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Brancaccio G, Pellerone S, Scharf C, Ronchi A, Iovino F, Napolitano S, Troiani T, Argenziano G. Sentinel node biopsy in thin melanoma: a retrospective descriptive cohort study. J Eur Acad Dermatol Venereol 2022; 36:e795-e796. [PMID: 35622455 DOI: 10.1111/jdv.18274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
Affiliation(s)
- G Brancaccio
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - S Pellerone
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - C Scharf
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - A Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - F Iovino
- General Surgery Unit, DepartmentofCardiothoracicSurgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - S Napolitano
- Oncology Unit, DepartmentofPrecision Medicine, UniversityofCampania "Luigi Vanvitelli", Naples, Italy
| | - T Troiani
- Oncology Unit, DepartmentofPrecision Medicine, UniversityofCampania "Luigi Vanvitelli", Naples, Italy
| | - G Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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Scharf C, Brancaccio G, Di Stefani A, Fargnoli MC, Kittler H, Kyrgidis A, Lallas A, Longo C, Malvehy J, Moscarella E, Peris K, Piana S, Puig S, Thomas L, Argenziano G. THE ASSOCIATION BETWEEN LOCKDOWNS DURING THE COVID-19 PANDEMIC AND MELANOMA DIAGNOSIS: A MULTICENTER RETROSPECTIVE STUDY FROM EUROPE. J Am Acad Dermatol 2022; 87:648-649. [PMID: 35588928 PMCID: PMC9110066 DOI: 10.1016/j.jaad.2022.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/04/2022] [Accepted: 05/11/2022] [Indexed: 11/24/2022]
Affiliation(s)
- C Scharf
- Dermatology Unit, University of Campania L.Vanvitelli, Naples, Italy.
| | - G Brancaccio
- Dermatology Unit, University of Campania L.Vanvitelli, Naples, Italy
| | - A Di Stefani
- Dermatologia, Università Cattolica e Fondazione Policlinico A. Gemelli - IRCCS, Rome, Italy
| | - M C Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - H Kittler
- Department of Dermatology, Medical University of Vienna, Austria
| | - A Kyrgidis
- Department of Oral & Maxillofacial Surgery, Aristotle University of Thessaloniki, General Hospital of Thessaloniki "George Papanikolaou", Thessaloniki, Greece
| | - A Lallas
- First Department of Dermatology, Medical School, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - C Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy; Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - J Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - E Moscarella
- Dermatology Unit, University of Campania L.Vanvitelli, Naples, Italy
| | - K Peris
- Dermatologia, Università Cattolica e Fondazione Policlinico A. Gemelli - IRCCS, Rome, Italy
| | - S Piana
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - S Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - L Thomas
- Centre Hospitalier Lyon Sud, Lyon, France; Lyons France, Lyon 1 University, Lyon, France; Lyons France and Lyons Cancer research center UMR INSERM U1052 - CNRS5286 - UCBL1, Lyons France
| | - G Argenziano
- Dermatology Unit, University of Campania L.Vanvitelli, Naples, Italy
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Lallas A, Martínez G, Arceu M, Kyrgidis A, Liopyris K, Brancaccio G, Longo C, Errichetti E, Sgouros D, Papageorgiou C, Fotiadou C, Siskou S, Manoli SM, Sotiriou E, Ioannides D, Katoulis A, Lazaridou E, Todorovska V, Argenziano G, Apalla Z. Clinical and dermatoscopic predictors of squamous cell carcinoma of the lips: a case-control, multicentric study. J Eur Acad Dermatol Venereol 2021; 36:222-227. [PMID: 34743367 DOI: 10.1111/jdv.17790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/29/2021] [Accepted: 10/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Squamous cell carcinoma of the lip accounts for 20% of all oral carcinomas. Its diagnosis may be challenging because it clinically resembles actinic cheilitis and inflammatory lesions of the lips. OBJECTIVES To determine clinical and dermatoscopic predictors of squamous cell carcinoma of the lip vs. other lip lesions. METHODS Multicentre retrospective morphological study, including histologically confirmed cases of squamous cell carcinoma of the lip and controls consisting of actinic cheilitis and inflammatory lesions of the lips. Clinical and dermatoscopic images were evaluated for the presence of predefined criteria. Crude and adjusted odds ratios and corresponding 95% confidence intervals were calculated by univariate and multivariate logistic regression respectively. RESULTS A total of 177 lip lesions were evaluated, 107 (60.5%) were squamous cell carcinomas and 70 (39.5%) were controls. The most frequent dermatoscopic criteria of lip squamous cell carcinoma were scales (100%), white halos (87.3%) and ulceration (79.4%). The majority of squamous cell carcinomas displayed polymorphic vessels (60.8%), with linear (68.6%) and hairpin (67.6%) being the most frequent types. Multivariate logistic regression analysis showed that clinical predictors of lip squamous cell carcinoma were exophytic appearance and clinical hyperkeratosis, with 43-fold and 6-fold higher probability respectively. White clods and ulceration in dermoscopy presented a 6-fold and 4-fold increased risk for squamous cell carcinoma respectively. CONCLUSIONS A scaly lesion with exophytic growth, dermatoscopically displaying white clods, ulceration and linear and hairpin vessels is very likely a squamous cell carcinoma of the lip.
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Affiliation(s)
- A Lallas
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Martínez
- Department of Dermatology, School of Medicine, University of Chile, Santiago, Chile
| | - M Arceu
- Department of Dermatology, School of Medicine, University of Chile, Santiago, Chile
| | - A Kyrgidis
- Department of Oral & Maxillofacial Surgery, Aristotle University of Thessaloniki, General Hospital of Thessaloniki "George Papanikolaou", Thessaloniki, Greece
| | - K Liopyris
- First Department of Dermatology, Andreas Syggros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - G Brancaccio
- Dermatology Department, University of Campania, Naples, Italy
| | - C Longo
- Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy.,Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - E Errichetti
- Institute of Dermatology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - D Sgouros
- Second Department of Dermatology, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - C Papageorgiou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - C Fotiadou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S Siskou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S M Manoli
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Sotiriou
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Ioannides
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Katoulis
- Second Department of Dermatology, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - E Lazaridou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - G Argenziano
- Dermatology Department, University of Campania, Naples, Italy
| | - Z Apalla
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Adorisio R, Grandinetti M, Giorni C, Selvaggio D, Filippelli S, Trezzi M, Iacobelli R, Brancaccio G, Amodeo A. Preliminary Data on the Clinical Use of Infant Jarvik 2015 in Children with Dilated Cardiomyopathy; Recovery Will Be the New Therapeutic Goal? J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Brancaccio G, Gussetti N, Sasset L, Alaibac M, Tarantello M, Salmaso R, Trevenzoli M, Cattelan AM. Cutaneous manifestations in a series of 417 patients with SARS-CoV-2 infection: epidemiological and clinical correlates of chilblain like lesions. Pathog Glob Health 2021; 115:483-486. [PMID: 33729097 DOI: 10.1080/20477724.2021.1901040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
A variety of dermatological lesions have been described in COVID-19, although the prevalence and pathogenic relationship remain unclear particularly for chilblain-like lesions. Dermatological examination was performed in a prospective cohort of consecutive patients seen at the service for SARS-CoV-2 infection. Out of 417 patients with confirmed SARS-CoV-2 infection [median age 29.5 years (range 15-65); 62.5% males], dermatological lesions were detected in 7 (1.7%). Three patients had acral lesions; their age (range) was 15-29 years; all had a negative nasopharyngeal swab and developed IgG and/or IgM-specific antibodies; all presented none or mild symptoms. A fourth patient remained negative at repeated testing; mother, father and sister had a documented mild COVID-19. Non-acral lesions were observed in four older patients, with severe COVID-19. Chilblain-like lesions may be the sole manifestation of SARS-CoV-2 infection; their presence in asymptomatic school children and adolescents should be considered a potential signal of familial or community spread of the virus.
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Affiliation(s)
- G Brancaccio
- Unit of Infectious Diseases, University Hospital of Padua, Padua, Italy
| | - N Gussetti
- Unit of Infectious Diseases, University Hospital of Padua, Padua, Italy
| | - L Sasset
- Unit of Infectious Diseases, University Hospital of Padua, Padua, Italy
| | - M Alaibac
- Unit of Dermatology, University of Padua, Padua, Italy
| | - M Tarantello
- Unit of Dermatology, University of Padua, Padua, Italy
| | - R Salmaso
- Unit of Pathology, University of Padua, Padua, Italy
| | - M Trevenzoli
- Unit of Infectious Diseases, University Hospital of Padua, Padua, Italy
| | - A M Cattelan
- Unit of Infectious Diseases, University Hospital of Padua, Padua, Italy
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Giunta E, Barra G, De Falco V, Vitale P, Zanaletti N, Terminiello M, Caputo V, Napolitano S, Vitiello P, Ciardiello D, Belli V, Brancaccio G, Argenziano G, De Palma R, Ciardiello F, Troiani T. IFN-γ/IL-10 ratio as predictive biomarker for response to anti-PD-1 therapy in metastatic melanoma patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz239.038] [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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7
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Moscarella E, Pampena R, Palmiotti G, Bonamonte D, Brancaccio G, Piccolo V, Longo C, Argenziano G. A meta-analysis on the influence of partial biopsy of primary melanoma on disease recurrence and patient survival. J Eur Acad Dermatol Venereol 2019; 34:279-284. [PMID: 31441557 DOI: 10.1111/jdv.15903] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/25/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Complete surgical excision is the preferred biopsy type for suspicious melanocytic lesions. However, partial biopsy is sometimes used in special situations. Previous studies have explored the effect of partial biopsy of a primary melanoma on patient outcome with controversial results. OBJECTIVE We performed a meta-analysis on the influence of the type of biopsy of a primary melanoma on recurrence-free survival (RFS) and melanoma-related survival (MRS). METHODS Clinical trials, observational cohort studies and case-control studies reporting absolute number of recurrences and/or melanoma-related deaths in patients undergoing a partial or excisional biopsy of melanoma were included in the meta-analysis. RESULTS In all, the five included studies reported 3249 patients, 1121 (34.5%) of them in the partial biopsy group and 2128 (65.5%) in the excisional biopsy group. Despite a trend in favour of excisional biopsy in reducing the risk for recurrences, the forest plot related to RFS failed to demonstrate significant differences among groups (RR: 1.27; 95% CI 0.97-1.67; P: 0.09; random effects; I2 : 55%). The forest plot showed no difference in the risk of dying for melanoma-related causes for patients undergoing partial biopsy vs. excisions biopsy (RR: 1.50; 95% CI 0.98-2.30; P: 0.06; random effects; I2 : 60%). LIMITATIONS The majority of the studies were retrospective, and follow-up time was not uniform among studies and not always reported. CONCLUSION In conclusion, a partial biopsy can be performed in special situations, such as large primary tumours located in surgically sensitive areas, without altering MRS and RFS.
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Affiliation(s)
- E Moscarella
- Dermatology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - R Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - G Palmiotti
- Dermatology Unit, Medical University of Bari, Bari, Italy
| | - D Bonamonte
- Dermatology Unit, Medical University of Bari, Bari, Italy
| | - G Brancaccio
- Dermatology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - V Piccolo
- Dermatology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - C Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
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Argenziano G, Brancaccio G. Genes or environment: what counts most in basal cell carcinoma? J Eur Acad Dermatol Venereol 2019; 33:461. [PMID: 30891847 DOI: 10.1111/jdv.15486] [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: 11/30/2022]
Affiliation(s)
- G Argenziano
- Dermatology Unit, University of Campania, Naples, Italy
| | - G Brancaccio
- Dermatology Unit, University of Campania, Naples, Italy
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Lampertico P, Brunetto MR, Craxì A, Gaeta GB, Rizzetto M, Rozzi A, Colombo M, Andreone P, Antonio D, Brancaccio G, Bronte F, Bruzzone L, Caccamo G, Caccianotti B, Calvaruso V, Chessa L, Ciarallo M, Coco B, Colombatto P, Cursaro C, D'Aluisio D, Demelia L, Marco V, Dissegna D, Invernizzi F, Lenisa I, Lembo T, Levrero M, Marchese V, Mangia G, Picciotto A, Pierconti S, Antonio D, Raimondo G, Rastelli C, Rizzo V, Santantonio T, Scuteri A, Sorbello O, Squadrito G, Subic M, Toniutto P, Vukotic R. Add-on peginterferon alfa-2a to nucleos(t)ide analogue therapy for Caucasian patients with hepatitis B 'e' antigen-negative chronic hepatitis B genotype D. J Viral Hepat 2019; 26:118-125. [PMID: 30187599 DOI: 10.1111/jvh.12999] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 03/05/2018] [Accepted: 08/14/2018] [Indexed: 12/13/2022]
Abstract
Nucleos(t)ide analogues (NAs) and peginterferon have complementary effects in chronic hepatitis B, but it is unclear whether combination therapy improves responses in genotype D-infected patients. We conducted an open-label study of peginterferon alfa-2a 180 μg/wk added to ongoing NA therapy in hepatitis B e antigen (HBeAg)-negative, genotype D-infected patients with hepatitis B virus DNA <20 IU/mL. The primary endpoint was proportion of patients with ≥50% decline in serum HBsAg by the end of the 48-week add-on phase. Seventy patients received treatment, 11 were withdrawn at week 24 for no decrease in HBsAg, and 14 withdrew for other reasons. Response rate (per-protocol population) was 67.4% (29/43) at week 48 (95% confidence interval [CI]: 51, 81) and 50.9% (28/55) at week 96 (95% CI: 38, 66). Median serum HBsAg decreased throughout peginterferon alfa-2a treatment and was significantly lower than baseline at weeks 48, 72 and 96 (P < 0.001). Decreases in HBsAg of ≥0.5-log10 and ≥1-log10 were documented in 19 (44.2%) and 6 (14.0%) patients at week 48 and 6 (10.9%) and 17 (30.9%) patients at week 96. The proportion of patients with HBsAg <1000, <500, <100 and <10 IU/mL at ≥1 timepoint during treatment was 78.6% (n = 44), 57.1% (n = 32), 21.4% (n = 12) and 7.1% (n = 4). Interferon gamma-induced protein 10 increased from baseline up to week 48, with week 12 levels significantly associated with response at week 48. Addition of peginterferon alfa-2a to ongoing NA therapy significantly decreased HBsAg levels in HBeAg-negative patients with genotype D infection (ClinicalTrials.gov NCT01706575).
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Affiliation(s)
- Pietro Lampertico
- Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Maurizia R Brunetto
- Internal Medicine, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Antonio Craxì
- Gastroenterology and Hepatology, Di.Bi.M.I.S., University of Palermo, Palermo, Italy
| | - Giovanni B Gaeta
- Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Mario Rizzetto
- Department of Gastroenterology, University of Turin, Turin, Italy
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Brancaccio G, Napolitano S, Troiani T, Franco R, Iovino F, Reginelli A, Ciardiello F, Argenziano G. Eighth American Joint Committee on Cancer (AJCC) melanoma classification: what about stage IIC? Br J Dermatol 2018; 179:1422-1423. [DOI: 10.1111/bjd.17145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- G. Brancaccio
- Dermatology Unit; Department of Internal & Experimental Medicine ‘F Magrassi’; University of Campania ‘Luigi Vanvitelli’; Via Pansini 5 80131 Naples Italy
| | - S. Napolitano
- Oncology Unit; Department of Internal & Experimental Medicine ‘F Magrassi’; University of Campania ‘Luigi Vanvitelli’; Via Pansini 5 80131 Naples Italy
| | - T. Troiani
- Oncology Unit; Department of Internal & Experimental Medicine ‘F Magrassi’; University of Campania ‘Luigi Vanvitelli’; Via Pansini 5 80131 Naples Italy
| | - R. Franco
- Pathology Unit; Department of Cardiothoracic and Respiratory Science; University of Campania ‘Luigi Vanvitelli’; Via Pansini 5 80131 Naples Italy
| | - F. Iovino
- Division of General Surgery; Department of Cardiothoracic and Respiratory Science; University of Campania ‘Luigi Vanvitelli’; Via Pansini 5 80131 Naples Italy
| | - A. Reginelli
- Department of Radiology & Radiotherapy, Department of Internal & Experimental Medicine ‘F Magrassi’; University of Campania ‘Luigi Vanvitelli’; Via Pansini 5 80131 Naples Italy
| | - F. Ciardiello
- Oncology Unit; Department of Internal & Experimental Medicine ‘F Magrassi’; University of Campania ‘Luigi Vanvitelli’; Via Pansini 5 80131 Naples Italy
| | - G. Argenziano
- Dermatology Unit; Department of Internal & Experimental Medicine ‘F Magrassi’; University of Campania ‘Luigi Vanvitelli’; Via Pansini 5 80131 Naples Italy
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Gencay M, Seffner A, Pabinger S, Gautier J, Gohl P, Weizenegger M, Neofytos D, Batrla R, Woeste A, Kim HS, Westergaard G, Reinsch C, Brill E, Thuy PTT, Hoang BH, Sonderup M, Spearman CW, Brancaccio G, Fasano M, Gaeta GB, Santantonio T, Kaminski WE. Detection of in vivo hepatitis B virus surface antigen mutations-A comparison of four routine screening assays. J Viral Hepat 2018; 25:1132-1138. [PMID: 29660206 DOI: 10.1111/jvh.12915] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 03/25/2018] [Indexed: 12/12/2022]
Abstract
An important requirement for a state-of-the-art hepatitis B surface antigen (HBsAg) screening assay is reliable detection of mutated HBsAg. Currently, there is a striking shortage of data regarding the detection rates of in vivo HBsAg mutations for these clinically important assays. Therefore, we compared the detection rates of four commercial HBsAg screening assays using a global cohort of 1553 patients from four continents with known HBV genotypes. These samples, which represent the broadest spectrum of known and novel HBsAg major hydrophilic region (MHR) mutations to date, were analyzed for the presence of HBsAg using the Roche Elecsys® HBsAg II Qualitative, Siemens ADVIA Centaur XP HBsAg II, Abbott Architect HBsAg Qualitative II and DiaSorin Liaison® HBsAg Qualitative assays, respectively. Of the 1553 samples, 1391 samples could be sequenced; of these, 1013 (72.8%) carried at least one of the 345 currently known amino acid substitutions (distinct HBsAg mutation) in the HBsAg MHR. All 1553 patient samples were positive for HBsAg using the Elecsys® HBsAg II Qual assay, with a sensitivity (95% confidence interval) of 99.94% (99.64%-100%), followed by the Abbott Architect 99.81% (99.44%-99.96%), Siemens ADVIA 99.81% (99.44%-99.96%) and DiaSorin Liaison® 99.36% (98.82%-99.69%) assays, respectively. Our results indicate that the Elecsys® HBsAg II Qual assay exhibits the highest sensitivity among the commercial HBsAg screening assays, and demonstrate that its capacity to detect HBV infection is not compromised by HBsAg MHR mutants.
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Affiliation(s)
- M Gencay
- Roche Diagnostics International Ltd, Rotkreuz, Switzerland
| | - A Seffner
- Department of Molecular Genetics and Microbiology, MVZ Labor Dr. Limbach & Kollegen GbR, Heidelberg, Germany
| | - S Pabinger
- Health and Environment Department, Molecular Diagnostics, Austrian Institute of Technology, Vienna, Austria
| | - J Gautier
- Cerba Spécimen Services, Saint-Ouen l'Aumône, France
| | - P Gohl
- Bioscientia, Institute for Medical Diagnostics GmbH, Ingelheim, Germany
| | - M Weizenegger
- Department of Molecular Genetics and Microbiology, MVZ Labor Dr. Limbach & Kollegen GbR, Heidelberg, Germany
| | - D Neofytos
- Roche Diagnostics International Ltd, Rotkreuz, Switzerland
| | - R Batrla
- Roche Diagnostics International Ltd, Rotkreuz, Switzerland
| | - A Woeste
- Roche Diagnostics GmbH, Penzberg, Germany
| | - H S Kim
- Department of Laboratory Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea
| | - G Westergaard
- Roche Diagnostics International Ltd, Rotkreuz, Switzerland
| | - C Reinsch
- Roche Diagnostics GmbH, Mannheim, Germany
| | - E Brill
- Bioscientia, Institute for Medical Diagnostics GmbH, Ingelheim, Germany
| | - P T T Thuy
- Hepatology Department, Medic Medical Center, Ho Chi Minh City, Vietnam
| | - B H Hoang
- Gastroenterology Department, Ho Chi Minh City University Medical Center, Ho Chi Minh City, Vietnam
| | - M Sonderup
- Division of Hepatology and Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - C W Spearman
- Division of Hepatology and Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - G Brancaccio
- Infectious Diseases and Viral Hepatitis Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - M Fasano
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - G B Gaeta
- Infectious Diseases and Viral Hepatitis Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - T Santantonio
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - W E Kaminski
- Bioscientia, Institute for Medical Diagnostics GmbH, Ingelheim, Germany
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Brancaccio G, Brunetti B, Fulgione E, Moscarella E, Alfano R, Argenziano G. Evolution of pigmented Spitz naevi with starburst pattern during childhood. J Eur Acad Dermatol Venereol 2018; 33:e29-e30. [DOI: 10.1111/jdv.15138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G. Brancaccio
- Dermatology Unit University of Campania Naples Italy
| | - B. Brunetti
- Ospedale Santa Maria della Speranza Battipaglia Italy
| | - E. Fulgione
- Dermatology Unit University of Campania Naples Italy
| | - E. Moscarella
- Dermatology Unit University of Campania Naples Italy
| | - R. Alfano
- Department of Anesthesiology, Surgery and Emergency University of Campania Naples Italy
| | - G. Argenziano
- Dermatology Unit University of Campania Naples Italy
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Napolitano S, Brancaccio G, Argenziano G, Martinelli E, Morgillo F, Ciardiello F, Troiani T. It is finally time for adjuvant therapy in melanoma. Cancer Treat Rev 2018; 69:101-111. [PMID: 29957365 DOI: 10.1016/j.ctrv.2018.06.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [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: 12/20/2017] [Revised: 06/05/2018] [Accepted: 06/08/2018] [Indexed: 12/23/2022]
Abstract
Although melanoma is amenable to early detection, there has been no decline in the mortality rate of this disease and the prognosis of patients with high-risk primary melanoma or with macroscopic nodal involvement remains poor. The best option for patients with higher-risk melanoma is to receive effective adjuvant therapy in order to reduce their chances of recurrence. Multiple systemic therapeutic agents have been tested as adjuvant therapy for melanoma with durable benefits seen only with interferon- to date. More recently ipilimumab at the high dose of 10 mg/kg has shown a significant improvement in terms of Relapse free survival and Overall survival for stage III melanoma patients but at a significant cost in terms of immune-related toxicities. More recently, novel treatment options have emerged. The results from the latest trials with immunotherapy (PD-1 inhibitors) and molecular targeted therapy (BRAF inhibitor + MEK inhibitor) have revolutionized the management of adjuvant treatment for melanoma. As the results from these trials will mature in the next years, a change in the landscape of adjuvant treatment for melanoma is expected, resulting in new challenges in treatment decisions such as optimizing patients' selection through predictive and prognostic biomarkers, and management of treatment related adverse events, in particular immune related toxicities.
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Affiliation(s)
- S Napolitano
- Oncologia Medica, Dipartimento di Internistica Clinica e Sperimentale "F. Magrassi", Università degli Studi della Campania "Luigi Vanvitelli", Via S. Pansini 5, Napoli 80131, Italy
| | - G Brancaccio
- Dermatologia e Venerologia, Dipartimento di salute mentale e fisica e medicina riabilitativa, Università degli Studi della Campania "Luigi Vanvitelli", Via S. Pansini 5, Napoli 80131, Italy
| | - G Argenziano
- Dermatologia e Venerologia, Dipartimento di salute mentale e fisica e medicina riabilitativa, Università degli Studi della Campania "Luigi Vanvitelli", Via S. Pansini 5, Napoli 80131, Italy
| | - E Martinelli
- Oncologia Medica, Dipartimento di Internistica Clinica e Sperimentale "F. Magrassi", Università degli Studi della Campania "Luigi Vanvitelli", Via S. Pansini 5, Napoli 80131, Italy
| | - F Morgillo
- Oncologia Medica, Dipartimento di Internistica Clinica e Sperimentale "F. Magrassi", Università degli Studi della Campania "Luigi Vanvitelli", Via S. Pansini 5, Napoli 80131, Italy
| | - F Ciardiello
- Oncologia Medica, Dipartimento di Internistica Clinica e Sperimentale "F. Magrassi", Università degli Studi della Campania "Luigi Vanvitelli", Via S. Pansini 5, Napoli 80131, Italy
| | - T Troiani
- Oncologia Medica, Dipartimento di Internistica Clinica e Sperimentale "F. Magrassi", Università degli Studi della Campania "Luigi Vanvitelli", Via S. Pansini 5, Napoli 80131, Italy.
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Barone M, Iannone A, Shahini E, Ippolito AM, Brancaccio G, Morisco F, Milella M, Messina V, Smedile A, Conti F, Gatti P, Santantonio T, Tundo P, Lauletta G, Napoli N, Masetti C, Termite AP, Francavilla R, Di Leo A, Pesce F, Andriulli A. A different perspective on sofosbuvir-ledipasvir treatment of patients with HCV genotype 1b cirrhosis: The ital-c network study. J Viral Hepat 2018; 25:56-62. [PMID: 28787102 DOI: 10.1111/jvh.12765] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 07/11/2017] [Indexed: 02/07/2023]
Abstract
The effectiveness of a 12-week course of sofosbuvir-ledipasvir in treatment-experienced HCV genotype 1b-infected patients with cirrhosis is still under debate. Our primary endpoint was to compare the sustained virological response at post-treatment week 12 (SVR12) of sofosbuvir-ledipasvir in combination with ribavirin for 12 weeks, and sofosbuvir-ledipasvir alone for 24 weeks. This was a prospective observational study that enrolled 424 (195 naive, 229 experienced; 164 treated for 12 weeks with Ribavirin and 260 with sofosbuvir-ledipasvir alone for 24 weeks) consecutive HCV genotype 1b-infected patients with cirrhosis. The SVR12 rates were 93.9% and 99.2% in patients treated for 12 and 24 weeks, respectively (P = .002). The baseline characteristics of patients treated for 12 weeks were significantly different from those treated for 24 weeks as regards their younger age (P = .002), prevalence of Child-Pugh class A (P = .002), lower MELD scores (P = .001) and smaller number of nonresponders (P = .04). The shorter treatment was significantly associated with a lower SVR12 in univariate and multivariate analyses (P = .007 and P = .008, respectively). The SVR rate was unaffected by age, gender, BMI, Child-Pugh class, MELD score or previous antiviral treatment. Patients receiving ribavirin experienced more episodes of ascites and headache but less recurrence of hepatocellular carcinoma (HCC), and were prescribed more diuretics and cardiopulmonary drugs. No patient discontinued treatment. The therapeutic regimen of sofosbuvir-ledipasvir plus ribavirin administered for 12 weeks was less effective than sofosbuvir-ledipasvir alone given for 24 weeks. At odds with European guidelines, the recommended 12-week treatment with sofosbuvir-ledipasvir alone might be suboptimal for this setting of patients.
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Affiliation(s)
- M Barone
- Department of Emergency and Organ Transplantation, Section of Gastroenterology, AOU Policlinico, University of Bari, Bari, Italy
| | - A Iannone
- Department of Emergency and Organ Transplantation, Section of Gastroenterology, AOU Policlinico, University of Bari, Bari, Italy
| | - E Shahini
- Department of Emergency and Organ Transplantation, Section of Gastroenterology, AOU Policlinico, University of Bari, Bari, Italy
| | - A M Ippolito
- Division of Gastroenterology, "Casa Sollievo Sofferenza" Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - G Brancaccio
- Clinics of Infectious Diseases, "Federico II" University of Naples, Naples, Italy
| | - F Morisco
- Division of Gastroenterology, Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
| | - M Milella
- Clinics of Infectious Diseases, University of Bari, Bari, Italy
| | - V Messina
- Infectious and Tropical Diseases Unit, S. Anna and S. Sebastiano Hospital, Caserta, Italy
| | - A Smedile
- Department of Medical Sciences, University of Turin, Turin, Italy
- Department of Gastroenterology and Hepatology, Azienda Ospedaliera Cittàdella Salute e della Scienza, Turin, Italy
| | - F Conti
- Department of Medical and Surgical Sciences (DIMEC), Centre for the Study of Hepatitis, University of Bologna, Bologna, Italy
| | - P Gatti
- Internal Medicine, Hospital of Ostuni, Ostuni, Italy
| | - T Santantonio
- Clinics of Infectious Diseases, University of Foggia, Foggia, Italy
| | - P Tundo
- Division of Infectious Diseases, Hospital of Galatina, Galatina, Italy
| | - G Lauletta
- Clinics of Internal Medicine "G. Baccelli", University of Bari, Bari, Italy
| | - N Napoli
- Clinics of Internal Medicine "C. Frugoni", University of Bari, Bari, Italy
| | - C Masetti
- Hepatology and Liver Transplantation Unit, University of Tor Vergata, Rome, Italy
| | - A P Termite
- Liver Unit, Hospital of Castellaneta, Castellaneta, Italy
| | - R Francavilla
- Unit of Infectious Diseases, Hospital of Bisceglie, Bisceglie, Italy
| | - A Di Leo
- Department of Emergency and Organ Transplantation, Section of Gastroenterology, AOU Policlinico, University of Bari, Bari, Italy
| | - F Pesce
- Department of Emergency and Organ Transplantation, Section of Nephrology, AOU Policlinico, University of Bari, Bari, Italy
| | - A Andriulli
- Division of Gastroenterology, "Casa Sollievo Sofferenza" Hospital, IRCCS, San Giovanni Rotondo, Italy
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Rubegni P, Tognetti L, Argenziano G, Nami N, Brancaccio G, Cinotti E, Miracco C, Fimiani M, Cevenini G. A risk scoring system for the differentiation between melanoma with regression and regressing nevi. J Dermatol Sci 2016; 83:138-44. [PMID: 27157925 DOI: 10.1016/j.jdermsci.2016.04.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 04/19/2016] [Accepted: 04/25/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Spontaneous regression of melanomas is relatively common, its prevalence ranging from 10 to 35%. However, regressing nevi can exhibit worrisome feature and simulate melanoma both clinically and dermoscopically. Thus, the presence of regression can represent a confounding factor. OBJECTIVE To investigate the frequency of dermoscopic patterns of "regression" in a series of benign and malignant melanocytic skin lesions, and to design an integrated scoring system. Scoring classifiers are very effective in selecting the significant parameters for discriminating two clinical conditions, thus can rapidly calculate a patient's risk for a given disease. METHODS We selected a series of 95 regressing melanocytic lesions, including 50 regressing nevi and 45 melanomas with regression. For each lesion, 12 dermoscopic variables (i.e. five types of regression structures, five atypical pigmentation structures, atypical vascular pattern and pink areas) were examined by three expert in dermoscopy (blinded to the histological diagnosis). The dermoscopic evaluation was then combined with patient age, gender, body site and the maximum diameter of lesion. Concordance analysis with Cohen's kappa was performed between the three clinicians. A risk scoring system was designed by the leave-one-out cross-validation procedure to ensure model prediction power. RESULTS The predictive score model revealed a sensitivity of 97.8% and a specificity of 75.5% in discriminating nevi and melanomas with regression. Using the score model, the diagnostic performance of the examiners increased by an average of 23.7% in sensitivity and 5.9% in specificity, compared with standard dermoscopic pattern analysis. CONCLUSIONS We assessed the validity of an integrated risk scoring model as a new methodological approach that could help the dermatologist in the differentiation between melanoma with regression and regressing nevus. Future studies could test the setting up of a score model over an even more complex pool of data obtained from different skin lesions with various diagnostic devices.
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Affiliation(s)
- P Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, AOUS "Le Scotte", Siena, Italy
| | - L Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, AOUS "Le Scotte", Siena, Italy.
| | - G Argenziano
- Dermatology Unit, Department of Mental and Physic Health and Preventive Medicine, Second University of Naples, Naples, Italy
| | - N Nami
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, AOUS "Le Scotte", Siena, Italy
| | - G Brancaccio
- Dermatology Unit, Department of Mental and Physic Health and Preventive Medicine, Second University of Naples, Naples, Italy
| | - E Cinotti
- Dermatology Department-University Hospital of Saint-Etienne, Saint-Etienne, France
| | - C Miracco
- Section of Human Patology, University of Siena, Siena, Italy
| | - M Fimiani
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, AOUS "Le Scotte", Siena, Italy
| | - G Cevenini
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
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Gandolfo F, Brancaccio G, Iannace E, Filippelli S, Grigioni M, Donatiello S, D'Amario D, Amodeo A. 103 * MECHANICALLY ASSISTED TOTAL CAVOPULMONARY CONNECTION WITH AN AXIAL FLOW PUMP: IN VIVO AND COMPUTATIONAL STUDY. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lo Schiavo A, Brancaccio G, Romano F, Caccavale S. Lymphangiomas arising on lymphedema: first step of malignant development. GIORN ITAL DERMAT V 2014; 149:372-374. [PMID: 24819768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- A Lo Schiavo
- Department of Dermatology, Second University of Naples, Naples, Italy -
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18
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Tirri R, Stornaiuolo G, Sessa P, Puca I, Brancaccio G, Gaeta G, Valentini G. AB0492 Long term safety of anti-TNF alfa in patients with inflammatory arthritis and hbv infection: Focus on hepatitis B surface antibody status. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.492] [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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19
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Tirri R, Stornaiuolo G, Sessa P, Orefice M, Brancaccio G, Valentini G, Gaeta G. AB0493 Anti-TNFα treatment is associated with increased liver stiffness in HBV occult carrier patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.493] [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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20
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Lo Schiavo A, Caccavale S, Brancaccio G, Cozzi R. Allergic contact dermatitis caused by mehindi: a further case. GIORN ITAL DERMAT V 2013; 148:234-235. [PMID: 23588152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Abstract
Popliteal vein aneurysms are rare but they have clinical relevance because of their propensity to cause thromboembolic complications. The widespread use of duplex scanning in the work-up of venous complaints will make their diagnosis increasingly frequent. Surgical therapy cures the disease with low morbidity. We present a typical case and review pertinent literature on the subject.
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Affiliation(s)
- G Celoria
- Department of Vascular Surgery, S. Andrea Hospital, Via dei Colli 54, 19100 La Spezia, Italy.
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Stornaiuolo G, Galli C, Stanzione M, Amato A, Brancaccio G, Chiodo F, Campisi D, Grassi L, Cò D, Masola M, Gesu G, Gaeta G. VALUTAZIONE QUANTITATIVA DI MARCATORI SIEROLOGICI E HBV-DNA IN PAZIENTI CON EPATITE CRONICA B. Microbiol Med 2006. [DOI: 10.4081/mm.2006.3231] [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: 11/23/2022] Open
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Brancaccio G, Celoria G, Berti S, Falco E. Recurrent Asymptomatic Retrohepatic Leiomyosarcoma of the Inferior Vena Cava. Eur J Vasc Endovasc Surg 2006. [DOI: 10.1016/j.ejvs.2005.08.032] [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: 10/25/2022]
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Brancaccio G, Di Gioia C, Prifti E, D'Amati G, Michielon G, Miraldi F. Antiphospholipid antibodies and intracardiac thrombosis. A case report. J Cardiovasc Surg (Torino) 2002; 43:479-82. [PMID: 12124558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
The antiphospholipid syndrome (APS) has been associated with multiple cardiac abnormalities. The present report describes a case of right ventricle thrombus in a 51-year-old woman with a history of autoimmune haemolytic anemia and antiphospholipid antibodies. Transthoracic echocardiography demonstrated the presence of a right ventricle mass, mimicking a myxoma. She underwent open heart removal of the mass and was started on indefinitely anticoagulant therapy. At 2 years follow-up she was free of symptoms.
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Affiliation(s)
- G Brancaccio
- Department of Cardiac Surgery, University La Sapienza, Rome, Italy
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Bonacchi M, Prifti E, Giunti G, Frati G, Leacche M, Brancaccio G, Sani G. Emergency management of spontaneous coronary artery dissection. J Cardiovasc Surg (Torino) 2002; 43:189-93. [PMID: 11887053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Six cases of spontaneous coronary arteries dissection are reported. In one patient, triple vessel spontaneous coronary artery dissection was identified. Another patient presented spontaneous left main coronary artery dissection. In one case we found the spontaneous dissection of the left anterior descending artery associated with distal aortic arch dissection. These conditions are very rare and may present a surgical dilemma. Causative factors and underlying pathology are clarified. Prompt diagnosis and surgical intervention is safe and effective. Early recognition of left main coronary artery dissection or three-vessel dissection is essential because urgent coronary artery bypass grafting may be life saving.
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Affiliation(s)
- M Bonacchi
- Chair of Cardiac Surgery, University of Florence, Florence, Italy.
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Brancaccio G, Prifti E, Cricco AM, Totaro M, Antonazzo A, Miraldi F. Chylothorax: a complication after internal thoracic artery harvesting. Ital Heart J 2001; 2:559-62. [PMID: 11501967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Chylothorax is a rare but serious complication of cardiac surgery. A 64-year-old man with three-vessel disease underwent coronary artery bypass grafting. Ten days later he developed left pleural effusion. An intercostal drain was inserted and 1600 ml of pale pink, milky fluid were obtained. The results of biochemical analysis were consistent with chyle. The diagnosis of a left chylothorax was made. Conservative treatment consisting of total parenteral nutrition and pleural drainage was successfully employed. In the literature we found 17 cases in which the development of chylothorax after a coronary revascularization procedure is described.
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Affiliation(s)
- G Brancaccio
- Institute of Cardiovascular Surgery, La Sapienza University of Rome, Italy.
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Abstract
BACKGROUND Arrhythmias remain an unsolved problem in Ebstein's anomaly. The aim of this study was to investigate the evolution of arrhythmias after surgical repair. METHODS Forty-five patients with Ebstein's anomaly and arrhythmias were studied. Mean age was 33 +/- 15 years. Twenty-four patients (53%) had paroxysmal supraventricular tachycardia, 12 (27%) had atrial fibrillation or flutter, 8 (18%) had ventricular preexcitation (Wolff-Parkinson-White syndrome), and 1 (2%) had a nonsustained ventricular tachycardia. Surgical technique included detachment of the tricuspid anterior leaflet and suture on the atrioventricular annulus associated with right ventricular longitudinal plication. RESULTS There were four hospital deaths (9%). A pacemaker was implanted early after operation in 5 patients (11%). During a mean follow-up of 57 +/- 50 months (range, 4 to 226 months), there were six additional deaths, three of which were sudden. Two patients were lost to follow-up. Of the 33 surviving patients, 8 (24%) continued to have symptomatic arrhythmias, and 15 (45%) were in permanent sinus rhythm. Of the 24 patients with preoperative paroxysmal supraventricular tachycardia and the 12 with atrial fibrillation or flutter preoperatively, 9 and 2 of the survivors, respectively, have had no further episodes of arrhythmia. The incidence of arrhythmia with or without symptoms was reduced to 39% (13/33) of the surviving patients. CONCLUSIONS Arrhythmia is not totally abolished after operation. However, patients with Ebstein's anomaly and arrhythmia show substantial improvement after conservative surgical intervention.
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Affiliation(s)
- S M Chauvaud
- Department of Cardiovascular Surgery, Hospital Européen Georges Pompidou, Paris, France.
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Abstract
Expanded polytetrafluoroethylene (e-PTFE) sutures have been used with increasing frequency to replace chordae tendineae in mitral valves prolapsing because of myxoid change. A case is reported where fibrosis and calcification of the endocardial overgrowth covering the synthetic chordae led to severe mitral regurgitation 7 years after plastic repair and required mechanical prosthetic valve implantation.
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Affiliation(s)
- C R di Gioia
- Department of Experimental Medicine and Pathology, "La Sapienza" University, Rome, Italy
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29
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Prifti E, Bonacchi M, Giunti G, Frati G, Proietti P, Leacche M, Salica A, Sani G, Brancaccio G. Does on-pump/beating-heart coronary artery bypass grafting offer better outcome in end-stage coronary artery disease patients? J Card Surg 2000; 15:403-10. [PMID: 11678463 DOI: 10.1111/j.1540-8191.2000.tb01300.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [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: 11/27/2022]
Abstract
OBJECTIVES The purpose of our study was to evaluate in a cohort of end-stage coronary artery disease (ESCAD) patients the effects of on-pump/beating-heart versus conventional coronary artery bypass grafting (CABG) requiring cardioplegic arrest. We report early and midterm survival, morbidity, and improvement of left ventricular (LV) function. METHODS Between January 1992 and October 1999, 107 (Group I) ESCAD patients underwent on-pump/beating-heart surgery and 191 (Group II) ESCAD patients underwent conventional CABG requiring cardioplegic arrest. Mean age in Group I was 65.8 +/- 6.5 years (58-79 years); New York Heart Association (NYHA) and Canadian Cardiovascular Society (CCS) classifications were 3.2 +/- 0.4 and 3.3 +/- 0.5, respectively. LV ejection fraction (LVEF) was 24.8% +/- 4%, LV end diastolic pressure (LVEDP) was 28.2 +/- 3.8 mmHg, and LV end diastolic diameter (LVEDD) was 69.6 +/- 4.6 mm. Mean age in Group II was 64.1 +/- 5 years (57-76 years), NYHA class was 3 +/- 0.6, CCS class was 3.4 +/- 0.4, LVEF was 26.2% +/- 4.3%, LVEDP was 27.2 +/- 3.4 mmHg, and LVED was 68 +/- 4.2 mm. RESULTS Preoperatively, Group I patients versus Group II patients had a markedly depressed LV function (LVEF, p = 0.006; LVEDP, p = 0.02; LVEDD, p = 0.003; and NYHA class, p = 0.002), older age (p = 0.012), and higher incidences of multiple acute myocardial infarction (AMI; p = 0.004), cardiovascular disease (CVD; p = 0.008), and chronic renal failure (CRH, p = 0.002). Cardiopulmonary bypass (CPB) time was longer in Group II patients (p = 0.028). The mean distal anastomosis per patient was similar between groups (p = NS). Operative mortality between Groups I and II was 7 (6.5%) and 19 (10%), respectively (p = NS). Perioperative AMI (p = 0.034), low cardiac output syndrome (LCOS; p = 0.011), necessity for ultrafiltration (p = 0.017), and bleeding (p = 0.012) were higher in Group II. Improvement of LV function within 3 months after the surgical procedure was markedly higher in Group I, demonstrated by increased LVEF (p = 0.035), lower LVEDP (p = 0.027), and LVEDD (p = 0.001) versus the preoperative data in Group II. The actuarial survivals at 1, 3, and 5 years were 95%, 86%, and 73% in Group I and 95%, 84%, and 72% in Group II (p = NS). CONCLUSIONS ESCAD patients with bypassable vessels to two or more regions of reversible ischemia can undergo safe CABG with acceptable hospital survival and mortality and morbidity. In higher risk ESCAD patients, who may poorly tolerate cardioplegic arrest, on-pump/beating-heart CABG may be an acceptable alternative associated with lower postoperative mortality and morbidity. Such a technique offers better myocardial and renal protection associated with lower postoperative complications.
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Affiliation(s)
- E Prifti
- Cardiovascular Surgery Department, University of Tirana, Albania.
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30
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Brancaccio G, Chauvaud S, Carpentier A. [Pre and Postoperative evaluation of the incidence of arrhythmia in patients undergoing corrective intervention for Ebstein anomaly]. Ital Heart J Suppl 2000; 1:1173-9. [PMID: 11140286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND Patients with Ebstein's anomaly frequently have troublesome cardiac arrhythmias. In particular, this malformation is the most common congenital defect associated with the Wolff-Parkinson-White syndrome. The aim of this study was to investigate the postoperative evolution of arrhythmias without the aid of any surgical techniques for arrhythmia. METHODS Between 1980 and 1999, 48 patients (22 males, 26 females), with a preoperatively documented arrhythmia, underwent an operation for the correction of Ebstein's anomaly at the Hôpital Broussais. Of these, 24 had paroxysmal supraventricular tachycardia, 12 had atrial fibrillation or flutter, 8 had Wolff-Parkinson-White syndrome, 1 had non-sustained ventricular tachycardia, and the remaining 3 patients had atrioventricular block. RESULTS The operative mortality was 8% (4/48). After operation 46% (20/44) of the patients regained permanent sinus rhythm (20/44 vs 2/48, p < 0.01), supraventricular tachyarrhythmia occurred in 16% of the patients (7/44), 8 patients (18%) had atrial fibrillation, and ventricular preexcitation syndrome was present in 3 patients (7%). The incidence of pacemaker implantation for complete heart block was 11% (5/44). Follow-up was achieved in 95% of patients (40/44) who survived the operation and the perioperative period. The mean follow-up was 63 +/- 54 months (range 4-226 months). During this time there were 6 additional deaths. Eight patients continued to have symptomatic arrhythmias (2 had paroxysmal supraventricular tachycardia, 6 had atrial fibrillation), but 55% of patients (20/36) reported no symptoms of arrhythmia (20/36 vs 2/48, p < 0.01). CONCLUSIONS Surgical repair improves the quality of life of these patients by reducing the incidence of arrhythmias, in fact less than one sixth of patients continued to have postoperative symptomatic arrhythmias. This can be explained by the interruption of accessory pathways that seem to be a major cause of arrhythmia in Ebstein's anomaly.
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MESH Headings
- Adolescent
- Adult
- Aged
- Arrhythmias, Cardiac/epidemiology
- Arrhythmias, Cardiac/etiology
- Arrhythmias, Cardiac/surgery
- Atrial Fibrillation/epidemiology
- Atrial Fibrillation/etiology
- Atrial Fibrillation/surgery
- Atrial Flutter/epidemiology
- Atrial Flutter/etiology
- Atrial Flutter/surgery
- Cardiac Surgical Procedures
- Child
- Child, Preschool
- Ebstein Anomaly/complications
- Ebstein Anomaly/mortality
- Ebstein Anomaly/surgery
- Female
- Follow-Up Studies
- Humans
- Incidence
- Male
- Middle Aged
- Postoperative Complications/epidemiology
- Postoperative Complications/mortality
- Tachycardia, Paroxysmal/epidemiology
- Tachycardia, Paroxysmal/etiology
- Tachycardia, Paroxysmal/surgery
- Tachycardia, Supraventricular/epidemiology
- Tachycardia, Supraventricular/etiology
- Tachycardia, Supraventricular/surgery
- Wolff-Parkinson-White Syndrome/epidemiology
- Wolff-Parkinson-White Syndrome/etiology
- Wolff-Parkinson-White Syndrome/surgery
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Affiliation(s)
- G Brancaccio
- Servizio di Chirurgia Cardiovascolare, Hôpital Broussais, Parigi, Francia.
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Abstract
Cardiopulmonary bypass (CPB) induces an increased capillary permeability and tissues water content due to hemodilution and the inflammatory response, resulting in organ dysfunction. The reduction of the water accumulation and inflammatory response can be achieved by employing ultrafiltration during CPB. Recently we developed a simple CPB circuit for ultrafiltration using the aortic venting tube as an inlet line. Such a technique offers the advantages of performing a combined ultrafiltration procedure and eliminating the danger of air embolism. We employed this circuit in 12 consecutive pediatric patients undergoing open heart surgery.
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Affiliation(s)
- G Brancaccio
- Institute of Cardiovascular Surgery, and Perfusion Service of Cardiac Surgery, University La Sapienza, Rome, Italy.
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Brancaccio G, Lettieri G, Monforte P, Larizza A. Synthesis and pharmacological activities of some 2,3-substituted bicyclo[3.3.0]oct-7-en-1-one and 2,3-substituted 4,5,6,7-tetrahydro (or perhydro) indan-1-one derivatives. Farmaco Sci 1983; 38:702-8. [PMID: 6641935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The title compounds were synthesized and tested for primary pharmacological activities. For several hydroindanon derivatives, pharmacological screening showed diuretic, choleretic, antiinflammatory, analgesic and sedative activities.
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Brancaccio G, Lettieri G, Monforte P, Larizza A. Synthesis and pharmacological properties of some 2-substituted dibenz[2,3:6,7]-3a,12b-dihydrooxepin[4,5-d]1,3-dioxolane derivatives. Farmaco Sci 1982; 37:711-8. [PMID: 7152010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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34
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Lettieri G, Brancaccio G, Monforte P, Larizza A. [Synthesis and pharmacological activity of N-(dialkylaminoethyl)amides and dialkylaminoethyl esters of alpha-(arylamino)phenylacetic acids]. Farmaco Sci 1982; 37:678-84. [PMID: 6982829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A series of N-(dialkylaminoethyl) amides and (dialkylaminoethyl) esters of alpha-(arylamino) phenylacetic acids were synthesized. For several amidic derivatives pharmacological screening showed appreciable analgesic antiinflammatory and sedative activity, whereas some esteric derivatives displayed significant antispasmodic activity.
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Lettieri G, Brancaccio G, Larizza A. [Synthesis and pharmacological activity of 4-((7-chloro-quinolyl)amino)acylamides]. Boll Chim Farm 1981; 120:308-10. [PMID: 6975106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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37
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Lettieri G, Brancaccio G, Larizza A, Viterbo R. [Synthesis of the o-carbamoylphenyl ester of thiamine monophosphate]. Boll Chim Farm 1981; 120:303-7. [PMID: 6975105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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38
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Lettieri G, Brancaccio G, Larizza A, Monforte P. [Synthesis and pharmacological properties of 1-phenyl-2-acylamido-4-alkyl 1-phenyl-2-acylamido-4-alkyl-pyrazolidin-3,5-diones]. Boll Chim Farm 1979; 118:266-73. [PMID: 454546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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39
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Brancaccio G, Lettieri G, Larizza A, Monforte P. [N1-aryl-N1-alkyl(or acetamido)-N4-arylsulfonyl-semicarbazides of potential hypoglycemic activity]. Boll Chim Farm 1979; 118:261-5. [PMID: 454545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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40
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Lettieri G, Brancaccio G, Larizza A, Viterbo R, Perri GC. [Acylamide derivatives of 6-aminochromane]. Farmaco Sci 1970; 25:422-6. [PMID: 5455039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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42
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Brancaccio G, Larizza A, Lettieri G, Viterbo R. [O-substituted N-n-propyl-(p-hydroxyanilino) acylamides with analgesic action]. Farmaco Sci 1967; 22:930-4. [PMID: 6077144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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45
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Brancaccio G, Caiazzo V. [On the use of fractionated turbidimetric determination of serum globulins in the study of liver disease]. Acta Med Ital Med Trop Subtrop Gastroenterol 1964; 19:19-26. [PMID: 5175732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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