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Fanni D, Gerosa C, Serra G, Miglianti M, Coghe F, Van Eyken P, Faa G, La Nasa G, Guido M. Autoimmune liver disease triggered by SARS-CoV-2: a case report and review of the literature. Eur Rev Med Pharmacol Sci 2024; 28:1632-1638. [PMID: 38436196 DOI: 10.26355/eurrev_202402_35493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
BACKGROUND An increasing number of coronavirus disease 2019 (COVID-19) related autoimmune hepatitis (AIH) and autoimmune liver disease (AILD) has been already described so far in the last three years. This rise has set up some diagnostic and therapeutic concerns, although steroid therapy has mostly been efficient, avoiding main significant side effects. CASE REPORT We report the case of a 52-year-old subject displaying liver function impairment at the laboratory tests while positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) swab. Needle liver biopsy showed severe portal inflammation, interface hepatitis, lobular inflammation, abundant plasma cells, bridging necrosis, endothelialitis, bile duct vanishing disease, and ductular reaction. The diagnosis of autoimmune liver disease (AILD) was performed. After a month of steroid and ursodeoxycholic acid medications, liver function fully recovered. Azathioprine was introduced, and steroids were gradually reduced. CONCLUSIONS Probably triggered by the SARS-CoV-2-induced cytokine storm, the association between COVID-19 and autoimmune-related inflammatory injury may display a particular paradigm of AILD pathogenesis.
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Affiliation(s)
- D Fanni
- Unit of Pathology, Department of Medical Sciences and Public Health, AOU of Cagliari, University of Cagliari, Cagliari, Italy.
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Saponaro S, Lizzi F, Serra G, Mainas F, Oliva P, Giuliano A, Calderoni S, Retico A. Deep learning based joint fusion approach to exploit anatomical and functional brain information in autism spectrum disorders. Brain Inform 2024; 11:2. [PMID: 38194126 PMCID: PMC10776521 DOI: 10.1186/s40708-023-00217-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/20/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND The integration of the information encoded in multiparametric MRI images can enhance the performance of machine-learning classifiers. In this study, we investigate whether the combination of structural and functional MRI might improve the performances of a deep learning (DL) model trained to discriminate subjects with Autism Spectrum Disorders (ASD) with respect to typically developing controls (TD). MATERIAL AND METHODS We analyzed both structural and functional MRI brain scans publicly available within the ABIDE I and II data collections. We considered 1383 male subjects with age between 5 and 40 years, including 680 subjects with ASD and 703 TD from 35 different acquisition sites. We extracted morphometric and functional brain features from MRI scans with the Freesurfer and the CPAC analysis packages, respectively. Then, due to the multisite nature of the dataset, we implemented a data harmonization protocol. The ASD vs. TD classification was carried out with a multiple-input DL model, consisting in a neural network which generates a fixed-length feature representation of the data of each modality (FR-NN), and a Dense Neural Network for classification (C-NN). Specifically, we implemented a joint fusion approach to multiple source data integration. The main advantage of the latter is that the loss is propagated back to the FR-NN during the training, thus creating informative feature representations for each data modality. Then, a C-NN, with a number of layers and neurons per layer to be optimized during the model training, performs the ASD-TD discrimination. The performance was evaluated by computing the Area under the Receiver Operating Characteristic curve within a nested 10-fold cross-validation. The brain features that drive the DL classification were identified by the SHAP explainability framework. RESULTS The AUC values of 0.66±0.05 and of 0.76±0.04 were obtained in the ASD vs. TD discrimination when only structural or functional features are considered, respectively. The joint fusion approach led to an AUC of 0.78±0.04. The set of structural and functional connectivity features identified as the most important for the two-class discrimination supports the idea that brain changes tend to occur in individuals with ASD in regions belonging to the Default Mode Network and to the Social Brain. CONCLUSIONS Our results demonstrate that the multimodal joint fusion approach outperforms the classification results obtained with data acquired by a single MRI modality as it efficiently exploits the complementarity of structural and functional brain information.
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Affiliation(s)
- Sara Saponaro
- Medical Physics School, University of Pisa, Pisa, Italy.
- National Institute for Nuclear Physics (INFN), Pisa Division, Pisa, Italy.
| | - Francesca Lizzi
- National Institute for Nuclear Physics (INFN), Pisa Division, Pisa, Italy
| | - Giacomo Serra
- Department of Physics, University of Cagliari, Cagliari, Italy
- INFN, Cagliari Division, Cagliari, Italy
| | - Francesca Mainas
- INFN, Cagliari Division, Cagliari, Italy
- Department of Computer Science, University of Pisa, Pisa, Italy
| | - Piernicola Oliva
- INFN, Cagliari Division, Cagliari, Italy
- Department of Chemical, Physical, Mathematical and Natural Sciences, University of Sassari, Sassari, Italy
| | - Alessia Giuliano
- Unit of Medical Physics, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Pisa, Italy
| | - Sara Calderoni
- Developmental Psychiatry Unit - IRCCS Stella Maris Foundation, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessandra Retico
- National Institute for Nuclear Physics (INFN), Pisa Division, Pisa, Italy
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Serra G, Mainas F, Golosio B, Retico A, Oliva P. Effect of data harmonization of multicentric dataset in ASD/TD classification. Brain Inform 2023; 10:32. [PMID: 38006422 PMCID: PMC10676338 DOI: 10.1186/s40708-023-00210-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/16/2023] [Indexed: 11/27/2023] Open
Abstract
Machine Learning (ML) is nowadays an essential tool in the analysis of Magnetic Resonance Imaging (MRI) data, in particular in the identification of brain correlates in neurological and neurodevelopmental disorders. ML requires datasets of appropriate size for training, which in neuroimaging are typically obtained collecting data from multiple acquisition centers. However, analyzing large multicentric datasets can introduce bias due to differences between acquisition centers. ComBat harmonization is commonly used to address batch effects, but it can lead to data leakage when the entire dataset is used to estimate model parameters. In this study, structural and functional MRI data from the Autism Brain Imaging Data Exchange (ABIDE) collection were used to classify subjects with Autism Spectrum Disorders (ASD) compared to Typical Developing controls (TD). We compared the classical approach (external harmonization) in which harmonization is performed before train/test split, with an harmonization calculated only on the train set (internal harmonization), and with the dataset with no harmonization. The results showed that harmonization using the whole dataset achieved higher discrimination performance, while non-harmonized data and harmonization using only the train set showed similar results, for both structural and connectivity features. We also showed that the higher performances of the external harmonization are not due to larger size of the sample for the estimation of the model and hence these improved performance with the entire dataset may be ascribed to data leakage. In order to prevent this leakage, it is recommended to define the harmonization model solely using the train set.
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Affiliation(s)
- Giacomo Serra
- Department of Physics, University of Cagliari, Cagliari, Italy
- National Institute for Nuclear Physics (INFN), Cagliari Division, Cagliari, Italy
| | - Francesca Mainas
- Department of Physics, University of Cagliari, Cagliari, Italy.
- National Institute for Nuclear Physics (INFN), Cagliari Division, Cagliari, Italy.
| | - Bruno Golosio
- Department of Physics, University of Cagliari, Cagliari, Italy
- National Institute for Nuclear Physics (INFN), Cagliari Division, Cagliari, Italy
| | - Alessandra Retico
- National Institute for Nuclear Physics (INFN), Pisa Division, Pisa, Italy
| | - Piernicola Oliva
- National Institute for Nuclear Physics (INFN), Cagliari Division, Cagliari, Italy
- Department of Chemical, Physical, Mathematical and Natural Sciences, University of Sassari, Sassari, Italy
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Serra G, Ruotolo I, Berardi A, Carlizza A, Galeoto G. The Effect of Hydrokinetic Therapy on Patients with Low Back Pain: A Systematic Review and Meta-Analysis. Muscles Ligaments Tendons J 2023. [DOI: 10.32098/mltj.01.2023.10] [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: 03/16/2023]
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Rodia R, Meloni PE, Mascia C, Balestrieri C, Ruggiero V, Serra G, Conti M, Loi M, Pes F, Onali S, Perra A, Littera R, Velluzzi F, Mariotti S, Chessa L, Boi F. Direct-acting antivirals used in HCV-related liver disease do not affect thyroid function and autoimmunity. J Endocrinol Invest 2023; 46:359-366. [PMID: 36048357 PMCID: PMC9859881 DOI: 10.1007/s40618-022-01909-0] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/19/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE It is well known that interferon-α (IFN-α), used for long time as the main therapy for HCV-related disease, induces thyroid alterations, but the impact of the new direct-acting antivirals (DAAs) on thyroid is not established. Aim of this prospective study was to evaluate if DAAs therapy may induce thyroid alterations. METHODS A total of 113 HCV patients, subdivided at the time of the enrollment in naïve group (n = 64) and in IFN-α group (n = 49) previously treated with pegylated interferon-α and ribavirin, were evaluated for thyroid function and autoimmunity before and after 20-32 weeks of DAAs. RESULTS Before starting DAAs, a total of 8/113 (7.1%) patients showed Hashimoto's thyroiditis (HT) all belonging to IFN-α group (8/49, 16.3%), while no HT cases were found in the naïve group. Overall, 7/113 (6.2%) patients were hypothyroid: 3/64 (4.7%) belonging to naïve group and 4/49 (8.2%) to IFN-α group. Furthermore, a total of 8/113 patients (7.1%) showed subclinical hyperthyroidism: 2/64 (3.1%) were from naïve group and 6/49 (12.2%) from IFN-α group. Interestingly, after DAAs therapy, no new cases of HT, hypothyroidism and hyperthyroidism was found in all series, while 6/11 (54.5%) patients with non-autoimmune subclinical thyroid dysfunction became euthyroid. Finally, the only association between viral genotypes and thyroid alterations was genotype 1 and hypothyroidism. CONCLUSIONS This study supports evidence that DAAs have a limited or missing influence on thyroid in patients with HCV-related diseases. Moreover, it provides preliminary evidence that subclinical non-autoimmune thyroid dysfunction may improve after HCV infection resolution obtained by DAAs.
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Affiliation(s)
- R Rodia
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - P E Meloni
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - C Mascia
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - C Balestrieri
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - V Ruggiero
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - G Serra
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - M Conti
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - M Loi
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - F Pes
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - S Onali
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - A Perra
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - R Littera
- Complex Structure of Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - F Velluzzi
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - S Mariotti
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - L Chessa
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - F Boi
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy.
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Serra G, Koukopoulos A, De Chiara L, Koukopoulos A, Sani G, Tondo L, Girardi P, Reginaldi D, Baldessarini R. Early clinical predictors and correlates of long-term morbidity in bipolar disorder. Eur Psychiatry 2020; 43:35-43. [DOI: 10.1016/j.eurpsy.2017.02.480] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/31/2017] [Accepted: 02/06/2017] [Indexed: 10/20/2022] Open
Abstract
AbstractObjectives:Identifying factors predictive of long-term morbidity should improve clinical planning limiting disability and mortality associated with bipolar disorder (BD).Methods:We analyzed factors associated with total, depressive and mania-related long-term morbidity and their ratio D/M, as %-time ill between a first-lifetime major affective episode and last follow-up of 207 BD subjects. Bivariate comparisons were followed by multivariable linear regression modeling.Results:Total % of months ill during follow-up was greater in 96 BD-II (40.2%) than 111 BD-I subjects (28.4%; P = 0.001). Time in depression averaged 26.1% in BD-II and 14.3% in BD-I, whereas mania-related morbidity was similar in both, averaging 13.9%. Their ratio D/M was 3.7-fold greater in BD-II than BD-I (5.74 vs. 1.96; P < 0.0001). Predictive factors independently associated with total %-time ill were: [a] BD-II diagnosis, [b] longer prodrome from antecedents to first affective episode, and [c] any psychiatric comorbidity. Associated with %-time depressed were: [a] BD-II diagnosis, [b] any antecedent psychiatric syndrome, [c] psychiatric comorbidity, and [d] agitated/psychotic depressive first affective episode. Associated with %-time in mania-like illness were: [a] fewer years ill and [b] (hypo)manic first affective episode. The long-term D/M morbidity ratio was associated with: [a] anxious temperament, [b] depressive first episode, and [c] BD-II diagnosis.Conclusions:Long-term depressive greatly exceeded mania-like morbidity in BD patients. BD-II subjects spent 42% more time ill overall, with a 3.7-times greater D/M morbidity ratio, than BD-I. More time depressed was predicted by agitated/psychotic initial depressive episodes, psychiatric comorbidity, and BD-II diagnosis. Longer prodrome and any antecedent psychiatric syndrome were respectively associated with total and depressive morbidity.
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Alañón ME, Castle SM, Serra G, Lévèques A, Poquet L, Actis-Goretta L, Spencer JPE. Acute study of dose-dependent effects of (-)-epicatechin on vascular function in healthy male volunteers: A randomized controlled trial. Clin Nutr 2019; 39:746-754. [PMID: 31014775 DOI: 10.1016/j.clnu.2019.03.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/24/2019] [Accepted: 03/28/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND & AIMS There is convincing clinical evidence to suggest that flavanol-containing foods/beverages are capable of inducing improvements in human vascular function. However, whilst (-)-epicatechin has been tested for efficacy, a full dose-dependency has yet to be established, particularly at doses below 1 mg/kg BW. The current study examined the dose-dependent effects of (-)-epicatechin on human vascular function with concurrent measurement of plasma (-)-epicatechin metabolites and levels of circulating nitrite and nitrate species, NOx. METHODS An acute, double-blind, placebo-controlled, crossover intervention trial was conducted in 20 healthy males with 4 treatment arms: water-based (-)-epicatechin (0.1, 0.5 and 1.0 mg/kg BW) and a water only as control. Vascular function was assessed by flow-mediated dilatation (FMD) measured at the brachial artery, laser Doppler imaging with iontophoresis (LDI) at the subcutaneous capillaries of the forearm (response to Ach and SNP) and peripheral blood pressure (BP) at baseline, 1, 2, 4 and 6 h post-intervention. Plasma analysis of epicatechin metabolites was conducted by LC-MS and circulating plasma of nitrite and nitrate species were performed using an HPLC-based system (ENO-30). RESULTS Significant increases in % FMD were found to occur at 1 and 2 h following intake of 1 mg/kg BW, and at 2 h for the 0.5 mg/kg BW intake. There were no significant changes in LDI or BP at any time-points or intake levels. Increases in FMD over the 6 h timeframe were closely paralleled by the appearance of total plasma (-)-epicatechin metabolites. Non-significant changes in circulating NOx was observed. CONCLUSIONS Our data add further evidence that (-)-epicatechin is a causal vasoactive molecule within flavanol-containing foods/beverages. In addition, we show for the first time that intake levels as low as 0.5 mg/kg BW are capable of inducing acute improvements in vascular function (FMD) in healthy volunteers.
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Affiliation(s)
- M E Alañón
- Regional Institute for Applied Scientific Research (IRICA), Area of Food Science and Technology, University of Castilla-La Mancha, Avd. Camilo José Cela 10, 13071, Ciudad Real, Spain; Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, PO Box 226, RG2 6AP, Reading, United Kingdom.
| | - S M Castle
- Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, PO Box 226, RG2 6AP, Reading, United Kingdom
| | - G Serra
- Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, PO Box 226, RG2 6AP, Reading, United Kingdom
| | - A Lévèques
- Nestlé Research, 1026 Lausanne, Switzerland
| | - L Poquet
- Nestlé Research, 1026 Lausanne, Switzerland
| | | | - J P E Spencer
- Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, PO Box 226, RG2 6AP, Reading, United Kingdom
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Serra G, Casini M, Maggiore V, Baldessarini R, Vicari S. Factors Associated with Depression Severity in Adolescence. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.2219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
IntroductionSevere depression is greatly impairing during adolescence and involves a high risk for suicidal behaviors.Objectives and aimsIdentify clinical and demographic factors associated with severity of depression in adolescents diagnosed with a major mood disorder so as to improve clinical treatment and prevent suicidal behaviors.MethodsWe analyzed factors associated with depression severity in 145 severely ill adolescents diagnosed with a major affective disorder using the K-SADS (Kiddie-Schedule for Affective Disorders and Schizophrenia) at the Mood Disorder Outpatient Program of Bambino Gesù Children's Hospital (Rome). Depressive and manic symptoms were rated with the CDRS-R (Children's Depression Rating Scale-Revised) and K-SADS-MRS (Mania Rating Scale), respectively. Bivariate comparisons were followed by multivariable linear regression modeling.ResultsDepression severity was greater among females than males (mean CDRS scores: 53.0 vs. 42.8; P < 0.0001) and with major depressive versus bipolar disorder diagnosis (50.4 vs. 45.4; P = 0.001). Manic symptoms, including irritability, mood lability, crowded thoughts, delusions, and insomnia, were more likely with more severe depression; their number and severity correlated with CDRS-R total score (respectively, β = 1.53 and 5.44;both P < 0.0001). Factors independently and significantly associated with CDRS-R depression score in multivariate modeling were:– presence of suicidal ideation;– absence of ADHD;– female sex;– greater number of manic symptoms.ConclusionsSevere depression was associated with manic symptoms and with suicidal ideation among adolescents diagnosed with either bipolar or major depressive disorders. This relationship should be considered in treatment planning and suicide prevention, including consideration of mood-stabilizing and antimanic agents in the treatment of severe adolescent depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Castaldo L, Mazzone L, Serra G, Vicari S. Risk Factors for Suicide Attempt: A Retrospective Study. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
IntroductionSuicide is a leading cause of death among adolescents.ObjectivesTo investigate suicidal behaviors among Italian adolescents.AimsTo assess the rates of suicidal ideation (SI) and suicide attempts (SA) and the associated risk factors in patients admitted to emergency department (ED) of the Bambino Gesù Children's Hospital.MethodsRetrospective study based on data of patients admitted to the ED from 1 January 2011 to 30 May 2016 who required a neuropsychiatric (NPI) consultation. We analyzed:– outcome of the NPI consultation (hospitalization or discharge);– risk factors for SA and SI;– methods employed for SA.ResultsThe number of NPI consultations for SI and SA increased from 6.45% in 2011 to 13.3% in 2015. More than 90% of consultations recommended hospitalization in the psychiatric unit (137 patient [66% female]; mean age of 15.5 ± 1.6 years) with average length of stay of 13.64 ± 10.63 days. Risk factors for SI and SA were non-suicidal self-injury, family conflicts and previous suicide attempts. Subjects evaluated for a SA reported a significantly higher frequency of family history of mood disorder (χ2 = 5.94; P = 0.02) and a comorbid substance abuse (χ2 = 4.49; P = 0.03) when compared with SI group. The method most frequently used to attempt suicide was ingestion of medications (52.83%).ConclusionsThere was an increasing demand of NPI consultation of SA and SI in the last years. A family history of mood disorder and a history of substance abuse are risk factors able to differentiate between SI and SA.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Tondo L, Pinna M, Serra G, De Chiara L, Baldessarini RJ. Age at menarche predicts age at onset of major affective and anxiety disorders. Eur Psychiatry 2016; 39:80-85. [PMID: 27992810 DOI: 10.1016/j.eurpsy.2016.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 06/18/2016] [Revised: 07/31/2016] [Accepted: 08/01/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Menarche age has been associated inconsistently with the occurrence, timing or severity of major depressive disorder (MDD), but rarely studied in women with bipolar (BDs) or anxiety disorders. METHODS We investigated women patients at a Sardinian mood disorder center for associations of age at menarche with age at illness onset for major affective or anxiety disorders, year of birth, and other selected factors, using bivariate comparisons and multivariate regression modeling. RESULTS Among women (n=1139) with DSM-IV MDD (n=557), BD-I (n=223), BD-II (n=178), or anxiety disorders (n=181), born in 1904-1998, of mean age 42.9 years, menarche age averaged 12.8 [CI: 12.7-12.9] years. Illness onset age averaged 30.9 [30.1-31.8] years, ranking: BD-I, 25.8; anxiety disorders, 28.0; BD-II, 30.3; MDD, 34.1 years. Menarche age declined secularly over birth years, and was associated with younger illness-onset, having no or fewer siblings, more psychiatrically ill first-degree relatives, living in rural environments, being suicidal, substance abuse, and being unemployed. Earlier menarche and earlier illness-onset were significantly associated for onset age groups of ≤ 20, 20-39, and > 40 years. Menarche age versus diagnosis ranked: BD-II<BD-I<anxiety disorders<MDD. CONCLUSIONS Age at menarche in Sardinia, as elsewhere, has declined over the past decades. It was strongly associated with age at onset of bipolar and anxiety, as well as major depressive disorders across the age range, suggesting sustained effects of biological maturational factors.
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Affiliation(s)
- L Tondo
- International Consortium for Psychotic & Mood Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Lucio Bini Mood Disorder Centers, Cagliari and Rome, Italy.
| | - M Pinna
- Lucio Bini Mood Disorder Centers, Cagliari and Rome, Italy
| | - G Serra
- International Consortium for Psychotic & Mood Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; NESMOS Department of Psychiatry, Faculty of Medicine, University (Sapienza) of Rome, Rome, Italy; Child Neuropsychiatry Unit, Department of Neuroscience, IRCCS Children Hospital Bambino Gesù, Rome, Italy
| | - L De Chiara
- NESMOS Department of Psychiatry, Faculty of Medicine, University (Sapienza) of Rome, Rome, Italy
| | - R J Baldessarini
- International Consortium for Psychotic & Mood Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Grego E, Robino P, Tramuta C, Giusto G, Boi M, Colombo R, Serra G, Chiadò-Cutin S, Gandini M, Nebbia P. Evaluation of antimicrobial activity of Italian honey for wound healing application in veterinary medicine. SCHWEIZ ARCH TIERH 2016; 158:521-7. [PMID: 27504886 DOI: 10.17236/sat00075] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Honey as a topical treatment for infected wounds dates back to ancient times. However, few studies have been reported concerning the medical properties of Italian honey. In this study, the microbial contamination, the antimicrobial activity and the antibiotic residues of 6 different varieties of Piedmont honeys were evaluated. The antimicrobial activity of honeys was tested by agar well diffusion method and 1 honey for each variety has been selected and tested by broth micro-dilution test to determine Minimum Inhibitory Concentrations (MICs) and evaluated by Minimum Bactericidal Concentrations (MBCs). The honeys with a high level of antibacterial activity were analyzed for the presence of tetracyclines, sulfonamides and macrolide residues. The agar well diffusion method showed the greatest antimicrobial activity for honeydew, chestnut and lime tree honeys. The MICs and MBCs identified the close similarity to the medical manuka honey of honeydew, polyfloral and chestnut honey. The levels of antibiotic residues on these honeys were below the limit of quantification. Based on our results the Italian variety of honeydew showed the best antimicrobial activity and can be considered for the treatment of infected wounds in animals.
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Affiliation(s)
- E Grego
- Department of Veterinary Sciences, University of Turin, Italy
| | - P Robino
- Department of Veterinary Sciences, University of Turin, Italy
| | - C Tramuta
- Department of Veterinary Sciences, University of Turin, Italy
| | - G Giusto
- Department of Veterinary Sciences, University of Turin, Italy
| | - M Boi
- Council for agricultural research and the analysis of Agrarian Economy, Beekeeping and Silkworm Research Unit (CRA-API), Bologna, Italy
| | - R Colombo
- Council for agricultural research and the analysis of Agrarian Economy, Beekeeping and Silkworm Research Unit (CRA-API), Bologna, Italy
| | - G Serra
- Council for agricultural research and the analysis of Agrarian Economy, Beekeeping and Silkworm Research Unit (CRA-API), Bologna, Italy
| | | | - M Gandini
- Department of Veterinary Sciences, University of Turin, Italy
| | - P Nebbia
- Department of Veterinary Sciences, University of Turin, Italy
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Cubeddu A, Astara G, Madeddu C, Ruggiero V, Cabula C, Serra G, Ganga R, Faloppi L, Cascinu S, Scartozzi M. Osteopontin (OPN) and interleukin-6 (IL-6) as predictive biomarkers in HCC receiving loco-regional treatment: preliminary results. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv344.47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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13
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Ciliberti M, De Lara F, Serra G, Tafuro F, Iazzetta F, De Martino V, Filosa A, Scognamiglio R, Ciliberti G, Veneri M. Effective management of pressure ulcers using Hydrofibre technology with silver ions. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.wndm.2014.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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14
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Vacca A, Loddo S, Melis MT, Funedda A, Puddu R, Verona M, Fanni S, Fantola F, Madrau S, Marrone VA, Serra G, Tore C, Manca D, Pasci S, Puddu MR, Schirru P. A GIS based method for soil mapping in Sardinia, Italy: a geomatic approach. J Environ Manage 2014; 138:87-96. [PMID: 24315681 DOI: 10.1016/j.jenvman.2013.11.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 10/29/2013] [Accepted: 11/14/2013] [Indexed: 06/02/2023]
Abstract
A new project was recently initiated for the realization of the "Land Unit and Soil Capability Map of Sardinia" at a scale of 1:50,000 to support land use planning. In this study, we outline the general structure of the project and the methods used in the activities that have been thus far conducted. A GIS approach was used. We used the soil-landscape paradigm for the prediction of soil classes and their spatial distribution or the prediction of soil properties based on landscape features. The work is divided into two main phases. In the first phase, the available digital data on land cover, geology and topography were processed and classified according to their influence on weathering processes and soil properties. The methods used in the interpretation are based on consolidated and generalized knowledge about the influence of geology, topography and land cover on soil properties. The existing soil data (areal and point data) were collected, reviewed, validated and standardized according to international and national guidelines. Point data considered to be usable were input into a specific database created for the project. Using expert interpretation, all digital data were merged to produce a first draft of the Land Unit Map. During the second phase, this map will be implemented with the existing soil data and verified in the field if also needed with new soil data collection, and the final Land Unit Map will be produced. The Land Unit and Soil Capability Map will be produced by classifying the land units using a reference matching table of land capability classes created for this project.
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Affiliation(s)
- A Vacca
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Cagliari, Via Trentino 51, 09127 Cagliari, Italy.
| | - S Loddo
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - M T Melis
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Cagliari, Via Trentino 51, 09127 Cagliari, Italy
| | - A Funedda
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Cagliari, Via Trentino 51, 09127 Cagliari, Italy
| | - R Puddu
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - M Verona
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - S Fanni
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - F Fantola
- Agenzia LAORE Sardegna, Via Caprera 8, 09123 Cagliari, Italy
| | - S Madrau
- Dipartimento di Ingegneria del Territorio, Università degli Studi di Sassari, Viale Italia 39, 07100 Sassari, Italy
| | - V A Marrone
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Cagliari, Via Trentino 51, 09127 Cagliari, Italy
| | - G Serra
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - C Tore
- Agenzia LAORE Sardegna, Via Caprera 8, 09123 Cagliari, Italy
| | - D Manca
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - S Pasci
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Cagliari, Via Trentino 51, 09127 Cagliari, Italy
| | - M R Puddu
- Agenzia LAORE Sardegna, Via Caprera 8, 09123 Cagliari, Italy
| | - P Schirru
- Agenzia LAORE Sardegna, Via Caprera 8, 09123 Cagliari, Italy
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Serra G. Neutropenia in newborn: A case report laboratory. Clin Biochem 2014. [DOI: 10.1016/j.clinbiochem.2014.04.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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16
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Serra G, Baranchuk A, Bayes-De-Luna A, Brugada J, Goldwasser D, Capulzini L, Arazo D, Boraita A, Heras ME, Garcia-Niebla J, Elosua R, Brugada R, Brugada P. New electrocardiographic criteria to differentiate the Type-2 Brugada pattern from electrocardiogram of healthy athletes with r'-wave in leads V1/V2. Europace 2014; 16:1639-45. [DOI: 10.1093/europace/euu025] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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17
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Peña S, Fagundez C, Medeiros A, Comini M, Scarone L, Sellanes D, Manta E, Tulla-Puche J, Albericio F, Stewart L, Yardley V, Serra G. Synthesis of cyclohexapeptides as antimalarial and anti-trypanosomal agents. Med Chem Commun 2014. [DOI: 10.1039/c4md00135d] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Azolic and non-azolic cyclohexapeptides were obtained and/or evaluated as promising antimalarial and/or anti-trypanosomal agents.
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Affiliation(s)
- S. Peña
- Cátedra de Química Farmacéutica
- (DQO)
- Facultad de Química
- Universidad de la República
- Montevideo, Uruguay
| | - C. Fagundez
- Cátedra de Química Farmacéutica
- (DQO)
- Facultad de Química
- Universidad de la República
- Montevideo, Uruguay
| | - A. Medeiros
- Group Redox Biology of Trypanosomes
- Institut Pasteur de Montevideo
- Montevideo, Uruguay
- Departamento de Bioquímica
- Facultad de Medicina
| | - M. Comini
- Group Redox Biology of Trypanosomes
- Institut Pasteur de Montevideo
- Montevideo, Uruguay
| | - L. Scarone
- Cátedra de Química Farmacéutica
- (DQO)
- Facultad de Química
- Universidad de la República
- Montevideo, Uruguay
| | - D. Sellanes
- Cátedra de Química Farmacéutica
- (DQO)
- Facultad de Química
- Universidad de la República
- Montevideo, Uruguay
| | - E. Manta
- Cátedra de Química Farmacéutica
- (DQO)
- Facultad de Química
- Universidad de la República
- Montevideo, Uruguay
| | - J. Tulla-Puche
- Institute for Research in Biomedicine (IRB Barcelona)
- 08028-Barcelona, Spain
- Centre on Bioengineering
- Biomaterials and Nanomedicine
- Barcelona Science Park
| | - F. Albericio
- Institute for Research in Biomedicine (IRB Barcelona)
- 08028-Barcelona, Spain
- Centre on Bioengineering
- Biomaterials and Nanomedicine
- Barcelona Science Park
| | - L. Stewart
- Faculty of Infectious & Tropical Disease
- LSHTM
- London, UK
| | - V. Yardley
- Faculty of Infectious & Tropical Disease
- LSHTM
- London, UK
| | - G. Serra
- Cátedra de Química Farmacéutica
- (DQO)
- Facultad de Química
- Universidad de la República
- Montevideo, Uruguay
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18
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19
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Todisco T, Dal Farra F, Ciliberti G, Pirina P, Guelfi R, Serra G, Paris R, Mancuso I, Cepparulo M. An Italian Experience of Sequential Intravenous and Oral Azithromycin Plus Intravenous Ampicillin/Sulbactam in Hospitalized Patients with Community-Acquired Pneumonia. J Chemother 2013. [DOI: 10.1179/joc.2008.20.6.768] [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: 10/31/2022]
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20
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Zoccarato M, Zuliani L, Saddi M, Serra G, Pelizza M, Rosellini I, Peddone L, Ticca A, Giometto B. AQP4-neuromyelitis optica following NMDAR-encephalitis: A case report. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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21
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Fraioli F, Anzidei M, Serra G, Liberali S, Fiorelli A, Zaccagna F, Longo F, Anile M, Catalano C. Whole-tumour CT-perfusion of unresectable lung cancer for the monitoring of anti-angiogenetic chemotherapy effects. Br J Radiol 2013; 86:20120174. [PMID: 23908346 DOI: 10.1259/bjr.20120174] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To determine whether CT-perfusion (CT-p) can be used to evaluate the effects of chemotherapy and anti-angiogenic treatment in patients with non-small-cell lung carcinoma (NSCLC) and whether CT-p and standard therapeutic response assessment (RECIST) data obtained before and after therapy correlate. METHODS 55 patients with unresectable NSCLC underwent CT-p before the beginning of therapy and 50 of them repeated CT-p 90 days after it. Therapeutic protocol included platinum-based doublets plus bevacizumab for non-squamous carcinoma and platinum-based doublets for squamous carcinoma. RECIST measurements and calculations of blood flow (BF), blood volume (BV), time to peak (TTP) and permeability surface (PS) were performed, and baseline and post-treatment measurements were tested for statistically significant differences. Baseline and follow-up perfusion parameters were also compared based on histopathological subclassification (2004 World Health Organization Classification of Tumours) and therapy response assessed by RECIST. RESULTS Tumour histology was consistent with large cell carcinoma in 14/50 (28%) cases, adenocarcinoma in 22/50 (44%) cases and squamous cell carcinoma in the remaining 14/50 (28%) cases. BF and PS differences for all tumours between baseline and post-therapy measurements were significant (p=0.001); no significant changes were found for BV (p=0.3) and TTP (p=0.1). The highest increase of BV was demonstrated in adenocarcinoma (5.2±34.1%), whereas the highest increase of TTP was shown in large cell carcinoma (6.9±22.4%), and the highest decrease of PS was shown in squamous cell carcinoma (-21.5±18.5%). A significant difference between the three histological subtypes was demonstrated only for BV (p<0.007). On the basis of RECIST criteria, 8 (16%) patients were classified as partial response (PR), 2 (4%) as progressive disease (PD) and the remaining 40 (80%) as stable disease (SD). Among PR, a decrease of both BF (18±9.6%) and BV (12.6±9.2%) were observed; TTP increased in 3 (37.5%) cases, and PS decreased in 6 (75%) cases. SD patients showed an increase of BF, BV, TTP and PS in 6 (15%), 21 (52.5%), 23 (57.5%) and 2 (5%) cases, respectively. PD patients demonstrated an increase of BF (26±0.2%), BV (2.7±0.1%) and TTP (3.1±0.8%) while only PS decreased (23±0.2%). CONCLUSION CT-p can adequately evaluate therapy-induced alterations in NSCLC, and perfusion parameters correlate with therapy response assessment performed with RECIST criteria. ADVANCES IN KNOWLEDGE Evaluating perfusional parameters, CT-p can demonstrate therapy-induced changes in patients with different types of lung cancer and identify response to treatment with excellent agreement to RECIST measurements.
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Affiliation(s)
- F Fraioli
- Department of Nuclear Medicine, University College London Hospitals, NHS Foundation Trust, London, UK.
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22
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Todisco T, Dal Farra F, Ciliberti G, Pirica P, Ghelfi R, Serra G, Paris R, Mancuso I, Cepparulo M. An Italian Experience of Sequential Intravenous and Oral Azithromycin Plus Intravenous Ampicillin/Sulbactam in Hospitalized Patients with Community-Acquired Pneumonia. J Chemother 2013; 20:225-32. [DOI: 10.1179/joc.2008.20.2.225] [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: 10/31/2022]
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23
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Colombo GL, Lundkvist J, Caruggi M, Serra G, Vinci M. Analisi dei costi in pazienti ad alto rischio di nefropatia indotta da mezzo di contrasto: i risultati per l’Italia dello studio NEPHRIC. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/bf03320544] [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: 11/28/2022]
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Lucioni C, Mazzi S, Serra G. Costi e profili di trattamento farmacologico nei pazienti con diabete di tipo 2: i risultati dello studio CODE-2. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/bf03320575] [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: 11/25/2022]
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25
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Colombo GL, Nicosia V, Lesma A, Madera A, Caruggi M, Serra G. Analisi costi-benefici di una strategia vaccinale antinfluenzale condotta presso una società del gruppo ENI (Snamprogetti). ACTA ACUST UNITED AC 2013. [DOI: 10.1007/bf03320581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pagni F, Ronchi S, Di Bella C, Serra G, Costantini M, Leone BE. Signet-ring cell differentiation in FNA cytology of a primitive thyroid carcinoma. Cytopathology 2012; 24:274-5. [PMID: 22409226 DOI: 10.1111/j.1365-2303.2012.00965.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Piccione M, Serra G, Sanfilippo C, Andreucci E, Sani I, Corsello G. A new mutation in EDA gene in X-linked hypohidrotic ectodermal dysplasia associated with keratoconus. Minerva Pediatr 2012; 64:59-64. [PMID: 22350046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Hypohidrotic ectodermal dysplasia (HED) was first described in 1848 by Thurnam. HED belongs to ectodermal dysplasias (EDs), which are developmental impairments of ectodermal-derived tissues. X-linked hypohidrotic ectodermal dysplasia (XLHED) is the most common form of the EDs and consists in abnormal development of teeth, hair, and eccrine sweat glands. XLHED is determined by mutations in the ED1 gene, which is responsible for the coding of ectodysplasin-A(EDA-A), a protein that regulates ectodermal appendage formation. In the present study we found both in our proband and in the mother the same missense mutation in exon 9 (c.957 C>A), which resulted in an aminoacid change at position 319 (Ser319Arg). This latter anomaly might alter the charges in the TNF domain of EDA-A, affecting the stability of the protein and therefore the interaction with its receptor. The male propositus presented classical manifestations of HED except for keratoconus (KC) and, to the best of our knowledge, this association has not been previously described. The identification of this new mutation may contribute to evaluating the genotype/phenotype correlations. Finally, this report can give useful information about the genetic basis of KC and HED. Future studies will allow us to understand if a genetic bond exists between them.
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Affiliation(s)
- M Piccione
- Operative Unit of Pediatrics and Neonatal Intensive Therapy, Mother and Child Department, University of Palermo, Palermo, Italy.
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Poisson A, Krack P, Thobois S, Loiraud C, Serra G, Vial C, Broussolle E. History of the ‘geste antagoniste’ sign in cervical dystonia. J Neurol 2012; 259:1580-4. [DOI: 10.1007/s00415-011-6380-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 12/07/2011] [Accepted: 12/13/2011] [Indexed: 12/01/2022]
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Cottoni F, Amadu V, Addis G, Serra G, Satta R, Montesu M. Rare diseases with skin involvement: a retrospective study (1996-2008). J Eur Acad Dermatol Venereol 2011; 25:1240-1. [DOI: 10.1111/j.1468-3083.2010.03890.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: 11/26/2022]
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Zolfino T, Piras MR, Zaru S, Santona MC, Arcadu F, Serra G, Chessa L, Vidili G, Spada F, Enne P, Bandiera F. Sorafenib and locoregional treatment in patients with stage B and stage C HCC: Sardinian experience. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14577] [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: 11/20/2022] Open
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32
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Fraioli F, Serra G, Passariello R. CAD (computed-aided detection) and CADx (computer aided diagnosis) systems in identifying and characterising lung nodules on chest CT: overview of research, developments and new prospects. Radiol Med 2010; 115:385-402. [PMID: 20077046 DOI: 10.1007/s11547-010-0507-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2009] [Accepted: 04/27/2009] [Indexed: 02/07/2023]
Abstract
Computer-aided detection (CAD) systems allow the automatic identification of lung nodules on chest computed tomography (CT), providing a second opinion to the radiologist's judgement and a volumetric evaluation of lesions - a very important aspect in oncological patients. The natural evolution of these systems has led to the introduction of computer-aided diagnosis (CADx) systems, which are able not only to identify nodules but also to characterise them by determining a likelihood of malignancy or benignity. The aim of this article is to describe the main technical principles of CAD and CADx systems, their applicability and influence in clinical practice and new prospects for their future development.
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Affiliation(s)
- F Fraioli
- Department of Radiological Sciences, University of Rome La Sapienza, V.le Regina Elena 324, 00161, Rome, Italy.
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Pompili M, Serafini G, Innamorati M, Serra G, Forte A, Lester D, Ducci G, Girardi P, Tatarelli R. White matter hyperintensities, suicide risk and late-onset affective disorders: an overview of the current literature. Clin Ter 2010; 161:555-563. [PMID: 21181087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
White matter hyperintensities (WMHs) refer to areas of hyperintense signal on T2- or proton density-weighted brain magnetic resonance imaging. Although WMHs are a common finding in patients with bipolar disorder (BD), particularly with a later disease onset, some studies report a higher frequency of WMHs only in unipolar affective disorders. We reviewed the literature examining examining both the severity and presence of WMHs in late life and particularly in individuals with late-onset BD (LOBD). Studies investigating white matter lesions in LOBD were systematically retrieved and the reference lists of these studies were scanned for additional relevant studies of neuroimaging in LOBD. The majority of neuroimaging studies reported an association between older age and LOBD and the presence of WMHs in LOBD. Also, we found in a small sample of patients preliminary evidence of a significant relationship between older age with late-onset BD and WMHs having a higher prevalence of cardiovascular and cerebrovascular risk factors. In conclusion over 60 years older individuals with LOBD and WMHs might have a type of illness characterized by more neuropathological changes and biologically different compared to non LOBD. This is consistent with the hypothesis of vascular mania. WMHs could be a reliable biological risk marker for late onset mood disorders.
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Affiliation(s)
- M Pompili
- Department of Psychiatry. Sant'Andrea Hospital, Sapienza University of Rome, Via Grottarossa, Rome, Italy.
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Scopesi F, Risso FM, Sannia A, Traggiai C, Arioni C, Zullino E, Campone F, Mezzano P, Massocco D, Baldi F, Serra G. The proper tidal volume target using volume guarantee ventilation in the course of neonatal respiratory distress syndrome: a crucial endpoint. J Matern Fetal Neonatal Med 2009; 23:692-4. [PMID: 19951009 DOI: 10.3109/14767050903440448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Volume guarantee ventilation (VGV) is an optional ventilation mode which has become the most widely and extensively studied in the last 10 years in premature infants. Nonetheless, theoretical expected endpoints are intriguing and even though VGV has not yet become 'the' standard ventilation mode, a great deal of information has been acquired and stored. In our experience, VGV during the course of respiratory distress syndrome is useful and can be considered a standard ventilation mode. Weaning occurs in real time as described earlier, and synchronized intermittent positive pressure ventilation and pressure support ventilation (PSV) seem to be the preferred combined modes. Management during the acute phase requires more care since several sudden changes take place in both the lung mechanics and clinical behavior. The software is designed to protect the lung, and subsequently, sudden changes in lung compliance following iatrogenic procedures such as surfactant administration are powerfully counteracted. VGV has been extensively studied and the proposed algorithm has been found to function as planned. Although the 'superiority' of one method over another cannot be demonstrated, the use of new technologies require 'a staff learning curve' and homogeneity of treatment, while at the same time other factors, such as patient heterogeneity or illness phase, should be taken into due account.
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Affiliation(s)
- F Scopesi
- Department of Neonatal Intensive Care, G. Gaslini Children's Hospital, University of Genoa, Genoa, Italy.
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Abstract
OBJECTIVE To produce a model for routine centralized hearing screening including all aspects of the screening, from diagnosis to psychological counseling and early rehabilitation. METHODS A prospective observational study on a geographically defined pediatric population (Liguria region, northwestern Italy) and data collection in a data bank. The model proposed was created for the audiological screening of all newborns of the Liguria region. The model includes four phases: (1) preliminary identification of contractual, administrative, legal aspects; (2) screening for identification of congenital hearing impairment; (3) therapy and rehabilitation of identified subjects and genetic analysis; (4) epidemiology, data management, and workload management. To test the feasibility of the model proposed and to establish the workload required according to the resources available in the regional health plan, we performed a pilot study on all infants born in four of the 13 regional birth centers of Liguria region from 1 April 2001 to 30 September 2001. RESULTS Out of the 3268 newborns enrolled during the 6-month pilot study, 3238 (99.1%) were screened with otoacoustic emissions (OAE), while screening was refused in 30 newborns (0.9%). OAE resulted in a 'pass' for 3180 newborns (98.2%) and a 'refer' in 58 (1.8%). The standard auditory brainstem response (ABR) test was performed in 156 newborns, 58 of them as a result of the 'refer' at the second OAE and 98 others at audiological risk. Results were positive or uncertain at first ABR in 45 patients. Workload was calculated on the basis of the data obtained in the pilot study to allocate financial and organizational resources. CONCLUSIONS The results of the pilot study allowed project planning. We think that the screening model proposed is an example of how a regional organization can deliver improved quality care through a rationalization and optimization process.
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Affiliation(s)
- M G Calevo
- Epidemiology and Biostatistics Service, G. Gaslini Institute, Genoa, Italy.
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Quattrucci S, Fraioli F, Mennini M, Menichella A, Patriarchi F, Serra G. The role of Magnetic Resonance Imaging (MRI) in predicting severity of disease using a dedicated scoring chest system in patients with cystic fibrosis (CF). J Cyst Fibros 2009. [DOI: 10.1016/s1569-1993(09)60266-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Santini P, Calevo MG, Caviglia MR, Asprea T, Bonacci W, Serra G, Cotellessa M, Revello G, Corciulo M, Boscarini A, Malvasio S, Renda R, Schiavetti P, Ivaldi M, Corona MF. Breastfeeding in Northern Italy. Acta Paediatr 2008; 97:613-9. [PMID: 18373720 DOI: 10.1111/j.1651-2227.2008.00711.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To describe the duration and type, as classified by World Health Organization (WHO) criteria, of breastfeeding in Ligurian newborns up to 1 year of age, and to identify possible related factors. METHODS A prospective, observational study on a cohort of 757 women recruited in 10 hospitals in Northern Italy. Women were followed up by means of a questionnaire at discharge and by telephone interviews in the 4th, 12th, 24th and 48th weeks postpartum using the 'recall period' method. RESULTS At discharge, 97.3% of mothers had started breastfeeding; regional breastfeeding rates at the 4th, 12th, 24th and 48th weeks were respectively 84.4%, 71.2%, 54.4% and 26.3%. Socio-demographic factors did not significantly influence these percentages. Median duration of breastfeeding was 6.5 months. No statistically significant differences were observed in duration of breastfeeding between women who started exclusive breastfeeding (EBF) and those who did predominant breastfeeding (PBF), while the difference was statistically significant when comparing complementary breastfeeding (CBF) with EBF and with PBF. CONCLUSIONS Our study is the first regional experience in the Liguria region and represents a starting point for the diffusion of the culture of breastfeeding. Our results are satisfactory with regards to the overall duration of breastfeeding until the first year of life (26.3%), while duration of EBF (9.5% at the 24th week) is still unsatisfactory according to WHO objectives that include EBF for all children up to the sixth month of life.
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Affiliation(s)
- P Santini
- Department of Neonatal Pathology, Genoa University, G. Gaslini Institute, Largo G. Gaslini 5, 16147 Genoa, Italy
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Ferrante A, Alberici A, Antonacci S, Serra G. EFFECT OF PROMOTER AND INHIBITORS OF PHENYLALANINE AMMONIA-LYASE ENZYME ON STEM BENDING OF CUT GERBERA FLOWERS. ACTA ACUST UNITED AC 2007. [DOI: 10.17660/actahortic.2007.755.64] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Trivellini A, Vernieri P, Ferrante A, Serra G. PHYSIOLOGICAL CHARACTERIZATION OF FLOWER SENESCENCE IN LONG LIFE AND EPHEMERAL HIBISCUS (HIBISCUS ROSA-SINENSIS L.). ACTA ACUST UNITED AC 2007. [DOI: 10.17660/actahortic.2007.755.62] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
AIM Early identification and rehabilitation of newborns with congenital hearing impairment (HI) by Universal Neonatal Hearing Screening (UNHS). METHODS The neonatal population was divided into two groups: babies with No Audiological Risk (NAR), and babies With Audiological Risk (WAR). NAR neonates underwent OAE testing, and in case of a doubtful (Refer) result, ABR testing was carried out. All WAR newborns underwent ABR testing within the third month of life. RESULTS Between February 1, 2002 and December 31, 2004, UNHS was carried out on 32 502 newborns at the 13 regional birth centres, representing 98.7% of the whole regional neonatal population. The prevalence of HI in the population we tested was estimated at about 1 per thousand, while Bilateral Hearing Impairment (BHI) was estimated at 0.65 per thousand. A 3.7% prevalence of HI and a 2.8% prevalence of BHI was observed among the WAR population. Median age at the end of the diagnostic procedures was 6.7 months in the WAR population and 6.9 months in the NAR population. CONCLUSIONS Our project is based on two levels of testing, which resulted in a 0.28% false-positive rate with 100% sensitivity and 99% specificity. Our screening is the first Italian experience that has been extended to a whole region and the results prove that regional neonatal hearing screening is feasible.
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Affiliation(s)
- M G Calevo
- Epidemiology and Biostatistics Service, Scientific Directorate, G. Gaslini Institute, Largo G. Gaslini 5, 16147 Genoa, Italy.
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Abstract
Despite recent advances in the treatment of chronic viral hepatitis, therapy of chronic hepatitis D is not yet satisfactory. The only option currently available is interferon-alpha (IFN), whose efficacy is related to the dose and duration of treatment. However, the rate of sustained hepatitis D virus (HDV) clearance after a 1-year course with high doses of standard IFN is low. Better results have recently been reported with pegylated IFN both in IFN-naïve and in previous nonresponders to standard IFN, suggesting the use of pegylated IFN as a first-line therapy in chronic hepatitis D. Nucleoside analogues that inhibit hepatitis B virus (HBV) are ineffective against HDV and combination therapy with lamivudine or ribavirin has not shown significant advantages over monotherapy with either standard or pegylated IFN. Because the ultimate goal of treatment is eradication of both HDV and HBV, in responders IFN therapy should be continued as long as possible until the loss of hepatitis B surface antigen, adjusting the dose to patient tolerance. However, because side-effects are common, continuous monitoring is mandatory. Although the first results obtained with pegylated IFN have been encouraging, the rate of sustained virological response is still low and the rate of relapse high, emphasizing the need for developing novel classes of antivirals specifically interfering with the life cycle of this unique virus.
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Affiliation(s)
- P Farci
- Department of Medical Sciences, University of Cagliari, Policlinico Universitario, Monserrato, Cagliari, Italy.
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Scopesi F, Calevo MG, Rolfe P, Arioni C, Traggiai C, Risso FM, Serra G. Volume targeted ventilation (volume guarantee) in the weaning phase of premature newborn infants. Pediatr Pulmonol 2007; 42:864-70. [PMID: 17726708 DOI: 10.1002/ppul.20667] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Several options are currently available in neonatal mechanical ventilation: complete breathing synchronization (patient triggered ventilation, synchronized intermittent positive pressure ventilation--SIPPV); positive pressure flow-cycled ventilation (pressure support ventilation, PSV); and volume targeted positive pressure ventilation (volume guarantee, VG). The software algorithm for the guarantee volume attempts to deliver a tidal volume (Vt) as close as possible to what has been selected by the clinician as the target volume. Main objectives of the present study were to compare patient-ventilator interactions and Vt variability in premature infants recovering from respiratory distress syndrome (RDS) who were weaned by various ventilator modes (SIMV/PSV + VG/SIPPV + VG and SIMV + VG). METHODS This was a short-term crossover trial in which each infant served as his/her own control. Ten premature infants born before the 32nd week of gestation in the recovery phase of RDS were enrolled in the study. All recruited infants started ventilation with SIPPV and in the weaning phase were switched to synchronized intermittent mandatory ventilation (SIMV). Baseline data were collected during an initial 20-min period of monitoring with the infant receiving SIMV alone, then they were switched to SIPPV + VG for a 20-min period and then switched back to SIMV for 15 min. Next, they were switched to PSV + VG for the study period and switched back to SIMV for a further 15 min. Finally, they were switched to SIMV + VG and, at the end of monitoring, they were again switched back to SIMV alone. RESULTS Each mode combined with VG discharged comparable Vts, which were very close to the target volume. Among the VG-combined modes, mean variability of Vt from preset Vt was significantly different. Variability from the target value was significantly lower in SIPPV and PSV modes than in SIMV (P < 0.0001 and P < 0.04 respectively). SIPPV + VG showed greater stability of Vt, fewer large breaths, lower respiratory rate, and allowed for lower peak inspiratory pressure than what was delivered by the ventilator during other modes. No significant changes in blood gases were observed after each of the study periods. CONCLUSIONS With regards to the weaning phase, among combined modes, both of the ones in which every breath is supported (SIPPV/PSV) are likely to be the most effective in the delivery of stable Vt using a low working pressure, thus, at least in the short term, likely more gentle for the neonatal lung. In summary, we can suggest that the VG option, when combined with traditional, patient triggered ventilation, adheres very closely to the proposed theoretical algorithm, achieving highly effective ventilation.
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Affiliation(s)
- F Scopesi
- Neonatal Intensive Care Unit G. Gaslini Hospital, Genoa University, Genoa, Italy.
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Cossu G, Modugno N, Deriu M, Murgia D, Serra G, Melis M, Breddveld G, Simons E, Oostra B, Bonifati V. 2.117 Clinical spectrum of a large Sardinian family with Parkinson's disease. Parkinsonism Relat Disord 2007. [DOI: 10.1016/s1353-8020(08)70609-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sellanes D, Scarone L, Mahler G, Manta E, Baz A, Dematteis S, Saldana J, Dominguez L, Wipf P, Serra G. Synthesis and Evaluation of Anthelmintic and Cytotoxic Properties of Bis- 1,3-Azole Analogs of Natural Products. LETT DRUG DES DISCOV 2006. [DOI: 10.2174/157018006775240962] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Colombo GL, Serra G, Morlotti L, Fara GM. [The role of economic evaluation for the implementation of vaccination strategies]. Ann Ig 2005; 17:479-90. [PMID: 16523707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
The analysis described below tries to underline the major economic aspects of vaccination strategies both in childhood (polio, diphtheria, tetanus, H influenzae, measles, rubella, mumps, et) and in the elderly (limited to influenza control). As a result we could demonstrate that, in spite of the formal recognition of the paramount importance of prevention in general, and of vaccinal prevention in particular; vaccinations are at present very poorly considered by policymakers and politicians. This in contrast with the fact that the studies so far examined show that vaccinations are among the most productive interventions (lowest cost per year of life-year spared, very good cost-benefit ratio, thanks to the cases of diseases avoided). Such a convenience is highest when, in front of a given disease, the vaccinal strategy has been duly selected. Therefore, it is suggested that additional resources should be provided in the future to complete the framework and to increase the coverage of vaccinations, including the new offers against Varicella, N meningitidis and Str pneumoniae: and, in the future, against Rotavirus and HPV.
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Affiliation(s)
- G L Colombo
- S.A.V.E. Studi Analisi Valutazioni Economiche, Milano.
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Tauzin L, Risso F, Buffat C, Serra G, Simeoni U. Vascular mechanisms in the developmental programming of cardio-vascular disease. Pediatr Med Chir 2005; 27:18-23. [PMID: 16913620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
Several studies suggest that adverse events during foetal life can program cardiovascular diseases in adulthood. Barker et al. identified a relationship between low birth weight and an increased risk of arterial hypertension, carotid arteriosclerosis, and mortality by coronary heart disease or stroke in adulthood. These findings led to the "foetal origins" hypothesis, which is that cardiovascular disease originates in the adaptations to an adverse intrauterine environment. Such adaptations may permanently alter the cardiovascular structure and physiology through the process of programming. Several factors, such as impaired foetal growth, premature birth or postnatal growth of low birth weight infants may be involved, but to which extent is still unclear.
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Affiliation(s)
- L Tauzin
- Université de la Méditerranée, Faculté de Médecine, Marseille, France
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Bellini C, Boccardo F, Campisi C, Toma P, Taddei G, Villa G, Nozza P, Serra G, Bonioli E. Pulmonary lymphangiectasia. Lymphology 2005; 38:111-21. [PMID: 16353488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Congenital pulmonary lymphangiectasia (PL) is a rare developmental disorder involving the lung and is characterized by pulmonary subpleural, interlobar, perivascular, and peribronchial lymphatic dilatation. Both frequency and etiology are unknown. PL presents at birth with severe respiratory distress, tachypnea, and cyanosis, with a very high mortality rate at or within a few hours of birth. At birth, mechanical ventilation and pleural drainage are nearly always necessary to obtain a favorable outcome of respiratory distress. Home supplemental oxygen therapy and symptomatic treatment of recurrent cough and wheeze are often necessary during childhood, sometimes associated to prolonged pleural drainage. Recent advances in intensive neonatal care have changed the previously nearly fatal outcome of PL at birth. Patients affected by PL who survive infancy present medical problems which are characteristic of chronic lung disease.
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Affiliation(s)
- C Bellini
- Servizio di Patologia Neonatale, Dipartimento di Pediatria, Università di Genova, Istituto G. Gaslini, Italia.
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Serra G. Post discharge nutrition of preterm infant. Pediatr Med Chir 2005; 27:15-7. [PMID: 16913619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Affiliation(s)
- G Serra
- Perinatal Department, Giannina Gaslini Institute, University of Genoa
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Bellini C, Boccardo F, Taddei G, Mazzella M, Arioni C, Villa G, Hennekam RC, Serra G, Campisi C. Diagnostic protocol for lymphoscintigraphy in newborns. Lymphology 2005; 38:9-15. [PMID: 15856680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The purpose of this methods paper is to offer pediatricians and nuclear medicine physicians a diagnostic protocol for performing lymphoscintigraphy in newborns that may be useful for enhancing diagnosis and management of newborns with congenital lymphatic abnormalities. Indications for lymphoscintigraphy, choice of tracer, optimal dose, routes of administration, methods of data acquisition, timing, and interpretation of results for newborns are presented and discussed.
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Affiliation(s)
- C Bellini
- Servizio di Patologia Neonatale, Dipartimento di Pediatria (DIPE), Università di Genova, Istituto G. Gaslini, Italy.
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Cargnel A, Angeli E, Mainini A, Gubertini G, Giorgi R, Schiavini M, Duca P, Scalise G, Cesare SD, Chiodo F, Verucchi G, Farci P, Serra G, Sagnelli E, Nacca C, Ferraro T, Scerbo A, Santoro D, Pusterla L, Viganò P, Magnani C, Ghinelli F, Sighinolfi L, Vigevani G, Pastecchia C, Moroni M, Milazzo L, Esposito R, Borghi V, Piccinino F, Filippini P, Cadrobbi P, Sattin A, Ferrari C, Antoni AD, Stagni G, Francisci D, Petrelli E, Alberici F, Sacchini D, Zauli T, Donà DD, Arlotti M, Mori F, Marranconi F, Caramello P, Lipani F, Soranzo ML, Macor A, Vaglia A, Rossi MC, Grossi P, Tambini R, De Lalla F, Tositti G. Open, Randomized, Multicentre Italian Trial on Peg-Ifn plus Ribavirin versus Peg-Ifn Monotherapy for Chronic Hepatitis C in HIV-Coinfected Patients on Haart. Antivir Ther 2005. [DOI: 10.1177/135965350501000215] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Chronic hepatitis C is common and aggressive in HIV-positive patients, so the development of a well-tolerated HCV therapy is a priority. We evaluated the efficacy and safety of pegylated interferon α2b (PEG-IFN) plus ribavirin (RBV) versus PEG-IFN monotherapy in HIV/HCV-coinfected patients undergoing highly active antiretroviral therapy (HAART), and analysed the predictive factors of response. Methods An Italian, multicentre, open-label trial including 135 coinfected patients, randomized to PEG-IFN 1.5 μg/kg/week plus RBV 400 mg twice daily ( n=69, arm A) or PEG-IFN 1.5 μg/kg/week ( n=66, arm B) for 48 weeks. We assessed the predictive values of early virological response (EVR) at week 8 (HCV-RNA drop >2 log10 compared with baseline or undetectable levels) on sustained virological response (SVR). Results Fifty-five patients (28 from arm A and 27 from arm B) completed 48 weeks of therapy. At the end of treatment, 20/28 patients in arm A and 11/27 in arm B had HCV-RNA <50 IU/ml. In a per-protocol analysis, SVR was reached by 54% of patients in arm A (genotype 2–3, 11/16; genotype 1–4, 4/12) and 22% in arm B (genotype 2–3, 3/15; genotype 1–4, 3/12). In an intention-to-treat analysis, the SVR was 22% in arm A (genotype 2–3, 11/32; genotype 1–4, 4/37) versus 9% in arm B (genotype 2–3, 3/32; genotype 1–4, 3/34). The best predictors of SVR were the use of combination therapy, infection with HCV genotype 3 versus genotype 1, and EVR at week 8. Thirty patients (15 from arm A and 15 from arm B) dropped out of the trial prematurely due to side effects. The positive predictive value of EVR at week 8 was 65%, the negative predictive value was 86%. Conclusions PEG-IFN plus RBV can be considered a solid option for the treatment of HIV/HCV-coinfected patients. The key to successfully improving efficacy is strong compliance through strict overall patient monitoring, in order to best manage drug toxicity. EVR assessment at week 8 may become a useful stategy in the management of therapy.
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Affiliation(s)
| | | | - Elena Angeli
- II Department Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
| | - Annalisa Mainini
- II Department Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
| | - Guido Gubertini
- II Department Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
| | - Riccardo Giorgi
- II Department Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
| | - Monica Schiavini
- II Department Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
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