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Magnoni F, Tinterri C, Corso G, Curigliano G, Leonardi MC, Toesca A, Rocco N, Catalano F, Bianchi B, Lauria F, Caldarella P, Pagani G, Galimberti V, Veronesi P. The multicenter experience in the multidisciplinary Italian breast units: a review and update. Eur J Cancer Prev 2024; 33:185-191. [PMID: 37997909 DOI: 10.1097/cej.0000000000000853] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
A breast unit is a multidisciplinary center specialized in the management of women with breast diseases, including breast cancer (BC). It represents a care path, passing from screening activities to diagnostic investigations, from surgery to the definition of the therapeutic strategy, from psychophysical rehabilitation to long-term checks (follow-up), and up to genetic counseling. Since 2006, following a resolution issued by the European Parliament to urge member states to activate multidisciplinary breast centers by 2016, work has been underway throughout Italy to improve the management of women with BC. In Italy, the State-Regions agreement was signed on 18 December 2014, sanctioning the establishment of breast units. These centers must adhere to specific quality criteria and requirements. In 2020, the experts of the EUSOMA group (European Society of Breast Cancer Specialists), in their latest document published, expanded the requirements of the breast units. Furthermore, Senonetwork was founded in 2012 with the aim of allowing BC to be treated in breast units that comply with European requirements to ensure equal treatment opportunities for all Italian women. Indeed, the available data indicate that the BC patient has a greater chance of better treatment in the breast units with a multidisciplinary team, thus increasing the survival rate with a better quality of life, compared to those managed in nonspecialized structures. The present review is a perspective on the current Italian reality of breast units, updated with the available literature and the most recent epidemiological data from Senonetwork and AgeNaS.
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Affiliation(s)
- Francesca Magnoni
- Division of Breast Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
- European Cancer Prevention Organization (ECP), Milan, Italy
| | - Corrado Tinterri
- Breast Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Giovanni Corso
- Division of Breast Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
- European Cancer Prevention Organization (ECP), Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Giuseppe Curigliano
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Division of Experimental Therapeutics, Division of Medical Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Antonio Toesca
- Division of Breast Surgical Oncology, Candiolo Cancer Institute FPO-IRCCS, Candiolo (To), Italy
| | - Nicola Rocco
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Francesca Catalano
- Multidisciplinary Breast Unit, Cannizzaro Hospital of Catania, Catania, Italy
| | - Beatrice Bianchi
- Division of Breast Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Federica Lauria
- Division of Breast Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Pietro Caldarella
- Division of Breast Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gianmatteo Pagani
- Division of Breast Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Viviana Galimberti
- Division of Breast Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Paolo Veronesi
- Division of Breast Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Silvestri V, Pontecorvi E, Sciuto A, Pacella D, Peltrini R, D'Ambra M, Lionetti R, Filotico M, Lauria F, Sarnelli G, Pirozzi F, Ruotolo F, Bracale U, Corcione F. Preservation of the inferior mesenteric artery VS ligation of the inferior mesenteric artery in left colectomy: evaluation of functional outcomes-a prospective non-randomized controlled trial. Updates Surg 2023; 75:1569-1578. [PMID: 37505437 DOI: 10.1007/s13304-023-01593-6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/11/2023] [Indexed: 07/29/2023]
Abstract
Vascular approach during elective laparoscopic left colectomy impacts post-operative outcomes. The aim of our study was to evaluate how different approaches impact positively defecatory, urinary and sexual functions and quality of life during elective laparoscopic left colectomy. A prospective non-randomized controlled trial at two tertiary center was conducted. All patients who underwent elective laparoscopic left colonic resection from January 2019 to July 2022 were analyzed. They were divided into two groups based on Inferior Mesenteric Artery (IMA) preservation with distal ligation of sigmoid branches close to a colonic wall for complicated diverticular disease and IMA high tie ligation for oncological disease. Patients were asked to fulfil standardized, validated questionnaires to evaluate pre and post-operative defecatory, urinary and sexual functions and quality of life. Defecatory disorders were assessed by high-resolution anorectal manometry preoperatively and six months after surgery. A total of 122 patients were included in the study. The 62 patients with IMA preservation showed a lower incidence of defecatory disorders also confirmed by manometer data, minor incontinence and less lifestyle alteration than the 60 patients with IMA high tie ligation. No urinary disorders such as incomplete emptying, frequency, intermittence or urgency were highlighted after surgery in the IMA preservation group. Evidence of any sexual disorders remained controversial. The IMA-preserving vascular approach seems to be an effective strategy to prevent postoperative functional disorders. It is a safe and feasible technique especially for diverticular disease. New prospective randomized and highly probative studies are needed to confirm the effectiveness in specific clinical situations.
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Affiliation(s)
- Vania Silvestri
- Department of General Surgery, SS Annunziata Hospital, 67039, Sulmona, L'Aquila, Italy.
| | - Emanuele Pontecorvi
- Department of General Surgery, SS Annunziata Hospital, 67039, Sulmona, L'Aquila, Italy
| | - Antonio Sciuto
- Department of General Surgery, Santa Maria Delle Grazie Hospital, Pozzuoli, 80078, Naples, Italy
| | - Daniela Pacella
- Department of Public Health, University of Naples Federico II, 80131, Naples, Italy
| | - Roberto Peltrini
- Department of Public Health, University of Naples Federico II, 80131, Naples, Italy
| | - Michele D'Ambra
- Department of Public Health, University of Naples Federico II, 80131, Naples, Italy
| | - Ruggero Lionetti
- Department of Public Health, University of Naples Federico II, 80131, Naples, Italy
| | - Marcello Filotico
- Department of Public Health, University of Naples Federico II, 80131, Naples, Italy
| | - Federica Lauria
- Department of Public Health, University of Naples Federico II, 80131, Naples, Italy
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131, Naples, Italy
| | - Felice Pirozzi
- Department of General Surgery, Santa Maria Delle Grazie Hospital, Pozzuoli, 80078, Naples, Italy
| | | | - Umberto Bracale
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084, Salerno, Italy
| | - Francesco Corcione
- Department of Public Health, University of Naples Federico II, 80131, Naples, Italy
- Department of General Surgery, Clinica Mediterranea, 80122, Naples, Italy
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Basile G, Greco ME, Lauria F, Leone MC. Update on fertility preservation: new opportunities and challenges in the fight against infertility. Clin Ter 2022; 173:226-227. [PMID: 35612336 DOI: 10.7417/ct.2022.2424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Infertility has been characterized as a disease by the World Health Organization (WHO) and reportedly affects about 10-12% of couples worldwide, while the incidence is even higher in Italy, at about 15%. The issue of iatrogenic infertility arising from treatments that can compromise an individual's reproductive capacity, it is necessary to inform patients of the possible damage on their future fertility and on the possibilities to preserve it. The complexities inherent in the various techniques and approaches aimed at preserving fertility should be expounded upon thoroughly to the patients, who should also receive proper psychological assistance and counseling, which ought to take into account the ethical distinctive challenges and the possible misgivings that may be caused in patients. Ovarian Tissue Cryopreservation (OTC) and ovarian tissue transplantation (OTT) can constitute a valuable part of the clinical armamentarium for preserving fertility, although the data are still inconclusive, particularly in over-36 patients. The multidisciplinary nature of the healthcare teams involved in such interventions is of paramount importance to optimize results.
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Affiliation(s)
- G Basile
- IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - M E Greco
- UOC Ostetricia e Ginecologia, AOOR Villa Sofia Cervello, University of Paler-mo, Italy
| | - F Lauria
- UOC Ostetricia e Ginecologia, AOOR Villa Sofia Cervello, University of Paler-mo, Italy
| | - M C Leone
- UOC Ostetricia e Ginecologia, AOOR Villa Sofia Cervello, University of Paler-mo, Italy
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Sciuto A, Peltrini R, Andreoli F, Di Santo Albini AG, Di Nuzzo MM, Pirozzi N, Filotico M, Lauria F, Boccia G, D’Ambra M, Lionetti R, De Werra C, Pirozzi F, Corcione F. Could Stoma Be Avoided after Laparoscopic Low Anterior Resection for Rectal Cancer? Experience with Transanal Tube in 195 Cases. J Clin Med 2022; 11:jcm11092632. [PMID: 35566757 PMCID: PMC9104879 DOI: 10.3390/jcm11092632] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/30/2022] [Accepted: 05/02/2022] [Indexed: 02/04/2023] Open
Abstract
Anastomotic leakage is the most-feared complication of rectal surgery. Transanal devices have been suggested for anastomotic protection as an alternative to defunctioning stoma, although evidence is conflicting, and no single device is widely used in clinical practice. The aim of this paper is to investigate the safety and efficacy of a transanal tube for the prevention of leakage following laparoscopic rectal cancer resection. A transanal tube was used in the cases of total mesorectal excision with low colorectal or coloanal anastomosis, undamaged doughnuts, and negative intraoperative air-leak test. The transanal tube was kept in place until the seventh postoperative day. A total of 195 consecutive patients were retrieved from a prospective surgical database and included in the study. Of these, 71.8% received preoperative chemoradiotherapy. The perioperative mortality rate was 1.0%. Anastomotic leakage occurred in 19 patients, accounting for an incidence rate of 9.7%. Among these, 13 patients underwent re-laparoscopy and ileostomy, while 6 patients were managed conservatively. Overall, the stoma rate was 6.7%. The use of a transanal tube may be a suitable strategy for anastomotic protection following restorative rectal cancer resection. This approach could avoid the burden of a stoma in selected patients with low anastomoses.
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Affiliation(s)
- Antonio Sciuto
- Department of General Surgery, Santa Maria delle Grazie Hospital, 80078 Pozzuoli, Italy;
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80125 Naples, Italy
- Correspondence:
| | - Roberto Peltrini
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.P.); (A.G.D.S.A.); (M.M.D.N.); (N.P.); (M.F.); (F.L.); (G.B.); (M.D.); (R.L.); (C.D.W.); (F.C.)
| | - Federica Andreoli
- Department of Minimally Invasive Surgery, Cristo Re Hospital, 00167 Rome, Italy;
| | - Andrea Gianmario Di Santo Albini
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.P.); (A.G.D.S.A.); (M.M.D.N.); (N.P.); (M.F.); (F.L.); (G.B.); (M.D.); (R.L.); (C.D.W.); (F.C.)
| | - Maria Michela Di Nuzzo
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.P.); (A.G.D.S.A.); (M.M.D.N.); (N.P.); (M.F.); (F.L.); (G.B.); (M.D.); (R.L.); (C.D.W.); (F.C.)
| | - Nello Pirozzi
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.P.); (A.G.D.S.A.); (M.M.D.N.); (N.P.); (M.F.); (F.L.); (G.B.); (M.D.); (R.L.); (C.D.W.); (F.C.)
| | - Marcello Filotico
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.P.); (A.G.D.S.A.); (M.M.D.N.); (N.P.); (M.F.); (F.L.); (G.B.); (M.D.); (R.L.); (C.D.W.); (F.C.)
| | - Federica Lauria
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.P.); (A.G.D.S.A.); (M.M.D.N.); (N.P.); (M.F.); (F.L.); (G.B.); (M.D.); (R.L.); (C.D.W.); (F.C.)
| | - Giuseppe Boccia
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.P.); (A.G.D.S.A.); (M.M.D.N.); (N.P.); (M.F.); (F.L.); (G.B.); (M.D.); (R.L.); (C.D.W.); (F.C.)
| | - Michele D’Ambra
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.P.); (A.G.D.S.A.); (M.M.D.N.); (N.P.); (M.F.); (F.L.); (G.B.); (M.D.); (R.L.); (C.D.W.); (F.C.)
| | - Ruggero Lionetti
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.P.); (A.G.D.S.A.); (M.M.D.N.); (N.P.); (M.F.); (F.L.); (G.B.); (M.D.); (R.L.); (C.D.W.); (F.C.)
| | - Carlo De Werra
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.P.); (A.G.D.S.A.); (M.M.D.N.); (N.P.); (M.F.); (F.L.); (G.B.); (M.D.); (R.L.); (C.D.W.); (F.C.)
| | - Felice Pirozzi
- Department of General Surgery, Santa Maria delle Grazie Hospital, 80078 Pozzuoli, Italy;
| | - Francesco Corcione
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.P.); (A.G.D.S.A.); (M.M.D.N.); (N.P.); (M.F.); (F.L.); (G.B.); (M.D.); (R.L.); (C.D.W.); (F.C.)
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Silvestri V, Pontecorvi E, Filotico M, Coppola A, Lauria F, Bracale U, Corcione F. Laparoscopic splenic artery aneurysmectomy with ICG guided partial splenectomy: alternative approach. MINIM INVASIV THER 2021; 31:810-814. [PMID: 34694196 DOI: 10.1080/13645706.2021.1994420] [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] [Indexed: 10/20/2022]
Abstract
We herein report the case of a voluminous splenic artery aneurysm (SAA) diagnosed in a 48 year-old Caucasian male patient. After endovascular treatment failure, considering the volumetric aneurysm increase and recurrent symptoms, a laparoscopic splenic artery aneurysmectomy with partial splenectomy guided by indocyanine green fluorescence (ICG) was performed. This conservative strategy leads to save a spleen volume of about 10 cm3 to avoid postsplenectomy thrombocytosis and infections, potential immunodeficiency and overwhelming postsplenectomy infection syndrome (OPSS) and to preserve pancreatic vascularization preventing distal pancreas injuries.
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Affiliation(s)
- Vania Silvestri
- Department of General and Oncological Minimally Invasive Surgery, University Federico II of Naples, Naples, Italy
| | - Emanuele Pontecorvi
- Department of General and Oncological Minimally Invasive Surgery, University Federico II of Naples, Naples, Italy
| | - Marcello Filotico
- Department of General and Oncological Minimally Invasive Surgery, University Federico II of Naples, Naples, Italy
| | - Andrea Coppola
- Department of General and Oncological Minimally Invasive Surgery, University Federico II of Naples, Naples, Italy
| | - Federica Lauria
- Department of General and Oncological Minimally Invasive Surgery, University Federico II of Naples, Naples, Italy
| | - Umberto Bracale
- Department of General and Oncological Minimally Invasive Surgery, University Federico II of Naples, Naples, Italy
| | - Francesco Corcione
- Department of General and Oncological Minimally Invasive Surgery, University Federico II of Naples, Naples, Italy
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Buck C, Lauria F, Eiben G, Konstabel K, Page A, Pigeot I, Ahrens W. A longitudinal study of urban moveability and physical activity in the transition phase from childhood to adolescence. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Lauria F, Raspadori D, Foà R, Tazzari PL, Lusso P, Fierro MT, Matera L, Baccarani M, Tura S. Normal T-Lymphocyte Function in Patients with Hodgkin's Disease in Long-Lasting Remission. Tumori 2018; 72:75-80. [PMID: 2937189 DOI: 10.1177/030089168607200111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In 18 patients with Hodgkin's disease (HD) in long-lasting remission (more than 5 years), the distribution of circulating T-lymphocytes was analyzed using a series of monoclonal antibodies (OKT3, T4, T8, Leu-7, Leu-11 and T10) and correlated with cell function (helper capacity in a pokeweed mitogen system and natural killer (NK) activity). A reduced proportion of OKT4 (helper/inducer)-positive cells associated with a normal absolute number was consistently accompanied by a significant increase (p < 0.005) in the proportion and absolute number of OKT8 (suppressor/cytotoxic)-positive cells. The OKT4-positive cells, despite their moderate percentage reduction, showed normal helper activity. A more extensive characterization of the lymphoid population in these patients documented a preserved cytotoxic function in a 51Cr release assay and increased proportion of cells expressing NK-associated antigens (Leu-7, Leu-11, OKT10) with a high number of cells coexpressing OKT8 and Leu-7. It is suggested that in patients with Hodgkin's disease in long-lasting remission no laboratory (or clinical) evidence of cellular immunodeficiency can be documented.
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Lauria F, Baccarani M, Barbieri E, Fiacchini M, Tura S. Combination Chemotherapy with Methotrexate, Endoxan, and Vincristine (M.E.V.) in the Treatment of non-Hodgkin's Lymphoma. Tumori 2018; 59:401-8. [PMID: 4598587 DOI: 10.1177/030089167305900602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Twelve patients with lymphocytic lymphoma (L.L.), and 9 patients with histiocytic lymphoma (H.L.), stage III and IV, were treated as outpatients with combination chemotherapy including six courses of cyclophosphamide (Endoxan), Methotrexate, and vincristine (M.E.V. regimen). Marrow depression and side-effects were moderate. In the 12 patients with L.L., there were 6 complete remissions (C.R.), 3 incomplete remission (I.R.), and 3 partial failures (P.F.). In the 9 patients with H.L., there were 7 C.R., 1 I.R. and 1 P.F. Median survival from the end of the therapy is 7 + mos. for the L.L. patients, and 10 + mos. for H.L. patients, all patients being alive but one.
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Formisano A, Bammann K, Fraterman A, Hadjigeorgiou C, Herrmann D, Iacoviello L, Marild S, Moreno LA, Nagy P, Van Den Bussche K, Veidebaum T, Lauria F, Siani A. Efficacy of neck circumference to identify metabolic syndrome in 3-10 year-old European children: Results from IDEFICS study. Nutr Metab Cardiovasc Dis 2016; 26:510-516. [PMID: 27089975 DOI: 10.1016/j.numecd.2016.02.012] [Citation(s) in RCA: 11] [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: 11/22/2015] [Revised: 01/29/2016] [Accepted: 02/16/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS Several studies demonstrated that larger neck circumference (NC) in children and adolescents may help to identify obesity and cardio-metabolic abnormalities. We aimed to evaluate the correlation between NC and metabolic syndrome (MetS) risk factors and to determine the utility of this anthropometric index to identify MetS in European children. METHODS AND RESULTS The present cross-sectional analysis includes 15,673 children (3-10 years) participating in the IDEFICS study. A continuous MetS (cMetS) score was calculated summing age and sex standardized z-scores of specific MetS risk factors. Receiver Operating Characteristic analysis, stratified by one-year age groups, was used to determine the ability of NC to identify children with unfavorable metabolic profile, corresponding to cMetS score ≥ 90th percentile. The areas under the curve values for NC associated with cMetS score values ≥ 90th percentile were significantly greater in girls than in boys (p < 0.001), except for 5 < 6 years group. For boys, optimal NC cut-off values ranged from 26.2 cm for the lowest age group (3 < 4 years), up to 30.9 cm for the highest age group (9 < 10 years). In girls, corresponding values varied from 24.9 cm to 29.6 cm. CONCLUSION The study demonstrated the efficacy of NC in identifying European children with an unfavorable metabolic profile.
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Affiliation(s)
- A Formisano
- Epidemiology and Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
| | - K Bammann
- Institute for Public Health and Nursing Science, Bremen University, Bremen, Germany; Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH, Bremen, Germany
| | - A Fraterman
- Laboratoriumsmedizin Dortmund, Eberhard & Partner, Dortmund, Germany
| | - C Hadjigeorgiou
- Child Health research and educational institute, Strovolos, Cyprus
| | - D Herrmann
- Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH, Bremen, Germany
| | - L Iacoviello
- Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Mediterranean Neurological Institute Neuromed, Pozzilli, Italy
| | - S Marild
- Department of Pediatrics, Queen Silvia Children's Hospital, University of Gothenburg, Sweden
| | - L A Moreno
- Growth, Exercise, Nutrition, and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - P Nagy
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | | | - T Veidebaum
- National Institute for Health Development, Tallinn, Estonia
| | - F Lauria
- Epidemiology and Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
| | - A Siani
- Epidemiology and Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy.
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Nicholls SG, Pohlabeln H, De Bourdeaudhuij I, Chadjigeorgiou C, Gwozdz W, Hebestreit A, Lauria F, Lissner L, Molnár D, Santaliestra-Pasías AM, Veidebaum T, Williams G. Parents' evaluation of the IDEFICS intervention: an analysis focussing on socio-economic factors, child's weight status and intervention exposure. Obes Rev 2015; 16 Suppl 2:103-18. [PMID: 26707020 DOI: 10.1111/obr.12332] [Citation(s) in RCA: 7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 09/08/2015] [Accepted: 09/08/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION From April 2008 to August 2010 the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) intervention aimed to encourage healthier diets, higher physical activity levels and lower stress levels among European children and their families. While the intervention was intended to improve children's health, we also wished to assess whether there were unwelcome aspects or negative side-effects. Therefore all parents of children who participated in the IDEFICS intervention were asked for their views on different aspects of the intervention. METHODS A total of 10,016 parents of children who participated in the IDEFICS survey and who were involved in the intervention were invited to complete a questionnaire on positive and negative impacts of the intervention. Responses to each of the statements were coded on a four point Likert-type scale. Demographic data were collected as part of the baseline (T0 ) and first follow-up (T1 ) surveys; intervention exposure data was also collected in the T1 follow-up survey. Anthropometric data was collected in the same surveys, and child's weight status was assessed according to Cole and Lobstein. After initial review of the univariate statistics multilevel logistic regression was conducted to analyse the influence of socio-economic factors, child's weight status and intervention exposure on parental responses. RESULTS In total 4,997 responses were received. Approval rates were high, and few parents reported negative effects. Parents who reported higher levels of exposure to the intervention were more likely to approve of it and were also no more likely to notice negative aspects. Less-educated and lower income parents were more likely to report that the intervention would make a lasting positive difference, but also more likely to report that the intervention had had negative effects. Parents of overweight and obese children were more likely to report negative effects - above all, that 'the intervention had made their child feel as if he/she was "fat" or "overweight." ' CONCLUSION While the results represent a broad endorsement of the IDEFICS intervention, they also suggest the importance of vigilance concerning the psychological effects of obesity interventions on overweight and obese children.
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Affiliation(s)
- S G Nicholls
- School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ontario, Canada.,Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada
| | - H Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - C Chadjigeorgiou
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - W Gwozdz
- Department of Intercultural Communication and Management, Copenhagen Business School, Denmark
| | - A Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - F Lauria
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - L Lissner
- Section for Epidemiology and Social Medicine (EPSO), Institute of Medicine, University of Gothenburg, Sweden
| | - D Molnár
- Department of Paediatrics, University of Pécs, Hungary
| | - A M Santaliestra-Pasías
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Spain; Red de Salud Materno Infantil y del Desarrollo (RED SAMID), Instituto Carlos III, Madrid, Spain
| | - T Veidebaum
- National Institute for Health Development, Tallinn, Estonia
| | - G Williams
- Department of Politics, Philosophy and Religion, Lancaster University, UK
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Donatiello E, Dello Russo M, Formisano A, Lauria F, Nappo A, Reineke A, Sparano S, Barba G, Russo P, Siani A. Physical activity, adiposity and urbanization level in children: results for the Italian cohort of the IDEFICS study. Public Health 2013; 127:761-5. [PMID: 23876300 DOI: 10.1016/j.puhe.2013.04.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [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: 06/22/2012] [Revised: 12/17/2012] [Accepted: 04/29/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVES While there is extensive evidence about the influence of environmental factors on adult obesity, fewer studies have assessed how the environment influences body fat in children. This cross-sectional study investigated the distribution of adiposity indices according to urbanization level and patterns of physical activity among children in the Italian cohort of the IDEFICS study. METHODS The sample included 1673 preschool and school-aged children (mean age 6.1 years, standard deviation 1.7) living in rural (n = 579), suburban (n = 442) and urban (n = 652) areas. Anthropometric measures were taken and questionnaires were used to assess children's lifestyles, including patterns of physical activity. RESULTS Children who lived in rural areas spent significantly more time in outdoor activities but participated in less structured physical activity compared with children living in suburban and urban areas. Adiposity estimated by the sum of skinfold thickness increased linearly from rural to urban areas, with results for suburban areas showing intermediate values. CONCLUSIONS The data show that geographical environmental factors influence patterns of physical activity and body fat in children. In particular, the results suggest an association between the time spent in unstructured outdoor activities and the degree of adiposity in schoolchildren. These results may have implications for public health, including efforts to increase freely available playgrounds as an effective measure to counteract the obesity epidemic in children.
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Affiliation(s)
- E Donatiello
- Epidemiology and Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
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12
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Barba G, Sieri S, Russo MD, Donatiello E, Formisano A, Lauria F, Sparano S, Nappo A, Russo P, Brighenti F, Krogh V, Siani A. Glycaemic index and body fat distribution in children: the results of the ARCA project. Nutr Metab Cardiovasc Dis 2012; 22:28-34. [PMID: 20674304 DOI: 10.1016/j.numecd.2010.03.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [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: 07/20/2009] [Revised: 03/17/2010] [Accepted: 03/26/2010] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND AIMS Various dietary factors may play a critical role in body weight regulation. Among them, the role of glycaemic index (GI) remains a subject of debate. The present study aimed at evaluating the association between dietary GI, body mass index (BMI) and body fat distribution in school children. METHODS AND RESULTS 3734 Italian children (M/F = 1883/1851; age range 6-11 years) were cross-sectionally screened for anthropometry (BMI, waist circumference), lifestyle and clinical history (questionnaire) and dietary habits (1-year food frequency questionnaire). Energy and macronutrients intake, dietary GI and glycaemic load (GL) were calculated. GI was directly associated with age, waist and BMI z-scores, energy, fibre and carbohydrate intake (r: from 0.080 to 0.238, P < 0.001), and negatively with fat intake (r: -0.060, P < 0.0001). BMI, waist circumference, energy intake, carbohydrate, protein and fibre intake and GL significantly increased, whilst fat intake decreased, going up across quartiles of residuals of dietary GI. At linear regression analysis, GI was associated with BMI and waist z-scores independently of age, sex, parental overweight/obesity, parental education, and energy intake, protein, fat, carbohydrate, fibre and GL residuals. In particular, GI was the sole nutritional factor among those under investigation, significantly associated with waist circumference. Controlling for covariates, the risk of overweight/obesity or of central fat distribution was almost two-folds higher in the upper quartile in comparison to the lowest quartile of dietary GI. CONCLUSION Dietary GI is an independent determinant of body fat distribution in children as well as of total adiposity.
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Affiliation(s)
- G Barba
- Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Via Roma 52 A/C, 83100 Avellino, Italy.
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13
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Fill C, Finelli C, Gobbi M, Martinelli G, Iacobucci I, Ottaviani E, Cocco L, Matilde F, Candoni A, Simeone E, Miglino M, Lauria F, Bocchia M, Defina M, Clissa C, Lanza F, Spedini P, Skert C, Bergonzi C, Malagola M, Peli A, Turra A, Cattina F, Colombi C, Russo D. 216 Azacitidine low-dose schedule in low-risk myelodysplastic syndromes. Clinical results of a multicenter phase II study. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70218-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Angelucci E, Di Tucci A, Storti S, Magro D, Tosi P, Amadori S, Leoni P, Gobbi M, Brugiatelli M, Pane F, Visani G, Nobile F, Lauria F, Fanin R, Specchia G, Ditonno P, Rossi G, Forni G, Abbadessa A, Olivieri A, Porcedda S, Pilo F, Piciocchi A A, Vignetti M, Tura S. 208 Iron chelation therapy with deferasirox in transfusion dependent myelodysplastic syndrome patients. Preliminary report from the prospective MDS0306 GIMEMA trial. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70210-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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15
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Abstract
Obesity is a complex disease, arising from the interaction between several genetic and environmental factors. Until recently, the genetic basis of complex diseases in general, and of obesity in particular, were poorly characterized. While the relatively rare monogenic and syndromic forms of obesity clearly recognize a genetic origin, the actual worldwide epidemics of obesity represent a challenge for the identification of the genetic factors involved, being likely the effect of several loci each having a subtle influence on the phenotypic expression. Progress in DNA analysis techniques and in computational tools, and the increasing level of characterization of the variability of the human genome has recently allowed to study comprehensively the association between genetic variants and obesity. To date, well-conducted and powered genome-wide association studies allowed to consistently identify genomic regions - lying on different chromosomes and affecting different metabolic pathways - influencing the predisposition to the accumulation of body fat, ultimately leading to overweight and obesity. However, the population attributable risk for obesity linked to the most statistically significant loci, like FTO and MC4R, remains discouragingly low, explaining only small fractions of the overall variance of body weight. In the last few years, the role of the complex interaction between genetic determinants and environmental factors in the rapid global increase of obesity has been further challenged by the entry of new players, that is the transcriptional and post-transcriptional regulation, summarized under the emerging discipline of epigenetics. The key challenge now is to move from the identification of causal genes and variants to the integration of different "omics" disciplines, finally allowing the molecular understanding of obesity and related conditions.
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Affiliation(s)
- P Russo
- Unit of Epidemiology and Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
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16
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Busi Rizzi E, Schininà V, Ferraro F, Rovighi L, Cristoforo M, Chiappetta D, Lisena F, Lauria F, Bibbolino C. Radiological findings of pneumonia in patients with swine-origin influenza A virus (H1N1). Radiol Med 2010; 115:507-15. [PMID: 20526820 PMCID: PMC7101976 DOI: 10.1007/s11547-010-0553-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Accepted: 01/13/2010] [Indexed: 01/15/2023]
Abstract
Purpose During spring 2009, a pandemic swine-origin influenza A (H1N1) virus (S-OIV) emerged and spread globally. We describe the chest X-ray and computed tomography (CT) findings of 40 patients with pneumonia due to S-OIV observed in our institution. Material and methods Among 534 patients with S-OIV, according to the US Centers for Disease Control and Prevention case definition, seen between June and November 2009, 121 underwent chest X-ray and 40 (median age 44 years, range 16–79) had pneumonia. The initial chest radiographs were evaluated for pattern, distribution and extent of lung abnormalities. Unenhanced chest CT scans were performed in two patients and were reviewed for the same findings. Underlying medical conditions were present in 42% of patients (17/40). Results Our patients had predominantly mild illness, and pneumonia was observed in 40 individuals (40/121 patients who had chest X-rays, 33%; and 40/534 patients with S-OIV, 7.5%). However, S-OIV can cause severe illness requiring admission to the intensive care unit for advanced mechanical ventilation and extracorporeal life support, including adult respiratory distress syndrome (ARDS) and death. The major radiological abnormalities observed were interstitial changes (60.0%), with (22.0%) or without patchy ground-glass appearance, mostly bilateral, and located in the lower lung zones (7.5%). Extensive disease was seen in 37.5% (15/40), and ARDS was observed in three individuals (0.30%)with underlying medical conditions. Subtle pleural effusion was noted in four patients. Conclusions In our series, the most frequent pneumonia patterns observed during S-OIV (H1N1) virus were interstitial changes and patchy ground-glass appearance, mostly bilateral, and located in the lower lung zones. CT, performed in severely ill patients, confirmed the ARDS identified with chest X-rays, better depicting the features and extent of lung abnormalities.
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Affiliation(s)
- E Busi Rizzi
- Diagnostic Department, Radiology, National Institute for Infectious Diseases L. Spallanzani, Via Portuense 292, 00149, Rome, Italy.
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Defina M, Gozzetti A, Rondoni M, Aprile L, Ippoliti M, Chitarrelli I, Lauria F, Bocchia M. Very late relapse in a patient with chronic myeloid leukemia in sustained complete cytogenetic response under imatinib. Leuk Res 2010; 34:e215-6. [PMID: 20334915 DOI: 10.1016/j.leukres.2010.02.037] [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] [Received: 02/07/2010] [Revised: 02/27/2010] [Accepted: 02/28/2010] [Indexed: 10/19/2022]
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18
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Foa R, Vischia F, Pini M, Lauria F, Guarini A. Use of the MTT Chemosensitivity Assay in B-Cell Chronic Lymphocytic Leukemia. Leuk Lymphoma 2009; 5 Suppl 1:71-5. [DOI: 10.3109/10428199109103382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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19
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Lauria F, Zinzani PL, Raspadori D, Foà R, Buzzi M, Gugliotta L, Bocchia M, Benfenati D, Tura S. Relationship between immunological phenotype and hematological response to alpha-IFN treatment in 35 patients with hairy cell leukemia. Eur J Haematol Suppl 2009; 52:3-6. [PMID: 2279543 DOI: 10.1111/j.1600-0609.1990.tb00895.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
During the past 6 years, clinical trials employing alpha-interferon (alpha-IFN) in hairy cell leukemia (HCL) have shown dramatic improvement in the management of this disease. Complete remissions (CR), however, are relatively rare (10-15%) and a minority of patients (10-25%) do not respond adequately to alpha-IFN. The possibility that the poor response to alpha-IFN treatment could be related to a peculiar immunological phenotype of the hairy cell (HC) was investigated in this study. The results demonstrated that, in the majority of patients who failed to respond to alpha-IFN, HC showed an immunological phenotype characterized by positivity with the CD5 monoclonal antibody which is usually absent on HC and characteristically expressed on B-chronic lymphocytic leukemia cells. In fact, among the 10 HCL patients who presented with this phenotype, only 5 partial remissions (PR) and 5 minor responses (MR) were achieved, as opposed to the 3 complete remissions (CR), 19 PR and 3 MR observed in the 25 CD5-negative patients. The possibility that a more extensive immunological analysis of HCL patients at diagnosis may be predictive of the response to IFN treatment is postulated.
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Affiliation(s)
- F Lauria
- Istituto di Ematologia e A. Seràgnoli, University of Bologna, Italy
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20
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Damasio EE, Federico M, Frassoldati A, Lamparelli T, Annino L, Bernasconi C, Chisesi T, Foá R, Lauria F, Pagnucco G. Splenectomy after initial therapy with alpha-IFN in patients with hairy-cell leukemia (HCL): a multi-center study by the Italian Cooperative Group for HCL. Preliminary results. Eur J Haematol Suppl 2009; 52:29-31. [PMID: 2279542 DOI: 10.1111/j.1600-0609.1990.tb00902.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Since December 1987, 115 patients with HCL have been enrolled in a prospective multicenter study to evaluate the role of splenectomy after an induction therapy with alpha interferon. The group of patients was divided into two categories: those younger and those older than 65 years. The schedule of treatment with IFN was, respectively, 1.8 MU/sm/daily and 1.0 MU/daily, 33 patients were treated with r-alpha-2a, 34 with r-alpha-2b, and 25 with alpha-Ly. To date, 92 patients are fully evaluable. The response was assessed every 3 months by bone marrow trephine biopsy. Patients in CR continued IFN therapy for 3 months and, if they were still in CR, could undergo an optional splenectomy. Patients in PR continued therapy for 12 months and subsequently were randomized for splenectomy or observation only. In these preliminary results of an ongoing protocol, CR was obtained in 5 cases (6%), PR in 59 (64%), MR in 25 (27%), NR in 3 (3%). Only 2 of the 5 patients in CR underwent splenectomy and are still in CR. Of the 59 patients in PR, only 15 completed 12 months of therapy. 9 patients in Group A were randomized, 4 were splenectomized and 5 were in the observation arm. All patients were splenectomized safely and no complications occurred. These preliminary results suggest that splenectomy could be effective in consolidating the response obtained with IFN.
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Affiliation(s)
- E E Damasio
- Divisione Ematologia I, Ospedale San Martino, Genova, Italy
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21
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Barba G, Casullo C, Dello Russo M, Russo P, Nappo A, Lauria F, Siani A. Gender-related differences in the relationships between blood pressure, age, and body size in prepubertal children. Am J Hypertens 2008; 21:1007-10. [PMID: 18617882 DOI: 10.1038/ajh.2008.228] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The blood pressure (BP) increase with age is well documented in adults and children. However, in the pediatric age group, body size is the most important determinant of age-related BP increases. The aim of the present analysis was to investigate the relationships between age, gender, and body size and BP in children. METHODS To this purpose, data were analyzed from 4,514 prepubertal children, aged 6-11 years (71% of the eligible sample; boys = 2,283, girls = 2,231) from the ARCA Project, a screening of childhood obesity carried out in southern Italy. Girls who reported the occurrence of menarche were excluded from the analysis. The sample constituted roughly 20% of all the children attending the primary schools in the area. Weight, height, waist circumference, and BP were measured according to standardized procedures. RESULTS As expected, both systolic and diastolic BP significantly increased (P < 0.001) with age in boys and girls. However, after adjustment for waist circumference (as index of adiposity) and height (as index of body size), BP significantly increased with age only in girls (systolic BP: F = 4.380, P = 0.002; diastolic BP: F = 3.093, P = 0.01) but not in boys (systolic BP: F = 0.711, P = 0.55; diastolic BP: F = 2.180, P = 0.07). The association, however, was no longer apparent after the exclusion of children aged >10 years. CONCLUSIONS In prepubertal girls in the age range 6-11 years, but not in boys, age is significantly associated with BP independently of body size and adiposity.
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Lauria F, Foa R, Mantovani V, Fierro MT, Catovsky D, Tura S. T-cell functional abnormality in B-chronic lymphocytic leukaemia: evidence of a defect of the T-helper subset. Br J Haematol 2008. [DOI: 10.1111/j.1365-2141.1983.00277.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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23
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Mangia A, Antonucci F, Brunetto M, Capobianchi M, Fagiuoli S, Guido M, Farci P, Lampertico P, Marzano A, Niro G, Pisani G, Prati D, Puoti M, Raimondo G, Santantonio T, Smedile A, Lauria F. The use of molecular assays in the management of viral hepatitis. Dig Liver Dis 2008; 40:395-404. [PMID: 18321798 DOI: 10.1016/j.dld.2007.12.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2007] [Revised: 12/14/2007] [Accepted: 12/18/2007] [Indexed: 02/07/2023]
Abstract
Molecular assays are instrumental in the clinical management of viral hepatitis. During the past years, a wide variety of molecular assays have been developed and implemented. This considerably improved the understanding of the natural history and pathogenesis of Hepatitis B virus (HBV), Hepatitis C virus (HCV) or Hepatitis delta virus (HDV) hepatitis, but also caused uncertainties in the selection of the most appropriate assays for clinical requirements. Indeed, a rational choice and application of these assays requires adequate knowledge of the performance of the single test. Moreover, the choice of the most accurate assay for patients' needs and physicians' objectives, needs to be oriented to specific contexts, such as diagnosis, management or treatment. In the past, a hurdle in the routine use of assays for hepatitis viruses nucleic acid quantification was represented by the availability of only "home brew" methods which lacked standardization. Major improvement in addressing the use of molecular assays for viral hepatitis has been derived from recent standardization procedures that allowed a comparison between different tests after results were given as International Units. In addition, it should be reminded that, before getting into the market, molecular assays should be approved by European regulation authorities and validated using internationally recognized standards. A subsequent clinical validation should address the diagnostic accuracy of the assay. These proceedings have the aim of identifying which molecular tests, among those currently available, meet clinical requirements for each specific application.
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Affiliation(s)
- A Mangia
- Liver Unit, IRCCS, Ospedale "Casa Sollievo della Sofferenza" San Giovanni Rotondo, Italy.
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Piccaluga PP, Malagola M, Rondoni M, Arpinati M, Paolini S, Candoni A, Fanin R, Messa E, Pirrotta MT, Lauria F, Visani G, Alberti D, Rancati F, Vinaccia V, Russo D, Saglio G, Baccarani M, Martinelli G. Imatinib mesylate in the treatment of newly diagnosed or refractory/resistant c-KIT positive acute myeloid leukemia. Results of an italian multicentric phase II study. Haematologica 2007; 92:1721-1722. [PMID: 18056005 DOI: 10.3324/haematol.11345] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
We evaluated safety and efficacy of imatinib (600 mg) in 36 c-KIT+ acute myeloid leukemia patients not amenable to receive conventional chemotherapy. No patient achieved complete remission. One patient obtained a hematologic improvement (platelet increase with transfusion independence). Median overall survival was 3 months (0.5-44+). Non-hematologic toxicity was overall mild.
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Verzola D, Gandolfo MT, Ferrario F, Rastaldi MP, Villaggio B, Gianiorio F, Giannoni M, Rimoldi L, Lauria F, Miji M, Deferrari G, Garibotto G. Apoptosis in the kidneys of patients with type II diabetic nephropathy. Kidney Int 2007; 72:1262-72. [PMID: 17851466 DOI: 10.1038/sj.ki.5002531] [Citation(s) in RCA: 143] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The occurrence and extent of apoptosis in the kidneys of patients with diabetic nephropathy is largely unknown. We evaluated apoptosis in renal biopsies obtained from patients with early or advanced type II diabetic nephropathy. Apoptosis was about 6- and 3-fold higher, respectively, in glomeruli and tubules in kidneys of patients with early nephropathy than in the normal kidney and this was not further increased in advanced diabetic nephropathy. Glomerular apoptosis was related directly to hemoglobin A1(c) and systolic blood pressure, whereas tubular cell apoptosis correlated to diabetes duration and low-density lipoprotein-cholesterol. Fas, Fas ligand, and p38 mitogen-activated protein kinase expressions were enhanced in glomeruli and tubules; however, this did not correlate with apoptosis. In patients with proteinuria, apoptosis was associated with the subsequent loss of kidney function. When these parameters were subjected to multivariate analysis, only glomerular apoptosis retained a significant independent predictive value. Our findings suggest that apoptosis might be a clinically relevant mechanism of glomerular and tubular cell loss in proteinuric type II diabetic patients.
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Affiliation(s)
- D Verzola
- Nephrology Division, Department of Internal Medicine, Genoa University, Genoa, Italy
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26
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Bocchia M, Ippoliti M, Gozzetti A, Abruzzese E, Calabrese S, Amabile M, Pirrotta MT, Crupi R, Tozzuoli D, Trawinska MM, Defina M, Martinelli G, Lauria F. CD34+/Ph+ cells are still detectable in chronic myeloid leukemia patients with sustained and prolonged complete cytogenetic remission during treatment with imatinib mesylate. Leukemia 2007; 22:426-8. [PMID: 17690698 DOI: 10.1038/sj.leu.2404893] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Russo P, Loguercio M, Lauria F, Barba G, Arnout J, Cappuccio FP, Iacoviello L, Siani A. Age- and gender-dependent association of the –344C/T polymorphism of CYP11B2 with blood pressure in European populations. J Hum Hypertens 2007; 21:333-6. [PMID: 17273158 DOI: 10.1038/sj.jhh.1002136] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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29
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Bocchia M, Abruzzese E, Forconi F, Ippoliti M, Trawinska MM, Pirrotta MT, Raspadori D, Tozzi M, Gozzetti A, Lauria F. Imatinib does not impair specific antitumor T-cell immunity in patients with chronic myeloid leukemia. Leukemia 2006; 20:142-3. [PMID: 16281064 DOI: 10.1038/sj.leu.2404029] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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30
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Rubegni P, Cuccia A, Sbano P, Cevenini G, Carcagnì MR, D'Ascenzo G, De Aloe G, Guidi S, Guglielmelli P, Guglielmetti P, Marotta G, Lauria F, Bosi A, Fimiani M. Role of extracorporeal photochemotherapy in patients with refractory chronic graft-versus-host disease. Br J Haematol 2005; 130:271-5. [PMID: 16029456 DOI: 10.1111/j.1365-2141.2005.05586.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Recent studies suggest that extracorporeal photochemotherapy (ECP) may be beneficial in patients with steroid-refractory chronic graft-versus-host disease (cGvHD). However, it is not yet clear whether certain conditions, such as age, mode of onset of cGvHD etc., influence clinical response and whether certain affected organs are more sensitive to ECP than others. We analysed the main clinical and laboratory parameters related to evolution of the disease in 32 steroid-refractory cGvHD patients, to identify any useful response predictors to ECP. ECP affected the course of the disease positively in 78% (25/32) of our cases.
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Affiliation(s)
- P Rubegni
- Department of Clinical Medicine and Immunological Science, Sections of Dermatology, University of Siena, Siena, Italy.
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Zaja F, Tomadini V, Zaccaria A, Lauria F, Molinari AL, Fabbri A, Battista R, Angelucci E, Gallamini A, Battista M, Fanin R. Liposomal doxorubicin-liposomal doxorubicin-rituximab for the treatment of elderly patients with diffuse large B-cell lymphoma. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6687] [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: 11/20/2022] Open
Affiliation(s)
- F. Zaja
- Div of Hematology, Policlinico Univ, Udine, Italy; Div of Hematology, Ravenna, Italy; Div of Hematology, Siena, Italy; Div of Hematology, Chioggia, Italy; Div of Hematology, Cagliari, Italy; Div of Hematology, Cuneo, Italy
| | - V. Tomadini
- Div of Hematology, Policlinico Univ, Udine, Italy; Div of Hematology, Ravenna, Italy; Div of Hematology, Siena, Italy; Div of Hematology, Chioggia, Italy; Div of Hematology, Cagliari, Italy; Div of Hematology, Cuneo, Italy
| | - A. Zaccaria
- Div of Hematology, Policlinico Univ, Udine, Italy; Div of Hematology, Ravenna, Italy; Div of Hematology, Siena, Italy; Div of Hematology, Chioggia, Italy; Div of Hematology, Cagliari, Italy; Div of Hematology, Cuneo, Italy
| | - F. Lauria
- Div of Hematology, Policlinico Univ, Udine, Italy; Div of Hematology, Ravenna, Italy; Div of Hematology, Siena, Italy; Div of Hematology, Chioggia, Italy; Div of Hematology, Cagliari, Italy; Div of Hematology, Cuneo, Italy
| | - A. L. Molinari
- Div of Hematology, Policlinico Univ, Udine, Italy; Div of Hematology, Ravenna, Italy; Div of Hematology, Siena, Italy; Div of Hematology, Chioggia, Italy; Div of Hematology, Cagliari, Italy; Div of Hematology, Cuneo, Italy
| | - A. Fabbri
- Div of Hematology, Policlinico Univ, Udine, Italy; Div of Hematology, Ravenna, Italy; Div of Hematology, Siena, Italy; Div of Hematology, Chioggia, Italy; Div of Hematology, Cagliari, Italy; Div of Hematology, Cuneo, Italy
| | - R. Battista
- Div of Hematology, Policlinico Univ, Udine, Italy; Div of Hematology, Ravenna, Italy; Div of Hematology, Siena, Italy; Div of Hematology, Chioggia, Italy; Div of Hematology, Cagliari, Italy; Div of Hematology, Cuneo, Italy
| | - E. Angelucci
- Div of Hematology, Policlinico Univ, Udine, Italy; Div of Hematology, Ravenna, Italy; Div of Hematology, Siena, Italy; Div of Hematology, Chioggia, Italy; Div of Hematology, Cagliari, Italy; Div of Hematology, Cuneo, Italy
| | - A. Gallamini
- Div of Hematology, Policlinico Univ, Udine, Italy; Div of Hematology, Ravenna, Italy; Div of Hematology, Siena, Italy; Div of Hematology, Chioggia, Italy; Div of Hematology, Cagliari, Italy; Div of Hematology, Cuneo, Italy
| | - M. Battista
- Div of Hematology, Policlinico Univ, Udine, Italy; Div of Hematology, Ravenna, Italy; Div of Hematology, Siena, Italy; Div of Hematology, Chioggia, Italy; Div of Hematology, Cagliari, Italy; Div of Hematology, Cuneo, Italy
| | - R. Fanin
- Div of Hematology, Policlinico Univ, Udine, Italy; Div of Hematology, Ravenna, Italy; Div of Hematology, Siena, Italy; Div of Hematology, Chioggia, Italy; Div of Hematology, Cagliari, Italy; Div of Hematology, Cuneo, Italy
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Bocchia M, Gentili S, Abruzzese E, Fanelli A, Iuliano F, Tabilio A, Amabile M, Forconi F, Gozzetti A, Raspadori D, Amadori S, Lauria F. Effect of a p210 multipeptide vaccine associated with imatinib or interferon in patients with chronic myeloid leukaemia and persistent residual disease: a multicentre observational trial. Lancet 2005; 365:657-62. [PMID: 15721470 DOI: 10.1016/s0140-6736(05)17945-8] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Although imatinib is the standard treatment for chronic myeloid leukaemia, not all patients reach complete cytogenetic remission (CCR) and most maintain detectable disease at the molecular level. We investigated whether a vaccine targeting the BCR-ABL-derived p210 fusion protein was an active and specific immunotherapy. METHODS We recruited 16 patients who had chronic myeloid leukaemia (with the b3a2 fusion point of p210), stable residual disease, a minimum treatment of 12 months of imatinib or 24 months of interferon alfa, and no further reduction of residual disease for at least 6 months preceding enrollment. They were given six vaccinations with a peptide vaccine derived from the sequence p210-b3a2 plus molgramostim and QS-21 as adjuvants (CMLVAX100) before assessment of immunological and disease response, which included detecting amounts of b3a2 transcripts by standardised quantitative real-time reverse-transcriptase PCR. RESULTS Of ten patients on imatinib, nine started CMLVAX100 having had a median of 10 months' stable cytogenetic disease (median 10% Philadelphia-chromosome-positive metaphases), whereas one started in stable CCR. All patients' cytogenetic responses improved after six vaccinations, with five reaching CCR. Notably, three of these five patients also had undetectable amounts of b3a2 transcript (BCR-ABL:beta2 microglobulin ratio <0.00001). Six patients on interferon alfa treatment with a median of 17 months' stable residual disease (median 13% Philadelphia-chromosome-positive cells) were also vaccinated. All but one had improved cytogenetic responses, and two reached CCR. Overall, we recorded peptide-specific delayed-type hypersensitivity (in 11 of 16 patients), CD4 cell proliferation (13 of 14 assessed), and interferon gamma production (five of five assessed). INTERPRETATION Addition of CMLVAX100 to conventional treatment in patients with chronic myeloid leukaemia might favour further reduction of residual disease and increase the number of patients reaching a molecular response.
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Affiliation(s)
- M Bocchia
- Department of Haematology, Siena University, Siena, Italy.
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Russo P, Lauria F, Caggiano R, Loguercio M, Strazzullo P, Cappuccio FP, Iacoviello L, Barba G, Siani A. HINDIII(+/???) Polymorphism of Y Chromosome and Cardiovascular Risk Factors in Three European Populations. High Blood Press Cardiovasc Prev 2005. [DOI: 10.2165/00151642-200512030-00047] [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: 11/02/2022] Open
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34
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Russo P, Venezia A, Lauria F, Loguercio M, Caggiano R, Barba G, Iacoviello L, Cappuccio FP, Arnout J, Siani A. C Allele of CYP11b2 ???344c/T Polymorphism is Associated with High Blood Pressure in Younger Caucasian Males. High Blood Press Cardiovasc Prev 2005. [DOI: 10.2165/00151642-200512030-00048] [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: 11/02/2022] Open
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35
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Barba G, Galletti F, Casullo C, Donatiello A, Lauria F, Russo P, Strazzullo P, Siani A. Prevalence of Paediatric Hypertension in a Sample of School-Age Children in the Campania Region. High Blood Press Cardiovasc Prev 2005. [DOI: 10.2165/00151642-200512030-00023] [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: 11/02/2022] Open
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36
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Abruzzese E, Bocchia M, Trawinska M, Morino L, Iuliano F, Orlandi G, Panetta P, Del Poeta G, Lauria F, Amadori S. Peptide-vaccine treatment associated with imatinib in patients with residual CML disease is able to induce both immunologic response and molecular remission. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.2517] [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: 11/20/2022] Open
Affiliation(s)
- E. Abruzzese
- Tor Vergata University, S. Eugenio Hospital, Rome, Italy; Hematology, Siena, Italy; Hematology, Catanzaro, Italy
| | - M. Bocchia
- Tor Vergata University, S. Eugenio Hospital, Rome, Italy; Hematology, Siena, Italy; Hematology, Catanzaro, Italy
| | - M. Trawinska
- Tor Vergata University, S. Eugenio Hospital, Rome, Italy; Hematology, Siena, Italy; Hematology, Catanzaro, Italy
| | - L. Morino
- Tor Vergata University, S. Eugenio Hospital, Rome, Italy; Hematology, Siena, Italy; Hematology, Catanzaro, Italy
| | - F. Iuliano
- Tor Vergata University, S. Eugenio Hospital, Rome, Italy; Hematology, Siena, Italy; Hematology, Catanzaro, Italy
| | - G. Orlandi
- Tor Vergata University, S. Eugenio Hospital, Rome, Italy; Hematology, Siena, Italy; Hematology, Catanzaro, Italy
| | - P. Panetta
- Tor Vergata University, S. Eugenio Hospital, Rome, Italy; Hematology, Siena, Italy; Hematology, Catanzaro, Italy
| | - G. Del Poeta
- Tor Vergata University, S. Eugenio Hospital, Rome, Italy; Hematology, Siena, Italy; Hematology, Catanzaro, Italy
| | - F. Lauria
- Tor Vergata University, S. Eugenio Hospital, Rome, Italy; Hematology, Siena, Italy; Hematology, Catanzaro, Italy
| | - S. Amadori
- Tor Vergata University, S. Eugenio Hospital, Rome, Italy; Hematology, Siena, Italy; Hematology, Catanzaro, Italy
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Sammassimo S, Mazzotta S, Tozzi M, Gentili S, Lenoci M, Santopietro R, Bucalossi A, Bocchia M, Lauria F. Disseminated mucormycosis in a patient with acute myeloblastic leukemia misdiagnosed as infection by Enterococcus faecium. J Clin Microbiol 2004; 42:487-9. [PMID: 14715813 PMCID: PMC321679 DOI: 10.1128/jcm.42.1.487-489.2004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Mucormycosis is a rare complication in cancer patients. This report presents the case of a acute myeloblastic leukemia patient who developed an ascending paralysis due to disseminated mucormycosis. The presentation was unusual because the early symptoms were fever and pain, and the disease was misdiagnosed because of a concomitant infection by Enterococcus faecium.
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Affiliation(s)
- S Sammassimo
- Department of Hematology and Hematopoietic Stem Cell Transplantation, University of Siena, Siena, Italy.
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Forconi F, Sahota SS, Lauria F, Stevenson FK. Revisiting the definition of somatic mutational status in B-cell tumors: does 98% homology mean that a VH-gene is unmutated? Leukemia 2004; 18:882-3. [PMID: 14973503 DOI: 10.1038/sj.leu.2403312] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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39
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Lauria F. L’UTILIZZAZIONE NELLA PRATICA CLINICA DEGLI ESAMI MICROBIOLOGICI: PROCESSO DECISIONALE E APPROPRIATEZZA NELLA RICHIESTA. Microbiol Med 2003. [DOI: 10.4081/mm.2003.4193] [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: 11/23/2022] Open
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40
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Tosi P, Zamagni E, Cellini C, Ronconi S, Patriarca F, Ballerini F, Musto P, Di Raimondo F, Ledda A, Lauria F, Masini L, Gobbi M, Vacca A, Ria R, Cangini D, Tura S, Baccarani M, Cavo M. Salvage Therapy With Thalidomide In Patients With Advanced Relapsed/Refractory Multiple Myeloma. J Peripher Nerv Syst 2002. [DOI: 10.1046/j.1529-8027.2002.02026_15.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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41
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Zinzani PL, Gherlinzoni F, Storti S, Zaccaria A, Pavone E, Moretti L, Gentilini P, Guardigni L, De Renzo A, Fattori PP, Falini B, Lauta VM, Mannina D, Zaja F, Mazza P, Volpe E, Lauria F, Aitini E, Ciccone F, Tani M, Stefoni V, Alinari L, Baccarani M, Tura S. Randomized trial of 8-week versus 12-week VNCOP-B plus G-CSF regimens as front-line treatment in elderly aggressive non-Hodgkin's lymphoma patients. Ann Oncol 2002; 13:1364-9. [PMID: 12196361 DOI: 10.1093/annonc/mdf208] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Among the third-generation chemotherapy regimens specifically adapted in the last decade for elderly aggressive non-Hodgkin's lymphoma (NHL) patients, we designed an 8-week cyclophosphamide, mitoxantrone, vincristine, etoposide, bleomycin and prednisone (VNCOP-B) plus granulocyte colony-stimulating factor (G-CSF) regimen which, in a national multicenter trial, induced good complete response (CR) and relapse-free survival rates with only moderate toxic effects. Here we report a prospective, multicenter, randomized trial comparing the efficacy and toxicity of 8- and 12-week regimens of VNCOP-B plus G-CSF. PATIENTS AND METHODS From February 1996 to June 2001, 306 consecutive previously untreated stage II-IV aggressive NHL patients > or =60 years of age were enrolled from 12 Italian cooperative institutions. Of the 297 evaluable patients, 149 and 148 received 8- and 12-week regimens, respectively, of VNCOP-B. RESULTS The CR rates were 63% and 56% in the 8- and 12-week groups; at a median of 32 months (range 3-62 months), relapse-free survival rates were 59% and 55%, respectively. Hematological and non-hematological toxicities were similar in both treatment groups. CONCLUSIONS Our data show that extending induction treatment with the VNCOP-B plus G-CSF regimen from 8 to 12 weeks does not raise the CR rate or provide a more durable remission.
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Affiliation(s)
- P L Zinzani
- Institute of Hematology 'Seràgnoli', University of Bologna, Bologna.
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42
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Lauria F, Lenoci M, Annino L, Raspadori D, Marotta G, Bocchia M, Forconi F, Gentili S, La Manda M, Marconcini S, Tozzi M, Baldini L, Zinzani PL, Foà R. Efficacy of anti-CD20 monoclonal antibodies (Mabthera) in patients with progressed hairy cell leukemia. Haematologica 2001; 86:1046-50. [PMID: 11602410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Recently, a chimeric monoclonal antibody (MoAb) directed against the CD20 antigen (rituximab) has been successfully introduced in the treatment of several CD20-positive B-cell neoplasias and particularly of follicular lymphomas. Based on these premises we evaluated the efficacy and the toxicity of chimeric anti-CD20 monoclonal antibody (MoAb) in relapsed/progressed hairy cell leukemia (HCL). DESIGN AND METHODS Ten patients with relapsed/progressed HCL entered the study. Eight patients were males and two females with a median age of 55 years (range 41-78) and all of them had been previously treated with 2-chlorodeoxyadenosine and/or deoxycoformycin and a-interferon. Two out of 10 patients were anemic (Hb < 10 g/dL), 4 thrombocytopenic (Plt < 100 x 10(9)/L), 3 had fewer than 1.0 x 10(9)/L neutrophils and 3 had circulating hairy cells (HC). All patients received 375 mg/m2 i.v. of anti-CD20 MoAb once a week for 4 doses. RESULTS All patients were evaluable for response, one patient showing a complete remission and 4 a partial response. Adverse reactions, such as fever, chills, bone pain, hypotension and thrombocytopenia, were transient and mild (grade 1-2) and occurred only during the first course of treatment. One month after the last infusion, patients who had had anemia, neutropenia or thrombocytopenia, recovered normal peripheral blood values. Circulating HC also disappeared within one month. Immunostained bone marrow biopsies were checked 1, 3 and 6 months after the end of therapy and in 5 out of 10 patients a >50% reduction of bone marrow HC infiltration was recorded. INTERPRETATION AND CONCLUSIONS On the basis of these preliminary results observed in 10 patients with progressed HCL, it appears that treatment with anti-CD20 MoAb is safe and effective in at least 50% of patients, particularly in those with a less evident bone marrow infiltration (50%) and in those previously splenectomized.
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Affiliation(s)
- F Lauria
- Department of Hematology "A. Sclavo" Hospital, via Tufi 1, 53100 Siena, Italy.
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Forconi F, Sahota SS, Raspadori D, Mockridge CI, Lauria F, Stevenson FK. Tumor cells of hairy cell leukemia express multiple clonally related immunoglobulin isotypes via RNA splicing. Blood 2001; 98:1174-81. [PMID: 11493467 DOI: 10.1182/blood.v98.4.1174] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Hairy cell leukemia (HCL) derives from a mature B cell and expresses markers associated with activation. Analysis of immunoglobulin variable region genes has revealed somatic mutation in most cases, consistent with an origin from a cell that has encountered the germinal center. One unusual feature of hairy cells (HCs) is the frequent expression of multiple immunoglobulin heavy chain isotypes, with dominance of immunoglobulin (Ig)--G3, but only a single light chain type. The origin and clonal relationship of these isotype variants have been unclear. In order to probe the isotype switching status of HCL, RNA transcripts of V(H)DJ(H)--constant region sequences from 5 cases of typical HCL, all expressing multiple surface immunoglobulin isotypes, were analyzed. Tumor V(H)DJ(H)--C(mu) sequences were identified and found to be somatically mutated (range, 1.4% to 6.5%), with a low level of intraclonal heterogeneity. Additional immunoglobulin isotypes of identical V(H)DJ(H) sequence were also identified, including IgD (5 of 5), IgG3 (5 of 5), IgG1 (3 of 5), IgG2 (2 of 5), IgA1 (4 of 5), and IgA2 (1 of 5). Derivation of multiple isotypes from individual cells was demonstrated by analyzing transcripts in single sorted cells from one patient, with evidence for coexistence of isotype variants in 10 of 10 cells. These findings indicate that clonally related multiple isotypes coexist in single HCs, with individual isotypes presumably generated via RNA splicing. Production of IgG3 appears common, but IgG1, IgG2, IgA1, and IgA2 also arise, indicating a continuing influence of a directed process on the tumor clone. These HCs appear to be arrested at the point of isotype switch, where RNA processing may precede deletional recombination. (Blood. 2001;98:1174-1181)
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Affiliation(s)
- F Forconi
- Molecular Immunology Group, Tenovus Laboratory, Southampton University Hospitals, Southampton, United Kingdom.
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Raspadori D, Damiani D, Lenoci M, Rondelli D, Testoni N, Nardi G, Sestigiani C, Mariotti C, Birtolo S, Tozzi M, Lauria F. CD56 antigenic expression in acute myeloid leukemia identifies patients with poor clinical prognosis. Leukemia 2001; 15:1161-4. [PMID: 11480556 DOI: 10.1038/sj.leu.2402174] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CD56 antigen, a 200-220 kDa cell surface glycoprotein, identified as an isoform of the neural adhesion molecules (NCAM), has been found frequently expressed in several lympho-hematopoietic neoplasms including acute myeloid leukemias (AML). In fact, in these latter diseases it has been reported that the presence of CD56 antigen on the blasts of AML patients with t(8;21) (q22;q22), and in those with M3 subtype, identifies a subgroup of patients with a more unfavorable prognosis. On the basis of these findings, we evaluated in 152 newly diagnosed AML patients CD56 surface expression, and results were correlated with morphology, immunophenotype, cytogenetic pattern and clinical outcome. CD56 antigen was recorded in 37 out of 152 cases (24%) and particularly in those with M2 and M5 cytotypes. Moreover, CD56 expression was significantly associated with P-glycoprotein (PGP) hyperexpression (P = 0.007), unfavorable cytogenetic abnormalities (P = 0.008) and with a reduced probability of achieving complete remission (CR) (36% vs 68%) (P = 0.035) as well as with a shorter survival (6 vs 12 months) (P = 0.032). In conclusion, CD56 antigenic expression on AML cells represents an important adverse prognostic factor and therefore its presence should be regularly investigated for a better prognostic assessment of AML patients at diagnosis.
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MESH Headings
- Acute Disease
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor
- CD56 Antigen/immunology
- Chromosomes, Human, Pair 21
- Chromosomes, Human, Pair 8
- Female
- Humans
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid/immunology
- Leukemia, Myeloid/pathology
- Leukemia, Myeloid/physiopathology
- Male
- Middle Aged
- Predictive Value of Tests
- Prognosis
- Translocation, Genetic
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Affiliation(s)
- D Raspadori
- Department of Hematology, University of Siena, Italy
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Galieni P, Moschettini D, Donati D, Tozzi M, Valensin PE, Lauria F. Long-term follow-up of human herpes virus 6 infection in autologous bone marrow transplant recipients. Haematologica 2001; 86:782-3. [PMID: 11454544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
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46
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Grelli S, Di Traglia L, Matteucci C, Lichtner M, Vullo V, Di Sora F, Lauria F, Montella F, Favalli C, Vella S, Macchi B, Mastino A. Changes in apoptosis after interruption of potent antiretroviral therapy in patients with maximal HIV-1-RNA suppression. AIDS 2001; 15:1178-81. [PMID: 11416721 DOI: 10.1097/00002030-200106150-00014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- S Grelli
- Department of Experimental Medicine, University of Rome Tor Vergata, Italy
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Russo D, Pricolo G, Michieli M, Michelutti A, Raspadori D, Bertone A, Marin L, Pierri I, Bucalossi A, Zuffa E, De Vivo A, Mazza P, Gobbi M, Lauria F, Zaccaria A, Baccarani M. Fludarabine, arabinosyl cytosine and idarubicin (FLAI) for remission induction in poor-risk acute myeloid leukemia. Leuk Lymphoma 2001; 40:335-43. [PMID: 11426555 DOI: 10.3109/10428190109057932] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Progress in treatment of acute myeloid leukemia (AML) is slow and treatment intensification alone has limited effects, particularly in poor-risk cases. Poor-risk cases, that are identified mainly by prior history, leukemic cell mass and cytogenetic abnormalities, share multiple mechanisms of drug resistance that are responsible for treatment failure. Since Pgp-mediated resistance to anthracycline can be reduced with Idarubicin (IDA) and resistance to arabinosyl cytosine (AC) can be reduced with Fludarabine (FLUDA), we tested a combination of high dose AC (2000 mg/sqm, 5 doses), FLUDA (30 mg/sqm, 5 doses) and IDA (12 mg/sqm, 3 doses) for remission induction and consolidation in 45 consecutive cases of poor-risk AML. The complete remission (CR) rate was 71% after the first course and 82% overall, with a projected 2-year survival and relapse-free survival of 44% and 50% respectively. Non-hematologic toxicity was very mild, that is very important in elderly patients, but hemopoietic toxicity was substantial, with a time to hematologic recovery of 3 to 4 weeks and two cases of death in CR. Peripheral blood stem cells (PBSC) could be mobilized and collected successfully only in 11 cases. This three-drug combination is effective and has a limited non-hematologic toxicity, but FLUDA may increase the difficulty of obtaining PBSC early after remission induction.
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Affiliation(s)
- D Russo
- Department of Bone Marrow Transplantation, University of Udine, Italy. Domenico@
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Marotta G, Bigazzi C, Lenoci M, Tozzi M, Bocchia M, Lauria F. Low-dose fludarabine and cyclophosphamide in elderly patients with B-cell chronic lymphocytic leukemia refractory to conventional therapy. Haematologica 2000; 85:1268-70. [PMID: 11114133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND AND OBJECTIVES In recent years fludarabine alone or in combination with other drugs has been reported to be effective in the treatment of B-cell chronic lymphocytic leukemia (B-CLL), both as first line and salvage therapy. Among the different combination regimens, the association of fludarabine and cyclophosphamide has shown a considerable therapeutic efficacy, although a relevant number of infectious complications have been described, particularly in elderly patients. The aim of this work was to evaluate the efficacy, the toxicity, and the incidence of infectious episodes of a regimen combining lower doses of fludarabine and cyclophosphamide in elderly patients with B-CLL refractory to conventional therapy. DESIGN AND METHODS Twenty patients with progressive B-CLL with a median age of 75 years (4 in stage B and 16 in stage C) and refractory to conventional therapy were enrolled in this study. The combination regimen was as follows: fludarabine 15 mg/m2/day i.v. [max 25 mg] and cyclophosphamide 200 mg/m2/day i.v. for four days. RESULTS All patients enrolled were evaluable for response. Three out of 20 (15%) patients achieved a complete remission (CR), 14/20 (70%) a partial response (PR) with an overall response rate (CR+PR) of 85%, according to National Cancer Institute-Working Group response criteria. Three patients were considered resistant. In four out of 20 patients (20%), a severe neutropenia (neutrophils < 0.5x10(9)/L) occurred and one of them developed an infectious complication which required treatment with systemic antibiotics and granulocyte colony- stimulating factor (G-CSF). Non-hematologic toxicity was negligible in all patients but one, who despite a adequate therapy with allopurinol and hydration, experienced a tumor lysis syndrome with transient but severe renal impairment. INTERPRETATION AND CONCLUSIONS The association of low-dose fludarabine and cyclophosphamide appeared to be effective in this subset of B-CLL patients, reproducing a similar overall response rate obtained with other fludarabine-based combination therapies. In addition, in this group of elderly patients, toxic side effects were negligible and infectious complications remarkably low.
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Affiliation(s)
- G Marotta
- Department of Hematology, A. Sclavo Hospital, via Tufi, 1 53100 Siena, Italy.
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Marotta G, Bucalossi A, Galieni P, Bigazzi C, Nuti S, Valenzin PE, Bocchia M, Lauria F. CD4+/CD45RA+ 'naive' T cells and immunological response to influenza virus vaccine in B-cell chronic lymphocytic leukaemia patients. Acta Haematol 2000; 99:18-21. [PMID: 9490560 DOI: 10.1159/000040709] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
B-cell chronic lymphocytic leukaemia (B-CLL) is characterized by a high frequency of infections, including those of viral aetiology. Previous reports have demonstrated a specific immunologic response to influenza virus vaccine in B-CLL patients with normal IgG levels. In this study, we have evaluated different immunophenotypically defined B and T cell subsets in 18 B-CLL patients before immunization with killed-influenza-virus vaccine. A correlation between immunological response to vaccination and both absolute numbers of CD4+/CD45RA+ naive T cells and CD5- B cells was found. These data may suggest a supporting role of the CD4+/CD45RA+ T cell subset in the specific antibody response to vaccination with influenza virus vaccine in B-CLL patients.
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Affiliation(s)
- G Marotta
- Cattedra e Divisione di Ematologia, Universitá degli Studi, Siena, Italia
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Simonsson B, Tötterman T, Hokland P, Lauria F, Carella AM, Fernandez MN, Rozman C, Ferrant A, de Witte T, Zander AR, Meier K, Hansson F, Nilsson BI. Roquinimex (Linomide) vs placebo in AML after autologous bone marrow transplantation. Bone Marrow Transplant 2000; 25:1121-7. [PMID: 10849523 DOI: 10.1038/sj.bmt.1702411] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Roquinimex, Linomide, a quinoline derivative with pleiotropic immunomodulatory activity, has previously been shown to enhance natural killer (NK) cell number and activity after ABMT in patients with AML. In this study 278 AML patients in remission were randomized to receive Roquinimex 0.2 mg/kg body weight or placebo twice weekly for 2 years following ABMT. Out of 139 patients in each group, 109 Roquinimex patients and 108 placebo patients were in their first CR. Median age at inclusion was 41 years for Roquinimex patients and 39 years for placebo patients. Twelve patients in each group had their marrow purged prior to reinfusion. Relapse and death were study endpoints. Surviving patients were followed for 2.6 to 6. 9 years. The total number of relapses was 60 in the Roquinimex group and 63 in the placebo group (not significant). Leukemia-free and overall survivals were similar in the two groups. Recovery of platelet counts was significantly delayed in the Roquinimex group as compared to placebo. No other significant differences regarding toxicity parameters were recorded. In conclusion, previous findings on NK cells could not be confirmed and the study showed no benefit for Roquinimex over placebo regarding relapse or survival following ABMT for AML in remission.
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Affiliation(s)
- B Simonsson
- Department of Medicine, Uppsala, Sweden. The Linomide in AML in Europe Study Group
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