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Rezaee M, Azizi N, Danaei B, Davari A, Nejadghaderi SA, Sarmastzadeh T, Rahmannia M, Khalili F, Shahidi-Bonjar AH, Centis R, D'Ambrosio L, Sotgiu G, Migliori GB, Nasiri MJ. TB and interstitial lung disease: a systematic review and meta-analysis. Int J Tuberc Lung Dis 2024; 28:130-135. [PMID: 38454180 DOI: 10.5588/ijtld.23.0428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION To determine the frequency of TB among patients with interstitial lung diseases (ILDs).METHODS We performed a comprehensive search in the PubMed/Medline, EMBASE and Scopus databases up to 1 August 2023 of studies reporting on the prevalence of TB among patients with ILDs.RESULTS Twelve studies comprising 3,817 patients with ILD were found: the pooled prevalence of TB among ILD patients was 11.0% (95% CI 5.4-21.0). In the subgroup analysis, the TB rate among patients with silicosis and idiopathic pulmonary fibrosis (IPF) was respectively 35.6% (95% CI 32.6-38.8) and 4.4% (95% CI 3.6-5.3) (P = 0.00). The frequency of TB among ILD patients was higher in high TB burden countries than in low/intermediate-burden countries: 26.3%, 95% CI 17.7-37.3 vs. 4.9%, 95% CI 3.3-7.2; P = 0.00.CONCLUSIONS This study shows the frequency of TB among ILD patients. The meta-analysis reveals a significantly increased prevalence of TB among ILD patients with silicosis compared to IPF, and among individuals in high TB burden countries than in those with low/intermediate burden. The study results can help physicians and policymakers make efficient decisions for prompt screening and anti-TB treatment initiation in ILD patients..
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Affiliation(s)
- M Rezaee
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran
| | - N Azizi
- School of Medicine, Tehran University of Medical Sciences, Tehran
| | - B Danaei
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran
| | - A Davari
- School of Medicine, Tehran University of Medical Sciences, Tehran
| | - S A Nejadghaderi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran
| | - T Sarmastzadeh
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran
| | - M Rahmannia
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran
| | - F Khalili
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran
| | - A H Shahidi-Bonjar
- Dental Materials and Restorative Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - R Centis
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri Istituto di Ricovero e Cura a Carattere Scientifico, Tradate, Italy
| | - L D'Ambrosio
- Public Health Consulting Group, Lugano, Switzerland
| | - G Sotgiu
- Unità di Epidemiologia Clinica e Statistica Medica, Dipartimento di Scienze Mediche Chirurgiche e Sperimentali, Università degli Studi di Sassari, Sassari, Italy
| | - G B Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri Istituto di Ricovero e Cura a Carattere Scientifico, Tradate, Italy
| | - M J Nasiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Oehadian A, Bastos ML, Centis R, D'Ambrosio L, Migliori GB, Santoso P, Ruslami R, Menzies D. Occurrence and predictors of adverse events associated with Linezolid in the treatment of patients with MDR-TB. Pulmonology 2024; 30:184-187. [PMID: 37783640 DOI: 10.1016/j.pulmoe.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 10/04/2023] Open
Affiliation(s)
- A Oehadian
- Hematology and Medical Oncology Division, Department of Internal Medicine, Dr. Hasan Sadikin General Hospital/Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; Doctoral Study Program Faculty of Medicine, Universitas Padjadjaran Bandung, West Java, Indonesia
| | - M L Bastos
- McGill International TB Centre Montreal Chest Institute, Research Institute of the McGill University Health Centre, Montreal, Canada; Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - R Centis
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - L D'Ambrosio
- Public Health Consulting Group, Lugano, Switzerland
| | - G B Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - P Santoso
- Division of Respirology and Critical Care, Department of Internal Medicine Dr. Hasan Sadikin General Hospital /Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - R Ruslami
- Department of Biomedical Science, Division of Pharmacology, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - D Menzies
- McGill International TB Centre Montreal Chest Institute, Research Institute of the McGill University Health Centre, Montreal, Canada.
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Silva DR, Dos Santos APC, Centis R, D'Ambrosio L, Migliori GB. Long-term sequelae of TB and COVID-19 co-infection: Prospective cohort evaluation after 1 year. Pulmonology 2023; 29:535-539. [PMID: 37349196 PMCID: PMC10258581 DOI: 10.1016/j.pulmoe.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/05/2023] [Accepted: 05/24/2023] [Indexed: 06/24/2023] Open
Affiliation(s)
- D R Silva
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Programa de Pós-Graduação em Ciências Pneumológicas da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
| | - A P C Dos Santos
- Programa de Pós-Graduação em Ciências Pneumológicas da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - R Centis
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
| | - L D'Ambrosio
- Public Health Consulting Group, Lugano, Switzerland
| | - G B Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
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Visca D, Centis R, Pontali E, Zampogna E, Russell AM, Migliori GB, Andrejak C, Aro M, Bayram H, Berkani K, Bruchfeld J, Chakaya JM, Chorostowska-Wynimko J, Crestani B, Dalcolmo MP, D'Ambrosio L, Dinh-Xuan AT, Duong-Quy S, Fernandes C, García-García JM, de Melo Kawassaki A, Carrozzi L, Martinez-Garcia MA, Martins PC, Mirsaeidi M, Mohammad Y, Naidoo RN, Neuparth N, Sese L, Silva DR, Solovic I, Sooronbaev TM, Spanevello A, Sverzellati N, Tanno L, Tiberi S, Vasankari T, Vasarmidi E, Vitacca M, Annesi-Maesano I. Clinical standards for diagnosis, treatment and prevention of post-COVID-19 lung disease. Int J Tuberc Lung Dis 2023; 27:729-741. [PMID: 37749839 PMCID: PMC10519381 DOI: 10.5588/ijtld.23.0248] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/06/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND: The aim of these clinical standards is to provide guidance on 'best practice' care for the diagnosis, treatment and prevention of post-COVID-19 lung disease.METHODS: A panel of international experts representing scientific societies, associations and groups active in post-COVID-19 lung disease was identified; 45 completed a Delphi process. A 5-point Likert scale indicated level of agreement with the draft standards. The final version was approved by consensus (with 100% agreement).RESULTS: Four clinical standards were agreed for patients with a previous history of COVID-19: Standard 1, Patients with sequelae not explained by an alternative diagnosis should be evaluated for possible post-COVID-19 lung disease; Standard 2, Patients with lung function impairment, reduced exercise tolerance, reduced quality of life (QoL) or other relevant signs or ongoing symptoms ≥4 weeks after the onset of first symptoms should be evaluated for treatment and pulmonary rehabilitation (PR); Standard 3, The PR programme should be based on feasibility, effectiveness and cost-effectiveness criteria, organised according to local health services and tailored to an individual patient's needs; and Standard 4, Each patient undergoing and completing PR should be evaluated to determine its effectiveness and have access to a counselling/health education session.CONCLUSION: This is the first consensus-based set of clinical standards for the diagnosis, treatment and prevention of post-COVID-19 lung disease. Our aim is to improve patient care and QoL by guiding clinicians, programme managers and public health officers in planning and implementing a PR programme to manage post-COVID-19 lung disease.
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Affiliation(s)
- D Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici (ICS) Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Tradate, Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese
| | - R Centis
- Respiratory Diseases Clinical Epidemiology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate
| | - E Pontali
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy
| | - E Zampogna
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici (ICS) Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Tradate
| | - A-M Russell
- Faculty of Health and Life Sciences, University of Exeter, Exeter, Royal Devon University Hospitals NHS Trust, Exeter, North Bristol NHS Trust, Bristol, UK
| | - G B Migliori
- Respiratory Diseases Clinical Epidemiology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate
| | - C Andrejak
- Respiratory Department, Centre Hospitalier Universitaire Amiens Picardie, Amiens, Unité de Recherche 4294, Agents Infectieux, Résistance et Chimiothérapie, Picardie Jules Verne University, Amiens, GREPI (Group pour la Recherche et enseignement en pneumo-infectiologie) Work group of French society of respiratory diseases, Paris, France
| | - M Aro
- Finnish Lung Health Association (FILHA), Helsinki, Finland
| | - H Bayram
- Department of Pulmonary Medicine, Koc University Research Center for Translational Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - K Berkani
- Pierre de Soleil Clinic, Respiratory Rehabilitation, Vetraz Monthoux, France
| | - J Bruchfeld
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Division of Infectious Diseases, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - J M Chakaya
- Department of Medicine, Therapeutics and Dermatology, Kenyatta University, Nairobi, Kenya, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - J Chorostowska-Wynimko
- Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
| | - B Crestani
- Université Paris Cité, Physiopathologie et épidémiologie des maladies respiratoires, Institut national de la santé et de la recherche médicale (INSERM), Paris, Assistance Publique des Hôpitaux de Paris (APHP), Hôpital Bichat, Service de Pneumologie A, FHU APOLLO, Paris, France
| | - M P Dalcolmo
- Hélio Fraga Reference Center, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - L D'Ambrosio
- Public Health Consulting Group, Lugano, Switzerland
| | - A-T Dinh-Xuan
- Service de Physiologie-Explorations Fonctionnelles, APHP, Hôpital Cochin, Université Paris Cité, Paris, France
| | - S Duong-Quy
- Respiratory Department, Lam Dong Medical College, Dalat, Vietnam
| | - C Fernandes
- Heart Institute, Cardio-pulmonology Department, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - J-M García-García
- Tuberculosis Research Programme (PII-TB), Sociedad Española de Neumología y Cirugía Torácica, Barcelona, Spain
| | - A de Melo Kawassaki
- Serviço de Pneumologia, Instituto do Câncer do Estado de São Paulo (ICESP) e do ambulatÓrio de Doenças Pulmonares Intersticiais, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brazil
| | - L Carrozzi
- Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Pulmonary Unit, Cardiothoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - M A Martinez-Garcia
- Respiratory Department, University and Polytechnic La Fe Hospital, Valencia, Centro de InvestigaciÓn Biomédica en Red, Respiratory Disorders, Madrid, Spain
| | - P Carreiro Martins
- Allergy and Clinical Immunology Department, Dona Estefânia Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, NOVA Medical School-Comprehensive Health Research Center, Lisbon, Portugal
| | - M Mirsaeidi
- Division of Pulmonary and Critical Care, University of Florida, Jacksonville, FL, USA
| | - Y Mohammad
- Al Sham private University, Faculty of Medicine and Pharmacy, Damascus and Latakia, Centre for Research on Chronic Respiratory Diseases, Tishreen University, Lattakia, Syria
| | - R N Naidoo
- Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, Durban, South Africa
| | - N Neuparth
- Allergy and Clinical Immunology Department, Dona Estefânia Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, NOVA Medical School-Comprehensive Health Research Center, Lisbon, Portugal
| | - L Sese
- Department of Physiology and Functional Explorations, Hôpital Avicenne, INSERM, Unité mixte de recherche 1272 Hypoxia and the Lung, Université Sorbonne Paris Nord, Bobigny, Department of Pneumology, Centre Constitutif de référence des maladies pulmonaires rares, Hôpital Avicenne, Bobigny, France
| | - D R Silva
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - I Solovic
- National Institute for TB, Lund Diseases and Thoracic Surgery, Vysne Hagy, Catholic University, Ruzomberok, Slovakia
| | - T M Sooronbaev
- Department of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - A Spanevello
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici (ICS) Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Tradate, Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese
| | - N Sverzellati
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - L Tanno
- Institut Desbrest of Epidemiology and Santé Publique, INSERM & Montpellier University, Montpellier and Department of Allergic and Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - S Tiberi
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - T Vasankari
- FILHA, Helsinki, University of Turku, Department of Pulmonary Diseases and Clinical Allergology, Turku, Finland
| | - E Vasarmidi
- Department of Respiratory Medicine and Laboratory of Molecular and Cellular Pneumonology, School of Medicine, University of Crete, Heraklion, Greece
| | - M Vitacca
- ICS Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy
| | - I Annesi-Maesano
- Institut Desbrest of Epidemiology and Santé Publique, INSERM & Montpellier University, Montpellier and Department of Allergic and Respiratory Diseases, Montpellier University Hospital, Montpellier, France
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Nasiri MJ, Silva DR, Rommasi F, Zahmatkesh MM, Tajabadi Z, Khelghati F, Sarmastzadeh T, Centis R, D'Ambrosio L, Bombarda S, Dalcolmo MP, Galvão T, de Queiroz Mello FC, Rabahi MF, Pontali E, Solovic I, Tadolini M, Marconi L, Tiberi S, van den Boom M, Sotgiu G, Migliori GB. Vaccination in post-tuberculosis lung disease management: A review of the evidence. Pulmonology 2023:S2531-0437(23)00129-0. [PMID: 37679219 DOI: 10.1016/j.pulmoe.2023.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/10/2023] [Accepted: 07/10/2023] [Indexed: 09/09/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Post-tuberculosis lung disease (PTLD), as other chronic respiratory disorders, may have infectious complications; some of them can be prevented with vaccinations. So far, no document has discussed the potential role of vaccination in PTLD. Therefore, the objective of this review was to describe vaccination recommendations to prevent infections potentially capable of complicating PTLD. MATERIALS AND METHODS A non-systematic review of the literature was conducted. The following keywords were used: tuberculosis, vaccination, vaccines and PTLD. PubMed/MEDLINE and Embase were used as the search engine, focusing on English-language literature only. RESULTS We identified 9 vaccines potentially useful in PTLD. Influenza, pneumococcal and anti-COVID-19 vaccinations should be recommended. Patients with PTLD can also benefit from vaccination against shingles. Vaccination against pertussis is mainly relevant during childhood. Diphtheria, tetanus and measles vaccination are recommended for general population and should be considered in patients with PTLD not previously vaccinated. Tdap (Tetanus, diphtheria, and pertussis) booster should be repeated in every adult every ten years. Vaccination against BCG retains its importance during early childhood in countries where TB is endemic. CONCLUSIONS Vaccination deserves to be considered among the strategies to prevent and/or mitigate PTLD complications. Further evidence is necessary to better understand which vaccines have the greatest impact and cost-benefit.
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Affiliation(s)
- M J Nasiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - D R Silva
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - F Rommasi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M M Zahmatkesh
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Z Tajabadi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - F Khelghati
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - T Sarmastzadeh
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - R Centis
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - L D'Ambrosio
- Public Health Consulting Group, Lugano, Switzerland
| | - S Bombarda
- Secretaria de Estado da Saúde de São Paulo, Programa de Controle da Tuberculose, São Paulo, Brazil
| | - M P Dalcolmo
- Reference Center Hélio Fraga, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - T Galvão
- Serviço de Pneumologia, Hospital Especializado Octávio Mangabeira, Secretaria de Saúde do Estado da Bahia, Salvador, Brazil
| | - F C de Queiroz Mello
- Thorax Diseases Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - M F Rabahi
- Faculdade de Medicina, Universidade Federal de Goiás (UFG), Goiânia, Brazil
| | - E Pontali
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy
| | - I Solovic
- Department of Public Health, Faculty of Health, Catholic University, Ruzomberok, Slovakia; National Institute of Tuberculosis, Pulmonary Diseases and Thoracic Surgery, Vysne Hagy, Slovakia
| | - M Tadolini
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - L Marconi
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - S Tiberi
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, E1 2AT United Kingdom
| | - M van den Boom
- World Health Organisation, Regional Office for the Eastern Mediterranean Region, Cairo, Egypt
| | - G Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Italy
| | - G B Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy.
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Pirozzi Palmese V, D'Ambrosio L, Di Gennaro F, Maisto C, de Marino R, Morisco A, Coluccia S, Di Gennaro P, De Lauro F, Raddi M, Gaballo P, Tafuto S, Celentano E, Lastoria S. A comparison of simplified protocols of personalized dosimetry in NEN patients treated by radioligand therapy (RLT) with [ 177Lu]Lu-DOTATATE to favor its use in clinical practice. Eur J Nucl Med Mol Imaging 2023; 50:1753-1764. [PMID: 36688980 PMCID: PMC10119237 DOI: 10.1007/s00259-023-06112-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/05/2023] [Indexed: 01/24/2023]
Abstract
The role of internal dosimetry is usually proposed for investigational purposes in patients treated by RLT, even if its application is not yet the standard method in clinical practice. This limited use is partially justified by several concomitant factors that make calculations a complex process. Therefore, simplified dosimetry protocols are required. METHODS In our study, dosimetric evaluations were performed in thirty patients with NENs who underwent RLT with [177Lu]Lu-DOTATATE. The reference method (M0) calculated the cumulative absorbed dose performing dosimetry after each of the four cycles. Obtained data were employed to assess the feasibility of simplified protocols: defining the dosimetry only after the first cycle (M1) and after the first and last one (M2). RESULTS The mean differences of the cumulative absorbed doses between M1 and M0 were - 10% for kidney, - 5% for spleen, + 34% for liver, + 13% for red marrow, and + 37% for tumor lesions. Conversely, differences lower than ± 10% were measured between M2 and M0. CONCLUSION Cumulative absorbed doses obtained with the M2 protocol resembled the doses calculated by M0, while the M1 protocol overestimated the absorbed doses in all organs at risk, except for the spleen.
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Affiliation(s)
| | - Laura D'Ambrosio
- S.C. Medicina Nucleare E Terapia Radiometabolica, INT IRCCS Fondazione G. Pascale, Naples, Italy
| | - Francesca Di Gennaro
- S.C. Medicina Nucleare E Terapia Radiometabolica, INT IRCCS Fondazione G. Pascale, Naples, Italy
| | - Costantina Maisto
- S.C. Medicina Nucleare E Terapia Radiometabolica, INT IRCCS Fondazione G. Pascale, Naples, Italy
| | - Roberta de Marino
- S.C. Medicina Nucleare E Terapia Radiometabolica, INT IRCCS Fondazione G. Pascale, Naples, Italy
| | - Anna Morisco
- S.C. Medicina Nucleare E Terapia Radiometabolica, INT IRCCS Fondazione G. Pascale, Naples, Italy
| | - Sergio Coluccia
- S.C. Epidemiologia E Biostatistica, INT IRCCS Fondazione G. Pascale, Naples, Italy
| | | | - Francesco De Lauro
- S.C. Medicina Nucleare E Terapia Radiometabolica, INT IRCCS Fondazione G. Pascale, Naples, Italy
| | - Marco Raddi
- S.C. Medicina Nucleare E Terapia Radiometabolica, INT IRCCS Fondazione G. Pascale, Naples, Italy
| | - Paolo Gaballo
- S.C. Medicina Nucleare E Terapia Radiometabolica, INT IRCCS Fondazione G. Pascale, Naples, Italy
| | - Salvatore Tafuto
- S.C. Sarcomi E Tumori Rari, INT IRCCS Fondazione G. Pascale, Naples, Italy
| | - Egidio Celentano
- S.C. Epidemiologia E Biostatistica, INT IRCCS Fondazione G. Pascale, Naples, Italy
| | - Secondo Lastoria
- S.C. Medicina Nucleare E Terapia Radiometabolica, INT IRCCS Fondazione G. Pascale, Naples, Italy.
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Kantidakis G, Litiere S, Neven A, Vinches M, Judson I, Blay JY, Wardelmann E, Stacchiotti S, D'Ambrosio L, Marreaud S, van der Graaf W, Kasper B, Fiocco M, Gelderblom H. 1491MO New benchmarks for designing clinical trials in advanced or metastatic liposarcoma (LPS) or synovial sarcoma (SS): An EORTC soft tissue and bone sarcoma group meta-analysis. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1594] [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: 11/24/2022] Open
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Singhal U, Nallandhighal S, Tosoian J, Pham T, Kareem R, Plouffe K, Morgan T, Luciano R, Shariat S, Finocchio N, D'Ambrosio L, Doglioni C, Tomlins S, Briganti A, Palapattu G, Udager A, Salami S. Molecular characterization to delineate the clonal evolution of primary prostate cancer with synchronous lymph node metastasis. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01020-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gandaglia G, Mazzone E, Pellegrino A, Fossati N, Stabile A, Scuderi S, Barletta F, Leni R, Robesti D, D'Ambrosio L, Vitale L, Samanes Gajate A, Picchio M, Gianolli L, Montorsi F, Briganti A. 99m-technetium-psma radio-guided surgery to detect nodal metastases in prostate cancer patients undergoing radical prostatectomy and extended pelvic lymph node dissection: A phase 2 prospective, single-institution study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01297-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Maisto C, Morisco A, de Marino R, Squame E, Porfidia V, D'Ambrosio L, Di Martino D, Gaballo P, Aurilio M, Buonanno M, Esposito A, Raddi M, Lastoria S. On site production of [ 18F]PSMA-1007 using different [ 18F]fluoride activities: practical, technical and economical impact. EJNMMI Radiopharm Chem 2021; 6:36. [PMID: 34643830 PMCID: PMC8514599 DOI: 10.1186/s41181-021-00150-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/23/2021] [Accepted: 09/20/2021] [Indexed: 12/03/2022] Open
Abstract
Background Prostate-specific membrane antigen is overexpressed in prostate cancer and it is considered a good target for positron emission tomography/computed tomography imaging of primary cancer and recurrent/metastatic disease, as well as for radioligand therapy. Different PSMA-analogues labeled with [68Ga]gallium have been investigated, showing excellent imaging properties; however, only small amounts can be produced for each radiolabeling. Recently, a [18F]fluoride labeled PSMA-inhibitor, [18F]PSMA-1007, has been introduced, and it has ensured large-scale productions, overcoming this limitation of [68Ga]PSMAs. In this study, PSMA-1007 has been labeled with low (A), medium (B) and high (C) starting activities of [18F]fluoride, in order to verify if radiochemical yield, radiochemical purity and stability of [18F]PSMA-1007 were affected. These parameters have been measured in sixty-five consecutive batches. In addition, the estimation of [18F]PSMA-1007 production costs is provided. Results The radiochemical yield for low and medium activities of [18F]fluoride was 52%, while for the high one it decreased to 40%. The radiochemical purity was 99% for all three activities. [18F]PSMA-1007 did not show radiolysis up to 8 h after the end of synthesis, confirming that the radiopharmaceutical is stable and suitable to perform diagnostic studies in humans for a long period of time after the end of radiolabeling. Furthermore, radiochemical stability was demonstrated in fetal bovine serum at 4 °C and 37 °C for 120′. Conclusions A starting activity of [18F]fluoride of 90 GBq (B) seems to be the best option enabling a final amount of about of 50 GBq of [18F]PSMA-1007, which is promising as it allows to: (a) perform a large number of scans, and/or (b) supply the radiopharmaceutical to any peripheral diagnostic centers in need.
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Affiliation(s)
- Costantina Maisto
- Nuclear Medicine Division, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Naples, Italy
| | - Anna Morisco
- Nuclear Medicine Division, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Naples, Italy
| | - Roberta de Marino
- Nuclear Medicine Division, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Naples, Italy
| | - Elisabetta Squame
- Nuclear Medicine Division, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Naples, Italy
| | - Valentina Porfidia
- Nuclear Medicine Division, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Naples, Italy
| | - Laura D'Ambrosio
- Nuclear Medicine Division, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Naples, Italy
| | - Daria Di Martino
- Nuclear Medicine Division, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Naples, Italy
| | - Paolo Gaballo
- Nuclear Medicine Division, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Naples, Italy
| | - Michela Aurilio
- Nuclear Medicine Division, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Naples, Italy
| | - Monica Buonanno
- Nuclear Medicine Division, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Naples, Italy
| | - Aureliana Esposito
- Nuclear Medicine Division, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Naples, Italy
| | - Marco Raddi
- Nuclear Medicine Division, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Naples, Italy
| | - Secondo Lastoria
- Nuclear Medicine Division, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Naples, Italy.
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Sotgiu G, Rosales-Klintz S, Centis R, D'Ambrosio L, Verduin R, Correia AM, Cirule A, Duarte R, Gadzheva B, Gualano G, Kunst H, Palmieri F, Riekstina V, Stefanova D, Tiberi S, van der Werf MJ, Migliori GB. TB management in the European Union/European Economic Area: a multi-centre survey. Int J Tuberc Lung Dis 2021; 25:126-133. [PMID: 33656424 PMCID: PMC7849393 DOI: 10.5588/ijtld.20.0849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Essential TB care in the European Union/European Economic Area (EU/EEA) comprises 21 standards for the diagnosis, treatment and prevention of TB that constitute the European Union Standards for Tuberculosis Care (ESTC). METHODS: In 2017, we conducted an audit on TB management and infection control measures against the ESTC standards. TB reference centres in five EU/EEA countries were purposely selected to represent the heterogeneous European TB burden and examine geographic variability. RESULTS: Data from 122 patients, diagnosed between 2012 and 2015 with multidrug-resistant TB (n = 49), extensively drug-resistant TB (XDR-TB) (n = 11), pre-XDR-TB (n = 29) and drug-susceptible TB (n = 33), showed that TB diagnosis and treatment practices were in general in agreement with the ESTC. CONCLUSION: Overall, TB management and infection control practices were in agreement with the ESTC in the selected EU/EEA reference centres. Areas for improvement include strengthening of integrated care services and further implementation of patient-centred approaches.
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Affiliation(s)
- G Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - S Rosales-Klintz
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - R Centis
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Tradate, Italy
| | - L D'Ambrosio
- Public Health Consulting Group, Lugano, Switzerland
| | - R Verduin
- Verduin Public Health Consult, Oegstgeest, the Netherlands
| | - A M Correia
- Regional Health Administration of the North, Department of Public Health, Porto, Portugal
| | - A Cirule
- Centre of TB and Lung Diseases, Riga East University Hospital, Riga, Latvia
| | - R Duarte
- National Reference Centre for MDR-TB, Hospital Centre Vila Nova de Gaia, Department of Pneumology; Public Health Science and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - B Gadzheva
- The Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM) Programme, Department of Management of Specialized Donor-Funded Programmes, Ministry of Health, Sofia, Bulgaria
| | - G Gualano
- Respiratory Infectious Diseases Unit, L Spallanzani National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - H Kunst
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University, London, UK
| | - F Palmieri
- Respiratory Infectious Diseases Unit, L Spallanzani National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - V Riekstina
- Centre of TB and Lung Diseases, Riga East University Hospital, Riga, Latvia
| | - D Stefanova
- St Sofia University Hospital for Active Treatment of Respiratory Diseases, Sofia, Bulgaria
| | - S Tiberi
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University, London, UK, Division of Infection, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - M J van der Werf
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - G B Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Tradate, Italy
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12
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Koirala S, Borisov S, Danila E, Mariandyshev A, Shrestha B, Lukhele N, Dalcolmo M, Shakya SR, Miliauskas S, Kuksa L, Manga S, Aleksa A, Denholm JT, Khadka HB, Skrahina A, Diktanas S, Ferrarese M, Bruchfeld J, Koleva A, Piubello A, Koirala GS, Udwadia ZF, Palmero DJ, Munoz-Torrico M, Gc R, Gualano G, Grecu VI, Motta I, Papavasileiou A, Li Y, Hoefsloot W, Kunst H, Mazza-Stalder J, Payen MC, Akkerman OW, Bernal E, Manfrin V, Matteelli A, Mustafa Hamdan H, Nieto Marcos M, Cadiñanos Loidi J, Cebrian Gallardo JJ, Duarte R, Escobar Salinas N, Gomez Rosso R, Laniado-Laborín R, Martínez Robles E, Quirós Fernandez S, Rendon A, Solovic I, Tadolini M, Viggiani P, Belilovski E, Boeree MJ, Cai Q, Davidavičienė E, Forsman LD, De Los Rios J, Drakšienė J, Duga A, Elamin SE, Filippov A, Garcia A, Gaudiesiute I, Gavazova B, Gayoso R, Gruslys V, Jonsson J, Khimova E, Madonsela G, Magis-Escurra C, Marchese V, Matei M, Moschos C, Nakčerienė B, Nicod L, Palmieri F, Pontarelli A, Šmite A, Souleymane MB, Vescovo M, Zablockis R, Zhurkin D, Alffenaar JW, Caminero JA, Codecasa LR, García-García JM, Esposito S, Saderi L, Spanevello A, Visca D, Tiberi S, Pontali E, Centis R, D'Ambrosio L, van den Boom M, Sotgiu G, Migliori GB. Outcome of treatment of MDR-TB or drug-resistant patients treated with bedaquiline and delamanid: Results from a large global cohort. Pulmonology 2021; 27:403-412. [PMID: 33753021 DOI: 10.1016/j.pulmoe.2021.02.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 02/15/2021] [Indexed: 01/08/2023] Open
Abstract
The World Health Organization (WHO) recommends countries introduce new anti-TB drugs in the treatment of multidrug-resistant tuberculosis. The aim of the study is to prospectively evaluate the effectiveness of bedaquiline (and/or delamanid)- containing regimens in a large cohort of consecutive TB patients treated globally. This observational, prospective study is based on data collected and provided by Global Tuberculosis Network (GTN) centres and analysed twice a year. All consecutive patients (including children/adolescents) treated with bedaquiline and/or delamanid were enrolled, and managed according to WHO and national guidelines. Overall, 52 centres from 29 countries/regions in all continents reported 883 patients as of January 31st 2021, 24/29 countries/regions providing data on 100% of their consecutive patients (10-80% in the remaining 5 countries). The drug-resistance pattern of the patients was severe (>30% with extensively drug-resistant -TB; median number of resistant drugs 5 (3-7) in the overall cohort and 6 (4-8) among patients with a final outcome). For the patients with a final outcome (477/883, 54.0%) the median (IQR) number of months of anti-TB treatment was 18 (13-23) (in days 553 (385-678)). The proportion of patients achieving sputum smear and culture conversion ranged from 93.4% and 92.8% respectively (whole cohort) to 89.3% and 88.8% respectively (patients with a final outcome), a median (IQR) time to sputum smear and culture conversion of 58 (30-90) days for the whole cohort and 60 (30-100) for patients with a final outcome and, respectively, of 55 (30-90) and 60 (30-90) days for culture conversion. Of 383 patients treated with bedaquiline but not delamanid, 284 (74.2%) achieved treatment success, while 25 (6.5%) died, 11 (2.9%) failed and 63 (16.5%) were lost to follow-up.
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Affiliation(s)
- S Koirala
- Damien Foundation Nepal, Kathmandu, Nepal
| | - S Borisov
- Moscow Research and Clinical Center for TB Control, Moscow Government's Health Department, Moscow, Russian Federation
| | - E Danila
- Clinic of Chest Diseases, Immunology and Allergology, Vilnius University Medical Faculty, Centre of Pulmonology and Allergology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - A Mariandyshev
- Northern State Medical University, Northern (Arctic) Federal University, Arkhangelsk, Russian Federation
| | - B Shrestha
- Kalimati Chest Hospital/GENETUP/Nepal Anti Tuberculosis Association, Kathmandu, Nepal
| | - N Lukhele
- TB/HIV, Hepatitis, & PMTCT Department, World Health Organization, Eswatini WHO Country Office, Mbabane, Eswatini
| | - M Dalcolmo
- Reference Center Hélio Fraga, Fundação Oswaldo Cruz (Fiocruz)/Ministry of Health, Rio de Janeiro, Brazil
| | - S R Shakya
- Lumbini Provincial Hospital, Butwal, Nepal
| | - S Miliauskas
- Department of Pulmonology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - L Kuksa
- MDR-TB Department, Riga East University Hospital for TB and Lung Disease Centre, Riga, Latvia
| | - S Manga
- Department of Infectious Diseases, University National San Antonio Abad Cusco, Cusco, Peru
| | - A Aleksa
- Department of Phthisiology and Pulmonology, Grodno State Medical University, Grodno, Belarus
| | - J T Denholm
- Victorian Tuberculosis Program, Melbourne Health, Department of Infectious Diseases, University of Melbourne, Melbourne, Australia
| | - H B Khadka
- Nepalgjunj TB Referral Center, TB Nepal, Nepalgunj, Nepal
| | - A Skrahina
- Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | - S Diktanas
- Tuberculosis Department, 3rd Tuberculosis Unit, Republican Klaipėda Hospital, Klaipėda, Lithuania
| | - M Ferrarese
- TB Reference Centre, Villa Marelli Institute, Niguarda Hospital, Milan, Italy
| | - J Bruchfeld
- Division of Infectious Diseases, Department of Medicine, Solna, Karolinska Institute, Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - A Koleva
- Pulmonology and Physiotherapy Department, Gabrovo Lung Diseases Hospital, Gabrovo, Bulgaria
| | | | - G S Koirala
- Nepal Anti Tuberculosis Association, Morang Branch, TB Clinic, Biratnagar, Province 1, Nepal
| | - Z F Udwadia
- Department of Respiratory Medicine, P.D. Hinduja National Hospital and MRC, Mumbai, India
| | - D J Palmero
- Pulmonology Division, Municipal Hospital F. J. Muñiz, Buenos Aires, Argentina
| | - M Munoz-Torrico
- Clínica de Tuberculosis, Instituto Nacional De Enfermedades Respiratorias Ismael Cosio Villegas, Ciudad De Mexico, Mexico
| | - R Gc
- Damien Foundation, Midpoint District Community Memorial Hospital, Danda, Nawalparasi, Nepal
| | - G Gualano
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases 'L. Spallanzani', IRCCS, Rome, Italy
| | - V I Grecu
- National Programme for Prevention, Surveillance and Control of Tuberculosis, Dolj Province, Romania
| | - I Motta
- Department of Medical Science, Unit of Infectious Diseases, University of Torino, Italy
| | - A Papavasileiou
- Department of Tuberculosis, Sotiria Athens Hospital of Chest Diseases, Athens, Greece
| | - Y Li
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - W Hoefsloot
- Radboud University Medical Center, Center Dekkerswald, Nijmegen, The Netherlands
| | - H Kunst
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - J Mazza-Stalder
- Division of Pulmonary Medicine, University Hospital of Lausanne CHUV, Lausanne, Switzerland
| | - M-C Payen
- Division of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - O W Akkerman
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, TB Center Beatrixoord, Haren, The Netherlands
| | - E Bernal
- Unidad de Enfermedades Infecciosas, Hospital General Universitario Reina Sofia, Murcia, Spain
| | - V Manfrin
- Infectious and Tropical Diseases Operating Unit, S. Bortolo Hospital, Vicenza, Italy
| | - A Matteelli
- Clinic of Infectious and Tropical Diseases, WHO Collaborating Centre for TB Elimination and TB/HIV Co-infection, University of Brescia, Brescia, Italy
| | | | - M Nieto Marcos
- Internal Medicine Department, Hospital Doctor Moliner, Valencia, Spain
| | - J Cadiñanos Loidi
- Internal Medicine Department, Hospital General de Villalba, Collado Villalba, Spain
| | | | - R Duarte
- National Reference Centre for MDR-TB, Hospital Centre Vila Nova de Gaia, Department of Pneumology, Public Health Science and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - N Escobar Salinas
- Division of Disease Prevention and Control, Department of Communicable Diseases, National Tuberculosis Control and Elimination Programme, Ministry of Health, Santiago, Chile
| | - R Gomez Rosso
- National Institute of Respiratory and Environmental Diseases ¨Prof. Dr. Juan Max Boettner¨ Asunción, Paraguay
| | - R Laniado-Laborín
- Universidad Autónoma de Baja California, Baja California, Mexico; Clínica de Tuberculosis del Hospital General de Tijuana, Tijuana, Baja California, Mexico
| | - E Martínez Robles
- Internal Medicine Department, Hospital de Cantoblanco- Hospital General Universitario La Paz, Madrid, Spain
| | - S Quirós Fernandez
- Pneumology Department, Tuberculosis Unit, Hospital de Cantoblanco- Hospital General Universitario La Paz, Madrid, Spain
| | - A Rendon
- Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias CIPTIR, University Hospital of Monterrey UANL (Universidad Autonoma de Nuevo Leon), Monterrey, Mexico
| | - I Solovic
- National Institute for TB, Lung Diseases and Thoracic Surgery, Vysne Hagy, Catholic University Ruzomberok, Slovakia
| | - M Tadolini
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Bologna, Italy; Department of Medical and Surgical Sciences Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - P Viggiani
- Reference Center for MDR-TB and HIV-TB, Eugenio Morelli Hospital, Sondalo, Italy
| | - E Belilovski
- Moscow Research and Clinical Center for TB Control, Moscow Government's Health Department, Moscow, Russian Federation
| | - M J Boeree
- Radboud University Medical Center, Center Dekkerswald, Nijmegen, The Netherlands
| | - Q Cai
- Zhejiang Integrated Traditional and Western Medicine Hospital, Hangzhou, China
| | - E Davidavičienė
- National TB Registry, Public Health Department, Ministry of Health, Vilnius, Lithuania; Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - L D Forsman
- Division of Infectious Diseases, Department of Medicine, Solna, Karolinska Institute, Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - J De Los Rios
- Centro de Excelencia de TBMDR, Hospital Nacional Maria Auxiliadora, Lima, Peru
| | - J Drakšienė
- Tuberculosis Department, 3rd Tuberculosis Unit, Republican Klaipėda Hospital, Klaipėda, Lithuania
| | - A Duga
- Baylor College of Medicine, Children's Foundation, Mbabane, Eswatini; National Pharmacovigilance Center, Eswatini Ministry of Health, Matsapha, Eswatini
| | - S E Elamin
- MDR-TB Department, Abu Anga Teaching Hospital, Khartoum, Sudan
| | - A Filippov
- Moscow Research and Clinical Center for TB Control, Moscow Government's Health Department, Moscow, Russian Federation
| | - A Garcia
- Pulmonology Division, Municipal Hospital F. J. Muñiz, Buenos Aires, Argentina
| | - I Gaudiesiute
- Department of Pulmonology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - B Gavazova
- Improve the Sustainability of the National TB Programme, Sofia, Bulgaria
| | - R Gayoso
- Reference Center Hélio Fraga, Fundação Oswaldo Cruz (Fiocruz)/Ministry of Health, Rio de Janeiro, Brazil
| | - V Gruslys
- Clinic of Chest Diseases, Immunology and Allergology, Vilnius University Medical Faculty, Centre of Pulmonology and Allergology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - J Jonsson
- Department of Public Health Analysis and Data Management, Public Health Agency of Sweden, Solna, Sweden
| | - E Khimova
- Northern State Medical University, Northern (Arctic) Federal University, Arkhangelsk, Russian Federation
| | - G Madonsela
- Eswatini National Aids Programme, Mbabane, Eswatini
| | - C Magis-Escurra
- Radboud University Medical Center, Center Dekkerswald, Nijmegen, The Netherlands
| | - V Marchese
- Clinic of Infectious and Tropical Diseases, WHO Collaborating Centre for TB Elimination and TB/HIV Co-infection, University of Brescia, Brescia, Italy
| | - M Matei
- Hospital of Pneumophtisiology Leamna, Dolj Province, Romania; University of Medicine and Pharmacy, Craiova, Romania
| | - C Moschos
- Department of Tuberculosis, Sotiria Athens Hospital of Chest Diseases, Athens, Greece
| | - B Nakčerienė
- National TB Registry, Public Health Department, Ministry of Health, Vilnius, Lithuania; Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - L Nicod
- Division of Pulmonary Medicine, University Hospital of Lausanne CHUV, Lausanne, Switzerland
| | - F Palmieri
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases 'L. Spallanzani', IRCCS, Rome, Italy
| | - A Pontarelli
- Respiratory Infectious Diseases Unit, Cotugno Hospital, A.O.R.N. dei Colli, Naples, Italy
| | - A Šmite
- MDR-TB Department, Riga East University Hospital for TB and Lung Disease Centre, Riga, Latvia
| | | | - M Vescovo
- Pulmonology Division, Municipal Hospital F. J. Muñiz, Buenos Aires, Argentina
| | - R Zablockis
- Clinic of Chest Diseases, Immunology and Allergology, Vilnius University Medical Faculty, Centre of Pulmonology and Allergology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - D Zhurkin
- Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | - J-W Alffenaar
- University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, Australia; Westmead Hospital, Sydney, Australia; Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
| | - J A Caminero
- Pneumology Department, Hospital General de Gran Canaria "Dr. Negrin", Las Palmas de Gran Canaria, Spain; Vital Strategies, New York, USA
| | - L R Codecasa
- TB Reference Centre, Villa Marelli Institute, Niguarda Hospital, Milan, Italy
| | | | - S Esposito
- Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
| | - L Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of z, University of Sassari, Sassari, Italy
| | - A Spanevello
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy; Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Tradate, Varese-Como, Italy
| | - D Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy; Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Tradate, Varese-Como, Italy
| | - S Tiberi
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; Department of Infection, Royal London and Newham Hospitals, Barts Health NHS Trust, London, United Kingdom
| | - E Pontali
- Department of Infectious Diseases, Galliera Hospital, Genova, Italy
| | - R Centis
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - L D'Ambrosio
- Public Health Consulting Group, Lugano, Switzerland
| | - M van den Boom
- World Health Organization Regional office for Europe, Copenhagen, Denmark
| | - G Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of z, University of Sassari, Sassari, Italy
| | - G B Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy.
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13
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Visca D, Ong CWM, Tiberi S, Centis R, D'Ambrosio L, Chen B, Mueller J, Mueller P, Duarte R, Dalcolmo M, Sotgiu G, Migliori GB, Goletti D. Tuberculosis and COVID-19 interaction: A review of biological, clinical and public health effects. Pulmonology 2021; 27:151-165. [PMID: 33547029 PMCID: PMC7825946 DOI: 10.1016/j.pulmoe.2020.12.012] [Citation(s) in RCA: 127] [Impact Index Per Article: 42.3] [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: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 01/10/2023] Open
Abstract
Evidence is accumulating on the interaction between tuberculosis (TB) and COVID-19. The aim of the present review is to report the available evidence on the interaction between these two infections. Differences and similarities of TB and COVID-19, their immunological features, diagnostics, epidemiological and clinical characteristics and public health implications are discussed. The key published documents and guidelines on the topic have been reviewed. Based on the immunological mechanism involved, a shared dysregulation of immune responses in COVID-19 and TB has been found, suggesting a dual risk posed by co-infection worsening COVID-19 severity and favouring TB disease progression. The available evidence on clinical aspects suggests that COVID-19 happens regardless of TB occurrence either before, during or after an active TB diagnosis. More evidence is required to determine if COVID-19 may reactivate or worsen active TB disease. The role of sequeale and the need for further rehabilitation must be further studied Similarly, the potential role of drugs prescribed during the initial phase to treat COVID-19 and their interaction with anti-TB drugs require caution. Regarding risk of morbidity and mortality, several risk scores for COVID-19 and independent risk factors for TB have been identified: including, among others, age, poverty, malnutrition and co-morbidities (HIV co-infection, diabetes, etc.). Additional evidence is expected to be provided by the ongoing global TB/COVID-19 study.
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Affiliation(s)
- D Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy; Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Tradate, Varese-Como, Italy
| | - C W M Ong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Institute for Health Innovation & Technology (iHealthtech), National University of Singapore, Singapore
| | - S Tiberi
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; Division of Infection, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - R Centis
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - L D'Ambrosio
- Public Health Consulting Group, Lugano, Switzerland
| | - B Chen
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - J Mueller
- The Mueller Health Foundation, Boston, MA, USA
| | - P Mueller
- The Mueller Health Foundation, Boston, MA, USA
| | - R Duarte
- Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; Public Health Science and Medical Education Dept, Faculty of Medicine, University of Porto, Porto, Portugal.
| | - M Dalcolmo
- Centro de Referência Professor Hélio Fraga, Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - G Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - G B Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy.
| | - D Goletti
- Translational Research Unit, Epidemiology and Preclinical Research Department, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
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14
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Marinelli D, Mazzotta M, Scalera S, Terrenato I, Sperati F, D'Ambrosio L, Pallocca M, Corleone G, Krasniqi E, Pizzuti L, Barba M, Carpano S, Vici P, Filetti M, Giusti R, Vecchione A, Occhipinti M, Gelibter A, Botticelli A, De Nicola F, Ciuffreda L, Goeman F, Gallo E, Visca P, Pescarmona E, Fanciulli M, De Maria R, Marchetti P, Ciliberto G, Maugeri-Saccà M. KEAP1-driven co-mutations in lung adenocarcinoma unresponsive to immunotherapy despite high tumor mutational burden. Ann Oncol 2020; 31:1746-1754. [PMID: 32866624 DOI: 10.1016/j.annonc.2020.08.2105] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/07/2020] [Accepted: 08/12/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) have demonstrated significant overall survival (OS) benefit in lung adenocarcinoma (LUAD). Nevertheless, a remarkable interpatient heterogeneity characterizes immunotherapy efficacy, regardless of programmed death-ligand 1 (PD-L1) expression and tumor mutational burden (TMB). KEAP1 mutations are associated with shorter survival in LUAD patients receiving chemotherapy. We hypothesized that the pattern of KEAP1 co-mutations and mutual exclusivity may identify LUAD patients unresponsive to immunotherapy. PATIENTS AND METHODS KEAP1 mutational co-occurrences and somatic interactions were studied in the whole MSKCC LUAD dataset. The impact of coexisting alterations on survival outcomes in ICI-treated LUAD patients was verified in the randomized phase II/III POPLAR/OAK trials (blood-based sequencing, bNGS cohort, N = 253). Three tissue-based sequencing studies (Rome, MSKCC and DFCI) were used for independent validation (tNGS cohort, N = 289). Immunogenomic features were analyzed using The Cancer Genome Atlas (TCGA) LUAD study. RESULTS On the basis of KEAP1 mutational co-occurrences, we identified four genes potentially associated with reduced efficacy of immunotherapy (KEAP1, PBRM1, SMARCA4 and STK11). Independent of the nature of co-occurring alterations, tumors with coexisting mutations (CoMut) had inferior survival as compared with single-mutant (SM) and wild-type (WT) tumors (bNGS cohort: CoMut versus SM log-rank P = 0.048, CoMut versus WT log-rank P < 0.001; tNGS cohort: CoMut versus SM log-rank P = 0.037, CoMut versus WT log-rank P = 0.006). The CoMut subset harbored higher TMB than the WT disease and the adverse significance of coexisting alterations was maintained in LUAD with high TMB. Significant immunogenomic differences were observed between the CoMut and WT groups in terms of core immune signatures, T-cell receptor repertoire, T helper cell signatures and immunomodulatory genes. CONCLUSIONS This study indicates that coexisting alterations in a limited set of genes characterize a subset of LUAD unresponsive to immunotherapy and with high TMB. An immune-cold microenvironment may account for the clinical course of the disease.
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Affiliation(s)
- D Marinelli
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - M Mazzotta
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - S Scalera
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - I Terrenato
- Biostatistics-Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - F Sperati
- Biostatistics Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - L D'Ambrosio
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Pallocca
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - G Corleone
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - E Krasniqi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - L Pizzuti
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Barba
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - S Carpano
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - P Vici
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Filetti
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - R Giusti
- Medical Oncology Unit, Sant'Andrea Hospital, Rome, Italy
| | - A Vecchione
- Department of Clinical and Molecular Medicine, Pathology Unit, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - M Occhipinti
- Medical Oncology Unit B, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - A Gelibter
- Medical Oncology Unit B, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - A Botticelli
- Medical Oncology Unit B, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - F De Nicola
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - L Ciuffreda
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - F Goeman
- Oncogenomic and Epigenetic Unit, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy
| | - E Gallo
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - P Visca
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - E Pescarmona
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Fanciulli
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - R De Maria
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Institute of General Pathology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - P Marchetti
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant'Andrea Hospital, Sapienza University, Rome, Italy; Medical Oncology Unit B, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - G Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Maugeri-Saccà
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
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15
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Muñoz-Torrico M, Cid-Juárez S, Gochicoa-Rangel L, Torre-Bouscolet L, Salazar-Lezama MA, Villarreal-Velarde H, Pérez-Padilla R, Visca D, Centis R, D'Ambrosio L, Spanevello A, Saderi L, Sotgiu G, Migliori GB. Functional impact of sequelae in drug-susceptible and multidrug-resistant tuberculosis. Int J Tuberc Lung Dis 2020; 24:700-705. [DOI: 10.5588/ijtld.19.0809] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Evidence on the impact of tuberculosis (TB) treatment on lung function is scarce. The aim of this study was to evaluate post-treatment sequelae in drug-susceptible and drug-resistant-TB (DR-TB) cases in Mexico and Italy.METHODS: At the end of TB treatment
the patients underwent complete clinical assessment, functional evaluation of respiratory mechanics, gas exchange and a 6-minute walking test. Treatment regimens (and definitions) recommended by the World Health Organization were used throughout.RESULTS: Of 61 patients, 65.6% had
functional impairment, with obstruction in 24/61 patients (39.4%), and 78% with no bronchodilator response. These effects were more prevalent among DR-TB cases (forced expiratory volume in 1 s/forced vital capacity [FEV1/FVC] < lower limit of normality, 14/24 vs. 10/34; P
= 0.075). DR-TB patients showed moderately severe (FEV1 < 60%) and severe obstruction (FEV1 < 50%) (P = 0.008). Pre- and post-bronchodilator FEV1 and FEV1/FVC (% of predicted) were significantly lower among DR-TB cases. Plethysmography
abnormalities (restriction, hyperinflation and/or air trapping) were more frequent among DR-TB cases (P = 0.001), along with abnormal carbon monoxide diffusing capacity (DLCO) (P = 0.003).CONCLUSION: The majority of TB patients suffer the consequences of post-treatment
sequelae (of differing levels), which compromise quality of life, exercise tolerance and long-term prognosis. It is therefore important that lung function is comprehensively evaluated post-treatment to identify patient needs for future medication and pulmonary rehabilitation.
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Affiliation(s)
- M. Muñoz-Torrico
- Tuberculosis Clinic, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City
| | - S. Cid-Juárez
- Physiology Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City
| | - L. Gochicoa-Rangel
- Physiology Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City
| | | | - M. A. Salazar-Lezama
- Dirección médica, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico
| | - H. Villarreal-Velarde
- Tuberculosis Clinic, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City
| | - R. Pérez-Padilla
- Clínica para dejar de fumar y EPOC, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico
| | - D. Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici (ICS) Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Tradate, Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como
| | - R. Centis
- Servizio di Epidemiologia, Clinica delle Malattie Respiratorie, ICS Maugeri, IRCCS, Tradate, Italy
| | | | - A. Spanevello
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici (ICS) Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Tradate, Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como
| | - L. Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - G. Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - G. B. Migliori
- Servizio di Epidemiologia, Clinica delle Malattie Respiratorie, ICS Maugeri, IRCCS, Tradate, Italy, Blizard Institute, Queen Mary University of London, London, UK
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16
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Visca D, Centis R, D'Ambrosio L, Muñoz-Torrico M, Chakaya JM, Tiberi S, Spanevello A, Sotgiu G, Migliori GB. The need for pulmonary rehabilitation following tuberculosis treatment. Int J Tuberc Lung Dis 2020; 24:720-722. [DOI: 10.5588/ijtld.20.0030] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- D. Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Tradate, Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como
| | - R. Centis
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | | | - M. Muñoz-Torrico
- Tuberculosis Clinic, Instituto Nacional De Enfermedades Respiratorias Ismael Cosio Villegas, Ciudad De Mexico, Mexico
| | - J. Muhwa Chakaya
- International Union Against Tuberculosis and Lung Disease, Paris, France, Department of Medicine, Therapeutics, Dermatology and Psychiatry, Kenyatta University, Nairobi, Kenya
| | - S. Tiberi
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, Division of Infection, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - A. Spanevello
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Tradate, Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como
| | - G. Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy, ,
| | - G. B. Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
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17
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Dara M, Sulis G, Centis R, D'Ambrosio L, de Vries G, Douglas P, Garcia D, Jansen N, Zuroweste E, Migliori GB. Cross-border collaboration for improved tuberculosis prevention and care: policies, tools and experiences. Int J Tuberc Lung Dis 2018. [PMID: 28633696 DOI: 10.5588/ijtld.16.0940] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
As tuberculosis (TB) spreads beyond borders with people movements, several interventions ensuring the continuity of care are essential, although difficult to put in place in the absence of well-defined agreements allowing data sharing and easy referral of patients to appropriate health facilities. This article first sets out general principles for cross-border collaboration and continuity of care. It then presents a series of case studies. Policies and practices on cross-border collaboration in selected low-incidence countries (Australia, Italy, Norway, The Netherlands, the United Kingdom and the United States) are described and critically appraised. Details of the World Health Organization's (WHO's) European Respiratory Society TB Consilium for transborder migration and those of the Health Network's TBNet activities are described. With increasing population movement, including migrants and travellers, it is time to build on good practices and existing tools and to remove legal, financial and social barriers to ensure early diagnosis, full treatment and continuity of care across our world. Data sharing between the sending and the receiving countries is of utmost importance and must be conducted in line with privacy protection rules. Successful implementation of these interventions is key to being on track with the WHO's End TB strategy targets for 2030.
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Affiliation(s)
- M Dara
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - G Sulis
- University Division of Infectious and Tropical Diseases, Spedali Civili Hospital, Brescia
| | - R Centis
- WHO Collaborating Centre for TB and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy
| | - L D'Ambrosio
- WHO Collaborating Centre for TB and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy, Public Health Consulting Group, Lugano, Switzerland
| | - G de Vries
- KNCV Tuberculosis Foundation, The Hague, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - P Douglas
- Health Services and Policy Division, Department of Immigration and Border Protection, Sydney, New South Wales, Australia
| | - D Garcia
- Johns Hopkins School of Medicine; Migrant Clinicians Network, New York, New York, USA
| | - N Jansen
- KNCV Tuberculosis Foundation, The Hague
| | - E Zuroweste
- Johns Hopkins School of Medicine; Migrant Clinicians Network, New York, New York, USA
| | - G B Migliori
- WHO Collaborating Centre for TB and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy
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18
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Tiberi S, Muñoz-Torrico M, Duarte R, Dalcolmo M, D'Ambrosio L, Migliori GB. New drugs and perspectives for new anti-tuberculosis regimens. Pulmonology 2018; 24:86-98. [PMID: 29487031 DOI: 10.1016/j.rppnen.2017.10.009] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 10/25/2017] [Indexed: 01/21/2023] Open
Abstract
Tuberculosis (TB) is the ninth cause of global death, more than any other infectious disease. With growing drug resistance the epidemic remains and will require significant attention and investment for the elimination of this disease to occur. With susceptible TB treatment not changing over the last four decades and the advent of drug resistance, new drugs and regimens are required. Recently, through greater collaboration and research networks some progress with significant advances has taken place, not withstanding the comparatively low amount of resources invested. Of late the availability of the new drugs bedaquiline, delamanid and repurposed drugs linezolid, clofazimine and carbapenems are being used more frequently in drug-resistant TB regimens. The WHO shorter multidrug-resistant tuberculosis regimen promises to reach more patients and treat them more quickly and more cheaply. With this new enthusiasm and hope we this review gives an update on the new drugs and perspectives for the treatment of drug-susceptible and drug-resistant tuberculosis.
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Affiliation(s)
- S Tiberi
- Barts Health NHS Trust, Royal London Hospital, Division of Infection, 80 Newark Street, E1 2ES London, United Kingdom; Blizard Institute, Barts and the London School of Medicine and Dentistry, Centre for Primary Care and Public Health, E1 2AB London, United Kingdom
| | - M Muñoz-Torrico
- Clínica de Tuberculosis, Instituto Nacional de Enfermedades Respiratorias - INER - Ciudad de México, Mexico
| | - R Duarte
- National Reference Centre for MDR-TB, Hospital Centre Vila Nova de Gaia, Department of Pneumology, Public Health Science and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - M Dalcolmo
- Hélio Fraga Reference Center, Fiocruz/MoH, Rio de Janeiro, Brazil
| | - L D'Ambrosio
- Public Health Consulting Group, Lugano 6900, Switzerland; World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS (Istituto di Ricovero e Cura a Carattere Sceintifico), Via Roncaccio 16, Tradate 21049, Italy
| | - G-B Migliori
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS (Istituto di Ricovero e Cura a Carattere Sceintifico), Via Roncaccio 16, Tradate 21049, Italy.
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19
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D'Ambrosio L, Bothamley G, Caminero Luna JA, Duarte R, Guglielmetti L, Muñoz Torrico M, Payen MC, Saavedra Herrera N, Salazar Lezama MA, Skrahina A, Tadolini M, Tiberi S, Veziris N, Migliori GB. Team approach to manage difficult-to-treat TB cases: Experiences in Europe and beyond. Pulmonology 2017; 24:132-141. [PMID: 29229274 DOI: 10.1016/j.rppnen.2017.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 10/29/2017] [Indexed: 01/17/2023] Open
Abstract
As recommended by the World Health Organization (WHO), optimal management of MDR-TB cases can be ensured by a multi-speciality consultation body known as 'TB Consilium'. This body usually includes different medical specialities, competences and perspectives (e.g., clinical expertise both for adults and children; surgical, radiological and public health expertise; psychological background and nursing experience, among others), thus lowering the risk of making mistakes - or managing the patients inappropriately, in order to improve their clinical outcomes. At present, several high MDR-TB burden countries in the different WHO regions (and beyond) have introduced TB Consilium-like bodies at the national or subnational level to reach consensus on the best treatment approach for their patients affected by TB. In addition, in countries/settings where a formal system of consultation does not exist, specialized staff from MDR-TB reference centres or international organizations usually spend a considerable amount of their working time responding to phone or e-mail clinical queries on how to manage M/XDR-TB cases. The aim of this manuscript is to describe the different experiences with the TB Consilia both at the international level (European Respiratory Society - ERS/WHO TB Consilium) and in some of the countries where this experience operates successfully in Europe and beyond. The Consilium experiences are described around the following topics: (1) history, aims and focus; (2) management and funding; (3) technical functioning and structure; (4) results achieved. In addition a comparative analysis of the TB Consilia in the different countries has been performed.
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Affiliation(s)
- L D'Ambrosio
- WHO Collaborating Centre for TB and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy; Public Health Consulting Group, Lugano, Switzerland.
| | - G Bothamley
- Homerton University Hospital, London, United Kingdom.
| | - J A Caminero Luna
- Pneumology Department, Hospital General de Gran Canaria "Dr. Negrin", Las Palmas de Gran Canaria, Spain; MDR-TB Unit, Tuberculosis Division, International Union against Tuberculosis and Lung Disease The Union, Paris, France.
| | - R Duarte
- National Reference Centre for MDR-TB, Hospital Centre Vila Nova de Gaia, Department of Pneumology, Public Health Science and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal.
| | - L Guglielmetti
- Sorbonne Universités, UPMC Univ Paris 06, CR7, INSERM U1135, Centre d'Immunologie et des Maladies Infectieuses, CIMI, F-75013 Paris, France; AP-HP, Hôpitaux Universitaires de l'Est Parisien, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, F-75013 Paris, France.
| | - M Muñoz Torrico
- Tuberculosis Clinic, National Institute of Respiratory Diseases of Mexico (INER), Mexico City, Mexico.
| | - M C Payen
- Division of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles ULB, Brussels, Belgium.
| | | | - M A Salazar Lezama
- Tuberculosis Clinic, National Institute of Respiratory Diseases of Mexico (INER), Mexico City, Mexico.
| | - A Skrahina
- Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus.
| | - M Tadolini
- Unit of Infectious Diseases, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy.
| | - S Tiberi
- Division of Infection, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom; Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, United Kingdom.
| | - N Veziris
- Sorbonne Universités, UPMC Univ Paris 06, CR7, INSERM U1135, Centre d'Immunologie et des Maladies Infectieuses, CIMI, F-75013 Paris, France; AP-HP, Hôpitaux Universitaires de l'Est Parisien, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, F-75013 Paris, France
| | - G B Migliori
- WHO Collaborating Centre for TB and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy.
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20
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Vincenzi B, Nannini M, Grignani G, Fumagalli E, Gasperoni S, D'Ambrosio L, Badalamenti G, Dei Tos A, Incorvaia L, Casali P, Santini D, Tonini G, Stellato M, Catania G, Spalato Ceruso M, Pantaleo M. Rechallenge in GIST progressing to imatinib, sunitinib and regorafenib: An Italian survey. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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De Maio E, Touati N, Litière S, Sleijfer S, van der Graaf W, Le Cesne A, D'Ambrosio L, Casali P, Italiano A, Desar I, Gronchi A. Evolution in neutrophil-to-lymphocyte ratio (NLR) among advanced soft tissue sarcoma (STS) patients treated with pazopanib within EORTC 62043/62072 trials. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx387.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Longhi A, Bielack SS, Grimer R, Whelan J, Windhager R, Leithner A, Gronchi A, Biau D, Jutte P, Krieg AH, Klenke FM, Grignani G, Donati DM, Capanna R, Casanova J, Gerrand C, Bisogno G, Hecker-Nolting S, De Lisa M, D'Ambrosio L, Willegger M, Scoccianti G, Ferrari S. Extraskeletal osteosarcoma: A European Musculoskeletal Oncology Society study on 266 patients. Eur J Cancer 2017; 74:9-16. [PMID: 28167373 DOI: 10.1016/j.ejca.2016.12.016] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 12/12/2016] [Accepted: 12/24/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE Prognosis of extraskeletal osteosarcoma (ESOS) is reported to be poorer than that of skeletal osteosarcoma. This multicenter retrospective study aimed to evaluate factors influencing ESOS prognosis. PATIENTS AND METHODS Members of the European Musculoskeletal Oncology Society (EMSOS) submitted institutional data on patients with ESOS. RESULTS Data from 274 patients treated from 1981 to 2014 were collected from 16 EMSOS centres; 266 patients were eligible. Fifty (18.7%) had metastases at diagnosis. Of 216 patients with localised disease, 211 (98%) underwent surgery (R0 = 70.6%, R1 = 27%). Five-year overall survival (OS) for all 266 patients was 47% (95% CI 40-54%). Five-year OS for metastatic patients was 27% (95% CI 13-41%). In the analysis restricted to the 211 localised patients who achieved complete remission after surgery 5-year OS was 51.4% (95% CI 44-59%) and 5-year disease-free survival (DFS) was 43% (95% CI 35-51%). One hundred twenty-one patients (57.3%) received adjuvant or neoadjuvant chemotherapy and 80 patients (37.9%) received radiotherapy. A favourable trend was seen for osteosarcoma-type chemotherapy versus soft tissue sarcoma-type (doxorubicin ± ifosfamide) regimens. For the 211 patients in complete remission after surgery, patient age, tumour size, margins and chemotherapy were positive prognostic factors for DFS and OS by univariate analysis. At multivariate analysis, patient age (≤40 years versus >40 years) (P = 0.05), tumour size (P = 0.0001) and receipt of chemotherapy (P = 0.006) were statistically significant prognostic factors for survival. CONCLUSION Patient age and tumour size are factors influencing ESOS prognosis. Higher survival was observed in patients who received perioperative chemotherapy with a trend in favour of multiagent osteosarcoma-type regimen which included doxorubicin, ifosfamide and cisplatin.
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Affiliation(s)
- A Longhi
- Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - S S Bielack
- Klinikum Stuttgart, Olgahospital, Cooperative Osteosarcoma Study Group (COSS), Stuttgart, Germany
| | - R Grimer
- Royal Orthopaedic Hospital, Birmingham, UK
| | - J Whelan
- London Sarcoma Service, University College Hospital, UK
| | - R Windhager
- Department of Orthopaedics, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - A Leithner
- Orthopaedic Surgery, Medical University Graz, Graz, Austria
| | - A Gronchi
- Chirurgia dei Sarcomi, Istituto Nazionale Tumori, Milano, Italy
| | - D Biau
- Chirurgie Orthopédique, Hôpital Cochin, Université Paris-Descartes, Paris, France
| | - P Jutte
- University Medical Center, Groningen, The Netherlands
| | - A H Krieg
- Paediatric Orthopaedic Department, University Childrens Hospital (UKBB), Basel, Switzerland
| | - F M Klenke
- INSELSPITAL, University Hospital, Bern, Switzerland
| | - G Grignani
- Candiolo Cancer Institute - FPO, IRCCS, Italy
| | - D M Donati
- Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - J Casanova
- Orthopedic University Hospital, University of Coimbra, Coimbra, Portugal
| | - C Gerrand
- Freeman Hospital, Newcastle upon Tyne, UK
| | - G Bisogno
- Oncoematologia Pediatrica, University of Padova, Padova, Italy
| | - S Hecker-Nolting
- Klinikum Stuttgart, Olgahospital, Cooperative Osteosarcoma Study Group (COSS), Stuttgart, Germany
| | - M De Lisa
- London Sarcoma Service, University College Hospital, UK
| | | | - M Willegger
- Department of Orthopaedics, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | | | - S Ferrari
- Istituto Ortopedico Rizzoli, Bologna, Italy
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Muñoz-Torrico M, Caminero Luna J, Migliori GB, D'Ambrosio L, Carrillo-Alduenda JL, Villareal-Velarde H, Torres-Cruz A, Flores-Ergara H, Martínez-Mendoza D, García-Sancho C, Centis R, Salazar-Lezama MÁ, Pérez-Padilla R. Comparison of bacteriological conversion and treatment outcomes among MDR-TB patients with and without diabetes in Mexico: Preliminary data. Rev Port Pneumol (2006) 2016; 23:27-30. [PMID: 28043788 DOI: 10.1016/j.rppnen.2016.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/23/2016] [Accepted: 11/26/2016] [Indexed: 11/30/2022] Open
Abstract
Diabetes mellitus (DM) is a well-known risk factor for tuberculosis (TB). However, it is not known to what extent DM affects the outcome in patients with multidrug-resistant (MDR-TB) and extensively drug-resistant TB (XDR-TB) treated with second-line anti-TB drugs. The objective of this study was to compare the microbiological evolution (sputum smear and culture conversion) and final outcomes of MDR/XDR-TB patients with and without DM, managed at the national TB reference centre in Mexico City. RESULTS Ninety patients were enrolled between 2010 and 2015: 73 with MDR-TB (81.1%), 11 with pre-XDR-TB (e.g. MDR-TB with additional resistance to one injectable drug or a fluoroquinolone, 12.2%) and 6 (6.7%) with XDR-TB. Out of these, 49 (54.4%) had DM and 42 (86%) were undergoing insulin treatment. No statistically significant differences were found in treatment outcomes comparing DM vs. non-DM MDR-TB cases: 18/32 (56.3%) of DM cases and 19/24 (79.2%) non DM patients achieved treatment success (p=0.07). The time to sputum smear and culture conversion was longer (although not statistically) in patients without DM, as follows: the mean (±SD) time to sputum smear conversion was 53.9 (±31.4) days in DM patients and 65.2 (±34.8) days in non-DM ones (p=0.15), while the time to culture conversion was 66.2 (±27.6) days for DM and 81.4 (±37.7) days for non-DM MDR-TB cases (p=0.06). CONCLUSIONS The study results support the Mexican National TB programme to strengthen its collaboration with the DM programme, as an entry point for TB (and latent TB infection) screening and management.
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Affiliation(s)
- M Muñoz-Torrico
- Tuberculosis Clinic, National Institute of Respiratory Diseases of Mexico (INER), Mexico City, Mexico
| | - J Caminero Luna
- Pneumology Department, University Hospital of Gran Canaria "Dr. Negrin", Las Palmas, Spain
| | - G B Migliori
- WHO Collaborating Centre for TB and Lug Diseases, Maugeri Institute, IRCCS Tradate, Italy.
| | - L D'Ambrosio
- WHO Collaborating Centre for TB and Lug Diseases, Maugeri Institute, IRCCS Tradate, Italy; Public Health Consulting Group, Lugano, Switzerland
| | - J L Carrillo-Alduenda
- Sleep Clinic, National Institute of Respiratory Diseases of Mexico (INER), Mexico City, Mexico
| | - H Villareal-Velarde
- Tuberculosis Clinic, National Institute of Respiratory Diseases of Mexico (INER), Mexico City, Mexico
| | - A Torres-Cruz
- Tuberculosis Clinic, National Institute of Respiratory Diseases of Mexico (INER), Mexico City, Mexico
| | - H Flores-Ergara
- Tuberculosis Clinic, National Institute of Respiratory Diseases of Mexico (INER), Mexico City, Mexico
| | - D Martínez-Mendoza
- Tuberculosis Clinic, National Institute of Respiratory Diseases of Mexico (INER), Mexico City, Mexico
| | - C García-Sancho
- Department of Epidemiology, National Institute of Respiratory Diseases of Mexico (INER), Mexico City, Mexico
| | - R Centis
- WHO Collaborating Centre for TB and Lug Diseases, Maugeri Institute, IRCCS Tradate, Italy
| | - M Á Salazar-Lezama
- Tuberculosis Clinic, National Institute of Respiratory Diseases of Mexico (INER), Mexico City, Mexico
| | - R Pérez-Padilla
- Sleep Clinic, National Institute of Respiratory Diseases of Mexico (INER), Mexico City, Mexico
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Arbex MA, Bonini EH, Kawakame Pirolla G, D'Ambrosio L, Centis R, Migliori GB. Effectiveness and safety of imipenem/clavulanate and linezolid to treat multidrug and extensively drug-resistant tuberculosis at a referral hospital in Brazil. Rev Port Pneumol (2006) 2016; 22:337-341. [PMID: 27481315 DOI: 10.1016/j.rppnen.2016.06.006] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 06/15/2016] [Accepted: 06/29/2016] [Indexed: 06/06/2023] Open
Abstract
Evidence on effectiveness, safety, and tolerability of imipenem/clavulanate (IC) and linezolid containing regimens to treat multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB) is scarce. The aim of this observational study is to evaluate the therapeutic contribution of IC and linezolid to manage MDR/XDR-TB cases at the reference centre of São Paulo state, Brazil. Twelve patients (9 males, 1 HIV positive in antiretroviral treatment, 4 MDR, 8 XDR) were treated with IC, 11 of them within linezolid-containing regimens. They all were previously treated with treatment failure, for a median (IQR, interquartile range) of 4.5 (2-6.5) times, having a severe resistance pattern (median number of resistances: 7 (5-8)) and being sputum smear and culture positive. IC and linezolid were prescribed at the dose of 1000mg/day and 600mg/day, respectively. The overall exposure was (median (IQR)) 419 (375.5-658) days for IC and 678 (392-720) days for linezolid. All of them converted their sputum (time to sputum conversion; 60 (37.5-90) days) and culture (75 (60-135) days), and 7 were cured while 5 are still on treatment with a gradually improving clinical picture. While no adverse events were reported for IC, 2 minor side effects, only, were attributed to linezolid (17%); in both cases the drug was re-started without further problems. Our study suggests that IC and linezolid-containing regimens can be used safely and with satisfactory outcomes in reference centres to treat MDR/XDR-TB patients.
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Affiliation(s)
- M A Arbex
- University Center of Araraquara, Sao Paulo, Brazil; Hospital Nestor Goulart Reis, Sao Paulo State Secretary of Health, Sao Paulo, Brazil
| | - E H Bonini
- University Center of Araraquara, Sao Paulo, Brazil; Hospital Nestor Goulart Reis, Sao Paulo State Secretary of Health, Sao Paulo, Brazil
| | - G Kawakame Pirolla
- Hospital Nestor Goulart Reis, Sao Paulo State Secretary of Health, Sao Paulo, Brazil
| | - L D'Ambrosio
- WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Tradate, Italy; Public Health Consulting Group, Lugano, Switzerland
| | - R Centis
- WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Tradate, Italy
| | - G B Migliori
- WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Tradate, Italy.
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Lastoria S, Marciello F, Faggiano A, Aloj L, Caracò C, Aurilio M, D'Ambrosio L, Di Gennaro F, Ramundo V, Camera L, De Luca L, Fonti R, Napolitano V, Colao A. Role of (68)Ga-DOTATATE PET/CT in patients with multiple endocrine neoplasia type 1 (MEN1). Endocrine 2016; 52:488-94. [PMID: 26242621 DOI: 10.1007/s12020-015-0702-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 07/20/2015] [Indexed: 11/26/2022]
Abstract
Multiple endocrine neoplasia type 1 (MEN1) is a hereditary syndrome predisposing to many endocrine and neuroendocrine tumors (NET). Conventional imaging (CI) cannot provide satisfactory results for all the different types of MEN1-related tumors. Objective of this prospective observational study was to evaluate the role of (68)Ga-DOTATATE PET/CT in MEN1 compared to CI. Diagnostic performance of (68)Ga-DOTATATE PET/CT for the detection of NET was evaluated as well as the prognostic role of SUVmax. Eighteen patients with genetically confirmed MEN1 were evaluated by (68)Ga-DOTATATE PET/CT, endoscopic ultrasounds, multidetector-row computed tomography, magnetic resonance imaging, and hormone/markers serum measurements. Four MEN1-related tumor sites (pancreas, pituitary, parathyroids, adrenals) were considered. Sensitivity and specificity of (68)Ga-DOTATATE PET/CT for the detection of NET were calculated. There was (68)Ga-DOTATATE PET/CT uptake in 11/11 patients with pancreatic lesions, in 9/12 with pituitary adenoma, in 5/15 with parathyroid enlargements, and in 5/7 with adrenal lesions. (68)Ga-DOTATATE PET/CT showed sensitivity and specificity of 100 and 100 % in pancreas, 75 and 83 % in pituitary, 28 and 100 % in parathyroids, and 62.5 and 100 % in adrenals, respectively. Compared with CI, no significant difference in sensitivity for pancreas, pituitary, and adrenals was found, while CI had a better sensitivity for parathyroids (p = 0.002). On the ROC analysis, progression of pancreatic lesions was significantly associated to SUVmax <12.3 (p < 0.05). (68)Ga-DOTATATE PET/CT is greatly helpful in the work-up of MEN1 providing a panoramic view of MEN1-related lesions. There is also a prognostic role of (68)Ga-PET in patients with MEN1-pancreatic lesions.
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Affiliation(s)
- Secondo Lastoria
- Division of Nuclear Medicine, Department of Diagnostic Imaging and Radiotherapy, Istituto Nazionale Tumori "Fondazione G.Pascale" - IRCCS Napoli, Naples, Italy.
| | - Francesca Marciello
- Division of Endocrinology, Department of Clinical Medicine and Surgery, "Federico II" University of Napoli, Via Sergio Pansini 5, 80131, Naples, Italy.
| | - Antongiulio Faggiano
- Division of Endocrinology, Department of Clinical Medicine and Surgery, "Federico II" University of Napoli, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Luigi Aloj
- Division of Nuclear Medicine, Department of Diagnostic Imaging and Radiotherapy, Istituto Nazionale Tumori "Fondazione G.Pascale" - IRCCS Napoli, Naples, Italy
| | - Corradina Caracò
- Division of Nuclear Medicine, Department of Diagnostic Imaging and Radiotherapy, Istituto Nazionale Tumori "Fondazione G.Pascale" - IRCCS Napoli, Naples, Italy
| | - Michela Aurilio
- Division of Nuclear Medicine, Department of Diagnostic Imaging and Radiotherapy, Istituto Nazionale Tumori "Fondazione G.Pascale" - IRCCS Napoli, Naples, Italy
| | - Laura D'Ambrosio
- Division of Nuclear Medicine, Department of Diagnostic Imaging and Radiotherapy, Istituto Nazionale Tumori "Fondazione G.Pascale" - IRCCS Napoli, Naples, Italy
| | - Francesca Di Gennaro
- Division of Nuclear Medicine, Department of Diagnostic Imaging and Radiotherapy, Istituto Nazionale Tumori "Fondazione G.Pascale" - IRCCS Napoli, Naples, Italy
| | - Valeria Ramundo
- Division of Endocrinology, Department of Clinical Medicine and Surgery, "Federico II" University of Napoli, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Luigi Camera
- Department of Biomorphological and Functional Sciences, "Federico II" University of Napoli, Naples, Italy
| | | | - Rosa Fonti
- Istitute of Biostructures and Bioimages (IBB), National Research Council, Naples, Italy
| | - Vincenzo Napolitano
- Department of General and Specialistic Surgery, Second University of Napoli, Caserta, Italy
| | - Annamaria Colao
- Division of Endocrinology, Department of Clinical Medicine and Surgery, "Federico II" University of Napoli, Via Sergio Pansini 5, 80131, Naples, Italy
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D'Ambrosio L, Aloj L, Chiaramida P, Cerciello V, Gaballo P, Prisco A, Lastoria S. Quantitative SPECT/CT imaging using a commercial software. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Maffei S, Iadanza L, Borzillo V, D'Ambrosio L, Imbimbo S, Mormile M, Villani N, Zambella C, Cerciello V. Evaluation of dose coming from radiological monitor images to pacemaker in patient undergoing CyberKnife® treatment. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.135] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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28
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D'Ambrosio L, Lastoria S, Rossano S, Calicchio G, Frattolillo C, Currarone R, Cerciello V, Luchini P, Calandrino R. Decommissioning procedures for a 17 MeV medical cyclotron. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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29
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Pontali E, Centis R, D'Ambrosio L, Migliori GB. Monitoring predictors of mortality: A necessary action to reach TB elimination. Rev Port Pneumol (2006) 2015; 21:S2173-5115(15)00187-6. [PMID: 26590095 DOI: 10.1016/j.rppnen.2015.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Indexed: 06/05/2023] Open
Affiliation(s)
- E Pontali
- Department of Infectious Diseases - Galliera Hospital, Genoa, Italy
| | - R Centis
- WHO Collaborating Centre for Tuberculosis & Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy
| | - L D'Ambrosio
- WHO Collaborating Centre for Tuberculosis & Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy; Public Health Consulting Group, Lugano, Switzerland
| | - G B Migliori
- WHO Collaborating Centre for Tuberculosis & Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy.
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30
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Strigari L, Caivano R, Avanzo M, Cremonesi M, Arrichiello C, Bianchi C, Botta F, Califano G, Ciscognetti N, D'Alessio D, D'Ambrosio L, D'Andrea M, Falco D, Guerriero F, Guerrisi M, Mola D, Pressello MC, Sarnelli A, Spiazzi L, Terlizzi A, Benassi M, Pedicini P. Twenty years of radiobiology in clinical practice: the Italian contribution. Tumori 2015; 100:625-35. [PMID: 25688496 DOI: 10.1700/1778.19266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS AND BACKGROUND To present the Italian state-of-the-art contribution to radiobiology of external beam radiotherapy, brachytherapy, and radionuclide radiotherapy. METHODS AND STUDY DESIGN A survey of the literature was carried out, using PubMed, by some independent researchers of the Italian group of radiobiology. Each paper was reviewed by researchers of centers not comprising its authors. The survey was limited to papers in English published over the last 20 years, written by Italian investigators or in Italian institutions, excluding review articles. RESULTS A total of 135 papers have been published in journals with an impact factor, with an increase in the number of published papers over time, for external beam radiotherapy rather than radionuclide radiotherapy. The quantity and quality of the papers researched constitutes a proof of the enduring interest in clinical radiobiology among Italian investigators. CONCLUSIONS The survey could be useful to individuate expert partners for an Italian network on clinical radiobiology, addressing future collaborative investigations.
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Esposito S, D'Ambrosio L, Tadolini M, Schaaf HS, Caminero Luna J, Marais B, Centis R, Dara M, Matteelli A, Blasi F, Migliori GB. ERS/WHO Tuberculosis Consilium assistance with extensively drug-resistant tuberculosis management in a child: case study of compassionate delamanid use. Eur Respir J 2014; 44:811-5. [DOI: 10.1183/09031936.00060414] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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van der Werf MJ, Sandgren A, D'Ambrosio L, Blasi F, Migliori GB. The European Union standards for tuberculosis care: do they need an update? Eur Respir J 2014; 43:933-42. [DOI: 10.1183/09031936.00216613] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lum D, Rodriguez E, Austin R, Lee T, Mansuria S, D'Ambrosio L, Guido R. Minimally Invasive Approach to Brush Cytology of the Fallopian Tubes: A Feasibility Study with Implications in Ovarian Cancer Screening. J Minim Invasive Gynecol 2013. [DOI: 10.1016/j.jmig.2013.08.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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D'Ambrosio L, Tadolini M, Dupasquier S, Tiberi S, Centis R, Dara M, Blasi F, Migliori GB. ERS/WHO Tuberculosis Consilium: reporting of the initial 10 cases. Eur Respir J 2013; 43:286-9. [DOI: 10.1183/09031936.00125813] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Tiberi S, De Lorenzo S, Centis R, Viggiani P, D'Ambrosio L, Migliori GB. Bedaquiline in MDR/XDR-TB cases: first experience on compassionate use. Eur Respir J 2013; 43:289-92. [DOI: 10.1183/09031936.00122313] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Migliori GB, Sotgiu G, Gandhi NR, Falzon D, DeRiemer K, Centis R, Hollm-Delgado MG, Palmero D, Pérez-Guzmán C, Vargas MH, D'Ambrosio L, Spanevello A, Bauer M, Chan ED, Schaaf HS, Keshavjee S, Holtz TH, Menzies D. Drug resistance beyond extensively drug-resistant tuberculosis: individual patient data meta-analysis. Eur Respir J 2013; 42:169-179. [PMID: 23060633 PMCID: PMC4498806 DOI: 10.1183/09031936.00136312] [Citation(s) in RCA: 181] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The broadest pattern of tuberculosis (TB) drug resistance for which a consensus definition exists is extensively drug-resistant (XDR)-TB. It is not known if additional drug resistance portends worsened patient outcomes. This study compares treatment outcomes of XDR-TB patients with and without additional resistance in order to explore the need for a new definition. Individual patient data on XDR-TB outcomes were included in a meta-analysis comparing outcomes between XDR alone and three nonmutually exclusive XDR-TB patient groups: XDR plus resistance to all the second-line injectables (sli) and capreomycin and kanamycin/amikacin (XDR+2sli) XDR plus resistance to second-line injectables and to more than one group 4 drug, i.e. ethionamide/protionamide, cycloserine/terizidone or para-aminosalicylic acid (XDR+sliG4) and XDR+sliG4 plus resistance to ethambutol and/or pyrazinamide (XDR+sliG4EZ). Of 405 XDR-TB cases, 301 were XDR alone, 68 XDR+2sli, 48 XDR+sliG4 and 42 XDR+sliG4EZ. In multivariate analysis, the odds of cure were significantly lower in XDR+2sli (adjusted OR 0.4, 95% CI 0.2-0.8) compared to XDR alone, while odds of failure and death were higher in all XDR patients with additional resistance (adjusted OR 2.6-2.8). Patients with additional resistance beyond XDR-TB showed poorer outcomes. Limitations in availability, accuracy and reproducibility of current drug susceptibility testing methods preclude the adoption of a useful definition beyond the one currently used for XDR-TB.
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Affiliation(s)
- G B Migliori
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute, Tradate, Italy
| | - G Sotgiu
- Epidemiology and Medical Statistics Unit, Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - N R Gandhi
- Department of Medicine and Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
| | - D Falzon
- STOP TB Department, World Health Organization, Geneva, Switzerland
| | - K DeRiemer
- School of Medicine, University of California Davis, Davis, California, USA
| | - R Centis
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute, Tradate, Italy
| | | | - D Palmero
- Pulmonology Division, Hospital F. J. Muñiz, Buenos Aires, Argentina
| | - C Pérez-Guzmán
- Instituto de Servicios de Salud del Estado de Aguascalientes, and Unidad de Medicina Ambulatoria Aguascalientes, Instituto Mexicano del Seguro Social, Aguascalientes, Mexico
| | - M H Vargas
- Instituto Nacional de Enfermedades Respiratorias, and Medical Research Unit in Respiratory Diseases, Instituto Mexicano del Seguro Social, Mexico DF, Mexico
| | - L D'Ambrosio
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute, Tradate, Italy
| | - A Spanevello
- Università degli Studi dell'Insubria, Varese, and Fondazione S. Maugeri, Care and Research Institute, Tradate, Italy
| | - M Bauer
- Montreal Chest Institute, McGill University, Montreal, Canada
| | - E D Chan
- Pulmonary Department, Denver Veterans Affair Medical Center and National Jewish Health, Denver, Colorado, USA
| | - H S Schaaf
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - S Keshavjee
- Department of Global Health & Social Medicine Harvard Medical School, Boston, Massachusetts, USA
| | - T H Holtz
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - D Menzies
- Montreal Chest Institute, McGill University, Montreal, Canada
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Migliori GB, Centis R, D'Ambrosio L, Spanevello A, Borroni E, Cirillo DM, Sotgiu G. Totally drug-resistant and extremely drug-resistant tuberculosis: the same disease? Clin Infect Dis 2013; 54:1379-80. [PMID: 22492321 DOI: 10.1093/cid/cis128] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Laniado-Laborín R, Kiy R, Spanevello A, D'Ambrosio L, Centis R, Migliori GB. Declaration on palliative care for MDR/XDR-TB. Int J Tuberc Lung Dis 2013; 16:1418-9; author reply 1419-20. [PMID: 23107639 DOI: 10.5588/ijtld.12.0388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Sotgiu G, D'Ambrosio L, Centis R, Bothamley G, Cirillo DM, De Lorenzo S, Guenther G, Kliiman K, Muetterlein R, Spinu V, Villar M, Zellweger JP, Sandgren A, Huitric E, Lange C, Manissero D, Migliori GB. TB and M/XDR-TB infection control in European TB reference centres: the Achilles' heel? Eur Respir J 2012; 38:1221-3. [PMID: 22045789 DOI: 10.1183/09031936.00029311] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Migliori GB, Zellweger JP, Abubakar I, Ibraim E, Caminero JA, De Vries G, D'Ambrosio L, Centis R, Sotgiu G, Menegale O, Kliiman K, Aksamit T, Cirillo DM, Danilovits M, Dara M, Dheda K, Dinh-Xuan AT, Kluge H, Lange C, Leimane V, Loddenkemper R, Nicod LP, Raviglione MC, Spanevello A, Thomsen VØ, Villar M, Wanlin M, Wedzicha JA, Zumla A, Blasi F, Huitric E, Sandgren A, Manissero D. European union standards for tuberculosis care. Eur Respir J 2012; 39:807-19. [PMID: 22467723 PMCID: PMC3393116 DOI: 10.1183/09031936.00203811] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 12/23/2011] [Indexed: 11/05/2022]
Abstract
The European Centre for Disease Prevention and Control (ECDC) and the European Respiratory Society (ERS) jointly developed European Union Standards for Tuberculosis Care (ESTC) aimed at providing European Union (EU)-tailored standards for the diagnosis, treatment and prevention of tuberculosis (TB). The International Standards for TB Care (ISTC) were developed in the global context and are not always adapted to the EU setting and practices. The majority of EU countries have the resources and capacity to implement higher standards to further secure quality TB diagnosis, treatment and prevention. On this basis, the ESTC were developed as standards specifically tailored to the EU setting. A panel of 30 international experts, led by a writing group and the ERS and ECDC, identified and developed the 21 ESTC in the areas of diagnosis, treatment, HIV and comorbid conditions, and public health and prevention. The ISTCs formed the basis for the 21 standards, upon which additional EU adaptations and supplements were developed. These patient-centred standards are targeted to clinicians and public health workers, providing an easy-to-use resource, guiding through all required activities to ensure optimal diagnosis, treatment and prevention of TB. These will support EU health programmes to identify and develop optimal procedures for TB care, control and elimination.
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Affiliation(s)
- G B Migliori
- WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute, Via Roncaccio 16, 21049 Tradate, Italy.
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Migliori GB, Sotgiu G, D'Ambrosio L, Centis R, Lange C, Bothamley G, Cirillo DM, De Lorenzo S, Guenther G, Kliiman K, Muetterlein R, Spinu V, Villar M, Zellweger JP, Sandgren A, Huitric E, Manissero D. TB and MDR/XDR-TB in European Union and European Economic Area countries: managed or mismanaged? Eur Respir J 2012; 39:619-25. [PMID: 22323578 DOI: 10.1183/09031936.00170411] [Citation(s) in RCA: 50] [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] [Indexed: 11/05/2022]
Abstract
In spite of the growing awareness of emerging drug-resistant Mycobacterium tuberculosis, the extent of inappropriate tuberculosis (TB) case management may be underestimated, even in Europe. We evaluated TB case management in the European Union/European Economic Area countries, with special focus on multidrug-resistant (MDR) and extensively drug-resistant (XDR)-TB, using a purposely developed, standardised survey tool. National reference centres in five countries representing different geographical, socioeconomic and epidemiological patterns of TB in Europe were surveyed. 40 consecutive, original clinical TB case records (30 MDR/XDR-TB cases) were reviewed in each of the five countries. The findings were recorded and, through the survey tool, compared with previously agreed and identified international standards. Deviations from international standards of TB care were observed in the following areas: surveillance (no information available on patient outcomes); infection control (lack of respiratory isolation rooms/procedures and negative-pressure ventilation rooms); clinical management of TB, MDR-TB and HIV co-infection (inadequate bacteriological diagnosis, regimen selection and treatment duration); laboratory support; and diagnostic/treatment algorithms. Gaps between present international standards of care and the management of MDR/XDR-TB patients were identified. Training, increased awareness, promotion of standards and allocation of appropriate resources are necessary to ensure appropriate care and management as well as to prevent further emergence of drug resistance.
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Affiliation(s)
- G B Migliori
- WHO Collaborating Centre forTuberculosis and Lung Diseases,Fondazione S. Maugeri, Care andReasearch Institute, Tradate, Italy
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Villar M, Sotgiu G, D'Ambrosio L, Raymundo E, Fernandes L, Barbedo J, Diogo N, Lange C, Centis R, Migliori GB. Linezolid safety, tolerability and efficacy to treat multidrug- and extensively drug-resistant tuberculosis. Eur Respir J 2012; 38:730-3. [PMID: 21885418 DOI: 10.1183/09031936.00195210] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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D'Ambrosio L, Ponzetti A, Lista P, Bombaci S, Palesandro E, Galizia D, Aliberti S, Allione P, Manca A, Gallo S, Grignani G, Aglietta M. Imatinib mesylate (IM) therapy in elderly patients affected by advanced gastrointestinal stromal tumor (GIST). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e20514] [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: 11/20/2022] Open
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Galizia D, Ortega C, Palesandro E, Prati V, Gallo S, D'Ambrosio L, Bonzano A, Rota Scalabrini D, Aliberti S, Grignani G, Aglietta M. Hypertension monitoring as a tool to predict congestive heart failure (CHF) during sunitinib (SU) therapy in GIST and renal cell carcinoma (RCC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lastoria S, D'Ambrosio L, Aurilio M, Marreno R, Giovannoni L, Menssen HD, Neri D, Shah A, Di Gennaro F, Caraco C, Pecori B, Aloj L. Preliminary evaluation of radioimmunotherapy with an 131I labelled small immunoprotein targeted against the extra domain B of fibronectin in combination with whole brain radiation therapy in patients with multiple brain metastases from solid tumors. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e12502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Aloj L, D'Ambrosio L, Aurilio M, Marreno R, Neri D, Menssen HD, Giovannoni L, Di Gennaro F, Caraco C, Arcamone M, Frigeri F, Pinto A, Lastoria S. Preliminary evaluation of radioimmunotherapy with Tenarad, a I-131 labeled antibody fragment targeting the extra-domain A1 of tenascin-C, in patients with refractory Hodgkin lymphoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.8063] [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: 11/20/2022] Open
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Grignani G, Palmerini E, Dileo P, Asaftei SD, D'Ambrosio L, Pignochino Y, Mercuri M, Picci P, Fagioli F, Casali PG, Ferrari S, Aglietta M. A phase II trial of sorafenib in relapsed and unresectable high-grade osteosarcoma after failure of standard multimodal therapy: an Italian Sarcoma Group study. Ann Oncol 2011; 23:508-16. [PMID: 21527590 DOI: 10.1093/annonc/mdr151] [Citation(s) in RCA: 257] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE After standard multimodal therapy, the prognosis of relapsed and unresectable high-grade osteosarcoma is dismal and unchanged over the last decades. Recently, mitogen-activated protein kinases were shown to be activated in osteosarcoma specimens, suggesting, therefore, they are suitable targets for the multikinase inhibitor sorafenib. Thus, we explored sorafenib activity in patients with relapsed and unresectable osteosarcoma. EXPERIMENTAL DESIGN Patients > 14 years, progressing after standard treatment, were eligible to receive 400 mg of sorafenib twice daily until progression or unacceptable toxicity. The primary end point was progression-free survival (PFS) at 4 months. Secondary objectives were PFS, overall survival (OS), clinical benefit rate (CBR), defined as no progression at 6 months and safety. This nonrandomized phase II study used a Simon two-stage design. PFS and OS at 95% confidence intervals (95% CIs) were calculated by the Kaplan-Meier method. All tests were two sided. RESULTS Thirty-five patients were enrolled. PFS at 4 months was 46% (95% CI 28% to 63%). Median PFS and OS were 4 (95% CI 2-5) and 7 (95% CI 7-8) months, respectively. The CBR was 29% (95% CI 13% to 44%). We observed 3 (8%) partial responses (PRs), 2 (6%) minor responses (< 30% tumor shrinkage) and 12 (34%) stable diseases (SDs). For six patients (17%), PR/SD lasted ≥ 6 months. Noteworthy, tumor density reduction and [(18)F]2-fluoro-2-deoxy-d-glucose-positron emission tomography responses were observed among SD patients. Sorafenib was reduced or briefly interrupted in 16 (46%) patients and permanently discontinued in one (3%) case due to toxicity. CONCLUSIONS Sorafenib demonstrated activity as a second- or third-line treatment in terms of PFS at 4 months with some unprecedented long-lasting responses. Sorafenib, the first targeted therapy showing activity in osteosarcoma patients, deserves further investigations.
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Affiliation(s)
- G Grignani
- Medical Oncology Unit, Institute for Cancer Research and Treatment, Candiolo, Italy.
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