 years (44 with epilepsy only and 24 with epilepsy and headache) and 50 controls were recruited.
The management of urothelial carcinoma has evolved with the introduction of minimally invasive techniques such as laparoscopic or robotic procedures, challenging the traditional approach of open surgery, and giving rise to atypical recurrences (ARs). ARs include port-site metastasis and peritoneal carcinomatosis, yet discrepancies persist among authors regarding their precise classification. Incidence rates of ARs vary widely across studies, ranging from less than 1% to over 10% in both muscle-invasive bladder cancer (MIBC) and upper tract urothelial tumor (UTUC).
View Article and Find Full Text PDFIntroduction: Post-stroke epilepsy (PSE) is one of the most common causes of acquired epilepsy. Nevertheless, there is limited evidence regarding the clinical profile of antiseizure medications (ASMs) in PSE. This study aims to evaluate the 12-month effectiveness and tolerability of perampanel (PER) used as only add-on treatment in patients with PSE in a real-world setting.
View Article and Find Full Text PDF