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Cabini RF, Barzaghi L, Cicolari D, Arosio P, Carrazza S, Figini S, Filibian M, Gazzano A, Krause R, Mariani M, Peviani M, Pichiecchio A, Pizzagalli DU, Lascialfari A. Fast deep learning reconstruction techniques for preclinical magnetic resonance fingerprinting. NMR Biomed 2024; 37:e5028. [PMID: 37669779 DOI: 10.1002/nbm.5028] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/05/2023] [Accepted: 07/27/2023] [Indexed: 09/07/2023]
Abstract
We propose a deep learning (DL) model and a hyperparameter optimization strategy to reconstruct T1 and T2 maps acquired with the magnetic resonance fingerprinting (MRF) methodology. We applied two different MRF sequence routines to acquire images of ex vivo rat brain phantoms using a 7-T preclinical scanner. Subsequently, the DL model was trained using experimental data, completely excluding the use of any theoretical MRI signal simulator. The best combination of the DL parameters was implemented by an automatic hyperparameter optimization strategy, whose key aspect is to include all the parameters to the fit, allowing the simultaneous optimization of the neural network architecture, the structure of the DL model, and the supervised learning algorithm. By comparing the reconstruction performances of the DL technique with those achieved from the traditional dictionary-based method on an independent dataset, the DL approach was shown to reduce the mean percentage relative error by a factor of 3 for T1 and by a factor of 2 for T2 , and to improve the computational time by at least a factor of 37. Furthermore, the proposed DL method enables maintaining comparable reconstruction performance, even with a lower number of MRF images and a reduced k-space sampling percentage, with respect to the dictionary-based method. Our results suggest that the proposed DL methodology may offer an improvement in reconstruction accuracy, as well as speeding up MRF for preclinical, and in prospective clinical, investigations.
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Affiliation(s)
- Raffaella Fiamma Cabini
- Department of Mathematics, University of Pavia, Pavia, Italy
- INFN, Istituto Nazionale di Fisica Nucleare, Pavia, Italy
| | - Leonardo Barzaghi
- Department of Mathematics, University of Pavia, Pavia, Italy
- INFN, Istituto Nazionale di Fisica Nucleare, Pavia, Italy
- Advanced Imaging and Artificial Intelligence, Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
| | - Davide Cicolari
- Department of Physics, University of Pavia, Pavia, Italy
- Department of Physics, University of Milan, Milan, Italy
- INFN, Istituto Nazionale di Fisica Nucleare, Milan, Italy
- Department of Medical Physics, ASST GOM Niguarda, Milan, Italy
| | - Paolo Arosio
- Department of Physics, University of Milan, Milan, Italy
- INFN, Istituto Nazionale di Fisica Nucleare, Milan, Italy
| | - Stefano Carrazza
- Department of Physics, University of Milan, Milan, Italy
- INFN, Istituto Nazionale di Fisica Nucleare, Milan, Italy
| | - Silvia Figini
- INFN, Istituto Nazionale di Fisica Nucleare, Pavia, Italy
- Department of Social and Political Science, University of Pavia, Pavia, Italy
| | - Marta Filibian
- INFN, Istituto Nazionale di Fisica Nucleare, Pavia, Italy
- Centro Grandi Strumenti, University of Pavia, Pavia, Italy
| | - Andrea Gazzano
- Laboratory of Cellular and Molecular Neuropharmacology, Department of Biology and Biotechnology "L. Spallanzani", University of Pavia, Pavia, Italy
| | | | - Manuel Mariani
- Department of Physics, University of Pavia, Pavia, Italy
| | - Marco Peviani
- Laboratory of Cellular and Molecular Neuropharmacology, Department of Biology and Biotechnology "L. Spallanzani", University of Pavia, Pavia, Italy
| | - Anna Pichiecchio
- Advanced Imaging and Artificial Intelligence, Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | | | - Alessandro Lascialfari
- INFN, Istituto Nazionale di Fisica Nucleare, Pavia, Italy
- Department of Physics, University of Pavia, Pavia, Italy
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2
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Ravà L, Fintini D, Mariani M, Deodati A, Inzaghi E, Pedicelli S, Bizzarri C, Cappa M, Cianfarani S, Manco M. High 1-h glucose in youths with obesity as marker of prediabetes and cardiovascular risk. J Endocrinol Invest 2023; 46:2555-2562. [PMID: 37204691 DOI: 10.1007/s40618-023-02111-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/09/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE Testing 1-h glucose (1HG) concentration during oral glucose tolerance test is cost-effective to identify individuals at risk of incident type 2 diabetes. Aim of the study was to define 1HG cutoffs diagnostic of incident impaired glucose tolerance (IGT) in youths with obesity, and to evaluate prevalence and association of cutoffs identified in the cohort and from the literature (133 and 155 mg/dl) to cardiovascular disease (CVD) in a population of youths with obesity. METHODS This is a longitudinal study of 154 youths to identify 1HG cutoffs, and cross-sectional study of 2295 youths to estimate prevalence of high 1HG and association to CVD. Receiver-operating characteristic curves (ROC) were used to establish 1HG cutoffs, and univariate regression analyses to test association of 1HG to blood pressure, lipids and aminotransferases. RESULTS ROC analysis identified the 1HG cutoff of 159 mg/dl as having diagnostic accuracy of IGT with area under the ROC 0.82 (95% CI 0.66-0.98), sensitivity 0.86% and specificity 0.79%. In the cross-sectional population, prevalence of high 1HG was 36% and 15% for 133 and 155 mg/dl cutoffs, respectively, and 17% for the 159 mg/dl value. All the examined cutoffs were significantly associated with worse lipid profile, liver function test, reduced insulin sensitivity, secretion and disposition index. CONCLUSION High 1HG is marker of persistent IGT and increased risk of metabolic abnormalities in youths. The 155 mg/dl cutoff is a convenient estimate in young people but longitudinal studies with retinopathy and overt diabetes as end points are advised to verify the 1HG cutoff with the best diagnostic accuracy.
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Affiliation(s)
- L Ravà
- Clinical Epidemiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - D Fintini
- Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Mariani
- Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - A Deodati
- Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - E Inzaghi
- Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - S Pedicelli
- Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - C Bizzarri
- Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Cappa
- Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - S Cianfarani
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy
- Diabetes and Growth Disorders Unit, Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - M Manco
- Research Area for Multifactorial Diseases and Complex Phenotypes, Bambino Gesù Children's Hospital, IRCCS, Via F. Baldelli 38, 00146, Rome, Italy.
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3
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Magugliani G, Marranconi M, Liosi GM, Locatelli F, Gambirasio A, Trombetta L, Hertsyk V, Torri V, Galluccio F, Macerata E, Mossini E, Santi A, Mariani M, Bombardieri E, Vavassori V, Salmoiraghi P. Pilot scale validation campaign of gel dosimetry for pre-treatment quality assurance in stereotactic radiotherapy. Phys Med 2023; 114:103158. [PMID: 37806152 DOI: 10.1016/j.ejmp.2023.103158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/25/2023] [Accepted: 09/28/2023] [Indexed: 10/10/2023] Open
Abstract
PURPOSE Complex stereotactic radiotherapy treatment plans require prior verification. A gel dosimetry system was developed and tested to serve as a high-resolution 3D dosimeter for Quality Assurance (QA) purposes. MATERIALS AND METHODS A modified version of a polyacrylamide polymer gel dosimeter based on chemical response inhibition was employed. Different sample geometries (cuvettes and phantoms) were manufactured for calibration and QA acquisitions. Irradiations were performed with a Varian Trilogy linac, and analyses of irradiated gel dosimeters were performed via MRI with a 1.5 T Philips Achieva at 1 mm3 or 2 mm3 isotropic spatial resolution. To assess reliability of polymer gel data, 54 stereotactic clinical treatment plans were delivered both on dosimetric gel phantoms and on the Delta4 dosimeter. Results from the two devices were evaluated through a global gamma index over a range of acceptance criteria and compared with each other. RESULTS A quantitative and tunable control of dosimetric gel response sensitivity was achieved through chemical inhibition. An optimized MRI analysis protocol allowed to acquire high resolution phantom dose data in timeframes of ≈ 1 h. Conversion of gel dosimeter data into absorbed dose was achieved through internal calibration. Polymer gel dosimeters (2 mm3 resolution) and Delta4 presented an agreement within 4.8 % and 2.7 % at the 3 %/1 mm and 2 %/2 mm gamma criteria, respectively. CONCLUSIONS Gel dosimeters appear as promising tools for high resolution 3D QA. Added complexity of the gel dosimetry protocol may be justifiable in case of small target volumes and steep dose gradients.
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Affiliation(s)
- G Magugliani
- Department of Energy, Nuclear Engineering Division, Politecnico di Milano, Milano, Italy.
| | - M Marranconi
- U. O. Medical Physics, Humanitas Gavazzeni, Bergamo, Italy
| | - G M Liosi
- Department of Energy, Nuclear Engineering Division, Politecnico di Milano, Milano, Italy
| | - F Locatelli
- U. O. Medical Physics, Humanitas Gavazzeni, Bergamo, Italy
| | - A Gambirasio
- U. O. Medical Physics, Humanitas Gavazzeni, Bergamo, Italy
| | - L Trombetta
- U. O. Medical Physics, Humanitas Gavazzeni, Bergamo, Italy
| | - V Hertsyk
- Fondazione Humanitas per la Ricerca, Milano, Italy
| | - V Torri
- Department of Oncologic Research, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - F Galluccio
- Department of Energy, Nuclear Engineering Division, Politecnico di Milano, Milano, Italy
| | - E Macerata
- Department of Energy, Nuclear Engineering Division, Politecnico di Milano, Milano, Italy
| | - E Mossini
- Department of Energy, Nuclear Engineering Division, Politecnico di Milano, Milano, Italy
| | - A Santi
- Department of Energy, Nuclear Engineering Division, Politecnico di Milano, Milano, Italy
| | - M Mariani
- Department of Energy, Nuclear Engineering Division, Politecnico di Milano, Milano, Italy
| | - E Bombardieri
- Scientific Direction, Humanitas Gavazzeni, Bergamo, Italy
| | - V Vavassori
- U. O. Radiotherapy, Humanitas Gavazzeni, Bergamo, Italy
| | - P Salmoiraghi
- U. O. Medical Physics, Humanitas Gavazzeni, Bergamo, Italy
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Haanen JBAG, Larkin J, Choueiri TK, Albiges L, Rini BI, Atkins MB, Schmidinger M, Penkov K, Michelon E, Wang J, Mariani M, di Pietro A, Motzer RJ. Extended follow-up from JAVELIN Renal 101: subgroup analysis of avelumab plus axitinib versus sunitinib by the International Metastatic Renal Cell Carcinoma Database Consortium risk group in patients with advanced renal cell carcinoma. ESMO Open 2023; 8:101210. [PMID: 37104931 DOI: 10.1016/j.esmoop.2023.101210] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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: 01/04/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND We report updated data for avelumab plus axitinib versus sunitinib in patients with advanced renal cell carcinoma from the third interim analysis of the phase III JAVELIN Renal 101 trial. PATIENTS AND METHODS Progression-free survival (PFS), objective response rate (ORR), and duration of response per investigator assessment (RECIST version 1.1) and overall survival (OS) were evaluated in the overall population and in International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk groups; safety was also assessed. RESULTS Overall, median OS [95% confidence interval (CI)] was not reached [42.2 months-not estimable (NE)] with avelumab plus axitinib versus 37.8 months (31.4-NE) with sunitinib [hazard ratio (HR) 0.79, 95% CI 0.643-0.969; one-sided P = 0.0116], and median PFS (95% CI) was 13.9 months (11.1-16.6 months) versus 8.5 months (8.2-9.7 months), respectively (HR 0.67, 95% CI 0.568-0.785; one-sided P < 0.0001). In patients with IMDC favorable-, intermediate-, poor-, or intermediate plus poor-risk disease, respectively, HRs (95% CI) for OS with avelumab plus axitinib versus sunitinib were 0.66 (0.356-1.223), 0.84 (0.649-1.084), 0.60 (0.399-0.912), and 0.79 (0.636-0.983), and HRs (95% CIs) for PFS were 0.71 (0.490-1.016), 0.71 (0.578-0.866), 0.45 (0.304-0.678), and 0.66 (0.550-0.787), respectively. ORRs, complete response rates, and durations of response favored avelumab plus axitinib overall and across all risk groups. In the avelumab plus axitinib arm, 81.1% had a grade ≥3 treatment-emergent adverse event (TEAE), and incidences of TEAEs and immune-related AEs were highest <6 months after randomization. CONCLUSIONS Avelumab plus axitinib continues to show improved efficacy versus sunitinib and a tolerable safety profile overall and across IMDC risk groups. The OS trend favors avelumab plus axitinib versus sunitinib, but data remain immature; follow-up is ongoing. TRIAL REGISTRATION ClinicalTrials.govNCT02684006; https://clinicaltrials.gov/ct2/show/NCT02684006.
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Affiliation(s)
- J B A G Haanen
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
| | - J Larkin
- Department of Medical Oncology, Royal Marsden NHS Foundation Trust, London, UK
| | - T K Choueiri
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - L Albiges
- Department of Oncology, Institut Gustave Roussy, Villejuif, France
| | - B I Rini
- Hematology Oncology, Vanderbilt-Ingram Cancer Center, Nashville, USA
| | - M B Atkins
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - M Schmidinger
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - K Penkov
- Private Medical Institution Euromedservice, St. Petersburg, Russia
| | | | | | | | | | - R J Motzer
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
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5
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De Luca G, Verdoia M, Morici N, Ferri LA, Piatti L, Grosseto D, Bossi I, Sganzerla P, Tortorella G, Cacucci M, Ferrario M, Murena E, Tondi S, Toso A, Bongioanni S, Ravera A, Corrada E, Mariani M, Di Ascenzo L, Petronio AS, Cavallini C, Vitrella G, Antonicelli R, Cesana BM, De Luca L, Ottani F, Moffa N, Savonitto S, De Servi S. Corrigendum to "Impact of hemoglobin levels at admission on outcomes among elderly patients with acute coronary syndrome treated with low-dose Prasugrel or clopidogrel: A sub-study of the ELDERLY ACS 2 trial" [Int J Cardiol. 2022 Dec 15;369:5-11]. Int J Cardiol 2023; 377:133. [PMID: 36774304 DOI: 10.1016/j.ijcard.2023.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- G De Luca
- Clinical and Experimental Cardiology Unit, Azienda Ospedaliera-Universitaria "Sassari", University of Sassari, Sassari, Italy.
| | - M Verdoia
- Division of Cardiology, Ospedale degli Infermi, Biella, Italy
| | - N Morici
- IRCCSS. Maria Nascente Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - L A Ferri
- IRCCS Ospedale San Raffaele, Milan, Italy
| | - L Piatti
- IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - I Bossi
- IRCCSS. Maria Nascente Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | | | | | | | - M Ferrario
- IRCCS Fondazione Policlinico S. Matteo, Pavia, Italy
| | - E Murena
- Ospedale S. Maria delle Grazie, Pozzuoli, Italy
| | - S Tondi
- Ospedale Baggiovara, Modena, Italy
| | - A Toso
- Ospedale S. Stefano, Prato, Italy
| | | | - A Ravera
- Ospedale Ruggi D'Aragona, Salerno, Italy
| | - E Corrada
- Humanitas Clinical and Research Center, Rozzano, Italy
| | | | - L Di Ascenzo
- Ospedale di San Donà di Piave-Portogruaro, Portogruaro, Italy
| | - A S Petronio
- Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - C Cavallini
- Ospedale S. Maria della Misericordia, Perugia, Italy
| | - G Vitrella
- Ospedali Riuniti di Trieste, Trieste, Italy
| | - R Antonicelli
- Istituto Nazionale di Ricerca e Cura per l' Anziano, Ancona, Italy
| | - B M Cesana
- Statistics and Biomathematics Unit, Department of Molecular and Transactional Medicine, University of Brescia, Brescia, Italy
| | - L De Luca
- Department of Cardiosciences, AO San Camillo-Forlanini, Roma, Italy
| | - F Ottani
- Ospedale Treviglio-Caravaggio, Treviglio, Italy
| | - N Moffa
- IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - S De Servi
- Department of Molecular Medicine, University of Pavia Medical School, Pavia, Italy
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6
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Arosio P, Orsini F, Brero F, Mariani M, Innocenti C, Sangregorio C, Lascialfari A. The effect of size, shape, coating and functionalization on nuclear relaxation properties in iron oxide core-shell nanoparticles: a brief review of the situation. Dalton Trans 2023; 52:3551-3562. [PMID: 36880505 DOI: 10.1039/d2dt03387a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
In this perspective article, we present a short selection of some of the most significant case studies on magnetic nanoparticles for potential applications in nanomedicine, mainly magnetic resonance. For almost 10 years, our research activity focused on the comprehension of the physical mechanisms on the basis of the nuclear relaxation of magnetic nanoparticles in the presence of magnetic fields; taking advantage of the insights gathered over this time span, we report on the dependence of the relaxation behaviour on the chemico-physical properties of magnetic nanoparticles and discuss them in full detail. In particular, a critical review is carried out on the correlations between their efficiency as contrast agents in magnetic resonance imaging and the magnetic core of magnetic nanoparticles (mainly iron oxides), their size and shape, and the coating and solvent used for making them biocompatible and well dispersible in physiological media. Finally, the heuristic model proposed by Roch and coworkers is presented, as it was extensively adopted to describe most of the experimental data sets. The large amount of data analyzed allowed us to highlight both the advantages and limitations of the model.
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Affiliation(s)
- Paolo Arosio
- Dipartimento di Fisica, INFN and INSTM RU, Università degli Studi di Milano, 20133 Milano, Italy.
| | - Francesco Orsini
- Dipartimento di Fisica, INFN and INSTM RU, Università degli Studi di Milano, 20133 Milano, Italy.
| | - Francesca Brero
- Dipartimento di Fisica, INFN and INSTM RU, Università degli Studi di Pavia, 27100 Pavia, Italy
| | - Manuel Mariani
- Dipartimento di Fisica, INFN and INSTM RU, Università degli Studi di Pavia, 27100 Pavia, Italy
| | - Claudia Innocenti
- Dipartimento di Chimica, Università di Firenze and INSTM, 50019 Sesto Fiorentino (FI), Italy
- ICCOM-CNR, 50019 Sesto Fiorentino (FI), Italy
| | - Claudio Sangregorio
- Dipartimento di Chimica, Università di Firenze and INSTM, 50019 Sesto Fiorentino (FI), Italy
- ICCOM-CNR, 50019 Sesto Fiorentino (FI), Italy
| | - Alessandro Lascialfari
- Dipartimento di Fisica, INFN and INSTM RU, Università degli Studi di Pavia, 27100 Pavia, Italy
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7
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Caldarola G, Chiricozzi A, Megna M, Dapavo P, Giunta A, Burlando M, Malagoli P, Dini V, Mariani M, Fabbrocini G, Quaglino P, Bianchi L, Parodi A, Peris K, De Simone C. Real-life experience with ixekizumab in plaque psoriasis: a multi-center, retrospective, 3-year study. Expert Opin Biol Ther 2023; 23:365-370. [PMID: 36927246 DOI: 10.1080/14712598.2023.2193288] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
BACKGROUND Confirmatory data on the long-term effectiveness and safety of ixekizumab in psoriatic patients from real-world studies are needed. OBJECTIVES The primary aim was to evaluate the 3-year drug survival of ixekizumab in the treatment of patients with moderate-to-severe plaque psoriasis, in a multicenter real-world setting. The secondary aim was to assess the influence of predictive factors on the drug survival of ixekizumab. METHODS A retrospective analysis was performed on a cohort of patients with chronic plaque psoriasis, who received at least one dose of ixekizumab before December 2018. The drug survival analysis was performed and descriptively analyzed using Kaplan-Meier survival curves. Multivariable Cox regression analyses were carried out including variables considered to be of clinical importance. RESULTS A total of 306 patients were enrolled. The overall drug survival at 12, 24, and 36 months of treatment with ixekizumab was 92.11%, 83.85%, and 80.19%, respectively. A higher probability (HR 2.34) of drug withdrawal was found among patients who had already received an anti-IL-17 agent compared with bio-naive patients (p 0.017). CONCLUSIONS We found that ixekizumab is a biological agent characterized by long-term effectiveness, not influenced by several clinical factors and associated with a good safety profile.
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Affiliation(s)
- Giacomo Caldarola
- Section of Dermatology, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A Chiricozzi
- Section of Dermatology, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - M Megna
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - P Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - A Giunta
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - M Burlando
- Section of Dermatology, Di.S.Sal. Department of Health Science, San Martino Polyclinic Hospital, University of Genoa, Genoa, Italy
| | - P Malagoli
- Dermatology Unit, Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - V Dini
- Dermatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Mariani
- Section of Hygiene, University Department of Health Sciences and Public Health, Rome, Italy
| | - G Fabbrocini
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - P Quaglino
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - L Bianchi
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - A Parodi
- Section of Dermatology, Di.S.Sal. Department of Health Science, San Martino Polyclinic Hospital, University of Genoa, Genoa, Italy
| | - K Peris
- Section of Dermatology, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C De Simone
- Section of Dermatology, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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8
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Brero F, Arosio P, Albino M, Cicolari D, Porru M, Basini M, Mariani M, Innocenti C, Sangregorio C, Orsini F, Lascialfari A. 1H-NMR Relaxation of Ferrite Core-Shell Nanoparticles: Evaluation of the Coating Effect. Nanomaterials (Basel) 2023; 13:804. [PMID: 36903682 PMCID: PMC10005490 DOI: 10.3390/nano13050804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
We investigated the effect of different organic coatings on the 1H-NMR relaxation properties of ultra-small iron-oxide-based magnetic nanoparticles. The first set of nanoparticles, with a magnetic core diameter ds1 = 4.4 ± 0.7 nm, was coated with polyacrylic acid (PAA) and dimercaptosuccinic acid (DMSA), while the second set, ds2 = 8.9 ± 0.9 nm, was coated with aminopropylphosphonic acid (APPA) and DMSA. At fixed core diameters but different coatings, magnetization measurements revealed a similar behavior as a function of temperature and field. On the other hand, the 1H-NMR longitudinal r1 nuclear relaxivity in the frequency range ν = 10 kHz ÷ 300 MHz displayed, for the smallest particles (diameter ds1), an intensity and a frequency behavior dependent on the kind of coating, thus indicating different electronic spin dynamics. Conversely, no differences were found in the r1 relaxivity of the biggest particles (ds2) when the coating was changed. It is concluded that, when the surface to volume ratio, i.e., the surface to bulk spins ratio, increases (smallest nanoparticles), the spin dynamics change significantly, possibly due to the contribution of surface spin dynamics/topology.
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Affiliation(s)
- Francesca Brero
- Istituto Nazionale di Fisica Nucleare, Sezione di Pavia, 27100 Pavia, Italy
| | - Paolo Arosio
- Dipartimento di Fisica, Università degli Studi di Milano, and INFN, 20133 Milano, Italy
| | - Martin Albino
- Dipartimento di Chimica, Università degli Studi di Firenze and INSTM, 50019 Sesto Fiorentino, Italy
- ICCOM-CNR, 50019 Sesto Fiorentino, Italy
| | - Davide Cicolari
- Dipartimento di Fisica, Università degli Studi di Milano, and INFN, 20133 Milano, Italy
- ASST GOM Niguarda, Struttura Complessa Fisica Sanitaria, 20162 Milano, Italy
| | - Margherita Porru
- Istituto Nazionale di Fisica Nucleare, Sezione di Pavia, 27100 Pavia, Italy
- Dipartimento di Fisica, Università degli Studi di Pavia, 27100 Pavia, Italy
| | - Martina Basini
- Physics Department, Stockholm University, 114201 Stockholm, Sweden
| | - Manuel Mariani
- Dipartimento di Fisica, Università degli Studi di Pavia, 27100 Pavia, Italy
| | - Claudia Innocenti
- Dipartimento di Chimica, Università degli Studi di Firenze and INSTM, 50019 Sesto Fiorentino, Italy
- ICCOM-CNR, 50019 Sesto Fiorentino, Italy
| | - Claudio Sangregorio
- Dipartimento di Chimica, Università degli Studi di Firenze and INSTM, 50019 Sesto Fiorentino, Italy
- ICCOM-CNR, 50019 Sesto Fiorentino, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Firenze, 50019 Sesto Fiorentino, Italy
| | - Francesco Orsini
- Dipartimento di Fisica, Università degli Studi di Milano, and INFN, 20133 Milano, Italy
| | - Alessandro Lascialfari
- Istituto Nazionale di Fisica Nucleare, Sezione di Pavia, 27100 Pavia, Italy
- Dipartimento di Fisica, Università degli Studi di Pavia, 27100 Pavia, Italy
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9
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Brero F, Calzolari P, Albino M, Antoccia A, Arosio P, Berardinelli F, Bettega D, Ciocca M, Facoetti A, Gallo S, Groppi F, Innocenti C, Laurenzana A, Lenardi C, Locarno S, Manenti S, Marchesini R, Mariani M, Orsini F, Pignoli E, Sangregorio C, Scavone F, Veronese I, Lascialfari A. Proton Therapy, Magnetic Nanoparticles and Hyperthermia as Combined Treatment for Pancreatic BxPC3 Tumor Cells. Nanomaterials (Basel) 2023; 13:791. [PMID: 36903670 PMCID: PMC10005040 DOI: 10.3390/nano13050791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
We present an investigation of the effects on BxPC3 pancreatic cancer cells of proton therapy combined with hyperthermia, assisted by magnetic fluid hyperthermia performed with the use of magnetic nanoparticles. The cells' response to the combined treatment has been evaluated by means of the clonogenic survival assay and the estimation of DNA Double Strand Breaks (DSBs). The Reactive Oxygen Species (ROS) production, the tumor cell invasion and the cell cycle variations have also been studied. The experimental results have shown that the combination of proton therapy, MNPs administration and hyperthermia gives a clonogenic survival that is much smaller than the single irradiation treatment at all doses, thus suggesting a new effective combined therapy for the pancreatic tumor. Importantly, the effect of the therapies used here is synergistic. Moreover, after proton irradiation, the hyperthermia treatment was able to increase the number of DSBs, even though just at 6 h after the treatment. Noticeably, the magnetic nanoparticles' presence induces radiosensitization effects, and hyperthermia increases the production of ROS, which contributes to cytotoxic cellular effects and to a wide variety of lesions including DNA damage. The present study indicates a new way for clinical translation of combined therapies, also in the vision of an increasing number of hospitals that will use the proton therapy technique in the near future for different kinds of radio-resistant cancers.
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Affiliation(s)
- Francesca Brero
- Istituto Nazionale di Fisica Nucleare, Sezione di Pavia, 27100 Pavia, Italy
| | - Paola Calzolari
- Dipartimento di Fisica “Aldo Pontremoli” and INFN (Sezione di Milano), Università degli Studi di Milano, 20133 Milano, Italy
| | - Martin Albino
- ICCOM-CNR, 50019 Sesto Fiorentino, Italy
- Dipartimento di Chimica, Università di Firenze and INSTM, 50019 Sesto Fiorentino, Italy
| | - Antonio Antoccia
- Dipartimento di Scienze and INFN, Università Roma Tre, 00146 Roma, Italy
| | - Paolo Arosio
- Dipartimento di Fisica “Aldo Pontremoli” and INFN (Sezione di Milano), Università degli Studi di Milano, 20133 Milano, Italy
| | | | - Daniela Bettega
- Dipartimento di Fisica “Aldo Pontremoli” and INFN (Sezione di Milano), Università degli Studi di Milano, 20133 Milano, Italy
| | | | | | - Salvatore Gallo
- Dipartimento di Fisica “Aldo Pontremoli” and INFN (Sezione di Milano), Università degli Studi di Milano, 20133 Milano, Italy
| | - Flavia Groppi
- Dipartimento di Fisica “Aldo Pontremoli” and INFN (Sezione di Milano), Università degli Studi di Milano, 20133 Milano, Italy
- Laboratorio Acceleratori e Superconduttività Applicata (L.A.S.A.), 20090 Segrate, Italy
| | - Claudia Innocenti
- ICCOM-CNR, 50019 Sesto Fiorentino, Italy
- Dipartimento di Chimica, Università di Firenze and INSTM, 50019 Sesto Fiorentino, Italy
| | - Anna Laurenzana
- Dipartimento di Scienze Biomediche Sperimentali e Cliniche “Mario Serio”, 50134 Firenze, Italy
| | - Cristina Lenardi
- Dipartimento di Fisica “Aldo Pontremoli” and INFN (Sezione di Milano), Università degli Studi di Milano, 20133 Milano, Italy
| | - Silvia Locarno
- Dipartimento di Fisica “Aldo Pontremoli” and INFN (Sezione di Milano), Università degli Studi di Milano, 20133 Milano, Italy
| | - Simone Manenti
- Dipartimento di Fisica “Aldo Pontremoli” and INFN (Sezione di Milano), Università degli Studi di Milano, 20133 Milano, Italy
- Laboratorio Acceleratori e Superconduttività Applicata (L.A.S.A.), 20090 Segrate, Italy
| | - Renato Marchesini
- Dipartimento di Fisica “Aldo Pontremoli” and INFN (Sezione di Milano), Università degli Studi di Milano, 20133 Milano, Italy
| | - Manuel Mariani
- Dipartimento di Fisica, Università degli Studi di Pavia, 27100 Pavia, Italy
| | - Francesco Orsini
- Dipartimento di Fisica “Aldo Pontremoli” and INFN (Sezione di Milano), Università degli Studi di Milano, 20133 Milano, Italy
| | - Emanuele Pignoli
- Fondazione IRCSS Istituto Nazionale dei Tumori, 20133 Milano, Italy
| | - Claudio Sangregorio
- ICCOM-CNR, 50019 Sesto Fiorentino, Italy
- Dipartimento di Chimica, Università di Firenze and INSTM, 50019 Sesto Fiorentino, Italy
- INFN, Sezione di Firenze, 50019 Sesto Fiorentino, Italy
| | - Francesca Scavone
- Dipartimento di Scienze Biomediche Sperimentali e Cliniche “Mario Serio”, 50134 Firenze, Italy
| | - Ivan Veronese
- Dipartimento di Fisica “Aldo Pontremoli” and INFN (Sezione di Milano), Università degli Studi di Milano, 20133 Milano, Italy
| | - Alessandro Lascialfari
- Istituto Nazionale di Fisica Nucleare, Sezione di Pavia, 27100 Pavia, Italy
- Dipartimento di Fisica, Università degli Studi di Pavia, 27100 Pavia, Italy
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10
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Panfili FM, Convertino A, Grugni G, Mazzitelli L, Bocchini S, Crinò A, Campana G, Cappa M, Delvecchio M, Faienza MF, Licenziati MR, Mariani M, Osimani S, Pajno R, Patti G, Rutigliano I, Sacco M, Scarano E, Fintini D. Multicentric Italian case-control study on 25OH vitamin D levels in children and adolescents with Prader-Willi syndrome. J Endocrinol Invest 2023:10.1007/s40618-022-01990-5. [PMID: 36708456 DOI: 10.1007/s40618-022-01990-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/09/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE 25OHD levels in patients with Prader-Willi Syndrome (PWS), the most frequent cause of genetic obesity with a peculiar fat mass distribution, are still debated. Insulin resistance (IR), Body Mass Index-SDS (BMI-SDS), Growth Hormone Therapy (GHT), and puberty onset seem to interact with 25OHD levels. The objectives of the study are: (1) To analyze 25OHD levels in pediatric PWS patients in comparison with a control group (CNT) (2) To evaluate a possible correlation between BMI-SDS, HOMA-IR, puberty, GHT, and 25OHD levels. METHODS This is a retrospective case-control, multicenter study. Data were collected among 8 different Italian Hospitals (outpatient clinics), over a period of four years (2016-2020). We included 192 genetically confirmed PWS and 192 CNT patients, aged 3-18 years, matched 1:1 for age, gender, BMI-SDS, Tanner stage, sun exposure, and month of recruitment. RESULTS No statistically significant differences in 25OHD levels were observed between the PWS population and the CNT (PWS 24.0 ng/mL vs CNT 22.5 ng/mL, p > 0.05), OR = 0.89 (95% CI 0.58-1.35). We observed a slight, although non-significant, reduction in 25OHD levels comparing NW and OB populations. HOMA-IR, puberty onset, genotype and GHT (previous or ongoing) did not show statistically significant correlation with 25OHD levels. CONCLUSIONS Our findings could be useful for clinicians to optimize the therapeutic management as well as to increase awareness of PWS.
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Affiliation(s)
| | - A Convertino
- Prader Willi Reference Center, Endocrinology Unit, Pediatric University Department, Bambino Gesù Children Hospital, Via Torre di Palidoro, 00050, Palidoro, Rome, Italy
| | - G Grugni
- Auxology Division, Istituto Auxologico Italiano IRCCS, Piancavallo di Oggebbio, Verbania, Italy
| | - L Mazzitelli
- Prader Willi Reference Center, Endocrinology Unit, Pediatric University Department, Bambino Gesù Children Hospital, Via Torre di Palidoro, 00050, Palidoro, Rome, Italy
| | - S Bocchini
- Prader Willi Reference Center, Endocrinology Unit, Pediatric University Department, Bambino Gesù Children Hospital, Via Torre di Palidoro, 00050, Palidoro, Rome, Italy
| | - A Crinò
- Prader Willi Reference Center, Endocrinology Unit, Pediatric University Department, Bambino Gesù Children Hospital, Via Torre di Palidoro, 00050, Palidoro, Rome, Italy
| | - G Campana
- Prader Willi Reference Center, Endocrinology Unit, Pediatric University Department, Bambino Gesù Children Hospital, Via Torre di Palidoro, 00050, Palidoro, Rome, Italy
| | - M Cappa
- Prader Willi Reference Center, Endocrinology Unit, Pediatric University Department, Bambino Gesù Children Hospital, Via Torre di Palidoro, 00050, Palidoro, Rome, Italy
| | - M Delvecchio
- Metabolic and Genetic Disease Unit, Pediatric Hospital Giovanni XXIII, Bari, Italy
| | - M F Faienza
- Department of Biomedical Science and Human Oncology Department, A. Moro University, Bari, Italy
| | - M R Licenziati
- Obesity and Endocrine Diseases Unit, Neuroscience and Rehabilitation Department, Santobono-Pausilipon Hospital, Naples, Italy
| | - M Mariani
- Prader Willi Reference Center, Endocrinology Unit, Pediatric University Department, Bambino Gesù Children Hospital, Via Torre di Palidoro, 00050, Palidoro, Rome, Italy
| | - S Osimani
- Pediatric Unit, IRCCS San Raffaele, Milan, Italy
| | - R Pajno
- Pediatric Unit, IRCCS San Raffaele, Milan, Italy
| | - G Patti
- Pediatric Department, Gaslini Hospital, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health-University of Genova, Genoa, Italy
| | - I Rutigliano
- Pediatric Unit, "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia, Italy
| | - M Sacco
- Pediatric Unit, "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia, Italy
| | - E Scarano
- Rare Disease Unit, Pediatric Unit, Sant'Orsola Hospital, Bologna, Italy
| | - D Fintini
- Prader Willi Reference Center, Endocrinology Unit, Pediatric University Department, Bambino Gesù Children Hospital, Via Torre di Palidoro, 00050, Palidoro, Rome, Italy.
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11
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Mariani M, Fintini D, Cirillo G, Palumbo S, Del Giudice EM, Bocchini S, Manco M, Cappa M, Grandone A. MKRN3 circulating levels in Prader-Willi syndrome: a pilot study. J Endocrinol Invest 2022; 45:2165-2170. [PMID: 35854182 DOI: 10.1007/s40618-022-01860-0] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/03/2022] [Indexed: 10/17/2022]
Abstract
CONTEXT Hypogonadism in Prader-Willi syndrome (PWS) is generally attributed to hypothalamic dysfunction or to primary gonadal defect. MKRN3, a maternal imprinted gene located on 15q11.2-q13 region, encodes makorin ring finger protein 3, whose deficiency causes precocious puberty, an extremely rare symptom in PWS. OBJECTIVE This study aimed to evaluate MKRN3 levels in patients with PWS and to analyze its correlation with sexual hormone levels, insulin resistance and Body Mass Index (BMI). METHODS We performed an observational cross-sectional study and enrolled 80 patients with genetically confirmed diagnosis of PWS with median age of 9.6 years. RESULTS MKRN3 levels were measurable in 49 PWS patients with a geometric mean of 34.9 ± 22 pg/ml (median: 28.4). Unmeasurable levels of MKRN3 were found in 31 patients. No statistically significant differences were found between patients with and without measurable MKRN3 levels for any clinical, biochemical, or genetic characteristics. However, MKRN3 levels were inversely correlated with HOMA-IR index (p: 0.005) and HbA1c (p: 0.046) values. No statistically significant correlations were found between MKRN3 and LH, estradiol and testosterone concentrations, pubertal development and genetic defect, whereas a direct correlation with FSH was found (p: 0.007). CONCLUSIONS The typical genetic defect of PWS should lead to unmeasurable levels of the MKRN3 protein due to the inactivation of the paternal allele. Measurable circulating MKRN3 could suggest the possible involvement of tissue-specific imprinting mechanisms and other regulatory factors in gene expression. Correlations with HOMA-IR index, HbA1c, and FSH suggest peripheral actions of MKRN3, but future studies are warranted to investigate this topic.
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Affiliation(s)
- M Mariani
- Endocrinology Unit, University Pediatric Department, Bambino Gesù Children's Hospital, Piazza S.Onofrio, 4, 00165, Rome, Italy.
| | - D Fintini
- Endocrinology Unit, University Pediatric Department, Bambino Gesù Children's Hospital, Piazza S.Onofrio, 4, 00165, Rome, Italy
| | - G Cirillo
- Department of Woman, Child, General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - S Palumbo
- Department of Woman, Child, General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - E M Del Giudice
- Department of Woman, Child, General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - S Bocchini
- Endocrinology Unit, University Pediatric Department, Bambino Gesù Children's Hospital, Piazza S.Onofrio, 4, 00165, Rome, Italy
| | - M Manco
- Research Area for Multifactorial Diseases and Complex Phenotypes, Bambino Gesù Children's Hospital, Rome, Italy
| | - M Cappa
- Endocrinology Unit, University Pediatric Department, Bambino Gesù Children's Hospital, Piazza S.Onofrio, 4, 00165, Rome, Italy
| | - A Grandone
- Department of Woman, Child, General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
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12
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Causio FA, Villani L, Mariani M, Pastorino R, De Waure C, Ricciardi W, Boccia S. Vaccination coverage trends in European Union from 1980 to 2020: A joinpoint Regression Analysis. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Vaccinations are successful, cost-effective public health interventions; nevertheless, vaccine hesitancy represents a concern and several EU countries have implemented mandatory vaccinations to counteract it. The assessment of vaccination coverage data is helpful to clarify the reason behind this choice better and assess its impact. Data were extracted from the WUENIC database as of July 2021. All the 27 EU countries were included, considering the period from 1980 to 2020 (depending on data availability). Coverage indicators on seven vaccinations scheduled during the first year of life to prevent nine vaccine-preventable diseases were considered. Joinpoint regression was run using Joinpoint Trend Analysis Software 4.9.0.0. For each coverage indicator, the last two trends in time identified by the joinpoint regression were considered to identify countries with a positive vaccination coverage trend (having either the last trend significantly positive or the second last significantly negative but followed by a trend reversal) or a negative coverage trend (having either the last trend significantly negative or the second last significantly positive but followed by a trend reversal). To assess each country, we collated together information on each coverage indicator. A total of 180 jointpoint regressions were run. At least one joinpoint was observed in 144 cases: 39 (27.1%) showed a significant positive trend, and 49 (34%) had a significantly negative one. In 36 cases, there was a single trend lacking a joinpoint, either positive (21, 58.3%), negative (8, 22.2%), or not showing a change (7, 19.4%). Overall, 14 countries had mostly negative vaccination coverage trends, whereas 13 had mostly positive vaccination coverage trends. Systematised data collection and analysis of vaccination coverage trends are needed to support public health systems. EU countries differ broadly, but the overall situation shows that coverage trends are a key issue to be addressed.
Key messages
• Vaccination coverage in the EU shows a general negative trend. The assessment and comparison of coverage trends across EU countries could make policymakers able to respond to critical issues timely.
• Mandatory vaccinations have been issued in different countries to prevent vaccination coverages from decreasing. Some countries have not issued any mandate but show high vaccination coverages.
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Affiliation(s)
- FA Causio
- Section of Hygiene, UCSC Rome , Rome, Italy
| | - L Villani
- Section of Hygiene, UCSC Rome , Rome, Italy
| | - M Mariani
- Section of Hygiene, UCSC Rome , Rome, Italy
| | | | - C De Waure
- Department of Medicine and Surgery, University of Perugia , Perugia, Italy
| | | | - S Boccia
- Section of Hygiene, UCSC Rome , Rome, Italy
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy
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13
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Porru M, Morales MDP, Gallo-Cordova A, Espinosa A, Moros M, Brero F, Mariani M, Lascialfari A, Ovejero JG. Tailoring the Magnetic and Structural Properties of Manganese/Zinc Doped Iron Oxide Nanoparticles through Microwaves-Assisted Polyol Synthesis. Nanomaterials (Basel) 2022; 12:3304. [PMID: 36234433 PMCID: PMC9565877 DOI: 10.3390/nano12193304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/17/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
Tuning the fundamental properties of iron oxide magnetic nanoparticles (MNPs) according to the required biomedical application is an unsolved challenge, as the MNPs' properties are affected by their composition, their size, the synthesis process, and so on. In this work, we studied the effect of zinc and manganese doping on the magnetic and structural properties of MNPs synthesized by the microwave-assisted polyol process, using diethylene glycol (DEG) and tetraethylene glycol (TEG) as polyols. The detailed morpho-structural and magnetic characterization showed a correspondence between the higher amounts of Mn and smaller crystal sizes of the MNPs. Such size reduction was compensated by an increase in the global magnetic moment so that it resulted in an increase of the saturation magnetization. Saturation magnetization MS values up to 91.5 emu/g and NMR transverse relaxivities r2 of 294 s-1mM-1 were obtained for Zn and Mn- doped ferrites having diameters around 10 nm, whereas Zn ferrites with diameters around 15 nm reached values of MS∼ 97.2 emu/g and of r2∼ 467 s-1mM-1, respectively. Both kinds of nanoparticles were synthesized by a simple, reproducible, and more sustainable method that makes them very interesting for diagnostic applications as MRI contrast agents.
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Affiliation(s)
- Margherita Porru
- Dipartimento di Fisica, Università degli Studi di Pavia, Via A. Bassi 6, 27100 Pavia, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Pavia, Via A. Bassi 6, 27100 Pavia, Italy
| | - María del Puerto Morales
- Instituto de Ciencia de Materiales de Madrid, ICMM/CSIC, C. Sor Juana Inés de la Cruz 3, 28049 Madrid, Spain
| | - Alvaro Gallo-Cordova
- Instituto de Ciencia de Materiales de Madrid, ICMM/CSIC, C. Sor Juana Inés de la Cruz 3, 28049 Madrid, Spain
| | - Ana Espinosa
- IMDEA Nanociencia, c/ Faraday, 9, 28049 Madrid, Spain
- Nanobiotecnología (IMDEA-Nanociencia) Unidad Asociada al Centro Nacional de Biotecnología (CSIC), 28049 Madrid, Spain
| | - María Moros
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC-Universidad de Zaragoza, 50018 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 50018 Zaragoza, Spain
| | - Francesca Brero
- Istituto Nazionale di Fisica Nucleare, Sezione di Pavia, Via A. Bassi 6, 27100 Pavia, Italy
| | - Manuel Mariani
- Dipartimento di Fisica, Università degli Studi di Pavia, Via A. Bassi 6, 27100 Pavia, Italy
| | - Alessandro Lascialfari
- Dipartimento di Fisica, Università degli Studi di Pavia, Via A. Bassi 6, 27100 Pavia, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Pavia, Via A. Bassi 6, 27100 Pavia, Italy
| | - Jesús G. Ovejero
- Instituto de Ciencia de Materiales de Madrid, ICMM/CSIC, C. Sor Juana Inés de la Cruz 3, 28049 Madrid, Spain
- Hospital General Universitario Gregorio Marañón, C. Dr. Esquerdo, 46, 28007 Madrid, Spain
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14
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Tomita Y, Larkin J, Venugopal B, Haanen J, Kanayama H, Eto M, Grimm MO, Fujii Y, Umeyama Y, Huang B, Mariani M, di Pietro A, Choueiri TK. Association of C-reactive protein with efficacy of avelumab plus axitinib in advanced renal cell carcinoma: long-term follow-up results from JAVELIN Renal 101. ESMO Open 2022; 7:100564. [PMID: 36037566 PMCID: PMC9588905 DOI: 10.1016/j.esmoop.2022.100564] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/17/2022] Open
Abstract
Background C-reactive protein (CRP) is an important prognostic and predictive factor in advanced renal cell carcinoma (aRCC). We report the association of CRP levels at baseline and early after treatment with efficacy of avelumab plus axitinib or sunitinib from the phase III JAVELIN Renal 101 trial. Patients and methods Patients were categorized into normal (baseline CRP <10 mg/l), normalized (baseline CRP ≥10 mg/l and ≥1 CRP value decreased to <10 mg/l during 6-week treatment), and non-normalized (CRP ≥10 mg/l at baseline and during 6-week treatment) CRP groups. Progression-free survival and best overall response from the second interim analysis and overall survival (OS) from the third interim analysis were assessed. Results In the avelumab plus axitinib and sunitinib arms, respectively, 234, 51, and 108 patients and 232, 36, and 128 patients were categorized into normal, normalized, and non-normalized CRP groups. In respective CRP groups, objective response rates [95% confidence interval (CI)] were 56.0% (49.4% to 62.4%), 66.7% (52.1% to 79.2%), and 45.4% (35.8% to 55.2%) with avelumab plus axitinib and 30.6% (24.7% to 37.0%), 41.7% (25.5% to 59.2%), and 19.5% (13.1% to 27.5%) with sunitinib; complete response rates were 3.8%, 11.8%, and 0.9% and 3.0%, 0%, and 1.6%, respectively. Median progression-free survival (95% CI) was 15.2 months (12.5-21.0 months), not reached (NR) [11.1 months-not estimable (NE)], and 7.0 months (5.6-9.9 months) with avelumab plus axitinib and 11.2 months (8.4-13.9 months), 11.2 months (6.7-13.8 months), and 4.2 months (2.8-5.6 months) with sunitinib; median OS (95% CI) was NR (42.2 months-NE), NR (30.4 months-NE), and 23.0 months (18.4-33.1 months) and NR (39.0 months-NE), 39.8 months (21.7-NE), and 19.1 months (16.3-25.3 months), respectively. Multivariate analyses demonstrated that normalized or non-normalized CRP levels were independent factors for the prediction of objective response rate or OS, respectively, with avelumab plus axitinib. Conclusions In patients with aRCC, CRP levels at baseline and early after treatment may predict efficacy with avelumab plus axitinib. C-reactive protein is an important prognostic and predictive factor in advanced renal cell carcinoma. The association between C-reactive protein levels and the efficacy of avelumab plus axitinib or sunitinib was evaluated. C-reactive protein levels at baseline and early after treatment might predict efficacy with avelumab plus axitinib.
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Affiliation(s)
- Y Tomita
- Department of Urology, Department of Molecular Oncology, Niigata University Graduate School of Medicine, Niigata, Japan.
| | - J Larkin
- Department of Medical Oncology, Royal Marsden NHS Foundation Trust, London, UK
| | - B Venugopal
- Institute of Cancer Sciences, University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - J Haanen
- Division of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - H Kanayama
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - M Eto
- Department of Urology, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - M-O Grimm
- Department of Urology, Jena University Hospital, Jena, Germany
| | - Y Fujii
- Pfizer R&D Japan, Tokyo, Japan
| | | | | | | | | | - T K Choueiri
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, USA
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15
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Grimm MO, Oya M, Choueiri T, Schmidinger M, Quinn D, Gravis-Mescam G, Marseille E, Van Den Eertwegh A, Di Pietro A, Mariani M, Wang J, Thomaidou D, Albiges L. Role of prior nephrectomy for synchronous metastatic Renal Cell Carcinoma (mRCC) on efficacy in patients treated with Avelumab + Axitinib (A + Ax) or Sunitinib (S): Results from JAVELIN Renal 101. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00765-0] [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: 11/29/2022] Open
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Van de Zande S, Kuijpers M, Van Roon A, Stel AJ, Smit A, Bouma W, Dejongste M, Mariani M, Klinkenberg T, Mulder DJ. POS1343 TREATMENT OF RESISTANT RAYNAUD’S PHENOMENON WITH SINGLE-PORT THORACOSCOPIC SYMPATHICOTOMY: ONE-YEAR FOLLOW-UP. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundRaynaud’s phenomenon (RP) usually results in discoloration of the extremities when provoked by cold or emotional stress [1]. Some patients do not respond to conventional therapies, such as lifestyle interventions and vasodilatory medication. These patients are confronted with limited options for treatment. In a previous study we have shown that minimally invasive Single-Port Thoracoscopic Sympathicotomy (SPTS) objectively and subjectively improves treatment-resistant RP, after one month [2]. This procedure for treatment-resistant RP is minimally invasive and potentially highly effective, because it specifically targets the sympathetic nerve at the third rib (R3), while leaving the ganglia untouched [3]. The procedure was only performed on the left side in the pilot study, which objectively resulted in improvement of left-hand perfusion in all patients after one month, when compared to the right hand. Furthermore, patient satisfaction after surgery was high and RP attacks of the left hand were less frequent and of shorter duration. Previous studies have shown that long-term effects of conventional sympathectomy is stable in the long run in the majority of patients [4, 5]. We have previously published the one-month results of SPTS for treatment-resistant RP in a concise report [2]. In the current study we sought to report the one-year follow-up results of SPTS for treatment-resistant RP in the same cohort of patients.ObjectivesFollow-up of patients with treatment-resistant Raynaud’s phenomenon (RP) one-year after single-port thoracoscopic sympathicotomy (SPTS).MethodsEight patients (six males, two females, median age of 45 years) with treatment-resistant RP underwent left-sided SPTS at the third rib (R3), unilaterally. Perfusion was assessed with a cooling and recovery procedure at baseline and one year after SPTS. Furthermore, laser speckle contrast analysis, pulse wave velocity, heart rate variability and nailfold capillaroscopy were performed. In addition, questionnaires were taken, and number and duration of RP attacks were reported over a 2-week period.ResultsOne year after SPTS the duration of the attacks of was reduced with 1.9 hours in the left hand versus 0.9 hours in the right hand. Furthermore, three aspects of the questionnaire showed a significant improvement (role limitations due to physical health (p=0.017), pain (p=0.027) and physical functioning (p=0.025)). The total area under the curve of the total cooling and recovery procedure of the left hand was larger one year after surgery (101 (75–140) at baseline versus 118 (95–190) one year post-operatively, p=0.012), implying a better perfusion in the fingers. This was mainly due to the improvement during the recovery phase (21 (1–41) at baseline versus 38 (24–43) one year post-operatively, p=0.028).ConclusionOne year after unilateral R3 SPTS there is clear benefit with regard to the majority of outcome variables, though some effects seem to attenuate. Long-term effects and five-year follow-up results will be investigated in an on-going study.References[1]Herrick AL. The pathogenesis, diagnosis and treatment of Raynaud phenomenon. Nat Rev Rheumatol. 2012;8(8):469-79.[2]van Roon AM, Kuijpers M, van de Zande SC, Abdulle AE, van Roon AM, Bos R, et al. Treatment of resistant Raynaud’s phenomenon with single-port thoracoscopic sympathicotomy: a novel minimally invasive endoscopic technique. Rheumatology (Oxford). 2020;59(5):1021-5.[3]Kuijpers M, Klinkenberg TJ, Bouma W, DeJongste MJ, Mariani MA. Single-port one-stage bilateral thoracoscopic sympathicotomy for severe hyperhidrosis: prospective analysis of a standardized approach. J Cardiothorac Surg. 2013;8:216.[4]Coveliers HM, Hoexum F, Nederhoed JH, Wisselink W, Rauwerda JA. Thoracic sympathectomy for digital ischemia: a summary of evidence. J Vasc Surg. 2011;54(1):273-7.[5]Sayers RD, Jenner RE, Barrie WW. Transthoracic endoscopic sympathectomy for hyperhidrosis and Raynaud’s phenomenon. Eur J Vasc Surg. 1994;8(5):627-31.Disclosure of InterestsNone declared
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Magnocavallo M, Della Rocca D, Vetta G, Lavalle C, Mariani M, Schiavone M, Carola G, Mohanty S, Bassiouny M, Forleo G, Burkhardt D, Al–Ahmad A, Gallinghouse J, Horton R, Lakireddy D, Di Biase L, Natale A. P94 LOWER RATE OF MAJOR BLEEDING IN HIGH–RISK PATIENTS UNDERGOING LEFT ATRIAL APPENDAGE OCCLUSION: A PROPENSITY MATCHED COMPARISON WITH DIRECT ORAL ANTICOAGULATION. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Background
Stroke prophylaxis in very high risk (CHA2DS2–VASc ≥ 5) patients with atrial fibrillation (AF) is one of the major challenges faced by physicians. Specifically, initiating direct oral anticoagulants (DOACs) in these patients poses a therapeutic conundrum due to the concomitant high risk of bleeding. Left atrial appendage occlusion (LAAO) might be a potential alternative for thromboembolic (TE) prevention; however, there are no studies comparing these two strategies in very high–risk patients.
Objective
To evaluate the efficacy of LAAO versus DOACs in AF patients at very high TE risk.
Methods
Data were extracted from two prospective databases including 1053 Watchman and 1328 DOAC patients. Watchman patients with a CHA2DS2–VASc ≥ 5 accounted for 26.3% (n = 277). In order to attenuate the imbalance in covariates, a 1:1 propensity score matching technique was used (co–variates: age, sex, CHA2DS2–VASc and HAS–BLED scores). This method resulted in 554 matched patients (277 patients per group; mean age: 79±7y; 57.4% F; CHA2DS2–VASc: 5.8±0.9). The primary endpoint was a composite of cardiovascular (CV) death, TE events (Stroke/TIA/peripheral embolism) and clinically significant bleeding. The annual TE and major bleeding risks were estimated based on the CHA2DS2–VASc score and compared with the annualized observed risk.
Results
After a mean follow–up of 26±7 months, total events were 55 (9.4 event rates per 100 patient–years) in LAAO group vs. 78 (14.9 event rates per 100 patient–years) in DOAC group. DOACs had a significantly higher risk of the primary endpoint (hazard ratio [HR]: 1.30; 95% confidence interval [CI]: 1.08 to 1.56; p = 0.03). TE events (HR: 1.15; 95% CI: 0.84 to 1.57; p = 0.63) and CV death (HR: 1.13; 95% CI: 0.84 to 1.54; p = 0.63) did not differ between groups. Major bleeding events were significantly lower in LAAO patients (HR: 0.75; 95% CI: 0.51 to 0.82; p = 0.04). The unadjusted estimated risk of TE events was 12.3% with LAAO and 12.4% with DOACs. The annualized incidence of TE was 3.2% with LAAO and 4.1% with DOACs, which led to a risk reduction of 74% and 67%, respectively.
Conclusion
In a large cohort of AF patients at very high TE risk (CHA2DS2–VASc ≥ 5), LAAO showed similar stroke prevention but a significantly lower risk of major bleeding than DOACs during a > 2year follow–up.
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Affiliation(s)
- M Magnocavallo
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - D Della Rocca
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - G Vetta
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - C Lavalle
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - M Mariani
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - M Schiavone
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - G Carola
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - S Mohanty
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - M Bassiouny
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - G Forleo
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - D Burkhardt
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - A Al–Ahmad
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - J Gallinghouse
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - R Horton
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - D Lakireddy
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - L Di Biase
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - A Natale
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
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Magnocavallo M, Della Rocca D, Lavalle C, Vetta G, Mariani M, Carola G, Mohanty S, Fengwei Z, Tarantino N, Aung L, Alisara A, Xiaodong Z, Bassiouny M, Gallinghouse J, Burkhardt D, Al–Ahmad A, Rodney H, Di Biase L, Natale A. P4 LEFT ATRIAL APPENDAGE ANATOMICAL CHANGES FOLLOWING RADIOFREQUENCY–BASED OSTIAL ISOLATION. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Left atrial appendage (LAA) electrical isolation (ei) may be achieved via radiofrequency (RF) energy applications at the level of the appendage ostium targeting the sites of earliest activation recorded by a mapping catheter. Notably, RF has long been used in vascular, orthopedic, and aesthetic surgery to promote thermal–induced collagen matrix contraction, fibrosis, and tissue retraction. LAA anatomical changes associated to RF–induced tissue retraction have never been reported.
Objective
To quantify the anatomical changes of the LAA ostium following RF–based LAAei.
Methods
Thirty–four consecutive patients requiring AF ablation with LAAei underwent transesophageal echocardiography (TEE) within 7 days before (baseline TEE) and >6 months after (follow–up TEE) ablation. The diameter of LAA orifice and landing zone were measured at 4 different views (0°, 45°, 90°, 135°). Measurements were performed by two independent reviewers blinded to the patient’s identity.
Results
Among 34 AF patients (68±7yrs, 73.5% males), the LAA morphology was classified as chicken wing in 15 (44%) patients, windsock in 10 (29%), cactus in 6 (18%), and cauliflower in 3 (9%). At baseline TEE, the mean maximum and mean minimum ostial diameters were 25±4mm and 22±4mm, respectively. The mean maximum and mean minimum diameters of the landing zone were 26±4mm and 23±3mm, respectively. On average, LAAei was achieved after 16±7 minutes of RF at a power of 45–47W. Follow–up TEE was performed 257±148 days after LAAei. The median LAA contraction velocity was 0.1 m/s (IQR: 0.04–0.18) and was significantly impaired in all patients. At follow–up TEE, the mean maximum and mean minimum ostial diameters were 19±4mm and 17±3mm, respectively. The mean maximum and mean minimum diameters of the landing zone were 20±4mm and 18±4mm, respectively. The mean relative reduction of the ostium and the landing zone were –24.4% and –22.5%, respectively. Box–Whisker plots of the maximum and minimum ostial diameters before and after LAAei are reported in Fig. 1.
Conclusion
RF led to a > 20% reduction of the diameters of the ostium and the landing zone. These changes may have important implications for a successful percutaneous occlusion procedure and justify a staged approach of isolation and occlusion.
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Affiliation(s)
- M Magnocavallo
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - D Della Rocca
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - C Lavalle
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - G Vetta
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - M Mariani
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - G Carola
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - S Mohanty
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - Z Fengwei
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - N Tarantino
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - L Aung
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - A Alisara
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - Z Xiaodong
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - M Bassiouny
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - J Gallinghouse
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - D Burkhardt
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - A Al–Ahmad
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - H Rodney
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - L Di Biase
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - A Natale
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
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Vetta G, Magnocavallo M, Della Rocca D, Mariani M, Piro A, Fedele F, Natale A, Chimenti C, Lavalle C. P26 “FUNCTION FOLLOWS FORM”: THE ROLE OF THE CARDIAC MAGNETIC RESONANCE IN THE ARRHYTHMIC RISK STRATIFICATION IN PATIENTS WITH CARDIAC SARCOIDOSIS. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Sarcoidosis is an inflammatory disorder characterized by non–caseating granulomatous infiltration in multiple organs, including the heart. The presence of granulomas within the myocardium can cause heart failure, atrio–ventricular block, ventricular arrhythmias (VA) and sudden cardiac death (SCD). Due to the patchy pattern of sarcoid infiltration, endomyocardial biopsy has a poor sensitivity and cardiac magnetic resonance (CMR) is becoming the gold standard imaging, detecting small area of myocardial fibrosis and scar using late gadolinium enhancement (LGE). The identification of LGE in patients with dilated cardiomyopathy is strongly associated with VA and SCD and similar findings were reported in cardiac sarcoidosis (CS) patients.
Methods
In order to assess the risk of VA and SCD related to LGE in the CS, we performed a meta–analysis including all the studies enrolling patients with suspected or confirmed CS undergoing CMR. We conducted a digital search in PubMed, Embase, Cochrane Database of Systematic Reviews, Web of Science, Scopus, and Google Scholar from inception through October 2021. Clinical outcomes of interest were arrhythmogenic events defined as VA (ventricular tachycardia or ventricular fibrillation), SCD or aborted SCD (appropriate ICD discharge) during follow–up.
Results
Eleven studies with a total of 1.123 CS patients (left ventricular ejection function [LVEF]: 59 ± 23%) with an appropriate follow–up were included in the final analysis. Overall, as depicted in the Figure 1, the identification of LGE at CMR was associated with a 13–fold increase risk in potentially lethal VA (R = 12.76, 95% CI [6.30–25.87]) than patients without LGE.
Conclusions
Our findings suggest that the presence of myocardial scarring as evidenced by the identification of LGE in CMR provides meaningful information about the arrhythmic risk stratification of CS patients.
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Affiliation(s)
- G Vetta
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - M Magnocavallo
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - D Della Rocca
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - M Mariani
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - A Piro
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - F Fedele
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - A Natale
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - C Chimenti
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - C Lavalle
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
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20
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Tomita Y, Motzer RJ, Choueiri TK, Rini BI, Miyake H, Uemura H, Albiges L, Fujii Y, Umeyama Y, Wang J, Mariani M, Schmidinger M. Efficacy and safety of avelumab plus axitinib in elderly patients with advanced renal cell carcinoma: extended follow-up results from JAVELIN Renal 101. ESMO Open 2022; 7:100450. [PMID: 35397432 PMCID: PMC9058903 DOI: 10.1016/j.esmoop.2022.100450] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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: 11/02/2021] [Revised: 02/06/2022] [Accepted: 02/16/2022] [Indexed: 11/12/2022] Open
Abstract
Background In the phase III JAVELIN Renal 101 trial, first-line avelumab plus axitinib demonstrated a progression-free survival (PFS) and objective response rate (ORR) benefit versus sunitinib in patients with advanced renal cell carcinoma (aRCC). However, efficacy in elderly patients remains unclear. We report efficacy and safety by age group from the second interim analysis of overall survival (OS). Patients and methods PFS and ORR as per blinded independent central review (RECIST 1.1), OS, and safety were assessed in patient groups aged <65, ≥65 to <75, and ≥75 years. Results In the avelumab plus axitinib and sunitinib arms, 271/138/33 and 275/128/41 patients aged <65, ≥65 to <75, and ≥75 years, respectively, were randomized. At data cut-off (January 2019), median PFS [95% confidence interval (CI)] with avelumab plus axitinib versus sunitinib in these respective age groups was 11.6 (8.4-19.4) versus 6.9 (5.6-8.4) months [hazard ratio (HR), 0.63; 95% CI 0.501-0.786], 13.8 (11.1-18.0) versus 11.0 (7.8-16.6) months (HR, 0.88; 95% CI 0.627-1.231), and 13.8 [7.0-not estimable (NE)] versus 9.8 (4.3-NE) months (HR, 0.76; 95% CI 0.378-1.511). Median OS (95% CI) in the respective age groups was not reached (NR) (NE-NE) versus 28.6 (25.5-NE) months (HR, 0.74; 95% CI 0.541-1.022), 30.0 (30.0-NE) versus NR (NE-NE) months (HR, 0.89; 95% CI 0.546-1.467), and 25.3 (19.9-NE) versus NR (19.4-NE) months (HR, 0.87; 95% CI 0.359-2.106). ORR (95% CI) in the respective age groups was 49.4% (43.3% to 55.6%) versus 27.3% (22.1% to 32.9%), 60.9% (52.2% to 69.1%) versus 28.9% (21.2% to 37.6%), and 42.4% (25.5% to 60.8%) versus 22.0% (10.6% to 37.6%). In the avelumab plus axitinib arm, grade ≥3 adverse events (AEs) and immune-related AEs occurred in 76.9%/81.2%/72.7% and 45.5%/48.1%/36.4% in the respective age groups. Conclusions First-line avelumab plus axitinib demonstrated favorable efficacy across age groups, including patients aged ≥75 years. OS data were still immature; follow-up is ongoing. The safety profile was generally consistent across age groups. Elderly patients experience a decline in immune activity that might affect response to immunotherapy. We evaluated avelumab plus axitinib versus sunitinib by age group in patients with aRCC. Avelumab plus axitinib had favorable efficacy versus sunitinib across age groups, including patients aged ≥75 years. The safety profile was generally consistent among age groups treated with avelumab plus axitinib or sunitinib.
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Affiliation(s)
- Y Tomita
- Department of Urology, Niigata University Graduate School of Medicine, Niigata, Japan; Department of Molecular Oncology, Niigata University Graduate School of Medicine, Niigata, Japan.
| | - R J Motzer
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - T K Choueiri
- The Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - B I Rini
- Department of Hematology and Medical Oncology, Vanderbilt University, Nashville, USA
| | - H Miyake
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - H Uemura
- Department of Urology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - L Albiges
- Department of Cancer Medicine, Institut Gustave Roussy, Villejuif, France
| | - Y Fujii
- Pfizer R&D Japan, Tokyo, Japan
| | | | | | | | - M Schmidinger
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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21
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Rinaldi L, Pezzotta F, Santaniello T, De Marco P, Bianchini L, Origgi D, Cremonesi M, Milani P, Mariani M, Botta F. HeLLePhant: A phantom mimicking non-small cell lung cancer for texture analysis in CT images. Phys Med 2022; 97:13-24. [PMID: 35334407 DOI: 10.1016/j.ejmp.2022.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/19/2021] [Revised: 02/01/2022] [Accepted: 03/14/2022] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Phantoms mimicking human tissue heterogeneity and intensity are required to establish radiomic features robustness in Computed Tomography (CT) images. We developed inserts with two different techniques for the radiomic study of Non-Small Cell Lung Cancer (NSCLC) lesions. METHODS We developed two insert prototypes: two 3D-printed made of glycol-modified polyethylene terephthalate (PET-G), and nine with sodium polyacrylate plus iodinated contrast medium. The inserts were put in a handcraft phantom (HeLLePhant). We also analysed four materials of a commercial homogeneous phantom (Catphan® 424) and collected 29 NSCLC patients for comparison. All the CT acquisitions were performed with the same clinical protocol and scanner at 120kVp. The HeLLePhant phantom was scanned ten times in fixed condition at 120kVp and 100kVp for repeatability investigation. We extracted 153 radiomic features using Pyradiomics. To compare the features between phantoms and patients, we computed how many phantom features fell in the range between 10th and 90th percentile of the corresponding patient values. We deemed repeatable the features with a coefficient of variation (CV) less than or equal to 0.10. RESULTS The best similarity with the patients was obtained with the polyacrylate inserts (55.6-90.2%), the worst with Catphan (15.7-19.0%). For the PET-G inserts 35.3% and 36.6% of the features match the patient range. We found high repeatability for all the inserts of the HeLLePhant phantom (74.3-100% at 120kVp, 75.7-97.9% at 100kVp), and observed a texture dependency in repeatability. CONCLUSIONS Our study shows a promising way to construct heterogeneous inserts mimicking a target tissue for radiomic studies.
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Affiliation(s)
- Lisa Rinaldi
- Department of Physics, Università degli Studi di Pavia and INFN, via Bassi 6, 27100 Pavia, Italy; Radiation Research Unit, IEO, European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy.
| | - Federico Pezzotta
- CIMaINa, Department of Physics, Università degli Studi di Milano, via Celoria 16, 20133, Milan, Italy
| | - Tommaso Santaniello
- CIMaINa, Department of Physics, Università degli Studi di Milano, via Celoria 16, 20133, Milan, Italy
| | - Paolo De Marco
- Medical Physics Unit, IEO European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy
| | - Linda Bianchini
- Department of Physics, Università degli Studi di Milano, via Celoria 16, 20133, Milan, Italy
| | - Daniela Origgi
- Medical Physics Unit, IEO European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy
| | - Marta Cremonesi
- Radiation Research Unit, IEO, European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy
| | - Paolo Milani
- CIMaINa, Department of Physics, Università degli Studi di Milano, via Celoria 16, 20133, Milan, Italy
| | - Manuel Mariani
- Department of Physics, Università degli Studi di Pavia and INFN, via Bassi 6, 27100 Pavia, Italy
| | - Francesca Botta
- Medical Physics Unit, IEO European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy
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22
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Cabini RF, Brero F, Lancia A, Stelitano C, Oneta O, Ballante E, Puppo E, Mariani M, Alì E, Bartolomeo V, Montesano M, Merizzoli E, Aluia D, Agustoni F, Stella GM, Sun R, Bianchini L, Deutsch E, Figini S, Bortolotto C, Preda L, Lascialfari A, Filippi AR. Preliminary report on harmonization of features extraction process using the ComBat tool in the multi-center “Blue Sky Radiomics” study on stage III unresectable NSCLC. Insights Imaging 2022; 13:38. [PMID: 35254525 PMCID: PMC8901939 DOI: 10.1186/s13244-022-01171-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 01/28/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background and purpose
In the retrospective-prospective multi-center "Blue Sky Radiomics” study (NCT04364776), we plan to test a pre-defined radiomic signature in a series of stage III unresectable NSCLC patients undergoing chemoradiotherapy and maintenance immunotherapy. As a necessary preliminary step, we explore the influence of different image-acquisition parameters on radiomic features’ reproducibility and apply methods for harmonization.
Material and methods
We identified the primary lung tumor on two computed tomography (CT) series for each patient, acquired before and after chemoradiation with i.v. contrast medium and with different scanners. Tumor segmentation was performed by two oncological imaging specialists (thoracic radiologist and radio-oncologist) using the Oncentra Masterplan® software. We extracted 42 radiomic features from the specific ROIs (LIFEx). To assess the impact of different acquisition parameters on features extraction, we used the Combat tool with nonparametric adjustment and the longitudinal version (LongComBat).
Results
We defined 14 CT acquisition protocols for the harmonization process. Before harmonization, 76% of the features were significantly influenced by these protocols. After, all extracted features resulted in being independent of the acquisition parameters. In contrast, 5% of the LongComBat harmonized features still depended on acquisition protocols.
Conclusions
We reduced the impact of different CT acquisition protocols on radiomic features extraction in a group of patients enrolled in a radiomic study on stage III NSCLC. The harmonization process appears essential for the quality of radiomic data and for their reproducibility.
ClinicalTrials.gov Identifier: NCT04364776, First Posted:April 28, 2020, Actual Study Start Date: April 15, 2020, https://clinicaltrials.gov/ct2/show/NCT04364776.
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Cicolari D, Lizio D, Pedrotti P, Moioli MT, Lascialfari A, Mariani M, Torresin A. A method for T 1 and T 2 relaxation times validation and harmonization as a support to MRI mapping. J Magn Reson 2022; 334:107110. [PMID: 34844075 DOI: 10.1016/j.jmr.2021.107110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/09/2021] [Accepted: 11/17/2021] [Indexed: 06/13/2023]
Abstract
We present a proof-of-concept study focusing on a method for the intra- and inter-center validation and harmonization of data obtained from MRI T1 and T2 maps. The method is based on a set of MnCl2 samples that provide in-scan ground-truth reference values regardless of the details of the MRI protocol. The relaxation times of MnCl2 aqueous solutions were first measured by means of an NMR laboratory relaxometer, as a function of concentration and temperature. The obtained T1 and T2 values, once renormalized at the scanner temperature, were used as reference values for the MRI mapping measurements of the MnCl2 relaxation times. By using different clinical MRI scanners and sequences, we found a good agreement for standard and turbo sequences (limits of agreement: 5% for IR, SE, IR-TSE; 10% for TSE), while an under-estimation and an over-estimation were found respectively for MOLLI and T2-prep TrueFISP, as already reported in the literature. The linearity of the relaxation rates with the concentration predicted by the Solomon-Bloembergen-Morgan theory was observed for every dataset at all temperatures, except for T2-prep TrueFISP maps results. Some preliminary results of an in vivo experiment are also presented.
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Affiliation(s)
- Davide Cicolari
- University of Pavia, Department of Physics, and INFN-Pavia Unit, Via Bassi 6, 27100 Pavia, Italy.
| | - Domenico Lizio
- ASST Grande Ospedale Metropolitano Niguarda, Department of Medical Physics, P.zza Ospedale Maggiore 3, 20162 Milan, Italy.
| | - Patrizia Pedrotti
- ASST Grande Ospedale Metropolitano Niguarda, Department of Cardiology, P.zza Ospedale Maggiore 3, 20162 Milan, Italy.
| | - Monica Teresa Moioli
- ASST Grande Ospedale Metropolitano Niguarda, Department of Medical Physics, P.zza Ospedale Maggiore 3, 20162 Milan, Italy.
| | - Alessandro Lascialfari
- University of Pavia, Department of Physics, and INFN-Pavia Unit, Via Bassi 6, 27100 Pavia, Italy.
| | - Manuel Mariani
- University of Pavia, Department of Physics, and INFN-Pavia Unit, Via Bassi 6, 27100 Pavia, Italy.
| | - Alberto Torresin
- ASST Grande Ospedale Metropolitano Niguarda, Department of Medical Physics, P.zza Ospedale Maggiore 3, 20162 Milan, Italy; University of Milan, Department of Physics, Via Celoria 16, 20133 Milan, Italy.
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24
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Cicolari D, Santanni F, Grassi L, Brero F, Filibian M, Recca T, Arosio P, Perfetti M, Mariani M, Sessoli R, Lascialfari A. Longitudinal and transverse NMR relaxivities of Ln(III)-DOTA complexes: A comprehensive investigation. J Chem Phys 2021; 155:214201. [PMID: 34879662 DOI: 10.1063/5.0072185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Longitudinal and transverse 1H nuclear magnetic resonance relaxivities of Ln(III)-DOTA complexes (with Ln = Gd, Tb, Dy, Er; DOTA = 1,4,7,10-tetraazacyclododecane-N,N',N″,N‴-tetraacetic acid) and Mn(II) aqueous solutions were measured in a wide range of frequencies, 10 kHz to 700 MHz. The experimental data were interpreted by means of models derived from the Solomon-Bloembergen-Morgan theory. The data analysis was performed assuming the orbital angular momentum L = 0 for Gd-DOTA and the aqua ion [Mn(H2O)6]2+ and L ≠ 0 for Dy-, Tb-, and Er-DOTA. A refined estimation of the zero-field-splitting barrier Δ and of the modulation correlation time τv was obtained for [Mn(H2O)6]2+ by extending the fitting of nuclear magnetic relaxation dispersion profiles to the low-field regime. The Gd-DOTA fitting parameters resulted in good agreement with the literature, and the fit of transverse relaxivity data confirmed the negligibility of the scalar interaction in the nuclear relaxation mechanism. Larger transverse relaxivities of Dy-DOTA and Tb-DOTA (∼10 mM-1 s-1) with respect to Er-DOTA (∼1 mM-1 s-1) were observed at 16 T. Such higher values are suggested to be due to a shorter residence time τm that is possibly linked to the fluctuations of the hyperfine interaction and the different shape of the magnetic anisotropy. The possible employment of Dy-DOTA, Tb-DOTA, and Er-DOTA as negative magnetic resonance imaging contrast agents for high-field applications was envisaged by collecting spin-echo images at 7 T. Particularly in Dy- and Tb-derivatives, the transverse relaxivity at 16 T is of the order of the Gd-one at 1.5 T.
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Affiliation(s)
- Davide Cicolari
- Department of Physics, University of Pavia, Via Bassi 6, Pavia (PV) 27100, Italy
| | - Fabio Santanni
- Department of Chemistry, University of Florence, Sesto Fiorentino (FI) 50019, Italy
| | - Leonardo Grassi
- Department of Chemistry, University of Florence, Sesto Fiorentino (FI) 50019, Italy
| | - Francesca Brero
- Department of Physics, University of Pavia, Via Bassi 6, Pavia (PV) 27100, Italy
| | - Marta Filibian
- INFN, Istituto Nazionale di Fisica Nucleare-Pavia Unit, Via Bassi 6, Pavia (PV) 27100, Italy
| | - Teresa Recca
- Centro Grandi Strumenti, University of Pavia, Via Bassi 21, Pavia (PV) 27100, Italy
| | - Paolo Arosio
- Department of Physics, University of Milan, Via Celoria 16, Milan (MI) 20133, Italy
| | - Mauro Perfetti
- Department of Chemistry, University of Florence, Sesto Fiorentino (FI) 50019, Italy
| | - Manuel Mariani
- Department of Physics, University of Pavia, Via Bassi 6, Pavia (PV) 27100, Italy
| | - Roberta Sessoli
- Department of Chemistry, University of Florence, Sesto Fiorentino (FI) 50019, Italy
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Trombetta L, Magugliani G, Marranconi M, Caprioli M, Gambirasio A, Locatelli F, Macerata E, Mossini E, Salmoiraghi P, Vavassori V, Mariani M, Bombardieri E. Polymer gel dosimeters for absolute high resolution pre-treatment dosimetric QA in RT. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00178-8] [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: 11/29/2022] Open
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26
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Rinaldi L, De Angelis S, Raimondi S, Origgi D, Rizzo S, Fanciullo C, Rampinelli C, Mariani M, Lascialfari A, Bellomi M, Cremonesi M, Botta F. Reproducibility of radiomic features in CT images of NSCLC patients. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00243-5] [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: 11/26/2022] Open
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27
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Cicolari D, Yushchenko M, Fiorito M, Ayde R, Mariani M, Salameh N, Sarracanie M. Effect of dictionary optimization on relaxation time maps in low field MR fingerprinting applications. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00034-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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28
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de Waure C, Calabrò GE, Tognetto A, Carini E, Giacchetta I, Bonanno E, Mariani M, Ricciardi W, de Waure C. Evidence and recommendations for a value-based decision making on vaccinations. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Issue/problem
Vaccinations are one of the most successful public health measures and contribute to the achievement of Sustainable Development Goals. Despite this, there are still several challenges, such as poor resources, unequal access, and vaccine hesitancy. An exploitation of the full value of vaccinations could help contrasting them.
Description of the problem
A dual approach was followed to exploit full value of vaccinations. First, the four pillars of value pinpointed by the Expert Panel on Effective Ways of Investing in Health of the European Commission, namely personal, societal, allocative, and technical value, were considered to carry out a systematic review of available papers addressing the value of vaccinations. The synthesis of data was the submitted to a panel of international experts in vaccinations who gave inputs on recommendations to drive a value-based decision-making.
Results
Overall, 54 papers published from 2010 onwards addressed at least one pillar of value with most of them (83.3%) assessing a single one. Two-thirds of papers addressed the technical pillar, namely the economic value, in most cases without catching the broad economic implications. Very few studies addressed allocative and societal value highlighting the need to generate evidence to support the application of these pillars. Furthermore, some aspects of the allocative pillar, such as equity, accessibility, and appropriate use, were not addressed so far. Recommendations on research on full value of vaccinations, decision-making process and public engagement were eventually issued.
Lessons
The project allowed to apply for the first the value-based approach to vaccinations. This led to the identification of current gaps in the assessment of full value of vaccinations and to recommendations to foster a value-based decision-making. These results have international relevance because of the growing attention to the value-based approach for sustainable health systems.
Key messages
The full value of vaccinations need to be further investigated according to the four pillars pinpointed by the Expert Panel on Effective Ways of Investing in Health. Different actions could be promoted with respect to research, decision-making process and public engagement in order to exploit the full value of vaccination and drive a value-based decision-making.
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Affiliation(s)
- C de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - GE Calabrò
- Section of Hygiene, University Department of Life Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
- VIHTALI, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Tognetto
- Section of Hygiene, University Department of Life Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - E Carini
- Section of Hygiene, University Department of Life Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - I Giacchetta
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - E Bonanno
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - M Mariani
- Section of Hygiene, University Department of Life Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - W Ricciardi
- Section of Hygiene, University Department of Life Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Choueiri TK, Larkin J, Pal S, Motzer RJ, Rini BI, Venugopal B, Alekseev B, Miyake H, Gravis G, Bilen MA, Hariharan S, Chudnovsky A, Ching KA, Mu XJ, Mariani M, Robbins PB, Huang B, di Pietro A, Albiges L. Erratum to 'Efficacy and correlative analyses of avelumab plus axitinib versus sunitinib in sarcomatoid renal cell carcinoma: post hoc analysis of a randomized clinical trial': [ESMO Open Volume 6, Issue 3, June 2021, 100101]. ESMO Open 2021; 6:100177. [PMID: 34474809 PMCID: PMC8411062 DOI: 10.1016/j.esmoop.2021.100177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- T K Choueiri
- Department of Medical Oncology, The Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, USA.
| | - J Larkin
- Renal and Skin Units, The Royal Marsden NHS Foundation Trust, Chelsea, London, UK
| | - S Pal
- Department of Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, USA
| | - R J Motzer
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - B I Rini
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, USA
| | - B Venugopal
- Institute of Cancer Sciences, University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, Scotland, UK
| | - B Alekseev
- P. Hertsen Moscow Oncology Research Institute, Moscow, Russia
| | - H Miyake
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - G Gravis
- Department of Medical Oncology, Institut Paoli-Calmettes, Aix-Marseille Université, Inserm, CNRS, CRCM, Marseille, France
| | - M A Bilen
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, USA
| | | | | | - K A Ching
- Computational Biology, Pfizer, San Diego, USA
| | - X J Mu
- Computational Biology, Pfizer, San Diego, USA
| | - M Mariani
- Immuno-Oncology, Pfizer, Milan, Lombardia, Italy
| | - P B Robbins
- Translational Oncology, Pfizer, San Diego, USA
| | - B Huang
- Biostatistics, Pfizer, Groton, USA
| | - A di Pietro
- Immuno-Oncology, Pfizer, Milan, Lombardia, Italy
| | - L Albiges
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
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Grimm MO, Oya M, Choueiri T, Schmidinger M, Quinn D, Gravis Mescam G, Verzoni E, Van den Eertwegh A, di Pietro A, Mariani M, Wang J, Thomaidou D, Albiges L. 665P Role of prior nephrectomy for synchronous metastatic renal cell carcinoma (mRCC) on efficacy in patients treated with avelumab + axitinib (A + Ax) or sunitinib (S): Results from JAVELIN Renal 101. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.061] [Citation(s) in RCA: 1] [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: 11/29/2022] Open
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Choueiri TK, Larkin J, Pal S, Motzer RJ, Rini BI, Venugopal B, Alekseev B, Miyake H, Gravis G, Bilen MA, Hariharan S, Chudnovsky A, Ching KA, Mu XJ, Mariani M, Robbins PB, Huang B, di Pietro A, Albiges L. Efficacy and correlative analyses of avelumab plus axitinib versus sunitinib in sarcomatoid renal cell carcinoma: post hoc analysis of a randomized clinical trial. ESMO Open 2021; 6:100101. [PMID: 33901870 PMCID: PMC8099757 DOI: 10.1016/j.esmoop.2021.100101] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Among patients with advanced renal cell carcinoma (RCC), those with sarcomatoid histology (sRCC) have the poorest prognosis. This analysis assessed the efficacy of avelumab plus axitinib versus sunitinib in patients with treatment-naive advanced sRCC. METHODS The randomized, open-label, multicenter, phase III JAVELIN Renal 101 trial (NCT02684006) enrolled patients with treatment-naive advanced RCC. Patients were randomized 1 : 1 to receive either avelumab plus axitinib or sunitinib following standard doses and schedules. Assessments in this post hoc analysis of patients with sRCC included efficacy (including progression-free survival) and biomarker analyses. RESULTS A total of 108 patients had sarcomatoid histology and were included in this post hoc analysis; 47 patients in the avelumab plus axitinib arm and 61 in the sunitinib arm. Patients in the avelumab plus axitinib arm had improved progression-free survival [stratified hazard ratio, 0.57 (95% confidence interval, 0.325-1.003)] and a higher objective response rate (46.8% versus 21.3%; complete response in 4.3% versus 0%) versus those in the sunitinib arm. Correlative gene expression analyses of patients with sRCC showed enrichment of gene pathway scores for cancer-associated fibroblasts and regulatory T cells, CD274 and CD8A expression, and tumors with The Cancer Genome Atlas m3 classification. CONCLUSIONS In this subgroup analysis of JAVELIN Renal 101, patients with sRCC in the avelumab plus axitinib arm had improved efficacy outcomes versus those in the sunitinib arm. Correlative analyses provide insight into this subtype of RCC and suggest that avelumab plus axitinib may increase the chance of overcoming the aggressive features of sRCC.
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Affiliation(s)
- T K Choueiri
- Department of Medical Oncology, The Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, USA.
| | - J Larkin
- Renal and Skin Units, The Royal Marsden NHS Foundation Trust, Chelsea, London, UK
| | - S Pal
- Department of Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, USA
| | - R J Motzer
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - B I Rini
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, USA
| | - B Venugopal
- Institute of Cancer Sciences, University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, Scotland, UK
| | - B Alekseev
- P. Hertsen Moscow Oncology Research Institute, Moscow, Russia
| | - H Miyake
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - G Gravis
- Department of Medical Oncology, Institut Paoli-Calmettes, Aix-Marseille Université, Inserm, CNRS, CRCM, Marseille, France
| | - M A Bilen
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, USA
| | | | | | - K A Ching
- Computational Biology, Pfizer, San Diego, USA
| | - X J Mu
- Computational Biology, Pfizer, San Diego, USA
| | - M Mariani
- Immuno-Oncology, Pfizer, Milan, Lombardia, Italy
| | - P B Robbins
- Translational Oncology, Pfizer, San Diego, USA
| | - B Huang
- Biostatistics, Pfizer, Groton, USA
| | - A di Pietro
- Immuno-Oncology, Pfizer, Milan, Lombardia, Italy
| | - L Albiges
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
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Monosilio S, Filomena D, Cimino S, Neccia M, Luongo F, Mariani M, Birtolo LI, Benedetti G, Fedele F, Maestrini V, Agati L. Improvement of left ventricular systolic performance during sacubitril/valsartan in a cohort of patients with heart failure and reduced ejection fraction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Sacubitril/valsartan is a well-established therapeutic option for patients with heart failure with reduced ejection fraction (HFrEF). While it was clearly demonstrated to improve patients’ clinical conditions, its potential role in inducing left ventricle (LV) reverse remodeling is still under investigation.
Purpose
to evaluate clinical and echocardiographic effect of sacubitril/valsartan on a cohort of patients with HFrEF after six months of therapy.
Methods
36 patients with HFrEF eligible to start a therapy with sacubitril/valsartan were enrolled. A standard and advanced echocardiographic evaluation was performed before starting the therapy and after six months of follow up (FU). Off-line analysis of left ventricle global longitudinal strain (GLS), longitudinal strain of the free wall of the right ventricle (RVFWSL) and left atrial strain (LAS) was conducted. Clinical and biochemical parameters were evaluated as well.
Results
At six months of FU NYHA class improved in the vast majority of patients (NYHA class III at baseline vs FU: 56% vs 5%, p 0.001). We observed a significant reduction in LV end-diastolic (99.62 ± 33.24 vs 91.54 ± 33.36, p 0.043) and end-systolic (69.99 ± 26.01 vs 58.68 ± 25.7, p 0.001) volumes and an improvement of LV ejection fraction (30.4 ± 5.02 vs 37.3 ± 6.4, p < 0.001). After six months of therapy, GLS significantly improved (-9.71 ± 2.87 vs -13.04 ± 3.14, p < 0.001). No differences in left and right atrial volumes (respectively 56.6 ± 29 vs 54 ± 30, p 0.349; 54.7 ± 23.7 vs 48.3 ± 19, p 0.157), RVFWSL (-16,5 ± 5,4 vs -16,8 ± 1,5) and LAS (14 ± 6 vs 19 ± 8, p 0.197) were found at FU.
Conclusion
Left ventricular function evaluated with standard and advanced echocardiographic parameters improved after six months of therapy with sacubitril/valsartan in HFrEF patients. Reduction in LV volumes was found as well.
Echo Analysis Baseline Echo Analysis (n= 36) 6 Months FU Echo Analysis (n= 36) p LVEDVi, mL/m2 99, 62 ± 33,24 91,54 ± 33,36 0,043 LVESVi, mL/m2 69,99 ± 26,01 58,68 ± 25,7 0,001 LVEF, % 30,4 ± 5, 02 37,3 ± 6,4 < 0,001 E/E’ average 12,16 ± 3,74 9,71 ± 1,33 0,023 LS Endo Average ,% -9,71 ± 2,87 -13,04 ± 3,14 < 0,001 LVEF left ventricular ejection fraction, LVEDVi: left ventricular end diastolic volume indexed, LVESVi: left ventricular end systolic volume indexed; LS: longitudinal strain
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Affiliation(s)
| | - D Filomena
- Sapienza University of Rome, Rome, Italy
| | - S Cimino
- Sapienza University of Rome, Rome, Italy
| | - M Neccia
- Sapienza University of Rome, Rome, Italy
| | - F Luongo
- Sapienza University of Rome, Rome, Italy
| | - M Mariani
- Sapienza University of Rome, Rome, Italy
| | - LI Birtolo
- Sapienza University of Rome, Rome, Italy
| | | | - F Fedele
- Sapienza University of Rome, Rome, Italy
| | | | - L Agati
- Sapienza University of Rome, Rome, Italy
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Beck KK, Mariani M, Fletcher MS, Schneider L, Aquino-López MA, Gadd PS, Heijnis H, Saunders KM, Zawadzki A. The impacts of intensive mining on terrestrial and aquatic ecosystems: A case of sediment pollution and calcium decline in cool temperate Tasmania, Australia. Environ Pollut 2020; 265:114695. [PMID: 32806416 DOI: 10.1016/j.envpol.2020.114695] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/24/2020] [Accepted: 04/28/2020] [Indexed: 06/11/2023]
Abstract
Mining causes extensive damage to aquatic ecosystems via acidification, heavy metal pollution, sediment loading, and Ca decline. Yet little is known about the effects of mining on freshwater systems in the Southern Hemisphere. A case in point is the region of western Tasmania, Australia, an area extensively mined in the 19th century, resulting in severe environmental contamination. In order to assess the impacts of mining on aquatic ecosystems in this region, we present a multiproxy investigation of the lacustrine sediments from Owen Tarn, Tasmania. This study includes a combination of radiometric dating (14C and 210Pb), sediment geochemistry (XRF and ICP-MS), pollen, charcoal and diatoms. Generalised additive mixed models were used to test if changes in the aquatic ecosystem can be explained by other covariates. Results from this record found four key impact phases: (1) Pre-mining, (2) Early mining, (3) Intense mining, and (4) Post-mining. Before mining, low heavy metal concentrations, slow sedimentation, low fire activity, and high biomass indicate pre-impact conditions. The aquatic environment at this time was oligotrophic and dystrophic with sufficient light availability, typical of western Tasmanian lakes during the Holocene. Prosperous mining resulted in increased burning, a decrease in landscape biomass and an increase in sedimentation resulting in decreased light availability of the aquatic environment. Extensive mining at Mount Lyell in the 1930s resulted in peak heavy metal pollutants (Pb, Cu and Co) and a further increase in inorganic inputs resulted in a disturbed low light lake environment (dominated by Hantzschia amphioxys and Pinnularia divergentissima). Following the closure of the Mount Lyell Co. in 1994 CE, Ca declined to below pre-mining levels resulting in a new diatom assemblage and deformed diatom valves. Therefore, the Owen Tarn record demonstrates severe sediment pollution and continued impacts of mining long after mining has stopped at Mt. Lyell Mining Co.
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Affiliation(s)
- K K Beck
- Lincoln Centre for Water and Planetary Health, School of Geography, University of Lincoln, Lincoln, UK; School of Geography, University of Melbourne, Melbourne, Australia.
| | - M Mariani
- School of Geography, University of Melbourne, Melbourne, Australia; School of Geography, University of Nottingham, Nottingham, UK; ANU College of Asia and the Pacific, Australian National University, Canberra, Australia
| | - M-S Fletcher
- School of Geography, University of Melbourne, Melbourne, Australia
| | - L Schneider
- ANU College of Asia and the Pacific, Australian National University, Canberra, Australia
| | - M A Aquino-López
- Maynooth University, Arts and Humanities Institute, Maynooth, Co. Kildare, Ireland
| | - P S Gadd
- Australian Nuclear Science and Technology Organisation, Lucas Heights, Australia
| | - H Heijnis
- Australian Nuclear Science and Technology Organisation, Lucas Heights, Australia
| | - K M Saunders
- Australian Nuclear Science and Technology Organisation, Lucas Heights, Australia
| | - A Zawadzki
- Australian Nuclear Science and Technology Organisation, Lucas Heights, Australia
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Brero F, Albino M, Antoccia A, Arosio P, Avolio M, Berardinelli F, Bettega D, Calzolari P, Ciocca M, Corti M, Facoetti A, Gallo S, Groppi F, Guerrini A, Innocenti C, Lenardi C, Locarno S, Manenti S, Marchesini R, Mariani M, Orsini F, Pignoli E, Sangregorio C, Veronese I, Lascialfari A. Hadron Therapy, Magnetic Nanoparticles and Hyperthermia: A Promising Combined Tool for Pancreatic Cancer Treatment. Nanomaterials (Basel) 2020; 10:nano10101919. [PMID: 32993001 PMCID: PMC7600442 DOI: 10.3390/nano10101919] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 12/24/2022]
Abstract
A combination of carbon ions/photons irradiation and hyperthermia as a novel therapeutic approach for the in-vitro treatment of pancreatic cancer BxPC3 cells is presented. The radiation doses used are 0–2 Gy for carbon ions and 0–7 Gy for 6 MV photons. Hyperthermia is realized via a standard heating bath, assisted by magnetic fluid hyperthermia (MFH) that utilizes magnetic nanoparticles (MNPs) exposed to an alternating magnetic field of amplitude 19.5 mTesla and frequency 109.8 kHz. Starting from 37 °C, the temperature is gradually increased and the sample is kept at 42 °C for 30 min. For MFH, MNPs with a mean diameter of 19 nm and specific absorption rate of 110 ± 30 W/gFe3o4 coated with a biocompatible ligand to ensure stability in physiological media are used. Irradiation diminishes the clonogenic survival at an extent that depends on the radiation type, and its decrease is amplified both by the MNPs cellular uptake and the hyperthermia protocol. Significant increases in DNA double-strand breaks at 6 h are observed in samples exposed to MNP uptake, treated with 0.75 Gy carbon-ion irradiation and hyperthermia. The proposed experimental protocol, based on the combination of hadron irradiation and hyperthermia, represents a first step towards an innovative clinical option for pancreatic cancer.
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Affiliation(s)
- Francesca Brero
- Dipartimento di Fisica and INFN, Università degli Studi di Pavia, 27100 Pavia, Italy; (M.A.); (M.C.); (M.M.)
- Correspondence: (F.B.); (A.L.); Tel.: +39-0382-987-483 (F.B. & A.L.)
| | - Martin Albino
- Dipartimento di Chimica, Università di Firenze and INSTM, 50019 Sesto Fiorentino (FI), Italy; (M.A.); (A.G.); (C.I.); (C.S.)
| | - Antonio Antoccia
- Dipartimento di Scienze and INFN, Università Roma Tre, 00146 Roma, Italy; (A.A.); (F.B.)
| | - Paolo Arosio
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Matteo Avolio
- Dipartimento di Fisica and INFN, Università degli Studi di Pavia, 27100 Pavia, Italy; (M.A.); (M.C.); (M.M.)
| | - Francesco Berardinelli
- Dipartimento di Scienze and INFN, Università Roma Tre, 00146 Roma, Italy; (A.A.); (F.B.)
| | - Daniela Bettega
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Paola Calzolari
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Mario Ciocca
- Fondazione CNAO, 27100 Pavia, Italy; (M.C.); (A.F.)
| | - Maurizio Corti
- Dipartimento di Fisica and INFN, Università degli Studi di Pavia, 27100 Pavia, Italy; (M.A.); (M.C.); (M.M.)
| | | | - Salvatore Gallo
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Flavia Groppi
- Dipartimento di Fisica, Università degli Studi di Milano and INFN, Lab. LASA, 20090 Segrate (MI), Italy; (F.G.); (S.M.)
| | - Andrea Guerrini
- Dipartimento di Chimica, Università di Firenze and INSTM, 50019 Sesto Fiorentino (FI), Italy; (M.A.); (A.G.); (C.I.); (C.S.)
| | - Claudia Innocenti
- Dipartimento di Chimica, Università di Firenze and INSTM, 50019 Sesto Fiorentino (FI), Italy; (M.A.); (A.G.); (C.I.); (C.S.)
- ICCOM-CNR, 50019 Sesto Fiorentino (FI), Italy
| | - Cristina Lenardi
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
- C.I.Ma.I.Na., Centro Interdisciplinare Materiali e Interfacce Nanostrutturati, 20133 Milano, Italy
| | - Silvia Locarno
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Simone Manenti
- Dipartimento di Fisica, Università degli Studi di Milano and INFN, Lab. LASA, 20090 Segrate (MI), Italy; (F.G.); (S.M.)
| | - Renato Marchesini
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Manuel Mariani
- Dipartimento di Fisica and INFN, Università degli Studi di Pavia, 27100 Pavia, Italy; (M.A.); (M.C.); (M.M.)
| | - Francesco Orsini
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Emanuele Pignoli
- Fondazione IRCSS Istituto Nazionale dei tumori, 20133 Milano, Italy;
| | - Claudio Sangregorio
- Dipartimento di Chimica, Università di Firenze and INSTM, 50019 Sesto Fiorentino (FI), Italy; (M.A.); (A.G.); (C.I.); (C.S.)
- ICCOM-CNR, 50019 Sesto Fiorentino (FI), Italy
- INFN, Sezione di Firenze, 50019 Sesto Fiorentino (FI), Italy
| | - Ivan Veronese
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Alessandro Lascialfari
- Dipartimento di Fisica and INFN, Università degli Studi di Pavia, 27100 Pavia, Italy; (M.A.); (M.C.); (M.M.)
- Correspondence: (F.B.); (A.L.); Tel.: +39-0382-987-483 (F.B. & A.L.)
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Mariani M, Castagna C, Pastorino R, Boccia S. The prognostic role of micro-RNAs in Head and Neck Cancers: an umbrella review. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Head and neck cancer (HNC) represents the sixth most common cancer and the seventh cause of cancer-related deaths worldwide. Because of HNC high mortality and morbidity a support from the development of new biomarkers and personalized care for patients is needed. The role of micro-RNAs (miRs), as new epigenetic biomarkers, aimed at improving early diagnosis, predicting prognosis and establishing effective cancer therapies, has recently received considerable attention. The aim of this study was to conduct an umbrella review that synthetizes all the findings of systematic reviews already available in literature that investigate the prognostic role of miRs as potential biomarkers in the field of tertiary prevention of HNC.
We selected systematic reviews, published in English until December 2019, related to human HNC with meta-analysis of observational studies that reported quantitative prognostic measures, Hazard Ratios (HRs), of Overall Survival (OS) or Disease-Free Survival (DFS). The methodological quality of the included reviews was assessed using the Assessment of Multiple Systematic Reviews AMSTAR 2 tool.
Six systematic reviews were included in the umbrella review. The most reported miRNAs were: miR21; the Let7 family (c,d,g), miR17, 18 family, 20a, 29 family, 125b, 375. A total of 4 reviews assessed miR-21 expression in HNC patients, all showing its upregulation.
The most frequently studied miR was miR21 which was reported either in the OS and DFS statistical analyses. The OS analysis showed a significant lower prognosis when miR21 was upregulated.
It is involved in oncogenic and oncosuppressive cell signals pathways: the overexpression of miR21 was shown to be associated with cell proliferation, migration, invasion and survival. Recently the cumulative effects of sets of miRs has been increasingly studied and they might be stronger predictor of survival than single. The role of miRNAs as a prognostic biomarker specifically in HNC still need to be investigated.
Key messages
Some miRs were demonstrated to have as tumor-suppressing and oncogenic roles according to their level of regulation (up/down-regulation) in Head and Neck cancer patients. The role of miRs as prognostic biomarkers in HNC patients still need to be addressed by performing large scale to verify and enhance the power of evidence and clinical utility of these.
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Affiliation(s)
- M Mariani
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C Castagna
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Pastorino
- Department of Woman and Child and Public Health Area, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - S Boccia
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child and Public Health Area, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
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Cavalli N, Boccia S, Giraldi L, Mariani M, Ricciardi W, Nicodemo C. The long-term effects of mandatory military on health outcomes. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
In the past many young men spent a period of time in military service. To enter in the military service the person should pass a health visit where the physical and mental health conditions were verified. We focus our analysis on the Italian military service that was stopped to be mandatory in 2004, to explore if health visits during the military service have effects in preventing future illnesses. To do that we compare health outcomes of the cohort of Italian people born in 1985 and in 1987, i.e. before and after the suppression of the mandatory military service, respectively.
Methods
Data on demographic characteristics of men potentially enrolling the last compulsory military visit and the one after the abrogation were obtained from the Italian National Statistics Institute. For health outcomes, we obtained for the same population the health records of hospital admissions from 2007 to 2017. A difference-in-difference analysis was performed to calculate whether the probability of being differed among the two cohorts of people.
Results
A total of 215,081 males born in 1985 and 210,616 males born in 1987 were admitted to hospital in the period 2007-2017. A decreasing trend from 2007 to 2017 in overall hospitalization rates were observed for both cohorts of 1987 (1.26 to 1.15) and 1985 (1.22 to 1.13). The regression model showed a significant lower probability for the 1985 cohort, respect to the 1987, of being admitted for an infectious or parasite disease (coefficient -0.83; 95% CI: -1.15 - -0.51) and for tumours (coefficient = -0.83, 95% CI:-1.57 - -0.09)
Conclusions
To our knowledge, this is the first study that attempted to quantify the potential preventive impact in the male population of the physical examination during the mandatory military visit. With an age difference of 2 years between the 2 cohorts, the results show a significant reduction in terms of hospital admission for certain types of health conditions
Key messages
The mandatory military service was helpful in detecting certain diseases whose diagnosis would otherwise be delayed or undetected. Physical and mental examinations for mandatory military service, could see how a potential screening programme of prevention among young men.
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Affiliation(s)
- N Cavalli
- University of Oxford, Nuffield College and Department of Sociology, Oxford, UK
| | - S Boccia
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Department of Woman and Child Health and Public Health - Public Health Area, Rome, Italy
| | - L Giraldi
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Rome, Italy
| | - M Mariani
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Rome, Italy
| | - W Ricciardi
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Department of Woman and Child Health and Public Health - Public Health Area, Rome, Italy
| | - C Nicodemo
- Oxford University, CHSEO, Nuffield Department of Primary Care, Oxford, UK
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Choueiri TK, Motzer RJ, Rini BI, Haanen J, Campbell MT, Venugopal B, Kollmannsberger C, Gravis-Mescam G, Uemura M, Lee JL, Grimm MO, Gurney H, Schmidinger M, Larkin J, Atkins MB, Pal SK, Wang J, Mariani M, Krishnaswami S, Cislo P, Chudnovsky A, Fowst C, Huang B, di Pietro A, Albiges L. Updated efficacy results from the JAVELIN Renal 101 trial: first-line avelumab plus axitinib versus sunitinib in patients with advanced renal cell carcinoma. Ann Oncol 2020; 31:1030-1039. [PMID: 32339648 PMCID: PMC8436592 DOI: 10.1016/j.annonc.2020.04.010] [Citation(s) in RCA: 266] [Impact Index Per Article: 66.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/25/2020] [Accepted: 04/13/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The phase 3 JAVELIN Renal 101 trial (NCT02684006) demonstrated significantly improved progression-free survival (PFS) with first-line avelumab plus axitinib versus sunitinib in advanced renal cell carcinoma (aRCC). We report updated efficacy data from the second interim analysis. PATIENTS AND METHODS Treatment-naive patients with aRCC were randomized (1 : 1) to receive avelumab (10 mg/kg) intravenously every 2 weeks plus axitinib (5 mg) orally twice daily or sunitinib (50 mg) orally once daily for 4 weeks (6-week cycle). The two independent primary end points were PFS and overall survival (OS) among patients with programmed death ligand 1-positive (PD-L1+) tumors. Key secondary end points were OS and PFS in the overall population. RESULTS Of 886 patients, 442 were randomized to the avelumab plus axitinib arm and 444 to the sunitinib arm; 270 and 290 had PD-L1+ tumors, respectively. After a minimum follow-up of 13 months (data cut-off 28 January 2019), PFS was significantly longer in the avelumab plus axitinib arm than in the sunitinib arm {PD-L1+ population: hazard ratio (HR) 0.62 [95% confidence interval (CI) 0.490-0.777]}; one-sided P < 0.0001; median 13.8 (95% CI 10.1-20.7) versus 7.0 months (95% CI 5.7-9.6); overall population: HR 0.69 (95% CI 0.574-0.825); one-sided P < 0.0001; median 13.3 (95% CI 11.1-15.3) versus 8.0 months (95% CI 6.7-9.8)]. OS data were immature [PD-L1+ population: HR 0.828 (95% CI 0.596-1.151); one-sided P = 0.1301; overall population: HR 0.796 (95% CI 0.616-1.027); one-sided P = 0.0392]. CONCLUSION Among patients with previously untreated aRCC, treatment with avelumab plus axitinib continued to result in a statistically significant improvement in PFS versus sunitinib; OS data were still immature. CLINICAL TRIAL NUMBER NCT02684006.
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Affiliation(s)
- T K Choueiri
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, USA.
| | - R J Motzer
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - B I Rini
- Cleveland Clinic, Cleveland, USA
| | - J Haanen
- Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M T Campbell
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - B Venugopal
- University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | | | - G Gravis-Mescam
- Institut Paoli-Calmettes, Department of Medical Oncology, Aix-Marseille Université, Inserm, CNRS, CRCM, Marseille, France
| | - M Uemura
- Osaka University Hospital, Osaka, Japan
| | - J L Lee
- University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - M-O Grimm
- Jena University Hospital, Department of Urology, Jena, Germany
| | - H Gurney
- Macquarie University, Sydney, Australia
| | - M Schmidinger
- Clinical Division of Oncology, Department of Medicine I Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - J Larkin
- Royal Marsden NHS Foundation Trust, London, UK
| | - M B Atkins
- Georgetown University Medical Center, Washington, DC
| | - S K Pal
- City of Hope National Medical Center, Duarte, USA
| | | | | | | | | | | | - C Fowst
- Pfizer Italia SRL, Milan, Italy
| | | | | | - L Albiges
- Institut Gustave Roussy, Villejuif, France
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Venema C, Erasmus M, Mariani M, Voors A, Damman K. Inotrope Score as a Predictor of Outcome after Adult Heart Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.622] [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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Bianchini L, Botta F, Origgi D, Rizzo S, Mariani M, Summers P, García-Polo P, Cremonesi M, Lascialfari A. PETER PHAN: An MRI phantom for the optimisation of radiomic studies of the female pelvis. Phys Med 2020; 71:71-81. [PMID: 32092688 DOI: 10.1016/j.ejmp.2020.02.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/29/2020] [Accepted: 02/04/2020] [Indexed: 01/26/2023] Open
Abstract
PURPOSE To develop a phantom for methodological radiomic investigation on Magnetic Resonance (MR) images of female patients affected by pelvic cancer. METHODS A pelvis-shaped container was filled with a MnCl2 solution reproducing the relaxation times (T1, T2) of muscle surrounding pelvic malignancies. Inserts simulating multi-textured lesions were embedded in the phantom. The relaxation times of muscle and tumour were measured on an MR scanner on healthy volunteers and patients; T1 and T2 of MnCl2 solutions were evaluated with a relaxometer to find the concentrations providing a match to in vivo relaxation times. Radiomic features were extracted from the phantom inserts and the patients' lesions. Their repeatability was assessed by multiple measurements. RESULTS Muscle T1 and T2 were 1128 (806-1378) and 51 (40-65) ms, respectively. The phantom reproduced in vivo values within 13% (T1) and 12% (T2). T1 and T2 of tumour tissue were 1637 (1396-2121) and 94 (79-101) ms, respectively. The phantom insert best mimicking the tumour agreed within 7% (T1) and 24% (T2) with in vivo values. Out of 1034 features, 75% (95%) had interclass correlation coefficient greater than 0.9 on T1 (T2)-weighted images, reducing to 33% (25%) if the phantom was repositioned. The most repeatable features on phantom showed values in agreement with the features extracted from patients' lesions. CONCLUSIONS We developed an MR phantom with inserts mimicking both relaxation times and texture of pelvic tumours. As exemplified with repeatability assessment, such phantom is useful to investigate features robustness and optimise the radiomic workflow on pelvic MR images.
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Affiliation(s)
- Linda Bianchini
- Department of Physics and INSTM RU, Università degli Studi di Milano, Italy.
| | - Francesca Botta
- Medical Physics Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Daniela Origgi
- Medical Physics Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Stefania Rizzo
- Clinica di Radiologia EOC, Istituto di Imaging della Svizzera Italiana, Sede Ospedale Regionale di Lugano, Switzerland
| | - Manuel Mariani
- Department of Physics and INSTM RU, Università degli Studi di Pavia, Italy
| | - Paul Summers
- Division of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Pablo García-Polo
- Southern Europe Global Research Organization, GE Healthcare, Madrid, Spain
| | - Marta Cremonesi
- Radiation Research Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Alessandro Lascialfari
- Department of Physics and INSTM RU, Università degli Studi di Milano, Italy; Department of Physics and INSTM RU, Università degli Studi di Pavia, Italy
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Mariani M, Cerillo AG, Maffei S, Marchi F, Benedetti G, Zezza L, Cerone E, Paradossi U, Sorbo S, Pizzino F, Chiappino S, Trianni G, Al Jabri A, Ravani M, Berti S. 1634 3D transoesofageal echocardiography in detection of anterior leaflet laceration during mitraclip implantation. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
MitraClip is a percutaneous way of treatment of mitral regurgitation. Recent trials demonstrate its value in modifying prognosis of patients with functional mitral regurgitation. During MitraClip implant imaging with 3D TEE is mandatory to guide the procedure and monitoring the results. Unfortunately, laceration of mitral leaflets is a well-described complication of Percutaneous Mitral valve repair by implantation of MitraClip. 3D TEE can be useful even to detect complication of the procedure and in particular leaflets lacerations. Here we describe a case where 3D TEE was capable to recognize and visualize a laceration in the anterior leaflet (AL) and we assume some mechanisms leading to this complication.
Methods
An 83 years old man with post-ischemic severe functional mitral regurgitation underwent to MitraClip implantation. The mitral valve shows a severe tenting and annulus was deformed and dilated.
The procedure was performed under fluoroscopic and 3D TEE guidance (Philips iE33). Due to the large central regurgitation and large coaptation gap, we decide to implant MitraClip XTR, this is the larger device 5 mm longer.
Results
A single MitraClip XTR was implanted in the central scallop (A2-P2) in the region of the larger jet, after device positioning a further jet was detected in the region of implant and the original jet was unchanged.
Using 3D color complete volume and X-plane reconstructions we recognize that the jet originates between the clip and the basal aspects of AL. Without color Doppler in 3D zoom and X plane reconstruction, a continuum solution was suspected in the body of AL but the shadow of the delivery system partially masked the region. After removal of the device, perforation of AL was clearly depicted also with 3D zoom without color Doppler. The patient was surgically treated and inspection confirmed the laceration and shows a worn thin AL. The laceration of AL can be caused by the tension on a thinned tissue carried out by the large device. The severe tethering and annular dilatation with a marked distance between anterior and posterior leaflet at the tip of the device may have been a determinant factor in the tear occurrence.
Conclusion
3D TEE can clearly depict lacerations of leaflets during MitraClip implantation. Preoperative extensive analysis of valve geometry and inspection of leaflets searching for a thinned region can avoid intraoperative complications. The distance between leaflets at the expected tips of the MitraClip can be a predictive parameter of tension applied on the leaflets and of the risk of tearing.
Abstract 1634 Figure. Image 1
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Affiliation(s)
- M Mariani
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - A G Cerillo
- Careggi University Hospital (AOUC), Florence, Italy
| | - S Maffei
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - F Marchi
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - G Benedetti
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - L Zezza
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - E Cerone
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - U Paradossi
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - S Sorbo
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - F Pizzino
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - S Chiappino
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - G Trianni
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - A Al Jabri
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - M Ravani
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
| | - S Berti
- Tuscany Foundation Gabriele Monasterio, Massa, Italy
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Mariani M, Pastorino R, Ricciardi W, Boccia S. European network staff eXchange for integrAting precision health in the health Care sysTems” project. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Precision health aims to prevent and predict illness, maintaining health and quality of life for as long as possible, by drawing on the new technological and data science tools to translate volumes of research and clinical data into information that citizens, patients and doctors can use.
Objective
The ExACT consortium, funded by the Marie Curie Research and Innovation Staff Exchange (RISE) 2017 - Horizon 2020, is aimed at building a community of academic and non-academic institutions that generates high quality, multidisciplinary collaboration by exchanging knowledge in research and training activities on precision health.
Results
From 2019 to 2023, 74 secondments are foreseen; staff involved will be trained on precision health research topics unavailable at their home institutions. The research topics include 5 domains: Integration of Big Data and digital solutions into healthcare systems; design and promotion of innovative citizen engagement models; education of healthcare professionals and leadership; HTA in precision health; Ethical-legal, social, organisational and policy issues surrounding precision health.
Conclusions
Secondees will produce key reports, policy recommendations, scientific papers, and informative materials for citizens, fostering public-private interplay and fostering integration of precision health in the EU health systems, contributing to better health for EU citizens.
Key messages
Once the secondees are back in their home institution, they will use competences acquired during the secondment to advance the research, and transfer the knowledge to the home organization. Sharing knowledge,building synergies and expertise and encouraging best practices,among top-level institutions,will stimulate translational effort for implementing precision health in EU health system.
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Affiliation(s)
- M Mariani
- Sezione di Igiene, Università Cattolica del Sacro Cuore, Istituto di Sanità Pubblica, Rome, Italy
- On behalf of the ExACT consortium, Italy
| | - R Pastorino
- Sezione di Igiene, Università Cattolica del Sacro Cuore, Istituto di Sanità Pubblica, Rome, Italy
- On behalf of the ExACT consortium, Italy
| | - W Ricciardi
- Sezione di Igiene, Università Cattolica del Sacro Cuore, Istituto di Sanità Pubblica, Rome, Italy
- UOC Igiene Ospedaliera, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- On behalf of the ExACT consortium, Italy
| | - S Boccia
- Sezione di Igiene, Università Cattolica del Sacro Cuore, Istituto di Sanità Pubblica, Rome, Italy
- UOC Igiene Ospedaliera, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- On behalf of the ExACT consortium, Italy
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Sisti LG, Mariani M, De Vito C, Isonne C, Nardi A, Mete R, Villari P, Ricciardi W, Damiani G. Paying attention to personnel in organizational changes: the impact of hospital mergers. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The importance of paying attention to personnel satisfaction for the well-being of an organization is clearly stated also in healthcare organization. The trend of mergers of healthcare organizations represents an evident case of organizational change that could undermine personnel satisfaction if not adequately managed. The aim of our study was to investigate the impact of hospital merger on personnel perceptions and satisfaction.
Methods
A systematic review of the literature was carried out by querying scientific databases and grey literature. A search string was built using keywords including: merger, healthcare, personnel, satisfaction and synonyms. Inclusion criteria were primary studies reporting the outcome of interest and set in hospitals that has undergone a merger. Studies characteristics such country setting, design and time frame of the study, number and role of personnel interviewed and main findings were extracted and narratively synthesized.
Results
Search resulted in 3662 studies of which 9 were finally included in the analysis. Studies were mainly represented by post-merger qualitative research (77.8%) of which 55.6% semi and 54.4% structured interviews. Sample size ranged from 14 to 3119 and was represented by unspecified employees (55.6%), nurses and hospital executives (22.2% both). Findings showed that hospital executives consider merger positively especially regarding increased negotiation skills and costs reduction. Conversely, the other personnel mainly expressed critical issues as differences in organization of hospitals merged, goals and confirmation uncertainty, communication impairment and especially no involvement in follow-up in the post-merger phase.
Conclusions
The merger process strongly impacts healthcare personnel satisfaction, depending on the role played in the organization. If an initial enthusiasm and staff engagement in pre-merger phase is seen, this is not generally followed by their proper involvement over time.
Key messages
As personnel satisfaction and perceptions are strongly related to healthcare quality, they represent a central point in the merger process of healthcare organization. More attention must be paid to follow-up staff satisfaction after the merger in a continuous staff engagement to ensure the success of merger process as well as that of all organizational changes.
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Affiliation(s)
- L G Sisti
- Department of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Mariani
- Department of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C De Vito
- Department of Public Health and Infectious Diseases, Sapienza Università di Roma, Rome, Italy
| | - C Isonne
- Department of Public Health and Infectious Diseases, Sapienza Università di Roma, Rome, Italy
| | - A Nardi
- Department of Public Health and Infectious Diseases, Sapienza Università di Roma, Rome, Italy
| | | | - P Villari
- Department of Public Health and Infectious Diseases, Sapienza Università di Roma, Rome, Italy
| | - W Ricciardi
- Department of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | - G Damiani
- Department of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
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Choueiri T, Larkin J, Pal S, Motzer R, Venugopal B, Alekseev B, Miyake H, Gravis G, Bilen M, Chudnovsky A, Ching K, Mariani M, Robbins P, Huang B, di Pietro A, Albiges L. Efficacy and biomarker analysis of patients (pts) with advanced renal cell carcinoma (aRCC) with sarcomatoid histology (sRCC): Subgroup analysis from the phase III JAVELIN renal 101 trial of first-line avelumab plus axitinib (A + Ax) vs sunitinib (S). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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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De Luca A, Mariani M, Riccardi MT, Damiani G. The role of the Cincinnati Prehospital Stroke Scale in the emergency department: evidence from a systematic review and meta-analysis. Open Access Emerg Med 2019; 11:147-159. [PMID: 31410071 PMCID: PMC6646799 DOI: 10.2147/oaem.s178544] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/21/2019] [Indexed: 01/01/2023] Open
Abstract
Introduction Stroke is one of the leading causes of morbidity, disability, and mortality in high-income countries. Early prehospital stroke recognition plays a fundamental role, because most clinical decisions should be made within the first hours after onset of symptoms. The Cincinnati Prehospital Stroke Scale (CPSS) is a validated screening tool whose utilization is suggested during triage. The aim of this study is to review the role of the CPSS by assessing its sensitivity and specificity in prehospital and hospital settings. Methods A systematic review and a meta-analysis of the literature reporting the CPSS sensitivity and specificity among patients suspected of stroke were undertaken. Electronic databases were searched up to December 2018, and the quality assessment was carried out by using the Revised Quality Assessment of Diagnostic Accuracy Studies −2 (QUADAS-2). Results Eleven studies were included in the meta-analysis. Results showed an overall sensitivity of 82.46% (95% confidence interval [CI] 74.83–88.09%) and specificity of 56.95% (95% CI 41.78–70.92). No significant differences were found in terms of sensitivity when CPSS was performed by physicians (80.11%, 95% CI 66.14–89.25%) or non-physicians (81.11%, 95% CI 69.78–88.87%). However, administration by physicians resulted in higher specificity (73.57%, 95% CI 65.78–80.12%) when compared to administration by non-physicians (50.07%, 95% CI 31.54–68.58%). Prospective studies showed higher specificity 71.61% (95% CI 61.12–80.18%) and sensitivity 86.82% (95% CI 74.72–93.63) when compared to retrospective studies which showed specificity of 33.37% (95% CI 22.79–45.94%) and sensitivity of 78.52% (95% CI 75.08–81.60). Conclusions The CPSS is a standardized and easy-to-use stroke screening tool whose implementation in emergency systems protocols, along with proper and consistent coordination with local, regional, and state agencies, medical authorities and local experts are suggested.
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Affiliation(s)
- A De Luca
- Istituti Fisioterapici Ospitalieri, Rome, Italy
| | - M Mariani
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - M T Riccardi
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Damiani
- Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Rome, Italy
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Maccora D, Rizzo V, Fortini D, Mariani M, Giraldi L, Giordano A, Bruno I. Parathyroid scintigraphy in primary hyperparathyroidism: comparison between double-phase and subtraction techniques and possible affecting factors. J Endocrinol Invest 2019; 42:889-895. [PMID: 30600433 DOI: 10.1007/s40618-018-0996-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 08/14/2018] [Accepted: 12/18/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE Parathyroid scintigraphy is superior to other imaging techniques in detecting hyperfunctioning parathyroid glands. It is mainly performed using double-phase or dual-tracer subtraction methods. Neither of the techniques is perfect and different protocols are being used. We aimed to evaluate the accuracy of double-phase and subtraction methods in detecting abnormal gland as well as the potential effects of coexisting thyroid disease and clinical-laboratory data. METHODS We considered patients with primary hyperparathyroidism who underwent parathyroid surgery, after a parathyroid scintigraphy between April 2015 and February 2017. Sixty-eight patients were included; in 45 cases (66.2%), a thyroid disease was coexistent. Diagnostic performances of the two techniques were compared. The effect of thyroid disease and clinical-pathological data on examination interpretation was considered. RESULTS Double-phase scintigraphy showed higher sensitivity and accuracy in detecting the exact abnormal gland compared to the digital subtraction (90% and 75% vs. 76% and 66%, respectively). For double-phase technique, sensitivity and accuracy were higher in cases with no thyroid disease when compared to those with thyroid disease (92% and 86% vs. 88% and 69%, respectively). Similarly, for digital subtraction, sensitivity and accuracy were higher in the absence of thyroid disease compared to their presence (84% and 79% vs. 70% and 58%, respectively). There was no significant variation in the performance of both techniques, considering clinical-laboratory data. CONCLUSIONS Double-phase scintigraphy has been more accurate than digital subtraction. The presence of thyroid disease could be a possible limit, affecting the subtraction more than the double-phase technique. Clinical data did not influence the scintigraphic outcome.
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Affiliation(s)
- D Maccora
- UOC di Medicina Nucleare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy.
- Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy.
| | - V Rizzo
- UOC di Medicina Nucleare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
- Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - D Fortini
- UOC di Medicina Nucleare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
| | - M Mariani
- Institute of Public Health, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - L Giraldi
- Institute of Public Health, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - A Giordano
- UOC di Medicina Nucleare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
- Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - I Bruno
- UOC di Medicina Nucleare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
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Cicolari D, Lizio D, Pedrotti P, Sironi R, Moioli MT, Lascialfari A, Mariani M, Milazzo A, Quattrocchi G, Sormani P, Torresin A. P417Assessment of magnetic resonance imaging scanner-dependence and software-dependence of T1 and T2 relaxation times measurements at 1.5 T. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez118.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Cicolari
- University of Milan, Physics, Milan, Italy
| | - D Lizio
- Niguarda Ca" Granda Hospital, Medical Physics, Milan, Italy
| | - P Pedrotti
- Niguarda Ca" Granda Hospital, Angelo De Gasperis, Department of Cardiovascular , Milan, Italy
| | - R Sironi
- Niguarda Ca" Granda Hospital, Radiology, Milan, Italy
| | - M T Moioli
- Niguarda Ca" Granda Hospital, Medical Physics, Milan, Italy
| | | | - M Mariani
- University of Pavia, Physics, Pavia, Italy
| | - A Milazzo
- Niguarda Ca" Granda Hospital, Angelo De Gasperis, Department of Cardiovascular , Milan, Italy
| | - G Quattrocchi
- Niguarda Ca" Granda Hospital, Angelo De Gasperis, Department of Cardiovascular , Milan, Italy
| | - P Sormani
- Niguarda Ca" Granda Hospital, Angelo De Gasperis, Department of Cardiovascular , Milan, Italy
| | - A Torresin
- Niguarda Ca" Granda Hospital, Medical Physics, Milan, Italy
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Mossini E, Codispoti L, Giola M, Castelli L, Macerata E, Porta A, Campi F, Mariani M. Topsoil radiological characterisation of L-54M reactor surroundings preliminary to decommissioning operations. J Environ Radioact 2019; 196:187-193. [PMID: 29187289 DOI: 10.1016/j.jenvrad.2017.11.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 11/13/2017] [Accepted: 11/21/2017] [Indexed: 06/07/2023]
Abstract
The radiological characterization of the topsoil of the L-54M reactor surroundings carried out in this work aims at obtaining the reference blank point for the forthcoming decommissioning operations and ascertain if unexpected radionuclide release occurred during the operational life of the plant. Standardised methods have been employed in order to collect representative samples and reliable results. Suitable sample pre-treatment procedures were applied. Gamma and beta spectrometric analyses were carried out to measure the activity concentrations of 60Co 137Cs, 152Eu, 241Am and 90Sr. These have been considered as representative radionuclides that could have been originated from reactor operations and that could still be present at four decades post reactor shutdown.
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Affiliation(s)
- E Mossini
- Department of Energy, Politecnico di Milano, Piazza L. da Vinci 32, I-20133 Milano, Italy.
| | - L Codispoti
- Department of Energy, Politecnico di Milano, Piazza L. da Vinci 32, I-20133 Milano, Italy
| | - M Giola
- Department of Energy, Politecnico di Milano, Piazza L. da Vinci 32, I-20133 Milano, Italy
| | - L Castelli
- Department of Energy, Politecnico di Milano, Piazza L. da Vinci 32, I-20133 Milano, Italy
| | - E Macerata
- Department of Energy, Politecnico di Milano, Piazza L. da Vinci 32, I-20133 Milano, Italy
| | - A Porta
- Department of Energy, Politecnico di Milano, Piazza L. da Vinci 32, I-20133 Milano, Italy
| | - F Campi
- Department of Energy, Politecnico di Milano, Piazza L. da Vinci 32, I-20133 Milano, Italy
| | - M Mariani
- Department of Energy, Politecnico di Milano, Piazza L. da Vinci 32, I-20133 Milano, Italy
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Mariani M, Sisti LG, Acampora A, Damiani G. Healthcare organization mergers: a systematic review of the literature on clinical outcomes. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Mariani
- Section of Hygiene, Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - LG Sisti
- Section of Hygiene, Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Acampora
- Section of Hygiene, Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Damiani
- Section of Hygiene, Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico “Agostino Gemelli”, Rome, Italy
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50
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Fanni BM, Gasparotti E, Vignali E, Capellini K, Vivoli G, Mariani M, Rezzaghi M, Landini L, Positano V, Celi S, Berti S. P6223Importance of left atrium fluid dynamics for the planning of LAA closure procedure: an intregated computational fluid dynamics and morphological study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B M Fanni
- Fondazione Toscana Gabriele Monasterio, UOC Bioingegneria - BioCardioLab, Massa, Italy
| | - E Gasparotti
- Fondazione Toscana Gabriele Monasterio, UOC Bioingegneria - BioCardioLab, Massa, Italy
| | - E Vignali
- Fondazione Toscana Gabriele Monasterio, UOC Bioingegneria - BioCardioLab, Massa, Italy
| | - K Capellini
- Fondazione Toscana Gabriele Monasterio, UOC Bioingegneria - BioCardioLab, Massa, Italy
| | - G Vivoli
- Fondazione Toscana Gabriele Monasterio, UOC Bioingegneria - BioCardioLab, Massa, Italy
| | - M Mariani
- Fondazione Toscana Gabriele Monasterio, UOC Cardiologia, Massa, Italy
| | - M Rezzaghi
- Sant'Anna School of Advanced Studies, Life Science, Pisa, Italy
| | - L Landini
- University of Pisa, Information Engineering, Pisa, Italy
| | - V Positano
- Fondazione Toscana Gabriele Monasterio, UOC Bioingegneria - BioCardioLab, Massa, Italy
| | - S Celi
- Fondazione Toscana Gabriele Monasterio, UOC Bioingegneria - BioCardioLab, Massa, Italy
| | - S Berti
- Fondazione Toscana Gabriele Monasterio, UOC Cardiologia, Massa, Italy
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