Application of a protocol for enhanced recovery after radical cystectomy: a before-and-after cohort study.

Purpose: Radical cystectomy with urinary diversion is a major urological surgery burdened both by a high rate of short- and long-term complications and by a high emotional and psychological impact. Post-operative recovery is extremely important and the application of ERAS protocols can facilitate the return to functional autonomy. The aim of the present study was to verify the efficacy of our ERAS programme on outcomes of recovery after surgery of patients undergoing radical cystectomy with various urinary diversions.

Occult Neck Metastases in Head and Neck Adenoid Cystic Carcinoma: A Systematic Review and Meta-Analysis.

Adenoid cystic carcinoma (AdCC) is a rare tumor whose clinical course is burdened by local recurrence and distant dissemination. Lymph node metastasis is not believed to be common and its clinical impact is controversial. The aim of this study was to determine: (1) the prevalence of occult metastasis at diagnosis in cN0 head and neck AdCC, (2) its prognostic role, and (3) the consequent need to perform elective neck dissection (END).

Vitamin D 25OH Deficiency and Mortality in Moderate to Severe COVID-19: A Multi-Center Prospective Observational Study.

Introduction: Several studies and meta-analyses suggested the role of vitamin D 25OH in preventing severe forms of coronavirus disease 2019 (COVID-19). However, the evidence on the clinical benefits of vitamin D 25OH adequacy in patients hospitalized for COVID-19 remain conflicting and speculative. We aimed to investigate the association between vitamin D 25OH serum levels and mortality in hospitalized patients with moderate to severe COVID-19.

De-escalation studies in HPV-positive oropharyngeal cancer: How should we proceed?

Human papilloma virus (HPV) is a well-established causative factor in a subset of squamous cell carcinomas of the head and neck (HNSCC). Although HPV can be detected in various anatomical subsites, HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) is the most common HPV-related malignancy of the head and neck, and its worldwide incidence is constantly rising. Patients with OPSCC are generally younger, have less co-morbidities and generally have better prognosis due to different biological mechanisms of carcinogenesis.

Antibiotic prophylaxis in head and neck cancer surgery: Systematic review and Bayesian network meta-analysis.

Postoperative surgical site infections (SSI) are worrisome complications after head and neck cancer surgery. Due to the lack of direct comparisons, it is difficult to indicate the best antibiotic in the setting of SSI prophylaxis for patients with head and neck cancer. For this reason, we decided to conduct a Bayesian network meta-analysis of clinical studies evaluating various antibiotic classes for SSI prophylaxis; thus, we directly and indirectly compared all the available antibiotics in the setting of head and neck oncological surgery.

Effect of a common missense variant in LIPA gene on fatty liver disease and lipid phenotype: New perspectives from a single-center observational study.

Lysosomal acid lipase deficiency (LAL-D) is an autosomal recessive disease characterized by hypoalphalipoproteinemia, mixed hyperlipemia, and fatty liver (FL) due to mutations in LIPAse A, lysosomal acid type (LIPA) gene. The rs1051338 single-nucleotide polymorphism (SNP) in LIPA gene, in vitro, could adversely affect the LAL activity (LAL-A). Nonalcoholic fatty liver disease (NAFLD) is often associated with metabolic syndrome, and the diagnosis requires the exclusion of excess of alcohol intake and other causes of hepatic disease.

Nutritional parameters associated with prognosis in non-critically ill hospitalized COVID-19 patients: The NUTRI-COVID19 study.

Background & Aims: To investigate the association between the parameters used in nutritional screening assessment (body mass index [BMI], unintentional weight loss [WL] and reduced food intake) and clinical outcomes in non-critically ill, hospitalized coronavirus disease 2019 (COVID-19) patients.

Methods: This was a prospective multicenter real-life study carried out during the first pandemic wave in 11 Italian Hospitals. In total, 1391 patients were included.

Effects of a Mediterranean Diet, Dairy, and Meat Products on Different Phenotypes of Dyslipidemia: A Preliminary Retrospective Analysis.

Background: Dyslipidemia is one of the major causes of atherosclerotic cardiovascular disease (ASCVD) and a Mediterranean Diet (MD) is recommended for its prevention. The objectives of this study were to evaluate adherence to an MD at baseline and follow-up, in a cohort of dyslipidemic patients, and to evaluate how different food intakes can influence lipid profile, especially how different sources of saturated fatty acids impact lipid phenotype.

Methods: A retrospective analysis was conducted on 106 dyslipidemic patients.

Nutritional therapy for patients with coronavirus disease 2019 (COVID-19): Practical protocol from a single center highly affected by an outbreak of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Objectives: Coronavirus disease 2019 (COVID-19) carries a high risk for malnutrition owing to the state of debilitation that results from acute respiratory failure symptoms. The aim of this study was to provide an approach to reduce the risk for malnutrition and improve patients' clinical outcomes.

Methods: Short age-adjusted Nutritional Risk Screening was performed with 94 non-intensive care unit (ICU) patients admitted to the Giovanni Borea Civil Hospital in Sanremo.

Elective neck dissection in primary parotid carcinomas: A systematic review and meta-analysis.

Background: To estimate the rate of occult cervical lymph node metastases in cN0 patients affected by primary parotid carcinomas and to scrutinize the evidence on the indication and extent of elective neck dissection in these neoplasms.

Methods: Medline, Embase, Web of Science, Cochrane Library and Scopus were searched until August 31, 2020, to identify studies reporting the use of elective neck dissection in the management of malignant parotid tumours. The PRISMA checklist was used.

Dietary Habits and Risk of Esophagitis and Barrett's Esophagus: A Multicenter Italian Case-Control Study.

Background: Barrett's esophagus (BE) and esophagitis share potentially modifiable risk factors such as obesity, smoking, and alcohol. The role of diet on BE and esophagitis is still debated.

Aims: The objective of this study was to examine the association between some dietary habits and the risk of BE and esophagitis in Italy.

Diet and Nutraceutical Supplementation in Dyslipidemic Patients: First Results of an Italian Single Center Real-World Retrospective Analysis.

Background: Dyslipidemias are a heterogeneous group of metabolic disorders mainly characterized by an increased risk of atherosclerotic cardiovascular disease (ASCVD) or other conditions, such as acute pancreatitis in hypertriglyceridemia. The aim of this study was to evaluate the effect of diet treatment and nutraceutical (NUTs) supplementation on the plasma lipid profile in outpatient dyslipidemic subjects, considering the influence of several factors (i.e.

Endoscopic nasopharyngoscopy and ENT specialist safety in the COVID 19 era: the back endoscopy approach to the patient.

Purpose: To propose a way to safely perform endoscopic nasopharyngoscopy in ENT outpatient clinic during the COVID-19 pandemic.

Methods: This manuscript highlights the importance of endoscopy in daily ENT clinical practice, which is a pivotal procedure in the diagnosis of many head and neck pathologies. However, since the beginning of the COVID-19 outbreak, the authors have witnessed a drastic reduction (91%) in the use of endoscopic nasopharyngoscopy at their institutions.

Lymph node yield and lymph node ratio in oral cavity and oropharyngeal carcinoma: Preliminary results from a prospective, multicenter, international cohort.

Objectives: Recently, Lymph Node Yield (LNY) and Lymph Node Ratio (LNR) have emerged as prognostic indicators in head and neck cancer. However, there is a lack of data regarding the LNY and LNR values in the specific neck levels dissected and regarding the factors that influence these values.

Materials And Methods: Preliminary results of the NCT03534778 trial are reported.

Lateral conservative approach for recurrent/persistent hypopharyngeal carcinoma: a case series.

Purpose: Early persistent/recurrent hypopharyngeal tumours represent a challenge for surgeons who have to balance the need for oncological radicality and the desire to maintain a functioning larynx with preservation of the patient's quality of life. The aim of this study was primarily to understand the technical feasibility, functional outcomes, and the possibility of obtaining oncological radicality using lateral hypopharyngectomy with laryngeal preservation in early recurrent post-radio/(chemo)therapy hypopharyngeal tumours.

Methods: Patients with recurrent T1 hypopharyngeal squamous cell carcinoma were retrospectively selected from our institutional database.

Performing the nasopharyngeal and oropharyngeal swab for 2019-novel coronavirus (SARS-CoV-2) safely: How to dress, undress, and technical notes.

Background: To show how to safely perform nasopharyngeal and/or oropharyngeal swabs for 2019-novel coronavirus.

Methods: The video describes in detail the dressing and undressing procedures of health personnel, with the appropriate personal protective equipment. Technical notes for the execution of the nasopharyngeal and oropharyngeal swab are also provided to avoid sampling errors.

Lateral cervical approach for salvage total laryngectomy without pharyngeal reinforcement with pedicled or free flaps: our preliminary experience in six patients.

Purpose: To analyze the surgical outcomes in terms of postoperative wound complications in a small case series of six patients treated with lateral cervical approach (LCA) for salvage total laryngectomy (STL) without prophylactic use of the pectoralis major myocutaneous flap (PMMF) or free flaps.

Methods: Between September 2018 and August 2019, six patients with recurrent/residual squamous-cell carcinoma after (chemo)radiotherapy [(C)RT] underwent STL with minimally invasive LCA with the anterior myocutaneous flap (AMCF), sparing the prelaryngeal tissue. Clinical records were retrospectively reviewed.

Trans-oral robotic surgery in the management of parapharyngeal space tumors: A systematic review.

Purpose: To perform a systematic review of studies evaluating Trans-oral Robotic Surgery (TORS) in the treatment of parapharyngeal space (PPS) tumors.

Methods: A comprehensive electronic search was performed in PubMed/MEDLINE, Cochrane Library, and Google Scholar databases for appropriate published studies. The last search was conducted on November 9, 2019.

Free flap microvascular anastomosis in head and neck reconstruction using a 4K three-dimensional exoscope system (VITOM 3D).

The aim of this study was to evaluate the feasibility of microvascular anastomosis using a 4K three-dimensional exoscope system (VITOM 3D) in 10 consecutive cases of free flap head and neck reconstructive surgery. This was a clinical human study of free flap microvascular anastomosis using a VITOM 3D exoscope in 10 consecutive patients undergoing reconstruction after ablative surgery for head and neck carcinoma. Microvascular anastomoses were performed successfully using the exoscope in all patients, without any need for the conventional microscope.

Potentially malignant disorders of the oral cavity and oral dysplasia: A systematic review and meta-analysis of malignant transformation rate by subtype.

Importance: Potentially malignant disorders of the oral cavity (OPMD) are a heterogeneous group of lesions associated with a variable risk of malignant transformation (MT) to invasive cancer. Leukoplakia (LE), lichen planus (LP), oral lichenoid lesions (OLL), oral erythroplakia (OE), oral submucous fibrosis (OSF), and proliferative verrucous leukoplakia (PVL) are among the most common of these lesions. Oral dysplasia is a mucosal area characterized by cellular and architectural derangement, which may be associated with OPMDs or not.

Narrow band imaging in head and neck unknown primary carcinoma: A systematic review and meta-analysis.

Objective: To estimate the diagnostic performance of Narrow Band Imaging (NBI) in patients with cervical metastasis from head and neck squamous cell carcinoma of unknown primary (SCCUP) origin.

Methods: PubMed, Embase, and Scopus databases were systematically scrutinized up to July 1, 2019, looking for studies that encompassed the NBI in the SCCUP diagnostic work up. The main inclusion criteria for eligible articles for the meta-analysis were non-evidence of primary tumor after physical examination and conventional cross-section imaging before NBI assessment and the availability of complete data on the diagnostic accuracy of NBI.

Anatomical-based classification for transoral lateral oropharyngectomy.

Purpose: The aim of the study is proposing a classification of different transoral lateral oropharyngectomy procedures in order to ensure better definitions of post-operative results.

Methods: The classification resulted from the consensus of the different authors and was based on anatomical-surgical principles.

Results: The classification comprises three types of lateral oropharyngectomy: type 1 is the resection of the palatine tonsil deep to the pharyngobasilar fascia; type 2 is performed by removing the entire palatine tonsil, the palatoglossus muscle, the palatopharyngeal muscle and the superior constrictor muscle; type 3 is performed by removing the entire palatine tonsil, the palatoglossus muscle, the palatopharyngeal muscle, the superior constrictor muscle, the buccopharyngeal fascia with extension to the pterygoid muscle and parapharyngeal space fat content.

Head and neck soft tissue reconstruction with anterolateral thigh flaps with various components: Development of an algorithm for flap selection in different clinical scenarios.

Objectives: The antero-lateral thigh free flap (ALT) is conventionally designed as a fasciocutaneous flap (FALT). However, the thickness of the flap can be designed in at least in two more variants: myocutaneous (MYALT), and myofascial (MALT). The aim of this study was to evaluate the use of ALT flap as a universal solution for head and neck soft tissue reconstruction and development of an algorithm for flap selection in different clinical scenarios.

Clinical outcomes, pharmacological treatment, and quality of life of patients with stable coronary artery diseases managed by cardiologists: 1-year results of the START study.

Aims: We evaluated the 1-year clinical events, pharmacological management, and quality of life in a contemporary cohort of stable coronary artery disease (CAD) patients managed by cardiologists.

Methods And Results: START (STable Coronary Artery Diseases RegisTry) was a prospective, observational, nationwide study that enrolled 5070 stable CAD patients over 3 months in 183 cardiology centres in Italy. At 1 year, 4790 (94.

Trial-level analysis of progression-free survival and response rate as end points of trials of first-line chemotherapy in advanced ovarian cancer.

Progression-free survival (PFS) has been reported as surrogate end point of overall survival (OS) in trials of advanced ovarian cancer (AOC). However, there is not a trial-level evaluation of surrogacy. The aim of this study is to perform an analysis of randomized trials enrolling patients with AOC receiving a first-line systemic chemotherapy, in order to evaluate the results of PFS, the other intermediate end points and their relationship with OS.