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Gatta E, Maltese V, Cimino E, Cavadini M, Anelli V, Di Lodovico E, Piovani E, Zammarchi I, Gozzoli G, Agosti B, Pirola I, Delbarba A, Girelli A, Buoso C, Bambini F, Alfieri D, Bremi W, Facondo P, Lupo R, Bezzi F, Fredi M, Mazzola AM, Gandossi E, Saullo M, Marini F, Licini M, Pezzaioli LC, Pini L, Franceschini F, Ricci C, Cappelli C. Evaluation of a large set of patients with Autoimmune Polyglandular Syndrome from a single reference centre in context of different classifications. J Endocrinol Invest 2024; 47:857-864. [PMID: 37752372 DOI: 10.1007/s40618-023-02200-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/13/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE To characterize patients with APS and to propose a new approach for their follow-up. Query ID="Q1" Text="Please check the given names and familynames." METHODS Monocentric observational retrospective study enrolling patients referred to the Outpatients clinic of the Units of Endocrinology, Diabetology, Gastroenterology, Rheumatology and Clinical Immunology of our Hospital for Autoimmune diseases. RESULTS Among 9852 patients, 1174 (11.9%) [869 (73.9%) female] were diagnosed with APS. In 254 subjects, the diagnosis was made at first clinical evaluation (Group 1), all the other patients were diagnosed with a mean latency of 11.3 ± 10.6 years (Group 2). Group 1 and 2 were comparable for age at diagnosis (35.7 ± 16.3 vs. 40.4 ± 16.6 yrs, p = .698), but different in male/female ratio (81/173 vs 226/696, p = .019). In Group 2, 50% of patients developed the syndrome within 8 years of follow-up. A significant difference was found after subdividing the first clinical manifestation into the different outpatient clinic to which they referred (8.7 ± 8.0 vs. 13.4 ± 11.6 vs. 19.8 ± 8.7 vs. 7.4 ± 8.1 for endocrine, diabetic, rheumatologic, and gastroenterological diseases, respectively, p < .001). CONCLUSIONS We described a large series of patients affected by APS according to splitters and lumpers. We propose a flowchart tailored for each specialist outpatient clinic taking care of the patients. Finally, we recommend regular reproductive system assessment due to the non-negligible risk of developing premature ovarian failure.
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Affiliation(s)
- E Gatta
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - V Maltese
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - E Cimino
- UOC Medicina Generale ad Indirizzo Metabolico e Diabetologico, ASST Spedali Civili of Brescia, Brescia, Italy
| | - M Cavadini
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - V Anelli
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - E Di Lodovico
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - E Piovani
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - I Zammarchi
- Department of Clinical and Experimental Sciences, Gastroenterology Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - G Gozzoli
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - B Agosti
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - I Pirola
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - A Delbarba
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - A Girelli
- UOC Medicina Generale ad Indirizzo Metabolico e Diabetologico, ASST Spedali Civili of Brescia, Brescia, Italy
| | - C Buoso
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - F Bambini
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - D Alfieri
- Department of Clinical and Experimental Sciences, Gastroenterology Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - W Bremi
- Department of Clinical and Experimental Sciences, Gastroenterology Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - P Facondo
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - R Lupo
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - F Bezzi
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - M Fredi
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - A M Mazzola
- Department of Clinical and Experimental Sciences, Gastroenterology Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - E Gandossi
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - M Saullo
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - F Marini
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - M Licini
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - L C Pezzaioli
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - L Pini
- Department of Clinical and Experimental Sciences, Respiratory Medicine Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - F Franceschini
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - C Ricci
- Department of Clinical and Experimental Sciences, Gastroenterology Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - C Cappelli
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy.
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Ricci C, Subburaj D, Lim K, Shukla N, Kaur J, Xie L, Laverty M, Zakaria D, Pole J, Pelland-Marcotte MC, Barber R, Israels SJ, Tran TH, Oberoi S, Renzi S, MacDonald T, Sung L, Kulkarni K. Second malignant neoplasms within 5 years from first primary diagnosis in pediatric oncology patients in Canada: a population-based retrospective cohort study. Front Oncol 2024; 14:1376652. [PMID: 38606094 PMCID: PMC11006957 DOI: 10.3389/fonc.2024.1376652] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/11/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction From the advancement of treatment of pediatric cancer diagnosis, the five-year survival rate has increased significantly. However, the adverse consequence of improved survival rate is the second malignant neoplasm. Although previous studies provided information on the incidence and risk of SMN in long term survivors of childhood cancer, there is still scarce information known for short term (< 5 years) prognosis. This study aims to assess the incidence, characteristics, management, and outcome of children who develop SMN malignancies within 5 years of diagnosis of their initial cancer. Method This is a retrospective cohort study of early Second Malignant Neoplasms (SMN) in pediatric oncology patients. The Cancer in Young People - Canada (CYP-C) national pediatric cancer registry was used and reviewed pediatric patients diagnosed with their first cancer from 2000-2015. Results A total of 20,272 pediatric patients with a diagnosis of a first malignancy were analyzed. Of them, 0.7% were diagnosed with a SMN within the first 5 years following their first cancer diagnosis. Development of a SMN impacted survival, shown by an inferior survival rate in the SMN cohort (79.1%) after three years compared to that of the non-SMN cohort (89.7%). Several possible risk factors have been identified in the study including the use of epipodophyllotoxins, exposure to radiation, and hematopoietic stem cell 169 transplant. Discussion This is the first national study assessing the incidence, 170 characteristics, risk factors and outcome of early SMN in Canadian children 171 from age 0-15 from 2000-2015.
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Affiliation(s)
- Christina Ricci
- Lifespan Chronic Disease and Conditions Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Divya Subburaj
- Department of Pediatrics, Division of Hematology-Oncology, Izzak Walton Killam (IWK) Health Centre, Halifax, NS, Canada
| | - Kate Lim
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Neetu Shukla
- Lifespan Chronic Disease and Conditions Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Jaskiran Kaur
- Surveillance Systems and Data Management Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Lin Xie
- Lifespan Chronic Disease and Conditions Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Meghan Laverty
- Lifespan Chronic Disease and Conditions Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Dianne Zakaria
- Lifespan Chronic Disease and Conditions Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Jason Pole
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Health Sciences Research, University of Queensland, Brisbane, QLD, Australia
| | - Marie-Claude Pelland-Marcotte
- Division of Pediatric Hematology-Oncology, CHU de Québec-Centre Mère-Enfant Soleil, Quebec City, QC, Canada
- Research Centre of the CHU de Québec, Axe Reproduction, Santé de la Mère et de l’Enfant, Quebec City, QC, Canada
| | - Randy Barber
- C17 Research Network, C17 Council, Edmonton, AB, Canada
| | - Sara J. Israels
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Thai-Hoa Tran
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, Charles-Bruneau Cancer Center, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Montréal, QC, Canada
- Immune Diseases and Cancers Axis, CHU Sainte-Justine Research Center, Montréal, QC, Canada
| | - Sapna Oberoi
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
- Department of Pediatric Hematology-Oncology, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Samuele Renzi
- Division of Hematology Oncology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Tamara MacDonald
- Department of Pharmacy, Izzak Walton Killam (IWK) Health, Halifax, NS, Canada
- Faculty of Health Professions, Dalhousie University, Halifax, NS, Canada
| | - Lillian Sung
- Division of Hematology Oncology, The Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Ketan Kulkarni
- Department of Pediatrics, Division of Hematology-Oncology, Izzak Walton Killam (IWK) Health Centre, Halifax, NS, Canada
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Onagbiye S, Guddemi A, Baruwa OJ, Alberti F, Odone A, Ricci H, Gaeta M, Schmid D, Ricci C. Association of sedentary time with risk of cardiovascular diseases and cardiovascular mortality: A systematic review and meta-analysis of prospective cohort studies. Prev Med 2024; 179:107812. [PMID: 38081421 DOI: 10.1016/j.ypmed.2023.107812] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 12/25/2023]
Abstract
Given the high prevalence of cardiovascular disease (CVD), we meta-analysed CVD relative risk (RR) in relation to high vs. low categories of self-reported and objectively assessed sedentary behaviours from cohort studies; in a sub-sample (n = 4 studies), the theoretical substitution of one hour spent sedentary with the same amount of time spent in light-intense physical activity was evaluated. Based on 19 studies (60,526 fatal and non-fatal CVD, 1,473,354 individuals and 13,559,139 persons-year) we estimated a 30% increased CVD risk for high vs. low categories of sedentary behaviour (RR = 1.29, confidence interval (CI) = 1.22;1.37). Every hour spent sedentary corresponds to a 5% increased fatal and non-fatal CVD risk (RR = 1.05, CI = 1.02;1.07). Dose-response meta-analysis revealed that sedentary behaviour is statistically significantly associated to fatal and non-fatal CVD risk following a J-shaped relation. Substituting one hour spent sedentary with physical activity of light intensity reduced the risk of fatal and non-fatal CVD events by one-fifth (RR =0.84, CI = 0.73;0.97). In meta-regression analysis, potential influential factors such as age, sex, and medical condition did not essentially alter the results.
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Affiliation(s)
- S Onagbiye
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa; Health & Exercise Science, Frederick Community College, MD, USA; Kinesiology & Nutrition Sciences, University of Nevada, Las Vegas, USA
| | - A Guddemi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - O J Baruwa
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa; UMIT TIROL - University for Health Sciences and Technology, Tirol, Austria
| | - F Alberti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - A Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - H Ricci
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa
| | - M Gaeta
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - D Schmid
- Division for Quantitative Methods in Public Health and Health Services Research, UMIT TIROL - University for Health Sciences and Technology, Hall i. Tirol, Austria
| | - C Ricci
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa.
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Paradisi A, Piccerillo A, Bocchino E, Cappilli S, Ricci C, Di Stefani A, Peris K. Surgery after sonidegib treatment achieves complete response in locally advanced basal cell carcinoma of the face. J Dermatol 2024; 51:106-109. [PMID: 37732421 DOI: 10.1111/1346-8138.16970] [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: 08/02/2023] [Revised: 08/29/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023]
Abstract
Basal cell carcinoma accounts for 75% of skin cancers worldwide and is the most common malignancy in Caucasians. Since chronic ultraviolet exposure is the major risk factor for its development, sun-exposed areas such as the face are frequently affected. The gold-standard treatment is surgical excision. Radiotherapy may be considered in selected cases such as unresectable primary tumors. In some patients, when the risk of a significant functional/cosmetic deficit advises against both surgery and radiotherapy, target therapy (hedgehog pathway inhibitors) can be administered alone or in a neoadjuvant setting, to reduce the tumor size and make it eligible for surgery. Vismodegib as a neoadjuvant treatment before surgery has been investigated in a single, multicentre, open-label, phase II trial (VISMONEO); however, sonidegib has not yet been evaluated in this setting. We report the cases of two patients with locally advanced basal cell carcinoma of the face who achieved complete remission with sonidegib followed by a more limited surgical excision than would have been needed without target therapy.
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Affiliation(s)
- A Paradisi
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - A Piccerillo
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - E Bocchino
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - S Cappilli
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - C Ricci
- Pathology Unit, Maggiore Hospital, AUSL Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - A Di Stefani
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - K Peris
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
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Srugo SA, Ricci C, Leason J, Jiang Y, Luo W, Nelson C. Disparities in primary and emergency health care among "off-reserve" Indigenous females compared with non-Indigenous females aged 15-55 years in Canada. CMAJ 2023; 195:E1097-E1111. [PMID: 37640405 PMCID: PMC10462408 DOI: 10.1503/cmaj.221407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Access to primary care protects the reproductive and non-reproductive health of females. We aimed to quantify health care disparities among "off-reserve" First Nations, Métis and Inuit females, compared with non-Indigenous females of reproductive age. METHODS We used population-based data from cross-sectional cycles of the Canadian Community Health Survey (2015-2020), including 4 months during the COVID-19 pandemic. We included all females aged 15-55 years. We measured health care access, use and unmet needs, and quantified disparities through weighted and age-standardized absolute prevalence differences compared with non-Indigenous females. RESULTS We included 2902 First Nations, 2345 Métis, 742 Inuit and 74 760 non-Indigenous females of reproductive age, weighted to represent 9.7 million people. Compared with non-Indigenous females, Indigenous females reported poorer health and higher morbidity, yet 4.2% (95% confidence interval [CI] 1.8% to 6.6%) fewer First Nations females and 40.7% (95% CI 34.3% to 47.1%) fewer Inuit females had access to a regular health care provider. Indigenous females waited longer for primary care, more used hospital services for nonurgent care, and fewer had consultations with dental professionals. Accordingly, 3.2% (95% CI 0.3% to 6.1%) more First Nations females and 4.0% (95% CI 0.7% to 7.3%) more Métis females reported unmet needs, especially for mental health (data for Inuit females not reported owing to high variability). INTERPRETATION During reproductive age, Indigenous females in Canada face many disparities in health care access, use and unmet needs. Solutions aimed at increasing access to primary care are urgently needed to advance health care reconciliation.
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Affiliation(s)
- Sebastian A Srugo
- Applied Research (Srugo, Jiang) and Lifespan Chronic Disease and Conditions Divisions (Ricci, Luo, Nelson), Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ont.; Department of Anthropology and Archaeology (Leason), University of Calgary, Calgary, Alta.
| | - Christina Ricci
- Applied Research (Srugo, Jiang) and Lifespan Chronic Disease and Conditions Divisions (Ricci, Luo, Nelson), Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ont.; Department of Anthropology and Archaeology (Leason), University of Calgary, Calgary, Alta
| | - Jennifer Leason
- Applied Research (Srugo, Jiang) and Lifespan Chronic Disease and Conditions Divisions (Ricci, Luo, Nelson), Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ont.; Department of Anthropology and Archaeology (Leason), University of Calgary, Calgary, Alta
| | - Ying Jiang
- Applied Research (Srugo, Jiang) and Lifespan Chronic Disease and Conditions Divisions (Ricci, Luo, Nelson), Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ont.; Department of Anthropology and Archaeology (Leason), University of Calgary, Calgary, Alta
| | - Wei Luo
- Applied Research (Srugo, Jiang) and Lifespan Chronic Disease and Conditions Divisions (Ricci, Luo, Nelson), Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ont.; Department of Anthropology and Archaeology (Leason), University of Calgary, Calgary, Alta
| | - Chantal Nelson
- Applied Research (Srugo, Jiang) and Lifespan Chronic Disease and Conditions Divisions (Ricci, Luo, Nelson), Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ont.; Department of Anthropology and Archaeology (Leason), University of Calgary, Calgary, Alta
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Cappilli S, Suppa M, Ricci C, Del Marmol V, Peris K, Di Stefani A. Line-field confocal optical coherence tomography of Cutaneous vascular lesions: morphological assessment and histopathological correlations. J Eur Acad Dermatol Venereol 2023. [PMID: 37118902 DOI: 10.1111/jdv.19149] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 04/05/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND Cutaneous vascular lesions (VLs) are benign or malignant processes involving blood and/or lymphatic vessels, usually readily diagnosed with dermoscopy. However, cases showing unclear clinical/dermoscopic findings may require further investigations. Line-field confocal optical coherence tomography (LC-OCT) is a new, non-invasive imaging technique displaying high resolution and deep penetration. The aim of this study was to describe the LC-OCT features of the most common benign and malignant VLs and to correlate them with histopathological substrates. METHODS Clinical, dermoscopic, LC-OCT and histopathological images of VLs were retrospectively collected. Detailed LC-OCT description and histopathological correlations were produced for different types of. VLs. RESULTS The study included 71 VLs belonging to 50 caucasian patients [31 (62%) females; median age 56.8 (30-83) years] study lesions included 25 cherry haemangiomas, 15 angiokeratomas, 10 thrombosed haemangiomas, 6 pyogenic granulomas, 5 venous lakes, 4 targetoid haemosiderotic haemangiomas, 4 Kaposi's sarcomas, and 2 extraungual glomus tumours. LC-OCT detected increased dermal vascularity, assuming different size and shape according to the particular type of VLs. LC-OCT criteria correlated well to established histopathologic findings. CONCLUSION The results of our preliminary observations indicates that in-vivo evaluation with LC-OCT may provide practical clues for the identification of the vascular nature of a lesion and its differential diagnosis.
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Affiliation(s)
- S Cappilli
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Suppa
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie, (SFD), Paris, France
- Department of Dermatology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - C Ricci
- Pathology Unit, Maggiore Hospital, AUSL Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - V Del Marmol
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - K Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Di Stefani
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
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Ricci C, Pablo LA, Brown HK. Response to: 'Pledging my time: In utero exposure to acetaminophen and childhood neurodevelopment'. Paediatr Perinat Epidemiol 2023. [PMID: 37102474 DOI: 10.1111/ppe.12982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 04/16/2023] [Indexed: 04/28/2023]
Affiliation(s)
- Christina Ricci
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Lesley A Pablo
- Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Hilary K Brown
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
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Heer E, Ruan Y, Pader J, Mah B, Ricci C, Nguyen T, Chow K, Ford-Sahibzada C, Gogna P, Poirier A, Forbes N, Heitman SJ, Hilsden RJ, Brenner DR. Performance of the fecal immunochemical test for colorectal cancer and advanced neoplasia in individuals under age 50. Prev Med Rep 2023; 32:102124. [PMID: 36875511 PMCID: PMC9981994 DOI: 10.1016/j.pmedr.2023.102124] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/19/2023] [Accepted: 01/26/2023] [Indexed: 02/10/2023] Open
Abstract
The increased demand for colonoscopy combined with increased incidence of colorectal cancer (CRC) among younger populations presents a need to determine FIT performance among individuals in this age group. We conducted a systematic review to assess test performance characteristics of FIT in detecting CRC and advanced neoplasia in younger age populations. A search through December 2022 identified published articles assessing the sensitivity and specificity of FIT for advanced neoplasia or CRC among populations under age 50. Following the search, 3 studies were included in the systematic review. Sensitivity to detect advanced neoplasia ranged from 0.19 to 0.36 and specificity between 0.94 and 0.97 and the overall sensitivity and specificity were 0.23 (0.17-0.30) and 0.96 (0.94-0.98), respectively. Two studies that assessed these metrics in multiple age categories found similar sensitivity and specificity across all age groups 30-49. Sensitivity and specificity to detect CRC was assessed in one study and found no significant differences by age groups. These results suggest that FIT performance may be lower for younger individuals compared to those typically screened for CRC. However, there were few studies available for analysis. Given increasing recommendations to expand screening in younger age groups, more research is needed to determine whether FIT is an adequate screening tool in this population.
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Affiliation(s)
- Emily Heer
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, AB, Canada
| | - Yibing Ruan
- Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, AB, Canada
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Joy Pader
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Brittany Mah
- Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, AB, Canada
| | | | - Teresa Nguyen
- Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, AB, Canada
| | - Kristian Chow
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Chelsea Ford-Sahibzada
- Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, AB, Canada
| | - Priyanka Gogna
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Abbey Poirier
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Nauzer Forbes
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Steve J. Heitman
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Robert J. Hilsden
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Darren R. Brenner
- Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, AB, Canada
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, AB, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Corresponding author at: Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, AB, Canada.
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9
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Ricci C, Albanese CM, Pablo LA, Li J, Fatima M, Barrett K, Levis B, Brown HK. In utero acetaminophen exposure and child neurodevelopmental outcomes: Systematic review and meta-analysis. Paediatr Perinat Epidemiol 2023. [PMID: 36939050 DOI: 10.1111/ppe.12963] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 03/21/2023]
Abstract
BACKGROUND Acetaminophen is a frequently used analgesic for pain and fever. There have been reports of adverse neurodevelopmental outcomes associated with in utero acetaminophen exposure. However, it is unclear whether this association is related directly to acetaminophen use, or the reasons for use. OBJECTIVES To summarise the literature on the association between in utero acetaminophen exposure and child neurodevelopmental outcomes, and assess the extent to which the association is due to confounding by indication. DATA SOURCES OVID for Medline, Embase, and PsycINFO, and EBSCO for CINAHL, from inception to August 18, 2022. STUDY SELECTION AND DATA EXTRACTION We searched for peer-reviewed, English-language studies on in utero acetaminophen exposure and child neurodevelopmental outcomes. Data were extracted using a standardised form created a priori, and quality was assessed using the Systematic Assessment of Quality in Observational Research. SYNTHESIS We generated pooled risk ratios (RR) for outcomes examined by ≥3 studies using random-effects models; outcomes that could not be meta-analysed were narratively summarised following Synthesis Without Meta-Analysis guidelines. RESULTS Twenty-two studies including 23 cohorts were eligible (n = 367,775 total participants; median: 51.7% with acetaminophen exposure). Studies were primarily prospective cohort studies from Europe and the US, with attention deficit/hyperactivity disorder (ADHD) being the most common outcome. Quality assessments resulted in 13.6% of studies being classified as high, 59.1% as medium, 22.7% as low, and 4.5% as very low quality. In utero acetaminophen exposure was associated with an elevated risk of ADHD (unadjusted pooled RR 1.32, 95% confidence interval [CI] 1.20, 1.44; I2 = 47%, n = 7 studies), with little difference after adjusting for confounders, including indications for acetaminophen use (adjusted pooled RR 1.34, 95% CI 1.15, 1.55; I2 = 50%, n = 4 studies). CONCLUSIONS Confounding by indication did not explain the association between in utero acetaminophen exposure and child ADHD. Further, high-quality research is needed on this and other neurodevelopmental outcomes.
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Affiliation(s)
- Christina Ricci
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Public Health Agency of Canada, Ottawa, Ontario, Canada
| | | | - Lesley A Pablo
- Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Jiaying Li
- Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Maryam Fatima
- Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Kathryn Barrett
- Library, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Quebec, Montreal, Canada
| | - Hilary K Brown
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario, Canada.,Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
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Ricci C, Otterman V, Bennett TL, Metcalfe S, Darling E, Semenic S, Dzakpasu S. Rates of and factors associated with exclusive and any breastfeeding at six months in Canada: an analysis of population-based cross-sectional data. BMC Pregnancy Childbirth 2023; 23:56. [PMID: 36690995 PMCID: PMC9869293 DOI: 10.1186/s12884-023-05382-2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/16/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Breastfeeding has many health, economic and environmental benefits for both the infant and pregnant individual. Due to these benefits, the World Health Organization and Health Canada recommend exclusive breastfeeding for the first six months of life. The purpose of this study is to examine the prevalence of exclusive and any breastfeeding in Canada for at least six months, and factors associated with breastfeeding cessation prior to six months. METHODS We performed a secondary analysis of breastfeeding-related questions asked on the cross-sectional 2017-2018 Canadian Community Health Survey. Our sample comprised 5,392 females aged 15-55 who had given birth in the five years preceding the survey. Descriptive statistics were carried out to assess the proportion of females exclusively breastfeeding and doing any breastfeeding for at least six months by demographic and behavioural factors. We also assessed, by baby's age, trends in the introduction of solids and liquids, breastfeeding cessation and the reasons females stopped breastfeeding. Multivariate log binominal regression was used to examine the association between breastfeeding at six months and selected maternal characteristics hypothesized a priori to be associated with breastfeeding behaviour. RESULTS Overall, for at least six months, 35.6% (95% confidence interval (CI): 33.3%-37.8%) of females breastfed exclusively and 62.2% (95% CI: 60.0%-64.4%) did any breastfeeding. The largest decline in exclusive breastfeeding occurred in the first month. Factors most strongly associated with breastfeeding for at least six months were having a bachelor's or higher degree, having a normal body mass index, being married and daily co-sleeping. Insufficient milk supply was given as the most common reason for breastfeeding cessation irrespective of when females stopped breastfeeding. CONCLUSION Six-month exclusive breastfeeding rates in Canada remain below targets set by the World Health Assembly. Continued efforts, including investment in monitoring of breastfeeding rates, are needed to promote and support exclusive breastfeeding, especially among females vulnerable to early cessation.
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Affiliation(s)
- Christina Ricci
- grid.415368.d0000 0001 0805 4386Lifespan Chronic Disease and Conditions Division, Public Health Agency of Canada, Ottawa, ON Canada
| | - Victoria Otterman
- grid.415368.d0000 0001 0805 4386Lifespan Chronic Disease and Conditions Division, Public Health Agency of Canada, Ottawa, ON Canada
| | - Terri-Lyn Bennett
- grid.415368.d0000 0001 0805 4386Lifespan Chronic Disease and Conditions Division, Public Health Agency of Canada, Ottawa, ON Canada
| | - Stephanie Metcalfe
- grid.415368.d0000 0001 0805 4386Lifespan Chronic Disease and Conditions Division, Public Health Agency of Canada, Ottawa, ON Canada
| | - Elizabeth Darling
- grid.25073.330000 0004 1936 8227Department of Obstetrics & Gynecology, McMaster University, Hamilton, ON Canada
| | - Sonia Semenic
- grid.14709.3b0000 0004 1936 8649Ingram School of Nursing, McGill University, Montreal, QC Canada
| | - Susie Dzakpasu
- grid.415368.d0000 0001 0805 4386Lifespan Chronic Disease and Conditions Division, Public Health Agency of Canada, Ottawa, ON Canada
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Lim S, McDougall ARA, Goldstein M, Tuttle A, Hastie R, Tong S, Ammerdorffer A, Rushwan S, Ricci C, Gülmezoglu AM, Vogel JP. Analysis of a maternal health medicines pipeline database 2000-2021: New candidates for the prevention and treatment of fetal growth restriction. BJOG 2023; 130:653-663. [PMID: 36655375 DOI: 10.1111/1471-0528.17392] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 09/12/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The Accelerating Innovation for Mothers project established a new database of candidate medicines under development between 2000 and 2021 for five pregnancy-related conditions, including fetal growth restriction. The objective was to assess medicines for fetal growth restriction and their potential for clinical use globally. DESIGN Landscape analysis. SETTING Global (focus on low- and middle-income countries, LMICs). SAMPLE Drugs, dietary supplements and biologics under investigation for prevention or treatment of fetal growth restriction. METHODS A research pipeline database of medicines was created through searching AdisInsight, PubMed and various grant and clinical trial databases. Analysis of clinical and preclinical candidates were descriptive. MAIN OUTCOMES MEASURES Fetal growth restriction candidates in clinical development were identified and ranked as high, medium or low potential based on prespecified criteria, including efficacy, safety and accessibility. RESULTS Of the 444 unique candidates in the database across all five pregnancy-related conditions, 63 were for fetal growth restriction. Of these, 31 were in clinical development (phases I, II or III) and 32 were in preclinical development. Three candidates, aspirin, l-arginine and vitamin D, were ranked as having high potential as preventive agents. There were no high-potential candidates for treating fetal growth restriction, although five candidates were ranked as having medium potential: allylestrenol, dalteparin, omega-3 fatty acids, tadalafil, and United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP). CONCLUSIONS l-Arginine, aspirin and vitamin D are promising, high-potential preventative agents for fetal growth restriction. Based on the medicines pipeline, new pharmacological agents for fetal growth restriction are unlikely to emerge in the near future.
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Affiliation(s)
- Shao Lim
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Annie R A McDougall
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Maya Goldstein
- Policy Cures Research, Sydney, New South Wales, Australia
| | - Andrew Tuttle
- Policy Cures Research, Sydney, New South Wales, Australia
| | - Roxanne Hastie
- Department of Obstetrics and Gynaecology, University of Melbourne, Heidelberg, Victoria, Australia
| | - Stephen Tong
- Department of Obstetrics and Gynaecology, University of Melbourne, Heidelberg, Victoria, Australia
| | | | | | | | | | - Joshua P Vogel
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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12
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Farrar DS, Drouin O, Moore Hepburn C, Baerg K, Chan K, Cyr C, Donner EJ, Embree JE, Farrell C, Forgie S, Giroux R, Kang KT, King M, Laffin Thibodeau M, Orkin J, Ouldali N, Papenburg J, Pound CM, Price VE, Proulx-Gauthier JP, Purewal R, Ricci C, Sadarangani M, Salvadori MI, Thibeault R, Top KA, Viel-Thériault I, Kakkar F, Morris SK. Risk factors for severe COVID-19 in hospitalized children in Canada: A national prospective study from March 2020–May 2021. The Lancet Regional Health - Americas 2022; 15:100337. [PMID: 35936225 PMCID: PMC9342862 DOI: 10.1016/j.lana.2022.100337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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13
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De Leo A, Vara G, Paccapelo A, Balacchi C, Vicennati V, Tucci L, Pagotto U, Selva S, Ricci C, Alberici L, Minni F, Nanni C, Ambrosi F, Santini D, Golfieri R, Di Dalmazi G, Mosconi C. Computerized tomography texture analysis of pheochromocytoma: relationship with hormonal and histopathological data. J Endocrinol Invest 2022; 45:1935-1944. [PMID: 35680695 PMCID: PMC9463266 DOI: 10.1007/s40618-022-01826-2] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 05/17/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Pheochromocytomas are rare tumors which can present with heterogeneous secretion profiles, clinical manifestations, and radiologic appearance. Under a histopathological point of view, they can be characterized as more or less aggressive with the Pheochromocytoma of the Adrenal gland Scaled Score (PASS) and the Grading system for Adrenal Pheochromocytoma and Paraganglioma (GAPP) score. The aim of this study is to analyze the texture analysis characteristics of pheochromocytoma and identify whether the texture analysis can yield information aiding in the diagnosis and the characterization of those tumors. METHODS Radiological, biochemical, and histopathological data regarding 30 consecutive patients with histologically confirmed pheochromocytoma were analyzed. Images obtained in the unenhanced, late arterial, venous, and delayed phases were used for the texture analysis. RESULTS Urinary epinephrine and metanephrine levels showed a significant correlation (R2 = 0.946; R2 = 699) in the multivariate linear model with texture features, as well as Ki-67 (R2 = 0.397), PASS score (R2 = 0.182), GAPP score (R2 = 0.705), and cellularity showed a significant correlation (R2 = 0.389). The cluster analysis based on radiomic features resulted in 2 clusters, with significative differences in terms of systolic and diastolic blood pressure values at the time of diagnosis (p = 0.025), GAPP score (4 vs 6, p = 0.05), histological pattern (1-2, p = 0.039), and comedonecrosis (0% vs 50%, p = 0.013). CONCLUSION In conclusion, our study provides the proof of concept for the use of texture analysis on contrast-enhanced CT images as a noninvasive, quantitative tool for helping in the characterization of the clinical, biochemical, and histopathological features of pheochromocytoma.
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Affiliation(s)
- A De Leo
- Pathology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
| | - G Vara
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy.
| | - A Paccapelo
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
| | - C Balacchi
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
| | - V Vicennati
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Unit of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - L Tucci
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Unit of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - U Pagotto
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Unit of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - S Selva
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Division of Pancreatic Surgery, Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - C Ricci
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Division of Pancreatic Surgery, Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - L Alberici
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Division of Pancreatic Surgery, Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - F Minni
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Division of Pancreatic Surgery, Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - C Nanni
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Nuclear Medicine Unit, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - F Ambrosi
- Pathology Unit, Maggiore Hospital, Bologna, Italy
| | - D Santini
- Pathology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
| | - R Golfieri
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
| | - G Di Dalmazi
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Unit of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - C Mosconi
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
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14
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Giudice E, Ghizzoni V, Carbone M, Salutari V, Cappuccio S, Nero C, Musacchio L, Ricci C, Ciccarone F, Camarda F, Perri M, Giannarelli D, Fanfani F, Scambia G, Lorusso D. 27P Clinical relevance of NGS analysis in endometrial cancer (EC) management. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Fung SG, Fakhraei R, Condran G, Regan AK, Dimanlig-Cruz S, Ricci C, Foo D, Sarna M, Török E, Fell DB. Neuropsychiatric outcomes in offspring after fetal exposure to maternal influenza infection during pregnancy: A systematic review. Reprod Toxicol 2022; 113:155-169. [PMID: 36100136 DOI: 10.1016/j.reprotox.2022.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 05/25/2022] [Revised: 08/24/2022] [Accepted: 09/05/2022] [Indexed: 01/15/2023]
Abstract
Increasing evidence suggests that influenza infection in pregnancy may disrupt fetal neurodevelopment. The impact of maternal influenza infection on offspring neuropsychiatric health has not been comprehensively reviewed. We systematically reviewed comparative studies evaluating associations between maternal influenza infection and neuropsychiatric health outcomes in offspring. We searched MEDLINE, EMBASE, CINAHL, and Web of Science for articles published until January 7, 2022. Included were English studies evaluating neuropsychiatric outcomes in offspring aged > 6 months born to women with and without influenza during pregnancy, defined as clinical or laboratory-confirmed influenza illness, or being pregnant during pandemics/epidemics. Of 12,010 records screened, 42 studies were included. Heterogeneity in study design, exposures, and outcome definitions precluded meta-analyses. Four of 14 studies assessing schizophrenia reported adjusted ratio estimates from 0.5 to 8.2; most 95% CIs contained the null value; study quality was high in three of four. Two studies reported an increased risk of schizophrenia with influenza exposure any time during pregnancy (adjusted incidence rate ratio 8.2, 95% CI: 1.4-48.8; adjusted odds ratio 1.3, 95% CI: 1.2-1.5); another reported a reduced risk with first-trimester exposure (adjusted risk ratio 0.5, 95% CI: 0.3-0.9). Seven studies of autism spectrum disorder reported adjusted ratio estimates from 0.9 to 4.0; all 95% CIs included the null value; study quality was high in four. No conclusions could be drawn about the association between exposure to maternal influenza and neuropsychiatric outcomes due to the limited quantity and quality of available research. Large observational studies with long-term follow-up are required to investigate these associations.
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Affiliation(s)
- Stephen G Fung
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
| | - Romina Fakhraei
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada; The Ottawa Hospital Research Institute, Ottawa, ON, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Annette K Regan
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, United States; Curtin School of Population Health, Curtin University, Perth, WA, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | | | | | - Damien Foo
- Curtin School of Population Health, Curtin University, Perth, WA, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Mohinder Sarna
- Curtin School of Population Health, Curtin University, Perth, WA, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | | | - Deshayne B Fell
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
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16
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Musacchio L, Cicala CM, Camarda F, Ghizzoni V, Giudice E, Carbone MV, Ricci C, Perri MT, Tronconi F, Gentile M, Salutari V, Scambia G, Lorusso D. Combining PARP inhibition and immune checkpoint blockade in ovarian cancer patients: a new perspective on the horizon? ESMO Open 2022; 7:100536. [PMID: 35849879 PMCID: PMC9294238 DOI: 10.1016/j.esmoop.2022.100536] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/17/2022] [Accepted: 06/14/2022] [Indexed: 12/21/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) have completely reshaped the treatment of many malignancies, with remarkable improvements in survival outcomes. In ovarian cancer (OC), however, this emerging class of drugs has not yet found a favorable use due to results from phase I and II studies, which have not suggested a substantial antitumoral activity of these agents when administered as monotherapy. Robust preclinical data seem to suggest that the combination ICIs with poly(ADP-ribose) polymerase (PARP) inhibitors (PARPis) may result in a synergistic activity; furthermore, data from phase II clinical studies, evaluating this combination, have shown encouraging outcomes especially for those OC patients not suitable for platinum retreatment. While waiting for ongoing phase III clinical trial results, which will clarify the role of ICIs in combination with PARPis in the newly diagnosed OC, this review aims to summarize the preclinical data and clinical evidence available to date. Preclinical data indicate that PARPis exhibit immune modulating properties. The combination of PARPi with ICIs displays significant synergistic activity in preclinical models. Phase I and II clinical trials showed encouraging results for this combination, especially in platinum-resistant OC. Four ongoing phase III trials exploring the combination in first-line setting will delineate the role of immunotherapy in OC.
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Affiliation(s)
- L Musacchio
- Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy. https://twitter.com/lucia_musacchio
| | - C M Cicala
- Department of Medical and Surgical Science, Medical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy. https://twitter.com/carlomcicala
| | - F Camarda
- Department of Medical and Surgical Science, Medical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy. https://twitter.com/florianacamarda
| | - V Ghizzoni
- Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - E Giudice
- Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - M V Carbone
- Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - C Ricci
- Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - M T Perri
- Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - F Tronconi
- Medical Oncology Unit, Marche Polytechnic University, Ancona, Italy
| | - M Gentile
- Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy
| | - V Salutari
- Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - G Scambia
- Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Department of Life Science and Public Health, Catholic University of Sacred Heart Largo Agostino Gemelli, Rome, Italy
| | - D Lorusso
- Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Department of Life Science and Public Health, Catholic University of Sacred Heart Largo Agostino Gemelli, Rome, Italy.
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Ricci C, Poulain T, Keil J, Rothenbacher D, Genuneit J. Association of sleep quality, media use and book reading with behavioral problems in early childhood. The Ulm SPATZ Health Study. Sleep Adv 2022; 3:zpac020. [PMID: 37193390 PMCID: PMC10104402 DOI: 10.1093/sleepadvances/zpac020] [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] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/01/2022] [Indexed: 05/18/2023]
Abstract
Study Objectives The objective of the study was to investigate the association of sleep quality, media use and book reading on internalizing, externalizing and prosocial behavior in early childhood. Methods In this cross-sectional study, we investigated a data set consisting of three consecutive yearly waves of the prospective Ulm SPATZ Health Study, conducted in southern Germany with 565, 496, and 421 children of 4-6 years of age, respectively.Standardized effects of the overall score and subscales of the Children's Sleep Habits Questionnaire, parent-reported child media use and book reading as well as their interaction term on the total score of the Strengths and Difficulties Questionnaire along with its externalizing, internalizing and prosocial subscales were estimated by multivariate adjusted random intercept mixed models. Results Overall sleep quality was associated more with internalizing than externalizing behavior; parasomnias associated with both behaviors. Night waking and sleep anxiety associated only with internalizing behavior. High levels of media use were associated with less internalizing behavior. More book reading resulted in less externalizing and internalizing behavior but more prosocial behavior. Finally, book reading and media use do not interact to determine child's behavior. Conclusions The current work supports a strategy of monitoring sleep quality, reducing media use and promoting book reading in order to avoid behavioral problems in early childhood.
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Affiliation(s)
- C Ricci
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - T Poulain
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Germany
| | - J Keil
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Leipzig , Leipzig, Germany
| | - D Rothenbacher
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - J Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
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Scambia G, Salutari V, Musacchio L, Siena S, Pignata S, Zavallone L, Valabrega G, Cormio G, Mosconi A, Ricci C, Ghizzoni V, Carbone M, Giudice E, Camarda F, Nero C, Tronconi F, Lorusso D. 45TiP A randomized, molecular driven phase II trial of carboplatin-paclitaxel-bev vs carboplatin-paclitaxel-bev-rucaparib vs carboplatin-paclitaxel-rucaparib, selected according to HRD status, in patients with advanced ovarian cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.063] [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] Open
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19
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Andreasi V, Ricci C, Partelli S, Guarneri G, Ingaldi C, Muffatti F, Crippa S, Casadei R, Falconi M. Predictors of disease recurrence after curative surgery for nonfunctioning pancreatic neuroendocrine neoplasms (NF-PanNENs): a systematic review and meta-analysis. J Endocrinol Invest 2022; 45:705-718. [PMID: 34773595 DOI: 10.1007/s40618-021-01705-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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: 07/26/2021] [Accepted: 11/03/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE Patients submitted to curative surgery for non-functioning pancreatic neuroendocrine neoplasms (NF-PanNENs) exhibit a variable risk of disease relapse. Aims of this meta-analysis were to estimate the rate of disease recurrence and to investigate the risk factors for disease relapse in patients submitted to curative surgery for NF-PanNENs. METHODS Medline/Pubmed and Web of Science databases were searched for relevant studies. A meta-regression analysis was performed to investigate the source of recurrence rate heterogeneity. Pooled hazard ratios (HRs) and 95% confidence intervals (95% CI) were used to assess the effect of each possible prognostic factor on disease-free survival. RESULTS Fifteen studies, involving 2754 patients submitted to curative surgery for NF-PanNENs, were included. The pooled rate of disease recurrence was 21% (95% CI 15-26%). Study quality (Odds ratio, OR 0.94, P = 0.016) and G3-PanNENs rate (OR 2.18, P = 0.040) independently predicted the recurrence rate variability. Nodal metastases (HR 1.63, P < 0.001), tumor grade G2-G3 (G1 versus G2: HR 1.72, P < 0.001, G1 versus G3 HR 2.57, P < 0.001), microvascular (HR 1.25, P = 0.046) and perineural (HR 1.29, P = 0.019) invasion were identified as significant prognostic factors. T stage (T1-T2 versus T3-T4, P = 0.253) and status of resection margins (R0 versus R1, P = 0.173) did not show any significant relationship with NF-PanNENs recurrence. CONCLUSION Disease relapse occurs in approximately one out of five patients submitted to curative surgery for NF-PanNENs. Nodal involvement, tumor grade, microvascular and perineural invasion are relevant prognostic factors, that should be taken into account for follow-up and for possible trials investigating adjuvant or neoadjuvant treatments.
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Affiliation(s)
- V Andreasi
- Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, San Raffaele Hospital Neuroendocrine Tumor Group (ENETS Center of Excellence), IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
| | - C Ricci
- Division of Pancreatic Surgery, IRCCS Azienda Ospedaliero Universitaria Di Bologna, Bologna, Italy
- Department of Internal Medicine and Surgery (DIMEC), S. Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - S Partelli
- Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, San Raffaele Hospital Neuroendocrine Tumor Group (ENETS Center of Excellence), IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy.
| | - G Guarneri
- Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, San Raffaele Hospital Neuroendocrine Tumor Group (ENETS Center of Excellence), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - C Ingaldi
- Division of Pancreatic Surgery, IRCCS Azienda Ospedaliero Universitaria Di Bologna, Bologna, Italy
- Department of Internal Medicine and Surgery (DIMEC), S. Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - F Muffatti
- Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, San Raffaele Hospital Neuroendocrine Tumor Group (ENETS Center of Excellence), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - S Crippa
- Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, San Raffaele Hospital Neuroendocrine Tumor Group (ENETS Center of Excellence), IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
| | - R Casadei
- Division of Pancreatic Surgery, IRCCS Azienda Ospedaliero Universitaria Di Bologna, Bologna, Italy
- Department of Internal Medicine and Surgery (DIMEC), S. Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - M Falconi
- Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, San Raffaele Hospital Neuroendocrine Tumor Group (ENETS Center of Excellence), IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
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Ledlie S, Ricci C, Pan C, Rojas A, Khromava A, Li L. Yellow fever vaccine usage in the United States and risk of neurotropic and viscerotropic disease: A retrospective cohort study using three healthcare databases. Vaccine 2022; 40:742-751. [PMID: 34996642 DOI: 10.1016/j.vaccine.2021.12.047] [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: 09/02/2021] [Revised: 12/10/2021] [Accepted: 12/20/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Yellow fever (YF) vaccines are highly effective and have a well-established safety profile despite the risk of rare serious adverse events (SAEs), vaccine-associated neurotropic (YEL-AND) and viscerotropic disease (YEL-AVD). This study aimed to describe US civilian YF vaccine usage, the population characteristics and pre-existing immunosuppressive medical conditions among those vaccinated, and to provide updated risk estimates of neurotropic and viscerotropic disease post-vaccination. METHODS A retrospective cohort study was conducted using de-identified patient information from Optum Electronic Healthcare Record (EHR) (2007-2019), Optum Clinformatics Data Mart (CDM) (2004-2019) and IBM MarketScan (2007-2019) databases. YF vaccine recipients were identified using relevant vaccination and procedural codes. Demographic characteristics and pre-existing medical conditions were described. Incidence proportions with 95% confidence intervals (CI) of neurotropic and viscerotropic diseases occurring ≤ 30 days post-vaccination, after exclusion of unlikely cases based on current clinical guidelines of YEL-AND and YEL-AVD, were calculated. RESULTS A total of 92,205, 46,539 and 125,235 YF vaccine recipients were retrieved from Optum EHR, Optum CDM and IBM MarketScan databases, respectively. The majority of vaccine recipients were aged < 60 years (highest proportion aged 18-29 years) with a higher proportion of females overall. Few vaccine recipients (<1%) had conditions predisposing them to immunosuppression. Four non-fatal cases of neurotropic disease and zero cases of viscerotropic disease were identified. The incidence proportion of post-vaccination neurotropic disease was 1.41 (95% CI: 0.15-6.61) and 3.04 (95% CI: 0.86-8.11) per 100,000 vaccine recipients in Optum EHR and IBM MarketScan, respectively, with no events identified in Optum CDM. CONCLUSIONS This study provides updated insights into current YF vaccine usage in US civilian recipients and supports the safety profile of YF vaccines in US practice. The low frequency of pre-existing immunosuppressive medical conditions among vaccine recipients suggests good adherence to vaccination guidelines by healthcare practitioners. The risk of developing neurotropic and viscerotropic disease post-vaccination remains rare.
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Affiliation(s)
- Shaleesa Ledlie
- Epidemiology and Benefit Risk, Sanofi Pasteur, North York, Ontario, Canada.
| | - Christina Ricci
- Epidemiology and Benefit Risk, Sanofi Pasteur, North York, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - Chunshen Pan
- Epidemiology and Benefit Risk, Sanofi US, Bridgewater, NJ, USA.
| | - Andrey Rojas
- Global Pharmacovigilance, Sanofi Pasteur, Bogota, Colombia.
| | - Alena Khromava
- Epidemiology and Benefit Risk, Sanofi Pasteur, North York, Ontario, Canada.
| | - Lin Li
- Epidemiology and Benefit Risk, Sanofi US, Bridgewater, NJ, USA.
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Ricci C, Rothenbacher D, Genuneit J. Media use in association to sleep quality in German preschoolers. A mediation analysis based on the Ulm SPATZ Health Study. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732745] [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: 10/20/2022]
Affiliation(s)
- C Ricci
- Pädiatrische Epidemiologie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Medizinische Fakultät, Universität Leipzig
| | - D Rothenbacher
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm
| | - J Genuneit
- Pädiatrische Epidemiologie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Medizinische Fakultät, Universität Leipzig
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Lo Preiato V, Salvagni S, Ricci C, Ardizzoni A, Pagotto U, Pelusi C. Diabetes mellitus induced by immune checkpoint inhibitors: type 1 diabetes variant or new clinical entity? Review of the literature. Rev Endocr Metab Disord 2021; 22:337-349. [PMID: 33409866 DOI: 10.1007/s11154-020-09618-w] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [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] [Accepted: 11/24/2020] [Indexed: 12/16/2022]
Abstract
Immune Check-Point Inhibitors (CPIs) have improved long-term patients' outcomes in several advanced cancers. Diabetes mellitus induced by CPIs (CPI-DM) is considered the second most frequent endocrine CPIs' side effects with a variable prevalence up to 2%. The aim of our study was to identify CPI-DM characteristics and differences from the classical form of diabetes. Therefore, we conducted a structured Pubmed® search collecting publications dated from January 2015 to December 2019. A total of 642 citations were identified and 121 publications met our study criteria. We analyzed 200 case reports, including our 3 cases under publication. The majority of CPI-DM occurred with anti-Programmed cell Death-1 in monotherapy or in combination, although few cases with Programmed cell Death Ligand-1 and Cytotoxic T Lymphocyte Antigen 4 were reported. Generally, CPI-DM arose early (an average of 9 weeks after CPIs starting), but also after the end of CPIs treatment. In all patients, CPI-DM has an acute onset and in 67.5% of cases diabetic ketoacidosis occurs. C-peptide levels were usually and permanently compromised, requiring lifelong insulin therapy. Moreover, autoimmunity and genetic profile was not always helpful. In particular, anti-glutamic acid decarboxylase (anti-GAD) antibodies and Human Leukocyte Antigen (HLA) DR4 were present in only 43.0% and 51.3% of cases respectively. In 51.0% of subjects a mild exocrine impairment coexisted. In short, though CPI-DM has similarities to type 1 diabetes mellitus, it represents a new, largely unknown, clinical entity. In addition, as CPI-DM is a relative frequent side-effect under CPI, a close monitoring of the glucose levels and early signs and symptoms of diabetes in patients affected by neoplasm is recommended.
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Affiliation(s)
- V Lo Preiato
- Endocrinology Unit and Prevention and Care of Diabetes, Department of Medical and Surgical Science (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola Hospital, Via Massarenti 9, 40138, Bologna, Italy
| | - S Salvagni
- Division of Medical Oncology, Department of Experimental Diagnostic and Speciality Medicine (DIMES), Alma Mater Studiorum, University of Bologna, S. Orsola Hospital, Bologna, Italy
| | - C Ricci
- Surgical Department, Department of Medical and Surgical Science (DIMEC), Alma Mater Studiorum, University of Bologna, Sant'Orsola Hospital, Bologna, Italy
| | - A Ardizzoni
- Division of Medical Oncology, Department of Experimental Diagnostic and Speciality Medicine (DIMES), Alma Mater Studiorum, University of Bologna, S. Orsola Hospital, Bologna, Italy
| | - U Pagotto
- Endocrinology Unit and Prevention and Care of Diabetes, Department of Medical and Surgical Science (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola Hospital, Via Massarenti 9, 40138, Bologna, Italy.
| | - C Pelusi
- Endocrinology Unit and Prevention and Care of Diabetes, Department of Medical and Surgical Science (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola Hospital, Via Massarenti 9, 40138, Bologna, Italy
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Ricci C, Partelli S, Landoni L, Rinzivillo M, Ingaldi C, Andreasi V, Nessi C, Muffatti F, Fontana M, Tamburrino D, Deiro G, Alberici L, Campana D, Panzuto F, Bassi C, Falconi M, Casadei R. Sporadic non-functioning pancreatic neuroendocrine tumours: multicentre analysis. Br J Surg 2021; 108:811-816. [PMID: 33724300 DOI: 10.1093/bjs/znaa141] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/05/2020] [Accepted: 11/24/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Outcomes after surgery for sporadic pancreatic neuroendocrine neoplasms (Pan-NENs) were evaluated. METHODS This multicentre study included patients who underwent radical pancreatic resection for sporadic non-functioning Pan-NENs. In survival analysis, the risk of mortality in this cohort was analysed in relation to that of the matched healthy Italian population. Relative survival (RS) was calculated as the rate between observed and expected survival. Factors related to RS were investigated using multivariable modelling. RESULTS Among 964 patients who had pancreatic resection for sporadic non-functioning Pan-NENs, the overall RS rate was 91.8 (95 per cent c.i. 81.5 to 96.5) per cent. 2019 WHO grade (hazard ratio (HR) 5.75 (s.e. 4.63); P = 0.030) and European Neuroendocrine Tumour Society (ENETS) TNM stage (6.73 (3.61); P < 0.001) were independent predictors of RS. The probability of a normal lifespan for patients with G1, G2, G3 Pan-NENS, and pancreatic neuroendocrine carcinomas (Pan-NECs) was 96.7, 54.8, 0, and 0 per cent respectively. The probability of a normal lifespan was 99.8, 99.3, 79.8, and 46.8 per cent for those with stage I, II, III, and IV disease respectively. The overall disease-free RS rate was 73.6 (65.2 to 79.5) per cent. 2019 WHO grade (HR 2.10 (0.19); P < 0.001) and ENETS TNM stage (HR 2.50 (0.24); P < 0.001) significantly influenced disease-free RS. The probability of disease-free survival was 93.2, 84.9, 45.2, and 6.8 per cent for patients with stage I, II, III, and IV disease, and 91.9, 45.2, 9.4, and 0.7 per cent for those with G1, G2, G3 Pan-NENS, and Pan-NECs, respectively. CONCLUSION A surgical approach seems without benefit for Pan-NECs, and unnecessary for small G1 sporadic Pan-NENs. Surgery alone may be insufficient for stage III-IV and G3 Pan-NENs.
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Affiliation(s)
- C Ricci
- Division of Pancreatic Surgery, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of Internal Medicine and Surgery; Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - S Partelli
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute, Milan, Italy.,'Vita-Salute' San Raffaele University, Milan, Italy
| | - L Landoni
- General and Pancreatic Surgery Department, Pancreas Institute-University of Verona Hospital Trust, Verona, Italy
| | - M Rinzivillo
- Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy
| | - C Ingaldi
- Division of Pancreatic Surgery, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of Internal Medicine and Surgery; Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - V Andreasi
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute, Milan, Italy.,'Vita-Salute' San Raffaele University, Milan, Italy
| | - C Nessi
- General and Pancreatic Surgery Department, Pancreas Institute-University of Verona Hospital Trust, Verona, Italy
| | - F Muffatti
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute, Milan, Italy.,'Vita-Salute' San Raffaele University, Milan, Italy
| | - M Fontana
- General and Pancreatic Surgery Department, Pancreas Institute-University of Verona Hospital Trust, Verona, Italy
| | - D Tamburrino
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute, Milan, Italy
| | - G Deiro
- General and Pancreatic Surgery Department, Pancreas Institute-University of Verona Hospital Trust, Verona, Italy
| | - L Alberici
- Division of Pancreatic Surgery, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of Internal Medicine and Surgery; Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - D Campana
- Division of Pancreatic Surgery, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Division of Oncology, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - F Panzuto
- Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy
| | - C Bassi
- General and Pancreatic Surgery Department, Pancreas Institute-University of Verona Hospital Trust, Verona, Italy
| | - M Falconi
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute, Milan, Italy.,'Vita-Salute' San Raffaele University, Milan, Italy
| | - R Casadei
- Division of Pancreatic Surgery, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of Internal Medicine and Surgery; Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Ricci C, Kakularam KR, Marzocchi C, Capecchi G, Riolo G, Boschin F, Kuhn H, Castagna MG, Cantara S. Thr92Ala polymorphism in the type 2 deiodinase gene: an evolutionary perspective. J Endocrinol Invest 2020; 43:1749-1757. [PMID: 32436183 DOI: 10.1007/s40618-020-01287-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/30/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE In the past, a role of thyroid hormones in human evolution has been hypothesized. T3, the metabolically active form, derives from extrathyroidal conversion of T4 by deionidase 2 (D2) enzyme encoded by DIO2 gene. In thyroid-deficient patients, decreased levels of free T3 have been associated with the polymorphism rs225014 A/G in DIO2, which causes the substitution of Threonine with Alanine (p.Thr92Ala) at protein level. METHODS We compared DNA and protein sequences of D2 from archaic human subspecies with those of contemporary humans. RESULTS Neanderthals and Denisovans displayed only the G allele at the rs225014 polymorphism, which encodes for an Alanine on the amino acid level. These data suggest that these hominines were homozygous for the Ala amino acid. These arcaic humans often lived in condition of iodine deficiency and thus, defective mechanisms of T3 biosynthesis could be life threatining. A reduced D2 activity is likely to cause decreased T3 levels, which could be critical for those individuals. Neanderthals and Denisovans were hunters/gatherers, and their diet was mainly based on the consumption of meat, with a low intake of carbohydrates. The need for circulating T3 is reduced at such alimentary conditions. On the basis of our genome comparisons the A allele, corresponding to Threonine and associated with higher levels of circulating T3 in thyroid-deficient patients, appeared for the first time during evolution in Anatomically Modern Humans during the Upper Pleistocene and has been conserved during the Neolithic age. With the advent of agriculture and herding, individuals carrying A allele might have a higher probability for surviving and reproducing. Thus, the variant was positively selected during the evolution. CONCLUSION Here we present an evolutionary perspective for p.Thr92Ala variant of D2 from Neanderthals to Anatomically Modern Humans.
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Affiliation(s)
- C Ricci
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale Bracci 16, 53100, Siena, Italy
| | - K R Kakularam
- Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Institute of Biochemistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - C Marzocchi
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale Bracci 16, 53100, Siena, Italy
| | - G Capecchi
- Department of Physical Sciences, Earth and Environment, University of Siena, Siena, Italy
| | - G Riolo
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale Bracci 16, 53100, Siena, Italy
| | - F Boschin
- Department of Physical Sciences, Earth and Environment, University of Siena, Siena, Italy
| | - H Kuhn
- Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Institute of Biochemistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - M G Castagna
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale Bracci 16, 53100, Siena, Italy
| | - S Cantara
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale Bracci 16, 53100, Siena, Italy.
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Filippini DM, Grassi E, Palloni A, Carloni R, Casadei R, Ricci C, Serra C, Ercolani G, Brandi G, Di Marco M. Searching for novel multimodal treatments in oligometastatic pancreatic cancer. BMC Cancer 2020; 20:271. [PMID: 32228504 PMCID: PMC7106565 DOI: 10.1186/s12885-020-06718-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 03/05/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Metastatic pancreatic cancer has a median overall survival of less than 12 months, even if treated with chemotherapy. Selected patients with oligometastatic disease could benefit from multimodal treatments connecting chemotherapy and surgical treatment or radiofrequency ablation (RFA) of metastases. CASE PRESENTATION We present a patient with oligometastatic pancreatic cancer recurrence who was successfully treated with a multimodal therapeutic approach. A 57-year-old male initially presenting with resectable pancreatic cancer underwent pancreatoduodenectomy. The histopathological diagnosis revealed ductal pancreatic adenocarcinoma with positive surgical resection margins and negative lymph nodes. He completed six cycles of adjuvant therapy with gemcitabine (1000 mg/mq 1,8,15q 28), followed by external radiotherapy (54 Gy in 25 fractions) associated with gemcitabine 50 mg/mq twice weekly. Three years later, the patient developed multiple liver metastases, and he started FOLFIRINOX (oxaliplatin 85 mg/mq, irinotecan 180 mg/mq, leucovorin 400 mg/mq and fluorouracil 400 mg/mq given as a bolus followed by 2400 mg/mq as a 46 h continuous infusion,1q 14) as a first-line treatment. The CT scan showed a partial response after 6 cycles. After multidisciplinary discussion, the patient underwent a laparotomic metastasectomy of the three hepatic lesions. After additional postsurgical chemotherapy with 4 cycles of the FOLFIRINOX schedule, the patient remained free of recurrence for 12 months. A CT scan showed a new single liver metastasis, which was treated with radiofrequency ablation (RFA). A second radiofrequency ablation was performed when the patient developed another single liver lesion 12 months after the first RFA; currently, the patient is free from recurrence with an overall survival of 6 years from the diagnosis. CONCLUSIONS Our case has benefited from successful multimodal treatment, including surgical and local ablative techniques and systemic chemotherapy. A multimodal approach may be warranted in selected patients with oligometastatic pancreatic cancer and could improve overall survival. Further research is needed to investigate this approach.
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Affiliation(s)
- D M Filippini
- Department of Experimental, Diagnostic and Specialty Medicine University of Bologna, Sant'Orsola-Malpighi Hospital, Massarenti Street 11, 40100, Bologna, Italy
| | - E Grassi
- Department of Experimental, Diagnostic and Specialty Medicine University of Bologna, Sant'Orsola-Malpighi Hospital, Massarenti Street 11, 40100, Bologna, Italy.
| | - A Palloni
- Department of Experimental, Diagnostic and Specialty Medicine University of Bologna, Sant'Orsola-Malpighi Hospital, Massarenti Street 11, 40100, Bologna, Italy
| | - R Carloni
- Department of Experimental, Diagnostic and Specialty Medicine University of Bologna, Sant'Orsola-Malpighi Hospital, Massarenti Street 11, 40100, Bologna, Italy
| | - R Casadei
- Department of Medical and Surgical Sciences, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - C Ricci
- Department of Medical and Surgical Sciences, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - C Serra
- Department of Organ Failure and Transplantation, Ultrasound Unit, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - G Ercolani
- Department of Medical and Surgical Sciences, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy.,General and Oncologic Surgery, Morgagni-Pierantoni Hospital, AUSL Romagna, Forlì, Italy
| | - G Brandi
- Department of Experimental, Diagnostic and Specialty Medicine University of Bologna, Sant'Orsola-Malpighi Hospital, Massarenti Street 11, 40100, Bologna, Italy
| | - M Di Marco
- Department of Experimental, Diagnostic and Specialty Medicine University of Bologna, Sant'Orsola-Malpighi Hospital, Massarenti Street 11, 40100, Bologna, Italy
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Preez GD, Fourie H, Daneel M, Miller H, Höss S, Ricci C, Engelbrecht G, Zouhar M, Wepener V. Oxygen consumption rate of Caenorhabditis elegans as a high-throughput endpoint of toxicity testing using the Seahorse XF e96 Extracellular Flux Analyzer. Sci Rep 2020; 10:4239. [PMID: 32144330 PMCID: PMC7060326 DOI: 10.1038/s41598-020-61054-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 02/17/2020] [Indexed: 12/25/2022] Open
Abstract
Caenorhabditis elegans presents functioning, biologically relevant phenotypes and is frequently used as a bioindicator of toxicity. However, most C. elegans in vivo effect-assessment methods are laborious and time consuming. Therefore, we developed a novel method to measure the oxygen consumption rate of C. elegans as a sublethal endpoint of toxicity. This protocol was tested by exposing 50 larval stage one C. elegans individuals for 48 h (at 20 °C) to different concentrations of two toxicants i.e. benzylcetyldimethylammonium chloride (BAC-C16) and cadmium (Cd). Following exposures, the oxygen consumption rate of the C. elegans individuals were measured using the high-throughput functionality of the Seahorse XFe96 Extracellular Flux Analyzer. Dose-response curves for BAC-C16 (R2 = 0.93; P = 0.001) and Cd (R2 = 0.98; P = 0.001) were created. Furthermore, a strong, positive correlation was evidenced between C. elegans oxygen consumption rate and a commonly used, ecologically relevant endpoint of toxicity (growth inhibition) for BAC-C16 (R2 = 0.93; P = 0.0001) and Cd (R2 = 0.91; P = 0.0001). The data presented in this study show that C. elegans oxygen consumption rate can be used as a promising functional measurement of toxicity.
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Affiliation(s)
- G Du Preez
- Unit for Environmental Sciences and Management, North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa.
- Agricultural Research Council - Institute for Tropical and Subtropical Crops, Private Bag X11208, Nelspruit, 1200, South Africa.
| | - H Fourie
- Unit for Environmental Sciences and Management, North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
| | - M Daneel
- Agricultural Research Council - Institute for Tropical and Subtropical Crops, Private Bag X11208, Nelspruit, 1200, South Africa
| | - H Miller
- Human Metabolomics, Faculty of Natural Sciences, North-West University, Potchefstroom, 2520, South Africa
| | - S Höss
- Ecossa, Giselastrasse 6, 82319, Starnberg, Germany
- University of Bielefeld, Department of Animal Ecology, Konsequenz 45, 33615, Bielefeld, Germany
| | - C Ricci
- Centre of Excellence for Nutrition (CEN), North-West University, Potchefstroom, South Africa
- Pediatric Epidemiology, Department of Pediatrics, University Medicine Leipzig, Leipzig, Germany
| | - G Engelbrecht
- Unit for Environmental Sciences and Management, North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
| | - M Zouhar
- Unit for Environmental Sciences and Management, North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
- Czech University of Life Sciences, Faculty of Agrobiology, Food and Natural Resources, Department of Plant Protection, Kamycka 129, 165 21, Prague, Czech Republic
| | - V Wepener
- Unit for Environmental Sciences and Management, North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
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Ricci C, Righi A, Ambrosi F, Gibertoni D, Maletta F, Uccella S, Sessa F, Asioli S, Pellilli M, Maragliano R, La Rosa S, Papotti MG, Asioli S. Prognostic Impact of MCPyV and TIL Subtyping in Merkel Cell Carcinoma: Evidence from a Large European Cohort of 95 Patients. Endocr Pathol 2020; 31:21-32. [PMID: 31808008 DOI: 10.1007/s12022-019-09601-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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] [Indexed: 12/20/2022]
Abstract
Merkel cell carcinoma is a rare (∼ 2000 cases/year in the USA) but aggressive neuroendocrine neoplasm of the skin. In 2008, the Merkel cell polyomavirus (MCPyV) was found to be clonally integrated in approximately 80% of Merkel cell carcinomas. The remaining 20% have large numbers of UV-associated mutations. Importantly, both the UV-induced neoantigens in virus-negative Merkel cell carcinoma and the Merkel cell polyomavirus oncogenes that are required for virus-positive tumor growth are highly immunogenic. Indeed, antigen-specific T cells detected in patients are frequently "dysfunctional/exhausted," and the inhibitory ligand PD-L1 is often expressed by Merkel cell carcinoma cells. These data led to point our attention on the quantity and the quality of the immune response in Merkel cell carcinoma. Here, we found CD8+ lymphocytes are the only singly evaluated lymphocyte subclass that strongly influenced overall survival and disease-specific survival in Merkel cell carcinoma. In addition, we highlighted as Merkel cell polyomavirus is a strong prognostic factor and as it prompts a host immune response involving various lymphocyte subclasses (CD3, CD8, FoxP3, and PD-L1 positive) in MCC. For this reason, we proposed a novel eye-based "immunoscore" model, obtained by tumor infiltrating lymphocytes subtyping (CD3, CD8, FoxP3, and PD-L1) that could provide additional prognostic information in Merkel cell carcinoma.
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Affiliation(s)
- C Ricci
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology "M. Malpighi", Bellaria Hospital, 40139, Bologna, Italy
| | - A Righi
- Department of Pathology, Rizzoli Institute, 40136, Bologna, Italy
| | - F Ambrosi
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology "M. Malpighi", Bellaria Hospital, 40139, Bologna, Italy
| | - D Gibertoni
- Department of Biomedical and Neuromotor Sciences, Unit of Hygiene and Biostatistics, University of Bologna, 40126, Bologna, Italy
| | - F Maletta
- Department of Oncology, University of Turin at Città della Salute Hospital, 10124, Turin, Italy
| | - S Uccella
- Unit of Pathology, Department of Medicine and Surgery, University of Insubria, 21100, Varese, Italy
| | - F Sessa
- Unit of Pathology, Department of Medicine and Surgery, University of Insubria, 21100, Varese, Italy
| | - S Asioli
- Department of Pathology, Morgagni-Pierantoni Hospital, 47121, Forlì, Italy
| | - M Pellilli
- Unit of Pathology, Department of Medicine and Surgery, University of Insubria, 21100, Varese, Italy
| | - R Maragliano
- Unit of Pathology, Department of Medicine and Surgery, University of Insubria, 21100, Varese, Italy
| | - S La Rosa
- Service of Clinical Pathology, Institute of Pathology, Lausanne University Hospital and University of Lausanne, CH-1011, Lausanne, Switzerland
| | - M G Papotti
- Department of Oncology, University of Turin at Città della Salute Hospital, 10124, Turin, Italy
| | - S Asioli
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology "M. Malpighi", Bellaria Hospital, 40139, Bologna, Italy.
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Ricci C, Scaldaferri F, Colombo F, Armuzzi A, Lopetuso LR, Leone S, Gasbarrini A, Scambia G, De Vincenzo RP. Prevalence of cervical HPV and attitude towards cervical screening in IBD patients under immunomodulatory treatment: a multidisciplinary management experience. Eur Rev Med Pharmacol Sci 2020; 24:564-570. [PMID: 32016957 DOI: 10.26355/eurrev_202001_20032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Therapeutic strategies for Inflammatory Bowel Diseases (IBD: Crohn's disease and Ulcerative Colitis) have improved but the risk for HPV infection in patients under immunomodulatory/biologic treatment is unclear. Objective of the study is to identify the attitude of patients and caregivers to cervical screening. To determine the prevalence of HPV and cervical lesions in IBD patients receiving immunomodulatory/biological treatment. PATIENTS AND METHODS IBD patients treated with immunomodulators were enrolled from November 2016 to September 2017, thanks to a multidisciplinary cooperation. A survey was administered to enrolled patients as well as to a selected network of IBD expert physicians. Patients who consented underwent gynecological examination, smear, HPV DNA test, colposcopy, vaginal and cervical microbiological swabs. RESULTS 294 patients from AMICI Onlus Association, 119 patients from the hospital clinic, 30 doctors from national IBD centers participated to the survey. 19 patients from the IBD clinic underwent cervical screening. More than 90% of doctors consider their patients at risk of cervical cancer. A low prevalence of high-risk genotypes and related HPV lesions and an increased prevalence of bacterial vaginosis emerged in the studied population. CONCLUSIONS Biological drugs could lead to a positive immunomodulation towards HPV infection. In IBD patients an alteration of the vaginal and intestinal microbiota seems to be coexisting.
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Affiliation(s)
- C Ricci
- Department of Woman and Child Health and Public Health, Woman Health Area, Division of Gynecologic Oncology, Fondazione Policlinico A. Gemelli - IRCCS, Rome, Italy.
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Cantara S, Ricci C, Maino F, Marzocchi C, Pacini F, Castagna MG. Variants in MCT10 protein do not affect FT3 levels in athyreotic patients. Endocrine 2019; 66:551-556. [PMID: 31280469 DOI: 10.1007/s12020-019-02001-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 03/29/2019] [Accepted: 06/29/2019] [Indexed: 02/05/2023]
Abstract
PURPOSE Several single-nucleotide polymorphisms in genes encoding for transporters have been associated with serum thyroid hormone concentrations with inconsistent results. The aim of this study was to assess the clinical significance of the rs17606253 in SLC16A10 gene alone and in combination with the DIO2 Thr92Ala variation in athyreotic patients. METHODS One-hundred patients submitted to total thyroidectomy and treated with levothyroxine were included. Pre- and post surgical serum TSH levels did not differ by more than ± 0.5 mIU/l. RESULTS Both patients carrying the wild-type allele or heterozygous for rs17606253 in SLC16A10 gene had a significant reduction in FT3 post surgical levels (p = 0.01 and p < 0.0001, respectively) while Thr92Ala in DIO2 gene was associated with reduced FT3 levels for heterozygous and rare homozygous patients (p < 0.0001 and p = 0.01, respectively). We identified two groups ("FT3 unchanged" and "FT3 reduced") using a cutoff of at least 0.5 pg/ml as a significant variation between pre- and post surgical FT3 values. In this case, the rs17606253 was not statistically associated with reduced FT3 levels at genotype and allele levels. On the contrary, the Thr92Ala in DIO2 gene was confirmed statistically associated with reduced FT3 levels after surgery with a p = 0.035 at genotype level and p = 0.014 at allele level. CONCLUSIONS We confirmed the role of DIO2 Thr92Ala polymorphism on T3 levels. On the contrary, SLC16A1 rs17606253 polymorphism did not impair hormone levels in athyreotic patients treated with levothyroxine therapy.
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Affiliation(s)
- S Cantara
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
| | - C Ricci
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - F Maino
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - C Marzocchi
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - F Pacini
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - M G Castagna
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
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Gatta L, Scarpignato C, Fiorini G, Belsey J, Saracino IM, Ricci C, Vaira D. Impact of primary antibiotic resistance on the effectiveness of sequential therapy for Helicobacter pylori infection: lessons from a 5-year study on a large number of strains. Aliment Pharmacol Ther 2018. [PMID: 29536561 DOI: 10.1111/apt.14597] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND The increasing prevalence of strains resistant to antimicrobial agents is a critical issue in the management of Helicobacter pylori (H. pylori) infection. AIMS (1) To evaluate the prevalence of primary resistance to clarithromycin, metronidazole and levofloxacin (2) to assess the effectiveness of sequential therapy on resistant strains (3) to identify the minimum number of subjects to enrol for evaluating the effectiveness of an eradication regimen in patients harbouring resistant strains. METHODS Consecutive 1682 treatment naïve H. pylori-positive patients referred for upper GI endoscopy between 2010 and 2015 were studied and resistances assessed by E-test. Sequential therapy was offered, effectiveness evaluated and analysed. RESULTS H. pylori-primary resistance to antimicrobials tested was high, and increased between 2010 and 2015. Eradication rates were (estimates and 95% CIs): 97.3% (95.6-98.4) in strains susceptible to clarithromycin and metronidazole; 96.1% (91.7-98.2) in strains resistant to metronidazole but susceptible to clarithromycin; 93.4% (88.2-96.4) in strains resistant to clarithromycin but susceptible to metronidazole; 83.1% (77.7-87.3) in strains resistant to clarithromycin and metronidazole. For any treatment with a 75%-85% eradication rate, some 98-144 patients with resistant strains need to be studied to get reliable information on effectiveness in these patients. CONCLUSIONS H. pylori-primary resistance is increasing and represents the most critical factor affecting effectiveness. Sequential therapy eradicated 83% of strains resistant to clarithromycin and metronidazole. Reliable estimates of the effectiveness of a given regimen in patients harbouring resistant strains can be obtained only by assessing a large number of strains.
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Affiliation(s)
- L Gatta
- Gastroenterogy Unit, Versilia Hospital, Azienda USL Toscana Nord Ovest, Lido di Camaiore, Italy.,Clinical Pharmacology and Digestive Pathophysiology Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - C Scarpignato
- Clinical Pharmacology and Digestive Pathophysiology Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - G Fiorini
- Department of Medical and Surgical Sciences, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | | | - I M Saracino
- Department of Medical and Surgical Sciences, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - C Ricci
- Gastroenterology Unit, 'Spedali Civili' Hospital, University of Brescia, Brescia, Italy
| | - D Vaira
- Department of Medical and Surgical Sciences, S. Orsola Hospital, University of Bologna, Bologna, Italy
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Rendina EA, Pescarmona EO, Venuta F, Nardi S, De Rosa G, Martelli M, Ricci C. Thymoma: A Clinico-Pathologic Study Based on Newly Developed Morphologic Criteria. Tumori 2018; 74:79-84. [PMID: 3354066 DOI: 10.1177/030089168807400114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A retrospective study of 28 cases of thymoma classified according to Marino and Müller-Hermelink (cortical, medullary, mixed common, mixed with cortical predominance, mixed with medullary predominance thymoma) was undertaken to determine the existence of correlations between histology and clinical behavior. Cortical thymoma was observed in 11 cases (39.2%), mixed common thymoma in 9 (32.1%), mixed with cortical predominance in 5 (18%), and medullary thymoma in 3 (10.7%). In patients with cortical thymoma the tumor was always invasive (stages II and III according to Bergh), whereas medullary thymomas were noninvasive in 2 cases (stage I) and slightly invasive with a moderate infiltration of the capsule in the remaining case (stage II). Mixed common and mixed with cortical predominance thymomas displayed intermediate behavior. Twelve patients were affected by myasthenia gravis: 1 had medullary thymoma, 6 had mixed common thymoma, 3 had mixed thymoma with cortical predominance, and 2 had cortical thymoma. One patient with cortical thymoma had superior vena cava syndrome and 1 had erythroid hypoplasia; mixed common thymoma was associated with Cushing's syndrome in 1 patient. These data confirm previously reported observations (16) showing a higher degree of malignancy in patients with cortical thymoma.
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Affiliation(s)
- E A Rendina
- Thoracic Surgery, University of Rome, La Sapienza, Italia
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Gates-Ferris K, Culler TA, Senter L, Ricci C, Huber D. Abstract P4-10-10: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-10-10] [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
This abstract was withdrawn by the authors.
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Affiliation(s)
- K Gates-Ferris
- CAI Global, New York, NY; Avon Breast Cancer Crusade, New York, NY
| | - TA Culler
- CAI Global, New York, NY; Avon Breast Cancer Crusade, New York, NY
| | - L Senter
- CAI Global, New York, NY; Avon Breast Cancer Crusade, New York, NY
| | - C Ricci
- CAI Global, New York, NY; Avon Breast Cancer Crusade, New York, NY
| | - D Huber
- CAI Global, New York, NY; Avon Breast Cancer Crusade, New York, NY
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Dokollari A, Cameli M, Sassi CG, Davoli G, Scolletta S, Ricci C, Lucatelli P, Mondillo S, Maccherini M. Case Report: Aortic Valve Replacement After JARVIK 2000 Left Ventricular Assist Device Implantation in Long-Time Survivor With Severe Aortic Valve Regurgitation. Transplant Proc 2017; 49:729-732. [PMID: 28457382 DOI: 10.1016/j.transproceed.2017.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND There are limited clinical records in the literature regarding aortic valve replacement in left ventricular assist device (L-VAD) patients. Previously we had two cases of severe aortic valve regurgitation in patients with L-VAD support treated with Corvalve prosthesis insertion and Amplatzer closure procedure. Both patients died a few days after the procedure from complications not related to the procedure itself. PATIENT HISTORY The patient was a male with previous coronary artery bypass graft surgery in 2001 that was complicated with postischemic dilated cardiomyopathy with severe heart failure (ejection fraction [EF], 20%). Cardiac resynchronization therapy was biventricular-pacemaker and cardiac defibrillator implantation in 2009 for recurrent ventricular arrhythmia. L-VAD implantation (Jarvik 2000) with graft apposition in descending thoracic aorta through left thoracotomy access and retro-auricolar cable was performed in October 2013. In 2015 the patient underwent surgical aortic valve replacement with bioprothesis due to progressive worsening of the aortic valve regurgitation. The Jarvik 2000 outflow was occluded with vascular ball occluder inserted via right axillary artery under fluoroscopy before CEC installation. The recovery was without major complications. DISCUSSION Long-time survivors with Jarvik 2000 are increasing in number and such late complication is expected to become a main future issue. Our previous experience with the interventional approach was delusive. Due to the fatal consequences in similar patients with nonsurgical approaches, we opted for surgical aortic valve replacement. At the moment, the international literature does not describe safe approaches regarding aortic valve replacement in patients with Jarvik 2000 L-VAD. This case shows that surgical valve replacement could be managed with success according to the described specific technique.
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Affiliation(s)
- A Dokollari
- Department of Cardiac Surgery, University of Siena, Siena, Italy.
| | - M Cameli
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - C G Sassi
- Department of Cardiac Surgery, University of Siena, Siena, Italy
| | - G Davoli
- Department of Cardiac Surgery, University of Siena, Siena, Italy
| | - S Scolletta
- Department of Medical Biotechnologies, Anesthesiology and Intensive Care, University Hospital of Siena, Siena, Italy
| | - C Ricci
- Interventional Radiology, Policlinico Santa Maria alle Scotte, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - P Lucatelli
- Interventional Radiology, Policlinico Santa Maria alle Scotte, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - S Mondillo
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - M Maccherini
- Department of Cardiac Surgery, University of Siena, Siena, Italy
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Gaeta M, Campanella F, Gentile L, Schifino GM, Capasso L, Bandera F, Banfi G, Arpesella M, Ricci C. European cardiovascular mortality over the last three decades: evaluation of time trends, forecasts for 2016. Ann Ig 2017; 29:206-217. [PMID: 28383612 DOI: 10.7416/ai.2017.2148] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The circulatory diseases, in particular ischemic heart diseases and stroke, represent the main causes of death worldwide both in high income and in middle and low income countries. Our aim is to provide a comprehensive report to depict the circulatory disease mortality in Europe over the last 30 years and to address the sources of heterogeneity among different countries. METHODS Our study was performed using the WHO statistical information system - mortality database - and was restricted to the 28 countries belonging to the European Union (EU-28). We evaluated gender and age time series of all circulatory disease mortality, ischemic heart diseases, cerebrovascular diseases, pulmonary and other circulatory diseases and than we performed forecast for 2016. Mortality heterogeneity was evaluated by countries using the Cochrane Q statistic and the I-squared index. RESULTS Between 1985 and 2011 SDR for deaths attributable to all circulatory system diseases decreased from 440.9 to 212.0 x 100,000 in EU-28 and a clear uniform reduction was observed. Heterogeneity among countries was found to be consistent, therefore different analysis were carried out considering geographical area. CONCLUSIONS We forecast a reduction in European cardiovascular mortality. Heterogeneity among countries could only in part be explained by both geographical and health expenditure factors.
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Affiliation(s)
- M Gaeta
- Department Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - F Campanella
- Department Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - L Gentile
- Department Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - G M Schifino
- Department Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - L Capasso
- Department Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - F Bandera
- Heart Failure Unit, IRCCS Policlinico San Donato, San Donato Milanese (MI), Italy
| | - G Banfi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy - Vita-Salute San Raffaele University, Milan, Italy
| | - M Arpesella
- Department Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - C Ricci
- Department Public Health, Experimental and Forensic Medicine, University of Pavia, Italy - Centre of Excellence for Nutrition (CEN), North-West University, Potchefstroom, South Africa
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Gaeta M, Campanella F, Capasso L, Schifino G, Gentile L, Banfi G, Pelissero G, Ricci C. An overview of different health indicators used in the European Health Systems. J Prev Med Hyg 2017; 58:E114-E120. [PMID: 28900351 PMCID: PMC5584080] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
INTRODUCTION In the European Union three different health systems could be defined according to service delivery, financing, and economic policies: Beveridge, Bismarck and Mixed system. Although health systems are hardly to compare, various organizations are developing methods assessing performance. In the present work the performance of the three systems were evaluated using European Community Health Indicators according to Organization for Economic Cooperation and Development. METHODS The study has been conducted among the 28 states of the European Union using the following indicators: Standardized death rate for diseases of the circulatory system, standardized death rate of malignant neoplasms, road traffic accidents with injury, life expectancy at birth, incidence of Human Immunodeficiency Virus (HIV), infant deaths, pure alcohol consumption, infants vaccinated against Diphtheria Tetanus Pertussis (DTP), public and total expenditure on health over the period 2001-2010. RESULTS The variation of health indicators over the observational time shows similar trend of circulatory system diseases and malignant neoplasms death rates, road accidents with injury, infant deaths, life expectancy at birth, public and total health expenditure. Some differences in the trend of HIV incidence, alcohol intake and DTP vaccination rates arise among systems. Grouping countries by health system paradigm and geographical area, resulted in a relevant heterogeneity (I2 ≥ 90%, Pvalue < 0.0001). No clear superiority of a given health delivery system was found with respect to other paradigms. CONCLUSIONS In accordance with the evidence of our study, it can be stated that best performances are more likely to be linked to country specific economic factors. In conclusion, it was not possible to identify the best health system model.
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Affiliation(s)
- M. Gaeta
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy;,Correspondence: Francesca Campanella. Department of Public Health, Experimental and Forensic Medicine, Unit of Hygiene, University of Pavia, via Forlanini 2, 27100 Pavia, Italy - Tel. +39 0382 987277 - Fax +39 038 2987291 - E-mail:
| | - F. Campanella
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - L. Capasso
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - G.M. Schifino
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - L. Gentile
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - G. Banfi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy;, Vita e Salute San Raffaele University, Milan, Italy
| | - G. Pelissero
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - C. Ricci
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy;, Centre of Excellence for Nutrition (CEN), North-West University, Potchefstroom, South Africa
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Matejcic M, de Batlle J, Ricci C, Biessy C, Perrier F, Huybrechts I, Weiderpass E, Boutron-Ruault MC, Cadeau C, His M, Cox DG, Boeing H, Fortner RT, Kaaks R, Lagiou P, Trichopoulou A, Benetou V, Tumino R, Panico S, Sieri S, Palli D, Ricceri F, Bueno-de-Mesquita HBA, Skeie G, Amiano P, Sánchez MJ, Chirlaque MD, Barricarte A, Quirós JR, Buckland G, van Gils CH, Peeters PH, Key TJ, Riboli E, Gylling B, Zeleniuch-Jacquotte A, Gunter MJ, Romieu I, Chajès V. Biomarkers of folate and vitamin B12 and breast cancer risk: report from the EPIC cohort. Int J Cancer 2017; 140:1246-1259. [PMID: 27905104 DOI: 10.1002/ijc.30536] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 10/18/2016] [Indexed: 01/13/2023]
Abstract
Epidemiological studies have reported inconsistent findings for the association between B vitamins and breast cancer (BC) risk. We investigated the relationship between biomarkers of folate and vitamin B12 and the risk of BC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Plasma concentrations of folate and vitamin B12 were determined in 2,491 BC cases individually matched to 2,521 controls among women who provided baseline blood samples. Multivariable logistic regression models were used to estimate odds ratios by quartiles of either plasma B vitamin. Subgroup analyses by menopausal status, hormone receptor status of breast tumors (estrogen receptor [ER], progesterone receptor [PR] and human epidermal growth factor receptor 2 [HER2]), alcohol intake and MTHFR polymorphisms (677C > T and 1298A > C) were also performed. Plasma levels of folate and vitamin B12 were not significantly associated with the overall risk of BC or by hormone receptor status. A marginally positive association was found between vitamin B12 status and BC risk in women consuming above the median level of alcohol (ORQ4-Q1 = 1.26; 95% CI 1.00-1.58; Ptrend = 0.05). Vitamin B12 status was also positively associated with BC risk in women with plasma folate levels below the median value (ORQ4-Q1 = 1.29; 95% CI 1.02-1.62; Ptrend = 0.03). Overall, folate and vitamin B12 status was not clearly associated with BC risk in this prospective cohort study. However, potential interactions between vitamin B12 and alcohol or folate on the risk of BC deserve further investigation.
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Affiliation(s)
- M Matejcic
- International Agency for Research on Cancer, Lyon, France
| | - J de Batlle
- International Agency for Research on Cancer, Lyon, France
| | - C Ricci
- International Agency for Research on Cancer, Lyon, France
| | - C Biessy
- International Agency for Research on Cancer, Lyon, France
| | - F Perrier
- International Agency for Research on Cancer, Lyon, France
| | - I Huybrechts
- International Agency for Research on Cancer, Lyon, France
| | - E Weiderpass
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
- Department of Community Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - M C Boutron-Ruault
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - C Cadeau
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - M His
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - D G Cox
- Centre Léon Bérard, INSERM U1052, Cancer Research Center of Lyon, Lyon, France
| | - H Boeing
- Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - R T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - R Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - P Lagiou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - A Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - V Benetou
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - R Tumino
- Cancer Registry and Histopathology Unit, Civic - M.P. Arezzo Hospital, ASP Ragusa, Ragusa, Italy
| | - S Panico
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - S Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - D Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - F Ricceri
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy
| | - H B As Bueno-de-Mesquita
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom
| | - G Skeie
- Department of Community Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - P Amiano
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - M J Sánchez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - M D Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - A Barricarte
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Navarra Public Health Institute, Pamplona, Spain
| | - J R Quirós
- Public Health Directorate, Asturias, Spain
| | - G Buckland
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - C H van Gils
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - T J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - E Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - B Gylling
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | | | - M J Gunter
- International Agency for Research on Cancer, Lyon, France
| | - I Romieu
- International Agency for Research on Cancer, Lyon, France
| | - V Chajès
- International Agency for Research on Cancer, Lyon, France
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Micheli V, Pieragalli D, Toti P, Forconi S, Guerrini M, Acciavatti A, Galigani C, Weber G, Ricci C, DiPerri T. Haemorheological changes during human erythrocyte life-span. Clin Hemorheol Microcirc 2016. [DOI: 10.3233/ch-1987-7211] [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: 11/15/2022]
Affiliation(s)
- V. Micheli
- Istituto di Chimica Biologica, University of Siena, Siena, Italy
| | - D. Pieragalli
- Istituto di Patologia Special Medica, University of Siena, Siena, Italy
| | - P. Toti
- Istituto di Anatomia Patologia, University of Siena, Siena, Italy
| | - S. Forconi
- Istituto di Patologia Special Medica, University of Siena, Siena, Italy
| | - M. Guerrini
- Istituto di Patologia Special Medica, University of Siena, Siena, Italy
| | - A. Acciavatti
- Istituto di Patologia Special Medica, University of Siena, Siena, Italy
| | - C. Galigani
- Istituto di Patologia Special Medica, University of Siena, Siena, Italy
| | - G. Weber
- Istituto di Anatomia Patologia, University of Siena, Siena, Italy
| | - C. Ricci
- Istituto di Chimica Biologica, University of Siena, Siena, Italy
| | - T. DiPerri
- Istituto di Patologia Special Medica, University of Siena, Siena, Italy
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Rainone V, Schneider L, Saulle I, Ricci C, Biasin M, Al-Daghri NM, Giani E, Zuccotti GV, Clerici M, Trabattoni D. Upregulation of inflammasome activity and increased gut permeability are associated with obesity in children and adolescents. Int J Obes (Lond) 2016; 40:1026-33. [PMID: 26876434 DOI: 10.1038/ijo.2016.26] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [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] [Received: 07/06/2015] [Revised: 12/15/2015] [Accepted: 01/13/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Immune activation contributes to the persistent state of inflammation associated with metabolic dysfunction in obesity. The specific immune receptors that sense metabolic stress signals and trigger inflammation are nevertheless largely unknown, and little is known on inflammatory and immune gene regulation in obesity. METHODS The study includes a cross-sectional and a longitudinal arm. Forty children and adolescents were enrolled: 22 obese subjects and 18 age-matched normal weight controls. Obese subjects participated in an 18-month therapeutic protocol, based on intensive lifestyle modification (dietary regimen, physical activity and behavioral interventions). Expression of genes involved in the inflammasome pathway, plasma concentration of the inflammasome-associated pro-inflammatory cytokines (interleukin (IL)-1β and IL-18) and indexes of microbial translocation (lipopolysaccharide (LPS), soluble CD14 (sCD14) and intestinal fatty acid-binding protein) were analyzed at baseline in obese subjects compared with controls, and after 18 months in obese subjects. RESULTS Cross-sectional analyses showed that the LPS-induced expression of genes involved in inflammasome (NLRP3, caspase 5 and NAIP), Nod-like receptors (NLRX1 and NOD1), downstream signaling (P2RX7, RAGE, RIPk2, TIRAP and BIRC2) and effector molecules (IFN-γ, IL-12β, IL-1β, CCL2, CCL5, IL-6 and TNFα) was significantly increased in obese subjects at baseline as compared with normal weight controls. The baseline plasma concentration of inflammasome-related cytokines (IL-1β and IL-18) and of microbial translocation markers (LPS and sCD14) was augmented in obese subjects as compared with controls as well. Longitudinal analyses indicated that intensive lifestyle modification resulted in a normalization of parameters in subjects with a significant reduction of BMI after 18 months. CONCLUSIONS In children and adolescents, obesity is characterized by the activation of the inflammasome and by an alteration of gut permeability. Successful lifestyle modification is effective in reducing inflammation, suggesting that inhibition of the inflammasome may be a potential therapeutic strategy in obesity.
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Affiliation(s)
- V Rainone
- Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Milan, Italy
| | - L Schneider
- Department of Pediatrics, University of Milan, L. Sacco Hospital, Milan, Italy
| | - I Saulle
- Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Milan, Italy
| | - C Ricci
- Department of Preventive Medicine and Epidemiology, University of Regensburg, Regensburg, Germany
| | - M Biasin
- Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Milan, Italy
| | - N M Al-Daghri
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
- Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia
| | - E Giani
- Department of Pediatrics, University of Milan, Ospedale dei Bambini V. Buzzi, Milan, Italy
| | - G V Zuccotti
- Department of Pediatrics, University of Milan, L. Sacco Hospital, Milan, Italy
- Department of Pediatrics, University of Milan, Ospedale dei Bambini V. Buzzi, Milan, Italy
| | - M Clerici
- Department of Medical-Surgery Physiopathology and Transplantation, University of Milan, Milan, Italy
- Don C. Gnocchi Foundation ONLUS, IRCCS, Milan, Italy
| | - D Trabattoni
- Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Milan, Italy
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Zanini B, Marullo M, Ricci C, Lanzini A. Letter: gluten challenge in the era of noncoeliac gluten sensitivity--a change in clinical practice? Author's reply. Aliment Pharmacol Ther 2016; 43:656-7. [PMID: 26843346 DOI: 10.1111/apt.13517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Affiliation(s)
- B Zanini
- Gastroenterology Unit, University and Spedali Civili, Brescia, Italy.
| | - M Marullo
- Gastroenterology Unit, University and Spedali Civili, Brescia, Italy
| | - C Ricci
- Gastroenterology Unit, University and Spedali Civili, Brescia, Italy
| | - A Lanzini
- Gastroenterology Unit, University and Spedali Civili, Brescia, Italy
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Gates-Ferris K, Senter L, Aliaga M, Hurlbert M, Ricci C. Abstract P1-09-06: The effect of Hispanic nativity and ethnicity on mammography use through the Avon breast health outreach program. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-09-06] [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
Introduction
Although Hispanic women have lower rates of breast cancer compared to non-Hispanic whites (NHW), breast cancer remains the leading cause of cancer death among Hispanic women . Some studies suggest that Hispanic women have lower rates of breast cancer screening compared to NHW women, primarily due to lack of health insurance and socioeconomic disadvantages . This study aims to understand the demographic characteristics of Hispanic women in the U.S. who access and utilize the Avon Breast Health Outreach Program (BHOP), and how Hispanic women's mammography history differs by nativity. Avon BHOP supports community-based organizations to conduct education and outreach to over 50,000 low-income and uninsured women each year, linking them to routine breast cancer screening and care.
Methods
This study analyzed 2014 Client Intake Forms (CIF) for all women aged 40 and older, who were served by BHOP for the first time (∼16,000 women). Descriptive analysis was conducted to summarize their demographic and breast health information, comparing Hispanics with NHW. Multivariate logistic regression was performed to examine the relationship between ethnicity and nativity and having a mammogram in the last two years. Lastly, a sub-analysis among foreign-born (FB) Hispanics only was conducted to assess how the length of time living in the U.S. (number of years) impacts the likelihood of having a mammogram in the last two years.
Results
Of the first time clients served through BHOP in 2014, 10.4% were US-born Hispanics, 45.2% were FB-Hispanics, and 44.4% were NHW. The majority of FB-Hispanic women were from Mexico (66.2%). FB-Hispanics are less likely to have insurance as compared to US-born Hispanic women (19.7% vs. 39.3%), and less likely to have a high school degree (34.3% vs. 44.8%). After controlling for demographic and socioeconomic variables, FB-Hispanics had significantly greater odds of having a mammogram in the past two years compared to US-born Hispanics (OR=1.6, 95% CI, 1.3-1.9), and NHW women (OR=1.4, 95% CI, 1.2-1.6). FB-Hispanics living in the U.S. for 5+ years had a 1.7 greater odds of having a mammogram in the past 2 years, as compared to recent immigrants living in the U.S. for less than one year (OR=1.7 ;95% CI, 1.1 – 2.7).
Discussion
In 2014, the percentage of BHOP Hispanic women aged 40+, reporting a mammogram in the last two years (41.1%) was lower than the overall U.S. Hispanic rate (61.4%) , suggesting confirmation that BHOP serves vulnerable and underserved populations, as it aims to do. This study also demonstrates how screening behaviors differ among Hispanic women served through BHOP, with FB-Hispanics having higher mammography utilization rates as compared to their US-born counterparts, with variation seen by the number of years living in the U.S. In conclusion, it is critical to view Hispanics as a heterogeneous group in order to best address their clinical needs. Specifically, the results point to how U.S.-born Hispanic BHOP clients may be at particularly high risk for low breast cancer screening.
Citation Format: Gates-Ferris K, Senter L, Aliaga M, Hurlbert M, Ricci C. The effect of Hispanic nativity and ethnicity on mammography use through the Avon breast health outreach program. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-09-06.
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Affiliation(s)
- K Gates-Ferris
- Cicatelli Associates Inc (CAI), NY, NY; Avon Foundation for Women, NY, NY
| | - L Senter
- Cicatelli Associates Inc (CAI), NY, NY; Avon Foundation for Women, NY, NY
| | - M Aliaga
- Cicatelli Associates Inc (CAI), NY, NY; Avon Foundation for Women, NY, NY
| | - M Hurlbert
- Cicatelli Associates Inc (CAI), NY, NY; Avon Foundation for Women, NY, NY
| | - C Ricci
- Cicatelli Associates Inc (CAI), NY, NY; Avon Foundation for Women, NY, NY
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Jais B, Rebours V, Malleo G, Salvia R, Fontana M, Maggino L, Bassi C, Manfredi R, Moran R, Lennon AM, Zaheer A, Wolfgang C, Hruban R, Marchegiani G, Fernández Del Castillo C, Brugge W, Ha Y, Kim MH, Oh D, Hirai I, Kimura W, Jang JY, Kim SW, Jung W, Kang H, Song SY, Kang CM, Lee WJ, Crippa S, Falconi M, Gomatos I, Neoptolemos J, Milanetto AC, Sperti C, Ricci C, Casadei R, Bissolati M, Balzano G, Frigerio I, Girelli R, Delhaye M, Bernier B, Wang H, Jang KT, Song DH, Huggett MT, Oppong KW, Pererva L, Kopchak KV, Del Chiaro M, Segersvard R, Lee LS, Conwell D, Osvaldt A, Campos V, Aguero Garcete G, Napoleon B, Matsumoto I, Shinzeki M, Bolado F, Fernandez JMU, Keane MG, Pereira SP, Acuna IA, Vaquero EC, Angiolini MR, Zerbi A, Tang J, Leong RW, Faccinetto A, Morana G, Petrone MC, Arcidiacono PG, Moon JH, Choi HJ, Gill RS, Pavey D, Ouaïssi M, Sastre B, Spandre M, De Angelis CG, Rios-Vives MA, Concepcion-Martin M, Ikeura T, Okazaki K, Frulloni L, Messina O, Lévy P. Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas). Gut 2016; 65:305-12. [PMID: 26045140 DOI: 10.1136/gutjnl-2015-309638] [Citation(s) in RCA: 173] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 05/11/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Serous cystic neoplasm (SCN) is a cystic neoplasm of the pancreas whose natural history is poorly known. The purpose of the study was to attempt to describe the natural history of SCN, including the specific mortality. DESIGN Retrospective multinational study including SCN diagnosed between 1990 and 2014. RESULTS 2622 patients were included. Seventy-four per cent were women, and median age at diagnosis was 58 years (16-99). Patients presented with non-specific abdominal pain (27%), pancreaticobiliary symptoms (9%), diabetes mellitus (5%), other symptoms (4%) and/or were asymptomatic (61%). Fifty-two per cent of patients were operated on during the first year after diagnosis (median size: 40 mm (2-200)), 9% had resection beyond 1 year of follow-up (3 years (1-20), size at diagnosis: 25 mm (4-140)) and 39% had no surgery (3.6 years (1-23), 25.5 mm (1-200)). Surgical indications were (not exclusive) uncertain diagnosis (60%), symptoms (23%), size increase (12%), large size (6%) and adjacent organ compression (5%). In patients followed beyond 1 year (n=1271), size increased in 37% (growth rate: 4 mm/year), was stable in 57% and decreased in 6%. Three serous cystadenocarcinomas were recorded. Postoperative mortality was 0.6% (n=10), and SCN's related mortality was 0.1% (n=1). CONCLUSIONS After a 3-year follow-up, clinical relevant symptoms occurred in a very small proportion of patients and size slowly increased in less than half. Surgical treatment should be proposed only for diagnosis remaining uncertain after complete workup, significant and related symptoms or exceptionally when exists concern with malignancy. This study supports an initial conservative management in the majority of patients with SCN. TRIAL REGISTRATION NUMBER IRB 00006477.
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Affiliation(s)
- B Jais
- Department of Gastroenterology and Pancreatology, Beaujon Hospital, AP-HP, Clichy, France
| | - V Rebours
- Department of Gastroenterology and Pancreatology, Beaujon Hospital, AP-HP, Clichy, France
| | - G Malleo
- The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy
| | - R Salvia
- The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy
| | - M Fontana
- The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy
| | - L Maggino
- The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy
| | - C Bassi
- The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy
| | - R Manfredi
- The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy
| | - R Moran
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - A M Lennon
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - A Zaheer
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - C Wolfgang
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - R Hruban
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - G Marchegiani
- Departments of Surgery and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - C Fernández Del Castillo
- Departments of Surgery and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - W Brugge
- Departments of Surgery and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Y Ha
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - M H Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - D Oh
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - I Hirai
- First Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - W Kimura
- First Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - J Y Jang
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - S W Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - W Jung
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - H Kang
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - S Y Song
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - C M Kang
- Department of Surgery, Yonsei University College of Medicine, Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
| | - W J Lee
- Department of Surgery, Yonsei University College of Medicine, Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
| | - S Crippa
- Pancreatic Surgery Unit, Department of Surgery, Polytechnic University of Marche Region, Ancona-Torrette, Italy
| | - M Falconi
- Pancreatic Surgery Unit, Department of Surgery, Polytechnic University of Marche Region, Ancona-Torrette, Italy
| | - I Gomatos
- NIHR Pancreas Biomedical Research Unit, Department of Molecular and Clinical Cancer Medicine, Royal Liverpool University Hospital, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - J Neoptolemos
- NIHR Pancreas Biomedical Research Unit, Department of Molecular and Clinical Cancer Medicine, Royal Liverpool University Hospital, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - A C Milanetto
- Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, Padua, Italy
| | - C Sperti
- Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, Padua, Italy
| | - C Ricci
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - R Casadei
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - M Bissolati
- Pancreatic Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - G Balzano
- Pancreatic Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - I Frigerio
- Hepato-Pancreato-Biliary Unit, Pederzoli Hospital, Peschiera del Garda, Italy
| | - R Girelli
- Hepato-Pancreato-Biliary Unit, Pederzoli Hospital, Peschiera del Garda, Italy
| | - M Delhaye
- Department of Gastroenterology, Hepatopancreatology and GI Oncology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - B Bernier
- Department of Gastroenterology, Hepatopancreatology and GI Oncology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - H Wang
- Institute of Hepatopancreatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - K T Jang
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D H Song
- Department of Pathology, Gyeongsang National University School of Medicine, Jinju, Korea
| | - M T Huggett
- Hepato-Pancreato-Biliary Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - K W Oppong
- Hepato-Pancreato-Biliary Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - L Pererva
- National Institute of Surgery and Transplantology named after Shalimov, Kiev, Ukraine
| | - K V Kopchak
- National Institute of Surgery and Transplantology named after Shalimov, Kiev, Ukraine
| | - M Del Chiaro
- Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - R Segersvard
- Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - L S Lee
- Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - D Conwell
- Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - A Osvaldt
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - V Campos
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - B Napoleon
- Hôpital Privé Mermoz, Gastroentérologie, Lyon, France
| | - I Matsumoto
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - M Shinzeki
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - F Bolado
- Gastroenterology Department, Hospital de Navarra, Pamplona, Spain
| | | | - M G Keane
- Department of Gastroenterology and Hepatology, University College Hospital, London, UK
| | - S P Pereira
- Department of Gastroenterology and Hepatology, University College Hospital, London, UK
| | - I Araujo Acuna
- Department of Gastroenterology, Hospital Clinic, CIBEREHD, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - E C Vaquero
- Department of Gastroenterology, Hospital Clinic, CIBEREHD, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - M R Angiolini
- Department of Pancreatic Surgery, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - A Zerbi
- Department of Pancreatic Surgery, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - J Tang
- Gastroenterology and Liver Services, Concord Hospital, Sydney, New South Wales, Australia
| | - R W Leong
- Gastroenterology and Liver Services, Concord Hospital, Sydney, New South Wales, Australia
| | - A Faccinetto
- Radiological Department, General Hospital Cá Foncello, Treviso, Italy
| | - G Morana
- Radiological Department, General Hospital Cá Foncello, Treviso, Italy
| | - M C Petrone
- Division of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Scientific Institute, Milan, Italy
| | - P G Arcidiacono
- Division of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Scientific Institute, Milan, Italy
| | - J H Moon
- Department of Internal Medicine, Digestive Disease Center and Research Institute, SoonChunHyang University School of Medicine, Bucheon, Korea
| | - H J Choi
- Department of Internal Medicine, Digestive Disease Center and Research Institute, SoonChunHyang University School of Medicine, Bucheon, Korea
| | - R S Gill
- Department of Gastroenterology, Bankstown-Lidcombe Hospital, Bankstown, New South Wales, Australia
| | - D Pavey
- Department of Gastroenterology, Bankstown-Lidcombe Hospital, Bankstown, New South Wales, Australia
| | - M Ouaïssi
- Department of Digestive Surgery, Timone Hospital, Marseille, France
| | - B Sastre
- Department of Digestive Surgery, Timone Hospital, Marseille, France
| | - M Spandre
- Gastrohepatology Department, San Giovanni Battista Molinette Hospital, University of Turin, Turin, Italy
| | - C G De Angelis
- Gastrohepatology Department, San Giovanni Battista Molinette Hospital, University of Turin, Turin, Italy
| | - M A Rios-Vives
- Gastroenterology Department, Hospital de la Santa Creu i Sant Pau, Institut de Reçerca-IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Concepcion-Martin
- Gastroenterology Department, Hospital de la Santa Creu i Sant Pau, Institut de Reçerca-IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - T Ikeura
- The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan
| | - K Okazaki
- The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan
| | - L Frulloni
- Department of Medicine, Pancreas Center, University of Verona, Verona, Italy
| | - O Messina
- Department of Medicine, Pancreas Center, University of Verona, Verona, Italy
| | - P Lévy
- Department of Gastroenterology and Pancreatology, Beaujon Hospital, AP-HP, Clichy, France
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Annuar A, Gandhi P, Alexander DM, Lansbury GB, Arévalo P, Ballantyne DR, Baloković M, Bauer FE, Boggs SE, Brandt WN, Brightman M, Christensen FE, Craig WW, Moro AD, Hailey CJ, Harrison FA, Hickox RC, Matt G, Puccetti S, Ricci C, Rigby JR, Stern D, Walton DJ, Zappacosta L, Zhang W. NuSTAROBSERVATIONS OF THE COMPTON-THICK ACTIVE GALACTIC NUCLEUS AND ULTRALUMINOUS X-RAY SOURCE CANDIDATE IN NGC 5643. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0004-637x/815/1/36] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Setacci C, Galzerano G, Setacci F, Mazzitelli G, de Donato G, Ricci C. The risk for type B aortic dissection in Marfan syndrome. J Cardiovasc Surg (Torino) 2015; 56:899-904. [PMID: 26350976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Marfan syndrome is the most prevalent connective tissue disorder, with an autosomal dominant inheritance with variable penetrance. This paper aims to summarize epidemiology and treatment for type B dissection in Marfan patients.
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Affiliation(s)
- C Setacci
- Vascular and Endovascular Surgery Unit, Department of Medicine, Surgery and Neurological Sciences, University of Siena, Siena, Italy -
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Schmid D, Ricci C, Behrens G, Leitzmann MF. Adiposity and risk of thyroid cancer: a systematic review and meta-analysis. Obes Rev 2015; 16:1042-54. [PMID: 26365757 DOI: 10.1111/obr.12321] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 08/11/2015] [Accepted: 08/11/2015] [Indexed: 11/30/2022]
Abstract
Thyroid cancer incidence has increased rapidly over time, as has obesity prevalence. A link between the two appears plausible, but the relation of adiposity to thyroid cancer remains incompletely understood. We performed a meta-analysis of adiposity measures and thyroid cancer using studies identified through October 2014. Twenty-one articles yielded data on 12,199 thyroid cancer cases. We found a statistically significant 25% greater risk of thyroid cancer in overweight individuals and a 55% greater thyroid cancer risk in obese individuals as compared with their normal-weight peers. Each 5-unit increase in body mass index (BMI), 5 kg increase in weight, 5 cm increase in waist or hip circumference and 0.1-unit increase in waist-to-hip ratio were associated with 30%, 5%, 5% and 14% greater risks of thyroid cancer, respectively. When evaluated by histologic type, obesity was significantly positively related to papillary, follicular and anaplastic thyroid cancers, whereas it revealed an inverse association with medullary thyroid cancer. Both general and abdominal adiposity are positively associated with thyroid cancer. However, relations with BMI vary importantly by tumour histologic type.
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Affiliation(s)
- D Schmid
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - C Ricci
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - G Behrens
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - M F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
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Terzoni S, Ferrara P, Cornelli R, Ricci C, Oggioni C, Destrebecq A. Violence and unsafety in a major Italian hospital: experience and perceptions of health care workers. Med Lav 2015; 106:403-411. [PMID: 26621061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 10/19/2015] [Accepted: 10/28/2015] [Indexed: 06/05/2023]
Abstract
UNLABELLED Workers' experience of violence and perceived unsafety can have a profound impact on job satisfaction, job performance, and workers' decision to leave. OBJECTIVES The aim of the study was to assess the prevalence of physical and non-physical violence among hospital workers, explore the complaints and reactions of victims, assess the relationship between violence and psychosocial/work factors and analyze the levels of perceived unsafety. METHODS A cross-sectional study was conducted, via a structured self-administered questionnaire given to all the employees of a major hospital in Italy. Cronbach's alpha coefficient was used to assess the internal consistency of the questionnaire. A logistic regression model was used for data analysis. RESULTS 903 questionnaires out of 1853 (48.7%) were correctly returned; 11.5% had experience of physical violence and 40.2% had been victims of verbal violence in the previous 12 months. The most common consequences were fear, anger, frustration, and anxiety. Verbal violence was influenced by age, role, department, night/holiday shift work and experience in the current ward. Experiences of physical violence were related to gender, role, and department; 469 responders (51.9%) reported feelings of unsafety, which were related to their professional role, department, shift work, experience of physical or psychological violence, having seen episodes of violence and having received specific training. CONCLUSIONS Our findings suggest that several factors are associated with workplace violence in health care settings and some of these also influenced the levels of perceived unsafety.
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Affiliation(s)
- S Terzoni
- Azienda Ospedaliera San Paolo, Milano.
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Zanini B, Ricci C, Lanzini A. Editorial: noncoeliac gluten sensitivity - the controversy rages on. Authors' reply. Aliment Pharmacol Ther 2015; 42:1235. [PMID: 26449864 DOI: 10.1111/apt.13411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Affiliation(s)
- B Zanini
- Gastroenterology Unit, University and Spedali Civili, Brescia, Italy
| | - C Ricci
- Gastroenterology Unit, University and Spedali Civili, Brescia, Italy
| | - A Lanzini
- Gastroenterology Unit, University and Spedali Civili, Brescia, Italy.
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Zanini B, Baschè R, Ferraresi A, Ricci C, Lanzarotto F, Marullo M, Villanacci V, Hidalgo A, Lanzini A. Randomised clinical study: gluten challenge induces symptom recurrence in only a minority of patients who meet clinical criteria for non-coeliac gluten sensitivity. Aliment Pharmacol Ther 2015; 42:968-76. [PMID: 26310131 DOI: 10.1111/apt.13372] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 04/02/2015] [Accepted: 07/28/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND It is unknown whether symptoms in non-coeliac patients (non-CD) meeting clinical diagnostic criteria for noncoeliac gluten sensitivity (NCGS) are specifically triggered by gluten. AIM To assess gluten sensitivity in patients diagnosed with NCGS. METHODS We studied 35 non-CD subjects (31 females) that were on a gluten-free diet (GFD), in a double-blind challenge study. Participants were randomised to receive either gluten-containing flour or gluten-free flour for 10 days, followed by a 2-week washout period and were then crossed over. The main outcome measure was their ability to identify which flour contained gluten. Secondary outcome measures were based upon Gastrointestinal Symptoms Rating Scale (GSRS) scores. RESULTS The gluten-containing flour was correctly identified by 12 participants (34%), who were classified as having NCGS. Their mean GSRS dimension scores were significantly higher following gluten challenge compared to baseline. The scores were: pain, 1.7 ± 0.8 vs. 2.6 ± 1.0; reflux, 1.6 ± 0.5 vs. 2.2 ± 0.9; indigestion, 1.9 ± 0.7 vs. 3.2 ± 1.1; diarrhoea, 1.6 ± 0.7 vs. 2.9 ± 1.5 and constipation, 1.9 ± 0.9 vs. 2.9 ± 1.3. Seventeen participants (49%) erroneously considered the gluten-free flour to contain gluten. Their mean GSRS dimension scores were significantly higher following gluten-free flour challenge compared to baseline. The scores were: pain, 1.6 ± 0.9 vs. 3.0 ± 0.9; reflux, 1.4 ± 0.5 vs. 2.3 ± 1.1; indigestion, 2.0 ± 1.1 vs. 3.7 ± 1.1; diarrhoea, 1.6 ± 0.7 vs. 3.0 ± 1.2 and constipation, 1.6 ± 0.9 vs. 2.6 ± 1.3. The other six participants (17%) were unable to distinguish between the flours. CONCLUSION Double-blind gluten challenge induces symptom recurrence in just one-third of patients fulfilling the clinical diagnostic criteria for non-coeliac gluten sensitivity.
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Affiliation(s)
- B Zanini
- Department of Gastroenterology, University and Spedali Civili of Brescia, Brescia, Italy
| | - R Baschè
- Department of Gastroenterology, University and Spedali Civili of Brescia, Brescia, Italy
| | - A Ferraresi
- Department of Gastroenterology, University and Spedali Civili of Brescia, Brescia, Italy
| | - C Ricci
- Department of Gastroenterology, University and Spedali Civili of Brescia, Brescia, Italy
| | - F Lanzarotto
- Department of Gastroenterology, University and Spedali Civili of Brescia, Brescia, Italy
| | - M Marullo
- Department of Gastroenterology, University and Spedali Civili of Brescia, Brescia, Italy
| | - V Villanacci
- Department of Pathology, University and Spedali Civili of Brescia, Brescia, Italy
| | - A Hidalgo
- Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - A Lanzini
- Department of Gastroenterology, University and Spedali Civili of Brescia, Brescia, Italy
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Abstract
Human p21Waf1 protein is well known for being transcriptionally induced by p53 and activating the cell cycle checkpoint arrest in response to DNA breaks. Here we report that p21Waf1 protein undergoes a bimodal regulation, being upregulated in response to low doses of DNA damage but rapidly and transiently degraded in response to high doses of DNA lesions. Responsible for this degradation is the checkpoint kinase Chk1, which phosphorylates p21Waf1 on T145 and S146 residues and induces its proteasome-dependent proteolysis. The initial p21Waf1 degradation is then counteracted by the ATM-Chk2 pathway, which promotes the p53-dependent accumulation of p21Waf1 at any dose of damage. We also found that p21Waf1 ablation favors the activation of an apoptotic program to eliminate otherwise irreparable cells. These findings support a model in which in human cells a balance between ATM-Chk2-p53 and the ATR-Chk1 pathways modulates p21Waf1 protein levels in relation to cytostatic and cytotoxic doses of DNA damage.
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Affiliation(s)
- G Buscemi
- a Department of Experimental Oncology; Fondazione IRCCS Istituto Nazionale dei Tumori ; Milan , Italy
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