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Fusco N, Ivanova M, Frascarelli C, Criscitiello C, Cerbelli B, Pignataro MG, Pernazza A, Sajjadi E, Venetis K, Cursano G, Pagni F, Di Bella C, Accardo M, Amato M, Amico P, Bartoli C, Bogina G, Bortesi L, Boldorini R, Bruno S, Cabibi D, Caruana P, Dainese E, De Camilli E, Dell'Anna V, Duda L, Emmanuele C, Fanelli GN, Fernandes B, Ferrara G, Gnetti L, Gurrera A, Leone G, Lucci R, Mancini C, Marangi G, Mastropasqua MG, Nibid L, Orrù S, Pastena M, Peresi M, Perracchio L, Santoro A, Vezzosi V, Zambelli C, Zuccalà V, Rizzo A, Costarelli L, Pietribiasi F, Santinelli A, Scatena C, Curigliano G, Guerini-Rocco E, Martini M, Graziano P, Castellano I, d'Amati G. Advancing the PD-L1 CPS test in metastatic TNBC: Insights from pathologists and findings from a nationwide survey. Crit Rev Oncol Hematol 2023; 190:104103. [PMID: 37595344 DOI: 10.1016/j.critrevonc.2023.104103] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/11/2023] [Accepted: 08/12/2023] [Indexed: 08/20/2023] Open
Abstract
Pembrolizumab has received approval as a first-line treatment for unresectable/metastatic triple-negative breast cancer (mTNBC) with a PD-L1 combined positive score (CPS) of ≥ 10. However, assessing CPS in mTNBC poses challenges. Firstly, it represents a novel analysis for breast pathologists. Secondly, the heterogeneity of PD-L1 expression in mTNBC further complicates the assessment. Lastly, the lack of standardized assays and staining platforms adds to the complexity. In KEYNOTE trials, PD-L1 expression was evaluated using the IHC 22C3 pharmDx kit as a companion diagnostic test. However, both the 22C3 pharmDx and VENTANA PD-L1 (SP263) assays are validated for CPS assessment. Consequently, assay-platform choice, staining conditions, and scoring methods can significantly impact the testing outcomes. This consensus paper aims to discuss the intricacies of PD-L1 CPS testing in mTNBC and provide practical recommendations for pathologists. Additionally, we present findings from a nationwide Italian survey elucidating the state-of-the-art in PD-L1 CPS testing in mTNBC.
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Affiliation(s)
- Nicola Fusco
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
| | - Mariia Ivanova
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Chiara Frascarelli
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Carmen Criscitiello
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Division of New Drugs and Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Bruna Cerbelli
- Department of Medical-Surgical Sciences and Biotechnologies Sapienza University of Rome, Rome, Italy
| | - Maria Gemma Pignataro
- Department of Medical-Surgical Sciences and Biotechnologies Sapienza University of Rome, Rome, Italy
| | - Angelina Pernazza
- Department of Medical-Surgical Sciences and Biotechnologies Sapienza University of Rome, Rome, Italy
| | - Elham Sajjadi
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | | | - Giulia Cursano
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Fabio Pagni
- Department of Medicine and Surgery, University Milan Bicocca, Monza (MB), Italy; Department of Pathology, IRCCS San Gerardo Hospital, Monza (MB), Italy
| | - Camillo Di Bella
- Department of Pathology, IRCCS San Gerardo Hospital, Monza (MB), Italy
| | - Marina Accardo
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania "L. Vanvitelli", Naples, Italy
| | - Michelina Amato
- Department of Pathology, San Giovanni-Addolorata Hospital, Rome Italy
| | - Paolo Amico
- Department of Pathology, Ospedale Maria Paternò Arezzo, Ragusa, Italy
| | - Caterina Bartoli
- Morphological Diagnostic and Biomolecular Characterization Area, Complex Unit of Pathological Anatomy Empoli-Prato, Oncological Department Azienda USL Toscana Centro, Italy
| | - Giuseppe Bogina
- Pathology Unit, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Laura Bortesi
- Pathology Unit, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Renzo Boldorini
- Pathology Unit, University of Eastern Piedmont, Novara, Italy
| | - Sara Bruno
- Division of Pathology, ASL2 Savona, Liguria, Italy
| | - Daniela Cabibi
- Department of Sciences for the Promotion of Health and Mother and Child Care, Anatomic Pathology, University of Palermo, Palermo, Italy
| | - Pietro Caruana
- Pathology Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Emanuele Dainese
- Surgical Pathology Division, Department of Oncology, ASST Lecco, "A. Manzoni" Hospital, Lecco, Italy
| | - Elisa De Camilli
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Loren Duda
- Department of Clinical and Experimental Medicine, Pathology Unit, University of Foggia, Foggia, Italy
| | - Carmela Emmanuele
- Division of Pathology, Umberto I Hospital Presidium, Enna Provincial Health Department (ASP), Enna, Italy
| | - Giuseppe Nicolò Fanelli
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Gerardo Ferrara
- Department of Anatomic Pathology and Cytopathology, G. Pascale National Cancer Institute Foundation (IRCCS) Naples, Italy
| | - Letizia Gnetti
- Division of Pathology, Umberto I Hospital Presidium, Enna Provincial Health Department (ASP), Enna, Italy
| | | | - Giorgia Leone
- Division of Pathology, Clinical Institute Humanitas Catania Cubba, Misterbianco (Catania), Italy
| | - Raffaella Lucci
- Pathology Unit, Monaldi Hospital, A.O. dei Colli of Naples, Naples, Italy
| | - Cristina Mancini
- Division of Pathology, Umberto I Hospital Presidium, Enna Provincial Health Department (ASP), Enna, Italy
| | - Grazia Marangi
- Anatomic Pathology Unit, SS. Annunziata Hospital, Taranto, Italy
| | - Mauro G Mastropasqua
- Department of Precision and Regenerative Medicine and Jonian Area, School of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Lorenzo Nibid
- Research Unit of Anatomical Pathology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Anatomical Pathology Operative Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
| | - Sandra Orrù
- Businco Oncologic Hospital, ARNAS Brotzu, Cagliari, Italy
| | - Maria Pastena
- IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Monica Peresi
- Pathology and Cytopathology Diagnostic Unit, Ospedale Villa Scassi di Genova, Genoa, Italy
| | - Letizia Perracchio
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Angela Santoro
- General Pathology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Vania Vezzosi
- Histopathology and Molecular Diagnostics Unit, Careggi Hospital, Firenze, Italy
| | | | - Valeria Zuccalà
- Pathology Unit, Pugliese-Ciaccio Hospital Catanzaro, Catanzaro, Italy
| | - Antonio Rizzo
- Division of Pathology, Clinical Institute Humanitas Catania Cubba, Misterbianco (Catania), Italy
| | | | | | - Alfredo Santinelli
- Anatomic Pathology, Azienda Sanitaria Territoriale di Pesaro-Urbino, Pesaro, Italy
| | - Cristian Scatena
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giuseppe Curigliano
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy; Division of New Drugs and Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Elena Guerini-Rocco
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Maurizio Martini
- Department of Human and Developmental Pathology, University of Messina, Messina, Italy
| | - Paolo Graziano
- Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | | | - Giulia d'Amati
- Department of Medical-Surgical Sciences and Biotechnologies Sapienza University of Rome, Rome, Italy
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Slaughter M, Ahmed M, Allen S, Answini G, Bartoli C, Dhingra R, Dowling R, Egnaczyk G, Griffith B, Gulati S, Hall S, Jeng E, Joseph S, Kiernan M, Lozonschi L, Mahr C, Meyer D, Ono M, Ravichandran A, Shafii A, Soleimani B, Toyoda Y, Yarboro L. Initial Safety Cohort Analysis: Prospective Multi-Center Randomized Study for Evaluating The EVAHEART®2 Left Ventricular Assist System (The COMPETENCE Trial). J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Lavacchi D, Fancelli S, Roviello G, Castiglione F, Caliman E, Rossi G, Venturini J, Pellegrini E, Brugia M, Vannini A, Bartoli C, Cianchi F, Pillozzi S, Antonuzzo L. Mutations matter: An observational study of the prognostic and predictive value of KRAS mutations in metastatic colorectal cancer. Front Oncol 2022; 12:1055019. [PMID: 36523988 PMCID: PMC9745189 DOI: 10.3389/fonc.2022.1055019] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/16/2022] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND About half of metastatic colorectal cancers (CRCs) harbor Rat Sarcoma (RAS) activating mutations as oncogenic driver, but the prognostic role of RAS mutations is not fully elucidated. Interestingly, specific hotspot mutations have been identified as potential candidates for novel targeted therapies in several malignancies as per G12C. This study aims at evaluating the association between KRAS hotspot mutations and patient characteristics, prognosis and response to antiangiogenic drugs. METHODS Data from RAS-mutated CRC patients referred to Careggi University Hospital, between January 2017 and April 2022 were retrospectively and prospectively collected. Tumor samples were assessed for RAS mutation status using MALDI-TOF Mass Spectrometry, Myriapod NGS-56G Onco Panel, or Myriapod NGS Cancer Panel DNA. RESULTS Among 1047 patients with available RAS mutational status, 183 KRAS-mutated patients with advanced CRC had adequate data for clinicopathological and survival analysis. KRAS mutations occurred at codon 12 in 67.2% of cases, codon 13 in 23.5%, codon 61 in 2.2%, and other codons in 8.2%. G12C mutation was identified in 7.1% of patients and exon 4 mutations in 7.1%. KRAS G12D mutation, as compared to other mutations, was significantly associated with liver metastases (1-sided p=0.005) and male sex (1-sided p=0.039), KRAS G12C mutation with peritoneal metastases (1-sided p=0.035), KRAS G12V mutation with female sex (1-sided p=0.025) and no surgery for primary tumor (1-sided p=0.005). No associations were observed between specific KRAS variants and age, ECOG PS, site of primary tumor, pattern of recurrence for resected patients, and lung, distant lymph node, bone, or brain metastases.Overall survival (OS) was significantly longer in patients with KRAS exon 4 mutations than in those with other KRAS mutations (mOS 43.6 months vs 20.6 months; HR 0.45 [0.21-0.99], p=0.04). No difference in survival was observed for mutations at codon 12/13/61 (p=0.1). Treatment with bevacizumab (BV) increased significatively mPFS (p=0.036) and mOS (p=0.019) of the entire population with a substantial benefit in mOS for G12V mutation (p=0.031). CONCLUSIONS Patterns of presentation and prognosis among patients with specific RAS hotspot mutations deserve to be extensively studied in large datasets, with a specific attention to the uncommon isoforms and the role of anti-angiogenic drugs.
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Affiliation(s)
- Daniele Lavacchi
- Clinical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Sara Fancelli
- Clinical Oncology Unit, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Francesca Castiglione
- Pathologic Histology and Molecular diagnostic Unit, Careggi University Hospital, Florence, Italy
| | - Enrico Caliman
- Clinical Oncology Unit, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Gemma Rossi
- Clinical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Jacopo Venturini
- Clinical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Elisa Pellegrini
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Marco Brugia
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Agnese Vannini
- Clinical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Caterina Bartoli
- Pathologic Histology and Molecular diagnostic Unit, Careggi University Hospital, Florence, Italy
| | - Fabio Cianchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Serena Pillozzi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Lorenzo Antonuzzo
- Clinical Oncology Unit, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
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Fancelli S, Caliman E, Mazzoni F, Paglialunga L, Gatta Michelet MR, Lavacchi D, Berardi R, Mentrasti G, Metro G, Birocchi I, Delmonte A, Priano I, Comin CE, Castiglione F, Bartoli C, Voltolini L, Pillozzi S, Antonuzzo L. KRAS G12 isoforms exert influence over up-front treatments: A retrospective, multicenter, Italian analysis of the impact of first-line immune checkpoint inhibitors in an NSCLC real-life population. Front Oncol 2022; 12:968064. [PMID: 36452502 PMCID: PMC9702560 DOI: 10.3389/fonc.2022.968064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND KRAS is commonly mutated in non-small cell lung cancer (NSCLC); however, the prognostic and predictive impact of each G12 substitution has not been fully elucidated. The approval of specific G12C inhibitors has modified the idea of KRAS "undruggability", and although the first-line standard consists of immune checkpoint inhibitors (ICIs) with or without chemotherapy, as suggested at ASCO 2022, the outcome in KRAS-mutated population is still controversial. METHODS We retrospectively described the clinical and pathological characteristics of a homogeneous G12 mutated cohort of 219 patients treated in four Italian oncologic units. We evaluated the outcome (PFS at 18 months and OS at 30 months) of those who underwent standard first-line treatment according to PD-L1 status, focusing on differences across single mutations. RESULTS In the study population, 47.9% of patients harbor the KRAS G12C mutation; 20.5%, G12V; 17.4%, G12D; and 8.2%, G12A. Smoking was a common behavior of patients harboring transversions and transition mutations. PD-L1 expression does not show particular distribution in the case series, although we recorded a prevalence of PD-L1 <1% in G12V (51.4%) compared to G12A (26.7%). ICIs alone was the clinician's choice in 32.7% of patients, and the chemo-immune combination in 17.3% of patients. We described the independent prognostic role of young age (p = 0.007), female gender (p = 0.016), and an ICI-based regimen (p = 0.034) regardless of mutations. Overall, our data confirm the worst prognostic value of G12V mutation apart from treatment choice unlike the other major mutations (C, D, and A) that showed a favorable trend in PFS. CONCLUSIONS KRAS G12 mutations are confirmed to have different characteristics, and the outcome is influenced by ICI first-line regimen. This study provides valuable information for further analysis in the future.
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Affiliation(s)
- Sara Fancelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Clinical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Enrico Caliman
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Clinical Oncology Unit, Careggi University Hospital, Florence, Italy
| | | | - Luca Paglialunga
- Clinical Oncology Unit, Careggi University Hospital, Florence, Italy
| | | | - Daniele Lavacchi
- Clinical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Rossana Berardi
- Department of Medical Oncology, Università Politecnica delle Marche, Azienda Ospedaliero Universitaria (AOU) Ospedali Riuniti di Ancona, Ancona, Italy
| | - Giulia Mentrasti
- Department of Medical Oncology, Università Politecnica delle Marche, Azienda Ospedaliero Universitaria (AOU) Ospedali Riuniti di Ancona, Ancona, Italy
| | - Giulio Metro
- Medical Oncology Unit, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Ilaria Birocchi
- Medical Oncology Unit, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Angelo Delmonte
- Scientific Institute of Romagna for the Study and Treatment of Tumors (IRST) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola, Italy
| | - Ilaria Priano
- Scientific Institute of Romagna for the Study and Treatment of Tumors (IRST) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola, Italy
| | - Camilla Eva Comin
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Surgery, Histopathology and Molecular Pathology Unit, Careggi University Hospital, Florence, Italy
| | - Francesca Castiglione
- Pathological Histology and Molecular Diagnostics Unit, Careggi University Hospital, Florence, Italy
| | - Caterina Bartoli
- Pathological Histology and Molecular Diagnostics Unit, Careggi University Hospital, Florence, Italy
| | - Luca Voltolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy
| | - Serena Pillozzi
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Lorenzo Antonuzzo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Clinical Oncology Unit, Careggi University Hospital, Florence, Italy
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
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Sparano C, Rotondi M, Verdiani V, Brunori P, Castiglione F, Bartoli C, Perigli G, Badii B, Vezzosi V, Simontacchi G, Livi L, Antonuzzo L, Maggi M, Petrone L. Classic and follicular variant of papillary thyroid microcarcinoma: two different phenotypes beyond tumour size. J Endocr Soc 2022; 6:bvac157. [PMID: 36397778 PMCID: PMC9664971 DOI: 10.1210/jendso/bvac157] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Indexed: 11/25/2022] Open
Abstract
Context Despite the wide revision of current guidelines, the management of papillary thyroid microcarcinoma (mPTC) still has to be decided case by case. There is conflicting evidence about the role of more frequent histological subtypes, and no data about potential differences at presentation. Objective Our aim was to compare the phenotype of the 2 most frequent mPTC variants, namely, classical papillary thyroid microcarcinoma (mPTCc) and the follicular variant of papillary thyroid microcarcinoma (mFVPTC) . Methods Retrospective observational study, from January 2008 to December 2017 of a consecutive series of patients with mPTCc and mFVPTC. All cases were classified according to the 2015 American Thyroid Association (ATA) risk classification. Clinical and preclinical features of mPTCc and mFVPTC at diagnosis were collected. The comparison was also performed according to the incidental/nonincidental diagnosis and differences were verified by binary logistic analysis. Results In total, 235 patients were eligible for the analysis (125 and 110 mPTCc and mFVPTC, respectively). Compared with mPTCc, mFVPTCs were more often incidental and significantly smaller (4 vs 7 mm) (P < .001 all), possibly influenced by the higher rate of incidental detection. mFVPTC and incidental (P < .001 both) tumors were significantly more often allocated within the low-risk class. A logistic regression model, with ATA risk class as the dependent variable, showed that both mFVPTC (OR 0.465 [0.235-0.922]; P = .028]) and incidental diagnosis (OR 0.074 [0.036-0.163]; P < .001) independently predicted ATA risk stratification. Conclusion mFVPTC shows some differences in diagnostic presentation compared with mPTCc, and seems to retain a significant number of favorable features, including a prevalent onset as incidental diagnosis.
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Affiliation(s)
- Clotilde Sparano
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence , Florence , Italy
| | - Mario Rotondi
- Istituti Clinici Scientifici Maugeri IRCCS, Unit of Internal Medicine and Endocrinology; Department of Internal Medicine and Therapeutics, University of Pavia , Pavia , Italy
| | - Valentina Verdiani
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence , Florence , Italy
| | - Paolo Brunori
- International Inequality Institute, London School of Economics , London , United Kingdom
| | - Francesca Castiglione
- Department of Histopathology and Molecular Diagnostics, Careggi Hospital , Florence , Italy
| | - Caterina Bartoli
- Department of Histopathology and Molecular Diagnostics, Careggi Hospital , Florence , Italy
| | - Giuliano Perigli
- Unit of General and Endocrine Surgery, Centre of Oncological and Minimally Invasive Surgery, Department of Surgery and Translational Medicine, University of Florence , Florence , Italy
| | - Benedetta Badii
- Unit of General and Endocrine Surgery, Centre of Oncological and Minimally Invasive Surgery, Department of Surgery and Translational Medicine, University of Florence , Florence , Italy
| | - Vania Vezzosi
- Department of Histopathology and Molecular Diagnostics, Careggi Hospital , Florence , Italy
| | | | - Lorenzo Livi
- Radiation Oncology Unit, Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence , Florence , Italy
| | - Lorenzo Antonuzzo
- Clinical Oncology Unit, Department of Experimental and Clinical Medicine, University of Florence , Florence , Italy
| | - Mario Maggi
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence , Florence , Italy
| | - Luisa Petrone
- Endocrinology Unit, Medical-Geriatric Department, Careggi Hospital , Florence , Italy
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Fancelli S, Caliman E, Pillozzi S, Napolitano B, Pieroni E, Mazzoni F, Paglialunga L, Gatta Michelet MR, Roviello G, Castiglione F, Bartoli C, Antonuzzo L. Weight loss affects outcome in KrasG12C non-small cell lung cancer first line treated patients. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e21054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21054 Background: Cachexia is a syndrome characterized by weight loss (WL), reduction of muscle mass, systemic inflammation and is an independent criteria of worse clinical outcomes in cancer. Patients with KRASmut non-small cell lung cancer (NSCLC) experience a higher rate of WL than KRASwt patients. However no data about the prognostic value of each Kras mutation subtype for WL and/or BMI status are available. Methods: We reviewed the clinicopathological data of 110 NSCLC patients harboring KRAS G12 mutation who were treated at Clinical Oncology Unit, Careggi University Hospital in Florence, from March 2016 to March 2020. Patients received either chemotherapy or anti-PD1 pembrolizumab or a combination of chemo-immunotherapy as first-line treatment. The prognostic value of basal BMI and WL (< and > 5%) was analyzed according to each mutation subtype. Results: In the study population, 49.1% of patients harbor the KRAS G12C mutation, 20.9% G12V, 18.2% G12D and 11.2% of patients have other subtypes of KRAS mutations. Overall, our data confirm the better prognostic value of G12C mutation. At a median follow-up of 18 months, median OS for G12C patients was 17.5 months, longer compared to any other mutation subtype ( p = 0.113), whereas G12V mutation was associated with significantly worse outcomes than in the whole population (mOS 9.5 months IC 95% 6.0-17.0, p = 0.018). WL within 6 months of first-line therapy was observed in 29.7% and 35.3% of G12C and G12V-mutated patients, respectively. WL statistically decreased survival outcomes both in G12C (mPFS 4.0 months vs NR, p < 0.001; mOS 12.0 months vs NR, p = 0.009) and in G12V patients (mPFS 3.0 months vs NR, p = 0.073; mOS 8.0 vs 12.0 months, p = 0.994), compared to patients who do not lose weight during treatment. Conclusions: WL significantly worsens clinical outcomes in G12C patients, with a similar trend in G12V. Further analyses in a larger population including a representative sample of less frequent mutations are needed.
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Affiliation(s)
- Sara Fancelli
- Clinical Oncology, Department of Clinical and Experimental Medicine, Florence, Italy
| | - Enrico Caliman
- Clinical Oncology, Department of Clinical and Experimental Medicine, Firenze, Italy
| | - Serena Pillozzi
- Clinical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Brunella Napolitano
- Graduate School of Medical Oncology, Department of Clinical and Experimental Medicine, Florence, Italy
| | - Edoardo Pieroni
- Graduate School of Medical Oncology, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Francesca Mazzoni
- Medical Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy
| | - Luca Paglialunga
- Clinical Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Marta Rita Gatta Michelet
- Graduate School of Medical Oncology, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | | | - Francesca Castiglione
- Pathological Histology and Molecular Diagnostics Unit, University Hospital Careggi, Florence, Italy
| | | | - Lorenzo Antonuzzo
- Clinical Oncology Unit, Careggi University Hospital - Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Solarino G, Bartoli C, Talini E, Del Meglio J, Lilli A, Baratto M, Della Tommasina V, Canale M, Arena G, Casolo G. P228 WEARABLE DEFIBRILLATOR IN CLINICAL PRACTICE. MULTIANNUAL MULTI–CENTER EXPERIENCE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.220] [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]
Abstract
Abstract
Introduction
Heart failure with reduced left ventricular ejection function (LVEF) represents a life–threatening condition for patients (pts). A period of time of 40–90 days, in optimal medical therapy, is indicated to evaluate the recovery of the LVEF and the indication to ICD implantation. In this period, from 1% to 5% of pts can experience sudden death. We evaluated the usefulness of the wearable cardioverter defibrillator (WCD) as a temporary antiarrhythmic therapy in the interval from discharge to the three–month follow–up.
Methods
From December 2015 to December 2021, 174 consecutive pts (141 M (81%); mean age 62 years ± 11.6 years) were discharged with reduced FE < 35% in OMT, with WCD and were re–evaluated within 3 months to establish indication for ICD implantation.
Results
110 pts (63.2%) recovered LVEF at 3 months and left the indication to ICD. 9 pts refused and/or returned the WCD due to poor compliance (5.2%); 52 pts (29.9%) did not recover LVEF and were implanted with ICD. The WCD was worn continuously by the majority of pts with good compliance for 87.4 ± 52.0 days (range 1 ÷ 303 days), for 22.08 hours / day. 23 episodes of AF were correctly recognized; 10 TVNS> 10 sec; 1 episode of VF in 1 patient in which 1 shock was correctly delivered. 1 inappropriate shock was delivered on tachycardic AF. During the WCD wearing period, 3 deaths occurred (1.7%): in 2 pts due to refractory HF (one of these pts had VF correctly recognized and treated by the WCD but degenerated into pulseless activities); 1 death for terminal cancer). The use of WCD has progressively increased over the years (from 4.5 LV / yy in 2015–16 to 45 LV / yy in 2020–21).
Conclusions
The use of WCD has gradually increased in clinical practice for patients who have not yet developed clear indications for ICD implantation. In the majority of them, ventricular dysfunction is transient. Wearable cardioverter defibrillator represents additional security during this period. Continuous monitoring makes it possible to identify supraventricular and ventricular arrhythmias, improving therapeutic appropriateness and in general the patients have excellent compliance with the device. Further studies are needed to substantiate this strategy.
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Affiliation(s)
- G Solarino
- UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST,, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA; UOC CARDIOLOGIA “OSPEDALI RIUNITI” AZIENDA USL TOSCANA NORD OVEST, LIVORNO; UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA, IT
| | - C Bartoli
- UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST,, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA; UOC CARDIOLOGIA “OSPEDALI RIUNITI” AZIENDA USL TOSCANA NORD OVEST, LIVORNO; UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA, IT
| | - E Talini
- UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST,, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA; UOC CARDIOLOGIA “OSPEDALI RIUNITI” AZIENDA USL TOSCANA NORD OVEST, LIVORNO; UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA, IT
| | - J Del Meglio
- UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST,, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA; UOC CARDIOLOGIA “OSPEDALI RIUNITI” AZIENDA USL TOSCANA NORD OVEST, LIVORNO; UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA, IT
| | - A Lilli
- UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST,, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA; UOC CARDIOLOGIA “OSPEDALI RIUNITI” AZIENDA USL TOSCANA NORD OVEST, LIVORNO; UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA, IT
| | - M Baratto
- UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST,, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA; UOC CARDIOLOGIA “OSPEDALI RIUNITI” AZIENDA USL TOSCANA NORD OVEST, LIVORNO; UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA, IT
| | - V Della Tommasina
- UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST,, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA; UOC CARDIOLOGIA “OSPEDALI RIUNITI” AZIENDA USL TOSCANA NORD OVEST, LIVORNO; UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA, IT
| | - M Canale
- UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST,, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA; UOC CARDIOLOGIA “OSPEDALI RIUNITI” AZIENDA USL TOSCANA NORD OVEST, LIVORNO; UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA, IT
| | - G Arena
- UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST,, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA; UOC CARDIOLOGIA “OSPEDALI RIUNITI” AZIENDA USL TOSCANA NORD OVEST, LIVORNO; UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA, IT
| | - G Casolo
- UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST,, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA; UOC CARDIOLOGIA “OSPEDALI RIUNITI” AZIENDA USL TOSCANA NORD OVEST, LIVORNO; UOC CARDIOLOGIA “OSPEDALE VERSILIA”, AZIENDA USL TOSCANA NORD OVEST, LIDO DI CAMAIORE; UOC CARDIOLOGIA “OSPEDALE APUANE” AZIENDA USL TOSCANA NORD OVEST, MASSA, IT
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8
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Gasperoni S, Papi L, Castiglione F, Gensini F, Sestini R, Messerini L, Bartoli C, Nozzoli F, Dimarino M, Cianchi F, Taddei A, Ferrara A, Calistri M, Bencini L, Perna F, Catalano M, Giorgione R, Winchler C, Venturi G, Mini E. Germline mutations in MSH2 and ATM gene in patients with GIST (gastrointestinal stromal tumor) and second epitelial tumors. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e23520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e23520 Background: In adult GISTs are frequently sporadic, while rarely GISTs are linked to Carney Triad and Carney-Stratakis Syndrome and NF1. GISTs with second primary tumors are reported in 4-33% of patients in literature and genetic counseling is suggested to explore an underlying germline mutations pathway. Methods: In our Academic Hospital Centre (EURACAN member) in Florence, Italy, we are following patients with GIST and multiple primary tumors with genetic counseling (72 GISTs with second tumors/185 patients with GIST) and germline analysis of the following genetic panel is performed as clinically indicated: BRCA1, BRCA2, MUTYH, MLH1, MSH2, MSH6, CDH1, ATM, TP53, PTEN, CHECK2, PALB2, BARD1, BRIP1, BLM, RAD51C, RAD51D, XRCC2, PMS2, MRE11A, RAD50, NBN, FAM175A, EPKAM, TSK1, MEN1 by sequencing analysis with Illumina MiSeq by kit multiplicom BRCA Hereditary cancer Mastr plus, and bioinformatic analysis by software SOPHIADDM (Sophia genetics) for point genetic alterations of BRCA1 NM_007294.3, BRCA2 NM_000059.3, MUTYH NM_000249, MSH2 NM_000251, MSH6 NM_000179, CDH1 NM_00444360, ATM NM_000051, TP53 NM_000546, PTEN NM_000314, CHEK2 NM_001005735, PALB2 NM_024675, BARD1 NM_000465, BRIP1 NM_032043, BLM NM_000057, RAD51C NM_002876, RAD51D NM_001142571, XRCC2 NM_005431, PMS2 NM_000535, MRE11A NM_005590, RAD50 NM_006732, NBN NM_002485, FAM175A NM_139076, EPCAM NM_002354, STK1 NM_000455, MEN1 NM_000244 and MLPA (Multiplex Ligation-dependent Probe Amplification) test analysis for patients with kit P087-BRCA1,P045-BRCA2(CHEK2, P248-MLH1-MSH2, P003-MLH1/MSH2, P072-MSH6-MUTYH (MRC-Holland). Results: In 3 patients germline mutations have been observed: 1 patient showed the c.1192dupG, p.(Ala398Glyfs*19) pathogenic mutation in exon 7 of MSH2 gene, confirmed by Sanger Sequencing, 1 patient showed c.565-?_1130+?del mutation consisting in heterozygous 3-4-5-6 exons deletion of MSH2 gene, confirmed by MLPA analysis, and in 1 patient the following ATM alteration has been identified in heterozygosis: ATM c.5319+2T > C, p.(?). In the 2 patients with Lynch syndrome with colon adenocarcinoma (MSI-H), synchronous GISTs (1 patient quadruple WT and 1 patient kit ex 11 mutated ) were diagnosed; in the patient with ATM mutation, the diagnosis of GIST (kit ex 11 mutated) occurred after prostate adenocarcinoma and before colon adenocarcinoma (MSI-H). Conclusions: Our analysis suggests that GIST diagnosis could be tumor-related to multiple hereditary tumor syndromes as Lynch Syndrome and Ataxia-Teleangectasia syndrome, the latter being linked in eterozygosis to tumor susceptibility to breast in female. This report represents a high value in terms of genetic counseling for relatives and in terms of therapeutic implications for the patients.
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Affiliation(s)
- Silvia Gasperoni
- Department of Oncology and Robotic Surgery, Traslational Oncology Unit, Florence, Italy
| | - Laura Papi
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio” Medical Genetics Unit University of Florence, Florence, Italy
| | - Francesca Castiglione
- Pathological Histology and Molecular Diagnostics Unit, University Hospital Careggi, Florence, Italy
| | - Francesca Gensini
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio” Medical Genetics Unit, Florence, Italy
| | - Roberta Sestini
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio” Medical Genetics Unit, Florence, Italy
| | - Luca Messerini
- Experimental and Clinic Department, University Hospital Careggi, Florence, Italy
| | | | - Filippo Nozzoli
- Pathological Histology and Molecular Diagnostics Unit, University Hospital Careggi, Florence, Italy
| | - Michele Dimarino
- Surgical Oncology and Robotics, Department of Oncology and Robotics University Hospital Careggi, Florence, Italy
| | - Fabio Cianchi
- Division of Digestive Surgery, University Hospital Careggi, Florence, Italy
| | - Antonio Taddei
- Hepatobiliary Surgery, Careggi University Hospital, Florence, Italy
| | - Angelo Ferrara
- Surgical Oncology and Robotics, Department of Oncology and Robotics, University Hospital Careggi, Florence, Italy
| | - Massimo Calistri
- Surgical Oncology and Robotics, Department of Oncology and Robotics University Hospital Careggi, Florence, Italy
| | - Lapo Bencini
- Surgical Oncology and Robotics, Department of Oncology and Robotics University Hospital Careggi, Florence, Italy
| | - Federico Perna
- Surgical Oncology and Robotics, Department of Oncology and Robotics University Hospital Careggi, Florence, Italy
| | - Martina Catalano
- School of Human Health Sciences, University of Florence, Florence, Italy
| | - Roberta Giorgione
- School of Human Health Sciences, University of Florence, Florence, Italy
| | - Costanza Winchler
- School of Human Health Sciences, University of Florence, Florence, Italy
| | - Giulia Venturi
- School of Human Health Sciences, University of Florence, Florence, Italy
| | - Enrico Mini
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
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9
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Gagnon C, Boismery S, Godio-Raboutet Y, Tuchtan L, Bartoli C, Adalian P, Chaumoitre K, Piercecchi-Marti MD, Thollon L. Biomechanical study of the thyroid cartilage: A model of bi-digital strangulation. Forensic Sci Int 2019; 302:109891. [PMID: 31400616 DOI: 10.1016/j.forsciint.2019.109891] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 03/14/2019] [Revised: 07/01/2019] [Accepted: 07/04/2019] [Indexed: 11/25/2022]
Abstract
The presence of fracture on neck elements is an indication of violence. Both the hyoid bone and the larynx can be damaged by a strangulation mechanism. Thyroid cartilage, more specifically, may present lesions in response to this mechanical stress. These lesions result in fractures at the bases of the horns of the thyroid cartilage. This study focuses on the thyroid cartilage behavior in cases of bi-digital strangulation, using an anthropometric and biomechanical approach. To develop a biomechanical model, we performed an anthropometric study taking into account 14 distances measurements as well as 3 measurements of angles. These measures allowed us to determine a significant sexual dimorphism between individuals. Then, we define 6 morphologies models, composed of 3 females and 3 males individuals. In order to visualize the ossification of the cartilage, each model has been tested with bone properties. Strangulation cases were simulated by applying an imposed velocity of 0.4m/s then 1m/s. We observed different behaviors of the thyroid cartilage according to the sex and the morphology.
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Affiliation(s)
- C Gagnon
- Aix Marseille Univ, IFSTTAR, LBA, UMR_T 24, 13916 Marseille, France.
| | - S Boismery
- Aix Marseille Univ, IFSTTAR, LBA, UMR_T 24, 13916 Marseille, France.
| | - Y Godio-Raboutet
- Aix Marseille Univ, IFSTTAR, LBA, UMR_T 24, 13916 Marseille, France.
| | - L Tuchtan
- Aix-Marseille Univ, CNRS, EFS, ADES, Faculté de médecine Secteur Nord, Marseille, France; APHM, CHU Timone, Service de Médecine Légale et Droit de la santé, Marseille, France.
| | - C Bartoli
- Aix-Marseille Univ, CNRS, EFS, ADES, Faculté de médecine Secteur Nord, Marseille, France; APHM, CHU Timone, Service de Médecine Légale et Droit de la santé, Marseille, France.
| | - P Adalian
- Aix-Marseille Univ, CNRS, EFS, ADES, Faculté de médecine Secteur Nord, Marseille, France.
| | - K Chaumoitre
- Aix-Marseille Univ, CNRS, EFS, ADES, Faculté de médecine Secteur Nord, Marseille, France; APHM, Hôpital Nord, Service de radiologie, Marseille, France.
| | - M-D Piercecchi-Marti
- Aix-Marseille Univ, CNRS, EFS, ADES, Faculté de médecine Secteur Nord, Marseille, France; APHM, CHU Timone, Service de Médecine Légale et Droit de la santé, Marseille, France.
| | - L Thollon
- Aix Marseille Univ, IFSTTAR, LBA, UMR_T 24, 13916 Marseille, France.
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10
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Chiesa F, Sala L, Costa L, Moglia D, Mauri M, Podrecca S, Andreola S, Marchesini R, Bandieramonte G, Bartoli C. Excision of Oral Leukoplakias by CO2 Laser on an Out-Patient Basis: A Useful Procedure for Prevention and Early Detection of Oral Carcinomas. Tumori 2018; 72:307-12. [PMID: 3739009 DOI: 10.1177/030089168607200312] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Several epidemiologic studies have shown that oral cancer develops among individuals with a prior diagnosis of an oral premalignant lesion. Canceration chance in these patients is 17 %, with the greatest rate occuring in the second year of observation. Based on this data, since 1981, 92 leucoplakias have been treated by out-patient laser surgery at the Istituto Nazionale Tumori of Milano. The therapeutic technique was laser excision to obtain a specimen for histology. Two groups were distinguished according to the diagnostic procedure. Thirtythree lesions (December 1981 to December 1982) were operated on without preliminary histologic examination, on the basis of a simple clinical diagnosis. Since January 1983 all leukoplakias have been biopsied in a systematic way and those negative for cancer treated with laser. Histology of the specimen showed 5 squamous cell carcinomas (15 %) in the group of patients who did not undergo preoperative biopsy. Postoperative histology showed malignancy in 6 of 59 (10.2 %) cases in spite of negative preoperative biopsies. Speckled and erosive leukoplakias had the highest canceration rate. Three of 11 patients with cancer were treated by knife excision or interstitial needle implantation because of margins in tumoral tissue or because they were unvaluable for injury by heat. Results have been satisfactory, only 2 of 54 followed leukoplakias and none of the cancers recurred during a 2 year follow-up.
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11
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Tradati N, Zurrida S, Bartoli C, Boracchi P, Sala L, Contardi N, Rossi N, Chiesa F. Outpatient Surgical Treatment with Co2 Laser in Oral Cancer: Immediate and Long-Term Results. Tumori 2018; 77:239-42. [PMID: 1862553 DOI: 10.1177/030089169107700311] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The immediate and long-term results of excising squamous cell carcinoma of the oral cavity or lip by CO, laser are analysed in 51 consecutive subjects treated as out-patients. From January 1982 to December 1989, 39 cases of T1 and 12 cases of small (< 2.5 cm) non-infiltrating recurrences of squamous cell carcinoma were treated at the Istituto Nazionale Tumori in Milan. Complete removal was obtained in 44 instances, while in 7 cases cancerous margins were observed on the specimen; 5 of these underwent another wider treatment and 2 refused further therapy. Two of 39 T1 patients developed local relapses and 6/12 recurrent cancers relapsed again. Long term results are complicated by second primary cancers in 19 instances. Out-patient laser therapy is well accepted by patients and its use involves lowered direct and indirect health organisation and social costs.
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Affiliation(s)
- N Tradati
- Head and Neck Oncology Surgical, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
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12
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Abstract
From 1977 to 1987, outpatient surgery was performed under local anesthesia on 131 patients with squamous cell carcinoma of the lip without regional lymph nodes at the Day Hospital of the Istituto Nazionale Tumori (INT) Milan. Radical surgery was achieved in 117 cases (89.3%), independently of the size of the neoplasm. Of the 7 patients in whom radical surgery was not achieved at first operation, 3 were reoperated on as outpatients, 2 were hospitalized and reoperated, and 2 underwent X-ray treatment. Finally, in the remaining 7 patients radical surgery was not obtained or was near the borderline of the neoplasm. Complications (diastasis and/or suppuration) arose in 4.6% of the cases. During the follow-up (mean duration, 30 months) 7 patients developed a relapse and 2 manifested regional metastasis. Twenty-three patients developed a second tumor (13 on the lip, 3 in the lung, and 7 in other areas). These results prove that day hospital surgery of T1–T2 lip squamous carcinoma is feasible. It is appreciated by the patient, requires very little postoperative care, is less expensive than hospitalization, and involves less psychologic stress for the patient.
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Affiliation(s)
- S Zurrida
- Division of Surgery and Diagnostic Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy
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13
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Tomatis S, Bono A, Bartoli C, Tragni G, Farina B, Marchesini R. Image Analysis in the RGB and HS Colour Planes for a Computer-Assisted Diagnosis of Cutaneous Pigmented Lesions. Tumori 2018; 84:29-32. [PMID: 9619710 DOI: 10.1177/030089169808400106] [Citation(s) in RCA: 14] [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: 11/15/2022]
Abstract
Aims and background A study was carried out to evaluate the effectiveness of image analysis performed by the two color representation models when a computer-assisted diagnosis of melanoma is involved. Methods Color images of 40 skin pigmented lesions, which included 12 melanomas, were acquired by a standard color RGB video camera and stored in a PC for off-line processing. Image analysis was performed in the red green and blue color representation model and using hue and saturation color components. To describe shape and color characteristics of each lesion, including area, roundness and color variegation, 16 parameters were derived from red, green, blue, hue and saturation color planes and tested as possible variables useful to differentiate melanomas from benign nevi. Results The test gave a result of significance for six of the 16 derived image descriptors. The general trend of our data was in agreement with clinical observations according to which melanoma is usually darker, more variegated and less round than a benign nevus, whereas lesion dimension of melanomas and benign lesions was not significantly different. Conclusions Our preliminary results suggested that image analysis performed on hue and saturation-derived and red green and blue-derived data could better discriminate melanoma from nevi than separately using the two color representation models.
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Affiliation(s)
- S Tomatis
- Division of Health Physics, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy
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14
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Bono A, Bartoli C, Tessandri L, Del Prato I, Tragni G, Bucci A, Moglia D, Cascinelli N. In Situ and Very thin Melanomas (< 0.75 mm) are Similarly and Commonly Recognizable. Tumori 2018; 82:600-2. [PMID: 9061073 DOI: 10.1177/030089169608200618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and Background Recent data have suggested that cutaneous melanoma in situ can be clinically recognized in most cases by its features, which resemble those of early invasive melanoma. The aim of the study was to verify whether the diagnostic sensitivity of melanoma in situ is actually equivalent to that of early invasive melanoma. Methods We retrospectively reviewed the clinical diagnosis of 274 consecutive cutaneous melanoma <0.75 mm thick. The series consisted of 84 in situ and 190 invasive lesions. Results The clinical diagnosis of melanoma was performed in 62% (52/84) of cases of in situ melanoma and in 68% (130/190) of the cases of invasive melanoma. The differences were not statistically significant. Conclusions Our results show that cutaneous melanoma can be clinically diagnosed at a very early stage. In situ and very thin melanomas (< 0.75 mm) are similarly recognizable.
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Affiliation(s)
- A Bono
- Division of Surgical Semeiotics & Ambulatory Surgery, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
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15
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Abstract
To investigate the relation between estrogen receptor (ER) status and timing of relapse, we retrospectively studied two groups of patients (200 cases in each group) who underwent radical mastectomy and developed an early relapse (within 3 years of the surgery) or a long-term relapse (more than 8 years after surgery). One-hundred and eighty-two (91%) patients who developed a long-term relapse were ER-positive (ER+), whereas only 64% of patients who developed an early relapse were ER+ (P<0.001), supporting the hypothesis that a long-term relapse is more frequently associated with an ER+ tumor. A review of the literature, which indicated that a long-term relapse arises more frequently in patients in whom a partial hormone control is maintained, seems to support this finding, albeit the presence of 18 ER-negative (ER-) cases in our study. However, this apparent contradictory observation could be explained by the fact that 12 of our patients were in premenopause and that ER-status could have been false ER- results due to the binding of endogenous estradiol to ER.
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Affiliation(s)
- S Basso-Ricci
- Divisione di Radioterapia B, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
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16
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Abstract
Malignant melanoma (MM) of the penis is a rare neoplasia. We report 4 cases by a retrospective survey of all cases of MM observed at the Istituto Nazionale Tumori of Milano from 1967 to 1988. The problem of the therapeutic approach is still unsolved. Therefore, any case is useful for a better knowledge of the natural history of this disease.
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Affiliation(s)
- S Zurrida
- Division of Diagnostic Oncology and Outpatient Clinic, Istituto Nazionale Tumori, Milano, Italy
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17
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Abstract
Two new Italian cases of breast infection by Dirofilaria Repens are presented. In one case the correct diagnosis was clinically achieved through needle aspiration. This case is documented by a surprising macrophotography.
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Affiliation(s)
- C Bartoli
- Division of Diagnostic Oncology, Istituto Nazionale Tumori, Milano, Italy
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18
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Chiesa F, Tradati N, Costa L, Podrecca S, Boracchi P, Garramone R, Sala L, Bartoli C, Molinari R. CO2 Laser Surgery in Laryngeal Cancers: Three Year Results. Tumori 2018; 77:151-4. [PMID: 2048227 DOI: 10.1177/030089169107700212] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this paper is to evaluate the relapse-free survival and the overall survival at three years of 39 laryngeal cancers (10 T1 and 29 small recurrent carcinomas with mobile vocal cord) operated on by CO2 laser surgery at the Istituto Nazionale Tumori in Milan from 1982 to 1987. The 10 patients with T1 cancers had two local recurrences, whereas the 29 patients with recurrent carcinomas had 14 local recurrences. Local relapses occurred in 2/16 patients with cancer limited to the vocal cord and in 9/17 patients with glottic tumors extended to the anterior commissure or to the ventricular band or to the arytenoid. Supraglottic cancers recurred in 3/4 patients. The authors conclude that transoral laser surgery is an effective modality for treatment of T1 primary and small recurrent carcinomas of the larynx, when limited to the middle third of the vocal cord.
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Affiliation(s)
- F Chiesa
- Divisione di Oncologia Chirurgica Cervico-Facciale, Istituto Nazionale Tumori, Milano, Italy
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Petrillo R, Balzarini L, Bargellini A, Bartoli C, Ceglia E, Coopmans de Yoldi G, Greco M, Tess JD, Musumeci R. The Role of Magnetic Resonance Imaging in the Evaluation of Neoplastic Lesions of the Breast. Tumori 2018; 75:14-7. [PMID: 2711470 DOI: 10.1177/030089168907500105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Thirty-seven patients were evaluated for suspected breast cancer by magnetic resonance imaging (MRI) using 0.5- and 1.5-Tesla. We esamined the patterns in breast images and the use of MRI in evaluating neoplasms. At the moment the cost/benefit ratio is unfavorable, mainly because of the availability of alternative methods of high accuracy and low cost, like mammography and ultrasonography. Furthermore fine needle aspiration biopsy is not possible with MRI. The widespread use of MRI for breast pathology seems not to be justified by the results obtained.
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Affiliation(s)
- R Petrillo
- Istituto Nazionale dei Tumori, Milano, Italy
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Basso-Ricci S, Bartoli C. Cutaneous Carcinomas and Soft Tissue Sarcomas Induced by Ionizing Radiation Therapy. Presentation of a Series of 42 Cases. Tumori 2018; 71:29-33. [PMID: 3984046 DOI: 10.1177/030089168507100105] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Forty-two cases of tumors of the skin and of the soft tissues immediately beneath the skin, presumably induced by ionizing radiotherapy, are reported: 35 were carcinomas, 2 angiosarcomas, 2 leiomyosarcomas of the dermis and 3 fibrosarcomas. In 31 of the 35 cases of carcinomas, multiple neoplastic foci were found in the skin area exposed to the ionizing radiation. The median age of the patients at the time of exposure to ionizing radiation was 32.5 years for those with carcinomas and 30 years for the others. The relatively young age at exposure to the ionizing radiation may have influenced onset of the tumor. The median interval between exposure to ionizing radiation and clinical finding of the tumor was 18.1 years for the carcinomas and 16 for the other tumor types. The radiation dose to which the patients had been subjected varied for the carcinomas from 12 to 25 Gy and for the other tumors from 40 to 50 Gy, administered over 1 to 4 years in the cases of carcinomas and 4 to 5 weeks in the other cases. The dose administered to the cases with cutaneous carcinomas was rather low, since almost all these patients had benign disease; however, it is in this dose range (12-25 Gy) that, according to Gray, a relatively high incidence of induced tumors is verified. In the opinion of the author of the present paper, the multiplicity of neoplastic carcinomatous foci in the skin area exposed to radiation confirms Gray's hypothesis; also, the time over which the dose was administered was presumably important in determining such multiplicity. The soft tissue sarcomas occurred only in patients previously subjected to radiotherapy, according to traditional modalities, for malignant neoplasms. The carcinomas were observed almost always in the trunk, and like spontaneous carcinomas at this site they were almost exclusively of basal cell type.
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Abstract
From 1928 to 1965, 383 cases of thyroid carcinoma were studied at the National Cancer Institute of Milan; among these cases 113 had distant metastases. The metastases were more frequent in patients aged fro 60 to 69. The female/male ratio was about 2:1. The lesions were more often in the skeleton (74 cases) and in the lungs (64 cases). Since a high incidence of skeletal metastases without lung involvement has been observed, the authors postulate that metastatic spread from thyroid carcinoma may occur also through vertebral veins. In undifferentiated carcinomas distant metastases occur quite early (87 % at 5 years). On the contrary, in differentiated carcinomas, metastases occur later: after 5 years from thyroidectomy in 31 per cent of patients with follicular carcinomas metastases were found and in 74 per cent after 10 years. In papillary carcinomas the percentage is 17 and 52 after 5 and 10 years respectively. Among 113 cases with distant metastases, 50 showed the first metastatic localization to the regional lymph nodes; this occurrence was found to be more frequent in papillary and unidifferentiated carcinomas (χ2 = 11.805).
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Abstract
Aims and background Melanoma of the external ear is a rare disease, and its management is controversial. To address this problem, we reviewed the data concerning the patients observed at our Institution. Methods We retrospectively reviewed the clinical records of the 20 patients bearing primary ear melanoma observed over a period of about 20 years at the Istituto Nazionale Tumori of Milan. Results Initial evaluation of the patients revealed 7 stage I, 12 stage II and 1 stage III. The thickness of the tumors varied from 0.39 to 6.62 mm. Fourteen patients underwent a wedge resection of the skin and cartilage with primary closure, and 6 patients had a partial amputation of the ear. In 8 cases the section was performed at about 1 cm from the border of the tumor, in 6 cases at about 0.5 cm, and in 6 cases at more than 1 cm. The average follow-up was 57 months (range, 1-18 years). Since there was no local recurrence, it could not be related to type and extent of the local resection performed. In contrast, the development of metastases was related to tumor thickness. Conclusions A conservative excision with margins of 1 cm can be a safe procedure for invasive ear melanoma, irrespective of tumor thickness. Like melanomas of other sites, the prognosis is linked to the thickness of the tumor.
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Affiliation(s)
- A Bono
- Division of Surgical Semiotics and Day Surgery, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
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Bonadonna G, De Lena M, Bartoli C, Monfardini S, Guzzon A, Molinari R, Bajetta E, Beretta G, Fossati-Bellani F, Orefice S. Preliminary Phase I Evaluation of Bleomycin, a New Antitumor Antibiotic. Tumori 2018; 57:21-53. [PMID: 4108879 DOI: 10.1177/030089167105700103] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Bleomycin (BLM), a new antitumor antibiotic isolated in Japan from cultures of Streptomyces Verticillus, was administered by single intravenous injections to patients with different types of lymphomas and miscellaneous solid tumors for phase I evaluation. 85 out of the 110 patients included in the study were suitable for the evaluation of acute and delayed toxicity, while 93 patients were evaluable to detect the therapeutic effects of the drug. The average age of the patients was 54 years (range 7–83). 16 patients were untreated and 77 had received one or more courses of radiotherapy and/or chemotherapy. During this trial different doses and schedules were employed (table 2): A) 30 mg/m2 × 2/week × 4 weeks; B) 30 mg/m2/day × 8 days; C) 15 mg/m2/day × 8 days. After a month interval all 3 courses were repeated; D) 15 mg/m2/day × 5 days to be repeated twice after 3 weeks interval. Maintenance therapy consisted of 15–30 mg/m2/week. To diminish the febrile reaction, a suppository of indometacin (100 mg) was given 30–60 minutes prior to drug administration. The incidence of toxic manifestations, irrespective of dose and schedule, was as follows (fig. 4): sclerotic changes of the skin of hands (80%), fever (67%), alopecia (61 %), skin hyperpigmentation (60 %), stomatitis (48 %), gastrointestinal disturbances (20%) and pulmonary symptoms (19%). No definite signs of marrow toxicity nor significant changes in the blood chemistry attributable to the drug were observed. Symptoms and signs of pulmonary toxicity, appearing 1–4 weeks after the last dose were: rhonchi, rales and pleural friction rubs, in some cases associated with fever and dyspnea. The chest X-ray showed evidence of interstitial lesions (in early phases most marked at the costophrenic angle) which may become widespread with a bronchopneumonia-like appearance (fig. 5 and 6). No clearcut radiological signs of pulmonary fibrosis were observed (patients were not followed for a period longer than 5 months). If BLM is stopped in time and carticosteroids are given in association to antibiotics, both clinical and radiological findings may disappear completely (fig. 7). Of the 7 patients studied post mortem, 6 revealed lesions attributable to drug toxicity (alveolar collapse with edema, histiocytic proliferation, hyaline membranes, alveolar and interstitial fibrosis (fig. 8–11). In 7 patients pulmonary toxicity was suspected only on clinical grounds, in 2 cases the radiological aspect of the lungs was suggestive of interstitial lesions without concomitant physical findings, in 9 cases a good correlation between clinical and radiological diagnosis was observed and, finally, in 6 patients the pulmonary fibrosis was detected on histological examination (table 3). In the 17 patients in whom the diagnosis of pulmonary toxicity was documented either radiologically or histologically, the average age was 56,5 years (7–78 years) and the mean total dose, producing toxicity was 230 mg/m2 (range 60–480). Practically, all these patients prior to the treatment had different grades of chronic pulmonary lesions (emphysema, fibrosis post RT or tuberculosis, silicosis in 1 case). It is difficult to estimate in what proportion BLM could have contributed to the cause of death, since most patients dying during treatment had also lung metastases. However, at least in 1 case in whom postmortem examination did not disclose lymphosarcoma cells (complete remission), the cause of death could be related to drug administration (total 225 mg/m2) since extensive pulmonary fibrosis was seen on histological examination (table 4). Table 5 shows the incidence of side-effects after the first course of BLM. No significant differences were observed among cases treated with 4 different schedules, and the first sign of toxicity appeared in all groups after the 4th–6th dose irrespective of the dose and schedule. Regressions in different types of tumors were observed during this phase I study (table 6). The overall regression rate was 69 % (24 % greater than 50 % and 5% complete). The therapeutic response was prompt but usually short-lived (average 4–6 weeks). No cross-resistance with radiotherapy nor with some of the conventional agents was observed. The most responsive tumors were carcinomas of head and neck, carcinomas of esophagus (fig. 17) and malignant lymphomas (fig. 16). One 7-year-old boy with acute lymphosarcoma cell leukemia had a complete remission and autopsy revealed no signs of neoplastic disease. In 2/3 patients with CLL a moderate decrease in the volume of hepato-splenomegaly was observed without significant fall in the WBC. The minimal toxic dose was 45–60 mg/m2 in malignant lymphomas and 60–120 mg/m2 in the other solid tumors. BLM appears to be a potent new growth-inhibiting compound specific for epidermoid carcinomas and devoid of bone marrow toxicity. The optimal dose schedule as well as the real incidence and course of pulmonary toxicity should be more clearly defined in future studies.
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Carballeira Álvarez A, Mancini J, Tuchtan-Torrents L, Gach P, Bartoli C, Desfeux J, Piercecchi MD, Gorincour G. Diagnostic value of unenhanced postmortem computed tomography in the detection of traumatic abdominal injuries. Diagn Interv Imaging 2018; 99:397-402. [PMID: 29475777 DOI: 10.1016/j.diii.2017.12.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 12/26/2017] [Accepted: 12/30/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the diagnostic capabilities of unenhanced postmortem computed tomography (UPMCT) in detecting traumatic abdominal injuries. MATERIAL AND METHODS Cases of traumatic death with both UPMCT and classical autopsy were collected retrospectively from our institution "virtopsy" database in a period of 5 years. Cadavers with gunshot injuries were excluded. Sensitivity, specificity, accuracy, negative (NPV) and positive (PPV) predictive values of PMCT globally and for hemoperitoneum, liver, spleen, pancreas and kidney injuries individually were estimated using the autopsy report as gold standard. RESULTS Seventy-one cadavers were included. UPMCT had a sensitivity of 80% and a specificity 94%, with an accuracy of 83%, a PPV of 98% and a NPV of 59% for the diagnosis of traumatic abdominal injuries. The highest sensitivity was obtained for the detection of hepatic injuries (71%) and the lowest for pancreatic injuries (12%). UPMCT had a specificity of 100% for the detection of hemoperitoneum. A NPV of 98% was found for the detection of perihepatic hematomas. CONCLUSION The low sensitivity and low NPV do not support the use of UPMCT as an alternative to conventional autopsy to diagnose and/or rule out traumatic abdominal injuries. Nevertheless, UPMCT remains a helpful tool as it helps detect hemoperitoneum and virtually exclude presence of perihepatic hematomas.
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Affiliation(s)
- A Carballeira Álvarez
- Department of Radiology, Donostia Hospital (Osakidetza), P° Doctor Beguiristain, s/n, 20014 San Sebastián, Spain.
| | - J Mancini
- Inserm, IRD, UMR912 SESSTIM, Aix-Marseille université, 105, 27, boulevard Leï Roure, CS 30059, 13273 Marseille cedex 09, France; Public Health Department (BIOSTIC), Timone hospital (APHM), 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - L Tuchtan-Torrents
- Department of Forensic Medicine, Timone hospital (APHM), 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - P Gach
- Department of Medical Imaging, Timone hospital (APHM), 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - C Bartoli
- Department of Forensic Medicine, Timone hospital (APHM), 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - J Desfeux
- Department of Forensic Medicine, Timone hospital (APHM), 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - M D Piercecchi
- Department of Forensic Medicine, Timone hospital (APHM), 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - G Gorincour
- Department of Medical Imaging, Timone hospital (APHM), 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
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Tuchtan L, Lesieur E, Bartoli C, Delteil C, Sarda-Quarello L, Torrents J, Sigaudy S, Piercecchi MD, Gorincour G. Diagnosis of congenital abnormalities with post-mortem ultrasound in perinatal death. Diagn Interv Imaging 2017; 99:143-149. [PMID: 29229509 DOI: 10.1016/j.diii.2017.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 10/18/2017] [Accepted: 11/14/2017] [Indexed: 01/01/2023]
Abstract
PURPOSE To determine the sensitivity and specificity of post-mortem ultrasound in the diagnosis of major congenital abnormalities of fetuses using conventional autopsy as the standard of reference. MATERIAL AND METHODS All fetuses coming from terminations of pregnancy or intrauterine fetal deaths in a single institution were included. A total of 75 fetuses were included during the study period. The results of post-mortem ultrasound examinations were compared to those of conventional autopsy that served as standard of reference. RESULTS Gestational age of the fetuses ranged from 15 to 38 weeks gestation. A complete post-mortem ultrasound assessment was possible in all fetuses. Regarding detection of brain abnormalities, post-mortem ultrasound had a sensitivity of 81.5% or 4/5 (95% CI: 63.3-91.8%), and a specificity of 97.9% (95% CI: 89.1-99.6%). Specificities for the diagnosis of thoracic, cardiac, urinary tract, spinal and bone abnormalities were 100%. CONCLUSION Post-mortem ultrasound shows high sensitivity and specificity for the diagnosis of congenital structural abnormalities as compared to conventional autopsy, with the exception of congenital cardiac diseases.
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Affiliation(s)
- L Tuchtan
- Department of forensic pathology, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; CNRS, EFS, ADES UMR 7268, Aix-Marseille university, 13916 Marseille, France; Department of fetopathology, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| | - E Lesieur
- Center for prenatal diagnosis, children hospital, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| | - C Bartoli
- Department of forensic pathology, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; CNRS, EFS, ADES UMR 7268, Aix-Marseille university, 13916 Marseille, France.
| | - C Delteil
- Department of forensic pathology, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; CNRS, EFS, ADES UMR 7268, Aix-Marseille university, 13916 Marseille, France.
| | - L Sarda-Quarello
- Department of fetopathology, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| | - J Torrents
- Department of forensic pathology, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; Department of fetopathology, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| | - S Sigaudy
- Center for prenatal diagnosis, children hospital, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| | - M-D Piercecchi
- Department of forensic pathology, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; CNRS, EFS, ADES UMR 7268, Aix-Marseille university, 13916 Marseille, France.
| | - G Gorincour
- Center for prenatal diagnosis, children hospital, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; Department of pediatric and prenatal imaging, La-Timone children hospital, Aix-Marseille university, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
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Tuchtan L, Gorincour G, Kolopp M, Massiani P, Léonetti G, Piercecchi-Marti MD, Bartoli C. Combined use of postmortem 3D computed tomography reconstructions and 3D-design software for postmortem ballistic analysis. Diagn Interv Imaging 2017; 98:809-812. [DOI: 10.1016/j.diii.2017.06.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 06/01/2017] [Accepted: 06/22/2017] [Indexed: 11/30/2022]
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Renault L, Perrot E, Pradat E, Bartoli C, Greillier L, Remacle-Bonnet A, Telmon N, Mazieres J, Molinier L, Couraud S. Cancer bronchique chez les prisonniers : une incidence élevée chez les jeunes. Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
The causes of balance disorder are many and various, and the subjective syndrome of cranial trauma patients is diagnosed by elimination. Progress in otoneurologic functional exploration and brain imaging, however, now generally allow this functional complaint to be given an objective basis. In recent years, new diagnoses have improved recognition of such pathologies in the appraisal of corporal injury for compensation purposes. The present article seeks to detail etiology and, by a review of the literature, to determine factors liable to influence management and appraisal in particular.
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Affiliation(s)
- M Elzière
- Service ORL, hôpital européen, 6, rue Désirée-Clary, 13003 Marseille, France.
| | - A Devèze
- Service ORL, Ramsay générale de santé, hôpital Clairval, 13009 Marseille, France
| | - C Bartoli
- UMR T24, IFSTTAR, laboratoire biomécanique appliqué, Aix-Marseille université, 13915 Marseille cedex, France; Service de médecine légale et droit de la santé, Aix-Marseille université, UFR médecine Timone, 27, boulevard Jean-Moulin, 13385 Marseille cedex 5, France
| | - G Levy
- 18, rue Gounod, 06000 Nice, France
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Borschinger B, Bartoli C, Chandeysson C, Guilbaud C, Parisi L, Bourgeay JF, Buisson E, Morris CE. A set of PCRs for rapid identification and characterization of Pseudomonas syringae phylogroups. J Appl Microbiol 2016; 121:903. [PMID: 27528015 DOI: 10.1111/jam.13219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- B Borschinger
- INRA, Unité de Pathologie Végétale, Domaine de St Maurice, BP 94, 84140, Montfavet, France.,IMBE, Université d'Avignon et des Pays de Vaucluse, UMR CNRS IRD Aix Marseille Université, Site Agroparc BP 61207, 84911, Avignon, France
| | - C Bartoli
- INRA, Laboratoire des Interactions Plantes-Microorganismes (LIPM), UMR441, F-31326, Castanet-Tolosan, France.,CNRS, Laboratoire des Interactions Plantes-Microorganismes (LIPM), UMR2594, F-31326, Castanet-Tolosan, France
| | - C Chandeysson
- INRA, Unité de Pathologie Végétale, Domaine de St Maurice, BP 94, 84140, Montfavet, France
| | - C Guilbaud
- INRA, Unité de Pathologie Végétale, Domaine de St Maurice, BP 94, 84140, Montfavet, France
| | - L Parisi
- INRA, Unité de Pathologie Végétale, Domaine de St Maurice, BP 94, 84140, Montfavet, France
| | - J F Bourgeay
- INRA, Unité de Pathologie Végétale, Domaine de St Maurice, BP 94, 84140, Montfavet, France
| | - E Buisson
- IMBE, Université d'Avignon et des Pays de Vaucluse, UMR CNRS IRD Aix Marseille Université, Site Agroparc BP 61207, 84911, Avignon, France
| | - C E Morris
- INRA, Unité de Pathologie Végétale, Domaine de St Maurice, BP 94, 84140, Montfavet, France
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Borschinger B, Bartoli C, Chandeysson C, Guilbaud C, Parisi L, Bourgeay JF, Buisson E, Morris CE. A set of PCRs for rapid identification and characterization of Pseudomonas syringae phylogroups. J Appl Microbiol 2016; 120:714-23. [PMID: 26661140 DOI: 10.1111/jam.13017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 10/29/2015] [Accepted: 11/26/2015] [Indexed: 12/13/2022]
Abstract
AIMS The aim of this study was to develop a rapid PCR-based method for the specific detection of individual phylogroups of the Pseudomonas syringae complex. METHODS AND RESULTS Seven primer pairs were developed by analysing whole genomes of 54 Ps. syringae strains. The specificity and sensitivity of these primer pairs were assessed on 236 strains from a large and comprehensive Ps. syringae collection. The method was also validated by characterizing the phylogenetic diversity of 174 putative Ps. syringae isolates from kiwifruit and apricot orchards of southeastern France. CONCLUSION Our PCR-based method allows for the detection and characterization of nine of the 13 Ps. syringae phylogroups (phylogroups 1, 2, 3, 4, 7, 8, 9, 10 and 13). SIGNIFICANCE AND IMPACT OF THE STUDY To date, phylogenetic affiliation within the Ps. syringae complex was only possible by sequencing housekeeping genes. Here, we propose a rapid PCR-based method for the detection of specific phylogroups of the Ps. syringae complex. Furthermore, for the first time we reveal the presence of Ps. syringae strains belonging to phylogroups 10 and 13 as epiphytes on plants, whereas they had previously only been observed in aquatic habitats.
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Affiliation(s)
- B Borschinger
- Unité de Pathologie Végétale, INRA, Montfavet, France.,IMBE, Université d'Avignon et des Pays de Vaucluse, UMR CNRS IRD Aix Marseille Université, Avignon, France
| | - C Bartoli
- Laboratoire des Interactions Plantes-Microorganismes (LIPM), INRA, Castanet-Tolosan, France.,Laboratoire des Interactions Plantes-Microorganismes (LIPM), CNRS, Castanet-Tolosan, France
| | - C Chandeysson
- Unité de Pathologie Végétale, INRA, Montfavet, France
| | - C Guilbaud
- Unité de Pathologie Végétale, INRA, Montfavet, France
| | - L Parisi
- Unité de Pathologie Végétale, INRA, Montfavet, France
| | - J F Bourgeay
- Unité de Pathologie Végétale, INRA, Montfavet, France
| | - E Buisson
- IMBE, Université d'Avignon et des Pays de Vaucluse, UMR CNRS IRD Aix Marseille Université, Avignon, France
| | - C E Morris
- Unité de Pathologie Végétale, INRA, Montfavet, France
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Chiellini F, Puppi D, Piras AM, Morelli A, Bartoli C, Migone C. Modelling of pancreatic ductal adenocarcinoma in vitro with three-dimensional microstructured hydrogels. RSC Adv 2016. [DOI: 10.1039/c6ra08420f] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Development of a novelin vitro3D model of pancreas cancer based on microstructured polyelectrolyte complex (mPEC) hydrogel.
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Affiliation(s)
- F. Chiellini
- BIOLab Research Group
- Department of Chemistry and Industrial Chemistry
- University of Pisa
- UdR INSTM Pisa
- Pisa
| | - D. Puppi
- BIOLab Research Group
- Department of Chemistry and Industrial Chemistry
- University of Pisa
- UdR INSTM Pisa
- Pisa
| | - A. M. Piras
- BIOLab Research Group
- Department of Chemistry and Industrial Chemistry
- University of Pisa
- UdR INSTM Pisa
- Pisa
| | - A. Morelli
- BIOLab Research Group
- Department of Chemistry and Industrial Chemistry
- University of Pisa
- UdR INSTM Pisa
- Pisa
| | - C. Bartoli
- BIOLab Research Group
- Department of Chemistry and Industrial Chemistry
- University of Pisa
- UdR INSTM Pisa
- Pisa
| | - C. Migone
- BIOLab Research Group
- Department of Chemistry and Industrial Chemistry
- University of Pisa
- UdR INSTM Pisa
- Pisa
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Pecorari G, Raimondo L, Bartoli C, Leombruni P, Garzaro M, Airoldi M. Effect of patient's alcohol abuse on caregiver's psychological asset: analysis of 60 couples of Head and Neck cancer patients and their caregivers. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv342.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Airoldi M, Garzaro M, Ceccarelli M, Monagheddu C, Pedani F, Bellini E, Fora G, Bartoli C, Raimondo L, Pecorari G. How clinical characteristics of recurrent/metastatic salivary gland malignancies (RMSGM) treated with first line chemotherapy (CT) impact on survival: multivariate analysis of 108 cases. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv342.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sarda-Quarello L, Tuchtan L, Bartoli C, Bourlière-Najean B, Petit P, Sigaudy S, Piercecchi-Marti MD, Gorincour G. [Post-mortem perinatal imaging: State of the art and perspectives, with an emphasis on ultrasound]. ACTA ACUST UNITED AC 2015; 43:612-5. [PMID: 26297165 DOI: 10.1016/j.gyobfe.2015.07.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 03/23/2015] [Accepted: 07/21/2015] [Indexed: 11/16/2022]
Abstract
The fields of application of post-mortem imaging have been exponentially growing for 10 years. Its potential to identify the cause of death in trauma and ballistic cases is now properly documented. In pediatric and perinatal practice, large significant series are less available, except for MRI and central nervous system analysis where scientific evidence is now robust. After a short historical and state-of-the-art review, we will try to depict the way we see the future of this sub-specialty of post-mortem imaging, especially in specific perinatal situations.
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Affiliation(s)
- L Sarda-Quarello
- Service d'anatomopathologie, hôpital de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France; Centre pluridisciplinaire de diagnostic prénatal, hôpital de la Timone-Enfants, 264, rue Saint-Pierre, 13005 Marseille, France
| | - L Tuchtan
- Service de médecine légale, hôpital de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - C Bartoli
- Service de médecine légale, hôpital de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - B Bourlière-Najean
- Service d'imagerie pédiatrique et prénatale, hôpital de la Timone-Enfants, 264, rue Saint-Pierre, 13005 Marseille, France
| | - P Petit
- Service d'imagerie pédiatrique et prénatale, hôpital de la Timone-Enfants, 264, rue Saint-Pierre, 13005 Marseille, France
| | - S Sigaudy
- Centre pluridisciplinaire de diagnostic prénatal, hôpital de la Timone-Enfants, 264, rue Saint-Pierre, 13005 Marseille, France
| | - M-D Piercecchi-Marti
- Service de médecine légale, hôpital de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - G Gorincour
- Centre pluridisciplinaire de diagnostic prénatal, hôpital de la Timone-Enfants, 264, rue Saint-Pierre, 13005 Marseille, France; Service d'imagerie pédiatrique et prénatale, hôpital de la Timone-Enfants, 264, rue Saint-Pierre, 13005 Marseille, France; Laboratoire d'imagerie interventionnelle et expérimentale, CERIMED, Aix-Marseille université, 13005 Marseille, France.
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Piercecchi-Marti MD, Tuchtan-Torrents L, Lassale B, Leonetti G, Bartoli C. [Responsibility for prescribing and monitoring an act transfusion and safety blood transfusion]. Transfus Clin Biol 2014; 21:158-61. [PMID: 25282487 DOI: 10.1016/j.tracli.2014.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 08/04/2014] [Indexed: 11/18/2022]
Abstract
The act to transfuse is a prescription following basic rules similar to drug prescriptions. If harm happens, potentially linked with this prescription, the harm's responsibility is borne by the physician, the paramedics, the care organization but by the supplier laboratory too. The setting of good practice rules consistent with science data at the time when the act is performed, the respect of the patient's rights and the quality of supplied products will be assessed during the expertise. Under restorative responsibility, it is necessary to previously establish a direct and certain causation between the litigious act and the harm to enforce the vicarious liability. Nowadays, legal precedents grant a larger protection to more and more numerous victims, enhancing the field of the fault with the appeal to assumption of fault. At the same time, the lawmaker himself promulgated objective conditions of compensation for many categories of victims of medical risk from which transfused people are part. The law of March the 4th of 2002 went one step closer devoting a new foundation of compensation: national solidarity.
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Affiliation(s)
- M D Piercecchi-Marti
- Service de médecine légale droit de la Santé-Aix-Marseille université UMR 7268 ADES, 13344 Marseille cedex 15, France.
| | - L Tuchtan-Torrents
- Service de médecine légale droit de la Santé-Aix-Marseille université UMR 7268 ADES, 13344 Marseille cedex 15, France
| | - B Lassale
- Unité d'hémovigilance APHM, hôpital Sainte-Marguerite, 274, boulevard Sainte-Marguerite, 13009, France.
| | - G Leonetti
- Service de médecine légale droit de la Santé-Aix-Marseille université UMR 7268 ADES, 13344 Marseille cedex 15, France
| | - C Bartoli
- Service de médecine légale droit de la Santé-Aix-Marseille université UMR 7268 ADES, 13344 Marseille cedex 15, France
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Niort F, Delteil C, Bartoli C, Leonetti G, Piercecchi-Marti MD. Inhomogénéité des évaluations de durée d’incapacité totale de travail. Comparaison d’évaluations des durées d’incapacité totale de travail entre les médecins légistes, les médecins généralistes et les urgentistes. Médecine & Droit 2014. [DOI: 10.1016/j.meddro.2014.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Laurent PE, Coulange M, Bartoli C, Louis G, Souteyrand P, Gorincour G. Retrograde cerebral venous air embolism: a rare cause of intracranial gas. Diagn Interv Imaging 2014; 95:1113-5. [PMID: 24589189 DOI: 10.1016/j.diii.2013.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- P-E Laurent
- Laboratoire d'imagerie interventionnelle expérimentale, faculté de médecine, Aix-Marseille université, boulevard Jean-Moulin, 13385 Marseille cedex 5, France; Pôle imagerie médicale, Assistance publique des Hôpitaux de Marseille, 13385 Marseille cedex 5, France.
| | - M Coulange
- Service de médecine Hyperbare, pôle RUSH, hôpital Ste-Marguerite, 270, boulevard Sainte-Marguerite, 13274 Marseille cedex 9, France
| | - C Bartoli
- Service de médecine légale et droit à la santé, hôpital Timone, Assistance publique des Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - G Louis
- Laboratoire d'imagerie interventionnelle expérimentale, faculté de médecine, Aix-Marseille université, boulevard Jean-Moulin, 13385 Marseille cedex 5, France; Pôle imagerie médicale, Assistance publique des Hôpitaux de Marseille, 13385 Marseille cedex 5, France
| | - P Souteyrand
- Laboratoire d'imagerie interventionnelle expérimentale, faculté de médecine, Aix-Marseille université, boulevard Jean-Moulin, 13385 Marseille cedex 5, France; Pôle imagerie médicale, Assistance publique des Hôpitaux de Marseille, 13385 Marseille cedex 5, France
| | - G Gorincour
- Laboratoire d'imagerie interventionnelle expérimentale, faculté de médecine, Aix-Marseille université, boulevard Jean-Moulin, 13385 Marseille cedex 5, France; Pôle imagerie médicale, Assistance publique des Hôpitaux de Marseille, 13385 Marseille cedex 5, France
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Riera F, Medeot M, Sartori L, Bergallo C, Minoli J, Vilchez V, Sánchez P, Abiega C, Pincheira C, Correa S, Bartoli C, Figueroa M, Montamat M, Spitale N, Minguez A, Caeiro JP. [Candidemia epidemiology in Córdoba Argentina. Surveillance study of five institutions]. Rev Fac Cien Med Univ Nac Cordoba 2014; 71:89-93. [PMID: 25365194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
UNLABELLED The incidence rate of invasive infections due to Candida species has increased drastically in the last 20 years, causing a 40% mortality rate in hospitalized patients. In order to comprehend the epidemiology of Candida bloodstream infection, the study was carried out. MATERIALS AND METHODS A retrospective study was done based on microbiology laboratory reports from five terciary care hospitals from the city of Cordoba between January 2010 and August 2012. RESULTS 158 patients had candidemia, the average age was 55,8 years, and 54% of patients were in the intensive care unit. Candida albicans (44%), Candida parapsilosis (22%) and Candida tropicalis (12%) were the main fungi isolated. Candida parapsilosis was commonly associated with catether infections. CONCLUSIONS The data from the city of Cordoba showed that C. albicans, C. parapsilosis y C. tropicalis were the more frequent species isolated from blood cultures. This is similar to what is seen in other series published from Argentina and Latinamerica. This study may have implications when it comes to deciding which empiric antifugal agent is best for the treatment of candidemia.
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Coulange M, Desfeux J, Perich P, Bartoli C, Laurent PE, Gorincour G, Piercecchi M, Auffray JP, Léonetti G. Analysis of causes of fatal scuba diving accidents and preventive measures. ARCH MAL PROF ENVIRO 2013. [DOI: 10.1016/j.admp.2013.07.087] [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: 10/26/2022]
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Berland-Benhaïm C, Bartoli C, Karsenty G, Piercecchi-Marti MD. Prescrire un médicament en 2013 : aspects légaux. Prog Urol 2013; 23:1201-7. [DOI: 10.1016/j.purol.2013.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 09/16/2013] [Indexed: 11/15/2022]
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Lebreton-Chakour C, Boval C, Torrents J, Bartoli C, Leonetti G, Piercecchi-Marti MD. [Fatal hemorrhage in postpartum by rupture of a splenic artery aneurysm]. ACTA ACUST UNITED AC 2013; 41:617-9. [PMID: 24094666 DOI: 10.1016/j.gyobfe.2013.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 03/18/2013] [Indexed: 11/25/2022]
Abstract
The maternal mortality is rare and when it arises, the family often puts the medical profession in guilty's position. We present the case of a 38-year-old woman, died in the post-partum in a context of intense back pains. The autopsy found an incidental hemorrhagic syndrome to a two-stage rupture of the splenic artery. We shall discuss the aetiology. The autopsy and the anatomopathological examination are practiced only in hardly more than a quarter of the cases while they will be important in proceedings and will allow the family to go into mourning.
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Affiliation(s)
- C Lebreton-Chakour
- Service de médecine légale et droit de la santé, CHU Timone, Aix Marseille université, 13005 Marseille, France.
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Bartoli C, Beug MF, Bruns T, Elster C, Esward T, Klaus L, Knott A, Kobusch M, Saxholm S, Schlegel C. Traceable dynamic measurement of mechanical quantities: objectives and first results of this european project. Int J Metrol Qual Eng 2013. [DOI: 10.1051/ijmqe/2012020] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Nine european national metrology institutes (NMIs) are collaborating in a new project funded by the european metrology research programme (EMRP) to establish traceable dynamic measurement of the mechanical quantities force, pressure, and torque. The aim of this joint research project (JRP) is to develop appropriate calibration methods, mathematical models, and uncertainty evaluation. The duration of the project is 3 years for a global amount of €3.6 million. It began in September 2011.
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Laurent PE, Coulange M, Desfeux J, Bartoli C, Coquart B, Vidal V, Gorincour G. Post-mortem computed tomography in a case of suicide by air embolism. Diagn Interv Imaging 2013; 94:460-2. [DOI: 10.1016/j.diii.2013.01.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Jolibert M, Cohen F, Bartoli C, Boval C, Vidal V, Gaubert JY, Moulin G, Petit P, Bartoli JM, Leonetti G, Gorincour G. [Postmortem CT-angiography: feasibility of US-guided vascular access]. ACTA ACUST UNITED AC 2011; 92:446-9. [PMID: 21621113 DOI: 10.1016/j.jradio.2011.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 02/25/2011] [Accepted: 03/22/2011] [Indexed: 10/18/2022]
Affiliation(s)
- M Jolibert
- Service de radiologie générale et vasculaire, hôpital de la Timone, 264 rue Saint-Pierre, Marseille cedex 5, France.
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Berland-Benhaïm C, Giocanti D, Bartoli C, Sastre C, Leonetti G, Pelissier-Alicot A. Medication misuse and abuse: duties and responsibilities of dispensing pharmacists. Med Sci Law 2011; 51:49-55. [PMID: 21595422 DOI: 10.1258/msl.2010.010089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Misuse of medications can have major consequences for the consumer or patient's health. In the case of a drug delivered only on medical prescription, the misuse usually results from an error or negligence on the part of the prescribing doctor and/or the pharmacist dispensing the medication. But whereas, under French Law, doctors are regularly prosecuted for their irresponsibility, pharmacists frequently avoid any legal charges. This is even more surprising in view of the fact that French Legislation controls the practice of pharmacy very strictly. The authors discuss four cases that illustrate this issue and present a study of comparative pharmaceutical law requirements.
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Affiliation(s)
- C Berland-Benhaïm
- Service de Médecine Légale, Faculté de Médecine, Université de La Méditerranée, F-13385 Marseille Cedex 05, France.
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Piercecchi-Marti MD, Sastre B, Zuck S, François A, Genety C, Bartoli C, Leonetti G. L’accident médical non fautif : bilan de deux années d’activité de la commission régionale de conciliation et d’indemnisation des accidents médicaux de la région PACA. ACTA ACUST UNITED AC 2008; 145:442-6. [DOI: 10.1016/s0021-7697(08)74653-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Christia-Lotter A, Bartoli C, Piercecchi-Marti MD, Demory D, Pelissier-Alicot AL, Sanvoisin A, Leonetti G. Fatal occupational inhalation of hydrogen sulfide. Forensic Sci Int 2007; 169:206-9. [PMID: 16564147 DOI: 10.1016/j.forsciint.2006.02.043] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2005] [Revised: 02/13/2006] [Accepted: 02/13/2006] [Indexed: 11/26/2022]
Abstract
A young man aged 22 years, a sewer worker by profession, died after massive inhalation of hydrogen sulfide while at work. He was rescued by the emergency services and admitted to the critical care department, where he died due to massive myocardial necrosis less than 24 h after admission. In this case, where the causes of the accident were not clearly established, autopsy and anatomopathologic examination made it possible to confirm the causal lesions which resulted in death and to question the initial version of the circumstances of the accident. Medicolegal investigation was valuable in determining possible liabilities and repercussions on coverage as an industrial accident by the national health insurance system.
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Affiliation(s)
- A Christia-Lotter
- Service de Médecine Légale et de Droit de la Santé, Faculté de Médecine, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
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Deville J, Salas S, Bartoli C, Dupuis C, Duffaud F, Sebahoun G, Figarella-Branger D, Ouafik L, Martin P, Daniel L. Adrenomedullin and its receptors expression in renal tumors. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.10568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10568 Background: Adrenomedullin (AM) is a 52 amino acid peptide that has an important role on tumor cell proliferation and neoangiogenesis through its receptors CRLR/RAMP2 and CRLR/RAMP3. AM gene expression is stimulated by Hypoxia Inductible Factor-1 (HIF- 1) and 60–80% of the human conventional renal carcinomas (cRCC) display mutations in the tumor suppressor protein von Hippel-Lindau, which leads to constitutively elevated HIF-1. Methods: Tumors and non-malignant kidney tissues were obtained from patients who underwent unilateral nephrectomy. We studied VEGFA, AM and its receptors expression by quantitative RT-PCR in 62 frozen renal tumors including: 40 cRCC; 5 cRCC metastasis; 5 chromophobe carcinomas; 5 Papillary carcinomas; 2 oncocytomas; 2 collecting duct carcinomas; 2 normal adjacent renal tissue; 1 unclassified renal tumor. AM and AM-receptors expression was studied in 42 paraffin-embedded renal tumors by immunohistochemistry using rabbit anti-AM, anti-CRLR, anti-RAMP2 and anti-RAMP3 polyclonal antibodies. Effects of these anti AM or anti AM- receptors antibodies on cell proliferation were examined in vitro on BIZ cell line (cRCC cells). Results: VEGFA, AM and AM-receptors genes were overexpressed in cRCC compared to other renal tumors (Except AM gene in chromophobe carcinoma). Their expressions were independent of classical prognostic factors (such as Fuhrman Grade and pT status). In cRCC, there was a strong positive correlation between VEGF-A gene expression and AM (r=0.7; p=0.01) and AM-receptors genes expressions (RAMP2 r=0.61; p= 0.01 and RAMP3 r=0.58; p= 0.01). Immunohistochemistry confirmed a tumor expression of CRLR, RAMP2 and AM in more than 80% cRCC. RAMP3 was expressed by inflammatory cells but not by tumoral cells. The cell proliferation assay showed a significant inhibition of BIZ cell proliferation by AM antibody or AM-receptors antibodies. Conclusion: AM and its receptor CRLR/RAMP2 are overexpressed in cRCC. In vitro cell proliferation assay results support that AM inhibition may suppress cRCC growth, independently of potential antiangiogenic effects. Further studies on animal models are needed but AM pathway may be a potential therapeutic target in cRCC. No significant financial relationships to disclose.
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Affiliation(s)
- J. Deville
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; Hopital Nord, Marseille, France; APHM, Marseille, France
| | - S. Salas
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; Hopital Nord, Marseille, France; APHM, Marseille, France
| | - C. Bartoli
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; Hopital Nord, Marseille, France; APHM, Marseille, France
| | - C. Dupuis
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; Hopital Nord, Marseille, France; APHM, Marseille, France
| | - F. Duffaud
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; Hopital Nord, Marseille, France; APHM, Marseille, France
| | - G. Sebahoun
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; Hopital Nord, Marseille, France; APHM, Marseille, France
| | - D. Figarella-Branger
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; Hopital Nord, Marseille, France; APHM, Marseille, France
| | - L. Ouafik
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; Hopital Nord, Marseille, France; APHM, Marseille, France
| | - P. Martin
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; Hopital Nord, Marseille, France; APHM, Marseille, France
| | - L. Daniel
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; Hopital Nord, Marseille, France; APHM, Marseille, France
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Salas S, Deville J, Bartoli C, Gaudart J, Bollini G, Curvale G, Gentet J, Duffaud F, Figarella-Branger D, Bouvier C. Immunohistochemical expression of ezrin correlates with Event-free and overall survival in osteosarcomas. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.10035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10035 Background: Ezrin is a cytoskeleton linker protein that is actively involved in the metastatic process of cancer cells. We have searched for a pronostic value of ezrin and some of its partners: a-smooth actin and CD44H in 37 patients with an osteosarcoma. Methods: Automate immunohistochemistry (IHC) with anti-ezrin, a-smooth actin and CD44H antibodies was performed in 37 biopsies before chemotherapy, 16 resected tumors of “poor” responders and 13 metastases. In addition the mRNA levels of ezrin of 13 frozen biopies and 4 metastases were evaluated by real time quantitative RT PCR. All results were correlated to the following clinical data: response to chemotherapy, onset of metastasis, event-free survival (EFS) and overall survival (OS). Results: Ezrin expression by IHC was found in 62% of 37 biopsies in the different histological subtypes especially chondroblastic osteosarcomas while chondrosarcomas were negative. A good correlation was found between positive or negative samples by IHC and mRNA levels. Ezrin expression was recorded in 84.5% of metastastic samples. The mean expression of ezrin was higher in metastases than biopsies (mean expression 38.1% versus 17.32%; p=0.024) but the onset of metastasis was not statistically correlated to ezrin positivity on biopsy (p = 0.183). In multivariate analysis, ezrin was an independent prognostic marker for EFS and OS with p<0.001 and p=0.003 respectively and a-smooth actin for OS only (p=0.024). No prognostic value was found for CD44H. Conclusions: We have shown that ezrin is expressed in the different subtypes of osteosarcomas especially chondroblastic osteosarcomas. Other studies are required to confirm that ezrin could be a useful tool for differential diagnosis with chondrosarcoma. Ezrin was an independent prognostic factor for event-free and overall survival rate in multivariate analysis and its partner a-smooth-actin was also an independent prognostic factor for overall survival only. These data confirm the role of ezrin signalling pathway for tumor dissemination in osteosarcomas in vivo. This also might be of interest for therapeutic strategy to select patient for dose intensification or to use new anticancer agents such as rapamycin which reduces experimental lung metastases through an ezrin-related pathway. No significant financial relationships to disclose.
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Affiliation(s)
- S. Salas
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; La Conception University Hospital, Marseille, France
| | - J. Deville
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; La Conception University Hospital, Marseille, France
| | - C. Bartoli
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; La Conception University Hospital, Marseille, France
| | - J. Gaudart
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; La Conception University Hospital, Marseille, France
| | - G. Bollini
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; La Conception University Hospital, Marseille, France
| | - G. Curvale
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; La Conception University Hospital, Marseille, France
| | - J. Gentet
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; La Conception University Hospital, Marseille, France
| | - F. Duffaud
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; La Conception University Hospital, Marseille, France
| | - D. Figarella-Branger
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; La Conception University Hospital, Marseille, France
| | - C. Bouvier
- La Timone University Hospital, Marseille, France; Medical Faculty, Marseille, France; La Conception University Hospital, Marseille, France
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