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Congia S, Palmas A, Marongiu G, Capone A. Is antegrade nailing a proper option in 2- and 3-part proximal humeral fractures? Musculoskelet Surg 2020; 104:179-185. [PMID: 31183680 DOI: 10.1007/s12306-019-00610-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 02/26/2018] [Accepted: 05/22/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE To report our experience with antegrade short locked intramedullary nail for treatment of proximal humeral fractures and to review the current literature. MATERIALS AND METHODS From January 2012 to July 2013, 41 patients affected by two and three-part proximal humeral fractures were treated with surgical internal fixation with short locked intramedullary nails. Outcome analysis included standard clinical follow-up, Constant shoulder score and plain radiographs. The mean follow-up was 30 months (range 24-42). Moreover, a review of the literature was carried out. RESULTS The mean Constant shoulder score was 81.5, excellent functional outcomes in 24/38 patients. All the fractures healed in an average time of 3.7 months. Five patients underwent additional operations, complications included hardware penetration into the joint (n = 2), backed out screw (n = 1), shoulder impingement due to protrusion of the nail (n = 2) and superficial infection (n = 1). The literature review showed 530 patients affected by proximal humeral fracture and treated with intramedullary nail with mean age of 65 years, mean follow-up of 22.2 months and a Constant shoulder score of 72.9 points; the major complications reported were backing out of the screws, shoulder impingement and joint protrusion of the screws. CONCLUSIONS Antegrade short locked intramedullary nail allows stable fixation, minimal soft tissue dissection, early mobilization of the shoulder and good outcomes. It is an efficacious therapeutic solution for 2- and 3-part proximal humeral fractures.
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Affiliation(s)
- S Congia
- Clinica Ortopedica, Università degli Studi di Cagliari, Viale Lungo Mare Poetto 12, 09100, Cagliari, Sardegna, Italy.
| | - A Palmas
- Clinica Ortopedica, Università degli Studi di Cagliari, Viale Lungo Mare Poetto 12, 09100, Cagliari, Sardegna, Italy
| | - G Marongiu
- Clinica Ortopedica, Università degli Studi di Cagliari, Viale Lungo Mare Poetto 12, 09100, Cagliari, Sardegna, Italy
| | - A Capone
- Clinica Ortopedica, Università degli Studi di Cagliari, Viale Lungo Mare Poetto 12, 09100, Cagliari, Sardegna, Italy
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Kronenberg P, Abreu R, Furtado A, Palmas A, Bargão P, Graça B, Lourenço M, Ferreira Coelho M, Ribeiro F, Fonseca J, Pepe Cardoso A, Varregoso J, Ferrito F, Carrasquinho Gomes F. UP-01.049 pT0 After Radical Cystectomy: A Sign of Improved Outcome? Urology 2011. [DOI: 10.1016/j.urology.2011.07.601] [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: 10/15/2022]
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Maina G, Palmas A, Bovenzi M, Filon FL. [Sex specific differences in physiologic response to stress evaluated by means of salivary cortisol]. G Ital Med Lav Ergon 2007; 29:359-360. [PMID: 18409724] [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: 05/26/2023]
Abstract
The psychophysiological mechanism behind the development of stress-related diseases includes a long-term both increase and decrease in circulating cortisol levels, leading to an allostatic disregulation of the hypothalamic-pituitary-adrenal (HPA) axis. This research explores the relationship between perceived stress (assessed by means of the Job Strain Model) and neuroendocrine response quantified by means of repeated measures of salivary cortisol in 46 call-centre operators. Job strain influenced the total amount of cortisol response to waking, but not the cortisol excretion in the remainder of the day. The cortisol response to waking showed gender-specific differences, women excreting greater cortisol than men [AUC(t): coeff (IC 95%) = 16.2 (5.3-27.1); AUC(i): coeff (IC 95%) = 8.3 (2.4-14.2); MnInc: coeff (IC 95%) = 5.2 (1.6-8.9)]. In long run the gender-specific differences of the dis-regulation of the hypothalamic -pituitary-adrenal (HPA) axis can be related to differences on prevalence of autoimmune diseases.
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Affiliation(s)
- G Maina
- Dipartimento di Traumatologia Ortopedia e Medicina del Lavoro, Università degli Studi di Torino, Via Zuretti, 29, 10126 Torino.
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Ferreri AJ, Ponzoni M, Guidoboni M, Cortelazzo S, Demeter J, Zallio F, Palmas A, Politi L, Doglioni C, Dolcetti R. Chlamydia psittaci (Cp)-eradicating therapy with doxycycline is an active treatment against ocular adnexa MALT lymphoma (OAML): Final results of a multicentre prospective trial. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7559 Background: An association between OAML and Cp infection has been reported. Preliminary data suggest that patients (pts) with Cp-related OAML could achieve lymphoma regression after eradicating therapy with doxycycline, while data on the activity of this strategy in Cp-negative OAML are not available. Methods: In this multicentre prospective trial, 27 consecutive pts with OAML and measurable disease, at diagnosis (n = 15) or relapse, were treated with doxycycline 100 mg, bid orally, for 3 weeks. Objective response was the primary endpoint. The presence of Cp DNA in lymphoma samples was evaluated by TETR-PCR. Results: Tolerability was excellent in all pts but one. At a median follow-up of 13 mo. (range 3–45), response was complete (CR) in 6 pts and partial in 7 (ORR = 48%; 95% CI:30%-66%); three pts had a response <50%, 9 had stable disease (3–13 mo.), two had progressive disease. Response was slow; 5 pts achieved the best response only after one year of follow-up (median time to the best response: 6 mo.). TETR-PCR resulted positive in 11 (41%) pts and negative in 16. Lymphoma regression was observed in both PCR-positive and -negative pts (64% vs. 38%; p = 0.25), with a CR rate of 36% and 13% (p = 0.18), respectively. Response rate was similar between pts with conjunctival and intra-orbital lymphomas (43% vs. 54%, p = 0.71). The three pts with regional lymphadenopathies and three of the 5 pts with bilateral OAL achieved objective response (4 CRs), which lasted 3+, 13+, 16+, 22+, 26+, and 37 mo. In relapsed pts, objective response was observed in 3 of 5 previously irradiated pts and in 5 of 7 non-irradiated pts (p = 0.99). Twenty pts are failure-free, with a 2-yr FFS of 66±12%. Conclusions: Doxycycline is a fast, cheap and safe therapy, able to induce durable regression in 64% of Cp-related OAML. This antibiotic is a valid alternative against OAML, even in pts with multiple failures, involving previously irradiated areas or regional lymph nodes. We report for the first time responses also in PCR-negative OAML; this finding stimulates the development of more sensitive and specific methods for Cp detection and the study of potential associations with other infectious agents responsive to doxycycline. No significant financial relationships to disclose.
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Affiliation(s)
- A. J. Ferreri
- San Raffaele H Scientific Institute, Milan, Italy; Centro di Riferimento Oncologico, Aviano, Italy; Ospedale Riuniti di Bergamo, Bergamo, Italy; Semmelweis University, Budapest, Hungary; Istituto Nazionale dei Tumori, Milan, Italy; Ospedale San Francesco, Nuoro, Italy
| | - M. Ponzoni
- San Raffaele H Scientific Institute, Milan, Italy; Centro di Riferimento Oncologico, Aviano, Italy; Ospedale Riuniti di Bergamo, Bergamo, Italy; Semmelweis University, Budapest, Hungary; Istituto Nazionale dei Tumori, Milan, Italy; Ospedale San Francesco, Nuoro, Italy
| | - M. Guidoboni
- San Raffaele H Scientific Institute, Milan, Italy; Centro di Riferimento Oncologico, Aviano, Italy; Ospedale Riuniti di Bergamo, Bergamo, Italy; Semmelweis University, Budapest, Hungary; Istituto Nazionale dei Tumori, Milan, Italy; Ospedale San Francesco, Nuoro, Italy
| | - S. Cortelazzo
- San Raffaele H Scientific Institute, Milan, Italy; Centro di Riferimento Oncologico, Aviano, Italy; Ospedale Riuniti di Bergamo, Bergamo, Italy; Semmelweis University, Budapest, Hungary; Istituto Nazionale dei Tumori, Milan, Italy; Ospedale San Francesco, Nuoro, Italy
| | - J. Demeter
- San Raffaele H Scientific Institute, Milan, Italy; Centro di Riferimento Oncologico, Aviano, Italy; Ospedale Riuniti di Bergamo, Bergamo, Italy; Semmelweis University, Budapest, Hungary; Istituto Nazionale dei Tumori, Milan, Italy; Ospedale San Francesco, Nuoro, Italy
| | - F. Zallio
- San Raffaele H Scientific Institute, Milan, Italy; Centro di Riferimento Oncologico, Aviano, Italy; Ospedale Riuniti di Bergamo, Bergamo, Italy; Semmelweis University, Budapest, Hungary; Istituto Nazionale dei Tumori, Milan, Italy; Ospedale San Francesco, Nuoro, Italy
| | - A. Palmas
- San Raffaele H Scientific Institute, Milan, Italy; Centro di Riferimento Oncologico, Aviano, Italy; Ospedale Riuniti di Bergamo, Bergamo, Italy; Semmelweis University, Budapest, Hungary; Istituto Nazionale dei Tumori, Milan, Italy; Ospedale San Francesco, Nuoro, Italy
| | - L. Politi
- San Raffaele H Scientific Institute, Milan, Italy; Centro di Riferimento Oncologico, Aviano, Italy; Ospedale Riuniti di Bergamo, Bergamo, Italy; Semmelweis University, Budapest, Hungary; Istituto Nazionale dei Tumori, Milan, Italy; Ospedale San Francesco, Nuoro, Italy
| | - C. Doglioni
- San Raffaele H Scientific Institute, Milan, Italy; Centro di Riferimento Oncologico, Aviano, Italy; Ospedale Riuniti di Bergamo, Bergamo, Italy; Semmelweis University, Budapest, Hungary; Istituto Nazionale dei Tumori, Milan, Italy; Ospedale San Francesco, Nuoro, Italy
| | - R. Dolcetti
- San Raffaele H Scientific Institute, Milan, Italy; Centro di Riferimento Oncologico, Aviano, Italy; Ospedale Riuniti di Bergamo, Bergamo, Italy; Semmelweis University, Budapest, Hungary; Istituto Nazionale dei Tumori, Milan, Italy; Ospedale San Francesco, Nuoro, Italy
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Piras G, Monne M, Uras A, Palmas A, Murineddu M, Arru L, Bianchi A, Calvisi A, Curreli L, Gaviano E, Lai P, Murgia A, Latte GC, Noli A, Gabbas A. Genetic analysis of the 2q33 region containing CD28-CTLA4-ICOS genes: association with non-Hodgkin's lymphoma. Br J Haematol 2005; 129:784-90. [PMID: 15953005 DOI: 10.1111/j.1365-2141.2005.05525.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [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: 11/29/2022]
Abstract
There is strong evidence that altered immunological function entails an increased risk of lymphoma, although the current knowledge of aetiological factors for lymphomas is limited. The CTLA4 gene encodes a receptor that provides a negative signal to the T-cell once an immune response is initiated and completed. We analysed the 2q33 chromosomal region harbouring CD28, CTLA4 and ICOS genes, which are closely linked and have related functions in immune regulation, for association in 100 non-Hodgkin's lymphoma (NHL) patients and in 128 healthy controls; both groups originated from Sardinia. There was a strong association of the CTLA4 49A and the 3'-untranslated region (AT)(82) alleles with NHL [odds ratio (OR) = 2, 95% confidence interval (CI) = 1.2-3.2, and OR = 1.6, 95% CI = 1.1-2.4 respectively]. CTLA4-318C:49A:(AT)(82) was the most represented haplotype in the studied population and was associated with NHL (P = 0.0029, OR = 1.76, 95% CI = 1.2-2.5). Strong linkage disequilibrium was detected between CD28, CTLA4 and ICOS and a 'common' haplotype was found very frequently among NHLs. However, no independent association between CD28, ICOS, D2S72 markers and NHL was observed. Our findings enable CTLA4 from adjacent functionally related genes as the true causative risk gene for NHL susceptibility at least in Sardinian patients.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antigens, CD
- Antigens, Differentiation/genetics
- Antigens, Differentiation, T-Lymphocyte/genetics
- CD28 Antigens/genetics
- CTLA-4 Antigen
- Chromosomes, Human, Pair 2/genetics
- Female
- Gene Frequency
- Genetic Predisposition to Disease
- Humans
- Inducible T-Cell Co-Stimulator Protein
- Linkage Disequilibrium
- Lymphoma, Non-Hodgkin/genetics
- Lymphoma, Non-Hodgkin/immunology
- Male
- Microsatellite Repeats
- Middle Aged
- Polymorphism, Single Nucleotide
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Affiliation(s)
- G Piras
- Haematology Division and Bone Marrow Transplantation Unit, San Francesco Hospital, Nuoro, Italy.
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Abstract
A cohort of 889 men and 1077 women employed for at least 1 month between 1946 and 1984 by a former Italian leading asbestos (mainly textile) company, characterised by extremely heavy exposures often for short durations, was followed up to 1996, for a total of 53 024 person-years of observation. Employment data were obtained from factory personnel records, while vital status and causes of death were ascertained through municipality registers and local health units. We observed 222 cancer deaths compared with 116.4 expected (standardized mortality ratio, SMR=191). The highest ratios were found for pleural (SMR=4105), peritoneal (SMR=1817) and lung (SMR=282) cancers. We observed direct relationships with duration of employment for lung and peritoneal cancer, and with time since first employment for lung cancer and mesothelioma. Pleural cancer risk was independent from duration (SMR=3428 for employment <1 year, 7659 for 1–4 years, 2979 for 5–9 years and 2130 for ⩾10 years). Corresponding SMRs for lung cancer were 139, 251, 233 and 531. Nonsignificantly increased ratios were found for ovarian (SMR=261), laryngeal (SMR=238) and oro-pharyngeal (SMR=226) cancers. This study confirms and further quantifies the central role of latency in pleural mesothelioma and of cumulative exposure in lung cancer.
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Affiliation(s)
- E Pira
- Dipartimento di Traumatologia, Ortopedia e Medicina del Lavoro, Università degli Studi di Torino, via Zuretti 29, 10126 Torino, Italy
| | - C Pelucchi
- Istituto di Ricerche Farmacologiche ‘Mario Negri’, via Eritrea 62, 20157 Milano, Italy
- Istituto di Ricerche Farmacologiche ‘Mario Negri’, Via Eritrea, 62-20157 Milano, Italy. E-mail:
| | - L Buffoni
- Dipartimento di Traumatologia, Ortopedia e Medicina del Lavoro, Università degli Studi di Torino, via Zuretti 29, 10126 Torino, Italy
| | - A Palmas
- Dipartimento di Traumatologia, Ortopedia e Medicina del Lavoro, Università degli Studi di Torino, via Zuretti 29, 10126 Torino, Italy
| | - M Turbiglio
- Dipartimento di Traumatologia, Ortopedia e Medicina del Lavoro, Università degli Studi di Torino, via Zuretti 29, 10126 Torino, Italy
| | - E Negri
- Istituto di Ricerche Farmacologiche ‘Mario Negri’, via Eritrea 62, 20157 Milano, Italy
| | - P G Piolatto
- Dipartimento di Traumatologia, Ortopedia e Medicina del Lavoro, Università degli Studi di Torino, via Zuretti 29, 10126 Torino, Italy
| | - C La Vecchia
- Istituto di Ricerche Farmacologiche ‘Mario Negri’, via Eritrea 62, 20157 Milano, Italy
- Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, via Venezian 1, 20133 Milano, Italy
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Spina M, Gabarre J, Vaccher E, Re A, Palmas A, Antinori A, Clerico M, Tirelli U. Feasibility of the integration of Stanford V ct regimen with highly active antiretroviral therapy (HAART) and G-CSF in patients (pts) with HD and HIV infection (HD-HIV). Eur J Cancer 2001. [DOI: 10.1016/s0959-8049(01)80811-x] [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: 11/26/2022]
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Montillo M, Tedeschi A, Pagano L, Venditti A, Ferrara F, Fabris P, Martino B, Musso M, De Rosa G, Specchia G, Monaco M, Sparaventi G, Spadea A, Palmas A, Deplano W, Manna A, Melillo L, Miraglia E, Mirto S, Mandelli F. Feasibility of peripheral blood stem cell rescue as intensification in elderly patients with acute myelocytic leukaemia: a pilot study from the Gimema Group. Gruppo Italiano Malattie Ematologiche Maligne Dell'Adulto. Br J Haematol 2000; 111:334-7. [PMID: 11091221 DOI: 10.1046/j.1365-2141.2000.02277.x] [Citation(s) in RCA: 14] [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: 11/20/2022]
Abstract
Elderly patients with untreated acute myeloid leukaemia (AML, n = 47) tested the feasibility of out-patient consolidation therapy and post-consolidation treatment (for patients aged < 71 years) with autologous peripheral blood stem cell transplantation (APBSCT). Overall, 13 patients out of 24 (51%) who achieved complete remission (CR) were eligible for further treatment after consolidation. Five patients were primed with granulocyte colony stimulating factor (G-CSF); a suitable number of CD34+ cells were harvested in three patients and were actually autotransplanted. The toxicity of APBSCT was negligible. Psychosocial problems impaired treatment of some patients on an out-patient basis. Resistant disease, toxicity and logistic problems reduced the number of patients to whom this procedure could actually be applied.
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Affiliation(s)
- M Montillo
- Divisione di Ematologia, Ospedale Niguarda Cà Granda, Milan, Italy.
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Palmas A, Tefferi A, Myers JL, Scott JP, Swensen SJ, Chen MG, Gastineau DA, Gertz MA, Inwards DJ, Lacy MQ, Litzow MR. Late-onset noninfectious pulmonary complications after allogeneic bone marrow transplantation. Br J Haematol 1998; 100:680-7. [PMID: 9531334 DOI: 10.1046/j.1365-2141.1998.00617.x] [Citation(s) in RCA: 150] [Impact Index Per Article: 5.8] [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: 02/07/2023]
Abstract
We examined the incidence and clinical outcome of late-onset noninfectious pulmonary complications (LONIPC) in a series of 234 patients who underwent allogeneic bone marrow transplantation at our institution between April 1982 and October 1996. The 179 patients who survived 3 months or more were evaluated. Clinical, radiologic, pulmonary function, and pathologic tests were reviewed to identify 18 patients (10%) who fulfilled the diagnostic criteria of LONIPC. Accordingly, the pulmonary processes included bronchiolitis obliterans (BO, five patients), bronchiolitis obliterans with organizing pneumonia (BOOP, three patients), diffuse alveolar damage (DAD, one patient), lymphocytic interstitial pneumonia (LIP, one patient), and nonclassifiable interstitial pneumonia (NCIP, eight patients). Various methods of enhanced immunosuppressive therapy resulted in marked durable remission in nine patients (50%) (3/3 with BOOP, 3/8 with NCIP, 1/1 with DAD, 1/1 with LIP, 1/5 with BO). The presence of chronic graft-versus-host disease (cGVHD) and prophylaxis for GVHD with cyclosporine and prednisone were the only variables significantly associated with the development of LONIPC (P = 0.0001 and 0.008, respectively). Regardless of histology, a reduction in the forced expiratory volume to < 45% of the predicted range was associated with poor response to treatment. These findings suggest a strong association between cGVHD and LONIPC and that the risk of LONIPC development may be influenced by the particular method of GVHD prophylaxis. Most patients with BOOP or mild airflow limitation at diagnosis achieved durable remissions.
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Affiliation(s)
- A Palmas
- Division of Hematology and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA
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Lopez M, Boccacio C, Mortel O, Pouillart P, Reiffers J, Douay L, Laporte JP, Michon J, Palmas A, Zucker JM, Gorin NC. Transplantation combining autologous bone marrow and peripheral blood The International Journal of Cell Cloning in france: A review. Stem Cells 1992. [DOI: 10.1002/stem.5530100754] [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: 11/07/2022]
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