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Prete A, Lanino E, Saglio F, Biffi A, Calore E, Faraci M, Rondelli R, Favre C, Zecca M, Casazza G, Porta F, Luksch R, Cesaro S, Rabusin M, Parasole R, Mura RM, Lo Nigro L, Leardini D, Pagliara D, Locatelli F, Fagioli F. Phase II Study of Allogeneic Hematopoietic Stem Cell Transplantation for Children with High-Risk Neuroblastoma Using a Reduced-Intensity Conditioning Regimen: Results from the AIEOP Trial. Transplant Cell Ther 2024; 30:530.e1-530.e8. [PMID: 38460729 DOI: 10.1016/j.jtct.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/20/2024] [Accepted: 03/01/2024] [Indexed: 03/11/2024]
Abstract
Despite aggressive multimodal treatment, the outcomes of pediatric patients with high-risk (HR) neuroblastoma (NB) remain poor. The rationale for allogeneic hematopoietic stem cell transplantation (allo-HCT) to treat NB was based on the possible graft-versus-tumor effect; however, toxicity limits its efficacy. We sought to prospectively assess the feasibility and efficacy of allo-HCT using a reduced-intensity conditioning regimen in pediatric patients with HR NB in a multicenter phase II trial. Primary endpoints were the rate of neutrophil and platelet engraftment, 5-year transplantation-related mortality (TRM), and disease-free survival (DFS). Secondary endpoint measures included the incidence of acute graft-versus-host disease (aGVHD) and chronic GVHD. Fifty-one patients were enrolled in the study. The 5-year cumulative incidence (CuI) of TRM was 29.4 ± 6.4%, and that of DFS was 11.8 ± 4.5%. Patients undergoing allo-HCT within 1 year of diagnosis or with bone marrow as their stem cell source had a higher DFS probability. The CuI of neutrophil engraftment, platelet engraftment, and grade II-IV aGVHD was 97.9 ± 2.1%, 93.8 ± 3.5%, and 47.1 ± 7.0%, respectively. The development of new therapeutic strategies could further improve disease control.
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Affiliation(s)
- Arcangelo Prete
- Pediatric Hematology and Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Edoardo Lanino
- Hematopoietic Stem Cell Transplantation Unit, IRCSS Istituto Giannina Gaslini, Genoa, Italy
| | - Francesco Saglio
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, AOU Città della Salute e della Scienza-Regina Margherita Children's Hospital, Turin, Italy
| | - Alessandra Biffi
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, University-Hospital of Padua, Padua, Italy
| | - Elisabetta Calore
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, University-Hospital of Padua, Padua, Italy
| | - Maura Faraci
- Hematopoietic Stem Cell Transplantation Unit, IRCSS Istituto Giannina Gaslini, Genoa, Italy
| | - Roberto Rondelli
- Pediatric Hematology and Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Claudio Favre
- Department of Pediatric Hematology/Oncology and Hematopoietic Stem Cell Transplantation, Meyer Children's University Hospital, Florence, Italy
| | - Marco Zecca
- Department of Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gabriella Casazza
- Pediatric Oncohematology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Fulvio Porta
- Pediatric Oncohematology and Bone Marrow Transplant Unit, Children's Hospital, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Roberto Luksch
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Simone Cesaro
- Pediatric Hematology Oncology Unit, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Marco Rabusin
- Department of Pediatrics, Institute of Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Rosanna Parasole
- Department of Pediatric Hemato-Oncology and Cellular Therapy, Azienda Sanitaria di Rilievo Nazionale Santobono-Pausilipon, Napoli, Italy
| | - Rosa Maria Mura
- Pediatric Oncology Unit, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Luca Lo Nigro
- Regional Reference Center for Pediatric Hematology and Oncology, Azienda Policlinico "G. Rodolico-San Marco", Catania, Italy
| | - Davide Leardini
- Pediatric Hematology and Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
| | - Daria Pagliara
- Department of Pediatric Hematology and Oncology, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Franco Locatelli
- Department of Pediatric Hematology and Oncology, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy; Catholic University of the Sacred Heart, Rome, Italy
| | - Franca Fagioli
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, AOU Città della Salute e della Scienza-Regina Margherita Children's Hospital, Turin, Italy; University of Turin, Turin, Italy
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2
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Nastasi N, Pasha A, Bruno G, Subbiani A, Pietrovito L, Leo A, Scala L, de Simone L, Casazza G, Lunardi F, Taddei ML, Tamburini A, Tondo A, Favre C, Calvani M. Blockade of IL-10 Signaling Ensures Mifamurtide Efficacy in Metastatic Osteosarcoma. Cancers (Basel) 2023; 15:4744. [PMID: 37835437 PMCID: PMC10571595 DOI: 10.3390/cancers15194744] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Osteosarcoma (OS) is the most common primary malignancy of the bone, highly aggressive and metastasizing, and it mainly affects children and adolescents. The current standard of care for OS is a combination of surgery and chemotherapy. However, these treatment options are not always successful, especially in cases of metastatic or recurrent osteosarcomas. For this reason, research into new therapeutic strategies is currently underway, and immunotherapies have received considerable attention. Mifamurtide stands out among the most studied immunostimulant drugs; nevertheless, there are very conflicting opinions on its therapeutic efficacy. Here, we aimed to investigate mifamurtide efficacy through in vitro and in vivo experiments. Our results led us to identify a new possible target useful to improve mifamurtide effectiveness on metastatic OS: the cytokine interleukin-10 (IL-10). We provide experimental evidence that the synergic use of an anti-IL-10 antibody in combination with mifamurtide causes a significantly increased mortality rate in highest-grade OS cells and lower metastasis in an in vivo model compared with mifamurtide alone. Overall, our data suggest that mifamurtide in combination with an anti-IL-10 antibody could be proposed as a new treatment protocol to be studied to improve the outcomes of OS patients.
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Affiliation(s)
- Nicoletta Nastasi
- Department of Pediatric Hematology–Oncology, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy; (N.N.); (A.P.); (G.B.); (A.S.); (A.T.); (A.T.); (C.F.)
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50139 Florence, Italy; (L.P.); (A.L.); (M.L.T.)
| | - Amada Pasha
- Department of Pediatric Hematology–Oncology, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy; (N.N.); (A.P.); (G.B.); (A.S.); (A.T.); (A.T.); (C.F.)
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50139 Florence, Italy; (L.P.); (A.L.); (M.L.T.)
| | - Gennaro Bruno
- Department of Pediatric Hematology–Oncology, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy; (N.N.); (A.P.); (G.B.); (A.S.); (A.T.); (A.T.); (C.F.)
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50139 Florence, Italy; (L.P.); (A.L.); (M.L.T.)
| | - Angela Subbiani
- Department of Pediatric Hematology–Oncology, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy; (N.N.); (A.P.); (G.B.); (A.S.); (A.T.); (A.T.); (C.F.)
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50139 Florence, Italy; (L.P.); (A.L.); (M.L.T.)
| | - Laura Pietrovito
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50139 Florence, Italy; (L.P.); (A.L.); (M.L.T.)
| | - Angela Leo
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50139 Florence, Italy; (L.P.); (A.L.); (M.L.T.)
| | - Lucia Scala
- Pharmaceutical Unit, A. Meyer Children’s Hospital, Scientific Institute for Research, Hospitalisation and Health Care, 50139 Florence, Italy; (L.S.); (L.d.S.)
| | - Lorena de Simone
- Pharmaceutical Unit, A. Meyer Children’s Hospital, Scientific Institute for Research, Hospitalisation and Health Care, 50139 Florence, Italy; (L.S.); (L.d.S.)
| | - Gabriella Casazza
- Pediatric Oncology–Hematology Unit, Pisa University Hospital, 56126 Pisa, Italy; (G.C.); (F.L.)
| | - Federica Lunardi
- Pediatric Oncology–Hematology Unit, Pisa University Hospital, 56126 Pisa, Italy; (G.C.); (F.L.)
| | - Maria Letizia Taddei
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50139 Florence, Italy; (L.P.); (A.L.); (M.L.T.)
| | - Angela Tamburini
- Department of Pediatric Hematology–Oncology, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy; (N.N.); (A.P.); (G.B.); (A.S.); (A.T.); (A.T.); (C.F.)
| | - Annalisa Tondo
- Department of Pediatric Hematology–Oncology, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy; (N.N.); (A.P.); (G.B.); (A.S.); (A.T.); (A.T.); (C.F.)
| | - Claudio Favre
- Department of Pediatric Hematology–Oncology, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy; (N.N.); (A.P.); (G.B.); (A.S.); (A.T.); (A.T.); (C.F.)
| | - Maura Calvani
- Department of Pediatric Hematology–Oncology, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy; (N.N.); (A.P.); (G.B.); (A.S.); (A.T.); (A.T.); (C.F.)
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Ceppi F, Gotti G, Möricke A, Silvestri D, Poyer F, Lentes J, Bergmann A, Trka J, Alten J, Elitzur S, Barbaric D, Buldini B, Dell'Acqua F, Schumacher F, Casazza G, Tchinda J, Nebral K, Conter V, Andishe A, Schrappe M. Near-tetraploid T-cell acute lymphoblastic leukaemia in childhood: Results of the AIEOP-BFM ALL studies. Eur J Cancer 2022; 175:120-124. [PMID: 36113241 DOI: 10.1016/j.ejca.2022.08.013] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/26/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Near-tetraploidy-defined by DNA index 1.79-2.28 or 81-103 chromosomes-is a rare cytogenetic abnormality observed both in children and adults with T-cell acute lymphoblastic leukaemia (T-ALL) and its prognostic value is not yet determined. PATIENTS AND METHODS We report a retrospective study conducted in paediatric patients with newly diagnosed T-ALL treated in AIEOP-BFM ALL 2000 and 2009 studies. 31 near-tetraploid T-ALL patients (1.4%) are compared to T-ALL patients without near-tetraploidy. RESULTS Near-tetraploid karyotype was associated with lower frequency of high-risk features: white blood cells count at diagnosis ≥100,000/μL (19.3% versus 41.0%, p-value < 0.001), PPR (13.3% versus 35.8%, p-value = 0.01) and minimal residual disease high-risk at the end of consolidation phase Induction B (4.03% versus 14.6%, p-value = 0.001). Complete remission was achieved at the end of induction phase (day 33) in 100% near-tetraploid T-ALL patients, compared to 93.2% T-ALL without near-tetraploidy. CONCLUSION Overall, we found that near-tetraploid T-ALL in newly diagnosed paediatric patients is associated with low-risk presenting features, with favourable treatment response and outcome.
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Affiliation(s)
- Francesco Ceppi
- Pediatric Hematology-Oncology Unit, Division of Pediatrics, Woman-Mother-Child Department, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
| | - Giacomo Gotti
- Pediatric Hemato-Oncology Center, Fondazione MBBM, University Milano-Bicocca, Ospedale San Gerardo-Monza, Italy
| | - Anja Möricke
- Department of Pediatrics, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Daniela Silvestri
- Pediatric Hemato-Oncology Center, Fondazione MBBM, University Milano-Bicocca, Ospedale San Gerardo-Monza, Italy
| | - Fiona Poyer
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - Jana Lentes
- Institute of Human Genetics, Medical School Hannover, Hannover, Germany
| | - Anke Bergmann
- Institute of Human Genetics, Medical School Hannover, Hannover, Germany
| | - Jan Trka
- CLIP - Childhood Leukaemia Investigation Prague, Second Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - Julia Alten
- Department of Pediatrics, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Sara Elitzur
- Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Draga Barbaric
- Centre for Children's Cancer and Blood Disorders, Sydney Children's Hospital, Sydney, Australia
| | - Barbara Buldini
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Maternal and Child Health Department, University of Padova, Padova, Italy
| | - Fabiola Dell'Acqua
- Pediatric Hemato-Oncology Center, Fondazione MBBM, University Milano-Bicocca, Ospedale San Gerardo-Monza, Italy
| | - Fabian Schumacher
- Pediatric Oncology Unit of Spedali Civili di Brescia, Brescia, Italy
| | - Gabriella Casazza
- Oncoematologia Pediatrica, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Joelle Tchinda
- Laboratory for Oncology, University Children's Hospital Zürich, Zürich, Switzerland
| | - Karin Nebral
- Labdia Labordiagnostik, Vienna, Austria; St. Anna Children's Cancer Research Institute (CCRI), Vienna, Austria
| | - Valentino Conter
- Pediatric Hemato-Oncology Center, Fondazione MBBM, University Milano-Bicocca, Ospedale San Gerardo-Monza, Italy
| | - Attarbaschi Andishe
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - Martin Schrappe
- Department of Pediatrics, University Hospital Schleswig-Holstein, Kiel, Germany
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4
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Santangelo A, Bartolini E, Nuzzi G, Foiadelli T, Michev A, Mina T, Trambusti I, Fichera V, Bonuccelli A, Massimetti G, Peroni DG, De Marco E, Coccoli L, Luti L, Bernasconi S, Nardi M, Menconi MC, Casazza G, Pruna D, Mura R, Marra C, Zama D, Striano P, Cordelli DM, Battini R, Orsini A. The Clinical Impact of Methotrexate-Induced Stroke-Like Neurotoxicity in Paediatric Departments: An Italian Multi-Centre Case-Series. Front Neurol 2022; 13:920214. [PMID: 35756920 PMCID: PMC9226576 DOI: 10.3389/fneur.2022.920214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Stroke-like syndrome (SLS) is a rare subacute neurological complication of intrathecal or high-dose (≥500 mg) Methotrexate (MTX) administration. Its clinical features, evoking acute cerebral ischaemia with fluctuating course symptoms and a possible spontaneous resolution, have elicited interest among the scientific community. However, many issues are still open on the underlying pathogenesis, clinical, and therapeutic management and long-term outcome. Materials and Methods We retrospectively analyzed clinical, radiological and laboratory records of all patients diagnosed with SLS between 2011 and 2021 at 4 National referral centers for Pediatric Onco-Hematology. Patients with a latency period that was longer than 3 weeks between the last MTX administration of MTX and SLS onset were excluded from the analysis, as were those with unclear etiologies. We assessed symptom severity using a dedicated arbitrary scoring system. Eleven patients were included in the study. Results The underlying disease was acute lymphoblastic leukemia type B in 10/11 patients, while fibroblastic osteosarcoma was present in a single subject. The median age at diagnosis was 11 years (range 4-34), and 64% of the patients were women. Symptoms occurred after a mean of 9.45 days (± 0.75) since the last MTX administration and lasted between 1 and 96 h. Clinical features included hemiplegia and/or cranial nerves palsy, paraesthesia, movement or speech disorders, and seizure. All patients underwent neuroimaging studies (CT and/or MRI) and EEG. The scoring system revealed an average of 4.9 points (± 2.3), with a median of 5 points (maximum 20 points). We detected a linear correlation between the severity of the disease and age in male patients. Conclusions SLS is a rare, well-characterized complication of MTX administration. Despite the small sample, we have been able to confirm some of the previous findings in literature. We also identified a linear correlation between age and severity of the disease, which could improve the future clinical management.
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Affiliation(s)
- Andrea Santangelo
- Paediatric Neurology, Paediatric Department, Santa Chiara University Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Emanuele Bartolini
- Department of Developmental Neuroscience, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
| | - Giulia Nuzzi
- Paediatric Neurology, Paediatric Department, Santa Chiara University Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Thomas Foiadelli
- Clinica Pediatrica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alexandre Michev
- Clinica Pediatrica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Tommaso Mina
- Paediatric Haematology/Oncology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Irene Trambusti
- Paediatric Neurology, Paediatric Department, Santa Chiara University Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Valeria Fichera
- Paediatric Neurology, Paediatric Department, Santa Chiara University Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Alice Bonuccelli
- Paediatric Neurology, Paediatric Department, Santa Chiara University Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Diego G Peroni
- Paediatric Neurology, Paediatric Department, Santa Chiara University Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Emanuela De Marco
- Paediatric Oncology and Haematology Department, Santa Chiara Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Luca Coccoli
- Paediatric Oncology and Haematology Department, Santa Chiara Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Laura Luti
- Paediatric Oncology and Haematology Department, Santa Chiara Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Sayla Bernasconi
- Paediatric Oncology and Haematology Department, Santa Chiara Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Margherita Nardi
- Paediatric Oncology and Haematology Department, Santa Chiara Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Maria Cristina Menconi
- Paediatric Oncology and Haematology Department, Santa Chiara Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Gabriella Casazza
- Paediatric Oncology and Haematology Department, Santa Chiara Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Dario Pruna
- Paediatric Neurology, Paediatric Department, ARNAS G. Brotzu, Cagliari, Italy
| | - Rosamaria Mura
- Paediatric Oncology and Haematology, Pediatric Department, ARNAS G. Brotzu, Cagliari, Italy
| | - Chiara Marra
- Paediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Daniele Zama
- Paediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Pasquale Striano
- Paediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Duccio M Cordelli
- Unitá Operativa Complessa (UOC) Neuropsichiatria dell'età Pediatrica, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Roberta Battini
- Department of Developmental Neuroscience, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessandro Orsini
- Paediatric Neurology, Paediatric Department, Santa Chiara University Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
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Di Cicco M, Del Tufo E, Parolo E, Menconi M, Bernasconi S, Romei C, Di Gangi A, Masini B, Peroni D, Casazza G. Effective treatment of late-onset noninfectious pulmonary complication with ruxolitinib in an 8-year-old boy. ERJ Open Res 2021; 7:00407-2021. [PMID: 34549045 PMCID: PMC8450453 DOI: 10.1183/23120541.00407-2021] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 07/09/2021] [Indexed: 11/22/2022] Open
Abstract
Haematopoietic stem cell transplantation (HSCT) is an effective treatment for many malignant and nonmalignant diseases both in adults and children, but this procedure can be burdened by the so-called “late-onset non-infectious pulmonary complications” (LONIPCs), which are characterised by significant morbidity and mortality [1]. LONIPCs include different forms of inflammatory lung involvement, occurring after 100 days and within 2–3 years following HSCT [2]. Ruxolitinib could be considered as an option in the treatment of LONIPCs in children when other treatments are ineffective. Spirometry is a valuable tool for both diagnosis and follow-up of LONIPCs in children.https://bit.ly/3BmOYfb
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Affiliation(s)
- Maria Di Cicco
- Dept of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Ester Del Tufo
- Dept of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Eva Parolo
- Dept of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | | | - Sayla Bernasconi
- Pediatric Onco-haematology Unit, Pisa University Hospital, Pisa, Italy
| | - Chiara Romei
- Dept of Diagnostic Imaging, 2nd Radiology Unit, Pisa University Hospital, Pisa, Italy
| | - Alessandro Di Gangi
- Dept of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Beatrice Masini
- Dept of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Diego Peroni
- Dept of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Gabriella Casazza
- Pediatric Onco-haematology Unit, Pisa University Hospital, Pisa, Italy
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6
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Genovese G, Maronese CA, Casazza G, Corti L, Venegoni L, Muratori S, Berti E, Fanoni D, Marzano AV. Clinical and serological predictors of relapse in pemphigus: a study of 143 patients. Clin Exp Dermatol 2021; 47:98-106. [PMID: 34288016 PMCID: PMC9290045 DOI: 10.1111/ced.14854] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pemphigus is an autoimmune bullous disease mediated by autoantibodies targeting epithelial cell-cell adhesion molecules. Predictors of relapse have not yet been clearly identified. AIMS To identify factors at diagnosis and during follow-up that could be predictors of relapse. METHODS Clinical and immunopathological data at diagnosis, clinical remission and first relapse from patients with pemphigus vulgaris or foliaceus and at least a 36-month follow-up were collected retrospectively. Based on the autoantibody profile at diagnosis, three serological patient subsets were devised: (i) anti-desmoglein (Dsg)1-positive and anti-Dsg3-negative; (iii) anti-Dsg1-negative and anti-Dsg3-positive; and (iii) anti-Dsg1-positive and anti-Dsg3-positive. RESULTS Data from 143 patients were collected. No significant differences were found between relapsers (n = 90) and nonrelapsers (n = 53) for time to remission or for anti-Dsg1 and anti-Dsg3 titres at diagnosis and remission. In the analysis of all patients, a higher risk of relapse was found for a body surface area (BSA) score of 3 compared with BSA < 3 (OR = 3.30, 95% CI 1.17-9.28; P = 0.02) and for a positive titre of either anti-Dsg1 or anti-Dsg3 autoantibodies at remission compared with both being negative (OR = 2.42, 95% CI 1.21-4.85, P = 0.01). In patients who were anti-Dsg3-positive and anti-Dsg1-negative at diagnosis, failure to achieve anti-Dsg3 negativity at clinical remission was a significant predictor of relapse (OR = 7.89, 95% CI 2.06-30.21; P < 0.01). Similarly, failure to achieve anti-Dsg1 negativity at clinical remission was a significant predictor of relapse in patients with both anti-Dsg1 and anti-Dsg3 positivity at diagnosis (OR = 5.74, 95% CI 1.15-28.61; P = 0.03), but not in those who were anti-Dsg1-positive/anti-Dsg3-negative at diagnosis (OR = 1.08, 95% CI 0.27-4.30; P = 0.91). CONCLUSION Regardless of pemphigus subtype, autoantibody titre negativity at clinical remission in patients classified based on their anti-Dsg1 and anti-Dsg3 profile at diagnosis and BSA were useful tools in predicting relapse.
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Affiliation(s)
- G Genovese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - C A Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - G Casazza
- Department of Biomedical and Clinical Sciences 'L. Sacco', Università degli Studi di Milano, Milan, Italy
| | - L Corti
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - L Venegoni
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - S Muratori
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - E Berti
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - D Fanoni
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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7
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Flor N, Casazza G, Saggiante L, Savoldi AP, Vitale R, Villa P, Martucci F, Ballone E, Castelli A, Brambilla AM. Chest radiography predictor of COVID-19 adverse outcomes. A lesson learnt from the first wave. Clin Radiol 2021; 76:549.e1-549.e8. [PMID: 33888302 PMCID: PMC8011632 DOI: 10.1016/j.crad.2021.03.011] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/22/2021] [Indexed: 11/30/2022]
Abstract
AIM To assess the role of a severity score based on chest radiography (CXR) in predicting the risk of adverse outcomes in coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS Of the patients who presented to L. Sacco Hospital (Milan, Italy) between 21 February and 31 March 2020, patients with a laboratory confirmation of COVID-19 who also underwent a CXR were included in the study. To quantify the extent of lung involvement, each CXR image was given a score (Milan score), ranging from 0 to 24, depending on the presence of reticular pattern and/or ground-glass opacities and/or extensive consolidations in each of the 12 areas in which the lungs were divided. The score was calculated by an expert radiologist, blinded to laboratory tests. The ability of the Milan score to predict hospital admission and mortality, after adjusting for some variables (age; gender; comorbidities; time between symptoms onset and admission), using univariate and multivariate statistical analysis was investigated retrospectively. RESULTS Among the 554 patients, 115 of which (21%) had a negative CXR, the in-hospital mortality was 16% (90/554). At univariate analysis, age, gender, and comorbidities were significant predictors of mortality and hospital admission. At multivariate analysis, adjusting for age and gender, the Milan score was an independent predictor of mortality and hospitalisation. In particular, patients with a Milan score ≥ 9 had a mortality risk five-times higher than those with a lower score. Other independent predictors of mortality were gender and age. CONCLUSIONS The CXR Milan score was an independent predictive factor of both in-hospital mortality and hospital admission.
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Affiliation(s)
- N Flor
- U.O. di Radiodiagnostica - Ospedale L. Sacco ASST Fatebenefratelli Sacco, Via Giovanni Battista Grassi, 74, 20157 Milano MI, Italy.
| | - G Casazza
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco" - Università degli Studi di Milano, Italy
| | - L Saggiante
- Postgraduation School in Radiodiagnostics - Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milano MI, Italy
| | - A P Savoldi
- Postgraduation School in Radiodiagnostics - Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milano MI, Italy
| | - R Vitale
- Postgraduation School in Radiodiagnostics - Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milano MI, Italy
| | - P Villa
- U.O. di Radiodiagnostica - Ospedale L. Sacco ASST Fatebenefratelli Sacco, Via Giovanni Battista Grassi, 74, 20157 Milano MI, Italy; U.O. di Medicina e Chirurgia d'Accettazione e d'Urgenza- Ospedale L. Sacco ASST Fatebenefratelli Sacco, Via Giovanni Battista Grassi, 74, 20157 Milano MI, Italy
| | - F Martucci
- U.O. di Radiodiagnostica - Ospedale L. Sacco ASST Fatebenefratelli Sacco, Via Giovanni Battista Grassi, 74, 20157 Milano MI, Italy; U.O. di Medicina e Chirurgia d'Accettazione e d'Urgenza- Ospedale L. Sacco ASST Fatebenefratelli Sacco, Via Giovanni Battista Grassi, 74, 20157 Milano MI, Italy
| | - E Ballone
- U.O. di Radiodiagnostica - Ospedale L. Sacco ASST Fatebenefratelli Sacco, Via Giovanni Battista Grassi, 74, 20157 Milano MI, Italy; U.O. di Anestesia e Rianimazione- Ospedale L. Sacco ASST Fatebenefratelli Sacco, Via Giovanni Battista Grassi, 74, 20157 Milano MI, Italy
| | - A Castelli
- U.O. di Radiodiagnostica - Ospedale L. Sacco ASST Fatebenefratelli Sacco, Via Giovanni Battista Grassi, 74, 20157 Milano MI, Italy; U.O. di Anestesia e Rianimazione- Ospedale L. Sacco ASST Fatebenefratelli Sacco, Via Giovanni Battista Grassi, 74, 20157 Milano MI, Italy
| | - A M Brambilla
- U.O. di Radiodiagnostica - Ospedale L. Sacco ASST Fatebenefratelli Sacco, Via Giovanni Battista Grassi, 74, 20157 Milano MI, Italy; U.O. di Medicina e Chirurgia d'Accettazione e d'Urgenza- Ospedale L. Sacco ASST Fatebenefratelli Sacco, Via Giovanni Battista Grassi, 74, 20157 Milano MI, Italy
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8
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Pieroni F, Massei F, Micheletti MV, Luti L, De Marco E, Ludovisi A, Casazza G, Bruschi F. Toxocariasis in a Child with Autism Spectrum Disorder. Int J Environ Res Public Health 2021; 18:ijerph18010283. [PMID: 33401653 PMCID: PMC7795894 DOI: 10.3390/ijerph18010283] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/24/2020] [Accepted: 12/31/2020] [Indexed: 01/09/2023]
Abstract
A boy affected by autism spectrum disorder was admitted for persistent high fever, without shiver, for two weeks. The boy referred to abdominal pain, in the first week of fever, and to mild anorexia in the last days before admittance to our hospital centre. The father reported that the boy suffered by geophagia and coprophagia and he has been going to a didactical farm (where he has been exposed to several kinds of animals) to improve his neuropsychiatric condition. Blood analysis shows severe eosinophilia and high levels of total IgE, and abdominal echocardiography showed hepatic lesions. Enzyme-linked immunosorbent assay (ELISA) and Western blot (WB) confirmed the suspicion of toxocariasis, linked to the habit of the boy to ingest ground or animal faeces in a didactic farm frequented by the boy. Treatment with albendazole and prednisone was administered with a rapid improvement of the symptoms and the laboratory findings and significant reduction of the hepatic lesion.
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Affiliation(s)
- Filippo Pieroni
- Postgraduate School of Paediatrics, Department of Clinical and Experimental Medicine, Section of Paediatric, University of Pisa, 56126 Pisa, Italy
- Correspondence: ; Tel.: +39-34-89-875-037
| | - Francesco Massei
- Pediatric Hematology Oncology, Bone Marrow Transplant, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy; (F.M.); (M.V.M.); (L.L.); (E.D.M.); (G.C.)
| | - Maria Vittoria Micheletti
- Pediatric Hematology Oncology, Bone Marrow Transplant, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy; (F.M.); (M.V.M.); (L.L.); (E.D.M.); (G.C.)
| | - Laura Luti
- Pediatric Hematology Oncology, Bone Marrow Transplant, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy; (F.M.); (M.V.M.); (L.L.); (E.D.M.); (G.C.)
| | - Emanuela De Marco
- Pediatric Hematology Oncology, Bone Marrow Transplant, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy; (F.M.); (M.V.M.); (L.L.); (E.D.M.); (G.C.)
| | - Alessandra Ludovisi
- Department of Infectious Diseases, EURLP, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Gabriella Casazza
- Pediatric Hematology Oncology, Bone Marrow Transplant, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy; (F.M.); (M.V.M.); (L.L.); (E.D.M.); (G.C.)
| | - Fabrizio Bruschi
- Department of Translational Research, N.T.M.S., University of Pisa, 56126 Pisa, Italy;
- Parasitic Disease Monitoring Program, AOUP, 56126 Pisa, Italy
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9
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Orsini A, Bernasconi S, Bianchi MC, Trivelli I, Menconi MC, Nardi M, Santangelo A, Casazza G, Carli N, Esposito M, Peroni D, Striano P, Foiadelli T, Bonuccelli A. PRES-like leukoencephalopathy presenting with status epilepticus associated with Brentuximab Vedotin treatment. Acta Biomed 2021; 92:e2021416. [PMID: 35441608 PMCID: PMC9179058 DOI: 10.23750/abm.v92is4.12665] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/27/2022] [Indexed: 11/23/2022]
Abstract
Posterior Reversible Encephalopathy Syndrome (PRES) is characterized by acute neurological symptoms with typical imaging features, primarily in the territories of the brain supplied by the posterior circulation, probably due to vasogenic edema. Both clinical and imaging features are generally reversible. We report a 13-year-old girl affected by Nodular Sclerosis Classical Hodgkin Lymphoma stage IIIB into complete remission, with a recurrence and autologous bone-marrow transplantation, who has been treated with an anti-CD30 monoclonal antibody, brentuximab-vedotin. The girl has suddenly presented a convulsive status epilepticus, that needed intubation and sedation. Therefore, an IV therapy with levetiracetam was started. Furthermore, the girl has presented high blood pressure and reduced kidney function. Brain MRI demonstrated a diffuse PRES-like disease, that went into regression after the first week. After another week, the girl presented a new prolonged generalized tonic clonic convulsive episode, that needed intubation and sedation and an association of clobazam and levetiracetam: a new brain MRI showed a recurrence of PRES-like lesions in addition to some signs of leukoencephalopathy with brain lactate accumulation on 1H-MRS, due to cerebral energetic failure. The girl also presented a refractory arterial hypertension. After 45 days of ICU hospitalization the patient has been discharged and followed up with neurological examinations. Brain MRI and brain 1H-MRS, 5 months after patient's discharge, showed incomplete regression of cerebral white matter signal abnormalities with MRS normalization.
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Affiliation(s)
- Alessandro Orsini
- Pediatric Neurology, Pediatrie University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa
| | - Sayla Bernasconi
- Pediatric Oncohematology Unit, Azienda Ospedaliera Universitaria Pisana
| | | | - Ilaria Trivelli
- Neuroradiology Unit, Azienda Ospedaliera Universitaria Pisana
| | | | - Margherita Nardi
- Pediatric Oncohematology Unit, Azienda Ospedaliera Universitaria Pisana
| | - Andrea Santangelo
- Pediatric Neurology, Pediatrie University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa
| | - Gabriella Casazza
- Pediatric Oncohematology Unit, Azienda Ospedaliera Universitaria Pisana
| | - Niccolò Carli
- Pediatric Neurology, Pediatrie University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa
| | - Mariagrazia Esposito
- Pediatric Neurology, Pediatrie University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa
| | - Diego Peroni
- Pediatric Neurology, Pediatrie University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa
| | - Pasquale Striano
- Pediatric Neurology Unit, Dinogmi, Giannina Gaslini’s Istitute, University of Genoa
| | - Thomas Foiadelli
- Pediatric Clinic, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia
| | - Alice Bonuccelli
- Pediatric Neurology, Pediatrie University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa
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10
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Ceriani E, Casazza G, Peta J, Torzillo D, Furlotti S, Cogliati C. Residual congestion and long-term prognosis in acutely decompensated heart failure patients. Intern Emerg Med 2020; 15:719-724. [PMID: 32266688 DOI: 10.1007/s11739-020-02326-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 03/25/2020] [Indexed: 10/24/2022]
Abstract
AIMS Recent studies have established the role of residual congestion evaluated by lung ultrasound in estimating short-term risk of readmission or death in patients admitted for heart failure (HF) decompensation. However, if lung ultrasounds maintain a prognostic role of in long-term survival is still unknown. Aim of our study was to evaluate if residual congestion could predict all-cause mortality during 4 year follow up in a cohort of unselected patients admitted for acute decompensated HF. METHODS One-hundred fifty patients were enrolled. The anterolateral chest was scanned to evaluate the presence of B-lines. A sonographic score was calculated attributing 1 to each positive sector (≥ 3 B-lines). Clinical, biochemical and echocardiographic data were recorded. A Cox proportional hazard regression analysis was performed to evaluate the association between variables and 4-year survival. RESULTS During the follow-up, 86 patients (58%) died. Univariate analysis showed a significant correlation between the sonographic score at discharge and events occurrence at long term follow up (HR 1.21; CI 1.11-1.31; p < 0.001) suggesting that, on average, the increase of 1 point in the sonographic score was associated with an increase of approximately 20% in the risk of death. CONCLUSIONS Our results suggest the role of LUS in the identification of more congested HF patients, that will be at risk for worse long term outcome.
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Affiliation(s)
- E Ceriani
- Department of Internal Medicine, L. Sacco Hospital, University of Milan, Milan, Italy.
- Department of Internal Medicine, Ca Granda Foundation IRCCS, Ospedale Maggiore Policlinico, University of Milan, Via F.Sforza 35, Milan, Italy.
| | - G Casazza
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - J Peta
- Department of Internal Medicine, Ca Granda Foundation IRCCS, Ospedale Maggiore Policlinico, University of Milan, Via F.Sforza 35, Milan, Italy
| | - D Torzillo
- Department of Internal Medicine, L. Sacco Hospital, University of Milan, Milan, Italy
| | - S Furlotti
- Department of Internal Medicine, L. Sacco Hospital, University of Milan, Milan, Italy
- Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste, Italy
| | - C Cogliati
- Department of Internal Medicine, L. Sacco Hospital, University of Milan, Milan, Italy
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11
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Marzano AV, Genovese G, Casazza G, Moltrasio C, Dapavo P, Micali G, Sirna R, Gisondi P, Patrizi A, Dini V, Bianchini D, Bianchi L, Fania L, Prignano F, Offidani A, Atzori L, Bettoli V, Cannavò SP, Venturini M, Bongiorno MR, Costanzo A, Fabbrocini G, Peris K. Evidence for a 'window of opportunity' in hidradenitis suppurativa treated with adalimumab: a retrospective, real-life multicentre cohort study. Br J Dermatol 2020; 184:133-140. [PMID: 32119111 DOI: 10.1111/bjd.18983] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND The anti-tumour necrosis factor (TNF)-α adalimumab is the only licenced biologic for moderate-to-severe hidradenitis suppurativa (HS). No predictors of response have been identified so far. OBJECTIVES To identify clinical parameters predicting response to adalimumab and confirm its efficacy/safety. METHODS The data of 389 patients with HS treated with adalimumab in 21 Italian centres were reviewed. Sex, age at onset/diagnosis/baseline, body mass index, smoking, phenotype, previous treatments, concomitant antibiotics and 'therapeutic delay', defined as the time from HS onset to adalimumab initiation, were assessed. Response to adalimumab and its impact on quality of life (QoL) were evaluated using the Hidradenitis Suppurativa Clinical Response (HiSCR) and the Dermatology Life Quality Index (DLQI) or the Visual Analogue Scale for pain (VAS pain), respectively. Logistic regression analysis was performed. RESULTS The therapeutic delay correlated to lack of response to adalimumab at week 16 [odds ratio (OR) 1·92 for therapeutic delay > 10 years; 95% confidence interval (CI) 1·28-2·89; P = 0·0016). HiSCR was achieved in 43·7% and 53·9% patients at week 16 and 52, respectively. Significant reductions in both DLQI and VAS pain were found between week 16 vs. baseline (P < 0·0001 for both) and week 52 vs. baseline (P < 0·0001 for both). Previous immunosuppressants inversely correlated to HiSCR at week 52 (OR = 1·74, 95% CI 1·04-2·91, P = 0·0342). CONCLUSIONS Inverse correlation between therapeutic delay and clinical response was found, supporting early adalimumab use and providing evidence for a 'window of opportunity' in HS treatment. Adalimumab efficacy and safety were confirmed, along with patients' QoL improvement. Immunosuppressants could negatively influence the response to adalimumab inducing a switch to non-TNF-α-driven pathways.
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Affiliation(s)
- A V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Physiopathology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - G Genovese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Physiopathology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - G Casazza
- Dipartimento di Scienze Biomediche e Cliniche 'L. Sacco', Università degli Studi di Milano, Milan, Italy
| | - C Moltrasio
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Physiopathology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - P Dapavo
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - G Micali
- Dermatology Clinic, University of Catania, Catania, Italy
| | - R Sirna
- Dermatology Unit, Department of Surgery, Misericordia Hospital, Grosseto, Italy
| | - P Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - A Patrizi
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - V Dini
- Department of Dermatology, University of Pisa, Pisa, Italy
| | - D Bianchini
- Dermatologic Clinic, Department of Internal Medicine and Medical Specialties, 'La Sapienza' University, Rome, Italy
| | - L Bianchi
- Department of Dermatology, University of Rome 'Tor Vergata', Rome, Italy
| | - L Fania
- First Dermatology Clinic and Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Rome, Italy
| | - F Prignano
- Department Health Science Section of Dermatology, University of Florence, Florence, Italy
| | - A Offidani
- Dermatological Clinic Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - L Atzori
- Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - V Bettoli
- Department of Medical Sciences, Section of Dermatology, University of Ferrara, Ferrara, Italy
| | - S P Cannavò
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy
| | - M Venturini
- Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - M R Bongiorno
- Section of Dermatology, Department of Health Promotion, Maternal-Infant, Internal Medicine and Specialization, University of Palermo, Palermo, Italy
| | - A Costanzo
- Dermatology Unit, IRCCS Humanitas Clinical and Research Center, Rozzano (Milan), Italy
| | - G Fabbrocini
- Department of Dermatology, University of Naples Federico II, Naples, Italy
| | - K Peris
- Institute of Dermatology, Università Cattolica - Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
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12
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Calvani M, Bruno G, Dabraio A, Subbiani A, Bianchini F, Fontani F, Casazza G, Vignoli M, De Logu F, Frenos S, Filippi L, Favre C. β3-Adrenoreceptor Blockade Induces Stem Cells Differentiation in Melanoma Microenvironment. Int J Mol Sci 2020; 21:ijms21041420. [PMID: 32093135 PMCID: PMC7073111 DOI: 10.3390/ijms21041420] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/14/2020] [Accepted: 02/17/2020] [Indexed: 12/11/2022] Open
Abstract
Although there is an increasing evidence that cancer stem cell (CSC) niches in the tumor microenvironment (TME) plays a crucial role in sustaining solid tumors progression, several molecular players involved in this regulation still remain unknown. The role of β-adrenergic signaling in enhancing tumor growth through β2-adrenoreceptors (β2-ARs) has been confirmed in different cancer models, but the role played by the β3-adrenergic receptor (β3-AR) has recently emerged. Previous studies showed that β3-AR promotes cancer growth through the activation of different stromal cells in the TME, and leads to melanoma malignancy progression through inflammation, angiogenesis, and immunotolerance. Here we show that in B16 melanoma-bearing mice, the pharmacological β3-AR blockade is able to reduce the expression of CSC markers, and to induce a differentiated phenotype of hematopoietic subpopulations in TME. In particular, cytofluorimetric analysis (FACS) of the tumor mass shows that β3-AR antagonist SR59230A promotes hematopoietic differentiation as indicated by increased ratios of lymphoid/hematopoietic stem cells (HSCs) and of myeloid progenitor cells/HSCs, and increases the number of Ter119 and natural killer (NK) precursor cells, and of granulocyte precursors, indicating active hematopoiesis within the tumor tissue. Moreover, pharmacological antagonism of β3-AR induces mesenchymal stem cell (MSC) differentiation into adipocytes subtracting a potential renewal of the stem compartment by these cells. Here we demonstrate that β3-AR blockade in the TME by inducing the differentiation of different stromal cells at the expense of stemness traits could possibly have a favorable effect on the control of melanoma progression.
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Affiliation(s)
- Maura Calvani
- Division of Pediatric Oncology/Hematology, Meyer University Children’s Hospital, 50139 Florence, Italy; (G.B.); (A.D.); (A.S.); (F.F.); (M.V.)
- Correspondence: ; Tel.: +39-055-7944573
| | - Gennaro Bruno
- Division of Pediatric Oncology/Hematology, Meyer University Children’s Hospital, 50139 Florence, Italy; (G.B.); (A.D.); (A.S.); (F.F.); (M.V.)
- Department of Health Sciences, University of Florence, 50139 Florence, Italy;
| | - Annalisa Dabraio
- Division of Pediatric Oncology/Hematology, Meyer University Children’s Hospital, 50139 Florence, Italy; (G.B.); (A.D.); (A.S.); (F.F.); (M.V.)
- Department of Health Sciences, University of Florence, 50139 Florence, Italy;
| | - Angela Subbiani
- Division of Pediatric Oncology/Hematology, Meyer University Children’s Hospital, 50139 Florence, Italy; (G.B.); (A.D.); (A.S.); (F.F.); (M.V.)
- Department of Health Sciences, University of Florence, 50139 Florence, Italy;
| | - Francesca Bianchini
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50139 Florence, Italy;
| | - Filippo Fontani
- Division of Pediatric Oncology/Hematology, Meyer University Children’s Hospital, 50139 Florence, Italy; (G.B.); (A.D.); (A.S.); (F.F.); (M.V.)
- Department of Health Sciences, University of Florence, 50139 Florence, Italy;
| | - Gabriella Casazza
- Paediatric Hematology Oncology, Bone Marrow Transplant, S. Chiara University Hospital of Pisa, 56126 Pisa, Italy;
| | - Marina Vignoli
- Division of Pediatric Oncology/Hematology, Meyer University Children’s Hospital, 50139 Florence, Italy; (G.B.); (A.D.); (A.S.); (F.F.); (M.V.)
- Department of Health Sciences, University of Florence, 50139 Florence, Italy;
| | - Francesco De Logu
- Department of Health Sciences, University of Florence, 50139 Florence, Italy;
| | - Stefano Frenos
- Hematology-Oncology Department, “Anna Meyer Children’s Hospital”, 50139 Florence, Italy; (S.F.); (C.F.)
| | - Luca Filippi
- Neonatal Intensive Care Unit, Medical Surgical Fetal-Neonatal Department, Meyer “University Children’s Hospital, 50139 Florence, Italy;
| | - Claudio Favre
- Hematology-Oncology Department, “Anna Meyer Children’s Hospital”, 50139 Florence, Italy; (S.F.); (C.F.)
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13
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Pavlov CS, Varganova DL, Casazza G, Tsochatzis E, Nikolova D, Gluud C. [Glucocorticosteroids for people with alcoholic hepatitis (Cochrane review)]. TERAPEVT ARKH 2019; 91:52-66. [PMID: 32598755 DOI: 10.26442/00403660.2019.08.000354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 04/16/2020] [Indexed: 12/12/2022]
Abstract
Alcoholic hepatitis (AH) is a form of alcoholic liver disease. Glucocorticosteroids (GCS) are used as anti - inflammatory drugs for people with alcoholic hepatitis. AIM To assess the benefits and harms of GCS in people with AH. MATERIAL AND METHODS We identified trials through electronic searches in Cochrane Hepato-Biliary's (CHB) Controlled Trials Register, CENTRAL, MEDLINE, Embase, LILACS, and Science Citation Index Expanded. We considered for inclusion randomised clinical trials (RCTs) assessing GCS versus placebo/no intervention in adult participants with AH. We allowed co - interventions in the trial groups if they were similar. We followed Cochrane methodology, CHB Group methodology using Review Manager 5 and Trial Sequential Analysis(TSA) to perform meta - analysis (M-A), assessed bias risk of the trials, certainty of evidence using GRADE. RESULTS AND DISCUSSION Sixteen trials fulfilled the inclusion criteria. Fifteen trials provided data for analysis (927 participants received GCS, 934 - placebo/no intervention). The GCS were administered to adult participants at different stages of AH orally or parenterally for a median of 28 days. There was no evidence of effect of GCCs on our primary outcomes all - cause mortality up to 3 months following randomisation (RR 0.90, 95% CI 0.70-1.15; n=1861), on health - related quality of life (MD - 0.04 points; 95% CI -0.11-0.03; n=377; trial = 1) (EQ-5D-3L scale), on the occurrence of serious adverse events during treatment (RR 1.05, 95% CI 0.85-1.29; n=1861). We found no evidence of a difference between the intervention groups. The risk of bias was high in all the trials except one. The certainty of evidence was very low or low. One of the trials seems to be not industry - funded. CONCLUSION We found no evidence of a difference between GCS and placebo or no intervention on all - cause mortality, health - related quality of life, and serious adverse events during treatment. We cannot exclude increases in adverse events and cannot rule out significant benefits and harms of GCSs. Future trials ought to report depersonalised individual participant data.
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Affiliation(s)
- C S Pavlov
- The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital.,Center for Evidence Based Medicine, Sechenov First Moscow State Medical University
| | - D L Varganova
- Center for Evidence Based Medicine, Sechenov First Moscow State Medical University.,Department of Gastroenterology, Ulyanovsk Regional Clinical Hospital
| | - G Casazza
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano
| | - E Tsochatzis
- Sheila Sherlock Liver Centre, Royal Free Hospital and the UCL Institute of Liver and Digestive Health
| | - D Nikolova
- The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital
| | - C Gluud
- The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital
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14
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Montuori M, Casella F, Casazza G, Franzetti F, Pini P, Invernizzi C, Torzillo D, Rizzardini G, Galli M, Cogliati C. Lung ultrasonography in pulmonary tuberculosis: A pilot study on diagnostic accuracy in a high-risk population. Eur J Intern Med 2019; 66:29-34. [PMID: 31235198 DOI: 10.1016/j.ejim.2019.06.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 02/01/2019] [Revised: 05/15/2019] [Accepted: 06/05/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The validity of lung ultrasound (LUS) in the diagnosis of interstitial or focal lung pathologies is well documented, we assessed its accuracy in the diagnosis of pulmonary tuberculosis (PTB). METHODS Sonographic signs suggestive of PTB and their diagnostic accuracy were evaluated in patients admitted with clinical suspicion of PTB. Consolidations, subpleural nodules, pleural thickenings or irregularities and pleural effusion were assessed. LUS signs significantly associated with PTB in the univariate analysis (p < .05) were entered in a multivariate logistic regression model. RESULTS PTB was confirmed in 51 out of 102 patients. Multiple consolidations (OR 3.54, 95%CI 1.43-8.78), apical consolidations (OR 9.65, 95%CI 3.02-30.78), superior quadrant consolidations (OR 4.01, 95%CI 1.76-9.14), and subpleural nodules (OR 5.29, 95%CI 2.27-12.33) were significantly associated with PTB diagnosis. Apical consolidation (OR 9.67, 95%CI 2.81-33.25, p 0.003) and subpleural nodules (OR 5.30, 95%CI 2.08-13.52, p 0.005) retained a significant association in a multivariate model, with an overall accuracy of 0.799. CONCLUSIONS Our data suggest a possible role of LUS in the diagnosis of PTB, a high burden pathological condition for which the delay in diagnosis still represents a critical point in the control of the disease.
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Affiliation(s)
- M Montuori
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco" University of Milan, ASST-FBF-Sacco, Italy.
| | - F Casella
- Department of Internal Medicine, ASST-FBF-Sacco, Italy
| | - G Casazza
- Dipartimento di Scienze Biomediche e Cliniche "Luigi Sacco", Università degli Studi di Milano, Italy
| | - F Franzetti
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco" University of Milan, ASST-FBF-Sacco, Italy
| | - P Pini
- Department of Internal Medicine, ASST-FBF-Sacco, Italy
| | - C Invernizzi
- Department of Internal Medicine, ASST-FBF-Sacco, Italy
| | - D Torzillo
- Department of Internal Medicine, ASST-FBF-Sacco, Italy
| | - G Rizzardini
- First Division of Infectious Diseases, ASST-FBF-Sacco, Milano, Italy
| | - M Galli
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco" University of Milan, ASST-FBF-Sacco, Italy
| | - C Cogliati
- Department of Internal Medicine, ASST-FBF-Sacco, Italy
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15
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Marzano AV, Genovese G, Casazza G, Fierro MT, Dapavo P, Crimi N, Ferrucci S, Pepe P, Liberati S, Pigatto PD, Offidani A, Martina E, Girolomoni G, Rovaris M, Foti C, Stingeni L, Cristaudo A, Canonica GW, Nettis E, Asero R. Predictors of response to omalizumab and relapse in chronic spontaneous urticaria: a study of 470 patients. J Eur Acad Dermatol Venereol 2018; 33:918-924. [PMID: 30451325 DOI: 10.1111/jdv.15350] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/18/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Chronic spontaneous urticaria (CSU) is defined as spontaneous occurrence of wheals and/or angioedema for ≥6 weeks. Omalizumab is a monoclonal anti-IgE antibody effective in refractory CSU, but its mechanism of action and markers predictive of response remain not completely defined. OBJECTIVES To correlate baseline levels of two proposed biomarkers, total IgE (bIgE) and d-dimer (bd-dimer), and clinical parameters to omalizumab response and to relapses after drug withdrawal. METHODS In this retrospective Italian multicentre study, clinical data were collected in 470 CSU patients, and bIgE and bd-dimer were measured in 340 and 342 patients, respectively. Disease activity was determined by Urticaria Activity Score 7 (UAS7) at week 1 and 12 after omalizumab starting. Relapses were evaluated during a 2- and 3-month interval after a first and a second course of treatment, respectively. RESULTS bIgE correlated to a good response to omalizumab since levels were significantly higher in responders than non-responders (P = 0.0002). Conversely, bd-dimer did not correlate to response. There was no correlation between both bIgE and d-dimer and either first or second relapse. Disease duration was significantly longer in patients who experienced either first or second relapse (P < 0.0001 and P = 0.0105, respectively), while baseline UAS7 correlated only to first relapse (P = 0.0023). CONCLUSIONS Our study confirms bIgE as a reliable biomarker predicting response to omalizumab in CSU, while it does not support the usefulness of bd-dimer unlike previous findings. CSU duration before omalizumab and baseline UAS7 may be clinical markers of relapse risk.
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Affiliation(s)
- A V Marzano
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - G Genovese
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - G Casazza
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - M T Fierro
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - P Dapavo
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - N Crimi
- Department of Clinical and Experimental Medicine-Respiratory Medicine & Allergy, University of Catania, Catania, Italy
| | - S Ferrucci
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P Pepe
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - S Liberati
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - P D Pigatto
- Clinical Dermatology, Department of Biomedical, Surgical and Dental Sciences, IRCCS Galeazzi Orthopaedic Institute, University of Milan, Milan, Italy
| | - A Offidani
- Dermatology Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - E Martina
- Dermatology Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - G Girolomoni
- Department of Medicine, Section of Dermatology, University of Verona, Verona, Italy
| | - M Rovaris
- Department of Medicine, Section of Dermatology, University of Verona, Verona, Italy
| | - C Foti
- Department of Biomedical Science and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - L Stingeni
- Section of Clinical, Allergological and Venereological Dermatology, Department of Medicine, University of Perugia, Perugia, Italy
| | - A Cristaudo
- Service of Occupational and Environmental Allergic Dermatology, San Gallicano Dermatology Institute for Research and Care, Rome, Italy
| | - G W Canonica
- Department of Internal Medicine, Respiratory Disease Clinic, IRCCS Humanitas Clinical and Research Center, Humanitas University, Milan, Italy
| | - E Nettis
- Department of Emergency and Organ Transplantation, School of Allergology and Clinical Immunology, University of Bari Aldo Moro, Bari, Italy
| | - R Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Milan, Italy
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16
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Cugno M, Genovese G, Ferrucci S, Casazza G, Asero R, Marzano AV. IgE and D-dimer baseline levels are higher in responders than nonresponders to omalizumab in chronic spontaneous urticaria. Br J Dermatol 2018; 179:776-777. [PMID: 29582427 DOI: 10.1111/bjd.16593] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- M Cugno
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy.,Medicina Interna, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Genovese
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy.,UOC Dermatologia, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - S Ferrucci
- UOC Dermatologia, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Casazza
- Department of Biomedical and Clinical Sciences Luigi Sacco, Università degli Studi di Milano, Milan, Italy
| | - R Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
| | - A V Marzano
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy.,UOC Dermatologia, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
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17
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Baccelli F, Di Gangi A, Bernasconi S, Casazza G, Favre C, Menconi M. The impact of CMV reactivation on HSCT outcomes in children with malignancies: A 13 years single center experience. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.10572] [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)
| | | | | | | | - Claudio Favre
- Azienda Ospedaliera Universitaria Meyer, Florence, Italy
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18
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Abraha I, Luchetta M, De Florio R, Cozzolino F, Casazza G, Duca P. Ultrasonography for Endoleak Detection After Endoluminal Abdominal Aortic Aneurysm Repair. J Vasc Surg 2018. [DOI: 10.1016/j.jvs.2017.11.024] [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: 11/15/2022]
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19
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Bottega R, Nicchia E, Cappelli E, Ravera S, De Rocco D, Faleschini M, Corsolini F, Pierri F, Calvillo M, Russo G, Casazza G, Ramenghi U, Farruggia P, Dufour C, Savoia A. Hypomorphic FANCA mutations correlate with mild mitochondrial and clinical phenotype in Fanconi anemia. Haematologica 2017; 103:417-426. [PMID: 29269525 PMCID: PMC5830397 DOI: 10.3324/haematol.2017.176131] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 12/14/2017] [Indexed: 11/16/2022] Open
Abstract
Fanconi anemia is a rare disease characterized by congenital malformations, aplastic anemia, and predisposition to cancer. Despite the consolidated role of the Fanconi anemia proteins in DNA repair, their involvement in mitochondrial function is emerging. The purpose of this work was to assess whether the mitochondrial phenotype, independent of genomic integrity, could correlate with patient phenotype. We evaluated mitochondrial and clinical features of 11 affected individuals homozygous or compound heterozygous for p.His913Pro and p.Arg951Gln/Trp, the two residues of FANCA that are more frequently affected in our cohort of patients. Although p.His913Pro and p.Arg951Gln proteins are stably expressed in cytoplasm, they are unable to migrate in the nucleus, preventing cells from repairing DNA. In these cells, the electron transfer between respiring complex I–III is reduced and the ATP/AMP ratio is impaired with defective ATP production and AMP accumulation. These activities are intermediate between those observed in wild-type and FANCA−/− cells, suggesting that the variants at residues His913 and Arg951 are hypomorphic mutations. Consistent with these findings, the clinical phenotype of most of the patients carrying these mutations is mild. These data further support the recent finding that the Fanconi anemia proteins play a role in mitochondria, and open up possibilities for genotype/phenotype studies based on novel mitochondrial criteria.
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Affiliation(s)
- Roberta Bottega
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Elena Nicchia
- Department of Medical Sciences, University of Trieste, Genoa, Italy
| | - Enrico Cappelli
- Clinical and Experimental Hematology Unit, "G. Gaslini" Children's Hospital, Genoa, Italy
| | - Silvia Ravera
- Department of Pharmacy (DIFAR), Biochemistry Lab, University of Genoa, Genoa, Italy
| | - Daniela De Rocco
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Michela Faleschini
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Fabio Corsolini
- U.O.S.D. Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche, "G. Gaslini" Children's Hospital, Genoa, Italy
| | - Filomena Pierri
- Clinical and Experimental Hematology Unit, "G. Gaslini" Children's Hospital, Genoa, Italy
| | - Michaela Calvillo
- Clinical and Experimental Hematology Unit, "G. Gaslini" Children's Hospital, Genoa, Italy
| | - Giovanna Russo
- Oncology Hematology Pediatric Unit, "Policlinico - Vittorio Emanuele", University of Catania, Pisa, Italy
| | - Gabriella Casazza
- Pediatric Onco-Hematology, Azienda Ospedaliera/Universitaria Pisana, Pisa, Italy
| | - Ugo Ramenghi
- Department of Pediatric and Public Health Sciences, University of Torino, Palermo, Italy
| | - Piero Farruggia
- Pediatric Onco-Hematology, ARNAS Civico Hospital, Palermo, Italy
| | - Carlo Dufour
- Clinical and Experimental Hematology Unit, "G. Gaslini" Children's Hospital, Genoa, Italy
| | - Anna Savoia
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy .,Department of Medical Sciences, University of Trieste, Genoa, Italy
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20
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Dagnino D, Minuto L, Casazza G. Divergence is not enough: the use of ecological niche models for the validation of taxon boundaries. Plant Biol (Stuttg) 2017; 19:1003-1011. [PMID: 28691341 DOI: 10.1111/plb.12600] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 07/04/2017] [Indexed: 06/07/2023]
Abstract
Delimiting taxon boundaries is crucial for any evolutionary research and conservation regulation. In order to avoid mistaken description of species, the approach of integrative taxonomy recommends considering multidisciplinary lines of evidence, including ecology. Unfortunately, ecological data are often difficult to quantify objectively. Here we test and discuss the potential use of ecological niche models for validating taxon boundaries, using three pairs of closely related plant taxa endemic to the south-western Alps as a case study. We also discuss the application of ecological niche models for species delimitation and the implementation of different approaches. Niche overlap, niche equivalency and niche similarity were assessed both in multidimensional environmental space and in geographic space to look for differences in the niche of three pairs of closely related plant taxa. We detected a high degree of niche differentiation between taxa although this result seems not due to differences in habitat selection. The different statistical tests gave contrasting outcomes between environmental and geographic spaces. According to our results, niche divergence does not seem to support taxon boundaries at species level, but may have had important consequences for local adaptation and in generating phenotypic diversity at intraspecific level. Environmental space analysis should be preferred to geographic space as it provides more clear results. Even if the different analyses widely disagree in their conclusions about taxon boundaries, our study suggests that ecological niche models may help taxonomists to reach a decision.
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Affiliation(s)
- D Dagnino
- Dipartimento di Scienze della Terra, Ambiente e Vita, Università degli Studi di Genova, Genova, Italy
| | - L Minuto
- Dipartimento di Scienze della Terra, Ambiente e Vita, Università degli Studi di Genova, Genova, Italy
| | - G Casazza
- Dipartimento di Scienze della Terra, Ambiente e Vita, Università degli Studi di Genova, Genova, Italy
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21
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Podda GM, Casazza G, Soru P, Scavone M, Vismara G, Cattaneo M. In vitro variations of Mean platelet volume over time in blood samples collected in different anticoagulants from thrombocytopenic patients and healthy subjects. Int J Lab Hematol 2017; 39:e151-e154. [PMID: 28990313 DOI: 10.1111/ijlh.12745] [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] [Received: 04/19/2017] [Revised: 07/01/2017] [Accepted: 07/28/2017] [Indexed: 10/18/2022]
Affiliation(s)
- G M Podda
- Unità di Medicina III, ASST Santi Paolo e Carlo - Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy
| | - G Casazza
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milano, Italy
| | - P Soru
- Unità di Medicina III, ASST Santi Paolo e Carlo - Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy
| | - M Scavone
- Unità di Medicina III, ASST Santi Paolo e Carlo - Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy
| | - G Vismara
- S.I.M.T, ASST Santi Paolo e Carlo, Milano, Italy
| | - M Cattaneo
- Unità di Medicina III, ASST Santi Paolo e Carlo - Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy
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22
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Fraquelli M, Baccarin A, Casazza G, Conti CB, Giunta M, Massironi S, Invernizzi F, Donato MF, Maggioni M, Aghemo A, Conte D, Colombo M. Liver stiffness measurement reliability and main determinants of point shear-wave elastography in patients with chronic liver disease. Aliment Pharmacol Ther 2016; 44:356-65. [PMID: 27363587 DOI: 10.1111/apt.13711] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 04/07/2016] [Revised: 04/21/2016] [Accepted: 06/08/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND Liver stiffness (LS) measured by transient elastography (TE) accurately predicts the severity of chronic liver diseases (CLD). Point quantification shear-wave elastography (pSWE) is a new technique incorporated into a conventional ultrasound system for measuring LS. We evaluated pSWE feasibility, reproducibility and diagnostic accuracy in consecutively recruited CLD patients who concomitantly underwent TE and liver biopsy. AIM To evaluate pSWE feasibility, reproducibility and diagnostic accuracy in consecutively recruited CLD patients who concomitantly underwent TE and liver biopsy. METHODS Over 2 years 186 CLD patients (116 males, 132 viral hepatitis) consecutively underwent pSWE (10 valid measurements by ElastPQ) blindly performed by two raters. A further operator performed TE. Inter-observer agreement for pSWE was analysed by intraclass correlation coefficient (ICC) and correlated with histological liver fibrosis (METAVIR). Main determinants of pSWE were investigated by linear regression model. RESULTS Three hundred and seventy-two (100%) reliable measurements were obtained by pSWE and 184 by TE (99%). LS was 8.1 ± 4.5 kPa for pSWE with the first rater and 8.0 ± 4.2 kPa with the second one vs. 8.8 ± 3.6 kPa for TE. pSWE ICC was 0.89 (95% CI 0.85-0.91), not influenced by age, sex, BMI, liver enzymes, liver aetiology. ICC increased over time with year 1 at 0.86 and 95% CI 0.81-0.90 vs. year 2 at 0.92 and 95% CI 0.87-0.95. Liver fibrosis was the only independent determinant of LS on pSWE. The AUROCs for diagnosing F ≥ 2, F ≥ 3 and F = 4 were 0.77, 0.85 and 0.88 for pSWE vs. 0.81, 0.88 and 0.94 for TE. After 1-year training they were 0.86, 0.94 and 0.91. CONCLUSION Point quantification shear-wave elastography reliably and reproducibly evaluates liver stiffness, matching transient elastography for accuracy after a 1-year learning curve or 130 examinations.
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Affiliation(s)
- M Fraquelli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Baccarin
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - G Casazza
- Department of Biomedical and Clinical Sciences L. Sacco, Università di Milano, Milan, Italy
| | - C B Conti
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - M Giunta
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - S Massironi
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - F Invernizzi
- Gastroenterology and Hepatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - M F Donato
- Gastroenterology and Hepatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - M Maggioni
- Pathology Unit, Fondazione IRCCS Ca' Granda, Ospedale Policlinico di Milano, Milan, Italy
| | - A Aghemo
- Gastroenterology and Hepatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - D Conte
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - M Colombo
- Gastroenterology and Hepatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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23
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Svahn J, Bagnasco F, Cappelli E, Onofrillo D, Caruso S, Corsolini F, De Rocco D, Savoia A, Longoni D, Pillon M, Marra N, Ramenghi U, Farruggia P, Locasciulli A, Addari C, Cerri C, Mastrodicasa E, Casazza G, Verzegnassi F, Riccardi F, Haupt R, Barone A, Cesaro S, Cugno C, Dufour C. Somatic, hematologic phenotype, long-term outcome, and effect of hematopoietic stem cell transplantation. An analysis of 97 Fanconi anemia patients from the Italian national database on behalf of the Marrow Failure Study Group of the AIEOP (Italian Association of Pediatric Hematology-Oncology). Am J Hematol 2016; 91:666-71. [PMID: 27013026 DOI: 10.1002/ajh.24373] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 03/11/2016] [Accepted: 03/17/2016] [Indexed: 12/24/2022]
Abstract
We analyzed 97 Fanconi anemia patients from a clinic/biological database for genotype, somatic, and hematologic phenotype, adverse hematological events, solid tumors, and treatment. Seventy-two patients belonged to complementation group A. Eighty percent of patients presented with mild/moderate somatic phenotype and most with cytopenia. No correlation was seen between somatic/hematologic phenotype and number of missense mutations of FANCA alleles. Over follow-up, 33% of patients improved or maintained mild/moderate cytopenia or normal blood count, whereas remaining worsened cytopenia. Eleven patients developed a hematological adverse event (MDS, AML, pathological cytogenetics) and three developed solid tumors. 10 years cumulative risk of death of the whole cohort was 25.6% with median follow-up 5.8 years. In patients eligible to hematopoietic stem cell transplantation because of moderate cytopenia, mortality was significantly higher in subjects transplanted from matched unrelated donor over nontransplanted subjects, whereas there was no significant difference between matched sibling donor transplants and nontransplanted patients. In patients eligible to transplant because of severe cytopenia and clonal disease, mortality risk was not significantly different in transplanted from matched unrelated versus matched sibling donor versus nontransplanted subjects. The decision to transplant should rely on various elements including, type of donor, HLA matching, patient comorbidities, impairment, and clonal evolution of hematopoiesis. Am. J. Hematol. 91:666-671, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
| | | | | | | | - Silvia Caruso
- Epidemiology and Statistics; Gaslini Institute; Genova Italy
| | - Fabio Corsolini
- Cell Repository and Bio Bank, Gaslini Institute; Genova Italy
| | | | - Anna Savoia
- Medical Genetics, Burlo Garofalo Institute; Trieste Italy
| | | | - Marta Pillon
- Pediatric Hemato-Oncology; University of Padova; Italy
| | | | - Ugo Ramenghi
- Pediatric Hematology; Regina Margherita Hospital; Torino Italy
| | - Piero Farruggia
- Pediatric Hematology-Oncology; a.R.N.A.S. Civico Fatebenefratelli; Palermo Italy
| | - Anna Locasciulli
- Pediatric Hematology; San Camillo- Forlanini Hospital; Rome Italy
| | - Carmen Addari
- Bone Marrow Transplantation Unit; Hospital of Microcytemia; Cagliari Italy
| | - Carla Cerri
- Pediatric Onco-Hematology; Hospital of Perugia; Perugia Italy
| | | | | | | | | | - Riccardo Haupt
- Epidemiology and Statistics; Gaslini Institute; Genova Italy
| | | | - Simone Cesaro
- Pediatric Onco-Hematology Hospital of Verona; Verona Italy
| | - Chiara Cugno
- Pediatric Onco-Hematology; San Matteo Hospital; Pavia Italy
| | - Carlo Dufour
- Hematology Unit; Gaslini Institute; Genova Italy
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24
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Schaal K, Tiollier E, Le Meur Y, Casazza G, Hausswirth C. Elite synchronized swimmers display decreased energy availability during intensified training. Scand J Med Sci Sports 2016; 27:925-934. [PMID: 27367601 DOI: 10.1111/sms.12716] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2016] [Indexed: 11/28/2022]
Abstract
Elite synchronized swimmers follow high-volume training regimen that result in elevated rates of exercise energy expenditure (ExEE). While adequate energy intake (EI) is important to optimize recovery, a number of sport-specific constraints may lead to chronically low energy availability (EA = EI-ExEE). This study aimed to quantify changes in EA, endocrine markers of energy conservation, and perceived fatigue in synchronized swimmers, during a week of baseline training followed by 4 weeks of intensified training (IT). EI, ExEE, and body composition were measured in nine swimmers at Baseline, midpoint (ITWK2 ), and end of IT (ITWK4 ). Waking saliva samples were obtained to measure [leptin]s , [ghrelin]s , and [cortisol]s . Fatigue ratings were provided daily. ExEE increased by 27% during IT. Swimmers increased EI from Baseline to ITWK2 , but decreased it significantly from ITWK2 to ITWK4 . EA, fat mass, and [leptin]s decreased from Baseline to ITWK4 , while [ghrelin]s increased significantly. Fatigue at ITWK4 was inversely correlated with Baseline EI and EA. The significant decrease in EA was accompanied by endocrine signs of energy conservation in elite swimmers. As perceived fatigue was associated with low EA, particular attention should be paid to these athletes' energy intake during phases of heavy training.
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Affiliation(s)
- K Schaal
- Laboratory of Sport, Expertise and Performance (EA 7370), Research Department, French National Institute of Sport, Expertise and Performance, Paris, France.,Sports Performance Laboratory, Sports Medicine Program, University of California, Davis, Sacramento, CA, USA
| | - E Tiollier
- Laboratory of Sport, Expertise and Performance (EA 7370), Research Department, French National Institute of Sport, Expertise and Performance, Paris, France
| | - Y Le Meur
- Laboratory of Sport, Expertise and Performance (EA 7370), Research Department, French National Institute of Sport, Expertise and Performance, Paris, France
| | - G Casazza
- Sports Performance Laboratory, Sports Medicine Program, University of California, Davis, Sacramento, CA, USA
| | - C Hausswirth
- Laboratory of Sport, Expertise and Performance (EA 7370), Research Department, French National Institute of Sport, Expertise and Performance, Paris, France
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25
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Pavlov C, Casazza G, Nikolova D, Gluud C. Editorial: in vino veritas--transient elastography for staging liver fibrosis in alcoholic liver disease--authors' reply. Aliment Pharmacol Ther 2016; 43:1015-6. [PMID: 27040165 DOI: 10.1111/apt.13587] [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: 12/08/2022]
Affiliation(s)
- C Pavlov
- The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark. .,Clinic of Internal Diseases Propedeutics, Gastroenterology and Hepatology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
| | - G Casazza
- The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark.,Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - D Nikolova
- The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - C Gluud
- The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark
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26
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Pavlov CS, Casazza G, Nikolova D, Tsochatzis E, Gluud C. Systematic review with meta-analysis: diagnostic accuracy of transient elastography for staging of fibrosis in people with alcoholic liver disease. Aliment Pharmacol Ther 2016; 43:575-85. [PMID: 26791825 DOI: 10.1111/apt.13524] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [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: 09/11/2015] [Revised: 10/04/2015] [Accepted: 12/20/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND The progression of hepatic fibrosis into cirrhosis is a main prognostic factor for survival in people with alcoholic liver disease. The range of cut-off values characterising the stage of hepatic fibrosis seems to be dependent on the aetiology of the liver disease. AIMS To determine the diagnostic accuracy of transient elastography (the index test) for diagnosis of fibrosis in alcoholic liver disease when compared with liver biopsy (the reference standard), using the METAVIR scoring system. To establish the optimal cut-off values for the hepatic fibrosis stages. METHODS We followed Cochrane Methodology for diagnostic test accuracy reviews. We identified 14 studies. Among the study participants with alcoholic liver disease, 834 provided numerical data for analysis (August 2014). Only half of the studies were monoaetiology studies. We used the bivariate model and estimated the summary sensitivities and summary specificities. Hence, we calculated the summary likelihood ratios (LRs) to rule in or rule out hepatic fibrosis. We investigated pre-defined sources of heterogeneity. RESULTS Severe fibrosis (F3 or worse): summary (95% CI) sensitivity 0.92(0.89-0.96) and specificity 0.70(0.61-0.79); LR+ 3.1(2.1-4.1), LR- 0.11(95% CI 0.06-0.16). Cirrhosis (F4): summary (95% CI) sensitivity of 0.95(0.87-0.98) and specificity 0.71(0.56-0.82); LR+ 3.3(2.1-5.0); LR- 0.07(0.03-0.19). CONCLUSIONS Transient elastography may be used as a diagnostic method to exclude cirrhosis or severe fibrosis when the test is negative. Cut-off values of around 12.5 kPa for cirrhosis may be used in clinical practice, but caution is needed, as the values reported in the review are not yet prospectively validated.
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Affiliation(s)
- C S Pavlov
- The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark.,Clinic of Internal Diseases Propedeutics, Gastroenterology and Hepatology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - G Casazza
- The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark.,Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - D Nikolova
- The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - E Tsochatzis
- Sheila Sherlock Liver Centre, Royal Free Hospital and the UCL Institute of Liver and Digestive Health, London, UK
| | - C Gluud
- The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark
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27
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Farruggia P, Fioredda F, Puccio G, Porretti L, Lanza T, Ramenghi U, Ferro F, Macaluso A, Barone A, Bonanomi S, Caruso S, Casazza G, Davitto M, Ghilardi R, Ladogana S, Mandaglio R, Marra N, Martire B, Mastrodicasa E, Dora Notarangelo L, Onofrillo D, Robustelli G, Russo G, Trizzino A, Tucci F, Pillon M, Dufour C. Autoimmune neutropenia of infancy: Data from the Italian neutropenia registry. Am J Hematol 2015; 90:E221-2. [PMID: 26361081 DOI: 10.1002/ajh.24187] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 09/09/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Piero Farruggia
- Pediatric Hematology and Oncology Unit; A.R.N.A.S. Ospedale Civico; Palermo Italy
| | - Francesca Fioredda
- Clinical and Experimental Hematology Unit; G. Gaslini Children's Hospital; Genova Italy
| | - Giuseppe Puccio
- Department of Sciences for Health Promotion; University of Palermo; Palermo Italy
| | - Laura Porretti
- Flow Cytometry Service, Laboratory of Clinical Chemistry and Microbiology; IRCCS “Ca' Granda” Foundation, Maggiore Hospital Policlinico; Milan Italy
| | - Tiziana Lanza
- Clinical and Experimental Hematology Unit; G. Gaslini Children's Hospital; Genova Italy
| | - Ugo Ramenghi
- Ematologia del Dipartimento Di Scienze Pediatriche; Ospedale Infantile Regina Margherita; Torino Italy
| | - Francesca Ferro
- Ematologia del Dipartimento Di Scienze Pediatriche; Ospedale Infantile Regina Margherita; Torino Italy
| | - Alessandra Macaluso
- Pediatric Hematology and Oncology Unit; A.R.N.A.S. Ospedale Civico; Palermo Italy
| | - Angelica Barone
- Department of Pediatric Onco-Hematology; University Hospital; Parma Italy
| | - Sonia Bonanomi
- Fondazione MBBM, Clinica Pediatrica; Università Di Milano - Bicocca; Monza Italy
| | - Silvia Caruso
- Servizio Di Epidemiologia E Biostatistica-Istituto; G. Gaslini Children's Hospital; Genova Italy
| | - Gabriella Casazza
- Paediatric Hematology Oncology, Bone Marrow Transplant; Azienda Ospedaliero Universitaria Pisana, Ospedale S. Chiara; Pisa Italy
| | - Mirella Davitto
- Ematologia del Dipartimento Di Scienze Pediatriche; Ospedale Infantile Regina Margherita; Torino Italy
| | - Roberta Ghilardi
- Department of Pediatrics; IRCCS “Ca' Granda” Foundation, Maggiore Hospital Policlinico; Milan Italy
| | - Saverio Ladogana
- Department of Hematology; IRCCS Casa Sollievo Della Sofferenza; San Giovanni Rotondo Italy
| | | | | | - Baldassare Martire
- Dipartimento Di Scienze E Chirurgia Pediatriche; U. O. Oncoematologia Pediatrica, Ospedale Policlinico- Giovanni XXIII; Bari Italy
| | - Elena Mastrodicasa
- Pediatric Oncology Hematology Unit; S. Maria Della Misericordia Hospital; Perugia Italy
| | - Lucia Dora Notarangelo
- Pediatric Oncology-Hematology and BMT Unit; Children’ Hospital, Spedali Civili; Brescia Italy
| | | | - Giuseppe Robustelli
- Fondazione MBBM, Clinica Pediatrica; Università Di Milano - Bicocca; Monza Italy
| | - Giovanna Russo
- Pediatric Hematology and Oncology Unit; Policlinico Hospital, University of Catania; Catania Italy
| | - Angela Trizzino
- Pediatric Hematology and Oncology Unit; A.R.N.A.S. Ospedale Civico; Palermo Italy
| | - Fabio Tucci
- Department of Pediatric Oncology-Hematology; Meyer Children's Hospital; Florence Italy
| | - Marta Pillon
- Dipartimento Di Oncoematologia Pediatrica; Università Di Padova; Padova Italy
| | - Carlo Dufour
- Clinical and Experimental Hematology Unit; G. Gaslini Children's Hospital; Genova Italy
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28
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Zanichelli A, Mansi M, Azin GM, Wu MA, Periti G, Casazza G, Vacchini R, Suffritti C, Cicardi M. Efficacy of on-demand treatment in reducing morbidity in patients with hereditary angioedema due to C1 inhibitor deficiency. Allergy 2015; 70:1553-8. [PMID: 26304015 DOI: 10.1111/all.12731] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Angioedema due to hereditary deficiency of C1 inhibitor causes temporarily disability. Guidelines recommend early on-demand treatment of attacks to reduce morbidity. In this prospective observational study, we evaluated the efficacy of on-demand approach. METHODS From January 2009 to August 2014, data on attacks and treatments were collected from 227 patients from our centre in Milan. RESULTS A total of 4244 attacks were reported; 50% were treated with approved therapies (pdC1-INH or icatibant), 15% were with tranexamic acid, and 35% were not treated. Attack locations were peripheral cutaneous (46%), abdominal (34%), multiple (12%), facial (5%) and laryngeal (3%). Attack severities were moderate (48%), mild (28%) and severe (24%). Median attack duration (data available for 2393 attacks) with approved therapies was 10 h, significantly shorter than without treatment (45 h) or with tranexamic acid (38 h). Most of the treatments were self-administered: 93% with icatibant and 59% with pd-C1-INH. Median attack duration with icatibant was 8 and 11.5 h with pd-C1 INH. Median time from onset of symptoms to drug administration was 1 h with icatibant and 2 h with pd-C1INH and median time from drug administration to complete resolution was 5.5 and 8 h, respectively. Second treatment was required in 12.7% of icatibant-treated attacks and in 1.9% of pdC1-INH-treated attacks. CONCLUSION This study provides evidence that on-demand treatment is effective in reducing disease-related morbidity. The use of on-demand treatment in Italy has increased up to 50% of attacks in the last years, reflecting a better adherence to international guidelines.
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Affiliation(s)
- A. Zanichelli
- Department of Biomedical and Clinical Sciences Luigi Sacco; Università degli Studi di Milano; Ospedale Luigi Sacco; Milan Italy
| | - M. Mansi
- Department of Biomedical and Clinical Sciences Luigi Sacco; Università degli Studi di Milano; Ospedale Luigi Sacco; Milan Italy
| | - G. M. Azin
- Department of Biomedical and Clinical Sciences Luigi Sacco; Università degli Studi di Milano; Ospedale Luigi Sacco; Milan Italy
| | - M. A. Wu
- Department of Biomedical and Clinical Sciences Luigi Sacco; Università degli Studi di Milano; Ospedale Luigi Sacco; Milan Italy
| | - G. Periti
- Department of Biomedical and Clinical Sciences Luigi Sacco; Università degli Studi di Milano; Ospedale Luigi Sacco; Milan Italy
| | - G. Casazza
- Department of Biomedical and Clinical Sciences Luigi Sacco; Università degli Studi di Milano; Ospedale Luigi Sacco; Milan Italy
| | - R. Vacchini
- Department of Biomedical and Clinical Sciences Luigi Sacco; Università degli Studi di Milano; Ospedale Luigi Sacco; Milan Italy
| | - C. Suffritti
- Department of Biomedical and Clinical Sciences Luigi Sacco; Università degli Studi di Milano; Ospedale Luigi Sacco; Milan Italy
| | - M. Cicardi
- Department of Biomedical and Clinical Sciences Luigi Sacco; Università degli Studi di Milano; Ospedale Luigi Sacco; Milan Italy
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29
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Fioredda F, Calvillo M, Lanciotti M, Cefalo MG, Tucci F, Farruggia P, Casazza G, Martire B, Bonanomi S, Notarangelo L, Barone A, Palazzi G, Davitto M, Barella S, Cardinale F, Mastrodicasa E, Cugno C, Russo G, Caviglia I, Caruso S, Castagnola E, Dufour C. Lethal sepsis and malignant transformation in severe congenital neutropenia: report from the Italian Neutropenia Registry. Pediatr Blood Cancer 2015; 62:1110-2. [PMID: 25619745 DOI: 10.1002/pbc.25401] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 11/21/2014] [Indexed: 11/10/2022]
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30
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Woodhouse L, Adams S, Burnett D, Casazza G, Chandler C, Domek J, Gustafson M, Keim N, Sheets C, Souza E. Effects of a Hypocaloric Diet and Exercise Intervention on Circulating Zinc and Inflammatory Markers in Obese, Sedentary, Insulin‐Resistant Women. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.761.1] [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: 11/11/2022]
Affiliation(s)
| | - S. Adams
- USDA ARS WHNRCDavisCAUnited States
| | | | | | | | - J. Domek
- USDA ARS WHNRCDavisCAUnited States
| | | | - N. Keim
- USDA ARS WHNRCDavisCAUnited States
| | - C Sheets
- CTSI UCSan FranciscoCAUnited States
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31
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De Rocco D, Bottega R, Cappelli E, Cavani S, Criscuolo M, Nicchia E, Corsolini F, Greco C, Borriello A, Svahn J, Pillon M, Mecucci C, Casazza G, Verzegnassi F, Cugno C, Locasciulli A, Farruggia P, Longoni D, Ramenghi U, Barberi W, Tucci F, Perrotta S, Grammatico P, Hanenberg H, Ragione FD, Dufour C, Savoia A. Molecular analysis of Fanconi anemia: the experience of the Bone Marrow Failure Study Group of the Italian Association of Pediatric Onco-Hematology. Haematologica 2014. [DOI: 10.3324/haematol.2014.116004] [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: 11/09/2022] Open
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32
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De Rocco D, Bottega R, Cappelli E, Cavani S, Criscuolo M, Nicchia E, Corsolini F, Greco C, Borriello A, Svahn J, Pillon M, Mecucci C, Casazza G, Verzegnassi F, Cugno C, Locasciulli A, Farruggia P, Longoni D, Ramenghi U, Barberi W, Tucci F, Perrotta S, Grammatico P, Hanenberg H, Della Ragione F, Dufour C, Savoia A. Molecular analysis of Fanconi anemia: the experience of the Bone Marrow Failure Study Group of the Italian Association of Pediatric Onco-Hematology. Haematologica 2014; 99:1022-31. [PMID: 24584348 DOI: 10.3324/haematol.2014.104224] [Citation(s) in RCA: 33] [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: 01/17/2023] Open
Abstract
Fanconi anemia is an inherited disease characterized by congenital malformations, pancytopenia, cancer predisposition, and sensitivity to cross-linking agents. The molecular diagnosis of Fanconi anemia is relatively complex for several aspects including genetic heterogeneity with mutations in at least 16 different genes. In this paper, we report the mutations identified in 100 unrelated probands enrolled into the National Network of the Italian Association of Pediatric Hematoly and Oncology. In approximately half of these cases, mutational screening was carried out after retroviral complementation analyses or protein analysis. In the other half, the analysis was performed on the most frequently mutated genes or using a next generation sequencing approach. We identified 108 distinct variants of the FANCA, FANCG, FANCC, FANCD2, and FANCB genes in 85, 9, 3, 2, and 1 families, respectively. Despite the relatively high number of private mutations, 45 of which are novel Fanconi anemia alleles, 26% of the FANCA alleles are due to 5 distinct mutations. Most of the mutations are large genomic deletions and nonsense or frameshift mutations, although we identified a series of missense mutations, whose pathogenetic role was not always certain. The molecular diagnosis of Fanconi anemia is still a tiered procedure that requires identifying candidate genes to avoid useless sequencing. Introduction of next generation sequencing strategies will greatly improve the diagnostic process, allowing a rapid analysis of all the genes.
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Affiliation(s)
| | - Roberta Bottega
- Department of Medical Sciences, University of Trieste, Italy
| | - Enrico Cappelli
- Clinical and Experimental Hematology Unit, G. Gaslini Children's Hospital, Genoa, Italy
| | - Simona Cavani
- Human Genetics laboratory, "E.O. Ospedali Galliera", Genoa, Italy
| | - Maria Criscuolo
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Italy
| | - Elena Nicchia
- Department of Medical Sciences, University of Trieste, Italy
| | - Fabio Corsolini
- Clinical and Experimental Hematology Unit, G. Gaslini Children's Hospital, Genoa, Italy
| | - Chiara Greco
- Pediatric Onco-Hematology, "Azienda Ospedaliero Universitaria Pisana", Pisa, Italy
| | - Adriana Borriello
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Italy
| | - Johanna Svahn
- Clinical and Experimental Hematology Unit, G. Gaslini Children's Hospital, Genoa, Italy
| | - Marta Pillon
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | | | | | - Federico Verzegnassi
- Pediatric Onco-Hematology, "Azienda Ospedaliero Universitaria Pisana", Pisa, Italy
| | - Chiara Cugno
- Pediatric Onco-Hematology, "Fondazione IRCCS Policlinico San Matteo", Pavia, Italy
| | - Anna Locasciulli
- Department of Pediatric and Pediatric Hematology, S.Camillo Hospital, Rome, Italy
| | - Piero Farruggia
- Pediatric Onco-Hematology, ARNAS Civico Hospital, Palermo, Italy
| | - Daniela Longoni
- Pediatrics Unit, University of Milano-Bicocca, Fondazione MBBM, Ospedale San Gerardo, Monza, Italy
| | - Ugo Ramenghi
- Department of Pediatric and Public Health Sciences, Sapienza Università di Roma, Firenze, Italy
| | - Walter Barberi
- Dipartimento di Biotecnologia Cellulari ed Ematologia, Sapienza Università di Roma, Firenze, Italy
| | - Fabio Tucci
- Pediatric Onco-Hematology, "Azienda Ospedaliero-Universitaria" Meyer, Firenze, Italy
| | | | - Paola Grammatico
- Department of Molecular Medicine, "La Sapienza" University, Rome, Italy
| | - Helmut Hanenberg
- Department of Otorhinolaryngology & Head/Neck Surgery, Heinrich Heine University School of Medicine, Duesseldorf, Germany Pediatric Hematology/Oncology, Wells Center for Pediatric Research, Department of Pediatrics, The Riley Hospital, Indiana University School of Medicine, Indianapolis, IN, USA Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Fulvio Della Ragione
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Italy
| | - Carlo Dufour
- Clinical and Experimental Hematology Unit, G. Gaslini Children's Hospital, Genoa, Italy
| | - Anna Savoia
- Department of Medical Sciences, University of Trieste, Italy Pediatric Onco-Hematology, "Azienda Ospedaliero Universitaria Pisana", Pisa, Italy
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Zocchi L, Perego F, Casella F, Arquati M, Renesto E, Casazza G, D'Ambrosio A, Cortellaro M. Does the metabolic syndrome predict subclinical atherosclerotic damage in an asymptomatic population at intermediate cardiovascular risk? Nutr Metab Cardiovasc Dis 2013; 23:864-870. [PMID: 22901845 DOI: 10.1016/j.numecd.2012.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2012] [Revised: 04/23/2012] [Accepted: 06/01/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS It is not clear whether the metabolic syndrome (MetS) is a distinct entity or a combination of risk factors. Several studies showed the association between MetS and cardiovascular disease (CVD). Subclinical target organ damage (TOD) is a recognized marker of atherosclerosis and predictor of cardiovascular events. Increased burden of subclinical atherosclerosis was detected in individuals with MetS. We thus aimed to examine the association between MetS and cumulative or specific TOD and to assess whether MetS predicts TOD better than the risk factors included in current definitions. METHODS AND RESULTS We recorded TOD in 979 patients at intermediate cardiovascular risk with and without MetS according to IDF and NCEP criteria. We measured common carotid intima-media thickness, left ventricular mass index (LVMI), urine albumin to creatinine ratio (UACR), and ankle-brachial index. We found no correlation between having at least one TOD and being positive for MetS. A high UACR was associated with MetS using both IDF and NCEP criteria, while only NCEP identified individuals with increased LVMI. Using a multivariate logistic regression model including MetS, age, sex, waist circumference, triglycerides, HDL cholesterol, blood pressure and blood glucose levels we found no correlations between the presence of MetS and at least one TOD. The associations with high UACR and LVMI disappeared when age, blood pressure and glycemia were counted in. CONCLUSION Although MetS showed some relation with subclinical renal and cardiac damage, it does not predict TOD any better than the risk factors specified in the definitions.
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Affiliation(s)
- L Zocchi
- Department of Internal Medicine, "Luigi Sacco" Hospital, University of Milan, via G.B. Grassi 74, 20154 Milan, Italy
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Angheben A, Giaconi E, Menconi M, Casazza G, Najajreh M, Anselmi M, Gobbi F, Bisoffi Z, Tascini C, Favre C. Reactivation of Chagas disease after a bone marrow transplant in Italy: first case report. Blood Transfus 2012; 10:542-544. [PMID: 22790268 PMCID: PMC3496236 DOI: 10.2450/2012.0015-12] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 02/09/2012] [Indexed: 06/01/2023]
Affiliation(s)
- Andrea Angheben
- Centre for Tropical Diseases, S. Cuore-Don Calabria Hospital, Negrar, Italy.
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Fioredda F, Calvillo M, Bonanomi S, Coliva T, Tucci F, Farruggia P, Pillon M, Martire B, Ghilardi R, Ramenghi U, Renga D, Menna G, Pusiol A, Barone A, Gambineri E, Palazzi G, Casazza G, Lanciotti M, Dufour C. Congenital and acquired neutropenias consensus guidelines on therapy and follow-up in childhood from the Neutropenia Committee of the Marrow Failure Syndrome Group of the AIEOP (Associazione Italiana Emato-Oncologia Pediatrica). Am J Hematol 2012; 87:238-43. [PMID: 22213173 DOI: 10.1002/ajh.22242] [Citation(s) in RCA: 36] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 10/26/2011] [Indexed: 12/12/2022]
Abstract
The management of congenital and acquired neutropenias presents some differences according to the type of the disease. Treatment with recombinant human granulocyte-colony stimulating factor (G-CSF) is not standardized and scanty data are available on the best schedule to apply. The frequency and the type of longitudinal controls in patients affected with neutropenias are not usually discussed in the literature. The Neutropenia Committee of the Marrow Failure Syndrome Group (MFSG) of the Associazione Italiana di Emato-Oncologia Pediatrica (AIEOP) elaborated this document following design and methodology formerly approved by the AIEOP board. The panel of experts reviewed the literature on the topic and participated in a conference producing a document that includes recommendations on neutropenia treatment and timing of follow-up.
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Franzetti M, Violin M, Casazza G, Meini G, Callegaro A, Corsi P, Maggiolo F, Pignataro AR, Paolucci S, Gianotti N, Francisci D, Rossotti R, Filice G, Carli T, Zazzi M, Balotta C. Human immunodeficiency virus-1 B and non-B subtypes with the same drug resistance pattern respond similarly to antiretroviral therapy. Clin Microbiol Infect 2011; 18:E66-70. [PMID: 22192680 DOI: 10.1111/j.1469-0691.2011.03740.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We analysed the 12-week virological response to protease inhibitor (PI) or non-nucleoside reverse transcriptase inhibitor (NNRTI) therapy in 1108 patients carrying B or non-B human immunodeficiency virus (HIV)-1 subtypes with matched resistance mutation patterns. Response rates were not significantly different for non-B and B subtypes stratified for treatment status (51.5% vs. 41.5% in naïve patients; 46.7% vs. 38.7% in experienced patients) or regimens (46.9% vs. 39.7% with PI; 56.7% vs. 40% with NNRTI). No difference in response was detected in patients harbouring B and non-B subtypes with any resistance profile. Further studies are advisable to fully test this approach on larger datasets.
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Affiliation(s)
- M Franzetti
- Department of Clinical Sciences L. Sacco, Section of Infectious Diseases and Immunopathology, University of Milan, Milan, Italy.
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Zecca G, Casazza G, Minuto L, Labra M, Grassi F. Allopatric divergence and secondary contacts in Euphorbia spinosa L: Influence of climatic changes on the split of the species. ORG DIVERS EVOL 2011. [DOI: 10.1007/s13127-011-0063-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Costantino G, Solbiati M, Sagone A, Vago T, Pisano G, Barbic F, Dipaola F, Casazza G, Viecca M, Furlan R. Time course of B-type natriuretic peptides changes after ventricular fibrillation in humans: Relationship with cardiac syncope. Auton Neurosci 2011. [DOI: 10.1016/j.autneu.2011.05.176] [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]
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Barbic F, Angaroni L, Orlandi M, Costantino G, Dipaola E, Borleri D, Borchini R, D'Adda F, Perego F, Borella M, Galli A, Solbiati M, Casazza G, Furlan R, Seghizzi P. [Syncope and occupational risk survey: the role of continuing education and multidisciplinary approach]. G Ital Med Lav Ergon 2011; 33:306-309. [PMID: 23393863] [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: 06/01/2023]
Abstract
Syncope is a common disorder characterized most of the times by a positive clinical outcome. However, it may turn to a life threatening event even for working colleagues and third party when occurring during an high risk job. We have recently found that, out of 670 patients admitted to the Emergency Department (ED) for syncope, about 50% were potential workers, being their age between 18 and 65 years. Also, we found that in this group of patients syncope recurrence was as high as 11% at 6 months. It is unknown how physicians address the problem of the occupational risk in patients suffering from syncope and how occupational aspects are taken into account in the clinical judgment before work readmission. One hundred eighty five doctors (149 occupational physicians, OP), participating in a work-shop on syncope, were asked to fulfill a questionnaire about their clinical experience and their attention to the occupational aspects in patients after syncope. Despite long lasting clinical experience, 41% of OP did not scrutinize syncope as a relevant symptom in their daily activity. 65% of the other specialists were used to address the occupational risk aspects in their syncope patients. A multidisciplinary approach involving continuing education on safety at work might reduce work accidents due to syncope relapse and promote a safe and suitable re-employment of patients with syncope. scrutinize syncope as a relevant symptom in their daily activity. 65% of the other specialists were used to address the occupational risk aspects in their syncope patients. A multidisciplinary approach involving continuing education on safety at work might reduce work accidents due to syncope relapse and promote a safe and suitable re-employment of patients with syncope.
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Affiliation(s)
- F Barbic
- Unità Sincopi, Ospedale Bolognini, Associazione di Ricerca sulle Neuroscienze, Seriate, Bergamo, Italy.
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Barbic F, Angaroni L, Orlandi M, Costantino G, Dipaola E, Borleri D, Borchini R, D'Adda F, Perego F, Borella M, Galli A, Solbiati M, Scanella E, Casazza G, Seghizzi P, Furlan R. [Syncope and work: role of the occupational physician and global risk stratification]. G Ital Med Lav Ergon 2011; 33:303-305. [PMID: 23393862] [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: 06/01/2023]
Abstract
Safety risk for subjects suffering from syncope while working has not been as yet addressed by occupational medicine. The present study was aimed at evaluating a new developed methodology for job tasks risk stratification in patients with syncope. During a work-shop on syncope and occupational risk, 149 occupational physicians (OP) with about 10 years of clinical experience were asked to fulfil a Visual Analogue Scale (VAS) concerning the doctor's estimated potential damage (D) to the worker and the probability of a damage to occur (P) should syncope take place during the job task. Five job tasks characterized by different risk for safety (1, driving; 2, toxic products handling; 3, job performed closed to hot surfaces o free flames; 4, surgical activity; 5, office job) were identified. OP correctly stratified the risk associated to the different job tasks in patients with syncope. Unexpectedly, task #3 was given a risk similar to that obtained in drivers. This might be of paramount clinical and social importance when patients with syncope have to return to their job tasks.
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Affiliation(s)
- F Barbic
- Unità Sincopi Ospedale Bolognini, Seriate, Bergamo, Italy.
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Orlando G, Merli S, Cordier L, Mazza F, Casazza G, Villa AM, Codecasa L, Negri E, Cargnel A, Ferrarese M, Rizzardini G. Interferon-gamma releasing assay versus tuberculin skin testing for latent tuberculosis infection in targeted screening programs for high risk immigrants. Infection 2010; 38:195-204. [PMID: 20411295 DOI: 10.1007/s15010-010-0015-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2009] [Accepted: 02/24/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND Recent immigrants from developing countries (<2 years since immigration) are at very high risk of active TB disease due to reactivation of latent infections acquired in the country of origin. In industrialized low-incidence TB countries targeted testing programs for high risk groups could allow the detection of latently infected persons who would likely benefit from a course of preventive treatment. In this study we evaluated the tuberculin skin test (TST) and interferon-gamma enzyme-linked immunosorbent assay (QuantiFERON TB-gold in tube, QFT-IT) strategies for TB infection screening programs in recent immigrants from highly endemic countries. PATIENTS AND METHODS This is a prospective cross-sectional study. Paired tests performed in 1,130 immigrants attending an outpatient ward, between 2005 and 2007 for any health problem were evaluated by intention-to-treat (ITT) and per-protocol (PP) analysis for efficiency and efficacy of screening program. RESULTS Positive TST and QFT-IT were observed in 36.04 versus 29.82% (ITT) and in 45.27 versus 30.22% (PP) respectively. A higher drop-out rate was observed for TST (20.35 vs. 1.33%) (p < 0.0001). Second level assessment was accepted by half of the TST positive patients. Overall agreement rate between 887 paired tests was fair (k = 0.38). Higher k values were observed for higher TB prevalence rate in the country of origin (k = 0.43), for TST induration diameters >20 mM (k = 0.47), in subjects aged 40-50 years (k = 0.41) and in unvaccinated persons (k = 0.40). In a multiple logistic regression model continent of origin, class of TB prevalence in the country of origin and contacts with TB patients were found to be significantly associated with the probability of TST and QFT-IT positive result. Low education levels were associated only to an increased risk of TST positive results. CONCLUSIONS The drawback of the TST screening strategy in recent immigrants from highly endemic countries is due to low sensitivity/specificity of the test and to high drop-out rate with an overall significant lowering in strategy efficacy/efficiency. The higher QFT-IT specificity prevents unnecessary overload of the health care system and, although more expensive, might represent a cost-effective alternative to TST in targeted screening programs directed to high risk populations.
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Affiliation(s)
- G Orlando
- II Division Infectious Diseases, Infectious Diseases Department, L Sacco University Hospital, Via GB Grassi, 74, 20157, Milan, Italy.
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Mauri D, Valachis A, Tsali L, Polyzos N, Casazza G. 5146 Does adjuvant bisphosphonate in early breast cancer modify the natural course of the disease – a meta-analysis of randomized controlled trials. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71038-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Grassi F, Minuto L, Casazza G, Labra M, Sala F. Haplotype richness in refugial areas: phylogeographical structure of Saxifraga callosa. J Plant Res 2009; 122:377-387. [PMID: 19363647 DOI: 10.1007/s10265-009-0230-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Accepted: 03/01/2009] [Indexed: 05/27/2023]
Abstract
This paper illustrates the phylogeographical structure of Saxifraga callosa in order to describe its genetic richness in refugial areas and to reconstruct its glacial history. S. callosa is a species spread throughout south-east France and Italy with a high distribution in the Maritime Alps. Four chloroplast microsatellite and AFLP markers were analyzed in populations of S. callosa. The size variants of all tested loci amount to 11 different haplotypes. Intrapopulational haplotype variation was found in two of the populations analyzed: on the Mt. Toraggio in the Maritime Alps, and in the Apuan Alps. On the other hand, no intrapopulational variation was found in 25 populations, most of which were sampled from isolated areas. Analysis of the haplotype distribution showed that population subdivision across all populations was high (G (ST) = 0.899). Moreover, its genetic structure was studied using AMOVA and STRUCTURE analysis. The study legitimated inferred conclusions about the phylogeographical structure of the species and identified centers of diversity. Considerations concerning genetic structure and divergence among three major clades (Maritime Alps, Apuan Alps and Apennines), the patchy distribution of haplotypes, and the high number of private haplotypes support the proposal that S. callosa survived in some refugia within the Italian Peninsula refugium, and that mainly northern populations of refugia were involved in postglacial recolonization.
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Affiliation(s)
- F Grassi
- Botanical Garden, Department of Biology, University of Milan, 20133 Milan, Italy.
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Valachis A, Mauri D, Polyzos NP, Mavroudis D, Georgoulias V, Casazza G. Partial breast irradiation or whole breast radiotherapy for early breast cancer: A meta-analysis of randomized controlled trials. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.18_suppl.cra532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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
CRA532 Background: The purpose of the study was to compare treatment outcomes in patients with breast cancer treated with partial breast irradiation and of those treated with whole breast radiation therapy. Methods: We conducted a systematic review and meta-analysis of published. Randomized clinical trials comparing partial breast irradiation versus whole breast radiation therapy. Primary outcome was overall survival and secondary outcomes were locoregional, distant and supraclavicular recurrences. Results: A search of the literature identified 3 trials with pooled total of 1,140 patients. We found no statistically significant difference between partial and whole breast radiation arms associated with death (OR 0.912, 95% CI 0.674–1.234, p = 0.550), distant metastasis (OR 0.740, 95% CI, 0.506–1.082, p = 0.120), or supraclavicular recurrences (pooled OR 1.415, 95% CI 0.278–7.202, p = 0.560). However, partial breast irradiation was statistically significantly associated with an increased risk of both local (pooled OR 2.150, 95% CI, 1.396–3.312; p = 0.001) and regional disease recurrences (pooled OR 3.430, 95% CI, 2.058–5.715; p < 0.0001) compared with whole breast radiation. Conclusions: Partial breast irradiation does not jeopardize survival and may be used as an alternative to whole breast radiation. Nevertheless, the issue of locoregional recurrence needs to be further addressed. No significant financial relationships to disclose.
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Affiliation(s)
- A. Valachis
- University of Crete, Heraklion, Greece; PACMeR: Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Milan, Milan, Italy
| | - D. Mauri
- University of Crete, Heraklion, Greece; PACMeR: Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Milan, Milan, Italy
| | - N. P. Polyzos
- University of Crete, Heraklion, Greece; PACMeR: Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Milan, Milan, Italy
| | - D. Mavroudis
- University of Crete, Heraklion, Greece; PACMeR: Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Milan, Milan, Italy
| | - V. Georgoulias
- University of Crete, Heraklion, Greece; PACMeR: Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Milan, Milan, Italy
| | - G. Casazza
- University of Crete, Heraklion, Greece; PACMeR: Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Milan, Milan, Italy
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Valachis A, Mauri D, Polyzos NP, Mavroudis D, Georgoulias V, Casazza G. Partial breast irradiation or whole breast radiotherapy for early breast cancer: A meta-analysis of randomized controlled trials. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.cra532] [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
CRA532 The full, final text of this abstract will be available in Part II of the 2009 ASCO Annual Meeting Proceedings, distributed onsite at the Meeting on May 30, 2009, and as a supplement to the June 20, 2009, issue of the Journal of Clinical Oncology. No significant financial relationships to disclose.
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Affiliation(s)
- A. Valachis
- University of Crete, Heraklion, Greece; PACMeR: Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Milan, Milan, Italy
| | - D. Mauri
- University of Crete, Heraklion, Greece; PACMeR: Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Milan, Milan, Italy
| | - N. P. Polyzos
- University of Crete, Heraklion, Greece; PACMeR: Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Milan, Milan, Italy
| | - D. Mavroudis
- University of Crete, Heraklion, Greece; PACMeR: Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Milan, Milan, Italy
| | - V. Georgoulias
- University of Crete, Heraklion, Greece; PACMeR: Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Milan, Milan, Italy
| | - G. Casazza
- University of Crete, Heraklion, Greece; PACMeR: Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Milan, Milan, Italy
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Mauri D, Valachis A, Polyzos NP, Mavroudis D, Georgoulias V, Casazza G. Fulvestrant in the treatment of advanced breast cancer: A systematic review and meta-analysis of randomized controlled trials. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.1087] [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
1087 Background: The purpose of the study was to compare efficacy and tolerability of fulvestrant with aromatase inhibitors and tamoxifen that actually represent the standard of care in hormonesensitive breast cancer. Methods: Systematic review and meta-analysis of available trials. Primary outcomes were overall survival, time to progression, clinical outcome, and objective response. Secondary outcome was the tolerability profile of the drugs. Results: Four trials were identified with 2,125 eligible patients. There was no statistically significant difference between fulvestrant and other hormonal agents in terms of overall survival (pooled HR: 1.047, 95% CI: 0.688 to 1.592), time to progression (pooled HR: 0.994, 95% CI: 0.691 to 1.431), clinical benefit (pooled OR: 1.044, 95% CI: 0.828 to 1.315), or objective response rate (pooled OR: 0.949, 95% CI: 0.736 to 1.224). A higher incidence of joint disorders (pooled OR: 0.621, 95% CI: 0.424 to 0.909; p = 0.014) was noted in patients receiving hormonal agents other than fulvestrant. Conclusions: Fulvestrant was similar to other hormonal agents with respect to efficacy measures, with good tolerability profile. No significant financial relationships to disclose.
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Affiliation(s)
- D. Mauri
- PACMeR, Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Crete, Heraklion, Greece; University of Milan, Milan, Italy
| | - A. Valachis
- PACMeR, Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Crete, Heraklion, Greece; University of Milan, Milan, Italy
| | - N. P. Polyzos
- PACMeR, Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Crete, Heraklion, Greece; University of Milan, Milan, Italy
| | - D. Mavroudis
- PACMeR, Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Crete, Heraklion, Greece; University of Milan, Milan, Italy
| | - V. Georgoulias
- PACMeR, Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Crete, Heraklion, Greece; University of Milan, Milan, Italy
| | - G. Casazza
- PACMeR, Oncology and Obstetrics and Gynaecology, Lamia, Greece; University of Crete, Heraklion, Greece; University of Milan, Milan, Italy
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Karathanasi I, Kamposioras K, Cortinovis I, Karampoiki V, Alevizaki P, Dambrosio M, Zorba E, Panou C, Pantazi E, Bristianou M, Kouiroukidou P, Bouiatiotis E, Xilomenos A, Zavou D, Casazza G, Mauri D. Moving ahead in diabetics' cancer screening; food for thought from the Hellenic experience. Eur J Cancer Care (Engl) 2009; 18:255-63. [PMID: 19175670 DOI: 10.1111/j.1365-2354.2007.00858.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Although data from literature suggest that diabetic women are frequently under screened for gynaecological cancers little is known about screening implementation for other cancers for both genders. This study investigates comprehensive cancer screening practices of diabetics as compared with non-diabetics; analyses screening patterns both by gender and level of evidence and reveals target subgroups that should be paid more attention for screening implementation. 675 diabetics vs. 5772 non-diabetic Greek individuals entered the PACMeR 02 cancer screening study. Diabetic women reported significantly lower performance for the sex-specific evidence-based cancer screening tests and digital rectal examination (DRE) as compared with non-diabetics (P < 0.05). Diabetic women older than 60 years old, of elementary education, housewives and farmers showed the lowest performance rates (P < 0.01). Prostate cancer screening was higher among diabetic men with ultrasound and DRE reaching statistical significance (P < 0.05). Subgroups analysis did not reveal a hidden relationship. Both genders of diabetics reported never performing skin examination at higher rates (P < 0.001), although screening intent is extremely low in both diabetics and non-diabetics (<1%). Evidence-based screening coverage was inconsistent in both genders independently by the diabetic status. Primary care efforts should be provided to implement presymptomatic cancer control.
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Affiliation(s)
- I Karathanasi
- Department Of Endocrinology, Polykliniki General Hospital, Athens, Greece
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Spreafico F, Bisogno G, Collini P, Jenkner A, Gandola L, D'Angelo P, Casazza G, Piva L, Luksch R, Perotti D, Pession A, Fagioli F, Dallorso S. Treatment of high-risk relapsed Wilms tumor with dose-intensive chemotherapy, marrow-ablative chemotherapy, and autologous hematopoietic stem cell support: experience by the Italian Association of Pediatric Hematology and Oncology. Pediatr Blood Cancer 2008; 51:23-8. [PMID: 18293386 DOI: 10.1002/pbc.21524] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [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: 11/09/2022]
Abstract
BACKGROUND We evaluated an intensified chemotherapy strategy in children with Wilms tumor who relapsed with high-risk features. PROCEDURES From January 2001 to June 2006, we treated 20 consecutive children with reinduction chemotherapy (using ifosfamide/carboplatin/etoposide in 15/20 cases), with (n = 15) or without (n = 5) subsequent high-dose chemotherapy and hematopoietic stem cell support, surgery where feasible, and radiation therapy. The median time to relapse was 10 months after nephrectomy. All but two children initially received doxorubicin as first-line therapy. RESULTS All patients were assessed for outcome: 13 are currently alive, 12 of them in remission a median 25 months since their relapse, one with progressing tumor. The treatment was unsuccessful in eight children: the disease progressed during reinduction in three, and relapsed in five. There was one toxic death. All transplanted patients engrafted to a neutrophil count >0.5 x 10(3)/microl after a median 11 days, and to an unsustained platelet count >25,000/microl after a median of 13 days. Three-year disease-free and overall survival rates were 56 +/- 12% and 55 +/- 13%, respectively. Neither recurrence within 12 months of nephrectomy nor extra-lung recurrence negatively affected outcome. A survival advantage was demonstrated in patients without disease evidence prior to transplant. CONCLUSION A disease-free survival rate nearing 50% is a realistic target in children with high-risk recurrent Wilms tumor. The benefit of autologous hematopoietic stem cell transplantation for consolidation deserves to be investigated in a randomized, controlled study.
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Affiliation(s)
- Filippo Spreafico
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
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Rigamonti C, Donato MF, Fraquelli M, Agnelli F, Ronchi G, Casazza G, Rossi G, Colombo M. Transient elastography predicts fibrosis progression in patients with recurrent hepatitis C after liver transplantation. Gut 2008; 57:821-7. [PMID: 18218676 DOI: 10.1136/gut.2007.135046] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.1] [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: 12/14/2022]
Abstract
OBJECTIVE Transient elastography (TE) allows non-invasive evaluation of the severity of liver disease in patients with chronic hepatitis C. This procedure, however, warrants further validation in the setting of liver transplantation (LT), including patients under follow-up for recurrent hepatitis C. SETTING Tertiary referral hospital. PATIENTS 95 patients (75 males) transplanted for end-stage liver disease due to hepatitis C virus. INTERVENTIONS Paired liver biopsy (LB) and TE were carried out 6-156 (median, 35) months after LT. 40 patients with recurrent hepatitis C sequentially evaluated 6-21 months apart. MAIN OUTCOME MEASURES Clinical, laboratory and graft histological features influencing TE results. RESULTS Median TE values were 7.6 kPa in the 90 patients with a successful TE examination, being 5.6 kPa in the 30 patients with Ishak fibrosis score (S) of 0-1, 7.6 kPa in the 38 with S2-3; 16.7 kPa in the 22 with S4-6, (p < 0.0001). Areas under the ROC curves were 0.85 (95% CI, 0.76 to 0.92) for S > or = 3, 0.90 (95% CI, 0.82 to 0.95) for S > or = 4 with 7.9 and 11.9 kPa optimal TE cut-off (81% and 82% sensitivity, 88% and 94% negative predictive value, respectively). Fibrosis, necroinflammatory activity and higher than 200 IU/l gamma-glutamyl transpeptidase levels independently influenced TE results. During post-LT follow-up, TE results changed in parallel with grading (r = 0.63) and staging (r = 0.71), showing 86% sensitivity and 92% specificity in predicting staging increases. CONCLUSIONS TE accurately predicts fibrosis progression in LT patients with recurrent hepatitis C, suggesting that protocol LB might be avoided in patients with improved or stable TE values during follow-up.
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Affiliation(s)
- C Rigamonti
- First Division of Gastroenterology, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via Sforza, 35-20122 Milano, Italy.
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Mauri D, Kamposioras K, Cortinovis I, Karampoiki V, Thanopoulou E, Koukourakis G, Tzachanis D, Zacharias G, Pectasides D, Casazza G. Rethinking economics of misplaced priorities within the Hellenic opportunistic cancer screening policy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.17521] [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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