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Kawai N, Noda Y, Nakamura F, Kaga T, Suzuki R, Miyoshi T, Mori F, Hyodo F, Kato H, Matsuo M. Low-tube-voltage whole-body CT angiography with extremely low iodine dose: a comparison between hybrid-iterative reconstruction and deep-learning image-reconstruction algorithms. Clin Radiol 2024; 79:e791-e798. [PMID: 38403540 DOI: 10.1016/j.crad.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/29/2024] [Accepted: 02/07/2024] [Indexed: 02/27/2024]
Abstract
AIM To evaluate arterial enhancement, its depiction, and image quality in low-tube potential whole-body computed tomography (CT) angiography (CTA) with extremely low iodine dose and compare the results with those obtained by hybrid-iterative reconstruction (IR) and deep-learning image-reconstruction (DLIR) methods. MATERIALS AND METHODS This prospective study included 34 consecutive participants (27 men; mean age, 74.2 years) who underwent whole-body CTA at 80 kVp for evaluating aortic diseases between January and July 2020. Contrast material (240 mg iodine/ml) with simultaneous administration of its quarter volume of saline, which corresponded to 192 mg iodine/ml, was administered. CT raw data were reconstructed using adaptive statistical IR-Veo of 40% (hybrid-IR), DLIR with medium- (DLIR-M), and high-strength level (DLIR-H). A radiologist measured CT attenuation of the arteries and background noise, and the signal-to-noise ratio (SNR) was then calculated. Two reviewers qualitatively evaluated the arterial depictions and diagnostic acceptability on axial, multiplanar-reformatted (MPR), and volume-rendered (VR) images. RESULTS Mean contrast material volume and iodine weight administered were 64.1 ml and 15.4 g, respectively. The SNRs of the arteries were significantly higher in the following order of the DLIR-H, DLIR-M, and hybrid-IR (p<0.001). Depictions of six arteries on axial, three arteries on MPR, and four arteries on VR images were significantly superior in the DLIR-M or hybrid-IR than in the DLIR-H (p≤0.009 for each). Diagnostic acceptability was significantly better in the DLIR-M and DLIR-H than in the hybrid-IR (p<0.001-0.005). CONCLUSION DLIR-M showed well-balanced arterial depictions and image quality compared with the hybrid-IR and DLIR-H.
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Affiliation(s)
- N Kawai
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Y Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - F Nakamura
- Department of Radiology, Gifu Municipal Hospital, 7-1 Kashima, Gifu 500-8513, Japan
| | - T Kaga
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - R Suzuki
- Department of Radiology Services, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan
| | - T Miyoshi
- Department of Radiology Services, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan
| | - F Mori
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - F Hyodo
- Department of Pharmacology, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Center for One Medicine Innovative Translational Research (COMIT), Institute for Advanced Study, Gifu University, Japan
| | - H Kato
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - M Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
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Palinkas ED, Re F, Peteiro J, Tesic M, Palinkas A, Torres MAR, Djordjevic Dikic A, Beleslin B, Van De Heyning CM, D'Alfonso MG, Mori F, Ciampi Q, Sepp R, Olivotto I, Picano E. Heterogeneous mechanisms of pulmonary congestion in hypertrophic cardiomyopathy unmasked by comprehensive exercise stress echocardiography. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
B-lines detected by lung ultrasound (LUS) during exercise stress echocardiography (ESE), indicating pulmonary congestion, are present in 1 out of 3 patients with hypertrophic cardiomyopathy (HCM).
Aim
To assess the functional and anatomical correlates of exercise B-lines in HCM.
Methods
We enrolled 191 HCM patients (age 53±15 years, 123 males) consecutively referred for ESE (treadmill in 74, bicycle in 117 patients) in 11 quality-controlled centers from 8 countries. ESE assessment at rest and peak stress included: left ventricular (LV) outflow tract gradient, left atrial (LAVi) and LV end-diastolic volume index (EDVi), mitral regurgitation (MR, score from 0 to 3); E/e'; systolic pulmonary arterial pressure (SPAP) and LV force (LV outflow tract gradient+systolic blood pressure/LV end-systolic volume). B-lines at rest and at peak exercise were assessed by LUS with the 4-site simplified scan. B-lines positivity was considered if the sum of detected B-lines was ≥2.
Results
LUS was feasible in all subjects. B-lines were present in 55 (29%) patients during stress. When compared to patients without stress B-lines (n=136), patients with B-lines (n=55) at peak exercise had lower peak EDVi (43±17 vs 52±18 ml/m2, p=0.003) higher peak E/e' (16±6 vs 12±5, p<0.001), increase in MR (34 vs 12%, p=0.001), greater stress LAVi (43±14 vs 37±14 ml/m2, p=0.003) and stress SPAP (56±18 vs 40±12 mm Hg p<0.0001): see Figure. Among baseline parameters, the number of B-lines (OR: 7.53, 95% CI 1.21–46.72 p=0.03), LAVi (OR: 1.05, 95% CI 1.00–1.09 p=0.04), and LV force (OR: 1.36, 95% CI 1.04–1.79 p=0.03) were the independent predictors of exercise pulmonary congestion.
Conclusion
HCM patients with pulmonary congestion on exercise show different, and not mutually exclusive mechanisms of diastolic dysfunction and worsening mitral regurgitation. These different hemodynamic mechanisms may require personalized therapeutic actions beyond a pulmonary decongestion therapy with diuretics.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E D Palinkas
- University of Szeged, Division of Non-Invasive Cardiology, Department of Internal Medicine , Szeged , Hungary
| | - F Re
- San Camillo Forlanini Hospital, Cardiology Department , Rome , Italy
| | - J Peteiro
- CIBER-CV, CHUAC and University of A Coruna , A Coruna , Spain
| | - M Tesic
- University of Belgrade, Cardiology Clinic, University Center Serbia, Medical School , Belgrade , Serbia
| | - A Palinkas
- Elisabeth Hospital of Csongrad , Hodmezovasarhely , Hungary
| | - M A R Torres
- Federal University of Rio Grande do Sul , Porto Alegre , Brazil
| | - A Djordjevic Dikic
- University of Belgrade, Cardiology Clinic, University Center Serbia, Medical School , Belgrade , Serbia
| | - B Beleslin
- University of Belgrade, Cardiology Clinic, University Center Serbia, Medical School , Belgrade , Serbia
| | - C M Van De Heyning
- Antwerp University Hospital, Department of Cardiology , Edegem , Belgium
| | - M G D'Alfonso
- Careggi University Hospital, Cardiovascular Imaging Division , Florence , Italy
| | - F Mori
- Careggi University Hospital, Cardiovascular Imaging Division , Florence , Italy
| | - Q Ciampi
- Fatebenefratelli Hospital of Benevento , Benevento , Italy
| | - R Sepp
- University of Szeged, Division of Non-Invasive Cardiology, Department of Internal Medicine , Szeged , Hungary
| | - I Olivotto
- Careggi University Hospital, Cardiomyopathy Unit , Florence , Italy
| | - E Picano
- CNR – National Research Council, Institute of Clinical Physiology , Pisa , Italy
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Palinkas ED, Marchi A, Milazzo A, Tassetti L, Zampieri M, D'Alfonso MG, Mori F, Palinkas A, Ciampi Q, Sepp R, Olivotto I, Picano E. Clinical, functional and prognostic correlates of excess left ventricular force in hypertrophic cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1719] [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: 11/12/2022] Open
Abstract
Abstract
Background
Excess force generation during myocardial contraction represents a cardinal feature of hypertrophic cardiomyopathy (HCM).
Purpose
To evaluate the anatomical, functional and prognostic correlates of left ventricular (LV) force in HCM.
Methods
We prospectively recruited a consecutive sample of 408 HCM patients with LV ejection fraction (EF) >50%, referred for baseline transthoracic echocardiography in 2 primary HCM centers in Hungary and Italy between 1999 and 2021. LV force was calculated as LV outflow tract gradient+systolic blood pressure/LV end-systolic volume. Patients were followed for a median of 107 months (IQ range, 58–158 months), the study endpoint was all-cause mortality.
Results
Mean LV force was 6.0±4.6 mm Hg/ml. Receiver-operating characteristic analysis identified 7.5 mm Hg/ml the best cut-off value to predict mortality. LV force >7.5 mm Hg/ml was present in 86 patients (21%), more frequently in women (58 vs 27%, p<0.0001), more often in patients with diabetes (16 vs 6%, p=0.003), beta-blocker (81 vs 58%, p<0.0001), calcium channel-blocker (19 vs 9%, p=0.012) and diuretic therapy (19 vs 8%, p=0.004), compared to patients with LV force ≤7.5 mm Hg/ml. Patients with excess LV force had more advanced NYHA class (1.8±0.7 vs 1.4±0.7, p=0.0001), greater left atrial diameter [(LAd), 46.7±6.6 vs 43.0±7.2 mm, <0.0001], LV maximal wall thickness (23.2±5.5 vs 21.6±5.5 mm p=0.01), LV EF (74.6±6.4 vs 67.0±6.8%, <0.0001), mitral regurgitation grade (1.2±0.7 vs 0.7±0.7, p<0.0001) and E/e' (10.3±5.0 vs 7.8±5.0, p=0.005). During follow-up 43 deaths occurred. All-cause death was more frequent in patients with excess LV force (21 vs 8%, p<0.0001). At multivariable Cox regression analysis, excess LV force was an independent predictor of mortality (HR 2.9, 95% CI 1.14–7.26, p=0.025) independent of age (HR 1.03, 95% CI 1.00–1.05, p=0.022) and LAd (HR 1.07, 95% CI 1.02–1.14, p=0.005).
Conclusion
LV force with a threshold of 7.5 mm Hg/ml, independently predicts adverse outcome in patients with HCM and preserved systolic function. Excess LV force generation is associated with female sex, diabetes, NYHA class, medications, LAd, LV wall thickness, EF, mitral regurgitation grade and E/e'.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E D Palinkas
- University of Szeged, Division of Non-Invasive Cardiology, Department of Internal Medicine , Szeged , Hungary
| | - A Marchi
- Careggi University Hospital, Cardiomyopathy Unit , Florence , Italy
| | - A Milazzo
- Careggi University Hospital, Cardiomyopathy Unit , Florence , Italy
| | - L Tassetti
- Careggi University Hospital, Cardiomyopathy Unit , Florence , Italy
| | - M Zampieri
- Careggi University Hospital, Cardiomyopathy Unit , Florence , Italy
| | - M G D'Alfonso
- Careggi University Hospital, Cardiovascular Imaging Division , Florence , Italy
| | - F Mori
- Careggi University Hospital, Cardiovascular Imaging Division , Florence , Italy
| | - A Palinkas
- Elisabeth Hospital of Csongrad , Hodmezovasarhely , Hungary
| | - Q Ciampi
- Fatebenefratelli Hospital of Benevento , Benevento , Italy
| | - R Sepp
- University of Szeged, Division of Non-Invasive Cardiology, Department of Internal Medicine , Szeged , Hungary
| | - I Olivotto
- Careggi University Hospital, Cardiomyopathy Unit , Florence , Italy
| | - E Picano
- CNR – National Research Council, Institute of Clinical Physiology , Pisa , Italy
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D"alfonso MG, Tesic M, Peteiro J, Palinkas ED, Re F, Losi MA, Palinkas A, Cruz I, Torres MAR, Van De Heyning CM, Djordjevic-Dikic A, Mori F, Ciampi Q, Olivotto I, Picano E. Adverse prognostic value of supernormal left ventricular force noninvasively assessed by resting transthoracic echocardiography in hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.256] [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
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
Stress Echo 2030 study group of the Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI).
Background The excessive cross-bridging of cardiac myosin and actin, resulting in increased left ventricular (LV) force development, is one of the biomechanical abormalities inhypertrophic cardiomyopathy (HCM).
Purpose
To assess the prognostic value of increased LV force development at rest in patients with HCM
Methods
We enrolled 918 HCM patients (age 48 ± 16 years, 502 males, New York Heart Association I or II, Class III in 48 patients, 6% and with LVOTG >30 mmHg in 211patients, 23%) with ejection fraction (EF) ≥50%, referred for rest transthoracic echocardiography (TTE) in 10 quality-controlled labs from 7 countries (Belgium, Hungary, Italy, Portugal, Serbia, Spain, Brazil). The maximal wall thickness was 21 ± 5 mm. TTE assessment included left ventricular outflow tract gradient (LVOTG, mmHg), EF (%), and LV force (systolic arterial pressure + LVOTG/LV endsystolic volume assessed with 2-D, mmHg/mL). All patients were followed-up. An age- and gender matched control group of 95 healthy subjects was also evaluated.
Results. Compared to normals, HCM showed higher values of EF (68 ± 8 vs 65 ± 5%, p < 0.001) and force (7.2 ± 5.5 vs 4.0 ± 1.8 mmHg/mL, p < 0.001). At a median follow-up of 94 months [interquartile range 40-140 months], 95 all-cause deaths occurred. Mortality was significantly increased in the force highest quartile compared to other quartiles (see figure). At multivariable Cox analysis, increased Force (highest quartile >8.5 mmHg/mL hazard ratio= 2.189 95% CI = 1.095-4.377, p = 0.027 and the intermediate quartile: Force 5.7-8.5 mmHg/mL hazard ratio= 2.525 95% CI = 1.2205.228, p = 0.013) were independent predictors of mortality with age (hazard ratio= 1.065 95% CI = 1.047-1.084, p < 0.001) and maximal wall thickness (hazard ratio= 1.094, 95% CI = 1.055-1.135, p < 0.001). At univariate analysis neither LVOTG (hazard ratio= 1.430, 95% CI = 0.920-2.222, p = 0.112) nor quartiles of EF (hazard ratio= 1.497, 95% CI = 0.868-2.582, p = 0.147) were significant.
Conclusion
HCM patients with preserved baseline LV function and higher values of resting LV force ("too good to be normal") show a worse survival, highlighting the dark prognostic side of an excess of force. The hypercontractile phenotype possibly indicates an increased activity of myosin resulting in increased force production at the sarcomere and cellular levels that propagates at the whole-organ level with unfavorable long-term effects on outcome.
Figure
Mortality rate based on quartiles of resting LV Force in HCM. Abstract Figure. Mortality rate
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Affiliation(s)
- MG D"alfonso
- Careggi University Hospital (AOUC), Florence, Italy
| | - M Tesic
- Clinical center of Serbia and School of medicine University of Belgrade, Belgrade, Serbia
| | | | | | - F Re
- San Camillo Forlanini Hospital, Rome, Italy
| | - MA Losi
- Federico II University Hospital, Department of Advanced Biomedical Sciences, Naples, Italy
| | - A Palinkas
- Elisabeth Hospital of Csongrad, Internal Medicine Department, Hodmezovasarhely, Hungary
| | - I Cruz
- Hospital Garcia de Orta, Lisbon, Portugal
| | - M A R Torres
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - CM Van De Heyning
- Antwerp University Hospital, Department of Cardiology, Edegem, Belgium
| | - A Djordjevic-Dikic
- Clinical center of Serbia and School of medicine University of Belgrade, Belgrade, Serbia
| | - F Mori
- Careggi University Hospital (AOUC), Florence, Italy
| | - Q Ciampi
- Fatebenefratelli Hospital of Benevento, Benevento, Italy
| | - I Olivotto
- Careggi University Hospital (AOUC), Florence, Italy
| | - E Picano
- Institute of Clinical Physiology (IFC), CNR, Pisa, Italy
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Palinkas ED, Ciampi Q, Tesic M, Palinkas A, Torres MAR, Djordievic-Dikic A, Beleslin B, Sepp R, Mori F, Picano E. Comprehensive stress echocardiography in hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
Stress Echo 2020 study group of the Italian Society of Echocardiography and Cardiovascular Imaging
Background
Stress echocardiography (SE) in hypertrophic cardiomyopathy (HCM) has more to offer beyond dynamic left ventricular outflow obstruction (LVOTO) to capture the functional heterogeneity of the disease.
Objectives
To determine the feasibility of comprehensive SE in HCM.
Methods
We prospectively enrolled 235 HCM patients (age = 48 ± 15 years, 113 men) assessed with exercise stress echocardiography (ESE) in 4 centers. ESE modality was semi-supine bicycle in 29 patients in one center, and treadmill in 206 (followed by same-day, same session, adenosine for step D) in another centers. During SE, we assessed stress-induced new regional wall motion abnormalities (RWMA, step A), coronary flow velocity reserve (CFVR) in left anterior descending coronary artery with Doppler (step D) by semi-supine exercise or adenosine, heart rate reserve (peak/rest heart rate) for EKG-based step E, mitral regurgitation (MR) flow for step F, and LVOTO (step G for gradient). A comprehensive SE score was generated from 0 (all parameters normal) to 5 (all abnormal).
Results
Technical success rate was 100% for all steps, except step D (80% with semi-supine, 100% with adenosine after treadmill) and F (232/235, 99%). Extra-analysis time was < 3 minutes for steps A + D + E + F + G. Rate of abnormal results ranged from 73% for step E (peak/rest heart rate reserve < 1.80) to 1% for step A (inducible RWMA), with intermediate values for step D (CFVR < 2.0, 44%), step F (at least moderate MR, 32%) and step G (LVOTG > 50 mm Hg, 26%): see figure. SE score was 0 in 14 pts (6%), 1 or 2 in 202 patients (86%) and ≥ 3 in 19 patients (8%).
Conclusions
Comprehensive SE is feasible in HCM with single stress (semi-supine exercise) or hybrid treadmill exercise followed by adenosine for step D. Phenotyping of the multiform manifestations of HCM with a personalized functional blueprint is now possible. Abstract Figure.
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Affiliation(s)
- ED Palinkas
- University of Szeged, Division of Non-Invasive Cardiology, Department of Internal Medicine, Albert Szent-Györgyi Clinical, Szeged, Hungary
| | - Q Ciampi
- Fatebenefratelli Hospital of Benevento, Benevento, Italy
| | - M Tesic
- University of Belgrade, Cardiology Clinic, University Center Serbia, Medical School, Belgrade, Serbia
| | - A Palinkas
- Elisabeth Hospital of Csongrad, Hodmezovasarhely, Hungary
| | - MAR Torres
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - A Djordievic-Dikic
- University of Belgrade, Cardiology Clinic, University Center Serbia, Medical School, Belgrade, Serbia
| | - B Beleslin
- University of Belgrade, Cardiology Clinic, University Center Serbia, Medical School, Belgrade, Serbia
| | - R Sepp
- University of Szeged, Division of Non-Invasive Cardiology, Department of Internal Medicine, Albert Szent-Györgyi Clinical, Szeged, Hungary
| | - F Mori
- Careggi University Hospital, Cardiovascular Imaging Division, Florence, Italy
| | - E Picano
- CNR – National Research Council, Institute of Clinical Physiology, Pisa, Italy
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Fumagalli C, Sasso L, Zocchi C, Tassetti L, Celata A, Berteotti M, Mori F, Mecacci F, Livi P, Cappelli F, Baldini K, Tomberli A, Favilli S, Olivotto I. Clinical course and outcome of pregnancy in patients with hypertrophic cardiomyopathy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Hypertrophic Cardiomyopathy (HCM) is the most common genetic cardiomyopathy. However, few studies have systematically investigated the clinical course of pregnancy in HCM.
Purpose
To determine whether pregnancy is well tolerated in HCM.
Methods
Women consecutively referred to our Tertiary Clinic for Cardiomyopathies from 1969 to
2019 were retrospectively reviewed. Only women with complete data regarding pregnancy and with a follow up (FU)>1 year were included in the study. Overall, of the 647 women followed at our center, 378 (58%) fulfilled our inclusion criteria. Demographic, clinical and instrumental records were retrieved. The peripartum period was defined as the timeframe from −1 to 6 months after delivery.
Results
There were 433 pregnancies in 239 (63%) women with 132 (62%) having >1 pregnancy. By contrast, 139 (37%) reported no pregnancy or miscarriages: in 6 cases pregnancy was discouraged due to advanced disease stage. Twenty-eight (12%) women had 39 pregnancies after HCM diagnosis and were followed by the obstetrics department: this subset was significantly younger at diagnosis (age at diagnosis: 21 [13–29] vs 56 [47–66] vs 45 [24–62] years, p<0.001, in women with a pregnancy after diagnosis vs women diagnosed after the pregnancy vs women with no pregnancy, respectively). Instrumental characteristics were comparable among women. Thirty percent presented with obstructive physiology at baseline. Among the 39 pregnancies in women who had a pregnancy after the diagnosis, there were 3 reported episodes of paroxysmal atrial fibrillation, one sustained ventricular tachycardia with pulse and three episodes of non-sustained ventricular tachycardia in the peripartum period. In this cohort, prevalence of intra-uterine growth delay and miscarriage was 8%. Only 3 women experienced a worsening clinical profile requiring hospitalization during the peripartum period: 2 were hospitalized for acute heart failure (AHF) and 1 was experienced a resuscitated cardiac arrest. Of note, 2/3 of patients were carriers of a (likely)pathogenic troponin mutation.
Long-term (FU: 5±3 years), nulligravida women were more symptomatic at last evaluation (NYHA III/IV: 25 vs 17, p<0.05), reported a higher incidence of ICD appropriate shocks (26 vs 12%p=0.02) but had similar rates of heart transplant (2.1 vs 0.5%, p=0.143) and episodes of AHF (12 vs 14%, p=0.193). Eighteen patients (8.2%) died: incidence of cardiovascular mortality was 4.8%, with a lower rate in patients who reported a pregnancy (0.8%/year vs 2.8%/year, p=0.01).
Conclusions
Women with HCM tolerate pregnancy well. Rare complications occurred in the peripartum period which were manageable. In the long-term, pregnancy, even when multiple, did not influence the long-term course of the disease nor its outcome. Strategies to support appropriate counselling and antenatal care should be implemented to identify those at greater risk of disease progression.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- C Fumagalli
- Careggi University Hospital (AOUC), Cardiomyopathies Unit, Florence, Italy
| | - L Sasso
- Careggi University Hospital (AOUC), Cardiomyopathies Unit, Florence, Italy
| | - C Zocchi
- Careggi University Hospital (AOUC), Cardiomyopathies Unit, Florence, Italy
| | - L Tassetti
- Careggi University Hospital (AOUC), Cardiomyopathies Unit, Florence, Italy
| | - A Celata
- Careggi University Hospital (AOUC), Cardiomyopathies Unit, Florence, Italy
| | - M Berteotti
- Careggi University Hospital (AOUC), Cardiomyopathies Unit, Florence, Italy
| | - F Mori
- Careggi University Hospital, Florence, Italy
| | - F Mecacci
- Careggi University Hospital, Florence, Italy
| | - P Livi
- Careggi University Hospital, Florence, Italy
| | - F Cappelli
- Careggi University Hospital (AOUC), Cardiomyopathies Unit, Florence, Italy
| | - K Baldini
- Careggi University Hospital (AOUC), Cardiomyopathies Unit, Florence, Italy
| | - A Tomberli
- Careggi University Hospital (AOUC), Cardiomyopathies Unit, Florence, Italy
| | - S Favilli
- Meyer Children's Hospital, Cardiology Department, Florence, Italy
| | - I Olivotto
- Careggi University Hospital (AOUC), Cardiomyopathies Unit, Florence, Italy
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7
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Palinkas E, Re F, Torres M, Peteiro J, Cotrim C, Van De Heyning C, Agoston G, D'Alfonso M, Mori F, De Castro E Silva Pretto J, Sepp R, Palinkas A, Simova I, Ciampi Q, Picano E. Pulmonary congestion during exercise stress echocardiography in hypertrophic cardiomyopathy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
B-lines detected by lung ultrasound (LUS) indicate pulmonary congestion during exercise stress echo (ESE).
Aim
To assess B-lines during ESE in hypertrophic cardiomyopathy (HCM).
Methods
We enrolled 110 HCM patients (age 52±16 years, 74 males) referred for ESE (treadmill in 39, semi-supine bicycle in 71 patients) in 10 quality-controlled centers from 8 countries (Belgium, Brazil, Bulgaria, Hungary, Italy, Portugal, Serbia, Spain). ESE assessment included: left ventricular outflow tract gradient (LVOTG); mitral regurgitation (MR, score from 0 to 3); E/e'; systolic pulmonary arterial pressure (SPAP, from tricuspid regurgitant jet velocity); end-diastolic volume (EDV); left atrial volume (LAV). B-lines were assessed by LUS with the 4-site simplified scan, each site scored from 0 (normal A-lines) to 10 (coalescing B-lines). The positivity criterion was a B-line score stress ≥2 points.
Results
LUS was feasible in all subjects, with additional scanning and analysis time <1 minute for each stage (rest and peak stress). B-lines were present in 13 patients at rest and in 33 during stress (12 vs 30%, p<0.001). When compared to patients without stress B-lines (Group 2, n=77), patients with B-lines (Group 1) showed higher values of change from rest to stress (Δ) in LVOTG (Group 1= 39±54 vs Group 2= 21±24 mm Hg, p=0.015) and ΔMR grade (Group 1= 0.7±0.8 vs Group 2= 0.1±0.5, p<0.001), more frequent peak stress E/e' ≥15 (Group 1=61% vs Group 2=27%, p=0.007), lower peak EDV (Group 1= 86±35 vs Group 2= 102±33 ml, p=0.039) and higher peak SPAP (Group 1= 60±21 vs Group 2= 39±12 mm Hg, p<0.001): see figure. At multivariable logistic regression analysis, presence of stress B-lines was predicted by ΔMR grade (odds ratio: 3.96, 95% CI 1.46–10.71) and stress E/e' ≥15 (odds ratio: 4.95, 95% CI 1.24–19.70).
Conclusion
B-lines are found in about 1 of 10 HCM patients at rest and in 1 of 3 during ESE. Acute backward heart failure during exercise can recognize multiple mechanisms in HCM, and ESE can help to capture this heterogeneity.
Funding Acknowledgement
Type of funding sources: None. Functional correlates of stress B-lines
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Affiliation(s)
- E.D Palinkas
- University of Szeged, 2nd Department of Internal Medicine and Cardiology Center, Szeged, Hungary
| | - F Re
- San Camillo Forlanini Hospital, Cardiology Department, Rome, Italy
| | - M.A.R Torres
- Universidade Federal do Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - J Peteiro
- University of La Coruna, CHUAC, A Coruna, Spain
| | - C Cotrim
- Heart Center do Hospital da Cruz Vermelha, Lisbon, Portugal
| | - C Van De Heyning
- University Hospital Antwerp, Department of Cardiology, Antwerp, Belgium
| | - G Agoston
- University of Szeged, Family Medicine Department, Szeged, Hungary
| | | | - F Mori
- Careggi University Hospital, Florence, Italy
| | | | - R Sepp
- University of Szeged, 2nd Department of Internal Medicine and Cardiology Center, Szeged, Hungary
| | - A Palinkas
- Elisabeth Hospital of Csongrad, Hodmezovasarhely, Hungary
| | - I Simova
- Heart and Brain Center of Excellence, University Hospital, Pleven, Bulgaria
| | - Q Ciampi
- Fatebenefratelli Hospital of Benevento, Benevento, Italy
| | - E Picano
- CNR, Institute of Clinical Physiology, Pisa, Italy
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8
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Giovannini M, Castagnoli R, Mori F, Arasi S, Barni S, Saretta F, Mastrorilli C, Pecoraro L, Liotti L, Caminiti L, Marseglia G, Novembre E. Hymenoptera venom allergy among children in Italy: time for pediatricians to take action. Allergol Immunopathol (Madr) 2020; 48:804-809. [PMID: 32653226 DOI: 10.1016/j.aller.2020.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 10/23/2022]
Abstract
Hymenoptera venom allergy (HVA) is one of the most frequent causes of anaphylaxis following a bee, vespid or ant sting. Real-life data regarding the management of HVA in children are lacking. To address this unmet need, we carried out a survey defining the current management of HVA in children among pediatric allergists in Italy. Educational investments on the improvement of the management of pediatric patients with HVA are urgently needed, and our analysis represents a relevant instrument in targeting a roadmap with this aim. The time for pediatric allergists to take action has come, and a task force from the Rare Allergic Diseases Commission of the Italian Society of Pediatric Allergy and Immunology is working on the topic to improve pediatricians' knowledge and optimize the care of these patients.
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Kamishima K, Jujo K, Tanaka H, Hata T, Ota Y, Oka T, Koganei H, Kobayashi H, Mori F, Sakamoto T, Yamaguchi J, Hagiwara N. Suppression of gastric acid secretion decreased cardiovascular events independent of severe bleeding events in patients after percutaneous coronary intervention – sub-analysis from multicenter registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2515] [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: 11/12/2022] Open
Abstract
Abstract
Background
Suppression of gastric acid secretion by proton-pump inhibitor (PPI) or potassium-competitive acid blocker (P-CAB) has recently been developed as a standard strategy for preventing gastrointestinal bleeding for patients receiving antiplatelet therapy after percutaneous coronary intervention (PCI). However, there has been limited evidences on the association between PPI/P-CAB administration and adverse cardiovascular events in patients undergoing PCI.
Purpose
We aimed to evaluate the prognostic impact of the prescription of PPI/P-CAB on clinical outcomes in patients after PCI.
Methods
This study is a subanalysis from the TWINCRE registry that is a multicentral prospective cohort including patients who underwent PCI at 12 hospitals in Japan between 2017 and 2019. Among registered patients, we ultimately evaluated 1,428 patients who were followed-up. They were divided into two groups by the prescriptions of PPI or P-CAB at discharge for the index PCI; the PPI/P-CAB group (n=1,023), and the Non-PPI/P-CAB group (n=407). The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE) including death, acute coronary syndrome, stent thrombosis, hospitalization due to heart failure and ischemic stroke. Secondary endpoints was major bleeding events defined BARC3, 4 and 5.
Results
The average age of the study population was 70.3 years and 80.3% were male. Baseline clinical profiles were comparable between the groups, except that the PPI/P-CAB group included significantly higher rate of patients who had history of prior PCI (28.4% vs 18.7%, P=0.02). Additionally, there was no significant difference in the duration of dual antiplatelet therapy between the PPI/P-CAB group and Non-PPI/P-CAB group (average duration; 287±8 vs. 285±8 days, P=0.66). Overall, MACCE was developed in 132 patients (9.3%), and bleeding event was observed in 24 patients (1.7%) during 574 days of median follow-up period. Kaplan-Meier analysis showed that patients in the PPI/P-CAB group had a significantly lower rate of MACCE than those in the Non-PPI/P-CAB group (Log-rank test, p=0.0003, Figure 1A). Multivariate Cox regression analysis revealed that the prescription of PPI/P-CAB still was independently associated with the primary endpoint (hazard ratio 0.532, 95% confidence interval 0.369–0.766, p=0.0007), even after the adjustment by diverse covariates. Whereas, there was no significant difference in the bleeding event (p=0.64, Figure 1B).
Conclusion
PPI or P-CAB therapy was associated with better clinical outcomes after PCI, independent of the incidences of severe bleeding events.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - K Jujo
- Tokyo Women's Medical University, cardiology, Tokyo, Japan
| | - H Tanaka
- Tokyo Metropolitan Tama Center, Cardiology, Tokyo, Japan
| | - T Hata
- Saiseikai Kurihashi Hospital, Cardiology, Kurihashimachi, Japan
| | - Y Ota
- Saiseikai Kurihashi Hospital, Cardiology, Kurihashimachi, Japan
| | - T Oka
- Seirei Hamamatsu General Hospital, Cardiology, Hamamatsu, Japan
| | - H Koganei
- Ogikubo Hospital, Cardiology, Tokyo, Japan
| | - H Kobayashi
- Sendai Cardiovascular Center, Cardiology, Sendai, Japan
| | - F Mori
- Yokohama Medical Center, Cardiology, Yokohama, Japan
| | - T Sakamoto
- Saiseikai Kumamoto Hospital, Cardiology, Kumamoto, Japan
| | - J Yamaguchi
- Tokyo Women's Medical University, cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, cardiology, Tokyo, Japan
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Piccorossi A, Liccioli G, Barni S, Sarti L, Giovannini M, Verrotti A, Novembre E, Mori F. Epidemiology and drug allergy results in children investigated in allergy unit of a tertiary-care paediatric hospital setting. Ital J Pediatr 2020; 46:5. [PMID: 31924232 PMCID: PMC6954623 DOI: 10.1186/s13052-019-0753-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 11/21/2019] [Indexed: 11/29/2022] Open
Abstract
Background and objective Drug Hypersensitivity Reactions (DHRs) are considered adverse effects of medications that resemble allergy symptoms. The reported positive clinical history of pediatric drug reactions is about 10%, however, after allergy investigations, only a small percent is confirmed as hypersensitivity. The aim of this study was to analyze the clinical history, allergy work-up results and sensitization profile of children and adolescents referred to our Allergy Unit for suspected DHRs. Methods The study evaluated data related to a group of children with a positive history of drug reactions during a two-year period. The allergy work-up consisted of in vivo and in vitro tests, in accordance with the recommendations of the ENDA/EAACI guidelines. Results Data from a group of 637 patients [348 M (54.6%); 289 F (45.4%)] were retrospectively analyzed. Beta lactams (BLs) were the most common drugs involved in the reported clinical history, followed by non-steroidal anti-inflammatory drugs (NSAIDs). Severe cutaneous adverse reactions (SCARs) were most frequently observed during BL treatment. The confirmation of BL hypersensitivity was higher for immediate reactions (IRs) [9.4%; 5.1% through positive skin tests (STs) and 5.5% through drug provocation test (DPT)] compared to non-immediate reactions (non-IRs) (8.1%; 2.2% through STs and 6.2% through DPT). A higher number of positive results was obtained for BLs and macrolides when the tests were performed within 12 months after the index reaction (p < 0.05). During DPTs with amoxicillin-clavulanic acid, four hypersensitivity reactions (including one anaphylaxis) occurred despite negative STs. Conclusion Our data demonstrated that only 9.1% of patients resulted in being positive to allergy tests which is in line with the data in literature. An allergy work-up is mandatory for excluding suspected hypersensitivity.
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Affiliation(s)
- A Piccorossi
- Department of Pediatrics, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - G Liccioli
- Allergy Unit, Anna Meyer Children's Hospital, Florence, Italy.
| | - S Barni
- Allergy Unit, Anna Meyer Children's Hospital, Florence, Italy
| | - L Sarti
- Allergy Unit, Anna Meyer Children's Hospital, Florence, Italy
| | - M Giovannini
- Allergy Unit, Anna Meyer Children's Hospital, Florence, Italy
| | - A Verrotti
- Department of Pediatrics, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - E Novembre
- Allergy Unit, Anna Meyer Children's Hospital, Florence, Italy
| | - F Mori
- Allergy Unit, Anna Meyer Children's Hospital, Florence, Italy
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11
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Gargani L, Codullo V, Argiento P, Moreo A, Pieri F, Mori F, Epis O, Moggi-Pignone A, Montecucco C, Valentini G, Matucci-Cerinic M, Sicari R, Ghio S, Bossone E, D'Alto M. P6478Resting and exercise pulmonary artery systolic pressure to rule out later development of pulmonary arterial hypertension in systemic sclerosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1069] [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
Patients with systemic sclerosis (SSc) are at risk of developing pulmonary arterial hypertension (PAH), which is often diagnosed late when the benefits of vasoactive therapies are limited. The concept of exercise pulmonary hypertension as a possible transitional phase anticipating resting PAH has been assessed in several pathologies, but has not been endorsed by the latest European Guidelines, because not supported by sufficient data.
Purpose
To evaluate whether PASP values at rest and at peak exercise, estimated at echocardiography, could be predictors of further development of PAH.
Methods
Four hundred and twenty-nine SSc patients without a previous diagnosis of PAH, enrolled at 4 referral Centres, underwent standard exercise Doppler echocardiography with PASP estimation at rest and at peak stress. Patients were then followed-up to assess the development of PAH, as diagnosed by a complete diagnostic work-up including right heart catheterization. PAH was defined by pre-capillary pulmonary hypertension (mean pulmonary artery pressure ≥25 mmHg with pulmonary arterial wedge pressure ≤15 mmHg), without significant interstitial lung disease and/or left heart disease.
Results
During the median follow-up of 75 months (IQR 29–114), 16 patients developed PAH. A combined cut-off of ≥24 mmHg as resting PASP and ≥40 as peak PASP was identified as the best predictor of further development of PAH (see Figure). Both resting PASP and peak PASP were predictors of PAH at univariate analysis (resting PASP OR 1.13, 95% C.I. 1.07–1.19, p<0.0001; peak PASP OR 1.13, 95% C.I. 1.07–1.18, p<0.0001). At multivariate analysis, only peak PASP was independently associated to PAH development (OR 1.13, 95% C.I. 1.04–1.18, p<0.001). Only one patient among those with resting PASP <24 mmHg and peak PASP <40 mmHg (34.7% of the total population) developed PAH during the follow-up (after 10 years from normal exercise Doppler echocardiography).
Kaplan-Meier curves
Conclusions
Exercise increase in PASP is an independent predictor of later development of PAH in SSc. An increase in exercise PASP is frequent and is not necessarily associated with a later development of PAH, whereas the very high negative predictive value of a normal PASP both at rest and at peak exercise can be used in the clinical practice to confidently rule out about one third of patients.
Acknowledgement/Funding
Italian Ministry of Health (Ricerca Finalizzata 2011-2012)
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Affiliation(s)
- L Gargani
- Institute of Clinical Physiology - National Research Council, Pisa, Italy
| | - V Codullo
- University of Pavia, Rheumatology, Pavia, Italy
| | - P Argiento
- AO dei Colli-Monaldi Hospital, Cardiology, Naples, Italy
| | - A Moreo
- Niguarda Ca' Granda Hospital, Cardiology, Milan, Italy
| | - F Pieri
- Careggi University Hospital (AOUC), Florence, Italy
| | - F Mori
- Careggi University Hospital (AOUC), Florence, Italy
| | - O Epis
- Niguarda Ca' Granda Hospital, Rheumatology, Milan, Italy
| | | | | | - G Valentini
- AO dei Colli-Monaldi Hospital, Rheumatology, Naples, Italy
| | | | - R Sicari
- Institute of Clinical Physiology - National Research Council, Pisa, Italy
| | - S Ghio
- University of Pavia, Cardiology, Pavia, Italy
| | | | - M D'Alto
- AO dei Colli-Monaldi Hospital, Cardiology, Naples, Italy
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12
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Ajiro Y, Koike T, Maeda R, Hasegawa S, Shibahashi E, Sugiyama K, Saito T, Mori F, Iwade K. PO121 Possible Contribution of Sleep Disorder Breathing to Heart Failure In the Patients With Hypertrophic Cardiomyopathy With Preserved Left Ventricular Ejection Fraction. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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13
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Mori F, Angelucci C, Cianferoni A, Barni S, Indolfi G, Casini A, Mangone G, Materassi M, Pucci N, Azzari C, Novembre E. Increase of natural killer cells in children with liver transplantation-acquired food allergy. Allergol Immunopathol (Madr) 2018; 46:447-453. [PMID: 29456038 DOI: 10.1016/j.aller.2017.09.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 09/14/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Transplantation-acquired food allergies (TAFA) are frequently reported and considered to be caused by immunosuppressive therapy. The aim of this study was to investigate the allergic and immunologic responses in children who had liver or kidney transplantations. METHODS Twelve children receiving liver transplantations and 10 children receiving kidney transplantations were investigated. All children underwent the allergy work-up and in most of them, lymphocyte screening and serum cytokine measurements were also performed. RESULTS TAFA were found in 7/12 (58%) children with liver transplantations and in none of the 10 children with kidney transplantations. The mean age at transplantation was significantly lower in children who underwent liver transplantations (p<0.001). The immunosuppressive therapy administered to children with liver transplantation was tacrolimus in 11 patients and cyclosporine in one patient, while all 10 children with kidney transplantation received tacrolimus plus mycophenolate. The most common antigenic food was egg. The natural killer (NK) cell numbers were significantly higher in liver-transplant children than in kidney-transplant children. No significant differences were found in the serum cytokine levels. CONCLUSIONS This study confirms that liver-transplant children treated with tacrolimus alone have a higher risk of developing TAFA than kidney-transplant children treated with tacrolimus plus mycophenolate. NK cells might be involved in this difference.
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Affiliation(s)
- F Mori
- Allergy Unit, Department of Paediatrics, Anna Meyer Children's University Hospital, Florence, Italy
| | - C Angelucci
- Allergy Unit, Department of Paediatrics, Anna Meyer Children's University Hospital, Florence, Italy
| | - A Cianferoni
- Allergy and Immunology Division, Children's Hospital of Philadelphia, PA, USA
| | - S Barni
- Allergy Unit, Department of Paediatrics, Anna Meyer Children's University Hospital, Florence, Italy.
| | - G Indolfi
- Pediatric and Liver Unit, Meyer Children's University Hospital of Florence, Florence, Italy
| | - A Casini
- Division of Immunology, Section of Paediatrics, Department of Health Sciences, Anna Meyer Children's University Hospital, Florence, Italy
| | - G Mangone
- Division of Immunology, Section of Paediatrics, Department of Health Sciences, Anna Meyer Children's University Hospital, Florence, Italy
| | - M Materassi
- Pediatric Nephrology Unit, Meyer Children's University Hospital, Florence, Italy
| | - N Pucci
- Allergy Unit, Department of Paediatrics, Anna Meyer Children's University Hospital, Florence, Italy
| | - C Azzari
- Pediatric and Liver Unit, Meyer Children's University Hospital of Florence, Florence, Italy
| | - E Novembre
- Allergy Unit, Department of Paediatrics, Anna Meyer Children's University Hospital, Florence, Italy
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14
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Liccioli G, Mori F, Barni S, Pucci N, Novembre E. Anaphylaxis to Polyvinylpyrrolidone in Eye Drops Administered to an Adolescent. J Investig Allergol Clin Immunol 2018; 28:263-265. [DOI: 10.18176/jiaci.0252] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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15
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Mecarocci V, Mori F. P210Long- term outcome of primary mitral valve prolapse: results from a population of 250 patients referred to a tertiary cardiovascular center. Eur Heart J Cardiovasc Imaging 2018; 17:ii29-ii37. [PMID: 28415082 DOI: 10.1093/ehjci/jew236.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Outcome of Mitral Valve Prolapse (MVP) was controversial for long time. Many studies reported great differences in the incidence of cardiovascular events due, above all, to heterogeneous and small studied populations. Most of theme were also published to late '80 of the last century till early '00. Purpose To make a contemporary survey on the incidence of cardiovascular events in a selected population of patients affected by primary MVP referred to a tertiary cardiovascular center for the medical and surgical care of valvular heart disease. Methods We reviewed our MVP database; patients with at least 2 cardiologic evaluations inclusive of echocardiographic examination and at least 6 months follow up were enrolled. A total of 250 patients (126 F) were selected. Their mean age was 52.1 years (ranging from 13 to 88 yo). The average follow-up time was 100 months (8,33 yrs). Results At the first medical and echocardiographic examination 8 patients (3,2%) had no mitral regurgitation (MR), 104 (41.6%) have a trace/mild MR, 93 (37,2%) a moderate MR and 46 (18,4%) a severe MR. They were widely asymptomatic (NYHA I 205-82%, NYHA II 44-17.60%, NYHA III 1- 0.40%). Most of theme presented a bileaflet (140-55.8%) or a posterior MVP (94 - 37.6%); an isolated anterior MVP was rare (16 - 6,4%). Flail leaflet was present in 8 (3,2%) and 25 (10%) had a chordal rupture. Respectively 165 (65,6%) and 115 (46,1%) patients had thick and redundant leaflets. Mean antero-posterior mitral annulus diameter was 37 mm. During the follow up 7 patients died of non-cardiac cause and 5 (2%) of suspected cardiac cause (2 because of acute coronary syndrome and 3 died suddenly). MR progresses in 43 (17,2%) patients and finally we observed 81 (32,4%) moderate/severe and severe MR. 12 new chordal rupture occurred during the follow up in most cases concerning mitral chordae linked to posterior mitral leaflet (10 cases-83,3%). The worsening of MR provoked an evolution of the clinical condition of 48 patients (19.2%) which developed Dyspnea On Excertion (DOE) with 42 new NYHA II and 6 new NYHA III. At the end of the follow up the amount of patients symptomatic for DOE was 93 (37.2% vs 18% at the initial evaluation). A total of 45 patients (18%) underwent mitral valve surgery. 40 needed in-hospital treatment in most cases due to the development of atrial fibrillation (19 -7.6%) or heart failure ( 8- 3,2%). Endocarditis occurred in 4 patients (1.6%) and cerebrovascular accidents/cardioembolic event in 6 (2.4%). The overall cardiovascular event rate was 4,33/100 patients-year, significantly higher than reported in community based studies. Conclusions The prognosis of a MVP population referred to a tertiary cardiovascular center is not benign. The most frequent complications are progression of MR and MV surgery. Sudden death is also more frequent than in general population. More studies are needed to identify what patients with MVP are at risk for it.
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Affiliation(s)
- V Mecarocci
- Careggi University Hospital (AOUC), cardiovascular diagnostics, Florence, Italy
| | - F Mori
- Careggi University Hospital (AOUC), cardiovascular diagnostics, Florence, Italy.,Careggi University Hospital (AOUC), cardiovascular diagnostics, Florence, Italy
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16
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Mori F, Sarti L, Barni S, Pucci N, Belli F, Stagi S, Novembre E. Donkey´s Milk Is Well Accepted and Tolerated by Infants With Cow´s Milk Food Protein-Induced Enterocolitis Syndrome: A Preliminary Study. J Investig Allergol Clin Immunol 2017; 27:269-271. [PMID: 28731417 DOI: 10.18176/jiaci.0167] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- F Mori
- Allergy Unit, Department of Pediatrics, Anna Meyer Children's University Hospital, Florence, Italy
| | - L Sarti
- Allergy Unit, Department of Pediatrics, Anna Meyer Children's University Hospital, Florence, Italy
| | - S Barni
- Allergy Unit, Department of Pediatrics, Anna Meyer Children's University Hospital, Florence, Italy
| | - N Pucci
- Allergy Unit, Department of Pediatrics, Anna Meyer Children's University Hospital, Florence, Italy
| | - F Belli
- Nutrition Unit, Department of Pediatrics, Anna Meyer Children's University Hospital, Florence, Italy
| | - S Stagi
- Department of Health Sciences, University of Florence, Anna Meyer Children´s University Hospital, Florence, Italy
| | - E Novembre
- Allergy Unit, Department of Pediatrics, Anna Meyer Children's University Hospital, Florence, Italy
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17
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Innocenti A, Melita D, Mori F, Ghezzi S, Innocenti M. Comment on: “A case report of a complete degloving injury of the penile skin”. Int J Surg Case Rep 2017; 36:108-109. [PMID: 28554105 PMCID: PMC5447507 DOI: 10.1016/j.ijscr.2017.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 05/03/2017] [Accepted: 05/06/2017] [Indexed: 11/10/2022] Open
Abstract
Genitalia are a key element for male self-esteem, contributing towards mental and physical balance and influencing their social life. Scrotal dartos-fascio-mio-cutaneous flap for shaft coverage offers a large amount of tissue with low donor site morbidity, avoiding unsightly scars in more visible parts of the body.
Introduction We recently published an article in the International Journal of Surgical Case Reports titled: “Scrotal dartos-fascio-myo-cutaneous flap for penis elongation after catastrophic iatrogenic skin shaft sub-amputation: A case of recovery using an extremely adaptable flap”. Presentation of case We propose a comment on a recent article titled “A case report of a complete degloving injury of the penile skin” by Helena Aineskog and Frederik Huss that we read with great interest. Discussion Genitalia are linked to self-esteem and male sexual identity, especially among young men, who sometimes require a surgical procedure to acquire more confidence. Various techniques are available for pe-nile skin covering, such as skin grafts or cutaneous flaps. The skin of the scrotum seems to be the most suitable tissue to be used to reconstruct the skin covering of the shaft as it is the most similar. Conclusion Scrotal flap is a single stage procedure that is easy and safe to perform.
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18
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Innocenti A, Tanini S, Mori F, Melita D, Innocenti M. Scrotal dartos-fascio-myo-cutaneous flaps for penis elongation after catastrophic iatrogenic skin shaft sub-amputation: A case of recovery using an extremely adaptable flap. Int J Surg Case Rep 2016; 28:300-302. [PMID: 27770738 PMCID: PMC5078681 DOI: 10.1016/j.ijscr.2016.10.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/05/2016] [Accepted: 10/06/2016] [Indexed: 11/27/2022] Open
Abstract
Introduction Genitalia are linked to self-esteem and male sexual identity, especially among young men, who sometimes require a surgical procedure to acquire more confidence. Among the surgical procedures requested for aesthetical purposes, circumcision is one of the most popular. Although it can be considered to be a simple surgical practice, it may cause severe complications such as penile skin necrosis. Presentation of case We report a case of a catastrophic situation after a circumcision performed on a 27-year-old HIV positive man resulted in a drastic reduction in the length of the penile shaft due to extensive skin loss; this was subsequently restored using dartos-fascio-myo-cutaneous flaps. Primary healing occurred in 10 days. No infection, dehiscence or flap ischemia were reported. Donor site morbidity was minimal. An adequate aesthetical appearance and satisfactory functional results were obtained. Discussion and conclusion Various techniques are available for penile skin covering, such as skin grafts or cutaneous flaps. The skin of the scrotum seems to be the most suitable tissue to be used to reconstruct the skin covering of the shaft as it is the most similar. Dartos-fascio-myo-cutaneous flap is a single stage procedure that is easy and safe to perform. It can provide satisfactory cosmetic and functional results, offering a large amount of tissue, with minimal donor site morbidity.
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Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy.
| | - Sara Tanini
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy
| | - F Mori
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy
| | - D Melita
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy
| | - M Innocenti
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy
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19
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Pucci N, Massai C, Bernardini R, Caputo R, Mori F, De Libero C, Novembre E, De Martino M, Vierucci A. Eyelash Length in Children with Vernal Keratoconjunctivitis: Effect of Treatment with Cyclosporine Eye Drops. Int J Immunopathol Pharmacol 2016; 20:595-9. [PMID: 17880772 DOI: 10.1177/039463200702000317] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The upper eyelashes in vernal keratoconjunctivitis (VKC) patients have been reported to be longer than in healthy age- and gender-matched subjects. Eyelash length positively correlated to the severity of the disease and negatively to the employment of cyclosporine eye drops, suggesting that specific humoral factors could be involved in both ocular inflammation and elongation of the eyelashes. The aim of the present study is to evaluate a possible relationship between eyelash length and the duration of topical cyclosporine treatment. The length of the upper eyelashes of 34 VKC patients never treated with topical cyclosporine (Cyc-NT) was matched with that of 58 VKC patients treated with cyclosporine (Cyc-T). The latter group was divided into three subgroups, depending on the duration of therapy: 1–6 months (group 1; 21 subjects), 7–12 months (group 2; 19 subjects), >12 months (group 3; 19 subjects). Cyc-NT patients' eyelashes were significantly longer than those of VKC patients treated for 1–6 months (group 1). No significant difference was found between Cyc-NT and Cyc-T patients in group 2 and group 3. The differences between Cyc-T patients and group 1 and 2, group 2 and 3, and group 1 and 3 were not statistically significant. The eyelash shortening observed seems directly related to the rapid improvement of ocular symptoms induced by the treatment. A receptor down-regulation by mediators of ocular inflammation may explain this data, although different cytokines, hormones or other humoral mediators could be expressed on the ocular surface at different stages of the disease, mainly in periods of rapid change of the clinical course.
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Affiliation(s)
- N Pucci
- Allergy and Clinical Immunology Unit, Department of Pediatrics, University of Florence, Florence, Italy.
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Novembre E, Calogero C, Mori F, Bernardini R, Pucci N, Neri P, Bonini M, Vierucci A, De Martino M. Biphasic Anaphylactic Reaction to Ketorolac Tromethamine. Int J Immunopathol Pharmacol 2016; 19:449-50. [PMID: 16831313 DOI: 10.1177/039463200601900223] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Ketorolac tromethamine is a recent injectable non-steroidal anti-inflammatory drug (NSAID) with analgesic properties approved for short-term pain management. In spite of its increasing use both in adults and children (1-2), relatively few allergic-like reactions have been reported (3–5). Reactions are often severe, and a death occurred following an intramuscular injection of ketorolac (6).
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Affiliation(s)
- E Novembre
- Allergy and Clinical Immunology Unit, Azienda Ospedaliero Universitaria A. Meyer, Via L. Giordano 13, 50132 Florence, Italy.
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21
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Bernardini R, Mistrello G, Pucci N, Roncarolo D, Lombardi E, Zanoni E, Mori F, De Martino M, Novembre E, Massai C, Azzari C, Vierucci A. Diagnostic Value of Three Different Latex Extracts. Int J Immunopathol Pharmacol 2016; 20:393-400. [PMID: 17624253 DOI: 10.1177/039463200702000221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The diagnosis of latex allergy is made on clinical history, but a confirmatory skin prick test (SPT) or a serological assay based on a commercial latex extract is always recommendable. Different raw materials can be used in the preparation of commercial latex extracts. Such extracts can consequently show both different qualitative profiles and a different diagnostic potential. Therefore, the selection of a proper latex extract is essential for in vitro and in vivo diagnosis of latex allergy. In the present study three different latex extracts, prepared from different raw materials (ammoniated -AL-, serum -SL-, or rubber particles -RPE- latex), are compared by in vitro techniques using sera from twenty patients with latex allergy. SDS-PAGE technique was used to compare the antigenic profile of the three latex extracts. Subsequently, their allergenic profiles were evaluated by immunoblotting technique using the individual sera from the twenty latex allergic patients. The diagnostic potential of the three latex extracts was also evaluated using direct Radio-Allergo-Sorbent Test (RAST) as well as skin prick tests (SPTs). In order to establish the more appropriate latex extract in a perspective of in vivo diagnosis of latex sensitization, the same latex extracts were subsequently compared by an in vivo SPT involving ten of the above subjects. The SDS-PAGE profiles of the three latex extracts examined were quite different. SL extract showed numerous bands comprised between 10–100 kDa. RPE extract was characterized by two intense bands at 14 and 20 kDa while AL extract showed the poorer antigenic composition. Analogously, immunoblotting analysis evidenced a different profile in relation to both different patients and extracts. For only two out of the twenty sera, direct RAST results showed a same positive class in relation to the different latex extracts used. SPT with SL extract showed, in respect to the other extracts (AL, RPE), a significantly higher wheal. This study showed that SL extract is able to express the best in vitro and in vivo diagnostic potential. Thus, its use should be preferred for the diagnosis of patients affected by latex allergy.
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Affiliation(s)
- R Bernardini
- Pediatric Allergy and Pulmonology Center, Department of Pediatrics, Anna Meyer Children Hospital, University of Florence, Italy.
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22
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Barni S, Mori F, Sarti L, Pucci N, Rossi EM, de Martino M, Novembre E. Utility of skin testing in children with a history of non-immediate reactions to amoxicillin. Clin Exp Allergy 2016; 45:1472-4. [PMID: 26178175 DOI: 10.1111/cea.12596] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Barni
- Allergy Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - F Mori
- Allergy Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - L Sarti
- Allergy Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - N Pucci
- Allergy Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - E M Rossi
- Allergy Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - M de Martino
- Infectious Diseases Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - E Novembre
- Allergy Unit, Anna Meyer Children's University Hospital, Florence, Italy
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Gomes ER, Brockow K, Kuyucu S, Saretta F, Mori F, Blanca-Lopez N, Ott H, Atanaskovic-Markovic M, Kidon M, Caubet JC, Terreehorst I. Drug hypersensitivity in children: report from the pediatric task force of the EAACI Drug Allergy Interest Group. Allergy 2016. [PMID: 26416157 DOI: 10.1111/all.12774)] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
When questioned, about 10% of the parents report suspected hypersensitivity to at least one drug in their children. However, only a few of these reactions can be confirmed as allergic after a diagnostic workup. There is still a lack of knowledge on drug hypersensitivity (DH) epidemiology, clinical spectrum, and appropriate diagnostic methods particularly in children. Meanwhile, the tools used for DH management in adults are applied also for children. Whereas this appears generally acceptable, some aspects of DH and management differ with age. Most reactions in children are still attributed to betalactams. Some manifestations, such as nonsteroidal anti-inflammatory drug-associated angioedema and serum sickness-like reactions, are more frequent among young patients as compared to adults. Risk factors such as viral infections are particularly frequent in children, making the diagnosis challenging. The practicability and validity of skin test and other diagnostic procedures need further assessment in children. This study presents an up-to-date review on epidemiology, clinical spectrum, diagnostic tools, and current management of DH in children. A new general algorithm for the study of these reactions in children is proposed. Data are presented focusing on reported differences between pediatric and adult patients, also identifying unmet needs to be addressed in further research.
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Affiliation(s)
- E R Gomes
- Allergology Department, Centro Hospitalar do Porto, Porto, Portugal
| | - K Brockow
- Division Environmental Dermatology and Allergology Helmholtz Zentrum München/TUM, Department of Dermatology und AllergologyBiederstein, Technical University Munich, Munich, Germany
| | - S Kuyucu
- Department of Pediatric Allergy and Clinical Immunology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - F Saretta
- Pediatric Department, Hospital of Palmanova, A.S.S.5 'Bassa Friulana', Palmanova, UD, Italy
| | - F Mori
- Allergy Unit, Department of Pediatric, Anna Meyer Children's Hospital, University of Florence, Florence, Italy
| | - N Blanca-Lopez
- Allergy Department, Infanta Leonor University Hospital, Madrid, Spain
| | - H Ott
- Division of Pediatric Dermatology, Children's Hospital Auf der Bult, Hannover, Germany
| | - M Atanaskovic-Markovic
- University Children's Hospital of Belgrade, Medical Faculty University of Belgrade, Belgrade, Serbia
| | - M Kidon
- Allergy and Clinical Immunology Unit and Institute for Pediatric Pulmonology and National CF Center, Safra Children's Hospital, Tel Hashomer, Israel
| | - J-C Caubet
- Division of Pediatric Allergy, University Hospital of Geneva, Geneva, Switzerland
| | - I Terreehorst
- Department of ENT and Pediatrics, AMC, Amsterdam, The Netherlands
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Gomes ER, Brockow K, Kuyucu S, Saretta F, Mori F, Blanca-Lopez N, Ott H, Atanaskovic-Markovic M, Kidon M, Caubet JC, Terreehorst I. Drug hypersensitivity in children: report from the pediatric task force of the EAACI Drug Allergy Interest Group. Allergy 2016; 71:149-61. [PMID: 26416157 DOI: 10.1111/all.12774] [Citation(s) in RCA: 173] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2015] [Indexed: 12/22/2022]
Abstract
When questioned, about 10% of the parents report suspected hypersensitivity to at least one drug in their children. However, only a few of these reactions can be confirmed as allergic after a diagnostic workup. There is still a lack of knowledge on drug hypersensitivity (DH) epidemiology, clinical spectrum, and appropriate diagnostic methods particularly in children. Meanwhile, the tools used for DH management in adults are applied also for children. Whereas this appears generally acceptable, some aspects of DH and management differ with age. Most reactions in children are still attributed to betalactams. Some manifestations, such as nonsteroidal anti-inflammatory drug-associated angioedema and serum sickness-like reactions, are more frequent among young patients as compared to adults. Risk factors such as viral infections are particularly frequent in children, making the diagnosis challenging. The practicability and validity of skin test and other diagnostic procedures need further assessment in children. This study presents an up-to-date review on epidemiology, clinical spectrum, diagnostic tools, and current management of DH in children. A new general algorithm for the study of these reactions in children is proposed. Data are presented focusing on reported differences between pediatric and adult patients, also identifying unmet needs to be addressed in further research.
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Affiliation(s)
- E. R. Gomes
- Allergology Department; Centro Hospitalar do Porto; Porto Portugal
| | - K. Brockow
- Division Environmental Dermatology and Allergology Helmholtz Zentrum München/TUM; Department of Dermatology und AllergologyBiederstein; Technical University Munich; Munich Germany
| | - S. Kuyucu
- Department of Pediatric Allergy and Clinical Immunology; Faculty of Medicine; Mersin University; Mersin Turkey
| | - F. Saretta
- Pediatric Department; Hospital of Palmanova; A.S.S.5 ‘Bassa Friulana’; Palmanova UD Italy
| | - F. Mori
- Allergy Unit; Department of Pediatric; Anna Meyer Children's Hospital; University of Florence; Florence Italy
| | - N. Blanca-Lopez
- Allergy Department; Infanta Leonor University Hospital; Madrid Spain
| | - H. Ott
- Division of Pediatric Dermatology; Children's Hospital Auf der Bult; Hannover Germany
| | - M. Atanaskovic-Markovic
- University Children's Hospital of Belgrade; Medical Faculty University of Belgrade; Belgrade Serbia
| | - M. Kidon
- Allergy and Clinical Immunology Unit and Institute for Pediatric Pulmonology and National CF Center; Safra Children's Hospital; Tel Hashomer Israel
| | - J.-C. Caubet
- Division of Pediatric Allergy; University Hospital of Geneva; Geneva Switzerland
| | - I. Terreehorst
- Department of ENT and Pediatrics; AMC; Amsterdam The Netherlands
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Narita T, Ri M, Masaki A, Mori F, Ito A, Kusumoto S, Ishida T, Komatsu H, Iida S. Lower expression of activating transcription factors 3 and 4 correlates with shorter progression-free survival in multiple myeloma patients receiving bortezomib plus dexamethasone therapy. Blood Cancer J 2015; 5:e373. [PMID: 26636288 PMCID: PMC4735074 DOI: 10.1038/bcj.2015.98] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 09/18/2015] [Accepted: 10/13/2015] [Indexed: 11/13/2022] Open
Abstract
Bortezomib (BTZ), a proteasome inhibitor, is widely used in the treatment of multiple myeloma (MM), but a fraction of patients respond poorly to this agent. To identify factors predicting the duration of progression-free survival (PFS) of MM patients on BTZ treatment, the expression of proteasome and endoplasmic reticulum (ER) stress-related genes was quantified in primary samples from patients receiving a combination of BTZ and dexamethasone (BD). Fifty-six MM patients were stratified into a group with PFS<6 months (n=33) and a second group with PFS⩾6 months (n=23). Of the 15 genes analyzed, the expression of activating transcription factor 3 (ATF3) and ATF4 was significantly lower in patients with shorter PFS (P=0.0157 and P=0.0085, respectively). Chromatin immunoprecipitation analysis showed that these ATFs bind each other and transactivate genes encoding the pro-apoptotic transcription factors, CHOP and Noxa, which promote ER stress-associated apoptosis. When either ATF3 or ATF4 expression was silenced, MM cells partially lost sensitivity to BTZ treatment. This was accompanied by lower levels of Noxa, CHOP and DR5. Thus low basal expression of ATF3 and ATF4 may attenuate BTZ-induced apoptosis. Hence, ATF3 and ATF4 could potentially be used as biomarkers to predict efficacy of BD therapy in patients with MM.
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Affiliation(s)
- T Narita
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - M Ri
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - A Masaki
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - F Mori
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - A Ito
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - S Kusumoto
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - T Ishida
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - H Komatsu
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - S Iida
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
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26
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Mori F, Pantano S, Rossi ME, Montagnani C, Chiappini E, Novembre E, Galli L, de Martino M. Skin prick test results to artesunate in children sensitized to Artemisia vulgaris L. Int J Immunopathol Pharmacol 2015; 28:411-4. [PMID: 26157064 DOI: 10.1177/0394632015589518] [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: 09/16/2014] [Accepted: 05/08/2015] [Indexed: 11/16/2022] Open
Abstract
Artemisia vulgaris L and Artemisia annua L (Chinese: qinghao) are similar plants of the Asterbaceae family. Artesunate, a semi-synthetic derivate of artemisin which is the active principle extract of the plant qinghao, has antimalarial properties. Some cases of severe allergic reactions to artesunate have been described. The purpose of this study was to evaluate the association between positive skin tests to Artemisia vulgaris L allergen and a preparation of injectable artesunate. A total of 531 children were skin prick tested with inhalants (including Artemisia vulgaris L), foods, and artesunate. Among the 59 patients positive to Artemisia vulgaris L only one child was also positive to artesunate. No child was positive to artesunate in those negative to Artemisia vulgaris L. We conclude that Artemisia vulgaris L sensitization is not associated with sensitization to artesunate; consequently, skin test to artesunate should not be carried out before using the drug considering the rare allergic reactions.
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Affiliation(s)
- F Mori
- Allergy Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - S Pantano
- Department of Pediatrics, St Salvatore Hospital, University of Aquila, Italy Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy
| | - M E Rossi
- Allergy Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - C Montagnani
- Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy
| | - E Chiappini
- Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy Infectious Diseases Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - E Novembre
- Allergy Unit, Anna Meyer Children's University Hospital, Florence, Italy Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy
| | - L Galli
- Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy Infectious Diseases Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - M de Martino
- Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy
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Musella A, Mandolesi G, Mori F, Gentile A, Centonze D. Linking synaptopathy and gray matter damage in multiple sclerosis. Mult Scler 2015; 22:146-9. [PMID: 25921048 DOI: 10.1177/1352458515581875] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 03/24/2015] [Indexed: 11/16/2022]
Affiliation(s)
- A Musella
- IRCCS Fondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC), Italy/Clinica Neurologica, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Italy
| | - G Mandolesi
- IRCCS Fondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC), Italy/Clinica Neurologica, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Italy
| | - F Mori
- Clinica Neurologica, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Italy/IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, Italy
| | - A Gentile
- IRCCS Fondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC), Italy/Clinica Neurologica, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Italy
| | - D Centonze
- Clinica Neurologica, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Italy/IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, Italy
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Floridia M, Tamburrini E, Ravizza M, Tibaldi C, Ravagni Probizer MF, Anzidei G, Sansone M, Mori F, Rubino E, Meli M, Dalzero S, Guaraldi G. Lipid Profile During Pregnancy in HIV-Infected Women. HIV Clinical Trials 2015; 7:184-93. [PMID: 17065030 DOI: 10.1310/hct0704-184] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE We investigated the evolution of serum lipid levels in HIV-infected pregnant women and the potential effect of antiretroviral treatment during pregnancy using data from a national surveillance study. METHOD Fasting lipid measurements collected during routine care in pregnancy were used, analyzing longitudinal changes and differences in lipid values at each trimester by protease inhibitors (PIs) and stavudine use. Multivariate analyses were used to control for simultaneous factors potentially leading to hyperlipidemia. Study population included 248 women. RESULTS Lipid values increased progressively and significantly during pregnancy: mean increases between the first and third trimesters were 141.6 mg/dL for triglycerides (p < .001), 60.8 mg/dL for total cholesterol (p < .001), 13.7 mg/dL for HDL cholesterol (p < .001), and 17.8 mg/dL for LDL cholesterol (p = .001). At all trimesters, women on PIs had significantly higher triglyceride values compared to women not on PIs. The effect of PIs on cholesterol levels was less consistent. Stavudine showed a dyslipidemic effect at first trimester only. Multivariate analyses confirmed these observations and suggested a potential role of other cofactors in the development of hyperlipidemia during pregnancy. CONCLUSION The changes observed point to the need to further explore the causes and the clinical correlates of hyperlipidemia during pregnancy in women with HIV.
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Affiliation(s)
- M Floridia
- Department of Drug Research and Evaluation, Istituto Superiore di Sanità, Rome.
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29
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Barni S, Butti D, Mori F, Pucci N, Rossi ME, Cianferoni A, Novembre E. Azithromycin is more allergenic than clarithromycin in children with suspected hypersensitivity reaction to macrolides. J Investig Allergol Clin Immunol 2015; 25:128-132. [PMID: 25997306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Macrolides are considered safe antibiotics with reduced allergenic activity. However, studies on the safety of macrolides are scarce, particularly in children. OBJECTIVE The aim of this study was to assess the frequency of hypersensitivity reactions to clarithromycin and azithromycin in a group of children referred to our allergy unit for suspected macrolide allergy. METHODS We retrospectively reviewed the charts of 90 children aged 1-17 years with symptoms suggestive of hypersensitivity reaction to clarithromycin or azithromycin between December 31, 2008 and December 31, 2013. The allergy workup included skin tests (ie, skin prick tests and/or intradermal tests), determination of serum specific IgE (sIgE) to clarithromycin and azithromycin, and, if necessary to reach a diagnosis, oral provocation tests. RESULTS Seventy-seven children completed the allergy workup. A reaction to clarithromycin was recorded in 58 children (75.3%): 21 (36.2%) had a history of immediate reactions, and 37 (63.8%) had a history of nonimmediate reactions. A reaction to azithromycin was recorded in 19 children (24.6%): 6 (31.5%) had a history of immediate reaction, and 13 (68.42%) had a history of nonimmediate reaction. Positive results in skin tests and oral provocation tests with the suspect drug confirmed the diagnosis in 15.5% of reactions to clarithromycin (9 of 58) and in 47.3% of reactions to azithromycin (9 of 19) (P = .004). CONCLUSION A complete allergy workup enabled us to confirm a diagnosis of clarithromycin and azithromycin allergy in 15.5% and 47.3% of cases, respectively. Azithromycin was more allergenic than clarithromycin in children.
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Krestjyaninov M, Gimaev R, Razin V, Halaph H, Shameeva O, Galli E, Oger E, Levery M, Mabo P, Donal E, Rodriguez Munoz D, Carbonell Sanroman A, Moya Mur J, Lazaro Rivera C, Fernandez Santos S, Rincon Diaz L, Casas Rojo E, Jimenez Nacher J, Fernandez-Golfin C, Zamorano Gomez J, Shamsheva D, Zaletova T, Parkhomenko O, Bogdanov A, Simova I, Katova T, Galderisi M, Pauncheva B, Ozawa K, Funabashi N, Takaoka H, Kobayashi Y, Moatemri F, Messaoudi Y, Mahdhaoui A, Bouraoui H, Hajri S, Jeridi G, Souza C, Nascimento C, Cordovil I, Belem L, Horcades R, Sahate A, Pereira S, Benchimol-Barbosa P, Barros C, Weitzel L, Altin C, Sade L, Gezmis E, Ozen N, Muderrisoglu H, Voilliot D, Magne J, Dulgheru R, Kou S, Henri C, Caballero L, De Sousa C, Sprynger M, Pierard L, Lancellotti P, Miglioranza M, Mihaila S, Muraru D, Cucchini U, Cecchetto A, Cavalli G, Romeo G, Iliceto S, Badano L, Brecht A, Wageloehner T, Oertelt-Prigione S, Seeland U, Ruecke M, Baumann G, Regitz-Zagrosek V, Stangl V, Knebel F, Khanna R, Raghuwanshi A, Kapoor A, Tewari S, Garg N, Kumar S, Goel P, Altin C, Sade L, Gezmis E, Ozen N, Duzceker O, Muderrisoglu H, Petre I, Tautu O, Onciul S, Iancovici S, Zamfir D, Onut R, Dorobantu M, Jashari F, Ibrahimi P, Johansson E, Gronlund C, Bajraktari G, Wester P, Henein M, Torbas O, Sirenko Y, Radchenko G, Page M, Gerber B, Pasquet A, Pouleur A, Vancreynest D, Vanoverschelde J, Wieczorek J, Wieczorek P, Mizia M, Gieszczyk-Strozik K, Sikora-Puz A, Lasota B, Mizia-Stec K, Coisne A, Levy F, Malaquin D, Richardson M, Quere J, Montaigne D, Tribouilloy C, Miskowiec D, Wierzbowska-Drabik K, Wejner-Mik P, Michalski B, Wdowiak-Okrojek K, Szymczyk E, Kasprzak J, Lipiec P, Grossi F, Oddo A, Pieri F, Cordisco A, Zucchini M, Mori F, Gensini G. Club 35 Poster session 1: Wednesday 3 December 2014, 09:00-16:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu238] [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: 11/12/2022] Open
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31
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Haraguchi A, Fujishima K, Ando T, Mori F, Imaizumi M, Abiru N, Yamasaki H, Matsumoto K, Takamura N, Kawakami A. Multiple drug combination of anti-diabetic agents as a predictor for poor clinical response to liraglutide. MINERVA ENDOCRINOL 2014; 39:289-297. [PMID: 25371055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Aim of the study was to retrospectively analyze the clinical parameters that contribute to the therapeutic outcome of GLP-1 analogues. METHODS We enrolled 106 patients with type 2 diabetes mellitus (T2DM), treated with liraglutide (N.=69) or exenatide (N.=37) for longer than three months. The patients were divided into two groups: good responders and poor responders to GLP-1 analogues, based on pretreatment and post-treatment HbA1c levels. Good responders were those whose HbA1c level had decreased by 1% or more, or maintained at less than 7%. All other patients were categorized as poor responders. We used univariate and multivariate analyses to assess pretreatment parameters between the two groups. RESULTS Approximately 35% of the patients were poor responders. Our analysis of the pretreatment clinical parameters revealed that number of anti-diabetic agents and use of sulfonylurea were significantly associated with poor response to liraglutide (P=0.02 and P=0.03, respectively) in a multivariate analysis. We were not able to find any candidate related to clinical response to exenatide. CONCLUSION Our study showed that the therapeutic effects of GLP-1 analogues on T2DM patients were heterogeneous. T2DM patients who require multiple anti-diabetic agents, especially sulfonylurea, do not benefit from liraglutide treatment.
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Affiliation(s)
- A Haraguchi
- Division of Endocrinology and Metabolism Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan -
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Mori F, Toyoshima Y, Tanji K, Kakita A, Takahashi H, Wakabayashi K. FUS colocalizes with polyglutamine, but not with TDP-43 in neuronal intranuclear inclusions in spinocerebellar ataxia type 2. Neuropathol Appl Neurobiol 2014; 40:351-5. [DOI: 10.1111/nan.12075] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 07/08/2013] [Indexed: 11/29/2022]
Affiliation(s)
- F. Mori
- Department of Neuropathology; Institute of Brain Science; Hirosaki University Graduate School of Medicine; Hirosaki Japan
| | - Y. Toyoshima
- Department of Pathology; Brain Research Institute; University of Niigata; Niigata Japan
| | - K. Tanji
- Department of Neuropathology; Institute of Brain Science; Hirosaki University Graduate School of Medicine; Hirosaki Japan
| | - A. Kakita
- Department of Pathological Neuroscience; Center for Bioresource-based Researches; Brain Research Institute; University of Niigata; Niigata Japan
| | - H. Takahashi
- Department of Pathology; Brain Research Institute; University of Niigata; Niigata Japan
| | - K. Wakabayashi
- Department of Neuropathology; Institute of Brain Science; Hirosaki University Graduate School of Medicine; Hirosaki Japan
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Affiliation(s)
- F. Mori
- Allergy Unit, A. Meyer Children's Hospital, Department of Pediatrics, the University of Florence, Italy
| | - L. Pecorari
- S. Anna Hospital, Department of Pediatrics, Ferrara, Italy
| | - S. Pantano
- S. Salvatore Hospital, Department of Pediatrics, the University of Aquila, Italy
| | - M.E. Rossi
- Allergy Unit, A. Meyer Children's Hospital, Department of Pediatrics, the University of Florence, Italy
| | - N. Pucci
- Allergy Unit, A. Meyer Children's Hospital, Department of Pediatrics, the University of Florence, Italy
| | - M. De Martino
- Pediatric Infectivology, A. Meyer Children's Hospital, Department of Pediatrics, the University of Florence, Italy
| | - E. Novembre
- Allergy Unit, A. Meyer Children's Hospital, Department of Pediatrics, the University of Florence, Italy
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Ando T, Morimoto S, Mori F, Watanabe D, Seki Y, Niiyama M, Yoshida N, Ono M, Miki N, Ichihara A. CVD Therapy for Unresectable Pheochromocytoma. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Sacconi A, Biagioni F, Canu V, Mori F, Di Benedetto A, Lorenzon L, Ercolani C, Di Agostino S, Cambria AM, Germoni S, Grasso G, Blandino R, Panebianco V, Ziparo V, Federici O, Muti P, Strano S, Carboni F, Mottolese M, Diodoro M, Pescarmona E, Garofalo A, Blandino G. miR-204 targets Bcl-2 expression and enhances responsiveness of gastric cancer. Cell Death Dis 2012; 3:e423. [PMID: 23152059 PMCID: PMC3542596 DOI: 10.1038/cddis.2012.160] [Citation(s) in RCA: 146] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Micro RNAs (miRs) are small non-coding RNAs aberrantly expressed in human tumors. Here, we aim to identify miRs whose deregulated expression leads to the activation of oncogenic pathways in human gastric cancers (GCs). Thirty nine out of 123 tumoral and matched uninvolved peritumoral gastric specimens from three independent European subsets of patients were analyzed for the expression of 851 human miRs using Agilent Platform. The remaining 84 samples were used to validate miRs differentially expressed between tumoral and matched peritumoral specimens by qPCR. miR-204 falls into a group of eight miRs differentially expressed between tumoral and peritumoral samples. Downregulation of miR-204 has prognostic value and correlates with increased staining of Bcl-2 protein in tumoral specimens. Ectopic expression of miR-204 inhibited colony forming ability, migration and tumor engraftment of GC cells. miR-204 targeted Bcl-2 messenger RNA and increased responsiveness of GC cells to 5-fluorouracil and oxaliplatin treatment. Ectopic expression of Bcl-2 protein counteracted miR-204 pro-apoptotic activity in response to 5-fluorouracil. Altogether, these findings suggest that modulation of aberrant expression of miR-204, which in turn releases oncogenic Bcl-2 protein activity might hold promise for preventive and therapeutic strategies of GC.
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Affiliation(s)
- A Sacconi
- Translational Oncogenomic Unit, Italian National Cancer Institute Regina Elena, Rome, Italy
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Biagioni F, Sacconi A, Canu V, Mori F, Di Benedetto A, Lorenzon L, Di Agostino S, Cambria A, Germoni S, Grasso G, Blandino R, Panebianco V, Ziparo V, Federici O, Muti P, Strano S, Carboni F, Mottolese M, Diodoro M, Pescarmona E, Garofalo A, Blandino G. miRNA profiling of gastric tumors unveils tumor suppressor pathway. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.07.041] [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] Open
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Mori F, Tanji K, Kon T, Odagiri S, Hattori M, Hoshikawa Y, Kono C, Yasui K, Yokoi S, Hasegawa Y, Yoshida M, Wakabayashi K. FUS immunoreactivity of neuronal and glial intranuclear inclusions in intranuclear inclusion body disease. Neuropathol Appl Neurobiol 2012; 38:322-8. [PMID: 21883376 DOI: 10.1111/j.1365-2990.2011.01217.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AIMS Recent studies have shown that fused-in-sarcoma (FUS) protein is a component of 'neuronal' intranuclear inclusion bodies (INIBs) in the brains of patients with intranuclear inclusion body disease (INIBD). However, the extent and frequency of FUS-immunoreactive structures in INIBD are uncertain. METHODS We immunohistochemically examined the brain, spinal cord and peripheral ganglia from five patients with INIBD and five control subjects, using anti-FUS antibodies. RESULTS In controls, the nuclei of both neurones and glial cells were intensely immunolabelled with anti-FUS and neuronal cytoplasm was weakly positive for FUS. In INIBD, neuronal and glial INIBs in the brain and spinal cord were positive for FUS. FUS-positive INIBs were also found in the peripheral ganglia. The proportion of FUS-positive neuronal INIBs relative to the total number of inclusion-bearing neurones ranged from 55.6% to 83.3% (average 73.2%) and that of FUS-positive glial INIBs ranged from 45.9% to 85.7% (average 62.7%). The nucleus and cytoplasm of inclusion-bearing neurones and glial cells showed no FUS immunoreactivity. CONCLUSIONS These findings suggest that FUS is incorporated into INIBs in both neurones and glial cells and that loss of normal FUS immunoreactivity may result from reduced protein expression and/or sequestration within inclusions.
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Affiliation(s)
- F Mori
- Departments of Neuropathology Neuroanatomy, Cell Biology and Histology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
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Sopo SM, Giorgio V, Iacono ID, Novembre E, Mori F, Onesimo R. A multicentre retrospective study of 66 Italian children with food protein-induced enterocolitis syndrome: different management for different phenotypes. Clin Exp Allergy 2012; 42:1257-65. [DOI: 10.1111/j.1365-2222.2012.04027.x] [Citation(s) in RCA: 150] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S. Miceli Sopo
- Department of Pediatrics; University of Sacred Heart Agostino Gemelli Rome; Rome; Italy
| | - V. Giorgio
- Department of Pediatrics; University of Sacred Heart Agostino Gemelli Rome; Rome; Italy
| | - I. Dello Iacono
- Unit of Paediatrics; Fatebenefratelli Hospital; Benevento; Italy
| | - E. Novembre
- Allergy and Clinical Immunology Unit; Anna Meyer Children's Hospital; Department of Paediatrics; University of Florence; Florence; Italy
| | - F. Mori
- Allergy and Clinical Immunology Unit; Anna Meyer Children's Hospital; Department of Paediatrics; University of Florence; Florence; Italy
| | - R. Onesimo
- Department of Pediatrics; University of Sacred Heart Agostino Gemelli Rome; Rome; Italy
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Caputo R, Pucci N, Mori F, De Libero C, Di Grande L, Bacci G. Surgical Debridement Plus Topical Cyclosporine a in the Treatment and Vernal Shield Ulcers. Int J Immunopathol Pharmacol 2012; 25:775-80. [DOI: 10.1177/039463201202500326] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Vernal Keratoconjunctivitis (VKC) is a severe chronic bilateral inflammation of the ocular surface characterized by seasonal exacerbations. Long-term prognosis is generally good; however, 6% develop sequelae responsible for permanent visual impairment. Corneal involvement is almost always present, consisting of punctate keratitis, shield ulcers (3–11%) and late corneal neovascularization. In recent years, topical cyclosporine A preparations at 2% in oil or at 1% in polyvinyl alcohol, have been successfully proposed for long term VKC treatments. It has been previously proven that medical treatment is not always sufficient, especially when it is employed to treat shield ulcer plaques. In such conditions, surgery may be effective for avoiding long term complications such as amblyopia, strabismus, infections and corneal perforation. In this paper, we show the efficacy of surgical debridement by means of simple scraping associated with topical cyclosporine treatment for the management of vernal shield ulcers complicated with plaques.
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Affiliation(s)
- R. Caputo
- Pediatric Ophthalmology Unit, University of Florence, Italy
| | - N. Pucci
- Allergy and Clinical Immunology Unit Anna Meyer Children's Hospital, Department of Pediatrics, University of Florence, Italy
| | - F. Mori
- Allergy and Clinical Immunology Unit Anna Meyer Children's Hospital, Department of Pediatrics, University of Florence, Italy
| | - C. De Libero
- Pediatric Ophthalmology Unit, University of Florence, Italy
| | - L. Di Grande
- Allergy and Clinical Immunology Unit Anna Meyer Children's Hospital, Department of Pediatrics, University of Florence, Italy
| | - G.M. Bacci
- Pediatric Ophthalmology Unit, University of Florence, Italy
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Pefani E, Panoskaltsis N, Mantalaris A, Georgiadis MC, Pistikopoulos EN, Aguilar-Mahecha A, Lafleur J, Seguin C, Rosenbloom M, Przybytkowski E, Pelmus M, Diaz Z, Batist G, Basik M, Tavernier J, Brunet L, Bazot J, Chemelle M, Dalban C, Guiu S, di Martino C, Lehtio J, Branca M, Johansson H, Orre M, Granholm V, Forshed J, Perez-Bercoff M, Kall L, Nielsen KV, Andresen L, Muller S, Matthiesen S, Schonau A, Oktriani R, Wahyono A, Haryono S, Utomo A, Aryandono T, Diaz Z, Gagnon-Kugler T, Rousseau C, Aguilar-Mahecha A, Alcindor T, Aloyz R, Assouline S, Basik M, Bachvarov D, Belanger L, Camlioglu E, Cartillone M, Chabot B, Christodoulopoulos R, Courtemanche C, Constantin A, Benlimame N, Dao I, Dalfen R, Gosselin L, Habbab F, Hains M, Haliotis T, Nielsen TH, Joncas M, Kavan P, Klink R, Langlaben A, Lebel M, Lesperance B, Mann K, Masson J, Metrakos P, McNamara S, Miller WH, Orain M, Panasci L, Paquet E, Phillie M, Qureshi S, Rodrigue D, Salman A, Spatz A, Tetu B, Tosikyan A, Tsatoumas M, Vuong T, Batist G, Ruijtenbeek R, Houtman R, de Wijn R, Boender P, Hilhorst R, Cohen Y, Onn A, Lax A, Yosepovich A, Litz S, Kalish S, Felemovicius R, Hout-Silony G, Gutman M, Shabtai M, Rosin D, Valeanu A, Winkler E, Sklair-Levy M, Kaufman B, Barshack I, Canu V, Sacconi A, Biagioni F, Mori F, di Benedetto A, Lorenzon L, di Agostino S, Cambria A, Germoni S, Grasso G, Blandino R, Panebianco V, Ziparo V, Federici O, Muti P, Strano S, Carboni F, Mottolese M, Diodoro MG, Pescarmona E, Garofalo A, Blandino G, Ho T, Feng L, Lintula S, Orpana KA, Stenman J, El Messaoudi S, Mouliere F, del Rio M, Guedj AS, Gongora C, Molina FM, Lamy PJ, Lopez-Crapez E, Rolet F, Mathonnet M, Ychou M, Pezet D, Thierry AR, Manuarii M, Tredan O, Bachelot T, Clapisson G, Courtier A, Parmentier G, Rabeony T, Grives A, Perez S, Mouret JF, Perol D, Chabaud S, Ray-Coquard I, Labidi-Galy I, Heudel P, Pierga JY, Caux C, Blay JY, Pasqual N, Menetrier-Caux C. Technology & tools development. Ann Oncol 2012. [DOI: 10.1093/annonc/mds163] [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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Einert TR, Schmidt G, Binnig G, Balacescu O, Balacescu L, Rus M, Buiga R, Tudoran O, Todor N, Nagy V, Irimie A, Neagoe I, Yacobi R, Ustaev E, Berger RR, Barshack I, Kaur K, Henderson S, Cutts A, Domingo E, Woods J, Motley C, Dougherty B, Middleton M, Hassan B, Wang Y, Beasley E, Naley M, Schuh A, Tomlinson I, Taylor J, Planchard D, Lueza B, Rahal A, Lacroix L, Ngocamus M, Auger N, Saulnier P, Dorfmuller P, Le Chevalier T, Celebic A, Pignon JP, Soria JC, Besse B, Sun YH, Wang R, Li CG, Pan YJ, Chen HQ, Chouchane L, Shan J, Kizhakayil D, Aigha I, Dsouza S, Noureddine B, Gabbouj S, Mathew R, Hassen E, Chouchane L, Shan S, al-Rumaihi K, al-Bozom I, al-Said S, Rabah D, Farhat K, Kizhakayil D, Aigha I, Jakobsen Falk IA, Green KHZ, Lotfi K, Fyrberg A, Pejovic T, Li H, Mhawech-Fauceglia P, Hoatlin M, Guo MG, Huang M, Ge Y, Hess K, Wei C, Zhang W, Bogush TA, Dudko EA, Nureev MV, Kamensky AA, Polotsky BE, Tjulandin SA, Davydov MI, Caballero M, Hasmats J, Green H, Quanz M, Buhler C, Sun JS, Dutreix M, Cebotaru CL, Buiga R, Placintar AN, Ghilezan N, Balogh ZB, Reiniger L, Rajnai H, Csomor J, Szepesi A, Balogh A, Deak L, Gagyi E, Bodor C, Matolcsy A, Bozhenko VK, Rozhkova NI, Kudinova EA, Bliznyukov OP, Vaskevich EN, Trotsenko ID, Bozhenko VK, Rozhkova NI, Kharchenko NV, Kudinova EA, Bliznyukov OP, Kiandarian IV, Trotsenko ID, Pulito C, Terrenato I, Sacconi A, Biagioni F, Mottolese M, Blandino G, Muti P, Falvo E, Strano S, Mori F, Sacconi A, Ganci F, Covello R, Zoccali C, Biagini R, Blandino G, Strano S, Palmer GA, Wegdam W, Meijer D, Kramer G, Langridge J, Moerland PD, de Jong SM, Vissers JP, Kenter GG, Buist MR, Aerts JMFG, Milione M, de Braud F, Buzzoni R, Pusceddu S, Mazzaferro V, Damato A, Pelosi G, Garassino M, de Braud F, Broggini M, Marabese M, Veronese S, Ganzinelli M, Martelli O, Ganci F, Bossel N, Sacconi A, Fontemaggi G, Manciocco V, Sperduti I, Falvo E, Strigari L, Covello R, Muti P, Strano S, Spriano G, Domany E, Blandino G, Donzelli S, Sacconi A, Bellissimo T, Alessandrini G, Strano S, Carosi MA, Pescarmona E, Facciolo F, Telera S, Pompili A, Blandino G, de Vriendt V, de Roock W, di Narzo AF, Tian S, Biesmans B, Jacobs B, de Schutter J, Budzinska E, Sagaert X, Delorenzi M, Simon I, Tejpar S, Zhu Y, Wang HK, Ye DW, Denisov E, Tsyganov M, Tashireva L, Zavyalova M, Perelmuter V, Cherdyntseva N, Kim YC, Jang T, Oh IJ, Kim KS, Ban H, Na KJ, Ahn SJ, Kang H, Kim WJ, Park C, Abousamra NK, El-Din MS, Azmy EA. Diagnostics. Ann Oncol 2012. [DOI: 10.1093/annonc/mds161] [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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Mori F, Tanji K, Miki Y, Nishijima H, Baba M, Kurotaki H, Wakabayashi K. Status epilepticus associated with extensive axonal swelling in the unilateral cerebral cortex and hippocampus. Neuropathol Appl Neurobiol 2012; 38:387-90. [DOI: 10.1111/j.1365-2990.2011.01223.x] [Citation(s) in RCA: 4] [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: 11/27/2022]
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Mori F, Kusayanagi H, Buttari F, Nicoletti CG, Bernardi G, Centonze D. Glatiramer Acetate Reverses Plasticity and Cognitive Deficits Associated with Acute Inflammation in MS (P04.118). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.118] [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: 11/15/2022] Open
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Gong L, Ye Z, Zeng Z, Xia M, Zhong Y, Yao Y, Lee E, Ionescu A, Dwivedi G, Mahadevan G, Jiminez D, Frenneaux M, Steeds R, Moore C, Samad Z, Jackson K, Castellucci J, Kisslo J, Von Ramm O, D'ascenzi F, Zaca' V, Cameli M, Lisi M, Natali B, Malandrino A, Mondillo S, Barbier P, Guerrini U, Franzosi M, Castiglioni L, Nobili E, Colazzo F, Li Causi T, Sironi L, Tremoli E, Clausen H, Macdonald S, Basaggianis C, Newton J, Cameli M, Lisi M, Bennati E, Reccia R, Malandrino A, Bigio E, Maccherini M, Chiavarelli M, Henein M, Mondillo S, Floria M, Jamart J, Arsenescu Georgescu C, Mantovani F, Barbieri A, Bursi F, Valenti C, Quaglia M, Modena M, Kutty S, Gribben P, Padiyath A, Polak A, Scott C, Waiss M, Danford D, Bech-Hanssen O, Selimovic N, Rundqvist B, Schmiedel L, Hohmann C, Katzke S, Haacke K, Rauwolf T, Strasser R, Tumasyan LR, Adamyan K, Kosmala W, Derzhko R, Przewlocka-Kosmala M, Mysiak A, Stachowska B, Jedrzejuk D, Bednarek-Tupikowska G, Chrzanowski L, Kasprzak J, Wojciechowska C, Wita K, Busz-Papiez B, Gasior Z, Mizia-Stec K, Kukulski T, Gosciniak P, Sinkiewicz W, Moelmen H, Stoylen A, Thorstensen A, Torp H, Dalen H, Groves A, Nicholson G, Lopez L, Goh CW, Ahn H, Byun Y, Kim J, Park J, Lee J, Park J, Kim B, Rhee K, Kim K, Park J, Yoon H, Hong Y, Park H, Kim J, Ahn Y, Jeong M, Cho J, Kang J, Grapsa J, Dawson D, Karfopoulos K, Jakaj G, Punjabi P, Nihoyannopoulos P, Ruisanchez Villar C, Lerena Saenz P, Gonzalez Vilchez F, Gonzalez Fernandez C, Zurbano Goni F, Cifrian Martinez J, Mons Lera R, Ruano Calvo J, Martin Duran R, Vazquez De Prada Tiffe J, Pietrzak R, Werner B, Voillot D, Huttin O, Zinzius P, Schwartz J, Sellal J, Lemoine S, Christophe C, Popovic B, Juilliere Y, Selton-Suty C, Ishii K, Furukawa A, Nagai T, Kataoka K, Seino Y, Shimada K, Yoshikawa J, Tekkesin A, Yildirimturk O, Tayyareci Y, Yurdakul S, Aytekin S, Jaroch J, Loboz-Grudzien K, Bociaga Z, Kowalska A, Kruszynska E, Wilczynska M, Dudek K, Kakihara R, Naruse C, Hironaka H, Tsuzuku T, Cucchini U, Muraru D, Badano L, Solda' E, Tuveri M, Al Nono O, Sarais C, Iliceto S, Santos L, Cortez-Dias N, Ribeiro S, Goncalves S, Jorge C, Carrilho-Ferreira P, Silva D, Silva-Marques J, Lopes M, Diogo A, Hristova K, Vassilev D, Pavlov P, Katova T, Simova I, Kostova V, Esposito R, Santoro A, Schiano Lomoriello V, Raia R, De Palma D, Dores E, De Simone G, Galderisi M, Zaborska B, Makowska E, Pilichowska E, Maciejewski P, Bednarz B, Wasek W, Stec S, Budaj A, Spinelli L, Morisco C, Assante Di Panzillo E, Crispo S, Di Marino S, Trimarco B, Santoro A, Schiano Lomoriello V, Esposito R, Farina F, Innelli P, Rapacciuolo A, Galderisi M, Polgar B, Banyai F, Rokusz L, Tomcsanyi I, Vaszily M, Nieszner E, Borsanyi T, Kerecsen G, Preda I, Kiss RG, Bull S, Suttie J, Augustine D, Francis J, Karamitsos T, Becher H, Prendergast B, Neubauer S, Myerson S, Lodge F, Broyd C, Milton P, Mikhail G, Mayet J, Davies J, Francis D, Clavel MA, Ennezat PV, Marechaux S, Dumesnil J, Bellouin A, Bergeron S, Meimoun P, Le Tourneau T, Pasquet A, Pibarot P, Herrmann S, Stoerk S, Niemann M, Hu K, Voelker W, Ertl G, Weidemann F, Tayyareci Y, Yurdakul S, Yildirimturk O, Aytekin V, Aytekin S, Kogoj P, Ambrozic J, Bunc M, Di Salvo G, Rea A, Castaldi B, Gala S, D'aiello A, Mormile A, Pisacane F, Pacileo G, Russo M, Calabro R, Nguyen L, Ricksten SE, Jeppsson A, Schersten H, Bech-Hanssen O, Boerlage-Van Dijk K, Yong Z, Bouma B, Koch K, Vis M, Piek J, Baan J, Scandura S, Ussia G, Caggegi A, Cammalleri V, Sarkar K, Mangiafico S, Chiaranda' M, Imme' S, Pistritto A, Tamburino C, Ring L, Nair S, Wells F, Shapiro L, Rusk R, Rana B, Madrid Marcano G, Solis Martin J, Gonzalez Mansilla A, Bravo L, Menarguez Palanca C, Munoz P, Bouza E, Yotti R, Bermejo Thomas J, Fernandez Aviles F, Tamayo T, Denes M, Balint O, Csepregi A, Csillik A, Erdei T, Temesvari A, Fernandez-Pastor J, Linde-Estrella A, Cabrera-Bueno F, Pena-Hernandez J, Barrera-Cordero A, Alzueta-Rodriguez F, De Teresa-Galvan E, Merlo M, Pinamonti M, Finocchiaro G, Pyxaras S, Barbati G, Buiatti A, Dilenarda A, Sinagra G, Kuperstein R, Freimark D, Hirsch S, Feinberg M, Arad M, Mitroi C, Garcia Lunar I, Monivas Palomero V, Mingo Santos S, Beltran Correas P, Gonzalez Lopez E, Garcia Pavia P, Gonzalez Mirelis J, Cavero Gibanel M, Alonso Pulpon L, Finocchiaro G, Pinamonti B, Merlo M, Barbati G, Dilenarda A, Sinagra G, Zaidi A, Ghani S, Sheikh N, Gati S, Howes R, Sharma R, Sharma S, Calcagnino M, O'mahony C, Coats C, Cardona M, Garcia A, Murphy E, Lachmann R, Mehta A, Hughes D, Elliott P, Di Bella G, Madaffari A, Donato R, Mazzeo A, Casale M, Zito C, Vita G, Carerj S, Marek D, Indrakova J, Rusinakova Z, Skala T, Kocianova E, Taborsky M, Musca F, De Chiara B, Belli O, Cataldo S, Brunati C, Colussi G, Quattrocchi G, Santambrogio G, Spano F, Moreo A, Rustad L, Nytroen K, Gullestad L, Amundsen B, Aakhus S, Maroz-Vadalazhskaya N, Shumavetc V, Kurganovich S, Seljun Y, Ostrovskiy A, Ostrovskiy Y, Rustad L, Nytroen K, Segers P, Amundsen B, Aakhus S, Przewlocka-Kosmala M, Orda A, Karolko B, Mysiak A, Driessen MMP, Eising JB, Uiterwaal C, Van Der Ent CK, Meijboom FJ, Shang Q, Tam L, Sun J, Sanderson J, Zhang Q, Li E, Yu C, Arroyo Ucar E, De La Rosa Hernandez A, Hernandez Garcia C, Jorge Perez P, Lacalzada Almeida J, Jimenez Rivera J, Duque Garcia A, Barragan Acea A, Laynez Cerdena I, Kaldararova M, Simkova I, Pacak J, Tittel P, Masura J, Tadic M, Ivanovic B, Zlatanovic M, Damjanov N, Maggiolini S, Gentile G, Bozzano A, Suraci S, Meles E, Carbone C, Tempesta A, Malafronte C, Piatti L, Achilli F, Luijendijk P, Stevens A, De Bruin-Bon H, Vriend J, Van Den Brink R, Vliegen H, Mulder B, Bouma B, Chow V, Ng A, Chung T, Kritharides L, Iancu M, Serban M, Craciunescu I, Hodo A, Ghiorghiu I, Popescu B, Ginghina C, Styczynski G, Szmigielski CA, Kaczynska A, Leszczynski J, Rosinski G, Kuch-Wocial A, Slavich M, Ancona M, Fisicaro A, Oppizzi M, Marone E, Bertoglio L, Melissano G, Margonato A, Chiesa R, Agricola E, Zito C, Mohammed M, Cusma-Piccione M, Piluso S, Arcidiaco S, Nava R, Giuffre R, Ciraci L, Ferro M, Carerj S, Uusitalo V, Luotolahti M, Pietila M, Wendelin-Saarenhovi M, Hartiala J, Saraste M, Knuuti J, Saraste A, Kochanowski J, Scislo P, Piatkowski R, Grabowski M, Marchel M, Roik M, Kosior D, Opolski G, Bartko PE, Graf S, Khorsand A, Rosenhek R, Burwash I, Beanlands R, Clavel MA, Baumgartner H, Pibarot P, Mundigler G, Kudrnova S, Apor A, Huttl H, Kudrnova S, Apor A, Huttl H, Mori F, Santoro G, Oddo A, Rosso G, Meucci F, Pieri F, Squillantini G, Gensini G, Scislo P, Kochanowski J, Piatkowski R, Roik M, Postula M, Opolski G, Park DG, Hong JY, Kim SE, Lee JH, Han KR, Oh DJ, Muraru D, Dal Bianco L, Beraldo M, Solda' E, Cucchini U, Peluso D, Tuveri M, Al Mamary A, Badano L, Iliceto S, Aggeli C, Felekos I, Poulidakis E, Pietri P, Roussakis G, Siasos G, Stefanadis C, Furukawa A, Hoshiba H, Miyasaka C, Sato H, Nagai T, Yamanaka A, Kataoka K, Seino Y, Ishii K, Lilli A, Baratto M, Magnacca M, Comella A, Poddighe R, Talini E, Canale M, Chioccioli M, Del Meglio J, Casolo G, Kuznetsov VA, Melnikov NN, Krinochkin DV, Calin A, Enache R, Popescu B, Beladan C, Rosca M, Lupascu L, Purcarea F, Calin C, Gurzun M, Ginghina C, Dulgheru R, Ciobanu A, Magda S, Mihaila S, Rimbas R, Margulescu A, Cinteza M, Vinereanu D, Sumin AN, Arhipov O, Yoon J, Moon J, Rim S, Nyktari E, Patrianakos A, Solidakis G, Psathakis E, Parthenakis F, Vardas P, Kordybach M, Kowalski M, Kowalik E, Hoffman P, Nagy KV, Kutyifa V, Edes E, Apor A, Merkely B, Gerlach A, Rost C, Schmid M, Rost M, Flachskampf F, Daniel W, Breithardt O, Altekin E, Karakas S, Yanikoglu A, Er A, Baktir A, Demir I, Deger N, Klitsie L, Hazekamp M, Roest A, Van Der Hulst A, Gesink- Van Der Veer B, Kuipers I, Blom N, Ten Harkel A, Farsalinos K, Tsiapras D, Kyrzopoulos S, Avramidou E, Vasilopoulou D, Voudris V, Werner B, Florianczyk T, Ivanovic B, Tadic M, Kalinowski M, Szulik M, Streb W, Rybus-Kalinowska B, Sliwinska A, Stabryla J, Kukla M, Nowak J, Kukulski T, Kalarus Z, Florescu M, Mihalcea D, Magda L, Suran B, Enescu O, Mincu R, Cinteza M, Vinereanu D, Salerno G, Scognamiglio G, D'andrea A, Dinardo G, Gravino R, Sarubbi B, Disalvo G, Pacileo G, Russo M, Calabro R, Liao JN, Sung S, Chen C, Park S, Shin S, Kim M, Shim S, Yildirimturk O, Helvacioglu F, Ulusoy O, Duran C, Tayyareci Y, Yurdakul S, Aytekin S, Kirschner R, Simor T, Moreo A, Ambrosio G, De Chiara B, Tran T, Raman S, Vidal Perez RC, Carreras F, Leta R, Pujadas S, Barros A, Hidalgo A, Alomar X, Pons-Llado G, Olofsson M, Boman K, Ledakowicz-Polak A, Polak L, Zielinska M, Fontana A, Schirone V, Mauro A, Zambon A, Giannattasio C, Trocino G, Dekleva M, Dungen H, Inkrot S, Gelbrich G, Suzic Lazic J, Kleut M, Markovic Nikolic N, Waagstein F, Khoor S, Balogh N, Simon I, Fugedi K, Kovacs I, Khoor M, Florian G, Kocsis A, Szuszai T, O'driscoll J, Saha A, Smith R, Gupta S, Sharma R, Lenkey Z, Gaszner B, Illyes M, Sarszegi Z, Horvath IG, Magyari B, Molnar F, Cziraki A, Elnoamany MF, Badran H, Ebraheem H, Reda A, Elsheekh N. Poster Session 5: Saturday 10 December 2011, 08:30-12:30 * Location: Poster Area. European Journal of Echocardiography 2011. [DOI: 10.1093/ejechocard/jer218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Fiorentino C, Motta C, Wolosinska DT, Monti S, Mori F, Toscano V. SOM230 in Cushing's disease complicated by poorly controlled diabetes mellitus. J Endocrinol Invest 2011; 34:731-2. [PMID: 22156906 DOI: 10.1007/bf03345407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rossi S, Mancino R, Bergami A, Mori F, Castelli M, De Chiara V, Studer V, Mataluni G, Sancesario G, Parisi V, Kusayanagi H, Bernardi G, Nucci C, Bernardini S, Martino G, Furlan R, Centonze D. Potential role of IL-13 in neuroprotection and cortical excitability regulation in multiple sclerosis. Mult Scler 2011; 17:1301-12. [PMID: 21677024 DOI: 10.1177/1352458511410342] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Inflammation triggers secondary neurodegeneration in multiple sclerosis (MS). OBJECTIVES It is unclear whether classical anti-inflammatory cytokines have the potential to interfere with synaptic transmission and neuronal survival in MS. METHODS Correlation analyses between cerebrospinal fluid (CSF) contents of anti-inflammatory cytokines and molecular, imaging, clinical, and neurophysiological measures of neuronal alterations were performed. RESULTS Our data suggest that interleukin-13 (IL-13) plays a neuroprotective role in MS brains. We found, in fact, that the levels of IL-13 in the CSF of MS patients were correlated with the contents of amyloid-β(1-42). Correlations were also found between IL-13 and imaging indexes of axonal and neuronal integrity, such as the retinal nerve fibre layer thickness and the macular volume evaluated by optical coherence tomography. Furthermore, the levels of IL-13 were related to better performance in the low-contrast acuity test and Multiple Sclerosis Functional Composite scoring. Finally, by means of transcranial magnetic stimulation, we have shown that GABAA-mediated cortical inhibition was more pronounced in patients with high IL-13 levels in the CSF, as expected for a neuroprotective, anti-excitotoxic effect. CONCLUSIONS The present correlation study provides some evidence for the involvement of IL-13 in the modulation of neuronal integrity and synaptic function in patients with MS.
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Affiliation(s)
- S Rossi
- Dipartimento di Neuroscienze, Università Tor Vergata, Rome, Italy
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Mori F, Rossi S, Bergami A, Kusayanagi H, Mancino R, Martino G, Furlan R, Centonze D. P18.4 IL-13, neuroprotection and cortical excitability in multiple sclerosis. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60494-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Pucci N, Caputo R, Mori F, De Libero C, Di Grande L, Massai C, Bernardini R, Novembre E. Long-Term Safety and Efficacy of Topical Cyclosporine in 156 Children with Vernal Keratoconjunctivitis. Int J Immunopathol Pharmacol 2010; 23:865-71. [DOI: 10.1177/039463201002300322] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Vernal keratoconjunctivitis (VKC) is a chronic and potentially sight-threatening disease. Topical corticosteroids (Cs) seem to be the only effective treatment for this condition, although severe side effects may occur owing to their prolonged use. More recently, cyclosporine (Cyc) eye drops have been reported as a valid alternative, but so far such treatment has only been successfully experimented for a short time and in small numbers of patients. The aim of our study is to evaluate the long term safety and efficacy of topical cyclosporine eye drops in children suffering from VKC. Over a period of 7 years we followed a large group of children suffering from severe VKC. They were selected to start cyclosporine eye drop treatment, because of the prompt relapse of their disease as soon as they stopped topical corticosteroids administration. All patients were followed-up in an ambulatory care assessment. A total of 156 children with VKC were treated with topical cyclosporine eye drops over a period ranging from two to seven years [mean time 3.8±1.09 years] during the seasonal relapse [range 9–66 months; mean time 24.7±10.4 months]. Two formulations, at 1% and 2% (82% and 18% respectively) concentrations, of cyclosporine eye drops were made. The dosage administered was one drop in each eye from two to four times a day, depending on the severity of the disease and the season. The ocular objective scores were determined and compared every year, at the beginning and at the end of each treatment period. Blood samples were collected once a year in order to check both kidney and liver functions, as well as cyclosporine serum levels. We enrolled 156 patients (mean age 8.31±2.79 years; 116 males and 40 females) who were followed-up over a period of 7 years [156 (100%) children during the first and the second year; 138 (88.5%) patients until the third year; 90 (57.7%) until the fourth year; 32 (20.5%) until the fifth year; 10 (6.4%) until the sixth year and 2 (1.3%) until the seventh year]. The ocular objective scores significantly improved (p<.001) over the years when comparing them at the beginning and the end of each seasonal treatment period, except for the last year. Over the treatment period, non-significant changes were recorded in terms of kidney and liver enzymatic activities and also in terms of cyclosporine serum levels. Cyclosporine eye drops, either at 1% or 2% concentrations, resulted safe and effective for long-term treatment of VKC in 156 children. The lack of significance of the score results during the seventh year can be explained by the small number of subjects treated for such a long period. A systematic ocular examination and both liver and kidney functional investigations allowed us to exclude the possibility of local or systemic side effects due to cyclosporine. If either transient or long-lasting, the occurrence of burning was referred by some of the patients treated, but none of them required to discontinue the drug. In conclusion, this is the first study showing that topical cyclosporine is easily handled even by children, with safe and effective results even when it is used over a long period of time. Our findings, though encouraging, need to be confirmed by further studies.
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Affiliation(s)
| | - R. Caputo
- Clinical Ophthalmology Unit, Anna Meyer Children's Hospital, Department of Pediatrics, University of Florence, Italy
| | | | - C. De Libero
- Clinical Ophthalmology Unit, Anna Meyer Children's Hospital, Department of Pediatrics, University of Florence, Italy
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Ri M, Iida S, Nakashima T, Miyazaki H, Mori F, Ito A, Inagaki A, Kusumoto S, Ishida T, Komatsu H, Shiotsu Y, Ueda R. Bortezomib-resistant myeloma cell lines: a role for mutated PSMB5 in preventing the accumulation of unfolded proteins and fatal ER stress. Leukemia 2010; 24:1506-12. [PMID: 20555361 DOI: 10.1038/leu.2010.137] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Bortezomib is an effective agent for treating multiple myeloma (MM). To investigate the underlying mechanisms associated with acquired resistance to this agent, we established two bortezomib-resistant MM cell lines, KMS-11/BTZ and OPM-2/BTZ, the 50% inhibitory concentration values of which were respectively 24.7- and 16.6-fold higher than their parental cell lines. No activation of caspase and BH3-only proteins such as Noxa was noted in bortezomib-resistant cells after exposure to the drug. The accumulation of polyubiquitinated proteins was reduced in bortezomib-resistant cells compared with the parental cells, associated with avoidance of catastrophic ER stress as assessed by downregulation of CHOP expression. These resistant MM cells have a unique point mutation, G322A, in the gene encoding the proteasome beta5 subunit (PSMB5), likely resulting in conformational changes to the bortezomib-binding pocket of this subunit. KMS-11 parental cells transfected to express mutated PSMB5 also showed reduced bortezomib-induced apoptosis compared with those expressing wild-type PSMB5 or the parental cells. Expression of mutated PSMB5 was associated with the prevention of the accumulation of unfolded proteins. Thus, a fraction of MM cells may acquire bortezomib resistance by suppressing apoptotic signals through the inhibition of unfolded protein accumulation and subsequent excessive ER stress by a mutation of the PSMB5 gene.
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Affiliation(s)
- M Ri
- Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
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Mori F, Tanji K, Miki Y, Kakita A, Takahashi H, Wakabayashi K. Relationship between Bunina bodies and TDP-43 inclusions in spinal anterior horn in amyotrophic lateral sclerosis. Neuropathol Appl Neurobiol 2010; 36:345-52. [DOI: 10.1111/j.1365-2990.2010.01081.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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