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Patel V, Patel J, Gan J, Rahiminejad M, Preston R, Mak SM, Benedetti G. Reporting of coronary artery calcification on chest CT studies in patients with interstitial lung disease. Clin Radiol 2024; 79:e532-e538. [PMID: 38242805 DOI: 10.1016/j.crad.2023.11.028] [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: 04/26/2023] [Revised: 11/03/2023] [Accepted: 11/29/2023] [Indexed: 01/21/2024]
Abstract
AIM To evaluate the prevalence of coronary artery calcification (CAC) on non-contrast computed tomography (CT) of the thorax in patients with interstitial lung disease (ILD), assess consistency of CAC reporting and assess incidence of subsequent cardiac events. MATERIALS AND METHODS Patients with known interstitial lung disease who underwent a CT thorax over a 2-year period were retrospectively reviewed. Presence of CAC was assessed using a visual scale for CAC reporting and graded as mild, moderate, or severe by two cardiothoracic radiologists. CT reports were reviewed to determine if presence of CAC had been described. Electronic medical records were reviewed for any subsequent cardiothoracic events from the date of the CT thorax to present. RESULTS 254 patients were included in the analysis (54.7% men; mean age 59.9 yo). 43.7% had CAC on their CT thorax; however, in 87.3% of those, reports did not comment on its presence. 8 patients had cardiac events; 7 of them had CAC on CT although only in 1 case this was reported. Global CAC and LAD CAC Patients with cardiac events had a significantly higher global CAC (p=0.016) and LAD CAC (p=0.048) when compared to patients without. CONCLUSION We demonstrated a high prevalence of CAC in ILD patients and its significant association with adverse cardiac events. Unfortunately, CAC on CT thorax is still largely unreported. As per recent BSCI/BSCCT and BSTI guidelines, reporting of CAC should become part of routine practice, as may prompt prevention and impact on patients outcome.
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Affiliation(s)
- V Patel
- The Royal Marsden, Fulham Road, London, SW3 6JJ, UK
| | - J Patel
- Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK
| | - J Gan
- Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK
| | - M Rahiminejad
- National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK
| | - R Preston
- Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK
| | - S M Mak
- Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK
| | - G Benedetti
- Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.
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Lechiancole A, Sponga S, Vendramin I, Ferrara V, Benedetti G, Guzzi G, Nalli C, Nora CD, Calandruccio R, Brindicci Y, Bressan M, Livi U. Graft Preservation in Heart Transplantation: Clinical and Histological Results Using Three Different Techniques. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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3
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Vitacca M, Paneroni M, Fracassi M, Mandora E, Cerqui L, Benedetti G, Zanoni C, Pluda A, Bertacchini L, Fiorenza D. Inhaler technique knowledge and skills before and after an educational program in obstructive respiratory disease patients: A real-life pilot study. Pulmonology 2023; 29:130-137. [PMID: 33268032 DOI: 10.1016/j.pulmoe.2020.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/10/2020] [Accepted: 04/01/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION AND OBJECTIVE Patients present poor knowledge and skills about their respiratory disease and inhaler device. We aimed to: (1) evaluate COPD and asthmatic patients... ability to manage inhaled drugs (2) identify differences among devices and (3) correlate clinical data with patient ability. MATERIAL AND METHODS Patients (n=134) admitted for pulmonary rehabilitation (PR) were given an ad-hoc questionnaire covering 0% as the worst and 100% the best value of global ability (indicating the sum of knowledge and skills in managing inhaled drugs) at baseline (T0) and discharge (T1). Educational program was provided during PR. Setting of rehabilitation, age, sex, diagnosis, spirometry, CIRS score, level of autonomy to use medications, if na..ve about PR, educational level, and number/type of prescribed inhaled drugs were recorded. RESULTS Most patients used 1 drug while 37% used 2 drugs. DPIs were the main device prescribed. At baseline, patients... mean level of knowledge and skills were 73% and 58%, respectively. There was a significant difference in level of skills (p=0.046) among device families, DPIs resulting worst and pMDIs best. Global ability, skills and knowledge improved after educational support (p<0.001) but did not reach the optimal level, 88%, 87% and 89%, respectively. Baseline global ability was positively correlated to female gender, younger age, previous PR access, outpatient status, higher education level and GOLD D class. CONCLUSIONS At hospital admission, global ability was not optimal. Education may improve this, irrespective of the type of device used, in particular in male, elderly, na..ve to PR, low educational level patients.
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Affiliation(s)
- M Vitacca
- Respiratory Rehabilitation of the Institute of Lumezzane. Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy.
| | - M Paneroni
- Respiratory Rehabilitation of the Institute of Lumezzane. Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - M Fracassi
- Respiratory Rehabilitation of the Institute of Lumezzane. Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - E Mandora
- Respiratory Rehabilitation of the Institute of Lumezzane. Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - L Cerqui
- Respiratory Rehabilitation of the Institute of Lumezzane. Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - G Benedetti
- Respiratory Rehabilitation of the Institute of Lumezzane. Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - C Zanoni
- Respiratory Rehabilitation of the Institute of Lumezzane. Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - A Pluda
- Respiratory Rehabilitation of the Institute of Lumezzane. Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - L Bertacchini
- Respiratory Rehabilitation of the Institute of Lumezzane. Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - D Fiorenza
- Respiratory Rehabilitation of the Institute of Lumezzane. Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
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4
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Valdi G, Ferrara V, Marinoni M, Nalli C, Di Nora C, Sponga S, Benedetti G, Parpinel M, Livi U, Moretti V. A dietary intervention study to reduce Metabolic Syndrome risks in heart-transplanted patients. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Since heart transplantation (HTx) has become the gold standard therapy in end-staged heart failure, many factors, including metabolic syndrome (MS), represent a burden in HTx patients. Considering key role of immunosuppressive therapy and its side effects on the appearance of MS, we focused on modifiable factors including adherence to Mediterranean Diet (MD) and improvement of dietary habits.
Methods
21 heart-transplanted patients were enrolled and randomized in a control group (CG; N 10) and an intervention group (IG; N 11). During two meetings (baseline, 6-month follow-up) were administered a validated Food Frequency Questionnaire (FFQ), to assess adherence to MD, and collected clinical and anthropometric parameters, IG were additionally requested to fill a food diary. IG received personalized advices, CG received standard recommendations. Comparison between IG and CG were analyzed, differences into the IG were also assessed.
Results
The prevalence of MS at baseline was 46% in IG and 20% in CG. During 6-month follow-up, significant lower blood pressure values were observed (median, 25th-75th: systolic 130, 120-130 IG vs 145, 130-147 CG; p = 0.004). Seven patients of IG underwent a 12-month meeting. In this group MD scores increased significantly (7 + 1.3 vs 4 + 1.5, p = 0.001). Furthermore, significant decrease of fat mass percentage (%) (23.3 + 6.3 vs 14.8 + 10.1, p = 0.014), increase of fat free mass % (76 + 6.3 vs 85.2 + 10.1, p = 0.014) and increase of body cell mass % (50.9 + 3.8 vs 53.4 + 3.4, p = 0.031) were observed. Dietary data in IG showed significant decrease of energy from saturated fatty acids % (13.0±2.1 vs 9.6±1.5, p = 0.001), sodium (mg) (2138±359 vs 1822±417, p = 0.045), and decreasing trend for cholesterol (mg) (219±82 vs 171±59, p = 0.082).
Conclusions
Dietary intervention based on MD perhaps can improve MS risks in heart-transplanted patients. Further investigations may be needed to assess the fundamental role of a structured nutritional follow-up in these patients.
Key messages
• Personalized nutritional advices based on the MD, compared to general recommendation, can significantly improve health and quality of life in heart-transplanted patients.
• A structured nutritional follow-up for heart-transplanted patients may be desirable to prevent risks of Metabolic Syndrome as a public health instrument in selected categories as these patients.
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Affiliation(s)
- G Valdi
- DAME, Università di Udine , Udine, Italy
| | - V Ferrara
- DAME, Università di Udine , Udine, Italy
- Cardiothoracic Department, Friuli Centrale Healthcare and University Trust , Udine, Italy
| | - M Marinoni
- DAME, Università di Udine , Udine, Italy
| | - C Nalli
- Cardiothoracic Department, Friuli Centrale Healthcare and University Trust , Udine, Italy
| | - C Di Nora
- Cardiothoracic Department, Friuli Centrale Healthcare and University Trust , Udine, Italy
| | - S Sponga
- DAME, Università di Udine , Udine, Italy
- Cardiothoracic Department, Friuli Centrale Healthcare and University Trust , Udine, Italy
| | - G Benedetti
- Cardiothoracic Department, Friuli Centrale Healthcare and University Trust , Udine, Italy
| | - M Parpinel
- DAME, Università di Udine , Udine, Italy
| | - U Livi
- DAME, Università di Udine , Udine, Italy
- Cardiothoracic Department, Friuli Centrale Healthcare and University Trust , Udine, Italy
| | - V Moretti
- DAME, Università di Udine , Udine, Italy
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5
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Ferrara V, Sponga S, Marinoni M, Valdi G, Di Nora C, Nalli C, Benedetti G, Lechiancole A, Parpinel M, Livi U. C54 METABOLIC SYNDROME IN HEART TRANSPLANTATION: AN UNDERESTIMATED RISK FACTOR? Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac011.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background and Aims
Metabolic Syndrome (MS) is a multifactorial condition that increases the risk of cardio–vascular events, it’s frequent in Heart transplant (HTx) candidates and worsens with immunosuppressive therapy.
Aim of the study was to analyse the impact of MS on long–term outcome of HTx patients in our centre.
Methods
MS was defined through the presence of at least 3 of the following factors: Triglyceride ≥150mg/dl or drug treatment for hypertriglyceridemia HDL <40mg/dl for men and <50mg/dl for women Blood glucose ≥100mg/dl or diabetes mellitus Arterial pressure ≥130/80 or hypertensive drug treatment BMI>30. In 349 HTx patients since 2007, mortality and morbidity predictors were evaluated.
Results
MS was present in 35% of patients pre–HTx and 47% within the first year of follow–up. Five–year survival in patients with pre–HTx MS was worst (65% vs 78%, p < 0.01), as well as in those with MS in the first year of follow–up (78% vs 89%, p < 0.01). At the univariate analysis, risk factors for mortality were recipient age (HR 1.07, 1.04–1.09, p < 0.01), pre–HTx MS (HR 1.86, 1.29–2.69, p < 0.01), pre–HTx hypertension (HR 2.46, 1.70–3.55, p < 0.01), pre–HTx hypertriglyceridemia (HR 1.50, 1.04–2.18, p = 0.03), chronic renal failure (HR 2.95, 2.03–4.27, p < 0.01), MS and diabetes at 1–year follow–up (HR 2.00, 1.25–3.19, p < 0.01; HR 2.02, 1.27–3.23, p < 0.01, respectively). The last two resulted also risk factors for CAV (HR 1.86, 1.16–2.99, p = 0.01; HR 1.67, 1.03–2.69, p = 0.04, respectively). MS at 1–year follow–up determined a significant higher risk to develop CAV at 5– and 10–year follow–up, compared to patients without MS (25% vs 14% and 44% vs 25%, p < 0.01).
Conclusions
MS is an important risk factor for both mortality and morbidity post–HTx, suggesting the need for a strict monitoring of metabolic disorders with a careful nutritional follow–up in HTx patients.
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Affiliation(s)
- V Ferrara
- DIPARTIMENTO DI AREA MEDICA, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO CARDIOTORACICO, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DOPARTIMENTO DI IGIENE E PREVENZIONE, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E PREVENZIONE,AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E P
| | - S Sponga
- DIPARTIMENTO DI AREA MEDICA, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO CARDIOTORACICO, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DOPARTIMENTO DI IGIENE E PREVENZIONE, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E PREVENZIONE,AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E P
| | - M Marinoni
- DIPARTIMENTO DI AREA MEDICA, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO CARDIOTORACICO, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DOPARTIMENTO DI IGIENE E PREVENZIONE, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E PREVENZIONE,AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E P
| | - G Valdi
- DIPARTIMENTO DI AREA MEDICA, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO CARDIOTORACICO, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DOPARTIMENTO DI IGIENE E PREVENZIONE, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E PREVENZIONE,AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E P
| | - C Di Nora
- DIPARTIMENTO DI AREA MEDICA, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO CARDIOTORACICO, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DOPARTIMENTO DI IGIENE E PREVENZIONE, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E PREVENZIONE,AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E P
| | - C Nalli
- DIPARTIMENTO DI AREA MEDICA, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO CARDIOTORACICO, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DOPARTIMENTO DI IGIENE E PREVENZIONE, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E PREVENZIONE,AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E P
| | - G Benedetti
- DIPARTIMENTO DI AREA MEDICA, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO CARDIOTORACICO, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DOPARTIMENTO DI IGIENE E PREVENZIONE, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E PREVENZIONE,AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E P
| | - A Lechiancole
- DIPARTIMENTO DI AREA MEDICA, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO CARDIOTORACICO, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DOPARTIMENTO DI IGIENE E PREVENZIONE, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E PREVENZIONE,AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E P
| | - M Parpinel
- DIPARTIMENTO DI AREA MEDICA, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO CARDIOTORACICO, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DOPARTIMENTO DI IGIENE E PREVENZIONE, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E PREVENZIONE,AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E P
| | - U Livi
- DIPARTIMENTO DI AREA MEDICA, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO CARDIOTORACICO, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DOPARTIMENTO DI IGIENE E PREVENZIONE, AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E PREVENZIONE,AZIENDA SANITARIA UNIVERSITARIA DEL FRIULI CENTRALE, UDINE; DIPARTIMENTO DI IGIENE E P
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Ferrara V, Sponga S, Marinoni M, Valdi G, Nora CD, Nalli C, Benedetti G, Lechiancole A, Parpinel M, Livi U. Metabolic Syndrome in Heart Transplantation: An Underestimated Risk Factor? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.289] [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: 10/18/2022] Open
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Monosilio S, Filomena D, Luongo F, Neccia M, Sannino M, Birtolo IL, Cimino S, Tonti G, Pedrizzetti G, Benedetti G, Fedele F, Maestrini V, Agati L. Cardio-vascular remodelling during sacubitril/valsartan therapy in patients with heart failure and reduced ejection fraction. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.352] [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.
Background
Sacubitril/valsartan (S/V) benefits in patients with heart failure and reduced ejection fraction (HFrEF) are partially related to cardiac reverse remodelling, in terms of volumes reduction and function improvement. Effects on vascular remodeling are less investigated.
Purpose
To evaluate cardiac and vascular remodelling in a cohort of patients with HFrEF after six months of therapy with S/V.
Methods
50 patients with HFrEF eligible to start a therapy with sacubitril/valsartan were enrolled. Clinical evaluation and standard and advanced echocardiography were performed at baseline and after six months of follow up (FU). Standard left ventricular dimension and function parameters, global longitudinal strain (GLS) were calculated. Non-invasive pressure-volume curves (P-V loop) estimation was assessed with an off-line dedicated software using ST-E derived time-resolved LV volumes and brachial pressure as input. The following hemodynamic parameters were calculated based on P-V loop curves: left ventricular elastance (Ees), arterial elastance (Ea) and ventricular-arterial coupling (VAC).
Results
At six months F/U, a reduction of NYHA class in the vast majority of patients was detected (NYHA Class ≥ II, baseline vs F/U = 100% vs 50%; p< 0,001). Systolic and diastolic blood pressure were lower, in comparison with baseline values (119 ± 16 vs 126 ± 11 mmHg; p = 0,002 and 71 ± 8 vs 78 ± 8 mmHg; p = 0,001, respectively). At echocardiographic evaluation, left ventricular end-diastolic and end-systolic volumes decreased (p< 0.001 and p< 0,001, respectively) and ejection fraction and GLS significantly improved (p< 0.001 and p < 0.001, respectively). Moreover, a significant reduction of Ea and a significant improvement of Ees and VAC were observed (p = 0.008, p< 0,001 and p< 0,001, respectively).
Conclusion
Therapy with S/V in HFrEF patients determines both cardiac and vascular remodelling reflecting the complex mechanisms behind clinical improvement. Abstract Figure.
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Affiliation(s)
| | - D Filomena
- Sapienza University of Rome, Rome, Italy
| | - F Luongo
- Sapienza University of Rome, Rome, Italy
| | - M Neccia
- Sapienza University of Rome, Rome, Italy
| | - M Sannino
- Sapienza University of Rome, Rome, Italy
| | - IL Birtolo
- Sapienza University of Rome, Rome, Italy
| | - S Cimino
- Sapienza University of Rome, Rome, Italy
| | - G Tonti
- G. d Annunzio University, Chieti, Italy
| | | | | | - F Fedele
- Sapienza University of Rome, Rome, Italy
| | | | - L Agati
- Sapienza University of Rome, Rome, Italy
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Monosilio S, Filomena D, Sannino M, Birtolo IL, Cimino S, Tonti G, Pedrizzetti G, Benedetti G, Fedele F, Maestrini V, Agati L. Left ventricular forces distribution in patients with heart failure and reduced ejection fraction. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.179] [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
Funding Acknowledgements
Type of funding sources: None.
Background
Hemodynamic forces (HDFs) are the forces exchanged between the blood and the myocardium. Estimation of their magnitude and alignment could be a novel marker of cardiac dysfunction.
Purpose
To describe left ventricular (LV) HDFs values and distribution in patients with heart failure with reduced ejection fraction (HFrEF) and to compare them with those of a group of healthy controls.
Methods
A cohort of 26 non-ischemic patients with an initial diagnosis of HFrEF was enrolled. All of them underwent basal 2D echocardiography evaluation. Off-line HDFs estimation using a dedicated software based on speckle-tracking echocardiography was conducted. HDFs were normalized for the LV volume and expressed as a percentage of the force of gravity. HDFs were assessed over the entire cardiac cycle, in systole and diastole, both in apex to base (A-B) and latero-septal (L-S) directions. The distribution of LV HDFs was evaluated by L-S over A-B HDFs ratio (L-S/A-B HDFs ratio). HDFs of HFrEF patients were compared with those of 24 healthy volunteers.
Results
HFrEF patients showed smaller values of A-B HDFs during the entire cardiac cycle (5,2 ± 1,24% vs 12,3 ± 3,6%; p = 0,001), in systole (7,2 ± 2% vs 16,6 ± 6,3%; p = 0,001) and diastole (3,3 ± 0,8% vs 7,1 ± 3,6%; p = 0,001). Moreover, comparing HFrEF subjects with healthy volunteers , the former had lower L-S HDFs during the entire cardiac cycle (1,6 ± 0,4% vs 2 ± 0,7%; p= 0,022) and in systole (1,6 ± 0,5% vs 2,3 ± 0,8%; p = 0,003), while in diastole they showed inappropriate high values of L-S HDFs (1,7 ± 0,6% vs 1,8 ± 0,9%; p = 0,999). Consequently, HFrEF patients had higher values of L-S/A-B ratio during the entire cardiac cycle (32 ± 6,9 vs 15 ± 7,7; p = 0,001), in systole (23,5 ± 7,4 vs 14,7± 4,2; p = 0,001), but particularly in diastole (52 ± 10,8 vs 28 ± 13,6; p = 0,001), showing an important HDFs misalignment.
Conclusion
When compared with healthy controls, HFrEF patients presented intraventricular fluid alterations characterized by lower HDFs magnitude and a significant HDFs misalignment, especially in diastole. Further studies are needed to confirm these initial results and to assess the effects of therapy on these new parameters. Abstract Figure. Abstract Figure.
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Affiliation(s)
| | - D Filomena
- Sapienza University of Rome, Rome, Italy
| | - M Sannino
- Sapienza University of Rome, Rome, Italy
| | - IL Birtolo
- Sapienza University of Rome, Rome, Italy
| | - S Cimino
- Sapienza University of Rome, Rome, Italy
| | - G Tonti
- G. d Annunzio University, Chieti, Italy
| | | | | | - F Fedele
- Sapienza University of Rome, Rome, Italy
| | | | - L Agati
- Sapienza University of Rome, Rome, Italy
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9
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Bhuva AN, D'Silva A, Torlasco C, Nadarajan N, Jones S, Boubertakh R, Van Zalen J, Scully P, Knott K, Benedetti G, Augusto JB, Bastiaenen R, Lloyd G, Sharma S, Moon JC, Parker KH, Manisty CH, Hughes AD. Non-invasive assessment of ventriculo-arterial coupling using aortic wave intensity analysis combining central blood pressure and phase-contrast cardiovascular magnetic resonance. Eur Heart J Cardiovasc Imaging 2021; 21:805-813. [PMID: 31501858 DOI: 10.1093/ehjci/jez227] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/01/2019] [Accepted: 08/20/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Wave intensity analysis (WIA) in the aorta offers important clinical and mechanistic insight into ventriculo-arterial coupling, but is difficult to measure non-invasively. We performed WIA by combining standard cardiovascular magnetic resonance (CMR) flow-velocity and non-invasive central blood pressure (cBP) waveforms. METHODS AND RESULTS Two hundred and six healthy volunteers (age range 21-73 years, 47% male) underwent sequential phase contrast CMR (Siemens Aera 1.5 T, 1.97 × 1.77 mm2, 9.2 ms temporal resolution) and supra-systolic oscillometric cBP measurement (200 Hz). Velocity (U) and central pressure (P) waveforms were aligned using the waveform foot, and local wave speed was calculated both from the PU-loop (c) and the sum of squares method (cSS). These were compared with CMR transit time derived aortic arch pulse wave velocity (PWVtt). Associations were examined using multivariable regression. The peak intensity of the initial compression wave, backward compression wave, and forward decompression wave were 69.5 ± 28, -6.6 ± 4.2, and 6.2 ± 2.5 × 104 W/m2/cycle2, respectively; reflection index was 0.10 ± 0.06. PWVtt correlated with c or cSS (r = 0.60 and 0.68, respectively, P < 0.01 for both). Increasing age decade and female sex were independently associated with decreased forward compression wave (-8.6 and -20.7 W/m2/cycle2, respectively, P < 0.01) and greater wave reflection index (0.02 and 0.03, respectively, P < 0.001). CONCLUSION This novel non-invasive technique permits straightforward measurement of wave intensity at scale. Local wave speed showed good agreement with PWVtt, and correlation was stronger using the cSS than the PU-loop. Ageing and female sex were associated with poorer ventriculo-arterial coupling in healthy individuals.
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Affiliation(s)
- Anish N Bhuva
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK.,Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - A D'Silva
- Cardiovascular Sciences Research Centre, St. George's University of London, Blackshaw Road, Tooting, London SW17 0QT, UK
| | - C Torlasco
- IRCCS, Istituto Auxologico Italiano, Via Ludovico Ariosto 13, 20145 Milan, Italy, Italy
| | - N Nadarajan
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK
| | - S Jones
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK
| | - R Boubertakh
- Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - J Van Zalen
- Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - P Scully
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK.,Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - K Knott
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK.,Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - G Benedetti
- Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - J B Augusto
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK.,Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - Rachel Bastiaenen
- Cardiovascular Sciences Research Centre, St. George's University of London, Blackshaw Road, Tooting, London SW17 0QT, UK
| | - G Lloyd
- Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - S Sharma
- Cardiovascular Sciences Research Centre, St. George's University of London, Blackshaw Road, Tooting, London SW17 0QT, UK
| | - J C Moon
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK.,Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - K H Parker
- Department of Bioengineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK
| | - C H Manisty
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK.,Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - Alun D Hughes
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK.,MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London WC1E 7HB, UK
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10
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Monosilio S, Filomena D, Cimino S, Neccia M, Luongo F, Mariani M, Birtolo LI, Benedetti G, Fedele F, Maestrini V, Agati L. Improvement of left ventricular systolic performance during sacubitril/valsartan in a cohort of patients with heart failure and reduced ejection fraction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.157] [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
Funding Acknowledgements
Type of funding sources: None.
Background
Sacubitril/valsartan is a well-established therapeutic option for patients with heart failure with reduced ejection fraction (HFrEF). While it was clearly demonstrated to improve patients’ clinical conditions, its potential role in inducing left ventricle (LV) reverse remodeling is still under investigation.
Purpose
to evaluate clinical and echocardiographic effect of sacubitril/valsartan on a cohort of patients with HFrEF after six months of therapy.
Methods
36 patients with HFrEF eligible to start a therapy with sacubitril/valsartan were enrolled. A standard and advanced echocardiographic evaluation was performed before starting the therapy and after six months of follow up (FU). Off-line analysis of left ventricle global longitudinal strain (GLS), longitudinal strain of the free wall of the right ventricle (RVFWSL) and left atrial strain (LAS) was conducted. Clinical and biochemical parameters were evaluated as well.
Results
At six months of FU NYHA class improved in the vast majority of patients (NYHA class III at baseline vs FU: 56% vs 5%, p 0.001). We observed a significant reduction in LV end-diastolic (99.62 ± 33.24 vs 91.54 ± 33.36, p 0.043) and end-systolic (69.99 ± 26.01 vs 58.68 ± 25.7, p 0.001) volumes and an improvement of LV ejection fraction (30.4 ± 5.02 vs 37.3 ± 6.4, p < 0.001). After six months of therapy, GLS significantly improved (-9.71 ± 2.87 vs -13.04 ± 3.14, p < 0.001). No differences in left and right atrial volumes (respectively 56.6 ± 29 vs 54 ± 30, p 0.349; 54.7 ± 23.7 vs 48.3 ± 19, p 0.157), RVFWSL (-16,5 ± 5,4 vs -16,8 ± 1,5) and LAS (14 ± 6 vs 19 ± 8, p 0.197) were found at FU.
Conclusion
Left ventricular function evaluated with standard and advanced echocardiographic parameters improved after six months of therapy with sacubitril/valsartan in HFrEF patients. Reduction in LV volumes was found as well.
Echo Analysis Baseline Echo Analysis (n= 36) 6 Months FU Echo Analysis (n= 36) p LVEDVi, mL/m2 99, 62 ± 33,24 91,54 ± 33,36 0,043 LVESVi, mL/m2 69,99 ± 26,01 58,68 ± 25,7 0,001 LVEF, % 30,4 ± 5, 02 37,3 ± 6,4 < 0,001 E/E’ average 12,16 ± 3,74 9,71 ± 1,33 0,023 LS Endo Average ,% -9,71 ± 2,87 -13,04 ± 3,14 < 0,001 LVEF left ventricular ejection fraction, LVEDVi: left ventricular end diastolic volume indexed, LVESVi: left ventricular end systolic volume indexed; LS: longitudinal strain
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Affiliation(s)
| | - D Filomena
- Sapienza University of Rome, Rome, Italy
| | - S Cimino
- Sapienza University of Rome, Rome, Italy
| | - M Neccia
- Sapienza University of Rome, Rome, Italy
| | - F Luongo
- Sapienza University of Rome, Rome, Italy
| | - M Mariani
- Sapienza University of Rome, Rome, Italy
| | - LI Birtolo
- Sapienza University of Rome, Rome, Italy
| | | | - F Fedele
- Sapienza University of Rome, Rome, Italy
| | | | - L Agati
- Sapienza University of Rome, Rome, Italy
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11
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Torlasco C, D"silva A, Bhuva AN, Faini A, Augusto JB, Knott KD, Benedetti G, Scully P, Parati G, Lloyd G, Hughes A, Sharma S, Manisty C, Osculati G, Moon JC. Pulsatile and resistive systolic loads as determinants of left ventricular remodelling after physical training. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.422] [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
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): British Heart Foundation Barts Cardiovascular Biomedical Research Centre
onbehalf
The Marathon Study Consortium
Introduction
Cardiovascular function depends on the inter-relation between heart and vasculature. The contribution of aorta and peripheral vessels to the total systolic load of the left ventricle (LV) can be represented respectively by a "pulsatile" and a "resistive" component. We sought to understand their interrelation by exploring how LV remodelling occurred with altered load associated with an external stimulus (training). Methods: 237 untrained healthy male and female subjects volunteering for their first-time marathon were recruited. At baseline and after 6 months of unsupervised training, race completers underwent 1.5T cardiac magnetic resonance, brachial and non-invasive central blood pressure assessment. For analysis, runners were divided into 4 groups according to the variation (positive versus null or negative) in Total Arterial Compliance Index (TACi), representing the pulsatile component of the LV load, and in Systemic Vascular Resistance Index (SVRI), representing the resistive component of the LV load. Results: 138runners (age 21-69 years; F: 51%) completed the race. Data are reported for each variable as Δ mean [95% Confidence Interval]. In the whole cohort, training was associated with a small increase in LV mass index (+3g/m2, [0, 6 g/m2]), indexed LV end-diastolic volume (EDVi) (+3ml/m2, [-2, 5 3ml/m2]), in LV mass/LVEDV ratio (+0.02g/ml, [0.00, 0.04 g/ml]) and in TACi (+0.02ml/m2, [0.02, 0.38 ml/m2]). SVRi mildly fell (-43dyn·s/cm2[-103, 17dyn·s/cm2]). TACi increase was associated with LVEDVi increase and no change in LV mass/EDV (eccentric remodelling). On the other hand, both TACi reduction and SVRi increase were associated with increase in LV mass/EDV and no significant change in LVEDVi (concentric remodelling). A similar increase in LV mass was observed in all groups. See Table. Conclusion: Cardiac remodelling observed after mild, medium term, unsupervised training seems to be related to the modifications of aorta and peripheral vessels. In particular, a reduction in pulsatile load seems associated with eccentric LV remodelling, while an increase in both pulsatile and resistive with concentric LV remodelling. Further research is needed to understand the interaction between TACi and SVRi.
Table 1 LV EDVi (ml/m2) LV mass index (g/m2) LV mass/EDV TACi increase (n = 75) +4 [0, 9] +3 [0, 7] 0 [-0.03, 0.03] TACi decrease (n = 62) -1 [-6, 4] +3 [0, 8] 0.04 [0.01, 0.07] SVRi increase (n = 63) 0 [-4,4] +3 [0, 7] +0.03 [0, 0.06] SVRi decrease (n = 73) +3 [-3, 7] +3 [-1, 6] +0.01 [-0.02, 0.04]
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Affiliation(s)
- C Torlasco
- IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - A D"silva
- St George"s University of London, London, United Kingdom of Great Britain & Northern Ireland
| | - AN Bhuva
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - A Faini
- IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - JB Augusto
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - KD Knott
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - G Benedetti
- Guy"s & St Thomas" NHS Foundation Trust, guy"s and , London, United Kingdom of Great Britain & Northern Ireland
| | - P Scully
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - G Parati
- IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - G Lloyd
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - A Hughes
- University College London, London, United Kingdom of Great Britain & Northern Ireland
| | - S Sharma
- St George"s University of London, London, United Kingdom of Great Britain & Northern Ireland
| | - C Manisty
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - G Osculati
- IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - JC Moon
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
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12
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Mak SM, Mak D, Hodson D, Preston R, Retter A, Camporota L, Benedetti G. Pulmonary ischaemia without pulmonary arterial thrombus in COVID-19 patients receiving extracorporeal membrane oxygenation: a cohort study. Clin Radiol 2020; 75:795.e1-795.e5. [PMID: 32778329 PMCID: PMC7368894 DOI: 10.1016/j.crad.2020.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/13/2020] [Indexed: 01/19/2023]
Abstract
AIM To evaluate the incidence of pulmonary ischaemia in COVID-19 patients on extracorporeal membrane oxygenation (ECMO), and its correlation with pulmonary artery thrombosis. MATERIALS AND METHODS Computed tomography (CT) thorax of all patients receiving ECMO with proven COVID-19 pneumonitis between March and May 2020 were analysed for the presence and extension of pulmonary thromboembolic disease. RESULTS Fifty-one patients were reviewed. The mean (range) age of 45 (26–66) years; 38/51 (74.5%) were men. All patients had severe COVID-19 pneumonitis, and 18/51 (35.3%) had macroscopic thrombosis (15 with associated ischaemia); however, 13/51 (25.5%) patients had ischaemia without associated thrombus. CONCLUSION The majority of patients with COVID-19 who received ECMO had areas of ischaemia within consolidated lungs, almost half of these without subtending pulmonary artery thrombosis. Although the prognostic significance of these findings is unclear, they are highly suggestive of lung ischaemia due to isolated microvascular immune thrombosis. High incidence of pulmonary artery thrombosis in COVID-19 ECMO patients. Lung ischaemia seen in patients with and without visible pulmonary artery thrombus. Ischaemia with no visible thrombus suggest microvascular thrombosis.
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Affiliation(s)
- S M Mak
- Department of Radiology, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 9RT, UK.
| | - D Mak
- Department of Radiology, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 9RT, UK
| | - D Hodson
- Department of Radiology, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 9RT, UK
| | - R Preston
- Department of Radiology, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 9RT, UK
| | - A Retter
- Department of Critical Care Medicine, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 9RT, UK
| | - L Camporota
- Department of Critical Care Medicine, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 9RT, UK
| | - G Benedetti
- Department of Radiology, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 9RT, UK
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13
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Lechiancole A, Sponga S, Vendramin I, Ferrara V, Maiani M, Spagna E, Guzzi G, Nalli C, Meneguzzi M, Nora CD, Piani D, Benedetti G, Tursi V, Zanuttini D, Livi U. Coronary Artery Disease of the Donor Graft: Any Impact on Survival and Cardiac Allograft Vasculopathy after Heart Transplantation? J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.533] [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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14
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Harouna SH, Ortuno-Gutierrez N, Souleymane MB, Kizito W, Morou S, Boukary I, Zolfo M, Benedetti G, Piubello A. Short-course treatment outcomes and adverse events in adults and children-adolescents with MDR-TB in Niger. Int J Tuberc Lung Dis 2020; 23:625-630. [PMID: 31097073 DOI: 10.5588/ijtld.17.0871] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
<sec id="st1"> <title>SETTING</title> Niger National Tuberculosis Programme. </sec> <sec id="st2"> <title>OBJECTIVE</title> To describe the outcomes and adverse events (AEs) in a cohort of adults, children and adolescents with multidrug-resistant tuberculosis (MDR-TB) who were treated with the 'short-course regimen'. </sec> <sec id="st3"> <title>DESIGN</title> The regimen comprised an intensive phase of 4-6 months with kanamycin, medium-high dose of isoniazid and prothionamide, and high doses of gatifloxacin, clofazimine, ethambutol and pyrazinamide throughout. Sixty-five patients were treated with a regimen of 12-14 months and 55 patients with a regimen of 9-11 months. </sec> <sec id="st4"> <title>RESULTS</title> Of the 120 patients evaluated, 110 (92%) were adults (median age 31 years) and 10 (8%) were children or adolescents (median age 17 years). The treatment success rate was respectively 88% and 83% with the 9-month regimen, and 90% and 75% with the 12-month regimen in adults and children/adolescents. Initial resistance to ethambutol and prothionamide did not affect treatment success rates but resistance to fluoroquinolones did, although this was not statistically significant. Vomiting was the most frequently encountered AE, followed by ototoxicity and hepatotoxicity. AEs experienced were mild or moderate in severity in most patients, and did not lead to treatment interruption. </sec> <sec id="st5"> <title>CONCLUSION</title> These results confirm the programmatic effectiveness and tolerability of the shorter regimen in second-line drug-naïve patients. </sec>.
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Affiliation(s)
| | | | | | - W Kizito
- Médecins Sans Frontières, Nairobi, Kenya
| | - S Morou
- Damien Foundation, Niamey, Niger
| | | | - M Zolfo
- Institute of Tropical Medicine, Antwerp
| | | | - A Piubello
- Damien Foundation, Niamey, Niger, International Union Against Tuberculosis and Lung Disease, Paris, France
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15
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Mariani M, Cerillo AG, Maffei S, Marchi F, Benedetti G, Zezza L, Cerone E, Paradossi U, Sorbo S, Pizzino F, Chiappino S, Trianni G, Al Jabri A, Ravani M, Berti S. 1634 3D transoesofageal echocardiography in detection of anterior leaflet laceration during mitraclip implantation. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1024] [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
MitraClip is a percutaneous way of treatment of mitral regurgitation. Recent trials demonstrate its value in modifying prognosis of patients with functional mitral regurgitation. During MitraClip implant imaging with 3D TEE is mandatory to guide the procedure and monitoring the results. Unfortunately, laceration of mitral leaflets is a well-described complication of Percutaneous Mitral valve repair by implantation of MitraClip. 3D TEE can be useful even to detect complication of the procedure and in particular leaflets lacerations. Here we describe a case where 3D TEE was capable to recognize and visualize a laceration in the anterior leaflet (AL) and we assume some mechanisms leading to this complication.
Methods
An 83 years old man with post-ischemic severe functional mitral regurgitation underwent to MitraClip implantation. The mitral valve shows a severe tenting and annulus was deformed and dilated.
The procedure was performed under fluoroscopic and 3D TEE guidance (Philips iE33). Due to the large central regurgitation and large coaptation gap, we decide to implant MitraClip XTR, this is the larger device 5 mm longer.
Results
A single MitraClip XTR was implanted in the central scallop (A2-P2) in the region of the larger jet, after device positioning a further jet was detected in the region of implant and the original jet was unchanged.
Using 3D color complete volume and X-plane reconstructions we recognize that the jet originates between the clip and the basal aspects of AL. Without color Doppler in 3D zoom and X plane reconstruction, a continuum solution was suspected in the body of AL but the shadow of the delivery system partially masked the region. After removal of the device, perforation of AL was clearly depicted also with 3D zoom without color Doppler. The patient was surgically treated and inspection confirmed the laceration and shows a worn thin AL. The laceration of AL can be caused by the tension on a thinned tissue carried out by the large device. The severe tethering and annular dilatation with a marked distance between anterior and posterior leaflet at the tip of the device may have been a determinant factor in the tear occurrence.
Conclusion
3D TEE can clearly depict lacerations of leaflets during MitraClip implantation. Preoperative extensive analysis of valve geometry and inspection of leaflets searching for a thinned region can avoid intraoperative complications. The distance between leaflets at the expected tips of the MitraClip can be a predictive parameter of tension applied on the leaflets and of the risk of tearing.
Abstract 1634 Figure. Image 1
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Affiliation(s)
- M Mariani
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - A G Cerillo
- Careggi University Hospital (AOUC), Florence, Italy
| | - S Maffei
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - F Marchi
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - G Benedetti
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - L Zezza
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - E Cerone
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - U Paradossi
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - S Sorbo
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - F Pizzino
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - S Chiappino
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - G Trianni
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - A Al Jabri
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - M Ravani
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - S Berti
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
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16
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Lombardi M, Lazzeroni D, Rimoldi O, Girolami F, Pisano A, Benedetti G, Alfieri O, D'Amati G, Foglieni C, Camici P. 1177Insights on mitochondrial energetics in obstructive hypertrophic cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0019] [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, heterogeneous in phenotype and clinical course. The genotype-phenotype relationship and associated molecular mechanisms are still incompletely understood. In the HCM milieu, increased energy cost of force production, impairing performance and mitochondrial function, may be associated to patients' genotype and/or phenotype.
Purpose
To determine abnormalities in mitochondrial energetics in HCM and their possible relationship with genotype and clinical phenotype of patients.
Methods
Septal myectomies from characterized patients with obstructive HCM (HOCM, n=18) and donor hearts discarded from transplantation (CTRL, n=8) have been compared. HOCM patients were screened and demographic, clinical and instrumental data (routine ECG, echocardiography and cardiac magnetic resonance-CMR) were collected.
Genetic analysis was performed on total DNA extracted from myectomies by NGS on MiSeq platform using the TruSight Cardio Sequencing kit and testing a panel of 26 genes.
Activity and amount of mitochondrial enzymes generating/scavenging reactive oxygen species were investigated.
Results
Within the HOCM cohort 30% of patients was bearing mutations in sarcomeric genes associated with HCM.
The amount and/or activity of mitochondrial Complex I NADH dehydrogenase, of SOD2 and (m)-aconitase were upregulated in HOCM vs. CTRL. NADH dehydrogenase level was inversely correlated with the degree of mitral valve regurgitation and mitral valve backward volume by CMR (Spearman R=−0.5 and −0.8, respectively).
The Complex V enzyme ATP synthase activity decreased, whilst its amount was comparable in HOCM vs. CTRL. Analogously the SOD1 activity was similar in HOCM and CTRL.
No difference in mitochondrial DNA (mtDNA) copy number was found.
Results were unrelated to HCM-associated mutations.
Conclusions
HOCM hearts are characterized by mitochondrial hyperactivity aimed at quenching reactive oxygen species, but decreased ATP synthase activity. Overall, these data suggest an abnormal mitochondrial activity in the myocardium of HOCM patients independent of the presence of HCM-associated mutations. Moreover, our results underpin the markedly abnormal cellular energetics of HOCM, identifying potential therapeutic targets.
Acknowledgement/Funding
NET-2011-02347173, Italian Minister of Health
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Affiliation(s)
- M Lombardi
- San Raffaele Scientific Institute, Milan, Italy
| | - D Lazzeroni
- San Raffaele Scientific Institute, Milan, Italy
| | - O Rimoldi
- Institute of Biomedical Technologies, Institute of Molecular Bioimaging and Physiology IBFM, Segrate (Milan), Italy
| | - F Girolami
- Meyer Children's Hospital, Florence, Italy
| | - A Pisano
- Sapienza University of Rome, Rome, Italy
| | - G Benedetti
- San Raffaele Scientific Institute, Milan, Italy
| | - O Alfieri
- San Raffaele Scientific Institute, Milan, Italy
| | - G D'Amati
- Sapienza University of Rome, Rome, Italy
| | - C Foglieni
- San Raffaele Scientific Institute, Milan, Italy
| | - P Camici
- San Raffaele Scientific Institute, Milan, Italy
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17
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Chiappino S, Della Pina F, Paradossi U, De Caterina AR, Parri MS, Emdin M, Berti S, Maffei S, Benedetti G, Pizzino F, Scattina R, Gianetti J. P4571PFA-100, a test of platelet adhesion/aggregation, predicts cardiovascular events after an acute coronary syndrome and can help in the decision-making for dual antiplatelet extension. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0961] [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
The dual antiplatelet therapy (DAPT) duration is a matter of great interest among cardiologists. Because of the conflicting evidences and the necessity to balance the reduction in major cardiac events (MACE) occurrence and the risk of major bleedings after an acute coronary syndrome (ACS), there is a general consensus on prolonging DAPT on an individual basis. There is less consensus on which parameters are to be evaluated. Nowadays tests of platelet reactivity are not included in the decision-making. Few data are available on the prognostic value of aspirin response tests that are sensitive to other mediators of platelet adhesion and aggregation in vivo under flow conditions.
Purpose
To demonstrate the role of the Platelet Function Analyzer (PFA-100) Collagen/Epinephrine (CEPI) cartridge, which is very sensitive to von Willebrand factor (VWF) levels, an emerging vascular risk factor, in risk stratification in ACS patients undergoing percutaneous coronary intervention (PCI).
Methods
We measured platelet reactivity by PFA-100 CEPI cartridges in a prospective cohort of 928 patients admitted for ACS between January 2006 to December 2009 and urgently treated by PCI at day 6±1 after admission. All the patients were treated with aspirin and clopidogrel according to current standard of that time.
Results
High platelet reactivity (HPR) defined as PFA-100 values <190”was found in 307 (33%) patients. No significant differences were found in demographic, angiographic and biochemical characteristics of both populations (PFA-100 <190” and PFA-100>190”). At a mean follow up of 5±1 years patients with HPR had a significant increase in cardiac death: 12.3% vs 2.6% (hazard ratio 6.05; 95% confidence interval: 3.34–10.95; p<0.0001) and recurrence of myocardial infarction (MI): 49% vs 17% (hazard ratio 4,29; 95% confidence interval: 3,27–5,64; p<0.0001). The trend in events incidence in our cohort of patients, in line with recent evidences, was maintained beyond the first year of follow-up
Conclusions
Using a multivariable Cox-proportional hazard model, HPR was found to be an independent predictor of MACE. These results indicate that PFA-100 CEPI cartridge, which correlates well with VWF levels, may be a useful point-of-care test to stratify the cardiovascular risk after an ACS. This also underlines the additional value of this test in the decision-making about the correct extension of DAPT.
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Affiliation(s)
- S Chiappino
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - F Della Pina
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - U Paradossi
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | | | - M S Parri
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - M Emdin
- Gabriele Monasterio Foundation-CNR Region Toscana, Pisa, Italy
| | - S Berti
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - S Maffei
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - G Benedetti
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - F Pizzino
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | | | - J Gianetti
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
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18
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Benedetti G, White RA, Pasquale HA, Stassijns J, van den Boogaard W, Owiti P, Van den Bergh R. Identifying exceptional malaria occurrences in the absence of historical data in South Sudan: a method validation. Public Health Action 2019; 9:90-95. [PMID: 31803579 DOI: 10.5588/pha.19.0002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 05/10/2019] [Indexed: 11/10/2022] Open
Abstract
Background Detecting unusual malaria events that may require an operational intervention is challenging, especially in endemic contexts with continuous transmission such as South Sudan. Médecins Sans Frontières (MSF) utilises the classic average plus standard deviation (AV+SD) method for malaria surveillance. This and other available approaches, however, rely on antecedent data, which are often missing. Objective To investigate whether a method using linear regression (LR) over only 8 weeks of retrospective data could be an alternative to AV+SD. Design In the absence of complete historical malaria data from South Sudan, data from weekly influenza reports from 19 Norwegian counties (2006-2015) were used as a testing data set to compare the performance of the LR and the AV+SD methods. The moving epidemic method was used as the gold standard. Subsequently, the LR method was applied in a case study on malaria occurrence in MSF facilities in South Sudan (2010-2016) to identify malaria events that required a MSF response. Results For the Norwegian influenza data, LR and AV+SD methods did not perform differently (P > 0.05). For the South Sudanese malaria data, the LR method identified historical periods when an operational response was mounted. Conclusion The LR method seems a plausible alternative to the AV+SD method in situations where retrospective data are missing.
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Affiliation(s)
- G Benedetti
- Operational Research Unit, Medical Department, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium
| | - R A White
- Department of Infectious Disease Epidemiology and Modelling, Norwegian Institute of Public Health, Oslo, Norway
| | - H Akello Pasquale
- National Malaria Control Programme, National Ministry of Health, Juba, Republic of South Sudan
| | - J Stassijns
- Medical Department, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium
| | - W van den Boogaard
- Operational Research Unit, Medical Department, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium
| | - P Owiti
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - R Van den Bergh
- Operational Research Unit, Medical Department, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium
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Palmisano A, Benedetti G, Palumbo D, Peretto G, Sala S, De Cobelli F, Esposito A. P177Cardiovascular magnetic resonance early predictors of unfavorable left ventricle remodeling in patients with acute myocarditis. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez117.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Palmisano
- San Raffaele Scientific Institute, Milan, Italy
| | - G Benedetti
- San Raffaele Scientific Institute, Milan, Italy
| | - D Palumbo
- San Raffaele Scientific Institute, Milan, Italy
| | - G Peretto
- San Raffaele Scientific Institute, Milan, Italy
| | - S Sala
- San Raffaele Scientific Institute, Milan, Italy
| | | | - A Esposito
- San Raffaele Scientific Institute, Milan, Italy
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20
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Lechiancole A, Sponga S, Ferrara V, Nalli C, Nora CD, Guzzi G, Piani D, Meneguzzi M, Benedetti G, Tursi V, Livi U. Long-Term Survival after Heart Transplantation: Interaction between Donor and Recipient Age. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.448] [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: 10/27/2022] Open
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21
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Sini C, Mori M, Benedetti G, Panzeri M, Barbera M, Partelli S, Falconi M, De Cobelli F, Fiorino C. 297. Radiomic CT features of pancreatic neuroendocrine tumors are robust against inter-observer delineation uncertainty. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.306] [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: 11/24/2022] Open
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Peretto G, Sala S, Benedetti G, Palmisano A, Rizzo S, Caforio ALP, Esposito A, De Cobelli F, Thiene G, Basso C, Camici PG, Della Bella P. P4526Multimodal diagnosis in clinically suspected myocarditis: behind discordancy between endomyocardial biopsy and cardiac magnetic resonance. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- G Peretto
- San Raffaele Hospital of Milan (IRCCS), Department of Arrhythmology and Cardiac Electrophysiology, Milan, Italy
| | - S Sala
- San Raffaele Hospital of Milan (IRCCS), Department of Arrhythmology and Cardiac Electrophysiology, Milan, Italy
| | - G Benedetti
- San Raffaele Hospital of Milan (IRCCS), Department of Radiology, Milan, Italy
| | - A Palmisano
- San Raffaele Hospital of Milan (IRCCS), Department of Radiology, Milan, Italy
| | - S Rizzo
- University Hospital of Padova, Department of Cardiac Pathology, Padua, Italy
| | - A L P Caforio
- University Hospital of Padova, Department of Cardiology, Padua, Italy
| | - A Esposito
- San Raffaele Hospital of Milan (IRCCS), Department of Radiology, Milan, Italy
| | - F De Cobelli
- San Raffaele Hospital of Milan (IRCCS), Department of Radiology, Milan, Italy
| | - G Thiene
- University Hospital of Padova, Department of Cardiac Pathology, Padua, Italy
| | - C Basso
- University Hospital of Padova, Department of Cardiac Pathology, Padua, Italy
| | - P G Camici
- San Raffaele Hospital of Milan (IRCCS), Milan, Italy
| | - P Della Bella
- San Raffaele Hospital of Milan (IRCCS), Department of Arrhythmology and Cardiac Electrophysiology, Milan, Italy
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23
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Torlasco C, D'Silva A, Augusto J, Faini A, Knott K, Bhuva A, Benedetti G, Scully P, Jones S, Lobascio I, Parati G, Lloyd G, Manisty C, Moon JC, Sharma S. P3688Age matters: differences in cardiac response to training in young and middle aged first-time marathon runners. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C Torlasco
- S.Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - A D'Silva
- St George's University of London, London, United Kingdom
| | - J Augusto
- Barts Health NHS Trust, London, United Kingdom
| | - A Faini
- S.Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - K Knott
- Barts Health NHS Trust, London, United Kingdom
| | - A Bhuva
- Barts Health NHS Trust, London, United Kingdom
| | - G Benedetti
- Barts Health NHS Trust, London, United Kingdom
| | - P Scully
- Barts Health NHS Trust, London, United Kingdom
| | - S Jones
- University College London, London, United Kingdom
| | - I Lobascio
- Barts Health NHS Trust, London, United Kingdom
| | - G Parati
- University of Milano-Bicocca - Cardiology II, S. Luca Hospital, Milano, Italy
| | - G Lloyd
- Barts Health NHS Trust, London, United Kingdom
| | - C Manisty
- Barts Health NHS Trust, London, United Kingdom
| | - J C Moon
- Barts Health NHS Trust, London, United Kingdom
| | - S Sharma
- St George's University of London, London, United Kingdom
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24
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Peretto G, Sala S, Vergara P, Pardi E, Benedetti G, Palmisano A, Rizzo S, Esposito A, De Cobelli F, Trevisi N, Margonato A, Camici PG, Thiene G, Basso C, Della Bella P. P4529Multilevel characterization of active myocarditis in athletes: a significant right ventricular involvement. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- G Peretto
- San Raffaele Hospital of Milan (IRCCS), Department of Arrhythmology and Cardiac Electrophysiology, Milan, Italy
| | - S Sala
- San Raffaele Hospital of Milan (IRCCS), Department of Arrhythmology and Cardiac Electrophysiology, Milan, Italy
| | - P Vergara
- San Raffaele Hospital of Milan (IRCCS), Department of Arrhythmology and Cardiac Electrophysiology, Milan, Italy
| | - E Pardi
- San Raffaele Hospital of Milan (IRCCS), Milan, Italy
| | - G Benedetti
- San Raffaele Hospital of Milan (IRCCS), Department of Radiology, Milan, Italy
| | - A Palmisano
- San Raffaele Hospital of Milan (IRCCS), Department of Radiology, Milan, Italy
| | - S Rizzo
- University Hospital of Padova, Department of Cardiac Pathology, Padua, Italy
| | - A Esposito
- San Raffaele Hospital of Milan (IRCCS), Department of Radiology, Milan, Italy
| | - F De Cobelli
- San Raffaele Hospital of Milan (IRCCS), Department of Radiology, Milan, Italy
| | - N Trevisi
- San Raffaele Hospital of Milan (IRCCS), Department of Arrhythmology and Cardiac Electrophysiology, Milan, Italy
| | - A Margonato
- San Raffaele Hospital of Milan (IRCCS), Milan, Italy
| | - P G Camici
- San Raffaele Hospital of Milan (IRCCS), Milan, Italy
| | - G Thiene
- University Hospital of Padova, Department of Cardiac Pathology, Padua, Italy
| | - C Basso
- University Hospital of Padova, Department of Cardiac Pathology, Padua, Italy
| | - P Della Bella
- San Raffaele Hospital of Milan (IRCCS), Department of Arrhythmology and Cardiac Electrophysiology, Milan, Italy
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25
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Merlano M, Conte PF, Tatarek R, Scarsi P, Barbieri A, Benedetti G, Rosso R. Ineffectiveness of 5-Fluorouracil and Cis-Platin as Second-Line Chemotherapy in Head and Neck Cancer. Tumori 2018; 70:267-9. [PMID: 6539969 DOI: 10.1177/030089168407000312] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Seventeen patients with heavily pretreated head and neck squamous cell carcinoma were submitted to a combination of 5-fluorouracil, 500 mg/m2 on days 1–4, and cis-platin, 50 mg/m2 on day 5, repeated every 21 days. Before administration of 5-fluorouracil, N5,N10-methyl-tetrahydrofolate, 200 mg/m2 i.v., was given. Only 1 partial response and 4 stable disease were observed, and the median survival of the entire group was 5 months. Although all patients had been heavily pretreated and a considerable percentage (6/17, 35.2 %) of these showed resistance to first-line therapy, this combination seems to be ineffective as second-line therapy in head and neck cancer.
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26
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Benedetti G, Mohite P, Smail H, Garcia Saez D, Patil N, Husain M, Jothidasan A, Monteagudo-Vela M, Hassan H, Riesgo Gil F, Dar O, Mahesh B, Banner N, Simon A. Long-Term Follow up and Predicting Factors of de Novo Aortic Regurgitation after LVAD Implantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.734] [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: 11/24/2022] Open
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27
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Smail H, Hassan H, Bowles C, Stock U, Mohite P, Benedetti G, Garcia-saez D, Zych B, Hussain M, Jothidasan A, Motagudo-vera M, Balakrishnan M, De Robertis F, Simon A. Impaired Baseline Renal Function May Not Influence Long Term Renal Function and Survival After LVAD Implantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.275] [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] Open
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28
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Romagnoli E, Tittini F, Valeri M, Verdecchia L, Benedetti G, Salvadori S, Torresi U. Management of folinic acid administration in patients with metastatic colo-rectal cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx422.024] [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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29
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Sardella G, Accapezzato D, Di Roma A, Iacoboni C, Francavilla V, Benedetti G, Musto C, Fedele F, Bruno G, Paroli M. Integrin β2-Chain (CD18) Over-Expression on CD4+ T Cells and Monocytes after Ischemia/Reperfusion in Patients Undergoing Primary Percutaneous Revascularization. Int J Immunopathol Pharmacol 2017; 17:165-70. [PMID: 15171817 DOI: 10.1177/039463200401700208] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
β2-integrin subunit (CD18) plays an essential role in leukocyte recruitment and adhesion in sites of endothelial injury. We analyzed the surface expression of CD18 on T lymphocytes and monocytes in a series of patients presenting acute coronary syndrome (ACS) who underwent primary percutaneous intervention (PCI) for coronary artery revascularization. We found that basal CD18 expression on peripheral blood-derived CD4+ (but not CD8+) T lymphocytes was significantly increased in ACS patients as compared with age-matched healthy volunteers. During primary PCI, a significant increase in CD18 molecule density was detected immediately after balloon deflation (reperfusion) on both CD4+ T cells and monocytes obtained from the right atrium (RT) as compared with basal values. These data suggest that upregulation of CD18 molecules plays an important role in local recruitment of CD4+ T cells and monocytes to the site of endothelial damage after ischemia/reperfusion, therefore being responsible, at least in part, for the inflammatory-mediated complications associated with primary PCI.
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Affiliation(s)
- G Sardella
- Cardiovascular and Respiratory Dept., La Sapienza University, Rome, Italy
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30
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Benedetti G, Cesana A, Sangiust V, Terrani M, Sandrelli G. Delayed Neutron Yields from Fission of Uranium-233, Neptunium-237, Plutonium-238, -240, -241, and Americium-241. NUCL SCI ENG 2017. [DOI: 10.13182/nse82-a19822] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- G. Benedetti
- Politecnico di Milano, Istituto di Ingegneria Nucleare–CESNEF, Via Ponzio 34/3 - 20133 Milano, Italy
| | - A. Cesana
- Politecnico di Milano, Istituto di Ingegneria Nucleare–CESNEF, Via Ponzio 34/3 - 20133 Milano, Italy
| | - V. Sangiust
- Politecnico di Milano, Istituto di Ingegneria Nucleare–CESNEF, Via Ponzio 34/3 - 20133 Milano, Italy
| | - M. Terrani
- Politecnico di Milano, Istituto di Ingegneria Nucleare–CESNEF, Via Ponzio 34/3 - 20133 Milano, Italy
| | - G. Sandrelli
- Ente Nazionale per I’Energia Elettrica, Centro Ricerca Termica e Nucleare, Via Rubattino 54 - 20134 Milano, Italy
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31
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Benedetti G, Mossoko M, Nyakio Kakusu JP, Nyembo J, Mangion JP, Van Laeken D, Van den Bergh R, Van den Boogaard W, Manzi M, Kibango WK, Hermans V, Beijnsberger J, Lambert V, Kitenge E. Sparks creating light? Strengthening peripheral disease surveillance in the Democratic Republic of Congo. Public Health Action 2016; 6:54-9. [PMID: 27358796 DOI: 10.5588/pha.15.0080] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 03/24/2016] [Indexed: 11/10/2022] Open
Abstract
SETTING The Democratic Republic of Congo suffers from an amalgam of disease outbreaks and other medical emergencies. An efficient response to these relies strongly on the national surveillance system. The Pool d'Urgence Congo (PUC, Congo Emergency Team) of Médecins Sans Frontières is a project that responds to emergencies in highly remote areas through short-term vertical interventions, during which it uses the opportunity of its presence to reinforce the local surveillance system. OBJECTIVE To investigate whether the ancillary strengthening of the peripheral surveillance system during short-term interventions leads to improved disease notification. DESIGN A descriptive paired study measuring disease notification before and after 12 PUC interventions in 2013-2014. RESULTS A significant increase in disease notification was observed after seven mass-vaccination campaigns and was sustained over 6 months. For the remaining five smaller-scaled interventions, no significant effects were observed. CONCLUSION The observed improvements after even short-term interventions underline, on the one hand, how external emergency actors can positively affect the system through their punctuated actions, and, on the other hand, the dire need for investment in surveillance at peripheral level.
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Affiliation(s)
- G Benedetti
- Médecins Sans Frontières (MSF), Kinshasa, Democratic Republic of Congo
| | - M Mossoko
- Ministère de la Santé Publique, Secrétariat Général à la Santé, Direction de Lutte contre la Maladie, Kinshasa, Democratic Republic of Congo
| | - J P Nyakio Kakusu
- Médecins Sans Frontières (MSF), Kinshasa, Democratic Republic of Congo
| | - J Nyembo
- Médecins Sans Frontières (MSF), Kinshasa, Democratic Republic of Congo
| | - J P Mangion
- Médecins Sans Frontières (MSF), Kinshasa, Democratic Republic of Congo
| | - D Van Laeken
- Médecins Sans Frontières (MSF), Kinshasa, Democratic Republic of Congo
| | - R Van den Bergh
- MSF, Medical Department (Operational Research), Operational Centre Brussels (OCB), Luxembourg, Luxembourg
| | - W Van den Boogaard
- MSF, Medical Department (Operational Research), Operational Centre Brussels (OCB), Luxembourg, Luxembourg
| | - M Manzi
- MSF, Medical Department (Operational Research), Operational Centre Brussels (OCB), Luxembourg, Luxembourg
| | | | - V Hermans
- Médecins Sans Frontières (MSF), Kinshasa, Democratic Republic of Congo
| | - J Beijnsberger
- Médecins Sans Frontières (MSF), Kinshasa, Democratic Republic of Congo
| | | | - E Kitenge
- Ministère de la Santé Publique, Secrétariat Général à la Santé, Direction de Lutte contre la Maladie, Kinshasa, Democratic Republic of Congo
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32
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Tombetti E, Tombolini E, Incerti E, Salerno A, Benedetti G, Papa M, Gianolli L, Sabbadini M, De Cobelli F, Manfredi A, Picchio M, Baldissera E. SAT0350 Functional Characterisation of Takayasu Arteritis Vascular Lesions by MR and FDG-PET/CT Provides Non-Redundant Information over Clinical Assessment. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.6014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pistilli B, Benedetti G, Rossi D, Baldelli A, Magalotti C, Casadei V, Foghini L, Staffolani M, Fiorentini G, Latini L. P211 Phase 2 neoadjuvant trial: myocet (M), cyclophosphamide (C) +/− trastuzumab (T) and paclitaxel (P) +/− T. Breast 2015. [DOI: 10.1016/s0960-9776(15)70245-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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34
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Campochiaro C, Benedetti G, Cavalli G, Berti A, Tomelleri A, Sabbadini M, De Cobelli F, Dagna L. THU0372 The Role of Echocardiography and Cardiac MRI in Erdheim-Chester Disease. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Secchi F, Cannao P, Pluchinotta F, Butera G, Carminati M, Sardanelli F, Lombardi M, Monney P, Piccini D, Rutz T, Vincenti G, Coppo S, Koestner S, Stuber M, Schwitter J, Romana P, Francesco S, Gianfranco B, Mario C, Francesco S, Massimo L, Alizadeh Sani Z, Vojdan-Parast M, Alimohammadi M, Sarafan-Sadeghi S, Seifi A, Fallahabadi H, Karami Tanha F, Jamshidi M, Hesamy M, Bonello B, Sorensen C, Fouilloux V, Gorincour G, Mace L, Fraisse A, Jacquier A, de Meester C, Amzulescu M, Bouzin C, Boileau L, Melchior J, Boulif J, Lazam S, Pasquet A, Vancrayenest D, Vanoverschelde J, Gerber B, Loudon M, Bull S, Bissell M, Joseph J, Neubauer S, Myerson S, Dorniak K, Hellmann M, Rawicz-Zegrzda D, W sierska M, Sabisz A, Szurowska E, Heiberg E, Dudziak M, Kwok T, Chin C, Dweck M, Hadamitzky M, Nadjiri J, Hendrich E, Pankalla C, Will A, Schunkert H, Martinoff S, Sonne C, Pepe A, Meloni A, Terrazzino F, Spasiano A, Filosa A, Bitti P, Tangari C, Restaino G, Resta M, Ricchi P, Meloni A, Tudisca C, Grassedonio E, Positano V, Piraino B, Romano N, Keilberg P, Midiri M, Pepe A, Meloni A, Positano V, Macchi S, Ambrosio D, De Marchi D, Chiodi E, Resta M, Salvatori C, Pepe A, Artang R, Bogachkov A, Botelho M, Bou-Ayache J, Vazquez M, Carr J, Collins J, Maret E, Ahlander B, Bjorklund P, Engvall J, Cimermancic R, Inage A, Mizuno N, Positano V, Meloni A, Santarelli M, Izzi G, Maddaloni D, De Marchi D, Salvatori C, Landini L, Pepe A, Pepe A, Meloni A, Carulli G, Oliva E, Arcioni F, Fraticelli V, Toia P, Renne S, Restaino G, Salvatori C, Rizzo M, Reinstadler S, Klug G, Feistritzer H, Aschauer A, Schocke M, Franz W, Metzler B, Melonil A, Positanol V, Roccamo G, Argento C, Benni M, De Marchil D, Missere M, Prezios P, Salvatoril C, Pepel A, Meloni A, Rossi G, Positano V, Cirotto C, Filati G, Toia P, Preziosi P, De Marchi D, Pepe A, Mongeon F, Fischer K, Teixeira T, Friedrich M, Marcotte F, Vincenti G, Monney P, Rutz T, Zenge M, Schmidt M, Nadar M, Chevre P, Rohner C, Schwitter J, Mouratoglou S, Kallifatidis A, Giannakoulas G, Grapsa J, Kamperidis V, Pitsiou G, Stanopoulos I, Hadjimiltiades S, Karvounis H, Ahmed N, Lawton C, Ghosh Dastidar A, Frontera A, Jackson A, Cripps T, Diab I, Duncan E, Thomas G, Bucciarelli-Ducci C, Kannoly S, Gosling O, Ninan T, Fulford J, Dalrymple-Haym M, Shore A, Bellenger N, Alegret J, Beltran R, Martin M, Mendoza M, Elisabetta C, Teresa C, Zairo F, Marcello N, Clorinda M, Bruna M, Vincenzo P, Alessia P, Giorgio B, Klug G, Feistritzer H, Reinstadler S, Mair J, Schocke M, Kremser C, Franz W, Metzler B, Aschauer S, Tufaro C, Kammerlander A, Pfaffenberger S, Marzluf B, Bonderman D, Mascherbauer J, Kliegel A, Sailer A, Brustbauer R, Sedivy R, Mayr H, Manessi M, Castelvecchio S, Votta E, Stevanella M, Menicanti L, Secchi F, Sardanelli F, Lombardi M, Redaelli A, Reiter U, Reiter G, Kovacs G, Greiser A, Olschewski H, Fuchsjager M, Kammerlander A, Tufaro C, Pfaffenberger S, Marzluf B, Aschauer S, Babayev J, Bonderman D, Mascherbauer J, Mlynarski R, Mlynarska A, Sosnowski M, Pontone G, Bertella E, Petulla M, Russo E, Innocenti E, Baggiano A, Mushtaq S, Gripari P, Andreini D, Tondo C, Nyktari E, Izgi C, Haidar S, Wage R, Keegan J, Wong T, Mohiaddin R, Durante A, Rimoldi O, Laforgia P, Gianni U, Benedetti G, Cava M, Damascelli A, Laricchia A, Ancona M, Aurelio A, Pizzetti G, Esposito A, Margonato A, Colombo A, De Cobelli F, Camici P, Zvaigzne L, Sergejenko S, Kal js O, Kannoly S, Ripley D, Swarbrick D, Gosling O, Hossain E, Chawner R, Moore J, Shore A, Bellenger N, Aquaro G, Barison A, Masci P, Todiere G, Strata E, Barison A, Di Bella G, Monasterio F, Feistritzer H, Reinstadler S, Klug G, Kremser C, Schocke M, Franz W, Metzler B, Levelt E, Mahmod M, Ntusi N, Ariga R, Upton R, Piechnick S, Francis J, Schneider J, Stoll V, Davis A, Karamitsos T, Leeson P, Holloway C, Clarke K, Neubauer S, Karwat K, Tomala M, Miszalski-Jamka K, Mrozi ska S, Kowalczyk M, Mazur W, Kereiakes D, Nessler J, Zmudka K, Ja wiec P, Miszalski-Jamka T, Ben Yaacoub-Kzadri I, Harguem S, Bennaceur R, Ganzoui I, Ben Miled A, Mnif N, Rodriguez Palomares J, Ortiz J, Bucciarelli-Ducci C, Tejedor P, Lee D, Wu E, Bonow R, Khanji M, Castiello T, Westwood M, Petersen S, Pepe A, Meloni A, Carulli G, Oliva E, Arcioni F, Storti S, Grassedonio E, Renne S, Missere M, Positano V, Rizzo M, Meloni A, Quota A, Smacchia M, Paci C, Positano V, Vallone A, Valeri G, Chiodi E, keilberg P, Pepe A, Barison A, De Marchi D, Gargani L, Aquaro G, Guiducci S, Pugliese N, Lombardi M, Pingitore A, Cole B, Douglas H, Rodden S, Horan P, Harbinson M, Johnston N, Dixon L, Choudhary P, Hsu C, Grieve S, Semsarian C, Richmond D, Celermajer D, Puranik R, Hinojar Baydes R, Varma N, Goodman B, Khan S, Arroyo Ucar E, Dabir D, Schaeffter T, Nagel E, Puntmann V, Hinojar R, Ucar E, Ngah N, Kuo N, D'Cruz D, Gaddum N, Schaeffter T, Nagel E, Puntmann V, Hinojar R, Foote L, Arroyo Ucar E, Dabir D, Schnackenburg B, Higgins D, Schaeffter T, Nagel E, Puntmann V, Nucifora G, Muser D, Morocutti G, Gianfagna P, Zanuttini D, Piccoli G, Proclemer A, Nucifora G, Prati G, Vitrella G, Allocca G, Buttignoni S, Muser D, Morocutti G, Delise P, Proclemer A, Sinagra G, Silva G, Almeida A, David C, Francisco A, Magalhaes A, Placido R, Menezes M, Guimaraes T, Mendes A, Nunes Diogo A, Aneq M, Maret E, Engvall J, Douglas H, Cole B, Rodden S, Horan P, Harbinson M, Dixon L, Johnston N, Papavassiliu T, Sandberg R, Schimpf R, Schoenberg S, Borggrefe M, Doesch C, Khan S, Tamin S, Tan L, Joshi S, Khan S, Memon S, Tamin S, Tan L, Joshi S, Tangcharoen T, Prasertkulchai W, Yamwong S, Sritara P, Hinojar R, Foote L, Arroyo Ucar E, Binti Ngah N, Cruz D, Schnackenburg B, Higgins D, Schaeffter T, Nagel E, Puntmann V, Nucifora G, Muser D, Masci P, Barison A, Rebellato L, Piccoli G, Daleffe E, Zanuttini D, Facchin D, Lombardi M, Proclemer A, Melao F, Paiva M, Pinho T, Martins E, Vasconcelos M, Madureira A, Macedo F, Ramos I, Maciel M, Agoston-Coldea L, Marjanovic Z, Hadj Khelifa S, Kachenoura N, Lupu S, Soulat G, Farge-Bancel D, Mousseaux E, Ben Yaacoub-Kzadri I, Harguem S, Bennaceur R, Ben Miled A, Mnif N, Dastidar A, Ahmed N, Frontera A, Lawton C, Augustine D, McAlindon E, Bucciarelli-Ducci C, Vasconcelos M, Leite S, Sousa C, Pinho T, Rangel I, Madureira A, Ramos I, Maciel M, El ghannudi S, Lefoulon A, Noel E, Germain P, Doutreleau S, Jeung M, Gangi A, Roy C, Todiere G, Pisciella L, Barison A, Zachara E, Federica R, Emdin M, Aquaro G, El ghannudi S, Lefoulon A, Noel E, Germain P, Doutreleau S, Jeung M, Gangi A, Roy C, Baydes R, Ucar E, Foote L, Dabir D, Mahmoud I, Jackson T, Schaeffter T, Higgins D, Nagel E, Puntmann V, Melao F, Paiva M, Pinho T, Martins E, Vasconcelos M, Madureira A, Macedo F, Ramos I, Maciel M. These abstracts have been selected for VIEWING only as ePosters and in print. ePosters will be available on Screen A & B throughout the meeting, Print Posters at the times indicated below. Please refer to the PROGRAM for more details. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pistilli B, Rossi D, Benedetti G, Baldelli AM, Decembrini-Cognigni P, Casadei V, Ciccioli G, Ranaldi R, Fiorentini G, Latini L. Abstract P3-14-16: A phase 2 trial of myocet®, cyclophosphamide +/- trastuzumab followed by weekly paclitaxel +/- trastuzumab as primary systemic therapy in operable and locally advanced breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-14-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: Anthracycline- and taxane-based chemotherapies are highly effective in primary systemic treatment of breast cancer (BC). Myocet® (M) is a non-pegylated liposomal doxorubicin exhibiting reduced cardiotoxicity as compared to doxorubicin. Combination of M and cyclophosphamide (C) has demonstrated efficacy in first line treatment of metastatic BC, however few data are available in neoadjuvant setting, especially in combination with trastuzumab (T). The aims of the study were activity, in terms of pathological complete response (pCR; ie, no remaining invasive tumor in breast and lymphnodes) and safety of a sequential schedule of M and C +/- T followed by weekly paclitaxel (P) +/- T. METHODS: Estrogen receptor (ER), progesterone receptor (PgR), HER2 positivity (defined as 3+ overexpression by immunoistochemical testing or HER2 amplification by fluorescent in situ hybridisation) and Ki67 index were assessed in core needle biopsies at baseline and in residual tumour after chemotherapy. Patients with stage II/III BC received 4 cycles of MC (myocet 60 mg/m2, cyclophosphamide 600 mg/m2 on day 1 every 3 weeks), followed by 12 weekly doses of P (paclitaxel 80 mg/m2); all patients with HER2+ disease received T in combination with chemotherapy (trastuzumab loading dose of 8 mg/kg followed by 3 cycles of 6 mg/kg alongside MC; 2 mg/kg per week with the following 12 P administrations). RESULTS: 49 patients were enrolled, with 44 patients having completed chemotherapy and undergoing surgery to date. Median age was 56 years (range, 34 to 72). Tumour characteristics were as follows: stage IIA 10 patients, IIB 16, IIIA 13, IIIB 5, IIIC 1, and 4 patients with inflammatory BC; ER+/PgR+ 21 patients, ER+/PgR- 13, triple negative 8, HER2+ 16; Ki67> 15% in 41 patients. Forty-four patients were evaluable for pathological response. pCR was obtained in 12 patients (27.3%). The rate of pCR in HER2+ and HER2- BC was 57.1% and 13.3%, respectively. Clinical response was obtained in 36 out of 41 clinically evaluable patients (87.8%): CR in 20 (48.8%) and PR in 16 (39%). Conservative surgery was performed in 16 patients (36.4%) and mastectomy in 28 (63.6%). The most frequently observed grade 3-4 AEs were: alopecia 47 patients (95.9%), grade 3 neutropenia 2 (4.1%), febrile neutropenia 2 (4,1%), grade 3 paresthesia 2 (4.1%), grade 3 vomiting 1 (2%), grade 3 cutaneous erythema 1 (2%). Only 1 patient experienced an asymptomatic decrease of ejection fraction lower than 50%. Five patients (10.2%) discontinued treatment with M+C because of: allergic reaction to M in 3 patients, grade 2 liver toxicity in 1 and grade 3 vomiting in 1. All of them completed the following treatment with P. Three patients (6.1%) discontinued P because of: allergic reaction in 1 patient, infectious pneumonia in 1 and grade 3 cutaneous erythema in 1. CONCLUSIONS: The use of M in this sequential anthracycline- and taxane-based regimen resulted tolerable even in combination with T and active despite of the high rate of patients with ER+ disease and with locally advanced cancer. Consistently with previous data, pCR was higher in patients with HER2+ BC.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-14-16.
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Affiliation(s)
- B Pistilli
- Oncology Unit-Area Vasta 3, Macerata, MC, Italy; Ospedali Riuniti Marche Nord, Pesaro, PU, Italy; Surgery Unit-Area Vasta 3, Civitanova Marche, MC, Italy; Radiology Unit-Area Vasta 3, Macerata, MC, Italy; Pathology Unit-Area Vasta 3, Macerata, MC, Italy
| | - D Rossi
- Oncology Unit-Area Vasta 3, Macerata, MC, Italy; Ospedali Riuniti Marche Nord, Pesaro, PU, Italy; Surgery Unit-Area Vasta 3, Civitanova Marche, MC, Italy; Radiology Unit-Area Vasta 3, Macerata, MC, Italy; Pathology Unit-Area Vasta 3, Macerata, MC, Italy
| | - G Benedetti
- Oncology Unit-Area Vasta 3, Macerata, MC, Italy; Ospedali Riuniti Marche Nord, Pesaro, PU, Italy; Surgery Unit-Area Vasta 3, Civitanova Marche, MC, Italy; Radiology Unit-Area Vasta 3, Macerata, MC, Italy; Pathology Unit-Area Vasta 3, Macerata, MC, Italy
| | - AM Baldelli
- Oncology Unit-Area Vasta 3, Macerata, MC, Italy; Ospedali Riuniti Marche Nord, Pesaro, PU, Italy; Surgery Unit-Area Vasta 3, Civitanova Marche, MC, Italy; Radiology Unit-Area Vasta 3, Macerata, MC, Italy; Pathology Unit-Area Vasta 3, Macerata, MC, Italy
| | - P Decembrini-Cognigni
- Oncology Unit-Area Vasta 3, Macerata, MC, Italy; Ospedali Riuniti Marche Nord, Pesaro, PU, Italy; Surgery Unit-Area Vasta 3, Civitanova Marche, MC, Italy; Radiology Unit-Area Vasta 3, Macerata, MC, Italy; Pathology Unit-Area Vasta 3, Macerata, MC, Italy
| | - V Casadei
- Oncology Unit-Area Vasta 3, Macerata, MC, Italy; Ospedali Riuniti Marche Nord, Pesaro, PU, Italy; Surgery Unit-Area Vasta 3, Civitanova Marche, MC, Italy; Radiology Unit-Area Vasta 3, Macerata, MC, Italy; Pathology Unit-Area Vasta 3, Macerata, MC, Italy
| | - G Ciccioli
- Oncology Unit-Area Vasta 3, Macerata, MC, Italy; Ospedali Riuniti Marche Nord, Pesaro, PU, Italy; Surgery Unit-Area Vasta 3, Civitanova Marche, MC, Italy; Radiology Unit-Area Vasta 3, Macerata, MC, Italy; Pathology Unit-Area Vasta 3, Macerata, MC, Italy
| | - R Ranaldi
- Oncology Unit-Area Vasta 3, Macerata, MC, Italy; Ospedali Riuniti Marche Nord, Pesaro, PU, Italy; Surgery Unit-Area Vasta 3, Civitanova Marche, MC, Italy; Radiology Unit-Area Vasta 3, Macerata, MC, Italy; Pathology Unit-Area Vasta 3, Macerata, MC, Italy
| | - G Fiorentini
- Oncology Unit-Area Vasta 3, Macerata, MC, Italy; Ospedali Riuniti Marche Nord, Pesaro, PU, Italy; Surgery Unit-Area Vasta 3, Civitanova Marche, MC, Italy; Radiology Unit-Area Vasta 3, Macerata, MC, Italy; Pathology Unit-Area Vasta 3, Macerata, MC, Italy
| | - L Latini
- Oncology Unit-Area Vasta 3, Macerata, MC, Italy; Ospedali Riuniti Marche Nord, Pesaro, PU, Italy; Surgery Unit-Area Vasta 3, Civitanova Marche, MC, Italy; Radiology Unit-Area Vasta 3, Macerata, MC, Italy; Pathology Unit-Area Vasta 3, Macerata, MC, Italy
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Rossi D, Pistilli B, Morale D, Baldelli, Casadei V, Benedetti G, Alessandroni P, Catalano V, Giordani P, Graziano F, Fedeli SL, Fiorentini G. "Short Course" of Nonpegylated Liposomal Doxorubicin Plus Paclitaxel and Trastuzumb as Primary Systemic Therapy for Operable and Locally-Advanced Breast Cancer: A Phase II Study (PacLiDox 07). World J Oncol 2011; 2:245-251. [PMID: 29147255 PMCID: PMC5649686 DOI: 10.4021/wjon393w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2011] [Indexed: 11/29/2022] Open
Abstract
Background Schedules with anthracyclines and taxanes are one of the best options for primary chemotherapy. The addition of trastuzumab showed an impressive percentage of pathological complete responses in Buzdar trial (66.7%). Recently, nonpegylated liposome-encapsulated doxorubicin (NLD) has been widely used in advanced breast cancer with high response rates (98.1 % in Cortes study). The aims of our study were to assess pathological responses and toxicity of NLD plus paclitaxel (and trastuzumab in patients with HER2 overexpression). Methods Thirty patients entered the study: 9 locally advanced and 21 operable. Median age was 58.5 years (range: 31-73). 23 patients without HER2 overexpression (or FISH not amplified) were treated with NLD 50 mg/m2 every three weeks for 3 courses and weekly paclitaxel 80 mg/m2 for 8 courses. 7 patients with HER2 overexpression or FISH amplified were treated with the same schedules plus trastuzumab (Herceptin) 4 mg/kg for the first administration and 2 mg/kg for the following 7 weekly administrations. Results Pathological complete response (pCR) was documented in 1 patient (treated with trastuzumab); no residual tumor (infiltrating or “in situ”) on breast was documented in other 2 patients. Objective clinical responses were documented in 22 patients (73.3%): 8 complete, 10 partial and 4 “minimal” responses. 7 patients have shown stable and 1 progressive disease. Clinical response in patients with HER2 overexpression treated with trastuzumab was 100% (4 complete and 3 partial responses). Conservative surgery was performed in 8 (38%) and mastectomy in 13 (62%) out of 21 operable patients; however, 7 out of 14 responding patients with operable disease underwent quadrantectomy (50%). Main toxicity was neutropenia: febrile in 2 patients (7%) and gr. 3-4 in 13 (43%). Other grade 3 toxicities were as follows: vomiting in 1 patient, asthenia in 1 patient, joint symptom in 1 patient. 3 patients were withdrawn from the study. No episodes of left ventricular ejection fraction (LVEF) < 50% were recorded (with a median reduction of 8%). Conclusions A “short course” of paclitaxel and NLD is active in terms of clinical response and conservative surgery for patients with potentially operable and locally advanced breast cancer; toxicity was manageable. High activity of the combination with trastuzumab has been confirmed. However, with this “short course” schedule, the result in term of clinical responses didn't turn into complete pathological responses.
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Affiliation(s)
- D Rossi
- Oncology Unit, Marche Nord Hospital, S. Salvatore, Italy
| | - B Pistilli
- Oncolgy Unit, Macerata General Hospital, Italy
| | - D Morale
- Oncology Unit, Ascoli Piceno General Hospital, Italy
| | - Baldelli
- Oncology Unit, Marche Nord Hospital, S. Salvatore, Italy
| | - V Casadei
- Oncology Unit, Marche Nord Hospital, S. Salvatore, Italy
| | - G Benedetti
- Oncolgy Unit, Macerata General Hospital, Italy
| | - P Alessandroni
- Oncology Unit, Marche Nord Hospital, S. Salvatore, Italy
| | - V Catalano
- Oncology Unit, Marche Nord Hospital, S. Salvatore, Italy
| | - P Giordani
- Oncology Unit, Marche Nord Hospital, S. Salvatore, Italy
| | - F Graziano
- Oncology Unit, Marche Nord Hospital, S. Salvatore, Italy
| | - S Luzi Fedeli
- Oncology Unit, Marche Nord Hospital, S. Salvatore, Italy
| | - G Fiorentini
- Oncology Unit, Marche Nord Hospital, S. Salvatore, Italy
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Jensen RL, Gilliespie D, Ajewung N, Faure R, Kamnasaran D, Ajewung N, Poirier D, Kamnasaran D, Tamura K, Wakimoto H, Rabkin SD, Martuza RL, Shah K, Hashizume R, Aoki Y, Serwer LP, Drummond D, Noble C, Park J, Bankiewicz K, James DC, Gupta N, Agerholm-Larsen B, Iversen HK, Jensen KS, Moller J, Ibsen P, Mahmood F, Gehl J, Corem E, Ram Z, Daniels D, Last D, Shneor R, Salomon S, Perlstein B, Margel S, Mardor Y, Charest G, Fortin D, Mathieu D, Sanche L, Paquette B, Li HF, Hashizume R, Aoki Y, Hariono S, Dasgupta T, Kim JS, Haas-Kogan D, Weiss WA, Gupta N, James CD, Waldman T, Nicolaides T, Ozawa T, Rao S, Sun H, Ng C, De La Torre J, Santos R, Prados M, James CD, Butowski N, Michaud K, Solomon DA, Li HF, Kim JS, Prados MD, Ozawa T, Waldman T, James CD, Pandya H, Gibo D, Debinski W, Vinchon-Petit S, Jarnet D, Jadaud E, Feuvret L, Garcion E, Menei P, Chen R, Yu JC, Liu C, Jaffer ZM, Chabala JC, Winssinger N, Rubenstein AE, Emdad L, Kothari H, Qadeer Z, Binello E, Germano I, Hirschberg H, Baek SK, Kwon YJ, Sun CH, Li SC, Madsen S, Debinski W, Liu T, Wang SW, Gibo DM, Fan QW, Cheng C, Hackett C, Feldman M, Houseman BT, Houseman BT, Nicolaides T, James CD, Haas-Kogan D, Oakes SA, Debnath J, Shokat KM, Weiss WA, Sai K, Chen F, Qiu Z, Mou Y, Zhang X, Yang Q, Chen Z, Patel TR, Zhou J, Piepmeier JM, Saltzman WM, Banerjee S, Kaul A, Gianino SM, Christians U, Gutmann DH, Wu J, Shen R, Puduvalli V, Koul D, Alfred Yung WK, Yun J, Sonabend A, Stuart M, Yanagihara T, Dashnaw S, Brown T, McCormick P, Romanov A, Sebastian M, Canoll P, Bruce JN, Piao L, Joshi K, Lee RJ, Nakano I, Madsen SJ, Chou CC, Blickenstaff JW, Sun CH, Zhou YH, Hirschberg H, Tome CML, Wykosky J, Palma E, Debinski W, Nduom E, Machaidze R, Kaluzova M, Wang Y, Nie S, Hadjipanayis C, Saito R, Nakamura T, Sonoda Y, Kumabe T, Tominaga T, Lun X, Zemp F, Zhou H, Stechishin O, Kelly JJ, Weiss S, Hamilton MG, Cairncross G, Rabinovich BA, Bell J, McFadden G, Senger DL, Forsyth PA, Kang P, Jane EP, Premkumar DR, Pollack IF, Yoo JY, Haseley A, Bratasz A, Powell K, Chiocca EA, Kaur B, Johns TG, Ferruzzi P, Mennillo F, De Rosa A, Rossi M, Giordano C, Magrini R, Benedetti G, Pericot GL, Magnoni L, Mori E, Thomas R, Tunici P, Bakker A, Yoo JY, Pradarelli J, Kaka A, Alvarez-Breckenridge C, Pan Q, Teknos T, Chiocca EA, Kaur B, Cen L, Ostrem JL, Schroeder MA, Mladek AC, Fink SR, Jenkins RB, Sarkaria JN, Madhankumar AB, Slagle-Webb B, Park A, Pang M, Klinger M, Harbaugh KS, Sheehan JM, Connor JR, Chen TC, Wang W, Hofman FM, Serwer LP, Michaud K, Drummond DC, Noble CO, Park JW, Ozawa T, James CD, Serwer LP, Noble CO, Michaud K, Drummond DC, Ozawa T, Zhou Y, Marks JD, Bankiewicz K, Park JW, James CD, Alonso MM, Gomez-Manzano C, Cortes-Santiago N, Roche FP, Fueyo J, Johannessen TCA, Grudic A, Tysnes BB, Nigro J, Bjerkvig R, Joshi AD, Parsons W, Velculescu VE, Riggins GJ, Bindra RS, Jasin M, Powell SN, Fu J, Koul D, Shen RJ, Colman H, Lang FF, Jensen MR, Alfred Yung WK, Friedman GK, Haas M, Cassady KA, Gillespie GY, Nguyen V, Murphy LT, Beauchamp AS, Hollingsworth CK, Debinski W, Mintz A, Pandya H, Garg S, Gibo D, Kridel S, Debinski W, Conrad CA, Madden T, Ji Y, Colman H, Priebe W, Seleverstov O, Purow BW, Grant GA, Wilson C, Campbell M, Humphries P, Li S, Li J, Johnson A, Bigner D, Dewhirst M, Sarkaria JN, Cen L, Pokorny JL, Mladek AC, Kitange GJ, Schroeder MA, Carlson BL, Suphangul M, Petro B, Mukhtar L, Baig MS, Villano J, Mahmud N, Keir ST, Reardon DA, Watson M, Shore GC, Bigner DD, Friedman HS, Keir ST, Gururangan S, Reardon DA, Bigner DD, Friedman HS. Pre-clinical Experimental Therapeutics and Pharmacology. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rossi D, Pistilli B, Morale D, Baldelli A, Casadei V, Benedetti G, Luzi Fedeli S. Liposome-encapsulated doxorubicin plus paclitaxel and trastuzumab as neoadjuvant chemotherapy for operable and locally advanced breast cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e11069] [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: 11/20/2022] Open
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Cognetti F, Gori S, Adamo V, Molino A, Benedetti G, Casadei Gardini A, Gildetti S, Riccardi F, Rossi S, Del Mastro L. NEMESI: A retrospective observational longitudinal study to investigate italian early breast cancer (EBC) patient characteristics and treatment. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e11046] [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: 11/20/2022] Open
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Cester N, Mazzanti L, Benedetti G, Cugini AM, Rabini RA, Tranquilli AL, Valensise H, Romanini C. Pregnancy Induced Hypertension: Observations on Chemical-Physical Properties of Syncytiotrophoblast Plasma Membranes from Human Placenta. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/10641958809023502] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Saibeni S, Virgilio T, D'Incà R, Spina L, Bortoli A, Paccagnella M, Peli M, Sablich R, Meucci G, Colombo E, Benedetti G, Girelli CM, Casella G, Grasso G, de Franchis R, Vecchi M. The use of thiopurines for the treatment of inflammatory bowel diseases in clinical practice. Dig Liver Dis 2008; 40:814-20. [PMID: 18479986 DOI: 10.1016/j.dld.2008.03.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [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] [Received: 11/30/2007] [Revised: 02/19/2008] [Accepted: 03/27/2008] [Indexed: 12/11/2022]
Abstract
BACKGROUND Thiopurines are the most commonly used immunomodulatory drugs in inflammatory bowel diseases. AIM To evaluate the use, the therapeutic and safety profiles of thiopurines in a large sample of IBD patients. METHODS We reviewed 3641 case histories of IBD patients. Thiopurines were prescribed in 582 patients (16.0%); the analysis was performed on the 553 (267 ulcerative colitis, 286 Crohn's disease) with exhaustive clinical data. RESULTS The main indications for treatment were steroid-dependence (328/553, 59.3%) and steroid-resistance (113/553, 20.7%). Thiopurines were started when CD were younger than UC patients (p<0.001) but earlier from diagnosis in UC than in CD patients (p=0.003). Efficacy was defined as optimal (258/553, 46.6%), partial (108/553, 19.5%), absent (85/553, 15.4%) and not assessable (102/553, 18.4%). Efficacy was independent of disease type, location/extension or duration and age at starting. Side effects were observed in 151/553 (27.3%) patients, leading to drug discontinuation in 101 (18.3%). 15 out of the 130 (11.5%) patients who took thiopurines for more than 4 years relapsed, more frequently in CD than in UC (OR=3.67 95% C.I. 0.98-13.69; p=0.053). CONCLUSIONS Thiopurines confirm their clinical usefulness and acceptable safety profile in managing complicated IBD patients. The majority of patients treated for longer than 4 years maintain response. No clinical and demographic predictive factors for efficacy and side effects were identified.
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Affiliation(s)
- S Saibeni
- IRCCS Policlinico Hospital, Mangiagalli and Regina Elena Foundation Milan, Italy.
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Piccolin G, Benedetti G, Doglioni C, Lorenzato C, Mancuso S, Papa N, Pitton L, Ramon MC, Zasio C, Bertiato G. A study of the presence of B. burgdorferi, Anaplasma (previously Ehrlichia) phagocytophilum, Rickettsia, and Babesia in Ixodes ricinus collected within the territory of Belluno, Italy. Vector Borne Zoonotic Dis 2007; 6:24-31. [PMID: 16584324 DOI: 10.1089/vbz.2006.6.24] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In the years 2000 and 2001, we sampled ticks in order to establish the distribution of Ixodes ricinus in the province of Belluno; 5987 tick samples from 244 sites throughout the province were gathered, by dragging for a 5-min period. In 40 sites, seasonal variations and cycle stages of the parasites were studied at monthly intervals from March to September. A polymerase chain reaction (PCR) technique was used to identify the tick-infected sites. Of 1931 individual ticks, 8.23% were positive for Borrelia burgdorferi, 4.4% were positive for Ehrlichia, 1.6% were positive for Rickettsia, and 1.6% were positive for Babesia. The co-presence of Borrelia and Ehrlichia (1.2%) and Babesia (0.5%), Borrelia, Ehrlichia and Rickettsia (0.1%) was also found.
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Affiliation(s)
- G Piccolin
- Observatory for the Study, Surveillance and Prevention of Tick-Borne Diseases, ULSS, Veneto, Belluno, Italy
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Falcone A, Masi G, Brunetti I, Benedetti G, Bertetto O, Picone V, Chiara S, Merlano M, Vitello S, Ricci S. The triplet combination of irinotecan, oxaliplatin and 5FU/LV (FOLFOXIRI) vs the doublet of irinotecan and 5FU/LV (FOLFIRI) as first-line treatment of metastatic colorectal cancer (MCRC): Results of a randomized phase III trial by the Gruppo Oncologico Nord Ovest (G.O.N.O.). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3513] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3513 Background: We demonstrated interesting activity and manageable toxicities for the FOLFOXIRI regimen in phase I-II studies. Methods: The G.O.N.O. conduced a phase III study comparing FOLFIRI (CPT11 180 mg/sqm d1, l-LV 100 mg/sqm d1+d2, 5FU 400 mg/sqm bolus d1+d2, 5FU 600 mg/sqm 22-h inf. on d1+d2, arm A), to FOLFOXIRI (CPT11 165 mg/sqm d1, LOHP 85 mg/sqm d1, l-LV 200 mg/sqm d1, 5FU 3200 mg/sqm 48-h inf. starting on d1, arm B). Both treatments were repeated every 2 weeks and at progression to FOLFIRI a FOLFOX combination was recommended. Selection criteria included measurable and not resectable MCRC, age 18–75 years, no prior chemotherapy for advanced disease. Primary endpoint was response rate (RR) and planned accrual was 240 pts. Secondary endpoints were PFS, OS, post-CT R0 surgical resections, safety and QoL. Results: A total of 244 pts were randomized. Main toxicities were (arm A/arm B): grade 3–4 diarrhea 12%/20%, grade 3–4 vomiting 2%/7%, grade 3–4 stomatitis 3%/5%, grade 2–3 peripheral neurotoxicity 0%/20%, grade 4 neutropenia 11%/17%, febrile neutropenia 3%/5%. Two pts in each arm died within 60 days, but no toxic deaths occurred. Responses, assessed by investigators, were (arm A/arm B): complete 6%/8%, partial 35%/58%, stable 33%/21%, progression 24%/11%, for an overall RR of 41% vs 66%, p=0.0002. RR confirmed by an external panel was 34%/60%, p<0.0001. This increased activity allowed a radical secondary resection of mts in a greater percentage of patients in the FOLFOXIRI arm (6% vs 14%, p=0.05, among all 244 pts and 12% vs 36%, p=0.02, among 81 patients with liver mts only). At a median follow-up of 15.2 months 112 vs 104 pts have progressed and 81 vs 65 have died with a significant improvement in progression-free and overall survival in favor of the triplet (median PFS 6.9 vs 9.8 mos, HR: 0.63, p=0.0006; median S 16.7 vs 22.6, HR:0.70, p=0.032). Conclusions: The FOLFOXIRI regimen is feasible with manageable toxicities and significantly increases RR, R0 resection of mts, PFS and overall S compared to FOLFIRI. (Partially supported by Fondazione ARCO). [Table: see text]
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Affiliation(s)
- A. Falcone
- Università degli Studi, Pisa, Italy; Ospedale Civile, Livorno, Italy; Ospedale S. Chiara, Pisa, Italy; Ospedale Bellaria, Bologna, Italy; Ospedale S. Giovanni Le Molinette, Torino, Italy; Università La Sapienza, Roma, Italy; IST, Genova, Italy; Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy; Ospedale S. Elia, Caltanissetta, Italy
| | - G. Masi
- Università degli Studi, Pisa, Italy; Ospedale Civile, Livorno, Italy; Ospedale S. Chiara, Pisa, Italy; Ospedale Bellaria, Bologna, Italy; Ospedale S. Giovanni Le Molinette, Torino, Italy; Università La Sapienza, Roma, Italy; IST, Genova, Italy; Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy; Ospedale S. Elia, Caltanissetta, Italy
| | - I. Brunetti
- Università degli Studi, Pisa, Italy; Ospedale Civile, Livorno, Italy; Ospedale S. Chiara, Pisa, Italy; Ospedale Bellaria, Bologna, Italy; Ospedale S. Giovanni Le Molinette, Torino, Italy; Università La Sapienza, Roma, Italy; IST, Genova, Italy; Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy; Ospedale S. Elia, Caltanissetta, Italy
| | - G. Benedetti
- Università degli Studi, Pisa, Italy; Ospedale Civile, Livorno, Italy; Ospedale S. Chiara, Pisa, Italy; Ospedale Bellaria, Bologna, Italy; Ospedale S. Giovanni Le Molinette, Torino, Italy; Università La Sapienza, Roma, Italy; IST, Genova, Italy; Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy; Ospedale S. Elia, Caltanissetta, Italy
| | - O. Bertetto
- Università degli Studi, Pisa, Italy; Ospedale Civile, Livorno, Italy; Ospedale S. Chiara, Pisa, Italy; Ospedale Bellaria, Bologna, Italy; Ospedale S. Giovanni Le Molinette, Torino, Italy; Università La Sapienza, Roma, Italy; IST, Genova, Italy; Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy; Ospedale S. Elia, Caltanissetta, Italy
| | - V. Picone
- Università degli Studi, Pisa, Italy; Ospedale Civile, Livorno, Italy; Ospedale S. Chiara, Pisa, Italy; Ospedale Bellaria, Bologna, Italy; Ospedale S. Giovanni Le Molinette, Torino, Italy; Università La Sapienza, Roma, Italy; IST, Genova, Italy; Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy; Ospedale S. Elia, Caltanissetta, Italy
| | - S. Chiara
- Università degli Studi, Pisa, Italy; Ospedale Civile, Livorno, Italy; Ospedale S. Chiara, Pisa, Italy; Ospedale Bellaria, Bologna, Italy; Ospedale S. Giovanni Le Molinette, Torino, Italy; Università La Sapienza, Roma, Italy; IST, Genova, Italy; Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy; Ospedale S. Elia, Caltanissetta, Italy
| | - M. Merlano
- Università degli Studi, Pisa, Italy; Ospedale Civile, Livorno, Italy; Ospedale S. Chiara, Pisa, Italy; Ospedale Bellaria, Bologna, Italy; Ospedale S. Giovanni Le Molinette, Torino, Italy; Università La Sapienza, Roma, Italy; IST, Genova, Italy; Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy; Ospedale S. Elia, Caltanissetta, Italy
| | - S. Vitello
- Università degli Studi, Pisa, Italy; Ospedale Civile, Livorno, Italy; Ospedale S. Chiara, Pisa, Italy; Ospedale Bellaria, Bologna, Italy; Ospedale S. Giovanni Le Molinette, Torino, Italy; Università La Sapienza, Roma, Italy; IST, Genova, Italy; Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy; Ospedale S. Elia, Caltanissetta, Italy
| | - S. Ricci
- Università degli Studi, Pisa, Italy; Ospedale Civile, Livorno, Italy; Ospedale S. Chiara, Pisa, Italy; Ospedale Bellaria, Bologna, Italy; Ospedale S. Giovanni Le Molinette, Torino, Italy; Università La Sapienza, Roma, Italy; IST, Genova, Italy; Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy; Ospedale S. Elia, Caltanissetta, Italy
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Hakim R, Poggi R, Pantaleo M, Benedetti G, Brandi G, Zannetti G, Astorino M, Fanello S, Dell’arte S, Biasco G. Phase II study of temozolomide and celecoxib in the treatment of metastatic melanoma. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.18015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
18015 Background: There is increasing evidence that the expression of Cyclo-oxygenase 2 correlates with development and progression of malignant melanoma. Celecoxib (C) has demonstrated some kind of activity in monotherapy in melanoma. Temozolomide (T) has consistent activity in melanoma, either as monotherapy or in combination. We designed a phase II study to determine the efficacy and toxicity of the combination of Celecoxib and Temozolomide in advanced melanoma as first line of therapy Methods: From January 2004 to October 2005, 13 patients with metastatic melanoma were enrolled in the study. There were 4 males and 9 females. The median age was 59 years. Patients received Temozolomide 200/mg/mq day po for 5 days every 4 weeks and Celecoxib 400 mg BID for 10 days every 4 weeks. Results: Among 12 evaluable patients there were 4 partial responses (30.8%), no complete response or disease stabilization. Progression occurred in 8 patients (61.5%). The median TTP was 3.14 months and the median survival was 9.06 months. The median number of cycles was 2, only 2 patients completed four cycles of treatment. Most commonly seen toxicities were nausea/vomiting (46%), fatigue (93%), thrombocytopenia (15.3%), leukopenia (7.6%). Two patients discontinued the treatment due to grade 4 thrombocytopenia. Conclusions: The combination of Temozolomide and Celecoxib is safe, manageable and provides clinical benefit, but its activity is not superior to standard therapy. No significant financial relationships to disclose.
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Affiliation(s)
- R. Hakim
- Institute of Hematology and Medical Oncology L.A., University of Bologna, Bologna, Italy; Institute of Hematology and Oncology L.A.Seragnoli, Bologna, Italy; Medical Oncology Hospital of Macerata, Macerata, Italy; Sant’Orsola-Malpighi Hospital, Bologna, Italy
| | - R. Poggi
- Institute of Hematology and Medical Oncology L.A., University of Bologna, Bologna, Italy; Institute of Hematology and Oncology L.A.Seragnoli, Bologna, Italy; Medical Oncology Hospital of Macerata, Macerata, Italy; Sant’Orsola-Malpighi Hospital, Bologna, Italy
| | - M. Pantaleo
- Institute of Hematology and Medical Oncology L.A., University of Bologna, Bologna, Italy; Institute of Hematology and Oncology L.A.Seragnoli, Bologna, Italy; Medical Oncology Hospital of Macerata, Macerata, Italy; Sant’Orsola-Malpighi Hospital, Bologna, Italy
| | - G. Benedetti
- Institute of Hematology and Medical Oncology L.A., University of Bologna, Bologna, Italy; Institute of Hematology and Oncology L.A.Seragnoli, Bologna, Italy; Medical Oncology Hospital of Macerata, Macerata, Italy; Sant’Orsola-Malpighi Hospital, Bologna, Italy
| | - G. Brandi
- Institute of Hematology and Medical Oncology L.A., University of Bologna, Bologna, Italy; Institute of Hematology and Oncology L.A.Seragnoli, Bologna, Italy; Medical Oncology Hospital of Macerata, Macerata, Italy; Sant’Orsola-Malpighi Hospital, Bologna, Italy
| | - G. Zannetti
- Institute of Hematology and Medical Oncology L.A., University of Bologna, Bologna, Italy; Institute of Hematology and Oncology L.A.Seragnoli, Bologna, Italy; Medical Oncology Hospital of Macerata, Macerata, Italy; Sant’Orsola-Malpighi Hospital, Bologna, Italy
| | - M. Astorino
- Institute of Hematology and Medical Oncology L.A., University of Bologna, Bologna, Italy; Institute of Hematology and Oncology L.A.Seragnoli, Bologna, Italy; Medical Oncology Hospital of Macerata, Macerata, Italy; Sant’Orsola-Malpighi Hospital, Bologna, Italy
| | - S. Fanello
- Institute of Hematology and Medical Oncology L.A., University of Bologna, Bologna, Italy; Institute of Hematology and Oncology L.A.Seragnoli, Bologna, Italy; Medical Oncology Hospital of Macerata, Macerata, Italy; Sant’Orsola-Malpighi Hospital, Bologna, Italy
| | - S. Dell’arte
- Institute of Hematology and Medical Oncology L.A., University of Bologna, Bologna, Italy; Institute of Hematology and Oncology L.A.Seragnoli, Bologna, Italy; Medical Oncology Hospital of Macerata, Macerata, Italy; Sant’Orsola-Malpighi Hospital, Bologna, Italy
| | - G. Biasco
- Institute of Hematology and Medical Oncology L.A., University of Bologna, Bologna, Italy; Institute of Hematology and Oncology L.A.Seragnoli, Bologna, Italy; Medical Oncology Hospital of Macerata, Macerata, Italy; Sant’Orsola-Malpighi Hospital, Bologna, Italy
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Benedetti G, Damiani S, Cancellieri A, Magrini E, Fedele M, Tamberi S, Frezza G, Crino L. Analysis of neuroendocrine, signal transduction and adhesion proteins in SCLC tissue to predict the tumor response and the rogression free survival (PFS) in limited stage SCLC (SCLC-LS) patients subjected to chemo-radiation therapy. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.17075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
17075 Background: Most of SCLC-LS patients (pts) relapse within 12 months because of chemo and radio resistance. This phenomenon seems related to the induction of morphologically variant cells, which lack the neuroendocrine expression proteins and seem to trigger Akt-dependent inhibition of apoptosis. We analyzed neuroendocrine, signal transduction and adhesion molecules on tumor tissue from pts treated with chemoradiation therapy for SCLC-LS. Methods: We treated twenty-two pts with cisplatin/etoposide and concurrent thoracic irradiation. Paraffin blocks of the tumor obtained from each pt were used in the immunohistochemical analysis (IHA). Sections were stained with antibodies against phospho-Akt (p-Akt), phospho-MAP Kinase (p-MAPK), by a routine IHA method. Sections were stained in parallel with an automated immunostainer with antibodies against chromogranin A (ChrA), Neuron Specific Enolase (NSE), E-cadherin (Cad). Results: A preliminary IHA analysis obtained in ten out of twenty-two pts demonstrated that 9 out of 10 (9/10) tumor were NSE-positive; 6/10 ChrA-positive; 8/10 Cad-positive; 3/10 p-MAPK-positive; 5/10 p-Akt-positive. The correlation with tumor response and progression free survival (PFS) showed that the five patients with prolonged (10–60 months) complete remission (CR) had a p-Akt-positive, on the opposite the pts with short CR (6–18 months ) or partial remission (PR) had a p-Akt-negative staining. The two patient with prolonged and mantained CR (30+ and 60+ months) had a p-Akt-positive and Cad-negative profile. Conclusions: The expression of p-Akt and the absence of E-cadherin seems predict a prolonged CR after chemo-radiation therapy in SCLC-LS pts. Conclusive analysis will be presented at the meeting. No significant financial relationships to disclose.
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Affiliation(s)
- G. Benedetti
- Medical Oncology Hospital of Macerata, Macerata, Italy; Pathology in Bellaria Hospital of Bologna, Bologna, Italy; pathology Maggiore Hospital of Bologna, Bologna, Italy; Medical Oncology Bellaria Hospital of Bologna, Bologna, Italy; Medical Oncology Hospital of Faenza, Faenza, Italy; Radiotherapy Bellaria Hospital of Bologna, Bologna, Italy
| | - S. Damiani
- Medical Oncology Hospital of Macerata, Macerata, Italy; Pathology in Bellaria Hospital of Bologna, Bologna, Italy; pathology Maggiore Hospital of Bologna, Bologna, Italy; Medical Oncology Bellaria Hospital of Bologna, Bologna, Italy; Medical Oncology Hospital of Faenza, Faenza, Italy; Radiotherapy Bellaria Hospital of Bologna, Bologna, Italy
| | - A. Cancellieri
- Medical Oncology Hospital of Macerata, Macerata, Italy; Pathology in Bellaria Hospital of Bologna, Bologna, Italy; pathology Maggiore Hospital of Bologna, Bologna, Italy; Medical Oncology Bellaria Hospital of Bologna, Bologna, Italy; Medical Oncology Hospital of Faenza, Faenza, Italy; Radiotherapy Bellaria Hospital of Bologna, Bologna, Italy
| | - E. Magrini
- Medical Oncology Hospital of Macerata, Macerata, Italy; Pathology in Bellaria Hospital of Bologna, Bologna, Italy; pathology Maggiore Hospital of Bologna, Bologna, Italy; Medical Oncology Bellaria Hospital of Bologna, Bologna, Italy; Medical Oncology Hospital of Faenza, Faenza, Italy; Radiotherapy Bellaria Hospital of Bologna, Bologna, Italy
| | - M. Fedele
- Medical Oncology Hospital of Macerata, Macerata, Italy; Pathology in Bellaria Hospital of Bologna, Bologna, Italy; pathology Maggiore Hospital of Bologna, Bologna, Italy; Medical Oncology Bellaria Hospital of Bologna, Bologna, Italy; Medical Oncology Hospital of Faenza, Faenza, Italy; Radiotherapy Bellaria Hospital of Bologna, Bologna, Italy
| | - S. Tamberi
- Medical Oncology Hospital of Macerata, Macerata, Italy; Pathology in Bellaria Hospital of Bologna, Bologna, Italy; pathology Maggiore Hospital of Bologna, Bologna, Italy; Medical Oncology Bellaria Hospital of Bologna, Bologna, Italy; Medical Oncology Hospital of Faenza, Faenza, Italy; Radiotherapy Bellaria Hospital of Bologna, Bologna, Italy
| | - G. Frezza
- Medical Oncology Hospital of Macerata, Macerata, Italy; Pathology in Bellaria Hospital of Bologna, Bologna, Italy; pathology Maggiore Hospital of Bologna, Bologna, Italy; Medical Oncology Bellaria Hospital of Bologna, Bologna, Italy; Medical Oncology Hospital of Faenza, Faenza, Italy; Radiotherapy Bellaria Hospital of Bologna, Bologna, Italy
| | - L. Crino
- Medical Oncology Hospital of Macerata, Macerata, Italy; Pathology in Bellaria Hospital of Bologna, Bologna, Italy; pathology Maggiore Hospital of Bologna, Bologna, Italy; Medical Oncology Bellaria Hospital of Bologna, Bologna, Italy; Medical Oncology Hospital of Faenza, Faenza, Italy; Radiotherapy Bellaria Hospital of Bologna, Bologna, Italy
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Benedetti G, Tamberi S, Fedele M, Rastelli F, Salvi F, Frezza G, Crinò L. 57 Cisplatin and etoposide followed by concurrent chemo-radiationtherapy for limited small cell lung cancer (SCLC-LD). The experience of two Italian institutions. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)81528-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Benedetti G, Fedele M, Tamberi S, Rastelli F, Finocchiaro G, Maestri A, Salvi F, Calandri C, Frezza G, Crino L. Cisplatin and etoposide followed by concurrent chemo-radiation therapy for limited stage small cell lung cancer (SCLC-LS). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- G. Benedetti
- Bellaria Hosp Med Onc, Bologna, Italy; Faenza Hosp, Faenza, Italy; Bellaria Hosp, Bologna, Italy
| | - M. Fedele
- Bellaria Hosp Med Onc, Bologna, Italy; Faenza Hosp, Faenza, Italy; Bellaria Hosp, Bologna, Italy
| | - S. Tamberi
- Bellaria Hosp Med Onc, Bologna, Italy; Faenza Hosp, Faenza, Italy; Bellaria Hosp, Bologna, Italy
| | - F. Rastelli
- Bellaria Hosp Med Onc, Bologna, Italy; Faenza Hosp, Faenza, Italy; Bellaria Hosp, Bologna, Italy
| | - G. Finocchiaro
- Bellaria Hosp Med Onc, Bologna, Italy; Faenza Hosp, Faenza, Italy; Bellaria Hosp, Bologna, Italy
| | - A. Maestri
- Bellaria Hosp Med Onc, Bologna, Italy; Faenza Hosp, Faenza, Italy; Bellaria Hosp, Bologna, Italy
| | - F. Salvi
- Bellaria Hosp Med Onc, Bologna, Italy; Faenza Hosp, Faenza, Italy; Bellaria Hosp, Bologna, Italy
| | - C. Calandri
- Bellaria Hosp Med Onc, Bologna, Italy; Faenza Hosp, Faenza, Italy; Bellaria Hosp, Bologna, Italy
| | - G. Frezza
- Bellaria Hosp Med Onc, Bologna, Italy; Faenza Hosp, Faenza, Italy; Bellaria Hosp, Bologna, Italy
| | - L. Crino
- Bellaria Hosp Med Onc, Bologna, Italy; Faenza Hosp, Faenza, Italy; Bellaria Hosp, Bologna, Italy
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