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Coviello N, Carella A, Dell'Aquila C, Masi GL, Prisciandaro C, Tarantino G, Taurisano M, Nisi MT, Rinaldi G, D'Elia F. [Chronic Inflammatory Polyradiculopathy Post-Covid-19 and the Role of Therapeutic Apheresis: A Clinical Case]. G Ital Nefrol 2023; 40:2023-vol3. [PMID: 37427907] [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] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
There is a strong correlation between SARS-CoV-2 and the onset of autoimmune neurological disease with atypical clinical presentation, characterized by limited response to medical therapy, likely caused by the underlying mechanism of the virus itself. In situations like these, after the failure of pharmacological therapy, therapeutic apheresis, including immunoadsorption, can be pursued. Treatments with IMMUSORBA TR-350 columns have proven to be particularly effective in managing refractory forms of post-Covid-19 nephropathies, leading to complete recovery of disability and elimination of neurological signs and symptoms. We discuss the case of a patient with chronic inflammatory polyradiculopathy post-Covid-19, resistant to medical therapy, effectively treated with immunoadsorption.
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Affiliation(s)
- N Coviello
- UOC Nefrologia e Dialisi, PO Di Venere, Bari
| | - A Carella
- UOC Nefrologia e Dialisi, PO Di Venere, Bari
| | | | - G L Masi
- UOC Neurologia, PO Di Venere, Bari
| | | | - G Tarantino
- UOC Nefrologia e Dialisi, PO Di Venere, Bari
| | - M Taurisano
- UOC Nefrologia e Dialisi, PO Di Venere, Bari
| | - M T Nisi
- UOC Nefrologia e Dialisi, PO Di Venere, Bari
| | | | - F D'Elia
- UOC Nefrologia e Dialisi, PO Di Venere, Bari
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Gaudio F, Mazza P, Mele A, Palazzo G, Carella A, Pastore D, Cascavilla N, Pavone V, Specchia G. BRENTUXIMAB VEDOTIN PRIOR TO ALLOGENEIC STEM CELL TRANSPLANTATION IN HODGKIN'S LYMPHOMAS: A RETROSPECTIVE EXPERIENCE BY THE RETE EMATOLOGICA PUGLIESE (REP). Hematol Oncol 2019. [DOI: 10.1002/hon.172_2631] [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: 11/06/2022]
Affiliation(s)
- F. Gaudio
- Haematology; Policlinico Hospital; Bari Italy
| | - P. Mazza
- Haematology; “G.Moscati” Hospital; Taranto Italy
| | - A. Mele
- Haematology; “G.Panico” Hospital; Tricase (LE) Italy
| | - G. Palazzo
- Haematology; “G.Moscati” Hospital; Taranto Italy
| | - A. Carella
- Haematology; “Casa Sollievo della sofferenza” Hospital; San Giovanni Rotondo (FG) Italy
| | - D. Pastore
- Haematology; “A.Perrino” Hospital; Brindisi Italy
| | - N. Cascavilla
- Haematology; “Casa Sollievo della sofferenza” Hospital; San Giovanni Rotondo (FG) Italy
| | - V. Pavone
- Haematology; “G.Panico” Hospital; Tricase (LE) Italy
| | - G. Specchia
- Haematology; Policlinico Hospital; Bari Italy
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Rule S, Barreto W, Briones J, Carella A, Casasnovas O, Pocock C, Wendtner C, Zaja F, Robson S, Tschopp R, Dreyling M. EFFICACY AND SAFETY OF PROLONGED MAINTENANCE WITH SUBCUTANEOUS RITUXIMAB IN PATIENTS WITH RELAPSED OR REFRACTORY INDOLENT NHL: RESULTS OF THE PHASE III MABCUTE STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.43_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- S. Rule
- Department of Haematology; Derriford Hospital and Plymouth University Medical School; Plymouth United Kingdom
| | - W.G. Barreto
- Hematology and Hemotherapy; Hemocentro Ribeirão Preto, University of São Paulo; São Paulo Brazil
| | - J. Briones
- Department of Hematology; Hospital de la Santa Creu i Sant Pau; Barcelona Spain
| | - A.M. Carella
- Division of Hematology and Stem Cell Transplantation Unit; L'Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria "San Martino" - Istituto Nazionale per la Ricerca sul Cancro; Genova Italy
| | - O. Casasnovas
- Service d'Hématologie Clinique; Centre Hospitalier Universitaire François Mitterand; Dijon France
| | - C. Pocock
- Department of Haematology; Kent & Canterbury Hospital; Canterbury United Kingdom
| | - C.M. Wendtner
- Department I of Internal Medicine; Klinikum Schwabing; Munich Germany
| | - F. Zaja
- SC Ematologia; Azienda Sanitaria Universitaria Integrata di Trieste; Trieste Italy
| | - S. Robson
- Product Development Medical Affairs; Biometrics, F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - R.R. Tschopp
- Product Development Medical Affairs; Oncology, F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - M. Dreyling
- Department of Medicine III; Klinikum der Universität München (LMU); Munich Germany
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Kostakoglu L, Martelli M, Belada D, Carella A, Chua N, Gonzalez-Barca E, Hong X, Pinto A, Sehn L, Shi Y, Tatsumi Y, Fingerle-Rowson G, Mattiello F, Nielsen T, Sahin D, Vitolo U, Trněný M. END OF TREATMENT PET-CT PREDICTS PROGRESSION-FREE SURVIVAL IN DLBCL AFTER FIRST-LINE TREATMENT: RESULTS FROM THE PHASE III GOYA STUDY. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_45] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- L. Kostakoglu
- Department of Radiology; Icahn School of Medicine at Mount Sinai; New York USA
| | - M. Martelli
- Department of Cellular Biotechnologies and Hematology; Sapienza University; Rome Italy
| | - D. Belada
- 4th Department of Internal Medicine-Hematology; University Hospital Hradec Kralove, and Charles University in Prague, Faculty of Medicine in Hradec Kralove; Hradec Kralove Czech Republic
| | - A.M. Carella
- U.O. Hematology I; IRCCS AO University, San Martino-IST; Genoa Italy
| | - N. Chua
- Cross Cancer Institute; University of Alberta; Edmonton Canada
| | - E. Gonzalez-Barca
- Institut Catalá d'Oncologia Hospitalet, IDIBELL; University of Barcelona; Barcelona Spain
| | - X. Hong
- Department of Medical Oncology; Fudan University Shanghai Cancer Center; Shanghai China
| | - A. Pinto
- Istituto Nazionale Tumori, Fondazione G. Pascale; IRCCS; Naples Italy
| | - L.H. Sehn
- Centre for Lymphoid Cancer; British Columbia Cancer Agency and the University of British Columbia; Vancouver Canada
| | - Y. Shi
- National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs; Beijing China
| | - Y. Tatsumi
- Department of Hematology and Rheumatology, Faculty of Medicine; Kinki University Hospital; Osaka Japan
| | - G. Fingerle-Rowson
- Pharma Development Clinical Oncology; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - F. Mattiello
- Pharma Development Biometrics Biostatistics; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - T. Nielsen
- Pharma Development Clinical Oncology; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - D. Sahin
- Department of Hematology and Rheumatology, Faculty of Medicine; Kinki University Hospital; Osaka Japan
| | - U. Vitolo
- Department of Hematology; Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino; Turin Italy
| | - M. Trněný
- Department of Medicine-Department of Hematology; Charles University; Prague Czech Republic
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Chiappella A, Agostinelli C, Martelli M, Evangelista A, Fabbri M, Melle F, Motta G, Righi S, Novero D, Balzarotti M, Cabras M, Carella A, Gotti M, Pavone V, Tucci A, Ladetto M, Gaidano G, Vitolo U, Pileri S. BIODLCL04: THE PROGNOSTIC ROLE OF CELL OF ORIGIN PROFILE, MYC, BCL2, AND TP53 IN UNTREATED POOR-RISK DIFFUSE LARGE B-CELL LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A. Chiappella
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - C. Agostinelli
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - M. Martelli
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - A. Evangelista
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - M. Fabbri
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - F. Melle
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - G. Motta
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - S. Righi
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - D. Novero
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - M. Balzarotti
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - M.G. Cabras
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - A.M. Carella
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - M. Gotti
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - V. Pavone
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - A. Tucci
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - M. Ladetto
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - G. Gaidano
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - U. Vitolo
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
| | - S.A. Pileri
- AOU Città della Salute e della Scienza di Torino; On behalf of Fondazione Italiana Linfomi (FIL); Torino Italy
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Pellegrini C, Pulsoni A, Rigacci L, Patti C, Gini G, Tani M, Rusconi C, Romano A, Vanazzi A, Hohaus S, Mazza P, Molica S, Corradini P, Gaudio F, Ronconi F, Pinto A, Pavone V, Volpetti S, Visentin A, Bonfichi M, Schiavotto C, Spina M, Carella A, Argnani L, Zinzani P. REAL LIFE EXPERIENCE WITH BRENTUXIMAB VEDOTIN: THE ITALIAN STUDY ON 234 RELAPSED/REFRACTORY HODGKIN'S LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_29] [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: 11/06/2022]
Affiliation(s)
- C. Pellegrini
- Institute of Hematology "L. e A. Seràgnoli"; University of Bologna; Bologna Italy
| | - A. Pulsoni
- Hematology, Department of Cellular Biotechnologies and Hematology; Sapienza University; Rome Italy
| | - L. Rigacci
- Hematology Department; University and Hospital Careggi; Florence Italy
| | - C. Patti
- Hematology; Azienda Ospedali Riuniti Villa Sofia Cervello; Palermo Italy
| | - G. Gini
- Hematology; Ospedali Riuniti; Ancona Italy
| | - M. Tani
- Hematology; Santa Maria delle Croci Hospital; Ravenna Italy
| | - C. Rusconi
- Division of Hematology Niguarda Cancer Center; Niguarda Hospital; Milan Italy
| | - A. Romano
- Hematology, Azienda Policlinico-OVE; University of Catania; Catania Italy
| | - A. Vanazzi
- Division of Clinical Haemato-Oncology; IEO; Milan Italy
| | - S. Hohaus
- Institute of Hematology; Catholic Unicversityof the Sacred Heart; Rome Italy
| | - P. Mazza
- Department of Hematology-Oncology; Ospedale Moscati; Taranto Italy
| | - S. Molica
- Hematology; Azienda Ospedaliera Pugliese-Ciaccio; Catanzaro Italy
| | - P. Corradini
- Hematology; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - F. Gaudio
- Hematology; Policlinico di Bari; Bari Italy
| | - F. Ronconi
- Division of Hematology and Stem Cell Transplantation Unit; Cardarelli Hospital; Naples Italy
| | - A. Pinto
- Hematology-Oncology and Stem Cell Transplantation Unit; National Cancer Institute, Fondazione Pascale, IRCCS; Naples Italy
| | - V. Pavone
- Hematology; Ospedale G. Panico; Lecce Italy
| | - S. Volpetti
- Hematology; Azienda Sanitaria Universitaria Integrata; Udine Italy
| | - A. Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine; University of Padua; Padova Italy
| | - M. Bonfichi
- Hematology; IRCCS Policlinico San Matteo; Pavia Italy
| | | | - M. Spina
- Division of Medical Oncology A; National Cancer Institute; Aviano Italy
| | - A. Carella
- Division of Hematology 1; IRCCS A.O.U. San Martino IST; Genoa Italy
| | - L. Argnani
- Institute of Hematology "L. e A. Seràgnoli"; University of Bologna; Bologna Italy
| | - P. Zinzani
- Institute of Hematology "L. e A. Seràgnoli"; University of Bologna; Bologna Italy
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Andreula C, Carella A, Colombo M, De Blasi R, Klaveness A, Mazza A, Simionato F, Scotti G. Valutazione della sicurezza ed efficacia di iodixanolo 270 mgI/ml e 320mgI/ml a confronto con iopamidolo 300 mgI/ml nella TC cerebrale. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/197140099300600404] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Scopo di questo studio doppio cieco, randomizzato, comparativo a tre gruppi paralleli, è stato il confronto della sicurezza tollerabilità ed efficacia della concentrazione più bassa (270 mgI/ml: 39 pazienti) e più alta (320 mgI/ml: 39 pazienti) di iodixanolo (Visipaque ®), un nuovo mezzo di contrasto iodato non-ionico dimero, con iopamidolo (300 mgI/ml: 40 pazienti) nell'esame di tomografia computerizzata della testa. Le caratteristiche generali dei pazienti risultarono simili nei 3 gruppi di trattamento. Nessuna differenza significativa (p > 0,05) fu riscontrata tra i 3 gruppi di trattamento nella informazione diagnostica, il principale parametro di efficacia (ottimale in 37, 36 e 39 pazienti del gruppo iodixanolo 270, iodixanolo 320 e iopamidolo 300 rispettivamente). I risultati riguardanti la sicurezza non mostrarono nessuna differenza significativa tra i 3 mezzi di contrasto considerati. Su 118 pazienti, 9 accusarono discomfort (7%, 5%, e 10% nel gruppo iodixanolo 270, iodixanolo 320 e iopamidolo 300 rispettivamente) e solo 1 pz. del gruppo iodixanolo 320 mgI/ml presentò un evento avverso diverso dal discomfort (transitoria e lieve nausea, tosse, e dispnea). Il test esatto di Fisher dette p = 0,50 nel confronto tra gruppo iodixanolo 320 e gruppo iopamidolo 300. In conclusione, iodixanolo 270 mgI/ml e 320 mgI/ml risultarono mezzi di contrasto sicuri ed efficaci nell'esame di tomografia computerizzata della testa, e non fu riscontrata nessuna differenza significativa nella sicurezza ed efficacia rispetto a iopamidolo 300 mgI/ml.
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Affiliation(s)
| | | | | | | | | | - A. Mazza
- Università di Milano, Ospedale S. Raffaele
| | | | - G. Scotti
- Università di Milano, Ospedale S. Raffaele
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Carella A, Andreula C. Impiego del Gadolinio-DTPA nello studio con risonanza magnetica della patologia infettiva del sistema nervoso centrale. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/19714009900030s307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
La risonanza magnetica diretta per la sua alta sensibilità svolge un ruolo fondamentale nella diagnosi della patologia infiammatoria e infettiva a carico del Sistema Nervoso Centrale. Al confronto con la TC eseguita con tecniche speciali (doppia dose di mezzo di contrasto e scansioni ritardate), la RM ha tuttavia minore specificità. L'uso del mezzo di contrasto paramagnetico (Gadolinio - DTPA) in RM permette almeno il raggiungimento della percentuale di specificità della TC. Comunque se qualsiasi diagnosi eziologica di malattie infettive basata solo sulle neuroimmagini è arbitraria e velleitaria, è possibile utilizzare i dati della dinamica del mezzo di contrasto in RM per la diagnosi di meningite, di stadiazione di fase di lesioni focali (cerebrite versus ascesso) e per la valutazione dello stato della Barriera Emato Encefalica nella patologia da germi non opportunisti della sostanza bianca. La nostra esperienza si basa su una casistica personale di più di 200 pazienti con patologia del SNC da virus HIV senza e con AIDS tra i quali è stato scelto un gruppo campione di 30 pazienti con sospetta meningite, lesioni focali da germi opportunisti e leucoencefalopatia da HIV stesso. Nella patologia infettiva ed infiammatoria del SNC il nostro suggerimento è di utilizzare la RM come esame di prima scelta per la sua alta sensibilità e di completare l'esame con somministrazione di mezzo di contrasto paramagnetico in caso di sospetta meningite, presenza di lesioni focali e patologia della sostanza bianca.
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Affiliation(s)
- A. Carella
- Servizio di Neuroradiologia. Università degli Studi di Bari
| | - C.F. Andreula
- Servizio di Neuroradiologia. Università degli Studi di Bari
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Abstract
Gli autori propongono la risonanza magnetica come esame di prima scelta nello studio delle trombosi venose cerebrali. La presenza di un segnale iperintenso nelle immagini pesate in T1 e T2, lungo il decorso delle vene cerebrali, conferma senza dubbio la diagnosi. Vengono discussi i problemi relativi all'effetto paradosso del flusso ematico cerebrale ed i protocolli d'indagine di questa patologia. The use of MR without any dependance on field strenght can solve the diagnostic problem of cerebral venous thrombosis, avoiding contrast media and/or vessel puncture. In fact the easy detection of hyperintense signal within venous structures, revealed in T1 weighted images and persistent in T2 weighted images, confirm the clinical hyphothesis of cerebral venous thrombosis, without any further examinations. The higher sensibility of MR will show venous infarcts and haemorragic soffusions, sometimes maldetected by CT.
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Affiliation(s)
| | - R. Paladini
- Servizio di Neuroradiologia, Università di Bari
| | - A. Carella
- Servizio di Neuroradiologia, Università di Bari
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Abstract
Scopo del nostro studio è stato quello di fornire una mappa quanto più possibile dettagliata del nervo trigemino, del suo decorso e della sua patologia. Nel percorso abbiamo preferito utilizzare come riferimento l'anatomia patologica topografica, diffidando dai singoli aspetti clinici, spesso contraddittori e non corrispondenti alla neuropatologia. Il nervo è stato suddiviso in quattro segmenti anatomici: porzione tronco-encefalica (comprendente nuclei e vie di proiezione), radice pregangliare, ganglio di Gasser e terminazioni periferiche (sensitive e motorie). Per ognuno di questi segmenti sono stati esaminati gli aspetti patologici su base vascolare (comprendente lesioni ischemiche, emorragiche, malformative ed il cosiddetto ‘conflitto neurovascolare»), infiammatoria (sclerosi multipla), malformativa e neoplastica. Secondo dati statistici più frequente è l'interessamento delle terminazioni periferiche, seguite dal segmento intracisternale, dai nuclei del tronco encefalico e dal ganglio di Gasser. Metodica neuroradiologica di scelta si è rivelata essere la risonanza magnetica in virtù del suo maggiore potere di risoluzione in alcuni distretti anatomici rispetto ad altre tecniche digitalizzate, della capacità di fornire immagini multiplanari e della maggiore sensibilità e specificità.
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Affiliation(s)
- A. Carella
- Cattedra e Servizio di Neuroradiologia, Policlinico dell'Università; Bari
| | - C.F. Andreula
- Cattedra e Servizio di Neuroradiologia, Policlinico dell'Università; Bari
| | - G. Marano
- Cattedra e Servizio di Neuroradiologia, Policlinico dell'Università; Bari
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Andreula C, Carella A. Lesioni cerebrali focali in corso di AIDS Studio della dinamica dell'accentuazione di contrasto per la diagnosi di lesione elementare. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/197140098900200104] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nei pazienti affetti da Sindrome di Immunodeficienza Acquisita (AIDS) la cornparsa di sintomatologia neurologica è riportata nell'ordine di circa il 30%. Gli studi autoptici rilevano, altresì, un'incidenza del 75–80% di coinvolgimento del sistema nervoso centrale. In tal senso per poter ridurre tale discrepanza di dati, è stata adottata la tecnica di tomografia computerizzata con doppia dose di contrasto ed esecuzione di scansioni ritardate. Tale tecnica consente il rilievo di lesioni non svelate da uno studio tradizionale standard, anche in uno studio preclinico di sintomatologia focale neurologica e permette, inoltre, una valutazione in senso maturativo delle lesioni flogistiche e/o infettive. Inoltre nello studio longitudinale è possibile valutare l'efficacia della terapia adottata e l'eventuale comparsa di recidive. Il nostro studio si basa su una casistica di 83 pazienti portatori di AIDS con sintomatologia neurologica e neuropsicologica. Nel 14.45% dei pazienti sono state rilevate lesioni focali con la tecnica speciale, in numero maggiore meglio definite e con maggiore accuratezza di stadiazione maturativa.
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Affiliation(s)
- C.F. Andreula
- Servizio di Neuroradiologia, USL BA/9, Università degli Studi, Bari
| | - A. Carella
- Servizio di Neuroradiologia, USL BA/9, Università degli Studi, Bari
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Balleari E, Salvetti C, Del Corso L, Filiberti R, Bacigalupo A, Bellodi A, Beltrami G, Bergamaschi M, Berisso G, Calzamiglia T, Carella A, Cavalleri M, Da Col A, Favorini S, Forni G, Goretti R, Miglino M, Mitscheuning L, Molinari E, Racchi O, Scudeletti M, Tassara R, Gobbi M, Lemoli R, Clavio M. Age and comorbidities deeply impact on clinical outcome of patients with myelodysplastic syndromes. Leuk Res 2015; 39:846-52. [DOI: 10.1016/j.leukres.2015.05.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 05/11/2015] [Accepted: 05/17/2015] [Indexed: 11/16/2022]
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Del Corso L, Salvetti C, Filiberti R, Clavio M, Lemoli R, Carella A, Forni G, Scudeletti M, Tassara R, Berisso G, Calzamiglia T, Arboscello E, Bellodi A, Beltrami G, Bergamaschi M, Cavalleri M, Dominietto A, Favorini S, Ghiso A, Goretti R, Miglino M, Mitscheunig L, Racchi O, Molinari E, Vignolo L, Gobbi M, Balleari E. 202 BOTH AGE AND COMORBIDITIES NEGATIVELY IMPACT ON CLINICAL OUTCOME OF PATIENTS WITH MYELODYSPLASTIC SYNDROMES: RESULTS FROM A REAL-LIFE REGIONAL SURVEY. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30203-4] [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: 11/17/2022]
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Vagge S, Lamanna G, Vidano G, Ibatici A, Agostinelli S, Carella A, Corvò R. PO-0804: Volumetric Total Lymphoid Irradiation: step-up an effective treatment for stem cell transplantation in lymphoma. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40796-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Luminari S, Biasoli I, Versari A, Rattotti S, Bottelli C, Rusconi C, Merli F, Spina M, Ferreri A, Zinzani P, Gallamini A, Franceschetto A, Boccomini C, Franceschetti S, Salvi F, Raimondo F, Carella A, Micol Q, Balzarotti M, Musto P, Federico M. The prognostic role of post-induction FDG-PET in patients with follicular lymphoma: a subset analysis from the FOLL05 trial of the Fondazione Italiana Linfomi (FIL). Ann Oncol 2014; 25:442-7. [DOI: 10.1093/annonc/mdt562] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [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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Luminari S, Biasoli I, Arcaini L, Versari A, Rusconi C, Merli F, Spina M, Ferreri A, Zinzani P, Gallamini A, Mastronardi S, Boccomini C, Gaidano G, D'Arco A, Di Raimondo F, Carella A, Santoro A, Musto P, Federico M. The use of FDG-PET in the initial staging of 142 patients with follicular lymphoma: a retrospective study from the FOLL05 randomized trial of the Fondazione Italiana Linfomi. Ann Oncol 2013; 24:2108-12. [DOI: 10.1093/annonc/mdt137] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Vagge S, Zeverino M, Vidano V, Fozza A, Barra S, Taccini G, Pica G, Carella A. EP-1037 FEASIBILITY OF TOTAL LYMPHOID IRRADIATION WITH HELICAL TOMOTHERAPY IN MALIGNANT LYMPHOMAS BEFORE AUTOGRAFT. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71370-1] [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: 11/28/2022]
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De Blasi R, Bracciolini E, Chiumarulo L, Salvati A, Monetti C, Federico F, Carella A. Pseudoaneurysm formation following intrasphenoid rupture of an idiopathic intracavernous carotid artery aneurysm: coil migration and early recurrence after endovascular treatment. Interv Neuroradiol 2010; 16:442-6. [PMID: 21162775 DOI: 10.1177/159101991001600411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2010] [Accepted: 09/04/2010] [Indexed: 11/15/2022] Open
Abstract
Intrasphenoid rupture of a non-traumatic aneurysm of the cavernous carotid artery is rare. We describe a patient in whom this condition manifested with epistaxis and led to the formation of a pseudoaneurysm occupying the right sphenoid sinus. The lesion recurred after repeated attempts at conservative endovascular therapy. Eventually the patient was treated with endovascular occlusion of the right internal carotid artery. Our report emphasizes the relapsing behaviour of a non-traumatic aneurysm of the cavernous portion of the internal carotid artery ruptured into the sphenoid sinus.
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Affiliation(s)
- R De Blasi
- Unit of Neuroradiology and Interventional Radiology, "Di Venere" Hospital, Bari, Italy
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De Blasi R, Medicamento N, Chiumarullo L, Salvati A, Maghenzani M, Dicuonzo F, Carella A. A case of aneurysm on a persistent hypoglossal artery treated by endovascular coiling. Interv Neuroradiol 2009; 15:175-8. [PMID: 20465895 DOI: 10.1177/159101990901500206] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2009] [Accepted: 04/05/2009] [Indexed: 11/16/2022] Open
Abstract
SUMMARY We describe a 22-year-old woman admitted to hospital in emergency with nuchal headache and vomiting. CT scan disclosed subarachnoid hemorrhage. Digital subtraction angiography with three-dimensional rotational acquisitions showed a ruptured aneurysm of a right persistent primitive hypoglossal artery as the cause of symptoms and hemorrhage. The patient was successfully treated with endovascular coiling of the aneurysm. This is the second literature report describing endovascular treatment in this unusual condition.
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Affiliation(s)
- R De Blasi
- Department of Neuroradiology, Bari University Hospital; Bari, Italy -
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Palumbo AP, Bringhen S, Rossi D, Berretta S, Montefusco V, Peccatori J, Galli M, Carella A, Omedè P, Boccadoro M. A phase III study of VMPT versus VMP in newly diagnosed elderly myeloma patients. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8515] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8515 Background: In MM patients VMP is superior to MP. In relapsed-refractory patients the 4 drug combination VMPT induced a high proportion of complete responses (CR). Methods: 500 newly diagnosed MM patients ≥ 65 years were randomly assigned to receive VMPT (N=247) or VMP (N=253). Patients were treated with nine 5-week cycles of VMPT (bortezomib 1.3 mg/m2 days 1, 8, 15, 22; melphalan 9 mg/m2 days 1–4; prednisone 60 mg/m2 days 1–4 and thalidomide 50 mg days 1–35) or VMP (bortezomib, melphalan and prednisone at the same doses and schedules previously described). Primary end-point was progression-free survival (PFS). Assuming the hazard ratio (VMP vs VMPT) of 1.35, the total sample size is 500 (250/arm) subjects (power 80%, 2-side alpha 0.05). Results: 354 patients (median age 71 years), who received at least 1 cycle were evaluated: 177 VMPT and 177 VMP. Data were analyzed in intention-to-treat. The VGPR rate was 55% in the VMPT group and 45% in the VMP group (p<0.001). After a median follow-up of 14.5 months, the 3-year PFS was 74% in the VMPT group and 70% in the VMP group (HR=0.75, 95% CI 0.45–1.26, p=0.28). The 3-year overall survival (OS) was 88% in the VMPT group and 87% in the VMP group (HR=0.89, 95% CI 0.42–1.87, p=0.75). Subgroup analyses did not show any statistical difference between responses/PFS and either ISS or chromosomal abnormalities (t(4;14) or t(14;16) or del17) in both groups. Age > 75 years was associated with lower VGPR rate (p=0.02) in VMPT but not in VMP. Factors predictive of longer PFS were age ≤ 75 years (p=0.003) and the achievement of VGPR (p=0.0005) in VMPT but not in VMP. The incidence of grade 3–4 adverse events (AEs) was similar in both groups. In the VMPT patients and in the VMP patients, the more frequent AEs were neutropenia (36% vs 31%), thrombocytopenia (20% vs 19%), peripheral neuropathy (18% vs 12%) and infections (14% vs 10%), respectively. Conclusions: VMPT is superior to VMP in terms of response rates. Longer follow-up is needed to assess their effects on PFS and OS. Both regimens appeared to overcome the poor prognosis of ISS and chromosomal abnormalities. An update of these data will be presented. [Table: see text]
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Affiliation(s)
- A. P. Palumbo
- Azienda Ospedaliera San Giovanni Battista, Torino, Italy; Università del Piemonte Orientale Amedeo Avogadro, Novara, Italy; Ospedale Ferrarotto, Università di Catania, Catania, Italy; Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; Istituto Scientifico San Raffaele, Milano, Italy; Ospedali Riuniti, Bergamo, Italy; A.O.U. San Martino, Genova, Italy
| | - S. Bringhen
- Azienda Ospedaliera San Giovanni Battista, Torino, Italy; Università del Piemonte Orientale Amedeo Avogadro, Novara, Italy; Ospedale Ferrarotto, Università di Catania, Catania, Italy; Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; Istituto Scientifico San Raffaele, Milano, Italy; Ospedali Riuniti, Bergamo, Italy; A.O.U. San Martino, Genova, Italy
| | - D. Rossi
- Azienda Ospedaliera San Giovanni Battista, Torino, Italy; Università del Piemonte Orientale Amedeo Avogadro, Novara, Italy; Ospedale Ferrarotto, Università di Catania, Catania, Italy; Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; Istituto Scientifico San Raffaele, Milano, Italy; Ospedali Riuniti, Bergamo, Italy; A.O.U. San Martino, Genova, Italy
| | - S. Berretta
- Azienda Ospedaliera San Giovanni Battista, Torino, Italy; Università del Piemonte Orientale Amedeo Avogadro, Novara, Italy; Ospedale Ferrarotto, Università di Catania, Catania, Italy; Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; Istituto Scientifico San Raffaele, Milano, Italy; Ospedali Riuniti, Bergamo, Italy; A.O.U. San Martino, Genova, Italy
| | - V. Montefusco
- Azienda Ospedaliera San Giovanni Battista, Torino, Italy; Università del Piemonte Orientale Amedeo Avogadro, Novara, Italy; Ospedale Ferrarotto, Università di Catania, Catania, Italy; Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; Istituto Scientifico San Raffaele, Milano, Italy; Ospedali Riuniti, Bergamo, Italy; A.O.U. San Martino, Genova, Italy
| | - J. Peccatori
- Azienda Ospedaliera San Giovanni Battista, Torino, Italy; Università del Piemonte Orientale Amedeo Avogadro, Novara, Italy; Ospedale Ferrarotto, Università di Catania, Catania, Italy; Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; Istituto Scientifico San Raffaele, Milano, Italy; Ospedali Riuniti, Bergamo, Italy; A.O.U. San Martino, Genova, Italy
| | - M. Galli
- Azienda Ospedaliera San Giovanni Battista, Torino, Italy; Università del Piemonte Orientale Amedeo Avogadro, Novara, Italy; Ospedale Ferrarotto, Università di Catania, Catania, Italy; Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; Istituto Scientifico San Raffaele, Milano, Italy; Ospedali Riuniti, Bergamo, Italy; A.O.U. San Martino, Genova, Italy
| | - A. Carella
- Azienda Ospedaliera San Giovanni Battista, Torino, Italy; Università del Piemonte Orientale Amedeo Avogadro, Novara, Italy; Ospedale Ferrarotto, Università di Catania, Catania, Italy; Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; Istituto Scientifico San Raffaele, Milano, Italy; Ospedali Riuniti, Bergamo, Italy; A.O.U. San Martino, Genova, Italy
| | - P. Omedè
- Azienda Ospedaliera San Giovanni Battista, Torino, Italy; Università del Piemonte Orientale Amedeo Avogadro, Novara, Italy; Ospedale Ferrarotto, Università di Catania, Catania, Italy; Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; Istituto Scientifico San Raffaele, Milano, Italy; Ospedali Riuniti, Bergamo, Italy; A.O.U. San Martino, Genova, Italy
| | - M. Boccadoro
- Azienda Ospedaliera San Giovanni Battista, Torino, Italy; Università del Piemonte Orientale Amedeo Avogadro, Novara, Italy; Ospedale Ferrarotto, Università di Catania, Catania, Italy; Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; Istituto Scientifico San Raffaele, Milano, Italy; Ospedali Riuniti, Bergamo, Italy; A.O.U. San Martino, Genova, Italy
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Pezzoli A, Pennazio M, Fusetti N, Simone L, Zelante A, Cifalà V, Sprujevnik T, Carella A, Gullini S. Occult intestinal haemorrhage due to lipoma of the small bowel detected with the combined use of the new endoscopic techniques. A report of two cases. Dig Liver Dis 2008; 40:306-9. [PMID: 18289948 DOI: 10.1016/j.dld.2007.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Revised: 02/09/2007] [Accepted: 02/13/2007] [Indexed: 12/11/2022]
Abstract
We report two unusual cases of occult intestinal bleeding due to lipoma of the small bowel. Both the patients underwent several inconclusive endoscopic and radiological procedures before the diagnosis of these lesions that was possible using video capsule endoscopy and double balloon enteroscopy. In the first case, the finding of capsule endoscopy was confirmed using enteroscopy, allowing us to diagnose the ileal mass. In the second and more recent case, we used double balloon enteroscopy for the further characterisation and management of the ileal lipoma. Lipoma is a very rare cause of intestinal bleeding and we describe the management and the outcome of our patients.
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Affiliation(s)
- A Pezzoli
- Endoscopy Unit, Department of Gastroenterology, Corso Giovecca 202, 44100 Ferrara, Italy.
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Ueno NT, Rizzo JD, Demirer T, Cheng YC, Hegenbart U, Zhang MJ, Bregni M, Carella A, Blaise D, Bashey A, Bitran JD, Bolwell BJ, Elfenbein GJ, Fields KK, Freytes CO, Gale RP, Lazarus HM, Champlin RE, Stiff PJ, Niederwieser D. Allogeneic hematopoietic cell transplantation for metastatic breast cancer. Bone Marrow Transplant 2007; 41:537-45. [PMID: 18084340 DOI: 10.1038/sj.bmt.1705940] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
We reviewed 66 women with poor-risk metastatic breast cancer from 15 centers to describe the efficacy of allogeneic hematopoietic cell transplantation (HCT). Median follow-up for survivors was 40 months (range, 3-64). A total of 39 patients (59%) received myeloablative and 27 (41%) reduced-intensity conditioning (RIC) regimens. More patients in the RIC group had poor pretransplant performance status (63 vs 26%, P=0.002). RIC group developed less chronic GVHD (8 vs 36% at 1 year, P=0.003). Treatment-related mortality rates were lower with RIC (7 vs 29% at 100 days, P=0.03). A total of 9 of 33 patients (27%) who underwent immune manipulation for persistent or progressive disease had disease control, suggesting a graft-vs-tumor (GVT) effect. Progression-free survival (PFS) at 1 year was 23% with myeloablative conditioning and 8% with RIC (P=0.09). Women who developed acute GVHD after an RIC regimen had lower risks of relapse or progression than those who did not (relative risk, 3.05: P=0.03), consistent with a GVT effect, but this did not affect PFS. These findings support the need for preclinical and clinical studies that facilitate targeted adoptive immunotherapy for breast cancer to explore the benefit of a GVT effect in breast cancer.
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Affiliation(s)
- N T Ueno
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Lahoz E, Caiazzo R, Carella A, Cozzolino E. First Report of Sclerotinia sclerotiorum on Buckwheat (Fagopyrum esculentum) in Italy. Plant Dis 2007; 91:1519. [PMID: 30780781 DOI: 10.1094/pdis-91-11-1519c] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In each of two fields of buckwheat (Fagopyrum esculentum L.) grown in Benevento Province (southern Italy), 60 to 70% of the plants developed severe root and crown rot. Symptoms included irregular, water-soaked spots on stems that were eventually covered with cottony mycelia as the lesions enlarged. Black sclerotia usually developed within the mycelium. The fungus was isolated on potato dextrose agar and 2% water agar. On the basis of colony morphology, including the production of black sclerotia (1), the fungus was identified as Sclerotinia sclerotiorum (Lib.) De Bary. The identity of the fungus was confirmed by near exact identity of internal transcribed spacer sequences (99%) with two isolates of S. sclerotiorum in GenBank (Accession Nos. Z73800 and Z73799). Pathogenicity of the fungus on buckwheat was evaluated by transplanting 20 20-day-old healthy plants in a mixture of soil and fungal inoculum (0.5% of wet millet seeds colonized by four isolates of S. sclerotiorum). Lesions on crowns and roots developed after 12 days and sclerotia appeared approximately 20 days later. No symptoms developed on noninoculated plants. Reisolation from inoculated plants yielded colonies of S. sclerotiorum. To our knowledge, this is the first report of S. sclerotiorum on buckwheat in Italy. The high incidence and severity of the disease may be limiting factors in the development of buckwheat as an alternative crop of tobacco in southern Italy. Reference: (1) J. E. M. Mordue and P. Holliday. Sclerotinia sclerotiorum. No. 513 in: Descriptions of Pathogenic Fungi and Bacteria. CMI, Kew, Surrey, UK, 1976.
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Affiliation(s)
- E Lahoz
- CRA (Agricultural Research Council), Scafati, I-84018, Italy
| | - R Caiazzo
- CRA (Agricultural Research Council), Scafati, I-84018, Italy
| | - A Carella
- CRA (Agricultural Research Council), Scafati, I-84018, Italy
| | - E Cozzolino
- CRA (Agricultural Research Council), Scafati, I-84018, Italy
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Mezzapesa DM, Ceccarelli A, Dicuonzo F, Carella A, De Caro MF, Lopez M, Samarelli V, Livrea P, Simone IL. Whole-brain and regional brain atrophy in amyotrophic lateral sclerosis. AJNR Am J Neuroradiol 2007; 28:255-9. [PMID: 17296989 PMCID: PMC7977419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2006] [Accepted: 03/24/2006] [Indexed: 05/13/2023]
Abstract
BACKGROUND AND PURPOSE Recent evidence from neuropsychologic and neuroimaging studies suggests that central nervous system involvement in amyotrophic lateral sclerosis (ALS) extends beyond motor neurons. Our purpose was to obtain measures of global and regional atrophy in nondemented patients with ALS to assess subtle structural brain changes. METHODS MR images, acquired from 16 patients and 9 healthy subjects (HS), were processed by using the Structural Imaging Evaluation of Normalized Atrophy (SIENA) software to estimate whole-brain atrophy measures and the voxel-based morphometry (VBM) method to highlight the selective volumetric decrease of single cerebral areas. In addition, each subject underwent a neuropsychologic examination. RESULTS In patients with ALS, brain parenchymal fraction was slightly lower compared with HS (P = .012), and seemed to be related to the presence of cognitive impairment. Patients showed a gray matter volume decrease in several frontal and temporal areas bilaterally (P < .001 uncorrected) compared with HS, with a slight prevalence in the right hemisphere. No volume reduction in primary motor cortices of patients was detected. Performances on Symbol Digit Modalities Test were significantly worse in patients compared with HS (P = .025). CONCLUSIONS The presence of mild whole-brain volume loss and regional frontotemporal atrophy in patients with ALS could explain the presence of cognitive impairment and confirms the idea of ALS as a degenerative brain disease not confined to motor system.
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Affiliation(s)
- D M Mezzapesa
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
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Mezzapesa DM, Petruzzellis M, Lucivero V, Prontera M, Tinelli A, Sancilio M, Carella A, Federico F. Multimodal MR examination in acute ischemic stroke. Neuroradiology 2006; 48:238-46. [PMID: 16508783 DOI: 10.1007/s00234-005-0045-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2005] [Accepted: 10/06/2005] [Indexed: 12/11/2022]
Abstract
In recent years, combined diffusion-weighted imaging (DWI) with perfusion imaging (PI) has become an important investigational tool in the acute phase of ischemic stroke, as it may differentiate reversible from irreversible brain tissue damage. We consecutively examined 20 subjects within 12 h of stroke onset using a multiparametric magnetic resonance (MR) examination consisting of DWI, mean transit time (MTT) as PI parameter, and MR angiography (MRA). T2-weighted and fluid-attenuated inversion recovery (FLAIR) on day 7 were also acquired in order to obtain final infarct volume. The following MR parameters were considered: volumetric measures of lesion growth and MTT abnormalities, quantification of regional apparent diffusion coefficient (ADC) and visual inspection of MRA findings. Our results showed: (1) an acute DWI lesion was not predictive of lesion growth and the DWI abnormality did not represent the irreversibly infarcted tissue; (2) ADC values in the ischemic penumbra could not predict tissue at risk; (3) the DWI-PI mismatch did not predict lesion growth, and the PI abnormality overestimated the amount of tissue at risk; and (4) patients with proximal middle cerebral artery occlusion had greater initial and final infarct volumes. This study did not demonstrate the prognostic value of a multimodal MR approach in early ischemic stroke; MRA alone provided predictive information about the volumetric evolution of the lesion.
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Affiliation(s)
- D M Mezzapesa
- Department of Neurological and Psychiatric Sciences, University of Bari, Italy
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Abstract
BACKGROUND Hereditary haemorrhagic telangiectasia (HHT) is a systemic autosomal dominant vascular disease. Although the clinical picture is that of a chronic disabling disease, vascular malformations can suddenly lead to life-threatening conditions. AIM To assess the frequency and type of emergency acute complications in HHT. DESIGN Retrospective case-note review. METHODS From August 2000 to December 2004, our specialized HHT centre saw 139 patients (74 males, 65 females, mean age 45.5 years, range 14-77) with a definite diagnosis of HHT. We reviewed their clinical files and recorded all visits for acute complications (massive nosebleeds, haematemesis, melaena, haematochezia, haemothorax, haemoptysis, TIA/ischaemic stroke, haemorrhagic stroke, brain abscess). RESULTS Fifty patients (35.9%) had at least one acute complication. There were a total of 93 visits potentially involving the emergency department. Most commonly, patients sought urgent medical attention for nosebleeds and gastrointestinal bleeding (63.4%), but there were also disorders of the brain, lung, heart and liver. DISCUSSION Acute complications of HHT are not uncommon and can be severe and wide-ranging. Physicians should be aware of HHT and its major complications, as a prompt diagnosis is essential to direct patients to the most appropriate therapies, and to suggest screening for visceral involvement in their relatives.
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Affiliation(s)
- M Gallitelli
- Department of Internal Medicine and Public Health, Section of Internal Medicine, Bari, Italy
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Lucivero V, Mezzapesa DM, Petruzzellis M, Carella A, Lamberti P, Federico F. Ischaemic stroke in progressive systemic sclerosis. Neurol Sci 2004; 25:230-3. [PMID: 15549510 DOI: 10.1007/s10072-004-0327-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2004] [Accepted: 07/24/2004] [Indexed: 11/28/2022]
Abstract
Progressive systemic sclerosis (PSS) or scleroderma is a multisystem disease affecting the skin, lungs, myocardium, kidneys and gastrointestinal tract. Primary involvement of cerebral arteries in PSS has been reported but is very rare. A 61-year-old woman suffering from scleroderma for six years was hospitalised for two subsequent episodes of transient acute dysarthria and left hemiparesis. After five hours from the first onset of symptoms, she was submitted to brain magnetic resonance (MR) protocol that showed a right subinsular ischaemic lesion and whole right middle cerebral artery (MCA) territory hypoperfusion. Intracranial and epiaortic MR angiography reported a focal stenosis in the M2 portion of MCA. She was immediately treated with i.v. high dose steroids and oral acetylsalicylic acid. At one-month follow up, MR findings were confirmed. We have documented a cerebral infarct in a PSS patient. In our opinion, the ischaemic stroke was caused by a localised autoimmune angiopathy.
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Affiliation(s)
- V Lucivero
- Department of Neurological and Psychiatric Sciences, University of Bari, Piazza G. Cesare 12, I-70124 Bari, Italy
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Lamberti F, D'Addabbo T, Greco P, Carella A. Efficacy of the liquid formulation of some nematicides. Meded Rijksuniv Gent Fak Landbouwkd Toegep Biol Wet 2003; 67:699-702. [PMID: 12696439] [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: 03/01/2023]
Abstract
Bunches of 25 g of tomato galled roots containing ca. 270 eggs and juveniles/g of Meloidogyne incognita were buried on 29 September 2001 in gauze bags at the depth of 15, 30 and 45 cm in a sandy loam. The liquid formulation of the nematicides 1,3 dichloropropene (at the rate of 100, 200 and 300 l/ha), metam sodium (at the rate of 500, 1000, and 1500 l/ha), oxamyl (at the rate of 50, 100 and 150 l/ha) and fenamiphos (at the rate of 30, 60, and 90 l/ha) were then applied in 10, 20 or 40 l/m2 of water. Control plots received only plain water. One month later all bags were recovered and the roots mixed with steamed soil and filled in plastic pots in which two tomato seeds were planted. Fifty days later plants were uprooted and aliquots of roots were macerated in blender to determine the number of eggs and juveniles. 1,3 dichloropropene, metam sodium and oxamyl were equally effective in controlling root-knot nematodes; fenamiphos was less effective. For all chemicals degree of control increased with the increase of rate of application and the volume of water of application, but decreased in the increase of depth of nematode burial.
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Affiliation(s)
- F Lamberti
- Istituto per la Protezione delle Piante, Sezione di Bari C.N.R. 70126 Bari, Italy
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Lamberti F, D'Addabbo T, Sasanelli N, Carella A. Control of Pratylenchus vulnus in stone fruit nurseries. Meded Rijksuniv Gent Fak Landbouwkd Toegep Biol Wet 2003; 66:629-32. [PMID: 12425087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Almond, peach and olive nurseries were prepared in sandy soil infested by Pratylenchus vulnus in southern Italy. Soil treatments before or at sowing included methyl bromide at the rate of 40 g/m2; 1.3 D at the rate of 15 ml/m2; dazomet at the rate of 100 g/m2 without plastic tarping, or at the rate of either 100 or 50 g/m2 with tarping, and fenamiphos Gr 5 at the rate of 100 g/m2 or 240 CS at the rate of 40 g/m2 as single application; fenamiphos Gr 10 and 240 CS were also applied at planting and two, four and six months after sowing, each time at the rate of 10 g/m2. The experiment was discontinued ten and thirteen months after sowing, respectively for olive and peach and almond. Methyl bromide, 1.3 D or fenamiphos, or dazomet, under certain circumstances, produced agronomically suitable plants, but none of the treatments eradicated the nematode.
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Affiliation(s)
- F Lamberti
- Istituto di Nematologia Agraria C.N.R. 70126 Bari, Italy
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30
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Fischer T, Reifenrath C, Hess GR, Corsetti MT, Kreil S, Beck J, Meinhardt P, Beltrami G, Schuch B, Gschaidmeier H, Hehlmann R, Hochhaus A, Carella A, Huber C. Safety and efficacy of STI-571 (imatinib mesylate) in patients with bcr/abl-positive chronic myelogenous leukemia (CML) after autologous peripheral blood stem cell transplantation (PBSCT). Leukemia 2002; 16:1220-8. [PMID: 12094246 DOI: 10.1038/sj.leu.2402565] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2001] [Accepted: 03/21/2002] [Indexed: 11/09/2022]
Abstract
We examined safety and efficacy of STI-571 in 24 bcr/abl-positive patients with CML post PBSCT. At start of STI-571 therapy, nine patients presented in blast crisis (BC) or in accelerated phase (AP), and 15 in chronic phase (CP). Patients were evaluated for hematologic, cytogenetic and molecular response, survival and toxicity. In general, STI-571 was well tolerated in this heavily pretreated group of patients with a non-hematologic and hematologic toxicity profile similar to that observed in a previous phase I trial at comparable doses. Five of nine patients with CML in transformation (AP, BC) were evaluable for hematologic response. Two of five patients had transient reductions in WBC and blasts, and three patients achieved a sustained hematologic response (>4 weeks). Cytogenetic analysis in these patients revealed numerical and/or structural responses. In CML chronic phase, STI-571 induced complete hematologic responses in all patients and major cytogenetic responses in 61% of patients with a complete cytogenetic response rate of 46%. This report indicates that STI-571 is a safe and effective drug in heavily pretreated patients. No apparent additional side-effects were noted in this patient cohort. The high rate of complete hematologic and complete cytogenetic responses in CP patients is remarkable, as intensive treatment approaches plus IFN-alpha failed to be efficient in achieving long-term stabilization of CML in this patient cohort.
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MESH Headings
- Adult
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/adverse effects
- Benzamides
- Blood Cell Count
- Combined Modality Therapy
- Enzyme Inhibitors/administration & dosage
- Enzyme Inhibitors/adverse effects
- Female
- Fusion Proteins, bcr-abl/antagonists & inhibitors
- Hematopoietic Stem Cell Transplantation
- Humans
- Imatinib Mesylate
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/enzymology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Male
- Middle Aged
- Piperazines/administration & dosage
- Piperazines/adverse effects
- Protein-Tyrosine Kinases/antagonists & inhibitors
- Pyrimidines/administration & dosage
- Pyrimidines/adverse effects
- Transplantation, Autologous
- Treatment Outcome
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Affiliation(s)
- T Fischer
- 3 rd Medical Department, Johannes Gutenberg-University, Mainz, Germany
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31
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Kim D, Wang L, Caldwell CG, Chen P, Finke PE, Oates B, MacCoss M, Mills SG, Malkowitz L, Gould SL, DeMartino JA, Springer MS, Hazuda D, Miller M, Kessler J, Danzeisen R, Carver G, Carella A, Holmes K, Lineberger J, Schleif WA, Emini EA. Design, synthesis, and SAR of heterocycle-containing antagonists of the human CCR5 receptor for the treatment of HIV-1 infection. Bioorg Med Chem Lett 2001; 11:3103-6. [PMID: 11720852 DOI: 10.1016/s0960-894x(01)00655-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Replacement of the large hydantoin-indole moiety from our previous work with a variety of smaller heterocyclic analogues gave rise to potent CCR5 antagonists having binding affinity comparable to the hydantoin analogues. The synthesis, SAR, and biological profiles of this class of antagonists are described.
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Affiliation(s)
- D Kim
- Department of Medicinal Chemistry, Merck Research Laboratories, RY 121-240, PO Box 2000, Rahway, NJ 07065, USA.
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32
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Kim D, Wang L, Caldwell CG, Chen P, Finke PE, Oates B, MacCoss M, Mills SG, Malkowitz L, Gould SL, DeMartino JA, Springer MS, Hazuda D, Miller M, Kessler J, Danzeisen R, Carver G, Carella A, Holmes K, Lineberger J, Schleif WA, Emini EA. Discovery of human CCR5 antagonists containing hydantoins for the treatment of HIV-1 infection. Bioorg Med Chem Lett 2001; 11:3099-102. [PMID: 11720851 DOI: 10.1016/s0960-894x(01)00654-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A series of hydantoin derivatives has been discovered as highly potent nonpeptide antagonists for the human CCR5 receptor. The synthesis, SAR, and biological profiles of this class of antagonists are described.
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Affiliation(s)
- D Kim
- Department of Medicinal Chemistry, Merck Research Laboratories, RY 121-240, PO Box 2000, Rahway, NJ 07065, USA.
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33
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Willoughby CA, Berk SC, Rosauer KG, Degrado S, Chapman KT, Gould SL, Springer MS, Malkowitz L, Schleif WA, Hazuda D, Miller M, Kessler J, Danzeisen R, Holmes K, Lineberger J, Carella A, Carver G, Emini EA. Combinatorial synthesis of CCR5 antagonists. Bioorg Med Chem Lett 2001; 11:3137-41. [PMID: 11720860 DOI: 10.1016/s0960-894x(01)00652-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Herein we report the preparation of a combinatorial library of compounds with potent CCR5 binding affinity. The library design was aided by SAR generated in a traditional medicinal chemistry effort. Compounds with novel combinations of subunits were discovered that have high binding affinity for the CCR5 receptor. A potent CCR5 antagonist from the library, compound 11 was found to have moderate anti-HIV-1 activity.
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Affiliation(s)
- C A Willoughby
- Department of Medicinal Chemistry, Merck Research Laboratories, Rahway, NJ 07065, USA.
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34
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Hale JJ, Budhu RJ, Holson EB, Finke PE, Oates B, Mills SG, MacCoss M, Gould SL, DeMartino JA, Springer MS, Siciliano S, Malkowitz L, Schleif WA, Hazuda D, Miller M, Kessler J, Danzeisen R, Holmes K, Lineberger J, Carella A, Carver G, Emini E. 1,3,4-Trisubstituted pyrrolidine CCR5 receptor antagonists. Part 2: lead optimization affording selective, orally bioavailable compounds with potent anti-HIV activity. Bioorg Med Chem Lett 2001; 11:2741-5. [PMID: 11591514 DOI: 10.1016/s0960-894x(01)00545-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Investigations of the structure-activity relationships of 1,3,4-trisubstituted pyrrolidine human CCR5 receptor antagonists afforded orally bioavailable compounds with the ability to inhibit HIV replication in vitro.
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Affiliation(s)
- J J Hale
- Department of Medicinal Chemistry, Merck Research Laboratories, Rahway, NJ 07065, USA.
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35
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Abstract
Paroxysmal dystonia (PD) is a usually painful, unilateral dystonic posture, precipitated by voluntary movement, tactile stimulation, startling noise or hyperventilation. We describe two cases of paroxysmal dystonia in multiple sclerosis, both with a critically localized lesion in the thalamus, contralateral to the paroxysmal symptoms. Only one other case of paroxysmal dystonia with a demyelinated lesion of the thalamus has been reported previously.
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Affiliation(s)
- A Zenzola
- Department of Neurological Science, Second Neurological Clinic, Policlinico, University of Bari, Italy
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36
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Finke PE, Oates B, Mills SG, MacCoss M, Malkowitz L, Springer MS, Gould SL, DeMartino JA, Carella A, Carver G, Holmes K, Danzeisen R, Hazuda D, Kessler J, Lineberger J, Miller M, Schleif WA, Emini EA. Antagonists of the human CCR5 receptor as anti-HIV-1 agents. Part 4: synthesis and structure-activity relationships for 1-[N-(methyl)-N-(phenylsulfonyl)amino]-2-(phenyl)-4-(4-(N-(alkyl)-N-(benzyloxycarbonyl)amino)piperidin-1-yl)butanes. Bioorg Med Chem Lett 2001; 11:2475-9. [PMID: 11549450 DOI: 10.1016/s0960-894x(01)00492-9] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
(2S)-2-(3-Chlorophenyl)-1-[N-(methyl)-N-(phenylsulfonyl)amino]-4-[spiro(2,3-dihydrobenzthiophene-3,4'-piperidin-1'-yl)]butane S-oxide (1b) has been identified as a potent CCR5 antagonist having an IC50=10 nM. Herein, structure-activity relationship studies of non-spiro piperidines are described, which led to the discovery of 4-(N-(alkyl)-N-(benzyloxycarbonyl)amino)piperidine derivatives (3-5) as potent CCR5 antagonists.
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Affiliation(s)
- P E Finke
- Department of Medicinal Chemistry, Merck Research Laboratories, PO Box 2000, Rahway, NJ 07065, USA.
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37
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Finke PE, Meurer LC, Oates B, Mills SG, MacCoss M, Malkowitz L, Springer MS, Daugherty BL, Gould SL, DeMartino JA, Siciliano SJ, Carella A, Carver G, Holmes K, Danzeisen R, Hazuda D, Kessler J, Lineberger J, Miller M, Schleif WA, Emini EA. Antagonists of the human CCR5 receptor as anti-HIV-1 agents. Part 2: structure-activity relationships for substituted 2-Aryl-1-[N-(methyl)-N-(phenylsulfonyl)amino]-4-(piperidin-1-yl)butanes. Bioorg Med Chem Lett 2001; 11:265-70. [PMID: 11206474 DOI: 10.1016/s0960-894x(00)00639-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
(2S)-2-(3,4-Dichlorophenyl)-1-[N-(methyl)-N-(phenylsulfonyl)amino]-4-[spiro(2,3-dihydrobenzthiophene-3,4'-piperidin-1'-yl)]butane S-oxide (3) has been identified as a potent CCR5 antagonist lead structure having an IC50 = 35 nM. Herein, we describe the structure-activity relationship studies directed toward the requirement for and optimization of the C-2 phenyl fragment. The phenyl was found to be important for CCR5 antagonism and substitution was limited to small moieties at the 3-position (13 and 16: X= H, 3-F, 3-Cl, 3-Me).
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Affiliation(s)
- P E Finke
- Department of Medicinal Chemistry, Merck Research Laboratories, Rahway, NJ 07065, USA.
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38
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Dorn CP, Finke PE, Oates B, Budhu RJ, Mills SG, MacCoss M, Malkowitz L, Springer MS, Daugherty BL, Gould SL, DeMartino JA, Siciliano SJ, Carella A, Carver G, Holmes K, Danzeisen R, Hazuda D, Kessler J, Lineberger J, Miller M, Schleif WA, Emini EA. Antagonists of the human CCR5 receptor as anti-HIV-1 agents. part 1: discovery and initial structure-activity relationships for 1 -amino-2-phenyl-4-(piperidin-1-yl)butanes. Bioorg Med Chem Lett 2001; 11:259-64. [PMID: 11206473 DOI: 10.1016/s0960-894x(00)00637-5] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Screening of the Merck sample collection for compounds with CCR5 receptor binding afforded (2S)-2-(3,4-dichlorophenyl)-1-[N-(methyl)-N-(phenylsulfonyl)amino]-4-[spiro(2,3-dihydrobenzthiophene-3,4'-piperidin-1'-yl)]butane S-oxide (4) as a potent lead structure having an IC50 binding affinity of 35 nM. Herein, we describe the discovery of this lead structure and our initial structure activity relationship studies directed toward the requirement for and optimization of the 1-amino fragment.
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Affiliation(s)
- C P Dorn
- Department of Medicinal Chemistry, Merck Research Laboratories, Rahway, NJ 07065, USA
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39
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De Blasi R, Zenzola A, Lanzilotti CM, Resta M, Caputi O, Lamberti P, Simone F, Pangrazio MT, Carella A. An unusual association of intracranial aneurysms and oesophageal duplication in a case of Klippel-Trenaunay syndrome. Neuroradiology 2000; 42:930-2. [PMID: 11198216 DOI: 10.1007/s002340000484] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The Klippel-Trenaunay syndrome (KTS) is a congenital disorder resulting from a mesodermal abnormality, characterised by cutaneous capillary haemangiomas, hypertrophy of bone and soft tissues and varicose veins. The presence of intracranial aneurysms has rarely been described, while oesophageal duplication has not been reported previously. We describe a patient with the KTS with both there additional abnormalities, which could be explained by a postulated mosaic gene abnormality.
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Affiliation(s)
- R De Blasi
- Department of Neuroradiology, University of Bari, Italy
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40
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D'Aprile P, Tarantino A, Santoro N, Carella A. Wernicke's encephalopathy induced by total parenteral nutrition in patient with acute leukaemia: unusual involvement of caudate nuclei and cerebral cortex on MRI. Neuroradiology 2000; 42:781-3. [PMID: 11110087 DOI: 10.1007/s002340000393] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
We report a 13-year-old girl with leukaemia and Wernicke's encephalopathy induced by total parenteral nutrition. MRI showed unusual bilateral lesions of the caudate nuclei and cerebral cortex, as well as typical lesions surrounding the third ventricle and aqueduct. After intravenous thiamine, the patient improved, and the abnormalities on MRI disappeared.
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Affiliation(s)
- P D'Aprile
- Department of Neurological Sciences, Policlinico, University of Bari, Italy
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41
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Ray SC, Arthur RR, Carella A, Bukh J, Thomas DL. Genetic epidemiology of hepatitis C virus throughout egypt. J Infect Dis 2000; 182:698-707. [PMID: 10950762 DOI: 10.1086/315786] [Citation(s) in RCA: 281] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2000] [Revised: 06/02/2000] [Indexed: 12/21/2022] Open
Abstract
Hepatitis C virus (HCV) infection is a major health problem in Egypt, where the seroprevalence is 10-20-fold higher than that in the United States. To characterize the HCV genotype distribution and concordance of genotype assessments on the basis of multiple genomic regions, specimens were obtained from blood donors in 15 geographically diverse governorates throughout Egypt. The 5' noncoding, core/E1, and NS5B regions were amplified by reverse transcription-polymerase chain reaction and analyzed by both restriction fragment length polymorphism (RFLP) and phylogenetic tree construction. For the 5' noncoding region, 122 (64%) of 190 specimens were amplified and analyzed by RFLP: 111 (91%) were genotype 4, 1 (1%) was genotype 1a, 1 (1%) was genotype 1b, and 9 (7%) could not be typed. Phylogenetic analyses of the core/E1 and NS5B regions confirmed the genotype 4 preponderance and revealed evidence of 3 new subtypes. Analysis of genetic distance between isolates was consistent with the introduction of multiple virus strains 75-140 years ago, and no clustering was detected within geographic regions, suggesting widespread dispersion at some time since then.
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Affiliation(s)
- S C Ray
- Division of Infectious Diseases, Baltimore, MD 21205, USA. sray@jhmi. edu
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42
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Carella A. Autografting with mobilized hematopoietic progenitor cells in 92 patients with chronic phase—cml. Exp Hematol 2000. [DOI: 10.1016/s0301-472x(00)00307-6] [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: 10/18/2022]
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43
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Carella A, Dicuonzo F, Ladisa P, Pierucci G, Villani PC. [Wegener's granulomatosis: the neuroradiological findings in a case of atypical clinical onset]. Radiol Med 2000; 100:69-70. [PMID: 11109457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- A Carella
- Cattedra di Neuroradiologia, Università, U.O. Malattie dell'Apparato Respiratorio I Ospedaliera, Bari.
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44
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Vella FS, Simone B, Carella A, Schiraldi O, Antonaci S. [Acute disseminated encephalomyelitis as initial clinical manifestation of common variable immunodeficiency. A case report]. Recenti Prog Med 2000; 91:365-7. [PMID: 10932921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Common variable immunodeficiency (CVID) is a primary immunodeficiency disease characterized by severe and recurrent infections which affect both lung and gastrointestinal systems. On the contrary, central nervous system involvement, related to virus infections, is an important, rare and usually fatal complication occurring in a later phase of the disease. Furthermore, CVID may predispose to a variety of autoimmune diseases. Here, we report the case of a 20 years old girl who developed acute disseminated encephalomyelitis as the first clinical feature in CVID. The infective agent was not determined and there was no history of recent vaccinations. CVID was diagnosed on the basis of the significant reduction of serum immunoglobulin concentration, in the absence of either diseases responsible for secondary immunodeficiency or functional and/or quantitative abnormalities of lymphocyte subsets, phagocytes and complement fractions. The treatment with high doses of native intravenous immunoglobulins (IVIG) combined with corticosteroids in the early phase led to a complete recovery with restitutio ad integrum. This case outlines the possible relationship between autoimmune diseases and infections in CVID, as suggested by the finding of either viral encephalitis in CVID patients and the well-known autoimmune pathogenesis of acute disseminated encephalomyelitis. In such a condition, the combination of IVIG and corticosteroids may offer considerable advantages in terms of therapeutical efficacy.
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Affiliation(s)
- F S Vella
- Dipartimento di Clinica Medica, Immunologia e Malattie Infettive, Università, Bari
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45
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Carella A. Autografting followed by mini-allografts for lymphomas. Exp Hematol 2000. [DOI: 10.1016/s0301-472x(00)00308-8] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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46
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Simone IL, Federico F, Tortorella C, De Blasi R, Bellomo R, Lucivero V, Carrara D, Bellacosa A, Livrea P, Carella A. Metabolic changes in neuronal migration disorders: evaluation by combined MRI and proton MR spectroscopy. Epilepsia 1999; 40:872-9. [PMID: 10403210 DOI: 10.1111/j.1528-1157.1999.tb00793.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess the role of 1H-magnetic resonance spectroscopy (MRS) in detecting biochemical abnormalities in neuronal migration disorders (NMDs). METHODS We performed 1H-MRS studies on 17 brain NMD areas [five polymicrogyria, eight subcortical heterotopia, and four cortical dysplasia on magnetic resonance imaging (MRI)]. The study group consisted of 15 patients, all but one affected by partial epileptic seizures. Spectra were acquired from volumes of interest localized on NMDs and contralateral sides and compared with those obtained on gray and white matter of 18 neurologic controls. RESULTS NMD lesions were characterized by lower N-acetylaspartate to creatine (NAA/Cr) and choline to Cr (Cho/Cr) ratios than those of the white (p = 0.002 and p = 0.004) and gray matter (p = 0.03 and p = 0.06) of neurologic controls. In addition, the normal-appearing contralateral sides to the NMD lesions showed a significant decrease of Cho/Cr ratio when compared with those of white (p = 0.003) and gray matter (p = 0.05) of neurologic controls. No relation was found between NAA/Cr decrease, EEG abnormalities, and NMD sides, or between NAA/Cr ratios, duration of epilepsy, and frequency of seizures. Lactate signal was detected in the spectra of four patients who had an epileptic seizure a short time before MR examination. CONCLUSIONS NAA/Cr decrease may be related more to structural and functional alteration of the NMD sides than to epileptic activity in these lesions. Low Cho/Cr may be related to a more extensive diffuse hypomyelination than suggested by the MRI findings. An activation of anerobic glycolysis during and after seizures could account for the presence of lactate. These data confirm that H-MRS is an advanced technique that may provide useful biochemical information in vivo on neurobiologic processes underlying NMDs.
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Affiliation(s)
- I L Simone
- Department of Neurological and Psychiatric Sciences, University of Bari, Italy
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47
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Carella A. Comparative analysis of autografting in chronic myelogenous leukemia: effect of priming regimen and marrow or blood origin of stem cells. Blood 1999; 93:2136-8. [PMID: 10189208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
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De Witte T, Van Biezen A, Hermans J, Labopin M, Runde V, Or R, Meloni G, Mauri SB, Carella A, Apperley J, Gratwohl A, Laporte JP. Autologous bone marrow transplantation for patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia following MDS. Chronic and Acute Leukemia Working Parties of the European Group for Blood and Marrow Transplantation. Blood 1997; 90:3853-7. [PMID: 9354651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Intensive chemotherapy followed by autologous bone marrow transplantation (ABMT) may provide an alternative therapy for young patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia following MDS (sAML) lacking a suitable donor. We report the results for 79 patients with MDS/sAML transplanted with autologous marrow in first complete remission (CR). Within the total group of 79, a cohort of 55 patients for whom the duration of first CR was known were compared with a matched control group of 110 patients with de novo AML. The 2-year survival, disease-free survival (DFS), and relapse rates for the 79 patients transplanted in first CR were 39%, 34%, and 64%, respectively. The relapse risk was greater than 55% for all stages and all disease categories. Patients younger than 40 years had a significantly (P = .04) better DFS (39%) than patients older than 40 years (25%). The DFS at 2 years was 28% for the cohort of 55 patients transplanted for MDS/sAML and 51% for those transplanted for de novo AML (P = .025). Relapse rates were 69% for patients with MDS/sAML and 40% for those with de novo AML (P = .007). ABMT for MDS or secondary leukemia results in a lower DFS when compared with similarly treated patients with de novo AML due to a higher relapse rate. The DFS of 28% for these patients suggests that autotransplantation may be a valuable therapy for this disease. The low treatment-related mortality rate of less than 10% supports the view that sufficient numbers of hematopoietic stem cells are present in patients with MDS to allow adequate repopulation after autologous stem-cell transplantation.
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Affiliation(s)
- T De Witte
- Department of Hematology, University Hospital Nijmegen, Nijmegen, The Netherlands
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Abstract
We report a patient suffering from neurofibromatosis type 1 in whom neoplasms developed from the areas of altered signal which are generally considered benign and typical of the disease. MRI, despite two previous examinations 3 and 2 years before development of the tumour, gave no clue to an unfavourable outcome.
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Affiliation(s)
- A Carella
- Servizio di Neuroradiologia Policlinico-A.S.L., Bari, Italy
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Frassoni F, Giordano D, Podestà M, Piaggio G, Benvenuto F, Pitto A, Figari O, Dejana A, Lerma E, Vassallo F, Sessarego M, Carella A. Autografting Ph-negative blood precursor cells in chronic myeloid leukaemia. Bone Marrow Transplant 1996; 17 Suppl 3:S59-62. [PMID: 8769704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The study was devised to evaluate whether it was possible to collect Philadelphia-negative precursor cells in patients with chronic myeloid leukaemia. The approach was based on previous experience showing that complete remission (Ph-negative bone marrow cells) is rarely achieved after chemotherapy and is very short-lasting. We decided to explore whether it was possible to collect Ph-negative precursor cells in peripheral blood during the early phase of haemopoietic recovery. These data show that: the collection of Ph-negative precursor cells occurred in 12/16 (75%) patients mobilized within one year of diagnosis (group A) versus 12/33 (36%) in patients with a history of more than one year of disease (group B). Furthermore the numbers of Ph-negative precursor cells were significantly much higher at diagnosis. Ten patients mobilized at diagnosis were subsequently autografted with such Ph-negative precursor cells. Five of them remain Ph-negative from 4 to 12 months while the other five have percentages of Ph-positive cells in their marrow ranging from 20% to 70%. In this stage of the disease the procedure is safe and associated with a very good compliance. Occasional restoration of Ph-negative haemopoiesis could be observed up to 40 months after autograft, in patients of group B, but most of patients revert to Ph-positive haemopoiesis. in conclusion these data suggest that it is possible to restore Ph-negative haemopoiesis in 70% of patients mobilized at diagnosis. This percentage represent the highest one can obtain without allogeneic BMT, and this includes patients who never would have been cytogenetic responders to IFN-alpha. Whether and how long for Ph-negative status can be maintained is a matter for future observation and study.
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MESH Headings
- Adult
- Blood Cells/ultrastructure
- Bone Marrow Transplantation
- Clinical Protocols
- Female
- Hematopoietic Stem Cell Transplantation/methods
- Hematopoietic Stem Cells/ultrastructure
- Humans
- Interferon-alpha/therapeutic use
- Leukapheresis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/blood
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Male
- Middle Aged
- Philadelphia Chromosome
- Transplantation, Autologous
- Transplantation, Homologous
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Affiliation(s)
- F Frassoni
- Dipartimento Ematologia, Ospedale San Martino, Genova, Italy
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