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Zanelli M, Zizzo M, Sanguedolce F, Soriano A, Martino G, Annessi V, Ascani S. Subcutaneous marginal zone lymphoma: an unusual lipoma-like presentation. Ann Hematol 2020; 99:1409-1410. [PMID: 32266425 DOI: 10.1007/s00277-020-04011-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 03/27/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy. .,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.
| | - Francesca Sanguedolce
- Pathology Unit, Azienda Ospedaliera Universitaria "Ospedali Riuniti" di Foggia, Foggia, Italy
| | - Alessandra Soriano
- Gastroenterology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Martino
- Hematology Unit, CREO, Azienda Ospedaliera di Perugia, University of Perugia, Perugia, Italy
| | - Valerio Annessi
- General and Emergency Surgery Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Guastalla, Reggio Emilia, Italy
| | - Stefano Ascani
- Pathology Unit, Ospedale di Terni-University of Perugia, Terni, Italy
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Escudero-Sanchez R, Senneville E, Digumber M, Soriano A, Del Toro MD, Bahamonde A, Del Pozo JL, Guio L, Murillo O, Rico A, García-País MJ, Rodríguez-Pardo D, Iribarren JA, Fernández M, Benito N, Fresco G, Muriel A, Ariza J, Cobo J. Suppressive antibiotic therapy in prosthetic joint infections: a multicentre cohort study. Clin Microbiol Infect 2020; 26:499-505. [PMID: 31539638 DOI: 10.1016/j.cmi.2019.09.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/01/2019] [Accepted: 09/07/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The aim was to describe the effectiveness of suppressive antibiotic treatment (SAT) in routine clinical practice when used in situations in which removal of a prosthetic implant is considered essential for the eradication of an infection, and it cannot be performed. METHODS This was a descriptive retrospective and multicentre cohort study of prosthetic joint infection (PJI) cases managed with SAT. SAT was considered to have failed if a fistula appeared or persisted, if debridement was necessary, if the prosthesis was removed due to persistence of the infection or if uncontrolled symptoms were present. RESULTS In total, 302 patients were analysed. Two hundred and three of these patients (67.2%) received monotherapy. The most commonly used drugs were tetracyclines (39.7% of patients) (120/302) and cotrimoxazole (35.4% of patients) (107/302). SAT was considered successful in 58.6% (177/302) of the patients (median time administered, 36.5 months; IQR 20.75-59.25). Infection was controlled in 50% of patients at 5 years according to Kaplan-Meier analysis. Resistance development was documented in 15 of 65 (23.1%) of the microbiologically documented cases. SAT failure was associated with age <70 years (sub-hazard ratio (SHR) 1.61, 95% CI 1.1-2.33), aetiology other than Gram-positive cocci (SHR 1.56, 95% CI 1.09-2.27) and location of the prosthesis in the upper limb (SHR 2.4, 95% CI 1.5-3.84). SAT suspension was necessary due to adverse effects in 17 of 302 patients (5.6%). CONCLUSIONS SAT offers acceptable results for patients with PJI when surgical treatment is not performed or when it fails to eradicate the infection.
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Affiliation(s)
| | - E Senneville
- Centre Hospitalier Gustave Dron, Tourcoing, France
| | - M Digumber
- Centre Hospitalier Gustave Dron, Tourcoing, France
| | | | | | | | | | - L Guio
- Hospital Cruces, Vizcaya, Spain
| | - O Murillo
- Hospital Bellvitge, Barcelona, Spain
| | - A Rico
- Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | | | - N Benito
- Hospital Santa Creu I Sant Pau, Barcelona, Spain
| | - G Fresco
- Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
| | - A Muriel
- Hospital Ramón y Cajal, IRYCIS, CIBER, Madrid, Spain
| | - J Ariza
- Hospital Bellvitge, Barcelona, Spain
| | - J Cobo
- Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
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Fratoni S, Zanelli M, Zizzo M, Sanguedolce F, Aimola V, Cerrone G, Ricci L, Filosa A, Martino G, Fara AM, Annessi V, Soriano A, Ascani S. The broad landscape of follicular lymphoma: Part II. Pathologica 2020; 112:79-92. [PMID: 32202535 PMCID: PMC7931560 DOI: 10.32074/1591-951x-6-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 01/16/2020] [Indexed: 12/15/2022] Open
Abstract
Follicular lymphoma is a neoplasm derived from follicle center B cells, typically both centrocytes and centroblasts, in variable proportions according to the lymphoma grading. The pattern of growth may be entirely follicular, follicular and diffuse and rarely completely diffuse. It represents the second most common non-Hodgkin lymphoma, after diffuse large B-cell lymphoma and it is the most common low-grade mature B-cell lymphoma in Western countries. In the majority of cases, follicular lymphoma is a nodal tumor, occurring in adults and is frequently associated with the translocation t(14;18)(q32;q21)/IGH-BCL2. However, in recent years the spectrum of follicular lymphoma has expanded and small subsets of follicular lymphoma, which differ from common follicular lymphoma, have been identified and included in the current 2017 WHO classification. The aim of our review is to describe the broad spectrum of follicular lymphoma, pointing out that the identification of distinct clinicopathological variants of follicular lymphoma is relevant for the patient outcomes and treatment.
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Affiliation(s)
- Stefano Fratoni
- Department of Anatomic Pathology, St. Eugenio Hospital of Rome, Rome, Italy
| | - Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesca Sanguedolce
- Pathology Unit, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Foggia, Foggia, Italy
| | | | | | - Linda Ricci
- Pathology Unit, University of Siena, Siena, Italy
| | | | - Giovanni Martino
- Hematology Unit, CREO, Azienda Ospedaliera di Perugia, University of Perugia, Perugia, Italy
| | - Antonella Maria Fara
- Pathology Unit, Department of Medical, Surgical and Experimental Surgery, University of Sassari, Italy
| | - Valerio Annessi
- General Surgery Unit, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Guastalla, Reggio Emilia, Italy
| | - Alessandra Soriano
- Gastroenterology Unit, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera Santa Maria Terni, University of Perugia, Terni, Italy
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Bonacini M, Soriano A, Cimino L, De Simone L, Bolletta E, Gozzi F, Muratore F, Nicastro M, Belloni L, Zerbini A, Fontana L, Salvarani C, Croci S. Cytokine Profiling in Aqueous Humor Samples From Patients With Non-Infectious Uveitis Associated With Systemic Inflammatory Diseases. Front Immunol 2020; 11:358. [PMID: 32210963 PMCID: PMC7077343 DOI: 10.3389/fimmu.2020.00358] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 02/14/2020] [Indexed: 12/14/2022] Open
Abstract
Non-infectious uveitis are intraocular inflammatory conditions caused by dysregulated activation of the immune response without any detectable infectious agents. The aim of this study was to explore potential markers and therapeutic targets for two distinct types of non-infectious uveitis associated with Behçet's disease (BD) and Vogt Koyanagi Harada (VKH) disease. Concentrations of 27 cytokines were investigated in aqueous humor (AH) samples from patients with active uveitis vs. healthy controls (HC) (n = 10 patients with BD-associated uveitis; n = 10 patients with VKH-associated uveitis; n = 10 HC) using the Bio-Plex ProTM human cytokine group I panel. Additionally, leukocytes in AH samples were counted with hemocytometers and characterized by flow cytometry. Eleven cytokines were differentially expressed between patients with uveitis and HC with a median concentration greater than 10 pg/ml. IL-6, IP-10, G-CSF, and IFNγ showed higher concentrations in AH samples from both BD and VKH patients while IL-2, IL-8, IL-13, TNFα, eotaxin, IL-1ra showed statistically significant higher concentrations only in AH samples from BD patients. GM-CSF was the sole cytokine with an opposite profile showing decreased levels in AH samples from BD patients. IL-1ra and IL-6 were detected at higher frequencies in AH samples from BD and VKH patients compared with those from HC while IFNγ and TNFα were not detected in HC. The concentrations of IL-6, IL-8, IP-10, G-CSF, IFNγ, TNFα, eotaxin, IL-1ra positively correlated with the concentrations of leukocytes in AH, suggesting that such cytokines can be produced by immune cells and/or attract and/or promote proliferation and survival of immune cells in these types of uveitis. The correlation matrix of cytokine concentrations in AH samples revealed that IFNγ, TNFα, eotaxin, IL-6, G-CSF highly correlated each other. The ratios of cytokine concentrations between AH and plasma intra-individuals showed that IL-2, IL-6, IP-10, GM-CSF were increased intraocularly. In conclusion, AH sampling followed by multiplex analysis of cytokines should be fostered in non-infectious uveitis to identify cytokines dysregulated intraocularly in each individual laying the groundwork for precision medicine.
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Affiliation(s)
- Martina Bonacini
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandra Soriano
- Rheumatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Cimino
- Ocular Immunology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca De Simone
- Ocular Immunology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elena Bolletta
- Ocular Immunology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Fabrizio Gozzi
- Ocular Immunology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Muratore
- Rheumatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria Nicastro
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Lucia Belloni
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandro Zerbini
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luigi Fontana
- Ophthalmology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Carlo Salvarani
- Rheumatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department of Surgery, Medicine, Dentistry and Morphological Sciences, With Interest in Transplants, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Croci
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Molist C, Navarro N, Giralt I, Zarzosa P, Gallo-Oller G, Pons G, Magdaleno A, Moreno L, Guillén G, Hladun R, Garrido M, Soriano A, Segura MF, Sánchez de Toledo J, Gallego S, Roma J. miRNA-7 and miRNA-324-5p regulate alpha9-Integrin expression and exert anti-oncogenic effects in rhabdomyosarcoma. Cancer Lett 2020; 477:49-59. [PMID: 32142919 DOI: 10.1016/j.canlet.2020.02.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 01/16/2020] [Accepted: 02/27/2020] [Indexed: 11/15/2022]
Abstract
The prognosis of patients with metastatic rhabdomyosarcoma (RMS), the most common type of soft tissue sarcoma in children, is poor and no strategies have been identified to improve their dismal prognosis. Alpha-9 integrin (ITGA9) plays a particularly crucial role in cancer progression and invasiveness. Despite the consensus on the remarkable pro-oncogenic potential of this protein, the miRNA-mediated regulation of ITGA9 has barely been studied to date. In the present study, miR-7 and miR-324-5p were selected as the best candidates after a screening to find ITGA9 regulators, and their effects on cell proliferation and invasion in RMS are described and characterized for the first time. Interestingly, the overexpression of both miRNA produced a clear impairment of cell proliferation, while miR-7 also induced a remarkable drop in cell invasion. Furthermore, the stable overexpression of both miRNA was found to reduce tumor growth in orthotopic RMS models and miR-7 was able to impair metastatic lung colonization. Consequently, we conclude that miR-7 and miR-324-5p show anti-oncogenic and anti-metastatic potential, thereby opening up the possibility of being used as novel therapeutic tools to avoid RMS progression.
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Affiliation(s)
- C Molist
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Navarro
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Giralt
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - P Zarzosa
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - G Gallo-Oller
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - G Pons
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Magdaleno
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Moreno
- Pediatric Oncology and Hematology Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - G Guillén
- Pediatric Surgery Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Spain
| | - R Hladun
- Pediatric Oncology and Hematology Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Garrido
- Pathology Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Spain
| | - A Soriano
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M F Segura
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Sánchez de Toledo
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; Pediatric Oncology and Hematology Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Gallego
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; Pediatric Oncology and Hematology Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - J Roma
- Laboratory of Translational Research in Child and Adolescent Cancer, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Soriano A, Oh J, Hassani D, Andy U, Arya L. 42: What do residents want in a surgical video? Trainee perspectives on the vaginal hysterectomy. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.12.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Suyama J, Yang F, Soriano A, Rao H, Arya L. 25: Mechanisms underlying nocturia in women with bladder pain syndrome/interstitial cystitis. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.12.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hassani D, Soriano A, Arya L, Uduak A. 33: Relationship between symptoms and urinary biomarkers in women with dry overactive bladder. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.12.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Herbst R, Arkenau H, Bendell J, Arrowsmith E, Wermke M, Soriano A, Penel N, Santana-Davila R, Bischoff H, Chau I, Chao B, Ferry D, Mi G, Paz-Ares L. MA14.07 Phase I Expansion Cohort of Ramucirumab Plus Pembrolizumab in Advanced Treatment-Naïve Non-Small Cell Lung Cancer (JVDF). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Farjadian S, Bonatti F, Soriano A, Reina M, Adorni A, Graziano C, Moghtaderi M, Percesepe A, Romeo G, Martorana D. A new MEFV gene mutation in an Iranian patient with familial Mediterranean fever. Reumatismo 2019; 71:85-87. [PMID: 31309779 DOI: 10.4081/reumatismo.2019.1141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 10/28/2018] [Indexed: 11/23/2022] Open
Abstract
Familial mediterranean fever (FMF) is an inherited autoinflammatory disorder characterized by recurrent episodes of fever and painful inflammation involving the intra-abdominal organs, the lungs and the joints, which is highly prevalent in specific ethnic groups including the Iranians. We report a 12-year-old boy from Iran, with a clinical history of recurrent fever. Based on the suggestive clinical data, mutational analysis revealed the presence of the novel c.1945C>T heterozygous variant in exon 10, which leads to a leucine to phenylalanine change at position 649 of the protein. The mutation was inherited from the mother. This novel mutation lies in exon 10 of the MEFV gene, which encodes for a domain called B30.2-SPRY, located in the C-terminal region of the pyrin protein and contains the most frequent mutations associated with FMF. The present report expands the spectrum of MEFV gene mutations associated with FMF. The uniqueness of this study, compared with other published case reports, consists in the new mutation found in the MEFV gene. In fact, new mutations in this gene are of high interest, in order to better understand the role of this gene in autoinflammation.
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Affiliation(s)
- S Farjadian
- Department of Immunology, Shiraz University of Medical Sciences, Shiraz.
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Viasus D, Puerta-Alcalde P, Cardozo C, Suárez-Lledó M, Rodríguez-Núñez O, Morata L, Fehér C, Marco F, Chumbita M, Moreno-García E, Fernández-Avilés F, Gutiérrez-Garcia G, Martínez JA, Mensa J, Rovira M, Esteve J, Soriano A, Garcia-Vidal C. Predictors of multidrug-resistant Pseudomonas aeruginosa in neutropenic patients with bloodstream infection. Clin Microbiol Infect 2019; 26:345-350. [PMID: 31295551 DOI: 10.1016/j.cmi.2019.07.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 06/07/2019] [Accepted: 07/01/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To assess risk factors for multidrug-resistant Pseudomonas aeruginosa (MDR-PA) infection in neutropenic patients. METHODS Single-centre retrospective analysis of consecutive bloodstream infection (BSI) episodes (2004-2017, Barcelona). Two multivariate regression models were used at BSI diagnosis and P. aeruginosa detection. Significant predictors were used to establish rules for stratifying patients according to MDR-PA BSI risk. RESULTS Of 661 Gram-negative BSI episodes, 190 (28.7%) were caused by P. aeruginosa (70 MDR-PA). Independent factors associated with MDR-PA among Gram-negative organisms were haematological malignancy (OR 3.30; 95% CI 1.15-9.50), pulmonary source of infection (OR 7.85; 95% CI 3.32-18.56), nosocomial-acquired BSI (OR 3.52; 95% CI 1.74-7.09), previous antipseudomonal cephalosporin (OR 13.66; 95% CI 6.64-28.10) and piperacillin/tazobactam (OR 2.42; 95% CI 1.04-5.63), and BSI occurring during ceftriaxone (OR 4.27; 95% CI 1.15-15.83). Once P. aeruginosa was identified as the BSI aetiological pathogen, nosocomial acquisition (OR 7.13; 95% CI 2.87-17.67), haematological malignancy (OR 3.44; 95% CI 1.07-10.98), previous antipseudomonal cephalosporin (OR 3.82; 95% CI 1.42-10.22) and quinolones (OR 3.97; 95% CI 1.37-11.48), corticosteroids (OR 2.92; 95% CI 1.15-7.40), and BSI occurring during quinolone (OR 4.88; 95% CI 1.58-15.05) and β-lactam other than ertapenem (OR 4.51; 95% CI 1.45-14.04) were independently associated with MDR-PA. Per regression coefficients, 1 point was assigned to each parameter, except for nosocomial-acquired BSI (3 points). In the second analysis, a score >3 points identified 60 (86.3%) out of 70 individuals with MDR-PA BSI and discarded 100 (84.2%) out of 120 with non-MDR-PA BSI. CONCLUSIONS A simple score based on demographic and clinical factors allows stratification of individuals with bacteraemia according to their risk of MDR-PA BSI, and may help facilitate the use of rapid MDR-detection tools and improve early antibiotic appropriateness.
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Affiliation(s)
- D Viasus
- Health Sciences Division, Universidad del Norte, and Hospital Universidad del Norte, Barranquilla, Colombia
| | - P Puerta-Alcalde
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - C Cardozo
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - M Suárez-Lledó
- Haematology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - O Rodríguez-Núñez
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - L Morata
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - C Fehér
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - F Marco
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Microbiology Department, Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain
| | - M Chumbita
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - E Moreno-García
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | | | - G Gutiérrez-Garcia
- Haematology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - J A Martínez
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - J Mensa
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - M Rovira
- Haematology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - J Esteve
- Haematology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - A Soriano
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - C Garcia-Vidal
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain.
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Orihuela-Martín J, Rodríguez-Núñez O, Morata L, Cardozo C, Puerta-Alcalde P, Hernández-Meneses M, Ambrosioni J, Linares L, Bodro M, de Los Angeles Guerrero-León M, Del Río A, Garcia-Vidal C, Almela M, Pitart C, Marco F, Soriano A, Martínez JA. Performance of differential time to positivity as a routine diagnostic test for catheter-related bloodstream infections: a single-centre experience. Clin Microbiol Infect 2019; 26:383.e1-383.e7. [PMID: 31288101 DOI: 10.1016/j.cmi.2019.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 06/05/2019] [Accepted: 07/01/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the performance of differential time to positivity (DTP) for the diagnosis of catheter-related bloodstream infections (CRBSI). METHODS From all episodes of bloodstream infections (BSI) diagnosed during a 15-year period (2003-17) those in which a paired set of blood cultures drawn from a catheter and a peripheral vein were positive for the same microorganism and had a clinically and/or microbiologically defined source were selected. To assess diagnostic discrimination ability and accuracy of DTP for CRBSI, area under the receiver operating characteristic curves (AUC) and performance characteristics of a DTP ≥2 h were computed. RESULTS A total of 512 BSI were included, of which 302 (59%) were CRBSI. Discrimination ability of DTP was low for Staphylococcus aureus (AUC 0.656 ± 0.06), coagulase-negative staphylococci (AUC 0.618 ± 0.081), enterococci (AUC 0.554 ± 0.117) and non-AmpC-producing Enterobacteriaceae (AUC 0.653 ± 0.053); moderate for Pseudomonas aeruginosa (AUC 0.841 ± 0.073), and high for AmpC-producing Enterobacteriaceae (AUC 0.944 ± 0.039). For the entire sample, DTP had a low-to-moderate discrimination ability (AUC 0.698 ± 0.024). A DTP ≥2 h has a low sensitivity for coagulase-negative staphylococci (60%) and very low for S. aureus (34%), enterococci (40%) and non-AmpC-producing Enterobacteriaceae (42%). A DTP cut-off of 1 h improved sensitivity (90%) for AmpC-producing Enterobacteriaceae. CONCLUSIONS Differential time to positivity performs well for diagnosing CRBSI only when AmpC-producing Enterobacteriaceae and P. aeruginosa are involved. Performance is low for common Gram-positive organisms and non-AmpC-producing enteric bacilli; a negative test should not be used to rule out CRBSI due to these microorganisms. A DTP ≥1 h may improve accuracy for AmpC-producing Enterobacteriaceae, particularly Enterobacter spp.
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Affiliation(s)
- J Orihuela-Martín
- Service of Internal Medicine, Insular University Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain.
| | - O Rodríguez-Núñez
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - L Morata
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - C Cardozo
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - P Puerta-Alcalde
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M Hernández-Meneses
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - J Ambrosioni
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - L Linares
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M Bodro
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M de Los Angeles Guerrero-León
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - A Del Río
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - C Garcia-Vidal
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M Almela
- Service of Microbiology, ISGlobal, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - C Pitart
- Service of Microbiology, ISGlobal, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - F Marco
- Service of Microbiology, ISGlobal, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - A Soriano
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - J A Martínez
- Service of Infectious Diseases, Hospital Clínic de Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Chau I, Bendell J, Soriano A, Arkenau H, Cultrera J, Santana-Davila R, Calvo E, Tourneau CL, Zender L, Mi G, Schelman W, Ferry D, Herbst R, Fuchs C. Safety and antitumor activity from the phase Ib study of ramucirumab plus pembrolizumab in treatment-naïve advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma (JVDF). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz157.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Arora E, Soriano A, Sansone S, Arya L, Andy U. 41: Contaminated mid-stream urine specimens in women with pelvic organ prolapse. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.01.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Croci S, Bonacini M, Muratore F, Caruso A, Fontana A, Boiardi L, Soriano A, Cavazza A, Cimino L, Belloni L, Perry O, Fridkin M, Parmeggiani M, Blank M, Shoenfeld Y, Salvarani C. The therapeutic potential of tuftsin-phosphorylcholine in giant cell arteritis. J Autoimmun 2019; 98:113-121. [PMID: 30638709 DOI: 10.1016/j.jaut.2019.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 12/09/2018] [Accepted: 01/02/2019] [Indexed: 01/13/2023]
Abstract
Tuftsin-PhosphorylCholine (TPC) is a novel bi-specific molecule which links tuftsin and phosphorylcholine. TPC has shown immunomodulatory activities in experimental mouse models of autoimmune diseases. We studied herein the effects of TPC ex vivo on both peripheral blood mononuclear cells (PBMCs) and temporal artery biopsies (TABs) obtained from patients with giant cell arteritis (GCA) and age-matched disease controls. GCA is an immune-mediated disease affecting large vessels. Levels of 18 cytokines in supernatants, PBMC viability, T helper (Th) cell differentiation of PBMCs and gene expression in TABs were analyzed. Treatment ex vivo with TPC decreased the production of IL-1β, IL-2, IL-5, IL-6, IL-9, IL-12(p70), IL-13, IL-17A, IL-18, IL-21, IL-22, IL-23, IFNγ, TNFα, GM-CSF by CD3/CD28 activated PBMCs whereas it negligibly affected cell viability. It reduced Th1 and Th17 differentiation while did not impact Th22 differentiation in PBMCs stimulated by phorbol 12-myristate 13-acetate plus ionomycin. In inflamed TABs, treatment with TPC down-regulated the production of IL-1β, IL-6, IL-13, IL-17A and CD68 gene expression. The effects of TPC were comparable to the effects of dexamethasone, included as the standard of care, with the exception of a greater reduction of IL-2, IL-18, IFNγ in CD3/CD28 activated PBMCs and CD68 gene in inflamed TABs. In conclusion our results warrant further investigations regarding TPC as an immunotherapeutic agent in GCA and potentially other autoimmune and inflammatory diseases.
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Affiliation(s)
- Stefania Croci
- Unit of Clinical Immunology, Allergy and Advanced Biotechnologies, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
| | - Martina Bonacini
- Unit of Clinical Immunology, Allergy and Advanced Biotechnologies, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Muratore
- Unit of Rheumatology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy; Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea Caruso
- Unit of Rheumatology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Antonio Fontana
- Unit of Vascular Surgery, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luigi Boiardi
- Unit of Rheumatology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandra Soriano
- Unit of Rheumatology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy; Campus Bio-Medico, University of Rome, Rome, Italy
| | - Alberto Cavazza
- Unit of Pathology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Cimino
- Unit of Ocular Immunology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Lucia Belloni
- Unit of Clinical Immunology, Allergy and Advanced Biotechnologies, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Ori Perry
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Mati Fridkin
- Department of Organic Chemistry, The Weizmann Institute of Sciences, Rehovot, Israel
| | - Maria Parmeggiani
- Unit of Clinical Immunology, Allergy and Advanced Biotechnologies, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Miri Blank
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
| | - Yehuda Shoenfeld
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
| | - Carlo Salvarani
- Unit of Rheumatology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy; Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
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Bonacini M, Soriano A, Zerbini A, Calò E, Cimino L, Muratore F, Fontana L, Braglia L, Parmeggiani M, Salvarani C, Croci S. Higher Frequencies of Lymphocytes Expressing the Natural Killer Group 2D Receptor in Patients With Behçet Disease. Front Immunol 2018; 9:2157. [PMID: 30319620 PMCID: PMC6167483 DOI: 10.3389/fimmu.2018.02157] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 08/31/2018] [Indexed: 12/31/2022] Open
Abstract
Behçet disease (BD) is an inflammatory systemic disease with a fluctuating course, which can affect the skin, eyes, central nervous system, musculoskeletal, gastrointestinal, and vascular systems. No laboratory tests are currently available for the diagnosis of BD and monitoring disease activity. Moreover there is a lack of knowledge on BD pathogenesis. This study focused on circulating Natural Killer (NK), NKT and T cells evaluated as CD3neg CD56pos, CD3pos CD56pos, and CD3pos CD56neg. Peripheral blood mononuclear cells (PBMCs) were collected from 38 BD patients and 20 healthy controls (HC). The frequencies of NK, NKT, and T cells expressing CD16, CD69, NKG2D, Nkp30, Nkp46, and NKG2A were assessed by flow cytometry. Cytotoxic potential of NK cells was evaluated by flow cytometry as the percentage of cells expressing the degranulation marker CD107a after incubation with K562 cells. The levels of 27 cytokines were determined in plasma with a multiplex bead-based assay. Higher percentages of NK, NKT, and T cells expressing NKG2D were detected in PBMCs of BD patients than HC. ROC curve analysis showed that the evaluation of NKG2Dpos NK, NKT, and T cell percentages discriminated between BD patients and HC. Moreover, there was a positive correlation between the BD Current Activity Form (BDCAF) scores and the frequencies of NKG2Dpos NK and NKT cells. A higher frequency of NK cells expressing CD107a was induced in PBMCs from BD patients than HC after incubation with K562 cells. Concentrations of IL-5, IL-6, IL-10, IL-13, IP-10, and MIP-1β were higher in plasma of BD patients than HC. Monitoring the frequencies of NKG2Dpos lymphocytes could help the clinicians in BD patients management. In addition, the increased expression of NKG2D in BD patients is likely involved in disease pathogenesis.
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Affiliation(s)
- Martina Bonacini
- Unit of Clinical Immunology, Allergy and Advanced Biotechnologies, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandra Soriano
- Unit of Rheumatology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Campus Bio-Medico, University of Rome, Rome, Italy
| | - Alessandro Zerbini
- Unit of Clinical Immunology, Allergy and Advanced Biotechnologies, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Eleonora Calò
- Unit of Clinical Immunology, Allergy and Advanced Biotechnologies, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Cimino
- Unit of Ocular Immunology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Muratore
- Unit of Rheumatology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi Fontana
- Unit of Ophtalmology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Braglia
- Research and Statistics Infrastructure, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria Parmeggiani
- Unit of Clinical Immunology, Allergy and Advanced Biotechnologies, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Carlo Salvarani
- Unit of Rheumatology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Croci
- Unit of Clinical Immunology, Allergy and Advanced Biotechnologies, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Puerta-Alcalde P, Cardozo C, Suárez-Lledó M, Rodríguez-Núñez O, Morata L, Fehér C, Marco F, Del Río A, Martínez JA, Mensa J, Rovira M, Esteve J, Soriano A, Garcia-Vidal C. Current time-to-positivity of blood cultures in febrile neutropenia: a tool to be used in stewardship de-escalation strategies. Clin Microbiol Infect 2018; 25:447-453. [PMID: 30096417 DOI: 10.1016/j.cmi.2018.07.026] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/19/2018] [Accepted: 07/21/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVES We aimed to describe the current time-to-positivity (TTP) of blood cultures in individuals with onco-haematological diseases with febrile neutropenia. We assessed the probability of having a multidrug-resistant Gram-negative bacilli (MDR-GNB) bloodstream infection (BSI) 24 h after cultures were taken, to use this information for antibiotic de-escalation strategies. METHODS BSI episodes were prospectively collected (2003-2017). When a patient experienced more than one BSI, only one episode was randomly chosen. Time elapsed from the beginning of incubation to a positive reading was observed; TTP was recorded when the first bottle had a positive result. RESULTS Of the 850 patient-unique episodes, 323 (38%) occurred in acute leukaemia, 185 (21.8%) in non-Hodgkin's lymphoma and 144 (16.9%) in solid neoplasms. Coagulase-negative staphylococci (225; 26.5%), Escherichia coli (207; 26.1%), Pseudomonas aeruginosa (136; 16%), Enterococcus spp. (81; 9.5%) and Klebsiella pneumoniae (67; 7.9%), were the most frequent microorganisms isolated. MDR-GNB were documented in 126 (14.8%) episodes. Median TTP was 12 h (interquartile range 9-16.5 h). Within the first 24 h, 92.1% of blood cultures were positive (783/850). No MDR-GNB was positive over 24 h. Of the 67 (7.9%) episodes with a TTP ≥24 h, 25 (37.3%) occurred in patients who were already receiving active antibiotics against the isolated pathogen. Most common isolations with TTP ≥24 h were coagulase-negative staphylococci, candidaemia and a group of anaerobic GNB. CONCLUSIONS Currently, the vast majority of BSI in individuals with onco-haematological diseases with febrile neutropenia have a TTP <24 h, including all episodes caused by MDR-GNB. Our results support reassessing empiric antibiotic treatment in neutropenic patients at 24 h, to apply antibiotic stewardship de-escalation strategies.
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Affiliation(s)
- P Puerta-Alcalde
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - C Cardozo
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - M Suárez-Lledó
- Haematology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - O Rodríguez-Núñez
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - L Morata
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - C Fehér
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - F Marco
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Microbiology Department, Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain
| | - A Del Río
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - J A Martínez
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - J Mensa
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - M Rovira
- Haematology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - J Esteve
- Haematology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - A Soriano
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - C Garcia-Vidal
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Barcelona, Spain; University of Barcelona, Barcelona, Spain.
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Masanas M, Soriano A, Boloix A, Masiá N, Jimenez C, Roma J, Sánchez de Toledo J, Santamaria A, Gallego S, Segura M. PO-353 Functional high-throughput screening reveals multiple tumour-suppressive microRNAs in neuroblastoma. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Soriano A, Alañón ME, Alarcón M, García-Ruíz A, Díaz-Maroto MC, Pérez-Coello MS. Oak wood extracts as natural antioxidants to increase shelf life of raw pork patties in modified atmosphere packaging. Food Res Int 2018; 111:524-533. [PMID: 30007715 DOI: 10.1016/j.foodres.2018.05.055] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/02/2018] [Accepted: 05/21/2018] [Indexed: 12/31/2022]
Abstract
The use of antioxidants and refrigeration storage in modified atmosphere packaging, MAP, are the main strategies to slow down the oxidative and microbial deterioration of fresh meat. Synthetic antioxidants are commonly used for this purpose, however due to their controversial health effects, natural alternatives for their replacement are being looked for. The main aim of this work is the evaluation of pressurised aqueous extracts from oak wood as natural preservative of pork patties. The effect of different amounts of oak wood extracts (0.05, 0.5 and 1.0%) on the self-life of pork patties packed in MAP in refrigeration during 12 days were studied in comparison with the use of sodium ascorbate as synthetic preservative. Samples treated with oak wood extracts showed lower lipid oxidation, higher antioxidant capacity and an inhibitory effect on the enterobacteria growth. Furthermore, the addition of oak wood extracts resulted in a dramatically decrease of the volatile compounds coming from the lipid oxidation reactions. On the other hand, it is noteworthy that the use of oak wood extracts modified sensorial characteristics. Intensity colour was higher and new sensorial features such as oak wood and sweet spices appeared which were well appreciated.
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Affiliation(s)
- A Soriano
- Area of Food Technology, Faculty of Chemical Sciences and Technologies, University of Castilla-La Mancha, Avda. Camilo José Cela, 10, 13071 Ciudad Real, Spain
| | - M E Alañón
- Regional Institute for Applied Scientific Research (IRICA), University of Castilla-La Mancha, Avda. Camilo José Cela, 10, 13071 Ciudad Real, Spain.
| | - M Alarcón
- Area of Food Technology, Faculty of Chemical Sciences and Technologies, University of Castilla-La Mancha, Avda. Camilo José Cela, 10, 13071 Ciudad Real, Spain
| | - A García-Ruíz
- Area of Food Technology, Faculty of Chemical Sciences and Technologies, University of Castilla-La Mancha, Avda. Camilo José Cela, 10, 13071 Ciudad Real, Spain
| | - M C Díaz-Maroto
- Area of Food Technology, Faculty of Chemical Sciences and Technologies, University of Castilla-La Mancha, Avda. Camilo José Cela, 10, 13071 Ciudad Real, Spain; Regional Institute for Applied Scientific Research (IRICA), University of Castilla-La Mancha, Avda. Camilo José Cela, 10, 13071 Ciudad Real, Spain
| | - M S Pérez-Coello
- Area of Food Technology, Faculty of Chemical Sciences and Technologies, University of Castilla-La Mancha, Avda. Camilo José Cela, 10, 13071 Ciudad Real, Spain
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Gonçalves-Ribeiro S, Sanz-Pamplona R, Vidal A, Sanjuan X, Guillen Díaz-Maroto N, Soriano A, Guardiola J, Albert N, Martínez-Villacampa M, López I, Santos C, Serra-Musach J, Salazar R, Capellà G, Villanueva A, Molleví DG. Prediction of pathological response to neoadjuvant treatment in rectal cancer with a two-protein immunohistochemical score derived from stromal gene-profiling. Ann Oncol 2018; 28:2160-2168. [PMID: 28911071 DOI: 10.1093/annonc/mdx293] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Preoperative chemoradiotherapy followed by surgical mesorectal resection is the standard of care for locally advanced rectal carcinomas. Yet, predicting that patients will respond to treatment remains an unmet clinical challenge. Experimental design Using laser-capture microdissection we isolated RNA from stroma and tumour glands from prospective pre-treatment samples (n = 15). Transcriptomic profiles were obtained hybridising PrimeView Affymetrix arrays. We modelled a carcinoma-associated fibroblast-specific genes filtering data using GSE39396. Results The analysis of differentially expressed genes of stroma/tumour glands from responder and non-responder patients shows that most changes were associated with the stromal compartment; codifying mainly for extracellular matrix and ribosomal components. We built a carcinoma-associated fibroblast (CAF) specific classifier with genes showing changes in expression according to the tumour regression grade (FN1, COL3A1, COL1A1, MMP2 and IGFBP5). We assessed these five genes at the protein level by means of immunohistochemical staining in a patient's cohort (n = 38). For predictive purposes we used a leave-one-out cross-validated model with a positive predictive value (PPV) of 83.3%. Random Forest identified FN1 and COL3A1 as the best predictors. Rebuilding the leave-one-out cross-validated regression model improved the classification performance with a PPV of 93.3%. An independent cohort was used for classifier validation (n = 36), achieving a PPV of 88.2%. In a multivariate analysis, the two-protein classifier proved to be the only independent predictor of response. Conclusion We developed a two-protein immunohistochemical classifier that performs well at predicting the non-response to neoadjuvant treatment in rectal cancer.
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Affiliation(s)
| | - R Sanz-Pamplona
- Program of Prevention and Cancer Control, Biomarkers Unit, Catalan Institute of Oncology
| | | | | | | | - A Soriano
- Department of Gastroenterology Endoscopy Unit, Hospital Universitari de Bellvitge
| | - J Guardiola
- Department of Gastroenterology Endoscopy Unit, Hospital Universitari de Bellvitge
| | - N Albert
- Program Against Cancer Therapeutic Resistance
| | | | - I López
- Department of Medical Oncology
| | | | | | | | - G Capellà
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Catalonia, Spain
| | | | - D G Molleví
- Program Against Cancer Therapeutic Resistance
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Sota J, Vitale A, Insalaco A, Sfriso P, Lopalco G, Emmi G, Cattalini M, Manna R, Cimaz R, Priori R, Talarico R, de Marchi G, Frassi M, Gallizzi R, Soriano A, Alessio M, Cammelli D, Maggio MC, Gentileschi S, Marcolongo R, La Torre F, Fabiani C, Colafrancesco S, Ricci F, Galozzi P, Viapiana O, Verrecchia E, Pardeo M, Cerrito L, Cavallaro E, Olivieri AN, Paolazzi G, Vitiello G, Maier A, Silvestri E, Stagnaro C, Valesini G, Mosca M, de Vita S, Tincani A, Lapadula G, Frediani B, De Benedetti F, Iannone F, Punzi L, Salvarani C, Galeazzi M, Angotti R, Messina M, Tosi GM, Rigante D, Cantarini L. Safety profile of the interleukin-1 inhibitors anakinra and canakinumab in real-life clinical practice: a nationwide multicenter retrospective observational study. Clin Rheumatol 2018; 37:2233-2240. [PMID: 29770930 DOI: 10.1007/s10067-018-4119-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 04/17/2018] [Indexed: 01/08/2023]
Abstract
A few studies have reported the safety profile of interleukin (IL)-1 blockers from real life. The aim of this study is to describe anakinra (ANA) and canakinumab (CAN) safety profile in children and adults, based on data from a real-life setting. Demographic, clinical, and therapeutic data from patients treated with ANA and CAN were retrospectively collected and analyzed. Four hundred and seventy five patients were enrolled; ANA and CAN were prescribed in 421 and 105 treatment courses, respectively. During a mean follow-up of 24.39 ± 27.04 months, 89 adverse events (AE) were recorded; 13 (14.61%) were classified as serious AE (sAE). The overall estimated rate of AE and sAE was 8.4 per 100 patients/year. Safety concerns were more frequent among patients aged ≥ 65 years compared with patients < 16 years (p = 0.002). No differences were detected in the frequency of safety concerns between monotherapy and combination therapy with immunosuppressants (p = 0.055), but a significant difference was observed when injection site reactions were excluded from AE (p = 0.01). No differences were identified in relation to gender (p = 0.462), different lines of biologic therapy (p = 0.775), and different dosages (p = 0.70 ANA; p = 0.39 CAN). The overall drug retention rate was significantly different according to the occurrence of safety concerns (p value < 0.0001); distinguishing between ANA and CAN, significance was maintained only for ANA (p < 0.0001 ANA; p > 0.05 CAN). Treatment duration was the only variable associated with onset of AE (OR = 0.399 [C.I. 0.250-0.638], p = 0.0001). ANA and CAN have shown an excellent safety profile; the risk for AE and sAE tends to decrease over time from the start of IL-1 inhibition.
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Affiliation(s)
- Jurgen Sota
- Research Center of Systemic Autoinflammatory Diseases, Behçet's Disease Clinic and Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, Rheumatology Unit, University of Siena, Policlinico "Le Scotte", viale Bracci 1, 53100, Siena, Italy
| | - Antonio Vitale
- Research Center of Systemic Autoinflammatory Diseases, Behçet's Disease Clinic and Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, Rheumatology Unit, University of Siena, Policlinico "Le Scotte", viale Bracci 1, 53100, Siena, Italy
| | - Antonella Insalaco
- Division of Rheumatology, Department of Pediatric Medicine, IRCCS, Bambino Gesù Children's Hospital, Rome, Italy
| | - Paolo Sfriso
- Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Giuseppe Lopalco
- Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Bari, Italy
| | - Giacomo Emmi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marco Cattalini
- Pediatric Clinic, University of Brescia and Spedali Civili di Brescia, Brescia, Italy
| | - Raffaele Manna
- Institute of Internal Medicine, Periodic Fever Research Center, Fondazione Policlinico A. Gemelli, Università Cattolica Sacro Cuore, Rome, Italy
| | - Rolando Cimaz
- Pediatric Rheumatology Unit, AOU Meyer, Florence, Italy
| | - Roberta Priori
- Department of Internal Medicine and Medical Specialties, Rheumatology Unit, Sapienza University of Rome, Rome, Italy
| | - Rosaria Talarico
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ginevra de Marchi
- Department of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Udine, Italy
| | - Micol Frassi
- Rheumatology and Clinical Immunology, Spedali Civili, and Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Romina Gallizzi
- Department of Pediatrics, Azienda G. Martino, University of Messina, Messina, Italy
| | - Alessandra Soriano
- Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
| | | | - Daniele Cammelli
- Experimental and Clinical Medicine Department, University of Florence, Florence, Italy
| | | | - Stefano Gentileschi
- Research Center of Systemic Autoinflammatory Diseases, Behçet's Disease Clinic and Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, Rheumatology Unit, University of Siena, Policlinico "Le Scotte", viale Bracci 1, 53100, Siena, Italy
| | - Renzo Marcolongo
- Clinical Immunology, Department of Medicine, University of Padua, Padua, Italy
| | - Francesco La Torre
- Pediatric Rheumatology Section, Pediatric Oncoematology Unit, Vito Fazzi Hospital, Lecce, Italy
| | - Claudia Fabiani
- Department of Ophthalmology, Humanitas Research Hospital, Rozzano, Milan, Italy.,Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Serena Colafrancesco
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesca Ricci
- Pediatric Clinic, University of Brescia and Spedali Civili di Brescia, Brescia, Italy
| | - Paola Galozzi
- Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Ombretta Viapiana
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Elena Verrecchia
- Institute of Internal Medicine, Periodic Fever Research Center, Fondazione Policlinico A. Gemelli, Università Cattolica Sacro Cuore, Rome, Italy
| | - Manuela Pardeo
- Division of Rheumatology, Department of Pediatric Medicine, IRCCS, Bambino Gesù Children's Hospital, Rome, Italy
| | - Lucia Cerrito
- Institute of Internal Medicine, Periodic Fever Research Center, Fondazione Policlinico A. Gemelli, Università Cattolica Sacro Cuore, Rome, Italy
| | - Elena Cavallaro
- Department of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Udine, Italy
| | - Alma Nunzia Olivieri
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Seconda Università degli Studi of Naples, Naples, Italy
| | | | - Gianfranco Vitiello
- Experimental and Clinical Medicine Department, University of Florence, Florence, Italy
| | - Armin Maier
- Struttura Semplice di Reumatologia, Ospedale di Bolzano, Bolzano, Italy
| | - Elena Silvestri
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Chiara Stagnaro
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Guido Valesini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marta Mosca
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Salvatore de Vita
- Department of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Udine, Italy
| | - Angela Tincani
- Rheumatology and Clinical Immunology, Spedali Civili, and Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giovanni Lapadula
- Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Bari, Italy
| | - Bruno Frediani
- Research Center of Systemic Autoinflammatory Diseases, Behçet's Disease Clinic and Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, Rheumatology Unit, University of Siena, Policlinico "Le Scotte", viale Bracci 1, 53100, Siena, Italy
| | - Fabrizio De Benedetti
- Division of Rheumatology, Department of Pediatric Medicine, IRCCS, Bambino Gesù Children's Hospital, Rome, Italy
| | - Florenzo Iannone
- Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Bari, Italy
| | - Leonardo Punzi
- Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Carlo Salvarani
- Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
| | - Mauro Galeazzi
- Research Center of Systemic Autoinflammatory Diseases, Behçet's Disease Clinic and Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, Rheumatology Unit, University of Siena, Policlinico "Le Scotte", viale Bracci 1, 53100, Siena, Italy
| | - Rossella Angotti
- Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Mario Messina
- Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Gian Marco Tosi
- Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Donato Rigante
- Institute of Pediatrics, Periodic Fever Research Center, Fondazione Policlinico A. Gemelli, Università Cattolica Sacro Cuore, Rome, Italy
| | - Luca Cantarini
- Research Center of Systemic Autoinflammatory Diseases, Behçet's Disease Clinic and Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, Rheumatology Unit, University of Siena, Policlinico "Le Scotte", viale Bracci 1, 53100, Siena, Italy.
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Soriano A, Allende MT, Vizoso F, Fernández García J, Vivanco J, Ruibal A. MCA and CA 15.3 Serum Levels in Non-malignant Diseases. Some Preliminary Results. Int J Biol Markers 2018; 5:46-7. [PMID: 2230351 DOI: 10.1177/172460089000500110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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74
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Soriano A, Pazzola G, Boiardi L, Casali M, Muratore F, Pipitone N, Catanoso M, Aldigeri R, Cimino L, Versari A, Salvarani C. Distribution patterns of 18F-fluorodeoxyglucose in large vessels of Takayasu's and giant cell arteritis using positron emission tomography. Clin Exp Rheumatol 2018; 36 Suppl 111:99-106. [PMID: 29799393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 04/16/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To compare patterns of vascular involvement using 18F-fluorodeoxyglucose-positron emission tomography computed tomography (FDG PET/CT) in patients with giant cell arteritis (GCA) and Takayasu's arteritis (TAK). METHODS A total of 130 consecutive 18F-FDG PET/CT scans performed during the disease course for evaluating disease activity in 15 GCA and 13 TAK patients were retrospectively examined by two nuclear physicians blinded to clinical data. Standardised uptake values (SUVmax) in 14 vascular districts including all the aortic segments and the main tributaries were measured. The average SUVmax value for each vascular district was also calculated. Principal component analysis (PCA) and agglomerative hierarchical cluster analysis (CA) were used to explore distribution patterns of vascular FDG uptake. RESULTS The aortic segments showed the highest SUV max values among the different districts in both GCA and TAK. SUV max values measured in the different districts were significantly higher in GCA compared to TAK, except for the axillary arteries. Regarding thoracic and abdominal aorta, ascending aorta and aortic arch had the highest correlation in both vasculitis (p<0.0001). CA confirmed that carotid, axillary, subclavian, iliac and femoral arteries clustered with their contralateral counterpart in both vasculitis. The 3 components of thoracic aorta clustered with abdominal aorta in TAK, while aortic arch clustered only with ascending aorta, and descending and abdominal aorta grouped together with iliac and femoral arteries in GCA. PCA analysis identified 3 different components for TAK and GCA explaining 72% and 71% of the total variance respectively in these two vasculitis. Confirming CA, a component including the entire aortic district was identified in TAK, but not in GCA. Similar results in PCA using averaged data were observed. CONCLUSIONS Strong similarities, but also a subtle skewing in terms of distribution patterns of arterial involvement assessed by SUVmax values were observed between GCA and TAK.
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Affiliation(s)
- Alessandra Soriano
- Rheumatology Unit, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
| | - Giulia Pazzola
- Rheumatology Unit, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, and Università di Modena e Reggio Emilia, Italy
| | - Luigi Boiardi
- Rheumatology Unit, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
| | - Massimiliano Casali
- Nuclear Medicine Unit, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
| | - Francesco Muratore
- Rheumatology Unit, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, and Università di Modena e Reggio Emilia, Italy
| | - Nicolò Pipitone
- Rheumatology Unit, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
| | - Mariagrazia Catanoso
- Rheumatology Unit, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
| | | | | | - Annibale Versari
- Nuclear Medicine Unit, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
| | - Carlo Salvarani
- Rheumatology Unit, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, and Università di Modena e Reggio Emilia, Italy.
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75
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Seimetz M, Bellido P, García P, Mur P, Iborra A, Soriano A, Hülber T, García López J, Jiménez-Ramos MC, Lera R, Ruiz-de la Cruz A, Sánchez I, Zaffino R, Roso L, Benlloch JM. Spectral characterization of laser-accelerated protons with CR-39 nuclear track detector. Rev Sci Instrum 2018; 89:023302. [PMID: 29495831 DOI: 10.1063/1.5009587] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
CR-39 nuclear track material is frequently used for the detection of protons accelerated in laser-plasma interactions. The measurement of track densities allows for determination of particle angular distributions, and information on the kinetic energy can be obtained by the use of passive absorbers. We present a precise method of measuring spectral distributions of laser-accelerated protons in a single etching and analysis process. We make use of a one-to-one relation between proton energy and track size and present a precise calibration based on monoenergetic particle beams. While this relation is limited to proton energies below 1 MeV, we show that the range of spectral measurements can be significantly extended by simultaneous use of absorbers of suitable thicknesses. Examples from laser-plasma interactions are presented, and quantitative results on proton energies and particle numbers are compared to those obtained from a time-of-flight detector. The spectrum end points of continuous energy distributions have been determined with both detector types and coincide within 50-100 keV.
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Affiliation(s)
- M Seimetz
- Instituto de Instrumentación para Imagen Molecular (I3M), CSIC-Universitat Politècnica de València, Camino de Vera s/n, Ed. 8B-N-1a, 46022 Valencia, Spain
| | - P Bellido
- Instituto de Instrumentación para Imagen Molecular (I3M), CSIC-Universitat Politècnica de València, Camino de Vera s/n, Ed. 8B-N-1a, 46022 Valencia, Spain
| | - P García
- Instituto de Instrumentación para Imagen Molecular (I3M), CSIC-Universitat Politècnica de València, Camino de Vera s/n, Ed. 8B-N-1a, 46022 Valencia, Spain
| | - P Mur
- Instituto de Instrumentación para Imagen Molecular (I3M), CSIC-Universitat Politècnica de València, Camino de Vera s/n, Ed. 8B-N-1a, 46022 Valencia, Spain
| | - A Iborra
- Instituto de Instrumentación para Imagen Molecular (I3M), CSIC-Universitat Politècnica de València, Camino de Vera s/n, Ed. 8B-N-1a, 46022 Valencia, Spain
| | - A Soriano
- Instituto de Instrumentación para Imagen Molecular (I3M), CSIC-Universitat Politècnica de València, Camino de Vera s/n, Ed. 8B-N-1a, 46022 Valencia, Spain
| | - T Hülber
- Radosys Kft., Vegyész u. 17-27, 1116 Budapest, Hungary
| | - J García López
- Departamento Física Atómica, Molecular y Nuclear, Universidad de Sevilla, Av. Reina Mercedes s/n, 41012 Sevilla, Spain
| | - M C Jiménez-Ramos
- Centro Nacional de Aceleradores (CNA), U. Sevilla-J. Andalucía-CSIC, Avda. Thomas Alva Edison 7, 41092 Sevilla, Spain
| | - R Lera
- Proton Laser Applications S.L. (PLA), Avda. Vilafranca del Penedès 11, 08734 Olèrdola, Spain
| | - A Ruiz-de la Cruz
- Proton Laser Applications S.L. (PLA), Avda. Vilafranca del Penedès 11, 08734 Olèrdola, Spain
| | - I Sánchez
- Proton Laser Applications S.L. (PLA), Avda. Vilafranca del Penedès 11, 08734 Olèrdola, Spain
| | - R Zaffino
- Instituto de Microelectrónica de Barcelona (IMB-CNM, CSIC), C/ dels Til.lers Campus UAB, 08193 Cerdanyola del Vallès (Barcelona), Spain
| | - L Roso
- Centro de Láseres Pulsados (CLPU), Calle del Adaja, 37185 Villamayor, Spain
| | - J M Benlloch
- Instituto de Instrumentación para Imagen Molecular (I3M), CSIC-Universitat Politècnica de València, Camino de Vera s/n, Ed. 8B-N-1a, 46022 Valencia, Spain
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De la Calle C, Ternavasio-de la Vega HG, Morata L, Marco F, Cardozo C, García-Vidal C, Del Rio A, Cilloniz C, Torres A, Martínez JA, Mensa J, Soriano A. Effectiveness of combination therapy versus monotherapy with a third-generation cephalosporin in bacteraemic pneumococcal pneumonia: A propensity score analysis. J Infect 2018; 76:342-347. [PMID: 29360520 DOI: 10.1016/j.jinf.2018.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 01/09/2018] [Accepted: 01/10/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Combining a macrolide or a fluoroquinolone to beta-lactam regimens in the treatment of patients with moderate to severe community-acquired pneumonia is recommended by the international guidelines. However, the information in patients with bacteraemic pneumococcal pneumonia is limited. METHODS A propensity score technique was used to analyze prospectively collected data from all patients with bacteraemic pneumococcal pneumonia admitted from 2000 to 2015 in our institution, who had received empirical treatment with third-generation cephalosporin in monotherapy or plus macrolide or fluoroquinolone. RESULTS We included 69 patients in the monotherapy group and 314 in the combination group. After adjustment by PS for receiving monotherapy, 30-day mortality (OR 2.89; 95% CI 1.07-7.84) was significantly higher in monotherapy group. A higher 30-day mortality was observed in monotherapy group in both 1:1 and 1:2 matched samples although it was statistically significant only in 1:2 sample (OR: 3.50 (95% CI 1.03-11.96), P = 0.046). CONCLUSIONS Our study suggests that in bacteraemic pneumococcal pneumonia, empirical therapy with a third-generation cephalosporin plus a macrolide or a fluoroquinolone is associated with a lower mortality rate than beta-lactams in monotherapy. These results support the recommendation of combination therapy in patients requiring admission with moderate to severe disease.
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Affiliation(s)
- C De la Calle
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain.
| | | | - L Morata
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | - F Marco
- Department of Microbiology, Hospital Clínic Barcelona, Barcelona, Spain
| | - C Cardozo
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | - C García-Vidal
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | - A Del Rio
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | - C Cilloniz
- Department of Pneumology, Hospital Clinic of Barcelona, University of Barcelona (UB), Barcelona, Spain
| | - A Torres
- Department of Pneumology, Hospital Clinic of Barcelona, University of Barcelona (UB), Barcelona, Spain
| | - J A Martínez
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | - J Mensa
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | - A Soriano
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
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Soriano A, Smerieri N, Bonilauri S, De Marco L, Cavazza A, Salvarani C. Colonic perforation due to severe cytomegalovirus disease in granulomatosis with polyangiitis after immunosuppression. Clin Rheumatol 2018; 37:1427-1432. [PMID: 29302827 DOI: 10.1007/s10067-017-3945-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/26/2017] [Accepted: 12/04/2017] [Indexed: 12/19/2022]
Abstract
Granulomatosis with polyangiitis (GPA) is a small-vessel necrotizing granulomatous vasculitis typically involving upper airways, lungs, and kidneys, which may lead to end-organ damage and life-threatening complications. Major infections during GPA course represent a considerable concern in the management of the disease. Cytomegalovirus (CMV) infection and disease are rare but significant complications in the course of GPA being associated with high morbidity and mortality rates. Colonic perforation due to CMV colitis is exceedingly rare and has so far almost exclusively been documented in HIV, renal transplant, and systemic lupus erythematosus patients. We reported the case of a patient affected with upper airways-limited GPA who developed acute renal failure from rapidly progressive glomerulonephritis and then experienced colonic perforation due to CMV colitis a few weeks after immunosuppressive treatment with high-dose steroids and cyclophosphamide (CYC) for remission induction of the disease. We also reviewed the literature on CMV-related gastro-intestinal complications in the course of GPA and discussed contributing factors to severe manifestations of CMV infection and its reactivation.
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Affiliation(s)
- Alessandra Soriano
- Rheumatology Unit, Department of Internal Medicine, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Viale Risorgimento 80, 42122, Reggio Emilia, Italy. .,Campus Bio-Medico University, Rome, Italy.
| | - Nazareno Smerieri
- General and Emergency Surgery, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Viale Risorgimento 80, 42122, Reggio Emilia, Italy.
| | - Stefano Bonilauri
- General and Emergency Surgery, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Viale Risorgimento 80, 42122, Reggio Emilia, Italy
| | - Loredana De Marco
- Pathology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Viale Risorgimento 80, 42122, Reggio Emilia, Italy
| | - Alberto Cavazza
- Pathology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Viale Risorgimento 80, 42122, Reggio Emilia, Italy
| | - Carlo Salvarani
- Rheumatology Unit, Department of Internal Medicine, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Viale Risorgimento 80, 42122, Reggio Emilia, Italy
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Oliver L, Candela-Juan C, Palma J, Pujades M, Soriano A, Vilar J, Martínez J, Mestre V, Ruiz-Rodríguez J, Llorca-Domaica N. Comparison of the dosimetric response of 4-elements OSL and TL passive personal dosimeters. RADIAT MEAS 2017. [DOI: 10.1016/j.radmeas.2017.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Salvarani C, Soriano A, Muratore F, Shoenfeld Y, Blockmans D. Is PET/CT essential in the diagnosis and follow-up of temporal arteritis? Autoimmun Rev 2017; 16:1125-1130. [DOI: 10.1016/j.autrev.2017.09.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 08/08/2017] [Indexed: 02/06/2023]
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Ruiz-Ortiz E, Iglesias E, Soriano A, Buján-Rivas S, Español-Rego M, Castellanos-Moreira R, Tomé A, Yagüe J, Antón J, Hernández-Rodríguez J. Disease Phenotype and Outcome Depending on the Age at Disease Onset in Patients Carrying the R92Q Low-Penetrance Variant in TNFRSF1A Gene. Front Immunol 2017; 8:299. [PMID: 28396659 PMCID: PMC5366323 DOI: 10.3389/fimmu.2017.00299] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/03/2017] [Indexed: 11/20/2022] Open
Abstract
Background Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is an autosomal-dominant autoinflammatory disease caused by mutations in the TNFRSF1A gene. R92Q, a low-penetrance variant, is usually associated with a milder TRAPS phenotype than structural or pathogenic mutations. No studies differentiating R92Q-related disease in patients with pediatric and adult onset have been performed to date. Objective To analyze clinical features and disease outcomes in patients diagnosed with TRAPS associated with R92Q variant and to investigate differences between patients with pediatric and adult disease onset. Methods A retrospective review of patients with R92Q-related disease from four reference centers for autoinflammatory diseases was performed. Clinical and laboratory features, family history of autoinflammatory diseases, treatments received, and outcomes during follow-up were recorded and separately analyzed in pediatric and adult patients. Our results were included in the analysis with other reported pediatric and adult R92Q-related disease series. Results Our series encompassed 18 patients (9 females and 9 males) with R92Q variant. In 61% of patients, disease onset occurred during infancy and in 39%, during adulthood, with a median diagnostic delay of 5 years and a follow-up of 5.4 years. A positive family history of autoinflammatory disease was detected in 28% of patients. All patients presented with febrile recurrent episodes. Other common symptoms included arthralgia/arthritis (61%), myalgia (39%), asthenia/fatigue (44%), abdominal pain (39%), headache (33%), odynophagia (33%), skin rash (28%), and chest pain (22%). During attacks, 80% of patients increased acute phase reactants levels. No patient had developed amyloidosis during the study period. At the end of follow-up, 28% of patients were asymptomatic and treatment free, 50% were receiving non-steroidal anti-inflammatory drugs or glucocorticoids on demand, and 22% were being treated with biologic agents. When differences between pediatric and adult patients were globally analyzed, adults tended to have longer attacks duration and presented more frequently with chest pain and headache, while abdominal pain, vomiting, cervical adenitis, and pharyngitis predominated in pediatric patients. No differences in outcomes and treatment requirements were observed in both age groups. Conclusion This study has contributed to characterize R92Q-related disease by identifying trends in disease phenotypes depending on the age at disease onset.
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Affiliation(s)
| | - Estíbaliz Iglesias
- Pediatric Rheumatology Unit, Department of Pediatrics, Hospital Sant Joan de Déu, University of Barcelona , Barcelona , Spain
| | - Alessandra Soriano
- Rheumatology Unit, Department of Internal Medicine, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Rome, Italy; Campus Bio-Medico University, Rome, Italy
| | - Segundo Buján-Rivas
- Autoimmune and Systemic Diseases Unit, Department of Internal Medicine, Hospital Vall d'Hebron , Barcelona , Spain
| | - Marta Español-Rego
- Department of Immunology-CDB, Hospital Clinic, IDIBAPS , Barcelona , Spain
| | - Raul Castellanos-Moreira
- Clinical Unit of Autoinflammatory Diseases and Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clinic, IDIBAPS, University of Barcelona , Barcelona , Spain
| | - Adrià Tomé
- Clinical Unit of Autoinflammatory Diseases and Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clinic, IDIBAPS, University of Barcelona , Barcelona , Spain
| | - Jordi Yagüe
- Department of Immunology-CDB, Hospital Clinic, IDIBAPS , Barcelona , Spain
| | - Jordi Antón
- Pediatric Rheumatology Unit, Department of Pediatrics, Hospital Sant Joan de Déu, University of Barcelona , Barcelona , Spain
| | - José Hernández-Rodríguez
- Clinical Unit of Autoinflammatory Diseases and Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clinic, IDIBAPS, University of Barcelona , Barcelona , Spain
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81
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Yahlali N, Garcia JM, Díaz J, Soriano A, Fernandes LMP. Ageing studies of TPB in noble gas detectors for dark matter and neutrinoless ββ decay searches. Spectrochim Acta A Mol Biomol Spectrosc 2017; 172:109-114. [PMID: 27160970 DOI: 10.1016/j.saa.2016.04.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 03/03/2016] [Accepted: 04/08/2016] [Indexed: 06/05/2023]
Abstract
Noble gases (Xe, Ar, Kr) are very attractive as detector media in Dark Matter search and neutrinoless double-beta decay experiments. However, the detection of their scintillation light (in the VUV spectral region) requires shifting the VUV light to visible light, where standard photosensors are more efficient. Tetraphenyl butadiene (TPB) is widely used as wavelength shifter, absorbing the VUV light and re-emitting in the blue region (~430nm). TPB is an organic molecule that may degrade due to exposure to environmental agents and also to ultraviolet light. In this work, we present TPB ageing studies due to exposure to VUV light, aiming at quantifying the reduction of the absolute fluorescence yield of TPB coatings of several thicknesses (130nm, 260nm, 390nm, 1600nm), exposed to various doses of VUV light at 170nm (similar to the Xe scintillation). In our setup, the VUV light is produced from a vacuum monochromator coupled to a deuterium lamp. The VUV exposure in our setup is compared to the exposure obtained in the electroluminescent gaseous Xe TPC of the NEXT-100 experiment for neutrinoless double-beta decay search.
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Affiliation(s)
- N Yahlali
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Catedrático José Beltrán 2, 46980 Paterna, Valencia, Spain.
| | - J M Garcia
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Catedrático José Beltrán 2, 46980 Paterna, Valencia, Spain
| | - J Díaz
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Catedrático José Beltrán 2, 46980 Paterna, Valencia, Spain
| | - A Soriano
- Instituto de Ciencia Molecular (ICMOL), Universitat de València, Catedrático José Beltrán 2, 46980 Paterna, Valencia, Spain
| | - L M P Fernandes
- LIBPhys, Department of Physics, University of Coimbra, 3004-516 Coimbra, Portugal
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82
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Cobos-Triguero N, Zboromyrska Y, Morata L, Alejo I, De La Calle C, Vergara A, Cardozo C, Arcas MP, Soriano A, Marco F, Mensa J, Almela M, Martínez JA. Time-to-positivity, type of culture media and oxidase test performed on positive blood culture vials to predict Pseudomonas aeruginosa in patients with Gram-negative bacilli bacteraemia. Rev Esp Quimioter 2017; 30:9-13. [PMID: 27897434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The aim of this study was to determine the usefulness of oxidase test and time-to-positivity (TTP) in aerobic and anaerobic blood culture vials to detect the presence of Pseudomonas aeruginosa in patients with Gram-negative bacilli (GNB) bacteraemia. METHODS TTP was recorded for each aerobic and anaerobic blood culture vial of monomicrobial bacteraemia due to GNB. Oxidase test was performed in a pellet of the centrifuged content of the positive blood culture. An algorithm was developed in order to perform the oxidase test efficiently taking into account TTP and type of vial. RESULTS A total of 341 episodes of GNB bacteraemia were analysed. Sensitivity, specificity, positive predictive value and negative predictive value of the oxidase test performed on positive vials with GNB to predict P. aeruginosa were 95%, 99%, 91%, and 99%, respectively. When growth was first or exclusively detected in anaerobic vials, P. aeruginosa was never identified hence the performance of the oxidase test could be avoided. When growth was only or first detected in aerobic vials, a TTP≥8h predicted P. aeruginosa in 37% or cases (63 of 169), therefore oxidase test is highly recommended. CONCLUSIONS Oxidase test performed onto positive blood culture vials previously selected by TTP and type of vials is an easy and inexpensive way to predict P. aeruginosa. In most cases, this can lead to optimization of treatment in less than 24 hours.
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Affiliation(s)
- N Cobos-Triguero
- Nazaret Cobos-Trigueros. Department of Infectious Diseases, Hospital Clínic. Villarroel 170, 08036, Barcelona, Spain.
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83
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Fabiani C, Vitale A, Emmi G, Vannozzi L, Lopalco G, Guerriero S, Orlando I, Franceschini R, Bacherini D, Cimino L, Soriano A, Frediani B, Galeazzi M, Iannone F, Tosi GM, Salvarani C, Cantarini L. Efficacy and safety of adalimumab in Behçet's disease-related uveitis: a multicenter retrospective observational study. Clin Rheumatol 2016; 36:183-189. [PMID: 27853889 DOI: 10.1007/s10067-016-3480-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 11/03/2016] [Accepted: 11/06/2016] [Indexed: 01/21/2023]
Abstract
The study aim was to evaluate the efficacy of adalimumab (ADA) in a large series of Behçet's disease (BD)-related uveitis. We performed a multicenter retrospective observational study including 40 selected patients (66 eyes) receiving ADA. Clinical data were retrospectively analyzed at baseline, at 3 and 12 months of treatment. Primary end point was reduction of ocular inflammatory flares. Secondary end points were improvement of best corrected visual acuity (BCVA), reduction of macular thickness measured by optical coherence tomography (OCT), reduction in the occurrence of vasculitis assessed by fluorescein angiography (FA), and evaluation of statistically significant differences between patients treated with ADA monotherapy and those undergoing ADA plus DMARDs and in patients firstly treated with ADA compared to patients previously administered with other biologics; ADA steroid sparing effect was also evaluated. During the first 12 months of ADA therapy, the number of flares significantly decreased from 200 flares/100 patients/year to 8.5 flares/100 patients/year (p < 0.0001). Similarly, BCVA improved if compared to baseline (7.4 ± 2.9 versus 8.5 ± 2.1, p = 0.03). OCT findings significantly improved showing a mean reduction of central macular thickness (CMT) of 27.27 ± 42.8 μm at the end of follow-up (p < 0.006). FA identified retinal vasculitis in 22 cases at baseline (55%), 8 (20%) cases after 3 months, and in only one (2.5%) case at 12-month follow-up. FA improvement was highly significant at 3- and 12-month follow-up if compared to baseline (p < 0.0001 and p = 0.006, respectively). ADA is highly effective and safe for the treatment of BD-related uveitis, providing a long-term control of ocular inflammation.
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Affiliation(s)
- Claudia Fabiani
- Department of Ophthalmology, Humanitas Research Hospital, Rozzano, Milan, Italy.
| | - Antonio Vitale
- Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Giacomo Emmi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Lorenzo Vannozzi
- Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence, Italy
| | - Giuseppe Lopalco
- Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Bari, Italy
| | - Silvana Guerriero
- Department of Ophthalmology and Otolaryngology, Bari University, Bari, Italy
| | - Ida Orlando
- Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | | | - Daniela Bacherini
- Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence, Italy
| | - Luca Cimino
- Department of Ophthalmology, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Alessandra Soriano
- Department of Rheumatology, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Bruno Frediani
- Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Mauro Galeazzi
- Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Florenzo Iannone
- Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Bari, Italy
| | - Gian Marco Tosi
- Ophthalmology and Neurosurgery Department, University of Siena, Siena, Italy
| | - Carlo Salvarani
- Department of Rheumatology, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Luca Cantarini
- Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
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84
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Vitale A, Insalaco A, Sfriso P, Lopalco G, Emmi G, Cattalini M, Manna R, Cimaz R, Priori R, Talarico R, Gentileschi S, de Marchi G, Frassi M, Gallizzi R, Soriano A, Alessio M, Cammelli D, Maggio MC, Marcolongo R, La Torre F, Fabiani C, Colafrancesco S, Ricci F, Galozzi P, Viapiana O, Verrecchia E, Pardeo M, Cerrito L, Cavallaro E, Olivieri AN, Paolazzi G, Vitiello G, Maier A, Silvestri E, Stagnaro C, Valesini G, Mosca M, de Vita S, Tincani A, Lapadula G, Frediani B, De Benedetti F, Iannone F, Punzi L, Salvarani C, Galeazzi M, Rigante D, Cantarini L. A Snapshot on the On-Label and Off-Label Use of the Interleukin-1 Inhibitors in Italy among Rheumatologists and Pediatric Rheumatologists: A Nationwide Multi-Center Retrospective Observational Study. Front Pharmacol 2016; 7:380. [PMID: 27822185 PMCID: PMC5076463 DOI: 10.3389/fphar.2016.00380] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 09/29/2016] [Indexed: 12/21/2022] Open
Abstract
Background: Interleukin (IL)-1 inhibitors have been suggested as possible therapeutic options in a large number of old and new clinical entities characterized by an IL-1 driven pathogenesis. Objectives: To perform a nationwide snapshot of the on-label and off-label use of anakinra (ANA) and canakinumab (CAN) for different conditions both in children and adults. Methods: We retrospectively collected demographic, clinical, and therapeutic data from both adult and pediatric patients treated with IL-1 inhibitors from January 2008 to July 2016. Results: Five hundred and twenty-six treatment courses given to 475 patients (195 males, 280 females; 111 children and 364 adults) were evaluated. ANA was administered in 421 (80.04%) courses, CAN in 105 (19.96%). Sixty-two (32.1%) patients had been treated with both agents. IL-1 inhibitors were employed in 38 different indications (37 with ANA, 16 with CAN). Off-label use was more frequent for ANA than CAN (p < 0.0001). ANA was employed as first-line biologic approach in 323 (76.7%) cases, while CAN in 37 cases (35.2%). IL-1 inhibitors were associated with corticosteroids in 285 (54.18%) courses and disease modifying anti-rheumatic drugs (DMARDs) in 156 (29.65%). ANA dosage ranged from 30 to 200 mg/day (or 1.0–2.0 mg/kg/day) among adults and 2–4 mg/kg/day among children; regarding CAN, the most frequently used posologies were 150mg every 8 weeks, 150mg every 4 weeks and 150mg every 6 weeks. The frequency of failure was higher among patients treated with ANA at a dosage of 100 mg/day than those treated with 2 mg/kg/day (p = 0.03). Seventy-six patients (14.4%) reported an adverse event (AE) and 10 (1.9%) a severe AE. AEs occurred more frequently after the age of 65 compared to both children and patients aged between 16 and 65 (p = 0.003 and p = 0.03, respectively). Conclusions: IL-1 inhibitors are mostly used off-label, especially ANA, during adulthood. The high frequency of good clinical responses suggests that IL-1 inhibitors are used with awareness of pathogenetic mechanisms; adult healthcare physicians generally employ standard dosages, while pediatricians are more prone in using a weight-based posology. Dose adjustments and switching between different agents showed to be effective treatment strategies. Our data confirm the good safety profile of IL-1 inhibitors.
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Affiliation(s)
- Antonio Vitale
- Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, University of Siena Siena, Italy
| | - Antonella Insalaco
- Division of Rheumatology, Department of Pediatric Medicine, IRCCS, Bambino Gesù Children's Hospital Rome, Italy
| | - Paolo Sfriso
- Rheumatology Unit, Department of Medicine, University of Padua Padua, Italy
| | - Giuseppe Lopalco
- Rheumatology Unit, Interdisciplinary Department of Medicine, University of Bari Bari, Italy
| | - Giacomo Emmi
- Department of Experimental and Clinical Medicine, University of Florence Florence, Italy
| | - Marco Cattalini
- Pediatric Clinic, University of Brescia and Spedali Civili di Brescia Brescia, Italy
| | - Raffaele Manna
- Periodic Fever Research Center, Institute of Internal Medicine, Università Cattolica Sacro Cuore, Fondazione Policlinico A. Gemelli Rome, Italy
| | - Rolando Cimaz
- Pediatric Rheumatology Unit, AOU Meyer Florence, Italy
| | - Roberta Priori
- Department of Internal Medicine and Medical Specialities, Rheumatology Unit, Sapienza University of Rome Rome, Italy
| | - Rosaria Talarico
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa Pisa, Italy
| | - Stefano Gentileschi
- Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, University of Siena Siena, Italy
| | - Ginevra de Marchi
- Department of Medical and Biological Sciences, Rheumatology Clinic, University of Udine Udine, Italy
| | - Micol Frassi
- Rheumatology and Clinical Immunology, Spedali Civili, and Department of Clinical and Experimental Sciences, University of Brescia Brescia, Italy
| | - Romina Gallizzi
- Department of Pediatrics, Azienda G. Martino, University of Messina Messina, Italy
| | - Alessandra Soriano
- Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico Reggio Emilia, Italy
| | - Maria Alessio
- Department of Pediatrics, University Federico II of Naples Naples, Italy
| | - Daniele Cammelli
- Rheumatology Section, Immunoallergology Unit, AOU Careggi Florence, Italy
| | - Maria C Maggio
- Universitary Department "Pro.S.A.M.I.", University of Palermo Palermo, Italy
| | - Renzo Marcolongo
- Clinical Immunology, Department of Medicine, University of Padua Padua, Italy
| | | | - Claudia Fabiani
- Department of Ophthalmology, Humanitas Research Hospital Milan, Italy
| | - Serena Colafrancesco
- Department of Internal Medicine and Medical Specialities, Rheumatology Unit, Sapienza University of Rome Rome, Italy
| | - Francesca Ricci
- Pediatric Clinic, University of Brescia and Spedali Civili di Brescia Brescia, Italy
| | - Paola Galozzi
- Rheumatology Unit, Department of Medicine, University of Padua Padua, Italy
| | - Ombretta Viapiana
- Rheumatology Section, Department of Medicine, University of Verona Verona, Italy
| | - Elena Verrecchia
- Periodic Fever Research Center, Institute of Internal Medicine, Università Cattolica Sacro Cuore, Fondazione Policlinico A. Gemelli Rome, Italy
| | - Manuela Pardeo
- Division of Rheumatology, Department of Pediatric Medicine, IRCCS, Bambino Gesù Children's Hospital Rome, Italy
| | - Lucia Cerrito
- Periodic Fever Research Center, Institute of Internal Medicine, Università Cattolica Sacro Cuore, Fondazione Policlinico A. Gemelli Rome, Italy
| | - Elena Cavallaro
- Department of Medical and Biological Sciences, Rheumatology Clinic, University of Udine Udine, Italy
| | - Alma N Olivieri
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Seconda Università degli Studi of Naples Naples, Italy
| | | | - Gianfranco Vitiello
- Experimental and Clinical Medicine Department, University of Florence Florence, Italy
| | - Armin Maier
- Struttura Semplice di Reumatologia, Ospedale di Bolzano Bolzano, Italy
| | - Elena Silvestri
- Department of Experimental and Clinical Medicine, University of Florence Florence, Italy
| | - Chiara Stagnaro
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa Pisa, Italy
| | - Guido Valesini
- Department of Internal Medicine and Medical Specialities, Rheumatology Unit, Sapienza University of Rome Rome, Italy
| | - Marta Mosca
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa Pisa, Italy
| | - Salvatore de Vita
- Department of Medical and Biological Sciences, Rheumatology Clinic, University of Udine Udine, Italy
| | - Angela Tincani
- Rheumatology and Clinical Immunology, Spedali Civili, and Department of Clinical and Experimental Sciences, University of Brescia Brescia, Italy
| | - Giovanni Lapadula
- Rheumatology Unit, Interdisciplinary Department of Medicine, University of Bari Bari, Italy
| | - Bruno Frediani
- Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, University of Siena Siena, Italy
| | - Fabrizio De Benedetti
- Division of Rheumatology, Department of Pediatric Medicine, IRCCS, Bambino Gesù Children's Hospital Rome, Italy
| | - Florenzo Iannone
- Rheumatology Unit, Interdisciplinary Department of Medicine, University of Bari Bari, Italy
| | - Leonardo Punzi
- Rheumatology Unit, Department of Medicine, University of Padua Padua, Italy
| | - Carlo Salvarani
- Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico Reggio Emilia, Italy
| | - Mauro Galeazzi
- Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, University of Siena Siena, Italy
| | - Donato Rigante
- Periodic Fever Research Center, Institute of Pediatrics, Università Cattolica Sacro Cuore, Fondazione Policlinico A. Gemelli Rome, Italy
| | - Luca Cantarini
- Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, University of Siena Siena, Italy
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Restuccia G, Boiardi L, Cavazza A, Catanoso M, Macchioni P, Muratore F, Soriano A, Cimino L, Aldigeri R, Crescentini F, Pipitone N, Salvarani C. Long-term remission in biopsy proven giant cell arteritis: A retrospective cohort study. J Autoimmun 2016; 77:39-44. [PMID: 27742223 DOI: 10.1016/j.jaut.2016.10.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/01/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To evaluate the frequency of long-term remission after glucocorticoids (GCs) suspension in an Italian cohort of patients with biopsy-proven GCA and to identify factors that may predict long-term remission. METHODS We evaluated 131 patients with biopsy-proven transmural GCA diagnosed and followed up at the Rheumatology Unit of Reggio Emilia Hospital (Italy) for whom sufficient information was available from the time of diagnosis until at least 18 months of follow-up. Long-term remission was defined as complete clinical remission without elevation of inflammatory markers for at least one year after the GC withdrawal. RESULTS 73 patients (56%) experienced long-term remission. Disease flares were less frequently observed in patients with long-term remission compared to those without (p = 0.002). The cumulative doses of prednisone at 1 year and for the entire followup duration were significantly lower (p < 0.0001 for both parameters) in patients with long-term remission; similarly, the duration of prednisone treatment was also significantly lower (p < 0.0001). The presence of PMR at diagnosis (HR 0.46) was significantly negatively associated with long-term remission (p = 0.008), while hemoglobin levels (HR 1.48) were significantly positively associated (p < 0.0001). Patients with long-term remission were able to reach 10 mg/day and 5 mg/day of prednisone sooner than the patients without (p = 0.02 and p < 0.0001, respectively). CONCLUSION In our cohort of GCA patients around half of the patients were able to attain long-term remission. Recognition of findings which predict disease course may aid decisions regarding therapy.
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Affiliation(s)
- Giovanna Restuccia
- Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luigi Boiardi
- Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alberto Cavazza
- Operative Unit of Pathologic Anatomy, Department of Oncology and Advanced Technology, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Mariagrazia Catanoso
- Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Pierluigi Macchioni
- Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Muratore
- Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandra Soriano
- Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Cimino
- Ophthalmology Unit, Department of Surgery, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Raffaella Aldigeri
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Filippo Crescentini
- Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Nicolò Pipitone
- Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Carlo Salvarani
- Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
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Zarzosa P, Navarro N, Giralt I, Molist C, Almazán-Moga A, Vidal I, Soriano A, Segura MF, Hladun R, Villanueva A, Gallego S, Roma J. Patient-derived xenografts for childhood solid tumors: a valuable tool to test new drugs and personalize treatments. Clin Transl Oncol 2016; 19:44-50. [PMID: 27718156 DOI: 10.1007/s12094-016-1557-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 09/22/2016] [Indexed: 12/23/2022]
Abstract
The use of preclinical models is essential in translational cancer research and especially important in pediatric cancer given the low incidence of each particular type of cancer. Cell line cultures have led to significant advances in cancer biology. However, cell lines have adapted to growth in artificial culture conditions, thereby undergoing genetic and phenotypic changes which may hinder the translational application. Tumor grafts developed in mice from patient tumor tissues, generally known as patient-derived xenografts (PDXs), are interesting alternative approaches to reproducing the biology of the original tumor. This review is focused on highlighting the interest of PDX models in pediatric cancer research and supporting strategies of personalized medicine. This review provides: (1) a description of the background of PDX in cancer, (2) the particular case of PDX in pediatric cancer, (3) how PDX can improve personalized medicine strategies, (4) new methods to increase engraftment, and, finally, (5) concluding remarks.
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Affiliation(s)
- P Zarzosa
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Navarro
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Giralt
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Molist
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Almazán-Moga
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Vidal
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Soriano
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M F Segura
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R Hladun
- Pediatric Oncology and Hematology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Villanueva
- Chemoresistance and Predicitive Factors Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Xenopat S.L. Business Bioincubator Bellvitge Health Science Campus, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - S Gallego
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
- Pediatric Oncology and Hematology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Roma
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain.
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Purrello SM, Garau J, Giamarellos E, Mazzei T, Pea F, Soriano A, Stefani S. Methicillin-resistant Staphylococcus aureus infections: A review of the currently available treatment options. J Glob Antimicrob Resist 2016; 7:178-186. [PMID: 27889013 DOI: 10.1016/j.jgar.2016.07.010] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 07/03/2016] [Accepted: 07/16/2016] [Indexed: 12/16/2022] Open
Abstract
This review is the result of discussions that took place at the 5th MRSA Working Group Consensus Meeting and explores the possible treatment options available for different types of infections due to methicillin-resistant Staphylococcus aureus (MRSA), focusing on those antibiotics that could represent a valid alternative to vancomycin. In fact, whilst vancomycin remains a viable option, its therapy is moving towards individualised dosing. Other drugs, such as the new lipoglycopeptides (oritavancin, dalbavancin and telavancin) and fifth-generation cephalosporins (ceftaroline and ceftobiprole), are showing good in vitro potency and in vivo efficacy, especially for patients infected with micro-organisms with higher vancomycin minimum inhibitory concentrations (MICs). Tedizolid is an attractive agent for use both in hospital and community settings, but the post-marketing data will better clarify its potential. Daptomycin and linezolid have shown non-inferiority to vancomycin in the treatment of MRSA bacteraemia and non-inferiority/superiority to vancomycin in the treatment of hospital-acquired pneumonia. Thus, several options are available, but more data from clinical practice, especially for invasive infections, are needed to assign specific roles to each antibiotic and to definitely include them in the new antibacterial armamentarium.
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Affiliation(s)
- S M Purrello
- Medical Molecular Microbiology and Antibiotic Resistance Laboratory (MMAR Lab), Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - J Garau
- Department of Medicine, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - E Giamarellos
- 4th Department of Internal Medicine, Attikon University Hospital, Athens, Greece
| | - T Mazzei
- Department of Health Sciences, Clinical Pharmacology and Oncology Section, University of Firenze, Firenze, Italy
| | - F Pea
- Institute of Clinical Pharmacology, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Udine, Italy; Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy
| | - A Soriano
- Department of Infectious Diseases, IDIBAPS, Hospital Clínic of Barcelona, Barcelona, Spain
| | - S Stefani
- Medical Molecular Microbiology and Antibiotic Resistance Laboratory (MMAR Lab), Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
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Oliver L, Candela C, Palma J, Pujades M, Soriano A, Alabau J, Martínez J, Mestre V, Ruiz J, Vilar J, Llorca N. Comparison of the dosimetric response of 4-element BeOSL and TLD-100 passive personal dosimeters. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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89
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Benito N, Franco M, Ribera A, Soriano A, Rodriguez-Pardo D, Sorlí L, Fresco G, Fernández-Sampedro M, Dolores Del Toro M, Guío L, Sánchez-Rivas E, Bahamonde A, Riera M, Esteban J, Baraia-Etxaburu JM, Martínez-Alvarez J, Jover-Sáenz A, Dueñas C, Ramos A, Sobrino B, Euba G, Morata L, Pigrau C, Coll P, Mur I, Ariza J. Time trends in the aetiology of prosthetic joint infections: a multicentre cohort study. Clin Microbiol Infect 2016; 22:732.e1-8. [PMID: 27181408 DOI: 10.1016/j.cmi.2016.05.004] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 04/24/2016] [Accepted: 05/03/2016] [Indexed: 02/05/2023]
Abstract
It is important to know the spectrum of the microbial aetiology of prosthetic joint infections (PJIs) to guide empiric treatment and establish antimicrobial prophylaxis in joint replacements. There are no available data based on large contemporary patient cohorts. We sought to characterize the causative pathogens of PJIs and to evaluate trends in the microbial aetiology. We hypothesized that the frequency of antimicrobial-resistant organisms in PJIs has increased in the recent years. We performed a cohort study in 19 hospitals in Spain, from 2003 to 2012. For each 2-year period (2003-2004 to 2011-2012), the incidence of microorganisms causing PJIs and multidrug-resistant bacteria was assessed. Temporal trends over the study period were evaluated. We included 2524 consecutive adult patients with a diagnosis of PJI. A microbiological diagnosis was obtained for 2288 cases (90.6%). Staphylococci were the most common cause of infection (1492, 65.2%). However, a statistically significant rising linear trend was observed for the proportion of infections caused by Gram-negative bacilli, mainly due to the increase in the last 2-year period (25% in 2003-2004, 33.3% in 2011-2012; p 0.024 for trend). No particular species contributed disproportionally to this overall increase. The percentage of multidrug-resistant bacteria PJIs increased from 9.3% in 2003-2004 to 15.8% in 2011-2012 (p 0.008), mainly because of the significant rise in multidrug-resistant Gram-negative bacilli (from 5.3% in 2003-2004 to 8.2% in 2011-2012; p 0.032). The observed trends have important implications for the management of PJIs and prophylaxis in joint replacements.
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Affiliation(s)
- N Benito
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau-Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Spain; Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain.
| | - M Franco
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau-Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Spain
| | - A Ribera
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitari Bellvitge, Barcelona, Spain
| | - A Soriano
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Clínic Universitari, Barcelona, Spain
| | - D Rodriguez-Pardo
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - L Sorlí
- Department of Infectious Diseases, Hospital del Mar, Barcelona, Spain
| | - G Fresco
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - M Fernández-Sampedro
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitario Valdecilla, Santander, Spain
| | - M Dolores Del Toro
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - L Guío
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitario Cruces, Bilbao, Spain
| | - E Sánchez-Rivas
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - A Bahamonde
- Department of Internal Medicine-Infectious Diseases, Hospital el Bierzo, León, Spain
| | - M Riera
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Infectious Diseases Unit, Department of Infectious Diseases, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - J Esteban
- Department of Clinical Microbiology, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | | | - J Martínez-Alvarez
- Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - A Jover-Sáenz
- Unit of Nosocomial Infection, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - C Dueñas
- Department of Internal Medicine, Hospital Universitario de Burgos, Burgos, Spain
| | - A Ramos
- Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - B Sobrino
- Department of Infectious Diseases, Hospital Regional Universitario Málaga, Málaga, Spain
| | - G Euba
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitari Bellvitge, Barcelona, Spain
| | - L Morata
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Clínic Universitari, Barcelona, Spain
| | - C Pigrau
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - P Coll
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Microbiology, Hospital de la Santa Creu i Sant Pau-Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - I Mur
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau-Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - J Ariza
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Hospital Universitari Bellvitge, Barcelona, Spain
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Di Lazzaro V, Rigon A, Soriano A, Capone F, Corbetto M, Florio L, Afeltra A, Onetti Muda A, Luigetti M. Sjögren's syndrome presenting with isolated sensory axonal polyneuropathy. Int J Rheum Dis 2016; 20:2165-2167. [PMID: 27453550 DOI: 10.1111/1756-185x.12898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.,Fondazione Alberto Sordi - Research Institute for Ageing, Rome, Italy
| | - Amelia Rigon
- Unit of Allergology, Immunology, Rheumatology, Department of Medicine, Università Campus Biomedico, Rome, Italy
| | - Alessandra Soriano
- Unit of Allergology, Immunology, Rheumatology, Department of Medicine, Università Campus Biomedico, Rome, Italy
| | - Fioravante Capone
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.,Fondazione Alberto Sordi - Research Institute for Ageing, Rome, Italy
| | - Marzia Corbetto
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.,Fondazione Alberto Sordi - Research Institute for Ageing, Rome, Italy
| | - Lucia Florio
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.,Fondazione Alberto Sordi - Research Institute for Ageing, Rome, Italy
| | - Antonella Afeltra
- Unit of Allergology, Immunology, Rheumatology, Department of Medicine, Università Campus Biomedico, Rome, Italy
| | - Andrea Onetti Muda
- Anatomic Pathology Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Marco Luigetti
- Department of Geriatrics, Neurosciences, Head and Neck surgery, and Orthopedics, Institute of Neurology, Fondazione Policlinico Agostino Gemelli, Rome, Italy.,Don Carlo Gnocchi Foundation, Milan, Italy
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91
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Majem B, Parrilla A, Soriano A, Gil-Moreno A, Segura M, Santamaria A. Functional characterization of a tumor suppressor micro-RNA in ovarian cancer. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61374-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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92
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Perricone C, Colafrancesco S, Mazor RD, Soriano A, Agmon-Levin N, Shoenfeld Y. Corrigendum to "Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) 2013: Unveiling the pathogenic, clinical and diagnostic aspects" [J. Autoimmun. 47C (2013) 1-16]. J Autoimmun 2016; 72:126. [PMID: 27269045 DOI: 10.1016/j.jaut.2016.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Carlo Perricone
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | - Serena Colafrancesco
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | - Roei D Mazor
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
| | - Alessandra Soriano
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Department of Clinical Medicine and Rheumatology, University Campus Bio-Medico of Rome, Italy
| | - Nancy Agmon-Levin
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
| | - Yehuda Shoenfeld
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel-Aviv University, Israel.
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93
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Soriano A, Pazzola G, Boiardi L, Muratore F, Macchioni P, Aldigeri R, Casali M, Versari A, Salvarani C. SAT0340 Distinct Distribution Patterns of Large Vessel Vasculitis Assessed with 18f-FDG PET/CT: A Cluster and Principal Component Analysis Study. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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94
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Morata L, De la Calle C, Gómez-Cerquera JM, Manzanedo L, Casals G, Brunet M, Cobos-Trigueros N, Martínez JA, Mensa J, Soriano A. Risk factors associated with high linezolid trough plasma concentrations. Expert Opin Pharmacother 2016; 17:1183-7. [PMID: 27156708 DOI: 10.1080/14656566.2016.1182154] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM The major concern of linezolid is the adverse events. High linezolid trough serum concentration (Cmin) has been associated with toxicity. The aim of this study was to analyze factors associated with high Cmin. METHODS Main clinical characteristics of 104 patients treated with 600 mg/12 hours of linezolid were retrospectively reviewed. Samples were obtained just before the next dose after at least three doses and within the first 8 days of treatment. High Cmin was considered when it was >8 mg/L. Univariate and multivariate analysis were performed. RESULTS 34.6% patients had a Cmin >8 mg/L, and they were older and had more frequently an estimated glomerular filtration by MDRD <40 mL/min. There were more patients co-treated with rifampin in the group with low Cmin. The only factor independently associated with Cmin >8 was the renal function. Patients with an eGF < 40 mL/min had significantly higher Cmin than those with eGF > 80 mL/min (OR: 4.273) and there was a trend towards a high Cmin in patients with eGF between 40-80 mL/min (OR: 2.109). CONCLUSIONS High Cmin were frequent, especially in patients with MDRD <40 mL/min. Therapeutic drug monitoring could be useful to avoid toxicity in patients with renal dysfunction.
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Affiliation(s)
- L Morata
- a Department of Infectious Diseases , Hospital Clínic of Barcelona , Barcelona , Spain
| | - C De la Calle
- a Department of Infectious Diseases , Hospital Clínic of Barcelona , Barcelona , Spain
| | - J M Gómez-Cerquera
- a Department of Infectious Diseases , Hospital Clínic of Barcelona , Barcelona , Spain
| | - L Manzanedo
- a Department of Infectious Diseases , Hospital Clínic of Barcelona , Barcelona , Spain
| | - G Casals
- b Department of Pharmacology and Toxicology , Hospital Clínic of Barcelona , Barcelona , Spain
| | - M Brunet
- b Department of Pharmacology and Toxicology , Hospital Clínic of Barcelona , Barcelona , Spain
| | - N Cobos-Trigueros
- a Department of Infectious Diseases , Hospital Clínic of Barcelona , Barcelona , Spain
| | - J A Martínez
- a Department of Infectious Diseases , Hospital Clínic of Barcelona , Barcelona , Spain
| | - J Mensa
- a Department of Infectious Diseases , Hospital Clínic of Barcelona , Barcelona , Spain
| | - A Soriano
- a Department of Infectious Diseases , Hospital Clínic of Barcelona , Barcelona , Spain
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95
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Jubierre L, Soriano A, Planells-Ferrer L, París-Coderch L, Tenbaum SP, Romero OA, Moubarak RS, Almazán-Moga A, Molist C, Roma J, Navarro S, Noguera R, Sánchez-Céspedes M, Comella JX, Palmer HG, Sánchez de Toledo J, Gallego S, Segura MF. BRG1/SMARCA4 is essential for neuroblastoma cell viability through modulation of cell death and survival pathways. Oncogene 2016; 35:5179-90. [PMID: 26996667 DOI: 10.1038/onc.2016.50] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 10/29/2015] [Accepted: 02/01/2016] [Indexed: 12/16/2022]
Abstract
Neuroblastoma (NB) is a neoplasm of the sympathetic nervous system, and is the most common solid tumor of infancy. NBs are very heterogeneous, with a clinical course ranging from spontaneous regression to resistance to all current forms of treatment. High-risk patients need intense chemotherapy, and only 30-40% will be cured. Relapsed or metastatic tumors acquire multi-drug resistance, raising the need for alternative treatments. Owing to the diverse mechanisms that are responsible of NB chemoresistance, we aimed to target epigenetic factors that control multiple pathways to bypass therapy resistance. We found that the SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily a, member 4 (SMARCA4/BRG1) was consistently upregulated in advanced stages of NB, with high BRG1 levels being indicative of poor outcome. Loss-of-function experiments in vitro and in vivo showed that BRG1 is essential for the proliferation of NB cells. Furthermore, whole-genome transcriptome analysis revealed that BRG1 controls the expression of key elements of oncogenic pathways such as PI3K/AKT and BCL2, which offers a promising new combination therapy for high-risk NB.
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Affiliation(s)
- L Jubierre
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | - A Soriano
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | | | - L París-Coderch
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | - S P Tenbaum
- Vall d'Hebron Institut of Oncology (VHIO), Stem Cell and Cancer Laboratory, Barcelona, Spain
| | - O A Romero
- Epigenetic and Cancer Biology Program-PEBC/Bellvitge Biomedical Research Institute-IDIBELL Barcelona, Barcelona, Spain
| | - R S Moubarak
- Cell Signaling and Apoptosis Group, VHIR-UAB, Barcelona, Spain
| | - A Almazán-Moga
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | - C Molist
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | - J Roma
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | - S Navarro
- School of Medicine, University of Valencia, Valencia, Spain
| | - R Noguera
- School of Medicine, University of Valencia, Valencia, Spain
| | | | - J X Comella
- Cell Signaling and Apoptosis Group, VHIR-UAB, Barcelona, Spain
| | - H G Palmer
- Vall d'Hebron Institut of Oncology (VHIO), Stem Cell and Cancer Laboratory, Barcelona, Spain
| | - J Sánchez de Toledo
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | - S Gallego
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | - M F Segura
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
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96
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Watad A, Neumann SG, Soriano A, Amital H, Shoenfeld Y. Vitamin D and Systemic Lupus Erythematosus: Myth or Reality? Isr Med Assoc J 2016; 18:177-182. [PMID: 27228639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
There is growing interest in the contribution of vitamin D deficiency to autoimmunity. Several studies have shown an association between low levels of vitamin D and autoimmune disorders, including multiple sclerosis, rheumatoid arthritis, type 1 diabetes, autoimmune thyroid diseases, celiac disease, and systemic lupus erythematosus (SLE). Vitamin D receptor ligands can mediate immunosuppressive effects. It has been suggested that low levels of this hormone contribute to the immune activation in lupus and other autoimmune diseases. This review updates and summarizes the literature on the association between vitamin D and SLE, and discusses the various correlations between vitamin D and SLE activity, clinical expressions, serology, and gene polymorphisms of vitamin D receptors.
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97
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De la Calle C, Morata L, Cobos-Trigueros N, Martinez JA, Cardozo C, Mensa J, Soriano A. Staphylococcus aureus bacteremic pneumonia. Eur J Clin Microbiol Infect Dis 2016; 35:497-502. [PMID: 26780692 DOI: 10.1007/s10096-015-2566-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 12/21/2015] [Indexed: 01/21/2023]
Abstract
Staphylococcus aureus bacteremic pneumonia is an uncommon cause of hospitalization, with a high mortality rate. However, published reports are scarce and have included a small number of cases. All patients with S. aureus bacteremic pneumonia were prospectively collected in our institution from 2000 to 2014, and a retrospective revision was performed to identify risk factors associated with methicillin resistance and to update the mortality of this entity. A total of 98 patients were admitted: 57.1 % were due to methicillin-susceptible S. aureus (MSSA) and 42.8 % due to methicillin-resistant S. aureus (MRSA). In 40 patients (40.8 %), the infection was community acquired. Thirteen were ventilator-associated pneumonia episodes. The most frequent comorbidities were chronic lung disease (34.7 %), chronic renal failure (31.6 %), diabetes mellitus (29.6 %), and cardiovascular disease (31.6 %). Septic shock was present in 46 patients (46.9 %). The 30-day mortality was 46.9 %. MRSA infections occurred in older patients, more frequently with cardiovascular diseases, and they had received antibiotic treatment in the previous month more often than MSSA-infected patients. Patients with infection due to MSSA presented more frequently with septic shock, but they received more frequently appropriate empirical antibiotic therapy than patients with MRSA pneumonia (96 % vs. 38.1 %), and no differences in mortality were observed between both groups. In conclusion, S. aureus bacteremic pneumonia is a severe infection that, nowadays, affects people with comorbidities and the mortality is still high.
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Affiliation(s)
- C De la Calle
- Department of Infectious Diseases Hospital Clínic, Barcelona, Spain.
| | - L Morata
- Department of Infectious Diseases Hospital Clínic, Barcelona, Spain
| | | | - J A Martinez
- Department of Infectious Diseases Hospital Clínic, Barcelona, Spain
| | - C Cardozo
- Department of Infectious Diseases Hospital Clínic, Barcelona, Spain
| | - J Mensa
- Department of Infectious Diseases Hospital Clínic, Barcelona, Spain
| | - A Soriano
- Department of Infectious Diseases Hospital Clínic, Barcelona, Spain
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98
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Soriano A, Montoro V, Vicente J, Sánchez-Migallón BF, Benítez S, Utrilla MC, García Ruiz A. Influence of evisceration time and carcass ageing conditions on wild venison quality. Preliminary study. Meat Sci 2015; 114:130-136. [PMID: 26773970 DOI: 10.1016/j.meatsci.2015.12.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 12/23/2015] [Accepted: 12/29/2015] [Indexed: 10/22/2022]
Abstract
The influence of common carcass preparation practices of wild red deer on the physicochemical, microbiological and sensory quality of venison was assessed by varying evisceration time and ageing method. Deer were head shot; half were eviscerated 30 min and the other half 4 h post mortem. In both groups (n=18), 6 carcasses were skinned immediately after evisceration and aged for 24 h; 6 were aged unskinned for 24 h and 6 were aged unskinned for 72 h at 10°C. Ageing method had a significant effect on the sensory quality of venison loin; unskinned ageing was associated with an increase of odour and taste intensity, and higher scores for gamey and sweet/caramel flavours. Carcasses aged for 72 h displayed darker and tender meat, but increased aerobic bacterial counts. Evisceration time had less influence on loin quality, although off-flavours were more often detected in deer eviscerated 4h post mortem.
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Affiliation(s)
- A Soriano
- Department of Analytical Chemistry and Food Technology, Faculty of Sciences and Technologies Chemistries, University of Castilla-La Mancha, Avda. Camilo José Cela s/n, 13071 Ciudad Real, Spain.
| | - V Montoro
- IREC Instituto de Investigación en Recursos Cinegéticos (CSIC-UCLM-JCCM), Ronda de Toledo, s/n, 13071 Ciudad Real, Spain
| | - J Vicente
- IREC Instituto de Investigación en Recursos Cinegéticos (CSIC-UCLM-JCCM), Ronda de Toledo, s/n, 13071 Ciudad Real, Spain
| | - B F Sánchez-Migallón
- Department of Analytical Chemistry and Food Technology, School of Engineers Agronomist, University of Castilla-La Mancha, Ronda de Calatrava 7, 13071 Ciudad Real, Spain
| | - S Benítez
- Department of Analytical Chemistry and Food Technology, School of Engineers Agronomist, University of Castilla-La Mancha, Ronda de Calatrava 7, 13071 Ciudad Real, Spain
| | - M C Utrilla
- Department of Analytical Chemistry and Food Technology, Faculty of Sciences and Technologies Chemistries, University of Castilla-La Mancha, Avda. Camilo José Cela s/n, 13071 Ciudad Real, Spain
| | - A García Ruiz
- Department of Analytical Chemistry and Food Technology, School of Engineers Agronomist, University of Castilla-La Mancha, Ronda de Calatrava 7, 13071 Ciudad Real, Spain
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99
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Ortega M, Soriano A, Marco F, Almela M, Martínez JA, Morata L, Cobos-Trigueros N, de la Calle C, Mensa J. Risk factors for the isolation of a third generation cephalosporin resistant strain in patients with community-acquired Enterobacteriaceae bacteraemia. J Infect 2015; 72:268-71. [PMID: 26702739 DOI: 10.1016/j.jinf.2015.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 11/25/2015] [Accepted: 11/28/2015] [Indexed: 10/22/2022]
Affiliation(s)
- M Ortega
- Emergency Department and Infectious Diseases Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain.
| | - A Soriano
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - F Marco
- Service of Clinical Microbiology, Barcelona Centre for International Health Research (CRESIB, Hospital Clínic, University of Barcelona), Barcelona, Spain
| | - M Almela
- Service of Clinical Microbiology, Barcelona Centre for International Health Research (CRESIB, Hospital Clínic, University of Barcelona), Barcelona, Spain
| | - J A Martínez
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - L Morata
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - N Cobos-Trigueros
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - C de la Calle
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - J Mensa
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
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100
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Varona MA, Soriano A, Aguirre-Jaime A, Garrido S, Oton E, Diaz D, Portero J, Bravo P, Barrera MA, Perera A. Risk factors of hepatocellular carcinoma recurrence after liver transplantation: accuracy of the alpha-fetoprotein model in a single-center experience. Transplant Proc 2015; 47:84-9. [PMID: 25645778 DOI: 10.1016/j.transproceed.2014.12.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Recurrence of hepatocellular carcinoma (HCC) and cirrhosis after a liver transplantation (LT) is a major concern, and a strict Milan criteria selection of candidates does not accurately discriminate the relapse rate after LT. PURPOSE This study sought to analyze the risk factors affecting tumor recurrence after LT for related cirrhosis HCC and the application of the French prognostic model (preLT alpha-fetoprotein [AFP], size, number) in a single center. METHODS In a retrospective observational study of LT for HCC and cirrhosis, clinicopathological features were analyzed. Also, the preoperative and postoperative AFP model score was calculated with a cutoff of 2. RESULTS Of 480, 109 patients underwent cadaveric LT for HCC. Eight of them had a relapse (7%). High AFP level, AFP model score >2, high pathological tumor-node-metastasis (pTNM) stage, poor differentiation, macrovascular-microvascular invasion, infiltration, and R1 margin were statistically significant (P < .05) for recurrence. Also, in the preoperative model, AFP score >2 was a predictor of worse survival (1-, 3-, 5-, 10-year survival of 81%, 51%, 30%, 30% vs 90%, 76%, 73%, 69% in ≤2, with P = .005). Regarding the postoperative model, similar results were found (1-, 3-, 5-, 10-year survival of 84%, 47%, 37%, 37% vs 90%, 78%, 73%, 52%, P = .028) between AFP model score >2 and ≤2, respectively. However, Milan and up-to-7 criteria were not accurate in recurrence nor in survival. CONCLUSIONS The French AFP model has proven to be a more discerning prognostic tool than other established criteria in the prediction of recurrence and survival. Also, in postoperative prognosis, pathological risk factors for relapse such as pTNM, differentiation grade, macrovascular-microvascular invasion, infiltration, and R1 margin have been predictors of recurrence.
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Affiliation(s)
- M A Varona
- Department of Surgery, Hospital Universitario Nuestra Sra. De Candelaria, S/C de Tenerife, Spain.
| | - A Soriano
- Department of Surgery, Hospital Universitario Nuestra Sra. De Candelaria, S/C de Tenerife, Spain
| | - A Aguirre-Jaime
- Investigation Unit, Hospital Universitario Nuestra Sra. De Candelaria, S/C de Tenerife, Spain
| | - S Garrido
- Department of Radiology/Hospital Universitario Nuestra Sra. De Candelaria, S/C de Tenerife, Spain
| | - E Oton
- Department of Hepatology/Hospital Universitario Nuestra Sra. De Candelaria, S/C de Tenerife, Spain
| | - D Diaz
- Department of Hepatology/Hospital Universitario Nuestra Sra. De Candelaria, S/C de Tenerife, Spain
| | - J Portero
- Department of Vascular Radiology, Crta. El Rosario, no. 145, 38010, S/C de Tenerife, Spain
| | - P Bravo
- Department of Anesthesiology/Hospital Universitario Nuestra Sra. De Candelaria, S/C de Tenerife, Spain
| | - M A Barrera
- Department of Surgery, Hospital Universitario Nuestra Sra. De Candelaria, S/C de Tenerife, Spain
| | - A Perera
- Department of Pathology/Hospital Universitario Nuestra Sra. De Candelaria, S/C de Tenerife, Spain
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