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An R, Fontana F, Van Daele E, Ventura M, Vlieger A, van Elburg RM, Knol J, Milani C, Belzer C. Longitudinal changes in bifidobacterial population during the first two years of life. Benef Microbes 2024:1-14. [PMID: 38677714 DOI: 10.1163/18762891-bja00012] [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] [Received: 09/15/2023] [Accepted: 04/09/2024] [Indexed: 04/29/2024]
Abstract
Early life microbiota encompasses of a large percentage of Bifidobacterium, while it is not sufficiently understood how the Bifidobacterium population develops after infant's birth. Current study investigated the longitudinal changes in Bifidobacterium population during the first two years of life in 196 term born infants (1,654 samples) using 16S rRNA-23S rRNA internal transcribed spacer (ITS) sequence analysis. Throughout the first two years of life, Bifidobacterium breve, Bifidobacterium longum subsp. longum and Bifidobacterium adolescentis were most dominant and prevalent in the Bifidobacterium population, while B. breve had the highest relative abundance and prevalence during the first week of life and it was taken over by B. longum subsp. longum around two years after birth. Sampling time points, early antibiotic(s) exposure (effect only measurable within a month after birth), delivery mode (effect still detectable two-months after birth) and feeding mode (effect lasted until six months after birth), significantly contributed to the overall variation in the bifidobacterial population. From six months onwards, introducing of solid food and cessation of breastfeeding were accompanied with drastic changes in the composition in bifidobacterial population. Altogether, current study confirmed the effect of potential contributors to the longitudinal changes within the bifidobacterial population during the first two years of life. Registered at https://clinicaltrials.gov: NCT02536560.
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Affiliation(s)
- R An
- Laboratory of Microbiology, 4508Wageningen University and Research, Wageningen, the Netherlands
- Department of Food Science and Technology, Shanghai Jiao Tong University, Shanghai, China
| | - F Fontana
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences, and Environmental Sustainability, University of Parma, Parco Area delle Scienze 11a, 43124 Parma, Italy
- GenProbio srl, Parma, Italy
| | - E Van Daele
- Laboratory of Microbiology, 4508Wageningen University and Research, Wageningen, the Netherlands
| | - M Ventura
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences, and Environmental Sustainability, University of Parma, Parco Area delle Scienze 11a, 43124 Parma, Italy
- Microbiome Research Hub, University of Parma, Parma, Italy
| | - A Vlieger
- Department of Pediatrics, St Antonius Hospital, Nieuwegein, the Netherlands
| | - R M van Elburg
- Amsterdam University Medical Center, University of Amsterdam, Department of Pediatrics, Amsterdam Gastroenterology and Metabolism Research Institute, Amsterdam, the Netherlands
| | - J Knol
- Laboratory of Microbiology, 4508Wageningen University and Research, Wageningen, the Netherlands
- Danone Nutricia Research, Uppsalalaan 12, 3584CT Utrecht, the Netherlands
| | - C Milani
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences, and Environmental Sustainability, University of Parma, Parco Area delle Scienze 11a, 43124 Parma, Italy
- Microbiome Research Hub, University of Parma, Parma, Italy
| | - C Belzer
- Laboratory of Microbiology, 4508Wageningen University and Research, Wageningen, the Netherlands
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Longhi G, Lugli GA, Bianchi MG, Rizzo SM, Tarracchini C, Mancabelli L, Vergna LM, Alessandri G, Fontana F, Taurino G, Chiu M, Milani C, van Sinderen D, Bussolati O, Ventura M, Turroni F. Highly conserved bifidobacteria in the human gut: Bifidobacterium longum subsp. longum as a potential modulator of elderly innate immunity. Benef Microbes 2024:1-18. [PMID: 38688490 DOI: 10.1163/18762891-bja00013] [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] [Received: 11/28/2023] [Accepted: 04/15/2024] [Indexed: 05/02/2024]
Abstract
Aging is a physiological and immunological process involving the deterioration of human health, characterised by the progressive alteration of organs and their functions. The speed and extent of such decline are dependent on lifestyle, environment, and genetic factors. Moreover, with advancing age, humans become progressively more fragile and prone to acute and chronic diseases. Although the intestinal microbiota is predisposed to perturbations that accompany aging and frailty, it is generally accepted that the gut microbiota engages in multiple interactions that affect host health throughout the host life span. In the current study, an exhaustive in silico investigation of gut-associated bifidobacteria in healthy individuals from birth to old age revealed that Bifidobacterium longum subsp. longum is the most prevalent member, especially during infancy and in centenarians. Moreover, B. longum subsp. longum genome reconstruction and strain tracing among human gut microbiomes allowed the identification of prototypes of this taxon in the human gut microbiota of healthy elderly individuals. Such analyses guided culturomics attempts to isolate B. longum subsp. longum strains that matched the genomic content of B. longum subsp. longum prototypes from healthy elderly individuals. The molecular effects of selected B. longum subsp. longum strains on the human host were further investigated using in vitro microbe-host interactions, revealing differences in the host immune system transcriptome, with a reduction in gene expression of inflammation-related cytokines. These intriguing findings support the potential anti-aging effects of elderly associated prototypes of B. longum subsp. longum.
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Affiliation(s)
- G Longhi
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences, and Environmental Sustainability, 9370University of Parma, Parco Area delle Scienze 11a, 43124 Parma, Italy
| | - G A Lugli
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences, and Environmental Sustainability, 9370University of Parma, Parco Area delle Scienze 11a, 43124 Parma, Italy
| | - M G Bianchi
- Department of Medicine and Surgery, 9370University of Parma, Parma, Italy
- Microbiome Research Hub, 9370University of Parma, Parma, Italy
| | - S M Rizzo
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences, and Environmental Sustainability, 9370University of Parma, Parco Area delle Scienze 11a, 43124 Parma, Italy
| | - C Tarracchini
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences, and Environmental Sustainability, 9370University of Parma, Parco Area delle Scienze 11a, 43124 Parma, Italy
| | - L Mancabelli
- Department of Medicine and Surgery, 9370University of Parma, Parma, Italy
- Microbiome Research Hub, 9370University of Parma, Parma, Italy
| | - L M Vergna
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences, and Environmental Sustainability, 9370University of Parma, Parco Area delle Scienze 11a, 43124 Parma, Italy
| | - G Alessandri
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences, and Environmental Sustainability, 9370University of Parma, Parco Area delle Scienze 11a, 43124 Parma, Italy
| | - F Fontana
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences, and Environmental Sustainability, 9370University of Parma, Parco Area delle Scienze 11a, 43124 Parma, Italy
| | - G Taurino
- Department of Medicine and Surgery, 9370University of Parma, Parma, Italy
- Microbiome Research Hub, 9370University of Parma, Parma, Italy
| | - M Chiu
- Department of Medicine and Surgery, 9370University of Parma, Parma, Italy
| | - C Milani
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences, and Environmental Sustainability, 9370University of Parma, Parco Area delle Scienze 11a, 43124 Parma, Italy
- Microbiome Research Hub, 9370University of Parma, Parma, Italy
| | - D van Sinderen
- APC Microbiome Institute and School of Microbiology, Bioscience Institute, National University of Ireland, T12YT20, Cork, Ireland
| | - O Bussolati
- Department of Medicine and Surgery, 9370University of Parma, Parma, Italy
- Microbiome Research Hub, 9370University of Parma, Parma, Italy
| | - M Ventura
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences, and Environmental Sustainability, 9370University of Parma, Parco Area delle Scienze 11a, 43124 Parma, Italy
- Microbiome Research Hub, 9370University of Parma, Parma, Italy
| | - F Turroni
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences, and Environmental Sustainability, 9370University of Parma, Parco Area delle Scienze 11a, 43124 Parma, Italy
- Microbiome Research Hub, 9370University of Parma, Parma, Italy
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Tubertini M, Menilli L, Milani C, Martini C, Navacchia ML, Nugnes M, Bartolini M, Naldi M, Tedesco D, Martella E, Guerrini A, Ferroni C, Moret F, Varchi G. HSA-nanobinders crafted from bioresponsive prodrugs for combined cancer chemoimmunotherapy-an in vitro exploration. Front Chem 2024; 12:1378233. [PMID: 38591056 PMCID: PMC7615814 DOI: 10.3389/fchem.2024.1378233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/12/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer still lacking effective treatment options. Chemotherapy in combination with immunotherapy can restrict tumor progression and repolarize the tumor microenvironment towards an anti-tumor milieu, improving clinical outcome in TNBC patients. The chemotherapeutic drug paclitaxel has been shown to induce immunogenic cell death (ICD), whereas inhibitors of the indoleamine 2,3- dioxygenase 1 (IDO1) enzyme, whose expression is shared in immune regulatory and tumor cells, have been revealed to enhance the anti-tumor immune response. However, poor bioavailability and pharmacokinetics, off-target effects and hurdles in achieving therapeutic drug concentrations at the target tissue often limit the effectiveness of combination therapies. Methods This work describes the development of novel biomimetic and carrier-free nanobinders (NBs) loaded with both paclitaxel and the IDO1 inhibitor NLG919 in the form of bioresponsive and biomimetic prodrugs. A fine tuning of the preparation conditions allowed to identify NB@5 as the most suitable nanoformulation in terms of reproducibility, stability and in vitro effectiveness. Results and discussion Our data show that NB@5 effectively binds to HSA in cell-free experiments, demonstrating its protective role in the controlled release of drugs and suggesting the potential to exploit the protein as the endogenous vehicle for targeted delivery to the tumor site. Our study successfully proves that the drugs encapsulated within the NBs are preferentially released under the altered redox conditions commonly found in the tumor microenvironment, thereby inducing cell death, promoting ICD, and inhibiting IDO1.
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Affiliation(s)
- Matilde Tubertini
- Institute for Organic Synthesis and Photoreactivity (ISOF), National Research Council of Italy (CNR), Bologna, Italy
| | - Luca Menilli
- Pharmacy Unit, Veneto Institute of Oncology IOV-IRCSS, Padua, Italy
| | - Celeste Milani
- Department of Biology (DiBio), University of Padova, Padua, Italy
| | - Cecilia Martini
- Institute for Organic Synthesis and Photoreactivity (ISOF), National Research Council of Italy (CNR), Bologna, Italy
| | - Maria Luisa Navacchia
- Institute for Organic Synthesis and Photoreactivity (ISOF), National Research Council of Italy (CNR), Bologna, Italy
| | - Marta Nugnes
- Department of Pharmacy and Biotechnology (FaBiT), University of Bologna, Bologna, Italy
| | - Manuela Bartolini
- Department of Pharmacy and Biotechnology (FaBiT), University of Bologna, Bologna, Italy
| | - Marina Naldi
- Department of Pharmacy and Biotechnology (FaBiT), University of Bologna, Bologna, Italy
| | - Daniele Tedesco
- Institute for Organic Synthesis and Photoreactivity (ISOF), National Research Council of Italy (CNR), Bologna, Italy
| | - Elisa Martella
- Institute for Organic Synthesis and Photoreactivity (ISOF), National Research Council of Italy (CNR), Bologna, Italy
| | - Andrea Guerrini
- Institute for Organic Synthesis and Photoreactivity (ISOF), National Research Council of Italy (CNR), Bologna, Italy
| | - Claudia Ferroni
- Institute for Organic Synthesis and Photoreactivity (ISOF), National Research Council of Italy (CNR), Bologna, Italy
| | - Francesca Moret
- Department of Biology (DiBio), University of Padova, Padua, Italy
| | - Greta Varchi
- Institute for Organic Synthesis and Photoreactivity (ISOF), National Research Council of Italy (CNR), Bologna, Italy
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Poggio E, Barazzuol L, Salmaso A, Milani C, Deligiannopoulou A, Cazorla ÁG, Jang SS, Juliá-Palacios N, Keren B, Kopajtich R, Lynch SA, Mignot C, Moorwood C, Neuhofer C, Nigro V, Oostra A, Prokisch H, Saillour V, Schuermans N, Torella A, Verloo P, Yazbeck E, Zollino M, Jech R, Winkelmann J, Necpal J, Calì T, Brini M, Zech M. ATP2B2 de novo variants as a cause of variable neurodevelopmental disorders that feature dystonia, ataxia, intellectual disability, behavioral symptoms, and seizures. Genet Med 2023; 25:100971. [PMID: 37675773 DOI: 10.1016/j.gim.2023.100971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/08/2023] Open
Abstract
PURPOSE ATP2B2 encodes the variant-constrained plasma-membrane calcium-transporting ATPase-2, expressed in sensory ear cells and specialized neurons. ATP2B2/Atp2b2 variants were previously linked to isolated hearing loss in patients and neurodevelopmental deficits with ataxia in mice. We aimed to establish the association between ATP2B2 and human neurological disorders. METHODS Multinational case recruitment, scrutiny of trio-based genomics data, in silico analyses, and functional variant characterization were performed. RESULTS We assembled 7 individuals harboring rare, predicted deleterious heterozygous ATP2B2 variants. The alleles comprised 5 missense substitutions that affected evolutionarily conserved sites and 2 frameshift variants in the penultimate exon. For 6 variants, a de novo status was confirmed. Unlike described patients with hearing loss, the individuals displayed a spectrum of neurological abnormalities, ranging from ataxia with dystonic features to complex neurodevelopmental manifestations with intellectual disability, autism, and seizures. Two cases with recurrent amino-acid variation showed distinctive overlap with cerebellar atrophy-associated ataxia and epilepsy. In cell-based studies, all variants caused significant alterations in cytosolic calcium handling with both loss- and gain-of-function effects. CONCLUSION Presentations in our series recapitulate key phenotypic aspects of Atp2b2-mouse models and underline the importance of precise calcium regulation for neurodevelopment and cerebellar function. Our study documents a role for ATP2B2 variants in causing heterogeneous neurodevelopmental and movement-disorder syndromes.
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Affiliation(s)
- Elena Poggio
- Department of Biology, University of Padua, Padua, Italy
| | - Lucia Barazzuol
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Andrea Salmaso
- Department of Biology, University of Padua, Padua, Italy
| | - Celeste Milani
- Department of Biology, University of Padua, Padua, Italy
| | | | - Ángeles García Cazorla
- European Reference Network for Hereditary Metabolic Diseases (MetabERN), Madrid, Spain; Neurometabolic Unit and Synaptic Metabolism Laboratory, Neurology Department Sant Joan de Déu Hospital, IPR, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Se Song Jang
- Seoul National University (SNU) College of Medicine, Seoul, South Korea
| | - Natalia Juliá-Palacios
- Neurology Department, Neurometabolic Unit, Institut de Recerca, CIBERER and MetabERN, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Boris Keren
- APHP.Sorbonne Université, Department of Medical Genetics, Pitié-Salpêtrière University Hospital, and Centre de Référence Maladies Rares Déficiences Intellectuelles de Causes Rares, Paris, France
| | - Robert Kopajtich
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany; Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany
| | - Sally Ann Lynch
- Department of Clinical Genetics, Temple Street Children's University Hospital, Dublin, Ireland
| | - Cyril Mignot
- APHP.Sorbonne Université, Department of Medical Genetics, Pitié-Salpêtrière University Hospital, and Centre de Référence Maladies Rares Déficiences Intellectuelles de Causes Rares, Paris, France
| | - Catherine Moorwood
- Exeter Genomics Laboratory, Royal Devon University Healthcare NHS Foundation Trust, Exeter, United Kingdom
| | - Christiane Neuhofer
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany; Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany
| | - Vincenzo Nigro
- Department of Precision Medicine, University of Campania, Luigi Vanvitelli, Napoli, Italy
| | - Anna Oostra
- Department of Pediatrics, Division of Pediatric Neurology and Metabolism, Ghent University Hospital, Ghent, Belgium
| | - Holger Prokisch
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany; Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany
| | - Virginie Saillour
- Laboratoire de biologie médicale multisites Seqoia - FMG2025, Paris, France
| | - Nika Schuermans
- Center for Medical Genetics Ghent, Ghent University Hospital, Ghent, Belgium; Department of Biomolecular Medicine, Ghent University Hospital, Ghent, Belgium
| | - Annalaura Torella
- Department of Precision Medicine, University of Campania, Luigi Vanvitelli, Napoli, Italy
| | - Patrick Verloo
- Department of Pediatric Neurology, Center for Inherited Metabolic Disorders and metabERN, University Hospital Ghent, Ghent, Belgium
| | - Elise Yazbeck
- Pediatric Neurology Department, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Saclay, Bicêtre Hospital, Le Kremlin Bicêtre, France
| | - Marcella Zollino
- Unit of Medical Genetics, Section of Genomic Medicine, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Robert Jech
- Department of Neurology, Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Prague, Czech Republic
| | - Juliane Winkelmann
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany; Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany; Munich Cluster for Systems Neurology, SyNergy, Munich, Germany
| | - Jan Necpal
- 2nd Department of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovakia; Department of Neurology, Zvolen Hospital, Zvolen, Slovakia
| | - Tito Calì
- Department of Biomedical Sciences, University of Padua, Padua, Italy; Centro Studi per la Neurodegenerazione (CESNE), University of Padua, Padua, Italy; Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Marisa Brini
- Department of Biology, University of Padua, Padua, Italy; Centro Studi per la Neurodegenerazione (CESNE), University of Padua, Padua, Italy
| | - Michael Zech
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany; Institute of Human Genetics, School of Medicine, Technical University of Munich, Munich, Germany; Institute for Advanced Study, Technical University of Munich, Garching, Germany.
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Dziegielewski C, Fernando SM, Milani C, Mahdavi R, Talarico R, Thompson LH, Tanuseputro P, Kyeremanteng K. Outcomes and cost analysis of patients with dementia in the intensive care unit: a population-based cohort study. BMC Health Serv Res 2023; 23:1124. [PMID: 37858178 PMCID: PMC10588096 DOI: 10.1186/s12913-023-10095-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 09/30/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Dementia is a neurological syndrome affecting the growing elderly population. While patients with dementia are known to require significant hospital resources, little is known regarding the outcomes and costs of patients admitted to the intensive care unit (ICU) with dementia. METHODS We conducted a population-based retrospective cohort study of patients with dementia admitted to the ICU in Ontario, Canada from 2016 to 2019. We described the characteristics and outcomes of these patients alongside those with dementia admitted to non-ICU hospital settings. The primary outcome was hospital mortality but we also assessed length of stay (LOS), discharge disposition, and costs. RESULTS Among 114,844 patients with dementia, 11,341 (9.9%) were admitted to the ICU. ICU patients were younger, more comorbid, and had less cognitive impairment (81.8 years, 22.8% had ≥ 3 comorbidities, 47.5% with moderate-severe dementia), compared to those in non-ICU settings (84.2 years, 15.0% had ≥ 3 comorbidities, 54.1% with moderate-severe dementia). Total mean LOS for patients in the ICU group was nearly 20 days, compared to nearly 14 days for the acute care group. Mortality in hospital was nearly three-fold greater in the ICU group compared to non-ICU group (22.2% vs. 8.8%). Total healthcare costs were increased for patients admitted to ICU vs. those in the non-ICU group ($67,201 vs. $54,080). CONCLUSIONS We find that patients with dementia admitted to the ICU have longer length of stay, higher in-hospital mortality, and higher total healthcare costs. As our study is primarily descriptive, future studies should investigate comprehensive goals of care planning, severity of illness, preventable costs, and optimizing quality of life in this high risk and vulnerable population.
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Affiliation(s)
- C Dziegielewski
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - S M Fernando
- Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Critical Care, Lakeridge Health Corporation, Oshawa, ON, Canada
| | - C Milani
- ICES, University of Ottawa, Ottawa, ON, Canada
| | - R Mahdavi
- ICES, University of Ottawa, Ottawa, ON, Canada
| | - R Talarico
- ICES, University of Ottawa, Ottawa, ON, Canada
| | | | - P Tanuseputro
- ICES, University of Ottawa, Ottawa, ON, Canada
- Bruyere Research Institute, Ottawa, ON, Canada
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - K Kyeremanteng
- Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
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Avancini G, Menilli L, Visentin A, Milani C, Mastrotto F, Moret F. Mesenchymal Stem Cell Membrane-Coated TPCS 2a-Loaded Nanoparticles for Breast Cancer Photodynamic Therapy. Pharmaceutics 2023; 15:1654. [PMID: 37376102 DOI: 10.3390/pharmaceutics15061654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Despite substantial improvements in breast cancer (BC) treatment there is still an urgent need to find alternative treatment options to improve the outcomes for patients with advanced-stage disease. Photodynamic therapy (PDT) is gaining a lot of attention as a BC therapeutic option because of its selectivity and low off-target effects. However, the hydrophobicity of photosensitizers (PSs) impairs their solubility and limits the circulation in the bloodstream, thus representing a major challenge. The use of polymeric nanoparticles (NPs) to encapsulate the PS may represent a valuable strategy to overcome these issues. Herein, we developed a novel biomimetic PDT nanoplatform (NPs) based on a polymeric core of poly(lactic-co-glycolic)acid (PLGA) loaded with the PS meso-tetraphenylchlorin disulfonate (TPCS2a). TPCS2a@NPs of 98.89 ± 18.56 nm with an encapsulation efficiency percentage (EE%) of 81.9 ± 7.92% were obtained and coated with mesenchymal stem cells-derived plasma membranes (mMSCs) (mMSC-TPCS2a@NPs, size of 139.31 ± 12.94 nm). The mMSC coating armed NPs with biomimetic features to impart long circulation times and tumor-homing capabilities. In vitro, biomimetic mMSC-TPCS2a@NPs showed a decrease in macrophage uptake of 54% to 70%, depending on the conditions applied, as compared to uncoated TPCS2a@NPs. Both NP formulations efficiently accumulated in MCF7 and MDA-MB-231 BC cells, while the uptake was significantly lower in normal breast epithelial MCF10A cells with respect to tumor cells. Moreover, encapsulation of TPCS2a in mMSC-TPCS2a@NPs effectively prevents its aggregation, ensuring efficient singlet oxygen (1O2) production after red light irradiation, which resulted in a considerable in vitro anticancer effect in both BC cell monolayers (IC50 < 0.15 µM) and three-dimensional spheroids.
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Affiliation(s)
- Greta Avancini
- Department of Biology, University of Padova, Via Ugo Bassi 58/B, 35131 Padova, Italy
| | - Luca Menilli
- Department of Biology, University of Padova, Via Ugo Bassi 58/B, 35131 Padova, Italy
| | - Adele Visentin
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Via F. Marzolo 5, 35131 Padova, Italy
| | - Celeste Milani
- Department of Biology, University of Padova, Via Ugo Bassi 58/B, 35131 Padova, Italy
| | - Francesca Mastrotto
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Via F. Marzolo 5, 35131 Padova, Italy
| | - Francesca Moret
- Department of Biology, University of Padova, Via Ugo Bassi 58/B, 35131 Padova, Italy
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Bonaccorsi G, Milani C, Giorgetti D, Setola N, Naldi E, Manzi F, Del Riccio M, Dellisanti C, Lorini C. Impact of Built Environment and Neighborhood on Promoting Mental Health, Well-being, and Social Participation in Older People: an Umbrella Review. Ann Ig 2023; 35:213-239. [PMID: 35788248 DOI: 10.7416/ai.2022.2534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background The built environment, especially in the context of the neighborhood, affects older people's health. This umbrella review aims to summarize the associations between factors and interventions in the built environment as regards modifying or improving mental health, well-being, social inclusion and participation in the elderly. Methods We searched articles in the following databases: PubMed, Embase, Cochrane Library, Scopus, Avery Index, Sage, Web of Science, Health Evidence, and Google Scholar, without any time limits. The factors and interventions examined have been classified into three categories (urban infrastructure, green infrastructure, built environment), and we have assessed their relationships with each of the health outcomes. Results Eight reviews have been included. The results show a positive association between factors and interventions and health outcomes, even though this tends to differ with respect to some of the elements (study design, sample size, built environment and health outcome measurements, and the quality of the primary studies included in the reviews) in the selected studies. Conclusions In conclusion, the present study suggests and confirms that acting on the built environment has a positive impact on mental health and social inclusion.
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Affiliation(s)
- G Bonaccorsi
- Department of Health Sciences, University of Florence, Italy
| | - C Milani
- Department of Health Sciences, University of Florence, Italy
| | - D Giorgetti
- Postgraduate medical school in Hygiene and Preventive Medicine, University of Florence, Italy
| | - N Setola
- Department of Architecture, University of Florence, Italy
| | - E Naldi
- PhD student, Department of Architecture, University of Florence, Italy
| | - F Manzi
- Department of Health Sciences, University of Florence, Italy
| | - M Del Riccio
- Postgraduate medical school in Hygiene and Preventive Medicine, University of Florence, Italy
| | - C Dellisanti
- Department of Epidemiology, Regional Health Agency of Tuscany, Florence, Italy
| | - C Lorini
- Department of Health Sciences, University of Florence, Italy
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Buscemi P, Velpini B, Cosma C, Milani C, Landi R, Innocenti M, Baggiani L, Nerattini M, Lorini C, Bonaccorsi G. USCA service utilization in the city of Florence (Italy) during the COVID-19 pandemic. Eur J Public Health 2022. [PMCID: PMC9594657 DOI: 10.1093/eurpub/ckac131.075] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background In order to support primary care during the first pandemic wave (March 2020), the Italian Government instituted multiprofessional health teams called “USCA” (Special Continuity Care Units), which ensured continuity of care for COVID-19 patients who do not need hospitalization. The aim of our study was to compare the volumes of USCA service utilization in Florence (Tuscany, Italy) during the peak of home visits of three pandemic waves. Methods This single-center study followed a retrospective cross-sectional design. The USCA of the Heath District of Florence served a population of 366,190 people. The following data were collected: home medical visits, nursing home (NH) visits, visits in health-care hotels. The peak periods of three epidemic waves were considered in the analyses: the second wave (23 October - 20 November 2020), the third wave (25 March - 22 April 2021), and the Omicron period (27 December 2021 - 6 February 2022). The maximum 7-day moving averages of the daily number of visits during the three periods were calculated. Relative percent differences for visits comparing the considered periods were computed. Results Home visits during the third pandemic wave increased by 14% compared to the second wave (second wave: N = 1370, third wave: N = 1562), while a decrease was observed during the Omicron period (Omicron vs third wave: -21%; peak value: 41 vs 60). Visits in health-care hotels during the third wave doubled compared to the second wave. After the start of the COVID-19 vaccination campaign, NH visits steeply declined (third wave vs second wave: -95%; N = 323 vs 15; peak value= 14 vs 2 visits per day). During the Omicron period, NH visits increased by almost four times compared to the third wave period. Conclusions The USCA service utilization was significant in all the analyzed periods. In a pandemic context, it is necessary to strengthen primary care services such as USCA, which have proved to respond to rapidly changing health needs. Key messages • The USCA service is an innovative model of integrated home care that has proved to respond to rapidly changing health needs during all phases of the COVID-19 pandemic. • The USCA service utilization was significant during all phases of the pandemic. The USCA service has introduced new ways of working and new relationships between services in primary care.
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Affiliation(s)
- P Buscemi
- School of Hygiene and Preventive Medicine, University of Florence , Florence, Italy
| | - B Velpini
- School of Hygiene and Preventive Medicine, University of Florence , Florence, Italy
| | - C Cosma
- School of Hygiene and Preventive Medicine, University of Florence , Florence, Italy
| | - C Milani
- Department of Health Sciences, University of Florence , Florence, Italy
| | - R Landi
- Azienda USL Toscana Centro , Florence, Italy
| | - M Innocenti
- Department of District Healthcare Network, Azienda USL Toscana Centro , Florence, Italy
| | - L Baggiani
- Department of District Healthcare Network, Azienda USL Toscana Centro , Florence, Italy
| | - M Nerattini
- Florence Local Health District, Società della Salute di Firenze , Florence, Italy
| | - C Lorini
- Department of Health Sciences, University of Florence , Florence, Italy
| | - G Bonaccorsi
- Department of Health Sciences, University of Florence , Florence, Italy
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9
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Menilli L, Milani C, Reddi E, Moret F. Overview of Nanoparticle-Based Approaches for the Combination of Photodynamic Therapy (PDT) and Chemotherapy at the Preclinical Stage. Cancers (Basel) 2022; 14:cancers14184462. [PMID: 36139623 PMCID: PMC9496990 DOI: 10.3390/cancers14184462] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary The present review represents the outstanding and promising recent literature reports (2017–2022) on nanoparticle-based formulations developed for anticancer therapy with photodynamic therapy (PDT), photosensitizers, and chemotherapeutics. Besides brief descriptions of chemotherapeutics’ classification and of PDT mechanisms and limitations, several examples of nanosystems endowed with different responsiveness (e.g., acidic pH and reactive oxygen species) and peculiarity (e.g., tumor oxygenation capacity, active tumor targeting, and biomimetic features) are described, and for each drug combination, in vitro and in vivo results on preclinical cancer models are reported. Abstract The widespread diffusion of photodynamic therapy (PDT) as a clinical treatment for solid tumors is mainly limited by the patient’s adverse reaction (skin photosensivity), insufficient light penetration in deeply seated neoplastic lesions, unfavorable photosensitizers (PSs) biodistribution, and photokilling efficiency due to PS aggregation in biological environments. Despite this, recent preclinical studies reported on successful combinatorial regimes of PSs with chemotherapeutics obtained through the drugs encapsulation in multifunctional nanometric delivery systems. The aim of the present review deals with the punctual description of several nanosystems designed not only with the objective of co-transporting a PS and a chemodrug for combination therapy, but also with the goal of improving the therapeutic efficacy by facing the main critical issues of both therapies (side effects, scarce tumor oxygenation and light penetration, premature drug clearance, unspecific biodistribution, etc.). Therefore, particular attention is paid to the description of bio-responsive drugs and nanoparticles (NPs), targeted nanosystems, biomimetic approaches, and upconverting NPs, including analyzing the therapeutic efficacy of the proposed photo-chemotherapeutic regimens in in vitro and in vivo cancer models.
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Affiliation(s)
- Luca Menilli
- Department of Biology, University of Padova, 35100 Padova, Italy
| | - Celeste Milani
- Department of Biology, University of Padova, 35100 Padova, Italy
- Institute of Organic Synthesis and Photoreactivity, ISOF-CNR, 40129 Bologna, Italy
| | - Elena Reddi
- Department of Biology, University of Padova, 35100 Padova, Italy
- Correspondence: (E.R.); (F.M.)
| | - Francesca Moret
- Department of Biology, University of Padova, 35100 Padova, Italy
- Correspondence: (E.R.); (F.M.)
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10
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Phillips W, Jooya A, Mahdavi R, Leigh J, Tawagi K, Webber C, Milani C, Morgan S, MacRae R, Bourque JM, Tanuseputro P, Ong M. 1395P Real-world association between bone targeted agents and palliative bone radiation in prostate cancer decedents: A province-wide study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1881] [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: 11/01/2022] Open
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11
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Milani C, Rota A, Olsson U, Paganotto A, Holst BS. Serum concentration of mineralocorticoids, glucocorticoids, and sex steroids in peripartum bitches. Domest Anim Endocrinol 2021; 74:106558. [PMID: 32980594 DOI: 10.1016/j.domaniend.2020.106558] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/29/2020] [Accepted: 08/31/2020] [Indexed: 10/23/2022]
Abstract
The aim of the work was to describe the profile of steroid hormones in the peripartum period of the bitch. Twenty-five healthy pregnant bitches presented for pregnancy monitoring and parturition assistance were included in the study. A blood sample was collected for routine progesterone assay, and serum was stored at -20°C. The day of parturition and the number of delivered puppies were registered. Concentrations of corticosteroids, androgens, progestogens, estrogens, for a total number of 17 different hormones, were measured using ultra-performance supercritical fluid chromatography-tandem mass spectrometry. Data were analyzed using a repeated measure, mixed-model approach, taking into account day (from day -4 to day +2 from parturition), age, parity (primiparous vs pluriparous), number of delivered puppies (<4 vs 4-8 vs > 8), and interactions between factors. Day related to parturition significantly affected the concentration of progesterone (P < 0.001), testosterone (P < 0.001), 17α-hydroxyprogesterone (P = 0.0002), and cortisone (P = 0.006). Estrogen concentration did not show any significant variation over time. Testosterone and androstenedione showed an abrupt decline on the day of parturition. The concentration of all glucocorticoids increased the day before parturition. Age or parity was not significantly associated with any of the steroids. Litter size significantly affected concentrations of aldosterone (P = 0.02) and etiocholanolone (P = 0.01). Aldosterone concentrations were higher in litters with 4 to 8 pups than in litters with more than 8 pups (P = 0.02). None of the steroids measured in our study, with the already known exception of progesterone, shows potential to be clinically useful in predicting the onset of parturition in the bitch.
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Affiliation(s)
- C Milani
- Department of Animal Medicine, Production and Health, Legnaro (PD), Italy
| | - A Rota
- Department of Veterinary Sciences, Grugliasco (TO), Italy.
| | - U Olsson
- Department of Energy and Technology, Unit of Applied Statistics and Mathematics, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - A Paganotto
- Department of Animal Medicine, Production and Health, Legnaro (PD), Italy
| | - B S Holst
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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12
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Milani C, Occhini G, Francini C, Orsini G, Baggiani L, Maciocco G, Bonaccorsi G. Health needs, community and network in primary care: an action research program. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Issue
According to the Alma Ata Declaration, Comprehensive Primary Health Care (C-PHC) addresses the main health problems in the community, promotes participation and involves all health related sectors. In Italy the so called Case della Salute model aims at realizing these principles. The purpose of the project is to understand how this model should be implemented in order to better answer the community needs. In the outskirts of Florence there is an area mostly made of public housing, devoted to people with housing and economic problems. There it is Casa della Salute (a health center where a PHC multidisciplinary team works), which could represent the key to cope with health inequalities and to create a network with the multiple associations rooted in the community. The implementation of an experimental model of C-PHC needs to involve local population, community actors, health professionals and researchers in a process of action-research.
Results
• An epidemiological study described a heavily deprived population compared with the rest of the city, with a burden of mortality especially affecting those most deprived and women. Mental health and addictions showed a deep need of care. A map of the neighbourhood was created in order to analyse formal and informal resources.The health needs of the community were deepened using social and ethnographic methodologies (semi-structured interviews, participant observation and focus groups with health workers, associations' representatives and individuals).Standing multi professional briefings were launched in order to facilitate the process of taking care of complex situations as a team.
Lessons
Preliminary results show the need for stronger collaborations with the actors in the community; further exploration of health related topics; community participation in the process of informing and transforming health practices; involvement of health workers in interprofessional practices to create a shared knowledge.
Key messages
Local health networks need a methodology to expand knowledge of peoples’ needs. Complexity in health and inequalities require a paradigm based on social determinants of health such as PHC.
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Affiliation(s)
- C Milani
- Department of Public health, University of Florence, Florence, Italy
| | - G Occhini
- LHO 'Toscana Centro', Tuscany, Italy
| | | | - G Orsini
- Department of Public health, University of Florence, Florence, Italy
| | | | - G Maciocco
- Department of Public health, University of Florence, Florence, Italy
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13
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Sessa G, Milani C, Occhini G, Marini G, Sarro A. Renewing primary care: the bottom-up experience of an Italian health professional movement. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Sustainability of the National Health Systems (NHS) has been facing different challenges. A community-oriented Comprehensive Primary Health Care (CommOr C-PHC) could help its survival. Such a framework, focused on health promotion, primary prevention, not communicable disease management, requires new capabilities among health professionals. Considering teamwork and interprofessional collaboration (IPC) as PHC core elements, there is growing recognition of the need of interprofessional education (IPE). Nevertheless, italian medical education is distant from other disciplines and mainly based on hospital care settings. Since this situation represents an obstacle to implement a CommOr C-PHC model of health service, new ways of training students and retraining actual health workers should be developed.
The aim of the project is to design IPE programs and to improve IPC within the C-PHC framework, shared learning environments placed in the community were developed.
At the end of 2017 a group of young italian health professionals (public health resident, young general practitioner, social assistant, nurse, medical anthropologist, etc) founded the Campaign “2018 Primary Health care: Now or never”, a cultural movement of public health advocacy. Its goals are: The creation of a common cultural background through the study of PHC evidence and best italian and international practices. Organization of workshops all over Italy: peer education training session, site-visits, lectures with Italian and foreigner health professionals, based on need assessment methods.
Individuation of learning environments placed in the community and in a primary care setting where students can apprehend social determinants of health, exercise critical thinking and develop transprofessional knowledge.
Key messages
Young health professionals from Italy, starting from the need for a different educational framework, based on IPE, created a movement to defend the NHS and promote PHC principles. The success and large participation of a national campaign sustaining PHC and aimed at promoting interprofessional education shows the need for a change in the medical education field.
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Affiliation(s)
- G Sessa
- Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C Milani
- Department of Public health, University of Florence, Florence, Italy
| | - G Occhini
- Local Health Organization Toscana Centro, Florence, Italy
| | - G Marini
- Dipartimento di medicina clinica e sperimentale, University of Ferrara, Ferrara, Italy
| | - A Sarro
- Dipartimento di medicina clinica e sperimentale, Università del Piemonte Orientale, Novara, Italy
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14
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Sessa G, Occhini G, Milani C, Marini G, Sarro A. A public health Italian ethical movement to sustain the beveridge model: health promotion and equity. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Worldwide sustainability of the National Health Systems (NHS) has been facing different challenges, such as population ageing, epidemiologic transition and deep social transformations. All these changes are struggling Italian welfare state and its public NHS. Following the principle of the Right to Health of the Declaration of Human Right and the Italian Constitution, a group of young health professionals from all over Italy founded a campaign called “2018 Primary Health care: Now or Never”(PHC Campaign) reminding WHO report of 2008 “primary Health Care: Now more than never”. This movement promotes a reform of the NHS focusing on comprehensive-PHC (C-PHC) and health promotion to guarantee sustainability of the Beveridge model italian system, fight health inequalities and answer the complexity of population needs in a period of spending cuts.
Since the beginning, the movement started an educational program through the study of the literature and the research of the Italian and international best practices of C-PHC and community health promotion. As a result, to achieve the goal of this project, PHC campaign organized peer education training sessions, educational site-visit of some Italian best practices, lectures and workshops with Italian and foreigner health professionals experts on the field. Several national and regional events had been organized all over Italy. Members of “PHC” Campaign have been invited to write books, news on web-based newspapers on this topic and participate in congresses. To date, PHC campaign might be considered one of the strongest not-institutional voices in Italy in supporting the public beveridge-model NHS
Moved from a strong ethical health policy view underlined the importance of the Right-to-Health and of a C-PHC based NHS, since the beginning, “2018 Primary Health care: Now or Never” Movement identified three asset of action: advocacy, education/knowledge and diffusion.
Key messages
The experience showed the importance of health professionals engagement in public health topics such as sustainability of public NHS in order to promote a reform towards health promotion and equity. PHC Campaign is an example of how a bottom-up ethical movement on public health from different Health professionals could actively contribute to promoting cultural and health policy change.
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Affiliation(s)
- G Sessa
- Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Occhini
- Local Health Organization Toscana Centro, Florence, Italy
| | - C Milani
- Department of Public health, University of Florence, Florence, Italy
| | - G Marini
- Dipartimento di medicina clinica e sperimentale, University of Ferrara, Ferrara, Italy
| | - A Sarro
- Dipartimento di medicina clinica e sperimentale, Università del Piemonte Orientale, Novara, Italy
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15
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Mammana L, Milani C, Bordin P, Del Riccio M, Sisti LG, Salvia C, Raguzzoni G. Migrants and access to healthcare: the Italian public health residents action plan. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Fighting health inequalities have been included in the WHO Sustainable Development Goals as a priority. Migrants are between the most vulnerable individuals and healthcare interventions, also during the post-migration period, should be oriented, context-specific and aimed at identifying reasons underlying inequalities, as suggested by the recent WHO report ’No public health without migrant health’. The “Inequality Working Group” of the Italian network of public health (PH) residents of the Italian Society of Hygiene, Preventive Medicine and Public Health (SItI) aims at identifying an interdisciplinary approach suitable to detect barriers to healthcare access for migrants in different Italian regions. Secondly, we aspire to develop some strategies to overcome unequal healthcare access.
Methods
Focus group methodology was applied to set working group educational needs, priorities of action and working plan. Moreover, we implemented a network between various professionals involved in migrant healthcare, particularly with the Regional Groups of the Italian Society of Migration Medicine (SIMM).
Results
After a period of peer-to-peer education about social determinants of health and migration, we reviewed Italian policies about migrants’ healthcare and considered potential discrepancies from WHO recommendations. Furthermore, we mapped practices regarding access to care for migrant population and we focused on causes underlying unequal healthcare access.
Conclusions
Although with regional differences, migrants have limited access to healthcare services and therefore represent a vulnerable subpopulation.
Key messages
Fighting against the barriers that limit access to care for migrants is a priority for health systems. PH residents have a relevant role in identifying and defining critical issues, designing enforcement measures and implementing advocacy actions.
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Affiliation(s)
- L Mammana
- Inequalities Working Groups, Italian Hygiene Society Committee of Residents, Rome, Italy
| | - C Milani
- Inequalities Working Groups, Italian Hygiene Society Committee of Residents, Rome, Italy
| | - P Bordin
- Inequalities Working Groups, Italian Hygiene Society Committee of Residents, Rome, Italy
| | - M Del Riccio
- Inequalities Working Groups, Italian Hygiene Society Committee of Residents, Rome, Italy
| | - L G Sisti
- Inequalities Working Groups, Italian Hygiene Society Committee of Residents, Rome, Italy
| | - C Salvia
- Inequalities Working Groups, Italian Hygiene Society Committee of Residents, Rome, Italy
| | - G Raguzzoni
- Inequalities Working Groups, Italian Hygiene Society Committee of Residents, Rome, Italy
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16
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Milani C, Bianchi J, Bordin P, Bortoluzzi S, Gianfredi V, Mammana L, Paglione L, Salvia C, Corsaro A. Asylum seekers’ healthcare in Italy: policies and practices among different regions. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The Italian law provides for international protection and universal health-care coverage for asylum seekers (AS). Indeed, they are entitled to be regularly registered at the National Healthcare Service. Before submitting the application for refugee status, medical assistance to migrants is up to local administration. Our aim was to describe and compare policies and protocols regulating AS healthcare from their arrival to their application for refugee status, at national and regional level. Moreover, we investigated the daily healthcare practice addressing potential gaps between policies and practice.
Methods
The research team is a subgroup of the Inequality working group of the Italian hygiene society and it is composed of public health residents. The research involved also local health workers and other professionals belonging to regional groups of Italian migrant medicine society (SIMM). We collected national, regional and local policies and protocols and we compared them using a specific framework. Furthermore, we achieved a mapping of daily practice implementation at local health organization (LHO) level using a checklist.
Results
The most relevant findings were that regional policies themselves vary notably from each other and, as regard practices, LHO implement differently the same regional legislation. Furthermore, we found some critical issues: the delayed inclusion in primary care assistance and lack of continuity of care and of a computerized system of recording information.
Conclusions
The lack of uniformity concerning policies and practices of AS healthcare might also result in unawareness and uncertainty about how to access to healthcare services by migrants. An enhanced cooperation between groups dealing with migrants’ issues may lead to avoid variability at the implementation. Finally, a computerized system for data collection might facilitate the continuity of care and the assessment of the real health needs of the AS population.
Key messages
It is a priority challenge for health systems to strengthen the interventions aimed at overcoming the linguistic, economic, cultural and administrative barriers to the health services access. It is crucial to improve the recording information system to detect the real health needs of AS, their change and the inequalities in access and to improve collaboration between groups and university.
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Affiliation(s)
- C Milani
- Department of Health Sciences, University of Florence, Florence, Italy
| | - J Bianchi
- Department of Health Sciences, University of Florence, Florence, Italy
| | - P Bordin
- Department of Public Health and Community Medicine, University of Verona, Verona, Italy
| | - S Bortoluzzi
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - V Gianfredi
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - L Mammana
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - L Paglione
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Salvia
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy
| | - A Corsaro
- SIMM, Italian Society of Migration Medicine, Rome, Italy
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Salvia C, Bianchi J, D'aloisio F, Gianfredi V, Mammana L, Milani C, Mormile P, Paglione L, Raguzzoni G. 2.11-P12Italian policy for asylum seekers health-care: from national to local application. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.084] [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: 11/13/2022] Open
Affiliation(s)
- C Salvia
- Inequality Working Group, Italian Hygiene Society Committee of Medical Resident, Italy
| | - J Bianchi
- Inequality Working Group, Italian Hygiene Society Committee of Medical Resident, Italy
| | - F D'aloisio
- Inequality Working Group, Italian Hygiene Society Committee of Medical Resident, Italy
| | - V Gianfredi
- Inequality Working Group, Italian Hygiene Society Committee of Medical Resident, Italy
| | - L Mammana
- Inequality Working Group, Italian Hygiene Society Committee of Medical Resident, Italy
| | - C Milani
- Inequality Working Group, Italian Hygiene Society Committee of Medical Resident, Italy
| | - P Mormile
- Inequality Working Group, Italian Hygiene Society Committee of Medical Resident, Italy
| | - L Paglione
- Inequality Working Group, Italian Hygiene Society Committee of Medical Resident, Italy
| | - G Raguzzoni
- Inequality Working Group, Italian Hygiene Society Committee of Medical Resident, Italy
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18
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Abreu A, Milani C, Katayama M, Barbosa E, da Fonseca LG, Góes J, Brentani M, Folgueira MK. Expression of Heterochromatin Protein 1 in the Primary Tumor of Breast Cancer Patients in the Presence or Absence of Occult Metastatic Cells in the Bone Marrow. Int J Biol Markers 2018; 23:219-24. [DOI: 10.1177/172460080802300404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Gene silencing may occur in breast cancer samples from patients presenting with occult metastatic cells in the bone marrow and one mechanism regulating gene suppression is heterochromatin formation. We have studied whether members of the heterochromatin protein 1 family (HP1Hsα, HP1Hsβ and HP1Hsγ), which take part in chromatin packaging and gene expression regulation, were differentially expressed in tumors from patients with and without occult metastatic cells in their bone marrow. Tumor samples and bone marrow aspirates were obtained from 37 breast cancer patients. Median age was 63 years and 68% of the patients presented with clinical stage I/II disease. Presence of occult metastatic cells in bone marrow was detected through keratin-19 expression by nested RT-PCR in samples from 20 patients (54.1%). The presence of occult metastatic cells in bone marrow was not associated with node involvement, histological grade, estrogen receptor and ERBB2 immunoexpression. Relative gene expression of HP1Hsα, HP1Hsβ and HP1Hsγ was determined by real-time RT-PCR and did not vary according to the presence of occult metastatic cells in bone marrow. In addition, the combined expression of these three transcripts could not be used to classify samples according to the presence of bone marrow micrometastasis. Our work indicates that regulation of heterochromatin formation through HP1 family members may not be the sole mechanism implicated in the metastatic process to the bone marrow.
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Affiliation(s)
- A.P.S. Abreu
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Radiologia, Disciplina de Oncologia, São Paulo
- Instituto Brasileiro de Controle do Câncer de São Paulo, São Paulo - Brasil
| | - C. Milani
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Radiologia, Disciplina de Oncologia, São Paulo
| | - M.L.H. Katayama
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Radiologia, Disciplina de Oncologia, São Paulo
| | - E.M. Barbosa
- Instituto Brasileiro de Controle do Câncer de São Paulo, São Paulo - Brasil
| | - L. Gomes da Fonseca
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Radiologia, Disciplina de Oncologia, São Paulo
| | - J.CS. Góes
- Instituto Brasileiro de Controle do Câncer de São Paulo, São Paulo - Brasil
| | - M.M. Brentani
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Radiologia, Disciplina de Oncologia, São Paulo
| | - M.A.A. Koike Folgueira
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Radiologia, Disciplina de Oncologia, São Paulo
- Instituto Brasileiro de Controle do Câncer de São Paulo, São Paulo - Brasil
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21
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Banzato T, Zovi G, Milani C. Estimation of fetal lung development using quantitative analysis of ultrasonographic images in normal canine pregnancy. Theriogenology 2017; 96:158-163. [PMID: 28532833 DOI: 10.1016/j.theriogenology.2017.03.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 12/02/2016] [Revised: 03/06/2017] [Accepted: 03/14/2017] [Indexed: 11/17/2022]
Abstract
We investigated the quantitative analysis of sonographic images to predict fetal lung maturity of the canine foetus in normal pregnancy. Twelve bitches were recruited in the present study. Serial ultrasonographic exams were performed at three pre-determined time periods corresponding to the pseudoglandular (40-48 days of pregnancy), canalicular (49-56 days of pregnancy) and saccular phase (57-63 days of pregnancy) of lung development. Mean grey level (MGL) and the standard deviation of the histogram (SDH) of fetal lung and liver sonographic images were measured with dedicated software. The lung-to-liver ratio (LLR) for both parameters was also calculated. Measurements were taken on the two caudal-most foetuses and then averaged. SDH did not show any statistically significant difference between the three time periods in the lungs or in the liver. MGL measured in the lungs significantly increased in the first period and reached a plateau during the last two periods. Liver echogenicity was constant during the first two periods and significantly increased during the last week of gestation. The LLR of MGL significantly decreased during the last week of pregnancy. The LLR was a very good test to detect fetal lung maturity (area under the receiver operator curve (AUROC) = 0.875); using a cut-off value of LLR < 1.541, sensitivity was 83.33% and specificity was 83.33%, positive likelihood ratio = 5. LLR of MGL is an accurate test to estimate lung development in normal canine pregnancies.
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Affiliation(s)
- T Banzato
- Department of Animal Medicine, Production and Health, Clinical Section, Radiology Unit, University of Padua, Viale dell'Università 16, AGRIPOLIS, Legnaro 35020, Padua, Italy.
| | - G Zovi
- Department of Animal Medicine, Production and Health, Clinical Section, Radiology Unit, University of Padua, Viale dell'Università 16, AGRIPOLIS, Legnaro 35020, Padua, Italy
| | - C Milani
- Department of Animal Medicine, Production and Health, Clinical Section, Radiology Unit, University of Padua, Viale dell'Università 16, AGRIPOLIS, Legnaro 35020, Padua, Italy
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Romagnoli S, Baldan A, Righetti C, Fontaine C, Scenna L, Badon T, Stelletta C, Milani C, Cecchetto M, Mollo A. Use of the gonadotropin-releasing hormone (GnRH) stimulation test to monitor gonadal function in intact adult male cats. Reprod Domest Anim 2016; 52:24-27. [PMID: 27862393 DOI: 10.1111/rda.12771] [Citation(s) in RCA: 6] [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] [Received: 12/08/2015] [Accepted: 07/25/2016] [Indexed: 11/30/2022]
Abstract
The gonadotropin-releasing hormone (GnRH) stimulation test is a common procedure used to investigate normality of the pituitary-gonadal axis in mammals. There is very little information on the technique, its efficacy and side effects in small animals and in particular no information for male cats. In dogs, such test is performed by intravenous (IV) administration. With cats, the number of times the animal needs to be restrained for blood sampling should be the least possible. The purpose of this study was to assess efficacy and side effects of the GnRH stimulation test in tomcats comparing the IV with the intramuscular (IM) route of administration. A GnRH stimulation test was performed in eight adult tomcats through IM or IV administration of 50 μg gonadorelin. The response of the pituitary-gonadal axis was assessed by measuring serum testosterone on blood samples collected prior to and 1 hr following treatment. When considering each single group of cats, the post-stimulation serum testosterone values were significantly higher than the pre-treatment ones (p < .05). When comparing the two groups of cats, basal testosterone concentrations did not differ, and also post-GnRH testosterone concentrations did not differ. In conclusion, in the cats of our study, the GnRH stimulation test produced the same results following the IM or the IV route of administration. Therefore, in tomcats, the IM route can be considered as effective as the IV one and should be preferred when doing a GnRH test.
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Affiliation(s)
- S Romagnoli
- Department of Animal Medicine, Production and Health, University of Padova, Padova, Italy
| | - A Baldan
- Private Practitioner, Padova, Italy
| | | | - C Fontaine
- Companion Animal Medical Department - Virbac group, Carros, France
| | - L Scenna
- Private Practitioner, Trento, Italy
| | - T Badon
- Department of Animal Medicine, Production and Health, University of Padova, Padova, Italy
| | - C Stelletta
- Department of Animal Medicine, Production and Health, University of Padova, Padova, Italy
| | - C Milani
- Department of Animal Medicine, Production and Health, University of Padova, Padova, Italy
| | - M Cecchetto
- Department of Animal Medicine, Production and Health, University of Padova, Padova, Italy
| | - A Mollo
- Department of Animal Medicine, Production and Health, University of Padova, Padova, Italy
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Milani C, Ferrario C, Turroni F, Duranti S, Mangifesta M, van Sinderen D, Ventura M. The human gut microbiota and its interactive connections to diet. J Hum Nutr Diet 2016; 29:539-46. [PMID: 27161433 DOI: 10.1111/jhn.12371] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The microbiota of the gastrointestinal tract plays an important role in human health. In addition to their metabolic interactions with dietary constituents, gut bacteria may also be involved in more complex host interactions, such as modulation of the immune system. Furthermore, the composition of the gut microbiota may be important in reducing the risk of contracting particular gut infections. Changes in the microbiota during an individual's lifespan are accompanied by modifications in multiple health parameters, and such observations have prompted intense scientific efforts aiming to understand the complex interactions between the microbiota and its human host, as well as how this may be influenced by diet.
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Affiliation(s)
- C Milani
- Laboratory of Probiogenomics, Department of Life Sciences, University of Parma, Parma, Italy
| | - C Ferrario
- Laboratory of Probiogenomics, Department of Life Sciences, University of Parma, Parma, Italy
| | - F Turroni
- Laboratory of Probiogenomics, Department of Life Sciences, University of Parma, Parma, Italy
| | - S Duranti
- Laboratory of Probiogenomics, Department of Life Sciences, University of Parma, Parma, Italy
| | | | - D van Sinderen
- APC Microbiome Institute and School of Microbiology, National University of Ireland, Cork, Ireland
| | - M Ventura
- Laboratory of Probiogenomics, Department of Life Sciences, University of Parma, Parma, Italy.
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Farina F, Milani C, Botto L, Lonati E, Bulbarelli A, Palestini P. ERK-Nrf2 pathway regulates the anti-oxidant response after in vitro diesel exhaust particles treatment. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.815] [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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Pagano F, Tasca A, Giunta A, Milani C, De Faveri D, Zattoni F. Percutaneous surgery in the management of renal stones. Contrib Nephrol 2015; 55:92-3. [PMID: 3829683 DOI: 10.1159/000413408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Romagnoli S, Siminica A, Sontas BH, Milani C, Mollo A, Stelletta C. Semen Quality and Onset of Sterility Following Administration of a 4.7-mg Deslorelin Implant in Adult Male Dogs. Reprod Domest Anim 2012; 47 Suppl 6:389-92. [DOI: 10.1111/rda.12058] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Romagnoli
- Department of Animal Medicine; Production and Health; University of Padova; Padova; Italy
| | | | - BH Sontas
- Klinik fur Geburtshilfe; Gynaekologie und Andrologie Veterinarrmedizinische; Universitaet Wien; Wien; Austria
| | - C Milani
- Department of Animal Medicine; Production and Health; University of Padova; Padova; Italy
| | - A Mollo
- Department of Animal Medicine; Production and Health; University of Padova; Padova; Italy
| | - C Stelletta
- Department of Animal Medicine; Production and Health; University of Padova; Padova; Italy
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Mahoney G, Milani C, Billinger M, Lywood V, Gruppioni G. Using a haptic device and virtual sculpting software for predicting a missing mandible: the case of Angelo Poliziano. J Biol Res 2012. [DOI: 10.4081/4170] [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] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Milani C, Corrò M, Drigo M, Rota A. Antimicrobial resistance in bacteria from breeding dogs housed in kennels with differing neonatal mortality and use of antibiotics. Theriogenology 2012; 78:1321-8. [DOI: 10.1016/j.theriogenology.2012.05.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Revised: 05/31/2012] [Accepted: 05/31/2012] [Indexed: 11/15/2022]
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Rota A, Milani C, Corrò M, Drigo I, Börjesson S. Misuse of antimicrobials and selection of methicillin-resistant Staphylococcus pseudintermedius strains in breeding kennels: genetic characterization of bacteria after a two-year interval. Reprod Domest Anim 2012; 48:1-6. [PMID: 22551469 DOI: 10.1111/j.1439-0531.2012.02012.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Methicillin-resistant Staphylococcus pseudintermedius (MRSP) strains have been isolated from dogs with increasing frequency; prolonged or excessive use of antimicrobials is associated with the selection of MRSP, and misuse of antimicrobials is frequent in breeding kennels. This study was carried out in two breeding kennels (A and B) in which we had isolated MRSP in 2008: the aim was to assess colonization of previously positive bitches and of other bitches sharing the same environment and to assess the genetic profile of both the old and the new strains [spa typing, staphylococcal cassette chromosome mec (SCCmec) typing and Pulsed-field Gel Electrophoresis (PFGE)]. Six animals from Kennel A (two from 2008) and eight from Kennel B (one from 2008) were tested: 16 MRSP strains were isolated only from bitches housed in Kennel B. Old and new isolates were mecA positive, resulted spa type t02 and carried SSCmec II-III. PGFE showed that all isolates were related and belonged to the main clone lineage dominating in Europe, ST71-J-t02-II-III. Kennels A and B differ in the use of antimicrobials, which has been reduced over time in Kennel A, while has remained excessive in Kennel B, where many agents belonging to different classes (third-generation cephalosporins, fluoroquinolones, macrolids) are administered to dogs, without veterinary supervision, especially around parturition. Misuse of antimicrobials is the key factor for the selection of MRSP strains in healthy dogs and for their persistence over time. Dog breeders should be aware that infections caused by multiresistant bacteria have very limited therapeutical options and represent a huge challenge for animal health.
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Affiliation(s)
- A Rota
- Dipartimento di Patologia Animale, Università di Torino, Grugliasco, Italy.
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Almeida A, Milani C, Sudkamp J, Bell R, Stewart G. Effect of Testing Environment on Pre-Participation Reaction Time in High School Athletes (P02.214). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p02.214] [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: 11/15/2022] Open
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Grinspon RP, Bedecarrás P, Ballerini MG, Iñiguez G, Rocha A, Mantovani Rodrigues Resende EA, Brito VN, Milani C, Figueroa Gacitúa V, Chiesa A, Keselman A, Gottlieb S, Borges MF, Ropelato MG, Picard JY, Codner E, Rey RA. Early onset of primary hypogonadism revealed by serum anti-Müllerian hormone determination during infancy and childhood in trisomy 21. ACTA ACUST UNITED AC 2011; 34:e487-98. [PMID: 21831236 DOI: 10.1111/j.1365-2605.2011.01210.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Male patients with an extra sex chromosome or autosome are expected to present primary hypogonadism at puberty owing to meiotic germ-cell failure. Scarce information is available on trisomy 21, a frequent autosomal aneuploidy. Our objective was to assess whether trisomy 21 presents with pubertal-onset, germ-cell specific, primary hypogonadism in males, or whether the hypogonadism is established earlier and affects other testicular cell populations. We assessed the functional status of the pituitary-testicular axis, especially Sertoli cell function, in 117 boys with trisomy 21 (ages: 2months-20year). To compare with an adequate control population, we established reference levels for serum anti-Müllerian hormone (AMH) in 421 normal males, from birth to adulthood, using a recently developed ultrasensitive assay. In trisomy 21, AMH was lower than normal, indicating Sertoli cell dysfunction, from early infancy, independently of the existence of cryptorchidism. The overall prevalence rate of AMH below the 3rd percentile was 64.3% in infants with trisomy 21. Follicle-stimulating hormone was elevated in patients <6months and after pubertal onset. Testosterone was within the normal range, but luteinizing hormone was elevated in most patients <6months and after pubertal onset, indicating a mild Leydig cell dysfunction. We conclude that in trisomy 21, primary hypogonadism involves a combined dysfunction of Sertoli and Leydig cells, which can be observed independently of cryptorchidism soon after birth, thus prompting the search for new hypotheses to explain the pathophysiology of gonadal dysfunction in autosomal trisomy.
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Affiliation(s)
- R P Grinspon
- División de Endocrinología, Centro de Investigaciones Endocrinológicas (CEDIE-CONICET), Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina.
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Sontas BH, Milani C, Romagnoli S, Bertolini G, Caldin M, Caliari D, Zappulli V, Mollo A. A Huge Ovarian Cyst in a Hysterectomized Bitch. Reprod Domest Anim 2011; 46:1107-11. [DOI: 10.1111/j.1439-0531.2011.01797.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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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Sontas HB, Stelletta C, Milani C, Mollo A, Romagnoli S. Full recovery of subinvolution of placental sites in an American Staffordshire terrier bitch. J Small Anim Pract 2010; 52:42-5. [DOI: 10.1111/j.1748-5827.2010.01015.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Milani C, Welsh J, Katayama MLH, Lyra EC, Maciel MS, Brentani MM, Folgueira MAAK. Human breast tumor slices: a model for identification of vitamin D regulated genes in the tumor microenvironment. J Steroid Biochem Mol Biol 2010; 121:151-5. [PMID: 20307664 DOI: 10.1016/j.jsbmb.2010.03.051] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Accepted: 03/13/2010] [Indexed: 10/19/2022]
Abstract
While many studies have addressed the direct effects of 1alpha,25(OH)2D3 on breast cancer (BC) cells, stromal-epithelial interactions, which are important for the tumor development, have been largely ignored. In addition, high concentrations of the hormone, which cannot be attained in vivo, have been used. Our aim was to establish a more physiological breast cancer model, represented by BC tissue slices, which maintain epithelial-mesenchymal interactions, cultured with a relatively low 1alpha,25(OH)2D3 concentration, in order to evaluate the vitamin D pathway. Freshly excised human BC samples were sliced and cultured in complete culture media containing vehicle, 0.5 nM or 100 nM 1alpha,25(OH)2D3 for 24 h. BC slices remained viable for at least 24 h, as evaluated by preserved tissue morphology in hematoxylin and eosin (HE) stained sections and bromodeoxyuridine (BrdU) incorporation by 10% of tumor cells. VDR mRNA expression was detected in all samples and CYP24A1 mRNA expression was induced by 1alpha,25(OH)2D3 in both concentrations (but mainly with 100 nM). Our results indicate that the vitamin D signaling pathway is functional in BC slices, a model which preserves stromal-epithelial interactions and mimics in vivo conditions.
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Affiliation(s)
- C Milani
- Departamento de Radiologia, Disciplina de Oncologia, LIM24, Faculdade de Medicina Universidade de São Paulo, São Paulo 01246903, Brazil
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Sontas BH, Milani C, Mollo A, Romagnoli S. Blood dripping from the penis of a German Shepherd dog. Aust Vet J 2010; 88:242-4. [PMID: 20553576 DOI: 10.1111/j.1751-0813.2010.00581.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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- B H Sontas
- Department of Obstetrics and Gynaecology, Faculty of Veterinary Medicine, Istanbul University, Istanbul, Turkey.
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Romagnoli S, Milani C, Perin S, Ballabio R, Stelletta C, Mollo A, Gelli D. Effect of an injectable cabergoline formulation on serum prolactin (PRL) and milk secretion in early postpartum Beagle bitches. Reprod Domest Anim 2010; 44 Suppl 2:148-51. [PMID: 19754555 DOI: 10.1111/j.1439-0531.2009.01440.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study was conducted in order to evaluate effects on prolactin (PRL) concentration and mammary milk secretion of an injectable cabergoline formulation administered to five lactating Beagle bitches during early postpartum (PP). Bitches were bled twice daily (from PP day 3 to PP day 12) and then daily (from PP day 13 to PP day 16) to assay serum PRL. On PP day 6, a subcutaneous (SC) injection of 0.1 ml/kg of placebo was administered. On PP day 9, a SC 0.1 ml/kg dose of injectable cabergoline was administered. All bitches were checked for milk production, using a clinical scoring in order to quantify milk expression from each teat. A circadian variation of serum PRL was evident during the 6 days of pre-treatment monitoring. The day after cabergoline injection, an 80% decrease of PRL serum concentration was observed (p < 0.05). The circadian oscillatory pattern of PRL secretion disappeared after administration of cabergoline, and PRL values remained significantly lower than in the previous days for the first 60 h following treatment (p < 0.001). Milk production was drastically reduced when comparing pre-treatment to post-treatment scores (p < 0.001). A single dose of injectable cabergoline caused a significant reduction in serum PRL concentration and a significant reduction in milk flow. The injectable formulation of cabergoline appeared to be safe and well tolerated.
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Affiliation(s)
- S Romagnoli
- Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, University of Padova, Padova, Italy.
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Rota A, Milani C, Romagnoli S, Zucchini P, Mollo A. Pregnancy and conception rate after two intravaginal inseminations with dog semen frozen either with 5% glycerol or 5% ethylene glycol. Anim Reprod Sci 2010; 118:94-7. [DOI: 10.1016/j.anireprosci.2009.06.007] [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] [Received: 03/17/2009] [Revised: 05/22/2009] [Accepted: 06/08/2009] [Indexed: 10/20/2022]
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Colvin G, Milani C, Berz D, Quesenberry P. Consolidation Therapy Following Autologous Stem Cell Transplantation For Non-Hodgkins And Hodgkins Lymphomas. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.168] [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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Urata Y, Milani C, Lyra E, Katayama M, Basso R, Schor A, Silva T, Goes J, Brentani M, Folgueira M. Breast Cancer Gene Expression Profile in Post-Menopausal Patients Supplemented with Vitamin D. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-6128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Vitamin D supplementation is indicated for post-menopausal women to prevent osteoporosis and lower 25(OH)2D3 or 1,25(OH)2D3 serum levels have been associated with breast cancer incidence or prognosis (metastasis). The antiproliferative effects of vitamin D are observed in breast cancer cell lines exposed to phamacological doses of calcitriol (1,25(OH)2D3, 100nM) but whether physiological doses are sufficient to produce growth inhibition in vivo is not known. The aim of our study was to investigate gene expression profile changes of breast cancer samples from patients supplemented with calcitriol, presenting an anti-proliferative effect on the tumor. Post-menopausal women diagnosed with breast cancer were instructed to take one (0.25ug/day, n=8) or two (0.50ug/day, n=8) tablets of calcitriol after tumor biopsy. Median time of supplementation was 30 days. Sixteen tumor samples were collected during biopsy (before supplementation) and breast surgery (after supplementation). Proliferation index was evaluated by tumor Ki-67 immunohistochemistry (IHC) expression in breast cancer samples before and after calcitirol supplementation and 1000 cells were counted by three observers (p < 0,001, Pearson's correlation). After establishing a counting error between observers, the cut-off value was fixed in 26.53% (percentile 60%) to define response. Patients were then categorized as responsive (a reduction of more than 26.53% on positive Ki-67 positive cells) and non-responsive (difference between samples before and after supplementation not exceeding 26.53%). Among our sixteen patients, all were categorized as responsive to calcitriol supplementation except for two. So far, gene expression profile of two patients (both categorized as responsive) has been analyzed using the U133 Plus 2.0 Affymetrix Gene Chips from 100ng of total RNA. To verify signalling pathways possibly involved in response to vitamin D exposure, additional five samples from a parallel study, in which breast cancer samples from post menopausal patients were collected at surgery and treated in vitro with a low concentration of calcitriol, 0.5nM (that can be attained with subcutaneous administration of doses of 8ug calcitriol, without hypercalcemia) for 24h, were included in the analysis. All samples had RNA hybridized to the same gene chips. Results were normalized and analyzed using RMA and Mev.TM4 softwares. CYP24A1, a target gene of vitamin D, presented a positive regulation after calcitriol supplementation in all samples analyzed. Differentially expressed genes were involved in the regulation of cell cycle [SMAD2, cyclin E, YWHAQ (14-3-3 family] and calcium signalling (HTR7, PTGER1 and PTGER2). Our results indicate that the tumor proliferation index is reduced upon calcitriol supplementation. Moreover, potentially regulated pathways in breast cancer specimens after administration of low doses of calcitriol are regulation of cell cycle and calcium signaling.Supported by FAPESP 2007/01111-0 – 2007/04799-2
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6128.
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Affiliation(s)
- Y. Urata
- 1Faculdade de Medicina - Universidade de Sao Paulo, SP, Brazil
| | - C. Milani
- 1Faculdade de Medicina - Universidade de Sao Paulo, SP, Brazil
| | - E. Lyra
- 2Instituto Brasileiro de Controle do Cancer, SP, Brazil
| | - M. Katayama
- 1Faculdade de Medicina - Universidade de Sao Paulo, SP, Brazil
| | - R. Basso
- 2Instituto Brasileiro de Controle do Cancer, SP, Brazil
| | - A. Schor
- 1Faculdade de Medicina - Universidade de Sao Paulo, SP, Brazil
| | - T. Silva
- 1Faculdade de Medicina - Universidade de Sao Paulo, SP, Brazil
| | - J. Goes
- 2Instituto Brasileiro de Controle do Cancer, SP, Brazil
| | - M. Brentani
- 1Faculdade de Medicina - Universidade de Sao Paulo, SP, Brazil
| | - M. Folgueira
- 1Faculdade de Medicina - Universidade de Sao Paulo, SP, Brazil
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Romagnoli S, Bonaccini P, Stelletta C, Garolla A, Menegazzo M, Foresta C, Mollo A, Milani C, Gelli D. Clinical Use of Testicular Fine Needle Aspiration Cytology in Oligozoospermic and Azoospermic Dogs. Reprod Domest Anim 2009; 44 Suppl 2:329-33. [DOI: 10.1111/j.1439-0531.2009.01439.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Romagnoli S, Stelletta C, Milani C, Gelli D, Falomo ME, Mollo A. Clinical Use of Deslorelin for the Control of Reproduction in the Bitch. Reprod Domest Anim 2009; 44 Suppl 2:36-9. [DOI: 10.1111/j.1439-0531.2009.01441.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [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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Castillo J, Milani C, Pantanowitz L. HIV-associated anaplastic large cell lymphoma. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e19563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19563 Background: Anaplastic large cell lymphoma (ALCL) is a CD30+ T-cell lymphoma that is generally unrelated to EBV in the non-HIV setting. Based upon anaplastic lymphoma kinase (ALK) expression, the new WHO classification provisionally distinguishes between ALK+ (favorable) and ALK- (unfavorable) ALCL. The characteristics of ALCL, such as ALK expression and EBV coinfection, in individuals with HIV infection have not been adequately evaluated. The aim of this study was to investigate these features in HIV-associated ALCL cases. Methods: A MEDLINE search for all cases of HIV-associated non-cutaneous ALCL was undertaken. Data regarding patient age, gender, HIV status (CD4 count, viral load, opportunistic infections), HAART, lymphoma features (B symptoms, stage, sites of involvement, immunophenotype, ALK expression, molecular studies), EBV coinfection, therapy and outcome (survival, cause of death) were extracted and analyzed. Results: A total of 23 cases were included. Patients were of median age 39 years with a male:female ratio of 7:1. Median CD4+ count was 76 cells/mm3 and HIV viral load 416,500 copies/ml. Most (67%) patients had an opportunistic infection, although only 3 (17%) were on HAART. ALCL was extranodal in 22 cases (96%) affecting most commonly lung, soft tissue and liver. Many (78%) patients had stage IV disease and B symptoms were reported in 9 cases (50%). T-cell receptor gene rearrangement was present in all cases, CD30 was positive in 22 (96%), and the vast majority (90%) were ALK-negative. EBV was identified in 8 (35%) cases. Therapy for ALCL was documented in 15 (67%) cases; 64% received CHOP. In 2 of the 3 patients who were on HAART, long-term survival was achieved. Many (68%) patients died, with a median survival of 9 months. Death was caused by either lymphoma progression (42%) or infection (58%). Conclusions: HIV-associated non-cutaneous ALCL appears to affect younger individuals and is associated with EBV infection in a subset of cases. Apart from marked immunosuppression, the poor prognosis of HIV-associated ALCL appears to be related to the absence of ALK expression, advanced stage at presentation with prominent extranodal disease, inadequate therapy including HAART, and poor response to CHOP. Further research is needed to better understand and treat this unique HIV-associated lymphoma. No significant financial relationships to disclose.
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Affiliation(s)
- J. Castillo
- The Miriam Hospital/BROWN Alpert Medical School, Providence, RI; Baystate Medical Center/Tufts School of Medicine, Springfield, MA
| | - C. Milani
- The Miriam Hospital/BROWN Alpert Medical School, Providence, RI; Baystate Medical Center/Tufts School of Medicine, Springfield, MA
| | - L. Pantanowitz
- The Miriam Hospital/BROWN Alpert Medical School, Providence, RI; Baystate Medical Center/Tufts School of Medicine, Springfield, MA
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Milani C, Castillo J. HIV-associated peripheral T-cell lymphoma. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e19551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19551 Background: T-cell lymphomas (TCL) constitute 3% of all AIDS-related lymphomas. Over the past 2 decades numerous case reports have documented the emergence of TCL among HIV-infected individuals. These lymphomas comprise a diverse group of disease entities, including peripheral T-cell lymphomas (PTCL), which represent the most common subtype. The aim of this study was to investigate the clinical and pathological features of HIV-associated PTCL. Methods: A MEDLINE search for cases of HIV-associated PTCL was conducted through December 2008. Data regarding patient age, gender, HIV status (CD4 count, viral load, opportunistic infections), use of HAART, lymphoma features (B symptoms, stage, sites of involvement, immunophenotype, molecular studies), EBV coinfection, therapy, and outcome (survival, cause of death) were analyzed and reported descriptively. Results: A total of 34 cases were included. Patients had a median age of 36 years with a male:female ratio of 4:1. Median CD4+ count was 126 cells/mm3. Seventeen patients (50%) had an opportunistic infection, but only 7 patients (26%) were on HAART treatment; 4 patients on HAART (57%) were alive at time of publication. PTCL was extranodal in 75% of cases, affecting predominantly the oral cavity, lung, and GI tract. B symptoms were present in 60% of cases. Stage III and IV disease was found in 17 and 5 cases, respectively, accounting for 76% of the total cases. T-cell receptor gene rearrangement was positive in 10 out of 10 (100%) analyzed cases. EBV was identified in 6 of 12 cases (50%). Median LDH level was 269 IU/L. Therapy for PTCL was administered in 23 cases (68%), while 10 cases (30%) did not receive therapy; 9 of the treated patients (39%) received CHOP with a 33% remission rate. Twenty-two patients (69%) died complicated by infections in 57% and lymphoma progression in 36% of cases. The reported median survival was 12 months. Conclusions: HIV-associated PTCL tends to affect young male individuals with low CD4 counts. Apart from marked immunosuppression, the poor prognosis of HIV-associated PTCL appears to be related to advanced stage at presentation, presence of B symptoms, elevated LDH levels, prominent extranodal disease, and poor response to CHOP chemotherapy. The role of HAART and EBV in the development of PTCL needs further clarification. No significant financial relationships to disclose.
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Affiliation(s)
- C. Milani
- Brown University/Roger Williams Medical Center, providence, RI; Brown University/The Miriam Hospital, providence, RI
| | - J. Castillo
- Brown University/Roger Williams Medical Center, providence, RI; Brown University/The Miriam Hospital, providence, RI
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Lyra EC, Katayama MH, Basso RA, Assis PE, Brentani M, Alves EM, Neto JG, Milani C, Goes JS, Folgueira MA. Ki67 tumor expression in breast cancer post-menopausal patients following calcitriol supplementation. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.14612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pagano F, Bassi P, Milani C, Garbeglio A, Meneghini A, Aragona F, Artibani W, Dal Bianco M, Oliva G. Topische BCG-Verabreichung in niedriger Dosierung beim oberflächlichen Blasenkarzinom. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1061221] [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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Abstract
In the last years, laser has gained increasingly high popularity in Endourology The newer generation Ho-YAG lasers represent the most updated laser used in Urology, being able to successfully treat both urinary stones and soft tissue lesions. The aim of this work was to report a multicentre 4-year experience using the Ho-YAG laser in the treatment of stones and soft tissue lesions, in order to offer parameters and modalities of use in several different situations. Materials and Methods Two urological Centers were asked between 2002 and 2005 to use Coherent Versa Pulse 20 Ho-YAG laser source in the treatment of urinary stones in 212 patients, and urinary soft tissue lesions (urethra, ureter or bladder neck strictures or urinary tract tumors) in 56 patients. According to the various situations (either stone fragmentation or treatment of soft tissue lesions), pulse frequency and energy per impulse were differently dosed and set. Results The following parameters were identified as the starting points for the correct use of the Ho-YAG laser: a) lithotripsy with rigid endoscope: 365 μm fiber, 0.8 - 1.2 Joule (J) energy and 6–8 Hz frequency; 365 μm fiber, 0.8–1.2 J energy and 10–12 Hz frequency; 550 μm fiber, 1.0–1.5 J energy and 10–12 Hz frequency. b) lithotripsy with flexible endoscope: 270 μm fiber, 0.6–1.0 J energy and 6–10 Hz frequency. c) soft tissue resection in case of: c1) ureteral stricture, 365 μm fiber, 0.6 J energy and 14–16 Hz frequency; c2) urethral stricture, 365 μm fiber, 0.7 J energy and 16–18 Hz frequency; c3) upper urinary tract tumors, 365 μm fiber, 0.7 J energy and 16 Hz frequency; c4) bladder tumors 365 μm fiber, 0.8 J energy and 16–20 Hz frequency; c5) bladder neck strictures, 365 μm fiber, 1.0 J energy and 16–18 Hz frequency. Conclusions In the light of these parameters, Ho-YAG laser is a very handy instrument for the treatment of both urinary stones and soft tissue lesions, which allows to put aside the current tools used for the same purposes.
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Affiliation(s)
- W. Cecchetti
- Dipartimento di Chimica Fisica, Università Cà Foscari di Venezia
| | - M.A. Cerruto
- Cattedra di Urologia, Università degli Studi di Verona
| | - M. Dal Bianco
- Unità Operativa di Urologia, Ospedale S. Antonio, Padova
| | - C. Milani
- Unità Operativa di Urologia, Ospedale Civile, Venezia
| | - F. Zattoni
- Cattedra di Urologia, Università degli Studi di Verona
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Breda A, Stepanian SV, Liao J, Lam JS, Guazzoni G, Stifelman M, Perry K, Celia A, Breda G, Fornara P, Jackman S, Rosales A, Palou J, Grasso M, Pansadoro V, Disanto V, Porpiglia F, Milani C, Abbou C, Gaston R, Janetschek G, Soomro NA, de la Rosette J, Laguna MP, Schulam PG. Positive margins in laparoscopic partial nephrectomy in 855 cases: a multi-institutional survey from the United States and Europe. J Urol 2007; 178:47-50; discussion 50. [PMID: 17574057 DOI: 10.1016/j.juro.2007.03.045] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2006] [Indexed: 12/17/2022]
Abstract
PURPOSE Open partial nephrectomy has emerged as the standard of care in the management of renal tumors smaller than 4 cm. While laparoscopic radical nephrectomy has been shown to be comparable to open radical nephrectomy with respect to long-term outcomes, important questions remain unanswered regarding the oncological efficacy of laparoscopic partial nephrectomy. We examined the practice patterns and pathological outcomes following laparoscopic partial nephrectomy. MATERIALS AND METHODS A survey was sent to academic medical centers in the United States and in Europe performing laparoscopic partial nephrectomy. The total number of laparoscopic partial nephrectomies, positive margins, indications for intraoperative frozen biopsy as well as tumor size and position were queried. RESULTS Surveys suitable for analysis were received from 17 centers with a total of 855 laparoscopic partial nephrectomy cases. Mean tumor size was 2.7 cm (+/-0.6). There were 21 cases with positive margins on final pathology, giving an overall positive margin rate of 2.4%. Intraoperative frozen sections were performed selectively at 10 centers based on clinical suspicion of positive margins on excised tumor. Random biopsies were routinely performed on the resection bed at 5 centers. Frozen sections were never performed at 2 centers. Of the 21 cases with positive margins 14 underwent immediate radical nephrectomy based on the frozen section and 7 were followed expectantly. CONCLUSIONS Early experience with laparoscopic partial nephrectomy in this multicenter study demonstrates oncological efficacy comparable to that of open partial nephrectomy with respect to the incidence of positive margins. The practice of intraoperative frozen sections varied among centers and is not definitive in guiding the optimal surgical treatment.
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Affiliation(s)
- A Breda
- Department of Urology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California 90095, USA, and San Raffaele Hospital, Milan, Italy.
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Fulcoli V, Lavelli D, Dal Bianco M, Milani C. Cavai Relapse with Budd-Chiari Syndrome after Radical Nephrectomy for Renal Cancer. Urologia 2004. [DOI: 10.1177/039156030407100304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 60-year-old man, who had undergone a right radical nephrectomy and cavaatrial thrombectomy for renal cell carcinoma (RCC), presented a recurrent neoplastic cavai thrombus six months later, associated with Budd-Chiari syndrome. A re-thrombectomy was attempted with technical success, but patient didn't survive the operation.
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Affiliation(s)
- V. Fulcoli
- Unità Operativa Autonoma di Urologia, Ospedale di Camposampiero, Padova
| | - D. Lavelli
- Unità Operativa Autonoma di Urologia, Ospedale di Camposampiero, Padova
| | - M. Dal Bianco
- Unità Operativa di Urologia, Ospedale Sant'Antonio, Padova
| | - C. Milani
- Unità Operativa di Urologia, Ospedale Sant'Antonio, Padova
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Cooper CS, Passerini-Glazel G, Hutcheson JC, Iafrate M, Camuffo C, Milani C, Snyder HM. Long-term followup of endoscopic incision of ureteroceles: intravesical versus extravesical. J Urol 2000; 164:1097-9; discussion 1099-100. [PMID: 10958751 DOI: 10.1097/00005392-200009020-00045] [Citation(s) in RCA: 12] [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
PURPOSE Endoscopic incision was performed as the initial therapy for ureteroceles in children presenting to our institutions between 1985 and 1990. To assess the long-term efficacy of this treatment modality we reevaluated the outcome of these patients. MATERIALS AND METHODS Parameters reviewed included patient age at surgery, position of the ureterocele, a duplex system, preoperative and postoperative reflux, and the need for additional operations. Statistical analysis consisted of chi-square and Wilcoxon's rank sum tests. RESULTS Of the patients 22 had intravesical and 22 had extravesical ureteroceles. Average age at initial surgery was 1.9 +/- 3.7 years with average followup of 7.2 +/- 3.1 years. A second operation was required in 18 cases (41%), which was significantly more likely for an extravesical ureterocele (18% versus 64%, p = 0. 002), a duplex system (p = 0.026) or preoperative reflux (p = 0.02). Second operations included reimplantation in 13 cases, upper pole partial nephrectomy in 7, total nephroureterectomy in 3, bladder neck reconstruction in 3 and lower pole pyeloplasty in 3. The only secondary operations performed for intravesical ureteroceles were reimplantation in 3 cases and upper pole nephrectomy in 1. New onset reflux developed in 14 of 27 patients (52%) postoperatively, including 7 with intravesical and 7 with extravesical ureteroceles. None required a second open operation. CONCLUSIONS With extended followup the percentage of patients requiring open surgery after endoscopic incision of ureteroceles increased from our original report of 27% to 41% (p = 0.166). Only 18% of cases with an intravesical ureterocele required a subsequent operation compared to 64% with an extravesical ureterocele (p = 0.002). The reduction in size of the obstructed ureter following endoscopic decompression facilitated successful reimplantation. Endoscopic puncture permits definitive treatment in the majority of children by at most a single incision, open operation at the bladder level.
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Affiliation(s)
- C S Cooper
- Division of Pediatric Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Milani C, Ishida A, Laredo Filho J, Dobashi ET. Racial and geographic differences of Wiberg's angle from 400 ultrasonographic normal hips in Italian and Brazilian infants younger than 3 months old. J Pediatr Orthop B 2000; 9:193-7. [PMID: 10904906 DOI: 10.1097/01202412-200006000-00009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The Wiberg center edge angle (CEA) of 400 hip sonographies among 200 infants, 100 Italians and 100 Brazilians, aged from 15 days to 90 days, whose hip joints were considered normal, from the ultrasonographic point of view (1a and 1b) according to Graf's classification were measured. For the CEA measurements in the studied material, the authors used their own methodology developed for this purpose, which is based on basic geometric concepts and applied by one graphic computer program. In the studied material, the statistical analysis of the results obtained in the measurement of the CEA showed a better conformation of the acetabular roof complex in the Brazilian infants compared with the Italian.
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Affiliation(s)
- C Milani
- Department of Orthopedic Surgery, Federal University of São Paulo-Escola Paulista de Medicina, Brazil
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