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Deloison B, Sonigo P, Millischer-Bellaiche AE, Quibel T, Cavallin M, Benoist G, Quelin C, Jouk PS, Lev D, Alison M, Baumann C, Beldjord C, Razavi F, Bessières B, Boddaert N, Ville Y, Salomon LJ, Bahi-Buisson N. Prenatally diagnosed periventricular nodular heterotopia: Further delineation of the imaging phenotype and outcome. Eur J Med Genet 2018; 61:773-782. [PMID: 30391507 DOI: 10.1016/j.ejmg.2018.10.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 11/17/2017] [Revised: 10/24/2018] [Accepted: 10/28/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Periventricular nodular heterotopia (PNH) is a malformation of cortical development which presents with heterogeneous imaging, neurological phenotype and outcome. There is a paucity of comprehensive description detailing the prenatal diagnosis of PNH. The aim of this study is to report neuroimaging features and correlated outcomes in order to delineate the spectrum of prenatally diagnosed PNH. METHODS It was a retrospective study over 15 years in five tertiary centers. All fetuses with prenatally diagnosed PNH were collected. Fetal ultrasound and MRI were reviewed and genetic screening collected. Prenatal findings were analyzed in correlation to fetopathological analyses and post-natal follow up. RESULTS Thirty fetuses (22 females and 8 males) with PNH were identified. The two major ultrasound signs were ventriculomegaly associated with dysmorphic frontal horns (60%) and posterior fossa anomalies (73.3%). On MRI, two groups of PNH were identified: the contiguous and diffuse PNH (n = 15, 50%), often associated with megacisterna magna, and the non-diffuse, either anterior, posterior or unilateral PNH. FLNA mutations were found in 6/11 cases with diffuse PNH. Additional cortical malformations were exclusively observed in non diffuse PNH (9/15; 60%). Twenty-four pregnancies (80%) were terminated. Six children aged 6 months to 5 years are alive. Five have normal neurodevelopment (all had diffuse PNH) whereas one case with non diffuse PNH has developmental delay and epilepsy. CONCLUSION PNH is heterogeneous but patients with diffuse PNH are a common subgroup with specific findings on prenatal imaging and implications for prenatal counseling.
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Affiliation(s)
- B Deloison
- Department of Obstetrics and Gynecology and SFAPE Société Française pour l'Amélioration des Pratiques Echographiques, Necker Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Paris Descartes - Sorbonne Paris Cités, France; EA 7328 FETUS, Université Paris Descartes, France
| | - P Sonigo
- Pediatric Radiology, Necker Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - A E Millischer-Bellaiche
- Pediatric Radiology, Necker Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - T Quibel
- Department of Obstetrics and Gynecology, Poissy Saint-Germain Hospital, Poissy, France
| | - M Cavallin
- Université Paris Descartes - Sorbonne Paris Cités, France; Institut Imagine-INSERM UMR-1163, Embryology and genetics of congenital malformations, France; Pediatric Neurology, Necker Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - G Benoist
- Department of Obstetrics and Gynecology, Caen Hospital, Caen Basse Normandie University, France
| | - C Quelin
- Clinical Genetic Department, Rennes Hospital, France
| | - P S Jouk
- Clinical Genetic Department, Grenoble Hospital, France
| | - D Lev
- Institute of Medical Genetics, Wolfson Medical Center, Holon, Israel
| | - M Alison
- Pediatric Radiology, Robert Debre Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - C Baumann
- Clinical Genetics Department, Robert Debre Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - C Beldjord
- Department of Molecular Genetics, Cochin-Port-Royal Université Paris Descartes - Sorbonne Paris Cités, Paris, France
| | - F Razavi
- Fetopathology Necker Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - B Bessières
- Fetopathology Necker Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - N Boddaert
- Université Paris Descartes - Sorbonne Paris Cités, France; Pediatric Radiology, Necker Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Y Ville
- Department of Obstetrics and Gynecology and SFAPE Société Française pour l'Amélioration des Pratiques Echographiques, Necker Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Paris Descartes - Sorbonne Paris Cités, France; EA 7328 FETUS, Université Paris Descartes, France
| | - L J Salomon
- Department of Obstetrics and Gynecology and SFAPE Société Française pour l'Amélioration des Pratiques Echographiques, Necker Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Paris Descartes - Sorbonne Paris Cités, France; EA 7328 FETUS, Université Paris Descartes, France
| | - N Bahi-Buisson
- Université Paris Descartes - Sorbonne Paris Cités, France; Institut Imagine-INSERM UMR-1163, Embryology and genetics of congenital malformations, France; Pediatric Neurology, Necker Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
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Basu B, Dean E, Puglisi M, Greystoke A, Ong M, Burke W, Cavallin M, Bigley G, Womack C, Harrington EA, Green S, Oelmann E, de Bono JS, Ranson M, Banerji U. First-in-Human Pharmacokinetic and Pharmacodynamic Study of the Dual m-TORC 1/2 Inhibitor AZD2014. Clin Cancer Res 2015; 21:3412-9. [PMID: 25805799 DOI: 10.1158/1078-0432.ccr-14-2422] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 03/11/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE AZD2014 is a novel, oral, m-TORC 1/2 inhibitor that has shown in vitro and in vivo efficacy across a range of preclinical human cancer models. EXPERIMENTAL DESIGN A rolling six-dose escalation was performed to define an MTD (part A), and at MTD a further cohort of patients was treated to further characterize toxicities and perform pre- and posttreatment biopsies (part B). AZD2014 was administered orally twice a day continuously. Flow cytometry, ELISA, and immunohistochemistry were used to quantify pharmacodynamic biomarkers. Pharmacokinetic analysis was carried out by mass spectrometry. RESULTS A total of 56 patients were treated across a dose range of 25 to 100 mg. The MTD was 50 mg twice daily. The dose-limiting toxicities were fatigue and mucositis. At the MTD, the most common adverse events (AE) were fatigue (78%), nausea (51%), and mucositis (49%), but these were equal to or greater than grade 3 in only 5% of patients. Drug levels achieved at the MTD (AUC SS: 6686 ng·h/mL, Cmax ss 1,664 ng/mL) were consistent with activity in preclinical models. A reduction in p-S6 levels and Ki67 staining was observed in 8 of 8 and 5 of 9 evaluable paired biopsy samples. Partial responses were seen in a patient with pancreatic cancer and a patient with breast cancer, who were found to have a PDGFR and ERBB2 mutation, respectively. CONCLUSIONS The recommended phase II dose for further evaluation of AZD2014 is 50 mg twice daily, and at this dose it has been possible to demonstrate pharmacologically relevant plasma concentrations, target inhibition in tumor, and clinical responses.
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Affiliation(s)
- Bristi Basu
- The Institute of Cancer Research and The Royal Marsden, London, United Kingdom
| | - Emma Dean
- University of Manchester and The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Martina Puglisi
- The Institute of Cancer Research and The Royal Marsden, London, United Kingdom
| | - Alastair Greystoke
- University of Manchester and The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Michael Ong
- The Institute of Cancer Research and The Royal Marsden, London, United Kingdom
| | | | | | | | | | | | | | | | - Johann S de Bono
- The Institute of Cancer Research and The Royal Marsden, London, United Kingdom
| | - Malcolm Ranson
- University of Manchester and The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Udai Banerji
- The Institute of Cancer Research and The Royal Marsden, London, United Kingdom.
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Cavallin M, Bertini P, Lopane P, Guarracino F. Portable Device Technology in Organ Donation: New “App” for Procurement Coordinators. Transplant Proc 2014; 46:2192-4. [DOI: 10.1016/j.transproceed.2014.07.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ciofi degli Atti M, Paolini V, Cavallin M, Corsetti T, Locatelli F, Trucco P, Raponi M. Proactive evaluation of clinical risk: a FMECA analysis in pediatric chemotherapy. Ann Ig 2013; 25:15-21. [PMID: 23435776 DOI: 10.7416/ai.2013.1902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In 2010-2011, we used FMECA to prospectively assess risk-management in chemotherapy of children with cancer, in a third level Italian children's Hospital (Ospedale Pediatrico Bambino Gesù; OPBG). We designed a flow chart representing the entire process; we described potential failure points for each step of the process, as well as their potential underlying causes. We calculated the risk priority number (RPN) of each failure point based on the severity of the failure, the frequency of occurrence, and the likelihood of detecting the failure prior to completion of the process. All FMECA activities were supported by a web-based tool. The highest RPN values were observed for failure points of the paper-based chemotherapy medication orders sent from clinicians to Pharmacy, the transcription of the orders into the Pharmacy paper-based work-sheet for medication preparation, and the selection of medications to be used for chemotherapy preparation. Causes of these failures were mostly related to illegible or incomplete handwriting. As a consequence of these results, the implementation of an electronic ordering process for children's chemotherapy medications was proposed as risk-reducing action.
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Cohen RB, Aamdal S, Nyakas M, Cavallin M, Green D, Learoyd M, Smith I, Kurzrock R. A phase I dose-finding, safety and tolerability study of AZD8330 in patients with advanced malignancies. Eur J Cancer 2013; 49:1521-9. [DOI: 10.1016/j.ejca.2013.01.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 01/15/2013] [Accepted: 01/17/2013] [Indexed: 11/27/2022]
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Tørring O, Cavallin M, Löw H, Werner S. Urinary cyclic AMP corrected for glomerular filtration rate in the differential diagnosis of hypercalcemia. Acta Med Scand 2009; 211:401-5. [PMID: 6287811 DOI: 10.1111/j.0954-6820.1982.tb01969.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
To evaluate the usefulness of urinary cyclic AMP (U-cAMP) expressed as nmol/100 ml glomerulus filtrate (GF) when discriminating various hypercalcemic states, we studied 99 patients. Patients with primary hyperparathyroidism (PHPT) showed a positive correlation between individual S-calcium levels and U-cAMP, nmol/100 ml GF (females r=0.49, n=40, p less than 0.01 and males r=0.91, n=7 p less than 0.001). There was also a correlation between U-cAMP, nmol/100 ml GF, and the weight of the adenomas (females r=0.36, n=32, p less than 0.05) and males r=0.79, n=6, p less than 0.05). Patients with PHPT and normal renal function excreted more U-cAMP than controls, 6.0 +/- 1.6 versus 4.3 +/- 1.0 nmol/100 ml GF (mean +/- SD). Of 47 patients with PHPT and normal renal function, 29 showed values below the upper normal limit, 6.3 nmol/100 ml GF (mean +/-2 SD), of the control group; the overlap was 62%. When U-cAMP was expressed as mumol/24 hours, the overlap was 40/47 (85%) and, when expressed as mumol/g creatinine, 31/47 (66%). Three patients with sarcoidosis and two with malignancies and hypercalcemia showed excretory values of U-cAMP, nmol/100 ml GF, above the upper normal limit. Patients with acromegaly or prolactinoma showed normal values of U-cAMP, nmol/100 ml GF. The present data indicate that all three types of determinations of urinary cAMP based on 24 hour urine collections are of little value in the differential diagnosis of hypercalcemic states.
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Zaja F, Battista ML, Pirrotta MT, Palmieri S, Montagna M, Vianelli N, Marin L, Cavallin M, Bocchia M, Defina M, Ippoliti M, Ferrara F, Patriarca F, Avanzini MA, Regazzi M, Baccarani M, Isola M, Soldano F, Fanin R. Lower dose rituximab is active in adults patients with idiopathic thrombocytopenic purpura. Haematologica 2008; 93:930-3. [DOI: 10.3324/haematol.12206] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Abstract
The results of the Randomized Aldactone Evaluation Study (RALES) and of several experimental studies have indicated that excess aldosterone detrimentally affects cardiovascular morbidity and mortality by acting through both classical and non-classical mineralocorticoid receptors. The effects mediated through classical mineralocorticoid receptors entail enhanced sodium and water reabsorption, potassium loss and hypokalaemia, congestion, increased vascular resistance and hypertension. Those occurring through non-classical mineralocorticoid receptors located on myofibroblasts comprise cardiac hypertrophy and fibrosis, which may be due to a direct effect of aldosterone on collagen synthesis. Data obtained in primary aldosteronism patients demonstrated left ventricular hypertrophy, as well as changes in left ventricular filling that can be accounted for by cardiac fibrosis. Available clinical data indicate that in a considerable proportion of congestive heart failure (CHF) patients treated with angiotensin converting enzyme (ACE) inhibitors, aldosterone secretion can escape from blockade of the renin-angiotensin system, thus suggesting that additional mechanisms, besides angiotensin II, can play an important role in the regulation of aldosterone secretion. Compelling evidence indicates that endothelin (ET)-1 is overtly increased in severe CHF and thus is a likely candidate for the aldosterone 'escape' phenomenon in CHF. Endothelin-1 is expressed in the adrenal cortex, together with its receptor subtypes A (ETA) and B (ETB), and directly stimulates aldosterone secretion in different species, in humans by acting via both ETA and ETB receptor subtypes. Moreover, we have recently found that the novel endothelin peptide ET-1 (1-31), by acting as an ETA agonist, can also be involved in the regulation of growth of the adrenal cortex, as well as in the pathogenesis of Conn's adenoma. In this paper, we review the findings suggesting a relationship between activation of the ET-1 system, enhanced aldosterone secretion and cardiac fibrosis and discuss the implications of endothelin antagonism for cardiovascular disease.
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Affiliation(s)
- G P Rossi
- Department of Clinical & Experimental Medicine, University of Padua Medical School, Italy.
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Cavallin M. ["Substitutive polyembryony" and the problem of germinal line origin in the phasma Carausius morosus Br]. C R Acad Hebd Seances Acad Sci D 1971; 272:462-5. [PMID: 4995095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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