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Castriconi R, Placidi L, Avanzo M, Cirio R, Gallo P, Mazzilli A, Milano A, Rancati T, Russo P, Garibaldi C. Survey on the interest and commitment of AIFM members to scientific activities (SicAS) - The initiative of the FutuRuS working group. Phys Med 2023; 110:102589. [PMID: 37254301 DOI: 10.1016/j.ejmp.2023.102589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/03/2023] [Accepted: 04/10/2023] [Indexed: 06/01/2023] Open
Abstract
PURPOSE The "FutuRuS" working group of the Italian Association of Medical Physics and Health Physics (AIFM) designed a survey (SicAS) to get feedback from its members regarding their interests and their experience in taking part in scientific activities and events, with the objective of focusing future efforts of the AIFM towards increasing the scientific activity of the medical physics expert (MPE). METHODS SicAS was sent out in March 2022 to all AIFM members by newsletter and official communication. SicAS was structured into three sections: personal information and institution of affiliation information, involvement in scientific activities, interest in and commitment to scientific activities. Responses were collected in a fully anonymised mode from the Google Forms platform and analysed with descriptive statistics. RESULTS Out of 1289 members (active at the end of 2021), 467 responded to the Survey (response rate of 36%). The Survey results highlighted that AIFM members ranked the involvement of the MPE in scientific activities as highly relevant to the profession. However, 34.7% indicated devoting less than 10% of their working time to scientific activities. 67.5% of the respondents were dissatisfied with the time spent on scientific activities. The primary barrier was the lack of time (77%), followed by a lack of mentoring (32%). CONCLUSIONS SicAS highlighted the need for AIFM initiatives to support members' scientific activities. National societies should help develop and support networks between members, create links among universities, hospitals, research institutions and industries, and provide guidelines and learning platforms for enhancing the MPEs' involvement in scientific activities.
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Affiliation(s)
- R Castriconi
- Medical Physics Dept, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - L Placidi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - M Avanzo
- Department of Medical Physics, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, PN, Italy
| | - R Cirio
- Università degli Studi di Torino, Torino 10125, Italy; INFN - National Institute for Nuclear Physics, Torino, Italy
| | - P Gallo
- IRCCS Humanitas Research Hospital, Medical Physics Unit, via Manzoni 56, Rozzano, Milan, Italy.
| | - A Mazzilli
- Medical Physics Dept, University Hospital of Parma AOUP, Parma, Italy
| | - A Milano
- Università Cattolica Sacro Cuore, Rome, Italy
| | - T Rancati
- Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - P Russo
- Università di Napoli Federico II, Dipartimento di Fisica "Ettore Pancini", Napoli, Italy; INFN - National Institute for Nuclear Physics, Napoli, Italy
| | - C Garibaldi
- Unit of Radiation Research, IEO European Institute of Oncology, IRCCS, Milano, Italy
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Giovannico L, d'Errico Ramirez A, Parigino D, Fischetti G, Santeramo V, Savino L, Silva A, Marzullo A, Bottio T, Milano A. Galectin-3 as an Early Marker of Renal Dysfunction in Heart Transplant Patients: Short-Term Results. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1296] [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: 04/05/2023] Open
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3
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Dente M, Riccardo F, Declich S, Milano A, Robbiati C, Agrimi U, Mantovani A, Morabito S, Scavia G, Cubadda F, Villa L, Monaco M, Mancini L, Carere M, Marcheggiani S, Lavazza A, Farina M, Dar O, Villa M, Coggi PT, Brusaferro S. Strengthening preparedness against global health threats: A paradigm shift based on One Health approaches. One Health 2022; 14:100396. [PMID: 35686149 PMCID: PMC9171516 DOI: 10.1016/j.onehlt.2022.100396] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 11/25/2022] Open
Abstract
The implementation of preparedness strategies to prevent and mitigate the impact of global health threats poses several challenges. It should promptly identify cross-cutting drivers of pandemic threats, assess context-specific risks, engage multiple stakeholders, and translate complex data from multiple sources into accessible information for action. This requires a coordinated, multidisciplinary and multisectoral effort engaging systems that, most of the time, work in isolation. The One Health (OH) approach promotes the collaboration and communication among different disciplines and sectors, and could be applied across the preparedness phases at national and international level. We discuss here gaps and needs in preparedness strategies, which can benefit from the OH approach, and a set of actionable recommendations, as shared with the G20–2021 with a dedicated Policy Brief. The discussion adds to the current debate about OH operationalization and promotes a paradigm shift towards coordinated prevention and preparedness strategies for early assessment and management of global health threats.
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Intra J, Milano A, Sarto C, Brambilla P. A rare case of Clostridium paraputrificum bacteremia in a 78-year-old Caucasian man diagnosed with an intestinal neoplasm. Anaerobe 2020; 66:102292. [DOI: 10.1016/j.anaerobe.2020.102292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/21/2020] [Accepted: 10/31/2020] [Indexed: 02/07/2023]
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Pham C, Munoz-Martin N, Podliesna S, Milano A, Beekman L, Vermeer A, Frantzen C, Jansen S, Van De Laar I, Nieuwhof K, Christiaans I, Bezzina C, Lodder E. Altered auto-phosphorylation of novel TNNI3K variants associated with AV-nodal re-entry tachycardia and conduction disease. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0339] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In the past decade, we and others have reported three families with rare genetic variants in TNNI3K, encoding the cardiac-specific troponin-I interacting kinase (TNNI3K), co-segregating with a mixed, but highly penetrant, cardiac phenotype that features predominant atrial/junctional tachycardia occurring in combination with cardiac conduction disease and dilated cardiomyopathy. We demonstrated that while the p.Thr539Ala and p.Gly526Asp TNNI3K variants had decreased auto-phosphorylation activity the p.Glu768Lys variant, present in 3 independent families, leads to increased auto-phosphorylation levels, in line with the finding that increased levels of Tnni3k expression are associated with slower atrial-ventricular conduction in mice.
Objective
Identifying new genetic variants in the TNNI3K gene associated with cardiac disease and assessing their impact on TNNI3K auto-phosphorylation levels.
Methods
Through next generation sequencing of a panel of genes associated with cardiac disease we assessed TNNI3K in patients with cardiac arrhythmias and cardiomyopathies. All variants identified were assessed in vitro for effects on auto-phosphorylation. Briefly, wild-type and mutant TNNI3K constructs were transfected into HEK293 cells, protein was extracted after 48 hours and analyzed with anti-flag and anti-phospho-tyrosine antibodies on Western blot.
Results
We identified 7 novel and rare variants in TNNI3K in 11 additional probands, with predominantly cardiac conduction disease, with or without dilated cardiomyopathy, and atrial-ventricular-re-entry-tachycardia (AVNRT). Of these, multiple variants were found to have aberrant auto-phosphorylation including almost absent auto-phosphorylation capacity for one (TNNI3K-p.Val510Leu). All three-independent wild type TNNI3K transfected HEK293 cell lysates showed similar phosphorylated TNNI3K levels and the kinase-dead negative control demonstrated no phosphorylation activity.
Conclusion
We here present 7 novel genetic variants in TNNI3K in patients with a remarkable overlap in cardiac phenotype consisting mainly of AVNRT and cardiac conduction disease. We further show that some of these variants alter the auto-phosphorylation of TNNI3K. These results indicate a more prevalent role of variants in TNNI3K in human cardiac disease and a possible in vitro functional assay to assess the pathogenicity of such variants.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Dutch Research Council (NWO Talent Scheme VIDI-91718361)
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Affiliation(s)
- C Pham
- Amsterdam UMC - Location Academic Medical Center, Amsterdam, Netherlands (The)
| | - N Munoz-Martin
- Amsterdam UMC - Location Academic Medical Center, Amsterdam, Netherlands (The)
| | - S Podliesna
- Amsterdam UMC - Location Academic Medical Center, Amsterdam, Netherlands (The)
| | - A Milano
- Amsterdam UMC - Location Academic Medical Center, Amsterdam, Netherlands (The)
| | - L Beekman
- Amsterdam UMC - Location Academic Medical Center, Amsterdam, Netherlands (The)
| | - A Vermeer
- Amsterdam UMC - Location Academic Medical Center, Amsterdam, Netherlands (The)
| | - C Frantzen
- University Medical Center Groningen, Groningen, Netherlands (The)
| | - S Jansen
- Amsterdam UMC - Location VUmc, Amsterdam, Netherlands (The)
| | - I Van De Laar
- Erasmus University Medical Centre, Rotterdam, Netherlands (The)
| | - K Nieuwhof
- University Medical Center Groningen, Groningen, Netherlands (The)
| | - I Christiaans
- Amsterdam UMC - Location Academic Medical Center, Amsterdam, Netherlands (The)
| | - C.R Bezzina
- Amsterdam UMC - Location Academic Medical Center, Amsterdam, Netherlands (The)
| | - E.M Lodder
- Amsterdam UMC - Location Academic Medical Center, Amsterdam, Netherlands (The)
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Roberto M, Arrivi G, Milano A, D’Antonio C, Romiti A, Falcone R, Mazzuca F, Fais S, Marchetti P. Updated results of a phase II randomized trial with high dose proton pump inhibitors and metronomic capecitabine as salvage treatment for patients with advanced gastrointestinal tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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7
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Ricci R, Ghiggia A, La Rosa I, Milano A, Troni W, George MS, Borckardt JJ, Castelli L, Salatino A. Anodal Transcranial Direct Current Stimulation of the motor cortex reduces chronic pain in Alcock canal syndrome. Brain Stimul 2018; 11:648-650. [DOI: 10.1016/j.brs.2018.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 01/30/2018] [Accepted: 02/01/2018] [Indexed: 02/02/2023] Open
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Occhipinti M, Botticelli A, Onesti C, Ghidini M, Righini R, Pizzo C, Milano A, Tomasello G, Di Pietro F, Toppo L, Ratti M, Passalacqua R, Marchetti P, Mazzuca F. Treatment and outcome for small bowel adenocarcinoma (SBA): a real life experience of two Italian centres. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx425.022] [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: 11/14/2022] Open
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9
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León JA, Romer M, Milano A, Suarez O. Cesarean Scar Defect (Istmocele): Hysterorrhaphic Technique as Etheologic Factor in Cesarean Section. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.284] [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: 10/20/2022]
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10
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Onesti C, Botticelli A, Mazzuca F, Milano A, Romiti A, Roberto M, Falcone R, Occhipinti M, Di Pietro F, Lionetto L, Simmaco M, Marchetti P. 5-fluorouracil degradation rate (5-FU-DR) as a new toxicity predictive biomarker for adjuvant FOLFOX in colorectal cancer (CRC) patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.134] [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: 11/14/2022] Open
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11
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Fabbri M, Sternberg C, Cortesi E, Santini D, Procopio G, Paolo M, Gamucci T, Carlini P, Roselli M, Longo F, Schinzari G, De Tursi M, Lanzetta G, Pellegrino A, Milano A, Sperduti I, Mancini M, Primi F, Ruggeri E. A real-life multicenter, retrospective analysis of Abiraterone Acetate (AA) in 340 metastatic castration-resistant prostate cancer (mCRPC) patients after chemotherapy, updated results. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw334.13] [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: 11/12/2022] Open
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12
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Lutrino E, Tucci M, Caffo O, Di Maio M, Procopio G, Scagliotti C, Mssari F, Milano A, Atzori F, Barni S, Gambino A, Fontanella C, Scavelli C, Cinieri S. Prognostic role of body mass index (BMI) in patients with metastatic castration resistant prostate cancer (mCRPC) receiving chemotherapy: PRO-BMI study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw334.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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13
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Roberto M, Romiti A, Lionetto L, D'Antonio C, Onesti C, Botticelli A, Milano A, Falcone R, Occhipinti M, Mazzuca F, Simmaco M, Marchetti P. P-039 5-Fluorouracil Degradation Rate in Patients with Recurrent Gastrointestinal Cancer Treated with Metronomic Capecitabine. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.37] [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: 11/12/2022] Open
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14
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Scuteri A, Ravasi M, Monfrini M, Milano A, D'Amico G, Miloso M, Tredici G. Human Mesenchymal Stem Cells Protect Dorsal Root Ganglia from the Neurotoxic Effect of Cisplatin. Anticancer Res 2015; 35:5383-5389. [PMID: 26408700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND/AIM Peripheral neurotoxicity is a dose-limiting factor of many chemotherapeutic agents, including cisplatin. Mesenchymal stem cells are promising for the treatment of several neurological disorders, and our aim was to verify the neuroprotective potential of human mesenchymal stem cells (hMSCs) on dorsal root ganglia (DRG) exposed to cisplatin. MATERIALS AND METHODS DRG were exposed to different cisplatin concentrations and then co-cultured with hMSCs or with hMSC-conditioned medium. RESULTS hMSCs showed a neuroprotective effect on cisplatin-induced death of DRG, mediated by direct contact. Moreover, DRG exhibited an MSC-dependent promotion of neurite outgrowth, in particular at early time points. For this effect, the expression of Neurite Outgrowth Inhibitor (NOGO) and Myelin Associated Glycoprotein (MAG) by hMSCs was pivotal. CONCLUSION hMSCs are a promising tool for reducing the neurotoxic effect of cisplatin.
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Affiliation(s)
- Arianna Scuteri
- Experimental Neurology Unit, Department of Surgery and Translational Medicine, Milano-Bicocca University, Monza, Italy Milan Center for Neuroscience, Milan, Italy
| | - Maddalena Ravasi
- Experimental Neurology Unit, Department of Surgery and Translational Medicine, Milano-Bicocca University, Monza, Italy
| | - Marianna Monfrini
- Experimental Neurology Unit, Department of Surgery and Translational Medicine, Milano-Bicocca University, Monza, Italy PhD Neuroscience Program, Milano-Bicocca University, Monza, Italy Milan Center for Neuroscience, Milan, Italy
| | - Azzurra Milano
- Experimental Neurology Unit, Department of Surgery and Translational Medicine, Milano-Bicocca University, Monza, Italy
| | - Giovanna D'Amico
- M.Tettamanti" Research Center, Pediatric Clinic, Milano-Bicocca University, Monza, Italy
| | - Mariarosaria Miloso
- Experimental Neurology Unit, Department of Surgery and Translational Medicine, Milano-Bicocca University, Monza, Italy Milan Center for Neuroscience, Milan, Italy
| | - Giovanni Tredici
- Experimental Neurology Unit, Department of Surgery and Translational Medicine, Milano-Bicocca University, Monza, Italy Milan Center for Neuroscience, Milan, Italy
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Fabbri M, Cortesi E, Marchetti P, Santini D, Gamucci T, Angelini F, Longo F, Milano A, Mancini M, Giuli A, Quadrini S, Sperduti I, Pellegrino A, Ratta R, Primi F, Chilelli M, Ruggeri E. 2544 Abiraterone acetate in metastatic castration-resistant prostate cancer after chemotherapy. A retrospective “Real Life” analysis of activity and safety. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31363-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Milano A, D'Antonio C, Roberto M, Falcone R, Pietro FD, Durante V, Romiti A, Marchetti P. 2146 Association between proton-pump inhibitors (PPI) and metronomic capecitabine (MCAP) as salvage treatment for patients with advanced gastro-intestinal tumours: A randomized phase II study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31067-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: 11/28/2022]
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17
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Milano A, Vermeer AMC, Lodder ER, Barc J, Verkerk AO, Van Der Bilt IAC, Pinto Y, Christiaans I, Wilde AA, Bezzina CR. P333HCN4 mutations in multiple families with bradycardia and left ventricular noncompaction cardiomyopathy. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu091.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dodonov M, Milano A, Van Oeveren W, Gu YJ, Tessari M, Menon T, Onorati F, Faggian G. 113 * A POSITIVE INFLUENCE OF PULSATILE CARDIOPULMONARY BYPASS ON RENAL FUNCTION IN ELDERLY PATIENTS UNDERGOING AORTIC VALVE SURGERY. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.113] [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: 11/12/2022] Open
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19
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Milano A, Vermeer A, Lodder EM, Postma AV, Barc JGM, Baars MJH, Pinto Y, Christiaans I, Wilde A, Bezzina CR. Novel HCN4 mutations in families with bradycardia and hypertrabeculation of the myocardium. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Falco VD, Milano A, Battilana M, Araosta F, Grosso A, Albanese D, Petrini F, Liberato LD. Metformin-associated lactic acidosis: risk factors and prognostic factors. Crit Care 2013. [PMCID: PMC3643038 DOI: 10.1186/cc12391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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21
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Milano A, Perri F, Caponigro F. The ubiquitin-proteasome system as a molecular target in solid tumors: an update on bortezomib. Onco Targets Ther 2009; 2:171-8. [PMID: 20616904 PMCID: PMC2886336 DOI: 10.2147/ott.s4503] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Indexed: 11/23/2022] Open
Abstract
The ubiquitin-proteasome system has become a promising molecular target in cancer therapy due to its critical role in cellular protein degradation, interaction with cell cycle and apoptosis regulation, and unique mechanism of action. Bortezomib (PS-341) is a potent and specific reversible proteasome inhibitor, which has shown strong in vitro antitumor activity as single agent and in combination with other cytotoxic drugs in a broad spectrum of hematological and solid malignancies. In preclinical studies, bortezomib induced apoptosis of malignant cells through the inhibition of NF-|B and stabilization of pro-apoptotic proteins. Bortezomib also promotes chemo- and radiosensitization of malignant cells in vitro and inhibits tumor growth in murine xenograft models. The proteasome has been established as a relevant target in hematologic malignancies and bortezomib has been approved for the treatment of multiple myeloma. This review summarizes recent data from clinical trials in solid tumors.
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Affiliation(s)
- A Milano
- Sandro Pitigliani Medical Oncology Unit, Department of Oncology, Hospital of Prato, Istituto Toscano Tumori, Prato, Italy
| | - F Perri
- Head and Neck Medical Oncology Unit, National Tumour Institute of Naples, Naples, Italy
| | - F Caponigro
- Head and Neck Medical Oncology Unit, National Tumour Institute of Naples, Naples, Italy
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Abstract
A 60-year-old patient underwent triple coronary artery bypass grafting following an inferoseptal myocardial infarction and early onset of exertional angina. Four years later he was involved in a car accident during which he sustained an abdominal and thoracic trauma. Approximately 1 month after discharge, a ventricular septal defect was diagnosed by two-dimensional Doppler echocardiography with patency of all grafts at coronary angiography. Closure of the septal defect was successfully accomplished through a right atrial approach. Rupture of the ventricular septum following blunt chest trauma in a patient with previous myocardial revascularization has not been previously reported.
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Affiliation(s)
- U Bortolotti
- Department of Cardiac Surgery, University of Pisa Medical School, Italy
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Balatsinou C, Milano A, Caldarella MP, Laterza F, Pierdomenico SD, Cuccurullo F, Neri M. Eosinophilic esophagitis is a component of the anticonvulsant hypersensitivity syndrome: description of two cases. Dig Liver Dis 2008; 40:145-8. [PMID: 17395557 DOI: 10.1016/j.dld.2007.01.017] [Citation(s) in RCA: 18] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2006] [Revised: 01/18/2007] [Accepted: 01/18/2007] [Indexed: 12/11/2022]
Abstract
Anticonvulsant hypersensitivity syndrome is a rare syndrome caused by a specific, severe unusual reaction to antiepileptic agents; anticonvulsant hypersensitivity syndrome develops 1 week to 3 months after the introduction of the drug and most frequently consists of a multisystemic and multiorgan involvement. Drug withdrawal usually leads to rapid improvement of symptoms. Up to now no oesophageal damage has been described. We present two cases of carbamazepine hypersensitivity syndrome with concomitant development of eosinophilic oesophagitis that resolved after drug withdrawal.
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Affiliation(s)
- C Balatsinou
- Department of Medicine and Aging Sciences, Section of Internal Medicine and Gastroenterology and Ce.S.I. Foundation, G. D'Annunzio University & Foundation Via dei Vestini, Chieti 66100 Italy
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Tringali A, Mutignani M, Milano A, Perri V, Costamagna G. No difference between supine and prone position for ERCP in conscious sedated patients: a prospective randomized study. Endoscopy 2008; 40:93-7. [PMID: 18058651 DOI: 10.1055/s-2007-995317] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND AIMS Endoscopic retrograde cholangiopancreatography (ERCP) is usually performed with the patient prone or in the left lateral position. The supine position could be more comfortable and may facilitate airway management. On the other hand, technical difficulties and a greater risk of adverse cardiorespiratory events have been shown when ERCP is performed in a supine patient. Our aim was to assess, in a tertiary referral center, the differences between performing ERCP with the patient supine or prone, in terms of technical features and complications both during and after the procedure. PATIENTS AND METHODS Between December 2005 and May 2006, 120 patients (66 female, mean age 62 years) who had an intact papilla and were candidates for therapeutic ERCP were prospectively randomized to undergo ERCP under conscious sedation with midazolam, in the prone (n = 60) or supine (n = 60) position, by an expert endoscopist (tutor) or a trainee. The following parameters were recorded: difficulty of cannulation and difficulty of ECRP procedure, time needed to visualize the papilla, time needed to achieve opacification and cannulation, exam duration, episodes of tachy/bradycardia and desaturation, episodes of duodenoscope displacement into the stomach, and complications. RESULTS Ninety-eight patients underwent ERCP for benign disease and 22 for malignant biliary strictures. The ERCP success rate was 98.3 % in the tutor group and 43.3 % in the trainee group. No significant differences were found between the two groups of operators (tutors and trainees) in the recorded parameters and complication rates encountered in prone versus supine patients. CONCLUSION Our results show that ERCP success rates and complications (intraoperative and postoperative) are similar whether ERCP is performed with the patient prone or supine, even when operators are of differing skill levels. Training, technique, and a proper learning phase are recommended in order to perform ERCP with no differences whether the patient is prone or supine.
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Affiliation(s)
- A Tringali
- Digestive Endoscopy Unit, Catholic University, Rome, Italy
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Rossi A, Bassani A, Berrone A, Baj A, Milano A, Pulvirenti R, Toniolo A. CONFRONTO DI DUE METODI PER CMV-DNA UTILIZZANDO UN POOL DI CAMPIONI DI SANGUE. Microbiol Med 2007. [DOI: 10.4081/mm.2007.2875] [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: 11/23/2022] Open
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Rossi A, Bassani A, Berrone A, Canali E, Milano A, Pinese L, Baj A, Toniolo A. DETERMINAZIONE DI CMV-ANTIGENEMIA E DI CMV-DNA QUANTITATIVO: TRE ANNI DI ESPERIENZA. Microbiol Med 2007. [DOI: 10.4081/mm.2007.2816] [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: 11/22/2022] Open
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27
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Lacombe DA, Caponigro F, Anthoney A, Bauer J, Govaerts A, Milano A, Marréaud S, Twelves C. A phase I study of bortezomib in combination with 5FU/LV plus oxaliplatin in patients (pts) with advanced colorectal cancer (CRC): EORTC 16029. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4090 Background: Bortezomib is a potent and reversible inhibitor of the ubiquitin-mediated proteasome pathway, whose inhibition results in the stabilization of p53, p21Cip1, p27Kip1, Bax, in cell-cycle dysregulation and, finally, apoptosis. A phase I study of the combination of 5FU/LV and bortezomib has shown a significant stable disease rate in advanced CRC (Iqbal, ASCO 2004). Methods: In this phase I study bortezomib was given as an IV push over 3 to 5 seconds on days 1, 8 and 15 in combination with standard FOLFOX-4 every 28 days in chemo-naïve pts with advanced CRC. Bortezomib starting dose level was 1.3 mg/m2. A 3+3 study design was utilized at predefined dose levels (DL). Dose-limiting-toxicity (DLT) was assessed during cycle 1. Exploratory pharmacogenetics research was conducted. Results: 15 pts were treated and 46 cycles given. At DL2 (1.6 mg/m2), 2/4 pts experienced a DLT: G3 febrile neutropenia causing treatment delay and bortezomib dose reduction in 1pt and one bortezomib dose skipped due to persistent G2 peripheral neuropathy and myalgia in 1pt. At DL1 (1.3 mg/m2), 2/6 pts had a DLT. Both pts experienced a G3 neutropenia on day 15, which prevented treatment from being given as scheduled. DL-1 (1 mg/m2) was therefore investigated and no DLT was observed among 5 pts. The most frequently reported toxicities in cycle 1 were γGT (64%), nausea, fatigue and sensory neuropathy (53%), pain (33%), diarrhea and fever (27%), vomiting (20%), anorexia, dyspnea and mucositis (13%) and neutropenia 29% (G2,3). 12 pts are currently evaluable for response; 6 had a partial response, 3 stable disease and 3 disease progression. Conclusion: The toxicity profile of this combination is predictable and early evidence of clinical activity has been observed. The recommended bortezomib dose for further investigation within this regimen is 1 mg/m2. No significant financial relationships to disclose.
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Affiliation(s)
- D. A. Lacombe
- EORTC Data Center, Brussels, Belgium; National Cancer Institute Fondazione G. Pascale, Naples, Italy; St. James’s Universiry Hospital, Leeds, United Kingdom; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - F. Caponigro
- EORTC Data Center, Brussels, Belgium; National Cancer Institute Fondazione G. Pascale, Naples, Italy; St. James’s Universiry Hospital, Leeds, United Kingdom; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - A. Anthoney
- EORTC Data Center, Brussels, Belgium; National Cancer Institute Fondazione G. Pascale, Naples, Italy; St. James’s Universiry Hospital, Leeds, United Kingdom; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - J. Bauer
- EORTC Data Center, Brussels, Belgium; National Cancer Institute Fondazione G. Pascale, Naples, Italy; St. James’s Universiry Hospital, Leeds, United Kingdom; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - A. Govaerts
- EORTC Data Center, Brussels, Belgium; National Cancer Institute Fondazione G. Pascale, Naples, Italy; St. James’s Universiry Hospital, Leeds, United Kingdom; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - A. Milano
- EORTC Data Center, Brussels, Belgium; National Cancer Institute Fondazione G. Pascale, Naples, Italy; St. James’s Universiry Hospital, Leeds, United Kingdom; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - S. Marréaud
- EORTC Data Center, Brussels, Belgium; National Cancer Institute Fondazione G. Pascale, Naples, Italy; St. James’s Universiry Hospital, Leeds, United Kingdom; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - C. Twelves
- EORTC Data Center, Brussels, Belgium; National Cancer Institute Fondazione G. Pascale, Naples, Italy; St. James’s Universiry Hospital, Leeds, United Kingdom; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Abstract
The methotrexate, vinblastine, doxorubicin, cisplatin (M-VAC) regimen has been considered as standard treatment of metastatic bladder carcinoma till recent years. The superiority of M-VAC both to cisplatin alone and to another cisplatin combination regimen has been demonstrated in randomized studies. During the last years, the use of gemcitabine in metastatic bladder carcinoma has considerably increased, mainly in combination with cisplatin (CG). A phase III trial comparing M-VAC and CG demonstrated similar activity and less toxicity for CG, which has now become the new standard of care for patients with metastatic bladder carcinoma. The substitution of cisplatin with carboplatin, the combination of platinum and taxanes, and the addition of a third drug to basal CG combination represent possible ways to improve outcome. Among the novel cytotoxic compounds, pemetrexed has raised interest, since a phase II second-line study showed a 28% response rate with a manageable toxicity profile. Vinflunine is a novel antitubulin agent with a relevant clinical activity in pretreated metastatic bladder carcinoma (18% response rate, 6.6 months median survival). Novel biologic compounds (in particular drugs targeting epidermal growth factor receptor) are being tested in metastatic bladder carcinoma also and much effort is being pursued in understanding the determinants of tumor response. Crucial mutations to which the tumor becomes addicted have to be discovered so that more effective and specific drugs or combinations can be delivered.
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Affiliation(s)
- R V Iaffaioli
- Istituto Nazionale Tumori Fondazione G. Pascale, Napoli, Italy.
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Balatsinou C, Milano A, Laterza F, Caldarella MP, Angelucci D, Vecchiet J, Zingariello P, Falasca K, Lapenna D, Neri M. Esophagitis and anticonvulsant hypersensitivity syndrome. Endoscopy 2006; 38:957. [PMID: 16981126 DOI: 10.1055/s-2006-925130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- C Balatsinou
- Department of Medicine and Science of Aging, Section of Internal Medicine and Gastroenterology and Section of Infectious Diseases, G. D'Annunzio University and Foundation, Chieti, Italy
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Brümmer U, Cappelli P, Laterza F, Di Liberato L, Sirolli V, Milano A, Mastrippolito S, D'Arezzo M, Muscianese P, Amoroso L, Neri M, Bonomini M. Wireless capsule endoscopy in the diagnostic of small intestine angiodysplasia in chronic uremic patient. MINERVA UROL NEFROL 2005; 57:61-9. [PMID: 15944523] [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: 05/02/2023]
Abstract
Gastroenteric bleeding due to angiodysplasia (AD) is a relatively common occurrence in patients with end-stage renal failure. Gastric and colon angiodysplasic lesions can be easily revealed by endoscopic procedures, whereas lesions of the small intestine are more difficult to detect. Imaging modalities used in the diagnostic imaging algorithm for the detection of small-bowel AD, include non-invasive methods like enema-helical computer tomography,(99m)Tc-labelled red blood cell scintigraphy, and angiography, and invasive methods such as intraoperative enteroscopy. We report the cases of 3 hemodialysis patients with recurrent episodes of gastrointestinal bleeding, caused by small-bowel AD diagnosed by means of wireless-capsule endoscopy. In all cases, previous gastroscopy and colonoscopy were unrevealing. Wireless-capsule endoscopy consists in swallowing a capsule endoscope (11 mmx27 mm) which contains a miniature video camera, a light source, batteries, and a radio transmitter. Video images are transmitted by means of radio telemetry to aerials taped to the body that allow images to be captured. Moving images from a period as long as 6 h are stored on a portable recorder. Wireless-capsule endoscopy may prove valuable in the assessment of gastrointestinal bleeding in uremic patients with unrevealing results at gastroscopy and colonoscopy.
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Affiliation(s)
- U Brümmer
- Institute of Nephrology, SS. Annunziata University Hospital, Chieti, Italy
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Bonomini M, Sirolli V, Milano A, Brummer U, Laterza F, Caldarella MP, Cappelli P, Neri M. [Angiodysplasia of the small bowel: a possible cause of anemia even in mild chronic renal failure]. G Ital Nefrol 2005; 22:171-6. [PMID: 15875281] [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: 05/02/2023]
Abstract
BACKGROUND Gastroenteric angiodysplasia (AD) is a vascular lesion characterized by vascular ectasias to the submucous sheath of the gastrointestinal tract. Lesions can be flat or raised, isolated or grouped and can break or ulcerate causing acute hemorrhage or, more commonly, chronic bleeding. CASE-REPORT We describe a 65-year-old patient with a 3-yr history of chronic renal failure (CRF), who gradually developed anemia (hemoglobin (Hb) 10 g/dl) without any episodes of clinically relevant bleeding or any exposure to bleeding risk factors. Blood pressure (BP) was normal and renal function was stable (serum creatinine (Cr) 1.9 mg/dl). Routine laboratory tests showed a slight reduction in serum iron and transferrin saturation and a slightly elevated absolute reticulocyte count. These findings were associated with a positive occult gastrointestinal blood test and raised the clinical suspicion of chronic gastrointestinal blood loss. Oesophagogastro-duodenoscopy and colonoscopy demonstrated an absence of significant lesions, suggesting the need to investigate for a lesion localized in the small intestine. Capsular endoscopy, a recently developed endoscopic technique, particularly suited for small bowel pathology, was performed, and demonstrated the presence of an angiodysplasic lesion, located in the jejunum. CONCLUSIONS Our case report supports the necessity for a complete clinical and laboratory evaluation of the possible causes of anemia superimposed on relative erythropoietin deficiency in CRF patients. When gastrointestinal blood loss is suspected, the entire gastroenteric tract should be examined to search for the bleeding sites. Our report also demonstrates that AD could be responsible for gastrointestinal bleeding even in mild CRF and not only, as usually reported, in end-stage renal disease (ESRD). Capsular endoscopy offers the unique possibility to determine the bleeding site in the small intestine and appears as an effective diagnostic procedure in CRF patients.
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Affiliation(s)
- M Bonomini
- Istituto di Clinica Nefrologica-Emodialisi, Universita' 'G. d'Annunzio' e Ospedale Clinicizzato 'SS. Annunziata', Chieti-Italy.
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32
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Rossi A, Rivetta E, Bassani A, Berrone A, Pinese L, Canali E, Milano A, Rinaldi L, Toniolo A. RELAZIONE TRA LIVELLI DI VIREMIA E DI ANTIGENE “s” IN UNA POPOLAZIONE DI PAZIENTI HBsAg POSITIVI. Microbiol Med 2004. [DOI: 10.4081/mm.2004.4027] [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: 11/23/2022] Open
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Terwilliger TC, Park MS, Waldo GS, Berendzen J, Hung LW, Kim CY, Smith CV, Sacchettini JC, Bellinzoni M, Bossi R, De Rossi E, Mattevi A, Milano A, Riccardi G, Rizzi M, Roberts MM, Coker AR, Fossati G, Mascagni P, Coates ARM, Wood SP, Goulding CW, Apostol MI, Anderson DH, Gill HS, Eisenberg DS, Taneja B, Mande S, Pohl E, Lamzin V, Tucker P, Wilmanns M, Colovos C, Meyer-Klaucke W, Munro AW, McLean KJ, Marshall KR, Leys D, Yang JK, Yoon HJ, Lee BI, Lee MG, Kwak JE, Han BW, Lee JY, Baek SH, Suh SW, Komen MM, Arcus VL, Baker EN, Lott JS, Jacobs W, Alber T, Rupp B. The TB structural genomics consortium: a resource for Mycobacterium tuberculosis biology. Tuberculosis (Edinb) 2004; 83:223-49. [PMID: 12906835 DOI: 10.1016/s1472-9792(03)00051-9] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.9] [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: 01/13/2023]
Abstract
The TB Structural Genomics Consortium is an organization devoted to encouraging, coordinating, and facilitating the determination and analysis of structures of proteins from Mycobacterium tuberculosis. The Consortium members hope to work together with other M. tuberculosis researchers to identify M. tuberculosis proteins for which structural information could provide important biological information, to analyze and interpret structures of M. tuberculosis proteins, and to work collaboratively to test ideas about M. tuberculosis protein function that are suggested by structure or related to structural information. This review describes the TB Structural Genomics Consortium and some of the proteins for which the Consortium is in the progress of determining three-dimensional structures.
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Affiliation(s)
- T C Terwilliger
- Los Alamos National Laboratory, Bioscience Division, Mail Stop M888, Los Alamos, NM 87545, USA.
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Neri M, Milano A, Laterza F, Di Bonaventura G, Piccolomini R, Caldarella MP, Balatsinou C, Lapenna D, Cuccurullo F. Role of antibiotic sensitivity testing before first-line Helicobacter pylori eradication treatments. Aliment Pharmacol Ther 2003; 18:821-7. [PMID: 14535876 DOI: 10.1046/j.1365-2036.2003.01757.x] [Citation(s) in RCA: 23] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND The resistance of Helicobacter pylori to antibiotics has been advocated as a major cause of treatment failure, and antimicrobial sensitivity testing has been proposed to improve efficacy; however, its role before first-line therapy has not been investigated in detail. AIM To assess whether antimicrobial sensitivity testing improves the eradication rate of first-line anti-Helicobacter treatments and to compare the effectiveness of ranitidine bismuth citrate and omeprazole in the presence of H. pylori resistance to antibiotics. METHODS Two hundred and forty-two patients were assigned to either empirical or antimicrobial sensitivity testing-based treatment; within each group, subjects were further randomized to receive ranitidine bismuth citrate, 400 mg b.d., tinidazole, 500 mg b.d., and clarithromycin, 500 mg b.d., or omeprazole, 20 mg b.d., clarithromycin, 500 mg b.d., and amoxicillin, 1 g b.d., for 1 week, with substitution of the resistant antibiotic in the antimicrobial sensitivity testing-based treatment group. RESULTS Eradication rates were 67% [confidence interval (CI), 55-79%] in the empirical treatment group and 76% (CI, 65-87%) in the antimicrobial sensitivity testing-based group (P=N.S.). The overall success rate was 60% (CI, 51-69%) with omeprazole and 82% (CI, 73-91%) with ranitidine bismuth citrate (P<0.03); the latter overcame antibiotic resistance in 12 of 15 strains vs. zero of eight strains by omeprazole. CONCLUSIONS Antimicrobial sensitivity testing before first-line treatment does not improve the eradication rate, which is greater when ranitidine bismuth citrate is included in the treatment.
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Affiliation(s)
- M Neri
- Department of Medicine and Ageing Sciences, Section of Internal Medicine and Gastroenterology, Centre of Excellence on Ageing, Università Gabriele D'Annunzio, Chieti, Italy.
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35
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Carlomagno C, Lauria R, De Laurentiis M, Arpino G, Massarelli E, Ferrara C, Milano A, Vernaglia Lombardi A, Costanzo R, Catalano G, Bianco AR, De Placido S. Second-line chemotherapy with a hybrid-alternating regimen of bolus 5FU modulated by methotrexate and infusional 5FU modulated by folinic acid in patients with metastatic colorectal cancer pretreated with 5FU. A phase 2 study. Oncology 2002; 63:219-25. [PMID: 12381900 DOI: 10.1159/000065468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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: 11/19/2022]
Abstract
BACKGROUND AND AIM In vitro, methotrexate (MTX) is the best modulator for bolus 5-fluorouracil (5FU), whereas folinic acid (FA) is the best for continuous infusion. We evaluated the effect of 5FU modulated by both MTX (bolus administration) and FA (continuous infusion) as second-line treatment of patients with metastatic colorectal cancer. PATIENTS AND METHODS Entry criteria were: at least one 5FU-based chemotherapy regimen as first-line treatment for metastatic disease, or progression within twelve months after 5FU-containing adjuvant therapy. Treatment schedule: MTX 200 mg/m2 i.v. days 1 and 15; 5FU 600 mg/m2 i.v. bolus, days 2 and 16; 5FU 200 mg/m2 i.v. continuous infusion for 21 days, starting on day 29; FA 20 mg/m2 i.v. bolus weekly during the three weeks of 5FU infusion. Cycles were repeated every 56 days. The primary end-point was tumour control rate, including partial responses and stabilizations. RESULTS 34/35 patients enrolled were evaluable for response. Five (14.7%) had a partial response, 13 (38.2%) disease stabilization, and 16 (47.1%) progressed; tumour control rate was 52.9%. Median TTP was 5.8 months (95% CI 4.03-7.83); 29 patients had died. Median OAS was 15.9 months (95% CI 8.8-21.9). Toxicity was mild. CONCLUSIONS The regimen constituted by 5FU modulated by MTX (bolus administration) and FA (continuous infusion) is active as second-line treatment of metastatic colorectal cancer.
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Affiliation(s)
- C Carlomagno
- Division of Medical Oncology, Department of Molecular and Clinical Endocrinology and Oncology, University of Naples Federico II, Naples, Italy
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Abstract
The DNA region upstream of katG in Mycobacterium smegmatis was cloned and sequenced. The furA gene, highly homologous to Mycobacterium tuberculosis furA, mapped in this region. The furA-katG organization appears to be conserved among several mycobacteria. The transcription pattern of furA and katG in M. smegmatis upon oxidative stress was analyzed by Northern blotting and primer extension. Although transcription of both furA and katG was induced upon oxidative stress, transcripts covering both genes could not be identified either by Northern blotting or by reverse transcriptase PCR. Specific transcripts and 5' ends were identified for furA and katG, respectively. By cloning M. smegmatis and M. tuberculosis DNA regions upstream of a reporter gene, we demonstrated the presence of two promoters, pfurA, located immediately upstream of the furA gene, and pkatG, located within the terminal part of the furA coding sequence. Transcription from pfurA was induced upon oxidative stress. A 23-bp sequence overlapping the pfurA -35 region is highly conserved among mycobacteria and streptomycetes and might be involved in controlling pfurA activity. Transcription from a cloned pkatG, lacking the upstream pfurA region, was not induced upon oxidative stress, suggesting a cis-acting regulatory role of this region.
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Affiliation(s)
- A Milano
- Dipartimento di Genetica e Microbiologia A. Buzzati Traverso, Università di Pavia, Pavia, Italy
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Bortolotti U, Milano A, D'Alfonso A, Piccin C, Mecozzi G, Magagna P, Fabbri A, Mazzucco A. Evaluation of valve-related complications in patients with Sorin Bicarbon prosthesis: a seven-year experience. J Heart Valve Dis 2001; 10:795-801. [PMID: 11767189] [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: 02/23/2023]
Abstract
BACKGROUND AND AIM OF THE STUDY The study aim was to evaluate the medium-term results of aortic valve replacement (AVR), mitral valve replacement (MVR) and double valve replacement (DVR) with the Sorin Bicarbon prosthesis. METHODS A total of 990 patients (568 men, 422 women; mean age 60+/-10 years; range: 20-86 years) was reviewed who received 1,108 Sorin Bicarbon prostheses between 1992 and 1998 at three institutions. AVR was performed in 541 patients (55%), MVR in 330 (33%) and DVR in 119 (12%). Concomitant procedures, mainly coronary artery grafting, were performed in 222 patients (22%). Follow up was 98% complete; total cumulative follow up was 3,091 patient-years. RESULTS Hospital mortality was 3.7% (n = 37). There were 49 late deaths; actuarial survival at seven years was 88+/-2% after AVR, 86+/-5% after MVR, and 78+/-8% after DVR. At last follow up, 915 survivors were in NYHA functional class I or II. At seven years, actuarial freedom from valve-related deaths, valve thrombosis, embolism and bleeding respectively was 96+/-1%, 99+/-1%, 93+/-2% and 91+/-3% after AVR; 97+/-2%, 97+/-3%, 90+/-3% and 86+/-7% after MVR; and 92+/-6%, 98+/-1%, 64+/-2% and 82+/-2% after DVR. Reoperation was required in 20 patients (due to valve thrombosis in six, endocarditis in five and periprosthetic leak in nine). At seven years, actuarial freedom from reoperation was 97+/-1%, 96+/-2% and 84+/-9% after AVR, MVR and DVR, respectively; actuarial freedom from endocarditis was 99+/-1%, 99+/-1% and 95+/-5%. Nine patients experienced a nonstructural valve dysfunction (all periprosthetic leak), while no cases of structural failure were observed. CONCLUSION The Sorin Bicarbon prosthesis has shown good medium-term results with regard to clinical improvement, and low incidence of valve-related complications. Thus, it appears to be a reliable valve substitute when the use of a mechanical prosthesis is indicated.
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Affiliation(s)
- U Bortolotti
- Division of Cardiac Surgery, Cardiac and Thoracic Department, University of Pisa, Italy
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38
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Abstract
We report a patient who presented with paraprosthetic leak complicated by dissection of the interatrial septum after mitral valve replacement. A review of the literature provides confirmation that only 3 cases have been previously reported of this potential, albeit extremely rare, complication of prosthetic mitral valve replacement. Prosthesis oversizing and improper mitral annular handling appeared to be the predisposing factors of this complication.
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Affiliation(s)
- O Di Gregorio
- Cardiac and Thoracic Department, University of Pisa Medical School, Italy
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39
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Milano A, De Carlo M, Gigoni R, Bortolotti U. Acute type-B aortic dissection in association with isthmic coarctation. Tex Heart Inst J 2001; 28:152-3. [PMID: 11453131 PMCID: PMC101159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- A Milano
- Cardiac and Thoracic Department, University of Pisa Medical School, Italy
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40
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Mariconda M, Lotti G, Ammendolia A, Milano A. Synovial cyst in a posterior lumbar joint associated with sacralization at L5. Description of a case. Chir Organi Mov 2001; 86:65-8. [PMID: 12025105] [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: 02/25/2023]
Abstract
Synovial cysts may occasionally be localized in the facet joints of the lumbar spine. These lesions are usually secondary to interapophyseal arthritis or trauma, that may cause hypermobility of the facet joints. Given the frequent association with arthrosis, synovial cysts are more often observed at L4-L5, which represents the level of greater mobility in the lumbar spine, in subjects aged over 50 years. A rare case of synovial cyst of the posterior joint of L5-S1 associated with sacralization of L5, a congenital anomaly that determines considerable segmental mechanical stability, is described.
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Affiliation(s)
- M Mariconda
- Cattedra di Ortopedia e Traumatologia, Università degli Studi Magna Graecio, Catanzaro
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Abstract
The effect of different bowel preparations on residual fluid during computed tomographic (CT) colonography was evaluated. Forty-two patients received either a polyethylene glycol electrolyte solution preparation or a phospho-soda preparation the day prior to CT colonography. The amount of residual fluid was calculated for each patient. On average, a phospho-soda preparation provided significantly less residual fluid than a polyethylene glycol electrolyte solution preparation.
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Affiliation(s)
- M Macari
- Department of Radiology, Division of Abdominal Imaging, New York University Medical Center, Tisch Hospital, New York, NY 10016, USA.
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D'Alfonso A, Scioti G, Milano A, Bortolotti U. Images in cardiovascular medicine. Combined aortic and pulmonary stenosis in a 79-year-old man. Ital Heart J 2000; 1:848. [PMID: 11152418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- A D'Alfonso
- Cardio Thoracic Department, University of Pisa Medical School, Italy
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Macari M, Milano A, Lavelle M, Berman P, Megibow AJ. Comparison of time-efficient CT colonography with two- and three-dimensional colonic evaluation for detecting colorectal polyps. AJR Am J Roentgenol 2000; 174:1543-9. [PMID: 10845478 DOI: 10.2214/ajr.174.6.1741543] [Citation(s) in RCA: 147] [Impact Index Per Article: 6.1] [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: 01/11/2023]
Abstract
OBJECTIVE We compared the findings of time-efficient CT colonography with complete two-dimensional (2D) and three-dimensional (3D) CT colonography and conventional colonoscopy in detecting colorectal polyps. SUBJECTS AND METHODS Forty-two patients undergoing colonoscopy screening were examined with CT colonography before endoscopy. Data were examined following one of two methods. In method 1, axial 2D data sets were examined in a cine mode. If findings were suggestive of abnormality, focal areas were examined with 3D CT colonography. In method 2, data sets were examined exactly as in method 1, and subsequent to that review, data sets were examined with simultaneous 3D "fly-through" CT colonography (surface-rendered images) and multiplanar reformatted images. The time required to examine CT colonography using each technique was recorded and abnormal findings were documented. Results of methods 1 and 2 were compared with findings on colonoscopy. RESULTS Colonoscopy detected 16 polyps in 13 patients (polyp size, 2-10 mm). Ten polyps measured 5 mm or less, five measured between 6 and 9 mm, and one measured 10 mm or more. Using method 1, two of 10 polyps measuring less than 5 mm, three of five polyps measuring between 6 and 9 mm, and one polyp measuring 10 mm were detected. We noted no false-positive polyps. Average evaluation time was 16 min. With method 2, the same polyps were seen as with method 1. No additional polyps were detected, and the average evaluation time was 40 min. CONCLUSION Axial 2D CT colonography can be performed quickly and is comparable with complete 2D and 3D CT colonography in detecting colorectal polyps.
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Affiliation(s)
- M Macari
- Department of Radiology, New York University Medical Center, NY 10016, USA
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Milano A, Codecasa R, De Carlo M, Nardi C, Tartarini G, Verunelli F, Bortolotti U. Mitral valve annuloplasty for degenerative disease: assessment of four different techniques. J Heart Valve Dis 2000; 9:321-6. [PMID: 10888085] [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
BACKGROUND AND AIM OF THE STUDY Mitral valve repair (MVR) is the treatment of choice in patients with degenerative valve disease. However, controversy persists as to whether mitral valve annuloplasty should always be included as part of the reconstructive procedure. METHODS The records of 62 consecutive patients undergoing MVR for degenerative disease between January 1994 and December 1996 were reviewed. Four different annuloplasty techniques were associated with various MVR procedures: local posterior annuloplasty (group 1, n = 10), rigid Carpentier ring (group 2, n = 20), Duran ring (group 3, n = 17), and posterior annular plication with autologous pericardium (group 4, n = 15). The four patient groups were similar in terms of preoperative clinical and echocardiographic characteristics. Serial clinical and echocardiographic follow up was performed to assess functional status and stability of repair. RESULTS There were no early or late deaths. Mean follow up in the entire patient series was 31 +/- 12 months. One patient in group 2 required reoperation 14 months after MVR. In all groups there was a significant improvement in NYHA functional class (from 2.7 +/- 0.6 to 0.9 +/- 0.5, p <0.001), with a reduction of left ventricular end-diastolic and end-systolic volumes (154 +/- 50 ml to 105 +/- 33 ml, p <0.001; and 64 +/- 23 ml to 52 +/- 22 ml, p <0.001). In patients of groups 2, 3 and 4, residual mitral incompetence at follow up (0.8 +/- 0.9 in group 2, 0.8 +/- 0.7 in group 3, and 0.2 +/- 0.6 in group 4) was not significantly different from discharge. However, in group 1, a higher degree of residual mitral regurgitation was present at discharge (0.9 +/- 0.6) with a trend to progress at follow up (1.6 +/- 0.5). CONCLUSION In patients with degenerative mitral valve disease, MVR provides clinical and functional improvement. Techniques of stabilization of the entire posterior mitral annulus achieve better early and medium-term results, and should be always considered as part of MVR. Autologous pericardium appears to be an excellent annuloplasty material, though its apparent superiority over synthetic rings must be confirmed at longer follow up.
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Affiliation(s)
- A Milano
- Cardio Thoracic Department, University of Pisa Medical School, Italy
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Codecasa R, Scioti G, Baglini R, Pratali S, Milano A, Bortolotti U. Concomitant aortic valve replacement and surgical angioplasty of left main coronary ostium. Thorac Cardiovasc Surg 2000; 48:105-7. [PMID: 11028714 DOI: 10.1055/s-2000-9936] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The association of calcific aortic valve disease and isolated coronary ostial stenosis is rare. A 80-year-old woman was found to have severe aortic stenosis with critical narrowing of the ostium of the left main coronary artery. She was successfully managed by simultaneous aortic valve replacement and patch angioplasty of the left main coronary artery, using a patch of autologous pericardium fixed in glutaraldehyde. Angiographic control at 1 month coupled with intravascular echographic imaging showed adequate relief of the ostial stenosis and patency of the left main trunk.
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Affiliation(s)
- R Codecasa
- Division of Cardiac Surgery, University of Pisa Medical School, Italy
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Affiliation(s)
- C Nardi
- Division of Cardiology, Cardiac and Thoracic Department, University of Pisa Medical School, Pisa, Italy
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Pratali S, Milano A, Codecasa R, De Carlo M, Borzoni G, Bortolotti U. Improving hemostasis during replacement of the ascending aorta and aortic valve with a composite graft. Tex Heart Inst J 2000; 27:246-9. [PMID: 11093407 PMCID: PMC101074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The use of a composite graft is an established treatment for patients with aortic valve disease and ascending aortic aneurysms. Since bleeding from suture lines is a potential complication of this procedure, we modified the technique and evaluated the effect on hemostasis. From January 1994 through December 1998, 35 patients underwent composite aortic graft replacement for chronic aortic disease. In the first 16 patients (Group 1), we used the standard open technique, with excision of the aortic aneurysm and anastomosis of aortic buttons containing the coronary ostia to the vascular graft. In the next 19 patients (Group 2), we modified the technique by placing an additional suture at the proximal graft anastomosis and harvesting large coronary buttons that were then attached to the graft by an "endo-button" buttress method. There were no operative deaths; the actuarial survival rate at 36 months was 92% +/- 5%. Between groups 1 and 2, a significant difference was found in postoperative bleeding (1,052 + 433 mL vs 806 +/- 257 mL, respectively; p = 0.02) and in number of blood transfusions required (2.1 +/- 2.0 units vs 0.4 +/- 0.7 units, respectively; p = 0.002). Multivariate analysis showed that the surgical technique used in Group 1 was the only independent risk factor for postoperative bleeding of 1,000 mL or more (p = 0.01) and for transfusion requirements of 3 or more units of blood (p = 0.004). Composite aortic valve and root replacement can be accomplished with excellent results. Technical modifications may reduce bleeding complications and related morbidity significantly
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Affiliation(s)
- S Pratali
- Division of Cardiac Surgery, University of Pisa Medical School, Italy
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Abstract
BACKGROUND Aortic valve replacement in elderly patients with a small aortic annulus may pose difficult problems in terms of prosthesis selection. We have evaluated the hemodynamic performance of the 21-mm Carpentier-Edwards Perimount bioprosthesis implanted in elderly patients. METHODS From July 1996 to June 1998, 19 patients (17 women and 2 men, mean age 76+/-4 years and mean body surface area 1.73+/-0.13 m2), had aortic valve replacement with a 21-mm Carpentier-Edwards Perimount bioprosthesis. The hemodynamic performance of the valve was evaluated in 16 patients, who completed at least a 6-month follow-up interval, with transthoracic color-Doppler echocardiography with particular reference to peak and mean transprosthetic gradients, effective orifice area index, and regression of left ventricular mass index. RESULTS There were no late deaths and no major postoperative complications. At a mean follow-up of 12+/-7 months, compared to discharge, all patients showed clinical improvement with a significant reduction of peak gradient (from 23+/-4 to 21+/-6 mm Hg, p = 0.04) and left ventricular mass index (from 181+/-23 to 153+/-20 g/m2; p<0.001), whereas mean gradient (from 13+/-3 to 13+/-4 mm Hg, p = not significant) and effective orifice area index (from 1.12+/-0.34 to 1.13+/-0.28 cm2/m2, p = not significant) remained substantially unchanged. CONCLUSIONS The use of a 21-mm Carpentier-Edwards Perimount bioprosthesis is associated with low transprosthetic gradients and significant reduction in left ventricular hypertrophy after aortic valve replacement. The results of our study suggest that a 21-m Carpentier-Edwards Perimount bioprosthesis should be considered a valid option in elderly patients with aortic valve disease and a small aortic annulus.
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Affiliation(s)
- U Bortolotti
- Department of Cardiology, Angiology and Pneumology, University of Pisa Medical School, Italy.
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Bortolotti U, Milano A, Pratali S, De Carlo M. Simultaneous coronary artery bypass grafting and transmyocardial laser revascularization through a small left thoracotomy. Thorac Cardiovasc Surg 1999; 47:389-90. [PMID: 10670798 DOI: 10.1055/s-2007-1013180] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We report a patient in whom coronary artery bypass grafting with the left internal mammary artery to the left anterior descending coronary artery and laser transmyocardial revascularization were simultaneously performed through a left small thoracotomy. The patient recovered uneventfully and 9 months following surgery he is free of angina and has increased effort tolerance. This case underlines the feasibility of combining these two minimally invasive procedures through the same approach in selected patients.
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Affiliation(s)
- U Bortolotti
- Department of Cardiology, Angiology and Pneumology, University of Pisa Medical School, Italy
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Abstract
BACKGROUND The Edwards Prima stentless valve (EPSV) is a porcine aortic root cylinder with resected coronary ostia, fixed in glutaraldehyde at low pressure. The purpose of this study was to evaluate the hemodynamic performance of the EPSV 1 year after aortic valve replacement. METHODS From December 1994 to February 1996, 29 patients underwent aortic valve replacement with EPSV used in the subcoronary position (group 1, n = 23) or as a root replacement (group 2, n = 6). Hemodynamic performance of EPSV was assessed by two-dimensional Doppler echocardiography at 1 week, 6 months, and 1 year by calculating peak transprosthetic velocity, peak and mean gradients, effective orifice area, degree of aortic regurgitation, and regression of left ventricular hypertrophy. RESULTS There were no operative deaths. One patient in group 2 died after 3 months at reoperation for endocarditis. In group 1 early mean gradient (25+/-5 mm Hg for 23 mm and 19+/-5 mm Hg for 25 mm) decreased at 6 months and 1 year in the 23-mm size (17+/-7 mm Hg and 15+/-4 mm Hg, p < 0.01) and at 1 year in the 25-mm size (14+/-4 mm Hg, p = 0.03) without modifications of the effective orifice area in both sizes. A significant reduction in left ventricular hypertrophy occurred at 6 months and 1 year in both sizes. In group 2 lower early gradients were recorded with subsequent improvement at follow-up; reduction in left ventricular hypertrophy occurred as well. CONCLUSIONS The EPSV used in the subcoronary position has shown high early gradients, which partially regressed at 6 months, with further improvement at 1 year. Gradients are attributed to inward folding of the Dacron cloth at the right coronary ostium, being more evident in patients with aortic stenosis without dilatation of the aortic root and coronary ostia close to the annulus. In such patients a better early hemodynamic result can be obtained by using the EPSV as a root replacement.
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Affiliation(s)
- U Bortolotti
- Department of Cardiology, Angiology and Pneumology, University of Pisa Medical School, Italy.
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