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Mennitto A, Biello F, Forti L, Siffredi G, Mokhtar Mahmoud A, Invernizzi F, Maggiora P, Rua A, Branni C, Gioffi E, Martini V, Gobbato S, Pisani C, Ferrara E, Cappelli M, Catania E, Ferrante D, Gaidano G, Krengli M, Gennari A. 1596P The G8 screening tool as an independent predictor of survival in elderly cancer patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Ferrara E, Puta E, Guaschino R, Turri L, Franco P, Gentilli S, Sacchetti G, Brambilla M, Krengli M. PO-1287 FDG PET/CT as predictive and prognostic factor in esophageal cancer treated with multimodal therapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03251-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ferrara E, Luciani I, Zannetti M, Mastroleo F, Brignoli A, Mattio B, Turri L, Vigna L, Mones E, Loi G, Krengli M. PO-1252 Chemoradiation for anal cancer: correlation of hematologic toxicity and dose to pelvic bone marrow. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07703-3] [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: 11/25/2022]
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Luciani I, Pisani C, Masini L, Destefanis V, Berretta S, Ferrara E, Loi G, Krengli M. PO-0956 Radiotherapy in fragile elderly head and neck cancer patients: a single centre experience. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07407-7] [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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De Icco R, Putortì A, De Paoli I, Ferrara E, Cremascoli R, Terzaghi M, Toscano G, Allena M, Martinelli D, Cosentino G, Grillo V, Colagiorgio P, Versino M, Manni R, Sances G, Sandrini G, Tassorelli C. Anodal transcranial direct current stimulation in chronic migraine and medication overuse headache: A pilot double-blind randomized sham-controlled trial. Clin Neurophysiol 2020; 132:126-136. [PMID: 33271482 DOI: 10.1016/j.clinph.2020.10.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 05/18/2020] [Revised: 08/14/2020] [Accepted: 10/01/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Little evidence is available on the role of transcranial direct current stimulation (tDCS) in patients affected by chronic migraine (CM) and medication overuse headache (MOH). We aim to investigate the effects of tDCS in patients with CM and MOH as well as its role on brain activity. METHODS Twenty patients with CM and MOH were hospitalized for a 7-day detoxification treatment. Upon admission, patients were randomly assigned to anodal tDCS or sham stimulation delivered over the primary motor cortex contralateral to the prevalent migraine pain side every day for 5 days. Clinical data were recorded at baseline (T0), after 1 month (T2) and 6 months (T3). EEG recording was performed at T0, at the end of the tDCS/Sham treatment, and at T2. RESULTS At T2 and T3, we found a significant reduction in monthly migraine days (p = 0.001), which were more pronounced in the tDCS group when compared to the sham group (p = 0.016). At T2, we found a significant increase of alpha rhythm in occipital leads, which was significantly higher in tDCS group when compared to sham group. CONCLUSIONS tDCS showed adjuvant effects to detoxification in the management of patients with CM and MOH. The EEG recording showed a significant potentiation of alpha rhythm, which may represent a correlate of the underlying changes in cortico-thalamic connections. SIGNIFICANCE This study suggests a possible role for tDCS in the treatment of CM and MOH. The observed clinical improvement is coupled with a potentiation of EEG alpha rhythm.
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Affiliation(s)
- R De Icco
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - A Putortì
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - I De Paoli
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - E Ferrara
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - R Cremascoli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy
| | - M Terzaghi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy
| | - G Toscano
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Stroke Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - M Allena
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - D Martinelli
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - G Cosentino
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - V Grillo
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - P Colagiorgio
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - M Versino
- Neurology and Stroke Unit, Circolo Hospital and Macchi Foundation, Varese, Italy; DMC Department, Insubria University, Varese, Italy
| | - R Manni
- Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy
| | - G Sances
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - G Sandrini
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - C Tassorelli
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Gallone G, D'Ascenzo F, Boccuzzi G, Cortese B, Di Biasi M, Omedè P, Capodanno D, Cerrato E, Vicinelli P, Infantino V, Poli A, Ugo F, Conrotto F, Grigis G, Varbella F, Latini RA, D'Urbano M, Montabone A, Senatore G, Ferrara E, D'Amico M, De Ferrari GM, Ielasi A. Real-world reasons and outcomes for 1-month versus longer dual antiplatelet therapy strategies with a polymer-free BIOLIMUS A9-coated stent. Catheter Cardiovasc Interv 2020; 96:E248-E256. [PMID: 32012453 DOI: 10.1002/ccd.28757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 01/19/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND A large trial established the favorable profile of a new polymer-free biolimus A9-eluting stent (PF-BES) with a 1-month dual antiplatelet therapy (DAPT) in high bleeding risk (HBR) patients. This is the first study comparing outcomes for a 1-month versus longer DAPT strategies following PF-BES-percutaneous coronary intervention (PCI). METHODS All patients undergoing PF-BES-PCI (January 2016 to July 2018) were included in the multicenter CHANCE registry. Patients were stratified according to DAPT strategy at discharge (planned 1-month vs. planned >1-month). Primary outcomes were the 390-day estimates of a patient-oriented and of a device-oriented composite endpoints (POCE: death, myocardial infarction [MI] or target vessel revascularization; DOCE: cardiac death, target vessel-MI or ischemia-driven target lesion revascularization). Landmark analyses from 1-month post-PCI were carried. RESULTS Following PF-BES-PCI, 328(40.3%) and 485(59.6%) patients were discharged with 1-month and longer DAPT (12 months [6-12]), respectively. Patients with a previous or index MI were less likely to be discharged on 1-month DAPT. Patients prescribed with 1-month DAPT were more likely to be at HBR than those with longer DAPT (90.2% vs. 69.9%, p = .001). No between-groups differences in the primary outcomes (planned 1-month vs. planned >1-month DAPT: POCE 11.9% vs. 13.2%, p = .747; DOCE: 4.8% vs. 8.1%, p = .500) were observed, also after adjusting for confoundings (POCE: adjusted-hazard ratio [adj-HR] 1.26, 95%CI 0.74-2.13; DOCE: adj-HR 1.00, 95%CI 0.49-1.99). Landmark analyses showed similar results. CONCLUSIONS In a large all-comers registry of PF-BES PCI, no interaction of planned DAPT strategy (1-month vs. >1-month) with outcomes was found. This observation warrants investigation in adequately powered randomized studies (ClinicalTrials.gov NCT03622203).
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Affiliation(s)
- Guglielmo Gallone
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Torino, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Torino, Italy
| | | | - Bernardo Cortese
- U.O.C. Cardiologia, Ospedale Fatebenefratelli, ASST Fatebenefratelli/Sacco, Milano, Italy
| | - Maurizio Di Biasi
- U.O.C. Cardiologia, Ospedale Sacco, ASST Fatebenefratelli/Sacco, Milano, Italy
| | - Pierluigi Omedè
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Torino, Italy
| | - Davide Capodanno
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Enrico Cerrato
- Department of Cardiology, Infermi Hospital, Rivoli, Italy
| | - Paolo Vicinelli
- U.O.C. Cardiologia, Ospedale di Magenta, ASST Milanese Ovest, Milano, Italy
| | | | - Arnaldo Poli
- U.O.C. Cardiologia, Ospedale di Legnano, ASST Milanese Ovest, Milano, Italy
| | - Fabrizio Ugo
- Division of Cardiology, San Giovanni Bosco, Torino, Italy
| | - Federico Conrotto
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Torino, Italy
| | - Giulietta Grigis
- U.O.C. Cardiologia, Ospedale di Seriate, ASST Bergamo Est, Milano, Italy
| | | | - Roberto A Latini
- U.O.C. Cardiologia, Ospedale Fatebenefratelli, ASST Fatebenefratelli/Sacco, Milano, Italy
| | - Maurizio D'Urbano
- U.O.C. Cardiologia, Ospedale di Magenta, ASST Milanese Ovest, Milano, Italy
| | | | | | - Erika Ferrara
- U.O.C. Cardiologia, Ospedale di Legnano, ASST Milanese Ovest, Milano, Italy
| | - Maurizio D'Amico
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Torino, Italy
| | - Gaetano M De Ferrari
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Torino, Italy
| | - Alfonso Ielasi
- U.O. Cardiologia Clinica ed Interventistica, Istituto Clinico S. Ambrogio, Milano, Italy
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Montefusco A, De Filippo O, Gili S, Mancone M, Calcagno S, Cirillo P, Esposito G, Poli A, Ferrara E, Smolka G, Wanha W, Palmieri C, Pastormerlo LE, Baumbach A, Sganzerla P, Tamburino C, Bruno F, Secco GG, Nicolino A, Yew KL, di Palma G, Wojakowski W, Sardella G, Rinaldi M, Cortese B, D'Ascenzo F. Safety and effectiveness of the self-aPposing, bAlloon-delivered, siRolimus-eluting stent for the Treatment of the coronary Artery disease: SPARTA, a multicenter experience. Coron Artery Dis 2019; 31:27-34. [PMID: 31658146 DOI: 10.1097/mca.0000000000000790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIMS To assess the long-term outcomes of patients treated with sirolimus-eluting Stentys stent in a real-life setting. BACKGROUND Few data regarding the safety and effectiveness of self-apposing sirolimus-eluting Stentys stent are available. METHODS 278 patients (30% stable coronary artery disease, 70% acute coronary syndromes, and 54% on unprotected left main) treated with sirolimus eluting Stentys stent were retrospectively included in the self-aPposing, bAlloon-delivered, siRolimus-eluting stent for the Treatment of the coronary Artery disease multicenter registry. Major adverse cardiovascular events (MACE, a composite of cardiac death, myocardial infarction, target lesion revascularization, stent thrombosis) were the primary end-point, single components of MACE were the secondary ones. RESULTS After 13 months (interquartile range 5-32), MACE was 14%. Stent thrombosis occurred in 3.9% of the patients (2.5% definite stent thrombosis and 1.4% probable stent thrombosis), 66% of them presenting with ST-segment elevation myocardial infarction (STEMI) at admission. Cardiovascular death, target lesion revascularization and myocardial infarction was 4.7%, 8.3%, and 7.2%, respectively. At multivariate analysis, risk of MACE was increased by diabetes (hazard ratios 4.76; P = 0.002) but was not affected by the indication leading to sirolimus-eluting Stentys stent implantation (marked vessel tapering vs. coronary ecstasies, hazard ratios 0.74, P = 0.71). CONCLUSION Sirolimus-eluting Stentys stent may represent a potential solution for specific coronary anatomies such as bifurcation, ectasic, or tapered vessels. Risk of stent thrombosis appears related to clinical presentation with STEMI and to anatomic features, stressing the importance of the use of intracoronary imaging for self-expandable stents implantation.
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Affiliation(s)
- Antonio Montefusco
- Department of Medical Sciences, Division of Cardiology, AOU Città della Salute e della Scienza, University of Turin, Turin
| | - Ovidio De Filippo
- Department of Medical Sciences, Division of Cardiology, AOU Città della Salute e della Scienza, University of Turin, Turin
| | - Sebastiano Gili
- Department of Medical Sciences, Division of Cardiology, AOU Città della Salute e della Scienza, University of Turin, Turin
| | - Massimo Mancone
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome
| | - Simone Calcagno
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome
| | - Plinio Cirillo
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples
| | - Giovanni Esposito
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples
| | - Arnaldo Poli
- Division of Cardiology, Ospedale Civile di Legnano - ASST Ovest Mi, Legnano, Italy
| | - Erika Ferrara
- Division of Cardiology, Ospedale Civile di Legnano - ASST Ovest Mi, Legnano, Italy
| | - Grzegorz Smolka
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Wojciech Wanha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | | | | | | | - Paolo Sganzerla
- Division of Cardiology, AO Ospedale Treviglio-Caravaggio, Treviglio
| | - Corrado Tamburino
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania
| | - Francesco Bruno
- Department of Medical Sciences, Division of Cardiology, AOU Città della Salute e della Scienza, University of Turin, Turin
| | - Gioel Gabrio Secco
- Interventional Cardiology, Santi Antonio, Biagio e Cesare Arrigo Hospital, Alessandria
| | | | - Kuang Leon Yew
- Cardiology Department, Manipal Hospital, Klang, Selangor, Malaysia
| | - Gaetano di Palma
- Department of Interventional Cardiology, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Gennaro Sardella
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome
| | - Mauro Rinaldi
- Department of Medical Sciences, Division of Cardiology, AOU Città della Salute e della Scienza, University of Turin, Turin
| | - Bernardo Cortese
- Fondazione Monasterio CNR-Regione Toscana, Massa, Italy.,Department of Interventional Cardiology, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Fabrizio D'Ascenzo
- Department of Medical Sciences, Division of Cardiology, AOU Città della Salute e della Scienza, University of Turin, Turin
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Pisani C, Beldì D, Ferrara E, Loi G, Yin J, Deantonio L, Mones E, Krengli M. EP-1563: An offline adaptive strategy for external beam radiotherapy in prostate cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31872-3] [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: 10/14/2022]
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Deantonio L, Paolini M, Puta E, Ferrara E, Vigna L, Matheoud R, Sacchetti G, Brambilla M, Krengli M. PO-076: Predictive and prognostic value of pretreatment fdg-pet suv parameters in head-and-neck. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30210-4] [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: 10/19/2022]
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Krengli M, Beldì D, Apicella G, Marchioro G, Pisani C, Ferrara E, Perotti C, Loi G, Volpe A, Terrone C. EP-1346: Intraoperative radioterapy (IORT) in the multimodality treatment of locally advanced prostate cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32596-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pisani C, Deantonio L, Surico D, Brambilla M, Galla A, Ferrara E, Masini L, Gambaro G, Surico N, Krengli M. Quality of life in patients treated by adjuvant radiotherapy for endometrial and cervical cancers: correlation with dose–volume parameters. Clin Transl Oncol 2015; 18:901-8. [DOI: 10.1007/s12094-015-1458-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 11/16/2015] [Indexed: 02/08/2023]
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Pisani C, Masini L, Paolini M, Ferrara E, Krengli M. PO-1016: Assessment of quality of life in patients treated for gynecological cancers using the EORTC questionnaires. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41008-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lovreglio P, D'Errico MN, Basso A, Ferrara E, Panuzzo L, Apostoli P, Soleo L. A pilot risk assessment study of strontium chromate among painters in the aeronautical industry. Med Lav 2013; 104:448-459. [PMID: 24640832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE A method for risk assessment of occupational exposure to strontium chromate (SrCrO4) in painters employed in the aeronautical industry is described. METHODS Assessment was made of 21 male workers of the painting division, potentially exposed to SrCrO4 (exposed), and 20 male workers of the tests and warehouse divisions (controls). All participants completed a questionnaire about work tasks, lifestyle habits, hobbies and diet. Personal active sampling for the determination of Cr and Sr was performed both during paint-spraying and during other operations in the painting division area. On the same day as environmental sampling, urine samples were collected at the beginning and end of the work shift in exposed workers to determine urinary chromium (CrU), and only at the end of the shift in controls. In the second half of the shift, a blood sample was taken in 10 exposed workers and 10 controls, to determine Cr in plasma (CrP) and in red blood cells (CrRBC). RESULTS During paint-spraying, Cr concentrations ranged between 1.38 and 17.10 microg/m3, versus 0.02 to 0.07 microg/mi in the painting division area, while the Sr concentration was 22.90 microg/m3 in the paint-spray booth versus 0.07 microg/m3 in the painting division area. CrU at the end of the work shift, CrP and CrRBC, did not show significant differences between exposed workers and controls. Moreover, in exposed workers there were no differences between CrU measured at the beginning and at the end of the work shift. CONCLUSIONS This approach, consisting of simultaneous environmental and biological monitoring, suggested no absorption of chromium in the painters thanks to the efficacy of the technical, organizational and personal protection measures adopted. However, the evident exposure to high levels of SrCrO4 during paint-spraying highlights how absolutely essential it is to ensure strict compliance with all the preventive measures foreseen by the EU and national regulations for occupational exposure to carcinogens.
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Krengli M, Beldì D, Apicella G, Marchioro G, Ferrara E, Loi G, Volpe A, Terrone C. OC-0485: Quality assurance procedures in intraoperative radioterapy (IORT) for locally advanced prostate cancer. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32791-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Repici A, Pagano N, Rando G, Carlino A, Vitetta E, Ferrara E, Strangio G, Zullo A, Hassan C. A retrospective analysis of early and late outcome of biodegradable stent placement in the management of refractory anastomotic colorectal strictures. Surg Endosc 2013; 27:2487-91. [PMID: 23443478 DOI: 10.1007/s00464-012-2762-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 12/07/2012] [Indexed: 01/01/2023]
Abstract
BACKGROUND Benign colorectal strictures are treated conventionally by endoscopic dilation. Experience using SEMS for benign colonic strictures is limited, and outcomes to date have been disappointing. Refractory colorectal strictures remain challenging to be treated with surgery. Polydioxanone-based stent are biodegradable (BD) stent CE approved for esophageal strictures. This study was designed to investigate retrospectively the safety and the efficacy of these stents for the management of strictures refractory to multiple sessions of dilation. METHODS Patients with postsurgical benign strictures located within 20 cm from anal verge, refractory to mechanical or pneumatic dilation (at least 3 sessions) were included in this analysis. Clinical success was defined as the absence of occlusive symptoms and the ability to pass through the stricture with a regular size colonoscope. All patients were predilated before stent placement. Stents were released under fluoroscopic control. All patients were under stool softeners for 3 months. Follow-up was scheduled with endoscopic and fluoroscopic controls within 90 days from stent deployment and afterwards by telephone interview and/or ambulatory consultation. RESULTS Eleven patients (7 males, mean age 62.3 ± 8.5 years) were included. Technical success was achieved in all the patients. Stent migration was observed in four patients within the first 2 weeks after stent placement. Stent migration was followed by recurrence of stricture and obstructive symptoms in all the cases. Among the seven patients who completed the process of stent biodegradation, five of them had complete resolution of the stricture and relief of symptoms. Two of 11 patients required surgical treatment during the follow-up period (mean 19.8 (range 42-15) months). The overall success rate of the BD stent was 45 %. CONCLUSIONS This retrospective analysis of a limited number of patients demonstrated that nondedicated esophageal BD stents are associated with high risk of migration and clinical success in less than 50 % of patients. Dedicated stents with large diameter and antimigration findings could potentially improve the outcome of patients with refractory benign colorectal strictures.
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Affiliation(s)
- A Repici
- Digestive Endoscopy Unit, Istituto Clinico Humanitas, Via Manzoni 56, 20089 Rozzano (Milano), Italy
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Repici A, Hassan C, Vitetta E, Ferrara E, Manes G, Gullotti G, Princiotta A, Dulbecco P, Gaffuri N, Bettoni E, Pagano N, Rando G, Strangio G, Carlino A, Romeo F, de Paula Pessoa Ferreira D, Zullo A, Ridola L, Malesci A. Safety of cold polypectomy for <10mm polyps at colonoscopy: a prospective multicenter study. Endoscopy 2012; 44:27-31. [PMID: 22125197 DOI: 10.1055/s-0031-1291387] [Citation(s) in RCA: 168] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cold polypectomy techniques (without electrocautery) by means of biopsy forceps or snare are widely adopted for the removal of subcentimetric polyps. However, few data are available on the safety of this approach. The aim of this study was to assess the safety of cold polypectomy for subcentimetric polyps, as well as the rate of advanced neoplasia in these lesions. PATIENTS AND METHODS In a prospective multicenter trial, consecutive patients with at least one < 10-mm polyp at colonoscopy were prospectively included. All of the < 10-mm polyps detected within the study period were removed by cold polypectomy. The rates of immediate or delayed bleeding and other complications were assessed at 7 and 30 days after cold polypectomy by telephone calls. The rate of advanced histology was also assessed. Predictive variables of postpolypectomy bleeding or advanced neoplasia were identified by multivariate analysis. RESULTS A total of 1015 < 10-mm polyps in 823 patients (15.5 % on antiplatelet agents) were removed. Of these, 822 (81 %) were ≤ 5 mm and 193 (19 %) were 6 - 9 mm. Immediate postpolypectomy bleeding occurred in 18 patients, corresponding to a per-patient and per-polyp bleeding rate of 2.2 % (95 % confidence interval [CI] 1.2 % - 3.2 %) and 1.8 % (95 %CI 1 % - 2.6 %), respectively. Therapy with antiplatelet agents (odds ratio [OR] 4; 95 %CI 1.5 - 10.6) and larger polyp size (OR 2; 95 %CI 1.1 - 6.9) were independent predictors of bleeding. Bleeding was successfully treated by endoscopic hemostasis in all cases and required no further medical intervention. Advanced neoplasia prevalence in polyps ≤ 5 mm was as high as 8.7 %. CONCLUSIONS The results from this study showed the high safety of a cold polypectomy approach for subcentimetric polyps. This was due to the low rate of postpolypectomy bleeding and to the high efficacy of endoscopic hemostasis in its treatment. The high rate of advanced neoplasia in polyps ≤ 5 mm should prompt some caution on the management of these lesions following detection at computed tomography colonography or colon capsule endoscopy.
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Affiliation(s)
- A Repici
- Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Milan, Italy.
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Abstract
Particle-image velocimetry (PIV) was used to visualize the flow within an optically transparent pediatric ventricular assist device (PVAD) under development in our laboratory. The device studied is a diaphragm type pulsatile pump with an ejection volume of 30 ml per beating cycle intended for temporary cardiac assistance as a bridge to transplantation or recovery in children. Of particular interest was the identification of flow patterns, including regions of stagnation and/or strong turbulence that often promote thrombus formation and hemolysis, which can degrade the usefulness of such devices. For this purpose, phase-locked PIV measurements were performed in planes parallel to the diaphram that drives the flow in the device. The test fluid was seeded with 10 μm polystyrene spheres, and the motion of these particles was used to determine the instantaneous flow velocity distribution in the illumination plane. These measurements revealed that flow velocities up to 1.0 m/s can occur within the PVAD. Phase-averaged velocity fields revealed the fixed vortices that drive the bulk flow within the device, though significant cycle-to-cycle variability was also quite apparent in the instantaneous velocity distributions, most notably during the filling phase. This cycle-to-cycle variability can generate strong turbulence that may contribute to greater hemolysis. Stagnation regions have also been observed between the input and output branches of the prototype, which can increase the likelihood of thrombus formation.
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Affiliation(s)
- E. Ferrara
- Optics Group, Physics Institute, University of São Paulo, São Paulo, SP Brazil
| | - M. Muramatsu
- Optics Group, Physics Institute, University of São Paulo, São Paulo, SP Brazil
| | - K. T. Christensen
- Department of Mechanical Science and Engineering, University of Illinois, Urbana, IL
| | - I. A. Cestari
- Department of Bioengineering, Heart Institute, InCor, University of São Paulo Medical School, SP, Brazil
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Martino F, Martino E, Iacobini M, Ferrara E, Pacifico L, Noto D, Cefalu AB, Averna M, Chiesa C. Down regulation of CD11b and CD18 expression in children with hypercholesterolemia: a preliminary report. Nutr Metab Cardiovasc Dis 2009; 19:105-109. [PMID: 18676132 DOI: 10.1016/j.numecd.2008.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2008] [Revised: 04/30/2008] [Accepted: 05/14/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIM Cell adhesion molecules play an important role in the development of atherosclerosis mediating the attachment of monocytes to the endothelium. The aim of our study was to assess the cell surface expression of CD11b/CD18 integrin on the phagocytes of children affected by hypercholesterolemia. METHODS AND RESULTS Twenty-six children with hypercholesterolemia (15 males, mean age 8.3, range 2-18) with a family history of early cardiovascular disease, as well as 26 children with normocholesterolemia matched for gender and age (15 males, mean age 8.3) were studied. Cell surface expression of CD11b/CD18 on peripheral blood mononuclear cells (PBMC) were analyzed by flow cytometry. The geometric mean percentages of CD11b and CD18 expression were significantly lower in the hypercholesterolemic group [52 (95% confidence intervals, 40-68) and 88 (84-93)] than in the control group [87 (83-91), P<0.0001 and 93 (89-96), P<0.05], respectively. After correction for age, gender, and pubertal status, CD11b cell surface expression on PBMC was inversely and independently correlated with total cholesterol concentrations (r=-0.395; P<0.01) and LDL (r=-0.307; P<0.05), as well as with triglycerides (r=-0.406; P<0.01). CONCLUSIONS In children with hypercholesterolemia, cell surface expression of CD11b and CD18 on PBMC was significantly decreased. Follow-up studies are necessary to determine the clinical implications of these findings in the context of the natural course and progression of atherosclerosis in high risk children.
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Affiliation(s)
- F Martino
- Center of Clinic Lipid Research, Department of Pediatrics, La Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy.
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Abstract
BACKGROUND Approximately 20% of patients with ulcerative colitis have a chronic active disease often requiring several courses of systemic steroids in order to achieve remission, but followed by relapse of symptoms during steroid tapering or soon after their discontinuation. Although short term control of symptoms can be achieved with steroid treatment, this pattern of drug response, known as steroid-dependency, leads to important complications of the treatment, while a significant proportion of patients requires colectomy. AIM To review the studies currently available specifically evaluating the management of steroid-dependent ulcerative colitis. RESULTS The clinical and biological mechanisms of steroid-dependency are not well understood compared with those determining steroid-refractoriness. Very few evidence-based data are available concerning the management of patients with steroid-dependent ulcerative colitis. The therapeutic role of aminosalicylates, thiopurines, methotrexate, infliximab, leukocyte apheresis and other drugs in the treatment of steroid-dependent ulcerative colitis are evaluated. CONCLUSIONS Outcomes of studies in steroid-refractory patients may not be applicable to steroid-dependency. Trials are needed to define the correct approaches and new strategies to ameliorate the therapy of steroid-dependent ulcerative colitis.
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Affiliation(s)
- G Bianchi Porro
- Department of Clinical Science, Chair of Gastroenterology, L Sacco University Hospital, Milan, Italy.
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20
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Lonardo MT, Marone U, Apice G, Ferrara E, De Chiara A, Cerra R, Chiofalo MG, Mozzillo N. Merkel cell carcinoma: experience of 14 cases and literature review. J Exp Clin Cancer Res 2006; 25:331-7. [PMID: 17167973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Merkel cell carcinoma is an aggressive skin cancer, with a significant incidence of locoregional lymphnode involvement, which requires timely diagnosis, adequate staging and aggressive therapy based essentially on surgical procedures. The aim of this study is to report our experience and to compare our results with literature findings, in order to discuss the role of the procedures adopted and their influence on prognosis. From July 1995 to April 2005, 14 patients were treated and followed-up for MCC in the National Cancer Institute of Naples. Tumor location was: buttocks (43%), extremities (36%) head (7%), unknown (14%). There were 7 Stage I, 5 Stage II and 2 Stage III patients. Surgical treatment consisted in wide excision (WE) in Stage I cases, WE and regional lymphadenectomy followed by radio- or chemo-therapy in Stage II and combined surgical and pre- and post-operative medical treatments in Stage III. Overall disease specific survival rate was 64% (median follow up 44 months). Recurrence occurred in 86% of Stage I and 20% of Stage II patients and involved, in 83.3% of Stage I patients, the lymph nodal draining basin. The treatment of recurrence implied surgery and radio or radiochemotherapy. Overall survival rate of recurrent patients was 57% (median follow-up 37.2 months). Due to the particular lymphotrophism of MCC, major care should be set on investigation and treatment of tumor lymph nodal draining basin. As long as the disease remains surgically manageable the prognosis for patients with MCC is favourable. The role of radio and chemotherapy is not yet assessed.
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Affiliation(s)
- M T Lonardo
- Unit of Surgery B, G. Pascale Foundation Cancer Institute, Naples, Italy.
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21
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Benador N, Grimm P, Reznik V, Mendoza S, Ferrara E. Marked functional improvement in a pediatric patient treated with hemodialysis for scleroderma related renal failure. Hemodial Int 2005. [DOI: 10.1111/j.1492-7535.2005.1121ch.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Giuditta A, Eyman M, Cefaliello C, Ferrara E, Kaplan BB, Lavina ZS, De Stefano R. Local Synthesis of Presynaptic RNA in Squid Optic Lobe Slices. Biol Bull 2004; 207:156. [PMID: 27690583 DOI: 10.1086/bblv207n2p156a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Abstract
Recent national and global initiatives have drawn attention to the importance of sexual health to individuals' well-being. These initiatives advocate enhancement of efforts to address this under-represented topic in health professions curricula. University of Massachusetts Medical School (UMMS) has undertaken a comprehensive effort to develop an integrated curriculum in sexual health. The UMMS project draws upon the expertise of a multidisciplinary faculty of clinicians, basic scientists, a medical ethicist, and educators. This article describes the project's genesis and development at UMMS, and reports on three innovations in sexual health education implemented as part of this endeavor.
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Affiliation(s)
- E Ferrara
- Office of Medical Education, Department of Family Medicine and Community Health, University of Massachusetts Medical School (UMMS), Massachusetts 01655, USA.
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24
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Abstract
We qualitatively examined themes covered in a creative writing elective designed to enhance pre-clinical medical students' writing, observation, and reflection skills relative to experiences in their medical education. Qualitative analysis of writings' themes was carried out via iterative consensus building process and validated through member checks and literature review. Fourteen students completed the elective, seven for each year it was given. Students submitted 86 written pieces. Qualitative analysis demonstrated the presence of nine themes: students' role confusion, developing a professional identity, medicine as a calling, physician privilege and power, humanizing the teacher, the limits of medicine, death and dying, anticipating future challenges, and identification with the patient. Students evaluated this creative writing course favorably, indicating value in writing and reflection. Themes covered are of concern to second-year medical students as well as other trainees and practicing physicians. Writing may aid in the professional development of physicians.
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Affiliation(s)
- D Hatem
- University of Massachusetts Memorial Medical Center, 55 Lake Avenue North, Worcester 01655, USA.
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25
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Ferrara E, Durbiano F, Capra PP, Marullo Reedtz G. Electrolytic conductivity: a reference system for aqueous solutions. Ann Chim 2001; 91:409-14. [PMID: 11554179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
To establish a system for the measurement of electrolytic conductivity in aqueous solutions with traceability to the SI, a cell has been developed with a removable central section providing an accurate determination of the geometrical constant. As the concentration unit mass/mass, based and referred to the amount of substance in the SI, is recommended by international organisations, 0.1 molal KCl samples have been prepared and analysed. Results over a temperature range from 20 degrees C to 35 degrees C are presented. The main sources of error have been estimated and relative uncertainty has been assessed to remain at the level of 0.6%. Satisfactory agreement is observed when the results are compared with the reference values available from literature.
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Affiliation(s)
- E Ferrara
- Istituto Elettrotecnico Nazionale Galileo Ferraris, Strada delle Cacce, 91, I-10135 Torino, Italy.
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26
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Sanguigni V, Caccese D, Magnaterra R, Ferrara E, Mazzolini S, De Vito F, Violi F, Lauro R. Platelet activation by oxygen free radicals in hypercholesterolemic patients. Atherosclerosis 2000. [DOI: 10.1016/s0021-9150(00)80256-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
A 32-year-old woman presented with severe headache, photophobia, fever, nausea, vomiting, and worsening vision. She had also noted several months of amenorrhea. She was febrile to 38.9 degrees C. Laboratory evaluation revealed a markedly elevated erythrocyte sedimentation rate. Lumbar puncture revealed a cerebrospinal fluid lymphocytic pleocytosis and an elevated protein level. Endocrine studies revealed evidence of panhypopituitarism without diabetes insipidus. A magnetic resonance imaging study showed a 2-cm pituitary mass with optic chiasmal compression. The patient had a trans-sphenoidal resection of the mass. Pathology revealed multinucleated giant cells in necrotic debris, but no evidence of pituitary tumor. Studies looking for evidence of systemic granulomatous disease were negative. The patient was considered to have idiopathic giant-cell granulomatous hypophysitis. After surgery, the patient's vision improved and hormone replacement therapy was initiated. This case illustrates that idiopathic giant-cell granulomatous hypophysitis should be considered in the differential diagnosis of a patient presenting with a pituitary mass, hypopituitarism, and meningitis-like symptoms.
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Affiliation(s)
- R Cooper
- Department of Medicine, Winthrop-University Hospital and The State University of New York at Stony Brook School of Medicine, Mineola, USA
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28
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Calogero AE, Burrello N, Ferrara E, Hall J, Fishel S, D'Agata R. Gamma-aminobutyric acid (GABA) A and B receptors mediate the stimulatory effects of GABA on the human sperm acrosome reaction: interaction with progesterone. Fertil Steril 1999; 71:930-6. [PMID: 10231059 DOI: 10.1016/s0015-0282(99)00063-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [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: 11/22/2022]
Abstract
OBJECTIVE To evaluate which gamma-aminobutyric acid (GABA) receptor mediates the stimulatory effects of this neurotransmitter on the human sperm acrosome reaction, and to examine the interaction of progesterone, a physiologic inducer of the acrosome reaction, with the GABA(A) receptor. DESIGN Prospective study. SETTING A university clinic of andrology. PATIENT(S) Men with normal sperm analysis parameters. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The acrosome reaction of motile spermatozoa. RESULT(S) The acrosome reaction was stimulated by GABA in a dose-dependent manner. This effect was inhibited completely by bicuculline, a GABA(A) receptor antagonist, and only partially by saclofen, a GABA(B) receptor antagonist. Accordingly, muscimol, a GABA(A) receptor agonist, stimulated the acrosome reaction to the same extent as GABA, whereas baclofen, a GABA(B) receptor agonist, was less effective. Preincubation with progesterone followed by the addition of GABA resulted in a significant increase in the percentage of acrosome-reacted spermatozoa compared with progesterone alone. However, this increase was less than a simple addition of effects, suggesting that GABA and progesterone act through the same receptor and/or use the same mechanism of action. To test this hypothesis, the ability of progesterone to induce acrosome reaction was tested in the presence of bicuculline, which suppressed the stimulatory effects of progesterone. Given that the GABA(A) receptor is linked to the chloride channel, we tested whether picrotoxin, a blocker of this channel, could modulate the effects of progesterone or GABA. Picrotoxin completely suppressed the acrosome reaction induced by progesterone and only partially suppressed that caused by GABA. CONCLUSION(S) gamma-Aminobutyric acid stimulated the acrosome reaction in human spermatozoa, acting mainly through the GABA(A) receptor and to a lesser extent through the GABA(B) receptor. Progesterone interacted with the GABA(A) receptor to induce the acrosome reaction, and the functional integrity of the chloride channel was vital for this effect.
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Affiliation(s)
- A E Calogero
- Department of Internal Medicine, University of Catania Medical School, Italy.
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Abstract
Making prenatal and birthing services accessible in rural communities no longer able to support a local full-service hospital and the introduction of managed care cost control has led to consideration of alternative models. One such model, the freestanding birth center located in an isolated rural community, challenges the guidelines of several state and professional organizations directed at assuring adequate emergency response, including cesarean sections. An extensive review of freestanding birth centers and their effect on birth outcomes revealed little outcomes data about birth centers distant from full-service hospitals. Most states have modeled their birth center regulations on recommendations from the National Association of Childbearing Centers, but others, such as New York, have more rigidly defined transport parameters that exclude many rural locations. A consensus panel convened by the New York State Rural Health Council concluded that demonstrations projects featuring a rural birthing center farther than 20 minutes from a full-service hospital and operated within a networked rural health system should be developed. Consumers would need to be fully informed about the implications of their choice of birth services and all qualified providers, including midwives, should be included in a team approach to care giving.
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Affiliation(s)
- T C Rosenthal
- New York Rural Health Research Center, State University of New York, Buffalo 14215, USA
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Lasser DH, Chuman A, Ferrara E, Gurwitz J. Use of a mini-grant program to stimulate generalist training at the University of Massachusetts Medical Center. Acad Med 1999; 74:S30-S35. [PMID: 9934306 DOI: 10.1097/00001888-199901001-00028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The authors describe and evaluate an annual competitive "mini-grant" program, funded by The Robert Wood Johnson Foundation's Generalist Physician Initiative established at the University of Massachusetts Medical School as a strategy to stimulate greater faculty involvement in the development of innovative, generalist-oriented projects. The mini-grant program stimulated proposals from across the academic community. The average award was small (mean = $7,039) but at times the awards led to results exceeding the scope of the original funding. In several cases, mini-grant support provided seed funding for faculty to undertake pilot projects to test new initiatives that would otherwise not have been developed. Some projects led to further ideas or to collaborations between generalists and basic scientists or specialists. More than half of funded projects were eventually institutionalized, and nearly 20% led to formal presentations at national meetings. Two problems are identified: (1) there were fewer proposals generated by specialist faculty and fewer collaborative proposals from generalists and specialists than anticipated, and (2) no funded proposals were generated by community-based faculty who were predominantly clinicians, such as preceptors. Despite these problems, and in light of available solutions, the authors conclude that an institutional mini-grant program can provide an ongoing, flexible mechanism to support a shift in institutional culture toward an enhanced status for generalism.
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Affiliation(s)
- D H Lasser
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester 01655, USA
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Calogero AE, Palumbo MA, Bosboom AM, Burrello N, Ferrara E, Palumbo G, Petraglia F, D'Agata R. The neuroactive steroid allopregnanolone suppresses hypothalamic gonadotropin-releasing hormone release through a mechanism mediated by the gamma-aminobutyric acidA receptor. J Endocrinol 1998; 158:121-5. [PMID: 9713333 DOI: 10.1677/joe.0.1580121] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The central nervous system (CNS) is able to synthesize and/or metabolize steroid hormones. These neuroactive steroids are capable of modulating several brain functions and, among these, they seem to regulate the hypothalamic-pituitary-gonadal (HPG) axis. Indeed, recent observations have shown that 5 alpha-pregnane-3 alpha-ol-20-one (allopregnanolone), one of the most abundant naturally occurring neuroactive steroids, suppresses ovulation and sexual behaviour when administered within the CNS. The present study was undertaken to evaluate the effects of allopregnanolone and its inactive stereoisomer, 5 alpha-pregnane-3 beta-ol-20-one, upon the release of gonadotropin-releasing hormone (GnRH) from individually-incubated hemihypothalami. Allopregnanolone suppressed GnRH release in a concentration-dependent manner with maximal activity in the nanomolar range, a range at which this neurosteroid is capable of playing a biological action. The specificity of allopregnanolone suppression of GnRH release was provided by the lack of effect of its known inactive stereoisomer. To evaluate the involvement of gamma-aminobutyric acidA (GABAA) receptor, we examined the effects of two neurosteroids with GABA-antagonistic properties, pregnanolone sulfate (PREG-S) and dehydroepiandrosterone sulfate (DHEAS), and of bicuculline, a selective antagonist of the GABA binding site on the GABAA receptor, on allopregnanolone (10 nM)-suppressed GnRH release. Both PREG-S and bicuculline overcame the inhibitory effects of allopregnanolone on GnRH release, whereas DHEAS did not. To substantiate the involvement of the GABAA receptor further, we tested the effects of muscimol, a selective agonist for this receptor, which suppressed GnRH release. In conclusion, allopregnanolone suppressed hypothalamic GnRH release in vitro and this effect appeared to be mediated by an interaction with the GABAA receptor. We speculate that the inhibitory effect of allopregnanolone on the HPG axis may also be caused by its ability to suppress hypothalamic GnRH release.
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Affiliation(s)
- A E Calogero
- Department of Internal Medicine, University of Catania, Italy
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Appino C, Appino C, Ferrara E, Fiorillo F, Suberbielle I, Degauge J, Lebourg C, Baricco M. Role of Si concentration on the magnetic and mechanical behavior of rapidly solidified Fe-Si laminations. ACTA ACUST UNITED AC 1998. [DOI: 10.1051/jp4:19982123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Calogero AE, Fishel S, Hall J, Ferrara E, Vicari E, Green S, Hunter A, Burrello N, Thornton S, D'Agata R. Correlation between intracellular cAMP content, kinematic parameters and hyperactivation of human spermatozoa after incubation with pentoxifylline. Hum Reprod 1998; 13:911-5. [PMID: 9619547 DOI: 10.1093/humrep/13.4.911] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.4] [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: 11/13/2022] Open
Abstract
Various compounds have been used in the attempt to improve sperm motility, including pentoxifylline (PF), a methylxanthine derivative. It has been postulated that PF, being a phosphodiesterase inhibitor, increases sperm kinematic parameters and the number of spermatozoa exhibiting hyperactivated motility by raising the intracellular content of cAMP, a molecule involved in the generation of sperm energy. However, it has not been clarified whether the biological effects of PF on sperm motility correlate with its ability to increase intracellular cAMP levels. To examine this relationship, the kinematic parameters, hyperactivation, and intracellular cAMP content were evaluated in motile spermatozoa, obtained by discontinuous Percoll gradient and swim-up from 21 normozoospermic semen samples, incubated without and with PF for 0, 1, 2, and 4 h. PF increased beat cross frequency after 1 and 2 h of incubation, curvilinear velocity and lateral head displacement (ALH) after 4 h, and hyperactivation after 1, 2, and 4 h, and decreased linearity (LIN) after 1 h of incubation. The intracellular cAMP content of spermatozoa incubated with PF increased at all time-points examined. Both intracellular cAMP content and increase in hyperactivation in response to PF decreased with the length of incubation. In the absence of PF, cAMP content was unchanged and was correlated significantly only with ALH and the percentage of spermatozoa with hyperactivated motility. Following incubation with PF, cAMP content correlated with hyperactivation and all sperm kinematic parameters, with the exception of LIN and straightness. These findings suggest that the beneficial effects of PF on sperm kinematic parameters and hyperactivation are related to its ability to increase intracellular cAMP content.
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Affiliation(s)
- A E Calogero
- Department of Internal Medicine, University of Catania Medical School, Italy
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34
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Kovner C, Stave CM, Lavelle K, Ferrara E. An analysis of vacancy rates, turnover, and wages among nursing occupations in New York state hospitals, nursing homes, and diagnostic and treatment facilities. J N Y State Nurses Assoc 1994; 25:20-7. [PMID: 7699477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This study investigates the balance between the supply and demand for nurses and nurse assistive personnel in New York state. Data collected in 1992 and 1993 from three surveys of hospitals, nursing homes, and diagnostic and treatment facilities are combined, reported, and analyzed. Although there were regional differences, the mean non-New York City vacancy rate was 4% for registered nurses and 5% for licensed practical nurses. The 6-month mean turnover rate for registered nurses was 8%; however, licensed practical nurses, nurse technicians, and nurse attendants had mean turnover rates of 16% and over. Turnover rates were lowest in hospitals. Nurse anesthetists earned the highest salary, a mean of about $61,000 per year. Salaries for nurse anesthetists and other nurses varied substantially by region.
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35
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Ferrara E, Romelli PB, Ringhini R. An high performance IRMA for CEA determination. J Nucl Med Allied Sci 1990; 34:211. [PMID: 2092122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- E Ferrara
- Sclavo S.p.A. RIA Research Development Cassina de' Pecchi Milan, Italy
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36
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Ferrara E, Cucchi G, Sardeo C. [Fibrinogen, a cardiovascular risk factor]. Minerva Cardioangiol 1989; 37:473-5. [PMID: 2622536] [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: 01/01/2023]
Abstract
Fibrinogen level is an independent predisposing factor for coronary heart disease and has a prognostic significance comparable with that of cigarette smoking, serum cholesterol level and hypertension. In our study fibrinogen levels were measured in 45 patients with cardiovascular disease of which 25 (55%) had a high fibrinogen level and in 45 persons healty, of which only 3 (6.6%) increased fibrinogen. The impact of fibrinogen level on the risk of cardiovascular disease was more consistent in men of all ages considered. The authors note that the independent contribution of fibrinogen to the cardiovascular risk may reflect hypercoagulability, hyperviscosity and increased platelet aggregation. Therefore they consider, the dosing of fibrinogen level important in the research of cardiovascular risk factors.
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Cucchi GF, Ferrara E, Giugni R. [The role of endorphin in silent myocardial ischemia]. Minerva Cardioangiol 1988; 36:483-6. [PMID: 3226559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Cucchi G, Ferrara E, Stiglich F, Di Lorenzo I. [Right atrial myxoma: echocardiographic diagnosis and review of the literature. Description of a clinical case]. G Ital Cardiol 1987; 17:893-6. [PMID: 3325329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Two-dimensional echocardiography is the method of first choice for diagnosing right atrial myxoma. A case of right atrial myxoma, documented by two-dimensional echocardiography, is here presented. Two-dimensional echocardiography allows accurate assessment of, tumor size, site of attachment, mobility and consistency. This non-invasive technique has replaced angiocardiography in the routine preoperative evaluation of these cases. The myxomatous nature of the mass was confirmed at surgery.
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Affiliation(s)
- G Cucchi
- Ospedale Generale Provinciale di Sondrio U.S.S.L. 22, Divisione di Cardiologia e Unità Coronarica
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Cucchi G, Robustelli Della Cuna F, Ferrara E, Giugni R. [Echocardiographic observations of 2 false chordae tendineae of the left ventricle. Clinical case and review of the literature]. Minerva Cardioangiol 1987; 35:341-3. [PMID: 3658197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Sardeo C, Ferrara E, Mantovani M, Cucchi GF, Racciatti M, Giugni R, Stiglich F, Bottinelli G. [Correlation between echocardiographic and angioscintigraphic methods in the study of the ejection fraction in subjects with dilated cardiomyopathy]. Minerva Cardioangiol 1986; 34:281-4. [PMID: 3748409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Bindi M, Ferrara E. [Biochemical and clinical principles in the therapy of alcoholism]. Clin Ter 1985; 113:385-92. [PMID: 2992865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Ferrara E, Mantovani M, Sardeo C, Giugni R. [Therapeutic uselessness of intracavitary electric stimulation in 3 cases of paroxysmal atrioventricular block in patients with apparently normal atrio-ventricular conduction]. Clin Ter 1984; 108:147-50. [PMID: 6232049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Ferrara E, Mantovani M, Sardeo C, Giugni R. [Exertion test and the female. An experience of false-positives revealed by pre-medication with oxprenolol]. Minerva Cardioangiol 1983; 31:509-14. [PMID: 6669271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Ferrara E, Mantovani M, Giugni R. [Updating hypotensive therapy, especially with beta-blocking agents]. Clin Ter 1981; 98:561-7. [PMID: 6118216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Di Girolamo V, Ferrara E, Prefumo G, Leone U, Quadri P. [Explosive rupture of the pregnant uterus in the 29th week of pregnancy, caused by a serious external injury, in a 15-year-old girl]. Minerva Ginecol 1978; 30:1153-8. [PMID: 740331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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