1
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Tontini GE, Dioscoridi L, Rimondi A, Cantù P, Cavallaro F, Giannetti A, Elli L, Pastorelli L, Pugliese F, Mutignani M, Vecchi M. [Not Available]. Endosc Int Open 2022; 10:E386-E393. [PMID: 35528218 PMCID: PMC9068277 DOI: 10.1055/a-1781-7066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 09/21/2021] [Indexed: 01/28/2023] Open
Abstract
Objectives and study aims
Recent pilot studies have assessed the feasibility of a novel 1.9-/1.5-μm dual emission endoscopic laser treatment (
1.9-/1.5-μm
DEELT) for endoscopic hemostasis, ablation and resection. In this study, we investigated the safety and efficacy of
1.9-/1.5-μm
DEELT in patients with chronic anemia due to gastrointestinal vascular lesions in a real-life multicenter cohort setting.
Patients and methods
Consecutive patients with moderate/severe iron-deficiency anemia undergoing
1.9-/1.5-μm
DEELT for upper and lower gastrointestinal bleeding due to vascular lesions were enrolled in three academic referral centers. Safety and successful ablation of vascular lesions were the primary outcomes. Long-term hemoglobin level, blood transfusion requirements, endoscopic severity scores of complex vascular disorders and technical lasing parameters were also assessed. Long-term hemoglobin variations have been further assessed, with repeated measure analysis of variance and univariate analyses.
Results
Fifty patients (median age 74; range 47 to 91 years) with gastric antral vascular ectasia (GAVE) (22), angioectasia (22) and radiation proctopathy (6) underwent 58
1.9-/1.5-μm
DEELT between 2016 and 2020. All procedures were technically feasible leading to successful ablation of the targeted lesion/s, with no incident or adverse event potentially related to the
1.9-/1.5-μm
DEELT technique. Within a 6-month follow-up, hemoglobin values significantly rose (+ 1.77 at 1 month and + 1.70 g/dL at 6 months,
P
< 0.01), the blood supply requirement decreased (at least one transfusion in 32 versus 13 patients,
P
< 0.01), and GAVE lesions showed a clear endoscopic improvement (from 5 points to 1 points,
P
< 0.01).
Conclusions
The 1.9-/1.5-μm laser system is a safe and effective endoscopic tool for haemostatic ablation of bleeding vascular lesions within the gastrointestinal tract in tertiary referral centers.
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Affiliation(s)
- Gian Eugenio Tontini
- Gastroenterology and Digestive Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy,Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy,Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenzo Dioscoridi
- Digestive and Interventional Endoscopy Unit, Niguarda Hospital, ASST Niguarda, Milan, Italy
| | - Alessandro Rimondi
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy,Postgraduate Specialization in Gastrointestinal Diseases, University of Milan, Milan, Italy
| | - Paolo Cantù
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Flaminia Cavallaro
- Gastroenterology and Digestive Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy,Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Aurora Giannetti
- Digestive and Interventional Endoscopy Unit, Niguarda Hospital, ASST Niguarda, Milan, Italy,Gastroenterology and Endoscopy Unit, IRCCS Multimedica, Sesto San Giovanni, Milano
| | - Luca Elli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luca Pastorelli
- Gastroenterology and Digestive Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Francesco Pugliese
- Digestive and Interventional Endoscopy Unit, Niguarda Hospital, ASST Niguarda, Milan, Italy
| | - Massimiliano Mutignani
- Digestive and Interventional Endoscopy Unit, Niguarda Hospital, ASST Niguarda, Milan, Italy
| | - Maurizio Vecchi
- Gastroenterology and Digestive Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy,Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy,Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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2
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Dioscoridi L, Giannetti A, Massad MT, Forti E, Pugliese F, Cintolo M, Bonato G, Rosa R, Mutignani M. A "double-hit" damage mechanism can explain self-limited GI bleeding in COVID-19 pneumonia. Gastrointest Endosc 2021; 93:1192-1193. [PMID: 33875144 PMCID: PMC8052210 DOI: 10.1016/j.gie.2020.12.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/22/2020] [Accepted: 12/09/2020] [Indexed: 02/08/2023]
Affiliation(s)
| | - Aurora Giannetti
- Digestive Endoscopy Unit, Istituto di Ricovero e Cura a Carattere Scientifico Multimedica, Sesto San Giovanni, Milan, Italy
| | - Mu Taz Massad
- Digestive Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Edoardo Forti
- Digestive Endoscopy Unit, ASST Niguarda, Milan, Italy
| | | | | | - Giulia Bonato
- Digestive Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Roberto Rosa
- Digestive Endoscopy Unit, ASST Niguarda, Milan, Italy
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3
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Dioscoridi L, Giannetti A, Bonato G, Vantaggiato G, Vicari F, Airoldi A. COVID-19 and Diarrhoea: the Therapeutic Role OF LMWH. SN Compr Clin Med 2021; 3:782-783. [PMID: 33644694 PMCID: PMC7896826 DOI: 10.1007/s42399-021-00825-3] [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] [Subscribe] [Scholar Register] [Accepted: 02/14/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Lorenzo Dioscoridi
- COVID DEA, Department of Emergency Medicine, ASST Niguarda, Piazza dell’Ospedale Maggiore 3, 20162 Milan, Italy
| | | | - Giulia Bonato
- COVID DEA, Department of Emergency Medicine, ASST Niguarda, Piazza dell’Ospedale Maggiore 3, 20162 Milan, Italy
| | - Giuseppe Vantaggiato
- COVID DEA, Department of Emergency Medicine, ASST Niguarda, Piazza dell’Ospedale Maggiore 3, 20162 Milan, Italy
| | - Francesco Vicari
- COVID DEA, Department of Emergency Medicine, ASST Niguarda, Piazza dell’Ospedale Maggiore 3, 20162 Milan, Italy
| | - Aldo Airoldi
- COVID DEA, Department of Emergency Medicine, ASST Niguarda, Piazza dell’Ospedale Maggiore 3, 20162 Milan, Italy
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4
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Affiliation(s)
- A. Giannetti
- Laboratoire Interdisciplinaire de Physique (LIPhy), CNRS, Université Grenoble Alpes, Grenoble, France
- Department of Chemical, Materials and Production Engineering, DICMaPI, University of Naples Federico II, Naples, Italy
| | - J. Revilloud
- Laboratoire Interdisciplinaire de Physique (LIPhy), CNRS, Université Grenoble Alpes, Grenoble, France
| | - C. Verdier
- Laboratoire Interdisciplinaire de Physique (LIPhy), CNRS, Université Grenoble Alpes, Grenoble, France
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Pugliese F, Bonato G, Dioscoridi L, Cintolo M, Aquilano MC, Forti E, Giannetti A, Italia A, Mutignani M. A tiny lesion arising within Barrett's esophagus. Turk J Gastroenterol 2020; 31:410-412. [PMID: 32519961 DOI: 10.5152/tjg.2020.19352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Francesco Pugliese
- Digestive and Interventional Endoscopy Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Giulia Bonato
- Digestive and Interventional Endoscopy Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Lorenzo Dioscoridi
- Digestive and Interventional Endoscopy Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marcello Cintolo
- Digestive and Interventional Endoscopy Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Maria Costanza Aquilano
- Surgical Pathology Unit, Department of Laboratory Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Edoardo Forti
- Digestive and Interventional Endoscopy Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Aurora Giannetti
- Digestive and Interventional Endoscopy Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Angelo Italia
- Digestive and Interventional Endoscopy Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Massimiliano Mutignani
- Digestive and Interventional Endoscopy Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
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6
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Pontecorvi V, Dioscoridi L, Forti E, Cintolo M, Giannetti A, Vagnarelli S, Mutignani M. Endoscopic treatment of complicated bile duct stricture after surgery for traumatic bile duct injury. Endoscopy 2020; 52:E172-E173. [PMID: 31791106 DOI: 10.1055/a-1045-4246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Valerio Pontecorvi
- Digestive and Interventional Endoscopy Unit, Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Lorenzo Dioscoridi
- Digestive and Interventional Endoscopy Unit, Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Edoardo Forti
- Digestive and Interventional Endoscopy Unit, Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Marcello Cintolo
- Digestive and Interventional Endoscopy Unit, Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Aurora Giannetti
- Digestive and Interventional Endoscopy Unit, Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | | | - Massimiliano Mutignani
- Digestive and Interventional Endoscopy Unit, Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
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7
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Dioscoridi L, Forti E, Pugliese F, Cintolo M, Bonato G, Giannetti A, Mutignani M. Buried lumen-apposing metal stent after gastrojejunal bypass. Endoscopy 2020; 52:E134-E135. [PMID: 31652467 DOI: 10.1055/a-1025-1919] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Lorenzo Dioscoridi
- Digestive and Interventional Endoscopy Unit, Niguarda-Ca' Granda Hospital, Milan, Italy
| | - Edoardo Forti
- Digestive and Interventional Endoscopy Unit, Niguarda-Ca' Granda Hospital, Milan, Italy
| | - Francesco Pugliese
- Digestive and Interventional Endoscopy Unit, Niguarda-Ca' Granda Hospital, Milan, Italy
| | - Marcello Cintolo
- Digestive and Interventional Endoscopy Unit, Niguarda-Ca' Granda Hospital, Milan, Italy
| | - Giulia Bonato
- Digestive and Interventional Endoscopy Unit, Niguarda-Ca' Granda Hospital, Milan, Italy
| | - Aurora Giannetti
- Digestive and Interventional Endoscopy Unit, Niguarda-Ca' Granda Hospital, Milan, Italy
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8
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Grimaudo S, Pipitone RM, Pennisi G, Celsa C, Cammà C, Di Marco V, Barcellona MR, Boemi R, Enea M, Giannetti A, Spatola F, Marchesini G, Craxì A, Petta S. Association Between PNPLA3 rs738409 C>G Variant and Liver-Related Outcomes in Patients With Nonalcoholic Fatty Liver Disease. Clin Gastroenterol Hepatol 2020; 18:935-944.e3. [PMID: 31419571 DOI: 10.1016/j.cgh.2019.08.011] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/20/2019] [Accepted: 08/02/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Patients with nonalcoholic fatty liver disease (NAFLD) have an increased risk for liver-related complications, such as decompensation, hepatocellular carcinoma (HCC), and death; the severity of liver fibrosis and metabolic comorbidities are the main risk factors. A single nucleotide polymorphism in patatin-like phospholipase domain-containing-3 (PNPLA3) gene is associated with higher prevalence of liver damage and HCC, but there are no data from prospective studies of outcomes of patients with this polymorphism. We investigated whether the common rs738409 variant in PNPLA3 gene associates with the occurrence of liver-related events and death in a large cohort of patients with NAFLD. METHODS We followed 471 consecutive individuals at a hospital in Italy with a diagnosis of NAFLD based on histologic factors or a diagnosis of compensated NAFLD-related cirrhosis based on clinical factors for at least 6 months, from March 2004 through December 2018. We collected data on the occurrence of hepatic and extrahepatic outcomes, including decompensation and HCC, cardiovascular events and extrahepatic cancers, and overall and liver-related death. We detected the rs738409 G>C polymorphism in DNA from patient blood samples using the TaqMan assay. RESULTS During a median follow-up time of 64.6 months (range 6.1-175 months) 26 cases of decompensation, 13 HCCs, and 16 deaths (12 liver-related) were recorded. All liver-related events, including liver-related death, occurred in patients with F3 fibrosis or cirrhosis. The prevalence of PNPLA3 rs738409 GG, GT, and TT genotypes was 31.8%, 45.6%, and 22.6%, respectively. After adjusting for clinical, metabolic, and histologic risk factors, PNPLA3 C>G variant was associated with a higher risk of decompensation (hazard ratio [HR], 2.10; 95% CI, 1.03-4.29; P = .04), HCC (HR, 2.68; 95% CI, 1.01-7.26; P = .04), and liver-related death (HR, 3.64; 95% CI, 1.18-11.2; P = .02) by multivariate Cox regression analysis. In the subgroup of 162 patients with F3 fibrosis or cirrhosis, we confirmed the independent association between the PNPLA3 variant and decompensation (HR, 2.00; 95% CI, 1.01-3.97; P = .04), HCC (HR, 2.66; 95% CI, 1.02-7.13; P = .04), and liver-related death (HR, 3.64, 95% CI, 1.18-11.2; P = .02). We found no association between PNPLA3 genotype and cardiovascular events, extrahepatic cancers, or overall mortality. CONCLUSIONS Patients with NAFLD carrying PNPLA3 rs738409 G>C variant are at higher risk of liver-related events and death.
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Affiliation(s)
- Stefania Grimaudo
- Sezione di Gastroenterologia e Epatologia, PROMISE, University of Palermo, Palermo, Italy
| | - Rosaria Maria Pipitone
- Sezione di Gastroenterologia e Epatologia, PROMISE, University of Palermo, Palermo, Italy
| | - Grazia Pennisi
- Sezione di Gastroenterologia e Epatologia, PROMISE, University of Palermo, Palermo, Italy
| | - Ciro Celsa
- Sezione di Gastroenterologia e Epatologia, PROMISE, University of Palermo, Palermo, Italy
| | - Calogero Cammà
- Sezione di Gastroenterologia e Epatologia, PROMISE, University of Palermo, Palermo, Italy
| | - Vito Di Marco
- Sezione di Gastroenterologia e Epatologia, PROMISE, University of Palermo, Palermo, Italy
| | - Maria Rosa Barcellona
- Sezione di Gastroenterologia e Epatologia, PROMISE, University of Palermo, Palermo, Italy
| | - Roberta Boemi
- Sezione di Gastroenterologia e Epatologia, PROMISE, University of Palermo, Palermo, Italy
| | - Marco Enea
- Dipartimento di Scienze Economiche, Aziendali e Statistiche, University of Palermo, Palermo, Italy
| | - Aurora Giannetti
- Sezione di Gastroenterologia e Epatologia, PROMISE, University of Palermo, Palermo, Italy
| | - Federica Spatola
- Sezione di Gastroenterologia e Epatologia, PROMISE, University of Palermo, Palermo, Italy
| | - Giulio Marchesini
- SSD Malattie del Metabolismo e Dietetica Clinica, Università "Alma Mater", Bologna, Italy
| | - Antonio Craxì
- Sezione di Gastroenterologia e Epatologia, PROMISE, University of Palermo, Palermo, Italy
| | - Salvatore Petta
- Sezione di Gastroenterologia e Epatologia, PROMISE, University of Palermo, Palermo, Italy.
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9
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Mutignani M, Dioscoridi L, Italia A, Forti E, Pugliese F, Cintolo M, Bonato G, Giannetti A, Massad M. Thulium laser to manage a difficult biliary lithiasis: a first case report. Endoscopy 2020; 52:E112-E113. [PMID: 31398743 DOI: 10.1055/a-0983-8278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
| | - Lorenzo Dioscoridi
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Angelo Italia
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Edoardo Forti
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Francesco Pugliese
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Marcello Cintolo
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Giulia Bonato
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Aurora Giannetti
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Mutaz Massad
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
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10
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Dioscoridi L, Forti E, Pugliese F, Cintolo M, Italia A, Bini M, Bonato G, Giannetti A, Mutignani M. A Modified Boston Bowel Preparation Scale After Colorectal Surgery. Ann Coloproctol 2020; 37:195. [PMID: 32054257 PMCID: PMC8391046 DOI: 10.3393/ac.2019.08.20] [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: 08/20/2019] [Accepted: 08/20/2019] [Indexed: 11/17/2022] Open
Affiliation(s)
- Lorenzo Dioscoridi
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Edoardo Forti
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Francesco Pugliese
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Marcello Cintolo
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Angelo Italia
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Marta Bini
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Giulia Bonato
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
| | - Aurora Giannetti
- Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan, Italy
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11
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Thomsen C, Gurgel-Giannetti J, Sunnerhagen Y, Giannetti A, Kok F, Vainzof M, Oldfors A. P.54Defects in iron-sulphur cluster assembly proteins ISCU and FDX2 cause characteristic mitochondrial myopathy. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.083] [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: 10/25/2022]
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12
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Pugliese F, Italia A, Dioscoridi L, Giannetti A, Bonato G, Mutignani M. Thermal coagulation of mucosal defect margins using monopolar forceps reduces adenoma recurrence after colonic endoscopic mucosal resection. Dig Liver Dis 2019; 51:1206. [PMID: 31272933 DOI: 10.1016/j.dld.2019.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 05/23/2019] [Accepted: 05/26/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Francesco Pugliese
- Digestive and Interventional Endoscopy, ASST Grande Ospedale Metropolitano Niguarda, Milan Italy.
| | - Angelo Italia
- Digestive and Interventional Endoscopy, ASST Grande Ospedale Metropolitano Niguarda, Milan Italy
| | - Lorenzo Dioscoridi
- Digestive and Interventional Endoscopy, ASST Grande Ospedale Metropolitano Niguarda, Milan Italy
| | - Aurora Giannetti
- Digestive and Interventional Endoscopy, ASST Grande Ospedale Metropolitano Niguarda, Milan Italy
| | - Giulia Bonato
- Digestive and Interventional Endoscopy, ASST Grande Ospedale Metropolitano Niguarda, Milan Italy
| | - Massimiliano Mutignani
- Digestive and Interventional Endoscopy, ASST Grande Ospedale Metropolitano Niguarda, Milan Italy
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13
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Abstract
Gastric outlet obstruction (GOO) is a clinical syndrome characterized by a variety of symptoms. It may be caused by motor disorders and by benign or malignant mechanical disease. Endoscopic management of benign disease is mainly based on balloon dilation, augmented by the use of covered self-expanding metal stents (SEMS) in refractory disease. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is increasingly used as an alternative method, although more studies with longer follow up are needed before it can be considered as a recommended therapy. Surgery remains the last resort. Endoscopic management of malignant GOO is based on SEMS placement as an alternative to palliative surgery, because it is a cost-effective method. The use of a covered or uncovered stent depends on patient-related variables, which include the stricture site, concomitant involvement of the bile duct, the patient's prognosis, probably the tumor type, and the use of chemotherapy. EUS-GE is a promising technique but needs more studies with longer follow up before any firm conclusions can be drawn.
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Affiliation(s)
- Alberto Tringali
- Endoscopy Unit Surgical Department, ASST GOM Niguarda, Milan, Italy (Alberto Tringali, Aurora Giannetti)
| | - Aurora Giannetti
- Endoscopy Unit Surgical Department, ASST GOM Niguarda, Milan, Italy (Alberto Tringali, Aurora Giannetti).,Section of Gastroenterology, Biomedical Department of Internal and Specialized Medicine (DI.BI.M.I.S.), University of Palermo, Palermo, Italy (Aurora Giannetti)
| | - Douglas G Adler
- Gastroenterology, and Hepatology Department, University of Utah School of Medicine, Salt Lake City, Utah USA (Douglas G. Adler)
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14
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Abstract
Gastric outlet obstruction (GOO) is a clinical syndrome characterized by a variety of symptoms. It may be caused by motor disorders and by benign or malignant mechanical disease. Endoscopic management of benign disease is mainly based on balloon dilation, augmented by the use of covered self-expanding metal stents (SEMS) in refractory disease. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is increasingly used as an alternative method, although more studies with longer follow up are needed before it can be considered as a recommended therapy. Surgery remains the last resort. Endoscopic management of malignant GOO is based on SEMS placement as an alternative to palliative surgery, because it is a cost-effective method. The use of a covered or uncovered stent depends on patient-related variables, which include the stricture site, concomitant involvement of the bile duct, the patient’s prognosis, probably the tumor type, and the use of chemotherapy. EUS-GE is a promising technique but needs more studies with longer follow up before any firm conclusions can be drawn.
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Affiliation(s)
- Alberto Tringali
- Endoscopy Unit Surgical Department, ASST GOM Niguarda, Milan, Italy (Alberto Tringali, Aurora Giannetti)
| | - Aurora Giannetti
- Endoscopy Unit Surgical Department, ASST GOM Niguarda, Milan, Italy (Alberto Tringali, Aurora Giannetti).,Section of Gastroenterology, Biomedical Department of Internal and Specialized Medicine (DI.BI.M.I.S.), University of Palermo, Palermo, Italy (Aurora Giannetti)
| | - Douglas G Adler
- Gastroenterology, and Hepatology Department, University of Utah School of Medicine, Salt Lake City, Utah USA (Douglas G. Adler)
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15
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Pontecorvi V, Dioscoridi L, Giannetti A, Mutignani M. Symptomatic huge diaphragmatic hernia. BMJ Case Rep 2019; 12:12/3/e229286. [PMID: 30898946 DOI: 10.1136/bcr-2019-229286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Valerio Pontecorvi
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Lorenzo Dioscoridi
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Aurora Giannetti
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Massimiliano Mutignani
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
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Giannetti A. Pioneers in dermatology and venereology: an interview with Prof. Alberto Giannetti. J Eur Acad Dermatol Venereol 2019; 33:17-18. [DOI: 10.1111/jdv.15376] [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: 11/26/2022]
Affiliation(s)
- A. Giannetti
- Università degli Studi di Modena e Reggio Emilia Modena Italy
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Barucci A, Bastiani P, Carpi R, Fondelli S, Giannetti A, Olmastroni M, Pini R, Ratto F, Rucco M, Zatelli G, Esposito M. 301. Prostate cancer Radiomics using multiparametric MR imaging: An exploratory study. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.310] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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18
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Gurgel-Giannetti J, Lynch D, Paiva A, Yamamoto G, Lucato L, Amorim S, Freua F, Giannetti A, Ripa B, Monti F, Ribeiro M, Van der Knaap M, Oldfors A, Vainzof M, Holden H, Kok F. Biallelic mutation in FDXIL leads to a complex phenotype: optic atrophy, reversible leukoencephalopathy, metabolic myopathy and axonal polyneuropathy. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.408] [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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Gurgel-Giannetti J, Linhares N, Giannetti A, Santos D, Silva L, Pena S. Rare phenotypes related to novel autosomal recessive TTN truncating mutations: Escobar syndrome and congenital heart defect in two Brazilian patients. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.514] [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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Odorici G, Mandel VD, Giannetti A, Pellacani G, Conti A. Clinical features and in vivo reflectance confocal microscopy of an atypical presentation of Herpesvirus-2 and Cytomegalovirus co-infection of the intergluteal sulcus. Skin Res Technol 2017; 23:619-620. [DOI: 10.1111/srt.12366] [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] [Accepted: 02/10/2017] [Indexed: 11/29/2022]
Affiliation(s)
- G. Odorici
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest transplant, Oncological and Regenerative Medicine; Dermatology Unit; University of Modena and Reggio Emilia; Modena Italy
| | - V. D. Mandel
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest transplant, Oncological and Regenerative Medicine; Dermatology Unit; University of Modena and Reggio Emilia; Modena Italy
| | - A. Giannetti
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest transplant, Oncological and Regenerative Medicine; Dermatology Unit; University of Modena and Reggio Emilia; Modena Italy
| | - G. Pellacani
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest transplant, Oncological and Regenerative Medicine; Dermatology Unit; University of Modena and Reggio Emilia; Modena Italy
| | - A. Conti
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest transplant, Oncological and Regenerative Medicine; Dermatology Unit; University of Modena and Reggio Emilia; Modena Italy
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Gurgel-Giannetti J, Ribeiro B, Uliana L, Sampaio G, Giannetti A, Van der Linden V, Vainzof M. Steroid benefit in a laminopathy-congenital muscular dystrophy patient with dropped head syndrome: A 10-year follow-up. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.337] [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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22
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Gurgel-Giannetti J, Concentino E, Lazar M, Van der Linden V, Giannetti A, Fernandes F, Campos W, Vainzof M. Next generation sequencing (NGS): A powerful tool for studying rigid spine patients and multiminicore myopathy. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.302] [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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Tenedini E, Artuso L, Bernardis I, Artusi V, Percesepe A, De Rosa L, Contin R, Manfredini R, Pellacani G, Giannetti A, Pagani J, De Luca M, Tagliafico E. Amplicon-based next-generation sequencing: an effective approach for the molecular diagnosis of epidermolysis bullosa. Br J Dermatol 2015; 173:731-8. [PMID: 25913354 DOI: 10.1111/bjd.13858] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Epidermolysis bullosa (EB) is caused by mutations in genes that encode proteins belonging to the epidermal-dermal junction assembly. Due to the extreme clinical/genetic heterogeneity of the disease, the current methods available for diagnosing EB involve immunohistochemistry of biopsy samples and transmission electron microscopy followed by single-candidate gene Sanger sequencing (SS), which are labour-intensive and expensive clinical pathways. OBJECTIVES According to the recently published recommendations for the diagnosis and treatment of EB, the assessment of the mutational landscape is now a fundamental step for developing a comprehensive diagnostic path. We aimed to develop a customized, cost-effective amplicon panel for the complete and accurate sequencing of all the pathogenic genes already identified in EB, and to minimize the processing time required for the execution of the test and to refine the analysis pipeline to achieve cost-effective results from the perspective of a routine laboratory set-up. Next-generation sequencing (NGS) via the parallel ultra-deep sequencing of many genes represents a proper method for reducing the processing time and costs of EB diagnostics. MATERIALS AND METHODS We developed an EB disease-comprehensive AmpliSeq panel to accomplish the NGS on an Ion Torrent Personal Genome Machine platform. The panel was performed on 10 patients with known genetic diagnoses and was then employed in eight family trios with unknown molecular footprints. RESULTS The panel was successful in finding the causative mutations in all 10 patients with known mutations, fully confirming the SS data and providing proof of concept of the sensitivity, specificity and accuracy of this procedure. In addition to being consistent with the clinical diagnosis, it was also effective in the trios, identifying all of the variants, including ones that the SS missed or de novo mutations. CONCLUSIONS The NGS and AmpliSeq were shown to be an effective approach for the diagnosis of EB, resulting in a cost- and time-effective 72-h procedure.
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Affiliation(s)
- E Tenedini
- Centre for Genome Research, University of Modena and Reggio Emilia, Via Campi 287, Modena, 41125, Italy
| | - L Artuso
- Centre for Genome Research, University of Modena and Reggio Emilia, Via Campi 287, Modena, 41125, Italy
| | - I Bernardis
- Centre for Genome Research, University of Modena and Reggio Emilia, Via Campi 287, Modena, 41125, Italy
| | - V Artusi
- Centre for Genome Research, University of Modena and Reggio Emilia, Via Campi 287, Modena, 41125, Italy
| | - A Percesepe
- Department of Medical and Surgical Sciences for Children and Adults, Medical Genetics Unit, University Hospital of Modena, Largo del Pozzo 71, Modena, 41126, Italy
| | - L De Rosa
- Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Via Campi 287, Modena, 41125, Italy
| | - R Contin
- Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Via Campi 287, Modena, 41125, Italy
| | - R Manfredini
- Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Via Campi 287, Modena, 41125, Italy
| | - G Pellacani
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplants, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Via Campi 287, Modena, 41125, Italy
| | - A Giannetti
- Emeritus of Dermatology, University of Modena and Reggio Emilia, Via Campi 287, Modena, 41125, Italy
| | - J Pagani
- Centre for Genome Research, University of Modena and Reggio Emilia, Via Campi 287, Modena, 41125, Italy
| | - M De Luca
- Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Via Campi 287, Modena, 41125, Italy
| | - E Tagliafico
- Centre for Genome Research, University of Modena and Reggio Emilia, Via Campi 287, Modena, 41125, Italy
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Berrettoni C, Trono C, Tombelli S, Giannetti A, Berneschi S, Baldini F, Grimaldi IA, Persichetti G, Testa G, Bernini R, Porro G, Gärtner C. A Point-of-Care Device for Immunosuppressants Monitoring in Transplanted Patients. Lecture Notes in Electrical Engineering 2015. [DOI: 10.1007/978-3-319-09617-9_6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Scalone L, Cortesi P, Mantovani L, Belisari A, Ayala F, Fortina A, Bonamonte D, Borroni G, Cannavò S, Guarneri F, Cristaudo A, De Pità O, Gallo R, Girolomoni G, Gola M, Lisi P, Pigatto P, Satta R, Giannetti A. Clinical epidemiology of hand eczema in patients accessing dermatological reference centres: results from Italy. Br J Dermatol 2014; 172:187-95. [DOI: 10.1111/bjd.13220] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2014] [Indexed: 11/27/2022]
Affiliation(s)
- L. Scalone
- Research Centre on Public Health (CESP); University of Milan-Bicocca; Villa Serena Via Pergolesi 33 I-20052 Monza Italy
- CHARTA Foundation; Milan Italy
| | - P.A. Cortesi
- Research Centre on Public Health (CESP); University of Milan-Bicocca; Villa Serena Via Pergolesi 33 I-20052 Monza Italy
- CHARTA Foundation; Milan Italy
| | - L.G. Mantovani
- CHARTA Foundation; Milan Italy
- Faculty of Pharmacy; University of Naples Federico II; Naples Italy
| | | | - F. Ayala
- Department of Dermatology; University of Naples Federico II; Naples Italy
| | - A.B. Fortina
- Pediatric Dermatology Unit; Department of Medicine; University of Padova; Padova Italy
| | - D. Bonamonte
- Department of Biomedical Science and Human Oncology; Unit of Dermatology; University of Bari ‘Aldo Moro’; Bari Italy
| | - G. Borroni
- Clinical-Surgical, Diagnostic and Pediatric Science; Dermatology Unit; University of Pavia; Fondazione IRCCS Policlinico San Matteo; Pavia Italy
| | - S.P. Cannavò
- Department of Clinical and Experimental Medicine-Unit of Dermatology; University of Messina; Messina Italy
| | - F. Guarneri
- Department of Clinical and Experimental Medicine-Unit of Dermatology; University of Messina; Messina Italy
| | - A. Cristaudo
- Department of Allergological and Occupational Dermatology; San Gallicano Dermatologic Institute, IRCCS; Rome Italy
| | - O. De Pità
- Laboratory of Immunology; Istituto Dermopatico dell'Immacolata (IDI)-IRCCS; Rome Italy
| | - R. Gallo
- Section of Dermatology; DISSAL - Department of Health Sciences; University of Genoa; Genoa Italy
| | - G. Girolomoni
- Department of Medicine; Section of Dermatology and Venereology; University of Verona; Verona Italy
| | - M. Gola
- Allergological and Occupational Dermatology Unit; Department of Critical Care Medicine and Surgery; University of Florence; Florence Italy
| | - P. Lisi
- Department of Medical and Surgical Specialities and Public Health; Section of Clinical, Allergological and Venereological Dermatology; University of Perugia; Perugia Italy
| | - P.D. Pigatto
- Department of Biomedical Science for Health IRCCS Galeazzi Hospital; University of Milan; Milan Italy
| | - R. Satta
- Institute of Dermatology; University of Sassari; Sassari Italy
| | - A. Giannetti
- Division of Dermatology; University of Modena and Reggio Emilia; Modena Italy
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26
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Paul C, Puig L, Kragballe K, Luger T, Lambert J, Chimenti S, Girolomoni G, Nicolas J, Rizova E, Lavie F, Mistry S, Bergmans P, Barker J, Reich K, Adamski Z, Altomare G, Aricò M, Aste N, Aubin F, Augustin M, Ayala F, Bachelez H, Baran E, Barker J, Belinchón I, Berbis P, Bernengo M, Bessis D, Beylot‐Barry M, Bordas Orpinell F, Burden D, Bylaite M, Cambazard F, Carazo S, Carrascosa J, Carretero G, Cerio R, Chimenti S, David M, Duval‐Modeste A, Eedy D, Estebaranz L, Filipe P, Flytström I, Fonseca E, Gamanya R, Ghislain P, Giannetti A, Girolomoni G, Gospodinov D, Griffiths C, Grob J, Guillet G, Hernanz Hermosa J, Hoffmann M, Ioannidis D, Jacobi A, Jemec G, Kadurina M, Kaszuba K, Katsambas A, Kemeny L, Kerkhof P, Kragballe K, Kuzmina N, Lambert K, Lázaro P, Lotti T, Luger T, Matz H, Modiano P, Moessner R, Moreno D, Moreno Jímenez J, Mørk N, Mrowietz U, Murphy R, Nicolas J, Nikkels A, Oliveira H, Ormerod A, Ortonne J, Parodi A, Pasternack R, Paul C, Pec J, Peserico A, Philipp S, Piquet L, Plantin P, Puig L, Reich K, Reményik E, Riedl E, Röcken M, Rustin M, Saari S, Saiag P, Salmhofer W, Schadendorf D, Sebastian M, Simaljakova M, Simon J, Spirén A, Stalder J, Stavrianeas N, Sticherling M, Ternowitz T, Thaci D, Thio B, Uhlig D, Valiukeviciene S, Vanaclocha Sebastián F, Wozel G. Transition to ustekinumab in patients with moderate‐to‐severe psoriasis and inadequate response to methotrexate: a randomized clinical trial (
TRANSIT
). Br J Dermatol 2014; 170:425-34. [DOI: 10.1111/bjd.12646] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2013] [Indexed: 12/25/2022]
Affiliation(s)
- C. Paul
- Hôpital Larrey Service de Dermatologie Toulouse cedex 9 31059 France
| | - L. Puig
- Department of Dermatology Hospital de la Santa Creu i Sant Pau Universitat Autònoma de Barcelona 08025 Barcelona Spain
| | - K. Kragballe
- Department of Dermatology Århus University Hospital Århus Sygehus 8000 Århus Denmark
| | - T. Luger
- Department of Dermatology University of Münster D‐48149 Münster Germany
| | - J. Lambert
- Department of Dermatology Ghent University 9000 Ghent Belgium
| | - S. Chimenti
- Policlinico Universitario Tor Vergata Clinica Dermatologica 00133 Rome Italy
| | - G. Girolomoni
- Clinica Dermatologica University of Verona 37126 Verona Italy
| | | | - E. Rizova
- Janssen‐Cilag 1 rue Camille Desmoulins TSA 91003 92787 Issy les Moulineaux, Cedex 9 France
| | - F. Lavie
- Janssen‐Cilag 1 rue Camille Desmoulins TSA 91003 92787 Issy les Moulineaux, Cedex 9 France
| | - S. Mistry
- Janssen 50‐100 Holmers Farm Way High Wycombe Bucks HP12 4EG U.K
| | - P. Bergmans
- Janssen‐Cilag B.V. Postbus 90240 5000 LT Tilburg the Netherlands
| | - J. Barker
- St John's Institute of Dermatology King's College London SE1 9RT U.K
| | - K. Reich
- Dermatologikum Hamburg Stephansplatz 5 20354 Hamburg Germany
- Georg‐August‐University Göttingen Germany
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Berrettoni C, Berneschi S, Bernini R, Giannetti A, Grimaldi I, Persichetti G, Testa G, Tombelli S, Trono C, Baldini F. Optical Monitoring of Therapeutic Drugs with a Novel Fluorescence- Based POCT Device. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.proeng.2014.11.732] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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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Giannetti A, Meglio P, Ricci G. Skin prick test: the only predictive tool of anaphylaxis? A case report. Eur Ann Allergy Clin Immunol 2014; 46:49-52. [PMID: 24702877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Currently, in the literature there is a lack of definite predictive values parameters to identify patients with the risk to develop anaphylaxis. The controlled oral food challenge remains the gold standard for food allergy diagnosis. We report a case of a girl allergic to cow's milk with low levels of specific IgE and large skin prick test wheal sizes for cow's milk. In some cases the high diameter of skin prick test wheal may be more reliable than specific IgE levels in predicting an anaphylactic reaction.
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Affiliation(s)
- A Giannetti
- Pediatric Unit, Department of Gynecologic, Obstetric and Pediatric Sciences, University of Bologna, Bologna, Italy
| | - P Meglio
- Research Centre, Department of Pediatric Allergy, San Pietro Hospital - Fatebenefratelli, Rome, Italy
| | - G Ricci
- Pediatric Unit, Department of Gynecologic, Obstetric and Pediatric Sciences, University of Bologna, Bologna, Italy.
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Ricci G, Piccinno V, Calamelli E, Giannetti A, Pession A. Latex-fruit syndrome in Italian children and adolescents with natural rubber latex allergy. Int J Immunopathol Pharmacol 2013; 26:263-8. [PMID: 23527732 DOI: 10.1177/039463201302600129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Approximately 30-50 percent of individuals with natural rubber latex (NRL) allergy show an associated hypersensitivity to particular plant-derived foods, which has been defined "latex-fruit syndrome" (LFS). In our population of 22 patients with IgE-mediated NRL allergy we found a relevant prevalence (36 percent) of LFS, which resulted significantly higher in the group of patients with more severe clinical manifestations of NRL allergy than in patients with contact symptoms due to NRL (78 percent vs 8 percent; less than 0.005).
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Surdo S, Merlo S, Carpignano F, Strambini LM, Trono C, Giannetti A, Baldini F, Barillaro G. Optofluidic microsystems with integrated vertical one-dimensional photonic crystals for chemical analysis. Lab Chip 2012; 12:4403-15. [PMID: 22930245 DOI: 10.1039/c2lc40613f] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
In this work, we report all-silicon, integrated optofluidic microsystems (OFMs) fabricated by electrochemical micromachining (ECM) technology, in which high aspect-ratio (HAR) photonic crystal (PhC) devices (i.e. micromirrors, optical cavities) are integrated by one-etching-step, together with microfluidic reservoirs/channels, for the infiltration of liquids in the PhC air gaps, and with fiber grooves for alignment/positioning of readout optical fibers in front of the PhC, on the same silicon die. This has not previously been reported in the literature, and opens up new ground in, though not limited to, the optofluidics field, due to the low-cost and high-flexibility of the ECM technology that allows optofluidic microsystem fabrication to be performed in any lab. Optofluidic characterization of PhC-OFMs by both capillary-action and pressure-driven operations is carried out through the measurement of the reflectivity spectra of HAR-PhCs upon injection of liquids featuring different refractive index values in the HAR-PhC air gaps, by using readout optical fibers positioned in the on-chip fiber grooves. High sensitivity and good limit of detection of PhC-OFMs are obtained for both capillary-action and pressure-driven operations. A best sensitivity value of 670 nm/RIU and a worst-case limit of detection of the order of 10(-3) RIU are measured, the former being comparable to state-of-the-art integrated refractive index sensors and the latter being limited by constraints of the experimental setup. The proof of concept about the biosensing potential of PhC-OFMs is given by successfully carrying out a sandwich assay based on antigen-antibody interactions for the detection of the C-reactive protein (CRP) at a concentration value of 10 mg L(-1), which represents the boundary level between physiological and pathological conditions.
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Affiliation(s)
- S Surdo
- Dipartimento di Ingegneria dell'Informazione: Elettronica, Informatica, Telecomunicazioni, Università di Pisa, via G, Caruso 16, 56126, Pisa, Italy
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31
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Gisondi P, Cazzaniga S, Chimenti S, Giannetti A, Maccarone M, Picardo M, Girolomoni G, Naldi L. Metabolic abnormalities associated with initiation of systemic treatment for psoriasis: evidence from the Italian Psocare Registry. J Eur Acad Dermatol Venereol 2012; 27:e30-41. [PMID: 22313340 DOI: 10.1111/j.1468-3083.2012.04450.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To evaluate variations in laboratory parameters and diagnoses of selected clinical conditions up to 16 weeks after starting a new systemic psoriasis treatment for Psocare Registry enrollees. DESIGN Prospective cohort study. SETTING Italian public referral centres for psoriasis treatment. PATIENTS First-time recipients (n = 10,539) of continuous systemic psoriasis treatment for at least 16 weeks. MAIN OUTCOME MEASURE Mean variations in (weeks 8 and 16) and proportions of patients reaching a clinically meaningful increase in serum levels (week 16) of total and low-density lipoprotein cholesterol, triglycerides, aspartate amino transferase, alanine amino transferase and creatinine, as well as week-16 cumulative incidences of new diagnoses of diabetes mellitus and arterial hypertension. RESULTS Mean cholesterol and triglyceride levels significantly increased in patients treated with acitretin or cyclosporine. Mean triglyceride levels also increased in efalizumab- and etanercept-treated patients. Mean transaminase values increased in methotrexate-treated patients, and mean aspartate amino transferase levels increased in infliximab-treated patients. The average serum creatinine value increased in cyclosporine-treated patients. Acitretin and cyclosporine were associated with risk of hypercholesterolaemia (odds ratios 1.51 and 1.34) and acitretin with risk of hypertriglyceridaemia (odds ratio 1.43). Methotrexate and infliximab were associated with risk of more than doubling the upper normal aspartate amino transferase (odds ratios 2.06 and 1.87) and alanine amino transferase (odds ratios 2.38 and 1.74) values. The relative risk of developing arterial hypertension and diabetes was increased for patients receiving cyclosporine (odds ratios 3.31 and 2.88). CONCLUSION Systemic treatments for psoriasis resulted in heterogeneous effects on the parameters analysed.
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Affiliation(s)
- P Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Italy GISED Study Centre, Ospedali Riuniti, Bergamo, Italy
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Fang G, Maurer T, Garrenton L, Skelton N, Fauber B, Malek S, Giannetti A, Jackson P, Rudolph J, Wang W. Drugging the Undruggable Small-molecule Inhibition of Ras Oncoprotein. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70114-9] [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: 11/30/2022]
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Ricci G, Piccinno V, Giannetti A, Miniaci A, Specchia F, Masi M. Evolution of Hypogammaglobulinemia in Premature and Full-Term Infants. Int J Immunopathol Pharmacol 2011; 24:721-6. [DOI: 10.1177/039463201102400318] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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] Open
Abstract
There are few data in the literature reporting the evolution of hypogammaglobulinemia in premature and full-term infants during the first years of life. The aim of this study was to assess the clinical and immunological evolution of premature and full-term infants with hypogammaglobulinemia. We included 24 children (11 premature and 13 full-term infants), aged 0–36 months, with hypogammaglobulinemia. Fifteen (62.5%) children had an isolated reduction in IgG, 7 (29.2%) had a decrease in both IgG and IgA and 2 (8.3%) a reduction in IgG and IgM. Normalization of IgG serum levels occurred in the premature infants at a mean age of 7.2 months. Full-term infants were divided into 3 groups based on age at normalization of IgG serum level: A) hypogammaglobulinemia with normalization within 12 months of life; B) with normalization within 36 months of life; C) normalization after 36 months. All the premature infants with hypogammaglobulinemia recovered, even though in the lower limits for age in the first years, while transient hypogammaglobulinemia observed in full-term infants has a different age of recovery.
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Affiliation(s)
- G. Ricci
- Department of Pediatrics, University of Bologna, Italy
| | - V. Piccinno
- Department of Pediatrics, University of Bologna, Italy
| | - A. Giannetti
- Department of Pediatrics, University of Bologna, Italy
| | - A. Miniaci
- Department of Pediatrics, University of Bologna, Italy
| | - F. Specchia
- Department of Pediatrics, University of Bologna, Italy
| | - M. Masi
- Department of Pediatrics, University of Bologna, Italy
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Ricci G, Giannetti A, Belotti T, Dondi A, Bendandi B, Cipriani F, Masi M. Allergy is not the main trigger of urticaria in children referred to the emergency room. J Eur Acad Dermatol Venereol 2011; 24:1347-8. [PMID: 20337828 DOI: 10.1111/j.1468-3083.2010.03634.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Urticaria is the disease that has the highest impact on quality of life and requires the most visits to the emergency room. OBJECTIVE To investigate the clinical presentation of acute urticaria in children referred to the paediatric emergency room of our hospital and to define possible related aetiologies. METHODS We included 814 children consecutively referred to the emergency room between January 2006 and December 2007 with a diagnosis of acute urticaria, isolated or associated with other clinical symptoms. RESULTS Only 2.0% of the cases studied were associated with severe clinical pictures. In 437 cases (53.7%), the cause of urticaria was not determined. The infections of the respiratory tract were the most frequently suspected aetiological factor. The diagnosis of allergic urticaria is more defined, but belongs to a minority group (10.8%). The first level treatment includes the use of non-sedating oral H1-antihistamine. CONCLUSION The children with urticaria are frequently referred to the paediatric emergency room, but only in a few cases were associated with severe clinical manifestations or allergy. The evidence of an inverse relationship between the number of accesses and the patients' age may be explained by the higher prevalence of this disease in early childhood and possibly also by a higher concern of the parents of the younger patients.
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Affiliation(s)
- G Ricci
- Department of Pediatric, University of Bologna, Bologna, Italy.
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Colombo D, Cassano N, Altomare G, Giannetti A, Vena G. Psoriasis Relapse Evaluation with Week-End Cyclosporine a Treatment: Results of a Randomized, Double-Blind, Multicenter Study. Int J Immunopathol Pharmacol 2010; 23:1143-52. [PMID: 21244763 DOI: 10.1177/039463201002300418] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [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] Open
Abstract
Cyclosporine A (CsA) effectively controls psoriasis, however, its long-term continuous use is not recommended. This study aims to evaluate the efficacy and tolerability of week-end CsA microemulsion for the reduction of relapse rate in patients with chronic plaque psoriasis who had achieved clinical remission following continuous CsA therapy. The PREWENT (Psoriasis Relapse Evaluation with Week-End Neoral Treatment) study was a 24-week, randomized, double-blind, multicenter study, carried out in 22 Italian hospital or university Dermatology units. CsA was discontinued for 8 days previous to the patients being randomized to oral CsA 5 mg/kg/day or placebo for two consecutive days/week, for a total period of 24 weeks. The primary endpoint was clinical success rate at week 24, defined as the proportion of patients with no clinical worsening (no relapse or a Psoriasis Area and Severity Index [PASI] <75% of pre-treatment PASI). A total of 162 patients were randomized to CsA and 81 to placebo. Clinical success rates at 24 weeks were 66.9% and 53.2% with CsA and placebo, respectively (p = 0.072). Time to first relapse was significantly prolonged with CsA versus placebo (p = 0.023), and PASI was significantly lower from weeks 4 to 16 in CsA recipients. In patients with moderate-severe psoriasis, the clinical success rate was significantly increased with CsA compared to placebo (69.9% vs 46.3%; p = 0.011), and significantly lower increases in PASI were observed from week 4 to week 24 (p < 0.05 vs placebo). CsA was well tolerated, with no differences in mean blood creatinine or blood pressure between CsA and placebo recipients. However, the high withdrawal rate (22.2% of randomized patients), which was not related to side effects, may have led to an overestimation of efficacy, but the study had a good statistical power (88% greater than that observed in similar studies, i.e. 80%). Week-end CsA administration was shown to prolong safely and effectively the time to first relapse in psoriasis patients.
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Affiliation(s)
| | - N. Cassano
- 2nd Dermatology Clinic, MIDIM Department, University of Bari
| | - G. Altomare
- Department of Dermatology, University of Milan
| | - A. Giannetti
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - G.A. Vena
- 2nd Dermatology Clinic, MIDIM Department, University of Bari
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Colombo D, Caputo A, Finzi A, Andreassi L, Chimenti S, Vena GA, Giannetti A. Evolution of and risk factors for psychological distress in patients with psoriasis: the PSYCHAE study. Int J Immunopathol Pharmacol 2010; 23:297-306. [PMID: 20378016 DOI: 10.1177/039463201002300128] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Psychological distress (PD) is common in patients with psoriasis but little is known about its evolution. The aim of this study is to assess the evolution of PD in psoriasis. For this purpose, 1,505 psoriatic patients, who had been previously enrolled in the PSYCHAE study, an observational multicenter Italian study, were re-evaluated after 6 and 12 months. Minor and major PD were assessed using the General Health Questionnaire (GHQ) and Brief Symptoms Inventory (BSI) questionnaires and coping using Brief COPE questionnaire. Minor PD was present in 46 percent of patients but halved during the study. Female gender, surface area, topical steroids, methotrexate, self-distraction, venting and behavioral disengagement were risk factors for minor PD; cyclosporine and humor were protective. Major PD was present in 11 percent of patients and remained stable. Female gender, venting, religion, behavioral disengagement and emotional support were risk factors for major PD; instrumental support was protective. In conclusion, the results obtained suggest that major PD remained stable after 12 months and that coping was a predictor of its evolution.
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Affiliation(s)
- D Colombo
- Department of Dermatology, Marchesi Hospital, Inzago, Milano, Italy.
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Marchesoni A, Altomare G, Matucci-Cerinic M, Balato N, Olivieri I, Salvarani C, Lotti T, Scarpa R, Vena GA, Valesini G, Giannetti A. An Italian shared dermatological and rheumatological proposal for the use of biological agents in psoriatic disease. J Eur Acad Dermatol Venereol 2010; 24:578-86. [DOI: 10.1111/j.1468-3083.2009.03474.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Scarpa R, Altomare G, Marchesoni A, Balato N, Matucci Cerinic M, Lotti T, Olivieri I, Vena GA, Salvarani C, Valesini G, Giannetti A. Psoriatic disease: concepts and implications. J Eur Acad Dermatol Venereol 2010; 24:627-30. [DOI: 10.1111/j.1468-3083.2010.03574.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Rossi R, Calzavara-Pinton PG, Giannetti A, Peserico A, Santucci M, Vena GA, Lotti T. Italian guidelines and therapeutic algorithm for actinic keratoses. GIORN ITAL DERMAT V 2009; 144:713-723. [PMID: 19907409] [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: 05/28/2023]
Abstract
The prevalence of actinic keratosis (AK) continues to rise among white people throughout the world and it is necessary to increase the level of attention paid to it from a diagnostic and a preventive point of view. Today, AK must be considered an in situ squamous cell carcinoma and as such, must be managed using one of the available approved therapeutic alternatives. However, when multiple AKs develop on severely photodamaged skin, the treatment of the lesion together with that of the field of cancerization is part of an optimal strategy that aims not only to solve alterations clinically evident but also those in the surrounding skin field cancerization, that most likely hosts genetic alterations and is the site of initial gradual replacement of normal cells with tumoral cells. This paper reports the most recent evidences from a careful review of the literature's key articles of the treatment of AKs and suggests guidelines for the clinicians. The guidelines indicated by the authors have also been based on practical evaluations and their own clinical experience. The present conclusions may be modified by new findings in the field of oncologic research.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Algorithms
- Carcinoma, Squamous Cell/etiology
- Carcinoma, Squamous Cell/prevention & control
- Cryotherapy
- Curettage
- Dermatologic Agents/therapeutic use
- Disease Progression
- Electrocoagulation
- Female
- Humans
- Italy/epidemiology
- Keratosis, Actinic/diagnosis
- Keratosis, Actinic/epidemiology
- Keratosis, Actinic/etiology
- Keratosis, Actinic/physiopathology
- Keratosis, Actinic/surgery
- Keratosis, Actinic/therapy
- Laser Therapy
- Male
- Middle Aged
- Neoplasms, Radiation-Induced/etiology
- Neoplasms, Radiation-Induced/prevention & control
- Phototherapy
- Practice Guidelines as Topic
- Precancerous Conditions/diagnosis
- Precancerous Conditions/epidemiology
- Precancerous Conditions/etiology
- Precancerous Conditions/surgery
- Precancerous Conditions/therapy
- Prevalence
- Risk Factors
- Sunscreening Agents
- Ultraviolet Rays/adverse effects
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Affiliation(s)
- R Rossi
- Section of Dermatology II, University of Florence, Local Health Unit 10, Florence, Italy.
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Soria S, Baldini F, Berneschi S, Cosi F, Giannetti A, Conti GN, Pelli S, Righini GC, Tiribilli B. High-Q polymer-coated microspheres for immunosensing applications. Opt Express 2009; 17:14694-14699. [PMID: 19687947 DOI: 10.1364/oe.17.014694] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Homogeneous polymeric thin layers have been used as functionalizing agents on silica microspherical resonators in view of the implementation of an immunosensor. We have characterized the microspheres functionalized with poly-L-lactic acid and Eudragit L100, as an alternative to the commonly used 3-Aminopropyltrimethoxysilane. It is shown that polymeric functionalization does not affect the high quality factor (Q greater than 10(7)) of the silica microspheres, and that the Q factor is about 3 x 10(5) after chemical activation and covalent binding of immunogammaglobulin (IgG). This functionalizing process of the microresonator constitutes a promising step towards the achievement of an ultra sensitive immunosensor.
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Affiliation(s)
- S Soria
- IFAC-CNR, NelloCarrara Institute of Applied Physics, via Madonna del Piano 10, 50019 Sesto Fiorentino, Florence, Italy.
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Pigatto PD, Marsili CB, Ayala F, Depità O, Gelmetti C, Giannetti A, Girolomoni G, Vena GA, Cassano N, Ayala F. Italian position paper on urticaria. Italian Board on Urticaria. GIORN ITAL DERMAT V 2009; 144:297-311. [PMID: 19528910] [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: 05/27/2023]
Abstract
The Italian Board on Urticaria has prepared a document focusing on the definition and classification of urticaria, taking into account the recent progress in identifying the causes, eliciting factors, and pathomechanisms of this disease. As urticaria has a profound impact on the quality of life, effective treatment is important. Therefore, specific treatment options for the management of urticaria are evaluated on the basis of the recent literature. Non-sedating H(1) antihistamines are recommended as the first-line treatment as they have proven effective in several randomized double-blind controlled studies. Dosages higher than those recommended may be necessary in some cases. However, additional or alternative therapies may be required for different urticaria subtypes and in view of individual variations in the course of the disease and response to treatment. Immunosuppressive drugs such as corticosteroids are not recommended for long-term treatment due to unavoidable, severe adverse effects.
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Affiliation(s)
- P D Pigatto
- Department for Health Technologies, IRCCS R. Galeazzi Hospital, Milan, Italy.
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Baldini F, Bolzoni L, Giannetti A, Kess M, Krämer PM, Kremmer E, Porro G, Senesi F, Trono C. A new procalcitonin optical immunosensor for POCT applications. Anal Bioanal Chem 2008; 393:1183-90. [DOI: 10.1007/s00216-008-2547-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2008] [Revised: 11/24/2008] [Accepted: 11/26/2008] [Indexed: 01/30/2023]
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Wollenberg A, Reitamo S, Girolomoni G, Lahfa M, Ruzicka T, Healy E, Giannetti A, Bieber T, Vyas J, Deleuran M. Proactive treatment of atopic dermatitis in adults with 0.1% tacrolimus ointment. Allergy 2008; 63:742-750. [PMID: 18592619] [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: 05/26/2023]
Abstract
BACKGROUND Long-term treatment for atopic dermatitis (AD) using low dose, intermittent, topical anti-inflammatory agents may control acute disease and prevent relapses. This 12-month, European, multicentre, randomized study investigated whether the proactive use of 0.1% tacrolimus ointment applied twice weekly can keep AD in remission and reduce the incidence of disease exacerbations (DE). METHODS During the initial open-label period, 257 adults with AD applied 0.1% tacrolimus ointment twice daily (b.i.d.) for up to 6 weeks to affected areas. When an Investigator Global Assessment (IGA) score of <or=2 was achieved, the patient entered the disease control period (DCP) and was randomized to either proactive tacrolimus (n = 116) or vehicle ointment (n = 108) twice weekly for 12 months. Exacerbations were treated with 0.1% tacrolimus ointment b.i.d. until an IGA <or=2 was regained, then randomized treatment was restarted. The primary endpoint was the number of DEs during the DCP that required a substantial therapeutic intervention. RESULTS Proactive tacrolimus 0.1% ointment application significantly reduced the number of DEs requiring substantial therapeutic intervention (median difference 2; P < 0.001; Wilcoxon rank sum test), the percentage of DE treatment days (median difference: 15.2%; P < 0.001; Wilcoxon rank sum test) and increased the time to first DE (median 142 vs 15 days; P < 0.001; stratified log-rank test). The adverse event profile was similar for the two treatment approaches. CONCLUSION A 12-month, twice weekly proactive tacrolimus ointment application was an effective treatment in most study patients which prevented, delayed and reduced the occurrence of AD exacerbations
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Affiliation(s)
- A Wollenberg
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
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Wollenberg A, Reitamo S, Atzori F, Lahfa M, Ruzicka T, Healy E, Giannetti A, Bieber T, Vyas J, Deleuran M. Proactive treatment of atopic dermatitis in adults with 0.1% tacrolimus ointment. Allergy 2008; 63:742-50. [PMID: 18445188 DOI: 10.1111/j.1398-9995.2008.01683.x] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.4] [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: 11/29/2022]
Abstract
BACKGROUND Long-term treatment for atopic dermatitis (AD) using low dose, intermittent, topical anti-inflammatory agents may control acute disease and prevent relapses. This 12-month, European, multicentre, randomized study investigated whether the proactive use of 0.1% tacrolimus ointment applied twice weekly can keep AD in remission and reduce the incidence of disease exacerbations (DE). METHODS During the initial open-label period, 257 adults with AD applied 0.1% tacrolimus ointment twice daily (b.i.d.) for up to 6 weeks to affected areas. When an Investigator Global Assessment (IGA) score of < or =2 was achieved, the patient entered the disease control period (DCP) and was randomized to either proactive tacrolimus (n = 116) or vehicle ointment (n = 108) twice weekly for 12 months. Exacerbations were treated with 0.1% tacrolimus ointment b.i.d. until an IGA < or =2 was regained, then randomized treatment was restarted. The primary endpoint was the number of DEs during the DCP that required a substantial therapeutic intervention. RESULTS Proactive tacrolimus 0.1% ointment application significantly reduced the number of DEs requiring substantial therapeutic intervention (median difference 2; P < 0.001; Wilcoxon rank sum test), the percentage of DE treatment days (median difference: 15.2%; P < 0.001; Wilcoxon rank sum test) and increased the time to first DE (median 142 vs 15 days; P < 0.001; stratified log-rank test). The adverse event profile was similar for the two treatment approaches. CONCLUSION A 12-month, twice weekly proactive tacrolimus ointment application was an effective treatment in most study patients which prevented, delayed and reduced the occurrence of AD exacerbations.
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Affiliation(s)
- A Wollenberg
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
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Wollenberg A, Reitamo S, Atzori F, Lahfa M, Ruzicka T, Healy E, Giannetti A, Bieber T, Vyas J, Deleuran M. Proactive treatment of atopic dermatitis in adults with 0.1% tacrolimus ointment. Allergy 2008. [DOI: 10.1111/j.1398-9995.2007.01406.x-i1] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [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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Finzi A, Colombo D, Caputo A, Andreassi L, Chimenti S, Vena G, Simoni L, Sgarbi S, Giannetti A. Psychological distress and coping strategies in patients with psoriasis: the PSYCHAE Study. J Eur Acad Dermatol Venereol 2007; 21:1161-9. [PMID: 17894699 DOI: 10.1111/j.1468-3083.2007.02079.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [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: 11/29/2022]
Abstract
OBJECTIVE Our objectives were to determine the prevalence of psychological distress in a large sample of Italian patients with psoriasis; to establish whether disease severity and psychological distress are associated; to identify the strategies employed to cope with psoriasis; to evaluate the coping strategies employed by dermatologists; and to identify potential predictors of psychological distress. DESIGN Cross-sectional. SETTING Thirty-nine Italian dermatology centres. SUBJECTS One thousand five hundred and eighty (1580) patients with psoriasis. METHODS Minor psychological distress was evaluated using the General Health Questionnaire-12 (GHQ-12) and major psychopathological distress using the Brief Symptom Inventory (BSI); coping strategies were evaluated using the Brief COPE questionnaire; disease severity was evaluated using the body surface area index. RESULTS Patients were aged 44 +/- 13 years (mean +/- SD) and were mainly men (57%). Minor psychological distress was present in 46% of patients and major psychopathological distress in 11% of them. Both minor (54% vs. 40%, P < 0.0001) and major (17% vs. 7%, P < 0.0001) distress were more frequent in women than in men. The psychological status of women was worse than that of men independently from the extension of psoriasis. There was no association between the presence of distress and the treatment prescribed by dermatologists. Planning and active coping were the strategies most commonly employed by patients to cope with psoriasis, but there were between-gender differences. Most dermatologists employed a 'problem-orientated' attitude in caring for patients. CONCLUSIONS (i) Psychological distress was relatively frequent in our patients with psoriasis; (ii) female gender was the most important predictive factor for psychological distress; (iii) there was no association between psoriasis severity and psychological distress; (iv) planning and active coping were the coping strategies most frequently employed by patients; and (v) most dermatologists employed a problem-orientated attitude in caring for patients.
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Affiliation(s)
- A Finzi
- Department of Dermatology, Maggiore Hospital, University of Milano, Milano, Italy.
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Gisondi P, Tessari G, Conti A, Piaserico S, Schianchi S, Peserico A, Giannetti A, Girolomoni G. Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based case?control study. Br J Dermatol 2007; 157:68-73. [PMID: 17553036 DOI: 10.1111/j.1365-2133.2007.07986.x] [Citation(s) in RCA: 422] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Psoriasis is a chronic inflammatory disease associated with an increased cardiovascular risk. Metabolic syndrome is a significant predictor of cardiovascular events. OBJECTIVE To investigate the prevalence of metabolic syndrome in patients with psoriasis. METHODS We performed a hospital-based case-control study on 338 adult patients with chronic plaque psoriasis and 334 patients with skin diseases other than psoriasis. RESULTS Metabolic syndrome was significantly more common in psoriatic patients than in controls (30.1% vs. 20.6%, odds ratio 1.65, 95% confidence interval 1.16-2.35; P = 0.005) after the age of 40 years. Psoriatic patients also had a higher prevalence of hypertriglyceridaemia and abdominal obesity, whereas hyperglycaemia, arterial hypertension and high-density lipoprotein cholesterol plasma levels were similar. Although psoriasis patients were more frequently smokers, the association of psoriasis with metabolic syndrome was independent from smoking. There was no correlation between severity of psoriasis and prevalence of metabolic syndrome. Psoriatic patients with metabolic syndrome were older and had a longer disease duration compared with psoriatic patients without metabolic syndrome. CONCLUSION Psoriatic patients have a higher prevalence of metabolic syndrome, which can favour cardiovascular events. We suggest psoriatic patients should be encouraged to correct aggressively their modifiable cardiovascular risk factors.
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Affiliation(s)
- P Gisondi
- Section of Dermatology, Department of Biomedical and Surgical Science, University of Verona, Verona, Italy.
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