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Barbieri F, Spitaler P, Adukauskaite A, Rubatscher A, Schgoer W, Pfeifer B, Hintringer F, Dichtl W. Heart failure medication and its effect on response to cardiac resynchronisation therapy in patients with pacing-induced cardiomyopathy: an UPGRADE post hoc analysis. Europace 2022. [DOI: 10.1093/europace/euac053.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): Austrian National Bank
Unlimited scientific grant from the Boston Scientific Investigator Sponsored Research (ISR) Committee
Background/Introduction
Current heart failure (HF) guidelines recommend optimal medical therapy (OMT) in patients with pacing-induced cardiomyopathy (PICM) prior upgrading to cardiac resynchronisation therapy (CRT). It is unknown, whether previous prescription of heart failure medication reduces the effect of CRT upgrading.
Purpose
To evaluate the effect of HF medication on CRT response in patients suffering from PICM receiving an upgrade to CRT.
Methods
The UPGRADE trial was a prospective investigator driven trial evaluating the effect of CRT upgrading in patients with PICM. Key inclusion criteria were symptomatic HF with left ventricular ejection fraction (LVEF) below 40% despite OMT and right ventricular pacing (RVP) above 40%. Device programming had to be adjusted to minimize RVP prior to enrolment. Echocardiographic examinations were performed prior to device implantation and 3-5 months after activation of CRT and were analyzed in blinded fashion. CRT response was defined by a reduction of > 15% in left ventricular end systolic volume (LVESV). Heart failure medication was assessed at implantation of the device.
Results
Overall, 54 patients were enrolled in the UPGRADE trial between 2014 and 2018. Beta-blockers (BB) were prescribed in 43 (79.6%), mineralcorticoid receptor antagonists (MRA) in 29 (53.7%) and either an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin II receptor blockers (ARB) in 45 (83.3%) of the patients. Therapy with CRT has led to significant improvement in LVEF (mean delta: 12.8 ± 7.8%) and LVESV (delta: 30.7 ± 33.2ml), whereas CRT response was achieved in 30 (55.6%) patients. There was no statistically significant difference in patients with BB intake regarding increase of LVEF (12.4 ± 7.5% vs. 14.6 ± 9.4%, p=0.431), decrease of LVESV (42.8 ± 32.8ml vs. 27.8 ± 33.0ml, p=0.201) or CRT response (22 (53.7%) vs. 8 (80%), p=0.167). Similar results were found regarding ACE inhibitor/ARB [LVEF: 13.1 ± 6.8% vs. 11.5 ± 11.8%, p=0.705; LVESV: 32.6 ± 32.6ml vs. 21.7 ± 36.3ml, p=0.373; CRT response: 26 (61.9%) vs. 4 (44.4%), p=0.460] and MRA intake [LVEF: 13.7 ± 7.3% vs. 11.8 ± 8.4%, p=0.382; LVESV: 34.3 ± 36.8ml vs. 26.7 ± 28.8ml, p=0.423; CRT response: 15 (55.6%) vs. 15 (62.5%), p=0.777].
Conclusion
Previous prescription of heart failure medication did not reduce the effect of CRT upgrading in patients suffering from PICM. It remains to be proven, whether similar results may be observed for newer HF agents like sodium-glucose co-transporter 2 inhibitors or angiotensin receptor-neprilysin inhibitors as both were not available in clinical routine at the time of study conduct.
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Affiliation(s)
- F Barbieri
- Charite Universitatsmedizin Berlin, Department of cardiology, Berlin, Germany
| | - P Spitaler
- Medical University of Innsbruck, Department of cardiology and angiology, Innsbruck, Austria
| | - A Adukauskaite
- Medical University of Innsbruck, Department of cardiology and angiology, Innsbruck, Austria
| | - A Rubatscher
- Medical University of Innsbruck, Department of cardiology and angiology, Innsbruck, Austria
| | - W Schgoer
- Medical University of Innsbruck, Department of cardiology and angiology, Innsbruck, Austria
| | - B Pfeifer
- University Teaching Hospital Hall in Tirol (UMIT), Division for health network and telehealth, Hall in Tyrol, Austria
| | - F Hintringer
- Medical University of Innsbruck, Department of cardiology and angiology, Innsbruck, Austria
| | - W Dichtl
- Medical University of Innsbruck, Department of cardiology and angiology, Innsbruck, Austria
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Bruni A, Bertolini F, D'Angelo E, Barbieri F, Imbrescia J, Trudu L, Cappelli A, Lohr F, Dominici M, Guaitoli G. 147P Chemo-immunotherapy with or without consolidative radiotherapy in extensive-stage small cell lung cancer: An initial report of clinical outcome and safety. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.178] [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: 11/29/2022] Open
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Barbieri F, Bleckwenn S, Stoessl L, Plank F, Beyer C, Gollmann-Tepekoeylue C, Holfeld J, Senoner T, Bonaros N, Schachner T, Dichtl W, Feuchtner G. Bicuspid aortic valve is associated with less coronary artery calcium and coronary artery disease burden by computed tomography. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0173] [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: 11/14/2022] Open
Abstract
Abstract
Background
Bicuspid aortic valve (BAV) is associated with genetic defects (NOTCH 1, GATA 5 mutations) and aortopathy. Differences in flow pattern and a genetic predisposition could also affect coronary arteries.
Purpose
To assess the coronary artery calcium score (CACS) and coronary artery disease (CAD) burden by coronary computed tomography angiography (CTA) in patients with BAV stenosis, as compared to those with tricuspid aortic valve (TAV) stenosis.
Methods
47 patients with congenital BAV (68.9 years±12.9, 38.3% females) who underwent cardiovascular CTA for TAVR planning were matched with 47 TAV patients for age, gender, smoking, arterial hypertension, dyslipidemia, diabetes, body-mass-index and chronic kidney disease. The coronary artery calcium score (CACS) (Agatston Units=AU) and coronary stenosis severity by CTA (CADRAD:<25% minimal,<50%milde,50–70%moderate,>70/%severe) were quantified.
Results
The coronary artery calcium score (CACS) was lower in BAV (237.4 vs. 1013.3AU; p<0.001), and coronary stenosis severity was less (CAD-RAD:p<0.001) as compared to patients with TAV.
More patients with BAV had CACS zero (27.7% vs. 0%, p<0.001). The majority (68.1%) of patients with BAV had no or non-obstructive CAD but only 25.5% of tricuspid (p<0.001).
Obstructive CAD (>50% stenosis) by CTA was more frequently observed in TAV patients (68.1%; p<0.001). There were no differences in statin use and NOAC, and other co-morbidities such as AF and COPD.
Conclusion
Patients with BAV have markedly less coronary artery calcium load and yielded less severe coronary stenosis. CTA succeeds to rule out obstructive CAD in the majority of patients with BAV, with adherent implications for TAVR planning.
Funding Acknowledgement
Type of funding sources: None. 72 YOM with BAV, zero CACS and no CADCACS was lower in BAV
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Affiliation(s)
- F Barbieri
- Innsbruck Medical University, Innsbruck, Austria
| | - S Bleckwenn
- Innsbruck Medical University, Innsbruck, Austria
| | - L Stoessl
- Innsbruck Medical University, Innsbruck, Austria
| | - F Plank
- Innsbruck Medical University, Innsbruck, Austria
| | - C Beyer
- Innsbruck Medical University, Innsbruck, Austria
| | | | - J Holfeld
- Innsbruck Medical University, Innsbruck, Austria
| | - T Senoner
- Innsbruck Medical University, Innsbruck, Austria
| | - N Bonaros
- Innsbruck Medical University, Innsbruck, Austria
| | - T Schachner
- Innsbruck Medical University, Innsbruck, Austria
| | - W Dichtl
- Innsbruck Medical University, Innsbruck, Austria
| | - G Feuchtner
- Innsbruck Medical University, Innsbruck, Austria
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Zweiker D, Sieghartsleitner R, Toth G, Stix G, Vock P, Schratter A, Fiedler L, Aichinger J, Steinwender C, Binder R, Barbieri F, Ablasser K, Verheyen N, Zirlik A, Scherr D. Low haemoglobin is associated with increased risk of complications in left atrial appendage closure patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Left atrial appendage closure is associated with a relevant procedural complication rate. Baseline risk factors, such as pre-procedural lab results, may identify patients that develop acute complications.
Methods
We performed a retrospective analysis of the impact of baseline characteristics and preprocedural lab results on the acute procedural outcome in patients undergoing left atrial appendage closure from the Austrian Left Atrial Appendage Closure Registry between 2010 and 2019. The endpoint for procedural complications was defined as death, stroke, major bleeding, necessity for intensive care, other complications requiring invasive interventions or failure to implant the device. We also evaluated a modified endpoint with the exclusion of bleeding events. Logistic regression was performed using stepwise approach (backward method with p_out = 0.1) and forced inclusion of age, left-ventricular function and kidney function.
Results
A total of 320 consecutive patients from 9 centres with a median age of 75 years (36.6% female) were included. Seventy-eight percent had a history of bleeding and 35% had a history of stroke. Median CHA2DS2-VASc score was 5 (interquartile range, 3–5) and median HAS-BLED score was 3 (2–4). Procedural complications occurred in 15.3% of cases. Low haemoglobin and low activated partial thromboplastin time were associated with an increased complication rate. Other significant baseline factors were liver disease, absence of intracranial haemorrhage and severe aortic stenosis. In multivariate analysis, low haemoglobin remained a significant predictor, even after adjustment for age, left-ventricular function and kidney function (Table). In the modified procedural complication endpoint excluding major bleeding events (14.1%), low haemoglobin remained a significant predictor (haemoglobin 11.9±2.0 vs. 12.8±2.0 g/dL in patients with vs. without modified endpoint, p=0.013). A baseline haemoglobin lower than 12 g/dL was present in 39.4% and it increased relative risk of procedural complications by 89% (21.4 vs. 11.3% in patients with reduced vs. normal haemoglobin), and risk of complications without bleeding by 92% (19.8 vs. 10.3%).
Conclusion
Low baseline haemoglobin is independently associated with a higher complication rate after left appendage closure compared to patients with normal haemoglobin levels, even in a modified endpoint excluding bleeding and requirement for transfusion.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Boston Scientific - unrestricted grant Table 1
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Affiliation(s)
- D Zweiker
- Medical University of Graz, Division of Cardiology, Graz, Austria
| | | | - G Toth
- Medical University of Graz, Division of Cardiology, Graz, Austria
| | - G Stix
- Medical University of Vienna, Division of Cardiology, Vienna, Austria
| | - P Vock
- University Hospital St. Polten, Department of Internal Medicine 3, St. Polten, Austria
| | - A Schratter
- Floridsdorf Clinic, Department of Cardiology, Vienna, Austria
| | - L Fiedler
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie, Wiener Neustadt, Austria
| | - J Aichinger
- Ordensklinikum Linz Elisabethinen, Department of Internal Medicine 2, Linz, Austria
| | - C Steinwender
- Kepler University Hospital, Division of Cardiology, Linz, Austria
| | - R.K Binder
- Klinikum Wels-Grieskirchen, Department of Internal Medicine 2, Wels, Austria
| | - F Barbieri
- Medical University of Innsbruck, Department of Internal Medicine 3, Innsbruck, Austria
| | - K Ablasser
- Medical University of Graz, Division of Cardiology, Graz, Austria
| | - N Verheyen
- Medical University of Graz, Division of Cardiology, Graz, Austria
| | - A Zirlik
- Medical University of Graz, Division of Cardiology, Graz, Austria
| | - D Scherr
- Medical University of Graz, Division of Cardiology, Graz, Austria
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Plank F, Beyer C, Langer C, Senoner T, Bleckwenn S, Widmann G, Barbieri F, Friedrich G, Dichtl W, Feuchtner G. The atherosclerosis profile by coronary CTA compared to the coronary artery calcium score (CACS) in a young symptomatic high-risk population between 19 and 49 years. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0189] [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: 11/14/2022] Open
Abstract
Abstract
Background
Whether the coronary artery calcium score (CACS) or coronary CTA should be used in young high-risk adults for screening of coronary artery disease (CAD), is an open debate and data sparse.
Aims
To evaluate the coronary atherosclerosis profile by coronary computed tomography angiography (CTA) in a young symptomatic high-risk population (age, 19–49 years) in comparison with the coronary artery calcium score (CACS).
Methods and results
1137 symptomatic high-risk patients between 19–49 years (mean 42.4y; 33.2%females) with suspected CAD who underwent CTA and CACS were assigned into 6 age groups (19–30; 31–35; 36–40; 41–45; 46–47; 48–49y).CTA-analysis included stenosis severity (CADRADS) and high-risk-plaque (“HRP”) criteria.
Atherosclerosis was more often detected by CTA than by CACS (45% vs. 27%; p<0.001), >50% stenosis in 13.6% and HRP in 17.7%. Prevalence of atherosclerosis was low and not different between CACS and CTA in the youngest (19–30y:5.2% and 6.4%; 30–35y:10.6% and 16%). Above >35 years, atherosclerosis detection by CTA increased (p=0.004, OR: 2.8, 95% CI: 1.45–5.89); and was higher by CTA as compared to CACS (34.9% vs 16.7%; p<0.001).
CTA outperformed CACS among all higher age groups >35 years, with an increasing gap towards a superior performance of CTA along with age: Above 35 years, stenosis severity (CADRADS) (p=0.002) and >50% stenosis increased from 2.6% to 12.5% (p<0.001).
The rate of HRP increased linearly with age from 6.4% to 26.5%.The distribution of HRP into CACS0 and CACS>0.1AU was similar among all age groups (CACS 0:45.1% had HRP), with an increasing proportion of HRP in CACS>0.1AU with age. 24.9% of CACS 0 patients had CAD by CTA, 4.4% >50% stenosis and 11.5% HRP.
Conclusion
Above 35 years of age, CTA outperforms CACS with an increasing power. Between 19 and 35 years, CACS 0 does not reliably rule out CAD and high-risk-plaque; hence for “noRISK100%safety”, CTA is superior.(#eachlifematters)
Funding Acknowledgement
Type of funding sources: None. 30 YOM diabetic, CACS 0 and HRP by CTAAtherosclerosis vs age: CACS vs CTA
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Affiliation(s)
- F Plank
- Innsbruck Medical University, Innsbruck, Austria
| | - C Beyer
- Innsbruck Medical University, Innsbruck, Austria
| | - C Langer
- Innsbruck Medical University, Innsbruck, Austria
| | - T Senoner
- Innsbruck Medical University, Innsbruck, Austria
| | - S Bleckwenn
- Innsbruck Medical University, Innsbruck, Austria
| | - G Widmann
- Innsbruck Medical University, Innsbruck, Austria
| | - F Barbieri
- Innsbruck Medical University, Innsbruck, Austria
| | - G Friedrich
- Innsbruck Medical University, Innsbruck, Austria
| | - W Dichtl
- Innsbruck Medical University, Innsbruck, Austria
| | - G Feuchtner
- Innsbruck Medical University, Innsbruck, Austria
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Banna GL, Cortellini A, Cortinovis DL, Tiseo M, Aerts JGJV, Barbieri F, Giusti R, Bria E, Grossi F, Pizzutilo P, Berardi R, Morabito A, Genova C, Mazzoni F, Di Noia V, Signorelli D, Gelibter A, Macerelli M, Rastelli F, Chiari R, Rocco D, Gori S, De Tursi M, Di Marino P, Mansueto G, Zoratto F, Filetti M, Montrone M, Citarella F, Marco R, Cantini L, Nigro O, D'Argento E, Buti S, Minuti G, Landi L, Guaitoli G, Lo Russo G, De Toma A, Donisi C, Friedlaender A, De Giglio A, Metro G, Porzio G, Ficorella C, Addeo A. The lung immuno-oncology prognostic score (LIPS-3): a prognostic classification of patients receiving first-line pembrolizumab for PD-L1 ≥ 50% advanced non-small-cell lung cancer. ESMO Open 2021; 6:100078. [PMID: 33735802 PMCID: PMC7988288 DOI: 10.1016/j.esmoop.2021.100078] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/26/2021] [Accepted: 02/02/2021] [Indexed: 12/30/2022] Open
Abstract
Background To stratify the prognosis of patients with programmed cell death-ligand 1 (PD-L1) ≥ 50% advanced non-small-cell lung cancer (aNSCLC) treated with first-line immunotherapy. Methods Baseline clinical prognostic factors, the neutrophil-to-lymphocyte ratio (NLR), PD-L1 tumour cell expression level, lactate dehydrogenase (LDH) and their combination were investigated by a retrospective analysis of 784 patients divided between statistically powered training (n = 201) and validation (n = 583) cohorts. Cut-offs were explored by receiver operating characteristic (ROC) curves and a risk model built with validated independent factors by multivariate analysis. Results NLR < 4 was a significant prognostic factor in both cohorts (P < 0.001). It represented 53% of patients in the validation cohort, with 1-year overall survival (OS) of 76.6% versus 44.8% with NLR > 4, in the validation series. The addition of PD-L1 ≥ 80% (21% of patients) or LDH < 252 U/l (25%) to NLR < 4 did not result in better 1-year OS (of 72.6% and 74.1%, respectively, in the validation cohort). Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 2 [P < 0.001, hazard ratio (HR) 2.04], pretreatment steroids (P < 0.001, HR 1.67) and NLR < 4 (P < 0.001, HR 2.29) resulted in independent prognostic factors. A risk model with these three factors, namely, the lung immuno-oncology prognostic score (LIPS)-3, accurately stratified three OS risk-validated categories of patients: favourable (0 risk factors, 40%, 1-year OS of 78.2% in the whole series), intermediate (1 or 2 risk factors, 54%, 1-year OS 53.8%) and poor (>2 risk factors, 5%, 1-year OS 10.7%) prognosis. Conclusions We advocate the use of LIPS-3 as an easy-to-assess and inexpensive adjuvant prognostic tool for patients with PD-L1 ≥ 50% aNSCLC. Immunotherapy/chemoimmunotherapy combinations are currently not superior to immunotherapy alone for high PD-L1 aNSCLC. NLR with a cut-off of 4 was validated as an independent prognostic factor for immunotherapy in high PD-L1 aNSCLC. The addition of either PD-L1 ≥ 80% or LDH < 252 U/l to NLR < 4 did not result in better prognostic stratification. The LIPS-3 is a validated 3-class prognostic classification based on the NLR, ECOG PS and pretreatment steroids. The LIPS-3 is a routinely assessable adjuvant prognostic tool for high PD-L1 aNSCLC patients.
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Affiliation(s)
- G L Banna
- Oncology Department, Portsmouth University Hospitals NHS Trust, Portsmouth, UK
| | - A Cortellini
- Department of Surgery and Cancer, Imperial College London, London, UK; Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | | | - M Tiseo
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy; Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - J G J V Aerts
- Department of Pulmonary Diseases, Erasmus Medical Center, Rotterdam, the Netherlands
| | - F Barbieri
- Department of Oncology and Hematology, Modena University Hospital, Modena, Italy
| | - R Giusti
- Medical Oncology, St. Andrea Hospital, Rome, Italy
| | - E Bria
- Comprehensive Cancer Center, Fondazione Policlinico Universitario 'A. Gemelli' IRCCS, Rome, Italy; Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Grossi
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P Pizzutilo
- Thoracic Oncology Unit, Clinical Cancer Center IRCCS Istituto Temorid 'Giovanni Paolo II', Bari, Italy
| | - R Berardi
- Oncology Clinic, Università Politecnica Delle Marche, Ospedali Riuniti Di Ancona, Ancona, Italy
| | - A Morabito
- Thoracic Medical Oncology, Istituto Nazionale Tumori 'Fondazione G Pascale', IRCCS, Napoli, Italy
| | - C Genova
- Lung Cancer Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - F Mazzoni
- Department of Oncology, Careggi University Hospital, Florence, Italy
| | - V Di Noia
- Medical Oncology, University Hospital of Foggia, Foggia, Italy
| | - D Signorelli
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Gelibter
- Medical Oncology (B), Policlinico Umberto I, 'Sapienza' University of Rome, Rome, Italy
| | - M Macerelli
- Department of Oncology, University Hospital Santa Maria Della Misericordia, Udine, Italy
| | - F Rastelli
- Medical Oncology, Fermo Area Vasta 4, Fermo, Italy
| | - R Chiari
- Medical Oncology, Ospedali Riuniti Padova Sud 'Madre Teresa Di Calcutta', Monselice, Italy
| | - D Rocco
- Pneumo-Oncology Unit, Monaldi Hospital, Naples, Italy
| | - S Gori
- Oncology Unit, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella VR, Italy
| | - M De Tursi
- Department of Medical, Oral & Biotechnological Sciences University G. D'Annunzio, Chieti-Pescara, Chieti, Italy
| | - P Di Marino
- Clinical Oncology Unit, S.S. Annunziata Hospital, Chieti, Italy
| | - G Mansueto
- Medical Oncology, F. Spaziani Hospital, Frosinone, Italy
| | - F Zoratto
- Medical Oncology, Santa Maria Goretti Hospital, Latina, Italy
| | - M Filetti
- Medical Oncology, St. Andrea Hospital, Rome, Italy
| | - M Montrone
- Thoracic Oncology Unit, Clinical Cancer Center IRCCS Istituto Temorid 'Giovanni Paolo II', Bari, Italy
| | - F Citarella
- Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - R Marco
- Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - L Cantini
- Department of Pulmonary Diseases, Erasmus Medical Center, Rotterdam, the Netherlands; Oncology Clinic, Università Politecnica Delle Marche, Ospedali Riuniti Di Ancona, Ancona, Italy
| | - O Nigro
- Medical Oncology, ASST-Sette Laghi, Varese, Italy
| | - E D'Argento
- Comprehensive Cancer Center, Fondazione Policlinico Universitario 'A. Gemelli' IRCCS, Rome, Italy
| | - S Buti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - G Minuti
- Department of Oncology and Hematology, AUSL Romagna, Ravenna, Italy
| | - L Landi
- Department of Oncology and Hematology, AUSL Romagna, Ravenna, Italy
| | - G Guaitoli
- Department of Oncology and Hematology, Modena University Hospital, Modena, Italy
| | - G Lo Russo
- Medical Oncology (B), Policlinico Umberto I, 'Sapienza' University of Rome, Rome, Italy
| | - A De Toma
- Medical Oncology (B), Policlinico Umberto I, 'Sapienza' University of Rome, Rome, Italy
| | - C Donisi
- Medical Oncology Unit, University Hospital and University of Cagliari, Cagliari, Italy
| | - A Friedlaender
- Oncology Department, University Hospital of Geneva, Geneva, Switzerland
| | - A De Giglio
- Division of Medical Oncology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - G Metro
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - G Porzio
- Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy
| | - C Ficorella
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy; Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy
| | - A Addeo
- Oncology Department, University Hospital of Geneva, Geneva, Switzerland
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7
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Schnabl D, Schanner LL, Barbieri F, Laimer J, Bruckmoser E, Steiner R, Grunert I. Is dental general anaesthesia in children an outdated concept? A retrospective analysis. Eur J Paediatr Dent 2020; 21:283-286. [PMID: 33337903 DOI: 10.23804/ejpd.2020.21.04.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM The aim of this retrospective study was to determine the prevalence of caries and treatment needs in the collective of patients ?16 years of age, who underwent scheduled dental general anaesthesia (DGA) at the University Clinic of Innsbruck from January 2015 to June 2019, with respect to demographic factors. MATERIALS AND METHODS A retrospective analysis of children's diagnoses, demographics, and dental treatment under general anaesthesia in Innsbruck, Austria, from 2015 to 2019 was performed. Anonymised demographic data (age; gender; the presence or absence of general disease or disablement; parents' first language (German- (GS) or non-German-speaking (non-GS), reflecting ethnicity; and the number of teeth restored and extracted under DGA were collected from patients' files. Data was analysed by means of descriptive and comparative statistics. RESULTS The main group consisted of 545 subjects at a median age of 5.3 (IQR 4.4-6.6) years, who had exclusively primary teeth and or first molars that received restorations or were extracted. Of the subjects, 84.4% were classified with uncooperativeness due to dental anxiety and 15.6% with systemic diseases or intellectual and or physical disablement. In this group, 47.9% were GS and 52.1% were non-GS or had GS or non- GS parents. In the total sample, 5 (IQR 3-7) primary teeth were restored and 4 (IQR 4-7) extracted. Subgroup analysis revealed statistically significant differences in the number of extracted primary teeth between children with and without systemic diseases or disablement - 3 (IQR 1-5) versus 4 (IQR 2-7) - and between children of GS and non-GS parents - 4 (IQR 2-6) versus 5 (IQR 3-7.8). Zero (IQR 0-0) first molars were filled and extracted. CONCLUSION Within the study collective of children in poor oral health, the offspring of non-GS families were overrepresented (compared to their prevalence in the total population) and displayed a higher prevalence of deep caries than those of GS parents. By intensifying and special gearing of prophylactic measures to the non-GS population and promoting the parents' insight into the importance of oral hygiene and regular dental attendance, the demand for scheduled DGA might be greatly reduced. In the small share of children who suffer from severe diseases or disablement and are thus unable to cooperate with home care or dental treatment, DGA will remain the treatment of choice.
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Affiliation(s)
- D Schnabl
- Department of Operative and Prosthetic Dentistry, Medical University of Innsbruck, Innsbruck, Austria
| | - L L Schanner
- Department of Operative and Prosthetic Dentistry, Medical University of Innsbruck, Innsbruck, Austria
| | - F Barbieri
- Department of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
| | - J Laimer
- Department of Operative and Prosthetic Dentistry, Medical University of Innsbruck, Innsbruck, Austria
| | - E Bruckmoser
- Private Practice for Oral and Maxillofacial Surgery, Salzburg, Austria
| | - R Steiner
- Department of Operative and Prosthetic Dentistry, Medical University of Innsbruck, Innsbruck, Austria
| | - I Grunert
- Department of Operative and Prosthetic Dentistry, Medical University of Innsbruck, Innsbruck, Austria
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8
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Barbieri F, Senoner T, Adukauskaite A, Lambert T, Zweiker D, Rainer P, Schmidt A, Feuchtner G, Steinwender C, Hoppe U, Hintringer F, Bauer A, Mueller S, Grimm M, Dichtl W. The prognostic value of preprocedural high-sensitivity troponin T in patients with severe aortic stenosis undergoing valve replacement: a gender analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1984] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Recent studies have demonstrated the predictive value of preprocedural cardiac biomarkers, such as N-terminal pro brain natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hsTnT), in patients with severe aortic valve stenosis undergoing valve replacement. Nonetheless, it remains still unclear whether hsTnT may be influenced by gender-specific differences.
Purpose
The aim of this subanalysis was to evaluate sex-related differences of preprocedural hsTnT in predicting postoperative long-term survival in a large cohort undergoing either surgical or transcatheter aortic valve replacement.
Methods
The TASS-2 group, a consortium of four university hospital centers, analysed 3595 consecutively enrolled patients admitted for valve implantation because of severe aortic stenosis between 2007 and 2017.
Results
The study cohort consisted of 1728 (48.1%) female and 1867 (51.9%) male patients. During a median follow-up of 2.9 years, cardiovascular mortality was found in 556 (15.5%) patients, amongst whom were 292 (16.9%) women and 264 (14.1%) men. All-cause mortality was detected in 919 (25.6%) patients dividing into 462 (26.7%) women and 457 (24.5%) men.
Preprocedural hsTnT was significantly higher (p<0.001) in male (19 ng/l, 11.8–34.0) than in female (16 ng/l, 10.0–30.0) patients. In contrary, NT-proBNP was lower (p=0.002) in male (1286 ng/l, 444.5–3225.5) than female (1407 ng/l, 604.5–3217.5) patients. For the univariate analysis of survival, hsTnT was categorized by using predefined subgroups (<5 ng/l; 5–13.99 ng/l; 14–50 ng/l; >50 ng/l). Cardiovascular and all-cause mortality were significantly increased with higher hsTnT plasma levels in women (p<0.001) as well as in men (<0.001).
In two separate multivariate cox regression models, one for either gender - adjusting for STS risk score, NT-proBNP plasma levels, degree of left ventricular systolic dysfunction, atrial fibrillation, age, renal function, chronic obstructive pneumonic disease, arterial hypertension, diabetes mellitus, concomitant significant coronary artery disease and type of procedure – pre-procedural hsTnT was a strong independent predictor for postoperative cardiovascular mortality with an hazard ratio [HR] of 3.34, 95% confidence interval [CI] 1.03–10.80, P=0.044 for mildly to moderately elevated hsTnT (14–50 ng/l) and an HR of 3.98, CI 1.19–13.30, P=0.025 for severely elevated hsTnT (>50 ng/l) in women, whereas an hazard ratio [HR] 4.09, 95% confidence interval [CI] 0.55–29.99, P=0.166 for mildly to moderately elevated hsTnT (14–50 ng/l) and an HR 7.48, CI 0.99–56.12, P=0.050 for severely elevated hsTnT (>50 ng/l) in men was yielded.
Conclusion
Long-term postoperative survival in patients with severe AS admitted for valve implantation was independently predicted by hsTnT, irrespective of gender.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): Tiroler Wissenschaftsförderung (Innsbruck, Austria)
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Affiliation(s)
- F Barbieri
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - T Senoner
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - A Adukauskaite
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - T Lambert
- Kepler University Hospital Linz, Department of cardiology, Linz, Austria
| | - D Zweiker
- Medical University of Graz, Department of Internal Medicine, Division of Cardiology, Graz, Austria
| | - P Rainer
- Medical University of Graz, Department of Internal Medicine, Division of Cardiology, Graz, Austria
| | - A Schmidt
- Medical University of Graz, Department of Internal Medicine, Division of Cardiology, Graz, Austria
| | - G Feuchtner
- Innsbruck Medical University, University Clinic of Radiology, Innsbruck, Austria
| | - C Steinwender
- Kepler University Hospital Linz, Department of cardiology, Linz, Austria
| | - U Hoppe
- Universitaetsklinikum Salzburg, University Clinic of Internal Medicine II, Salzburg, Austria
| | - F Hintringer
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - A Bauer
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - S Mueller
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - M Grimm
- Innsbruck Medical University, University Clinic of Heart Surgery, Innsbruck, Austria
| | - W Dichtl
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
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9
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Grego L, Pignatto S, Alfier F, Arigliani M, Rizzetto F, Rassu N, Samassa F, Prosperi R, Barbieri F, Dall'Amico R, Cogo P, Lanzetta P. Optical coherence tomography (OCT) and OCT angiography allow early identification of sickle cell maculopathy in children and correlate it with systemic risk factors. Graefes Arch Clin Exp Ophthalmol 2020; 258:2551-2561. [PMID: 32518974 DOI: 10.1007/s00417-020-04764-y] [Citation(s) in RCA: 2] [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: 11/26/2019] [Revised: 05/13/2020] [Accepted: 05/20/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To determine the presence of sickle cell retinopathy and maculopathy and to identify associations between markers of hemolysis and systemic and ocular manifestations in children affected by sickle cell disease. METHODS Eighteen children with sickle cell disease, aged 5-16 years, underwent complete eye examination including best-corrected visual acuity, slit-lamp biomicroscopy, ophthalmoscopy after pharmacological mydriasis, spectral-domain optical coherence tomography (SD-OCT), and optical coherence tomography angiography (OCTA). Blood test results and clinical history information were collected for each child, including fetal hemoglobin (HbF), hemoglobin (Hb), hematocrit (Htc), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), reticulocytes percentage (%ret), lactic dehydrogenase (LDH), total and direct bilirubin, glomerular filtration rate, number of painful crises, acute chest syndromes, and splenic sequestration. Therapeutic regimen and transfusion therapy were also evaluated. RESULTS Sixteen of 36 eyes (44.4%) had non-proliferative sickle cell retinopathy on ophthalmoscopic evaluation. No patients had proliferative sickle cell retinopathy. In 13 of 36 eyes (36.1%), SD-OCT and OCTA detected signs of sickle cell maculopathy. Nine eyes (25%) presented sickle cell retinopathy and maculopathy, 7 eyes (19.4%) sickle cell retinopathy alone, and 4 eyes (11.1%) sickle cell maculopathy alone. A statistically significant association was found between sickle cell retinopathy; lower levels of HbF, Hb, and Htc; and higher MCV and percentage of reticulocytes. Sickle cell maculopathy was associated with lower values of H and Htc and higher levels of reticulocytes and total bilirubin. CONCLUSIONS We identified early signs of sickle cell retinopathy and maculopathy in a pediatric population with SD-OCT and OCTA. These two retinal complications were more frequent in children with higher hemolytic rates.
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Affiliation(s)
- L Grego
- Department of Medicine- Ophthalmology, University of Udine, Udine, Italy
| | - S Pignatto
- Department of Medicine- Ophthalmology, University of Udine, Udine, Italy
| | - F Alfier
- Department of Medicine- Ophthalmology, University of Udine, Udine, Italy
| | - M Arigliani
- Department of Medicine- Paediatrics, University of Udine, Udine, Italy
| | - F Rizzetto
- Department of Ophthalmology, Hospital of Pordenone, Pordenone, Italy
| | - N Rassu
- Department of Medicine- Ophthalmology, University of Udine, Udine, Italy
| | - F Samassa
- Department of Medicine- Ophthalmology, University of Udine, Udine, Italy
| | - R Prosperi
- Department of Medicine- Ophthalmology, University of Udine, Udine, Italy
| | - F Barbieri
- Department of Paediatrics, Hospital of Pordenone, Pordenone, Italy
| | - R Dall'Amico
- Department of Paediatrics, Hospital of Pordenone, Pordenone, Italy
| | - P Cogo
- Department of Medicine- Paediatrics, University of Udine, Udine, Italy
| | - P Lanzetta
- Department of Medicine- Ophthalmology, University of Udine, Udine, Italy.
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Barbieri F, Adukauskaite A, Heidbreder A, Brandauer E, Bergmann M, Senoner T, Rubatscher A, Schgoer W, Stuehlinger M, Pfeifer B, Bauer A, Hintringer F, Hoegl B, Dichtl W. P534Central sleep apnea in pacing-induced cardiomyopathy: prevalence, improvement by upgrading to cardiac resynchronisation therapy and impact on structural responder rates and long-term outcome. Europace 2020. [DOI: 10.1093/europace/euaa162.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
ÖNB Jubiläumsfondsprojekt Nr. 15974, ISR grant by Boston Scientific, St. Paul, MN, USA
Background
Central sleep apnea (CSA) in pacing induced cardiomyopathy (PICM) is poorly studied. Specifically, it is unknown whether upgrading from right ventricular pacing (RVP) to cardiac resynchronisation therapy (CRT) improves CSA.
Methods
Fifty-three patients with impaired left ventricular ejection fraction, frequent right ventricular pacing due to high-grade atrioventricular block and heart failure symptoms despite optimal medical therapy underwent upgrading to CRT. Within one month after left ventricular lead implantation (but still not activated), sleep apnea was assessed in all participants by single-night polysomnography (PSG). Nineteen patients with moderate or severe CSA defined by an apnea hypopnea index (AHI) > 15 events per hour were re-scheduled for a follow up PSG 3-5 months after initiation of cardiac resynchronization therapy. Of this cohort, thirteen patients with stable mild heart failure agreed to be randomized to CRT versus RVP in a cross-over design.
Results
CSA (AHI > 5 events per hour) was diagnosed in 26 (49.1%), OSA in 16 (30.2%) patients suffering from PICM . Eleven (20.8%) patients did not have any form of sleep apnea. Moderate to severe CSA (AHI > 15 events per hour) was significantly improved (without specific CPAP therapy) by 102 (96-172) days of CRT: AHI decreased from 39.4 events per hour at baseline to 21.6 by CRT (p < 0.001). Furthermore, CRT led to a substantial decrease in left ventricular endsystolic volumes: baseline 141 ml (103-155), significant improvement under CRT (102 ml, 65-138; p < 0.001), whereas no effect with ongoing RV-pacing (147 ml, 130-161; p = 0.865). Preexistent CSA did not affect the structural response of CRT (56.5% in patients with CSA, 62.5% of patients with obstructive sleep apnea and 54.5% in patients without sleep apnea; p = 0.901) and had no impact on major adverse cardiac events (p = 0.412) and/or survival (p = 0.623) during long-term follow-up.
Conclusions
CSA is highly prevalent in patients with PICM and is significantly improved by upgrading to CRT. Preexistent CSA does not hamper structural improvement and long-term outcome after upgrading to CRT. Thus, CSA seems to occur as a consequence of PICM, rather than as a pathophysiological mediator.
Abstract Figure.
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Affiliation(s)
- F Barbieri
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - A Adukauskaite
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - A Heidbreder
- Muenster University Hospital, Department of Neurology, Division of Sleep Medicine and Neuromuscular Disorders, Muenster, Germany
| | - E Brandauer
- Innsbruck Medical University, Department of Neurology, Sleep Disorders Clinic, Innsbruck, Austria
| | - M Bergmann
- Innsbruck Medical University, Department of Neurology, Sleep Disorders Clinic, Innsbruck, Austria
| | - T Senoner
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - A Rubatscher
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - W Schgoer
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - M Stuehlinger
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - B Pfeifer
- University Teaching Hospital Hall in Tirol (UMIT), Institute of Electrical and Biomedical Engineering, Hall in Tyrol, Austria
| | - A Bauer
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - F Hintringer
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - B Hoegl
- Innsbruck Medical University, Department of Neurology, Sleep Disorders Clinic, Innsbruck, Austria
| | - W Dichtl
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
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11
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Barbieri F, Senoner T, Holfeld J, Semsroth S, Lambert T, Zweiker D, Theurl T, Rainer PP, Schmidt A, Feuchtner GM, Steinwender C, Hoppe U, Mueller S, Grimm M, Dichtl W. P4665High sensitivity troponin t and n-terminal pro brain natriuretic peptide plasma levels predict long-term postoperative survival in patients with severe aortic stenosis admitted for valve implantation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Optimal timing of valve implantation in patients with severe aortic stenosis (AS) is under debate, considering the subjective nature of symptom onset. We aimed to investigate the pre-procedural value of routinely available cardiac biomarkers in predicting postoperative long-term outcome in a large cohort undergoing either surgical or transcatheter aortic valve implantation.
Methods
The Tyrolean Aortic Stenosis Study-2 (TASS-2) group, a consortium of four university hospital centers in Austria, analysed pre-procedural high-sensitivity troponin T (hsTnT) and N-terminal pro brain natriuretic peptide (NT-proBNP) plasma levels in 3595 patients admitted for valve implantation because of severe aortic stenosis since 2007.
Results
Transcatheter aortic valve implantation was performed in 1517 (42.2%) of patients. During a median follow-up of 2.93 (1.91–4.92) years, 919 patients (25.6%) died, among them 556 (15.5%) due to cardiovascular causes. In multivariate cox regression analysis - adjusting for STS risk score (intermediate risk 4–8%, high risk >8%), degree of left ventricular systolic dysfunction (ejection fraction 30–50% and <30%), atrial fibrillation, sex, age, renal function, COPD, arterial hypertension, diabetes mellitus, concomitant significant coronary artery disease and type of procedure (surgical aortic valve replacement or transcatheter aortic valve implantation) - pre-procedural hsTnT as well as NT-proBNP plasma levels were strong independent predictors for postoperative survival: hazard ratio [HR] 1.82, 95% confidence interval [CI] 1.07–3.11, P=0.028 for mildly to moderately elevated hsTnT (14–50 ng/l); HR 2.80, CI 1.61–4.89, P<0.001 for severely elevated hsTnT (>50 ng/l); HR 1.38, CI 1.06–1.81, P=0.018 for mildly to moderately elevated NT-proBNP (defined by an increase of up to threefold of age- and sex-corrected normal range); HR 1.68, CI 1.29–2.18, P<0.001 for severely elevated NT-proBNP (defined by an increase of more than threefold of age- and sex-corrected normal range). For direct comparison of these two biomarkers a second cox regression model was conducted including only hsTnT and NT-proBNP revealing the strength of hsTnT as a predictive biomarker: HR 2.20, 95% CI 1.29–3.77, P=0.004 for minimally elevated hsTnT (5–13.99 ng/l); HR 4.05, CI 2.41–6.82, P<0.001 for mildly to moderately elevated hsTnT (14–50 ng/l); HR 8.63, CI 5.07–14.70, P<0.001 for severely elevated hsTnT (>50 ng/l); HR 1.47, CI 1.13–1.91, P=0.004 for mildly to moderately elevated NT-proBNP; HR 1.96, CI 1.54–2.51, P<0.001 for severely elevated NT-proBNP.
Conclusion
hsTNT and NT-proBNP strongly predict long-term postoperative survival in patients with severe AS admitted for valve implantation.
Acknowledgement/Funding
This work was supported by the Tiroler Wissenschaftsförderung: grant number TWF-2017-1-5, GZ: UNI-0404-2104
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Affiliation(s)
- F Barbieri
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - T Senoner
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - J Holfeld
- Innsbruck Medical University, Department of cardiac surgery, Innsbruck, Austria
| | - S Semsroth
- Innsbruck Medical University, Department of cardiac surgery, Innsbruck, Austria
| | - T Lambert
- General Hospital (AKH) of Linz, Department of cardiology, Linz, Austria
| | - D Zweiker
- Medical University of Graz, Department of cardiology, Graz, Austria
| | - T Theurl
- Paracelsus Private Medical University, University clinic of Internal Medicine II, Salzburg, Austria
| | - P P Rainer
- Medical University of Graz, Department of cardiology, Graz, Austria
| | - A Schmidt
- Medical University of Graz, Department of cardiology, Graz, Austria
| | - G M Feuchtner
- Innsbruck Medical University, Department of radiology, Innsbruck, Austria
| | - C Steinwender
- General Hospital (AKH) of Linz, Department of cardiology, Linz, Austria
| | - U Hoppe
- Paracelsus Private Medical University, University clinic of Internal Medicine II, Salzburg, Austria
| | - S Mueller
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - M Grimm
- Innsbruck Medical University, Department of cardiac surgery, Innsbruck, Austria
| | - W Dichtl
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
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12
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Senoner T, Barbieri F, Adukauskaite A, Sarcletti M, Plank F, Beyer C, Dichtl W, Feuchtner GM. P6156Coronary atherosclerosis characteristics in long-term antiretroviral therapy and HIV infection: insights from coronary CTA. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Purpose
To assess coronary artery disease (CAD) characteristics by coronary CT-angiography (CTA) in individuals with HIV-infection on long-term ART in a retrospective matched case-controlled cohort study.
Methods
69 HIV positive patients who underwent 128-slice dual source coronary CTA (mean age 54.9 years, 26.1% females) with mean 17.8±9.4 years of HIV-infection and a mean duration on ART of 13±7.3 years were propensity score matched with 69 HIV negative controls.
CTA was evaluated for: Stenosis severity (CAD-RADS), total plaque burden, mixed-non-calcified plaque burden (G-score), high-risk-plaque (HRP) features (Napkin-Ring-Sign, low-attenuation-plaque, spotty calcification, positive remodeling), perivascular fat attenuation index (FAI) and ectatic coronary segments.
Results
CAD-RADS was higher in HIV-positive participants as compared to controls (2.21±1.4 vs 1.69±1.5, p=0.031). A higher prevalence of CAD and G-score (p=0.043 and p=0.003) were found.
HRP prevalence (23 (34.3%) vs 8 (12.1%); p=0.002) and the number of HRP (36 vs 10, p<0.001) were higher in HIV-positive individuals. A positive perivascular FAI >-70 HU was present in 27.8% of HRP. Ectatic coronary arteries were found in 10 (14.5%) individuals with HIV-infection vs 0% in controls (p=0.003).
Conclusion(s)
HIV positive individuals on long-term ART display higher CAD burden and more HRP indicating vulnerable, potentially inflamed plaques.
CT- Angiography results HIV+ (N=67) HIV− (N=67) P-value CAD prevalence (any plaque), n (%) 56 (83.6) 46 (68.7) 0.043 SSS, mean ±SD 1.16±1.6 0.95±2.1 0.038 CAD RADS 0 11 22 1 11 7 2 10 21 <0.001 3 23 4 4 12 13 Total >50%, n (%) 35 (52.2) 17 (25.4) 0.001 CAD RADS, mean ±SD 2.21±1.4 1.69±1.5 0.031 SIS, mean ±SD 3.93±3.0 3.06±3.1 0.067 G-score, mean ±SD 10.04±8.5 5.76±5.9 0.003 Calcium score, mean ±SD 149.4±287.1 133.2±329.3 0.015 HRP, n (%) 23 (34.3) 8 (12.1) 0.002 HRP, n 36 10 <0.001 Non-calcifying plaque component, n (%) 44 (65.7) 34 (51.5) 0.097 Ectatic coronary segments, n (%) 10 (14.5) 0 (0) 0.003 CAD RADS: coronary artery disease reporting and data system; CCS: coronary calcium score; HRP: high-risk plaque; SIS: segment involvement score; SSS: stenosis severity score.
60 yo HIV-infected (31 yrs) male patient
These features strongly support the predominant inflammatory theory of cardiovascular events in HIV-infected individuals.
Acknowledgement/Funding
None
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Affiliation(s)
- T Senoner
- Innsbruck University Hospital, Cardiology, Innsbruck, Austria
| | - F Barbieri
- Innsbruck University Hospital, Cardiology, Innsbruck, Austria
| | - A Adukauskaite
- Innsbruck University Hospital, Cardiology, Innsbruck, Austria
| | - M Sarcletti
- Innsbruck University Hospital, Dermatology, Innsbruck, Austria
| | - F Plank
- Innsbruck University Hospital, Cardiology, Innsbruck, Austria
| | - C Beyer
- Innsbruck University Hospital, Radiology, Innsbruck, Austria
| | - W Dichtl
- Innsbruck University Hospital, Cardiology, Innsbruck, Austria
| | - G M Feuchtner
- Innsbruck University Hospital, Radiology, Innsbruck, Austria
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Adukauskaite A, Barbieri F, Senoner T, Plank F, Knoflach M, Boehme C, Hintringer F, Mueller S, Dichtl W, Feuchtner G. P3383Left atrial appendage and left atrial morphology is associated with cryptogenic stroke. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0259] [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: 11/14/2022] Open
Abstract
Abstract
Background
Stroke causes a high burden of morbidity and mortality worldwide. Approximately 30% of stroke cases remain cryptogenic (CS), of which one third is due to occult atrial fibrillation (AF) with left atrial appendage (LAA) being the most frequent thrombus source.
Hence, aim of our study was to assess if LAA morphological parameters analysed by computed tomography angiography (CTA) are associated with CS.
Methods and materials
In 184 patients (Table 1), 82 CS patients and 102 controls (age median 62 (52,2–72), 40.2% females), matched for BMI, a CTA was performed, and LAA morphology evaluated retrospectively.
LAA morphology was classified into 5 types (Figure 1): Cactus, Cauliflower, Chicken-wing, Windsock and the new “Seahorse” with a distinctive tip angulation of ≤90° and 2 bends (Z-shape). Further measurements included: LAA tip angulation (≤90°, 91–110°, >110°), LAA lobe number, LAA ostium size (length) and angulation, left atrium wall thickness (LAWT).
Results
LAA and left atrium (LA) parameters associated with CS on multivariable analysis after adjusting for CHA2DS2-VASc score were: Chicken-wing type (OR 2.15; 95% CI: 1.01–4.56, p=0.046), a greater lobe number (OR 2.01; 95% CI: 1.52–2.64, p<0.001), a greater middle and mean LAWT (respectively, OR 2.13; 95% CI: 1.49–3.05, p<0.001, OR 2.64; 95% CI: 1.63–4.29, p<0.001), a larger (length, OR 1.08; 95% CI: 1.0–1.16, p=0.039) and a less bent LAA ostium (OR 1.02; 95% CI: 1.01–1.03, p=0.006). In contrast, a sharp-angled LAA tip (≤90°) was protective from CS (OR 0.43; 95% CI: 0.23–0.83, p=0.012) on multivariable analysis.
Table1. Clinical patient characteristics CS (n=82) Non-stroke (n=102) p value Females 21 (25.6%) 53 (52%) p<0.001 Age, y 66.5 (57–73) 57.5 (50–70) 0.001 BMI, kg/m2 25.6 (23.9–28.2) 26 (23.3–30.1) 0.320 CHA2DS2-VASc score 2 (1–3) 2 (1–3) 0.387 AF (paroxysmal/permanent) 0 4 0.071 Hypertension 68 (82.9%) 54 (56.3%) p<0.001 Diabetes mellitus, type 2 16 (19.8%) 11 (11.5%) 0.145 Values are given in median ± IQR. AF, atrial fibrillation; BMI, body mass index.
LAA and LA morphology in CTA.
Conclusion
In CS, a Chicken-wing LAA, a greater number of lobes and a thicker LA wall are independently associated with CS while a sharp LAA tip (≤90°) mostly seen in Seahorse type LAA is protective. Such “high-risk” LAA and LA morphology could help to select CS patients benefiting from extended rhythm-monitoring to detect an occult AF, however, further prospective studies are needed to confirm this hypothesis.
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Affiliation(s)
| | - F Barbieri
- Innsbruck University Hospital, Internal Medicine III, Innsbruck, Austria
| | - T Senoner
- Innsbruck University Hospital, Internal Medicine III, Innsbruck, Austria
| | - F Plank
- Innsbruck University Hospital, Internal Medicine III, Innsbruck, Austria
| | - M Knoflach
- Innsbruck University Hospital, Neurology, Innsbruck, Austria
| | - C Boehme
- Innsbruck University Hospital, Neurology, Innsbruck, Austria
| | - F Hintringer
- Innsbruck University Hospital, Internal Medicine III, Innsbruck, Austria
| | - S Mueller
- Innsbruck University Hospital, Internal Medicine III, Innsbruck, Austria
| | - W Dichtl
- Innsbruck University Hospital, Internal Medicine III, Innsbruck, Austria
| | - G Feuchtner
- Innsbruck University Hospital, Radiology, Innsbruck, Austria
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Feuchtner GM, Barbieri F, Langer C, Beyer C, Friedrich G, Plank F. 38The secret of INOCA: High-risk plaque but not calcium density predicts ischemia, and their relationship with perivascular fat gradient. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez135.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - F Barbieri
- Innsbruck Medical University, Innsbruck, Austria
| | - C Langer
- Innsbruck Medical University, Innsbruck, Austria
| | - C Beyer
- Innsbruck Medical University, Innsbruck, Austria
| | - G Friedrich
- Innsbruck Medical University, Innsbruck, Austria
| | - F Plank
- Innsbruck Medical University, Innsbruck, Austria
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Salati M, Pifferi M, Baldessari C, Bertolini F, Tomasello C, Cascinu S, Barbieri F. Stevens-Johnson syndrome during nivolumab treatment of NSCLC. Ann Oncol 2019; 29:283-284. [PMID: 29045532 DOI: 10.1093/annonc/mdx640] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- M Salati
- Department of Oncology, Università di Modena e Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - M Pifferi
- Unit of Oncology, Hospital of Sassuolo, Modena, Italy
| | - C Baldessari
- Department of Oncology, Università di Modena e Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - F Bertolini
- Department of Oncology, Università di Modena e Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - C Tomasello
- Department of Oncology, Università di Modena e Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - S Cascinu
- Department of Oncology, Università di Modena e Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - F Barbieri
- Department of Oncology, Università di Modena e Reggio Emilia, Policlinico di Modena, Modena, Italy
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Oezpeker C, Barbieri F, Bonaros N, Grimm M, Hoefer D, Mueller L. Partial Upper Sternotomy versus full Sternotomy for Mitral Valve Surgery: A Propensity Score Matched Analysis. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- C.U. Oezpeker
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - F. Barbieri
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - N. Bonaros
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - M. Grimm
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - D. Hoefer
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - L. Mueller
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
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Losi L, Bertolini F, Scurani L, Guaitoli G, Baldessari C, Ambrosini Spaltro A, Botticelli L, Maiorana A, Barbieri F, Cascinu S. Role of evaluating tumor infiltrating lymphocytes, programmed death-ligand 1 and mismatch-repair proteins expression in malignant mesothelioma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy301.002] [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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18
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Mariniello A, Ghisoni E, Righi L, Catino A, Chiari R, Del Conte A, Barbieri F, Cecere F, Gelibter A, Giaj Levra M, Soto Parra H, Zichi C, Valabrega G, Novello S. P2.09-21 Women with Synchronous or Metachronous Lung and Ovarian Cancers: A Multi-Institutional Report. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1318] [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: 11/17/2022]
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19
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Gelsomino F, Tiseo M, Barbieri F, Riccardi F, Cavanna L, Frassoldati A, Delmonte A, Longo L, Dazzi C, Cinieri S, Colantonio I, Tognetto M, Baldari D, Tofani L, Ardizzoni A. Phase II study of NAB-paclitaxel in sensitive and refractory relapsed SCLC (NABSTER TRIAL). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy298.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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20
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Feuchtner GM, Langer CL, Barbieri F, Beyer C, Dichtl W, Friedrich GJ, Plank F. P3186The effect of omega-3 fatty acid supplementation on coronary atherosclerosis by quantitative coronary computed tomography angiography (CTA). Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - C L Langer
- Innsbruck Medical University, Innsbruck, Austria
| | - F Barbieri
- Innsbruck Medical University, Innsbruck, Austria
| | - C Beyer
- Innsbruck Medical University, Innsbruck, Austria
| | - W Dichtl
- Innsbruck Medical University, Innsbruck, Austria
| | | | - F Plank
- Innsbruck Medical University, Innsbruck, Austria
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21
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Barbieri F, Dichtl W, Brandauer E, Heibreder A, Stefani A, Adukauskaite A, Schgoer W, Hintringer F, Hoegl B. P808Sleep apnea detection by a cardiac resynchronization device integrated thoracic impedance sensor - a validation study against the gold standard polysomnography. Europace 2018. [DOI: 10.1093/europace/euy015.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- F Barbieri
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - W Dichtl
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - E Brandauer
- Innsbruck Medical University, Department of neurology, Innsbruck, Austria
| | - A Heibreder
- Medical University Münster, Department of neurology, Münster, Germany
| | - A Stefani
- Innsbruck Medical University, Department of neurology, Innsbruck, Austria
| | - A Adukauskaite
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - W Schgoer
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - F Hintringer
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - B Hoegl
- Innsbruck Medical University, Department of neurology, Innsbruck, Austria
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Romano N, Fischetti A, Prono V, Migone S, Barbieri F, Pizzorni C, Garlaschi G, Cimmino MA. Plantar pain is not always fasciitis. Reumatismo 2017; 69:189-190. [PMID: 29320846 DOI: 10.4081/reumatismo.2017.989] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/18/2017] [Accepted: 07/28/2017] [Indexed: 11/22/2022] Open
Abstract
The case is described of a patient with chronic plantar pain, diagnosed as fasciitis, which was not improved by conventional treatment. Magnetic resonance imaging revealed flexor hallucis longus tenosynovitis, which improved after local glucocorticoid injection.
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Affiliation(s)
- N Romano
- Division of Radiology, Department of Internal Medicine, University of Genoa, Genoa.
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Mengoli MC, Bertolini F, Maur M, Barbieri F, Longo L, Gasparri P, Tiseo M, Rossi G. ALK-positive adenocarcinoma of the lung expressing neuroendocrine markers and presenting as a "pituitary adenoma". Pathologica 2017; 109:408-411. [PMID: 29449735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
We report an ALK-rearranged adenocarcinoma of the lung presenting as a pituitary metastasis, clinically simulating a pituitary adenoma. The patient, a 50 year-old, former-smoking woman was admitted with a Parinaud's syndrome characterized by progressive oculomotor impairment of visual verticality, bitemporal hemianopsia and nystagmus. Imaging studies showed a sellar tumor and the biopsy revealed a TTF-1 and napsin positive lung adenocarcinoma strongly expressing synaptophysin and CD56, also harboring ALK rearrangement. A subsequent CT scan disclosed the primary lung mass of the left upper lobe. The patient progressed after 4 cycles of cisplatin/pemetrexed as first line treatment, but showed a partial response and a significant clinical benefit from the combination of ceritinib and nivolumab in a phase Ib trial. Despite its central nervous system tropism, ALK-rearranged adenocarcinoma manifesting with pituitary gland involvement was never reported. Second generation ALK inhibitors seem the best therapeutic strategy.
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Affiliation(s)
- M C Mengoli
- Unit of Pathology, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - F Bertolini
- Department of Oncology, Modena University Hospital, Modena, Italy
| | - M Maur
- Department of Oncology, Modena University Hospital, Modena, Italy
| | - F Barbieri
- Department of Oncology, Modena University Hospital, Modena, Italy
| | - L Longo
- Medical Oncology, Azienda USL, Hospital "Ramazzini", Carpi, Italy
| | - P Gasparri
- Unit of Pathology, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - M Tiseo
- Medical Oncology, University Hospital of Parma, Italy
| | - G Rossi
- Pathology Section, Santa Maria delle Croci Hospital, Ravenna, Italy
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Minari R, Bordi P, Del Re M, Facchinetti F, Mazzoni F, Barbieri F, Camerini A, Comin CE, Gnetti L, Azzoni C, Nizzoli R, Bortesi B, Rofi E, Petreni P, Campanini N, Rossi G, Danesi R, Tiseo M. Primary resistance to osimertinib due to SCLC transformation: Issue of T790M determination on liquid re-biopsy. Lung Cancer 2017; 115:21-27. [PMID: 29290257 DOI: 10.1016/j.lungcan.2017.11.011] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [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: 07/30/2017] [Revised: 11/01/2017] [Accepted: 11/13/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVES EGFR T790M mutation is the most common mechanism of resistance to first-/second-generation EGFR tyrosine kinase inhibitors (TKIs) in non-small cell lung cancer (NSCLC) and could be overcome by third-generation EGFR-TKIs, such as osimertinib. Liquid biopsy, a non-invasive technique used to test the presence of the resistant mutation, may help avoiding tissue re-biopsy. However, analysing only circulating-free DNA, information about other less frequent and coexisting resistance mechanisms may remain unrevealed. MATERIALS AND METHODS All patients reported in this series participated in the ASTRIS trial, a real world treatment study testing the efficacy of osimertinib (80mg os die) in advanced T790M-positive NSCLC progressed to prior EGFR-TKI. Patients were considered eligible to osimertinib if T790M positive on tissue or plasma samples. In our patients, EGFR molecular testing on blood sample was conducted with digital droplet PCR (ddPCR). RESULTS We report our experience of five patients treated with osimertinib after T790M detection on liquid biopsy that presented a disease progression at first tumor assessment mediated by SCLC transformation, as evidenced at tissue re-biopsies. All patients showed low ratio T790M/activating mutation in the blood before osimertinib (lower than 0.03). For three patients, EGFR mutational analysis was T790M-negative when re-assessed by using a less sensitive method (therascreen®) on the same liquid biopsy sample analysed by ddPCR before osimertinib therapy. CONCLUSION Although liquid biopsy is a relevant tool to diagnose T790M presence in NSCLC patients resistant to EGFR-TKI, in case of a low ratio T790M/activating mutation, tissue biopsy should be considered to exclude the presence of SCLC transformation and/or other concomitant resistance mechanisms.
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Affiliation(s)
- R Minari
- Medical Oncology Unit, University Hospital of Parma, Italy
| | - P Bordi
- Medical Oncology Unit, University Hospital of Parma, Italy
| | - M Del Re
- Clinical Pharmacology and Pharmacogenetic Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - F Facchinetti
- Medical Oncology Unit, University Hospital of Parma, Italy
| | - F Mazzoni
- Department of Medical Oncology, Careggi Hospital of Firenze, Firenze, Italy
| | - F Barbieri
- Department of Oncology, University Hospital Policlinico of Modena, Modena, Italy
| | - A Camerini
- Medical Oncology, Versilia Hospital, Lido di Camaiore, Italy
| | - C E Comin
- Department of Experimental and Clinical Medicine, Section of Surgery, Histopathology and Molecular Pathology, University of Florence, Italy
| | - L Gnetti
- Pathology Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - C Azzoni
- Pathology Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - R Nizzoli
- Medical Oncology Unit, University Hospital of Parma, Italy
| | - B Bortesi
- Medical Oncology Unit, University Hospital of Parma, Italy
| | - E Rofi
- Clinical Pharmacology and Pharmacogenetic Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - P Petreni
- Department of Medical Oncology, Careggi Hospital of Firenze, Firenze, Italy
| | - N Campanini
- Pathology Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - G Rossi
- Pathology Unit, Azienda USL Valle d'Aosta, Regional Hospital "Parini", Aosta, Italy
| | - R Danesi
- Clinical Pharmacology and Pharmacogenetic Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - M Tiseo
- Medical Oncology Unit, University Hospital of Parma, Italy.
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Landi L, Chiari R, Dazzi C, Tiseo M, Chella A, Delmonte A, Bonanno L, Cortinovis D, De Marinis F, Minuti G, Buosi R, Morabito A, Spitaleri G, Gridelli C, Maione P, Galetta D, Barbieri F, Grossi F, Novello S, Bruno R, Alì G, Proietti A, Fontanini G, Joseph A, Crinò L, Cappuzzo F. P1.01-015 Crizotinib in ROS1 Rearranged or MET Deregulated Non-Small-Cell Lung Cancer (NSCLC): Final Results of the METROS Trial. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Landi L, Chiari R, Dazzi C, Tiseo M, Chella A, Delmonte A, Bonanno L, Cortinovis D, de Marinis F, Minuti G, Buosi R, Morabito A, Maione P, Galetta D, Barbieri F, Grossi F, Novello S, Bruno R, Fontanini G, Crinò L, Cappuzzo F. Crizotinib in ROS1 rearranged or MET deregulated non-small-cell lung cancer (NSCLC): final results of the METROS trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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28
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Giorgini M, Barbieri F, Aleotti J. Ground Segmentation From Large-Scale Terrestrial Laser Scanner Data of Industrial Environments. IEEE Robot Autom Lett 2017. [DOI: 10.1109/lra.2017.2715378] [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] [Indexed: 11/08/2022]
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Feuchtner G, Langer C, Beyer C, Barbieri F, Dichtl W, Bonaros N, Friedrich G, Plank F. P1543The influence of endurance sport exercise level on atherosclerotic coronary plaque burden: a coronary computed tomography study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ferrari A, Petterino C, Ratto A, Campanella C, Wurth R, Thellung S, Vito G, Barbieri F, Florio T. Proliferative Role of the SDF1-CXCR4 Chemokinergic System in Feline Mammary Carcinoma. J Comp Pathol 2017. [DOI: 10.1016/j.jcpa.2016.11.208] [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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31
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Vitali M, Crinò L, Logroscino A, Ardizzoni A, Caponnetto S, Landi L, Bordi P, Luana C, Barbieri F, Santo A, Santarpia M, Carteni G, Mini E, Vasile E, Morgillo F, De Galitiis F, Conca R, Macerelli M, Tedde N, Vitiello F. Preliminary efficacy and safety data of nivolumab in never smoker patients with advanced squamous NSCLC: Experience from Italian sites participating in the Expanded Access Programme (EAP). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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32
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Landi L, Chiari R, Delmonte A, Morabito A, Tamberi S, Barbieri F, Buosi R, Gridelli C, Tiseo M, Gebbia V, Fontanini G, Crinò L, Cappuzzo F. Crizotinib in ROS1 rearranged or MET deregulated Non-Small-Cell Lung Cancer (NSCLC): Preliminary results of the METROS trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw332.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Barbieri F, Bongiovanni L, Fondrieschi L, Monaco S. 48. PoTS: Long term follow-up of an Italian cohort. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.056] [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: 11/17/2022]
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Bongiovanni L, Barbieri F, Rossini F, Brigo F, Paluani F, Fondrieschi L, Marchi SD, Monaco S. 49. Disrupted autonomic control in spinal cord injury. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Spadaro S, Dalla Corte F, Alvisi V, Mauri T, Cricca V, Biondi G, Rizzuto C, Valpiani G, Barbieri F, Ferrararese A, Ragazzi R, Volta CA. Diaphragmatic function assessed during an SBT trial using m-mode ultrasonography and MIP: a pilot study. Intensive Care Med Exp 2015. [PMCID: PMC4797796 DOI: 10.1186/2197-425x-3-s1-a455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Spallanzani A, Bertolini F, Barbieri F, Longo L, Tomasello C, Noventa S, Cavazza A, Pelosi G, Carella R, Graziano P, Ascani S, Asioli S, Murer B, Rossi G. Pleuro-pulmonary synovial sarcoma: clinico-pathologic and molecular characteristics from a multi-institutional series of 48 cases. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv338.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Longo L, Barbieri F, Bertolini F, Tiseo M, Migaldi M, Giardina D, Montanari G, Vincenzi G, Tomasello C, Noventa S, Spallanzani A, Sighinolfi P, Sartori G, Bordi P, Rossi G. Mutational analysis of EGFR, c-KIT, PDGFRs, BRAF and KRAS, and expression of ALK and PD-L1 in a series of 103 thymic epithelial tumors with different histology. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv343.10] [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: 11/13/2022] Open
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Barbieri F, Ambrosetti E, Tomatis V, Aleo E, Migone S, Prono V, Cutolo M, Cimmino M. SAT0608 MRI of the Hand in Palyndromic Rheumatism: A Study with Dedicated-Extremity MRI. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.6066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Cosso C, Pastorino M, Barbieri F, Aleo E, Migone S, Prono V, Cutolo M, Cimmino M. AB1046 Can MRI of the Metatarsophalangeal Joints Differentiate Mechanical from Early Inflammatory Metatarsal Pain?: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5671] [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: 11/04/2022]
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Rossi G, Baldi L, Barbieri F, Bertolini F, Tiseo M. Concomitant EGFR and KRAS mutations in ALK-rearranged lung cancer. Ann Oncol 2015; 26:1035-1036. [DOI: 10.1093/annonc/mdv067] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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41
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Bongiovanni L, Rossini F, Bonato G, Barbieri F, Tonin P, Vattemi G, Franchini E, Demrozi A, Benini L. 60. Dysphagia in different types of myopathy. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2014.10.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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42
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Pagano M, Tamagnini I, Baldi L, Bisagni A, Ragazzi M, Gardini G, Barbieri F, Cantile F, Nicoli D, Boni C, Rossi G. Immunohistochemical Screening Using Egfr Mutation-Specific Antibodies in Lung Adenocarcinomas: Diamond Project. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Barbieri F, Tomatis V, Cosso C, Aleo E, Prono V, Migone S, Cutolo M, Cimmino M. AB0965 Learning Curve in RAMRIS Scoring of Rheumatoid Hand Mri:. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2348] [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: 11/04/2022]
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44
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Cosso C, Barbieri F, Franconeri A, Piccazzo R, Fabbro E, Seriolo B, Garlaschi G, Cutolo M, Cimmino M. SAT0504 Mri Bone Marrow Oedema is A Frequent Feature in Patients with Gout. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4380] [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: 11/03/2022]
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Rossi S, Motta C, Studer V, Rocchi C, Macchiarulo G, Barbieri F, Marfia GA, Furlan R, Martino G, Mancino R, Centonze D. Interleukin-8 is associated with acute and persistent dysfunction after optic neuritis. Mult Scler 2014; 20:1841-50. [DOI: 10.1177/1352458514537365] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background: Acute optic neuritis is often in association with multiple sclerosis (MS). Proinflammatory cytokines trigger neuronal damage in neuroinflammatory disorders but their role in optic neuritis is poorly investigated. Objective: The objective of this work is to investigate the associations of intrathecal contents of proinflammatory cytokines with transient and persistent dysfunctions after optic neuritis. Methods: In 50 MS patients followed for up to six months, cerebrospinal fluid (CSF) levels of IL-1β, TNF and IL-8 were determined, along with clinical, neurophysiological and morphological measures of optic neuritis severity. Results: Visual impairment, measured by high- and low-contrast visual acuity, and delayed visual-evoked potential (VEP) latencies were significantly correlated to IL-8 levels during optic neuritis. IL-8 at the time of optic neuritis was also associated with persistent demyelination and final axonal loss, inferred by VEP and optical coherence tomography measures, respectively. Contents of IL-8 were correlated to functional visual outcomes, being higher among patients with incomplete recovery. Multivariate analysis confirmed that IL-8 significantly predicted final visual acuity, at equal values of demographics and baseline visual scores. Conclusion: Our study points to IL-8 as the main inflammatory cytokine associated with demyelination and secondary neurodegeneration in the optic nerve after optic neuritis.
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Affiliation(s)
- S Rossi
- Clinica Neurologica, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Italy/Fondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC), Italy
| | - C Motta
- Clinica Neurologica, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Italy/Fondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC), Italy
| | - V Studer
- Clinica Neurologica, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Italy/Fondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC), Italy
| | - C Rocchi
- Clinica Neurologica, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Italy
| | - G Macchiarulo
- Clinica Neurologica, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Italy/Fondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC), Italy
| | - F Barbieri
- Clinica Neurologica, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Italy/Fondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC), Italy
| | - GA Marfia
- Clinica Neurologica, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Italy
| | - R Furlan
- Neuroimmunology Unit, Institute of Experimental Neurology (INSpe), Division of Neuroscience, San Raffaele Scientific Institute, Italy
| | - G Martino
- Neuroimmunology Unit, Institute of Experimental Neurology (INSpe), Division of Neuroscience, San Raffaele Scientific Institute, Italy
| | - R Mancino
- Clinica Oculistica, Dipartimento di Biopatologia, Università Tor Vergata, Italy
| | - D Centonze
- Clinica Neurologica, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Italy/Fondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC), Italy
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Barbieri F, Parascandolo P, Vosilla L, Cesario L, Viano G, Cimmino M. AB1257 Assessing MRI erosions in the rheumatoid wrist: A comparison between RAMRIS and a semiautomated segmentation software. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2012-eular.1253] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Capalbo D, Improda N, Esposito A, De Martino L, Barbieri F, Betterle C, Pignata C, Salerno M. Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy from the pediatric perspective. J Endocrinol Invest 2013; 36:903-12. [PMID: 23723078 DOI: 10.3275/8999] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is a rare autosomal recessive disease caused by mutations of the AutoImmune REgulator gene. The clinical spectrum of the disease encompasses several autoimmune endocrine and non-endocrine manifestations, which may lead to acute metabolic alterations and eventually life-threatening events. The clinical diagnosis is defined by the presence of at least two components of the classic triad including chronic mucocoutaneous candidiasis (CMC), chronic hypoparathyroidism (CH), Addison's disease (AD). Other common features of the disease are hypergonadotropic hypogonadism, alopecia, vitiligo, autoimmune hepatitis, Type 1 diabetes, gastrointestinal dysfunction. APECED usually begins in childhood. CMC is the first manifestation to appear, usually before the age of 5 yr, followed by CH and then by AD. The clinical phenotype may evolve over several years and many components of the disease may not appear until the 4th or 5th decade of life. The phenotypical expression of the syndrome shows a wide variability even between siblings with the same genotype. In view of this heterogeneity, an early diagnosis of APECED can be very challenging often leading to a considerable diagnostic delay. Therefore, clinicians should be aware that the presence of even a minor component of APECED in children should prompt a careful investigation for other signs and symptoms of the disease, thus allowing an early diagnosis and prevention of severe and life-threatening events. Aim of this review is to focus on clinical presentation, diagnosis and management of the major components of APECED in children particularly focusing on endocrine features of the disease.
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Affiliation(s)
- D Capalbo
- Pediatric Endocrinology Unit, Department of Translational Medical Sciences, University "Federico II" of Naples, Naples, Italy
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Bongiovanni L, Rossini F, Barbieri F, Riva SD, Paluani F, Fondreschi L, Brigo F, Marchi ED, Monaco S. 129. Heart rate variability in patients with spinal cord injuries. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.156] [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: 11/29/2022]
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Abreu MSL, Machado R, Barbieri F, Freitas NS, Oliveira LR. Anomalous colour in Neotropical mammals: a review with new records for Didelphis sp. (Didelphidae, Didelphimorphia) and Arctocephalus australis (Otariidae, Carnivora). BRAZ J BIOL 2013; 73:185-94. [PMID: 23644801 DOI: 10.1590/s1519-69842013000100020] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Accepted: 04/02/2012] [Indexed: 11/22/2022] Open
Abstract
Anomalous colourations occur in many tropical vertebrates. However, they are considered rare in wild populations, with very few records for the majority of animal taxa. We report two new cases of anomalous colouration in mammals. Additionally, we compiled all published cases about anomalous pigmentation registered in Neotropical mammals, throughout a comprehensive review of peer reviewed articles between 1950 and 2010. Every record was classified as albinism, leucism, piebaldism or eventually as undetermined pigmentation. As results, we report the new record of a leucistic specimen of opossum (Didelphis sp.) in southern Brazil, as well as a specimen of South American fur seal (Arctocephalus australis) with piebaldism in Uruguay. We also found 31 scientific articles resulting in 23 records of albinism, 12 of leucism, 71 of piebaldism and 92 records classified as undetermined pigmentation. Anomalous colouration is apparently rare in small terrestrial mammals, but it is much more common in cetaceans and michrochiropterans. Out of these 198 records, 149 occurred in cetaceans and 30 in bats. The results related to cetaceans suggest that males and females with anomolous pigmentation are reproductively successful and as a consequence their frequencies are becoming higher in natural populations. In bats, this result can be related to the fact these animals orient themselves primarily through echolocation, and their refuges provide protection against light and predation. It is possible that anomalous colouration occurs more frequently in other Neotropical mammal orders, which were not formally reported. Therefore, we encourage researchers to publish these events in order to better understand this phenomenon that has a significant influence on animal survival.
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Affiliation(s)
- M S L Abreu
- Laboratório de Ecologia de Mamíferos, Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
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De Chiara V, Motta C, Rossi S, Studer V, Barbieri F, Lauro D, Bernardi G, Centonze D. Interleukin-1β alters the sensitivity of cannabinoid CB1 receptors controlling glutamate transmission in the striatum. Neuroscience 2013; 250:232-9. [PMID: 23856068 DOI: 10.1016/j.neuroscience.2013.06.069] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [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: 04/23/2013] [Revised: 06/25/2013] [Accepted: 06/26/2013] [Indexed: 01/30/2023]
Abstract
Proinflammatory cytokines such as tumor necrosis factor-α and interleukin-1β (IL1β) regulate both excitatory and inhibitory synaptic transmission in the central nervous system. The interaction between IL1β and endocannabinoid system (ECS) is also emerging, based on the evidence that IL1β effects on striatal spontaneous excitatory and inhibitory postsynaptic currents are regulated by transient receptor potential vanilloid 1 (TRPV1) channels, members of the ECS. Furthermore, IL1β has also been shown to control the sensitivity of cannabinoid CB1 receptors controlling GABA transmission (CB1Rs(GABA)) in the striatum. To better detail the synaptic action of IL1β, and to clarify its complex interaction with the ECS, here we investigated the possible interplay between IL1β and CB1Rs controlling glutamate transmission (CB1Rs(glu)), other critical elements of the ECS. Our results show that the sensitivity of CB1Rs(glu) is fully blocked in the presence of IL1β in corticostriatal brain slices, and that the protein kinase C/TRPV1 pathway is involved in this effect. IL1β failed to modulate the sensitivity of glutamate synapses to the stimulation of GABAB receptors. We also provided evidence that IL1β-CB1Rs(GABA) but not IL1β-CB1Rs(glu) interaction is under the control of the brain-derived neurotrophic factor (BDNF)/trkB signaling and of lipid raft composition, because BDNF gene partial deletion, pharmacological blockade of trkB and membrane cholesterol removal with methyl-β-cyclodextrin all blocked IL1β-mediated inhibition of CB1Rs(GABA) but left unaltered the sensitivity of CB1Rs(glu) to this cytokine. Our results provide further evidence that synaptic transmission and the ECS are regulated by IL1β in the striatum.
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Affiliation(s)
- V De Chiara
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; Fondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC), Via del Fosso di Fiorano 64, 00143 Rome, Italy
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