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Reese PP, Diamond JM, Goldberg DS, Potluri V, Prenner S, Blumberg EA, Van Deerlin VM, Reddy KR, Mentch H, Hasz R, Woodards A, Gentile C, Smith J, Bermudez C, Crespo MM. The SHELTER Trial of Transplanting Hepatitis C Virus-Infected Lungs Into Uninfected Recipients. Transplant Direct 2023; 9:e1504. [PMID: 37389016 PMCID: PMC10306429 DOI: 10.1097/txd.0000000000001504] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/11/2023] [Accepted: 05/05/2023] [Indexed: 07/01/2023] Open
Abstract
SHELTER is a trial of transplanting lungs from deceased donors with hepatitis C virus (HCV) infection into HCV-negative candidates (sponsor: Merck; NCT03724149). Few trials have reported outcomes using thoracic organs from HCV-RNA+ donors and none have reported quality of life (QOL). Methods This study is a single-arm trial of 10 lung transplants at a single center. Patients were included who were between 18 and 67 y of age and waitlisted for lung-only transplant. Patients were excluded who had evidence of liver disease. Primary outcome was HCV cure (sustained virologic response 12 wk after completing antiviral therapy). Recipients longitudinally reported QOL using the validated RAND-36 instrument. We also applied advanced methods to match HCV-RNA+ lung recipients to HCV-negative lung recipients in a 1:3 ratio at the same center. Results Between November 2018 and November 2020, 18 patients were consented and opted-in for HCV-RNA+ lung offers in the allocation system. After a median of 37 d (interquartile range [IQR], 6-373) from opt-in, 10 participants received double lung transplants. The median recipient age was 57 y (IQR, 44-67), and 7 recipients (70%) had chronic obstructive pulmonary disease. The median lung allocation score at transplant was 34.3 (IQR, 32.7-86.9). Posttransplant, 5 recipients developed primary graft dysfunction grade 3 on day 2 or 3, although none required extracorporeal membrane oxygenation. Nine patients received elbasvir/grazoprevir, whereas 1 patient received sofosbuvir/velpatasvir. All 10 patients were cured of HCV and survived to 1 y (versus 83% 1-y survival among matched comparators). No serious adverse events were found to be related to HCV or treatment. RAND-36 scores showed substantial improvement in physical QOL and some improvement in mental QOL. We also examined forced expiratory volume in 1 s-the most important lung function parameter after transplantation. We detected no clinically important differences in forced expiratory volume in 1 s between the HCV-RNA+ lung recipients versus matched comparators. Conclusions SHELTER adds important evidence regarding the safety of transplanting HCV-RNA+ lungs into uninfected recipients and suggests QOL benefits.
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Affiliation(s)
- Peter P. Reese
- Renal-Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Biostatistics, Epidemiology and Bioinformatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Joshua M. Diamond
- Division of Pulmonary Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - David S. Goldberg
- Division of Digestive Health and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL
| | - Vishnu Potluri
- Renal-Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Biostatistics, Epidemiology and Bioinformatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Stacey Prenner
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Emily A. Blumberg
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Vivianna M. Van Deerlin
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - K. Rajender Reddy
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Heather Mentch
- Renal-Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | | | - Caren Gentile
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jennifer Smith
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Christian Bermudez
- Division of Cardiothoracic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Maria M. Crespo
- Division of Pulmonary Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Apponi A, Betti M, Borghesi M, Boyarsky A, Canci N, Cavoto G, Chang C, Cheianov V, Cheipesh Y, Chung W, Cocco A, Colijn A, D’Ambrosio N, de Groot N, Esposito A, Faverzani M, Ferella A, Ferri E, Ficcadenti L, Frederico T, Gariazzo S, Gatti F, Gentile C, Giachero A, Hochberg Y, Kahn Y, Lisanti M, Mangano G, Marcucci L, Mariani C, Marques M, Menichetti G, Messina M, Mikulenko O, Monticone E, Nucciotti A, Orlandi D, Pandolfi F, Parlati S, Pepe C, Pérez de los Heros C, Pisanti O, Polini M, Polosa A, Puiu A, Rago I, Raitses Y, Rajteri M, Rossi N, Rozwadowska K, Rucandio I, Ruocco A, Strid C, Tan A, Teles L, Tozzini V, Tully C, Viviani M, Zeitler U, Zhao F. Heisenberg’s uncertainty principle in the PTOLEMY project: A theory update. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.106.053002] [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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Attaway C, El-Sharkawy Navarro F, Richard-Greenblatt M, Herlihy S, Gentile C, Glaser L, Morris B, Abella B, Collman R. Comparison of Saliva and Nasopharyngeal Swabs for SARS-CoV-2 Detection in an Emergency Department and Ambulatory Testing Locations. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.269] [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: 11/13/2022] Open
Abstract
Abstract
Introduction/Objective
Nasopharyngeal (NP) swabs have been the traditional specimen source used for testing for respiratory viruses. However, at the start of the COVID-19 pandemic, several studies suggested that saliva could also be used as a specimen source for testing for SARS-CoV-2. Despite potential benefits, there was limited data on the characteristics of this specimen type and few commercial assays with FDA emergency use authorization allowed saliva as a specimen source. In order to explore the feasibility and validate using saliva as a specimen source for ambulatory and emergency department patients we designed a study to compare saliva to NP swabs for SARS-CoV-2 testing.
Methods/Case Report
Specimens were collected in the emergency department and ambulatory testing sites between May 6, 2020-July 7, 2020. Nasopharyngeal swabs were collected as part of routine clinical practice and patients were given written instructions to self-collect 1mL of saliva into a sterile specimen cup with or without a straw. SARS-CoV-2 testing was performed in parallel with both specimen types using the TaqPath COVID-19 Combo Kit (Thermo Fisher Waltham, MA). Saliva was diluted 1:1 in saline prior to testing. Specimens were transported to the lab at 4C and frozen at -80C prior to testing.
Results (if a Case Study enter NA)
Seventy-four patients had both an NP swab and saliva tested in this study. Thirty of the 74 patients (41%) were unable to produce the full 1mL of saliva requested, but all samples had sufficient volume for testing after dilution. There were 34 positive samples obtained with an 82% positive agreement between the NP swabs and saliva. In 6 cases, the NP swab was positive, and the paired saliva was negative. In 1 case, only the saliva was positive. The average Ct of the positive NP swabs with a paired negative saliva sample was 39.6. There was only a single invalid test for one of the saliva samples.
Conclusion
Saliva was a straightforward sample to collect and test for SARS-CoV-2. Challenges included obtaining sufficient sample and a less predictable matrix that required dilution to ensure proper pipeting. In this study, NP swabs were more sensitive for detection of SARS-CoV-2. Paired saliva was more often negative in patients shedding small amounts of SARS-CoV-2 based on a high Ct of the positive NP sample.
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Affiliation(s)
- C Attaway
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, UNITED STATES
| | - F El-Sharkawy Navarro
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, UNITED STATES
| | - M Richard-Greenblatt
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, UNITED STATES
| | - S Herlihy
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, UNITED STATES
| | - C Gentile
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, UNITED STATES
| | - L Glaser
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, UNITED STATES
| | - B Morris
- Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, UNITED STATES
| | - B Abella
- Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, UNITED STATES
| | - R Collman
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine and Division of of Pulmonary, Allergy and Critical Care Medicine,University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, UNITED STATES
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Till JE, Black TA, Gentile C, Abdalla A, Wang Z, Sangha HK, Roth JJ, Sussman R, Yee SS, O'Hara MH, Thompson JC, Aggarwal C, Hwang WT, Elenitoba-Johnson KSJ, Carpenter EL. Optimization of Sources of Circulating Cell-Free DNA Variability for Downstream Molecular Analysis. J Mol Diagn 2021; 23:1545-1552. [PMID: 34454115 DOI: 10.1016/j.jmoldx.2021.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 06/10/2021] [Accepted: 08/09/2021] [Indexed: 02/08/2023] Open
Abstract
Circulating cell-free DNA (ccfDNA) is used increasingly as a cancer biomarker for prognostication, as a correlate for tumor volume, or as input for downstream molecular analysis. Determining optimal blood processing and ccfDNA quantification are crucial for ccfDNA to serve as an accurate biomarker as it moves into the clinical realm. Whole blood was collected from 50 subjects, processed to plasma, and used immediately or frozen at -80°C. Plasma ccfDNA was extracted and concentration was assessed by real-time quantitative PCR (qPCR), fluorimetry, and droplet digital PCR (ddPCR). For the 24 plasma samples from metastatic pancreatic cancer patients, the variant allele fractions (VAF) of KRAS G12/13 pathogenic variants in circulating tumor DNA (ctDNA) were measured by ddPCR. Using a high-speed (16,000 × g) or slower-speed (4100 × g) second centrifugation step showed no difference in ccfDNA yield or ctDNA VAF. A two- versus three-spin centrifugation protocol also showed no difference in ccfDNA yield or ctDNA VAF. A higher yield was observed from fresh versus frozen plasma by qPCR and fluorimetry, whereas a higher yield was observed for frozen versus fresh plasma by ddPCR, however, no difference was observed in ctDNA VAF. Overall, our findings suggest factors to consider when implementing a ccfDNA extraction and quantification workflow in a research or clinical setting.
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Affiliation(s)
- Jacob E Till
- Division of Hematology-Oncology, Department of Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Taylor A Black
- Division of Hematology-Oncology, Department of Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Caren Gentile
- Division of Precision and Computational Diagnostics, Department of Pathology and Laboratory Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Aseel Abdalla
- Division of Hematology-Oncology, Department of Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Zhuoyang Wang
- Division of Hematology-Oncology, Department of Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Hareena K Sangha
- Division of Hematology-Oncology, Department of Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jacquelyn J Roth
- Division of Precision and Computational Diagnostics, Department of Pathology and Laboratory Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robyn Sussman
- Division of Precision and Computational Diagnostics, Department of Pathology and Laboratory Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Stephanie S Yee
- Division of Hematology-Oncology, Department of Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mark H O'Hara
- Division of Hematology-Oncology, Department of Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jeffrey C Thompson
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Charu Aggarwal
- Division of Hematology-Oncology, Department of Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Wei-Ting Hwang
- Department of Biostatistics, Epidemiology and Informatics, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kojo S J Elenitoba-Johnson
- Division of Precision and Computational Diagnostics, Department of Pathology and Laboratory Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Erica L Carpenter
- Division of Hematology-Oncology, Department of Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
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Petriglia C, Vaiarelli A, Cimadomo D, Gentile C, Fiorini F, Sansone A, Uher P, Masip MA, Chelo E, Pellegrini S, Ubaldi N, Gennarelli G, Revelli A, Brodin T, Ubaldi FM. P–304 The endometrial preparation protocol does not affect the live-birth-rate after vitrified-warmed euploid single blastocyst transfers: an analysis of 1884 procedures. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.303] [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: 11/14/2022] Open
Abstract
Abstract
Study question
Is the live-birth-rate (LBR) different when comparing artificial (AC) and modified-natural (M-NC) cycle for endometrial preparation to vitrified-warmed euploid blastocyst transfer?
Summary answer
The LBR after vitrified-warmed euploid blastocyst transfer seem independent of the endometrial preparation administered.
What is known already
Only the transfer of a competent embryo on a receptive endometrium might result in successful implantation. Three main protocols for endometrial preparation to vitrified-warmed embryo transfer exist: NC, M-NC, and AC. None among them, though, has been shown more appropriate than the others to date, especially since, only in a few studies, the analysis was restricted to single euploid blastocyst transfers to limit the impact of embryonic issues on implantation. In conclusion, no clear consensus exists and the choice is still largely based on menstrual/ovarian cycle characteristics and patient’s needs.
Study design, size, duration
All first vitrified-warmed single euploid blastocyst transfers performed between April–2013 and March–2020 were included in the analysis. Endometrial preparation was conducted with either an AC (N = 1211) or a M-NC (N = 673). The protocol was chosen based on patients’ logistical reasons. The primary outcome was the LBR per transfer. Sub-analyses based on blastocyst quality and day of development were conducted. Birthweight, gestational age, gestational and perinatal issues were secondary outcomes.
Participants/materials, setting, methods
AC: oral estradiol-valerate 3-times/day from day2–3 of the cycle until the endometrial thickness reached ≥7mm, then 600 mg/day of micronized progesterone. The transfer was conducted on day6 of progesterone administration. M-NC: an intramuscular dose of 10,000IU hCG was administrated when the leading follicle was >17 mm and the endometrium was thicker than 7mm and trilaminar, plus 400 mg/day of micronized-progesterone as luteal phase support starting 36–40hr post-hCG. The transfer was conducted on day7 after trigger.
Main results and the role of chance
The two groups were similar for maternal age at retrieval (38.0±3.3yr) and transfer (38.3±3.3yr), reproductive history, embryological outcomes of the IVF cycle, body-mass-index, basal hormonal levels, and blastocyst features (Gardner’s classification: AA = 73%, AB/BA=11%, BB/AC/CA=8%, CC/BC/CB=8%; day5=48%, day6=47%, day7=5%). The LBR was 46.7% (N = 565/1211) and 49.9% (N = 336/673) after AC and M-NC, respectively, resulting in an odds-ratio 1.14, 95%CI:0.94–1.37. The absence of significant differences was confirmed also when adjusted for blastocyst quality and day of full-development (1.16, 95%CI:0.96–1.41). Among the 565 and 336 deliveries, the birthweight was similar (3290.3±470.7 versus 3251.7±521.5 g, Mann-Whitney-U-test=0.5), the gestational age was similar (38.5±1.7 versus 38.4±1.9 weeks, Mann-Whitney-U-test=0.5). Also, the rates of newborns who were normal (81% versus 82%), large (8% versus 9%), and small (11% versus 9%) for gestational age were similar (Chi-squared-test=0.5). The rates of patients experiencing gestational (6% versus 7%) and/or perinatal issues (3% versus 3%) were also similar (Fisher’s-exact-tests=0.4).
Limitations, reasons for caution
This is a retrospective study conducted in poor prognosis patients indicated to preimplantation genetic testing for aneuploidies. Future randomized controlled trials and cost-effectiveness analysis are desirable, as well as studies in different patient populations. Lastly, each gestational/perinatal issue shall be analyzed per se (e.g. different placentation disorders).
Wider implications of the findings: The absence of clinical and perinatal differences between the two protocols for endometrial preparation supports the adoption, whenever needed, of AC. This approach, in fact, allows a higher flexibility in patients’ and daily workload management.
Trial registration number
None
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Affiliation(s)
- C Petriglia
- Clinica Valle GIulia, GeneraLife IVF, Rome, Italy
| | - A Vaiarelli
- Clinica Valle GIulia, GeneraLife IVF, Rome, Italy
| | - D Cimadomo
- Clinica Valle GIulia, GeneraLife IVF, Rome, Italy
| | - C Gentile
- Genera Veneto, GeneraLife IVF, Marostica, Italy
| | - F Fiorini
- Genera Umbria, GeneraLife IVF, Umbertide, Italy
| | - A Sansone
- Clinica Ruesch, GeneraLife IVF, Naples, Italy
| | - P Uher
- FertiCare, GeneraLife IVF, Karlovy Vary, Czech Republic
| | | | - E Chelo
- Demetra, GeneraLife IVF, Florence, Italy
| | | | - N Ubaldi
- Catholic University of the Sacred Heart, Department of Obstetrics and Gynecology, Rome, Italy
| | | | | | - T Brodin
- Carl von Linnèkliniken, GeneraLife IVF, Uppsala, Sweden
| | - F M Ubaldi
- Clinica Valle GIulia, GeneraLife IVF, Rome, Italy
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Farello G, Iapadre G, Lizzi M, Gentile C, Altobelli E, Ciocca F, Verrotti A. Carotid intima media-thickness is increased in obese children metabolically healthy, metabolically unhealthy, and with metabolic syndrome, compared to the non-obese controls. Eur Rev Med Pharmacol Sci 2021; 25:241-249. [PMID: 33506913 DOI: 10.26355/eurrev_202101_24390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The prevalence of obesity continues to increase. Obesity is associated with cardiovascular risk factors: elevated blood pressure, dyslipidemia and glycemic alterations, causing metabolic syndrome. A subgroup of obese, Metabolically Healthy Obese (MHO), appears to be less prone to the development of metabolic disturbances. Carotid intima-media thickness (cIMT) is a non-invasive marker of subclinical atherosclerosis and it is associated with increased risk of CVD events. To investigate the cardiovascular risk, demonstrated through the increase of cIMT in obese subjects without Metabolic Syndrome (MetS), we have studied cIMT in MHO, metabolically unhealthy obese (MUO) and obese with MetS diagnosed with the IDEFICS criteria and compared to a control group. 224 obese children aged 6 to 21 years (13,50 ± 4.01 years) and 103 normal weight subjects aged 7 to 19 years (13.2 ± 4.1 years) were studied. The body mass index (BMI) of the obese children was ≥ the 95th percentile. Based on the IDEFICS criteria, we divided the obese subjects in three groups: MHO if no criteria were out of range, MUO if, at least, one of the criteria was out of range and MetS group if all the IDEFICS criteria were present. In all the subjects cIMT was measured with color Doppler by a vascular surgeon. Differences in the means of the variables were tested by ANOVA. Based on the IDEFICS criteria, 32 subjects were affected by MetS (14..3%), 66 were considered MUO (29.4%) and 126 MHO (56.3%). Comparison of mean cIMT highlighted a significant difference (p < 0.05) between the groups of obese children (MHO, MUO and MetS) and controls for both carotid arteries. We did not find significative difference in the value of cIMT in MHO, MUO and MetS subjects, and all groups showed cIMT value higher compared to cIMT of the controls.
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Affiliation(s)
- G Farello
- Department of Life, Health and Environmental Sciences - Pediatric Unit, University of L'Aquila, L'Aquila, Italy.
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Milligan JN, Larson JL, Filipovic-Sadic S, Laosinchai-Wolf W, Huang YW, Ko TM, Abbott KM, Lemmink HH, Toivonen M, Schleutker J, Gentile C, Van Deerlin VM, Zhu H, Latham GJ. Multisite Evaluation and Validation of a Sensitive Diagnostic and Screening System for Spinal Muscular Atrophy that Reports SMN1 and SMN2 Copy Number, along with Disease Modifier and Gene Duplication Variants. J Mol Diagn 2021; 23:753-764. [PMID: 33798739 DOI: 10.1016/j.jmoldx.2021.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/17/2021] [Accepted: 03/16/2021] [Indexed: 11/24/2022] Open
Abstract
Spinal muscular atrophy is a severe autosomal recessive disease caused by disruptions in the SMN1 gene. The nearly identical SMN2 gene copy number is associated with disease severity. SMN1 duplication markers, such as c.∗3+80T>G and c.∗211_∗212del, can assess residual carrier risk. An SMN2 disease modifier (c.859G>C) can help inform prognostic outcomes. The emergence of multiple precision gene therapies for spinal muscular atrophy requires accurate and rapid detection of SMN1 and SMN2 copy numbers to enable early treatment and optimal patient outcomes. We developed and evaluated a single-tube PCR/capillary electrophoresis assay system that quantifies SMN1/2 copy numbers and genotypes three additional clinically relevant variants. Analytical validation was performed with human cell lines and whole blood representing varying SMN1/2 copies on four capillary electrophoresis instrument models. In addition, four independent laboratories used the assay to test 468 residual clinical genomic DNA samples. The results were ≥98.3% concordant with consensus SMN1/2 exon 7 copy numbers, determined using multiplex ligation-dependent probe amplification and droplet digital PCR, and were 100% concordant with Sanger sequencing for the three variants. Furthermore, copy number values were 98.6% (SMN1) and 97.1% (SMN2) concordant to each laboratory's own reference results.
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Affiliation(s)
| | | | | | | | - Ya-Wen Huang
- GenePhile Bioscience Laboratory, Ko's Obstetrics and Gynecology Clinic, Taipei City, Taiwan
| | - Tsang-Ming Ko
- GenePhile Bioscience Laboratory, Ko's Obstetrics and Gynecology Clinic, Taipei City, Taiwan
| | - Kristin M Abbott
- Department of Genetics, University Medical Center Groningen, Groningen, the Netherlands
| | - Henny H Lemmink
- Department of Genetics, University Medical Center Groningen, Groningen, the Netherlands
| | - Minna Toivonen
- Department of Medical Genetics, Genomics, Laboratory Division, Turku University Hospital, Turku, Finland
| | - Johanna Schleutker
- Department of Medical Genetics, Genomics, Laboratory Division, Turku University Hospital, Turku, Finland; Institute of Biomedicine, University of Turku, Turun yliopisto, Finland
| | - Caren Gentile
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Huiping Zhu
- Research and Development, Asuragen Inc., Austin, Texas
| | - Gary J Latham
- Research and Development, Asuragen Inc., Austin, Texas
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Ruggieri S, Tagliaferri V, Taccaliti C, Gentile C, Didonna T, D'Asta M, Legge F, Guida P, Scambia G, Guido M. Comparison between Delayed Absorbable and Permanent Sutures in Laparoscopic Sacral Colpopexy: A Randomized Controlled Trial. J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.059] [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: 10/23/2022]
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Sise ME, Strohbehn IA, Chute DF, Gustafson J, Van Deerlin VM, Smith JR, Gentile C, Wojciechowski D, Williams WW, Elias N, Chung RT. Preemptive Treatment With Elbasvir and Grazoprevir for Hepatitis C-Viremic Donor to Uninfected Recipient Kidney Transplantation. Kidney Int Rep 2020; 5:459-467. [PMID: 32280841 PMCID: PMC7136432 DOI: 10.1016/j.ekir.2020.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/03/2020] [Accepted: 01/06/2020] [Indexed: 01/25/2023] Open
Abstract
Introduction Long wait times for kidney transplants have prompted investigation into strategies to decrease the discarding of potentially viable organs. Recent reports suggest that kidneys from hepatitis C virus (HCV)-infected donors may be transplanted into HCV-naive donors followed by direct-acting antiviral therapy. Methods This was a pilot clinical trial to transplant kidneys from HCV-infected donors into HCV-naive recipients with preemptive use of elbasvir and grazoprevir for 12 weeks. The primary outcome was sustained virologic response 12 weeks after completion of therapy. Secondary outcomes were safety, quality of life, and early viral kinetics. Results A total of 33 patients were screened, and 8 underwent kidney transplantation from a HCV-viremic donors from August 2017 to March 2019. The median donor kidney donor profile index was 31% (range, 29%-65%), and patients who underwent transplantation waited a median of 6.5 months (range, 1-19 months). None had detectable HCV viremia beyond 2 weeks post-transplantation, and all achieved sustained virologic response 12 weeks after therapy (SVR12). There were no study-related severe adverse events. One patient experienced early graft loss due to venous thrombosis, whereas the remaining 7 patients had excellent allograft function at 6 months. Conclusion Preemptive elbasvir and grazoprevir eliminated HCV infection in HCV-naive patients who received a kidney transplant from an HCV-infected donor.
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Affiliation(s)
- Meghan E Sise
- Department of Medicine, Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ian A Strohbehn
- Department of Medicine, Liver Center, Gastrointestinal Division, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Donald F Chute
- Department of Medicine, Liver Center, Gastrointestinal Division, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jenna Gustafson
- Department of Medicine, Liver Center, Gastrointestinal Division, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Vivianna M Van Deerlin
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Jennifer R Smith
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Caren Gentile
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - David Wojciechowski
- Division of Nephrology, University of Texas Southwestern, Dallas, Texas, USA
| | - Winfred W Williams
- Department of Medicine, Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Nahel Elias
- Department of Surgery, Division of Transplant Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Raymond T Chung
- Department of Medicine, Liver Center, Gastrointestinal Division, Massachusetts General Hospital, Boston, Massachusetts, USA
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11
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McLean RC, Reese PP, Acker M, Atluri P, Bermudez C, Goldberg LR, Abt PL, Blumberg EA, Van Deerlin VM, Reddy KR, Bloom RD, Hasz R, Suplee L, Sicilia A, Woodards A, Zahid MN, Bar KJ, Porrett P, Levine MH, Hornsby N, Gentile C, Smith J, Goldberg DS. Transplanting hepatitis C virus-infected hearts into uninfected recipients: A single-arm trial. Am J Transplant 2019; 19:2533-2542. [PMID: 30768838 DOI: 10.1111/ajt.15311] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/10/2019] [Accepted: 02/11/2019] [Indexed: 02/06/2023]
Abstract
The advent of direct-acting antiviral therapy for hepatitis C virus (HCV) has generated tremendous interest in transplanting organs from HCV-infected donors. We conducted a single-arm trial of orthotopic heart transplantation (OHT) from HCV-infected donors into uninfected recipients, followed by elbasvir/grazoprevir treatment after recipient HCV was first detected (NCT03146741; sponsor: Merck). We enrolled OHT candidates aged 40-65 years; left ventricular assist device (LVAD) support and liver disease were exclusions. We accepted hearts from HCV-genotype 1 donors. From May 16, 2017 to May 10, 2018, 20 patients consented for screening and enrolled, and 10 (median age 52.5 years; 80% male) underwent OHT. The median wait from UNOS opt-in for HCV nucleic-acid-test (NAT)+ donor offers to OHT was 39 days (interquartile range [IQR] 17-57). The median donor age was 34 years (IQR 31-37). Initial recipient HCV RNA levels ranged from 25 IU/mL to 40 million IU/mL, but all 10 patients had rapid decline in HCV NAT after elbasvir/grazoprevir treatment. Nine recipients achieved sustained virologic response at 12 weeks (SVR-12). The 10th recipient had a positive cross-match, experienced antibody-mediated rejection and multi-organ failure, and died on day 79. No serious adverse events occurred from HCV transmission or treatment. These short-term results suggest that HCV-negative candidates transplanted with HCV-infected hearts have acceptable outcomes.
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Affiliation(s)
- Rhondalyn C McLean
- Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Peter P Reese
- Renal-Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Biostatistics, Epidemiology and Bioinformatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael Acker
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Pavan Atluri
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Christian Bermudez
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lee R Goldberg
- Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Peter L Abt
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Emily A Blumberg
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Vivianna M Van Deerlin
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - K Rajender Reddy
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Roy D Bloom
- Renal-Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Richard Hasz
- Gift of Life Donor Program, Philadelphia, Pennsylvania
| | | | - Anna Sicilia
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | - Ashley Woodards
- Department of Biostatistics, Epidemiology and Bioinformatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Muhammad Nauman Zahid
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Katharine J Bar
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Paige Porrett
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Matthew H Levine
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nicole Hornsby
- Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Caren Gentile
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania
| | - Jennifer Smith
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania
| | - David S Goldberg
- Renal-Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.,Division of Gastroenterology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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12
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Porrett PM, Reese PP, Holzmayer V, Coller KE, Kuhns M, Van Deerlin VM, Gentile C, Smith JR, Sicilia A, Woodards A, McLean R, Abt P, Bloom RD, Reddy KR, Blumberg E, Cloherty G, Goldberg D. Early emergence of anti-HCV antibody implicates donor origin in recipients of an HCV-infected organ. Am J Transplant 2019; 19:2525-2532. [PMID: 31066215 DOI: 10.1111/ajt.15415] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/26/2019] [Accepted: 04/18/2019] [Indexed: 01/25/2023]
Abstract
Hepatitis C virus (HCV) seroconversion among HCV-uninfected transplant recipients from HCV-infected (NAT+/Antibody+) or HCV-exposed (NAT-/Antibody+) donors has been reported. However, the origin of anti-HCV antibody and the implications of seroconversion remain unknown. We longitudinally tested plasma from HCV-uninfected kidney (n = 31) or heart transplant recipients (n = 9) of an HCV NAT+ organ for anti-HCV antibody (both IgG and IgM isotypes). Almost half of all participants had detectable anti-HCV antibody at any point during follow-up. The majority of antibody-positive individuals became positive within 1-3 days of transplantation, and 6 recipients had detectable antibody on the first day posttransplant. Notably, all anti-HCV antibody was IgG, even in samples collected posttransplant day 1. Late seroconversion was uncommon (≈20%-25% of antibody+ recipients). Early antibody persisted over 30 days in kidney recipients, whereas early antibody dropped below detection in 50% of heart recipients within 2 weeks after transplant. Anti-HCV antibody is common in HCV-uninfected recipients of an HCV NAT+ organ. The IgG isotype of this antibody and the kinetics of its appearance and durability suggest that anti-HCV antibody is donor derived and is likely produced by a cellular source. Our data suggest that transfer of donor humoral immunity to a recipient may be much more common than previously appreciated.
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Affiliation(s)
- Paige M Porrett
- Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Peter P Reese
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | - Mary Kuhns
- Abbott Laboratories, Abbott Park, Illinois
| | - Vivianna M Van Deerlin
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Caren Gentile
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jennifer R Smith
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anna Sicilia
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ashley Woodards
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rhondalyn McLean
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Peter Abt
- Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Roy D Bloom
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - K Rajender Reddy
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Emily Blumberg
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - David Goldberg
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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13
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D'Asta M, Tagliaferri V, Romano F, Martulli B, Gentile C, Taccaliti C, Ruggieri S, Scambia G, Guido M. Laparoscopic Sacral Colpopexy versus Pelvic Organ Prolapse Suspension: A Randomized Phase II Trial for Surgical Management of Pelvic Organ Prolapse. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.751] [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: 11/30/2022]
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14
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Reese PP, Abt PL, Blumberg EA, Van Deerlin VM, Bloom RD, Potluri VS, Levine M, Porrett P, Sawinski D, Nazarian SM, Naji A, Hasz R, Suplee L, Trofe-Clark J, Sicilia A, McCauley M, Gentile C, Smith J, Niknam BA, Bleicher M, Reddy KR, Goldberg DS. Twelve-Month Outcomes After Transplant of Hepatitis C-Infected Kidneys Into Uninfected Recipients: A Single-Group Trial. Ann Intern Med 2018; 169:273-281. [PMID: 30083748 DOI: 10.7326/m18-0749] [Citation(s) in RCA: 173] [Impact Index Per Article: 28.8] [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: 11/22/2022] Open
Abstract
BACKGROUND Organs from hepatitis C virus (HCV)-infected deceased donors are often discarded. Preliminary data from 2 small trials, including THINKER-1 (Transplanting Hepatitis C kidneys Into Negative KidnEy Recipients), suggested that HCV-infected kidneys could be safely transplanted into HCV-negative patients. However, intermediate-term data on quality of life and renal function are needed to counsel patients about risk. OBJECTIVE To describe 12-month HCV treatment outcomes, estimated glomerular filtration rate (eGFR), and quality of life for the 10 kidney recipients in THINKER-1 and 6-month data on 10 additional recipients. DESIGN Open-label, nonrandomized trial. (ClinicalTrials.gov: NCT02743897). SETTING Single center. PARTICIPANTS 20 HCV-negative transplant candidates. INTERVENTION Participants underwent transplant with kidneys infected with genotype 1 HCV and received elbasvir-grazoprevir on posttransplant day 3. MEASUREMENTS The primary outcome was HCV cure. Exploratory outcomes included 1) RAND-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) quality-of-life scores at enrollment and after transplant, and 2) posttransplant renal function, which was compared in a 1:5 matched sample with recipients of HCV-negative kidneys. RESULTS The mean age of THINKER participants was 56.3 years (SD, 6.7), 70% were male, and 40% were black. All 20 participants achieved HCV cure. Hepatic and renal complications were transient or were successfully managed. Mean PCS and MCS quality-of-life scores decreased at 4 weeks; PCS scores then increased above pretransplant values, whereas MCS scores returned to baseline values. Estimated GFRs were similar between THINKER participants and matched recipients of HCV-negative kidneys at 6 months (median, 67.5 vs. 66.2 mL/min/1.73 m2; 95% CI for between-group difference, -4.2 to 7.5 mL/min/1.73 m2) and 12 months (median, 72.8 vs. 67.2 mL/min/1.73 m2; CI for between-group difference, -7.2 to 9.8 mL/min/1.73 m2). LIMITATION Small trial. CONCLUSION Twenty HCV-negative recipients of HCV-infected kidneys experienced HCV cure, good quality of life, and excellent renal function. Kidneys from HCV-infected donors may be a valuable transplant resource. PRIMARY FUNDING SOURCE Merck.
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Affiliation(s)
- Peter P Reese
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
| | - Peter L Abt
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
| | - Emily A Blumberg
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
| | - Vivianna M Van Deerlin
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
| | - Roy D Bloom
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
| | - Vishnu S Potluri
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
| | - Matthew Levine
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
| | - Paige Porrett
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
| | - Deirdre Sawinski
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
| | - Susanna M Nazarian
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
| | - Ali Naji
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
| | - Richard Hasz
- Gift of Life Donor Program, Philadelphia, Pennsylvania (R.H., L.S.)
| | - Lawrence Suplee
- Gift of Life Donor Program, Philadelphia, Pennsylvania (R.H., L.S.)
| | - Jennifer Trofe-Clark
- Perelman School of Medicine and Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (J.T.)
| | - Anna Sicilia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
| | - Maureen McCauley
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
| | - Caren Gentile
- University of Pennsylvania Health System, Philadelphia, Pennsylvania (C.G., J.S.)
| | - Jennifer Smith
- University of Pennsylvania Health System, Philadelphia, Pennsylvania (C.G., J.S.)
| | - Bijan A Niknam
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (B.A.N.)
| | - Melissa Bleicher
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
| | - K Rajender Reddy
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
| | - David S Goldberg
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (P.P.R., P.L.A., E.A.B., V.M.V., R.D.B., V.S.P., M.L., P.P., D.S., S.M.N., A.N., A.S., M.M., M.B., K.R.R., D.S.G.)
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15
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Rouil R, Garey W, Gentile C, Golmie N, Schwinghammer P. Increasing Public Safety Broadband Network Resiliency Through Traffic Control. Digit Commun Netw 2018; 4:10.1016/j.dcan.2017.09.005. [PMID: 38495632 PMCID: PMC10941297 DOI: 10.1016/j.dcan.2017.09.005] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Long Term Evolution (LTE)-based cellular networks are being deployed around the world to provide public safety with enhanced capabilities and access to broadband technology. In the United States, the First Responder Network Authority (FirstNet) is on the verge of deploying a nationwide network called the National Public Safety Broadband Network (NPSBN). Commercial networks typically aim at maximizing network capacity, i.e. the aggregate data rate, in order to increase revenue. In public safety networks, however, coverage, not capacity, is paramount, especially during an outage when sites are down. Through traffic control and preemption, the service level of low-priority users is reduced or denied, freeing up resources to restore coverage to high-priority users, e.g. users responding to an incident. In this study, we examine the effect of outages on network coverage and throughput. As our main contribution, we propose three traffic-control schemes that exploit variable modulation and coding, a feature that LTE enhances with respect to its 3G predecessors. The schemes differ based on the proportion of low- and high-priority users preempted. We show that indeed the network coverage can be restored significantly and we investigate the tradeoff between the three schemes. Finally, we perform sensitivity analysis to confirm the effectiveness of the schemes across a wide range of scenarios.
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Affiliation(s)
- R Rouil
- National Institute of Standards and Technology, USA
| | - W Garey
- National Institute of Standards and Technology, USA
| | - C Gentile
- National Institute of Standards and Technology, USA
| | - N Golmie
- National Institute of Standards and Technology, USA
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16
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Affiliation(s)
- S. Raftopoulos
- Princeton Plasma Physics Laboratory, PO Box 451, Princeton, New Jersey 08543
| | - C. Gentile
- Princeton Plasma Physics Laboratory, PO Box 451, Princeton, New Jersey 08543
| | - P. LaMarche
- Princeton Plasma Physics Laboratory, PO Box 451, Princeton, New Jersey 08543
| | - J. Langford
- General Physics Corporation (on assignment to PPPL), Aiken, SC 29803
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17
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Di Stasio D, Romano AN, Paparella RS, Gentile C, Minervini G, Serpico R, Candotto V, Laino L. How social media meet patients questions: YouTube review for children oral thrush. J BIOL REG HOMEOS AG 2018; 32:101-106. [PMID: 29460525] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
YouTube is increasingly being used by patients to obtain health-related information. No studies have evaluated the content of YouTube videos on children oral thrush. The aim of this work is to examine the quality of information offered by this platform about oral thrush in children. Searching term oral thrush in children (OTC) displayed a total of 2.790 results. Of the top 60 videos analyzed, 27 were excluded. The main source of upload was from generalist information YouTube® channels (GC) followed by healthcare professionals (HP), individual users (IU), and healthcare information channels (HC); usefulness of videos is successfully correlated with the number of visualization, number of likes and viewing rate and was interdependent with the number of visualizations, number of likes and VR. However, videos on the oral thrush do not have satisfactory quality information. HP themselves, along with HC, do not seem to provide more appropriate information on COT, than GC or IU.
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Affiliation(s)
- D Di Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - A N Romano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - R S Paparella
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - C Gentile
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - G Minervini
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - R Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - V Candotto
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - L Laino
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
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18
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Di Stasio D, Romano A, Gentile C, Maio C, Lucchese A, Serpico R, Paparella R, Minervini G, Candotto V, Laino L. Systemic and topical photodynamic therapy (PDT) on oral mucosa lesions: an overview. J BIOL REG HOMEOS AG 2018; 32:123-126. [PMID: 29460529] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Photodynamic Therapy (PDT) is a minimally invasive treatment that has shown promising results in treating preneoplasticlesions. PDT reckons on the administration of a drug (photosensitizer), which can be used in a topical or systemic form. Photodynamic therapy has been successfully used in the management of a variety of pathologies from different anatomical sites, including the head, neck, brain and lungs, hepatobiliary tree and other gastrointestinal and urological pathologies, skin, gynaecological conditions and in vascular anomalies. Starting from these same considerations, PDT has also been adopted for oral malignant and premalignant lesions treatment, and should be kept under investigation as a promising therapeutic management of leukoplakia and preneoplastic lesions of the oral cavity.
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Affiliation(s)
- D Di Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - A Romano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - C Gentile
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - C Maio
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - A Lucchese
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - R Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - R Paparella
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - G Minervini
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - V Candotto
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - L Laino
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
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Di Stasio D, Romano A, Paparella RS, Gentile C, Serpico R, Minervini G, Candotto V, Laino L. How social media meet patients questions: YouTube review for mouth sores in children. J BIOL REG HOMEOS AG 2018; 32:117-121. [PMID: 29460528] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Recurrent aphthous stomatitis (RAS) is one of the most common causes of mouth sores in children so the management of this condition is a matter of great importance. YouTube is increasingly being used by patients to obtain health-related information. The aim of this work is to examine the quality of information offered by YouTube about mouth sores in children (MSC). Searching the term mouth sores in children, (MSC) displayed 12.300 results. Of the top 60 videos analyzed, 31 were excluded following exclusion criteria. The major source of upload was from healthcare information channels (HC-41,38%), followed by individual users (HP-25.59%), healthcare professionals (IU-17.24%) and generalist information channels (HC-13.78%); 20.69% of them deal with predisposing factors, and related pathologies, the majority of these propose home remedies (60.72%) rather than topical analgesic drugs (21.43%), antimicrobials (7.14%) and topical steroids (3.57). Most of the videos analyzed were slightly useful (68.97%). Information about mouth sores in children on YouTube was poor regardless of the upload source. Analyzing health content on social platforms is a starting point for providing greater quality of health-related information.
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Affiliation(s)
- D Di Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - A Romano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - R S Paparella
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - C Gentile
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - R Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - G Minervini
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - V Candotto
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - L Laino
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
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20
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Gentile C, Van Deerlin VM, Goldberg DS, Reese PP, Hasz RD, Abt P, Blumberg E, Farooqi MS. Hepatitis C virus genotyping of organ donor samples to aid in transplantation of HCV-positive organs. Clin Transplant 2017; 32. [PMID: 29220079 DOI: 10.1111/ctr.13172] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2017] [Indexed: 02/06/2023]
Abstract
Given the availability of new highly efficacious anti-HCV therapies, some clinicians have advocated for wider use of kidneys from hepatitis C virus-positive (HCV+) donors, including transplanting them into HCV-negative recipients. As treatment regimens for HCV are commonly guided by genotype, pretransplant HCV genotyping of tissue donors would be beneficial. To our knowledge, donor HCV genotyping has never been reported. We retrieved archived frozen plasma samples for 17 previous organ donors through a local organ procurement organization. We performed HCV genotyping using the eSensor HCVg Direct Test (GenMark Diagnostics) and also by Sanger sequencing, for confirmation (Retrogen). In addition, viral loads were measured using the COBAS AmpliPrep/TaqMan system (Roche Diagnostics). We found that most of the samples (n = 14) were HCV Genotype 1a with the remainder being Genotype 2b (n = 1) or Genotype 3 (n = 2). All genotyping results were concordant with Sanger sequencing. The average HCV viral load in the sample group was ~ 1.6 million IU/mL (range: ~16 000 IU/mL to 7 million IU/mL). We demonstrate that viral RNA from organ donor plasma can be successfully genotyped for HCV. This ability suggests that transplantation of HCV+ kidneys into HCV-negative recipients, followed by genotype-guided antiviral therapy, could be feasible.
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Affiliation(s)
- Caren Gentile
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Vivianna M Van Deerlin
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David S Goldberg
- Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, USA.,Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - Peter P Reese
- Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.,Renal-Electrolyte and Hypertension Division, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Peter Abt
- Division of Transplant Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Emily Blumberg
- Infectious Diseases Division, University of Pennsylvania, Philadelphia, PA, USA
| | - Midhat S Farooqi
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, MO, USA
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21
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Zuo GZ, Hu JS, Maingi R, Yang QX, Sun Z, Huang M, Chen Y, Yuan XL, Meng XC, Xu W, Gentile C, Carpe A, Diallo A, Lunsford R, Mansfield D, Osborne T, Tritz K, Li JG. Upgraded flowing liquid lithium limiter for improving Li coverage uniformity and erosion resistance in EAST device. Rev Sci Instrum 2017; 88:123506. [PMID: 29289198 DOI: 10.1063/1.4997806] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We report on design and technology improvements for a flowing liquid lithium (FLiLi) limiter inserted into auxiliary heated discharges in the experimental advanced superconducting tokamak device. In order to enhance Li coverage uniformity and erosion resistance, a new liquid Li distributor with homogenous channels was implemented. In addition, two independent electromagnetic pumps and a new horizontal capillary structure contributed to an improvement in the observed Li flow uniformity (from 30% in the previous FLiLi design to >80% in this FLiLi design). To improve limiter surface erosion resistance, hot isostatic press technology was applied, which improved the thermal contact between thin stainless steel protective layers covering the Cu heat sink. The thickness of the stainless steel layer was increased from 0.1 mm to 0.5 mm, which also helped macroscopic erosion resilience. Despite the high auxiliary heating power up to 4.5 MW, no Li bursts were recorded from FLiLi, underscoring the improved performance of this new design.
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Affiliation(s)
- G Z Zuo
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, Anhui 230031, China
| | - J S Hu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, Anhui 230031, China
| | - R Maingi
- Princeton Plasma Physics Laboratory, Princeton University, Princeton, New Jersey 08543, USA
| | - Q X Yang
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, Anhui 230031, China
| | - Z Sun
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, Anhui 230031, China
| | - M Huang
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, Anhui 230031, China
| | - Y Chen
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, Anhui 230031, China
| | - X L Yuan
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, Anhui 230031, China
| | - X C Meng
- Department of Applied Physics, Hunan University, Changsha 410082, China
| | - W Xu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, Anhui 230031, China
| | - C Gentile
- Princeton Plasma Physics Laboratory, Princeton University, Princeton, New Jersey 08543, USA
| | - A Carpe
- Princeton Plasma Physics Laboratory, Princeton University, Princeton, New Jersey 08543, USA
| | - A Diallo
- Princeton Plasma Physics Laboratory, Princeton University, Princeton, New Jersey 08543, USA
| | - R Lunsford
- Princeton Plasma Physics Laboratory, Princeton University, Princeton, New Jersey 08543, USA
| | - D Mansfield
- Princeton Plasma Physics Laboratory, Princeton University, Princeton, New Jersey 08543, USA
| | - T Osborne
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| | - K Tritz
- Johns Hopkins University, Baltimore, Maryland 21211, USA
| | - J G Li
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, Anhui 230031, China
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22
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Goldberg DS, Abt PL, Blumberg EA, Van Deerlin VM, Levine M, Reddy KR, Bloom RD, Nazarian SM, Sawinski D, Porrett P, Naji A, Hasz R, Suplee L, Trofe-Clark J, Sicilia A, McCauley M, Farooqi M, Gentile C, Smith J, Reese PP. Trial of Transplantation of HCV-Infected Kidneys into Uninfected Recipients. N Engl J Med 2017; 376:2394-2395. [PMID: 28459186 DOI: 10.1056/nejmc1705221] [Citation(s) in RCA: 263] [Impact Index Per Article: 37.6] [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: 12/20/2022]
Affiliation(s)
| | - Peter L Abt
- University of Pennsylvania, Philadelphia, PA
| | | | | | | | | | - Roy D Bloom
- University of Pennsylvania, Philadelphia, PA
| | | | | | | | - Ali Naji
- University of Pennsylvania, Philadelphia, PA
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23
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Perevezentsev A, Bell A, Brennan D, Miller A, Healer A, Gentile C, Ciebiera L, Langish S. Detritiation of the JET Carbon Tiles by Flame Heating. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-42] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- A. Perevezentsev
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB, UK
| | - A. Bell
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB, UK
| | - D. Brennan
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB, UK
| | - A. Miller
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB, UK
| | - A. Healer
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB, UK
| | - C. Gentile
- Princeton Plasma Physics Laboratory, Princeton University, PO Box 451, Princeton, New Jersey, 08453, USA
| | - L. Ciebiera
- Princeton Plasma Physics Laboratory, Princeton University, PO Box 451, Princeton, New Jersey, 08453, USA
| | - S. Langish
- Princeton Plasma Physics Laboratory, Princeton University, PO Box 451, Princeton, New Jersey, 08453, USA
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24
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Raffray AR, Robson AE, Sethian J, Gentile C, Marriott E, Rose D, Sawan M. Laser IFE Direct Drive Chamber Concepts with Magnetic Intervention. Fusion Science and Technology 2017. [DOI: 10.13182/fst09-a8924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- A. R. Raffray
- University of California-San Diego, La Jolla, CA 92093-0417,
| | - A. E. Robson
- Consultant, Naval Research Laboratory, Washington, DC 20375,
| | - J. Sethian
- Naval Research Laboratory, Washington, DC 20375,
| | - C. Gentile
- Princeton Plasma Physics Laboratory, Princeton, NJ 08543-0451,
| | - E. Marriott
- University of Wisconsin-Madison, Madison, WI 53706,
| | - D. Rose
- Voss Scientific LLC, Albuquerque, NM 87108,
| | - M. Sawan
- University of Wisconsin-Madison, Madison, WI 53706,
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25
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Gentile C, Reig C, Corona O, Todaro A, Mazzaglia A, Perrone A, Gianguzzi G, Agusti M, Farina V. Pomological Traits, Sensory Profile and Nutraceutical Properties of Nine Cultivars of Loquat (Eriobotrya japonica Lindl.) Fruits Grown in Mediterranean Area. Plant Foods Hum Nutr 2016; 71:330-338. [PMID: 27392960 DOI: 10.1007/s11130-016-0564-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In this paper the diversity of fruit quality within nine loquat cultivars, including five international affirmed cultivars (Algerie, Golden Nugget, Peluche, Bueno, El Buenet) and four local cultivars (Sanfilippara, Nespolone di Trabia, BRT20 and Claudia), were investigated in order to discriminate the variation in pomological characteristics, sensory profile, and antioxidant properties. Finally, to evaluate potential bioactivity, antiproliferative activity of hydrophilic extracts from loquat fruits was assessed, at dietary relevant concentrations, against three human epithelial cell lines. Even though the international cultivars confirmed an appropriate level of commercial qualities in association to high levels in antioxidant compounds, the local cultivars revealed the best performances in a wide range of chemical-physical and sensory characteristics. Concerning bioactivity, our results indicate that hydrophilic extracts from all tested cultivars showed concentration-dependent antiproliferative activity with a significant variability of effects between different cell lines and between different cultivars. HeLa cells, the most sensitive and hydrophilic extracts from Peluche, showed the highest inhibitory effect followed by Nespolone di Trabia and Claudia. The results of this trial provide useful information on the pomological traits and the not yet known specific nutritional and functional properties of loquat fruits. Our data, besides helping to promote specific local cultivars, could serve to establish a database that will permit to improve the utilization of specific genetic resources in breeding programs.
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Affiliation(s)
- C Gentile
- Dipartimento di Scienze e Tecnologie Biologiche, Chimiche e Farmaceutiche, Università degli Studi di Palermo, Viale delle Scienze, 90128, Palermo, Italy
| | - C Reig
- Instituto Agroforestal Mediterraneo, Universidad Politecnica de Valencia, Camino de Vera s/n, 46022, Valencia, Spain
| | - O Corona
- Dipartimento di Scienze Agrarie e Forestali, Università degli Studi di Palermo, Viale delle Scienze, 90128, Palermo, Italy.
| | - A Todaro
- Dipartimento di Scienze Agrarie e Forestali, Università degli Studi di Palermo, Viale delle Scienze, 90128, Palermo, Italy
| | - A Mazzaglia
- Dipartimento di Scienze delle Produzioni Agrarie e Alimentari, Università degli Studi di Catania, Via Valdisavoia 5, 95123, Catania, Italy
| | - A Perrone
- Dipartimento di Scienze e Tecnologie Biologiche, Chimiche e Farmaceutiche, Università degli Studi di Palermo, Viale delle Scienze, 90128, Palermo, Italy
| | - G Gianguzzi
- Dipartimento di Scienze Agrarie e Forestali, Università degli Studi di Palermo, Viale delle Scienze, 90128, Palermo, Italy
| | - M Agusti
- Instituto Agroforestal Mediterraneo, Universidad Politecnica de Valencia, Camino de Vera s/n, 46022, Valencia, Spain
| | - V Farina
- Dipartimento di Scienze Agrarie e Forestali, Università degli Studi di Palermo, Viale delle Scienze, 90128, Palermo, Italy
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26
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Frank R, Baloch ZW, Gentile C, Watt CD, LiVolsi VA. Multifocal fibrosing thyroiditis and its association with papillary thyroid carcinoma using BRAF pyrosequencing. Endocr Pathol 2014; 25:236-40. [PMID: 24337906 DOI: 10.1007/s12022-013-9289-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Multifocal fibrosing thyroiditis (MFT) is characterized by numerous foci of fibrosis in a stellate configuration with fibroelastotic and fibroblastic centers entrapping epithelial structures. MFT has been proposed as a risk factor for papillary thyroid carcinoma (PTC) development. We attempted to identify whether MFT showed such molecular changes and could possibly be related to PTC. We identified seven cases of PTC with MFT in our institutional pathology database and personal consult service of one of the authors (VAL) for the years 1999 to 2012. Areas of PTC, MFT, and normal tissue were selected for BRAF analysis. Macro-dissection, DNA extraction and PCR amplification, and pyrosequencing were performed to detect BRAF mutations in codon 600. All of the MFT lesions and normal thyroid tissue were negative for BRAF mutations. Of the seven PTCs analyzed, five (71 %) were negative for BRAF mutations, while two cases were positive. In our study, none of the MFT lesions harbored BRAF mutations, whereas 29 % (two of seven) PTCs in the same gland were positive. Hence, in this small study, we found no evidence that the MFT lesion is a direct precursor to PTC. It is likely an incidental bystander in the process and a reflection of the background thyroiditis.
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Affiliation(s)
- Renee Frank
- Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, University of Pennsylvania, 3400 Spruce Street, 6th Floor Founders Building, Philadelphia, PA, 19104, USA
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27
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Trofe-Clark J, Sparkes T, Gentile C, Van Deerlin V, Sawinski D, Bloom RD. BK virus genotype variance and discordant BK viremia PCR assay results. Am J Transplant 2013; 13:1112-1113. [PMID: 23432963 DOI: 10.1111/ajt.12169] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- J Trofe-Clark
- Department of Pharmacy Services, Hospital of the University of Pennsylvania, Philadelphia, PA.,Renal Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - T Sparkes
- Department of Pharmacy Services, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - C Gentile
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - V Van Deerlin
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - D Sawinski
- Renal Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - R D Bloom
- Renal Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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28
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Mapelli P, Mangili G, Picchio M, Gentile C, Rabaiotti E, Giorgione V, Spinapolice EG, Gianolli L, Messa C, Candiani M. Role of 18F-FDG PET in the management of gestational trophoblastic neoplasia. Eur J Nucl Med Mol Imaging 2013; 40:505-13. [PMID: 23314259 DOI: 10.1007/s00259-012-2324-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 12/10/2012] [Indexed: 12/13/2022]
Abstract
PURPOSE Gestational trophoblastic neoplasia (GTN) is a rare and aggressive tumour that is usually sensitive to chemotherapy. The usefulness of conventional imaging modalities in evaluating treatment response is limited, mainly due to the difficulty in differentiating between residual tumour tissue and necrosis. The aim of the present study was to evaluate the role of FDG PET or PET/CT in primary staging and in monitoring treatment efficacy. The effect of FDG PET and combined PET/CT on the management of patients with GTN was also evaluated comparing the differences between standard treatments based on conventional imaging and alternative treatments based on PET. METHODS This retrospective study included 41 patients with GTN referred to San Raffaele Hospital between 2002 and 2010. All patients were studied by either PET or PET/CT in addition to conventional imaging. Of the 41 patients, 38 were evaluated for primary staging of GTN and 3 patients for chemotherapy resistance after first-line chemotherapy performed in other Institutions. To validate the PET data, PET and PET/CT findings were compared with those from conventional imaging, including transvaginal ultrasonography (TV-US) in those with uterine disease, CT and chest plain radiography in those with lung disease and whole-body CT in those with systemic metastases. Conventional imaging was considered positive for the presence of uterine disease and/or metastases when abnormal findings relating to GTN were reported. PET and PET/CT were considered concordant with conventional imaging when metabolic active disease was detected at the sites corresponding to the pathological findings on conventional imaging. In addition, in 12 of the 41 patients showing extrauterine disease, FDG PET/CT was repeated to monitor treatment efficacy, in 8 after normalization of beta human chorionic gonadotropin (βHCG) and in 4 with βHCG resistance. In some patients, PET or PET/CT findings led to an alternative nonconventional treatment, and this was considered a change in patient management for the study analysis. RESULTS When compared to TV-US, chest radiography and CT for staging, PET showed a concordance in 91 %, 84 % and 81 % of patients, respectively. In 8 of the 41 patients with extrauterine disease during staging, PET/CT showed a complete response to therapy after βHCG normalization. PET and PET/CT identified the sites of persistent disease in all seven high-risk patients with βHCG resistance, of whom four underwent second-line chemotherapy, two surgical removal of resistant disease instead of additional chemotherapy, and one surgical removal of resistant disease and second-line chemotherapy with subsequent negative βHCG. CONCLUSION In staging, PET cannot replace conventional imaging and does not show any information in addition to that shown by conventional imaging. The additional value of PET/CT in GTN with respect to conventional imaging is found in patients with high-risk disease. PET can identify the sites of primary and/or metastatic disease in patients with persistent high levels of βHCG after first-line chemotherapy and may be of additional value in patient management for guiding alternative treatment.
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Affiliation(s)
- P Mapelli
- Department of Nuclear Medicine, San Raffaele Scientific Institute, Milan, Italy
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29
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Abstract
The investigation on the differences occurring in the manufacture of silver coins allows to get information on their elemental composition and represents a powerful support to the methodology to identify the producing technologies, workshops being also instrumental to distinguish between original and counterfeit ones. Aim of the present work is to study recent and old silver coins through non-destructive X-Ray Fluorescence (XRF) analysis. The XRF was applied to extend the analysis to the deepest layers of the coins; for surface layers an X-ray tube or an electron beam were employed to induce the atom fluorescence to obtain information on the surface elemental composition. Moreover, a detailed study has been performed to evaluate the influence of the surface curvature on the measurement, by deducing a proper corrective factor to keep into account in the data analysis. The elemental atomic composition was measured for each coin, mainly by means of the X-ray tube excitation for the bulk and the electron Scanning Electron Microscope (SEM) microbeam probe for the surface patina analysis. Ionization was induced by an X-ray tube using an Ag anode for the bulk and by an electron microprobe for the surface composition. X-ray detection was performed by using a semiconductor Si device cooled by a Peltier system. The Ag L-lines X-ray yield is affected by coin surface morphology and geometry. The comparison between coin spectra and standard samples, shows that the Ag quantitative analysis is influenced by error of the atomic concentration lower that 10%.
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Affiliation(s)
- L Torrisi
- Dipartimento di Fisica e Scienze della Terra, Università di Messina, Messina, Italy
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30
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Reyes S, Babineau D, Davis R, Taylor C, Anklam T, Dunne M, Flowers D, Gentile C, Latkowski J, Maroni V, Martinez-Frias J, Miles R, Willms S. Overview of the LIFE fuel cycle. EPJ Web of Conferences 2013. [DOI: 10.1051/epjconf/20135911002] [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: 11/15/2022] Open
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31
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Milinkeviciute G, Gentile C, Neely GG. Drosophila as a tool for studying the conserved genetics of pain. Clin Genet 2012; 82:359-66. [PMID: 22880632 DOI: 10.1111/j.1399-0004.2012.01941.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 07/23/2012] [Accepted: 07/23/2012] [Indexed: 11/27/2022]
Abstract
Survival of all animals depends on an accurate representation of the world, and an organism must be capable of prioritizing and responding to potentially hazardous conditions. This ability is dependent on nociception, the sensory process allowing animals to detect and avoid potentially harmful stimuli. Nociception is the sensory process that results in the subjective experience of 'pain' in humans. Because of its vital and broad role in animal biology, pain/nociception is a complex, whole-body physiological process that is under stringent evolutionary pressure. Here, we discuss the utility of Drosophila melanogaster as an emerging model organism for studying the conserved genetics of nociception, particularly with respect to recently developed high-throughput Drosophila 'pain' paradigms.
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Affiliation(s)
- G Milinkeviciute
- Neuroscience Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
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32
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Tesoriere L, Gentile C, Angileri F, Attanzio A, Tutone M, Allegra M, Livrea MA. Trans-epithelial transport of the betalain pigments indicaxanthin and betanin across Caco-2 cell monolayers and influence of food matrix. Eur J Nutr 2012; 52:1077-87. [DOI: 10.1007/s00394-012-0414-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 06/27/2012] [Indexed: 11/30/2022]
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33
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Cavoretto P, Gentile C, Mangili G, Garavaglia E, Valsecchi L, Spagnolo D, Montoli S, Candiani M. Transvaginal ultrasound predicts delayed response to chemotherapy and drug resistance in stage I low-risk trophoblastic neoplasia. Ultrasound Obstet Gynecol 2012; 40:99-105. [PMID: 22262502 DOI: 10.1002/uog.11097] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Methotrexate (MTX) resistance is defined on the basis of the human chorionic gonadotropin (hCG) curve. The aim of this study was to identify low-risk non-metastatic patients with gestational trophoblastic neoplasia (GTN) who can achieve resolution by continuing MTX treatment despite a transient hCG plateau. METHODS Before starting chemotherapy, 24 patients with FIGO Stage I GTN underwent transvaginal ultrasonography with power Doppler in order to identify myometrial lesions (areas of increased echogenicity and increased power Doppler signal). Ultrasound response to chemotherapy was defined when myometrial lesions decreased in echogenicity, Doppler signal or size. When ultrasound response occurred, despite chemoresistance defined by hCG values, MTX treatment was continued. RESULTS MTX was continued in three out of seven chemoresistant patients because ultrasound suggested response to MTX. All three of these patients achieved a complete response, thus nearly halving the MTX-resistance rate. CONCLUSION Among patients who are candidates for second-line treatment on the basis of hCG, ultrasound may identify those in whom further MTX administration can induce a delayed complete response.
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Affiliation(s)
- P Cavoretto
- IRCCS San Raffaele Hospital, Obstetrics and Gynecology Department, Vita-Salute University, Milan, Italy.
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34
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Ingordo V, Cazzaniga S, Gentile C, Iannazzone SS, Cusano F, Naldi L. Dermatology Life Quality Index score in vitiligo patients: a pilot study among young Italian males. GIORN ITAL DERMAT V 2012; 147:83-90. [PMID: 22370571] [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: 05/31/2023]
Abstract
AIM A negative impact on vitiligo patients in terms of quality of life (QoL) has been suggested. The aim of this report was to study the QoL in a sample of Italian vitiligo patients by using the Dermatology Life Quality Index (DLQI) questionnaire. METHODS A sample of forty seven vitiligo subjects, identified among 34,740 potential conscripts resident in southern Italy underwent the Italian version of the DLQI questionnaire. RESULTS The median total DLQI score was 1 (IQR: 2; mean: 1.82). In univariate analysis, DLQI total score was significantly influenced by the clinical course of vitiligo, disease extension over the body, and location on face and/or hands. Multivariate analysis using logistic stepwise regression showed that only the localization on the hands and on the face influenced significantly the mean DLQI. CONCLUSION Our study conducted on a random sample of individuals affected by vitiligo selected from the general young male population in Italy, does not document a large impact of vitiligo on QoL. However, variations exist and the location of lesions on the face and/or hands may impact on QoL. Population-based studies are not affected by selection biases connected with seeking medical care and should be more widely performed.
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Affiliation(s)
- V Ingordo
- Department of Italian Navy Health, Taranto, Italy.
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35
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Servillo P, Vigna E, De Stefano L, Gentile M, Lucia E, Mazzone C, Bossio S, Gigliotti V, Franzese S, Caruso N, Cartolano A, Scarpelli D, Bisconte M, Gentile C, Recchia A, Morabito F. 249 Two novel TET2 gene mutations in myelodysplastic syndrome. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70251-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: 11/16/2022]
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Ingordo V, Gentile C, Iannazzone SS, Cusano F, Naldi L. Vitiligo and autoimmunity: an epidemiological study in a representative sample of young Italian males. J Eur Acad Dermatol Venereol 2011; 25:105-9. [PMID: 20477923 DOI: 10.1111/j.1468-3083.2010.03696.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND It is stated that patients with vitiligo have an increased risk of developing autoimmune diseases. OBJECTIVE The aim of this study was to estimate the prevalence of autoantibodies or overt autoimmune diseases in a group of vitiligo patients examined among a sample deemed to be representative of the general population of young men living in southern Italy. METHODS A total of 60 vitiligo patients were identified among 34,740 potential conscripts visited to evaluate their fitness to compulsory service in Italian Navy, obtaining a prevalence of 0.17% (95% CI: 0.13-0.22), which was deemed the prevalence of vitiligo in the Italian general population of the same age and sex. Forty of these vitiligo patients underwent blood test including also the search of the main autoantibodies. RESULTS Circulating autoantibodies were detected in 42.5% of subjects. Anti-thyroglobulin antibodies were documented in 27.5%, anti-thyroperoxidase in 22.5%, anti-smooth muscle in 17.3%, anti-nuclear, anti-mitochondrial and anti-gastric parietal cells in 2.5% respectively. Only in two cases (5%) an overt thyroid disease was diagnosed. No significant association between the extension of the skin involved ⁄ clinical course of the disease and circulating autoantibodies was detected. Circulating autoantibodies (particularly anti-thyroid antibodies) were statistically associated with a lower duration of the disease. CONCLUSIONS In agreement with other studies, autoantibodies in the lack of clinical manifestations have been frequently observed in our vitiligo patients, especially during the early phase of the disease. The clinical significance of this finding seems to be limited, with the possible exception of thyroid disease, and it needs further exploration, through large cohort studies.
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Affiliation(s)
- V Ingordo
- Department of Italian Navy Health, Taranto, Italy.
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Gentile M, Vigna E, Mazzone C, Lucia E, Recchia AG, Morabito L, Bisconte MG, Gentile C, Morabito F. Rituximab for the treatment of patients with chronic lymphocytic leukemia. Cancer Manag Res 2010; 2:71-81. [PMID: 21188098 PMCID: PMC3004569 DOI: 10.2147/cmar.s5621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Indexed: 12/18/2022] Open
Abstract
Chronic lymphocytic leukemia (CLL) is a lymphoproliferative disorder that originates from antigen-experienced B lymphocytes that do not die and hence accumulate due to external survival signals or undergo apoptosis and are replenished by proliferating precursors. These neoplastic lymphocytes exhibit a characteristic immunophenotype of CD5(+)/CD19(+)/CD20(+)/HLA-DR+/CD23(+)/sIgdim. Thus, the CD20 antigen has been an appealing target for therapy. The introduction of the monoclonal antibody rituximab (anti-CD20) enabled an outstanding advance in CLL treatment. The introduction of this monoclonal antibody into chemotherapy regimens has dramatically improved complete response rates and progression-free survival in patients with both untreated and relapsed CLL. Although only preliminary data from phase III confirmatory trials have been reported, the FCR regimen, which combines fludarabine and cyclophosphamide with rituximab, is currently the most effective treatment regimen for CLL patients, and has also been demonstrated to significantly improve overall survival. The success of rituximab and the identification of other CLL lymphocyte surface antigens have spurred the development of a multitude of monoclonal antibodies targeting distinct proteins and epitopes in an attempt to target CLL cells more effectively.
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Affiliation(s)
- M Gentile
- Correspondence: Massimo Gentile, Unità Operativa Complessa di Ematologia, Dipartimento di Medicina Interna, Azienda Ospedaliera di Cosenza, Viale della Repubblica, 87100 Cosenza, Italy, Tel +39 0984 681329, Fax +39 0984 791751, Email
| | | | | | | | | | - L Morabito
- Servicio de Hematología y Hemoterapia, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain
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Tesoriere L, Allegra M, Gentile C, Livrea MA. Betacyanins as phenol antioxidants. Chemistry and mechanistic aspects of the lipoperoxyl radical-scavenging activity in solution and liposomes. Free Radic Res 2010; 43:706-17. [DOI: 10.1080/10715760903037681] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [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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Tesoriere L, Allegra M, Butera D, Gentile C, Livrea MA. Kinetics of the lipoperoxyl radical-scavenging activity of indicaxanthin in solution and unilamellar liposomes. Free Radic Res 2009; 41:226-33. [PMID: 17364949 DOI: 10.1080/10715760601026614] [Citation(s) in RCA: 24] [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: 10/23/2022]
Abstract
The reaction of the phytochemical indicaxanthin with lipoperoxyl radicals generated in methyl linoleate methanol solution by 2,2'-azobis(2,4-dimethylvaleronitrile), and in aqueous soybean phosphatidylcholine unilamellar liposomes by 2,2'-azobis(2-amidinopropane)hydrochloride, was studied. The molecule acts as a chain-terminating lipoperoxyl radical scavenger in solution, with a calculated inhibition constant of 3.63 x 10(5) M(-1) s(-1), and a stoichiometric factor approaching 2. Indicaxanthin incorporated in liposomes prevented lipid oxidation, inducing clear-cut lag periods and decrease of the propagation rate. Both effects were concentration-dependent, but not linearly related to the phytochemical concentration. The consumption of indicaxanthin during liposome oxidation was remarkably delayed, the lower the concentration the longer the time-interval during which it remained in its native state. Indicaxanthin and alpha-tocopherol, simultaneously incorporated in liposomes, exhibited cooperative antioxidant effects and reciprocal protective interactions. The extent of synergism decreased at the increase of the ratio (indicaxanthin)/(alpha-tocopherol). A potential antioxidant mechanism of indicaxanthin is discussed in the context of the chemistry of the molecule, and of the possible reactivity of a short-lived intermediate.
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Affiliation(s)
- L Tesoriere
- Dipartimento Farmacochimico Tossicologico e Biologico, Università di Palermo, Via Archirafi, 32, Palermo, Italy
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Tesoriere L, Allegra M, Butera D, Gentile C, Livrea MA. Cytoprotective effects of the antioxidant phytochemical indicaxanthin in β-thalassemia red blood cells. Free Radic Res 2009; 40:753-61. [PMID: 16984002 DOI: 10.1080/10715760600554228] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Antioxidant phytochemicals are investigated as novel treatments for supportive therapy in beta-thalassemia. The dietary indicaxanthin was assessed for its protective effects on human beta-thalassemic RBCs submitted in vitro to oxidative haemolysis by cumene hydroperoxide. Indicaxanthin at 1.0-10 microM enhanced the resistance to haemolysis dose-dependently. In addition, it prevented lipid and haemoglobin (Hb) oxidation, and retarded vitamin E and GSH depletion. After ex vivo spiking of blood from thalassemia patients with indicaxanthin, the phytochemical was recovered in the soluble cell compartment of the RBCs. A spectrophotometric study showed that indicaxanthin can reduce perferryl-Hb generated in solution from met-Hb and hydrogen peroxide (H2O2), more effectively than either Trolox or vitamin C. Collectively our results demonstrate that indicaxanthin can be incorporated into the redox machinery of beta-thalassemic RBC and defend the cell from oxidation, possibly interfering with perferryl-Hb, a reactive intermediate in the hydroperoxide-dependent Hb degradation. Opportunities of therapeutic interest for beta-thalassemia may be considered.
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Affiliation(s)
- L Tesoriere
- Dipartimento Farmacochimico Tossicologico e Biologico, Università di Palermo, Via Archirafi 32, Palermo 90128, Italy.
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Gentile C, Alberini I, Manini I, Rossi S, Montomoli E, Pozzi T, Rizzo C, Alfonsi V. Hepatitis A seroprevalence in Tuscany, Italy. Euro Surveill 2009; 14:19146. [PMID: 19317984] [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: 05/27/2023] Open
Abstract
Information regarding the current seroprevalence of hepatitis A virus (HAV) is useful for the control of HAV infections. The objective of our study was to evaluate the prevalence of anti-HAV antibodies among children (1-5 years old) and young adults (15-20 years old) in Tuscany, in central Italy. A total of 565 sera were collected in three years 1992, 1998 and 2004, equally distributed between the two age groups. The overal proportion of those that tested positive for anti-HAV antibodies was 8.3%. The proportion of immune children (1-5 years old) statistically significantly increased over the years. The percentage of immune subjects among 15-20-year-old young adults varied over the years, not showing a significant statistical trend, nevertheless our findings indicate that in a low endemicity area, adolescents and young adults are becoming increasingly susceptible to HAV infection. On-going monitoring of immunity to HAV is necessary for detecting trends over time.
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Affiliation(s)
- C Gentile
- University of Siena, Department of Physiopathology, Experimental Medicine and Public Health, Tuscany, Italy
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Abstract
Information regarding the current seroprevalence of hepatitis A virus (HAV) is useful for the control of HAV infections. The objective of our study was to evaluate the prevalence of anti-HAV antibodies among children (1-5 years old) and young adults (15-20 years old) in Tuscany, in central Italy. A total of 565 sera were collected in three years 1992, 1998 and 2004, equally distributed between the two age groups. The overal proportion of those that tested positive for anti-HAV antibodies was 8.3%. The proportion of immune children (1-5 years old) statistically significantly increased over the years. The percentage of immune subjects among 15-20-year-old young adults varied over the years, not showing a significant statistical trend, nevertheless our findings indicate that in a low endemicity area, adolescents and young adults are becoming increasingly susceptible to HAV infection. On-going monitoring of immunity to HAV is necessary for detecting trends over time.
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Affiliation(s)
- C Gentile
- University of Siena, Department of Physiopathology, Experimental Medicine and Public Health
| | - I Alberini
- University of Siena, Department of Physiopathology, Experimental Medicine and Public Health
| | - I Manini
- University of Siena, Department of Physiopathology, Experimental Medicine and Public Health
| | - S Rossi
- University of Siena, Department of Physiopathology, Experimental Medicine and Public Health
| | - E Montomoli
- University of Siena, Department of Physiopathology, Experimental Medicine and Public Health
| | - T Pozzi
- University of Siena, Department of Physiopathology, Experimental Medicine and Public Health
| | - C Rizzo
- Istituto Superiore di Sanità, National Centre for Epidemiology Surveillance and Promotion of Health
| | - V Alfonsi
- Istituto Superiore di Sanità, National Centre for Epidemiology Surveillance and Promotion of Health
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Gentile M, Verta M, Vigna E, Lucia E, Mazzone C, Perugini D, Gentile C, Bisconte MG, Romeo F, Leo P, Betterle C, Morabito F. Autoimmune hemolityc anemia concomitant with sequential autoimmune hepatitis-primary biliary cirrhosis overlap syndrome and Hashimoto's thyroiditis: a new entity of autoimmune polyendocrine syndrome. J Endocrinol Invest 2009; 32:287-8. [PMID: 19542751 DOI: 10.1007/bf03346469] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
MESH Headings
- Anemia, Hemolytic, Autoimmune/complications
- Anemia, Hemolytic, Autoimmune/diagnosis
- Anemia, Hemolytic, Autoimmune/drug therapy
- Anti-Inflammatory Agents/administration & dosage
- Budesonide/administration & dosage
- Female
- Hashimoto Disease/complications
- Hashimoto Disease/diagnosis
- Hashimoto Disease/drug therapy
- Hepatitis, Autoimmune/complications
- Hepatitis, Autoimmune/diagnosis
- Hepatitis, Autoimmune/drug therapy
- Humans
- Liver Cirrhosis, Biliary/complications
- Liver Cirrhosis, Biliary/diagnosis
- Liver Cirrhosis, Biliary/drug therapy
- Middle Aged
- Polyendocrinopathies, Autoimmune/diagnosis
- Polyendocrinopathies, Autoimmune/drug therapy
- Syndrome
- Ursodeoxycholic Acid/administration & dosage
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Gasparini R, Rizzetto R, Sasso T, Rizzitelli E, Manfredi P, Risso D, Gentile C, Ciofi degli Atti M, Panatto D. Seroprevalence of bactericidal antibody against Neisseria meningitidis serogroup C in pre-vaccinal era: the Italian epidemiological scenario. Vaccine 2009; 27:3435-8. [PMID: 19200821 DOI: 10.1016/j.vaccine.2009.01.076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Meningococcal disease is particularly severe. The case-fatality rate is 7.78% in Europe and 10-14% in the USA. This paper reports the results of a sero-epidemiological study in Italy on meningitis due to Meningococcus C before the introduction of the monovalent conjugate vaccine. In 2003-2004, a total of 577 sera were collected in 17 of the 20 Italian Regions. Serum Bactericidal Assay (SBA) was performed by using rabbit complement serum according to standardized SBA. The results showed that the percentages of protected subjects decreased from 6 to 12 months of age, increased from 1 to 4 years, decreased again until the age of 8 years and from 13 to 16 years, and were particularly high in 9- and 17-year-old subjects. The geometric mean titre of bactericidal antibodies (SBAbs GMT) was low in subjects under 1 year of age, significantly increased in 1-9-year-old children and decreased in adolescents and young adults. Finally, in each one-year age-group, low levels of antibodies were observed in subjects under 1 year of age, in 10-year-old subjects and in 14-16-year-old adolescents. High titres were observed in 3-, 8-, 9- and 17-year-old subjects. Our results therefore indicate that meningococcus C has the highest probability of spreading among 1-4, 8-10 and 14-17-year-old subjects in Italy.
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Affiliation(s)
- R Gasparini
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy.
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Groth N, Montomoli E, Gentile C, Manini I, Bugarini R, Podda A. Safety, tolerability and immunogenicity of a mammalian cell-culture-derived influenza vaccine: A sequential Phase I and Phase II clinical trial. Vaccine 2009; 27:786-91. [DOI: 10.1016/j.vaccine.2008.11.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Revised: 07/28/2008] [Accepted: 11/02/2008] [Indexed: 11/26/2022]
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Brauer V, Laghi-Pasini F, Capecchi P, Gentile C, di Giovanni P, Staniscia T, Montomoli E, Hilbert A, Tilman S, Durando P, Sticchi L, Gasparini R, Banzhoff A. Priming for Pandemic Influenza: Antigen-sparing MF59™-adjuvanted A/H5N1 Vaccine Induces Immunological Memory and Shows Cross-Reactive Potential in Adults Including the Elderly. Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.358] [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: 10/21/2022] Open
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Pippi F, Bracciale L, Stolzuoli L, Giaccherini R, Montomoli E, Gentile C, Filetti S, De Luca A, Cellesi C. Serological response to hepatitis B virus vaccine in HIV-infected children in Tanzania. HIV Med 2008; 9:519-25. [PMID: 18554311 DOI: 10.1111/j.1468-1293.2008.00598.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND HIV-infected children have a lower seroconversion rate to hepatitis B virus (HBV) immunization than healthy children. Previous studies have produced conflicting results on CD4 cell counts as predictors of vaccine response. No study has evaluated the response rate to HBV vaccination in HIV-infected children receiving highly active antiretroviral therapy (HAART). Our aim was to vaccinate HIV-infected children living in a close community and to investigate the anamnestic response rate after vaccination with its predictors. METHODS Eighty-four HIV-positive children aged 1-10 years who were negative for antibodies to the HBV core antigen (anti-HBc) completed immunization with three doses of 5 microg HBVAXPRO (Aventis, Milan, Italy). Quantitative testing for antibodies to the HBV surface antigen (anti-HBs) was performed: a seroprotective titre was defined as anti-HBs>10 mUI/mL. RESULTS After the vaccination, the anti-HBs seroconversion rate was 59.5%. It was higher in individuals in Centers for Disease Control and Prevention (CDC) immune category 1 than in those in CDC categories 2 and 3. Seroconversion was found in 70.8% of HAART-treated and 44.4% of treatment-naïve children. In multivariable models, HAART use and absolute CD4 cell counts were independently associated with probability of seroconversion and with higher anti-HBs titres. CONCLUSIONS We found a higher seroconversion rate compared with previous studies in HIV-infected children. In children who are candidates to receive antiretroviral therapy, it may be advisable to defer HBV vaccination until after treatment initiation.
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Affiliation(s)
- F Pippi
- Clinic of Infectious Diseases, University of Siena, Siena, Italy.
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Abstract
We propose a novel two-layer neural network to answer a point query in R(n) which is partitioned into polyhedral regions; such a task solves among others nearest neighbor clustering. As in previous approaches to the problem, our design is based on the use of Voronoi diagrams. However, our approach results in substantial reduction of the number of neurons, completely eliminating the second layer, at the price of requiring only two additional clock steps. In addition, the design process is also simplified while retaining the main advantage of the approach, namely its ability to furnish precise values for the number of neurons and the connection weights necessitating neither trial and error type iterations nor ad hoc parameters.
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Affiliation(s)
- C Gentile
- Wireless Communications Technologies Group, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA.
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Mangili G, Petrone M, Gentile C, De Marzi P, Viganò R, Rabaiotti E. Prevention strategies in palmar–plantar erythrodysesthesia onset: The role of regional cooling. Gynecol Oncol 2008; 108:332-5. [DOI: 10.1016/j.ygyno.2007.10.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2007] [Revised: 10/16/2007] [Accepted: 10/17/2007] [Indexed: 12/29/2022]
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Tesoriere L, Butera D, Gentile C, Livrea MA. Bioactive components of caper (Capparis spinosa L.) from Sicily and antioxidant effects in a red meat simulated gastric digestion. J Agric Food Chem 2007; 55:8465-71. [PMID: 17887802 DOI: 10.1021/jf0714113] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
An increasing body of evidence on the association between adherence to the Mediterranean diet and healthy status is being accumulated. Floral buds of Capparis spinosa L. are commonly used in the Mediterranean cuisine as flavoring for meat and other foods. The present study evaluated bioactive components and antioxidant activity of Sicilian capers stabilized in salt. Whereas alpha-tocopherol was absent, low levels of gamma-tocopherol and vitamin C were measured. With reference to one serving size (8.6 g of capers), rutin was 13.76 mg, isothiocyanates, recently acknowledged as anticarcinogen phytochemicals, were 42.14 micromol, total phenols were 4.19 mg of gallic acid equivalents (GAE), and the total antioxidant potential measured using the [2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid)] diammonium salt (ABTS) cation radical decolorization assay was 25.8 micromol of Trolox equivalents. The antioxidative activity of a caper hydrophilic extract was assessed in a number of assays. The extract at 3.5 and 7.0 microM GAE exhibited a dose-dependent peroxyl radical scavenging activity in a methyl linoleate methanol solution oxidized by azo initiator, and reduced hypervalent iron myoglobin species formed from met-Mb an H 2O 2, at 180 microM GAE. The hydrophilic extract, at 70-280 microM GAE, caused a dose-dependent inhibition of lipid autoxidation in heated red meat, incubated with simulated gastric fluid for 180 min. In the same model rutin tested at a concentration corresponding to its content in the extract was ineffective, and alpha-tocopherol at 25 microM was poorly effective. The hydrophilic extract (70 microM GAE) prevented the consumption of the co-incubated alpha-tocopherol, whereas lipid oxidation was inhibited for the experimental time, suggesting cooperative interactions between extract components and the vitamin. The findings encourage the use of caper with foods that contribute oxidizable lipids in view of the association between dietary oxidized lipids and risk of oxidative stress-based diseases.
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Affiliation(s)
- L Tesoriere
- Dipartimento Farmacochimico Tossicologico e Biologico, Università di Palermo, Via M. Cipolla 74, 90128 Palermo, Italy.
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