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Cicchetti A, Mangili P, Fodor A, Mori M, Chiara A, Deantoni C, Pasetti M, Palazzo G, Ubeira Gabellini MG, Rancati T, Del Vecchio A, Muzio NGD, Fiorino C. Dosimetry Predictors of Late Skin Reactions after Whole Breast Radiotherapy on a Large Mono-Institutional Cohort of Patients. Int J Radiat Oncol Biol Phys 2023; 117:e171. [PMID: 37784780 DOI: 10.1016/j.ijrobp.2023.06.1012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To develop an NTCP model predicting late skin toxicity using dosimetric parameters from the breast dermis to identify possible RT constraints on such a structure. MATERIALS/METHODS The skin structure was defined as the 5 mm inner isotropic expansion from the outer CT body contour. It was retrospectively segmented on a large mono-Institutional cohort of early-stage breast cancer patients enrolled between 2009 and 2017 (n = 1066). Patients were treated with tangential-field RT, delivering 40 Gy in 15 fractions without a RT boost. Toxicity was reported during FU using SOMA/LENT scoring. The study endpoint was moderate-severe late toxicity consisting of Fibrosis-Atrophy-Telangiectasia-Pain (FATP G2+) developed within 42 months after RT completion. Automatic delineation of skin and DVH extraction were accomplished by scripting using the MIM_assistant software. Also, the impact of changes in the dose calculation algorithms during enrolment time was quantified. A logistic model was created by combining multifactorial variables, considering both clinical factors and the absolute skin DVH (cc). Variance Inflation Factor (VIF) was performed to reduce the multicollinearity. Repeated 5-fold cross-validation with SMOTE approach to overcome the class unbalance was applied for model feature selection. The predictive model was then developed on the entire population due to the limited G2+ events. RESULTS The FATP G2+ rate was 3.8% with 40/1066 experiencing late toxicity. Among them, a 40% had already developed acute symptoms after RT completion showing a consequential effect. The multicollinearity analysis selected 27 clinical-treatment-dosimetric factors. After repeated (20 times) 5-fold cross-validation, the best-performing model included Post-Surgery Cosmetic alterations, Aromatase Inhibitors (as a protective factor), V20 Gy (50% of the prescribed dose - DVH plateau region) and V42 Gy (105% of the prescribed dose - DVH high-dose tail). Accuracy and f1-score were 0.76 and 0.58 in both training and test sets, providing good reliability for selected variables. AUC for the final model on the entire population was 0.76+/-0.04. CONCLUSION We quantified the association between fibrosis and skin DVH when delivering 40 Gy in 15fr. The model suggested an independent role of V20 and V42 Gy and a heavy risk modulation by surgical effects and aromatase inhibitors. This last factor could interfere with adipose tissue and water-content distribution within the breast. For this purpose, a CT-based densitometry characterization of toxicity patients is ongoing.
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Affiliation(s)
- A Cicchetti
- Fondazione IRCCS Istituto Nazionale dei Tumori, Data Science Unit, Milan, Italy
| | - P Mangili
- San Raffaele Scientific Institute, Milan, Italy
| | - A Fodor
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Mori
- San Raffaele Scientific Institute - IRCCS, Milano, Italy
| | - A Chiara
- San Raffaele Scientific Institute, Milan, Italy
| | - C Deantoni
- San Raffaele Scientific Institute, Milan, Italy
| | - M Pasetti
- San Raffaele Scientific Institute, Milano, Italy
| | - G Palazzo
- San Raffaele Scientific Institute, Milan, Italy
| | | | - T Rancati
- Fondazione IRCCS Istituto Nazionale dei Tumori, Data Science Unit, Milan, Italy
| | | | - N G Di Muzio
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - C Fiorino
- San Raffaele Scientific Institute - IRCCS, Milano, Italy
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deantoni C, Chiara A, Mirabile A, Broggi S, Fiorino C, Fodor A, Pasetti M, Tummineri R, Zerbetto F, Baroni S, Sanchez Galvan A, Gregorc V, Dell'Oca I, Di Muzio N. PO-1100 Impact of sarcopenia in oropharyngeal cancer patients treated with radical chemo-radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03064-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mori M, Deantoni C, Olivieri M, Spezi E, Chiara A, Baroni S, Picchio M, Del Vecchio A, Di Muzio N, Fiorino C, Dell'Oca I. PO-1760 Independent validation of a PET radiomic model predicting outcome after Radiotherapy for HN cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03724-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Calimeri T, Steffanoni S, Gagliardi F, Chiara A, Ferreri AJM. Erratum to 'How we treat primary central nervous system lymphoma': [ESMO Open Volume 6, Issue 4, August 2021, 100213]. ESMO Open 2021; 6:100326. [PMID: 34773905 DOI: 10.1016/j.esmoop.2021.100326] [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: 11/19/2022] Open
Affiliation(s)
- T Calimeri
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - S Steffanoni
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - F Gagliardi
- Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - A Chiara
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A J M Ferreri
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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Fodor A, Brombin C, Mangili P, Pasetti M, Tummineri R, Longobardi B, Zerbetto F, Castriconi R, Esposito P, Broggi S, Dell’Oca I, Deantoni C, Sanchez Galvan A, Perna L, Deli A, Chiara A, Rancoita P, Fiorino C, Del Vecchio A, Di Serio M, Di Muzio N. PO-1139 Skin toxicity in 1325 breast cancer patients treated with hypofractionated RT without boost. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07590-3] [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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Zerbetto F, Foti S, Deantoni C, Pasetti M, Chiara A, Roberta T, Broggi S, Di Muzio N. PO-1401 Lung metastasis from renal cell carcinoma: SBRT alone or in association with target therapy as a potential treatment option. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07852-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Calimeri T, Steffanoni S, Gagliardi F, Chiara A, Ferreri AJM. How we treat primary central nervous system lymphoma. ESMO Open 2021; 6:100213. [PMID: 34271311 PMCID: PMC8287145 DOI: 10.1016/j.esmoop.2021.100213] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- T Calimeri
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan
| | - S Steffanoni
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan
| | - F Gagliardi
- Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan
| | - A Chiara
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A J M Ferreri
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan.
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Panisi C, Guerini FR, Abruzzo PM, Balzola F, Biava PM, Bolotta A, Brunero M, Burgio E, Chiara A, Clerici M, Croce L, Ferreri C, Giovannini N, Ghezzo A, Grossi E, Keller R, Manzotti A, Marini M, Migliore L, Moderato L, Moscone D, Mussap M, Parmeggiani A, Pasin V, Perotti M, Piras C, Saresella M, Stoccoro A, Toso T, Vacca RA, Vagni D, Vendemmia S, Villa L, Politi P, Fanos V. Autism Spectrum Disorder from the Womb to Adulthood: Suggestions for a Paradigm Shift. J Pers Med 2021; 11:70. [PMID: 33504019 PMCID: PMC7912683 DOI: 10.3390/jpm11020070] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/10/2021] [Accepted: 01/19/2021] [Indexed: 02/07/2023] Open
Abstract
The wide spectrum of unique needs and strengths of Autism Spectrum Disorders (ASD) is a challenge for the worldwide healthcare system. With the plethora of information from research, a common thread is required to conceptualize an exhaustive pathogenetic paradigm. The epidemiological and clinical findings in ASD cannot be explained by the traditional linear genetic model, hence the need to move towards a more fluid conception, integrating genetics, environment, and epigenetics as a whole. The embryo-fetal period and the first two years of life (the so-called 'First 1000 Days') are the crucial time window for neurodevelopment. In particular, the interplay and the vicious loop between immune activation, gut dysbiosis, and mitochondrial impairment/oxidative stress significantly affects neurodevelopment during pregnancy and undermines the health of ASD people throughout life. Consequently, the most effective intervention in ASD is expected by primary prevention aimed at pregnancy and at early control of the main effector molecular pathways. We will reason here on a comprehensive and exhaustive pathogenetic paradigm in ASD, viewed not just as a theoretical issue, but as a tool to provide suggestions for effective preventive strategies and personalized, dynamic (from womb to adulthood), systemic, and interdisciplinary healthcare approach.
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Affiliation(s)
- Cristina Panisi
- Fondazione Istituto Sacra Famiglia ONLUS, Cesano Boscone, 20090 Milan, Italy;
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Franca Rosa Guerini
- IRCCS Fondazione Don Carlo Gnocchi, ONLUS, 20148 Milan, Italy; (M.C.); (M.S.)
| | | | - Federico Balzola
- Division of Gastroenterology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy;
| | - Pier Mario Biava
- Scientific Institute of Research and Care Multimedica, 20138 Milan, Italy;
| | - Alessandra Bolotta
- DIMES, School of Medicine, University of Bologna, 40126 Bologna, Italy; (P.M.A.); (A.B.); (A.G.)
| | - Marco Brunero
- Department of Pediatric Surgery, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | - Ernesto Burgio
- ECERI—European Cancer and Environment Research Institute, Square de Meeus 38-40, 1000 Bruxelles, Belgium;
| | - Alberto Chiara
- Dipartimento Materno Infantile ASST, 27100 Pavia, Italy;
| | - Mario Clerici
- IRCCS Fondazione Don Carlo Gnocchi, ONLUS, 20148 Milan, Italy; (M.C.); (M.S.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Luigi Croce
- Centro Domino per l’Autismo, Universita’ Cattolica Brescia, 20139 Milan, Italy;
| | - Carla Ferreri
- National Research Council of Italy, Institute of Organic Synthesis and Photoreactivity (ISOF), 40129 Bologna, Italy;
| | - Niccolò Giovannini
- Department of Obstetrics and Gynecology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Alessandro Ghezzo
- DIMES, School of Medicine, University of Bologna, 40126 Bologna, Italy; (P.M.A.); (A.B.); (A.G.)
| | - Enzo Grossi
- Autism Research Unit, Villa Santa Maria Foundation, 22038 Tavernerio, Italy;
| | - Roberto Keller
- Adult Autism Centre DSM ASL Città di Torino, 10138 Turin, Italy;
| | - Andrea Manzotti
- RAISE Lab, Foundation COME Collaboration, 65121 Pescara, Italy;
| | - Marina Marini
- DIMES, School of Medicine, University of Bologna, 40126 Bologna, Italy; (P.M.A.); (A.B.); (A.G.)
| | - Lucia Migliore
- Medical Genetics Laboratories, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56126 Pisa, Italy; (L.M.); (A.S.)
| | - Lucio Moderato
- Fondazione Istituto Sacra Famiglia ONLUS, Cesano Boscone, 20090 Milan, Italy;
| | - Davide Moscone
- Associazione Spazio Asperger ONLUS, Centro Clinico CuoreMenteLab, 00141 Rome, Italy;
| | - Michele Mussap
- Neonatal Intensive Care Unit, Department of Surgical Sciences, Puericulture Institute and Neonatal Section, Azienda Ospedaliera Universitaria, 09100 Cagliari, Italy; (M.M.); (V.F.)
| | - Antonia Parmeggiani
- Child Neurology and Psychiatry Unit, IRCCS ISNB, S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Valentina Pasin
- Milan Institute for health Care and Advanced Learning, 20124 Milano, Italy;
| | | | - Cristina Piras
- Department of Biomedical Sciences, University of Cagliari, 09042 Cagliari, Italy;
| | - Marina Saresella
- IRCCS Fondazione Don Carlo Gnocchi, ONLUS, 20148 Milan, Italy; (M.C.); (M.S.)
| | - Andrea Stoccoro
- Medical Genetics Laboratories, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56126 Pisa, Italy; (L.M.); (A.S.)
| | - Tiziana Toso
- Unione Italiana Lotta alla Distrofia Muscolare UILDM, 35100 Padova, Italy;
| | - Rosa Anna Vacca
- Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies (IBIOM), National Research Council of Italy, 70126 Bari, Italy;
| | - David Vagni
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, 98164 Messina, Italy;
| | | | - Laura Villa
- Scientific Institute, IRCCS Eugenio Medea, Via Don Luigi Monza 20, 23842 Bosisio Parini, Italy;
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Department of Surgical Sciences, Puericulture Institute and Neonatal Section, Azienda Ospedaliera Universitaria, 09100 Cagliari, Italy; (M.M.); (V.F.)
- Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria, 09042 Cagliari, Italy
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Di Muzio N, Deantoni C, Cozzarini C, Dell'Oca I, Zerbetto F, Mangili P, Broggi S, Pasetti M, Chiara A, Borroni F, Tummineri R, Perna L, Calandrino R, Fiorino C, Fodor A. PO-1173: Long term results of IG-IMRT in high risk prostate cancer patients: a monoinstitutional experience. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01191-9] [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: 10/22/2022]
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Fodor A, Mangili P, Brombin C, Zerbetto F, Longobardi B, Borroni F, Tummineri R, Pasetti M, Rancoita P, Perna L, Dell'Oca I, Deantoni C, Esposito P, Deli A, Rossi E, Chiara A, Broggi S, Slim N, Passoni P, Cattaneo M, Bolognesi A, Fiorino C, Di Serio M, Di Muzio N. PO-0955: Molecular subtypes and local control in 1054 breast cancer patients treated with de-escalated 3DCRT. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00973-7] [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: 10/22/2022]
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Zerbetto F, Deantoni C, Borroni F, Tummineri R, Fodor A, Pasetti M, Chiara A, Broggi S, Longobardi B, Perna L, Fiorino C, Di Muzio N. PO-1246: Stereotactic Body Radiotherapy For Bone Metastases In Oligometastatic-Oligoprogressive Patients. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01264-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chiara A, Broggi S, Salvadori G, Peccatori J, Assanelli A, Piemontese S, Pasetti M, Selli S, Calandrino R, Ciceri F, Fiorino C, Di Muzio N. PO-0915: Clinical Activation Of An Efficient Low-Dose Total Body Irradiation Using The Tomodirect Approach. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00932-4] [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: 11/24/2022]
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Lubrano R, Villani A, Berrettini S, Caione P, Chiara A, Costantino A, Formigari R, Franzoni E, Gattinara GC, Giustardi A, La Marca G, Lionetti P, Lima M, Maffei C, Malamisura M, Manzoni G, Marseglia GL, Memeo A, Mosca F, Perricone G, Peruzzi L, Piacentini G, Pozzobon G, Riva E, Tesoro S, Zampino G, Zanetto F, Zecca M, Bloise S. Point of view of the Italians pediatric scientific societies about the pediatric care during the COVID-19 lockdown: what has changed and future prospects for restarting. Ital J Pediatr 2020; 46:142. [PMID: 33008445 PMCID: PMC7531060 DOI: 10.1186/s13052-020-00907-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/23/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) is currently rare in children and they seem to have a milder disease course and better prognosis than adults. However, SARS-Cov-2 pandemic has indirectly caused problems in pediatric medical assistance. In view of this we wanted to draw a picture of what happened during health emergency and analyze future prospects for restarting. METHODS We involved the Italian pediatric scientific societies institutionally collected in the Italian Federation of Associations and Scientific Societies of the Pediatric Area (FIARPED); We sent a questionnaire to all scientific societies about the pediatric care activity during the COVID-19 emergency and future perspectives for the phase of post-containment. RESULTS The analysis of the questionnaires showed significant decrease of:admission, outpatient visits and specialist consultancy activities during the COVID-19 emergency, primarily linked to the fear of infection. Instead it was increased the serious degree of diseases admitted. Most of scientific societies maintained the relationship with chronic patients through some form of telemedicine, reporting a strong positive opinion about this modality. Finally showed the need to give life a new approach for hospitalizations and outpatient visits through a greater use of telemedicine, educational programs on families and a more decisive role of family pediatricians. CONCLUSIONS Our study highlighted many aspects that can be improved in pediatric care. We think that It will be necessary a new shared strategy to improve the management and continuity of care for pediatric patients, primarily developing a network of collaboration between families, family pediatrician and hospitals and by enhancing the use of new methods of telecommunications.
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Affiliation(s)
- Riccardo Lubrano
- Federazione Italiana delle Associazioni e Società Scientifiche dell'Area Pediatrica e Società Italiana di Emergenza Urgenza Pediatrica, Rome, Italy. .,Dipartimento Materno Infantile e di Scienze Urologiche, Sapienza Università di Roma, UOC di Pediatria e Neonatologia, Ospedale Santa Maria Goretti, Polo di Latina, Latina, Italy.
| | | | | | - Paolo Caione
- Società Italiana di Videochirurgia Infantile, Rome, Italy
| | | | - Antonella Costantino
- Società Italiana di Neuropsichiatria dell'Infanzia e dell'Adolescenza, Milan, Italy
| | - Roberto Formigari
- Società Italiana di Cardiologia Pediatrica e delle Cardiopatie Congenite, Firenze, Italy
| | | | | | | | - Giancarlo La Marca
- Società Italiana per lo Studio delle Malattie Metaboliche Ereditarie e lo Screening neonatale, Milan, Italy
| | - Paolo Lionetti
- Società Italiana di Gastroenterologia Epatologia e Nutrizione Pediatrica, Milan, Italy
| | - Mario Lima
- Società Italiana di Chirurgia Pediatriaca, Milan, Italy
| | - Claudio Maffei
- Società Italiana di Endocrinologia e Diabetologia Pediatrica, Ferrara, Italy
| | | | | | | | - Antonio Memeo
- Società Italiana di Ortopedia e Traumatologia Pediatrica, Rome, Italy
| | - Fabio Mosca
- Società Italiana di Neonatologia, Rome, Italy
| | | | - Licia Peruzzi
- Società Italiana di Nefrologia Pediatrica, Milan, Italy
| | | | | | - Enrica Riva
- Società Italiana di Nutrizione Pediatrica, Milan, Italy
| | - Simonetta Tesoro
- Società di Anestesia e Rianimazione Neonatale e Pediatrica Italiana, Rome, Italy
| | - Giuseppe Zampino
- Società Italiana di Malattie Genetiche Pediatriche e Disabilità, Rome, Italy
| | | | - Marco Zecca
- Associazione Italiana di Ematologia e Oncologia Pediatrica, Rome, Italy
| | - Silvia Bloise
- Federazione Italiana delle Associazioni e Società Scientifiche dell'Area Pediatrica e Società Italiana di Emergenza Urgenza Pediatrica, Rome, Italy.,Dipartimento Materno Infantile e di Scienze Urologiche, Sapienza Università di Roma, UOC di Pediatria e Neonatologia, Ospedale Santa Maria Goretti, Polo di Latina, Latina, Italy
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Martinelli M, Banderali G, Bobbio M, Civardi E, Chiara A, D'Elios S, Lo Vecchio A, Olivero M, Peroni D, Romano C, Stronati M, Turra R, Viola I, Staiano A, Villani A. Correction to: Probiotics' efficacy in paediatric diseases: which is the evidence? A critical review on behalf of the Italian Society of Pediatrics. Ital J Pediatr 2020; 46:116. [PMID: 32807216 PMCID: PMC7430011 DOI: 10.1186/s13052-020-00880-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/12/2020] [Indexed: 11/10/2022] Open
Affiliation(s)
- Massimo Martinelli
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Giuseppe Banderali
- ClinicalDepartment of Pediatrics and Neonatology, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | | | - Elisa Civardi
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo Pavia, Pavia, Italy
| | - Alberto Chiara
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo Pavia, Pavia, Italy
| | - Sofia D'Elios
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Andrea Lo Vecchio
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | | | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, University of Messina, Messina, Italy
| | - Mauro Stronati
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo Pavia, Pavia, Italy
| | | | - Irene Viola
- Pediatric Gastroenterology and Cystic Fibrosis Unit, University of Messina, Messina, Italy
| | - Annamaria Staiano
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy.
| | - Alberto Villani
- Pediatric and Infectious Disease Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Martinelli M, Banderali G, Bobbio M, Civardi E, Chiara A, D'Elios S, Lo Vecchio A, Olivero M, Peroni D, Romano C, Stronati M, Turra R, Viola I, Staiano A, Villani A. Probiotics' efficacy in paediatric diseases: which is the evidence? A critical review on behalf of the Italian Society of Pediatrics. Ital J Pediatr 2020; 46:104. [PMID: 32711569 PMCID: PMC7382135 DOI: 10.1186/s13052-020-00862-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 07/06/2020] [Indexed: 12/12/2022] Open
Abstract
During the last decade several paediatric studies have been published with different possible indications for probiotics, leading to a global increase of probiotics' market. Nevertheless, different study designs, multiple single/combined strains and small sample size still leave many uncertainties regarding their efficacy. In addition, different regulatory and quality control issues make still very difficult the interpretation of the clinical data. The objective of this review is to critically summarise the current evidence on probiotics' efficacy and safety on a different number of pathologies, including necrotizing enterocolitis, acute infectious diarrhoea, allergic diseases and functional gastrointestinal disorders in order to guide paediatric healthcare professionals on using evidence-based probiotics' strains. To identify relevant data, literature searches were performed including Medline-PubMed, the Cochrane Library and EMBASE databases. Considering probiotics strain-specific effects, the main focus was on individual probiotic strains and not on probiotics in general.
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Affiliation(s)
- Massimo Martinelli
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Giuseppe Banderali
- Clinical Department of Pediatrics and Neonatology, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | | | - Elisa Civardi
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo Pavia, Pavia, Italy
| | - Alberto Chiara
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo Pavia, Pavia, Italy
| | - Sofia D'Elios
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Andrea Lo Vecchio
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | | | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, University of Messina, Messina, Italy
| | - Mauro Stronati
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo Pavia, Pavia, Italy
| | | | - Irene Viola
- Pediatric Gastroenterology and Cystic Fibrosis Unit, University of Messina, Messina, Italy
| | - Annamaria Staiano
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy.
| | - Alberto Villani
- Pediatric and Infectious Disease Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Bozzola E, Spina G, Ruggiero M, Vecchio D, Caruso C, Bozzola M, Staiano AM, Agostiniani R, Del Vecchio A, Banderali G, Peroni D, Chiara A, Memo L, Turra R, Corsello G, Villani A. Media use during adolescence: the recommendations of the Italian Pediatric Society. Ital J Pediatr 2019; 45:149. [PMID: 31775828 PMCID: PMC6880642 DOI: 10.1186/s13052-019-0725-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/26/2019] [Indexed: 12/13/2022] Open
Abstract
Background The use of media device, such as smartphone and tablet, is currently increasing, especially among the youngest. Adolescents spend more and more time with their smartphones consulting social media, mainly Facebook, Instagram and Twitter because. Adolescents often feel the necessity to use a media device as a means to construct a social identity and express themselves. For some children, smartphone ownership starts even sooner as young as 7 yrs, according to internet safety experts. Material and methods We analyzed the evidence on media use and its consequences in adolescence. Results In literature, smartphones and tablets use may negatively influences the psychophysical development of the adolescent, such as learning, sleep and sigh. Moreover, obesity, distraction, addiction, cyberbullism and Hikikomori phenomena are described in adolescents who use media device too frequently. The Italian Pediatric Society provide action-oriented recommendations for families and clinicians to avoid negative outcomes. Conclusions Both parents and clinicians should be aware of the widespread phenomenon of media device use among adolescents and try to avoid psychophysical consequences on the youngest.
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Chiara A, Broggi S, Pasetti M, Dell'oca I, Azizi M, Salvadori G, Selli S, Marcatti M, Assanelli A, Peccatori J, Cattaneo M, Ciceri F, Di Muzio N. PO-0868 Total Marrow Irradiation in Myeloma Multiple patients candidate to allogeneic transplant. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31288-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Di Muzio N, Deantoni C, Zerbetto F, Cozzarini C, Broggi S, Mangili P, Chiara A, Dell'Oca I, Deli A, Calandrino R, Fiorino C, Fodor A. EP-1553 High-dose hypofractionated helical IG-IMRT in high-risk prostate cancer patients. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31973-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Di Muzio N, Deantoni C, Brombin C, Cozzarini C, Broggi S, Mangili P, Di Serio M, Dell'Oca I, Chiara A, Calandrino R, Fiorino C, Fodor A. EP-1593: Hypofractionated IGRT in high-intermediate and high/very-high risk prostate cancer patients. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31902-9] [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: 10/14/2022]
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Calimeri T, Lopedote P, Repetto M, Vignati A, Sassone M, Cecchetti C, Perrone S, Foppoli M, Ciboddo G, Girlanda S, Peccatori J, Chiara A, Memoli M, Ferreri A. Safety and tolerability of chemotherapy (CT) containing high doses of methotrexate (HD-MTX) and cytarabine (Ara-C) in patients with primary central nervous system lymphoma (PCNSL) and hepatitis B virus (HBV) infection. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx373.028] [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: 11/12/2022] Open
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Di Muzio N, Fodor A, Deantoni C, Noris Chiorda B, Broggi S, Mangili P, Dell'Oca I, Chiara A, Passoni P, Slim N, Pasetti M, Calandrino R, Cozzarini C, Fiorino C. EP-1318: Is hypofractionation combined to WPRT effective in high risk prostate cancer patients? Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31753-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pasetti M, Fodor A, Sini C, Zerbetto F, Mangili P, Signorotto P, Dell’Oca I, Gumina C, Azizi M, Deli A, Passoni P, Slim N, Deantoni C, Noris Chiorda B, Foti S, Chiara A, Rossi G, Fiorino C, Bolognesi A, Di Muzio N. EP-1159: Hypofractionated adjuvant radiotherapy and concomitant trastuzumab for breast cancer: 5-year results. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31595-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Chiorda BN, Sini C, Fiorino C, Badenchini F, Briganti A, Chiara A, Deantoni C, Slim N, Suardi N, Montorsi F, Di Muzio N, Cozzarini C. PO-0749: Factors predicting late severe urinary incontinence after postprostatectomy RT: a longitudinal study. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31999-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sini C, Fiorino C, Perna L, Noris Chiorda B, Sacco V, Pasetti M, Chiara A, Calandrino R, Di Muzio N, Cozzarini C. EP-1725: Predictors of diarrhea after whole-pelvis post-prostatectomy radiotherapy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32976-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Broggi S, Dell'Oca I, Fiorino C, Incerti E, Picchio M, Belli M, Mapelli P, Chiara A, Muzio ND, Cattaneo G, Calandrino R. EP-1852: Predictive role of FDG-PET/CT image-derived parameters in locally advanced oropharyngeal cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33103-6] [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: 11/29/2022]
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Chiara A, Fiorino C, Picchio M, Fodor A, Broggi S, Pasetti M, Incerti E, Mapelli P, Zerbetto F, De Antoni C, Azizi M, Calandrino R, Dell'Oca I, Di Muzio N. EP-1079: Clinical outcomes in locally advanced oropharyngeal cancer 18FDG PET-guided dose escalation IMRT-SIB. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32329-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Di Muzio NG, Fodor A, Noris Chiorda B, Broggi S, Mangili P, Valdagni R, Dell'Oca I, Pasetti M, Deantoni CL, Chiara A, Berardi G, Briganti A, Calandrino R, Cozzarini C, Fiorino C. Moderate Hypofractionation with Simultaneous Integrated Boost in Prostate Cancer: Long-term Results of a Phase I-II Study. Clin Oncol (R Coll Radiol) 2016; 28:490-500. [PMID: 26961088 DOI: 10.1016/j.clon.2016.02.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 01/18/2016] [Accepted: 01/19/2016] [Indexed: 10/22/2022]
Abstract
AIMS To report 5 year outcome and late toxicity in prostate cancer patients treated with image-guided tomotherapy with a moderate hypofractionated simultaneous integrated boost approach. MATERIALS AND METHODS In total, 211 prostate cancer patients, 78 low risk, 53 intermediate risk and 80 high risk were treated between 2005 and 2011. Intermediate- and high-risk patients received 51.8 Gy to pelvic lymph nodes and concomitant simultaneous integrated boost to prostate up to 74.2 Gy/28 fractions, whereas low-risk patients were treated to the prostate only with 71.4 Gy/28 fractions. Daily megavoltage computed tomography (MVCT) image guidance was applied. Androgen deprivation was prescribed for a median duration of 6 months for low-risk patients (for downsizing), 12 months for intermediate-risk and 36 months for high-risk patients. The 5 year biochemical relapse-free survival (bRFS), cancer-specific survival (CSS), overall survival and late gastrointestinal and genitourinary CTCAE.v3 toxicity were assessed. The effect of several clinical variables on both outcome and gastrointestinal/genitourinary toxicity was tested by uni- and multivariate Cox regression analyses. RESULTS After a median follow-up of 5 years, the late toxicity actuarial incidence was: genitourinary ≥ grade 2: 20.2%; genitourinary ≥ grade 3: 5.9%; gastrointestinal ≥ grade 2: 17%; gastrointestinal ≥ grade 3: 6.3% with lower prevalence at the last follow-up visit (≥ grade 3: genitourinary: 1.9%; gastrointestinal: 1.9%). Major predictors of ≥ grade 3 genitourinary and gastrointestinal late toxicity were genitourinary acute toxicity ≥ grade 2 (hazard ratio: 4.9) and previous surgery (hazard ratio: 3.4). The overall 5 year bRFS was 93.7% (low risk: 94.6%; intermediate risk: 96.2%; high risk: 91.1%), overall survival and CSS were 88.6% (low risk: 90.5%; intermediate risk: 87.4%; high risk: 87%) and 97.5% (low risk: 98.7%; intermediate risk: 95%; high risk: 94.3%), respectively. Risk classes and androgen deprivation were not significantly correlated with either bRFS, overall survival or CSS. Twelve patients experienced a biochemical relapse but none experienced clinically proven local and/or pelvic recurrence. CONCLUSION A satisfactory 5 year outcome with an acceptable toxicity profile was observed. The combination of image-guided radiotherapy-intensity-modulated radiotherapy, high equivalent 2 Gy dose (EQD2) with a moderate hypofractionated approach and extensive prophylactic lymph node irradiation also leads to very good outcome in high-risk patients.
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Affiliation(s)
- N G Di Muzio
- Department of Radiation Oncology, San Raffaele Scientific Institute, Milan, Italy.
| | - A Fodor
- Department of Radiation Oncology, San Raffaele Scientific Institute, Milan, Italy
| | - B Noris Chiorda
- Department of Radiation Oncology, San Raffaele Scientific Institute, Milan, Italy
| | - S Broggi
- Medical Physics, San Raffaele Scientific Institute, Milan, Italy
| | - P Mangili
- Medical Physics, San Raffaele Scientific Institute, Milan, Italy
| | - R Valdagni
- Fondazione IRCCS Istituto Nazionale dei Tumori, Radiotherapy, Milan, Italy
| | - I Dell'Oca
- Department of Radiation Oncology, San Raffaele Scientific Institute, Milan, Italy
| | - M Pasetti
- Department of Radiation Oncology, San Raffaele Scientific Institute, Milan, Italy
| | - C L Deantoni
- Department of Radiation Oncology, San Raffaele Scientific Institute, Milan, Italy
| | - A Chiara
- Department of Radiation Oncology, San Raffaele Scientific Institute, Milan, Italy
| | - G Berardi
- Department of Radiation Oncology, San Raffaele Scientific Institute, Milan, Italy
| | - A Briganti
- Department of Urology, San Raffaele Scientific Institute, Milan, Italy
| | - R Calandrino
- Medical Physics, San Raffaele Scientific Institute, Milan, Italy
| | - C Cozzarini
- Department of Radiation Oncology, San Raffaele Scientific Institute, Milan, Italy
| | - C Fiorino
- Medical Physics, San Raffaele Scientific Institute, Milan, Italy
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Belli M, Dell'Oca I, Raso R, Zerbetto F, Chiara A, Cattaneo G, Picchio M, Di Muzio N, Fiorino C, Calandrino R. FDG-PET positive lymph node variations during image-guided IMRT for head and neck cancer identify non-responding patients. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Sini C, Fiorino C, Noris Chiorda B, Chiara A, Deantoni C, Gumina C, Perna L, Sbalchiero A, Calandrino R, Di Muzio N, Cozzarini C. PD-0530: Predictors of hematological toxicity after whole-pelvis intensity-modulated post-prostatectomy radiotherapy. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40525-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Di Muzio N, Fodor A, Noris Chiorda B, Cozzarini C, Broggi S, Mangili P, Valdagni R, Dell'Oca I, Pasetti M, Deantoni C, Chiara A, Berardi G, Briganti A, Calandrino R, Fiorino C. PO-0719: Excellent 5 year outcome with image guided moderate hypofractionation in prostate cancer : phase I-II study results. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40711-x] [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: 11/28/2022]
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Cozzarini C, Fiorino C, Noris Chiorda B, Agnello G, Perna L, Brenna S, Chiara A, Sacco V, Zerbetto F, Di Muzio N. PO-0729: Haematologic toxicity from post-prostatectomy whole pelvis RT is not negligible and prolonged. A prospective study. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30847-1] [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: 11/26/2022]
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Belli M, Zerbetto F, Raso R, Cattaneo G, Chiara A, Dell'Oca I, Fiorino C, Di Muzio N, Calandrino R. PO-0899: Lymphnodes shrinkage measured during RT by daily MVCT predicts tumour relapses of head-and-neck cancer. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31017-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Noris Chiorda B, Cozzarini C, La Macchia M, Fiorino C, Iacovelli N, Bolognesi A, Chiara A, Briganti A, Montorsi F, Di Muzio N. PD-0459: Whole-pelvis RT improves bRFS of node-negative patients treated with post-prostatectomy high-dose salvage RT. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32765-1] [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: 11/24/2022]
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Fodor A, Bolognesi A, Mangili P, Pasetti M, Fiorino C, Chiara A. 753 poster EARLY TOXICITY RESULTS OF A FORWARD PLANNED HYPOFRACTIONATED IMRT FOR WHOLE BREAST ADJUVANT TREATMENT. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70875-1] [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: 10/18/2022]
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Dell'Oca I, Fiorino C, Fodor A, Chiara A, Villa E, Casagrande W, Rognone A, Pasetti M, Broggi S, Busnardo E, Landoni C, Gianolli L, Calandrino R, Di Muzio N. 868 poster SIMULTANEOUS INTEGRATED BOOST 18FDG-PET BASED HELICAL TOMOTHERAPY IN RADICAL LOCALLY ADVANCED HEAD AND NECK CANCER. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70990-2] [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: 11/16/2022]
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Berardi G, Cozzarini C, Fiorino C, Alongi F, Chiara A, Mangili P, Perna L, Valdagni R, Rigatti P, Di Muzio N. Excellent Biochemical Control and Late Toxicity after Moderately Hypofractionated Adjuvant Helical Tomotherapy: Updated Results of a Phase I-II Study. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dell'oca I, Fiorino C, Caimi M, Chiara A, Rognone A, Pasetti M, Broggi S, Landoni C, Calandrino R, Di Muzio N. Helical Tomotherapy with Simultaneous Integrated Boost 18FDG-Pet Based in Radical Locally Advanced Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.929] [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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Savasta S, Chiapedi S, Perrini S, Tognato E, Corsano L, Chiara A. Pai syndrome: a further report of a case with bifid nose, lipoma, and agenesis of the corpus callosum. Childs Nerv Syst 2008; 24:773-6. [PMID: 18369643 DOI: 10.1007/s00381-008-0613-9] [Citation(s) in RCA: 15] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Pai syndrome is a rare genetic disorder mainly characterized by the association of complete median cleft of palate and upper lip, midline facial cutaneous, and mid-anterior alveolar process polyps, duplicated maxillary median frenulum, bifid nose, and midline lipoma(s) of the central nervous system, in particular, the corpus callosum. The incidence of this syndrome is much higher in males than in females. The etiology remains unknown: The syndrome may be associated with autosomal-dominant inheritance, but X-linked recessive inheritance could not be excluded. DISCUSSION A de novo apparently balanced reciprocal traslocation, 46,X,t(X;16) has been described in a 13-year-old girl with median cleft of the upper lip, pedunculated skin masses on the nasal septum, short stature, and mental retardation. We describe a new case that presents the main clinical features associated with bifid nose, lipoma, and partial agenesis of corpus callosum.
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Affiliation(s)
- S Savasta
- Department of Pediatrics, Fondazione Policlinico S.Matteo IRCCS, Univesity of Pavia, P.le Golgi, 2, 27100 Pavia, Italy.
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Chiara A, Saronni A. [Topics on cerebral echography]. Minerva Pediatr 2007; 59:516-517. [PMID: 17947897] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- A Chiara
- U.O. di Neonatologia, Patologia Neonatale e Pediatria, Ospedale Maggiore di Crema, Cremona, Italy
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Abstract
OBJECTIVE To evaluate the prognostic value of umbilical artery Doppler studies in premature deliveries. METHODS In this cohort study of 582 singleton pregnancies delivered between 24 and 35 weeks of gestation, we evaluated the ratio of peak-systolic to end-diastolic (S/D) blood flow velocities in the umbilical artery of all the patients. The correlations among the results of the Doppler studies, short-term neonatal complications, and the infants' neurodevelopmental outcome at 2 years were studied by univariable and multivariable methods. RESULTS The prevalences of either neonatal death or cerebral palsy among the 266 (45.7%) growth restricted fetuses were 3.4% (3/88) in pregnancies with a S/D ratio below the 95th percentile, 4.9% (5/103) in pregnancies with a S/D at or above the 95th percentile, and 17.3% (13/75) in those with absent or reversed end-diastolic blood flow in the umbilical artery (P for trend = .001). The corresponding figures in the 316 pregnancies with adequate fetal growth were 6.4% (15/234) and 4.3% (3/69) among pregnancies with a S/D ratio below and at or above 95th percentile, respectively, whereas no cases of either neonatal death or cerebral palsy were recorded in the 13 pregnancies with adequate fetal growth and absent or reversed end-diastolic blood flow velocity (P for trend = .28; chi(2) for heterogeneity of linear trends compared with growth-restricted infants = 7.02, P = .008). In logistic regression, in pregnancies complicated by fetal growth restriction, absent or reversed end-diastolic blood flow in the umbilical artery was still associated with an increased risk of either neonatal death or cerebral palsy even after adjustment for gestational age and proportion of expected birth weight, (odds ratio 3.2, 95% confidence interval 1.18-8.66, P = .02). CONCLUSION Absent or reversed end-diastolic flow in the umbilical artery is an independent predictor of either neonatal death or cerebral palsy in preterm growth-restricted fetuses. In the absence of fetal growth restriction, umbilical artery Doppler study was associated with none of the infant outcome parameters studied.
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Affiliation(s)
- Arsenio Spinillo
- Departments of Obstetrics and Gynecology, Neonatal Intensive Care, and Child Neuropsychiatry, University of Pavia, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy.
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Spinillo A, Chiara A, Bergante C, Biancheri D, Fabiana D, Fazzi E. Obstetric risk factors and persistent increases in brain parenchymal echogenicity in preterm infants. BJOG 2004; 111:913-8. [PMID: 15327604 DOI: 10.1111/j.1471-0528.2004.00229.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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
OBJECTIVE To assess the risk of persistent (>7 days) increases in brain parenchymal echogenicity in preterm infants and their association with known obstetric risk factors. DESIGN Case-control study of prospectively collected data. SETTING A University hospital in Northern Italy. POPULATION Eighty-five singleton infants between 24 and 34 weeks of gestation with a cranial ultrasonographic diagnosis of persistently increased parenchymal echogenicity without development of cystic degeneration, and 170 control infants with negative cranial ultrasonographic findings. METHODS A comparison of the prevalence of selected obstetric risk factors between infants with persistent echo-dense lesions and negative controls. MAIN OUTCOME MEASURES Odds ratios of persistent echo-dense lesions including first-degree interactions between variables. RESULTS After adjusting for birthweight, logistic regression analysis showed that the only factor associated with an increased risk of persistent brain echo-dense lesions in infants was multiple courses of antenatal steroids (OR = 2.14, 95% CI = 1.11-4.15, P= 0.024). In this group, the risk of persistent echo-dense lesions was particularly high in: (i) mothers receiving dexamethasone rather than betamethasone (P value for interaction = 0.015) and (ii) after expectant management of pre-eclampsia or intrauterine growth retardation (P value for interaction = 0.03). CONCLUSIONS Multiple doses of antenatal steroids, especially dexamethasone, could influence the prevalence of persistent increases in brain parenchymal echogenicity in preterm infants.
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Affiliation(s)
- Arsenio Spinillo
- Department of Obstetrics and Gynecology, IRCCS Policlinico S. Matteo, University of Pavia, Piazzale Golgi 2, 27100 Pavia, Italy
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Spinillo A, Viazzo F, Colleoni R, Chiara A, Maria Cerbo R, Fazzi E. Two-year infant neurodevelopmental outcome after single or multiple antenatal courses of corticosteroids to prevent complications of prematurity. Am J Obstet Gynecol 2004; 191:217-24. [PMID: 15295369 DOI: 10.1016/j.ajog.2003.12.023] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study was undertaken to evaluate the effect of exposure to multiple antenatal steroid courses on short-term neonatal morbidity and 2-year infant neurodevelopmental outcome. STUDY DESIGN This was a prospective observational study of 201 preterm singleton infants who received 1 or more courses of corticosteroids to prevent complications of prematurity and were delivered between 24 and 34 weeks' gestation at a single institution. Neurodevelopmental outcome of the infants was evaluated at 2 years corrected age. Logistic regression analysis was used to perform multivariate analyses of associations and trends. RESULTS One hundred thirty-eight subjects (68.7%) received at least 1 complete course of betamethasone, whereas 63 (31.3%) patients were treated with dexamethasone. The prevalence of multiple steroid doses exposure was 26.8% (37/138) in betamethasone and 52.4% (33/63) in dexamethasone group. The prevalence of infant leukomalacia, including both prolonged echogenicity and cystic leukomalacia, was 25.9% (34/131) after a complete corticosteroid course, 40% (6/15) after 1, 42.3% (12/28) after 2, and 44.4% (12/27) after more than 2 additional courses, respectively (adjusted P for trend=.011). In the same categories of steroid exposure, the corresponding prevalences of 2-year infant neurodevelopmental abnormalities were 18% (20/111), 21.4% (3/14), 29.2% (7/24), and 34.8% (8/23), respectively (adjusted P for trend=.038). Multivariate study of first grade interaction suggested that the risk of leukomalacia and 2-year infant neurodevelopmental abnormalities associated with multiple doses exposure was confined to dexamethasone. In fact, compared with betamethasone, exposure to multiple doses of dexamethasone was associated with an increased risk of leukomalacia (19/33 compared with 11/37; odds ratio [OR]=3.21, 95% CI=1.07-9.77) and overall 2-year infant neurodevelopmental abnormalities (12/28 compared with 6/35; OR=3.63, 95% CI=1.03-13.58). CONCLUSION In this study, multiple antenatal courses of dexamethasone but not betamethasone were associated with an increased risk of leukomalacia and 2-year infant neurodevelopmental abnormalities.
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Affiliation(s)
- Arsenio Spinillo
- Department of Obstetrics and Gynecology, University of Pavia, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico S. Matteo, Pavia, Italy.
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Spinillo A, Montanari L, Sanpaolo P, Bergante C, Chiara A, Fazzi E. Fetal Growth and Infant Neurodevelopmental Outcome After Preterm Premature Rupture of Membranes. Obstet Gynecol 2004; 103:1286-93. [PMID: 15172866 DOI: 10.1097/01.aog.0000127706.78192.95] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the prognostic values of fetal size before birth and fetal growth during the latency period in patients with preterm premature rupture of the membranes (PROM). METHODS A prospective cohort study of 69 singleton pregnancies complicated by prolonged (14 days or more) PROM (24 to 31 weeks of gestation). Measures of fetal size and growth were compared with corresponding expected values from our reference curves. The correlations between deviations from expected measures of fetal size and growth, short-term neonatal complications, and infant neurodevelopmental outcome at 2 years were studied by univariate methods and logistic regression. RESULTS The mean gestational ages and standard deviations at membrane rupture and at birth were 27.9 +/- 2.4 and 31.5 +/- 2.1 weeks. At a corrected age of 2 years, of the 65 (94.2%) survivors, 3 infants (4.6%) had cerebral palsy, 13 (20%) had minor neurodevelopmental impairment, and 49 (75.4%) were judged to have had normal development. Compared with surviving infants without a major handicap, the group of infants who died and those with cerebral palsy had lower proportions of expected birth weight (0.766 +/- 0.1 as compared with 0.859 +/- 0.13, P =.029), head (0.869 +/- 0.07 as compared with 0.950 +/- 0.07, P =.05), and abdominal (0.793 +/- 0.04 as compared with 0.888 +/- 0.1, P =.001) circumference growth during latency period. In logistic regression analysis, lower-than-expected ultrasound measures of fetal abdominal circumference before birth (odds ratio 1.09; 95% confidence interval 1.01, 1.18) or of abdominal circumference growth during the latency period (odds ratio 1.1; 95% confidence interval 1.01, 1.2) were significantly associated with an increased likelihood of an infant neurodevelopmental abnormality at 2-year follow-up. CONCLUSION In pregnancies complicated by preterm PROM, lower-than-expected measures of fetal size and fetal growth were associated with an increased rate of infant neurodevelopmental outcome at 2-year follow-up. LEVEL OF EVIDENCE II-2
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Affiliation(s)
- Arsenio Spinillo
- Department of Obstetrics and Gynecology, University of Pavia, IRCCS Policlinico S. Matteo, Piazzale Golgi, 27100 Pavia, Italy.
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Beluffi G, Vivarelli M, Mongini ME, Chiara A. Hepatic calcification following umbilical vein catheterization in a premature baby. Eur Radiol 2003; 14:1320-1. [PMID: 14564472 DOI: 10.1007/s00330-003-2093-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2003] [Accepted: 09/02/2003] [Indexed: 11/30/2022]
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Abstract
Neonatal adrenal hemorrhage presenting as scrotal swelling has been reported in 17 cases, with unnecessary surgical exploration in 7. We report 2 new cases, emphasizing the knowledge of this clinical association and the role of ultrasonography in the differential diagnosis for this specific condition and in all cases of neonatal acute scrotum.
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Affiliation(s)
- Luigi Avolio
- Divisione di Chirurgia Pediatrica, IRCCS Policlinico San Matteo, Pavia, Italy
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Antonini C, Forgiarini O, Chiara A, Briani G, Azzini V, Sacchi G. [Fallopian tube adenocarcinoma: synchronous neoplasia and severe uterine endocervical squamous epithelial dysplasia]. Pathologica 2001; 93:672-5. [PMID: 11785120] [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: 02/23/2023] Open
Abstract
We report a rare case of primary carcinoma of the fallopian tube. A 72-year-old post-menopausal woman presenting with abnormal secretion of blood-stained liquid, underwent surgery because of findings of atypical squamous cells (ASCUS) on a routine Papanicolaou smear. The histological diagnosis on cervical biopsy was of CIN 3. Adenocarcinoma of the Fallopian tube was incidentally found.
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Affiliation(s)
- C Antonini
- Servizio di Anatomia e Istologia Patologica, Dipartimento di Oncologia, ULSS 10 Veneto Orientale, Via N. Sauro 125, I-30027 S. Donà di Piave, VE, Italia.
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Abramson LY, Alloy LB, Hogan ME, Whitehouse WG, Cornette M, Akhavan S, Chiara A. Suicidality and cognitive vulnerability to depression among college students: a prospective study. J Adolesc 1998; 21:473-87. [PMID: 9757411 DOI: 10.1006/jado.1998.0167] [Citation(s) in RCA: 100] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Using a behavioral high-risk two-site prospective design, we tested the cognitive vulnerability hypotheses about suicidality. Consistent with prediction, the high cognitive risk (HR) participants were more likely than the low cognitive risk (LR) participants to exhibit suicidality, measured by both structured diagnostic interview and questionnaire self-report, during the 2 1/2 year prospective follow-up period. Moreover, when the prospective period was examined as a whole, the mediation hypothesis derived from the cognitive theories was strongly supported. Hopelessness appeared to mediate the obtained relationship between cognitive vulnerability and suicidality. Finally, the obtained relationship between cognitive vulnerability and suicidality was not mediated by other hypothesized risk factors for suicidality not specified in the cognitive theories, such as past suicidality, personal history of depressive disorders, borderline and antisocial personality dysfunction, and parental history of depression.
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Affiliation(s)
- L Y Abramson
- Department of Psychology, University of Wisconsin, Madison 53706, USA
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Antonini C, Forgiarini O, Chiara A, Briani G, Belmonte P, Zucconelli R, Fiaccavento G, Sacchi G. [Stromal tumor of the ileum (GIST) at the same time as a renal carcinoma. Description of a case and review of the literature]. Pathologica 1998; 90:160-4. [PMID: 9619061] [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: 02/07/2023] Open
Abstract
The gastrointestinal mesenchymal tumors from a heterogenous group that include several entities: leiomyomas, schwanomas and less differentiated tumors often referred as GIST. These neoplasm are uncommon and their clinical behaviour is most difficult to predict. We describe a malignant gastrointestinal stromal tumor of the ileum coexisting with renal cell carcinoma. The neoplasms were fixed in formaldehyde, embedded in paraffin and stained with hematoxylin-eosin. For immunohistochemical studies deparaffinized tissue sections were incubated with antibodies against vimentin, desmin, muscle specific actin, S100, CD34, GFAP, NSE and keratin. The epithelioid and spindle cells of ileal neoplasm were arranged in interlacing fascicle with occasional palisading and were positive for vimentin and CD34. Positivity for muscle specific actin was focally found. The renal neoplasm required differential diagnosis from metastatic GIST. The morphological and immunohistochemical investigations in our case were consistent with GIST coexisting with primitive renal cell carcinoma. One of the problems connected to the anatomo-clinical evaluation of GIST consist in the difficulty of making a prognosis. An almost complete review of the literature and view point on the topic has been performed. As a conclusion judging from papers regarding this argument, no clear parameters of biological behaviour exist excluding mitotic index.
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Affiliation(s)
- C Antonini
- Servizio di Anatomia e Istologia Patologica, ULSS 10 Veneto Orientale San Donà di Piave, Venezia
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García-Borreguero D, Dale JK, Rosenthal NE, Chiara A, O'Fallon A, Bartko JJ, Straus SE. Lack of seasonal variation of symptoms in patients with chronic fatigue syndrome. Psychiatry Res 1998; 77:71-7. [PMID: 9541142 DOI: 10.1016/s0165-1781(97)00141-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Several of the symptoms involved in chronic fatigue syndrome (CFS) such as fatigue, hypersomnia, hyperphagia, weight gain, and mood show seasonal variations in the general population. The aim of this study was to investigate whether patients with CFS experience seasonal fluctuations in these symptoms as well. Seasonal variation of symptoms was assessed in a group of 41 patients with CFS and 41 controls closely matched for age, gender, and city of residence. Participants were recruited across the US and were asked to complete the Seasonal Pattern Assessment Questionnaire (SPAQ) and the Profile of Mood States (POMS). CFS patients showed significantly lower scores on multiple SPAQ-derived measures as compared with controls. These included seasonal variation in energy, mood, appetite, weight, and sleep length. Patients also reported a significantly reduced sensitivity toward sunny, dry, and long days than controls. No association was noted between intensity of seasonal changes and severity of depressive symptoms. Patients with CFS exhibit an abnormally reduced seasonal variation in mood and behavior and would not be expected to benefit from light therapy.
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Affiliation(s)
- D García-Borreguero
- Clinical Psychobiology Branch, National Institute of Mental Health, Bethesda, MD 20892, USA
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Chiara A. [The pediatrician and urinary tract malformations]. Pediatr Med Chir 1997; 19:349-52. [PMID: 9493226] [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: 02/06/2023] Open
Abstract
Malformations of the renal system, the most common cause of renal failure in infants, are object of large interest clinically and experimentally. In the present paper we have considered several cases with early prenatal diagnosis and frequent symptoms: urinary tract infections, unilateral or bilateral abdominal mass, alteration of renal function.
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Affiliation(s)
- A Chiara
- Divisione di Patologia Neonatale, Policlinico S. Matteo, IRCCS di Pavia
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