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Dalmonte S, Golinelli P, Oberhofer N, Strocchi S, Rossetti V, Berta L, Porzio M, Angelini L, Paruccini N, Villa R, Bertolini M, Delle Canne S, Cavallari M, D'Ercole L, Guerra G, Rosasco R, Cannillo B, D'Alessio A, Di Nicola E, Origgi D, De Marco P, Maldera A, Scabbio C, Rottoli F, Castriconi R, Lorenzini E, Pasquali G, Pietrobon F, Bregant P, Giovannini G, Favuzza V, Bruschi A, D'Urso D, Maestri D, De Novellis S, Fracassi A, Boschiroli L, Quattrocchi M, Gilio MA, Roberto E, Altabella L, Califano G, Cimmino MC, Bortoli E, Deiana E, Pagan L, Berardi P, Ardu V, Azzeroni R, Campoleoni M, Ravaglia V. Typical values of z-resolution for different Digital Breast Tomosynthesis systems evaluated in a multicenter study. Phys Med 2024; 119:103300. [PMID: 38325222 DOI: 10.1016/j.ejmp.2024.103300] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/07/2023] [Accepted: 01/23/2024] [Indexed: 02/09/2024] Open
Abstract
PURPOSE The aim of the present study, conducted by a working group of the Italian Association of Medical Physics (AIFM), was to define typical z-resolution values for different digital breast tomosynthesis (DBT) models to be used as a reference for quality control (QC). Currently, there are no typical values published in internationally agreed QC protocols. METHODS To characterize the z-resolution of the DBT models, the full width at half maximum (FWHM) of the artifact spread function (ASF), a technical parameter that quantifies the signal intensity of a detail along reconstructed planes, was analyzed. Five different commercial phantoms, CIRS Model 011, CIRS Model 015, Modular DBT phantom, Pixmam 3-D, and Tomophan, were evaluated on reconstructed DBT images and 82 DBT systems (6 vendors, 9 models) in use at 39 centers in Italy were involved. RESULTS The ASF was found to be dependent on the detail size, the DBT angular acquisition range, the reconstruction algorithm and applied image processing. In particular, a progressively greater signal spread was observed as the detail size increased and the acquisition angle decreased. However, a clear correlation between signal spread and angular range width was not observed due to the different signal reconstruction and image processing strategies implemented in the algorithms developed by the vendors studied. CONCLUSIONS The analysis led to the identification of typical z-resolution values for different DBT model-phantom configurations that could be used as a reference during a QC program.
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Affiliation(s)
- S Dalmonte
- Medical Physics Specialization School, University of Bologna, Bologna, Italy; Medical Physics Unit, AUSL Romagna, Ravenna, Italy.
| | - P Golinelli
- Medical Physics Unit, Azienda USL Modena, Modena, Italy
| | | | - S Strocchi
- Medical Physics Unit, ASST dei Sette Laghi, Varese, Italy
| | - V Rossetti
- Medical Physics Unit, Città della salute e della scienza, Torino, Italy
| | - L Berta
- Medical Physics Unit, Città della salute e della scienza, Torino, Italy
| | - M Porzio
- Medical Physics Unit, ASL CN1, Cuneo, Italy
| | - L Angelini
- Medical Physics Unit, AUSL Romagna, Ravenna, Italy
| | - N Paruccini
- Medical Physics Unit, ASST Monza, Monza, Italy
| | - R Villa
- Medical Physics Unit, ASST Monza, Monza, Italy
| | - M Bertolini
- Medical Physics Unit, Azienda AUSL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - S Delle Canne
- Medical Physics Unit, Fatebenefratelli Isola Tiberina-Gemelli Isola, Roma, Italy
| | - M Cavallari
- Medical Physics Unit, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - L D'Ercole
- Medical Physics Unit, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - G Guerra
- Medical Physics Unit, Studio Associato Fisici Sanitari, Lugo, Italy
| | - R Rosasco
- Medical Physics Unit, ASL3 Sistema Sanitario Regione Liguria, Genova, Italy
| | - B Cannillo
- Medical Physics Unit, AOU Maggiore della Carità, Novara, Italy
| | - A D'Alessio
- Medical Physics Unit, AOU Maggiore della Carità, Novara, Italy
| | - E Di Nicola
- Medical Physics Unit, ASUR Marche Area Vasta3, Macerata, Italy
| | - D Origgi
- Medical Physics Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - P De Marco
- Medical Physics Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - A Maldera
- Medical Physics Unit, P.O. Dimiccoli - ASL BT, Barletta, Italy
| | - C Scabbio
- Medical Physics Unit, ASST Santi Paolo e Carlo - Presidio San Paolo, Milano, Italy
| | - F Rottoli
- Medical Physics Unit, ASST Santi Paolo e Carlo - Presidio San Paolo, Milano, Italy
| | - R Castriconi
- Medical Physics Unit, IRCCS Ospedale San Raffaele - Gruppo San Donato, Milano, Italy
| | - E Lorenzini
- Medical Physics Unit, Ospedale Civico di Carrara, Carrara, Italy
| | - G Pasquali
- Medical Physics Unit, ASST Bergamo Ovest, Treviglio, Italy
| | - F Pietrobon
- Medical Physics Unit, Ospedale di Belluno, Belluno, Italy
| | - P Bregant
- Medical Physics Unit, Ospedale Cattinara, Trieste, Italy
| | - G Giovannini
- Medical Physics Unit, ASL2 Ospedale Santa Corona, Pietra Ligure, Italy
| | - V Favuzza
- Medical Physics Unit, USL Toscana Centro, Empoli, Italy
| | - A Bruschi
- Medical Physics Unit, USL Toscana Centro, Empoli, Italy
| | - D D'Urso
- Medical Physics Unit, ULSS 2 Marca Trevigiana, Treviso, Italy
| | - D Maestri
- Medical Physics Unit, ULSS 2 Marca Trevigiana, Treviso, Italy
| | | | - A Fracassi
- Medical Physics Unit, ASL Pescara, Pescara, Italy
| | - L Boschiroli
- Medical Physics Unit, ASST Nord Milano, Milano, Italy
| | - M Quattrocchi
- Medical Physics Unit, Azienda Toscana Nord Ovest, Lucca, Italy
| | - M A Gilio
- Medical Physics Unit, Azienda Toscana Nord Ovest, Lucca, Italy
| | - E Roberto
- Medical Physics Unit, ASL CN2 Cuneo, Italy
| | - L Altabella
- Medical Physics Unit, AOUI VR, Verona, Italy
| | - G Califano
- Medical Physics Unit, AOR San Carlo Potenza, Potenza, Italy
| | - M C Cimmino
- Medical Physics Unit, USL Toscana sud est, Siena, Italy
| | - E Bortoli
- Medical Physics Unit, USL Toscana sud est, Grosseto, Italy
| | - E Deiana
- Medical Physics Unit, ASL Cagliari, Cagliari, Italy
| | - L Pagan
- Medical Physics Unit, Azienda USL Bologna, Bologna, Italy
| | - P Berardi
- Medical Physics Unit, Azienda USL Bologna, Bologna, Italy
| | - V Ardu
- Medical Physics Unit, Fondazione IRCCS Ca' Granda, Milano, Italy
| | - R Azzeroni
- Medical Physics Unit, Fondazione IRCCS Ca' Granda, Milano, Italy
| | - M Campoleoni
- Medical Physics Unit, Fondazione IRCCS Ca' Granda, Milano, Italy
| | - V Ravaglia
- Medical Physics Unit, AUSL Romagna, Ravenna, Italy
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Bruno F, Mo F, Meletti S, Belcastro V, Quadri S, Napolitano M, Bello L, Dainese F, Scarpelli M, Florindo I, Mascia A, Pauletto G, Pellerino A, Giovannini G, Polosa M, Sessa M, Conti Nibali M, Di Gennaro G, Gigli G, Cavallieri F, Pisanello A, Rudà R. OS02.6.A Lacosamide in monotherapy in brain tumour-related epilepsy (BTRE): results from an Italian multicentre retrospective study. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.034] [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
Lacosamide (LCM) is a third-generation anti-seizure medication (ASM) approved for focal onset epilepsy in patients aged ≥4 years. Previous studies have reported an efficacy of LCM as add-on treatment in brain tumour-related epilepsy (BTRE). To date, there are no studies in the literature focusing on lacosamide used in monotherapy to treat BTRE. In our retrospective study we investigated efficacy and tolerability of LCM in monotherapy in a multicentre national cohort of primary brain tumour patients.
Patients and Methods
Adult patients who were treated with LCM in monotherapy were collected from 12 Italian Centres (either mainly involved in neuro-oncology or in epileptology). Main inclusion criteria were diagnosis of primary brain tumour; at least two focal-onset seizures in the disease course; LCM used either as primary or secondary monotherapy after withdrawal of previous ASMs. For each patient, we evaluated seizure freedom at 3 and 6 months (primary endpoints), side effects and drop-out rate (secondary endpoints).
Results
We collected 132 patients. The majority of patients had a diagnosis of diffuse gliomas, being those with lower-grade glioma 66 (50.0%) and those with glioblastoma 33 (25.0%). Overall, LCM led to seizure-freedom in 64.4% of patients at 3 months and 55% at 6 months. Patients who used two or more ASMs before LCM had a worse seizure control than patients in monotherapy with LCM as first choice.In 14 patients, we observed seizure control despite tumour progression on magnetic resonance (MRI). Multivariate analysis showed that gross-total resection at diagnosis and use of steroids were significantly associated with higher seizure freedom rate at 6 months. Side effects were mainly mild (grade 1-2 according to the CTCAE classification), and the drop-out rate was low (1.5%). The main side effects were dizziness and somnolence.
Conclusion
This is the first study on the role of LCM in monotherapy in BTRE. The study has shown a good efficacy and tolerability of LCM with more than a half of patients becoming seizure-free at 6 months and with a very low rate of drop-out. Further studies are needed to confirm these preliminary data in a prospective manner, adding quality of life and neurocognitive functions as endpoints.
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Affiliation(s)
- F Bruno
- University and City of Health and Science, Turin, Italy , Turin , Italy
| | - F Mo
- University and City of Health and Science, Turin, Italy , Turin , Italy
| | - S Meletti
- Division of Neurology, Modena University Hospital, Modena, Italy , Modena , Italy
- Center for Neuroscience and Neurotechnology, Department of Biomedical, Metabolic and Neural Sciences; University of Modena and Reggio Emilia, Italy , Modena and Reggio Emilia , Italy
| | - V Belcastro
- Division of Neurology, Maggiore Hospital, Lodi, Italy , Lodi , Italy
| | - S Quadri
- Division of Neurology, ASST Papa Giovanni XXIII of Bergamo, Italy , Bergamo , Italy
| | - M Napolitano
- Division of Neurology and Stroke Unit, Hospital A. Cardarelli, Napoli, Italy , Naples , Italy
| | - L Bello
- Division of Neurosurgical Oncology, Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Italy , Milan , Italy
| | - F Dainese
- Epilepsy Centre, Division of Neurology, Hospital of Venezia, Italy , Venice , Italy
| | - M Scarpelli
- Division of Neurology, Department of Neuroscience, AOUI Verona, Verona, Italy , Verona , Italy
| | - I Florindo
- Division of Neurology, Hospital of Parma, Italy , Parma , Italy
| | - A Mascia
- IRCCS Neuromed, Pozzilli, Italy , Pozzilli , Italy
| | - G Pauletto
- Neurology Unit, Department of Neuroscience, “S. Maria della Misericordia” University Hospital, Udine, Italy , Udine , Italy
| | - A Pellerino
- University and City of Health and Science, Turin, Italy , Turin , Italy
| | - G Giovannini
- Division of Neurology, Modena University Hospital, Modena, Italy , Modena , Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy , Modena and Reggio Emilia , Italy
| | - M Polosa
- Division of Neurosurgery, ASST Lariana, Como, Italy , Como , Italy
| | - M Sessa
- Division of Neurology, ASST Papa Giovanni XXIII of Bergamo, Italy , Bergamo , Italy
| | - M Conti Nibali
- Division of Neurosurgical Oncology, Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Italy , Milan , Italy
| | - G Di Gennaro
- IRCCS Neuromed, Pozzilli, Italy , Pozzilli , Italy
| | - G Gigli
- Department of Medicine (DAME), University of Udine, Udine, Italy , Udine , Italy
- Clinical Neurology Unit, “S. Maria della Misericordia” University Hospital, Udine, Italy , Udine , Italy
| | - F Cavallieri
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy , Modena and Reggio Emilia , Italy
- Neurology Unit, Neuromotor & Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy , Reggio Emilia , Italy
| | - A Pisanello
- Neurology Unit, Neuromotor & Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy , Reggio Emilia , Italy
| | - R Rudà
- University and City of Health and Science, Turin, Italy , Turin , Italy
- Dept. of Neurology, Castelfranco and Treviso Hospitals, Italy , Treviso , Italy
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3
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Mo F, Meletti S, Belcastro V, Quadri S, Napolitano M, Bello L, Dainese F, Scarpelli M, Florindo I, Mascia A, Pauletto G, Bruno F, Pellerino A, Giovannini G, Polosa M, Sessa M, Conti Nibali M, Di Gennaro G, Gigli GL, Pisanello A, Cavallieri F, Rudà R. Lacosamide in monotherapy in BTRE (brain tumor-related epilepsy): results from an Italian multicenter retrospective study. J Neurooncol 2022; 157:551-559. [DOI: 10.1007/s11060-022-03998-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/24/2022] [Indexed: 10/18/2022]
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Giovannini G, Barra S, Levrero F, Cavagnetto F, Meroni S, Pignoli E, Diletto B. Implementation of cranio-spinal irradiation in VMAT for pediatric medulloblastoma. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00341-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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De Pascalis G, Morbelli S, Levrero F, Giovannini G, Di Palermo R, Bauckneht M, Ippoliti M, Bagnara M. Day hospital radioiodine remnant ablation: our experience. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00258-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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6
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Belli G, Coniglio A, Bettarini S, Tortoli P, Fedeli L, Giannelli M, Mazzoni L, Nocetti L, Sghedoni R, Tarducci R, Belligotti E, Canzi C, Chiappiniello A, Cimolai S, Giovannini G, Lizio D, Marzi S, Mascaro L, Mazzocchi S, Meliadò G, Morzenti S, Niespolo A, Noferini L, Oberhofer N, Origgi D, Paruccini N, Quattrocchi M, Savini A, Solla I, Taddeucci A, Busoni S. Multicentre comparison of MR scanners (15T, 3T) for MR T1-T2 relaxometry. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00490-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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7
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Vaudano AE, Mirandola L, Talami F, Giovannini G, Monti G, Riguzzi P, Volpi L, Michelucci R, Bisulli F, Pasini E, Tinuper P, Di Vito L, Gessaroli G, Malagoli M, Pavesi G, Cardinale F, Tassi L, Lemieux L, Meletti S. fMRI-Based Effective Connectivity in Surgical Remediable Epilepsies: A Pilot Study. Brain Topogr 2021; 34:632-650. [PMID: 34152513 DOI: 10.1007/s10548-021-00857-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 06/13/2021] [Indexed: 11/24/2022]
Abstract
Simultaneous EEG-fMRI can contribute to identify the epileptogenic zone (EZ) in focal epilepsies. However, fMRI maps related to Interictal Epileptiform Discharges (IED) commonly show multiple regions of signal change rather than focal ones. Dynamic causal modeling (DCM) can estimate effective connectivity, i.e. the causal effects exerted by one brain region over another, based on fMRI data. Here, we employed DCM on fMRI data in 10 focal epilepsy patients with multiple IED-related regions of BOLD signal change, to test whether this approach can help the localization process of EZ. For each subject, a family of competing deterministic, plausible DCM models were constructed using IED as autonomous input at each node, one at time. The DCM findings were compared to the presurgical evaluation results and classified as: "Concordant" if the node identified by DCM matches the presumed focus, "Discordant" if the node is distant from the presumed focus, or "Inconclusive" (no statistically significant result). Furthermore, patients who subsequently underwent intracranial EEG recordings or surgery were considered as having an independent validation of DCM results. The effective connectivity focus identified using DCM was Concordant in 7 patients, Discordant in two cases and Inconclusive in one. In four of the 6 patients operated, the DCM findings were validated. Notably, the two Discordant and Invalidated results were found in patients with poor surgical outcome. Our findings provide preliminary evidence to support the applicability of DCM on fMRI data to investigate the epileptic networks in focal epilepsy and, particularly, to identify the EZ in complex cases.
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Affiliation(s)
- A E Vaudano
- Neurology Unit, OCB Hospital, Azienda Ospedaliero-Universitaria of Modena, Via Giardini 1355, 41100, Modena, Italy. .,Center for Neuroscience and Neurotechnology, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
| | - L Mirandola
- Center for Neuroscience and Neurotechnology, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - F Talami
- Center for Neuroscience and Neurotechnology, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - G Giovannini
- Neurology Unit, OCB Hospital, Azienda Ospedaliero-Universitaria of Modena, Via Giardini 1355, 41100, Modena, Italy.,Center for Neuroscience and Neurotechnology, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - G Monti
- Neurology Unit, AUSL Modena, Ospedale Ramazzini, Carpi, MO, Italy
| | - P Riguzzi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Unit of Neurology, Bellaria Hospital, Bologna, Italy
| | - L Volpi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Unit of Neurology, Bellaria Hospital, Bologna, Italy
| | - R Michelucci
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Unit of Neurology, Bellaria Hospital, Bologna, Italy
| | - F Bisulli
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Epilepsy Center (Reference Center for Rare and Complex Epilepsies - EpiCARE), Bologna, Italy
| | - E Pasini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Unit of Neurology, Bellaria Hospital, Bologna, Italy
| | - P Tinuper
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Epilepsy Center (Reference Center for Rare and Complex Epilepsies - EpiCARE), Bologna, Italy
| | - L Di Vito
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Epilepsy Center (Reference Center for Rare and Complex Epilepsies - EpiCARE), Bologna, Italy
| | - G Gessaroli
- Neurology Unit, OCB Hospital, Azienda Ospedaliero-Universitaria of Modena, Via Giardini 1355, 41100, Modena, Italy
| | - M Malagoli
- Neuroradiology Unit, OCB Hospital, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - G Pavesi
- Center for Neuroscience and Neurotechnology, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Neurosurgery Unit, OCB Hospital, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - F Cardinale
- "Claudio Munari" Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy
| | - L Tassi
- "Claudio Munari" Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy
| | - L Lemieux
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - S Meletti
- Neurology Unit, OCB Hospital, Azienda Ospedaliero-Universitaria of Modena, Via Giardini 1355, 41100, Modena, Italy.,Center for Neuroscience and Neurotechnology, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Giovannini G, Turchi G, Mazzoli M, Vaudano AE, Meletti S. New onset status epilepticus in influenza associated encephalopathy: The presenting manifestation of genetic generalized epilepsy. Epilepsy Behav Rep 2021; 16:100413. [PMID: 33598653 PMCID: PMC7868800 DOI: 10.1016/j.ebr.2020.100413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/01/2020] [Accepted: 11/08/2020] [Indexed: 10/24/2022] Open
Abstract
We hereby present a case of a young woman with no history of seizures or epilepsy who experienced a de novo generalized Non Convulsive Status Epilepticus (NCSE) followed by encephalopathy lasting for several days during influenza B infection. Influenza can have a broad spectrum of presentation ranging from an uncomplicated illness to many serious conditions as is the case of influenza associated encephalitis/encephalopathy (IAE). In this context however, it is possible to observe seizures and/or status epilepticus as the presenting manifestation of a genetic generalized epilepsy.
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Affiliation(s)
- G Giovannini
- Neurology Unit, OCB Hospital, Azienda Ospedaliero-Universitaria, Modena, Italy.,PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - G Turchi
- Neurology Unit, OCB Hospital, Azienda Ospedaliero-Universitaria, Modena, Italy
| | - M Mazzoli
- Neurology Unit, OCB Hospital, Azienda Ospedaliero-Universitaria, Modena, Italy.,Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - A E Vaudano
- Neurology Unit, OCB Hospital, Azienda Ospedaliero-Universitaria, Modena, Italy
| | - S Meletti
- Neurology Unit, OCB Hospital, Azienda Ospedaliero-Universitaria, Modena, Italy.,Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
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Ramírez JM, Varela-Montes L, Gómez-Costa D, Giovannini G, Romero-Maroto M, Gómez de Diego R. Management of odonto-stomatological emergencies during the COVID-19 alarm state in dental clinics in the Autonomous Community of Madrid (CAM), Spain: An observational study. Med Oral Patol Oral Cir Bucal 2021; 26:e114-e117. [PMID: 33037804 PMCID: PMC7806342 DOI: 10.4317/medoral.24075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 06/09/2020] [Accepted: 09/10/2020] [Indexed: 11/24/2022] Open
Abstract
Background Odontology practice has been severely compromised by the pandemic caused by COVID-19 and Spain is one of the countries with higher incidence. Our aim with this study is to find out the number of cases and type of odonto-stomatological emergencies (OSE) treated in four dental clinics of the Madrid capital area and region (CAM) in the period covered between March 17th and 4th of May.
Material and Methods We search the cases in the demographic/epidemiological databases of the CAM regional government and the Illustrious Official College of Dentists and Stomatologists of the First Region (Madrid).
Results We found that the most prevalent pathology was acute apical periodontitis whereas odontogenic abscess showed the lowest frequency. Prosthetic-orthodontic OSE represented 14% of cases.
Conclusions In this period of time, the most prevalent pathology acute apical periodontitis, odontogenic abscess reported the lowest frequency and prosthetic-orthodontic treatments were the third in number of cases. Most of OSE were resolved, without referring the patient to a hospital emergency department. Key words:Odonto-stomatological emergencies, COVID-19, Spain.
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Affiliation(s)
- J-M Ramírez
- Oral Surgery at the School of Dentistry Universidad Rey Juan Carlos Avda. de Atenas s/n 28922 Alcorcón-Madrid, Spain
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Manuali E, Morgante RA, Maresca C, Leonardi L, Purificato I, Giaimo MD, Giovannini G. A web-based tumor registration system for a regional Canine Cancer Registry in Umbria, central Italy. Ann Ist Super Sanita 2020; 55:357-362. [PMID: 31850863 DOI: 10.4415/ann_19_04_09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The Umbria Canine Cancer Registry (CCR) is a web-based platform for cancer registration set up in order to estimate the incidence of spontaneous tumors. It is an integral part of the regional canine demographic registry in which veterinary practitioners and pathologists interact. Veterinary pathologists perform double-blind comparisons and classify neoplasms in an automated classification process using the WHO criteria for canine neoplasms and the ICD-O tumor topographical and morphological keys. Here we describe the organization, on-line procedures and the methods used to assess canine demography, a pre-requisite for accurately estimating the incidence of cancer. In its first 4 years the CCR recruited 4857 cases of suspected tumors, as diagnosed by practitioners, clinics and a veterinary hospital. After the first year the number of enrolled cases increased by 63%, suggesting growing interest from the regional veterinary community.
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Affiliation(s)
- Elisabetta Manuali
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche "Togo Rosati", Perugia, Italy
| | | | - Carmen Maresca
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche "Togo Rosati", Perugia, Italy
| | - Leonardo Leonardi
- Dipartimento di Medicina Veterinaria, Università degli Studi di Perugia, Perugia, Italy
| | - Ivana Purificato
- Dipartimento Sanità Pubblica Veterinaria e Sicurezza Alimentare,Istituto Superiore di Sanità, Rome, Italy
| | - Maria Donata Giaimo
- Prevenzione, Sanità Veterinaria e Sicurezza Alimentare, Regione Umbria, Perugia, Italy
| | - Gianni Giovannini
- Prevenzione, Sanità Veterinaria e Sicurezza Alimentare, Regione Umbria, Perugia, Italy
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Abraha I, Montedori A, Giovannini G, Cozzolino F, Orso M, De Giorgi M, Franchini D, Di Renzo GC, Angelozzi P, Micheli M, Germani A, Carloni D, Scaccetti A, Palmieri G, Casali M, Nenz CMG, Gargano E, Pazzaglia M, Agea E, Moscetti C, Berchicci L, Tesoro S, Albi N, Epicoco G, Marchesi M. [Postpartum haemorrhage in Umbria: accuracy of the regional health information system for the code ICD-9-CM 666.x.]. Recenti Prog Med 2019; 110:420-425. [PMID: 31593178 DOI: 10.1701/3215.31935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Postpartum haemorrhage (PPH) is the main cause of morbidity and mortality for pregnant women. Administrative databases are useful sources of information for the assessment of PPH and related outcomes, once the corresponding ICD-9-CM code is validated. The objective of the present study is to evaluate the accuracy of the ICD-9-CM code related to PPH. MATERIAL AND METHODS Source of the data was the Regional Healthcare Database of the Umbria Region. The population of interest were women with at least 20 weeks of gestation that delivered in any hospital in the Umbria Region during 2012-2016. Cases of interest were identified using the ICD-9-CM 666.x code. For validation purposes, both cases (women who delivered and developed PPH) and non-cases (women who delivered without occurrence of PPH) were considered and algorithms proposed. The basic criterion used for the validity of ICD-9-CM codes was the presence of bleeding ≥500 ml. Additional criteria based on values of haemoglobin or transfusion of red blood cells were considered. Sensitivity, specificity and predictive values were calculated. RESULTS Medical charts of 422 cases and 200 non-cases were examined. Accuracy results for code 666.x related to the presence of bleeding ≥500 ml were: sensitivity 97% (95% CI, 96-99%), specificity 70% (65-76%), positive predictive value (PPV) 79% (76-82%) and negative predictive value (NPV) 95% (91-97%). The best algorithm was the one that, in addition to the basic criterion, considered both the haemoglobin values and red blood cell transfusion: sensitivity 93% (90-95%), specificity 85% (80-90%), PPV 92% (89-94%) and NPV 86% (81-90%). ICD-9 subcodes showed a higher specificity and PPV for immediate bleeding (666.0, 666.1) than delayed or secondary haemorrhage (666.2). CONCLUSIONS The accuracy data from the present study confirm that the Regional Healthcare Database of the Umbria Region can be used as a reliable source for the evaluation of epidemiological studies relating to PPHs, in order to improve the quality of maternity care.
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Affiliation(s)
- Iosief Abraha
- Centro Regionale Sangue, Servizio Immunotrasfusionale, Azienda Ospedaliera di Perugia, Perugia - Direzione Regionale Salute, Regione Umbria, Perugia
| | | | | | - Francesco Cozzolino
- Direzione Regionale Salute, Regione Umbria, Perugia - Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche "Togo Rosati", Perugia
| | - Massimiliano Orso
- Direzione Regionale Salute, Regione Umbria, Perugia - Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche "Togo Rosati", Perugia
| | | | | | | | | | | | | | | | | | | | - Marta Casali
- Anestesia e Rianimazione, Azienda Ospedaliera di Terni
| | | | | | | | | | | | | | | | - Nicola Albi
- Centro Regionale Sangue, Servizio Immunotrasfusionale, Azienda Ospedaliera di Perugia, Perugia
| | | | - Mauro Marchesi
- Centro Regionale Sangue, Servizio Immunotrasfusionale, Azienda Ospedaliera di Perugia, Perugia
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12
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Abraha I, Montedori A, Giovannini G, Cozzolino F, Orso M, De Giorgi M, Franchini D, Di Renzo GC, Angelozzi P, Micheli M, Germani A, Carloni D, Scaccetti A, Palmieri G, Casali M, Nenz CMG, Gargano E, Pazzaglia M, Agea E, Moscetti C, Berchicci L, Tesoro S, Albi N, Epicoco G, Marchesi M. [Epidemiology of postpartum hemorrhages in the Umbrian population in the years 2006-2017.]. Recenti Prog Med 2019; 110:412-419. [PMID: 31593177 DOI: 10.1701/3215.31934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Postpartum haemorrhage (PPH) is one of the main causes of mortality and severe maternal morbidity and its incidence is increasing also in Western countries. Aim of this study is to estimate the incidence and the trend of PPH in the Umbrian population using the validated Umbrian health database and to identify possible determinants for the development of PPH. METHODS The source of the data was the regional Healthcare Database of the Umbria Region. The population of interest was represented by women who gave birth in Umbria between 2006 and 2017. The PPH was identified from the hospital data using the ICD-9-CM 666.x codes. Demographic data, principal and secondary diagnoses and data on maternal morbidity and blood component transfusion were collected. The incidence of PPH was calculated taking into account cases of PPH over the total number of births. The determinants of PPH, the associated morbidity and the variation in the severity of the PPH over time have been identified by logistic regression models. RESULTS In Umbria, between 2006 and 2017, 93,403 births were registered (69% by vaginal delivery and 31% by caesarean section) and the rate of caesarean sections decreased by about 4%. The incidence of PPH increased three-fold during this period with an increase (p<0.001) of women with PPH who received transfusions. Regarding the caesarean sections, the PPH trend increased by 53% (p=0.3), while in the vaginal deliveries the PPHs increased by 233% (p<0.001). Logistic regression analysis showed that possible risk factors for the occurrence of PPH are maternal morbidity (OR 22.8, 95% CI 18.5-30.0), twin birth (OR 2.0, 95% CI 1.3-3.2) and antepartum haemorrhage (OR 5.7, 95% CI 3.1-10.4). CONCLUSIONS The incidence of PPH has increased in recent years, while the morbidity associated with PPH has remained substantially unchanged. The study identified several risk factors responsible for PPH that can be used in the monitoring of pregnant women and for planning prevention strategies such as Patient Blood Management.
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Affiliation(s)
- Iosief Abraha
- Centro Regionale Sangue, Servizio Immunotrasfusionale, Azienda Ospedaliera di Perugia, Perugia - Direzione Regionale Salute, Regione Umbria, Perugia
| | | | | | - Francesco Cozzolino
- Direzione Regionale Salute, Regione Umbria, Perugia - Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche "Togo Rosati", Perugia
| | - Massimiliano Orso
- Direzione Regionale Salute, Regione Umbria, Perugia - Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche "Togo Rosati", Perugia
| | | | | | | | | | | | | | | | | | | | - Marta Casali
- Anestesia e Rianimazione, Azienda Ospedaliera di Terni
| | | | | | | | | | | | | | | | - Nicola Albi
- Centro Regionale Sangue, Servizio Immunotrasfusionale, Azienda Ospedaliera di Perugia, Perugia
| | | | - Mauro Marchesi
- Centro Regionale Sangue, Servizio Immunotrasfusionale, Azienda Ospedaliera di Perugia, Perugia
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13
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Govoni F, Orrù E, Bonafede A, Iacobelli M, Paladino R, Vazza F, Murgia M, Vacca V, Giovannini G, Feretti L, Loi F, Bernardi G, Ferrari C, Pizzo RF, Gheller C, Manti S, Brüggen M, Brunetti G, Cassano R, de Gasperin F, Enßlin TA, Hoeft M, Horellou C, Junklewitz H, Röttgering HJA, Scaife AMM, Shimwell TW, van Weeren RJ, Wise M. A radio ridge connecting two galaxy clusters in a filament of the cosmic web. Science 2019; 364:981-984. [DOI: 10.1126/science.aat7500] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 05/13/2019] [Indexed: 11/02/2022]
Abstract
Galaxy clusters are the most massive gravitationally bound structures in the Universe. They grow by accreting smaller structures in a merging process that produces shocks and turbulence in the intracluster gas. We observed a ridge of radio emission connecting the merging galaxy clusters Abell 0399 and Abell 0401 with the Low-Frequency Array (LOFAR) telescope network at 140 megahertz. This emission requires a population of relativistic electrons and a magnetic field located in a filament between the two galaxy clusters. We performed simulations to show that a volume-filling distribution of weak shocks may reaccelerate a preexisting population of relativistic particles, producing emission at radio wavelengths that illuminates the magnetic ridge.
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Sbarciog M, Giovannini G, Chamy R, Wouwer AV. Control and estimation of anaerobic digestion processes using hydrogen and volatile fatty acids measurements. Water Sci Technol 2018; 78:2027-2035. [PMID: 30629530 DOI: 10.2166/wst.2018.465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The anaerobic digestion (AD) technology is widely used in the treatment of waste and wastewater. To ensure the treatment efficiency and to increase the production of biogas, which can be reused as a renewable energy source, a good understanding of the process and tight control are needed. This paper presents an estimation and control scheme, which can be successfully used in the operation of the AD process. The process is simulated by the ADM1 model, the most complex and detailed model developed so far to characterize AD. The controller and the observer, which provides estimates of the unmeasurable variables needed in the computation of the control law, are designed based on a simplified model developed in a previous work. Since it has been shown that hydrogen concentration is an accurate and fast indicator of process stability, it was chosen as controlled variable. Aside from the hydrogen concentration, the only measurement employed by the proposed control structure is the volatile fatty acids concentration. Simulation results prove the effectiveness of the proposed control structure.
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Affiliation(s)
- M Sbarciog
- UMONS, Automatic Control Laboratory, 31 Boulevard Dolez, 7000 Mons, Belgium E-mail:
| | - G Giovannini
- UMONS, Automatic Control Laboratory, 31 Boulevard Dolez, 7000 Mons, Belgium E-mail: ; Escuela de Ingeniería Bioquímica, Pontificia Universidad Católica de Valparaíso, Av. Brasil 2085, Valparaíso, Chile
| | - R Chamy
- Escuela de Ingeniería Bioquímica, Pontificia Universidad Católica de Valparaíso, Av. Brasil 2085, Valparaíso, Chile
| | - A Vande Wouwer
- UMONS, Automatic Control Laboratory, 31 Boulevard Dolez, 7000 Mons, Belgium E-mail:
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Abraha I, Montedori A, Di Renzo GC, Angelozzi P, Micheli M, Carloni D, Germani A, Palmieri G, Casali M, Nenz CMG, Gargano E, Pazzaglia M, Berchicci L, Tesoro S, Epicoco G, Giovannini G, Marchesi M. Diagnostic, preventive and therapeutic evidence in obstetrics for the implementation of patient blood management: a systematic review protocol. BMJ Open 2018; 8:e021322. [PMID: 30327399 PMCID: PMC6196839 DOI: 10.1136/bmjopen-2017-021322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Patientblood management (PBM) is defined as the application of evidence-based diagnostic, preventive and therapeutic approaches designed to maintain haemoglobin concentration, optimise haemostasis and minimise blood loss in an effort to improve patient outcome. We propose a protocol for the assessment of the evidence of diagnostic, preventive and therapeutic approaches for the management of relevant outcomes in obstetrics with the aim to create a framework for PBM implementation. METHODS AND ANALYSIS Diagnostic, preventive and therapeutic tools will be considered in the gynaecological conditions and obstetrics setting (antenatal care, peripartum care and maternity care). For each condition, (1) clinical questions based on prioritised outcomes will be developed; (2) evidence will be retrieved systematically from electronic medical literature (MEDLINE, EMBASE, the Cochrane Library, Web of Science, and CINAHL); (3) quality of the reviews will be assessed using the AMSTAR (A Measurement Tool to Assess Systematic Reviews) checklist; quality of primary intervention studies will be assessed using the risk of bias tool (Cochrane method); quality of diagnostic primary studies will be assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies); (4) the Grading of Recommendations Assessment, Development and Evaluation method will be applied to rate the quality of the evidence and to develop recommendations. ETHICS AND DISSEMINATION For each diagnostic, preventive or therapeutic intervention evaluated, a manuscript comprising the evidence retrieved and the recommendation produced will be provided and published in peer-reviewed journals. Ethical approval is not required.
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Affiliation(s)
- Iosief Abraha
- Centro Regionale Sangue, Servizio Immunotrasfusionale, Azienda Ospedaliera di Perugia, Perugia, Italy
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | | | - Gian Carlo Di Renzo
- Clinica Ostetrica e Ginecologica, Policlinico, Università di Perugia, Perugia, Italy
| | | | - Marta Micheli
- Servizio Immunotrasfusionale, USL Umbria 2, Foligno, Italy
| | | | | | - Gianluca Palmieri
- Servizio Immunotrasfusionale, Azienda Ospedaliera Santa Maria di Terni, Terni, Italy
| | - Marta Casali
- Anestesia e Rianimazione, Azienda Ospedaliera Santa Maria di Terni, Terni, Italy
| | | | | | | | | | - Simonetta Tesoro
- Anestesia e Rianimazione, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Giorgio Epicoco
- Ginecologia e Ostetricia, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Gianni Giovannini
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Mauro Marchesi
- Centro Regionale Sangue, Servizio Immunotrasfusionale, Azienda Ospedaliera di Perugia, Perugia, Italy
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Abraha I, Serraino D, Montedori A, Fusco M, Giovannini G, Casucci P, Cozzolino F, Orso M, Granata A, De Giorgi M, Collarile P, Chiari R, Foglietta J, Vitale MF, Stracci F, Orlandi W, Bidoli E. Sensitivity and specificity of breast cancer ICD-9-CM codes in three Italian administrative healthcare databases: a diagnostic accuracy study. BMJ Open 2018; 8:e020627. [PMID: 30037866 PMCID: PMC6059298 DOI: 10.1136/bmjopen-2017-020627] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 04/25/2018] [Accepted: 05/14/2018] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES To assess the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in identifying patients diagnosed with incident carcinoma in situ and invasive breast cancer in three Italian administrative databases. DESIGN A diagnostic accuracy study comparing ICD-9-CM codes for carcinoma in situ (233.0) and for invasive breast cancer (174.x) with medical chart (as a reference standard). Case definition: (1) presence of a primary nodular lesion in the breast and (2) cytological or histological documentation of cancer from a primary or metastatic site. SETTING Administrative databases from Umbria Region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) and Friuli VeneziaGiulia (FVG) Region. PARTICIPANTS Women with breast carcinoma in situ (n=246) or invasive breast cancer (n=384) diagnosed (in primary position) between 2012 and 2014. OUTCOME MEASURES Sensitivity and specificity for codes 233.0 and 174.x. RESULTS For invasive breast cancer the sensitivities were 98% (95% CI 93% to 99%) for Umbria, 96% (95% CI 91% to 99%) for NA and 100% (95% CI 97% to 100%) for FVG. Specificities were 90% (95% CI 82% to 95%) for Umbria, 91% (95% CI 83% to 96%) for NA and 91% (95% CI 84% to 96%) for FVG.For carcinoma in situ the sensitivities were 100% (95% CI 93% to 100%) for Umbria, 100% (95% CI 95% to 100%) for NA and 100% (95% CI 96% to 100%) for FVG. Specificities were 98% (95% CI 93% to 100%) for Umbria, 86% (95% CI 78% to 92%) for NA and 90% (95% CI 82% to 95%) for FVG. CONCLUSIONS Administrative healthcare databases from Umbria, NA and FVG are accurate in identifying hospitalised news cases of carcinoma of the breast. The proposed case definition is a powerful tool to perform research on large populations of newly diagnosed patients with breast cancer.
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Affiliation(s)
- Iosief Abraha
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
- Innovation and Development, Agenzia Nazionale per i Servizi Sanitari Regionali (Age.Na.S.), Rome, Italy
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico Aviano, Aviano, Italy
| | | | - Mario Fusco
- Registro Tumori Regione Campania, ASL Napoli 3 Sud, Brusciano, Italy
| | - Gianni Giovannini
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Paola Casucci
- Health ICT Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Francesco Cozzolino
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Massimiliano Orso
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Annalisa Granata
- Health ICT Service, Regional Health Authority of Umbria, Perugia, Italy
| | | | - Paolo Collarile
- SOC Epidemiologia Oncologica, Centro di Riferimento Oncologico Aviano, Aviano, Italy
| | - Rita Chiari
- Dipartimento di Oncologia, Azienda Ospedaliera Perugia, Perugia, Italy
| | | | | | | | - Walter Orlandi
- Direzione Sanità, Regional Health Authority of Umbria, Perugia, Italy
| | - Ettore Bidoli
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico Aviano, Aviano, Italy
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Abraha I, Montedori A, Serraino D, Orso M, Giovannini G, Scotti V, Granata A, Cozzolino F, Fusco M, Bidoli E. Accuracy of administrative databases in detecting primary breast cancer diagnoses: a systematic review. BMJ Open 2018; 8:e019264. [PMID: 30037859 PMCID: PMC6059263 DOI: 10.1136/bmjopen-2017-019264] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To define the accuracy of administrative datasets to identify primary diagnoses of breast cancer based on the International Classification of Diseases (ICD) 9th or 10th revision codes. DESIGN Systematic review. DATA SOURCES MEDLINE, EMBASE, Web of Science and the Cochrane Library (April 2017). ELIGIBILITY CRITERIA The inclusion criteria were: (a) the presence of a reference standard; (b) the presence of at least one accuracy test measure (eg, sensitivity) and (c) the use of an administrative database. DATA EXTRACTION Eligible studies were selected and data extracted independently by two reviewers; quality was assessed using the Standards for Reporting of Diagnostic accuracy criteria. DATA ANALYSIS Extracted data were synthesised using a narrative approach. RESULTS From 2929 records screened 21 studies were included (data collection period between 1977 and 2011). Eighteen studies evaluated ICD-9 codes (11 of which assessed both invasive breast cancer (code 174.x) and carcinoma in situ (ICD-9 233.0)); three studies evaluated invasive breast cancer-related ICD-10 codes. All studies except one considered incident cases.The initial algorithm results were: sensitivity ≥80% in 11 of 17 studies (range 57%-99%); positive predictive value was ≥83% in 14 of 19 studies (range 15%-98%) and specificity ≥98% in 8 studies. The combination of the breast cancer diagnosis with surgical procedures, chemoradiation or radiation therapy, outpatient data or physician claim may enhance the accuracy of the algorithms in some but not all circumstances. Accuracy for breast cancer based on outpatient or physician's data only or breast cancer diagnosis in secondary position diagnosis resulted low. CONCLUSION Based on the retrieved evidence, administrative databases can be employed to identify primary breast cancer. The best algorithm suggested is ICD-9 or ICD-10 codes located in primary position. TRIAL REGISTRATION NUMBER CRD42015026881.
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Affiliation(s)
- Iosief Abraha
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
- Innovation and Development, Agenzia Nazionale per i Servizi Sanitari Regionali (Age.Na.S.), Rome, Italy
| | | | - Diego Serraino
- Cancer Epidemiology Unit, IRCCS Centro di Riferimento Oncologico Aviano, Aviano, Italy
| | - Massimiliano Orso
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
- Innovation and Development, Agenzia Nazionale per i Servizi Sanitari Regionali (Age.Na.S.), Rome, Italy
| | - Gianni Giovannini
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Valeria Scotti
- Center for Scientific Documentation, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
| | - Annalisa Granata
- Registro Tumori Regione Campania, ASL Napoli 3 Sud, Brusciano, Italy
| | - Francesco Cozzolino
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Mario Fusco
- Registro Tumori Regione Campania, ASL Napoli 3 Sud, Brusciano, Italy
| | - Ettore Bidoli
- Cancer Epidemiology Unit, IRCCS Centro di Riferimento Oncologico Aviano, Aviano, Italy
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Cozzolino F, Bidoli E, Abraha I, Fusco M, Giovannini G, Casucci P, Orso M, Granata A, De Giorgi M, Collarile P, Ciullo V, Vitale MF, Cirocchi R, Orlandi W, Serraino D, Montedori A. Accuracy of colorectal cancer ICD-9-CM codes in Italian administrative healthcare databases: a cross-sectional diagnostic study. BMJ Open 2018; 8:e020630. [PMID: 29980543 PMCID: PMC6042611 DOI: 10.1136/bmjopen-2017-020630] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
UNLABELLED Objectives To assess the accuracy of International Classification of Diseases, Ninth Revision - Clinical Modification (ICD-9-CM) codes in identifying subjects with colorectal cancer. DESIGN A diagnostic accuracy study comparing ICD-9-CM codes (index test) for colorectal cancers with medical chart (as a reference standard). Case ascertainment based on neoplastic lesion(s) within the colon/rectum and histological documentation from a primary or metastatic site positive for colorectal cancer. SETTING Administrative databases from the Umbria region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) region and Friuli Venezia Giulia (FVG) region. PARTICIPANTS We randomly selected 130 incident patients from each hospital discharge database, admitted between 2012 and 2014, having colorectal cancer ICD-9 codes located in primary position, and 94 non-cases, that is, patients having a diagnosis of cancer (ICD-9 140-239) other than colorectal cancer in primary position. OUTCOME MEASURES Sensitivity, specificity and predictive values for 153.x code (colon cancer) and for 154.x code (rectal cancer). RESULTS The positive predictive value (PPV) for colon cancer diagnoses was 80% for Umbria (95% CI 73% to 87%), 81% for NA (95% CI 73% to 88%) and 80% for FVG (95% CI 72% to 87%).The sensitivity ranged from 98% to 99%, while the specificity ranged from 78% to 80% in the three units.For rectal cancer, the PPV was 84% for Umbria (95% CI 77% to 90%), 80% for NA (95% CI 72% to 87%) and 81% for FVG (95% CI 73% to 87%). The sensitivities ranged from 98% to 100%, while the specificity estimates from 79% to 82%. CONCLUSIONS Administrative databases in Italy can be a valuable tool for cancer surveillance as well as monitoring geographical and temporal variation of cancer practice.
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Affiliation(s)
- Francesco Cozzolino
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Ettore Bidoli
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico Aviano, Aviano, Italy
| | - Iosief Abraha
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
- Centro Regionale Sangue, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Mario Fusco
- Registro Tumori Regione Campania, ASL NA 3 Sud, Brusciano, Italy
| | - Gianni Giovannini
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Paola Casucci
- Health ICT Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Massimiliano Orso
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Annalisa Granata
- Registro Tumori Regione Campania, ASL NA 3 Sud, Brusciano, Italy
| | | | - Paolo Collarile
- SOC Epidemiologia Oncologica, Centro di Riferimento Oncologico, Aviano, Italy
| | - Valerio Ciullo
- Registro Tumori Regione Campania, ASL NA 3 Sud, Brusciano, Italy
| | | | - Roberto Cirocchi
- Department of Digestive Surgery and Liver Unit, University of Perugia, Perugia, Italy
| | - Walter Orlandi
- Direzione Regionale Salute, Regional Health Authority of Umbria, Perugia, Italy
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico Aviano, Aviano, Italy
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Montedori A, Bidoli E, Serraino D, Fusco M, Giovannini G, Casucci P, Franchini D, Granata A, Ciullo V, Vitale MF, Gobbato M, Chiari R, Cozzolino F, Orso M, Orlandi W, Abraha I. Accuracy of lung cancer ICD-9-CM codes in Umbria, Napoli 3 Sud and Friuli Venezia Giulia administrative healthcare databases: a diagnostic accuracy study. BMJ Open 2018; 8:e020628. [PMID: 29773701 PMCID: PMC5961589 DOI: 10.1136/bmjopen-2017-020628] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES To assess the accuracy of International Classification of Diseases 9th Revision-Clinical Modification (ICD-9-CM) codes in identifying subjects with lung cancer. DESIGN A cross-sectional diagnostic accuracy study comparing ICD-9-CM 162.x code (index test) in primary position with medical chart (reference standard). Case ascertainment was based on the presence of a primary nodular lesion in the lung and cytological or histological documentation of cancer from a primary or metastatic site. SETTING Three operative units: administrative databases from Umbria Region (890 000 residents), ASL Napoli 3 Sud (NA) (1 170 000 residents) and Friuli Venezia Giulia (FVG) Region (1 227 000 residents). PARTICIPANTS Incident subjects with lung cancer (n=386) diagnosed in primary position between 2012 and 2014 and a population of non-cases (n=280). OUTCOME MEASURES Sensitivity, specificity and positive predictive value (PPV) for 162.x code. RESULTS 130 cases and 94 non-cases were randomly selected from each database and the corresponding medical charts were reviewed. Most of the diagnoses for lung cancer were performed in medical departments.True positive rates were high for all the three units. Sensitivity was 99% (95% CI 95% to 100%) for Umbria, 97% (95% CI 91% to 100%) for NA, and 99% (95% CI 95% to 100%) for FVG. The false positive rates were 24%, 37% and 23% for Umbria, NA and FVG, respectively. PPVs were 79% (73% to 83%)%) for Umbria, 58% (53% to 63%)%) for NA and 79% (73% to 84%)%) for FVG. CONCLUSIONS Case ascertainment for lung cancer based on imaging or endoscopy associated with histological examination yielded an excellent sensitivity in all the three administrative databases. PPV was moderate for Umbria and FVG but lower for NA.
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Affiliation(s)
| | - Ettore Bidoli
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico Aviano, Aviano, Italy
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico Aviano, Aviano, Italy
| | - Mario Fusco
- Registro Tumori Regione Campania, ASL Napoli 3 Sud, Brusciano, Italy
| | - Gianni Giovannini
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Paola Casucci
- Health ICT Service, Regional Health Authority of Umbria, Perugia, Italy
| | - David Franchini
- Health ICT Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Annalisa Granata
- Registro Tumori Regione Campania, ASL Napoli 3 Sud, Brusciano, Italy
| | - Valerio Ciullo
- Registro Tumori Regione Campania, ASL Napoli 3 Sud, Brusciano, Italy
| | | | - Michele Gobbato
- SOC Epidemiologia Oncologica, Centro di Riferimento Oncologico Aviano, Aviano, Italy
| | - Rita Chiari
- Dipartimento di Oncologia, Azienda Ospedaliera Perugia, Perugia, Italy
| | - Francesco Cozzolino
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Massimiliano Orso
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Walter Orlandi
- Direzione salute, Regional Health Authority of Umbria, Perugia, Italy
| | - Iosief Abraha
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
- Centro Regionale Sangue, Azienda Ospedaliera di Perugia, Perugia, Italy
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Piffanelli A, Pelizzola D, Giovannini G, Catozzi L, Faggioli L, Giganti M. Characterization of Laboratory Working Standard for Quality Control of Immunometric and Radiometric Estrogen Receptor Assays. Clinical Evaluation on Breast Cancer Biopsies. Tumori 2018; 75:550-6. [PMID: 2482565 DOI: 10.1177/030089168907500607] [Citation(s) in RCA: 19] [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]
Abstract
The objective of the study was to characterize a low-cost and reliable working standard material for quality control of estrogen receptor (ER) determination with dextran-coated charcoal (DCC) and enzyme immunoassay (EIA) methods. Human fibromatous uterine lyophilized cytosol demonstrated good characteristics of stability and applicability for this purpose. Eleven laboratories participated in the intralaboratory and interlaboratory quality control study, and they achieved slightly higher coefficients of variation for ER-EIA (interlaboratory, 37.7 %; intralaboratory, 22.9 %) than for ER-DCC (Interlaboratory, 24.2 %; intralaboratory, 15.7 %). There was an excellent correlation between ER results with ER-EIA and ER-DCC for 268 breast cancer biopsies. Quality assurance for ER assays using DCC techniques and immunometric methods with monoclonal antibodies (ER-EIA) can be set up with this available material of human origin to satisfy the characteristics of both techniques and the species specificity of monoclonal antibodies.
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Affiliation(s)
- A Piffanelli
- Institute of Radiology, University of Ferrara, Italy
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21
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Orso M, Serraino D, Abraha I, Fusco M, Giovannini G, Casucci P, Cozzolino F, Granata A, Gobbato M, Stracci F, Ciullo V, Vitale MF, Eusebi P, Orlandi W, Montedori A, Bidoli E. Validating malignant melanoma ICD-9-CM codes in Umbria, ASL Napoli 3 Sud and Friuli Venezia Giulia administrative healthcare databases: a diagnostic accuracy study. BMJ Open 2018; 8:e020631. [PMID: 29678984 PMCID: PMC5914898 DOI: 10.1136/bmjopen-2017-020631] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To assess the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in identifying subjects with melanoma. DESIGN A diagnostic accuracy study comparing melanoma ICD-9-CM codes (index test) with medical chart (reference standard). Case ascertainment was based on neoplastic lesion of the skin and a histological diagnosis from a primary or metastatic site positive for melanoma. SETTING Administrative databases from Umbria Region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) and Friuli Venezia Giulia (FVG) Region. PARTICIPANTS 112, 130 and 130 cases (subjects with melanoma) were randomly selected from Umbria, NA and FVG, respectively; 94 non-cases (subjects without melanoma) were randomly selected from each unit. OUTCOME MEASURES Sensitivity and specificity for ICD-9-CM code 172.x located in primary position. RESULTS The most common melanoma subtype was malignant melanoma of skin of trunk, except scrotum (ICD-9-CM code: 172.5), followed by malignant melanoma of skin of lower limb, including hip (ICD-9-CM code: 172.7). The mean age of the patients ranged from 60 to 61 years. Most of the diagnoses were performed in surgical departments.The sensitivities were 100% (95% CI 96% to 100%) for Umbria, 99% (95% CI 94% to 100%) for NA and 98% (95% CI 93% to 100%) for FVG. The specificities were 88% (95% CI 80% to 93%) for Umbria, 77% (95% CI 69% to 85%) for NA and 79% (95% CI 71% to 86%) for FVG. CONCLUSIONS The case definition for melanoma based on clinical or instrumental diagnosis, confirmed by histological examination, showed excellent sensitivities and good specificities in the three operative units. Administrative databases from the three operative units can be used for epidemiological and outcome research of melanoma.
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Affiliation(s)
- Massimiliano Orso
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico Aviano, Aviano, Italy
| | - Iosief Abraha
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
- Innovation and development, Agenzia Nazionale per i Servizi Sanitari Regionali (Agenas), Rome, Italy
| | - Mario Fusco
- Registro Tumori Regione Campania, ASL Napoli 3 Sud, Brusciano, Italy
| | - Gianni Giovannini
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Paola Casucci
- SOC Epidemiologia Oncologica, Centro di Riferimento Oncologico Aviano, Aviano, Italy
| | - Francesco Cozzolino
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Annalisa Granata
- Registro Tumori Regione Campania, ASL Napoli 3 Sud, Brusciano, Italy
| | - Michele Gobbato
- SOC Epidemiologia Oncologica, Centro di Riferimento Oncologico Aviano, Aviano, Italy
| | | | - Valerio Ciullo
- Registro Tumori Regione Campania, ASL Napoli 3 Sud, Brusciano, Italy
| | | | - Paolo Eusebi
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Walter Orlandi
- Direzione Regionale Salute, Regional Health Authority of Umbria, Perugia, Italy
| | | | - Ettore Bidoli
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico Aviano, Aviano, Italy
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22
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Montesco MC, Pluchinotta A, Piffanelli A, Pelizzola D, Giovannini G, Pagnini CA. Hormone Receptors and Breast Cancer: Correlations with Clinical and Histologic Features. Tumori 2018; 70:445-50. [PMID: 6506229 DOI: 10.1177/030089168407000510] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The possible relationships between hormone receptor status and several clinical (age, gynecologic history, clinical stage) and morphologic aspects (histologic grade, vascular invasion, lymphocytic infiltration, necrosis, fibrosis, elastosis and lymph node metastasis) were evaluated. A highly significant correlation between estrogen receptor levels, patient age, menses regularity and postmenopausal status was found. The histologic features most significantly related to tumor receptor status were histologic grade, lymphocytic infiltrate, necrosis and elastosis. Since these same histologic aspects appear to influence prognosis in breast cancer, the prognostic significance attributed to tumor receptor levels is substantiated. Therefore the importance of this assay is confirmed, not only for its diagnostic and therapeutic purposes, but also for its prognostic value.
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23
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Gion M, Mione R, Becciolini A, Balzi M, Correale M, Piffanelli A, Giovannini G, Saccani Jotti G, Fontanesi M. Relationship between Cytosol Tps, Tpa and Cell Proliferation. Int J Biol Markers 2018; 9:109-14. [PMID: 7930761 DOI: 10.1177/172460089400900208] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The serological tumor marker tissue polypeptide antigen (TPA) and the more recently identified tissue-specific polypeptide antigen (TPS) have been reported to be indicators of the proliferation rate of the tumor. In the present investigation we compared the cytosol level of the two markers with the proliferative activity of the tumor measured using the 3H-thymidine labelling index. The preliminary results presented here show that higher TLI is associated with lower cytosol levels of both TPA and TPS. TPA and TPS in the cytosol were significantly associated. These findings are in agreement with the previously demonstrated association between high TPA cytosol levels and better prognosis in breast cancer. Further studies are ongoing in order to: 1. confirm these findings in a larger patient series; 2. investigate any possible prognostic indication provided by TPS; 3. evaluate any possible biological meaning of the negative association between TPA/ TPS and TLI in the cytosol of breast cancer.
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Affiliation(s)
- M Gion
- Center for the Study of Biological Markers of Malignancy, General Hospital, Venezia, Italy
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24
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Piffanelli A, Giovannini G, Pelizzola D, De Bortoli M. Estrogen and Progesterone Measurement and its Quality Control in Breast Cancer: A Reappraisal. Int J Biol Markers 2018; 1:15-28. [PMID: 3320222 DOI: 10.1177/172460088600100104] [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: 11/16/2022]
Abstract
This article illustrates the two main methods for routine measurement of cytoplasmic estrogen receptor status in neoplastic biopsy. The first is the Dextran Coated Charcoal Technique (D.C.C. Assay) which is still the method of choice in the majority of clinical laboratories for its simplicity, reproducibility and low cost. The second is a more advanced technique based on the specific binding, enzimatically displayed, of commercially available antiestrogen monoclonal antibodies (Enzyme Immuno Assay - ABBOTT). The sui generis characteristics of endocrine sensitivity assessment on tumor tissues and the importance of decision-making connected with the assay justify rigorous quality assurance schemes. The quality control design proposed by the Italian Committee concerned the evaluation of several lyophilized preparations with scalar receptor content; this permits the identification through linear regression analysis of systematic and non-systematic errors. The Italian Committee has currently connected 50 labs from most regions of the country.
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25
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Agrimonti F, Berruto GP, Fornaro D, De Bortoli M, Fumero S, Frairia R, Pelizzola D, Giovannini G, Piffanelli A. Quality Control for Estrogen and Progesterone Receptor Assay in Human Breast Cancer: The Influence of Computation Methods on Intra and Interlaboratory Variability. Tumori 2018; 71:597-602. [PMID: 4082293 DOI: 10.1177/030089168507100613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The importance of evaluating receptors for estrogen and progestin in human breast cancer has been pointed out by many authors. In the absence of a reference standard, receptor assays must be controlled by intra and interlaboratory quality control programs. Much interlaboratory variability exists due to non-uniform analytical protocols, non-uniform ligands, intrinsic errors and also errors in computation methods. The goals of our Italian Quality Control Program on Multicenter Trials are to standardize the analytical procedures and computation methods. Twenty Italian laboratories participated in the Quality Control Program. Each specimen was assayed for steroid receptor content according to the standardized dextran-coated-charcoal method. Data were subjected to computerized analyses by 5 different methods of calculation (Scatchard plot, direct plot, Lineweaver-Burk method, Brunauer-Emmet-Teller analysis, single-point approach). The results were than evaluated to identify intra- and inter-assay variation coefficients and to define other statistical parameters. The authors suggest different calculation methods depending on the specific experimental and/or physiopathological conditions.
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26
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Piffanelli A, Pelizzola D, De Bortoli M, Agrimonti F, Frairia R, Giovannini G, Fumero S. Quality Assurance for Steroid Receptor Assay in Human Breast Cancer: Six Years Experience of the Italian Committee. Tumori 2018; 71:589-95. [PMID: 4082292 DOI: 10.1177/030089168507100612] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Since 1979 the quality control design proposed by the Italian ad hoc Committee has evaluated several lyophilized preparations with scalar receptor content; this permits the identification by linear regression analysis of systematic and non systematic errors. At present 41 laboratories from most of the national regions have joined the Italian Committee. The overall results of five years application of quality assurance in Italy show that there was a different pattern of imprecision with satisfactory indexes for intralaboratory performances but major variations in interlaboratory controls. There was also a remarkable difference of variability indices between the so-called "expert" and "new" laboratories; this problem can be reduced with practical seminars for new centers. On the basis of the results and experience achieved the Committee is starting another program of quality assurance for different new methodologies to provide guidelines for international working reference standards.
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27
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Tutinelli F, Bisbano A, Cremona G, Giovannini G, Musumeci V, Ciappi G. Haemorheological changes in chronic respiratory failure. Clin Hemorheol Microcirc 2016. [DOI: 10.3233/ch-1986-6408] [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: 11/15/2022]
Affiliation(s)
- F. Tutinelli
- Istituto di Patologia Speciale Medica e Metodologia Clinica
| | - A. Bisbano
- Istituto di Patologia Speciale Medica e Metodologia Clinica
| | - G. Cremona
- Istituto di Patologia Speciale Medica e Metodologia Clinica
| | - G. Giovannini
- Istituto di Patologia Speciale Medica e Metodologia Clinica
| | - V. Musumeci
- Istituto di Patologia Speciale Medica e Metodologia Clinica
| | - G. Ciappi
- Istituto di Clinica Medica, Servizio di Fisiopatologia Respiratoria, Universita Cattolica del Sacra Cuore, Rome
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28
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Gensicke H, Frih AA, Strbian D, Zini A, Pezzini A, Padjen V, Haueter M, Seiffge DJ, Mäkitie L, Traenka C, Poli L, Martinez-Majander N, Putaala J, Bonati LH, Sibolt G, Giovannini G, Curtze S, Beslac-Bumbasirevic L, Vandelli L, Lyrer PA, Nederkoorn PJ, Tatlisumak T, Engelter ST. Prognostic significance of proteinuria in stroke patients treated with intravenous thrombolysis. Eur J Neurol 2016; 24:262-269. [DOI: 10.1111/ene.13179] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 09/16/2016] [Indexed: 11/27/2022]
Affiliation(s)
- H. Gensicke
- Stroke Center and Neurology; University Hospital Basel; Basel Switzerland
| | - A. A. Frih
- Stroke Center and Neurology; University Hospital Basel; Basel Switzerland
| | - D. Strbian
- Clinical Neurosciences; Neurology; University of Helsinki, and Department of Neurology; Helsinki University Hospital; Helsinki Finland
| | - A. Zini
- Stroke Unit; Department of Neuroscience; Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena; Modena Italy
| | - A. Pezzini
- Department of Clinical and Experimental Sciences; Neurology Clinic; University of Brescia; Modena Italy
| | - V. Padjen
- Neurology Clinic; Clinical Centre of Serbia; Beograd Serbia
| | - M. Haueter
- Stroke Center and Neurology; University Hospital Basel; Basel Switzerland
- Neurorehabilitation Unit; Felix Platter Hospital; University of Basel and University Center for Medicine of Aging; Basel Switzerland
| | - D. J. Seiffge
- Stroke Center and Neurology; University Hospital Basel; Basel Switzerland
| | - L. Mäkitie
- Clinical Neurosciences; Neurology; University of Helsinki, and Department of Neurology; Helsinki University Hospital; Helsinki Finland
| | - C. Traenka
- Stroke Center and Neurology; University Hospital Basel; Basel Switzerland
| | - L. Poli
- Department of Clinical and Experimental Sciences; Neurology Clinic; University of Brescia; Modena Italy
| | - N. Martinez-Majander
- Clinical Neurosciences; Neurology; University of Helsinki, and Department of Neurology; Helsinki University Hospital; Helsinki Finland
| | - J. Putaala
- Clinical Neurosciences; Neurology; University of Helsinki, and Department of Neurology; Helsinki University Hospital; Helsinki Finland
| | - L. H. Bonati
- Stroke Center and Neurology; University Hospital Basel; Basel Switzerland
| | - G. Sibolt
- Clinical Neurosciences; Neurology; University of Helsinki, and Department of Neurology; Helsinki University Hospital; Helsinki Finland
| | - G. Giovannini
- Stroke Unit; Department of Neuroscience; Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena; Modena Italy
| | - S. Curtze
- Clinical Neurosciences; Neurology; University of Helsinki, and Department of Neurology; Helsinki University Hospital; Helsinki Finland
| | | | - L. Vandelli
- Stroke Unit; Department of Neuroscience; Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena; Modena Italy
| | - P. A. Lyrer
- Stroke Center and Neurology; University Hospital Basel; Basel Switzerland
| | - P. J. Nederkoorn
- Department of Neurology; Academic Medical Center Amsterdam; The Netherlands
| | - T. Tatlisumak
- Clinical Neurosciences; Neurology; University of Helsinki, and Department of Neurology; Helsinki University Hospital; Helsinki Finland
- Institute of Neuroscience and Physiology; Sahlgrenska Academy at University of Gothenburg; Gothenburg Sweden
- Department of Neurology; Sahlgrenska University Hospital; Gothenburg Sweden
| | - S. T. Engelter
- Stroke Center and Neurology; University Hospital Basel; Basel Switzerland
- Neurorehabilitation Unit; Felix Platter Hospital; University of Basel and University Center for Medicine of Aging; Basel Switzerland
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Gensicke H, Wicht A, Bill O, Zini A, Costa P, Kägi G, Stark R, Seiffge DJ, Traenka C, Peters N, Bonati LH, Giovannini G, De Marchis GM, Poli L, Polymeris A, Vanacker P, Sarikaya H, Lyrer PA, Pezzini A, Vandelli L, Michel P, Engelter ST. Impact of body mass index on outcome in stroke patients treated with intravenous thrombolysis. Eur J Neurol 2016; 23:1705-1712. [DOI: 10.1111/ene.13071] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 05/13/2016] [Indexed: 11/30/2022]
Affiliation(s)
- H. Gensicke
- Stroke Centre and Neurology; University Hospital Basel; Basel Switzerland
| | - A. Wicht
- Stroke Centre and Neurology; University Hospital Basel; Basel Switzerland
| | - O. Bill
- Department of Neurology; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne Switzerland
| | - A. Zini
- Stroke Unit; Department of Neuroscience; Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena; Modena Italy
| | - P. Costa
- Department of Clinical and Experimental Sciences; Neurology Clinic; University of Brescia; Brescia Italy
| | - G. Kägi
- Department of Neurology; Kantonsspital St Gallen; St Gallen Switzerland
| | - R. Stark
- Department of Neurology; Kantonsspital St Gallen; St Gallen Switzerland
| | - D. J. Seiffge
- Stroke Centre and Neurology; University Hospital Basel; Basel Switzerland
| | - C. Traenka
- Stroke Centre and Neurology; University Hospital Basel; Basel Switzerland
| | - N. Peters
- Stroke Centre and Neurology; University Hospital Basel; Basel Switzerland
| | - L. H. Bonati
- Stroke Centre and Neurology; University Hospital Basel; Basel Switzerland
| | - G. Giovannini
- Stroke Unit; Department of Neuroscience; Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena; Modena Italy
| | - G. M. De Marchis
- Stroke Centre and Neurology; University Hospital Basel; Basel Switzerland
| | - L. Poli
- Department of Clinical and Experimental Sciences; Neurology Clinic; University of Brescia; Brescia Italy
| | - A. Polymeris
- Stroke Centre and Neurology; University Hospital Basel; Basel Switzerland
| | - P. Vanacker
- Department of Neurology; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne Switzerland
- Department of Neurology; University Hospital Antwerp; Edegem Belgium
| | - H. Sarikaya
- Department of Neurology; University Hospital Berne; Berne Switzerland
| | - P. A. Lyrer
- Stroke Centre and Neurology; University Hospital Basel; Basel Switzerland
| | - A. Pezzini
- Department of Clinical and Experimental Sciences; Neurology Clinic; University of Brescia; Brescia Italy
| | - L. Vandelli
- Stroke Unit; Department of Neuroscience; Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena; Modena Italy
| | - P. Michel
- Department of Neurology; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne Switzerland
| | - S. T. Engelter
- Stroke Centre and Neurology; University Hospital Basel; Basel Switzerland
- Neurorehabilitation Unit; University Centre for Medicine of Aging and Rehabilitation; Felix Platter Hospital; Basel Switzerland
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Abraha I, Serraino D, Giovannini G, Stracci F, Casucci P, Alessandrini G, Bidoli E, Chiari R, Cirocchi R, De Giorgi M, Franchini D, Vitale MF, Fusco M, Montedori A. Validity of ICD-9-CM codes for breast, lung and colorectal cancers in three Italian administrative healthcare databases: a diagnostic accuracy study protocol. BMJ Open 2016; 6:e010547. [PMID: 27016247 PMCID: PMC4809074 DOI: 10.1136/bmjopen-2015-010547] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/31/2016] [Accepted: 02/22/2016] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Administrative healthcare databases are useful tools to study healthcare outcomes and to monitor the health status of a population. Patients with cancer can be identified through disease-specific codes, prescriptions and physician claims, but prior validation is required to achieve an accurate case definition. The objective of this protocol is to assess the accuracy of International Classification of Diseases Ninth Revision-Clinical Modification (ICD-9-CM) codes for breast, lung and colorectal cancers in identifying patients diagnosed with the relative disease in three Italian administrative databases. METHODS AND ANALYSIS Data from the administrative databases of Umbria Region (910,000 residents), Local Health Unit 3 of Napoli (1,170,000 residents) and Friuli--Venezia Giulia Region (1,227,000 residents) will be considered. In each administrative database, patients with the first occurrence of diagnosis of breast, lung or colorectal cancer between 2012 and 2014 will be identified using the following groups of ICD-9-CM codes in primary position: (1) 233.0 and (2) 174.x for breast cancer; (3) 162.x for lung cancer; (4) 153.x for colon cancer and (5) 154.0-154.1 and 154.8 for rectal cancer. Only incident cases will be considered, that is, excluding cases that have the same diagnosis in the 5 years (2007-2011) before the period of interest. A random sample of cases and non-cases will be selected from each administrative database and the corresponding medical charts will be assessed for validation by pairs of trained, independent reviewers. Case ascertainment within the medical charts will be based on (1) the presence of a primary nodular lesion in the breast, lung or colon-rectum, documented with imaging or endoscopy and (2) a cytological or histological documentation of cancer from a primary or metastatic site. Sensitivity and specificity with 95% CIs will be calculated. DISSEMINATION Study results will be disseminated widely through peer-reviewed publications and presentations at national and international conferences.
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Affiliation(s)
- Iosief Abraha
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Diego Serraino
- Epidemiology and Biostatistic Unit, Centro di Riferimento Oncologico Aviano, Aviano, Italy
| | - Gianni Giovannini
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | | | - Paola Casucci
- Health ICT Service, Regional Health Authority of Umbria, Perugia, Italy
| | | | - Ettore Bidoli
- Epidemiology and Biostatistic Unit, Centro di Riferimento Oncologico Aviano, Aviano, Italy
| | - Rita Chiari
- Dipartimento di Oncologia, Azienda Ospedaliera Perugia, Perugia, Italy
| | - Roberto Cirocchi
- Department of Digestive Surgery and Liver Unit, University of Perugia, Perugia, Italy
| | | | - David Franchini
- Health ICT Service, Regional Health Authority of Umbria, Perugia, Italy
| | | | - Mario Fusco
- Registro Tumori Regione Campania, ASL NA3 Sud, Brusciano, Italy
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Abstract
INTRODUCTION Breast, lung and colorectal cancers constitute the most common cancers worldwide and their epidemiology, related health outcomes and quality indicators can be studied using administrative healthcare databases. To constitute a reliable source for research, administrative healthcare databases need to be validated. The aim of this protocol is to perform the first systematic review of studies reporting the validation of International Classification of Diseases 9th and 10th revision codes to identify breast, lung and colorectal cancer diagnoses in administrative healthcare databases. METHODS AND ANALYSIS This review protocol has been developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) 2015 statement. We will search the following databases: MEDLINE, EMBASE, Web of Science and the Cochrane Library, using appropriate search strategies. We will include validation studies that used administrative data to identify breast, lung and colorectal cancer diagnoses or studies that evaluated the validity of breast, lung and colorectal cancer codes in administrative data. The following inclusion criteria will be used: (1) the presence of a reference standard case definition for the disease of interest; (2) the presence of at least one test measure (eg, sensitivity, positive predictive values, etc) and (3) the use of data source from an administrative database. Pairs of reviewers will independently abstract data using standardised forms and will assess quality using a checklist based on the Standards for Reporting of Diagnostic accuracy (STARD) criteria. ETHICS AND DISSEMINATION Ethics approval is not required. We will submit results of this study to a peer-reviewed journal for publication. The results will serve as a guide to identify appropriate case definitions and algorithms of breast, lung and colorectal cancers for researchers involved in validating administrative healthcare databases as well as for outcome research on these conditions that used administrative healthcare databases. TRIAL REGISTRATION NUMBER CRD42015026881.
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Affiliation(s)
- Iosief Abraha
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Gianni Giovannini
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Diego Serraino
- Epidemiology and Biostatistic Unit, IRCCS Centro di Riferimento Oncologico Aviano, Aviano, Italy
| | - Mario Fusco
- Registro Tumori Regione Campania, ASL NA3 Sud, Brusciano (Na), Italy
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Bauer J, Giovannini G, Böhlen T, Gabal G, Tessonnier T, Frey K, Debus J, Mairani A, Parodi K. Variable RBE in proton therapy: comparison of model predictions and their impact on clinical-like cranial lesions. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)30015-9] [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: 10/22/2022]
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33
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Giovannini G, Flöck A, Nellessen C, Mayer K, Gembruch U, Merz W. Akute Promyelozytenleukämie in der Schwangerschaft: erfolgreiche Behandlung mit ATRA Monotherapie. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566617] [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: 10/22/2022]
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34
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Abraha I, Orso M, Grilli P, Cozzolino F, Eusebi P, Casucci P, Marchesi M, Luchetta M, Fruttini L, Ciappelloni R, Florio R, Giovannini G, Montedori A. The Current State of Validation of Administrative Healthcare Databases in Italy: A Systematic Review. ACTA ACUST UNITED AC 2014. [DOI: 10.6000/1929-6029.2014.03.03.10] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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35
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Lico R, Casadio C, Gómez J, Giroletti M, Orienti M, Giovannini G, Blasi M, Cotton W, Edwards PG, Fuhrmann L, Jorstad S, Kino M, Kovalev Y, Krichbaum T, Marscher A, Paneque D, Perez-Torres M, Piner G, Sokolovsky K. Very Long Baseline Polarimetric monitoring at 15 GHz of the TeV blazar Markarian 421. EPJ Web of Conferences 2013. [DOI: 10.1051/epjconf/20136107004] [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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36
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Orienti M, D’Ammando F, Giroletti M, Dallacasa D, Venturi T, Giovannini G. On the connection between radio and gamma rays. EPJ Web of Conferences 2013. [DOI: 10.1051/epjconf/20136104009] [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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37
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Giovannini G, Liuzzo E, Giroletti M, Boccardi B, Tamburri S, Casadio C, Taylor G, Kadler M, Tosti G, Mignano AA. Exploring the bulk of the BL Lac object population: parsec scale radio properties and gamma ray emission. EPJ Web of Conferences 2013. [DOI: 10.1051/epjconf/20136108006] [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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38
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Folletti I, Belardinelli V, Giovannini G, Cresta B, Fabrizi G, Tacconi C, Stopponi R, Ferrari L, Siracusa A. [Prevalence and determinants of low back pain in hospital workers]. G Ital Med Lav Ergon 2005; 27:359-61. [PMID: 16240595] [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: 05/04/2023]
Abstract
This study evaluated the prevalence and determinants of low back pain (LBP) in Terni hospital workers. Each ward sister completed a questionnaire about potential determinants of LBP associated with physical loads. Moreover, a trained ward sister administered a questionnaire about the characteristics of low back pain to 512 subjects. In the previous year the prevalence of LBP was 58.8%. It was more common in subjects under 45 years of age. >3 LBP episodes annually were more frequent in operating rooms and medical wards. LBP lasted >1 week in 29% of females and in 23% of males. LBP caused change of duties or time off work in 11% of females and in 8% of males.
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Affiliation(s)
- I Folletti
- Medico del lavoro, Monteleone di Orvieto, Terni
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39
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Vesce F, Scapoli C, Giovannini G, Tralli L, Gotti G, Valerio A, Piffanelli A. Cytokine imbalance in pregnancies with fetal chromosomal abnormalities. Hum Reprod 2002; 17:803-8. [PMID: 11870140 DOI: 10.1093/humrep/17.3.803] [Citation(s) in RCA: 20] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The aim of the present study is to investigate the levels of some of the cytokines which may be involved in the mechanisms leading to the impairment of placental perfusion and to the onset of uterine contractions in pregnancies with fetal genetic abnormalities compared with controls. METHODS The amniotic fluid and maternal plasma levels of interleukin-6, interleukin-8 and tumour necrosis factor-beta in patients with fetal chromosomal abnormalities were measured, as well as in euploid pregnancies in the seventh week of gestation. RESULTS An increase of interleukin-6 (P = 0.034) and a decrease of interleukin-8 (P < or =0.0001) in amniotic fluid, and a decrease of interleukin-6 in the maternal plasma (P = 0.026) was shown in pregnancies with fetal chromosomal abnormalities. A positive correlation was observed between amniotic interleukin-8 and serum interleukin-6 in the presence of fetal aneuploidy (P < 0.006). CONCLUSION Further investigations of cytokine imbalance in pregnancies with poor outcome as a consequence of genetic disorders rather than infection is warranted.
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Affiliation(s)
- F Vesce
- Department of Biomedical Sciences and Advanced Therapy, Section of Obstetrics and Gynaecology, University of Ferrara, 44100 Ferrara, Italy.
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40
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Piffanelli A, Morganti A, Mantero F, Cianetti A, Zucchelli GC, Giovannini G, Pelizzola D. Supraregional interlaboratory quality-control survey for an immunoradiometric renin assay. Clin Chem 2001; 47:2148-50. [PMID: 11719480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- A Piffanelli
- Department of Experimental and Clinical Medicine, Section of Nuclear Medicine University, 44100 Ferrara, Italy.
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41
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Abstract
Mycotic aneurysms of the thoracic aorta rarely occur in children. We report an unusual case of a mycotic aneurysm of the descending aorta in a 4-year-old boy presenting with respiratory tract infection, which was rapidly complicated by atelectasis of the left lung. The patient's mycotic aortic aneurysm was diagnosed by contrast-enhanced spiral CT, whereas conventional chest radiographs did not detect its presence. An unsuspected mild aortic coarctation was also diagnosed at the time of admission. This case demonstrates that an aortic aneurysm may clinically and radiologically manifest itself with respiratory tract infection and atelectasis and that contrast-enhanced spiral CT is a fast and powerful tool for establishing the diagnosis.
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Affiliation(s)
- E Mengozzi
- 1st Department of Radiology, Maggiore Hospital, Bologna, Italy.
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42
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Vesce F, Scapoli C, Giovannini G, Piffanelli A, Geurts-Moespot A, Sweep FC. Plasminogen activator system in serum and amniotic fluid of euploid and aneuploid pregnancies. Obstet Gynecol 2001; 97:404-8. [PMID: 11239646 DOI: 10.1016/s0029-7844(00)01144-3] [Citation(s) in RCA: 9] [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: 11/26/2022]
Abstract
OBJECTIVE To compare euploid and aneuploid pregnancies with respect to maternal serum and amniotic fluid (AF) levels of the components of the plasminogen system. METHODS The study population consisted of 123 single pregnancies at the 17th gestational week, 16 with minor chromosomal abnormalities, 15 aneuploid, and 92 euploid. RESULTS Both groups with chromosomal abnormalities had significantly higher serum levels of urokinase plasminogen activator and its complexed form with its type-1 inhibitor compared with euploid pregnancies. In AF, tissue plasminogen activator was significantly lower in the aneuploid than the euploid group, whereas type-1 inhibitor of plasminogen activator was significantly higher in the cases with minor chromosomal abnormalities compared with euploid. At cutoff levels set at 100% sensitivity, the complexed form of urokinase plasminogen activator with its type-1 inhibitor had the strongest specificity (66.3%); after logarithmic transformation, its serum level was 7.53 times higher in aneuploidies than euploidies. CONCLUSION Aneuploid pregnancies appear to be accompanied by abnormalities of the plasminogen activation system, which could lead to impaired placental perfusion and thus to abortion, fetal death, and fetal growth restriction.
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Affiliation(s)
- F Vesce
- Department of Biomedical Science and Advanced Therapy, Section of Obstetrics and Gynecology, University of Ferrara, Ferrara, Italy
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43
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Zecconi A, Hamann J, Bronzo V, Moroni P, Giovannini G, Piccinini R. Relationship between teat tissue immune defences and intramammary infections. Adv Exp Med Biol 2001; 480:287-93. [PMID: 10959436 DOI: 10.1007/0-306-46832-8_33] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The teat is the main entrance for pathogens into the mammary gland. It also acts as a sensory, motor and primary defence organ. This latter function is important in preventing intramammary infections while efficiency in preventing new infections is determined by teat tissue integrity. Machine milking may evoke mechanical and circulatory impairment in teat tissues. These local metabolic disorders may decrease the efficiency of the local immune defence mechanisms. Teat tissue changes can be estimated by measuring teat thickness before and after milking. Experimental and field studies showed a high correlation between changes in thickness and infection risk. Teats with > 5% change in thickness have significantly increased teat duct colonisation rates and intramammary infection rates. The link between changes in teat thickness and infections should be found in changes in local immune defences and measurable changes in cytological and biochemical immune factors are expected. Indeed, the application of experimental milking conditions (i.e. no pulsation milking and positive pressure milking) showed to have a significant influence on some non specific immune factors in teat secretion. Positive pressure milking increases PMNs content and decreases macrophages content of teat secretion. Some enzymes such as NAGase and lysozyme were decreased by positive pressure milking, the concentration of the same enzymes were higher after no pulsation milking. A better knowledge on the interaction between the teat apex immune defense mechanisms and the machine milking process is necessary to reduce the new infection rate of the bovine mammary gland.
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Affiliation(s)
- A Zecconi
- Faculty of Veterinary Medicine, Institute for Infectious Diseases, Milan, Italy
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44
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Fusco-Femiano R, Feretti L, Giovannini G, Grandi P, Malizia A, Matt G, Molendi S. Hard X-Ray Emission from the Galaxy Cluster A2256. Astrophys J 2000; 534:L7-L10. [PMID: 10790058 DOI: 10.1086/312639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2000] [Accepted: 03/09/2000] [Indexed: 05/23/2023]
Abstract
After the positive detection by BeppoSAX of hard X-ray radiation up to approximately 80 keV in the Coma Cluster spectrum, we present evidence for nonthermal emission from A2256 in excess of thermal emission at a 4.6 sigma confidence level. In addition to this power-law component, a second nonthermal component already detected by ASCA could be present in the X-ray spectrum of the cluster, which is not surprising given the complex radio morphology of the cluster central region. The spectral index of the hard tail detected by the Phoswich Detection System on board BeppoSAX is marginally consistent with that expected for the inverse Compton model. A value of approximately 0.05 µG is derived for the intracluster magnetic field of the extended radio emission in the northern regions of the cluster, while a higher value of approximately 0.5 µG could be present in the central radio halo, which is likely related to the hard tail detected by ASCA.
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45
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Abstract
A vast number of substances have been suggested as possibly contributing to perturbation of the endocrine system. Several have been tested with different approaches ranging from yeast expression system of human oestrogenic receptors to human breast cancer cells assays. Surprisingly, no inhibition-binding experiments to steroid receptors on healthy human tissue have been performed so far. Our study provides inhibition binding experiments to oestrogens, progesterone, testosterone and retinoic acid receptors in prostate and uterine human tissue of organochlorine pesticides, phthalate esters, oestrogenic constituents derived from plants and phenol derivates. Affinities of significant extent of phthalates on oestrogenic, progestinic and androgenic receptors have not been detected. As for retinoic acid receptors, mono(2-ethylexyl)phthalate provokes a notable reduction of the binding of the tritiated retinoic acid, phtalic acid ethyl-n-butyl ester and 4-octylphenol show an affinity comparable to that of isoflavonoid genistein, whereas 4-nonylphenol reduces the binding of retinoic acid in prostate.
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Affiliation(s)
- G Paganetto
- Polyolefins G. Natta Research Center, Montell, Ferrara, Italy
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46
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Pelizzola D, Malagutti R, Giovannini G, Indelli M, Carcoforo P, Piffanelli A. Immunometric Assays of Ras and c-erbB-2/Neu Overexpression in Breast Cancer: A Pilot Study. Int J Biol Markers 1999; 14:178-85. [PMID: 10569141 DOI: 10.1177/172460089901400310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The expression of the ras and c-erbB2 oncoproteins (p21 and p185, respectively), together with estrogen receptor (ER) and progesterone receptor (PgR) determination, has been retrospectively analyzed in 68 primary breast carcinomas and in 19 normal breast tissue samples. The aims of this study were: a) to explore the association between ras and c-erbB2 expression; b) to evaluate the relationship between ras and c-erbB2 expression and both steroid receptor status and the classical clinical and pathological parameters; and c) to compare two different methods for p185 determination. p185 and p21 were measured by enzyme immunoassay (EIA); p185 was also determined by Western blotting (WB); ER and PgR were assayed by radioligand binding assay. The highest value of p185 in benign breast lesions was used as the threshold to distinguish between positive and negative samples. With this threshold the c-erbB2 oncoprotein was overexpressed in 41.2% (with EIA) and in 50% (with WB) of cancer samples. The concordance rate between the two methods was 79.4. No significant association was found between p21 and p185 levels either in cancer or in normal breast tissue samples. Increasing levels of tumor p21 were associated with a shorter time to recurrence and overall survival. Increasing levels of p185 were associated with a significantly shorter time to recurrence (p185 EIA: p=0.04, p185 WB: p=0.029) and overall survival (p185 EIA: p=0.04, p185 WB: p=0.029).
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Affiliation(s)
- D Pelizzola
- Department of Clinical and Experimental Medicine, University of Ferrara, Italy
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47
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Zanini R, Curello S, Bonandi L, Giovannini G, Boldi E, D'Aloia A, Metra M, Nodari S, Dei Cas L. [Etiopathogenesis of acute myocardial infarction: role of early leukocytosis]. Cardiologia 1998; 43:925-31. [PMID: 9859607] [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: 02/09/2023]
Abstract
It has recently been suggested that inflammation may play an important role in the pathogenesis of acute ischemic syndromes. It may therefore be important to relate their clinical features with plasma indexes of inflammation. We have studied leukocyte, platelet and fibrinogen blood levels in 57 consecutive patients with acute myocardial infarction admitted to our Intensive Care Unit within 90 min after the onset of chest pain and treated with primary coronary angioplasty. Patients were divided into two groups on the basis of blood leukocyte levels: Group A, 24 patients, 17 males, mean age 54.2 +/- 13.7 years, with high blood leukocytes and Group B, 33 patients, 28 males, mean age 60.9 +/- 10.3 years, with normal blood leukocytes. Group A patients also had higher serum fibrinogen (p = 0.05) and blood platelet levels (p < 0.05). The stenosis observed after guidewire advancement was significant (> 75%) in 33% of the patients with leukocytosis vs 94% of the others (p < 0.01). No difference between the two groups was observed in the success rate of coronary angioplasty and prevalence of stent placement (100 vs 97%, and 43 vs 42% of the patients of Group A and B, respectively). In contrast, a tendency to rethrombosis requiring Rheopro administration was observed in 62% Group A patients vs 21% Group B patients (p < 0.01). In conclusion, the finding of leukocytosis in the acute phase of myocardial infarction suggests that coronary occlusion is mainly caused by a coronary thrombus occurring at the site of a non significant stenosis. In contrast, when blood leukocytes are normal, the underlying coronary stenosis is more often critical and the thrombotic process is less important. The high blood leukocytes, platelet and fibrinogen levels of Group A patients are consistent with a significant role of inflammation in the pathogenesis of the thrombotic process while hemodynamic and local mechanical factors are probably more important in patients with normal blood leukocytes.
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Affiliation(s)
- R Zanini
- Cattedra e Divisione di Cardiologia, Università degli Studi, Brescia
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48
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Baligan M, Giardina A, Giovannini G, Laghi MG, Ambrosioni G. [L-arginine and immunity. Study of pediatric subjects]. Minerva Pediatr 1997; 49:537-42. [PMID: 9549298] [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: 02/07/2023]
Abstract
BACKGROUND Nitric oxide (NO) play a pivotal role in many biological processes, as in the vessel tone control, the atherogenesis, the platelets aggregation and the immune system modulation. The physiologic precursor of NO is the L-arginine. Evidence exists that the L-arginine administration can stimulate immune system in children with recurrent infections. This clinical trial was designed to evaluate the effects of oral administration of L-arginine on the number of infective events and on the lymphocytes subsets in children suffering from airways recurrent infections. METHODS Forty outpatients, 21 male and 19 female, aging from 2 to 13 yrs. Two balanced groups, treated for 60 days with L-arginine or a placebo. Evaluation criteria: number of septic episodes; number of circulating white blood cells, % of the lymphocytes; lymphocytes subsets. STATISTICAL ANALYSIS Descriptive analysis; inference tests: chi 2; "t" test; variance analysis. Statistical significance: p = 0.05. RESULTS Fifteen patients treated with L-arginine and five treated with placebo (p < 0.01) were free from infections. The percentage of CD3 and CD4 subsets significantly (p < 0.05) increased in the L-arginine group than in the placebo group, while the CD8 subset significantly decreased. The CD4/CD8 ratio raised from 1.05 +/- 0.29 to 1.51 +/- 0.46 (p < 0.01) in the L-arginine group, from 1.12 +/- 0.16 to 1.27 +/- 0.24 in the placebo group. There were no side effects in both groups. CONCLUSIONS L-arginine seems able to increase the immune system defences and to protect against the airway infections.
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Affiliation(s)
- M Baligan
- Dipartimento di Pediatria, Ospedale Maggiore C. A. Pizzardi, Bologna
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49
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Zanini R, Bonandi L, Curello S, Bersatti F, Giovannini G, Metra M, Dei Cas L. [Evolution in coronary stenting: use of ticlopidine with and without oral anticoagulants]. Cardiologia 1997; 42:837-43. [PMID: 9312409] [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: 02/05/2023]
Abstract
Implantation of intracoronary stents has been rapidly increasing in the last few years, especially after a reduction of restenosis has been shown. The main limitation in the use of coronary endoprosthesis is still represented by acute and subacute thrombosis. In order to limit this dangerous complication a very strong coagulant regimen, which has been improved since 1993-94, was initially recommended. We report our experience with patients who underwent a stent implantation comparing two therapeutic regimens with or without oral coagulants associated with antiplatelet agents. During 700 consecutive coronary angioplasties 128 Palamatz-Schatz and Wiktor stents have been implanted in 118 patents (16.9%). After stent implantation, 33 patients underwent a traditional anticoagulant therapy with heparin followed by oral anticoagulants for 3 months. They were also treated with ticlopidine 250 mg/die started 2 days before the procedure and then kept at least one month (group A). Eighty-five patients were treated only with antiplatelet therapy (ticlopidine 500 mg/die) started 2 days before implantation (group B). These two groups of patients were similar in age, sex, type and number of treated vessels and in diameter of the vessel with stent implantation. Subacute thrombosis rate was not significantly different between groups (3 vs 2.3%, NS). The predictive factors of thrombosis were acute myocardial infarction and implantation of multiple stents. No significant differences were found between thrombosis of the stents implanted in bail-out conditions compared to the elective ones. Ticlopidine started 2 days before stent implantation seems to be sufficient to limit thrombosis rate; moreover it allows a reduction of the hemorrhagic complications and hospitalization period.
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Affiliation(s)
- R Zanini
- Divisione e Cattedra di Cardiologia, Università degli Studi, Brescia
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50
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Ferrari G, Giovannini G. [Technical evolution of radiofrequency coils in a magnetic resonance system]. Radiol Med 1997; 94:76-80. [PMID: 9424656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- G Ferrari
- Servizio di Risonanza Magnetica, Azienda USL, Imola, Bologna
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