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Spadera L, Lugarà M, Spadera M, Conticelli M, Oliva G, Bassi V, Apuzzi V, Calderaro F, Fattoruso O, Guzzi P, D'Amora M, Catapano O, Marra R, Galdo M, Zappalà M, Inui T, Mette M, Vitiello G, Corvino M, Tortoriello G. Adjunctive use of oral MAF is associated with no disease progression or mortality in hospitalized patients with COVID-19 pneumonia: The single-arm COral-MAF1 prospective trial. Biomed Pharmacother 2023; 169:115894. [PMID: 37988850 DOI: 10.1016/j.biopha.2023.115894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023] Open
Abstract
Based on a growing body of evidence that a dysregulated innate immune response mediated by monocytes/macrophages plays a key role in the pathogenesis of COVID-19, a clinical trial was conducted to investigate the therapeutic potential and safety of oral macrophage activating factor (MAF) plus standard of care (SoC) in the treatment of hospitalized patients with COVID-19 pneumonia. Ninety-seven hospitalized patients with confirmed COVID-19 pneumonia were treated with oral MAF and a vitamin D3 supplement, in combination with SoC, in a single-arm, open label, multicentre, phase II clinical trial. The primary outcome measure was a reduction in an intensive care unit transfer rate below 13% after MAF administration. At the end of the study, an additional propensity score matching (PSM) analysis was performed to compare the MAF group with a control group treated with SoC alone. Out of 97 patients treated with MAF, none needed care in the ICU and/or intubation with mechanical ventilation or died during hospitalization. Oxygen therapy was discontinued after a median of nine days of MAF treatment. The median length of viral shedding and hospital stay was 14 days and 18 days, respectively. After PSM, statistically significant differences were found in all of the in-hospital outcomes between the two groups. No mild to serious adverse events were recorded during the study. Notwithstanding the limitations of a single-arm study, which prevented definitive conclusions, a 21-day course of MAF treatment plus SoC was found to be safe and promising in the treatment of hospitalized adult patients with COVID-19 pneumonia. Further research will be needed to confirm these preliminary findings.
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Affiliation(s)
- Lucrezia Spadera
- Department of Otolaryngology-Head and Neck Surgery, Ospedale del Mare hospital, ASL Napoli 1 Centro, Naples, Italy.
| | - Marina Lugarà
- Department of General Medicine, Ospedale del Mare hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Maria Spadera
- Department of Anesthesiology and Intensive Care, San Giovanni Bosco hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Mariano Conticelli
- Department of Clinical Pathology, Ospedale del Mare Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Gabriella Oliva
- Department of General Medicine, Ospedale del Mare hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Vincenzo Bassi
- Department of General Medicine, San Giovanni Bosco Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Valentina Apuzzi
- Department of General Medicine, San Giovanni Bosco Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Francesco Calderaro
- Department of General Medicine, San Giovanni Bosco Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Olimpia Fattoruso
- Department of Clinical Pathology, San Giovanni Bosco Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Pietro Guzzi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Campus Universitario, Germaneto, 88100 Catanzaro, Italy
| | - Maurizio D'Amora
- Department of Laboratory Medicine and Clinical Pathology, San Paolo Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Oriana Catapano
- Department of Laboratory Medicine and Clinical Pathology, San Paolo Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Roberta Marra
- Department of Pharmacy, Ospedale del Mare Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Maria Galdo
- Department of Pharmacy, AORN Ospedali dei Colli Monaldi - Cotugno - C.T.O. Hospital, Naples, Italy
| | - Michele Zappalà
- Department of Medicine, Vesuvio Clinic, ASL Napoli 1 Centro, Naples, Italy
| | - Toshio Inui
- Department of Life System, Institute of Technology and Science, Graduate School, Tokushima University, Tokushima, Japan; Saisei Mirai Cell Processing Center, Osaka, Japan; Saisei Mirai Keihan Clinic, Osaka, Japan; Saisei Mirai Kobe Clinic, Kobe, Japan
| | - Martin Mette
- Saisei Mirai Keihan Clinic, Osaka, Japan; Saisei Mirai Kobe Clinic, Kobe, Japan
| | - Giuseppe Vitiello
- Department of Health Management, Ospedale del Mare hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Maria Corvino
- Department of Health Management, ASL Napoli 1 Centro, Naples, Italy
| | - Giuseppe Tortoriello
- Department of Otolaryngology-Head and Neck Surgery, AORN Ospedali dei Colli Monaldi - Cotugno - C.T.O. Hospital, Naples, Italy
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Di Francia R, Crisci S, Muto T, Giancola C, Petriccone L, Catapano O, Cummarro A, Pinto A, Frigeri F. Optimization of a Low-Cost, Sensitive PNA Clamping PCR Method for JAK2 V617F Variant Detection. J Appl Lab Med 2021; 5:643-655. [PMID: 32407536 DOI: 10.1093/jalm/jfaa041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 02/14/2020] [Indexed: 11/13/2022]
Abstract
BACKGROUND The JAK2 V617F variant is diagnostic for myeloproliferative neoplasms, a group of clonal disorders of hematopoietic stem and progenitor cells. Although several approaches have been developed to detect the variant, a gold standard diagnostic method has not yet been defined. We describe a simple, fast, and cost-effective PCR-based approach that enhances test specificity and sensitivity by blocking the amplification of the large excess of wild-type DNA. METHODS The method involves using an oligo peptide nucleic acid (PNA) perfectly matching its corresponding DNA sequence. The PCR protocol was optimized by collecting a detailed thermodynamic data set on PNA-DNA wild-type duplexes by circular dichroism melting experiments. The specificity and sensitivity of PNA clamping PCR were assessed by genotyping 50 patients with myeloproliferative neoplasm who carried the JAK2 V617F variant and 50 healthy donors. RESULTS The optimized protocol enabled selective amplification of the variant alleles, achieving maximum sensitivity (100%) and specificity (100%). Analytical sensitivity was 0.05% of variant alleles as assessed by serial dilutions of DNA from the HEL cell line (which carries the JAK2 V617F variant) mixed to wild-type DNA from healthy donors. The JAK2 V617F variant test performed according to this method has better diagnostic performance than its 2 main PCR-based competitors, at much lower cost. CONCLUSIONS High sensitivity and specificity and cost-effectiveness make PNA clamping PCR a useful testing platform for the detection of minor allele variants in small-scale diagnostic laboratories. It promises to improve patient care while enabling significant healthcare savings.
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Affiliation(s)
- Raffaele Di Francia
- Italian Association of Pharmacogenomics and Molecular Diagnostics, Ancona, Italy
| | - Stefania Crisci
- Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione "G. Pascale" IRCCS, Napoli, Italy
| | - Tommaso Muto
- Hematology and Cellular Immunology (Clinical Biochemistry) A.O. dei Colli Monaldi Hospital, Naples, Italy
| | - Concetta Giancola
- Department of Pharmacy, University of Naples Federico II, Napoli, Italy
| | - Luigi Petriccone
- Department of Chemical Sciences, University of Naples Federico II, Naples, Italy
| | - Oriana Catapano
- Italian Association of Pharmacogenomics and Molecular Diagnostics, Ancona, Italy
| | - Annunziata Cummarro
- Pharmacy Unit, Istituto Nazionale Tumori, Fondazione "G. Pascale" IRCCS, Napoli, Italy
| | - Antonio Pinto
- Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione "G. Pascale" IRCCS, Napoli, Italy
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Cerino P, Gallo A, Pierri B, Buonerba C, Di Concilio D, Cuomo MC, Vassallo L, Lo Conte G, Coppola A, Pizzolante A, Boccia G, Ferrucci V, Atripaldi L, Triassi M, Pacella D, Cennamo M, Romano P, Sorbo TM, Furno A, Catapano O, Contina A, Perruolo G, D'Amora M, Terracciano D, Portella G. Seroprevalence of SARS-CoV-2 Assessed by Four Chemiluminescence Immunoassays and One Immunocromatography Test for SARS-Cov-2. Front Public Health 2021; 9:649781. [PMID: 33996728 PMCID: PMC8116632 DOI: 10.3389/fpubh.2021.649781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/05/2021] [Indexed: 12/30/2022] Open
Abstract
The onset of the new SARS-CoV-2 coronavirus encouraged the development of new serologic tests that could be additional and complementary to real-time RT-PCR-based assays. In such a context, the study of performances of available tests is urgently needed, as their use has just been initiated for seroprevalence assessment. The aim of this study was to compare four chemiluminescence immunoassays and one immunochromatography test for SARS-Cov-2 antibodies for the evaluation of the degree of diffusion of SARS-CoV-2 infection in Salerno Province (Campania Region, Italy). A total of 3,185 specimens from citizens were tested for anti-SARS-CoV-2 antibodies as part of a screening program. Four automated immunoassays (Abbott and Liaison SARS-CoV-2 CLIA IgG and Roche and Siemens SARS-CoV-2 CLIA IgM/IgG/IgA assays) and one lateral flow immunoassay (LFIA Technogenetics IgG–IgM COVID-19) were used. Seroprevalence in the entire cohort was 2.41, 2.10, 1.82, and 1.85% according to the Liaison IgG, Abbott IgG, Siemens, and Roche total Ig tests, respectively. When we explored the agreement among the rapid tests and the serologic assays, we reported good agreement for Abbott, Siemens, and Roche (Cohen's Kappa coefficient 0.69, 0.67, and 0.67, respectively), whereas we found moderate agreement for Liaison (Cohen's kappa coefficient 0.58). Our study showed that Abbott and Liaison SARS-CoV-2 CLIA IgG, Roche and Siemens SARS-CoV-2 CLIA IgM/IgG/IgA assays, and LFIA Technogenetics IgG-IgM COVID-19 have good agreement in seroprevalence assessment. In addition, our findings indicate that the prevalence of IgG and total Ig antibodies against SARS-CoV-2 at the time of the study was as low as around 3%, likely explaining the amplitude of the current second wave.
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Affiliation(s)
- Pellegrino Cerino
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Italy
| | - Alfonso Gallo
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Italy
| | - Biancamaria Pierri
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Italy.,Department of Medicine, Surgery, and Dentistry 'Scuola Medica Salernitana', University of Salerno, Baronissi, Italy
| | - Carlo Buonerba
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Italy.,Regional Reference Center for Rare Tumors, Department of Oncology and Hematology, Azienda Ospedaliera Universitaria Federico II of Naples, Naples, Italy
| | - Denise Di Concilio
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Italy
| | - Maria Concetta Cuomo
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Italy
| | - Lucia Vassallo
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Italy
| | - Gabriella Lo Conte
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Italy
| | - Annachiara Coppola
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Italy
| | - Antonio Pizzolante
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Italy
| | - Giovanni Boccia
- Department of Medicine, Surgery, and Dentistry 'Scuola Medica Salernitana', University of Salerno, Baronissi, Italy
| | | | - Luigi Atripaldi
- Cotugno Hospital, Azienda Ospedaliera di Rilievo Nazionale Ospedali dei Colli, Naples, Italy
| | - Maria Triassi
- Department of Public Health, Section of Hygiene, University of Naples Federico II, Naples, Italy
| | - Daniela Pacella
- Department of Public Health, Section of Hygiene, University of Naples Federico II, Naples, Italy
| | - Michele Cennamo
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Paolo Romano
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Teresa Maria Sorbo
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Alessandro Furno
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Oriana Catapano
- Unità Operativa Complessa Medicina di laboratorio P. O. San Paolo, Azienda Sanitaria Locale Naples 1 Centro, Naples, Italy
| | - Aldo Contina
- Unità Operativa Complessa Medicina di laboratorio P. O. San Paolo, Azienda Sanitaria Locale Naples 1 Centro, Naples, Italy
| | - Giuseppe Perruolo
- Unità Operativa Complessa Medicina di laboratorio P. O. San Paolo, Azienda Sanitaria Locale Naples 1 Centro, Naples, Italy
| | - Maurizio D'Amora
- Unità Operativa Complessa Medicina di laboratorio P. O. San Paolo, Azienda Sanitaria Locale Naples 1 Centro, Naples, Italy
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Giuseppe Portella
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
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Di Spigna G, Ladogana P, Covelli B, Ricciardone M, Salzano S, Spalletti Cernia D, Mormile I, Varriale G, Catapano O, Spadaro G, Mormile M, Postiglione L. Component resolved diagnosis by recombinant allergens in patients with allergies to inhalants. J BIOL REG HOMEOS AG 2021; 34:1729-1737. [PMID: 33143407 DOI: 10.23812/20-297-a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Molecular characterization of IgE reactivity of specific individual components of allergenic extracts is now possible due to the technology of recombinant allergens derived from studies of molecular biology of allergic pathology. The identification of the immunoreactivity to single allergenic components in allergic subjects allows to specifically define her/his allergic profile and obtain the so-termed Component Resolved Diagnosis (CRD). Molecular allergens can be classified into those that induce the respiratory allergic reactivity and those that identify the food-related allergic pathology. It is also essential to identify those molecular allergens whose immunoreactivity is able to connect the two clinical conditions: respiratory symptoms and food allergy symptoms. The present study was conducted on 50 patients with a clinical history of hypersensitivity to pollen and/or allergy and positivity to Skin Prick Test. The sera were analyzed in our laboratories and the panel of recombinant allergens was applied in the case of positivity of the specific IgE. Of the 50 patients enrolled, 31 were selected as positive to 4 main pan-allergen Bet v1, Par j2, Art v1 and Phl p1; among these, 14 subjects showed one allergen-specific IgE towards natural extracts of tested foods even in absence of clinical history. CRD allows for an increased accuracy in allergy diagnosis and prognosis and plays an important role in: a) resolving genuine vs cross-reactive sensitization in poly-sensitized patients, b) assessing, in selected cases, the risk of severe, systemic vs mild, local reactions in food allergy, and c) identifying patients and triggering allergens for specific immunotherapy (ITS). In light of our results, we believe that the transition from a diagnostic based on the use of allergenic extracts to another one based on the use of single allergenic molecules that is able to define the specific allergenic profile of each patient, seems to be able to revolutionize the allergy diagnosis.
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Affiliation(s)
- G Di Spigna
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - P Ladogana
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - B Covelli
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - M Ricciardone
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - S Salzano
- Institute of Experimental Endocrinology and Oncology "G. Salvatore" (National Research Council), Naples, Italy
| | - D Spalletti Cernia
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - I Mormile
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - G Varriale
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - O Catapano
- Italian Association of Pharmacogenomics and Molecular Diagnostics, Ancona, Italy
| | - G Spadaro
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.,Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Naples, Italy
| | - M Mormile
- Department of Clinical and Surgical Medicine University of Naples "Federico II", Naples, Italy
| | - L Postiglione
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.,Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Naples, Italy
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Di Martino S, Catapano O, Siesto SR, Di Paolo M, Pugliese S, Morelli CD, Fiorica F, Varriale E, Di Francia R, Abbadessa A. Quantitative PCR detection of t(11;14) bcl-1/JH in mantle cell lymphoma patients: comparison of peripheral blood and bone marrow aspirate samples. Eur Rev Med Pharmacol Sci 2015; 19:4801-4810. [PMID: 26744872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Mantle cell lymphoma (MCL) is a non-Hodgkin lymphoma (NHL) featured by participation of the lymph nodes, spleen, blood and bone marrow with a short remission period to standard therapies and a median overall survival of 4-5 years. PATIENTS AND METHODS In this study, we compare the levels of bcl-1/JH fusion products detected by q-PCR in the concurrent peripheral blood (PB) and bone marrow (BM) aspirate samples from 7 patients with MCL. RESULTS In patients with moderate to high levels of bcl-1/JH copies, the results of q-PCR analysis of PB and BM aspirate samples correlate well. In patients with high levels of bcl-1/JH copies, instead, PB levels are a good indication of tumor burden. Finally, in patients with low levels of bcl-1/JH copies, the t(11;14) may be detected by identification of neoplastic cells. CONCLUSIONS Our data suggest that PB can be reliably used in place of BM aspirate both for detection of translocation status during minimal residual disease monitoring and for a possible molecular relapse, especially in those patients who have moderate to high levels of bcl-1/JH copies. If these results will be confirmed on a wider number of MCL patients, future study will be required to address the issue.
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Affiliation(s)
- S Di Martino
- Pathology Unit, A.O. Sant'Anna e San Sebastiano, Caserta, Italy.
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Altieri V, Capozzi O, Marzano MC, Catapano O, Di Biase I, Rocchi M, De Tollis G. Molecular characterization of an analphoid supernumerary marker chromosome derived from 18q22.1➔qter in prenatal diagnosis: a case report. Mol Cytogenet 2014; 7:69. [PMID: 25360155 PMCID: PMC4213471 DOI: 10.1186/s13039-014-0069-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 08/28/2014] [Accepted: 10/06/2014] [Indexed: 11/30/2022] Open
Abstract
Background Small supernumerary marker chromosomes (sSMC) occur in 0.072% of unselected cases of prenatal diagnoses, and their molecular cytogenetic characterization is required to establish a reliable karyotype-phenotype correlation. A small group of sSMC are C-band-negative and devoid of alpha-satellite DNA. We report the molecular cytogenetic characterization of a de novo analphoid sSMC derived from 18q22.1→qter in cultured amniocytes. Results We identified an analphoid sSMC in cultured amniocytes during a prenatal diagnosis performed because of advanced maternal age. GTG-banding revealed an sSMC in all metaphases. FISH experiments with a probe specific for the chromosome 18 centromere, and C-banding revealed neither alphoid sequences nor C-banding-positive satellite DNA thereby suggesting the presence of a neocentromere. To characterize the marker in greater detail, we carried out additional FISH experiments with a set of appropriate BAC clones. The pattern of the FISH signals indicated a symmetrical organization of the marker, the breakpoint likely representing the centromere of an inverted duplicated chromosome that results in tetrasomy of 18q22.1→qter. The karyotype after molecular cytogenetic investigations was interpreted as follows: 47,XY,+inv dup(18)(qter→q22.1::q22.1→neo→qter) Conclusion Our case is the first report, in the prenatal diagnosis setting, of a de novo analphoid marker chromosome originating from the long arm of chromosome 18, and the second report of a neocentromere formation at 18q22.1.
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Di Francia R, Valente D, Catapano O, Rupolo M, Tirelli U, Berretta M. Knowledge and skills needs for health professions about pharmacogenomics testing field. Eur Rev Med Pharmacol Sci 2012; 16:781-788. [PMID: 22913211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Promise in the future, a disease could be ranked into genetic categories, allowing bespoke tailoring of medicine to maximize therapeutic effects and to reduce the potential for adverse drug response. This new feature requires for health professionals to have competencies not only for the basic skills of their discipline, but also for the understanding on why, when, and how that knowledge should be applied to improve personalized therapies for their patients. Current opinion on basic competences of health professions includes knowledge and skills on two fundamental features: (1) genetics of disease, to allow the understanding and the identification of diseases associated to genetic variations, and to facilitate the development of new genomic tests; and (2) ethical, social and economical implications that are fundamental to identify those factors that might contribute to a successful integration of pharmacogenomics into international health and public policy. AIM Briefly, we described (1) current knowledge on genetic variations that interact with therapies and the need to detect them; (2) the most common available methods for detecting mutations; and (3) ethical, social and economic issues related to pharmacogenetic testing and recording of genetic information (e.g., critical evaluation of the development of new tests, privacy, the current absence of public reimbursement, etc). CONCLUSIONS These could be useful recommendations for academic institutions and educational programs to prepare health professionals with the necessary abilities for their future practice.
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Affiliation(s)
- R Di Francia
- Hematology-Oncology and Stem Cell Transplantation Unit, National Cancer Institute, Fondazione G. Pascale IRCCS, Naples, Italy.
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Ferrini D, Galvani M, Catapano O, Ottani F, Rusticali F. [Echocardiographic study of left ventricular function using automated border detection in normal subjects]. G Ital Cardiol 1994; 24:723-31. [PMID: 8088471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Two-dimensional (2D) echocardiographic automated border detection (ABD) can provide on-line measurement of left ventricular cavity area and fractional area change. However, this new quantitative method has not been extensively validated. METHODS Values of manually traced areas on 2D-echo images were compared with those obtained from ABD in 34 consecutive normal subjects (age 16-65 years). Only subjects with more than 70% of endocardial border circumferences clearly seen in both selected imaging planes were included in the study. We evaluated left ventricular end-diastolic and end-systolic area, and fractional area change obtained from mid-left ventricular short axis and apical 4-chamber view. Left ventricular volumes (area/length method) and ejection fraction were manually calculated off-line from apical 4-chamber view. RESULTS From the short axis view, left ventricular cavity area measurements with ABD were obtained in 85% of subjects. The values closely correlated with off-line measurements: end-diastolic area 15.6 +/- 3.1 vs 14.8 +/- 3.3 cm2, r = 0.88 SEE = 1.58; end-systolic area 7.2 +/- 1.7 vs 6.7 +/- 1.7 cm2, r = 0.88 SEE = 0.80. A good correlation was also found for the apical 4-chamber view; end-diastolic area 25.9 +/- 5.9 vs 25.3 +/- 5.5 cm2, r = 0.97 SEE = 1.36; end-systolic area 16.3 +/- 4.1 vs 15.0 +/- 3.8 cm2, r = 0.92 SEE = 1.51. In this view ABD measurements were obtained in 79% of subjects. A significant correlation was also found between the end-diastolic volume and short axis (r = 0.54, SEE = 2.63; p 0.003) and apical 4-chamber (r = 0.66, SEE = 4.51; p = 0.0002) ABD diastolic area. Similarly, the end-systolic volume was significantly correlated with short axis (r = 0.57, SEE = 1.42; p = 0.001) and apical 4-chamber (r = 0.55, SEE = 3.54; p = 0.003) ABD systolic area. However, the on-line fractional area change correlated with off-line ejection fraction better from short axis view: (r = 0.72 SEE = 3.52) than from apical 4-chamber view (r = 0.45 SEE = 6.84). CONCLUSIONS These data indicate that: 1) left ventricular areas measured by ABD correlate well with manually measured areas and volumes; 2) short axis ABD fractional area change may be a reliable substitute of off-line manually traced ejection fraction in normal subjects.
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Affiliation(s)
- D Ferrini
- Divisione di Cardiologia, Ospedale G.B. Morgagni, Forli
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Catapano O. [Family counseling and its role in prevention of hereditary diseases]. Prof Inferm 1978; 31:172-82. [PMID: 107530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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