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Claire Ellis M, Gonzalez S, Winstead-Derlega C, Freiberger J, Kuchibhatla M, Luedke M, Posada-Quintero H, Chon K, D'Agostino D, Derrick B. 78 Physiologic Monitoring for Central Nervous System Oxygen Toxicity in Working Divers. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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D'Agostino D, Greco A, Masselli C, Minichiello F. The employment of an earth-to-air heat exchanger as pre-treating unit of an air conditioning system for energy saving: A comparison among different worldwide climatic zones. Energy Build 2020; 229:110517. [PMID: 33041474 PMCID: PMC7532812 DOI: 10.1016/j.enbuild.2020.110517] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/14/2020] [Accepted: 09/26/2020] [Indexed: 06/11/2023]
Abstract
A great fraction (20-40%) of primary energy is required for building air conditioning, so the use of renewable energy sources is increasing. The geothermal energy for Heating, Ventilating and Air Conditioning (HVAC) systems can be used considering an Earth-to-Air Heat eXchanger (EAHX). This work analyses the performance of an EAHX through a mathematical model (2D), as a function of diameter and length of the air ducts. The problem is solved with finite element method. A case study office building is analyzed. The air conditioning plant is characterized by fan-coil units and primary air; the EAHX is positioned upstream the Air Handling Unit (AHU) to pre-cool/pre-heat the air. The building is virtually placed initially in six Italian cities (different climatic zones according to Italian regulation DPR 412/93) and subsequently in eight worldwide cities according to Köppen climate classification. The following parameters are calculated: air temperature variation and thermal efficiency of the EAHX; the decreasing of cooling and heating capacity of the coils into the AHU. The best results refer to a duct length of 100 m for Ottawa (warm-summer humid continental climate, 65% capacity reduction), the worst ones for Rio de Janeiro (tropical wet and dry climate, maximum 24% reduction).
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Affiliation(s)
- D D'Agostino
- Department of Industrial Engineering, University of Naples Federico II, P.le Tecchio 80, 80125 Napoli, Italy
| | - A Greco
- Department of Industrial Engineering, University of Naples Federico II, P.le Tecchio 80, 80125 Napoli, Italy
| | - C Masselli
- Department of Industrial Engineering, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, SA, Italy
| | - F Minichiello
- Department of Industrial Engineering, University of Naples Federico II, P.le Tecchio 80, 80125 Napoli, Italy
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Alesini D, Braggio C, Carugno G, Crescini N, D'Agostino D, Di Gioacchino D, Di Vora R, Falferi P, Gambardella U, Gatti C, Iannone G, Ligi C, Lombardi A, Maccarrone G, Ortolan A, Pengo R, Pira C, Rettaroli A, Ruoso G, Taffarello L, Tocci S. High quality factor photonic cavity for dark matter axion searches. Rev Sci Instrum 2020; 91:094701. [PMID: 33003802 DOI: 10.1063/5.0003878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 08/19/2020] [Indexed: 06/11/2023]
Abstract
Searches for dark matter axions involve the use of microwave resonant cavities operating in a strong magnetic field. Detector sensitivity is directly related to the cavity quality factor, which is limited, until recently, to the use of non-superconducting metals by the presence of the external magnetic field. In this paper, we present a cavity of novel design whose quality factor is not affected by a magnetic field. It is based on a photonic structure by the use of sapphire rods. The quality factor at cryogenic temperature is in excess of 5 × 105 for a selected mode.
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Affiliation(s)
- D Alesini
- INFN, Laboratori Nazionali di Frascati, Via E. Fermi 40, 00044 Frascati, Roma, Italy
| | - C Braggio
- INFN, Sezione di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - G Carugno
- INFN, Sezione di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - N Crescini
- Dipartimento di Fisica e Astronomia, Via Marzolo 8, 35131 Padova, Italy
| | - D D'Agostino
- Dipartimento di Fisica, Via Giovanni Paolo II 132, 84084 Fisciano, Salerno, Italy
| | - D Di Gioacchino
- INFN, Laboratori Nazionali di Frascati, Via E. Fermi 40, 00044 Frascati, Roma, Italy
| | - R Di Vora
- INFN, Sezione di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - P Falferi
- Istituto di Fotonica e Nanotecnologie, CNR, Fondazione Bruno Kessler and INFN - TIFPA, Via Sommarive 14, 38123 Povo, Trento, Italy
| | - U Gambardella
- Dipartimento di Fisica, Via Giovanni Paolo II 132, 84084 Fisciano, Salerno, Italy
| | - C Gatti
- INFN, Laboratori Nazionali di Frascati, Via E. Fermi 40, 00044 Frascati, Roma, Italy
| | - G Iannone
- Dipartimento di Fisica, Via Giovanni Paolo II 132, 84084 Fisciano, Salerno, Italy
| | - C Ligi
- INFN, Laboratori Nazionali di Frascati, Via E. Fermi 40, 00044 Frascati, Roma, Italy
| | - A Lombardi
- INFN, Laboratori Nazionali di Legnaro, Viale Dell'Università 2, 35020 Legnaro, Padova, Italy
| | - G Maccarrone
- INFN, Laboratori Nazionali di Frascati, Via E. Fermi 40, 00044 Frascati, Roma, Italy
| | - A Ortolan
- INFN, Laboratori Nazionali di Legnaro, Viale Dell'Università 2, 35020 Legnaro, Padova, Italy
| | - R Pengo
- INFN, Laboratori Nazionali di Legnaro, Viale Dell'Università 2, 35020 Legnaro, Padova, Italy
| | - C Pira
- INFN, Laboratori Nazionali di Legnaro, Viale Dell'Università 2, 35020 Legnaro, Padova, Italy
| | - A Rettaroli
- INFN, Laboratori Nazionali di Frascati, Via E. Fermi 40, 00044 Frascati, Roma, Italy
| | - G Ruoso
- INFN, Laboratori Nazionali di Legnaro, Viale Dell'Università 2, 35020 Legnaro, Padova, Italy
| | - L Taffarello
- INFN, Sezione di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - S Tocci
- INFN, Laboratori Nazionali di Frascati, Via E. Fermi 40, 00044 Frascati, Roma, Italy
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Crescini N, Alesini D, Braggio C, Carugno G, D'Agostino D, Di Gioacchino D, Falferi P, Gambardella U, Gatti C, Iannone G, Ligi C, Lombardi A, Ortolan A, Pengo R, Ruoso G, Taffarello L. Axion Search with a Quantum-Limited Ferromagnetic Haloscope. Phys Rev Lett 2020; 124:171801. [PMID: 32412290 DOI: 10.1103/physrevlett.124.171801] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/12/2020] [Accepted: 04/17/2020] [Indexed: 05/27/2023]
Abstract
A ferromagnetic axion haloscope searches for dark matter in the form of axions by exploiting their interaction with electronic spins. It is composed of an axion-to-electromagnetic field transducer coupled to a sensitive rf detector. The former is a photon-magnon hybrid system, and the latter is based on a quantum-limited Josephson parametric amplifier. The hybrid system consists of ten 2.1 mm diameter yttrium iron garnet spheres coupled to a single microwave cavity mode by means of a static magnetic field. Our setup is the most sensitive rf spin magnetometer ever realized. The minimum detectable field is 5.5×10^{-19} T with 9 h integration time, corresponding to a limit on the axion-electron coupling constant g_{aee}≤1.7×10^{-11} at 95% C.L. The scientific run of our haloscope resulted in the best limit on dark matter axions to electron coupling constant in a frequency span of about 120 MHz, corresponding to the axion-mass range 42.4-43.1 μeV. This is also the first apparatus to perform a wide axion-mass scanning by only changing the static magnetic field.
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Affiliation(s)
- N Crescini
- INFN-Laboratori Nazionali di Legnaro, Viale dell'Università 2, 35020 Legnaro (PD), Italy
- Dipartimento di Fisica e Astronomia, Via Marzolo 8, 35131 Padova, Italy
| | - D Alesini
- INFN-Laboratori Nazionali di Frascati, Via Enrico Fermi 40, 00044 Roma, Italy
| | - C Braggio
- Dipartimento di Fisica e Astronomia, Via Marzolo 8, 35131 Padova, Italy
- INFN-Sezione di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - G Carugno
- Dipartimento di Fisica e Astronomia, Via Marzolo 8, 35131 Padova, Italy
- INFN-Sezione di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - D D'Agostino
- INFN-Sezione di Napoli, Via Cinthia, 80126 Napoli, Italy and Dipartimento di Fisica, Via Giovanni Paolo II 132, 84084 Fisciano (SA), Italy
| | - D Di Gioacchino
- INFN-Laboratori Nazionali di Frascati, Via Enrico Fermi 40, 00044 Roma, Italy
| | - P Falferi
- IFN-CNR, Fondazione Bruno Kessler, and INFN-TIFPA, Via alla Cascata 56, 38123 Povo (TN), Italy
| | - U Gambardella
- INFN-Sezione di Napoli, Via Cinthia, 80126 Napoli, Italy and Dipartimento di Fisica, Via Giovanni Paolo II 132, 84084 Fisciano (SA), Italy
| | - C Gatti
- INFN-Laboratori Nazionali di Frascati, Via Enrico Fermi 40, 00044 Roma, Italy
| | - G Iannone
- INFN-Sezione di Napoli, Via Cinthia, 80126 Napoli, Italy and Dipartimento di Fisica, Via Giovanni Paolo II 132, 84084 Fisciano (SA), Italy
| | - C Ligi
- INFN-Laboratori Nazionali di Frascati, Via Enrico Fermi 40, 00044 Roma, Italy
| | - A Lombardi
- INFN-Laboratori Nazionali di Legnaro, Viale dell'Università 2, 35020 Legnaro (PD), Italy
| | - A Ortolan
- INFN-Laboratori Nazionali di Legnaro, Viale dell'Università 2, 35020 Legnaro (PD), Italy
| | - R Pengo
- INFN-Laboratori Nazionali di Legnaro, Viale dell'Università 2, 35020 Legnaro (PD), Italy
| | - G Ruoso
- INFN-Laboratori Nazionali di Legnaro, Viale dell'Università 2, 35020 Legnaro (PD), Italy
| | - L Taffarello
- INFN-Sezione di Padova, Via Marzolo 8, 35131 Padova, Italy
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Porreca A, Mineo Bianchi F, Romagnoli D, D'Agostino D, Corsi P, Giampaoli M, Salvaggio A, Bianchi L, Schiavina R, Brunocilla E, Artibani W. Robot-assisted radical cystectomy with totally intracorporeal urinary diversion: surgical and early functional outcomes through the learning curve in a single high-volume center. J Robot Surg 2019; 14:261-269. [PMID: 31124038 DOI: 10.1007/s11701-019-00977-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/21/2019] [Indexed: 12/19/2022]
Abstract
The aim of the study is to report surgical and early functional outcomes of first 100 patients undergoing robot-assisted radical cystectomy (RARC) with totally intracorporeal urinary diversion (ICUD) in a single center. The main surgeon (A.P.) attended a modular training program at a referring center mentored by a worldwide-recognized robotic surgeon (P.W.). The program consisted of: (a) 10 h of theoretical lessons; (b) video session (c) step-by-step in vivo modular training. Each procedure was performed as taught, without any technique variation. Demographics, intra-operative data and post-operative complications, along with early functional outcomes, were recorded for each patient. We retrospectively evaluated the first consecutive 100 patients submitted to RARC with totally ICUD from July 2015 to December 2018. Median age at surgery was 69 years (IQR 60-74). 52 (52%), 32 (32%), and 17 (17%) patients received orthotopic neobladder, ileal conduit and uretero-cutaneostomy, respectively. Median operative time was 410 min. A median number of lymph nodes retrieved were 27 and median estimated blood loss was 240 mL with median hospitalization time of 7 days. All procedures were completed successfully without open conversion. A statistically significant improvement was found in the late (30-90 post-operative days) post-operative complications (p = 0.02) and operative time for urinary derivation. At multivariate logistic regression model ASA score ≥ 3 (OR = 4.2, p = 0.002) and number of lymph nodes retrieved (OR = 1.16, p = 0.02) were found to be predictors of 90-day complications. An adequate modular training is paramount to obtain successful results and reduce the learning curve of RARC, as demonstrated by our experience.
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Affiliation(s)
- A Porreca
- Department of Urology, Policlinico Di Abano, Abano Terme, Italy
| | - F Mineo Bianchi
- Department of Urology, Policlinico Di Abano, Abano Terme, Italy.
- Department of Urology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
| | - D Romagnoli
- Department of Urology, Policlinico Di Abano, Abano Terme, Italy
| | - D D'Agostino
- Department of Urology, Policlinico Di Abano, Abano Terme, Italy
| | - P Corsi
- Department of Urology, Policlinico Di Abano, Abano Terme, Italy
| | - M Giampaoli
- Department of Urology, Policlinico Di Abano, Abano Terme, Italy
| | - A Salvaggio
- Department of Urology, Policlinico Di Abano, Abano Terme, Italy
| | - L Bianchi
- Department of Urology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - R Schiavina
- Department of Urology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - E Brunocilla
- Department of Urology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - W Artibani
- Department of Urology, Policlinico Di Abano, Abano Terme, Italy
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Martinón-Torres F, Bernatowska E, Shcherbina A, Esposito S, Szenborn L, Marti MC, Hughes S, Faust SN, Gonzalez-Granado LI, Yu LM, D'Agostino D, Calabresi M, Toneatto D, Snape MD. Meningococcal B Vaccine Immunogenicity in Children With Defects in Complement and Splenic Function. Pediatrics 2018; 142:peds.2017-4250. [PMID: 30068713 DOI: 10.1542/peds.2017-4250] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The capsular group B meningococcal vaccine (4CMenB) is recommended for children with complement deficiencies, asplenia, and splenic dysfunction; however, data on the immunogenicity of 4CMenB in these "at-risk" children are missing. METHODS Participants aged 2 to 17 years in Italy, Spain, Poland, the United Kingdom, and Russia with complement deficiencies, asplenia, or splenic dysfunction received 2 doses of 4CMenB 2 months apart, as did healthy children in the control group. Exogenous and endogenous human complement serum bactericidal activity (SBA) was determined at baseline and 1 month after the second immunization against 4 test strains: H44/76 (assessing vaccine antigen factor H binding protein), 5/99 (Neisserial adhesion A), NZ98/254 (Porin A), and M10713 (Neisserial heparin binding antigen). RESULTS Of 239 participants (mean age 10.3 years, 45% female), 40 children were complement deficient (9 eculizumab therapy, 4 terminal-chain deficiencies, 27 "other"), 112 children had asplenia or splenic dysfunction (8 congenital asplenia, 8 functional asplenia, 96 splenectomy), and 87 children were in the control group. After immunization, the proportions of complement-deficient participants with exogenous complement SBA titers ≥1:5 were 87% (H44/76), 95% (5/99), 68% (NZ98/254), and 73% (M10713), compared with 97%, 100%, 86%, and 94%, respectively, for asplenic children and 98%, 99%, 83%, and 99% for children in the control group. When testing with endogenous complement, strain-specific bactericidal activity was evident in only 1 eculizumab-treated participant and 1 terminal chain complement-deficient participant. CONCLUSIONS 4CMenB administration is similarly immunogenic in healthy children and those with asplenia or splenic dysfunction. The significance of the trend to lower responses of SBA titers in complement-deficient children (especially those with terminal chain complement deficiency or those on eculizumab therapy) must be determined by ongoing surveillance for vaccine failures.
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Affiliation(s)
- Federico Martinón-Torres
- Translational Pediatrics and Infectious Diseases, Hospital Clinico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ewa Bernatowska
- Department of Immunology, The Children's Memorial Health Institute, Warsaw, Poland
| | - Anna Shcherbina
- Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Moscow, Russian Federation
| | - Susanna Esposito
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, Perugia, Italy
| | - Leszek Szenborn
- Department of Pediatric Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland
| | | | - Stephen Hughes
- Royal Manchester Children's Hospital, Manchester, United Kingdom
| | - Saul N Faust
- National Institute for Health Research Wellcome Trust Clinical Research Facility, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Luis I Gonzalez-Granado
- Immunodeficiencies Unit, Department of Pediatrics, University Hospital 12 de Octubre, Research Institute Hospital 12 Octubre (i+12) and Associate Professor of Pediatrics, Complutense University of Madrid, Madrid, Spain
| | - Ly-Mee Yu
- Nuffield Department of Primary Care Health Sciences and
| | | | | | | | - Matthew D Snape
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom; .,National Institute for Health Research Oxford Biomedical Research Centre, Oxford, United Kingdom
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Porreca A, D'Agostino D, Dente D, Dandrea M, Salvaggio A, Cappa E, Zuccala A, Del Rosso A, Chessa F, Romagnoli D, Mengoni F, Borghesi M, Schiavina R. Retroperitoneal approach for robot-assisted partial nephrectomy: technique and early outcomes. Int Braz J Urol 2018; 44:63-68. [PMID: 29211396 PMCID: PMC5815533 DOI: 10.1590/s1677-5538.ibju.2017.0104] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 08/07/2017] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES The aim of our study is to present early outcomes of our series of retroperitoneal-RAPN (Robot Assisted Partial Nephrectomy). MATERIALS AND METHODS From September 2010 until December 2015, we performed 81 RAPN procedures (44 at left kidney and 37 at right). Average size was 3cm (1-9). Average PADUA score 7.1 (5-10). Average surgical time (overall and only robot time), ischemia time, blood loss, pathological stage, complications and hospital stay have been recorded. RESULTS All of the cases were completed successfully without any operative complication or surgical conversion. Average surgical time was 177 minutes (75-340). Operative time was 145 minutes (80-300), overall blood loss was 142cc (60-310cc). In 30 cases the pedicle was late clamped with an average ischemia time of 4 minutes (2-7). None of the patient had positive surgical margins at definitive histology (49pT1a, 12pT1b, 3pT2a, 2pT3a). Hospital stay was 3 days (2-7). CONCLUSIONS The retroperitoneal robotic partial nephrectomy approach is safe and allows treatment of even quite complex tumors. It also combines the already well known advantages guaranteed by the da Vinci® robotic surgical system, with the advantages of the retroperitoneoscopic approach.
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Affiliation(s)
- A Porreca
- Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy
| | - D D'Agostino
- Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy
| | - D Dente
- Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy
| | - M Dandrea
- Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy
| | - A Salvaggio
- Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy
| | - E Cappa
- Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy
| | - A Zuccala
- Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy
| | - A Del Rosso
- Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy
| | - F Chessa
- Department of Urology, University of Bologna, Bologna, Italy
| | - D Romagnoli
- Department of Urology, University of Bologna, Bologna, Italy
| | - F Mengoni
- Department of Urology, University of Bologna, Bologna, Italy
| | - M Borghesi
- Department of Urology, University of Bologna, Bologna, Italy
| | - R Schiavina
- Department of Urology, University of Bologna, Bologna, Italy
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Volpe A, Racioppi M, D'Agostino D, Cappa E, Gardi M, Totaro A, Pinto F, Sacco E, Marangi F, Palermo G, Bassi P. Bladder Tumor Markers: A Review of the Literature. Int J Biol Markers 2018; 23:249-61. [DOI: 10.1177/172460080802300409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Bladder cancer is among the top eight most frequent cancers. Its natural history is related to a combination of factors that impact on its aggressiveness. Cystoscopy and urine cytology are the currently used techniques for the diagnosis and surveillance of non-invasive bladder tumors. The sensitivity of urine cytology for diagnosis is not high, particularly in low-grade tumors. The combination of voided urine cytology and new diagnostic urine tests would be ideal for the diagnosis and follow-up of bladder cancer. However, in order to have some clinical utility, new diagnostic and/or prognostic markers should achieve better predictive capacity that the currently used diagnostic tools. None of the markers evaluated over the last years showed remarkable sensitivity or specificity for the identification of any of the diverse types of bladder cancer in clinical practice. The limitations of the known prognostic markers have led to the research of new molecular markers for early detection of bladder cancer. This research focused in particular on the discovery of biomarkers capable of reducing the need for periodic cystoscopies or, ideally, offering a non-invasive examination instead. In this review, we will examine various new markers of bladder cancer and their value in the diagnosis and follow-up of non-muscle-invasive bladder cancer. When compared with urine cytology, which showed the highest specificity, most of these markers demonstrated an increased sensitivity.
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Affiliation(s)
- A. Volpe
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - M. Racioppi
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - D. D'Agostino
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - E. Cappa
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - M. Gardi
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - A. Totaro
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - F. Pinto
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - E. Sacco
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - F. Marangi
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - G. Palermo
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - P.F. Bassi
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
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9
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Szenborn L, Block SL, Jackowska T, Daly W, Welsch JA, D'Agostino D, Han L, Smolenov I. A Booster Response to an Investigational Meningococcal MenABCWY Vaccine in Adolescents Previously Vaccinated With MenACWY, 4CMenB or MenABCWY: A Phase 2, Observer-Blind, Placebo-Controlled, Randomized Study. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.586] [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: 11/14/2022] Open
Affiliation(s)
- Leszek Szenborn
- Department of Pediatric Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Stan L. Block
- Kentucky Pediatric and Adult Research Inc, Bardstown, Kentucky
| | - Teresa Jackowska
- Department of Pediatrics, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Wendy Daly
- Bluegrass Clinical Research Inc, Louisville, Kentucky
- Brownsboro Park Pediatrics, Louisville, Kentucky
| | | | | | - Linda Han
- Novartis Vaccines and Diagnostics Inc, Cambridge, Massachusetts
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Chaudhari K, Sumien N, Johnson L, D'Agostino D, Edwards M, Paxton RJ, Hall JR, O'Bryant S. Vitamin C Supplementation, APOE4 Genotype and Cognitive Functioning in a Rural-Dwelling Cohort. J Nutr Health Aging 2016; 20:841-844. [PMID: 27709233 DOI: 10.1007/s12603-016-0705-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Apolipoprotein E4 (APOE4) genotype has been implicated as a moderating factor in cognitive function studies. Although prior studies have suggested that vitamin C is associated with better cognitive function in elders, link between the two has been mixed. Limited data exist as to whether the APOE4 genotype influences these associations. Therefore, this study sought to determine whether the association between vitamin C and cognition in a rural community dwelling cohort differs by the APOE4 genotype. DESIGN AND PARTICIPANTS Data were analyzed on 582 participants (n=183 men; n=399 women) from a rural community-based cohort. Cognition was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status and The Executive Interview. APOE genotyping was ascertained by standard methods. The relation between vitamin C supplementation and cognition were analyzed first with ANOVA and then ANCOVA with age, gender, education as covariates. Analyses were initially run in the full sample and then split by APOE4 presence (yes/no). RESULTS Overall, Vitamin C supplementation was associated with significantly better immediate memory (p=0.04), visuospatial skills (p=0.002), language (p=0.01), and global cognitive functioning (p=0.006). Among APOE4 non-carriers, vitamin C supplementation was positively associated with immediate memory (F[1,392] =6.7, p=0.01), visuospatial skills (F[1,391]=10.6, p=0.001), language (F[1,392]=13.0, p<0.001), attention (F[1,386]=7.9, p=0.005, and global cognition (F[1,382]=11.0, p=0.001. However, there was no significant link between vitamin C supplementation and cognition among APOE4 carriers. CONCLUSION Vitamin C supplementation was found to be positively associated with cognition among this rural-dwelling community-based sample; however, the associations appeared to differ by APOE4 status. These data may suggest that targeted genotype-specific cognitive enhancement studies are needed to clarify the potential benefits of vitamin C supplementation.
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Affiliation(s)
- K Chaudhari
- Sid E. O'Bryant, Ph.D., University of North Texas, Health Sciences Center, Department of Internal Medicine, 3500 Camp Bowie Blvd, Fort Worth, Texas, 76107, USA. Phone: (817)735-2961. E-mail:
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11
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Esposito P, Israel GL, Belfiore A, Novara G, Sidoli L, Rodríguez Castillo GA, De Luca A, Tiengo A, Haberl F, Salvaterra R, Read AM, Salvetti D, Sandrelli S, Marelli M, Wilms J, D'Agostino D. EXTraS discovery of an 1.2-s X-ray pulsar in M 31. ACTA ACUST UNITED AC 2015. [DOI: 10.1093/mnrasl/slv194] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Nedungadi T, Johnson L, Edwards M, Barber R, Hall J, D'Agostino D, Ross S, Large S, O'Bryant S. Comorbid Diabetes and Depression Impacts Diabetic, Cognitive and Affective Outcomes among Mexican Americans. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.840.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- T.Prashant Nedungadi
- Physiology and Anatomy, Internal Medicine, Pharmacology and NeuroscienceUniversity of North Texas Health Science CenterUnited States
| | - L Johnson
- Physiology and Anatomy, Internal Medicine, Pharmacology and NeuroscienceUniversity of North Texas Health Science CenterUnited States
| | - M Edwards
- Physiology and Anatomy, Internal Medicine, Pharmacology and NeuroscienceUniversity of North Texas Health Science CenterUnited States
| | - R Barber
- Physiology and Anatomy, Internal Medicine, Pharmacology and NeuroscienceUniversity of North Texas Health Science CenterUnited States
| | - J Hall
- Physiology and Anatomy, Internal Medicine, Pharmacology and NeuroscienceUniversity of North Texas Health Science CenterUnited States
| | - D D'Agostino
- Physiology and Anatomy, Internal Medicine, Pharmacology and NeuroscienceUniversity of North Texas Health Science CenterUnited States
| | - S Ross
- Physiology and Anatomy, Internal Medicine, Pharmacology and NeuroscienceUniversity of North Texas Health Science CenterUnited States
| | - S Large
- Physiology and Anatomy, Internal Medicine, Pharmacology and NeuroscienceUniversity of North Texas Health Science CenterUnited States
| | - S O'Bryant
- Physiology and Anatomy, Internal Medicine, Pharmacology and NeuroscienceUniversity of North Texas Health Science CenterUnited States
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McQuaid F, Snape MD, John TM, Kelly S, Robinson H, Yu LM, Toneatto D, D'Agostino D, Dull PM, Pollard AJ. Persistence of specific bactericidal antibodies at 5 years of age after vaccination against serogroup B meningococcus in infancy and at 40 months. CMAJ 2015; 187:E215-E223. [PMID: 25802309 DOI: 10.1503/cmaj.141200] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 03/06/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The multicomponent serogroup B meningococcal (4CMenB) vaccine induces antibodies against indicator strains of serogroup B meningococcus under various schedules. We investigated the persistence of antibodies in 5-year-old children 18-20 months after their last dose (at about 3.5 years of age). METHODS We assessed 5-year-old children who received the 4CMenB vaccine or a recombinant protein vaccine in a previous randomized trial. We also recruited 50 vaccine-naive 5-year-olds and administered 2 doses of 4CMenB to each child. We measured serum bactericidal antibody titres against 4 indicator strains of serogroup B meningococcus matched to each individual vaccine component and against 4 mismatched strains. RESULTS Of those who received the 4CMenB vaccine at 2, 4, 6, 12 and 40 months (n = 16), the percentage with protective antibody titres (≥ 1:4) at 60 months ranged from 44% to 88% against matched strains and from 13% to 81% against mismatched strains. Loss of protective titres was also observed for those who received the 4CMenB vaccine at 12, 40 and 42 months (n = 5) (80%-100% against matched strains, 60%-100% against mismatched strains) or at 40 and 42 months (n = 29) (31%-100% against matched strains, 41%-81% against mismatched strains). Administering the 4CMenB vaccine to 5-year-old children yielded protective titres against matched strains in 92%-100% and against mismatched strains in 59%-100%. The majority of these children reported injection-site pain (40/50 [80%] after dose 1, 39/46 [85%] after dose 2) and erythema (47/50 [94%] and 40/46 [87%], respectively); rates of fever were low (5/50 [10%] and 2/46 [4%], respectively). INTERPRETATION Waning of immunity by 5 years of age occurred after receipt of the 4CMenB vaccine in infancy, even with an additional booster at 40 months. The 4CMenB vaccine is immunogenic and was fairly well tolerated by 5-year-old children, although injection-site pain was noteworthy. TRIAL REGISTRATION ClinicalTrials.gov, no. NCT01027351.
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Affiliation(s)
- Fiona McQuaid
- Oxford Vaccine Group, Department of Paediatrics (McQuaid, Snape, John, Kelly, Robinson, Pollard), and Nuffield Department of Primary Care Health Sciences (Yu), University of Oxford, Oxford, UK; Oxford Biomedical Research Centre (McQuaid, Snape, John, Kelly, Robinson, Pollard), National Institute for Health Research, Oxford, UK; Novartis Vaccines and Diagnostics S.r.l. (Toneatto), Siena, Italy; Novartis Pharma BV (D'Agostino), Amsterdam, Netherlands; Novartis Vaccines and Diagnostics Inc. (Dull), Cambridge, Mass.
| | - Matthew D Snape
- Oxford Vaccine Group, Department of Paediatrics (McQuaid, Snape, John, Kelly, Robinson, Pollard), and Nuffield Department of Primary Care Health Sciences (Yu), University of Oxford, Oxford, UK; Oxford Biomedical Research Centre (McQuaid, Snape, John, Kelly, Robinson, Pollard), National Institute for Health Research, Oxford, UK; Novartis Vaccines and Diagnostics S.r.l. (Toneatto), Siena, Italy; Novartis Pharma BV (D'Agostino), Amsterdam, Netherlands; Novartis Vaccines and Diagnostics Inc. (Dull), Cambridge, Mass
| | - Tessa M John
- Oxford Vaccine Group, Department of Paediatrics (McQuaid, Snape, John, Kelly, Robinson, Pollard), and Nuffield Department of Primary Care Health Sciences (Yu), University of Oxford, Oxford, UK; Oxford Biomedical Research Centre (McQuaid, Snape, John, Kelly, Robinson, Pollard), National Institute for Health Research, Oxford, UK; Novartis Vaccines and Diagnostics S.r.l. (Toneatto), Siena, Italy; Novartis Pharma BV (D'Agostino), Amsterdam, Netherlands; Novartis Vaccines and Diagnostics Inc. (Dull), Cambridge, Mass
| | - Sarah Kelly
- Oxford Vaccine Group, Department of Paediatrics (McQuaid, Snape, John, Kelly, Robinson, Pollard), and Nuffield Department of Primary Care Health Sciences (Yu), University of Oxford, Oxford, UK; Oxford Biomedical Research Centre (McQuaid, Snape, John, Kelly, Robinson, Pollard), National Institute for Health Research, Oxford, UK; Novartis Vaccines and Diagnostics S.r.l. (Toneatto), Siena, Italy; Novartis Pharma BV (D'Agostino), Amsterdam, Netherlands; Novartis Vaccines and Diagnostics Inc. (Dull), Cambridge, Mass
| | - Hannah Robinson
- Oxford Vaccine Group, Department of Paediatrics (McQuaid, Snape, John, Kelly, Robinson, Pollard), and Nuffield Department of Primary Care Health Sciences (Yu), University of Oxford, Oxford, UK; Oxford Biomedical Research Centre (McQuaid, Snape, John, Kelly, Robinson, Pollard), National Institute for Health Research, Oxford, UK; Novartis Vaccines and Diagnostics S.r.l. (Toneatto), Siena, Italy; Novartis Pharma BV (D'Agostino), Amsterdam, Netherlands; Novartis Vaccines and Diagnostics Inc. (Dull), Cambridge, Mass
| | - Ly-Mee Yu
- Oxford Vaccine Group, Department of Paediatrics (McQuaid, Snape, John, Kelly, Robinson, Pollard), and Nuffield Department of Primary Care Health Sciences (Yu), University of Oxford, Oxford, UK; Oxford Biomedical Research Centre (McQuaid, Snape, John, Kelly, Robinson, Pollard), National Institute for Health Research, Oxford, UK; Novartis Vaccines and Diagnostics S.r.l. (Toneatto), Siena, Italy; Novartis Pharma BV (D'Agostino), Amsterdam, Netherlands; Novartis Vaccines and Diagnostics Inc. (Dull), Cambridge, Mass
| | - Daniela Toneatto
- Oxford Vaccine Group, Department of Paediatrics (McQuaid, Snape, John, Kelly, Robinson, Pollard), and Nuffield Department of Primary Care Health Sciences (Yu), University of Oxford, Oxford, UK; Oxford Biomedical Research Centre (McQuaid, Snape, John, Kelly, Robinson, Pollard), National Institute for Health Research, Oxford, UK; Novartis Vaccines and Diagnostics S.r.l. (Toneatto), Siena, Italy; Novartis Pharma BV (D'Agostino), Amsterdam, Netherlands; Novartis Vaccines and Diagnostics Inc. (Dull), Cambridge, Mass
| | - Diego D'Agostino
- Oxford Vaccine Group, Department of Paediatrics (McQuaid, Snape, John, Kelly, Robinson, Pollard), and Nuffield Department of Primary Care Health Sciences (Yu), University of Oxford, Oxford, UK; Oxford Biomedical Research Centre (McQuaid, Snape, John, Kelly, Robinson, Pollard), National Institute for Health Research, Oxford, UK; Novartis Vaccines and Diagnostics S.r.l. (Toneatto), Siena, Italy; Novartis Pharma BV (D'Agostino), Amsterdam, Netherlands; Novartis Vaccines and Diagnostics Inc. (Dull), Cambridge, Mass
| | - Peter M Dull
- Oxford Vaccine Group, Department of Paediatrics (McQuaid, Snape, John, Kelly, Robinson, Pollard), and Nuffield Department of Primary Care Health Sciences (Yu), University of Oxford, Oxford, UK; Oxford Biomedical Research Centre (McQuaid, Snape, John, Kelly, Robinson, Pollard), National Institute for Health Research, Oxford, UK; Novartis Vaccines and Diagnostics S.r.l. (Toneatto), Siena, Italy; Novartis Pharma BV (D'Agostino), Amsterdam, Netherlands; Novartis Vaccines and Diagnostics Inc. (Dull), Cambridge, Mass
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics (McQuaid, Snape, John, Kelly, Robinson, Pollard), and Nuffield Department of Primary Care Health Sciences (Yu), University of Oxford, Oxford, UK; Oxford Biomedical Research Centre (McQuaid, Snape, John, Kelly, Robinson, Pollard), National Institute for Health Research, Oxford, UK; Novartis Vaccines and Diagnostics S.r.l. (Toneatto), Siena, Italy; Novartis Pharma BV (D'Agostino), Amsterdam, Netherlands; Novartis Vaccines and Diagnostics Inc. (Dull), Cambridge, Mass
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Block SL, Szenborn L, Daly W, Jackowska T, D'Agostino D, Han L, Dull PM, Smolenov I. A comparative evaluation of two investigational meningococcal ABCWY vaccine formulations: Results of a phase 2 randomized, controlled trial. Vaccine 2015; 33:2500-10. [PMID: 25795256 DOI: 10.1016/j.vaccine.2015.03.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 02/04/2015] [Accepted: 03/01/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND A meningococcal vaccine protective against all major disease-associated serogroups (A, B, C, W and Y) is an unmet public health need. In this phase 2 observer-blinded, randomized, controlled study, two investigational meningococcal ABCWY vaccine formulations were evaluated to assess their immunological noninferiority to a licensed quadrivalent meningococcal ACWY glycoconjugate vaccine (MenACWY-CRM) for serogroups ACWY and immunogenicity against serogroup B test strains, as well as for formulation selection based on a desirability index (DI). Each investigational MenABCWY formulation contained recombinant protein and outer membrane vesicle (OMV) components of a licensed serogroup B vaccine (4CMenB) combined with components of MenACWY-CRM. METHODS A total of 484 healthy 10-25 year-old participants were randomized to receive two doses, two months apart, of an investigational MenABCWY formulation that contained either a full or one-quarter dose of OMV, 4CMenB alone, or a Placebo followed by MenACWY-CRM. Immunogenicity against each of serogroups ACWY and four serogroup B test strains was assessed by serum bactericidal assay with human complement (hSBA). MenABCWY formulations were compared by a DI based on key immunogenicity and reactogenicity parameters. RESULTS Seroresponse rates for serogroups ACWY were significantly higher after two doses of either MenABCWY formulation than after one dose of MenACWY-CRM: respectively, A: 90-92% vs. 73%; C: 93-95% vs. 63%; W: 80-84% vs. 65%; and Y: 90-92% vs. 75%. Prespecified noninferiority criteria were met. Both MenABCWY formulations induced substantial immune responses against serogroup B test strains, although 4CMenB responses were higher. Overall DIs for both MenABCWY formulations were similar. Reactogenicity profiles of the MenABCWY formulations were similar to each other and to that of 4CMenB. No vaccine-related serious adverse events were reported. CONCLUSIONS Both investigational MenABCWY formulations elicited robust immune responses against serogroups ACWY and serogroup B test strains, and had acceptable reactogenicity profiles, with no safety concerns identified.
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Affiliation(s)
- Stan L Block
- Kentucky Pediatric and Adult Research, Bardstown, KY, USA
| | - Leszek Szenborn
- Department of Pediatric Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Wendy Daly
- Bluegrass Clinical Research Inc, Louisville, KY, USA
| | - Teresa Jackowska
- Department of Pediatrics, Medical Center of Postgraduate Education, Warsaw, Poland
| | | | - Linda Han
- Novartis Vaccines and Diagnostics, Inc., Cambridge, MA, USA
| | - Peter M Dull
- Novartis Vaccines and Diagnostics, Inc., Cambridge, MA, USA
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D'Agostino D, Lenstra D, Ambrosius HPMM, Smit MK. Coupled cavity laser based on anti-resonant imaging via multimode interference. Opt Lett 2015; 40:653-656. [PMID: 25680173 DOI: 10.1364/ol.40.000653] [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] [Indexed: 06/04/2023]
Abstract
We report the experimental demonstration of two coupled laser cavities via self-imaging interference in a multimode waveguide. The coupling is optimized by considering images formed by two coherent phase-delayed signals at the input of a 3×3 splitter. As a result, the complex transfer coefficients of the coupling element can be chosen to increase the mode selectivity of the coupled system. A demonstration is given by the successful fabrication of a tunable laser with a side-mode suppression ratio (SMSR) up to 40 dB and a 6.5 nm tuning range. The laser delivers milliwatts of output power to a lensed fiber and is fully compatible with processes supporting vertically-etched sidewalls.
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Block SL, Szenborn L, Daly W, Jackowska T, Narasimhan V, D'Agostino D, Han L, Dull PM, Smolenov I. 1083Comparative Evaluation of Two Different Investigational Meningococcal ABCWY Vaccine Formulations in Adolescents and Young Adults. Open Forum Infect Dis 2014. [PMCID: PMC5782156 DOI: 10.1093/ofid/ofu052.791] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Stan L. Block
- Kentucky Pediatric and Adult Research Center, Bardstown, KY
| | - Leszek Szenborn
- Clinic of Pediatrics and Infectious Diseases, Wroclaw, Poland
| | - Wendy Daly
- Bluegrass Clinical Research Inc., Louisville, KY
| | - Teresa Jackowska
- Department of Pediatrics, Medical Center of Postgraduate Education, Warsaw, Poland
| | | | | | - Linda Han
- Novartis Vaccines and Diagnostics Inc., Cambridge, MA
| | - Peter M Dull
- Novartis Vaccines and Diagnostics Inc., Cambridge, MA
| | - Igor Smolenov
- Novartis Vaccines and Diagnostics Inc., Cambridge, MA
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17
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Racioppi M, Salmaso L, Brombin C, Arboretti R, D'Agostino D, Colombo R, Serretta V, Brausi M, Casetta G, Gontero P, Hurle R, Tenaglia R, Altieri V, Bartoletti R, Maffezzini M, Siracusano S, Morgia G, Bassi PF. The clinical use of statistical permutation test methodology: a tool for identifying predictive variables of outcome. Urol Int 2014; 94:262-9. [PMID: 25171377 DOI: 10.1159/000365292] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 06/16/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To identify the predictive variables affecting the outcome after radical surgery for bladder cancer by a newer statistical methodology, i.e. nonparametric combination (NPC). METHODS A multicenter study enrolled 1,312 patients who had undergone radical cystectomy for bladder cancer in 11 Italian oncological centers from January 1982 to December 2002. A statistical analysis of their medical history and diagnostic, pathological and postoperative variables was performed using a NPC test. The patients were included in a comprehensive database with medical history and clinical and pathological data. Five-year survival was used as the dependent variable, and p values were corrected for multiplicity using a closed testing procedure. The newer nonparametric approach was used to evaluate the prognostic importance of the variables. All of the analyses were performed using routines developed in MATLAB© and the significance level was set at α = 0.05. RESULTS A significant prognostic predictive value (p < 0.01) for tumor clinical staging, hydronephrosis, tumor pathological staging, grading, presence of concomitant carcinoma in situ, regional lymph node involvement, corpora cavernosa invasion, microvascular invasion, lymphatic invasion and prostatic stroma involvement was found. CONCLUSIONS The NPC test could handle any type of variable (categorical and quantitative) and take into account the multivariate relation among variables. This newer methodology offers a significant contribution in biomedical studies with several endpoints and is recommended in presence of non-normal data and missing values, as well as solving high-dimensional data and problems relating to small sample sizes.
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Affiliation(s)
- M Racioppi
- Department of Urology, Catholic University of the Sacred Heart, Rome, Italy
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Giordano P, Scrascia G, D'Agostino D, Mastro F, Rotunno C, Conte M, Rociola R, Paparella D. Myocardial damage following cardiac surgery: comparison between single-dose Celsior cardioplegic solution and cold blood multi-dose cardioplegia. Perfusion 2013; 28:496-503. [PMID: 23670806 DOI: 10.1177/0267659113486827] [Citation(s) in RCA: 9] [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] [Indexed: 11/17/2022]
Abstract
Myocardial protection during cardiac surgery can be accomplished by different cardioplegic solutions. The aim of this study was to assess myocardial damage after heart valve surgery performed with myocardial protection of a single dose of Celsior cardioplegia or with repeated cold blood cardioplegia. After the stratification of 139 valvular patients by means of matching according to cross-clamp and cardiopulmonary bypass time, 32 patients were retained for comparison (16 patients received Celsior and 16 patients received cold blood cardioplegia). Creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) release were evaluated until six days after the operation. Pre-operative characteristics were similar in both groups. In the Celsior group, CK-MB and cTnI values were significantly higher from the first up to the sixth post-operative day. Peak cTnI values were 19.4 ± 13.4 and 9.7 ± 7 ng/mL (p=0.01) in the Celsior and the Cold Blood group, respectively. Peak CK-MB values were 79.6 ± 58.8 and 45.9 ± 20.6 U/L (p=0.07) in the Celsior and the Cold Blood group, respectively. Cold blood cardioplegia reduces perioperative myocardial damage compared to the Celsior solution in elective cardiac valve operations.
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Affiliation(s)
- P Giordano
- Division of Cardiac Surgery, Department of Emergency and Organ Transplant, University of Bari "Aldo Moro", Bari, Italy
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Racioppi M, Cappa E, D'Agostino D, Filianoti A, Pugliese D, Cadeddu C, De Wore C, Sacco E, Pinto F, D'Addessi A, Ghera P, Bassi P. Size of Bladder Cancers: Correlation among Different Types of Measurement. Urol Int 2013; 90:191-4. [DOI: 10.1159/000343666] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 08/31/2012] [Indexed: 11/19/2022]
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Linder A, Budihardjo-Welim H, Velehorschi W, Coche T, Gruselle O, D'Agostino D, Louahed J, Lehmann F, Brichard VG. Prognostic value of MAGE-A3 and PRAME gene expression in non-small-cell lung cancer (NSCLC). J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.7056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7056 Background: We investigated the expression of some cancer–testis genes and their association with disease prognosis. Here we report our results for the expression, in resected NSCLC samples, of two tumor-specific antigens (Ags): MAGE‑A3 and PRAME, both under evaluation in clinical trials. Methods: We conducted a single-center, uncontrolled, retrospective study of tissue from resected stage I–III NSCLC patients (pts): 650 were in stage I, 215 in stage II and 395 in stage III. 1260 FFPE tumor tissue samples from the tumor tissue bank of the Department of Pathology, Lungenklinik Hemer (Germany), were tested for MAGE‑A3 and PRAME expression by specific qRT-PCR assays. The prognostic value of these Ags was determined by estimating the median overall survival (OS), disease-free interval (DFI) and disease-free survival (DFS). Results: Expression rates were 36% for MAGE‑A3 and 66% for PRAME. The co‑expression rate was 30%. Almost all tumors expressing MAGE‑A3 also expressed PRAME. We observed no difference overall in Ag expression according to stage, tumor size and pts’ age. Squamous tumors expressed MAGE‑A3 and PRAME more frequently than did adenocarcinomas (43 vs. 27 % and 80 vs. 44% respectively), and PRAME expression rates were higher in males than in females (70 vs. 53%). In the overall population, which included stages IA–IIIB, no prognostic value was detected for the expression of either Ag. In subset analyses, we found in 83 stage IIIB pts a trend to worse OS linked to MAGE‑A3 expression (HR=1.977, p=0.0312). In 395 stage IB pts, PRAME expression was associated with worse OS (HR=1.483, p=0.0344) and DFS (HR=1.492, p=0.0167). Conclusions: The MAGE‑A3 expression rate found is consistent with the results observed in the phase III MAGRIT trial (J‑H Kim et al., 2011). No prognostic value for either PRAME or MAGE‑A3 was observed in the overall population, in contrast to previous reports with smaller sample sizes (Gure et al., 2005, Boli et al., 2002) and in other tumors (Vourch’jourdain et al., 2009, Epping et al., 2008). We observed a trend toward poor prognostic value of MAGE‑A3 in stage IIIB pts and of PRAME in stage IB pts.
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Affiliation(s)
- Albert Linder
- Lungenklinik Hemer, Hemer Nordrhein-Westfalen, Germany
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Therasse P, Linder A, Thongprasert S, Yang PC, Lee PH, Tanwandee T, Kang JH, Lee J, Sittampalam K, Chotirosniramit A, Soo RA, Van Poppel H, Lerut E, Joniau S, Coche T, Gruselle O, D'Agostino D, Myo A, Louahed J. Expression of PRAME and MAGE-A3 in Asian and European patients with non-small cell lung cancer (NSCLC), bladder cancer, or hepatocellular carcinoma (HCC). J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e13061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13061 Background: Antigen (Ag)-specific cancer immunotherapy is based on induction of immune responses (humoral and cell-mediated) specifically targeting Ags expressed by tumor cells. This may be achieved by delivering the Ag as a recombinant protein combined with potent immunostimulants. PRAME and MAGE-A3 are tumor Ags with distinct tumor expression patterns, both under investigation as targets for immunotherapy in NSCLC and malignant melanoma. For additional clinical development of these immunotherapies in other cancer types, expression of PRAME and MAGE-A3 in these cancers must be investigated taking into account patient ethnicity and tumor characteristics. Methods: 4 retrospective studies were performed, each including all tumor stages: NSCLC pts (in Asia and Europe); bladder cancer pts in Europe; HCC pts in Asia. Formalin-fixed paraffin embedded tumor tissues were tested for PRAME and MAGE-A3 expression by quantitative RT-PCR using an expression cut-off value for positivity. Exploratory analyses of possible associations with patient and tumor characteristics were done to identify factors that may impact Ag expression. Results: The overall Ag expression rates are shown in the table below. In NSCLC, both Ags were expressed less frequently in Asian than in European patients (the histological distribution was the same). NSCLC tumors more frequently expressed PRAME than MAGE-A3 while the reverse tendency was seen for bladder tumors and HCC. In the NSCLC studies, squamous cell carcinomas expressed both Ags more frequently than adenocarcinomas. No study found any association between tumor stage and Ag expression. Some 60% of the tumors express at least one of the Ags. Conclusions: The expression rates of PRAME and MAGE-A3 are sufficiently high to consider these Ags as targets for immunotherapy against NSCLC, bladder cancer and HCC. [Table: see text]
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Affiliation(s)
| | - Albert Linder
- Lungenklinik Hemer, Hemer Nordrhein-Westfalen, Germany
| | - Sumitra Thongprasert
- Department of Medicine, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University, Chiang Mai, Thailand
| | - Pan-Chyr Yang
- National Taiwan University Hospital, College of Medicine, Taipei, Taiwan
| | - Po-Huang Lee
- National Taiwan University Hospital, Department of surgery, Taipei, Taiwan
| | - Tawesak Tanwandee
- Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jin Hyoung Kang
- Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Jungsin Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | | | - Anon Chotirosniramit
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ross A. Soo
- National University Cancer Institute Singapore, Singapore, Singapore
| | | | | | | | | | | | | | - Aung Myo
- GlaxoSmithKline, Singapore, Singapore
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Andermann E, Amrom D, D'Agostino D, Dubeau F, Andermann F, Dobyns W. Subcortical Band Heterotopia without Detectable DCX or LIS1 Gene Mutations (PD3.002). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.pd3.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Racioppi M, D'Agostino D, Totaro A, Pinto F, Sacco E, D'Addessi A, Marangi F, Palermo G, Bassi PF. Value of current chemotherapy and surgery in advanced and metastatic bladder cancer. Urol Int 2012; 88:249-58. [PMID: 22354060 DOI: 10.1159/000335556] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of the present paper was to review findings from the most relevant studies and to evaluate the value of current chemotherapy and surgery in advanced unresectable and metastatic bladder cancer. Studies were identified by searching the MEDLINE® and PubMed® databases up to 2011 using both medical subject heading (Mesh) and a free text strategy with the name of the known individual chemotherapeutic drug and the following key words: 'muscle-invasive bladder cancer', 'chemotherapeutics agents', and 'surgery in advanced bladder cancer'. At the end of our literature research we selected 141 articles complying with the aim of the review. The results showed that it has been many years since the MVAC (methotrexate, vinblastine, adriamycin, cisplatin) regimen was first developed. The use of cisplatin-based combination chemotherapy is associated with significant toxicity and produces long-term survival in only approximately 15-20% of patients. Gemcitabine + cisplatin represents the gold standard in the treatment of metastatic bladder cancer. In conclusion, the optimal approach in the management of advanced urothelial cancer continues to evolve. Further progress relies on the expansion of research into tumor biology and an understanding of the underlying molecular 'fingerprints' that can be used to enhance diagnostic and therapeutic strategies. Cisplatin-based therapy has had the best track record thus far.
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Affiliation(s)
- M Racioppi
- Department of Urology, Catholic University of the Sacred Heart, Rome, Italy
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Bassi PF, Volpe A, D'Agostino D, Palermo G, Renier D, Franchini S, Rosato A, Racioppi M. Paclitaxel-hyaluronic acid for intravesical therapy of bacillus Calmette-Guérin refractory carcinoma in situ of the bladder: results of a phase I study. J Urol 2010; 185:445-9. [PMID: 21167517 DOI: 10.1016/j.juro.2010.09.073] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE Carcinoma in situ represents high grade anaplasia of the bladder mucosa. Intravesical immunotherapy with bacillus Calmette-Guérin is the gold standard treatment for patients with carcinoma in situ. Patients with carcinoma in situ refractory to bacillus Calmette-Guérin are candidates for major surgery such as radical cystectomy. We identified the maximum tolerated dose and the recommended dose, and evaluated the safety profile of paclitaxel-hyaluronic acid bioconjugate given by intravesical instillation to patients with carcinoma in situ refractory to bacillus Calmette-Guérin. MATERIALS AND METHODS A total of 16 patients with carcinoma in situ refractory to bacillus Calmette-Guérin were enrolled in a phase I, open label, single institution study. A minimum of 3 eligible patients were included per dose level. Paclitaxel-hyaluronic acid solution (ONCOFID-P-B™) was administered for 6 consecutive weeks. The primary objective was to identify the maximum tolerated dose and the recommended dose. As secondary objectives the safety profile of ONCOFID-P-B, the pharmacokinetic profile after each instillation and the tumor response were also evaluated. RESULTS No dose limiting toxicity occurred at any drug level evaluated. The plasma levels of the study drug were always below the lower limit of quantification at all tested doses after each instillation. A total of 11 adverse events were reported by 7 patients and 9 (60%) showed complete treatment response. CONCLUSIONS Intravesical instillation of ONCOFID-P-B for carcinoma in situ refractory to bacillus Calmette-Guérin showed minimal toxicity and no systemic absorption in the first human intravesical clinical trial to our knowledge. Finally, satisfactory response rates were observed.
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Affiliation(s)
- P F Bassi
- Department of Urology, Catholic University School of Medicine, Rome, Italy
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Volpe A, Racioppi M, D'Agostino D, Cappa E, Filianoti A, Bassi PF. Mitomycin C for the treatment of bladder cancer. MINERVA UROL NEFROL 2010; 62:133-144. [PMID: 20562793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Bladder cancer is a heterogeneous disease: approximately 75% of its forms are non muscle invasive neoplasms. Standard treatment for non muscle invasive bladder cancer (NMIBC) consists of complete transurethral resection (TURB) of all visible lesions. Recurrence rates following TURB and intravesical chemoprophylaxis seem to decrease to 25-50% in 2 years of follow-up. The aim of the present paper is to review findings from the most relevant studies and evaluate the potentials of mitomycin C (MMC) in the treatment of non muscle invasive bladder cancer. Studies were identified by searching MEDLINE(R) and Pubmed(R) databases up to 2010 using both medical subject heading (Mesh) and a free text strategy with the name of known individual chemotherapeutic drug and the following key words: "non muscle-invasive bladder cancer", "intravesical therapy", "Mitomycin C", "Device Therapy". At the end of our research in literature we selected 66 articles. From literature is clear that in case of low or intermediate risk superficial bladder cancer, MMC is one of the most used agents with limited side effects. In fact MMC has a high molecular weight and is relatively hydrophobic, resulting in less sistemic absorption. Regimens are based on weekly instillations but despite many studies there is not universal consensus on timing and duration of therapy. MMC early istillation seems effective in preventing tumour recurrence in low risk non muscle invasive neoplasms. MMC maintenance chemotherapy continue to be considered effective in reducing tumour recurrence rate in low and intermediate risk tumours. It is known in literature that the lack of response to intravesical chemotherapy in patients with non muscle invasive bladder cancer is due to two factors: lack of sensitivity of the neoplasm to intravesical chemotherapy and inadequate drug delivery to the tumour. In order to resolve these limitations in the last years MMC, in many centers, is used with device assisted therapies or with new administration scheme.
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Affiliation(s)
- A Volpe
- Department of Urology, Catholic University, Rome, Italy.
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Racioppi M, Cappa E, Volpe A, D'Agostino D, Bassi PF. [Integrated treatment with hyperthermia and chemotherapy for non-muscle invasive bladder cancer]. Urologia 2009; 76:61-65. [PMID: 21086297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Oncology-applied hyperthermia is a very old form of therapy. In recent years hyperthermia has been investigated with the aim of improving the treatment for non-muscle invasive bladder cancer to prevent relapse and disease progression, in association with mitomycin-C, a well-known chemotherapeutic agent, to enhance its effect. Target patients are those with non-muscle invasive transitional cell carcinoma, showing medium (Ta-T1, G1-2, multifocal, diameter >3 cm) or high (T1, G3, multifocal or rapidly relapsing, CIS) risk for recurrence or progression. The treatment may be prophylactic following tumor eradication, or ablative when tumor cannot be otherwise eradicated. Several studies have shown the benefits of thermochemotherapy with lower risk for relapse than other treatment options, and 66-80% complete responses following ablative treatment. This association of treatments has a synergic therapeutic effect, higher than administering hyperthermia and drug therapy as single treatment.
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Kollannoor Samuel G, Fernandez ML, Chhabra J, Vega‐López S, Segura‐Pérez S, Damio G, Calle M, D'Agostino D, Pérez‐Escamilla R. Determinants of fasting plasma glucose and HbA1c among Latinos with type 2 diabetes: DIALBEST trial preliminary results. FASEB J 2009. [DOI: 10.1096/fasebj.23.1_supplement.736.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | | | - G Damio
- Hispanic Health CouncilHartfordCT
| | - M Calle
- Univ. of ConnecticutStorrsCT
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Postolache T, Zimmerman S, Lapidus M, Cabassa J, D'Agostino D, Langenberg P, Tonelli L. Changes in Severity of Allergy and Anxiety Symptoms Are Positively Correlated in Patients with Recurrent Mood Disorders Who Are Exposed to Seasonal Peaks of Aeroallergens. J Allergy Clin Immunol 2009. [DOI: 10.1016/j.jaci.2008.12.900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tedesco A, D'Agostino D, Soriente I, Amato P, Piccoli R, Sabatini P. A new strategy for the early diagnosis of rheumatoid arthritis: A combined approach. Autoimmun Rev 2009; 8:233-7. [DOI: 10.1016/j.autrev.2008.07.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gianuzzi V, D'Agostino D, Merlo A, Clematis A. Efficient management of resources and entities using the HyVonNe P2P architecture. IJGUC 2009. [DOI: 10.1504/ijguc.2009.027649] [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: 11/21/2022]
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Volpe A, Racioppi M, D'Agostino D, Cappa E, Gardi M, Totaro A, Sacco E. [Methodology of clinical trials for non-muscle infiltrating bladder cancer. Objective evaluation: standardization requirements]. Urologia 2008; 75:207-213. [PMID: 21086334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The formulation of proper evaluation criteria after superficial bladder cancer therapy poses several methodological problems that are often peculiar to the disease. The Achilles' heel of many trials is possibly found in the criteria used for the evaluation of the trial outcomes. As a consequence of that, total agreement regarding the criteria for response and the evaluation of response is needed. The adoption of standard response criteria should be given high priority. Uniform response criteria should be chosen because they meet standards of reliability and statistical validity. Thus, the criteria must be reproducible, and they should correlate with some measures of patient's benefit, such as quantity and quality of survival. A proposal of standardization in superficial bladder cancer clinical trials is presented based upon current knowledge on the methodology for conducting clinical trials and upon the experience coming from major clinical research groups.
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La Mura V, De Renzo A, Perna F, D'Agostino D, Masarone M, Romano M, Bruno S, Torella R, Persico M. Antiviral therapy after complete response to chemotherapy could be efficacious in HCV-positive non-Hodgkin's lymphoma. J Hepatol 2008; 49:557-63. [PMID: 18678434 DOI: 10.1016/j.jhep.2008.06.025] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Revised: 06/09/2008] [Accepted: 06/25/2008] [Indexed: 12/16/2022]
Abstract
BACKGROUND/AIMS Prevalence of HCV infection in non-Hodgkin's lymphoma is high. The impact of antiviral therapy on the natural history of this subgroup of lymphomas after a successful chemotherapy regimen is still an argument of debate. METHODS We retrospectively examined 343 chemotherapy-treated patients referred to our centre for five consecutive years. Clinical and histological characteristics, disease free-survival (DFS) and overall-survival (OS) were compared in HCV-positive (69/343) and HCV-negative (274/343) patients. Twenty-five HCV-positive patients received antiviral treatment following chemotherapy discontinuation. Uni- and multivariate analyses were performed. RESULTS 20% of lymphomas were HCV-positive. Indolent histology was prevalent in the HCV-positive group (p<0.05); no significant differences in OS or DFS were found between the two groups; in HCV-positive subjects, antiviral therapy, was associated with a longer DFS (p<0.05); none of the HCV-positive subjects who achieved a virological response experienced any lymphoma relapse; 29% of non responders did; at multivariate analysis, the independent factors related to a better clinical outcome were: indolent histology at the onset of lymphoma and antiviral therapy. CONCLUSIONS Antiviral treatment in HCV-positive non-Hodgkin's lymphoma may be an important strategy to reinforce the results of a successful chemotherapy regimen; further studies are needed to validate this combined approach.
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Affiliation(s)
- Vincenzo La Mura
- Internal Medicine and Hepatology Unit, Second University of Naples, Napoli, Italy
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Cancello G, Montagna E, D'Agostino D, Giuliano M, Giordano A, Di Lorenzo G, Plaitano M, De Placido S, De Laurentiis M. Continuing trastuzumab beyond disease progression: outcomes analysis in patients with metastatic breast cancer. Breast Cancer Res 2008; 10:R60. [PMID: 18631394 PMCID: PMC2575533 DOI: 10.1186/bcr2119] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2007] [Revised: 06/13/2008] [Accepted: 07/16/2008] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION We performed a retrospective analysis of HER2-overexpressing metastatic breast cancer patients to describe clinical outcomes of those who, despite progression of the disease (PD), maintained trastuzumab for multiple chemotherapy lines. We also compared survival of these patients with that of those who halted trastuzumab at first PD. METHODS We identified 101 patients treated between July 2000 and January 2007. Nineteen were still receiving the first-line trastuzumab-based treatment without evidence of PD and were not included in this analysis. Of the remaining 82 patients, 59 retained trastuzumab for one or more additional lines of chemotherapy after PD, according to our institution policy. Twenty-three patients who changed treating institution and stopped trastuzumab at first progression were used as a control group. RESULTS For patients retaining trastuzumab, the median follow-up was 39.6 months. Clinical outcomes showed the typical degradation between first and second lines of therapy which we would expect by halting trastuzumab at first progression. Response rates were 35% and 16% and median times to progression were 7.25 and 5.25 months for the first and second lines of trastuzumab therapy, respectively. The median overall survival (OS) rates were 70 months for patients who retained trastuzumab and 56 months for patients who halted the drug (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.51 to 1.18; P = 0.52). If we consider OS from the start of trastuzumab therapy, the figures are 53.9 and 34.8 months, respectively (HR 0.78, 95% CI 0.58 to 1.32; P = 0.2). CONCLUSION A nonstatistically significant trend of improved survival for patients retaining trastuzumab is observed. This is in line with most retrospective analyses and recent randomized data. Retaining trastuzumab after progression is a reasonable option, but further randomized data are warranted to better define its role in comparison with other available options.
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Affiliation(s)
- Giuseppe Cancello
- Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Università 'Federico II', via Sergio Pansini, 5, 80131 – Napoli, Italy
- Unità di Ricerca Senologia Medica, Istituto Europeo di Oncologia, via Ripamonti, 435, 20141-Milano, Italy
| | - Emilia Montagna
- Unità di Ricerca Senologia Medica, Istituto Europeo di Oncologia, via Ripamonti, 435, 20141-Milano, Italy
| | - Diego D'Agostino
- Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Università 'Federico II', via Sergio Pansini, 5, 80131 – Napoli, Italy
| | - Mario Giuliano
- Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Università 'Federico II', via Sergio Pansini, 5, 80131 – Napoli, Italy
| | - Antonio Giordano
- Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Università 'Federico II', via Sergio Pansini, 5, 80131 – Napoli, Italy
| | - Giuseppe Di Lorenzo
- Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Università 'Federico II', via Sergio Pansini, 5, 80131 – Napoli, Italy
| | - Monica Plaitano
- Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Università 'Federico II', via Sergio Pansini, 5, 80131 – Napoli, Italy
| | - Sabino De Placido
- Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Università 'Federico II', via Sergio Pansini, 5, 80131 – Napoli, Italy
| | - Michele De Laurentiis
- Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Università 'Federico II', via Sergio Pansini, 5, 80131 – Napoli, Italy
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De Laurentiis M, Cancello G, D'Agostino D, Giuliano M, Giordano A, Montagna E, Lauria R, Forestieri V, Esposito A, Silvestro L, Pennacchio R, Criscitiello C, Montanino A, Limite G, Bianco AR, De Placido S. Taxane-based combinations as adjuvant chemotherapy of early breast cancer: a meta-analysis of randomized trials. J Clin Oncol 2008; 26:44-53. [PMID: 18165639 DOI: 10.1200/jco.2007.11.3787] [Citation(s) in RCA: 320] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE We conducted a meta-analysis of randomized trials that evaluated the efficacy of incorporating taxanes into anthracycline-based regimens for early breast cancer (EBC). We aimed to determine whether this approach improves disease-free survival (DFS) and overall survival (OS) and whether benefits are maintained across relevant patient subgroups. METHODS Studies were retrieved by searching the PubMed database and the proceedings of major conferences. We extracted hazard ratios (HR) and 95% CIs for DFS and OS from each trial and obtained pooled estimates using an inverse-variance model. RESULTS Thirteen studies were included in the meta-analysis (N = 22,903 patients). The pooled HR estimate was 0.83 (95% CI, 0.79 to 0.87; P < .00001) for DFS and 0.85 (95% CI, 0.79 to 0.91; P < .00001) for OS. Risk reduction was not influenced by the type of taxane, by estrogen receptor (ER) expression, by the number of axillary metastases (N1 to 3 v N4+), or by the patient's age/menopausal status. Sensitivity analysis showed that taxanes given in combination with anthracyclines, unlike sequential administration, did not significantly improve OS. However, the test for interaction showed that HR did not differ between the two schedules (P = .54). Taxane administration resulted in an absolute 5-year risk reduction of 5% for DFS and 3% for OS. CONCLUSION The addition of a taxane to an anthracycline-based regimen improves the DFS and OS of high-risk EBC patients. The DFS benefit was independent of ER expression, degree of nodal involvement, type of taxane, age/menopausal status of patient, and administration schedule.
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Affiliation(s)
- Michele De Laurentiis
- Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Università di Napoli Federico II, Napoli, Italy.
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Piantedosi FV, Caputo F, Mazzarella G, Gilli M, Pontillo A, D'Agostino D, Campbell S, Marsico SA, Bianco A. Gemcitabine, ifosfamide and paclitaxel in advanced/metastatic non-small cell lung cancer patients: a phase II study. Cancer Chemother Pharmacol 2007; 61:803-7. [PMID: 17639396 DOI: 10.1007/s00280-007-0537-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2007] [Accepted: 05/25/2007] [Indexed: 11/26/2022]
Abstract
UNLABELLED Although platinum-based two-drug combinations represent the elective therapeutic approach for advanced/metastatic NSCLC, there is still interest in exploring the efficacy and tolerability of platinum-free combinations including third generation agents in selected NSCLC population. Based on the satisfying activity of gemcitabine (G), ifosfamide (I) and paclitaxel (T) as single agents in NSCLC, we have designed a phase II study to explore an alternative approach to platinum-containing regimens using a combination of these three drugs. To investigate the activity/toxicity of T 175 mg/m2 on day 1, I 3 g/m2 on day 1 (with Mesna uroprotection) and G 1,000 mg/m2 on day 1-8, every 3 weeks in the treatment of advanced/metastatic NSCLC, 46 patients (38 male, 8 female) with NSCLC were enrolled: mean age 58 (range 33-70); Stage IIIB/IV=15/31; ECOG PS 0-1/2=31/15; HISTOLOGY adenocarcinoma=20, squamous=14, large cell=3, NSCLC=8, adenosquamous=1. A total of 221 cycles have been administered (median number 4.8 for patients). In intent-to-treat analysis, partial response was achieved in 17 patients (36.95%), stable disease and progressive disease was detected in 16 (34.78%) and 10 (21.73%) patients, respectively. Time to progression was 30.9 weeks; median survival time was 42.7 weeks; the survival rates at 12 and 18 months were 34.79 and 15.21%, respectively. No toxic deaths occurred. No patients experienced grade 4 neutropenia and thrombocytopenia. Neutropenia grade 3 occurred in 10 patients (21.7%); Anemia grade 3 in 1 (2.1%); Thrombocytopenia grade 2 in two patients (4.3%) and grade 3 in one (2.1%). Peripheral neuropathy grade 1 occurred in ten (21.7%) and grade 2 in two patients (4.3%). Additional non-haematological toxicities were mild nausea, emesis and fatigue. GIT is well tolerated and active regimen in both advanced and metastatic NSCLC. These data suggest future investigations for GIT schedule as a possible alternative to platinum-based regimens in selected advanced/metastatic NSCLC patients where survival, tolerability and quality of life are the primary goals.
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Affiliation(s)
- F V Piantedosi
- Department of Medical-Surgical Oncology and Thoracic Diseases, AORN Monaldi, Via L Bianchi, 80131 Naples, Italy
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Abstract
Bladder cancer treatment is a challenge for both urologists and oncologists. Particularly during these last years many changes have been made in the management of superficial bladder cancer. In the case of superficial bladder cancer, intravesical instillation of chemo/immunotherapeutic agents after transurethral resection is the standard. The treatment goals include: complete removal of the initial tumor, prevention of recurrences and inhibition of disease progression. This work aims at reviewing the new developments in the therapeutic field of superficial bladder cancer. A growing trend involves the use of multimodality treatment to obtain the activation of the host immunity against the tumor, and to enhance the cytotoxic effects of chemotherapeutic agents. The new therapeutic modalities, which are under preclinical and clinical investigations, are showing promising results.
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Affiliation(s)
- M. Racioppi
- Cattedra di Urologia, Università Cattolica del Sacro Cuore, Roma
| | - A. Volpe
- Cattedra di Urologia, Università Cattolica del Sacro Cuore, Roma
| | - R. Falabella
- Cattedra di Urologia, Università Cattolica del Sacro Cuore, Roma
| | - E. Cappa
- Cattedra di Urologia, Università Cattolica del Sacro Cuore, Roma
| | - D. D'Agostino
- Cattedra di Urologia, Università Cattolica del Sacro Cuore, Roma
| | - F. Pinto
- Cattedra di Urologia, Università Cattolica del Sacro Cuore, Roma
| | - PF Bassi
- Cattedra di Urologia, Università Cattolica del Sacro Cuore, Roma
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Hedera P, Blair MA, Andermann E, Andermann F, D'Agostino D, Taylor KA, Chahine L, Pandolfo M, Bradford Y, Haines JL, Abou-Khalil B. Familial mesial temporal lobe epilepsy maps to chromosome 4q13.2-q21.3. Neurology 2007; 68:2107-12. [PMID: 17377072 DOI: 10.1212/01.wnl.0000261246.75977.89] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To report results of linkage analysis in a large family with autosomal dominant (AD) familial mesial temporal lobe epilepsy (FMTLE). BACKGROUND Although FMTLE is a heterogeneous syndrome, one important subgroup is characterized by a relatively benign course, absence of antecedent febrile seizures, and absence of hippocampal sclerosis. These patients have predominantly simple partial seizures (SPS) and infrequent complex partial seizures (CPS), and intense and frequent déjà vu phenomenon may be the only manifestation of this epilepsy syndrome. No linkage has been described in this form of FMTLE. METHODS We identified a four-generation kindred with several affected members meeting criteria for FMTLE and enrolled 21 individuals who gave informed consent. Every individual was personally interviewed and examined; EEG and MRI studies were performed on three affected subjects. DNA was extracted from every enrolled individual. We performed a genome-wide search using an 8 cM panel and fine mapping was performed in the regions with a multipoint lod score >1. We sequenced the highest priority candidate genes. RESULTS Inheritance was consistent with AD mode with reduced penetrance. Eleven individuals were classified as affected with FMTLE and we also identified two living asymptomatic individuals who had affected offspring. Seizure semiologies included predominantly SPS with déjà vu feeling, infrequent CPS, and rare secondarily generalized tonic-clonic seizures. No structural abnormalities, including hippocampal sclerosis, were detected on MRI performed on three individuals. Genetic analysis detected a group of markers with lod score >3 on chromosome 4q13.2-q21.3 spanning a 7 cM region. No ion channel genes are predicted to be localized within this locus. We sequenced all coding exons of sodium bicarbonate cotransporter (SLC4A) gene, which plays an important role in tissue excitability, and cyclin I (CCNI), because of its role in the cell migration and possibility of subtle cortical abnormalities. No disease-causing mutations were identified in these genes. CONCLUSION We report identification of a genetic locus for familial mesial temporal lobe epilepsy. The identification of a disease-causing gene will contribute to our understanding of the pathogenesis of temporal lobe epilepsies.
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Affiliation(s)
- P Hedera
- Department of Neurology, Vanderbilt University, Nashville, TN 37232- 8552, USA.
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Picardi M, Ciancia R, De Renzo A, Montante B, Ciancia G, Zeppa P, Lobello R, Pane F, D'Agostino D, Nicolai E, Sirignano C, Salvatore M, Rotoli B. Estimation of bulky lymph nodes by power Doppler ultrasound scanning in patients with Hodgkin's lymphoma: a prospective study. Haematologica 2006; 91:960-3. [PMID: 16818285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
The accuracy of standard methods in estimating bulky lesions requires validation. We used clinical/computed tomography (CT) evaluation and power Doppler ultrasound (US) to detect bulky disease in 137 consecutive Hodgkin's lymphoma patients, and analyzed the prognostic relevance of each method. Bulky disease was detected by clinical/CT evaluation in 47% of the patients and by power Doppler US in 20%. After treatment, at multivariate analysis power Doppler US-selected bulky disease was the parameter that best correlated with freedom from treatment failure (p<0.001). Power Doppler US, a readily available imaging technique, provides a better prognostic classification by detecting true bulky disease more accurately.
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Affiliation(s)
- Marco Picardi
- Department of Biochemistry and Medical Biotechnology, Federico II University Medical School, Naples, Italy
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De Cillis E, Burdi N, Bortone AS, D'Agostino D, Fiore T, Ettorre GC, Resta M. Endovascular Treatment of Pulmonary and Cerebral Arteriovenous Malformations in Patients Affected by Hereditary Haemorrhagic Teleangiectasia. Curr Pharm Des 2006; 12:1243-8. [PMID: 16611106 DOI: 10.2174/138161206776361237] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [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: 11/22/2022]
Abstract
Hereditary Haemorrhagic Teleangiectasia (HHT) is a vascular disorder of angiogenesis transmitted in an autosomal dominant pattern, characterised by heterogeneity in clinical manifestations. One of the most important organ involved is lung, including pulmonary arteriovenous malformations (PAVM). PAVM occur in 20 to 30% of the HHT population and recently are considered a marker of disease. PAVM are direct artery-to-vein connections with low pressure and without an interveining capillary bed. PAVM are classified as simple (supplied by one feeding artery) or complex (receiving blood supply from two or more feeding artery). According to the international reports, treatment it's recommendable for all PAVM with feeding vessels 3mm or larger, in order to reduce the risk of cerebral ischaemia and neurologic manifestations frequently attributed to paradoxical embolisation. Transcatheter embolotherapy of PAVM is a form of treatment based on occlusion of the feeding artery to a PAVM by using platinum coils or detachable balloons. The technique of coil embolisation involves the exact localisation of PAVM by pulmonary angiography followed by superselective percutaneous caheterisation of feeding artery obtained by using a dedicated 7F guiding catheter, which coaxially allocates a 5F hydrophilic catheter advanced in order to perform both superselective angiography of feeding artery and embolisation itself. Inside the 5F catheter the platinum coils are advanced using a .035'' guide-wire and released until an optimal occlusion of feeding artery is achieved. At the end of the procedure angiographic control is performed in order to verify the occlusion of feeding artery. The use of platinum coils is preferable over detachable balloons when feeding artery are greater than 7 mm in diameter and have irregular anatomical configuration. On the other hand, the principal advantage of using detachable balloons is that the balloon itself can be deflated and repositioned if necessary. Transcatheter embolotherapy is technically safe and clinically effective and may represent the primary choice of treatment in HHT patients. On the other hand the most common complications of this treatment (pleurisy and air embolism) can be prevented by using some tips during the embolisation procedure like "anchor technique," "scaffold technique" and "balloon assisted technique." Cerebral arteriovenous malformations (CAVM) are present in 10-20% of patients with HHT and multiple in 50% of cases. Cortical surface is the most frequent localisation. Angiography is needed to diagnose all CAVM and to clarify the angioarchitecture of the lesion. In HHT CAVM are usually either micro-AVM, with a nidus not bigger than 1 cm, or small AVM, with a nidus between 1 and 3 cm. Quite frequently there are lesions characterised by arteriovenous fistulas. In the three patterns of CAVM usually found in HHT, small AVM are the most risky for bleeding although the risk is lower than that associated with sporadic ones. It is estimated from 0.38 to 0.69% per year in spite of the general incidence of bleeding in sporadic CAVM that ranges from 2 to 4% per year. In HHT patients, at present, the precise indications and timing of treatment are not established. Trend is to treat small AVM and AVF and to follow-up micro-AVM with MRI and angiography. As for sporadic CAVM, treatment of small AVM is usually referred to stereotactic radiosurgery. Endovascular embolisation is proposable if the lesion is easily reachable by microcatheterism and the position of the microcatheter is safe. Glue is used for embolisation and the technique is briefly discussed.
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Affiliation(s)
- E De Cillis
- Institute of Cardiac Surgery, University of Bari, Bari, Italy
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Carlomagno C, Orditura M, Pepe S, De Vita F, Romano C, Ciardiello F, Ferrara C, Martinelli E, Bianco R, Aurilio G, D'Agostino D, Tortora G, Catalano G, De Placido S. Capecitabine plus weekly oxaliplatin in gastrointestinal tumors: a phase I study. Am J Clin Oncol 2006; 29:85-9. [PMID: 16462509 DOI: 10.1097/01.coc.0000195087.24930.e7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To investigate the maximum tolerated dose (MTD) and the dose-limiting toxicity (DLT) of capecitabine plus oxaliplatin. MATERIALS AND METHODS Oxaliplatin was given by 2-hour iv infusion on days 1 and 8, and capecitabine was given orally, from day 1 to 14, every 3 weeks. We tested 4 levels of doses: 1) capecitabine 1650 mg/m2 + oxaliplatin 50 mg/m2; 2) capecitabine 2000 mg/m2 + oxaliplatin 50 mg/m2; 3) capecitabine 2000 mg/m2 + oxaliplatin 60 mg/m2; and 4) capecitabine 2500 mg/m2 + oxaliplatin 60 mg/m2. Patients with gastrointestinal neoplasm were eligible for the study. RESULTS Thirty-two patients were enrolled. At dose level 4, 3 patients had unacceptable toxicity (grade 3 diarrhea, grade 4 diarrhea, and grade 3 mucositis, respectively), thus, level 4 was the MTD. Apart from DLT, overall toxicity was mild: grade > or =3 nonhematological toxicity occurred in 3 patients, and hematological toxicity was sporadic. CONCLUSION This study demonstrates that clinically relevant doses of capecitabine (2000 mg/m2 from day 1 to 14) plus oxaliplatin (60 mg/m2 on days 1 and 8) every 3 weeks can be given without causing unacceptable toxicity.
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Affiliation(s)
- Chiara Carlomagno
- Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Università di Napoli Federico II, Napoli, Italy
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42
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De Laurentiis M, Arpino G, Massarelli E, Ruggiero A, Carlomagno C, Ciardiello F, Tortora G, D'Agostino D, Caputo F, Cancello G, Montagna E, Malorni L, Zinno L, Lauria R, Bianco AR, De Placido S. A meta-analysis on the interaction between HER-2 expression and response to endocrine treatment in advanced breast cancer. Clin Cancer Res 2005; 11:4741-8. [PMID: 16000569 DOI: 10.1158/1078-0432.ccr-04-2569] [Citation(s) in RCA: 264] [Impact Index Per Article: 13.9] [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: 02/07/2023]
Abstract
PURPOSE Experimental data suggest a complex cross-talk between HER-2 and estrogen receptor, and it has been hypothesized that HER-2-positive tumors may be less responsive to certain endocrine treatments. Clinical data, however, have been conflicting. We have conducted a meta-analysis on the interaction between the response to endocrine treatment and the overexpression of HER-2 in metastatic breast cancer. EXPERIMENTAL DESIGN Studies have been identified by searching the Medline, Embase, and American Society of Clinical Oncology abstract databases. Selection criteria were (a) metastatic breast cancer, (b) endocrine therapy (any line of treatment), and (c) evaluation of HER-2 expression (any method). For each study, the relative risk for treatment failure for HER-2-positive over HER-2-negative patients with 95% confidence interval was calculated as an estimate of the predictive effect of HER-2. Pooled estimates of the relative risk were computed by the Mantel-Haenszel method. RESULTS Twelve studies (n = 2,379 patients) were included in the meta-analysis. The overall relative risk was 1.42 (95% confidence interval, 1.32-1.52; P < 0.00001; test for heterogeneity = 0.380). For studies involving tamoxifen, the pooled relative risk was 1.33 (95% confidence interval, 1.20-1.48; P < 0.00001; test for heterogeneity = 0.97); for studies involving other hormonal drugs, a pooled relative risk of 1.49 (95% confidence interval, 1.36-1.64; P < 0.00001; test for heterogeneity = 0.08) was estimated. A second meta-analysis limited to tumors that were either estrogen receptor positive, estrogen receptor unknown, or estrogen receptor negative/progesterone receptor positive yielded comparable results. CONCLUSIONS HER-2-positive metastatic breast cancer is less responsive to any type of endocrine treatment. This effect holds in the subgroup of patients with positive or unknown steroid receptors.
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Affiliation(s)
- Michele De Laurentiis
- Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Università Federico II, Napoli, Italy.
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Petrosillo G, Di Venosa N, Ruggiero FM, Pistolese M, D'Agostino D, Tiravanti E, Fiore T, Paradies G. Mitochondrial dysfunction associated with cardiac ischemia/reperfusion can be attenuated by oxygen tension control. Role of oxygen-free radicals and cardiolipin. Biochimica et Biophysica Acta (BBA) - Bioenergetics 2005; 1710:78-86. [PMID: 16325647 DOI: 10.1016/j.bbabio.2005.10.003] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2005] [Revised: 10/13/2005] [Accepted: 10/17/2005] [Indexed: 01/16/2023]
Abstract
Reactive oxygen species (ROS) are considered an important factor in ischemia/reperfusion injury to cardiac myocites. Mitochondrial respiration is an important source of ROS generation and hence a potential contributor to cardiac reperfusion injury. Appropriate treatment strategy could be particularly useful to limit this ROS generation and associated mitochondrial dysfunction. In the present study, we examined the effect of lowering the oxygen tension, at the onset of the reperfusion, on various parameters of mitochondrial bioenergetics in rat heart tissue. After isolation of mitochondria from control, ischemic, normoxic and hypoxic reperfused rat heart, various bioenergetic parameters were evaluated such as rates of mitochondrial oxygen consumption, complex I and complex III activity, H2O2 production and in addition, the degree of lipid peroxidation, cardiolipin content and cardiolipin oxidation. We found that normoxic reperfusion significantly altered all these mitochondrial parameters, while hypoxic reperfusion had a protective effect attenuating these alterations. This effect appears to be due, at least in part, to a reduction of mitochondrial ROS generation with subsequent preservation of cardiolipin integrity, protection of mitochondrial function and improvement of post-ischemic hemodynamic function of the heart.
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Affiliation(s)
- G Petrosillo
- Department of Biochemistry and Molecular Biology and CNR Institute of Biomembranes and Bioenergetics, via E. Orabona, 4, 70126 Bari, Italy
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D'Agostino D, Bertelli M, Gallo S, Cecchin S, Albiero E, Garofalo PG, Gambardella A, St Hilaire JM, Kwiecinski H, Andermann E, Pandolfo M. Mutations and polymorphisms of the CLCN2 gene in idiopathic epilepsy. Neurology 2004; 63:1500-2. [PMID: 15505175 DOI: 10.1212/01.wnl.0000142093.94998.1a] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The authors analyzed the CLCN2 chloride channel gene in 112 probands with familial epilepsy, detecting 18 common polymorphisms. Two brothers with generalized epilepsy and their asymptomatic father, and a father and son with focal epilepsy carried variants of possible functional significance that were not found in 192 controls. The authors conclude that CLCN2 mutations may be a rare cause of familial epilepsy. Further studies are needed to test if polymorphisms in this gene are associated with epilepsy.
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Affiliation(s)
- D D'Agostino
- Department of Neurology, Montreal Neurological Institute
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Abstract
Orthotopic liver transplantation (Tx) has improved survival in infants with extrahepatic biliary atresia (BA) when portoenteroanastomosis fails. Symptoms leading to Tx include liver failure, poor quality of life and growth failure. The objective of the study was to determine catch-up growth in children with BA. Medical records and growth data of 36 patients (24 girls) who received a Tx due to BA were analyzed. Thirty-two patients completed 3 yr and 15 patients 7 yr of follow-up after Tx. At Tx, the median age was 2.7 yr (range 0.7-12.6) and mean height Z score (+/-s.d.) was -1.56 (+/-1.3). Patients were divided in two groups according to age at Tx: group I (n = 10), younger than 1.0 yr, and group II (n = 26) older than 1.0 yr. Median age (range) at Tx in group I was 0.8 yr (0.7-1.0) and in group II it was 3.35 yr (1.25-12.6). Thirteen patients (nine in group I) were receptors of living related donors. We evaluated linear growth, liver and renal function, immunosuppressive regimen and allograft rejection episodes. We did not find any significant differences in allograft or renal function, immunosuppressive therapy and number of acute rejection episodes or height Z score at Tx, second and third year post-Tx between both groups. The mean height Z score at Tx in group I was -1.61 and in group II -1.54; at the second year, group I -0.66 and group II -1.08; at the third year, group I -0.17 and group II -0.85; and at the seventh year (total group) -0.3. However, the height gain at the third year was better in group I than in group II (p < 0.01, t-test). Height Z score at the third year improved more than 1 SDS in seven out of eight patients in group I and in only nine out of 24 in group II (odds ratio 11.6). We also found a correlation between height gain at the third year and age at Tx (r-0.65) and between height gain at the third year and height Z score at Tx (r-0.54) (Pearson, p < 0.05). Children with BA who are transplanted before 12 months of age presented better catch-up growth without change survival and morbidity. Orthotopic liver Tx improves survival and also enables height gain in these children.
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Affiliation(s)
- G Alonso
- Section of Endocrinology, Liver Transplant Center, Pediatric Department, Hospital Italiano de Buenos Aires, Argentina
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De Santibañes E, Mc Cormack L, Pekolj J, Mattera J, Acuña Barrios J, Aldet A, García Monaco R, Gadano A, D'Agostino D, Bonofiglio C, Ciardullo M. [Multimodal treatment of hepatocellular carcinoma]. Acta Gastroenterol Latinoam 2002; 31:367-75. [PMID: 11873663] [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: 02/23/2023]
Abstract
BACKGROUND Several options now available create the need for a multidisciplinary approach to the treatment of patients with hepatocellular carcinoma (HCC). OBJECTIVE To describe the experience with a group of patients with HCC diagnosed and treated with the current modalities for control of this entity. POPULATION AND METHOD A total of 169 consecutive patients with HCC treated between January 1990 and February 1998; 41 liver resections, 14 liver transplants, 87 chemoembolizations and 8 alcoholizations were performed. The median follow-up time was 23.6 months (range: 0.2-94). In the other 29 patients, only support treatment was administered. RESULTS Resected patients had a lower median hospitalization rate, blood transfusions, and hospitalization mortality. Recurrence was 42.1% in the resected group but 0% in transplanted patients. The overall survival at 36 months was better for transplanted than for resected patients (100% vs. 62.3%; p < 0.02). The median survival time was 13 months (IC: 95%: 11-15 months) in chemoembolizated patients. CONCLUSIONS 1. The outcome of patients with HCC is influenced by several factors, therefore calling for multimodal approach. 2. Surgical procedures should be indicated with low morbimortality rates. 3. The overall survival and disease free survival time is better in transplanted patients than in the resected group. 4. The survival time of patients with unresectable HCC without extra-liver disease could be improved with chemoembolization.
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Bernasconi A, Martinez V, Rosa-Neto P, D'Agostino D, Bernasconi N, Berkovic S, MacKay M, Harvey AS, Palmini A, da Costa JC, Paglioli E, Kim HI, Connolly M, Olivier A, Dubeau F, Andermann E, Guerrini R, Whisler W, de Toledo-Morrell L, Morrell F, Andermann F. Surgical resection for intractable epilepsy in "double cortex" syndrome yields inadequate results. Epilepsia 2001; 42:1124-9. [PMID: 11580758 DOI: 10.1046/j.1528-1157.2001.39900.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.2] [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: 11/20/2022]
Abstract
PURPOSE To analyze the results of surgical treatment of intractable epilepsy in patients with subcortical band heterotopia, or double cortex syndrome, a diffuse neuronal migration disorder. METHODS We studied eight patients (five women) with double cortex syndrome and intractable epilepsy. All had a comprehensive presurgical evaluation including prolonged video-EEG recordings and magnetic resonance imaging (MRI). RESULTS All patients had partial seizures, with secondary generalization in six of them. Neurologic examination was normal in all. Three were of normal intelligence, and five were mildly retarded. Six patients underwent invasive EEG recordings, three of them with subdural grids and three with stereotactic implanted depth electrodes (SEEG). Although EEG recordings showed multilobar epileptic abnormalities in most patients, regional or focal seizure onset was recorded in all. MRI showed bilateral subcortical band heterotopia, asymmetric in thickness in three. An additional area of cortical thickening in the left frontal lobe was found in one patient. Surgical procedures included multiple subpial transections in two patients, frontal lesionectomy in one, temporal lobectomy with amygdalohippocampectomy in five, and an additional anterior callosotomy in one. Five patients had no significant improvement, two had some improvement, and one was greatly improved. CONCLUSION Our results do not support focal surgical removal of epileptogenic tissue in patients with double cortex syndrome, even in the presence of a relatively localized epileptogenic area.
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Affiliation(s)
- A Bernasconi
- Department of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, McGill University, Montreal, Quebec, Canada.
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Di Venosa N, Masciopinto F, Romito FM, Altea Tiravanti E, Schena S, Fasanella E, D'Agostino D, Pappagallo L, Federici A, Fiore T. Hypoxic reperfusion limits functional impairment following cardioplegic arrest in isolated rat heart. Minerva Anestesiol 2001; 67:509-17. [PMID: 11602871] [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: 02/21/2023]
Abstract
BACKGROUND Reperfusion injury decreases both systolic contractility and diastolic compliance. Several studies indicate that the sustained decrease in diastolic compliance is mainly due to reactive oxygen intermediates (ROI) generation and calcium overload. METHODS Male Wistar isolated rat hearts were divided into 2 groups (n=10 each), perfused according to Langendorff technique and exposed to 45 min of ischemia. Hearts belonging to the first group were reperfused with Krebs-Henseleit solution at 600 mmHg pO2; a 150 mmHg pO2 perfusate was utilized in the second group during the first minute and switched to 600 mmHg pO2 thereafter. Modifications in diastolic compliance and systolic contractility were assessed by changes in left ventricular end-diastolic (LVEDP) and developed pressure (LVDP), and first derivative of the pressure curve (dP/dt). RESULTS Increase in LVEDP values, with respect to pre-ischemic data, were detected at 1, 5, 10, 20 min following reperfusion at 600 mmHg pO2, and were respectively: +40.17+/-18.61, +57.5+/-28.8, +59.8+/-30.5 and +63.2+/-34.1 mmHg. At 150 mmHg pO2 they were: +15.69+/-13.13, +22.4+/-14.1, +26.2+/-13.7 and +28.9+/-15.8, with a significant difference within the first 20 min (p<0.05). At high pO2 levels, LVDP decreased of 53.0+/-27.35, 60.5+/-22.6, 59.8+/-23.3 and 50.7+/-25.0 mmHg, versus 42.7+/-25.7, 38.0+/-29.5, 39.2+/-30.9 and 38.7+/-32.7 mmHg at lower pO2 (p=NS). The correspondent values of the dP/dt were 37.8+/-27.7, 30.1+/-17.2, 32.2+/-13.6 and 35.4+/-14.0% of pre-ischemic values at high pO2, versus 43.3+/-27.09, 51.9+/-25.1, 50.1+/-24.6 and 53.1+/-29.9% at lower pO2. Statistical significance was lower for LVDP and dP/dt than LVEDP. CONCLUSIONS Diastolic functional impairment was partially reduced within the first 20 min following low pO2 reperfusion, but without any significant improvement of contractility.
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Affiliation(s)
- N Di Venosa
- Department of Emergency and Organ Transplantation, Anesthesiology and Resuscitation Service, Municipal Hospital, Trani, Italy
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Fedi M, Reutens D, Dubeau F, Andermann E, D'Agostino D, Andermann F. Long-term efficacy and safety of piracetam in the treatment of progressive myoclonus epilepsy. Arch Neurol 2001; 58:781-6. [PMID: 11346373 DOI: 10.1001/archneur.58.5.781] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Piracetam has been proven to be effective and well tolerated in the treatment of myoclonus in short-term studies. OBJECTIVE To assess its long-term clinical efficacy, 11 patients with disabling myoclonus due to progressive myoclonus epilepsy were treated with piracetam in an open-label study. METHODS Neurologic outcome (at the 1st, 6th, 12th, and 18th month of treatment) was assessed by an adjusted sum score of the following 3 indices: motor impairment, functional disability, and global assessment of disability due to myoclonus. Severity of other neurologic symptoms (seizure frequency and severity, dysarthria, and gait ataxia) also was assessed. Treatment with piracetam was initiated at a dose of 3.2 g/d that was gradually increased until stable benefit was noted (maximal dose in the trial was 20 g/d). Concomitant antiepileptic drugs were maintained at their previous dose. RESULTS Statistically significant improvement in the total rating score was observed after introduction of piracetam at the 1st, 6th, and 12th month of treatment. Severity of other neurologic symptom scores did not improve significantly. Two patients reported drowsiness during the first 2 weeks of treatment. CONCLUSIONS Piracetam given as add-on therapy seems to be an effective, sustained, and well-tolerated treatment of myoclonus. In patients with progressive myoclonus epilepsy, the efficacy of the drug increased during the first 12 months of treatment and then stabilized.
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Affiliation(s)
- M Fedi
- FRCP(C), Montreal Neurological Institute and Hospital, 3801 University St, Room 127, Montreal, Quebec, Canada H3A 2B4.
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Abstract
BACKGROUND Patients who undergo liver transplantation require multifaceted general care, and vaccination has a fundamental role before and after transplantation. The purpose of this study was to provide a prospective evaluation of the immunogenicity of the recombinant vaccine (RV) against Hepatitis B in pediatric patients with liver transplants (TxH) who for different reasons did not receive a pretransplantation vaccine. METHODS From June 1996 to December 1999, 47 pediatric patients with liver transplants were vaccinated with RV. Patients older than 1 year of age, in stable condition, and 6 months post-transplantation were included. The vaccination scheme was 0-1 and 6 months, intramuscular 10 microg in less than 30 kg body weight, and 20 microg in more than 30 kg body weight. The nonresponder patients were vaccinated with a booster dose and a double dose 1 to 6 months after the last dose. Responders to titer HBs Ab enzyme immunoassay (EIA) <10 UI/ml were defined as nonresponders, to titer between 10-100 UI/ml as responders, and to higher titer of 100 UI/ml as high responders. RESULTS The following data were obtained from the 47 patients: mean +/- standard deviation (SD) age at vaccination was 10.76 +/- 5.96 years old and the mean +/- SD post-transplant time at the beginning of vaccination was 3.56 +/- 2.19 years. Thirty-three of 47 patients (70%) responded to doses according to body weight, and 14 (30%) did not respond, necessitating a booster dose after which 7 responded (50%). The global seroconversion was 85%. There was not a significant responder cyclosporine concentration dosage (154 vs. 150 ng/ml) difference between responders and nonresponders. Sixty-six percent (8 of 12) of patients receiving a triple immunosuppressive scheme (cyclosporine, steroids, and Azathioprine) had a positive response, while 84% (16 of 19) receiving a double scheme (cyclosporine and steroids) and 100% (16 of 16) receiving monotherapy with cyclosporine had a positive response. By comparing a triple scheme with monotherapy, the Fisher exact test found a P < 0.01. Incidence of adverse effects (local pain) was 2.63%. CONCLUSION Immunization with RV was well-tolerated with acceptable seroconversion and safety in recipients after liver transplantation, particularly in those undergoing cyclosporine monotherapy. The population studied showed better results than did other populations of immunosuppressed patients.
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Affiliation(s)
- P Duca
- Liver Transplant Center, Department of Pediatrics, Hospital Italiano, Buenos Aires, Argentina
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