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Costanzo L, Di Paola F, Pedi AM, Failla G, Mangiafico M. Long-Term Efficacy and Safety of Direct Oral Anticoagulants at Reduced Doses in the Secondary Prevention of Venous Thromboembolism and Post-Thrombotic Syndrome. J Clin Med 2024; 13:2394. [PMID: 38673665 PMCID: PMC11051129 DOI: 10.3390/jcm13082394] [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: 03/26/2024] [Revised: 04/14/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Anticoagulation for venous thromboembolism (VTE) is required for at least three to six months; however, it is advisable to extend the duration in certain cases, in which case a reduced dose of Direct Oral Anticoagulants (DOACs) may be an option. Our objective was to investigate the efficacy and safety of reduced-dose DOACs in extended anticoagulation treatment compared to full doses. Methods and Results: This retrospective single-centre study included 185 patients treated with DOACs for at least 6 months who were divided into two groups: (1) the Full Dose (FD) group (n = 113) and (2) the Reduced Dose (RD) group (n = 72), which included patients treated with Apixaban at 2.5 mg bis in die (BID) and Rivaroxaban at 10 mg once daily (OD). Post-thrombotic syndrome (PTS) and its progression were evaluated. During an overall follow-up of 48.32 ± 29.49 months, no VTE occurred, and no patients experienced major bleeding; clinically relevant non-major bleeding occurred in three patients in each group (2.7% vs. 4.2% in FD vs. RD, respectively, p = 0.57). From baseline to follow-up, the prevalence of PTS was not significantly decreased in either group (FD: 54.9% vs. 51.3%, p = 0.29; RD 51.4% vs. 44.4%, p = 0.12); conversely, the Villalta score values were significantly decreased at the last follow-up (FD: 5.51 ± 4.18 vs. 5.51 ± 4.18, p < 0.001; RD 5.49 ± 4.06 vs. 5.11 ± 3.73, p = 0.006). Conclusion: In this real-world retrospective registry, very long-term extended anticoagulant therapy with DOACs at full or reduced doses showed comparable efficacy, safety, and impact on PTS progression. Larger studies are needed.
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Affiliation(s)
- Luca Costanzo
- Unit of Angiology, Department of Cardio-Thoraco-Vascular, Policlinico ”G. Rodolico-San Marco” University Hospital, University of Catania, 95124 Catania, Italy; (F.D.P.); (G.F.)
| | - Federico Di Paola
- Unit of Angiology, Department of Cardio-Thoraco-Vascular, Policlinico ”G. Rodolico-San Marco” University Hospital, University of Catania, 95124 Catania, Italy; (F.D.P.); (G.F.)
| | - Anastasia Maria Pedi
- Unit of Internal Medicine, Policlinico “G. Rodolico-San Marco”, 95123 Catania, Italy; (A.M.P.); (M.M.)
| | - Giacomo Failla
- Unit of Angiology, Department of Cardio-Thoraco-Vascular, Policlinico ”G. Rodolico-San Marco” University Hospital, University of Catania, 95124 Catania, Italy; (F.D.P.); (G.F.)
| | - Marco Mangiafico
- Unit of Internal Medicine, Policlinico “G. Rodolico-San Marco”, 95123 Catania, Italy; (A.M.P.); (M.M.)
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Pesaresi C, Pavia D, Casini L, Renzi E, Failla G, Kerr M, Villari P, De Vito C. The Sapienza University of Rome network of automated external defibrillators: a prototype webMap developed to speed access to community defibrillators and increase survival from out-of-hospital cardiac arrest. Eur Rev Med Pharmacol Sci 2023; 27:9363-9374. [PMID: 37843349 DOI: 10.26355/eurrev_202310_33964] [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: 10/17/2023]
Abstract
OBJECTIVE In Italy, only around 10% of people who experience out-of-hospital cardiac arrest (OHCA) survive. A large portion of OHCA events in public settings are characterized by an initial shockable rhythm, which requires prompt defibrillation. We aimed to create a system to quickly locate nearby public access automated external defibrillators (AEDs) on the campus of Sapienza University of Rome, the largest public university in Europe. MATERIALS AND METHODS We developed the AED webMap through a 6-step process involving the: 1) collection of information and geographical coordinates for each AED from the university management system; 2) development of a new geolocation database; 3) integration of information contained in the new database with data provided by university departments; 4) geolocation of AEDs in the Google MyMaps environment; 5) graphic representation of all AEDs on digital map templates using specific symbols, with pop-ups containing additional information for each AED; and 6) publication of the webMap on the university website. RESULTS The AED webMap was published on the university website (https://www.uniroma1.it/it/pagina/defibrillatori-sapienza-in-rete) and facilitates prompt identification of nearby AEDs by providing: 1) detailed AED geolocalization with interactive pop-up information for each AED, including whether the AED is located internally or externally; 2) the option to use different base maps (e.g., digital street map); 3) calculation and display of the route to reach the chosen AED; and 4) the possibility to migrate towards multiple platforms. CONCLUSIONS The webMap can help bystanders quickly identify, locate, and reach nearby AEDs present on the campus of the largest public university in Europe, a measure that could help speed defibrillation and maximize the life-saving potential of AEDs in the event of OHCA.
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Affiliation(s)
- C Pesaresi
- Department of Letters and Modern Cultures, Sapienza University, Rome, Italy.
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Romano F, Barbato C, Arundine D, Ambrosio F, Ronga R, Failla G, Moccia L, Corcione N, Guggino G, Raucci A, Romano L, Campione S, De Dominicis G, Santoriello C, Tinto A, Russo C, De Michele F, Russo A, Starace A, Riccardi F. 13P High neutrophils-to-lymphocyte ratio (NLR) predicts poor survival of high-PD-L1-expressing metastatic non-small cell lung carcinoma patients undergoing first-line immunotherapy with pembrolizumab. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Puleo V, Gentili A, Failla G, Melnyk A, Di Tanna G, Ricciardi W, Cascini F. Digital health technologies: a systematic review of their cost-effectiveness. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Digital health interventions have a potential to improve safety, efficacy and quality of care, reducing waste in healthcare costs. Despite premises, the evidence regarding cost and effectiveness of digital tools in health is scarce and limited.
Objectives: The aim of this systematic review is to summarize the evidence on cost-effectiveness of digital health interventions and to assess whether the studies meet the established quality criteria.
Methods
We queried PubMed, Scopus and Web of Science databases for articles in English published from 1 January 2016 to 31 December 2020 that performed economic evaluations of digital health technologies. The methodological rigorousness of studies was assessed with a well-established checklist (CHEERS). The incremental cost-effectiveness ratio (ICER)was calculated when the reviewed study reported related data but did not express the ICER.
Results
Searches identified 1476 results, 552 of which were selected for abstract and 35 were included in this review. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The qualitative analysis identified the economic and effectiveness evaluation of seven different types of interventions: fourteen studies on a new telemedicine service; five on telecounseling; five on teletherapy; two on telemonitoring; five on new mobile applications; two on m-health programs; one on digital platforms and one on electronic health records.
Conclusions
Findings on cost-effectiveness of digital interventions showed a growing body of evidence and suggested a generally favorable effect in terms of costs and health outcomes. However, due to the heterogeneity across study methods, the comparison between interventions still remains difficult. Further research based on a standardized approach is needed in order to methodically analyze incremental cost-effectiveness ratios, costs, and health benefits.
Key messages
Digital interventions suggested a favorable effect in terms of costs and health outcomes. Digital health interventions have a potential to improve safety, efficacy and quality of care.
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Affiliation(s)
- V Puleo
- Department of Life Sciences and Public Health, Section of Hygiene and Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - A Gentili
- Department of Life Sciences and Public Health, Section of Hygiene and Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - G Failla
- Department of Public Health, University of Verona, Verona, Italy
| | - A Melnyk
- Department of Life Sciences and Public Health, Section of Hygiene and Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - G Di Tanna
- Statistics Division, University of New South Wales, Sydney, Australia
| | - W Ricciardi
- Department of Life Sciences and Public Health, Section of Hygiene and Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - F Cascini
- Department of Life Sciences and Public Health, Section of Hygiene and Public Health, Catholic University of Sacred Heart, Rome, Italy
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Failla G, Pantovic A, Al-Ajlouni Y, Ricciardi W, Cascini F. How the population worldwide is reacting to the COVID-19 vaccines: a systematic review on hesitancy. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
High rates of vaccination are worldwide required to establish a herd immunity stopping the current COVID-19 pandemic evolution. Vaccine hesitancy is a major barrier in achieving herd immunity across different populations. This study sought to conduct a systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide.
Methods
A systematic literature search was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Multiple databases were searched, namely PubMed and Web of Science, on February 24th, 2021 using a set of developed keywords. Inclusion criteria included the study to be 1) conducted in English; 2) investigated attitudes, hesitancy, and/or barriers to COVID-19 vaccine acceptability among a given population; 3) utilized validated measurements techniques; 4) have the full text paper available and 5) be peer-reviewed prior to final publication. The Newcastle Ottawa (NOS) scale for cross sectional studies was used to assess the quality of the studies.
Results
73 studies were included in qualitative synthesis. Overall, vaccine acceptance rates ranged from 23.6% in Kuwait to 94.3% in Malaysia and Nepal. A variety of different factors contributed to increased hesitancy, some of which included having negative perception of vaccine efficacy, safety, convenience and price. Some of the consistent socio-demographic groups that were identified to be associated with increased hesitancy included: women, younger participants, less educated, with lower income, with no insurance, living in the rural area and self-identified as a racial/ethnic minority.
Conclusions
Vaccine hesitancy rates against COVID-19 vaccine ranged widely among across different populations. Identifying the factors that interplay and result in high hesitancy rates among a population can allow formulating a directed intervention to increase their vaccination uptake rates.
Key messages
It is necessary to understand the factors that contribute to the COVID-19 vaccine hesitancy. It is important to inform policy-makers and formulate direct intervention measures that will successfully handle the pandemic.
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Affiliation(s)
- G Failla
- Department of Public Health, University of Verona, Verona, Italy
| | - A Pantovic
- Faculty of Biology, University of Belgrade, Belgrade, Serbia
| | - Y Al-Ajlouni
- Department of Epidemiology, Mailman School of Public Health at Columbia University, New York, USA
| | - W Ricciardi
- Section of Hygiene, Department of Life Sciences and Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - F Cascini
- Section of Hygiene, Department of Life Sciences and Public Health, Catholic University of Sacred Heart, Rome, Italy
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Monteagudo JF, Peyre-Costa D, De Souza S, Alonso-Jaquete A, Failla G, Grosso FM, Chen-Xu J, Miranda JO, Borghi G. EuroNet MRPH: Networking Opportunities for Public Health Medical Residents. Eur J Public Health 2021. [PMCID: PMC8574757 DOI: 10.1093/eurpub/ckab165.458] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The European Network of Medical Residents in Public Health (EuroNet MRPH) is a non-profit, international, independent and non-governmental network of national associations of public health residents around Europe. Objectives To describe the results accomplished by EuroNet MRPH and to show networking opportunities provided to medical residents in public health (MRPH) from 2011 to 2021. Results EuroNet's mission is to improve and facilitate connection between MRPH, to promote pan-European Research, and to facilitate international mobility. Digital and quarterly face-to-face meetings are used as a way of communication. Since 2011, 10 European MRPH associations and 4 individual members have joined the network, representing the UK, France, Spain, Italy, Portugal, Ireland, the Netherlands, Croatia, Slovenia, Turkey, Malta, Poland, Bosnia and Herzegovina, and Austria. In this period, 27 face-to-face meetings have been organised, promoting cooperation and exchanging of ideas between MRPH. Moreover, three working groups (WG) have been established, focusing on research, internships, and communication. Regarding research, studies about e-cigarettes, conflicts of interest, and the impact of COVID-19 on mental health of MRPH have been conducted. When it comes to internships, more than 20 possible destinations and an online form are available on our website, providing MRPH information and support. Finally, thanks to the communication WG, 20 newsletters have been published, sharing experiences and thoughts from members of the network. Moreover, EuroNet has an established presence in social media, with active accounts in Twitter, Instagram and Facebook, where public health information and opportunities for young professionals are promoted. Conclusions In the last ten years, EuroNet MRPH has actively promoted networking opportunities among European Medical Residents in Public Health. Key messages Enhancing international cooperation among young public health professionals is fundamental in order to face current and future public health challenges. EuroNet MRPH represents a useful tool to promote collaboration among young public health professionals.
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Affiliation(s)
- JF Monteagudo
- Unidad Docente MPYSP Región de Murcia, Servicio Murciano de Salud, Murcia, Spain
| | - D Peyre-Costa
- Epidemiology Unit, University Hospital of Montpellier, Montpellier, France
| | - S De Souza
- Lyon-Est Faculty of Medicine, Lyon Claude-Bernard University, Lyon, France
| | - A Alonso-Jaquete
- Unidad Docente MPYSP de Cantabria, Consejeria de Sanidad de Cantabria, Santander, Spain
| | - G Failla
- Department of Public Health, University of Verona, Verona, Italy
| | - FM Grosso
- Post Graduate School of Public Health, University of Milan, Milan, Italy
| | - J Chen-Xu
- Baixo Mondego Public Health Unit, Administração Regional de Saúde do Centro, Coimbra, Portugal
| | - JO Miranda
- Pinhal Interior Norte Public Health Unit, Administração Regional de Saúde do Centro, Coimbra, Portugal
| | - G Borghi
- Pays de la Loire Regional Office, Santé Publique France, Nantes, France
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Failla G, Peyre-Costa D, Croci R, Lo Moro G, Chen-Xu J, Ferreira MC, Jaquete A, Malcata F, Vasiliu A. Assessing COVID-19-related depression, anxiety and stress among European public health residents. Eur J Public Health 2021. [PMCID: PMC8574902 DOI: 10.1093/eurpub/ckab164.534] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In Europe, Public Health Residents (PHR) have participated in the response against COVID-19.The pandemic has had a profound mental health (MH) impact on healthcare workers, but little evidence has been accrued about the Public Health (PH) workforce.The current study aims at assessing prevalence and risk factors for pandemic-related depression (D), anxiety (A) and stress (S).
Methods
Between March 22 and April 11, 2021 we administered an online survey to PHR from France, Italy, Portugal and Spain, recruited through the national associations of PHR.We collected socio-demographic data and assessed changes in the working conditions due to COVID-19.We used the Depression Anxiety Stress Scales-21.Cut-off scores for D, A and S were: 9, 7, and 14.Multivariable logistic regression models were applied to determine risk factors for pandemic-related MH outcomes.Data analysis was performed with SPSS version 27.
Results
443 out of approximately 2000 PHR completed the survey, response rate: 22.15%. Most responders (n = 226; 51%) were from Italy, 87 (19.6%) from Portugal, 74 (16.47%) from Spain and 56 (12.6%) from France. Median age: 29 years (IQR 25 - 33). Female/male ratio: 1.6. PHR above the cut-offs for D, A and S were: 60.5%, 43.1%, 61.2%.DASS-21 scores were 13.3 (± 10.27), 8.13 (± 7.79), 19.06 (± 9.71), respectively.Across the multivariable logistic regression models, the main identified predictors were: for D - the COVID-19 impact on PH training (OR 1.78, 95% CI [1.12-2.80], p = 0.014); for A - the loss of research opportunities (OR 1.94, 95% CI [1.28-2.93], p = 0.002) and for psychological S - the year of residency (last year vs other years of residency: OR 2.3, 95% CI [1.20-4.38], p = 0.012).
Conclusions
Our sample featured mild-to-moderate levels of prevalent D, A and moderate levels of psychological stress.Overall, the main risk factors associated with negative psychometric outcomes were training challenges, loss of research opportunities and residency seniority.
Key messages
During the pandemic it is vital to increase knowledge and awareness about the impact of the health emergency on mental health in the Public Health workforce. It is important to deploy concrete efforts into building healthy work environments, guarantee adequate training and research opportunities for Public Health Residents.
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Affiliation(s)
- G Failla
- Department of Public Health, University of Verona, Verona, Italy
- Training Service, Italian National Institute of Health, Rome, Italy
| | - D Peyre-Costa
- Department of Public Health, University Hospital of Montpellier, Montpellier, France
| | - R Croci
- Scientific Communication Service, Italian National Institute of Health, Rome, Italy
| | - G Lo Moro
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - J Chen-Xu
- Public Health Unit, Primary Health Care Cluster Baixo Mondego, Coimbra, Portugal
| | - MC Ferreira
- Public Health Unit, Primary Health Care Cluster Pinhal Litoral, Leiria, Portugal
| | - A Jaquete
- Preventive Medicine and Public Health Teaching Unit, Unit of Cantabria, Cantabria, Spain
| | - F Malcata
- Public Health Unit, Primary Health Care Cluster Porto Ocidental, Porto, Portugal
| | - A Vasiliu
- Department of Public Health, University of Montpellier, IRD, INSERM, TRANSVIHMI, Montpellier, France
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Abstract
BACKGROUND Seventy percent of patients affected by SARS-COV-2 disease are asymptomatic or with symptoms that not required Hospitalization. A prodromal period lasting about 5 days can be identified. In this phase a patient with a positive swab for viral RNA may or may not evolve towards the phase of symptomatic disease. METHODS In this paper we reviewed the literature related to COVID-19 therapy we propose a reasoned treatment protocols in outpatients according to the age and the comorbidity. RESULTS The aim of this study was to reduce the impact of the virus by reducing its ability to attack cells and the inflammatory burden and the prothrombotic effects proposing two therapeutic schemes of proven efficacy according to the age of the patients and the comorbidities. CONCLUSIONS We aimed to reduce worsening of clinical status and hospitalization while protecting patients at home.
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Affiliation(s)
- Claudio Allegra
- Department of Angiology, Union Internationale de Phlebologie (UIP), S.Giovanni Hospital, Rome, Italy
| | - Giacomo Failla
- Unit of Angiology, Department of Cardiovascular Disease, San Marco Hospital, Rodolico, S. Marco University Hospital, University of Catania, Catania, Italy -
| | - Luca Costanzo
- Unit of Angiology, Department of Cardiovascular Disease, San Marco Hospital, Rodolico, S. Marco University Hospital, University of Catania, Catania, Italy
| | - Ferdinando Mannello
- Unit of Clinical Biochemistry, Section of Biochemistry and Biotechnology, Department of Biomolecular Sciences, Carlo Bo University of Urbino, Urbino, Pesaro-Urbino, Italy
| | - Francesco Montella
- Department of Internal Medicine, San Giovanni-Addolorata Hospital, Rome, Italy
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Costanzo L, Failla G, Antignani PL, Fareed J, Gu Y, Pitha J, Aluigi L, Karplus T, Mansilha A. The vascular side of COVID-19 disease. Position paper of the International Union of Angiology. INT ANGIOL 2020; 39:445-451. [PMID: 32892615 DOI: 10.23736/s0392-9590.20.04539-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The SARS-CoV-2 infection (COVID-19) is causing an ongoing pandemic and potentially fatal disease. Development of coagulopathy with thrombotic complications such as deep vein thrombosis and pulmonary embolism are emerging as factors for progression to severe disease and death. Also, a markedly increased level of D-dimer, a protein product of fibrin degradation, has been associated to mortality. Furthermore, activation of immune response due to virus infection may led to uncontrolled severe inflammation with damage to host cells and induction of endotheliitis and cellular apoptosis and pyroptosis. The use of low molecular weight heparin in early stage of the disease could prevent vascular complications and reduce the progression to severe stage of the disease. Aim of this paper was to summarize current evidence about vascular involvement in COVID-19 disease and potential antithrombotic therapy.
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Affiliation(s)
- Luca Costanzo
- Unit of Angiology, Department of Cardio-Thoraco-Vascular, Policlinico-San Marco University Hospital, University of Catania, Catania, Italy -
| | - Giacomo Failla
- Unit of Angiology, Department of Cardio-Thoraco-Vascular, Policlinico-San Marco University Hospital, University of Catania, Catania, Italy
| | | | - Jawied Fareed
- Hemostasis and Thrombosis Research Laboratories, Loyola University Medical Center, Maywood, IL, USA
| | - Yongquan Gu
- Department of Vascular Surgery, XuanWu Hospital, Capital Medical University, Beijing, China
| | - Jan Pitha
- Laboratory for Atherosclerosis Research, Center for Clinical and Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Leonardo Aluigi
- Angiology Care Unit, Private Villalba Hospital (GVM), Bologna, Italy
| | - Thomas Karplus
- Department of Vascular Medicine, Sydney Local Health District, Concord Hospital, Sidney, Australia
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Costanzo L, Palumbo FP, Ardita G, Antignani PL, Arosio E, Failla G. Coagulopathy, thromboembolic complications, and the use of heparin in COVID-19 pneumonia. J Vasc Surg Venous Lymphat Disord 2020; 8:711-716. [PMID: 32561465 PMCID: PMC7297687 DOI: 10.1016/j.jvsv.2020.05.018] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [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: 04/16/2020] [Accepted: 05/22/2020] [Indexed: 01/08/2023]
Abstract
The SARS-CoV-2 (COVID-19) is causing a pandemic and potentially fatal disease of global public health concern. Viral infections are known to be associated with coagulation impairment; thus, thrombosis, hemorrhage, or both may occur. Understanding the pathophysiologic mechanisms underlying the development of coagulation disorders during viral infection is essential for the development of therapeutic strategies. Coagulopathy in COVID-19 infection is emerging as a precipitant factor for severe respiratory complications and death. An increase in coagulation markers, such as fibrinogen and D-dimer, has been found in severe COVID-19 cases. Heparin, clinically used as an anticoagulant, also has anti-inflammatory properties, including binding of inflammatory cytokines, inhibition of neutrophil chemotaxis, and protection of endothelial cells, and a potential antiviral effect. We hypothesized that low-molecular-weight heparin may attenuate cytokine storm in COVID-19 patients; therefore, low-molecular-weight heparin could be a valid adjunctive therapeutic drug for the treatment of COVID-19 pneumopathy. In this paper, we review potential mechanisms involved in coagulation impairment after viral infection and the possible role of heparin in the treatment of COVID-19 patients.
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Affiliation(s)
- Luca Costanzo
- Angiology Unit, San Marco Hospital, Department of Cardiovascular Disease, A.O.U. "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy.
| | - Francesco Paolo Palumbo
- Angiology Unit, San Marco Hospital, Department of Cardiovascular Disease, A.O.U. "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Giorgio Ardita
- Angiology Unit, San Marco Hospital, Department of Cardiovascular Disease, A.O.U. "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | | | - Enrico Arosio
- Department of Medicine, University of Verona, Verona, Italy
| | - Giacomo Failla
- Angiology Unit, San Marco Hospital, Department of Cardiovascular Disease, A.O.U. "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
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Di Paola M, Alotta G, Burlon A, Failla G. A novel approach to nonlinear variable-order fractional viscoelasticity. Philos Trans A Math Phys Eng Sci 2020; 378:20190296. [PMID: 32389079 PMCID: PMC7287323 DOI: 10.1098/rsta.2019.0296] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/28/2020] [Indexed: 06/11/2023]
Abstract
This paper addresses nonlinear viscoelastic behaviour of fractional systems with variable time-dependent fractional order. In this case, the main challenge is that the Boltzmann linear superposition principle, i.e. the theoretical basis on which linear viscoelastic fractional operators are formulated, does not apply in standard form because the fractional order is not constant with time. Moving from this consideration, the paper proposes a novel approach where the system response is derived by a consistent application of the Boltzmann principle to an equivalent system, built at every time instant based on the fractional order at that instant and the response at all the previous ones. The approach is readily implementable in numerical form, to calculate either stress or strain responses of any fractional system where fractional order may change with time. This article is part of the theme issue 'Advanced materials modelling via fractional calculus: challenges and perspectives'.
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Affiliation(s)
- M. Di Paola
- Department of Engineering (DI), University of Palermo, Viale delle Scienze Ed. 8, 90128 Palermo, Italy
| | - G. Alotta
- Department of Civil, Energy, Environmental and Materials Engineering (DICEAM), ‘Mediterranean’ University of Reggio Calabria, via Graziella, 89124 Reggio Calabria, Italy
| | - A. Burlon
- Department of Civil, Energy, Environmental and Materials Engineering (DICEAM), ‘Mediterranean’ University of Reggio Calabria, via Graziella, 89124 Reggio Calabria, Italy
| | - G. Failla
- Department of Civil, Energy, Environmental and Materials Engineering (DICEAM), ‘Mediterranean’ University of Reggio Calabria, via Graziella, 89124 Reggio Calabria, Italy
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Bilancini S, Allegra C, Bonadeo P, Failla G, Guarnera G, Leonardo G, Lucchi M, Mollo P, Nicosia P, Trevisan G. Coronavirus disease-2019 and its macro- and microvascular implications: The Italian Microcirculation Society's analyses. Vasc Invest Ther 2020. [DOI: 10.4103/vit.vit_12_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Antignani P, Failla G, Aluigi L, Magnoni F, Baroncelli T, Benevento D, De Marchi S, Diaco E, Kontothanassis D, Mannello F, Varetto G, Costanzo L. Outpatient execution of vascular ultrasound diagnostic tests during the COVID-19 pandemic position paper of the Italian Society for Vascular Investigation. Vasc Invest Ther 2020. [DOI: 10.4103/vit.vit_27_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Bordonaro R, Ferraù F, Giuffrida D, Calì S, Priolo D, Colina P, Ursino M, Failla G. Fludarabine Phosphate as an Active and Well Tolerated Salvage Therapy in an Elderly Heavily Pretreated Hodgkin's Disease Patient: A Case Report. Tumori 2018; 85:288-9. [PMID: 10587034 DOI: 10.1177/030089169908500415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Up to two thirds of all patients affected by advanced Hodgkin's disease will be cured by chemotherapy alone or by combined chemoradiation modalities. High-dose chemotherapy with autologous stem cell rescue may be potentially curative for patients progressing under frontline chemotherapy or developing early relapse of disease. In spite of this, an unacceptably high percentage of these highrisk patients will relapse after salvage treatments and die of their disease. Fludarabine phosphate is an adenosine nucleoside analog highly active in chronic lymphocytic leukemia and low-grade non-Hodgkin's lymphomas. There are only few data in the literature concerning its use in the management of Hodgkin's disease. We report the case of an elderly, heavily pretreated Hodgkin's disease patient in progression under third-line chemotherapy who experienced good palliation of her B symptoms and a major clinical response of her refractory bone lesions with the administration of fludarabine as monotherapy. The treatment was well tolerated, without grade 4 hematological toxicity or opportunistic infections. The duration of clinical remission and systemic symptom palliation was 9 and 11 months, respectively. Further evaluation of fludarabine phosphate as salvage therapy in relapsed/refractory elderly Hodgkin's disease patients is needed.
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Affiliation(s)
- R Bordonaro
- Division of Medical Oncology, Garibaldi-S. Luigi-S. Currò Hospital, Catania, Italy
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Figlia V, Cuccia F, Valenti V, Tripoli A, Terranova G, Lo Casto A, Failla G, Cucchiara T, Mortellaro G, Ferrera G. 227P Stereotactic body radiotherapy with helical tomotherapy for lung tumors: A single-center experience. J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30499-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Failla G, Calais Júnior A, Pavanelli L, Nunes L. Histomorphometric analysis of gonads of green turtles (chelonia mydas) stranded on the coast of Espírito Santo state, Brazil. ARQ BRAS MED VET ZOO 2018. [DOI: 10.1590/1678-4162-9431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
ABSTRACT Studies on reproduction in sea turtles are important due to its life cycle, migratory patterns, high juvenile mortality and environmental impacts. This study aimed to analyse histomorphometrically gonads of C. mydas from the coastline of the Espírito Santo State, Brazil. Ovaries and testicles were collected between 2014 and 2015 from stranded animals. The material was fixed in formalin 10%, assessed macroscopically and processed for histomorphometrical evaluation. Gonads from 34 individuals were evaluated, twenty-four females and ten males. Macroscopic sexual identification presented 100% accuracy confirmed by histology. Sexual dimorphism was observed in one individual, which was considered as adult (CCL=1.023 m). Microscopy of female gonads revealed predominant previtellogenic follicles; oocyte diameter ranged between 161µm and 750µm and a positive correlation between ovarian length, largest oocyte and CCL was found. In males, autolysis was verified in five individuals. Viable testicles revealed predominant spermatogonia, primary spermatocytes and Sertoli cells in the seminiferous tubules and, Leydig cells and fibroblasts in the stroma. There was a positive correlation between tubular diameter and CCL and testicle length and CCL. Maturation of stromal tissue and a positive correlation between tubular lumen and CCL were also observed. Gonad development is proportional to individual growth.
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Affiliation(s)
- G. Failla
- Universidade Federal Fluminense, Brazil
| | | | | | - L.C. Nunes
- Universidade Federal do Espírito Santo, Brazil
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Fiorelli A, D’Andrilli A, Anile M, Cascone R, Occhiati L, Diso D, Cassiano F, Poggi C, Ibrahim M, Cusumano G, Terminella A, Failla G, La Sala A, Bezzi M, Innocenti M, Torricelli E, Venuta F, Rendina EA, Santini M, Andreetti C. F-075THE COST/BENEFIT OF UNIDIRECTIONAL ENDOBRONCHIAL VALVES IMPLANT FOR MANAGEMENT OF PERSISTENT AIR-LEAKS: RESULTS OF A MULTICENTRE STUDY. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Liew A, Failla G, Molinari G, Prior M, Zalunardo B, Pergolini D, Knavs K, Kozak M, Cortelazzo A, Van Dreden P, Elalamy I, Catalano M, Gerotziafas GT. Thrombin Generation Profile in Patients With Steady State Peripheral Arterial Disease. Clin Appl Thromb Hemost 2017; 24:193-194. [PMID: 28854808 DOI: 10.1177/1076029617699086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Aaron Liew
- 1 VAS Vascular-Independent Research and Education-European Organization- www.vas-int.net.,2 National University of Ireland Galway (NUIG), Portiuncula University Hospital and Galway University Hospital, Saolta University Health Care Group, Galway, Ireland.,3 Newcastle University, Newcastle, United Kingdom
| | - Giacomo Failla
- 1 VAS Vascular-Independent Research and Education-European Organization- www.vas-int.net.,4 U.O.C. di Angiologia A.O.U. "Policlinico Vittorio Emanuele," Catania, Italy
| | - Giulia Molinari
- 1 VAS Vascular-Independent Research and Education-European Organization- www.vas-int.net.,5 Struttura Semplice di Angiologia, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Perugia, Perugia, Italy
| | - Manlio Prior
- 1 VAS Vascular-Independent Research and Education-European Organization- www.vas-int.net.,6 U.O.C. di Angiologia, AOUI di Verona Sezione di Angiologia, Università degli Studi di Verona, Verona, Italy
| | - Beniamino Zalunardo
- 1 VAS Vascular-Independent Research and Education-European Organization- www.vas-int.net.,7 U.O.C. Angiologia, Ospedale Castelfranco Veneto, Azienda ULSS 8-Regione Veneto, Castelfranco Veneto, Italy
| | - Daniela Pergolini
- 1 VAS Vascular-Independent Research and Education-European Organization- www.vas-int.net.,8 U.O.C. Angiologia, Dipartimento Cardioscienze, Azienda Ospedaliera San Camillo-Forlanini, Roma, Italy
| | - Katja Knavs
- 1 VAS Vascular-Independent Research and Education-European Organization- www.vas-int.net.,9 Department of Intensive Care, University Clinical Center Ljubljana, Ljubljana, Slovenia
| | - Matija Kozak
- 1 VAS Vascular-Independent Research and Education-European Organization- www.vas-int.net.,9 Department of Intensive Care, University Clinical Center Ljubljana, Ljubljana, Slovenia
| | - Adriano Cortelazzo
- 1 VAS Vascular-Independent Research and Education-European Organization- www.vas-int.net.,10 Research Center on Vascular Diseases and Angiology Unit, University of Milan, L. Sacco Hospital, Milan, Italy
| | - Patrick Van Dreden
- 1 VAS Vascular-Independent Research and Education-European Organization- www.vas-int.net.,11 Clinical Research Department, Diagnostica Stago, Gennevilliers, France
| | - Ismail Elalamy
- 1 VAS Vascular-Independent Research and Education-European Organization- www.vas-int.net.,12 Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine, Institut National de la Santé et de la Recherche Médicale (INSERM) U938 and Université Pierre et Marie Curie (UPMC), Sorbonne Universities, Paris, France.,13 Service d'Hématologie Biologique, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique Hôpitaux de, Paris, France
| | - Mariella Catalano
- 1 VAS Vascular-Independent Research and Education-European Organization- www.vas-int.net.,10 Research Center on Vascular Diseases and Angiology Unit, University of Milan, L. Sacco Hospital, Milan, Italy
| | - Grigoris T Gerotziafas
- 1 VAS Vascular-Independent Research and Education-European Organization- www.vas-int.net.,12 Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine, Institut National de la Santé et de la Recherche Médicale (INSERM) U938 and Université Pierre et Marie Curie (UPMC), Sorbonne Universities, Paris, France.,13 Service d'Hématologie Biologique, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique Hôpitaux de, Paris, France
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Mille M, Lee C, Failla G. SU-F-T-111: Investigation of the Attila Deterministic Solver as a Supplement to Monte Carlo for Calculating Out-Of-Field Radiotherapy Dose. Med Phys 2016. [DOI: 10.1118/1.4956247] [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: 11/07/2022] Open
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Apollonio A, Antignani PL, Di Salvo M, Failla G, Guarnera G, Mosti G, Ricci E. A large Italian observational multicentre study on vascular ulcers of the lower limbs (Studio Ulcere Vascolari). Int Wound J 2016; 13:27-34. [PMID: 24618175 PMCID: PMC7949669 DOI: 10.1111/iwj.12216] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 10/18/2013] [Revised: 12/15/2013] [Accepted: 12/19/2013] [Indexed: 11/28/2022] Open
Abstract
An observational study of 2 years was promoted by the Italian Association for Cutaneous Ulcers (AIUC) in order to monitor the epidemiology of leg ulcers, the trend of healing and the more frequent therapeutic approaches in lower limb ulcers. Fifty-nine sites in 14 different Italian regions involved in the study, with 1333 enrolled patients (1163 patients fully evaluated and followed up for 9 months). A prevalence of females (62%) was observed with a mean age of 70 years and a high rate of hypertension (62%), diabetes (38%) and obesity (29%). Venous ulcer was most frequent (55%), followed by mixed (25%) and diabetic (8·3%) ulcers. Basically, all patients received a local therapy (LT) (compression and advanced local therapies), while 63% of patients have an associated systemic pharmaceutical treatment. Ulcer healing rates progressively increased throughout the study and despite the type of observational study does not allow conclusions on the treatment, it was observed that the patients receiving additional systemic drugs were associated with a more rapid acceleration of healing rates of ulcers compared to LT alone (3 months: 39·7% versus 29·2%; 6 months: 62·0% versus 47·0%; 9 months: 74·7% versus 63·8%). In particular, the Studio Ulcere Vascolari (SUV) study showed that a combination treatment with sulodexide and compression therapy allows for a greater increase in the healing rates in venous ulcers.
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Fiorelli A, D'Andrilli A, Poggi C, Diso D, Anile M, Polverino M, Failla G, Venuta F, Rendina E, Santini M. O-018SEQUENTIAL BILATERAL BRONCHOSCOPIC LUNG VOLUME REDUCTION WITH ONE-WAY VALVES FOR HETEROGENEOUS EMPHYSEMA. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Carling ER, Binks W, Bugnard L, Failla G, Holthusen H, Jacobsen JC, Jaeger RG, Mayneord VW, Morgan KZ, Sievert RM, Stone RS, Taylor LS. Repoet on Amendments Dueing 1956 to the Recommendations of the International Commission on Radiological Protection. Acta Radiol 2013. [DOI: 10.1177/028418515704800614] [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: 11/16/2022]
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Castrogiovanni P, Scuderi R, Travali S, Failla A, Failla G, Imbesi R. Paracrine activity of heparin-binding EGF-like growth factor in atherogenesis: an immunohistochemical study. Minerva Med 2013; 104:85-91. [PMID: 23392541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM Cells involved in atherogenesis produce growth factors crucial for the progression of the atherosclerotic lesions. One of them is the heparin-binding EGF-like growth factor (HB-EGF), a member of the epidermal growth factor (EGF) family, synthesized as a transmembrane precursor (proHB-EGF). This anchored insoluble juxtacrine growth factor can be converted into a soluble molecule with paracrine activity and mature HB-EGF is released in the extracellular matrix from the cell surface. HB-EGF is a potent stimulator of cell proliferation, migration and cell motility and several studies show that HB-EGF is associated with pathologies of hyperplasia of smooth muscle cells including atherosclerosis. METHODS We localized HB-EGF by immunohistochemistry within the atherosclerotic lesions collected from right or left internal carotid artery of 20 patients with evident clinical symptoms. RESULTS In the 20 samples we tested, the proportion of positive samples was significant. Considering the only positive samples the proportion difference related to the gender of patients was highly significant. CONCLUSION The aim of our investigation was to better understand if this growth factor exerts its role through a juxtacrine or paracrine mechanism, or both in the process of atherogenesis. According to the results, the paracrine role of HB-EGF was clear.
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Affiliation(s)
- P Castrogiovanni
- Department of Bio-Medical Science, University of Catania, Catania, Italy.
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Antignani PL, Benedetti-Valentini F, Aluigi L, Baroncelli TA, Camporese G, Failla G, Martinelli O, Palasciano GC, Pulli R, Rispoli P, Amato A, Amitrano M, Dorigo W, Gossetti B, Irace L, Laurito A, Magnoni F, Minucci S, Pedrini L, Righi D, Verlato F. Diagnosis of vascular diseases. Ultrasound investigations--guidelines. INT ANGIOL 2012; 31:1-77. [PMID: 23470846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Palmucci S, Mauro LA, Veroux P, Failla G, Milone P, Ettorre GC, Sinagra N, Giuffrida G, Zerbo D, Veroux M. Magnetic resonance with diffusion-weighted imaging in the evaluation of transplanted kidneys: preliminary findings. Transplant Proc 2011; 43:960-6. [PMID: 21620026 DOI: 10.1016/j.transproceed.2011.01.157] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The aim of this study was to compare values of apparent diffusion coefficient (ADC) and diffusion (D) with renal function indexes, in a population of kidney transplant recipients who underwent magnetic resonance with diffusion-weighted imaging (DWI) of the transplanted graft. MATERIALS AND METHODS We studied 21 patients using a 1.5-Tesla magnetic resonance; DWI sequences were acquired with several b-values. Patients were divided into 3 groups by their creatinine clearance values: group A, clearance >60 mL/min; group B, clearance >30 and ≤60 mL/min; and group C, clearance ≤30 mL/min. ADCs values between groups were compared using the Mann-Whitney U test. Receiver operating characteristic (ROC) curves were created for prediction of normal renal function (group A) and renal failure (group C). RESULTS Comparing mean values of ADC between groups A and C, we observed a difference (P=0.0012), with higher values in group A. Regarding mean values of D, we observed a difference between groups A and C (P=0.022). In the comparison between contiguous groups, we observed no difference for ADC and D values. In the prediction of normal clearance values (group A), ROC curve showed an area under curve (AUC) of 0.861, with a sensitivity of 88.89% and specificity of 75% using a threshold ADC value ≥2.1 × 10(-3) mm(2)/sec. For prediction of normal clearance values (group A), ROC curve showed an AUC of 0.787, with a sensitivity of 77.8% and specificity of 83.3% using a threshold D value ≥2.3 × 10(-3) mm(2)/sec. CONCLUSION Although studies with a larger number of patients are needed, DWI represents a promising tool for noninvasive assessment of renal function. An ADC ≥ 2.1 × 10(-3) mm(2)/sec and a D ≥ 2.3 × 10(-3) mm(2)/sec may be used as a threshold for predicting normal clearance.
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Affiliation(s)
- S Palmucci
- Section of Radiological Sciences, Maternal-Child and Radiological Sciences Department, University Hospital Policlinico-Vittorio Emanuele, Catania, Italy.
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Patti F, Ventimiglia B, Failla G, Genazzani AA, Reggio A. Micturition disorders in multiple sclerosis patients: neurological, neurourodynamic and magnetic resonance findings. Eur J Neurol 2011. [DOI: 10.1111/j.1468-1331.1997.tb00345.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lionetti E, Pavone P, Kennerknecht I, Failla G, Schepis C, De Pasquale R, Pavone L, Ruggieri M. Neurological manifestations in individuals with pure cutaneous or syndromic (Ruggieri-Happle syndrome) phenotypes with "cutis tricolor": a study of 14 cases. Neuropediatrics 2010; 41:60-5. [PMID: 20799151 DOI: 10.1055/s-0030-1261919] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The term cutis tricolor describes the combination of congenital hyper- and hypo-pigmented skin lesions in close proximity to each other in a background of normal complexion. This phenomenon has been reported so far: (i) as pure cutaneous trait, (ii) as a part of a complex malformation syndrome (Ruggieri-Happle syndrome--RHS), (iii) as a distinct type (cutis tricolor parvimaculata); (iv) in association with other (e. g., vascular) skin disturbances. AIM The aim of this study was to define the spectrum of neurological abnormalities in cutis tricolor. METHODS A retrospective and prospective 14-year study of clinical, electroencephalographic (EEG), neuroradiological (MRI), cytogenetic and ZFHX1B gene studies of 14 individuals (8 M, 6 F; aged 2-28 years) with cutis tricolor (4 pure cutaneous; 10 syndromic) was undertaken. RESULTS Neurological involvement was recorded in 71.4% (10/14) of the patients [100% (10/10) in RHS and null (0/4) in cases with isolated skin manifestations] and included psychomotor delay (n=8), seizures (n=9), EEG abnormalities (n=6), a behavioural phenotype (n=4), non-specific brain abnormalities (n=6). Genetic analyses excluded ZFHX1B mutations and revealed a 19qter deletion (n=1). CONCLUSIONS Even though we could not exclude the ascertainment and referral biases, we concluded that cutis tricolor may be a marker of underlying neurological involvement particularly in subjects with a syndromic (RHS) phenotype.
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Affiliation(s)
- E Lionetti
- Department of Paediatrics, University of Catania, Catania, Italy
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Abstract
It has been estimated that 92 per cent of the total radiation emitted by radium in equilibrium with its subsequent products is given off in the form of α-rays. This, however, cannot be utilized when the source is enclosed in an ordinary container, because the α-rays are absorbed completely by even a small thickness of glass. About 3.2 per cent of the total radiation is emitted in the form of β-rays, and 4.8 per cent as gamma radiation. The effects produced on the radiated mice of these experiments were due mainly to the β-rays, which are easily absorbed by tissue. The γ-rays, being only slightly absorbed by organic matter, probably contributed very little to the observed effects. It is interesting to correlate the different effects produced by the same dose of radiation. The mice which received a dose of 1.9 millicurie hours showed no local effects on the skin or hair. Neither females nor males were sterilized, and the time at which they opened their eyes or reached sexual maturity was not affected, as far as we could tell. The only difference noted between the radiated animals and the controls was in the body weight. This dose accelerated the growth of the young mice, that is, while initially of the same weight, soon after irradiation they became distinctly bigger than the controls, but finally the animals of each group had substantially the same average weight. That this variation in body weight should be accidental is unlikely, since it was observed also in the animals treated by a slightly larger dose (2.4 millicurie hours). The number of animals (seven) which showed this effect is too small to prove conclusively the accelerating effect of small doses of radiation on the body growth of mice. But considering that similar results have been. obtained by radiating plants and beetles, it is reasonable that the observed increase in weight might be attributed, at least in part, to the effects of radiation. Since this paper was first written Russ, Chambers, and Scott have shown that small doses of x-rays accelerate the body growth of rats. In view of this additional evidence there can be little doubt that the increase in weight observed in our experiments was due to the radiation. A dose of 2.4 millicurie hours applied over the backs of the animals produced no local skin effects, but it accelerated the growth of the mice as in the previous case. In addition it caused permanent sterilization of all the females. A similar result was obtained with 4.9 millicurie hours, except that the effect on the rate of growth was uncertain. A dose of 6.8 millicurie hours produced a definite but mild skin erythema and retarded the development of lanugo hair. But since in this instance the emanation was applied over the heads of the animals, the dose reaching the ovaries was not sufficient to cause sterilization, as already explained. No other definite effect was noted. In connection with the sterilization of the females it should be noted that a dose of radiation which produced no visible skin changes was sufficient to cause permanent sterility. On account of the greater distance of the ovaries from the source of radiation as compared with that of the skin directly below the tube, and the depth of tissue which the rays had to traverse to reach the ovaries, the amount of radiation acting on the latter was much smaller than the amount falling on the skin. The radiation emitted by the emanation tube is reduced to about 50 per cent of its initial value after traversing 1 mm. of tissue. Still, while the skin was not visibly affected, the mice were sterilized. This shows that the ovaries are influenced very easily by radiation of this type. We can estimate the amount of radiation reaching the ovaries which is sufficient to cause sterility to be less than 25 per cent of the amount necessary to produce visible skin changes in the mice. It should be noted also that whenever sterility of the female mice was induced, it was permanent. Furthermore, those mice which were not rendered sterile by radiation were, as far as the experiments enable us to say, as prolific as the controls. Remembering that a dose of 1.9 millicurie hours had no apparent effect on the ovaries, while a slightly larger dose, 2.4 millicurie hours, caused permanent sterility, it might be concluded that it is not possible to produce temporary sterility by radiation. We know, however, that temporary sterility can be produced, at least when the animals are radiated at a later stage in their development. The mice in our experiments were radiated for the first time soon after birth, and it is not improbable that under these conditions temporary sterility cannot be obtained. Large sublethal doses produced severe skin burns, retarded the body growth of the animals, but failed to sterilize the males. About one-third of the total skin area of the mice showed marked effects from the radiation. The animals were very sick for a time, and their growth was temporarily stunted. But nevertheless they recovered and finally became apparently normal except for the narrow hairless strip of skin which had been closest to the emanation tube. Only the females were rendered permanently sterile. The males did not show even temporary sterility when the doses of radiation were close to the lethal dose. While the testes of mammals are known to be very easily affected by radiation, still they are more resistant than the ovaries. In addition, in these experiments they were at a greater distance from the source of radiation than the ovaries, and they were better protected by the thicker layer of tissue in the path of the rays. The fact that no sublethal dose in these experiments sterilized the males shows that under the conditions of irradiation adopted the amount of radiation reaching the testes was not sufficient to affect them noticeably. If the source of radiation had been applied closer to the reproductive organs of the males, they would have been sterilized by millicurie hour doses much smaller than the lethal dose. Some of the radiated animals were killed with ether, and macroscopic and microscopic examinations of the reproductive organs were made. The ovaries of the sterile females were generally atrophied and colored yellow. The normal histological structure was altered. The characteristic findings were the destruction of the Graafian follicles, with absence of ovum cells. The testes and the epididymis of the radiated mice of the present experiment appeared macroscopically and histologically normal, with the presence of abundant spermatozoa. Owing to the method adopted for the irradiation of the mice, the testes were too far from the source of radiation, and too well protected by the intervening tissue to be definitely affected by the rays.
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Affiliation(s)
- K Sugiura
- Harriman Research Laboratory, The Roosevelt Hospital, and Memorial Hospital, New York
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Vassiliev O, Wareing T, McGhee J, Failla G, Salehpour M, Mourtada F. SU-EE-A2-02: Validation of a Grid-Based Boltzmann Solver for 6 and 18 MV Photon Beams Impinging On a Heterogeneous Phantom. Med Phys 2009. [DOI: 10.1118/1.3181100] [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: 11/07/2022] Open
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Scuderi R, Travali S, Castrogiovanni P, Imbesi RM, Mazzone V, Failla G, Failla A. [Immunolocalization of HB-EGF in human atherosclerotic plaques]. Clin Ter 2009; 160:435-439. [PMID: 20198283] [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: 05/28/2023]
Abstract
AIMS Heparin-binding epidermal growth factor is a member of the EGF family, it is a potent mitogen for smooth muscle cells and has been implicated in atherosclerosis, angiogenesis. In athererogenesis, HB-EGF has been detected in medial smooth cells and foamy macrofages. In this work, we have investigate about immunohistocemical localization of HB-EGF in atherosclerotic plaques. MATERIALS AND METHODS Three cases of man affected by atherosclerosis have been examined. We have collected and examined atherosclerotic plaques by immunohistochemical procedure in optical microscopy. Samples have been incubated with primary Ac (anti-human HB-EGF- goat IgG). RESULTS In the three examined cases, results are partly overlap-ping, but with some difference in relation to location of positivity to HB-EGF. Only in one case, HB-EGF staining is rather weak and located just below endothelium where is a thickened area of tissue rich in fibres and few cells, In another case, positivity to HB-EGF is present in an area of connective tissue of the intima. In the last case, positivity to HB-EGF is evident in the context of a presumed elastic tissue with fusiform cells following fibres orientation, and that could be fibroblasts or smooth muscle cells. CONCLUSIONS These results indicate that HB-EGF is involved in the development of atherosclerotic plaques and that HB-EGF is a possible target for atherosclerosis therapy.
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Affiliation(s)
- R Scuderi
- Dipartimento di Medicina Interna e Patologie Sistemiche Policlinico, Università di Catania, Italia.
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36
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Failla G, Campo S, Ardita G, Finocchiaro P, Mugno F, Attanasio L, Di Salvo M. Proteases and chronic leg ulcers. Minerva Cardioangiol 2008; 56:409-415. [PMID: 18614985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
AIM The aim of this study was to compare the effect of cadexomer on reducing wound surface area of leg ulcers compared to that obtained in a group patients whose ulcers were treated by compression therapy. METHODS For each ulcer group, wound surface area was calculated at day 0 and after 28 days of treatment: this allowed to calculate the average wound surface area reduction, the percent reduction in wound size, as well as the weekly wound size reduction index. RESULTS In the cadexomer-treated ulcers the total wound area reduction was 9.67 cm(2)/week, with a weekly wound size reduction index per patient of 0.96 cm(2); in the controls (compression therapy-treated patients) the total wound area reduction was 6.11 cm(2)/week, with a weekly reduction index per patient of 0.61 cm(2). At the end of treatment, in the group of patients whose ulcers were treated with cadexomer ointment the average wound size reduction was 43%, whereas in the control-treated patient group the average wound size reduction was 28%. CONCLUSION These data suggest that cadexomer can play an important role in the healing of chronic leg ulcers.
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Affiliation(s)
- G Failla
- Department of Angiology, Vittorio Emanuele Ferrarotto, S. Bambino Hospital, Catania, Italy.
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37
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Wareing T, Vassiliev O, Failla G, Davis I, McGhee J, Barnett D, Horton J, Mourtada F. TU-EE-A1-01: Validation of a Prototype Deterministic Solver for Photon Beam Dose Calculations On Acquired CT Data in the Presence of Narrow Beams and Heterogeneities. Med Phys 2007. [DOI: 10.1118/1.2761416] [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: 11/07/2022] Open
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38
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Wareing T, Failla G, Vassiliev O, Barnett A, McGhee J, Titt U, Horton J, Mourtada F. TH-E-224C-02: Performance Assessment of a Deterministic Method Incorporating Coupled Photon-Electron Transport for Photon Beam Dose Calculations On Acquired CT Data. Med Phys 2006. [DOI: 10.1118/1.2241957] [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: 11/07/2022] Open
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39
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Gifford K, Price M, Failla G, Wareing T, Horton J, Mourtada F. WE-C-224C-09: Calculation of the Dose Distribution Around a High Dose-Rate 192Ir Brachytherapy Source Via a Multi-Group Discrete Ordinates Method. Med Phys 2006. [DOI: 10.1118/1.2241732] [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: 11/07/2022] Open
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40
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Gifford K, Horton J, Failla G, Barnett D, McGhee J, Wareing T, Eifel P, Mourtada F. SU-FF-T-02: Comparison of a 3D Multi-Group Sn Particle Transport Code with Monte Carlo for Intracavitary Brachytherapy of the Cervix Uteri. Med Phys 2005. [DOI: 10.1118/1.1997673] [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: 11/07/2022] Open
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41
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Palmeri S, Leonardi V, Tamburo De Bella M, Morabito A, Vaglica M, Accurso V, Ferraù F, Failla G, Agostara B, Massidda B, Valenza R, Fanelli M, Gasparini G. Doxorubicin-docetaxel sequential schedule: results of front-line treatment in advanced breast cancer. Oncology 2002; 63:205-12. [PMID: 12381898 DOI: 10.1159/000065466] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE We conducted a multi-institutional phase II study to evaluate the tolerability and activity of a sequential schedule of treatment with doxorubicin and docetaxel in chemotherapy-naive women with advanced breast cancer. METHODS A total of 73 patients with PS (ECOG) 0-2, aged <70 years and adequate bone marrow, renal, liver and cardiac functions were included in the study (13 stage III B and 60 stage IV). The schedule of administration was doxorubicin 50 mg/m2 by intravenous (i.v.) 30 min injection on day 1 followed the day after by docetaxel 75 mg/m2, by i.v. 60 min infusion. Cycles were repeated every 28 days. RESULTS Overall, the median number of administered cycles was 6 (range 1-14). The most common toxicity was hematological, with 56.2% of the patients who experienced grade 3-4 neutropenia. However, febrile neutropenia occurred only in 2.8% of the cases. The median cumulative dose of doxorubicin was 350 mg/m2 (range 50-700 mg/m2). Eleven patients (15.4%) were documented to have >10% but <20% decrease in the left ventricular ejection fraction. No case of congestive heart failure was recorded. No patient experienced treatment-related death. Among the 68 evaluable patients, the overall objective response rate was 73.5% (95% confidence limits: 63-84%): 10 patients (14.7%) obtained a complete remission and 40 (58.8%) had a partial response. Only 10 patients (14.7%) experienced progressive disease. The median duration of response was 10 months (2-54+). CONCLUSION This sequential treatment with doxorubicin and docetaxel is an effective, feasible and a well-tolerated regimen. The main toxicity was neutropenia. The lack of cardiotoxicity is an important advantage of such a doxorubicin-docetaxel combination and it justifies phase III comparative studies with other anthracyclines/taxanes containing schedules in both advanced and early-stage breast cancer.
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Affiliation(s)
- S Palmeri
- Istituto di Clinica Medica, Cattedra di Oncologia Medica, Università di Palermo, Italy
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42
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Scagliotti GV, De Marinis F, Rinaldi M, Crinò L, Gridelli C, Ricci S, Matano E, Boni C, Marangolo M, Failla G, Altavilla G, Adamo V, Ceribelli A, Clerici M, Di Costanzo F, Frontini L, Tonato M. Phase III randomized trial comparing three platinum-based doublets in advanced non-small-cell lung cancer. J Clin Oncol 2002; 20:4285-91. [PMID: 12409326 DOI: 10.1200/jco.2002.02.068] [Citation(s) in RCA: 729] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate whether two commonly used newer platinum-based regimens offer any advantage over vinorelbine-cisplatin (reference regimen) in response rate for patients with advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Chemotherapy-naive patients were randomized to receive gemcitabine 1,250 mg/m(2) days 1 and 8 plus cisplatin 75 mg/m(2) day 2 every 21 days (GC arm), or paclitaxel 225 mg/m(2) (3-hour infusion) then carboplatin (area under the concentration-time curve of 6 mg/mL x min), both on day 1 every 21 days (PCb arm), or vinorelbine 25 mg/m(2)/wk for 12 weeks then every other week plus cisplatin 100 mg/m(2) day 1 every 28 days (VC arm). RESULTS Six hundred twelve patients were randomized to treatment (205 GC, 204 PCb, and 203 VC). Overall response rates for the GC (30%) and PCb (32%) arms were not significantly different from that of the VC arm (30%). There were no differences in overall survival, time to disease progression, or time to treatment failure. Median survival for the GC, PCb, and VC groups was 9.8, 9.9, and 9.5 months, respectively. Neutropenia was significantly higher on the VC arm (GC 17% or PCb 35% v VC 43% of cycles, P <.001), as was thrombocytopenia on the GC arm (GC 16% v VC 0.1% of cycles, P <.001). Alopecia and peripheral neurotoxicity were most common on the PCb arm, as was nausea/vomiting on the VC arm (P <.05). CONCLUSION Efficacy end points were not significantly different between experimental and reference arms, although toxicities showed differences. These findings suggest that chemotherapy in NSCLC has reached a therapeutic plateau.
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Affiliation(s)
- G V Scagliotti
- Department of Clinical and Biological Sciences, University of Torino, Turin.
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43
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Giuffrida D, Lavenia G, Aiello RA, Di Blasi C, Gambera G, Pappalardo A, Petralia G, Ursino M, Failla G. [Anaplastic carcinoma of the thyroid: diagnosis and treatment]. Clin Ter 2001; 152:255-61. [PMID: 11725619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Anaplastic thyroid carcinoma (ATC), accounting for 5% to 15% of primary malignant thyroid neoplasm, is one of the most aggressive solid tumors in humans. It is rapidly fatal, with a mean survival of 6 months after diagnosis. Multimodality treatment with surgery and/or external beam radiotherapy and chemotherapy are of fundamental importance for local control of disease and to enhance survival. Molecular biology studies have shown that ATC is associated with a p 53 mutation. ATC usually does not concentrate radioiodine or express thyroglobulin. It is essential to verify the diagnosis histologically because insular thyroid cancer, lymphomas, and medullary thyroid cancer are occasionally confused with undifferentiated neoplasms. Immunohistochemical study is helpful in establishing the diagnosis. Multimodal therapy and development of effective systemic chemotherapy agents would provide to result in improvements in survival although no single agent has yet been identified. Aggressive multimodality treatment regimens show promise in improving local control in patients with ATC. Survival rates however remain low. Despite intense applications of such integrated therapy, no standardized successful treatment protocol has yet been established.
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Affiliation(s)
- D Giuffrida
- Divisione di Oncologia Medica, Ospedale S. Luigi, Azienda Ospedaliera Garibaldi-S. Luigi- Currò- Ascoli-Tomaselli, Viale Fleming 24, 95100 Catania., Italia.
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Sichel L, Chiavetta A, Soma PF, Failla G, Basile A, La Greca G, Scalisi A. [Critical ischemia of the diabetic patient]. MINERVA CHIR 2001; 56:265-71. [PMID: 11423793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND Critical ischemia of the lower limbs is the final result of diabetic arteriopathy. The surgeon is more and more forced to choose between amputation d emblée and the attempt to revascularization in very old patients and in deficient general conditions. Shall we point out some principle to address our strategy? METHODS To answer this question we reviewed retrospectively our surgical choices and the results obtained during two years, from January 1997 to December 1998 (medium follow-up 11.3 months), at the Emergency Division of the Cannizzaro Hospital of Catania. In this period 143 diabetic patients were selected by our ambulatory. Of these, nineteen had a critical lower limb ischemia and therefore were submitted to a revascularization and/or amputation. All the revascularized patients were controlled by Doppler-sonography immediately after operation and then daily, till their discharge. Controls were done at the first, third, sixth month and after one year, except for patients who complained a new objective or subjective ischemic symptomatology. RESULTS The primary patency rate was 84.2% and the secondary patency rate was 89.4%. The amputation rate due to the procedure failure was 5%. The complications were three: two graft infections (10.5%) and one early thrombosis of a femoro-popliteal bypass graft, due to technical defect (5.2%). Perioperative mortality rate was 15.7%. CONCLUSIONS These results, if related with those reported in the letterature about amputations, are in favour of the attempt to revascularization.
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Affiliation(s)
- L Sichel
- Dipartimento d Emergenza, Divisione Clinicizzata di Chirurgia d Urgenza e Pronto Soccorso, Cattedra di Patologia Chirurgica C.O.Azienda Ospedaliera, Cannizzaro, Catania, Italy
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45
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Tralongo P, Di Mari A, Moruzzi G, Conti G, Aiello R, Risicato R, Ferrau F, Scifo G, Failla G. CMF hepatic toxicity can be reduced by SAMe (S-adenosyl-L-methionine) administration. Eur J Cancer 2001. [DOI: 10.1016/s0959-8049(01)81818-9] [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: 10/26/2022]
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46
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Giuffrida D, Attard M, Marasà L, Ferraù F, Marletta F, Restuccia N, Gambino L, Janni F, Failla G. Thyroid carcinosarcoma, a rare and aggressive histotype: a case report. Ann Oncol 2000; 11:1497-9. [PMID: 11142492 DOI: 10.1023/a:1026538410510] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Thyroid carcinosarcoma is a rare and aggressive thyroid tumor. Histological examination of a tumor showed the characteristic of epithelial carcinoma and mesenchymal differentiation. We retrospectively analyzed the course of the patient and reviewed the literature in which only 19 other cases are described. Carcinosarcoma of the thyroid is a very aggressive tumor with a clinical course similar to anaplastic thyroid carcinoma. Survival is very short despite aggressive multimodal treatment.
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Affiliation(s)
- D Giuffrida
- Department of Oncology, Ospedale S. Luigi-S. Currò, Catania, Italy.
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Nicoletti A, Reggio A, Bartoloni A, Failla G, Bartalesi F, Roselli M, Gamboa H, Salazar E, Paradisi F, Tempera G, Hall A. A neuroepidemiological survey in rural Bolivia: background and methods. Neuroepidemiology 2000; 17:273-80. [PMID: 9705587 DOI: 10.1159/000026180] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A door-to-door survey was carried out in rural areas of the Cordillera province, Santa Cruz Department, Bolivia. A cluster sample of 10,124 inhabitants was selected. The aim was to determine the prevalence of the most common neurological diseases (epilepsy, stroke, parkinsonism and peripheral neuropathy) in this population using a modification of the World Health Organization screening instrument. 1,130 subjects screened positive and were then investigated by neurologists. In this paper we describe the background and methods of the survey and the characteristics of the population.
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Affiliation(s)
- A Nicoletti
- Institute of Neurological Science, University of Catania, Italy.
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Giuffrida D, Ferraù F, Bordonaro R, Mattina M, Priolo D, Aiello RA, Cordio S, Motta S, Failla G. [Medullary carcinoma of the thyroid: diagnosis and therapy]. Clin Ter 2000; 151:29-35. [PMID: 10822879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Medullary thyroid carcinoma (MTC) originates in the thyroid C cells, or parafollicular cells, secreting calcitonin. It may be either sporadic or familial. Familial form can be isolated or expression of a multiple endocrine neoplasia type II. Mutations of the RET proto-oncogene have been identified in the germline DNA of patients with familial MTC syndromes. Genetic testing can identify patients affected by multiple endocrine neoplasia and familial MTC, allowing early diagnosis and possible cure. The initial treatment is surgical and the adequate surgery consists of total thyroidectomy. The treatment of occult or minimal disease can be curative. Plasma calcitonin measurements are excellent markers for post-operative follow-up. Imaging study can help to discover recurrent or metastatic disease. Adjunctive therapy includes radiotherapy and chemotherapy. Radiotherapy is reserved for bone metastases or for non resectable neck recurrences. Chemotherapy is reserved for patients with progressive MTC. Many chemotherapeutic regimens have been tried, results are controversial.
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Affiliation(s)
- D Giuffrida
- Divisione di Oncologia Medica, Ospedale San Luigi, Azienda Ospedaliera Garibaldi, Catania, Italia
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Nicoletti A, Reggio A, Bartoloni A, Failla G, Sofia V, Bartalesi F, Roselli M, Gamboa H, Salazar E, Osinaga R, Paradisi F, Tempera G, Dumas M, Hall AJ. Prevalence of epilepsy in rural Bolivia: a door-to-door survey. Neurology 1999; 53:2064-9. [PMID: 10599782 DOI: 10.1212/wnl.53.9.2064] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To carry out a door-to-door survey in rural areas of the Cordillera Province, Santa Cruz Department, Bolivia, to determine the prevalence of neurologic diseases (epilepsy, stroke, parkinsonism, and peripheral neuropathy) in a sample of approximately 10,000 inhabitants. METHODS A team of nondoctor health workers administered a standard screening instrument for neurologic diseases-a slightly modified version of the World Health Organization protocol. All subjects found positive during the screening underwent a neurologic examination. RESULTS On screening, the authors found 1,130 positive subjects, of whom 1,027 were then investigated by neurologists. On the basis of the definition proposed by the International League Against Epilepsy, we detected 124 epileptic patients (prevalence, 12.3/1,000), 112 of whom had active epilepsy (prevalence, 11.1/1,000) on the prevalence day (November 1, 1994). Peak age-specific prevalence occurred in the 15 to 24-year age group (20.4/1,000). Sex-specific prevalence was higher in women (13.1/1,000) than men (11.4/1,000). Eighty-nine patients (71.8%) underwent a standard EEG recording. Considering both EEG and clinical data, partial seizures were the most common type (53.2%) based on the classification of the International League Against Epilepsy. The mean age at onset was 20.7 years for partial seizures and 13.6 years for generalized seizures. Only 10.5% of patients had received specific treatment for more than 2 months of their life. CONCLUSION This report on epilepsy prevalence in Bolivia confirms that epilepsy is a major health problem in rural areas of developing countries.
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Affiliation(s)
- A Nicoletti
- Institutes of Neurological Science, University of Catania, Italy
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