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Pastore G, Guala A. Vitamin K deficiency bleeding in neonates. J Pediatr Gastroenterol Nutr 2001; 32:108-9. [PMID: 11176340 DOI: 10.1097/00005176-200101000-00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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202
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Favia A, Di Stefano M, Lepera A, Mangiacotti L, Saracino A, Fiore JR, Angarano G, Pastore G. "In vitro" spontaneous production of B-chemokines by endocervical and endometrial short-term bioptic cultures. New Microbiol 2001; 24:95-8. [PMID: 11209849] [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: 02/19/2023]
Abstract
Several studies indicate that HIV-1 is present in the cervico-vaginal tissues and secretions of infected women representing an important determinant of both sexual and mother-to-child transmission. HIV-1 genital shedding is influenced by various factors; among these, proinflammatory cytokines, in particular the beta/C-C chemokine group (RANTES, MIP-1alpha and MIP-1beta), are known to suppress HIV-1 replication and thus might affect both sexual and vertical transmission. This study aimed to standardize a procedure to measure "in vitro" uterine spontaneous chemokine production by means of short-term cultures of endocervical and endometrial bioptic fragments. In most cases, "in vitro" chemokine production was observed in both fragment cultures. These results further confirm that beta/C-C chemokines exist in the female genital tract and that uterine mucosa actively produces basal levels of these immuno-active substances. This method constitutes a useful approach to evaluate cytokine production and expression in the female genital tract, their influence on HIV-1 expression and infectivity in this site, and their possible role in viral transmission.
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Affiliation(s)
- A Favia
- Clinic of Infectious Diseases, University of Bari, Italy
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203
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Saracino A, Di Stefano M, Vimercati A, Greco P, Fiore JR, Monno L, Angarano G, Pastore G. Cervicovaginal HIV-1 Shedding in Pregnant Women near Delivery. Antivir Ther 2001. [DOI: 10.1177/135965350100600109] [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: 11/17/2022]
Affiliation(s)
- Annalisa Saracino
- Clinic of Infectious Diseases, University of Bari, Bari, Italy
- Clinic of Infectious Diseases, University of Foggia, Foggia, Italy
| | - Mariantonietta Di Stefano
- Clinic of Infectious Diseases, University of Bari, Bari, Italy
- Clinic of Infectious Diseases, University of Foggia, Foggia, Italy
| | | | - Pantaleo Greco
- Obstetrical and Gynaecological Clinic II, University of Bari, Bari, Italy
| | | | - Laura Monno
- Clinic of Infectious Diseases, University of Bari, Bari, Italy
| | - Gioacchino Angarano
- Clinic of Infectious Diseases, University of Bari, Bari, Italy
- Clinic of Infectious Diseases, University of Foggia, Foggia, Italy
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Floridia M, Tomino C, Bucciardini R, Ricciardulli D, Fragola V, Pirillo MF, Amici R, Giannini G, Galluzzo CM, Andreotti M, Seeber AC, Ammassari A, Cingolani A, Lazzarin A, Scalise G, Cargnel A, Suter F, Milazzo F, Pastore G, Moroni M, Ciammarughi R, Pini R, Carosi G, D'Amato C, Contu L, Concia E, Bonazzi L, Aiuti F, Vigevani G, Vella S. A randomized trial comparing the introduction of ritonavir or indinavir in 1251 nucleoside-experienced patients with advanced HIV infection. AIDS Res Hum Retroviruses 2000; 16:1809-20. [PMID: 11118067 DOI: 10.1089/08892220050195775] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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: 11/12/2022] Open
Abstract
ISS-IP1, a multicenter, randomized, 48-week open trial, was designed to compare the introduction of ritonavir or indinavir in patients with previous nucleoside experience and CD4+ cell counts below 50/mm3. Concomitant antiretroviral treatment with nucleoside analogs was allowed. Primary efficacy measures were survival and time to a new AIDS-defining event or death, analyzed through the whole period of observation by the intention-to-treat approach. Primary toxicity measures were time to treatment discontinuation and adverse events, grade at least 3/serious, analyzed by an on-treatment approach. Evaluation-of efficacy also included CD4+ cell and RNA response. The trial enrolled 1251 patients in 5 months. At baseline, mean CD4+ cell count was about 20 cells/mm3 and mean HIV RNA copy number was 4.9 log10/ml in both groups. Overall, 402 patients in the ritonavir group and 250 patients in the indinavir group permanently discontinued the assigned treatment (relative risk, 1.96; 95% CI, 1.68-2.30; p = 0.0001), with most of this difference dependent on a higher number of discontinuation for adverse events in the ritonavir group. After a mean follow-up of 307 days (ritonavir, 304; indinavir, 309), 124 deaths (ritonavir, 61; indinavir, 63; relative risk, 0.96; 95% CI, 0.67-1.36; p = 0.80) and 330 new AIDS-defining events (ritonavir, 170; indinavir, 160; relative risk, 1.05; 95% CI, 0.85-1.31; p = 0.60) were observed. CD4+ cell counts increased in both groups in patients still receiving treatment, with about 100 cells gained by week 24 and 150 cells gained by week 48. Body weight also increased over time in both groups. Analysis of RNA response showed a decrease of 1.5 log10 or higher in both treatment groups. Overall, 400 patients in the ritonavir group and 338 patients in the indinavir group developed at least one grade 3/serious new adverse event during follow-up (relative risk, 1.48; 95% CI, 1.28-1.72; p = 0.0001). Favorable CD4+ cell and RNA responses at 24 and 48 weeks were observed in both groups of patients remaining on treatment. Indinavir showed slightly better effects in sustaining RNA, CD4+ cell, and body weight responses. Ritonavir and indinavir results were comparable in terms of clinical outcome (survival and AIDS-defining events).
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Affiliation(s)
- M Floridia
- Laboratory of Virology, Istituto Superiore di Sanità, Rome, Italy
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Maggi P, Serio G, Epifani G, Fiorentino G, Saracino A, Fico C, Perilli F, Lillo A, Ferraro S, Gargiulo M, Chirianni A, Angarano G, Regina G, Pastore G. Premature lesions of the carotid vessels in HIV-1-infected patients treated with protease inhibitors. AIDS 2000; 14:F123-8. [PMID: 11101050 DOI: 10.1097/00002030-200011100-00001] [Citation(s) in RCA: 168] [Impact Index Per Article: 7.0] [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: 01/23/2023]
Abstract
OBJECTIVES To evaluate the presence of premature atherosclerotic lesions of epiaortic vessels in HIV-1-infected protease inhibitor-(PI) treated patients compared with PI-naive patients and healthy individuals. DESIGN One-hundred and two HIV-1-positive patients, including 55 treated with PI for at least 12 months and 47 either naive or treated with PI-sparing regimens, were subjected to epiaortic vessel ultrasonography. These data were compared with those obtained from 104 healthy individuals. METHODS Intima characteristics, pulsation and resistance indexes, and minimal, peak and mean speed were evaluated using a colour power doppler. Atherosclerotic plaques were described. Independent risk factors and values for glycaemia, cholesterolaemia and triglyceridaemia were considered. Statistical analysis included the chi-square test, Mantel-Haenszel test, odds ratio and logistic regression analysis. RESULTS Of the PI-treated patients, 29 out of 55 (52.7%) presented acquired lesions of the vascular wall at ultrasonography, whereas similar lesions were found in seven out of 47 (14.9%) PI-naive patients. Of the 104 healthy individuals, seven cases (6.7%) of intimal medial thickness were noted. A slightly significant correlation was found between carotid lesions and age, male sex and hypercholesterolaemia, whereas cigarette smoking, hypertriglyceridaemia and Centers for Disease Control and Prevention stage significantly increased the risk of vascular lesions (P= 0.022, P= 0.017 and P= 0.079 respectively). However, the highest significance regarded use of PI (P= 0.011). These results were confirmed by logistic regression analysis. CONCLUSIONS These data demonstrate a higher than expected prevalence of premature carotid lesions in the PI-treated compared with PI-naive patients. If confirmed, a periodic ultrasonographic study of the vascular wall should be included in the follow-up of HIV infected patients.
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Affiliation(s)
- P Maggi
- Clinic of Infectious Diseases, University of Bari, Italy
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210
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Marinescu RC, Mainardi PC, Collins MR, Kouahou M, Coucourde G, Pastore G, Eaton-Evans J, Overhauser J. Growth charts for cri-du-chat syndrome: an international collaborative study. Am J Med Genet 2000; 94:153-62. [PMID: 10982972 DOI: 10.1002/1096-8628(20000911)94:2<153::aid-ajmg8>3.0.co;2-#] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Low birth weight and slow growth are frequently observed in the patients with cri-du-chat syndrome. To provide a growth reference standard for children with cri-du-chat syndrome, syndrome-specific growth charts have been developed from a combination of cross-sectional and longitudinal measurements on 374 patients from North America, Italy, Australia, and the British Isles. The data were obtained from pediatric records, parent reporting, and personal examinations at national 5p- parent support group meetings in the U.S., Italy, U.K., and Australia. The growth curves include height and weight measurements for patients ages 0 to 18 years and head circumference measurements for patients ages 0 to 15 years. Birth weight was above the 5th percentile of general population in 50% of cases: mean weight 2.8 kg +/- 1.85 SD for males and 2.6 kg +/- 1.51 SD for females. Growth curve medians were usually at or below the 5th centile of reference populations throughout life. The median head circumference falls below the 2nd centile, and this change increases with age. The charts show that compared with the standard population, most children with cri-du-chat syndrome are small at birth and as they grow most, but not all, have significant microcephaly and compromised weight for age, and to a lesser extent, compromised height for age. Am. J. Med. Genet. 94:153-162, 2000.
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Affiliation(s)
- R C Marinescu
- Department of Biochemistry and Molecular Pharmacology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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211
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Nardone L, Terribile D, Belli P, Pastore G, Ausili-Cefaro G. Breast cancer: new trends of clinical research. Rays 2000; 25:387-91. [PMID: 11367908] [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: 04/16/2023]
Abstract
In breast physiopathology, in spite of the crop of information and clinical studies, a number of questions are still unsolved. The adequacy of research sources and the transmission of information to clinical practice through consistent and validated efficacy evidences are required to ensure the treatment quality. In this article the different specialist approaches and the main themes debated in the interdisciplinary approach to breast cancer are considered: the genetical risk factors, the role of diagnostic imaging, the mapping and assessment of sentinel lymph node, the role of nodal radiation therapy following mastectomy.
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Affiliation(s)
- L Nardone
- Divisione di Radioterapia, Università Cattolica del S. Cuore, Policlinico A. Gemelli, Largo A. Gemelli 8, 00168 Roma, Italy
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213
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Pession A, Rondelli R, Paolucci P, Pastore G, Dini G, Bonetti F, Madon E, Mandelli F, Zanesco L, Uderzo C, Prete A, Rabusin M, Ugazio A, Di Bartolomeo P, Favre C, Bojd-Faulkner L, Poggi V, Luksch R, Donfrancesco A, Argiolu F, La Nasa G, Amici A, Locatelli F. Hematopoietic stem cell transplantation in childhood: report from the bone marrow transplantation group of the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP). Haematologica 2000; 85:638-46. [PMID: 10870122] [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] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Transplantation of hematopoietic stem cells from different sources is being increasingly used to treat a variety of diseases in children. Transplant procedures and indications have changed considerably during recent years. Monitoring of information about these changes is useful for interpretation of nationwide collected data. DESIGN AND METHODS Since 1985, Centers belonging to the AIEOP (Associazione Italiana Ematologia Oncologia Pediatrica), performing hematopoietic stem cell transplants (HSCT) in children, and members of the AIEOP-Bone Marrow Transplant (BMT) Group annually report data on their transplant activity to the AIEOP-BMT Registry employing specially prepared patient-oriented forms. RESULTS From January 1985 to December 1998, a total of 2,474 bone marrow (BM), peripheral blood (PB) or umbilical cord blood (CB) transplants were reported: 1,296 (52%) were allogeneic (Allo) and 1,178 (48%) autologous (Auto) transplants. These transplants were performed in 19 Italian Centers on 2,249 patients aged less than 17 years. Among Allo-transplants, 1,198 (92%) were performed using BM progenitor cells, whereas 49 (4%) CB, 42 (3%) were PB, 4 BM plus PB, and 3 BM plus CB allografts; they were performed using HLA-identical sibling donors in 867 cases (67%) and alternative donors (i.e. partially-matched relatives or unrelated donors) in the remaining 429 (33%) cases. Allogeneic transplants were performed on 786 (67%) patients with malignancy and on 395 (33%) patients with non-malignant disorders. In the last 6 years, the number of Allo-transplants per year exceeded that of Auto-transplants. Of the Auto-transplants, 775 (66%) were performed using BM, and 403 (34%) using PB alone or combined with BM hematopoietic stem cells. Indications for Auto-BMT were myelo-lymphoproliferative disorders in 524 (49%) cases, solid tumor in 533 (50%) cases and non-malignant disease in 11 (1%) cases. In the last 5 years, the use of PB for autografts has increased from 7% to 70%. INTERPRETATION AND CONCLUSIONS These data reflect the development and present status of HSCT in Italy and provide a basis for patient counseling and health care planning.
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Affiliation(s)
- A Pession
- Department of Pediatrics, University of Bologna, Ospedle Sant'Orsola, Bologna, Italy.
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214
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Guala A, Pastore G, Paoletti R, Pagani L. Rubella immunization during postpartum. Pediatr Infect Dis J 2000; 19:586-7. [PMID: 10877187 DOI: 10.1097/00006454-200006000-00028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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215
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Monno L, Appice A, Scarabaggio T, Di Stefano M, Pastore G, Angarano G. Mutations in the reverse transcriptase gene of HIV type 1 from subjects after stavudine-didanosine dual therapy. AIDS Res Hum Retroviruses 2000; 16:821-3. [PMID: 10826489 DOI: 10.1089/088922200308828] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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217
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Carbonara S, Tortoli E, Costa D, Monno L, Fiorentino G, Grimaldi A, Boscia D, Rollo MA, Pastore G, Angarano G. Disseminated Mycobacterium terrae infection in a patient with advanced human immunodeficiency virus disease. Clin Infect Dis 2000; 30:831-5. [PMID: 10816157 DOI: 10.1086/313773] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [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: 11/03/2022] Open
Abstract
Mycobacterium terrae has been rarely implicated in human disease and never in patients infected with human immunodeficiency virus (HIV). We describe an HIV-infected patient with disseminated infection by M. terrae with pulmonary and cutaneous clinical manifestations. M. terrae was isolated from both sputum and urine, and identified by both conventional tests and high-performance liquid chromatography. Clinical and microbiological characteristics of this case are compared with those reported in the literature.
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Affiliation(s)
- S Carbonara
- Clinica di Malattie Infettive ed Istituto di Igiene, Università di Bari, Italy.
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218
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Maggi P, Larocca AM, Quarto M, Serio G, Brandonisio O, Angarano G, Pastore G. Effect of antiretroviral therapy on cryptosporidiosis and microsporidiosis in patients infected with human immunodeficiency virus type 1. Eur J Clin Microbiol Infect Dis 2000; 19:213-7. [PMID: 10795595 DOI: 10.1007/s100960050461] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.1] [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: 10/27/2022]
Abstract
To better understand whether potent antiretroviral therapies can modify the natural history of HIV-1-associated microsporidiosis and cryptosporidiosis, the response to antimicrobial treatment of these opportunistic infections was evaluated in patients with or without antiretroviral treatment. Fifty patients with diarrhoea, all positive for Cryptosporidium parvum or Enterocytozoon bieneusi, were included in the study. Retrospective data were collected concerning demographics, clinical and microbiological characteristics of the parasitic infection, antiretroviral therapy and prophylaxis against opportunistic infections. Faecal samples were prepared using the Richie formalin-ethyl acetate method and stained using the modified Ziehl-Neelsen method for detection of Cryptosporidium parvum and Isospora belli, the modified trichrome and calcofluor white technique for detection of Enterocytozoon spp., and iodine for detection of ova, cysts or vegetative forms. Diarrhoea was defined as an abnormal increase in stool liquidity, an abnormal increase in stool frequency and a daily stool weight of more than 250 g for a period of at least 4 days. Patients treated with double antiretroviral therapy or protease inhibitors demonstrated an excellent response and a sustained therapeutic effect after follow-up (range, 5-36 months). The relapse of cryptosporidiosis in two patients who discontinued antiretroviral therapy suggests that the infection might remain in a latent stage. The resolution of the diarrhoea seems to be related to an increased CD4+ cell count rather than to the viral load. In conclusion, these data strongly support the hypothesis that combination antiretroviral therapy is able to greatly modify the course of cryptosporidiosis and microsporidiosis in patients infected with HIV-1.
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Affiliation(s)
- P Maggi
- Institute of Infectious Disease, University of Bari - Policlinico, Italy.
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219
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Santantonio T, Mazzola M, Iacovazzi T, Miglietta A, Guastadisegni A, Pastore G. Long-term follow-up of patients with anti-HBe/HBV DNA-positive chronic hepatitis B treated for 12 months with lamivudine. J Hepatol 2000; 32:300-6. [PMID: 10707871 DOI: 10.1016/s0168-8278(00)80076-8] [Citation(s) in RCA: 191] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND/AIMS Interferon alpha provides benefit in only a limited number of patients with chronic anti-HBe-positive hepatitis B. The aim of this study was to verify the long-term efficacy of lamivudine treatment of these patients and the incidence of lamivudine-resistant hepatitis B virus mutants. METHODS Fifteen consecutive patients with chronic anti-HBe-positive hepatitis B were treated with lamivudine 100 mg once daily for 52 weeks. Levels of alanine aminotransferase, HBV DNA, hepatitis B surface antigen, and IgM antibodies to hepatitis B core antigen were monitored during therapy and 12-month follow up. The polymerase gene was amplified by polymerase chain reaction and the region coding for YMDD amino acid motif was directly sequenced. RESULTS Only 2/15 patients (13%) had a sustained virological and biochemical response and improved histologically. Eleven out of 15 (74%) showed inhibition of viral replication and normalization of alanine aminotransferase levels during lamivudine treatment but relapsed 1-12 months after terminating therapy. In the two remaining patients (13%), HBV DNA initially became negative but reappeared in the serum after 24 weeks, and in both patients the emergence of YMDD mutants was demonstrated. CONCLUSIONS Our data confirm the antiviral efficacy of lamivudine in anti-HBe-positive patients, but response to a 1-year course was only transient as the majority of patients relapsed after therapy withdrawal. The lack of a sustained effect and the emergence of lamivudine-resistant mutants suggest that therapy for chronic hepatitis B should be based on a combination of several therapeutic agents.
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Affiliation(s)
- T Santantonio
- Clinica Malattie Infettive Università di Bari, Italy.
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220
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Maggi P, Caputi-Iambrenghi O, Scardigno A, Scoppetta L, Saracino A, Valente M, Pastore G, Angarano G. Gastrointestinal infection due to Anisakis simplex in southern Italy. Eur J Epidemiol 2000; 16:75-8. [PMID: 10780346 DOI: 10.1023/a:1007617002972] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [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: 11/12/2022]
Abstract
The authors present four cases of infection due to Anisakis in an area where people are prone to infectious diseases transmitted by raw fish, but in which the presence of this parasite has never been reported. Three of four cases were discovered accidently during surgical procedures for co-existing abdominal pathologies. Raw fish was apparently not involved in all patients. Characteristics of the patients are discussed.
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Affiliation(s)
- P Maggi
- Department of Medical Clinics, Immunology and Infectious Diseases, University of Bari, Italy
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221
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Saracino A, Di Stefano M, Fiore JR, Lepera A, Raimondi D, Angarano G, Pastore G. Frequent detection of HIV-1 RNA but low rates of HIV-1 isolation in cervicovaginal secretions from infected women. New Microbiol 2000; 23:79-83. [PMID: 10946409] [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: 02/17/2023]
Abstract
Information regarding the presence of HIV-1 in the female genital tract is necessary to gain insight into the mechanism of HIV-1 heterosexual transmission. Herein, we present the results of a study on virus isolation and HIV-1 RNA detection from cervicovaginal lavage (CVL) samples from 25 HIV-1 seropositive women. Despite detectable levels of HIV-1 RNA in 88% of CVL samples, HIV-1 was isolated in only four (19%) samples. Although HIV-1 shedding in cervicovaginal secretions is a common event at all disease stages, the recovery of infectious virus in cell cultures appears to be rare; this renders viral isolation in studies aimed to evaluate the infectivity of cervicovaginal secretions relatively useless.
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Affiliation(s)
- A Saracino
- Clinic of Infectious Diseases, University of Bari, Italy
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222
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Fiore JR, Laddago V, Lepera A, La Grasta L, Di Stefano M, Saracino A, Lopalco P, Pastore G, Angarano G. Limited secretory-IgA response in cervicovaginal secretions from HIV-1 infected, but not high risk seronegative women: lack of correlation to genital viral shedding. New Microbiol 2000; 23:85-92. [PMID: 10946410] [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: 02/17/2023]
Abstract
The presence and antigen specificity of IgG and secretory-IgA (s-IgA) to HIV-1 were evaluated in cervicovaginal lavages (CVL) from 26 infected and 10 high-risk seronegative women. All the seropositive women had detectable IgG recognizing several viral antigens, while a smaller percentage of women demonstrated s-IgA to the virus. In addition, s-IgA were of limited specificity and provided weak reactivities on Immunoblot bands; an almost constant absence of s-IgA to gp120 was also observed. Neither the presence nor the specificity of either IgG or s-IgA to the virus in CVL prevented the shedding of HIV-1 in this body fluid; in fact, viral RNA was detected in all the women studied and the amounts of viral shedding was unrelated to the genital antibody response. On the other hand, none of the high-risk seronegative women had detectable antibodies to HIV-1 in CVL of either the IgG or s-IgA isotype. Our results a) confirm an impairment of mucosal antibody response during HIV-1 infection and suggest that mucosal immunity is not able to prevent viral shedding in the female genital tract and thus cannot modulate the infectivity of genital secretions; aa) do not provide evidence for a mucosal "memory/protective" antibody response in the genital tract of high-risk seronegative women.
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Affiliation(s)
- J R Fiore
- Clinic of Infectious Diseases, University of Bari, Italy
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223
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Pastore G, Mosso ML, Dalmasso P, Magnani C. [Pediatric Tumor Registry of Piedmont. Descriptive epidemiology of malignant tumors in children in Piedmont, 1976-1994]. Epidemiol Prev 1999; 23:360-8. [PMID: 10730477] [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: 02/15/2023]
Abstract
Since 1967, the Childhood Cancer Registry of Piedmont measures cancer incidence and lethality among children aged 0-14 residents in the Region. Two thousand seven hundred twenty cases were recorded in the period 1967-94. Males were 55.4%. The highest frequency was observed in the age class 0-4 including 41.3% of cases. The most frequent malignancies were: Acute Lymphocytic Leukemias, CNS Tumours and Lymphomas. Incidence rates showed limited variation, both for total neoplasm and for the largest diagnostic categories. On the contrary, lethality decreased markedly: rate (per million children years) was 77.2 in 1967-69 and 59.4 in 1988-94. This trend as more evident for acute leukemias and CNS tumours. Better diagnostic techniques, anticancer and support therapies are the likely explanation for the improved prognosis. Prevalence increased, as a consequence of improved survival and curability: in the Province of Torino it increased from 62 cases per 100,000 children (age 0-14) in 1980 to 98 cases in 1994.
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Affiliation(s)
- G Pastore
- Unità di Epidemiologia dei Tumori, CPO Piemonte, Ospedale S. Giovanni Torino
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224
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Favia A, Di Stefano M, Fiore JR, Pastore G, Angarano G. Phenotypic patterns of HIV-1 clonal populations during highly active antiretroviral therapy (HAART). New Microbiol 1999; 22:301-7. [PMID: 10555199] [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: 02/14/2023]
Abstract
Several studies have demonstrated that during HIV-1 infection many different viral clones may co-exist in the same individual. These clones may differ regarding their biological phenotype and may influence both the natural history of infection and the clinical response to antiretroviral therapy. The aim of the present study was to investigate the influences of combination therapies including protease inhibitors (HAART) on the phenotypical pattern of HIV-1 biological clones in peripheral blood mononuclear cells. Viral isolation and biological characterisation of bulk isolates and clonal viral isolates were performed on two AIDS patients, before and after three months of antiretroviral therapy. A decrease of viral load in plasma specimens in association with a change of clonal composition during antiretroviral therapy was observed in both patients during treatment. Before therapy both of the patients had a syncytium inducing (SI) bulk isolate and the majority of the biological clones were characterised as SI. After treatment, the bulk isolates were still SI in both cases, but the majority of biological clones were characterised as non-syncytium inducing (NSI). These results suggest that HIV clonal composition and relative phenotypic pattern undergo different changes not only during the natural course of HIV infection but also while patients are on antiretroviral combination therapy.
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Affiliation(s)
- A Favia
- Clinic of Infectious Disease, University of Bari, Italy
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225
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Greco P, Vimercati A, Fiore JR, Saracino A, Buccoliero G, Loverro G, Angarano G, Pastore G, Selvaggi L. Reproductive choice in individuals HIV-1 infected in south eastern Italy. J Perinat Med 1999; 27:173-7. [PMID: 10503177 DOI: 10.1515/jpm.1999.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the impact of counseling on reproductive choices in seropositive women in South-Eastern Italy. SETTING University Hospital, Apulia region, South-Eastern Italy, tertiary referral center for high risk obstetrics and infectious diseases. METHODS Between March 1985 and December 1996, two hundred and twenty-five HIV-infected women, receiving treatment at our clinic for infectious diseases were enrolled. They were all regularly given treatment and counseling and their sexual partners, if negative, tested for HIV-1 antibodies. Their reproductive choices and their attitude toward pregnancy were recorded and analyzed. RESULTS Seventy-six pregnancies were observed during this period in 76 women. Twenty-one of these women (27.7%) decided to terminate the pregnancy. Women that were intravenous drug users or with a longer history of known seropositivity were more likely to have a termination. A decreasing trend in the request of abortion was observed with time. CONCLUSIONS The data show that the scenario of HIV-infected women is changing in our setting. As a consequence, many seropositive women deliberately choose to have a pregnancy and factors different from those we expect to be modified by the counseling influence their reproductive choice. They should be taken into account in the management of these women before and during pregnancy.
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Affiliation(s)
- P Greco
- Department of Obstetrics and Gynecology, University of Bari, Italy.
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226
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Fiore JR, Buccoliero G, Pezzotti P, Rezza G, Saracino A, Pastore G, Fenyo EM, Angarano G. HIV-1 disease progression in women: role of the viral phenotype of the HIV-positive steady partner. AIDS 1999; 13:1801-2. [PMID: 10509595 DOI: 10.1097/00002030-199909100-00037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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227
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Schalm SW, Weiland O, Hansen BE, Milella M, Lai MY, Hollander A, Michielsen PP, Bellobuono A, Chemello L, Pastore G, Chen DS, Brouwer JT. Interferon-ribavirin for chronic hepatitis C with and without cirrhosis: analysis of individual patient data of six controlled trials. Eurohep Study Group for Viral Hepatitis. Gastroenterology 1999; 117:408-13. [PMID: 10419923 DOI: 10.1053/gast.1999.0029900408] [Citation(s) in RCA: 113] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND & AIMS The aim of this study was to compare interferon (IFN)-ribavirin combination therapy with IFN monotherapy in chronic hepatitis C with particular focus on its efficacy in cirrhosis. METHODS A multivariate analysis of individual patient data of all randomized controlled trials using an IFN-ribavirin arm, reported between 1991 and March 1998, was performed. Centers included 1 Asian and 5 European university-based referral centers for liver disease. A total of 197 patients with chronic hepatitis C received IFN-alpha (3 MU three times weekly) and ribavirin (1-1.2 g daily) for 6 months, and 147 patients received IFN-alpha (3 MU three times weekly) for 6 months. Patients were characterized according to previous IFN therapy, presence of cirrhosis, and genotype 1. Efficacy of therapy was evaluated by assessing the sustained response rate by logistic regression analysis. RESULTS Patients without cirrhosis treated with IFN-ribavirin had a significantly higher sustained response rate than those treated with IFN, approximately 3-fold for previously untreated patients (IFN-ribavirin: genotype 1, 33%; genotype 2/3, 65%; IFN: genotype 1, 8%; genotype 2/3, 24%). In cirrhosis, sustained response rates with IFN-ribavirin (previously untreated: genotype 1, 7%; genotype 2/3, 24%) were also significantly higher than those with IFN (previously untreated: genotype 1, 1%; genotype 2/3, 5%). Clinical relevant superiority of combination therapy over IFN monotherapy was also observed for relapse; the same trend was observed for nonresponders. Tolerance for IFN-ribavirin was similar for patients with or without cirrhosis. CONCLUSIONS Combination with ribavirin significantly enhances the sustained response rate of IFN therapy in major patient types (cirrhosis, genotype 1) with chronic hepatitis C. Thus, IFN-ribavirin combination is likely to become the antiviral therapy of choice for cirrhosis caused by hepatitis C.
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Affiliation(s)
- S W Schalm
- Department of Hepatogastroenterology and Biostatistics, Erasmus University Hospital Rotterdam, Rotterdam, The Netherlands
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228
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Fiore JR, Di Stefano M, Lepera A, Saracino A, Monno L, Angarano G, Pastore G. Evidence for a local synthesis of beta-chemokines within the genital tract of both HIV-1-infected and uninfected women. J Acquir Immune Defic Syndr 1999; 21:255-7. [PMID: 10421252 DOI: 10.1097/00126334-199907010-00013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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229
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Nardone L, Pastore G, Terribile D, Palazzoni G, Marmiroli L, Ausili-Cefaro G. The impact of the new organization on the management of breast cancer. Rays 1999; 24:435-46. [PMID: 10605304] [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: 02/14/2023]
Abstract
The radical change in the health care service now going on for some years requires the commitment of medical specialists, as well as the acquisition of an adequate knowledge of the economic implications associated to the therapeutic choice. Among primary objectives of health care management in the field of breast cancer, the best cost-effective strategy and the rationalization and standardization of diagnostic and therapeutic approaches, should be identified. Problems related to breast cancer are examined for effective, efficient and economic optimization.
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Affiliation(s)
- L Nardone
- Divisione di Radioterapia, Università Cattolica del S. Cuore, Policlinico A. Gemelli, Roma, Italy
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230
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Carbonara S, Ingravallo G, Fiorentino G, Monno L, Pastore G, Angarano G. Efficacy of protease inhibitor-based anti-retroviral therapy in severe HIV-associated thrombocytopenia unresponsive to AZT. Br J Haematol 1999; 105:1147-9. [PMID: 10554838 DOI: 10.1111/j.1365-2141.1999.01533.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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231
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Di Stefano M, Fiore JR, Monno L, Lepera A, Pastore G, Angarano G. Detection of multiple drug-resistance-associated pol mutations in cervicovaginal secretions from women largely treated with antiretroviral agents. AIDS 1999; 13:992-4. [PMID: 10371183 DOI: 10.1097/00002030-199905280-00018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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232
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Santantonio T, Gunther S, Sterneck M, Rendina M, Messner M, Launois B, Francavilla A, Pastore G, Will H. Liver graft infection by HBV S-gene mutants in transplant patients receiving long-term HBIg prophylaxis. Hepatogastroenterology 1999; 46:1848-54. [PMID: 10430358] [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: 02/13/2023]
Abstract
BACKGROUND/AIMS HBV reinfection of transplant livers occurs frequently even in the presence of high doses of anti-HBs immunoglobulins. We analyzed, retrospectively, whether and which type of S-gene variants were selected by long-term polyclonal anti-HBs (HBIg) treatment leading to reinfection of patients transplanted because of chronic HBs-positive end-stage liver disease. METHODOLOGY The preS2/S gene of the viral genomes obtained from sera before transplantation and during HBV reinfection was amplified by PCR and directly sequenced. RESULTS According to transaminase and HBV DNA hybridization analysis, 3/18 (17%) liver transplant patients had HBV and hepatitis recurrence during anti-HBs therapy. A HBV S-gene mutant containing a G to A nucleotide mutation at position 587, converting Glycine to Arginine (G145A), was identified in all three patients as the dominant population at reinfection but not pre-transplantation. Contrary to the S-gene, no consistent nucleotide changes were found in the pre-S2 region of HBV genomes when comparing the reinfection and pre-transplantation samples. CONCLUSIONS These data demonstrate that long-term polyclonal anti-HBs immunoprophylaxis selected the most commonly described G145R S-gene escape HBV variant which became the dominant virus population and was responsible for graft infection. Therefore, immunoglobulins with high affinity for the G145R HBs variant should be included in HBIg to prevent recurrent HBV infection in transplant patients.
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Affiliation(s)
- T Santantonio
- Heinrich-Pette-Institut für Experimentelle Virologie und Immunologie an der Universität Hamburg, Germany.
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233
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Oliveri F, Santantonio T, Bellati G, Colombatto P, Mels GC, Carriero L, Dastoli G, Pastore G, Ideo G, Bonino F, Brunetto MR. Long term response to therapy of chronic anti-HBe-positive hepatitis B is poor independent of type and schedule of interferon. Am J Gastroenterol 1999; 94:1366-72. [PMID: 10235220 DOI: 10.1111/j.1572-0241.1999.01088.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The response rate to alpha interferon (IFN) of chronic anti-HBe-positive hepatitis B is variable. We studied whether type, dose, and schedule of IFN, and type and frequency of posttreatment monitoring, influence the response rate. METHODS Seventy-two consecutive anti-HBe-positive chronic hepatitis B patients (59 male and 13 female, median age 41 yr) stratified by sex and histology were randomly allocated to three treatment arms. Twenty-seven patients (A) received 10 million units alpha-N1 IFN i.m. t.w. for 24 wk (total dose: 720 million units); 21 (B) received 9 million units alpha-2a IFN i.m. t.w. for 4 wk, followed by 18 million units for 12 wk and 9 million units for 8 wk (972 million units); 24 (C) received 2 alpha-2a IFN courses (9 million units i.m. t.w. for 16 and 12 wk separated by a 6-month interval [756 million units]). Primary response was defined by normal ALT and serum HBV-DNA levels below 10 pg/ml at the end of therapy and sustained response by normal ALT (tested monthly), undetectable HBV-DNA and IgM anti-HBc (<7 I.U. Paul Ehrlich Institute) (tested every 3 months) during the posttreatment follow-up. RESULTS At the end of treatment, 12, 8, and 13 patients from groups A, B, and C, respectively, were responders. At the 18-month follow-up, two patients in group A and only one in groups B and C maintained the response. Overall, after 34 months (median posttreatment follow-up), three patients were long term responders, whereas three showed a sustained remission after relapse. CONCLUSIONS The rate of long term response to interferon of anti-HBe-positive chronic hepatitis B is poor, independent of IFN type, dose, or schedule; the more stringent the monitoring, the higher the relapse rate.
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Affiliation(s)
- F Oliveri
- Gastroenterology Department, Azienda Ospedaliera San Giovanni Battista, Torino, Italy
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234
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Pastore G, Marano P, Romani M, Costantini M, Belli P. [Critical review of 215 cases of non-palpable mammary lesions]. Radiol Med 1999; 97:344-8. [PMID: 10432964] [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: 02/13/2023]
Abstract
PURPOSE The natural history of human breast cancer shows that lesion size correlates directly with nodal metastases and distant spread. Nodal metastases are found in only 6% of cases in the preclinical stage of the tumor and therefore imaging must detect a breast cancer before it becomes palpable. We reviewed 215 nonpalpable breast lesions studied in the last 10 years to assess observers performance and ultimately improve the interpretation of suspicious mammograms, evaluating "cost" in terms of the ratio between benign and malignant lesions (B/M). MATERIAL AND METHODS From 1988 to October 1998, two hundred and fifteen women with nonpalpable breast lesions suspected at mammography were examined. The lesions were removed after stereotaxic or US location and a radiograph of the surgical specimen was always performed. Mammographic patterns were interpreted retrospectively by two blinded radiologist experienced in breast imaging and specialized in locating nonpalpable breast lesions. Mammographic patterns were classified as poorly/highly suspicious calcifications, regular/irregular masses, spiculated masses, masses with calcifications and parenchymal distortions. Radiographic findings were compared with surgical results and the data used to calculate the B/M, positive predictive value (PPV) for malignancy and the trend of operator's performance. RESULTS Modern techniques permit to detect a very high number of in situ breast carcinomas. Nineteen of 22 lesions (86%) were detected by mammography as highly suspicious calcifications, 2/22 as spiculated masses and 1/22 as a mass with calcifications. No in situ carcinoma was detected as an irregular mass. All regular masses were proven to be benign at histology. B/M analysis showed a decreasing trend (from 1.94 in the first 3 years to .57 in 1994-96, to .83 in 1997-98) and an overall value of .90. The PPV for malignancy was 83.33% for spiculated masses, 65.5% for highly suspicious calcifications, 63.63% for irregular masses, 47.05% for masses with more or less dysmorphic calcifications, 32.65% for poorly suspicious calcifications, 8.33% for parenchymal distortions and 0% for regular masses. DISCUSSION AND CONCLUSIONS All spiculated masses and highly suspicious calcifications and microcalcifications should be removed. Biopsy is recommended in parenchymal distortions, despite its low predictive value for malignancy, because these lesions are uncommon and the cost of biopsy is therefore acceptable. Needle aspiration or long-term monitoring can be reconsidered for irregular masses and poorly suspicious microcalcifications. Finally, relative to possible different interpretations of mammographic patterns by center and operator's experience, we suggest that the PPV for every single pattern be continually reassessed based on personal case records rather than on literature data. This holds true especially for microcalcifications.
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Affiliation(s)
- G Pastore
- Istituto di Radiologia, Policlinico Universitario A. Gemelli, UCSC, Roma
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235
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Milella M, Santantonio T, Pietromatera G, Maselli R, Casalino C, Mariano N, Genchi C, Pastore G. Retreatment of non-responder or relapser chronic hepatitis C patients with interferon plus ribavirin vs interferon alone. Ital J Gastroenterol Hepatol 1999; 31:211-5. [PMID: 10379482] [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: 02/12/2023]
Abstract
BACKGROUND AND AIM Interferon-alpha treatment of chronic hepatitis C is beneficial in only 20-30% of patients. This study evaluates if combination therapy with Interferon-alfa plus ribavirin is effective in inducing a response in patients who did not respond to, or relapsed after, a standard Interferon-alfa treatment. PATIENTS AND METHODS A total of 88 patients, 49 non-responders and 39 relapsers to previous Interferon-alfa therapy, were randomized to receive either natural Interferon-alfa (6 MU t.i.w.) plus ribavirin (1000 mg/daily) or natural Interferon-alfa alone (6 MU t.i.w.) for 6 months. All were followed for 12 months after stopping therapy. Serum aminotransferase levels were assessed monthly and HCV RNA was evaluated by RT-PCR (Amplicor, Roche) at end of therapy and the end of follow-up. RESULTS After treatment, a higher response rate defined as return to normal of aminotransferases and absence of serum HCV RNA was observed among patients treated with Interferon-alfa-ribavirin: 4/28 (14%) vs 1/21 (5%) non-responder patients and 9/19 (47%) vs 5/20 (25%) in the relapsers group. At the end of follow-up, a sustained response was found only in the combination treatment group: 4% and 32% in non-responder and relapser patients, respectively. CONCLUSIONS Our results suggest that retreatment with natural Interferon-alfa plus ribavirin is more effective than Interferon-alfa alone in increasing the response rate in patients with chronic hepatitis C who relapse after a previous standard IFN treatment whereas it is less effective in non-responder patients.
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Affiliation(s)
- M Milella
- Clinic of Infectious Diseases, University of Bari, Italy
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236
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Fiore JR, Lepera A, Di Stefano M, Saracino A, Favia A, Pastore G, Angarano G. Frequent cervicovaginal shedding of HIV-1 in asymptomatic, non-severely immunodeficient women. AIDS 1999; 13:626-7. [PMID: 10203392 DOI: 10.1097/00002030-199904010-00016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tassopoulos NC, Volpes R, Pastore G, Heathcote J, Buti M, Goldin RD, Hawley S, Barber J, Condreay L, Gray DF. Efficacy of lamivudine in patients with hepatitis B e antigen-negative/hepatitis B virus DNA-positive (precore mutant) chronic hepatitis B. Lamivudine Precore Mutant Study Group. Hepatology 1999; 29:889-96. [PMID: 10051494 DOI: 10.1002/hep.510290321] [Citation(s) in RCA: 376] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This placebo controlled, double-blind study evaluated the efficacy and safety of lamivudine in patients with hepatitis B e antigen (HBeAg)-negative/hepatitis B virus (HBV) DNA-positive chronic hepatitis B. Patients were randomized to receive 100 mg lamivudine orally once daily for 52 weeks (n = 60) or placebo for 26 weeks (n = 65). Patients who were HBV DNA positive at week 24 were withdrawn at week 26. The primary efficacy endpoint was loss of serum HBV DNA plus normalization of alanine transaminase (ALT) at week 24. A significantly higher proportion of patients receiving lamivudine (63%) had a complete response at week 24 compared with patients receiving placebo (6%) (P <.001). Secondary efficacy parameters included histological response from baseline to week 52 in the lamivudine-treated patients. At week 52, 60% of lamivudine-treated patients with liver biopsy specimens available showed histological improvement (>/=2-point reduction in Knodell necro-inflammatory score), 29% showed no change, and 12% worsened. In a ranked assessment of pretreatment and post-treatment biopsy pairs 11% improved, 86% showed no change, and 2% worsened in fibrosis. At week 52, 27% of patients receiving lamivudine had YMDD (tyrosine-methionine-aspartate-aspartate amino acid motif of HBV polymerase) variant HBV. The incidence of adverse events and laboratory abnormalities was similar in both groups. In conclusion, lamivudine treatment results in a significant virological and biochemical improvement compared with placebo, induces an improvement or no change in histology in most patients, and is well tolerated. The response to lamivudine therapy in HBeAg-negative patients is similar to the response reported in previous studies of patients with HBeAg-positive chronic hepatitis B.
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Affiliation(s)
- F. Saija
- Istituto Tecniche Spettroscopiche, CNR, Contrada Papardo, Salita Sperone 31, 98166 Messina, Italy, Istituto Nazionale per la Fisica della Materia, Unità di Ricerca di Trieste, Strada Costiera 11, 34014 Trieste, Italy, Università degli Studi di Trieste, Dipartimento di Fisica Teorica, Strada Costiera 11, 34014 Trieste, Italy, Istituto Nazionale per la Fisica della Materia, Unità di Ricerca di Messina, Contrada Papardo, 98166 Messina, Italy, and Università degli Studi di Messina, Dipartimento di Fisica,
| | - G. Pastore
- Istituto Tecniche Spettroscopiche, CNR, Contrada Papardo, Salita Sperone 31, 98166 Messina, Italy, Istituto Nazionale per la Fisica della Materia, Unità di Ricerca di Trieste, Strada Costiera 11, 34014 Trieste, Italy, Università degli Studi di Trieste, Dipartimento di Fisica Teorica, Strada Costiera 11, 34014 Trieste, Italy, Istituto Nazionale per la Fisica della Materia, Unità di Ricerca di Messina, Contrada Papardo, 98166 Messina, Italy, and Università degli Studi di Messina, Dipartimento di Fisica,
| | - P. V. Giaquinta
- Istituto Tecniche Spettroscopiche, CNR, Contrada Papardo, Salita Sperone 31, 98166 Messina, Italy, Istituto Nazionale per la Fisica della Materia, Unità di Ricerca di Trieste, Strada Costiera 11, 34014 Trieste, Italy, Università degli Studi di Trieste, Dipartimento di Fisica Teorica, Strada Costiera 11, 34014 Trieste, Italy, Istituto Nazionale per la Fisica della Materia, Unità di Ricerca di Messina, Contrada Papardo, 98166 Messina, Italy, and Università degli Studi di Messina, Dipartimento di Fisica,
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Abstract
OBJECTIVES To assess the influence of stature on the basal metabolic rate (BMR) and on the energy cost of standardised walking. A second objective was assess the accuracy of the FAO/UNU/WHO (1985) equations to predict BMR. DESIGN/SUBJECTS Forty-six young men were selected on the basis of their stature and assigned to the group of short, S (n = 25, mean stature = 1.65 +/- 0.03 m) or of tall, T (n = 21, mean stature = 1.87 +/- 0.04 m). SETTING Rome, Italy. INTERVENTIONS Body composition was assessed by underwater weighing. BMR and energy cost walking at 5 km/h was measured by the Douglas bag. RESULTS Body fat % was similar in the two groups (15.2 +/- 4.3 for S; 17.4 +/- 5.3 for T; ns). The BMR of T was 20% higher than that of S, but 12% and 10% lower when standardised respectively for body weight (BW) and fat free mass (FFM). However these differences were removed when BMR was covaried for BW or FFM, or normalised by BW0.62 or FFM0.64. Measured BMR was 7% for T and 6% for S lower than that predicted by the FAO/WHO/UNU (1985) equation; the inclusion of stature did not reduce the overestimation. The energy cost of walking was 27% higher in T than in S, but 9% and 5% lower when standardised respectively for BW and FFM. The differences disappeared when expressing the energy cost of walking as net cost per kg FFM. CONCLUSIONS Tall people have lower BMR per unit of BW or FFM than short people, and it is necessary to control for the diverse body mass by the appropriate method. However, qualitative differences in the composition of FFM are plausible, due to the diverse proportion of metabolically active internal organs in people of different height, which might be reflected in the higher BMR/kg FFM of the shorter subjects. The sex- and age-specific FAO/WHO/UNU (1985) equation significantly overestimates the BMR of both short and tall people, but there is no simple explanation of this observation. The energy cost of walking is not affected by stature when expressed as net cost per kg FFM.
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Affiliation(s)
- L Censi
- National Institute of Nutrition, Rome, Italy
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Di Stefano M, Monno L, Fiore JR, Buccoliero G, Appice A, Perulli LM, Pastore G, Angarano G. Neurological disorders during HIV-1 infection correlate with viral load in cerebrospinal fluid but not with virus phenotype. AIDS 1998; 12:737-43. [PMID: 9619805 DOI: 10.1097/00002030-199807000-00010] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [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: 02/07/2023]
Abstract
OBJECTIVES To verify the compartmentalization of HIV-1 within the central nervous system (CNS) and to define whether viral phenotype of HIV-1 isolates from cerebrospinal fluid (CSF) samples and CSF viral load correlate with the presence and type of neurological disorders. METHODS A total of 33 HIV-1-infected patients with and without neurological disorders were included in the study. HIV-1 isolation from paired CSF and peripheral blood mononuclear cell (PBMC) samples was attempted by a standard cocultivation technique; the biological phenotype of HIV-1 isolates was assessed by the MT-2 cell assay. CSF and plasma HIV-RNA levels were measured by a quantitative reverse transcripase-polymerase chain reaction. RESULTS The rate of HIV-1 isolation from CSF and PBMC was 66% (22 isolates) and 85% (28 isolates), respectively. Seventeen out of 22 (77%) CSF HIV-1 isolates were characterized as non-syncytium-inducing, and 15 out of 28 (68%) isolates from PBMC were typed as syncytium-inducing (SI). The presence of SI isolates in CSF was limited to patients with HIV-1-, cytomegalovirus- or JC virus-related disorders and was often associated with high levels of HIV-1 RNA in the CSF. DISCUSSION Our results demonstrate a correlation between high levels of HIV RNA in CSF and the presence of neurological disorders thus indicating a possible role for HIV-1 RNA in the CSF as a biological marker of neurological disease. The finding of viruses with a different phenotype in paired CSF and PBMC indicates that HIV-1 may evolve differently in the brain and in the blood. This suggests compartmentalization of HIV-1 within the CNS.
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Affiliation(s)
- M Di Stefano
- Clinic of Infectious Diseases, University of Bari, Italy
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Monno L, Di Stefano M, Zimatore GB, Andreula CF, Appice A, Perulli LM, Fiore JR, Pastore G, Angarano G. Measurement of viral sequences in cerebrospinal fluid of AIDS patients with cerebral white-matter lesions using polymerase chain reaction. AIDS 1998; 12:581-90. [PMID: 9583597 DOI: 10.1097/00002030-199806000-00006] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [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: 02/07/2023]
Abstract
OBJECTIVES To optimize the use of polymerase chain reaction (PCR) on cerebrospinal fluid (CSF) for the evaluation of central nervous system (CNS) white-matter lesions that along with clinical findings and magnetic resonance imaging (MRI) can allow a definite diagnosis to be made; also to evaluate treatment with zidovudine plus foscarnet. DESIGN AND METHODS Fifteen AIDS patients with uncertain CNS white-matter lesions were identified. HIV-1 RNA, cytomegalovirus (CMV) and JC virus (JCV) DNA were measured in a total of 29 CSF samples. The results were correlated with clinical and MRI findings and treatment with zidovudine plus foscarnet was evaluated. RESULTS Four and five out of 15 patients with CMV DNA > or = 1 : 625 and JCV DNA > or = 10(3) copies/microl detected in the CSF were diagnosed with CMV and progressive multifocal leukoencephalopathy (PML), respectively. Six patients who were CMV/JCV-negative with the highest levels of HIV RNA (median, 6.87 log10 copies/ml) in CSF were considered as having HIV-1 encephalitis. Neurological symptoms were non-supportive for diagnosis as was MRI in 11 out of 15 patients. Nine patients completed a 21-day course of zidovudine plus foscarnet. HIV RNA decreased irrespective of neurological diagnosis. All three HIV-1 encephalitis patients and two out of three patients with CMV leukoencephalopathy improved. In these two latter patients, relief of clinical symptoms coincided with decreased CMV DNA. JCV DNA remained unchanged and all three PML patients deteriorated. CONCLUSIONS Measurement of CSF viral sequences supports the diagnosis of CNS white-matter lesions in AIDS patients. While effective therapy for PML remains elusive, treatment including zidovudine plus foscarnet may be a promising option for HIV-1 and CMV-related manifestations.
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Affiliation(s)
- L Monno
- Clinic of Infectious Diseases, University of Bari, Italy
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243
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Marano P, Pastore G, Vecchioli Scaldazza A. The staff of the department of diagnostic imaging: radical changes and training. Rays 1998; 23:370-5. [PMID: 9689858] [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: 02/08/2023]
Abstract
When a complex reality as the Department of Diagnostic Imaging and its staff is aimed at the provision of a service, it may be extremely difficult to identify all present correlations and in turn, correlate them with the final goal. The relationship between human and technical resources, between organization and environment are of the utmost importance in planning the structure design. It should be kept in mind that "the person" is the pivot of any innovation for change. Participation by all members, a more flexible, structure, is required. In education and teaching, the global network we are heading for, could become the determining factor in a continuing training process and multispecialized research, facilitating the circulation of information in an interactive, formative dialogue.
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Affiliation(s)
- P Marano
- Istituto di Radiologia, Universitá Cattolica del S. Cuore, Policlinico A. Gemelli, Roma, Italy
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244
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Artillo S, Pastore G, Alberti A, Milella M, Santantonio T, Fattovich G, Giustina G, Ryff JC, Chaneac M, Bartolomé J, Carreño V. Double-blind, randomized controlled trial of interleukin-2 treatment of chronic hepatitis B. J Med Virol 1998; 54:167-72. [PMID: 9580313 DOI: 10.1002/(sici)1096-9071(199803)54:3<167::aid-jmv4>3.0.co;2-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [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: 11/10/2022]
Abstract
Pilot studies have demonstrated that recombinant interleukin 2 (rIL-2) has an indirect antiviral activity against hepatitis B virus, but the minimal dose of rIL-2 for induction of this effect was not defined. The aim of the study was to ascertain the most efficient dose of rIL-2 for induction of the loss of detectable serum HBV-DNA or a 50% or greater decrease in its level. Thirty-one patients with chronic hepatitis B, hepatitis B e antigen and serum HBV-DNA positive were enrolled in this double-blind randomized controlled trial. Patients were divided: Group I (n = 8) placebo; Group II (n = 7) treated with 0.9 MU of rIL-2 subcutaneously administered daily for 8 weeks; Group III (n = 8) treated with 1.8 MU of rIL-2 under the same schedule; Group IV (n = 8) which received 3.6 MU of rIL-2 under the same conditions. At the end of treatment 25% of the patients in the placebo group, and 13% and 25% in rIL-2 groups III and IV, respectively, had a decrease in HBV-DNA higher than 50% of the basal value. None of the patients lost serum HBV-DNA. Only three patients (one from group II and two from group IV) normalized the ALT levels. Overall, during treatment, ALT levels decreased in the treated groups. This decrease occurred simultaneously with an increase in serum HBV-DNA concentration. Since the response rate in the treated groups was similar to that of the placebo group, rIL-2 is not useful as monotherapy for the treatment of chronic hepatitis B at the doses and schedules used in this study.
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Affiliation(s)
- S Artillo
- Department of Hepatology, Fundación Jiménez Díaz and Fundación Estudio Hepatitis Virales, Madrid, Spain
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245
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Bock E, Bock C, Campioni P, Goletti S, Pastore G, Romani M. [Clinico-radiologic problems in the study of the male breast in gynecomastia]. Radiol Med 1998; 95:44-8. [PMID: 9636726] [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: 02/07/2023]
Abstract
INTRODUCTION Gynecomasty is usually classified as normal of abnormal, except for 25% of cases which are classified as idiopathic because their causes and pathogenesis remain unknown. Gynecomasty is diagnosed mainly on clinical grounds, while integrated imaging, sometimes combined with cytology, is used to distinguish benign from malignant forms. Bilateral gynecomasty is easy to diagnose, especially when patients report assuming particular drugs or present other risk factors, but unilateral or asymmetrical gynecomasty is a diagnostic problem. Primary male breast cancer usually presents as a unilateral hard mass, often infiltrating the dermis and with early lymph node metastases; it is associated with gynecomasty in 20% of cases. MATERIAL AND METHODS We examined 76 men (age range, 15-75 years) referred for breast enlargement; the patients with radiologic findings of breast adiposis were not included in our series. All patients were submitted to standard projection mammography with a high resolution dedicated film and to real time US with high frequency probes (7.5-12 MHz). RESULTS Breast enlargement was unilateral in 48% of cases and bilateral in 52%. The radiologic patterns, compared with histologic or clinical-therapeutic follow-up, permitted the correct diagnosis in 72 of 76 patients (94%). The extant four patients had chronic inflammation (3 cases) and a malignant tumor with questionable imaging features. Overall imaging findings were: 55 cases (72%) of actual gynecomasty--unilateral in 17 and bilateral in 38 cases--9 unilateral malignant tumors (12%), eleven cases of inflammation (14%) and 1 case (2%) of unilateral metastasis from plasmocytoma. Sixteen (29%) actual gynecomasty patients (21% of the whole series) had a nodular form (unilateral in 6 and bilateral in 10 cases), 23 (42% and 30% of the whole series) had a dendritic form (unilateral in 7 and bilateral in 16 cases) and 16 (29%, 21% of the whole series) had a glandular form. CONCLUSIONS Diagnosing gynecomasty is relatively easy in the patients with bilateral forms with a positive history of associated exogenous or endogenous factors, while focal unilateral or asymmetrical forms are difficult to distinguish into benign and malignant. The radiologic pattern may be questionable especially in chronic inflammation and in some malignant forms and must therefore be integrated with cytologic or surgical findings.
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Affiliation(s)
- E Bock
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma.
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246
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Bock E, Bock C, Belli P, Campioni P, Manfredi R, Pastore G. [Role of diagnostic imaging of the breast in patients treated with postsurgical radiotherapy or presurgical radiotherapy or chemotherapy]. Radiol Med 1998; 95:38-43. [PMID: 9636725] [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: 02/07/2023]
Abstract
INTRODUCTION In the last 25 years, random trials on the advantages of combined surgery and irradiation/chemotherapy of breast cancer demonstrated similar survival rates to those of massive surgery. However, both irradiation and chemotherapy have advanced and now yield good local control of the disease, so that even large breast cancers can be made operable. Breast cancer follow-up is carried out with imaging and clinical examinations to detect early locoregional recurrences, contralateral lesions and distant recurrences: to this purpose, we carried out a comparative study of all imaging modalities. MATERIAL AND METHODS We retrospectively reviewed the data of 42 breast cancer (T2-T3 N0-N+) patients of the Senology Center of the Catholic University (Rome, Italy) treated with irradiation and/or chemotherapy for tumor debulking to permit conservative surgery. We investigated the sensitivity and the indications of mammography, B-mode and color Doppler US and MRI in measuring the exact tumor size and detecting locoregional metastatic nodes. RESULTS After 3 years' treatment, our recurrence rate (19%) is a little higher than those in the major international trials (4.2-9% and 5 tears). The recurrence was on the surgical scar in 75% of cases (6/8), while multifocal tumors were found in 25% of cases. US was the most accurate method in measuring tumor size in 90% of cases (18/20), while mammography frequently overstaged the lesion and yielded exact measurements in 65% of cases (13/20). MRI was as accurate as US, but this technique is too expensive and little available in Italy. US accurately diagnosed lymph node recurrences (70% sensitivity), but MR rate was even higher (80%), while mammography and color Doppler US had only 5-10%. As for treatment outcome, an irregular and blurred nodule or multifocal lesions at mammography indicate poor/no response, while a much smaller radial scar than at previous similar follow-ups indicates treatment success. CONCLUSIONS When correctly integrated, mammographic, US and MR patterns permit exact tumor size measurement and show possible locoregional lymph node involvement in the patients submitted to conservative surgery and irradiation/chemotherapy. In contrast, color Doppler findings remain poorly specific in this disease, with about 55% sensitivity. Therefore, radiologic studies, with clinical and laboratory data, have a major prognostic value in assessing the biological response to combined treatment.
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Affiliation(s)
- E Bock
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma.
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247
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Fiore JR, La Grasta L, Di Stefano M, Buccoliero G, Pastore G, Angarano G. The use of serum-free medium delays, but does not prevent, the cytotoxic effects of seminal plasma in lymphocyte cultures: implications for studies on HIV infection. New Microbiol 1997; 20:339-44. [PMID: 9385604] [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: 02/05/2023]
Abstract
Evidence indicates that seminal plasma is cytotoxic when used in lymphocyte cultures. In fact, an amine oxidase which is normally present in Fetal Calf Serum (FCS) causes spermine oxidation and, finally, cytotoxic substances are released. This seminal quality might obviously hamper studies aiming to evaluate the role of semen in HIV sexual transmission, since lymphocytes are generally used as target or effector cells in virological or immunological studies on HIV. We evaluated the efficacy of FCS free-medium, heat inactivated seminal plasma and/or the washing-out of cultures after a three hour incubation period in preventing the cytotoxicity to lymphocytes. Results show that when cultures are carried out in the absence of FCS and/or after seminal plasma removal, cytotoxicity is not prevented, although delayed. This finding indicates that, along with still unrecognized additional factors, spermine oxidation is still an important factor for semen cytotoxicity, and this considerably hampers any immunological and virological study, requiring the use of lymphocytes, concerning seminal fluid.
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Affiliation(s)
- J R Fiore
- Clinic of Infectious Diseases, University of Bari, Italy
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248
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Abstract
OBJECTIVES To study the role of HIV-1 biological phenotype, viral load and neutralizing antibodies in male-to-female heterosexual transmission of HIV-1. METHODS Seven transmitting and seven non-transmitting HIV-1-seropositive heterosexual male index cases were included in the present study. All couples had engaged in unprotected sex for a period of over 1 year. Transmission was defined by the seroconversion of the female sexual partner. Virus isolates were tested in MT-2 cells for replication and syncytia induction. HIV-1 RNA plasma load was measured by the branched DNA technique. Serum neutralizing activity to primary HIV-1 isolates was tested by using peripheral blood mononuclear cells (PBMC) as target cells. RESULTS Non-transmitting index cases had a lower HIV-1 RNA concentration in plasma than transmitting index cases. Non-transmitting index cases also tended to have serum neutralizing activity with broad specificity and to have viruses with low replicative capacity, as characterized by 50% infectious dose titres in PBMC and by the lack of MT-2 tropism. CONCLUSIONS The results indicate that plasma viral-RNA load is a marker for transmission. Moreover, an interplay between the host immune response and viral replication may modulate the level of viral load and thereby influence HIV-1 transmission.
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Affiliation(s)
- J R Fiore
- Microbiology and Tumorbiology Centre, Karolinska Institute, Stockholm, Sweden
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249
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Guala A, Pastore G, Cerruti Mainardi P, Liverani E, Ghini T, Tagliabue A, Capo A, Quazza G, Cigolotti AC, Zaffaroni M, Foracchia P, Garassino L, Uasone R. [Malformations of the midline. A case-control study]. Pediatr Med Chir 1997; 19:117-9. [PMID: 9312746] [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] [Indexed: 02/05/2023] Open
Abstract
Defects of the middle line are an heterogeneous group of congenital malformations due to commune pathogenetic mechanisms. We have made a case-control study about 150 newborns, who have at least 1 defect of the middle line. Results prove an excess of males between the cases, due mostly to hypospadias. We haven't found families with defects of the middle line with x-linked manner of hereditary transmission. We haven't found any particular risk present in cases and not in controls. We haven't found any case with 2 or more middle line defects.
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Affiliation(s)
- A Guala
- Divisione Pediatrica, Ospedale S. Andrea di Vercelli, Italia
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250
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Maietta G, Fiore JR, Pellegrino V, Milillo G, Tagliaferro L, Corbelli M, Pastore G. Leucocyte identification and analysis in human semen. Arch Androl 1997; 38:99-105. [PMID: 9049030 DOI: 10.3109/01485019708987886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The analysis of leucocyte population in human semen could be useful in the diagnosis and therapeutic monitoring of male genital infections, but it is difficult due the low percentage of leucocytes, often not easily recognizable from immature cells of spermatogenesis. A method was developed for the isolation and identification of different leucocyte populations in human semen in healthy subjects using anti-CD45-covered magnetic beads. The seminal fluid was incubated with anti-CD45-covered magnetic beads and the samples were placed in contact with a magnet. The CD45-positive cells recovered were analyzed by light microscopy. The leucocyte formula was compared with a leucocyte formula performed on seminal fluid sediment. The method, even if laborious, eliminates all spermatozoa and most of cells of spermatogenetic lineage, thus permitting phenotyping and functional analysis on isolated leucocytes.
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Affiliation(s)
- G Maietta
- Department of Immunology, Pignatelli Institute, Lecce, Italy
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