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Wagner N, Crippa L, Amaricci A, Hansmann P, Klett M, König EJ, Schäfer T, Sante DD, Cano J, Millis AJ, Georges A, Sangiovanni G. Mott insulators with boundary zeros. Nat Commun 2023; 14:7531. [PMID: 37985660 PMCID: PMC10662449 DOI: 10.1038/s41467-023-42773-7] [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: 08/21/2023] [Accepted: 10/17/2023] [Indexed: 11/22/2023] Open
Abstract
The topological classification of electronic band structures is based on symmetry properties of Bloch eigenstates of single-particle Hamiltonians. In parallel, topological field theory has opened the doors to the formulation and characterization of non-trivial phases of matter driven by strong electron-electron interaction. Even though important examples of topological Mott insulators have been constructed, the relevance of the underlying non-interacting band topology to the physics of the Mott phase has remained unexplored. Here, we show that the momentum structure of the Green's function zeros defining the "Luttinger surface" provides a topological characterization of the Mott phase related, in the simplest description, to the one of the single-particle electronic dispersion. Considerations on the zeros lead to the prediction of new phenomena: a topological Mott insulator with an inverted gap for the bulk zeros must possess gapless zeros at the boundary, which behave as a form of "topological antimatter" annihilating conventional edge states. Placing band and Mott topological insulators in contact produces distinctive observable signatures at the interface, revealing the otherwise spectroscopically elusive Green's function zeros.
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Affiliation(s)
- N Wagner
- Institut für Theoretische Physik und Astrophysik, Universität Würzburg, 97074, Würzburg, Germany
| | - L Crippa
- Institut für Theoretische Physik und Astrophysik and Würzburg-Dresden Cluster of Excellence ct.qmat, Universität Würzburg, 97074, Würzburg, Germany
| | - A Amaricci
- CNR-IOM, Istituto Officina dei Materiali, Consiglio Nazionale delle Ricerche, Via Bonomea 265, 34136, Trieste, Italy
| | - P Hansmann
- Department of Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - M Klett
- Max-Planck-Institut für Festkörperforschung, Heisenbergstr. 1, 70569, Stuttgart, Germany
| | - E J König
- Max-Planck-Institut für Festkörperforschung, Heisenbergstr. 1, 70569, Stuttgart, Germany
| | - T Schäfer
- Max-Planck-Institut für Festkörperforschung, Heisenbergstr. 1, 70569, Stuttgart, Germany
| | - D Di Sante
- Department of Physics and Astronomy, University of Bologna, Bologna, Italy
- Center for Computational Quantum Physics, Flatiron Institute, New York, NY, USA
| | - J Cano
- Center for Computational Quantum Physics, Flatiron Institute, New York, NY, USA
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York, NY, 11974, USA
| | - A J Millis
- Center for Computational Quantum Physics, Flatiron Institute, New York, NY, USA
- Department of Physics, Columbia University, New York, NY, USA
| | - A Georges
- Center for Computational Quantum Physics, Flatiron Institute, New York, NY, USA
- Collège de France, PSL University, 11 place Marcelin Berthelot, 75005, Paris, France
- Department of Quantum Matter Physics, University of Geneva, 24 quai Ernest-Ansermet, 1211, Geneva, Switzerland
- CPHT, CNRS, École Polytechnique, IP Paris, F-91128, Palaiseau, France
| | - G Sangiovanni
- Institut für Theoretische Physik und Astrophysik and Würzburg-Dresden Cluster of Excellence ct.qmat, Universität Würzburg, 97074, Würzburg, Germany.
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Crippa L, Sangiovanni G, Budich JC. Spontaneous Formation of Exceptional Points at the Onset of Magnetism. Phys Rev Lett 2023; 130:186403. [PMID: 37204907 DOI: 10.1103/physrevlett.130.186403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 01/20/2023] [Accepted: 03/31/2023] [Indexed: 05/21/2023]
Abstract
We reveal how symmetry-protected nodal points in topological semimetals may be promoted to pairs of generically stable exceptional points (EPs) by symmetry-breaking fluctuations at the onset of long-range order. This intriguing interplay between non-Hermitian (NH) topology and spontaneous symmetry breaking is exemplified by a magnetic NH Weyl phase spontaneously emerging at the surface of a strongly correlated three-dimensional topological insulator, when entering the ferromagnetic regime from a high-temperature paramagnetic phase. Here, electronic excitations with opposite spin acquire significantly different lifetimes, thus giving rise to an anti-Hermitian structure in spin that is incompatible with the chiral spin texture of the nodal surface states, and hence facilitate the spontaneous formation of EPs. We present numerical evidence of this phenomenon by solving a microscopic multiband Hubbard model nonperturbatively in the framework of dynamical mean-field theory.
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Affiliation(s)
- L Crippa
- Institut für Theoretische Physik und Astrophysik and Würzburg-Dresden Cluster of Excellence ct.qmat, Universität Würzburg, 97074 Würzburg, Germany
| | - G Sangiovanni
- Institut für Theoretische Physik und Astrophysik and Würzburg-Dresden Cluster of Excellence ct.qmat, Universität Würzburg, 97074 Würzburg, Germany
| | - J C Budich
- Institute of Theoretical Physics, Technische Universität Dresden and Würzburg-Dresden Cluster of Excellence ct.qmat, 01062 Dresden, Germany
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Mittone A, Ivanishko Y, Kovalev S, Lisutina P, Lotoshnikov M, Tkachev S, Tkacheva M, Crippa L, Dmitriev V, Bravin A. High resolution hard X-ray 3D mapping of a Macaca fascicularis eye: A feasibility study without contrast agents. Phys Med 2018; 51:7-12. [DOI: 10.1016/j.ejmp.2018.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/28/2018] [Accepted: 06/02/2018] [Indexed: 11/30/2022] Open
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Beggiolin G, Crippa L, Menta E, Manzotti C, Cavalletti E, Pezzoni G, Torriani D, Randisi E, Cavagnoli R, Sala F, Giuliani FC, Spinelli S. Bbr 2778, an Aza-anthracenedione Endowed with Preclinical Anticancer Activity and Lack of Delayed Cardiotoxicity. Tumori 2018; 87:407-16. [PMID: 11989596 DOI: 10.1177/030089160108700611] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
With the aim to provide second-generation anthracenedione analogues endowed with reduced side effects and a wider spectrum of action than mitoxantrone and doxorubicin, a large number of new molecules bearing nitrogen atoms in the chromophore was synthesized and screened in vitro and in vivo. From this screening, BBR 2778 (6,9-bis[(2-aminoethyl)amino] benzo[g]isoquinoline-5,10-dione dimaleate) emerged as the most interesting compound. BBR 2778 was tested in vitro on several murine and human tumor cell lines and showed cytotoxic potency lower than that of mitoxantrone and doxorubicin. BBR 2778 was more cytotoxic in leukemia and lymphoma cell lines than in solid tumor cell lines. Although against in vivo models BBR 2778 was less potent than mitoxantrone and doxorubicin, its antitumor activity was equal or superior (in certain tumor models) to that of the above standard compounds. In particular, BBR 2778 was curative against L1210 murine leukemia and YC-8 murine lymphoma. Moreover, it showed an antitumor activity comparable to that of mitoxantrone and doxorubicin on solid tumors. No cardiotoxic effect of BBR 2778 in animals not pretreated with anthracyclines was observed compared to standards. In light of its spectrum of activity and marked efficacy against lymphomas and leukemias over a wide dose range, together with its lack of delayed cardiotoxicity, BBR 2778 has been entered in clinical studies.
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Affiliation(s)
- G Beggiolin
- Biology Direction, Novuspharma SpA Monza, Italy.
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5
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Avallone G, Pellegrino V, Roccabianca P, Lepri E, Crippa L, Beha G, De Tolla L, Sarli G. Tyrosine Kinase Receptor Expression in Canine Liposarcoma. Vet Pathol 2016; 54:212-217. [DOI: 10.1177/0300985816671379] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The expression of tyrosine kinase receptors is attracting major interest in human and veterinary oncological pathology because of their role as targets for adjuvant therapies. Little is known about tyrosine kinase receptor (TKR) expression in canine liposarcoma (LP), a soft tissue sarcoma. The aim of this study was to evaluate the immunohistochemical expression of the TKRs fibroblast growth factor receptor 1 (FGFR1) and platelet-derived growth factor receptor–β (PDGFRβ); their ligands, fibroblast growth factor 2 (FGF2) and platelet-derived growth factor B (PDGFB); and c-kit in canine LP. Immunohistochemical labeling was categorized as high or low expression and compared with the mitotic count and MIB-1–based proliferation index. Fifty canine LPs were examined, classified, and graded. Fourteen cases were classified as well differentiated, 7 as myxoid, 25 as pleomorphic, and 4 as dedifferentiated. Seventeen cases were grade 1, 26 were grade 2, and 7 were grade 3. A high expression of FGF2, FGFR1, PDGFB, and PDGFRβ was identified in 62% (31/50), 68% (34/50), 81.6% (40/49), and 70.8% (34/48) of the cases, respectively. c-kit was expressed in 12.5% (6/48) of the cases. Mitotic count negatively correlated with FGF2 ( R = –0.41; P < .01), being lower in cases with high FGF2 expression, and positively correlated with PDGFRβ ( R = 0.33; P < .01), being higher in cases with high PDGFRβ expression. No other statistically significant correlations were identified. These results suggest that the PDGFRβ-mediated pathway may have a role in the progression of canine LP and may thus represent a promising target for adjuvant cancer therapies.
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Affiliation(s)
- G. Avallone
- Department of Veterinary Medical Sciences (DIMEVET), University di Bologna, Ozzano dell’Emilia, Italy
| | - V. Pellegrino
- Department of Veterinary Medical Sciences (DIMEVET), University di Bologna, Ozzano dell’Emilia, Italy
| | - P. Roccabianca
- Department of Veterinary Medicine (DIMEVET), University of Milan, Milan, Italy
| | - E. Lepri
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | | | - G. Beha
- Department of Veterinary Medical Sciences (DIMEVET), University di Bologna, Ozzano dell’Emilia, Italy
| | - L. De Tolla
- Department of Pathology, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - G. Sarli
- Department of Veterinary Medical Sciences (DIMEVET), University di Bologna, Ozzano dell’Emilia, Italy
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Avallone G, Roccabianca P, Crippa L, Lepri E, Brunetti B, Bernardini C, Forni M, Olandese A, Sarli G. Histological Classification and Immunohistochemical Evaluation of MDM2 and CDK4 Expression in Canine Liposarcoma. Vet Pathol 2016; 53:773-80. [DOI: 10.1177/0300985815626573] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Canine liposarcoma is an uncommon soft tissue sarcoma usually arising in the subcutis. While liposarcoma classification in dogs is based solely on histology, in humans it depends on the detection of genetic abnormalities that can lead to specific protein overexpression. This study is an immunohistochemical evaluation of MDM2 and CDK4 expression in canine liposarcoma designed to assess the correlation of these proteins with histologic type, grade, mitotic index and Ki67 labeling index and evaluate their utility in improving tumor classification. Fifty-three liposarcomas were retrospectively collected: 24 were well differentiated liposarcomas (WDL), 16 of which expressed MDM2 and 21 CDK4; 7 were myxoid liposarcomas (ML), 1 of which expressed MDM2 and 5 expressed CDK4; 18 were pleomorphic liposarcomas (PL), all were MDM2 negative and 12 expressed CDK4. Four tumors were morphologically consistent with dedifferentiated liposarcoma (DDL) a subtype described only in humans: 3 expressed MDM2 and 4 expressed CDK4. MDM2 expression correlated with histotype (highly expressed in WDL and DDL) and grade (highly expressed in grade 1 tumors). Histotype correlated with the Ki67 labeling index (lowest in WDL and highest in DDL). A revised classification, considering MDM2 expression, allowed 8 WDL to be reclassified as PL and correlated significantly with mitotic and Ki67 labeling index (both significantly lower in WDL and progressively higher in ML and DDL). These results partially parallel data reported for human liposarcomas, suggesting that WDL and DDL are distinct neoplastic entities characterized by MDM2 expression, which may represent a useful diagnostic and potentially prognostic marker for canine liposarcoma.
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Affiliation(s)
- G. Avallone
- Department of Veterinary Medical Sciences
(DIMEVET), University of Bologna, Ozzano dell’Emilia, Italy
| | - P. Roccabianca
- Department of Veterinary Sciences and Public
Health (DIVET), University of Milan, Milan, Italy
| | | | - E. Lepri
- Department of Veterinary Medicine, University
of Perugia, Perugia, Italy
| | - B. Brunetti
- Department of Veterinary Medical Sciences
(DIMEVET), University of Bologna, Ozzano dell’Emilia, Italy
| | - C. Bernardini
- Department of Veterinary Medical Sciences
(DIMEVET), University of Bologna, Ozzano dell’Emilia, Italy
| | - M. Forni
- Department of Veterinary Medical Sciences
(DIMEVET), University of Bologna, Ozzano dell’Emilia, Italy
| | - A. Olandese
- Department of Veterinary Medical Sciences
(DIMEVET), University of Bologna, Ozzano dell’Emilia, Italy
| | - G. Sarli
- Department of Veterinary Medical Sciences
(DIMEVET), University of Bologna, Ozzano dell’Emilia, Italy
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Roccabianca P, Avallone G, Rodriguez A, Crippa L, Lepri E, Giudice C, Caniatti M, Moore PF, Affolter VK. Cutaneous Lymphoma at Injection Sites. Vet Pathol 2016; 53:823-32. [DOI: 10.1177/0300985815623620] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Feline primary cutaneous lymphomas (FPCLs) account for 0.2% to 3% of all lymphomas in cats and are more frequently dermal nonepitheliotropic small T-cell tumors. Emergence of FPCL seems unrelated to feline leukemia virus (FeLV) serological positivity or to skin inflammation. A total of 17 cutaneous lymphomas with a history of vaccine injection at the site of tumor development were selected from 47 FPCLs. Clinical presentation, histology, immunophenotype, FeLV p27 and gp70 expression, and clonality were assessed. A majority of male (12/17), domestic short-haired (13/17) cats with a mean age of 11.3 years was reported. Postinjection time of development ranged from 15 days to approximately 9 years in 5 cats. At diagnosis, 11 of 17 cats had no evidence of internal disease. Lymphomas developed in interscapular (8/17), thoracic (8/17), and flank (1/17) cutaneous regions; lacked epitheliotropism; and were characterized by necrosis (16/17), angiocentricity (13/17), angioinvasion (9/17), angiodestruction (8/17), and peripheral inflammation composed of lymphoid aggregates (14/17). FeLV gp70 and/or p27 proteins were expressed in 10 of 17 tumors. By means of World Health Organization classification, immunophenotype, and clonality, the lesions were categorized as large B-cell lymphoma (11/17), anaplastic large T-cell lymphoma (3/17), natural killer cell–like (1/17) lymphoma, or peripheral T-cell lymphoma (1/17). Lineage remained uncertain in 1 case. Cutaneous lymphomas at injection sites (CLIS) shared some clinical and pathological features with feline injection site sarcomas and with lymphomas developing in the setting of subacute to chronic inflammation reported in human beings. Persistent inflammation induced by the injection and by reactivation of FeLV expression may have contributed to emergence of CLIS.
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Affiliation(s)
- P. Roccabianca
- DIVET: Dipartimento di Scienze Veterinarie e Sanità Pubblica, University of Milano, Italy
| | - G. Avallone
- DIMEVET: Dipartimento di Scienze Mediche Veterinarie, University of Bologna, Italy
| | | | - L. Crippa
- ISTOVET, via W. Tobagi, 15-20842 Besana in Brianza (MB), Italy
| | - E. Lepri
- Dipartimento di Medicina Veterinaria, University of Perugia, Italy
| | - C. Giudice
- DIVET: Dipartimento di Scienze Veterinarie e Sanità Pubblica, University of Milano, Italy
| | - M. Caniatti
- DIVET: Dipartimento di Scienze Veterinarie e Sanità Pubblica, University of Milano, Italy
| | - P. F. Moore
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, Davis, CA, USA
| | - V. K. Affolter
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, Davis, CA, USA
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Avallone G, Pellegrino V, Roccabianca P, Lepri E, Crippa L, Beha G, De Tolla L, Sarli G. Tyrosine Kinase Receptor Expression in Canine Liposarcoma. J Comp Pathol 2016. [DOI: 10.1016/j.jcpa.2015.10.136] [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: 11/16/2022]
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9
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Avallone G, Brunetti B, Bernardini C, Roccabianca P, Forni M, Lepri E, Crippa L, Olandese A, Sarli G. MDM2 and CDK4 expression in canine liposarcoma. J Comp Pathol 2015. [DOI: 10.1016/j.jcpa.2014.10.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Meregalli C, Carozzi VA, Sala B, Chiorazzi A, Canta A, Oggioni N, Rodriguez-Menendez V, Ballarini E, Ceresa C, Nicolini G, Crippa L, Orciani M, Cavaletti G, Marmiroli P. Bortezomib-induced peripheral neurotoxicity in human multiple myeloma-bearing mice. J BIOL REG HOMEOS AG 2015; 29:115-124. [PMID: 25864747] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The proteasome inhibitor bortezomib is an antineoplastic drug mainly used for the treatment of multiple myeloma (MM). Despite its effectiveness, bortezomib clinical use is often limited by the onset of peripheral neuropathy (BiPN). To better understand the mechanisms of BiPN several rat and mice models have been proposed, but no studies in MM-bearing animals allowing to test the antitumor activity of the selected schedules and the role of MM by itself in peripheral nervous system damage have been reported to date. Here, we carried out a study using immunodeficient C.B-17/Prkdcscid (SCID) mice injected with RPMI8266 human MM cells and treated with bortezomib 1 mg/kg once a week for five weeks. Animals were assessed with neurophysiological, behavioral and pathological methods and tumor volume measurement was performed along the study. At the end of the study BiPN was evident in bortezomib-treated animals, and this neurotoxic effect was evident using a schedule able to effectively prevent tumor growth. However, neurophysiological and pathological evidence of MM induced peripheral nervous system damage was also reported. This model based on MM-bearing animals is more reliable in the reproduction of the clinical setting and it is, therefore, more suitable than the previously reported models of BiPN to study its pathogenesis. Moreover, it represents an optimal model to test the efficacy of neuroprotective agents and at the same time their non-interference with bortezomib antineoplastic activity.
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Affiliation(s)
- C Meregalli
- Experimental Neurology Unit and Milan Center for Neuroscience, Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza (MB), Italy
| | - V A Carozzi
- Experimental Neurology Unit and Milan Center for Neuroscience, Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza (MB), Italy
| | - B Sala
- Experimental Neurology Unit and Milan Center for Neuroscience, Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza (MB), Italy
| | - A Chiorazzi
- Experimental Neurology Unit and Milan Center for Neuroscience, Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza (MB), Italy
| | - A Canta
- Experimental Neurology Unit and Milan Center for Neuroscience, Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza (MB), Italy
| | - N Oggioni
- Experimental Neurology Unit and Milan Center for Neuroscience, Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza (MB), Italy
| | - V Rodriguez-Menendez
- Experimental Neurology Unit and Milan Center for Neuroscience, Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza (MB), Italy
| | - E Ballarini
- Experimental Neurology Unit and Milan Center for Neuroscience, Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza (MB), Italy
| | - C Ceresa
- Experimental Neurology Unit and Milan Center for Neuroscience, Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza (MB), Italy
| | - G Nicolini
- Experimental Neurology Unit and Milan Center for Neuroscience, Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza (MB), Italy
| | - L Crippa
- Veterinary Pathology Labs, ISTOVET, Monza, Italy
| | - M Orciani
- Department of Clinical and Molecular Sciences-Histology, Marche Polytechnic University, Ancona, Italy
| | - G Cavaletti
- Experimental Neurology Unit and Milan Center for Neuroscience, Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza (MB), Italy
| | - P Marmiroli
- Experimental Neurology Unit and Milan Center for Neuroscience, Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza (MB), Italy
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Della Valle P, Crippa L, Fattorini A, Viganò S, D’Angelo A. C0370: Effect of Thrombomodulin and Fondaparinux on Thrombin Generation in Selected Disease States. Thromb Res 2014. [DOI: 10.1016/s0049-3848(14)50241-1] [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: 11/16/2022]
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12
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Porcaro G, Barbano L, Monfrini M, Crippa L, Carini F. Riabilitazione implantare complessa in pazienti in trattamento con bifosfonati orali: caso clinico. Dental Cadmos 2013. [DOI: 10.1016/s0011-8524(13)70033-3] [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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13
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Pengo V, Crippa L, Falanga A, Finazzi G, Marongiu F, Moia M, Palareti G, Poli D, Testa S, Tiraferri E, Tosetto A, Tripodi A, Siragusa S, Manotti C. Phase III studies on novel oral anticoagulants for stroke prevention in atrial fibrillation: a look beyond the excellent results. J Thromb Haemost 2012; 10:1979-87. [PMID: 22827490 DOI: 10.1111/j.1538-7836.2012.04866.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [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: 11/30/2022]
Abstract
In this overview we address the three phase III studies that compared new oral anticoagulants (dabigatran, rivaroxaban and apixaban) with warfarin in the setting of stroke prevention in atrial fibrillation. Strengths and weaknesses of the studies were examined in detail through indirect comparison. We analyze and comment the inclusion and exclusion criteria, the characteristics of randomized patients, the primary efficacy and safety end points and side effects. All new oral anticoagulants resulted in being non-inferior to vitamin K antagonists in reducing stroke or systemic embolism in patients with atrial fibrillation. Dabigatran 150 mg and apixaban were superior to vitamin K antagonists. Importantly, new oral anticoagulants significantly reduced hemorrhagic stroke in all three studies. Major differences among new oral anticoagulants include the way they are eliminated and side effects. Both dabigatran and apixaban were tested in low- to moderate-risk patients (mean CHADS2 [Congestive heart failure, Hypertension, Age, Diabetes, Stroke] score = 2.1-2.2) whereas rivaroxaban was tested in high-risk patients (mean CHADS2 score = 3.48) and at variance with dabigatran and apixaban was administered once daily. Apixaban significantly reduced mortality from any cause. The choice of a new oral anticoagulant should take into account these and other differences between the new drugs.
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Affiliation(s)
- V Pengo
- Department of Clinical Cardiology, Thrombosis Centre, University of Padua, Padua, Italy.
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Fattorini A, Crippa L, D'Angelo A. Artificially depleted plasmas are not necessarily commutable with native patient plasmas for International Sensitivity Index calibration and International Normalized Ratio derivation: a rebuttal. J Thromb Haemost 2012; 10:1715-6. [PMID: 22642315 DOI: 10.1111/j.1538-7836.2012.04795.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Pengo V, Crippa L, Falanga A, Finazzi G, Marongiu F, Palareti G, Poli D, Testa S, Tiraferri E, Tosetto A, Tripodi A, Manotti C. Questions and answers on the use of dabigatran and perspectives on the use of other new oral anticoagulants in patients with atrial fibrillation. A consensus document of the Italian Federation of Thrombosis Centers (FCSA). Thromb Haemost 2011; 106:868-76. [PMID: 21946939 DOI: 10.1160/th11-05-0358] [Citation(s) in RCA: 137] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 08/19/2011] [Indexed: 12/21/2022]
Abstract
Dabigatran and other new oral anticoagulants (OAC) represent a step forward in stroke prevention in patients with atrial fibrillation (AF). They indeed have been shown to be an alternative to vitamin K antagonists (VKAs) without the burden of laboratory control. However, these new drugs compete with an effective and well-established therapy, thus bringing about a series of questions and doubts. In this report members of the board of the Italian Federation of Thrombosis Centers (FCSA) answer some questions every clinician might be confronted with.
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Affiliation(s)
- V Pengo
- Clinical Cardiology, Thrombosis Center, Padova, Italy.
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Canta A, Chiorazzi A, Carozzi V, Meregalli C, Oggioni N, Sala B, Crippa L, Avezza F, Forestieri D, Rotella G, Zucchetti M, Cavaletti G. In vivo comparative study of the cytotoxicity of a liposomal formulation of cisplatin (lipoplatin™). Cancer Chemother Pharmacol 2011; 68:1001-8. [PMID: 21327681 DOI: 10.1007/s00280-011-1574-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 01/26/2011] [Indexed: 12/15/2022]
Abstract
PURPOSE Cisplatin is one of the most effective cytotoxic agents in the treatment of solid malignancies, but its use is limited by several side effects. Among them, peripheral neurotoxicity can be dose limiting. A liposomal formulation of cisplatin, Lipoplatin™, was developed to reduce the systemic toxicity of cisplatin but without preventing its efficacy. The aim of this study was to use an animal model to establish, through a multimodal approach, whether chronic treatment with two different schedules of Lipoplatin™, selected within the range of its anticancer effective dose, is less neurotoxic than cisplatin administration. METHODS Female Wistar rats were treated intraperitoneally with cisplatin at a dose of 4 mg/kg or with Lipoplatin™ at doses delivering 12 or 24 mg/kg of cisplatin once weekly for 4 weeks. General toxicity was assessed by daily observation, body weight change, hematological and blood chemistry analysis, and histopathology of liver and kidney. The onset of peripheral neurotoxicity was assessed by measuring tail nerve conduction velocity (NCV), morphological and morphometric analysis of dorsal root ganglia (DRG), and morphological analysis of the sciatic nerve. RESULTS Cisplatin induced a statistically significant reduction in body weight, the development of renal failure, and impairment in NCV with pathological alterations in the DRG and sciatic nerve. By contrast, Lipoplatin™ was markedly less nephrotoxic, and no significant weight gain reduction was observed in animals treated with both doses of the drug. Moreover, the lowest dose induced less severe damage to the peripheral nervous system with a moderate decrease in NCV and mild pathological alterations in DRG and the sciatic nerve. CONCLUSIONS The results suggest that Lipoplatin™ 12 mg/kg is less neurotoxic than cisplatin 4 mg/kg, thus opening up the possibility of using this new formulation in future studies where its anticancer activity and the peripheral neurotoxicity will be assessed in parallel.
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Affiliation(s)
- A Canta
- Department of Neuroscience and Biomedical Technologies, University of Milan Bicocca, Via Cadore 48, 20052, Monza, MB, Italy.
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17
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Remuzzi A, Cornolti R, Bianchi R, Figliuzzi M, Porretta-Serapiglia C, Oggioni N, Carozzi V, Crippa L, Avezza F, Fiordaliso F, Salio M, Lauria G, Lombardi R, Cavaletti G. Regression of diabetic complications by islet transplantation in the rat. Diabetologia 2009; 52:2653-61. [PMID: 19789851 DOI: 10.1007/s00125-009-1537-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [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: 06/09/2009] [Accepted: 08/10/2009] [Indexed: 11/29/2022]
Abstract
AIMS/HYPOTHESIS Type 1 diabetes is a chronic disease leading to complications such as peripheral neuropathies, nephropathy and cardiovascular disease. Pancreatic islet transplantation is being extensively investigated for blood glucose control in animals and in human type 1 diabetic patients, but the question of whether it can reverse long-term diabetic complications has not been fully explored. We investigated the effects of islet transplantation on diabetic complications in a rat model of streptozotocin-induced diabetes. METHODS Three groups of rats were used: healthy controls, diabetic and diabetic rats transplanted with microencapsulated islets at 2 months after diabetes induction, when neuropathy was detectable by a decrease in tail nerve conduction velocity (NCV) and impaired nociceptive thresholds. Blood glucose levels and body weight were measured weekly. The variables considered were: thermal (hot plate test) and mechanical sensitivity (Randal-Selitto paw withdrawal test), NCV and Na+, K+-ATPase activity in the sciatic nerve. At the end of the experiments hearts were removed for morphometric determination and myocyte number, and kidneys removed for histological examination. RESULTS Islet transplantation in diabetic rats induced normoglycaemia in a few days, accompanied by a rapid rise in body weight and amelioration of impaired nociceptive thresholds, as well as normalisation of NCV and Na(+), K(+)-ATPase, which were both about 25% below normal in diabetic rats. Myocyte loss was reduced (-34%) by islet transplantation and the observed mild kidney damage of diabetic rats was prevented. CONCLUSIONS/INTERPRETATION Besides controlling glycaemia, transplantation of microencapsulated pancreatic islets induced almost complete regression of neuropathy and prevented cardiovascular alterations.
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Affiliation(s)
- A Remuzzi
- Department of Biomedical Engineering, Mario Negri Institute for Pharmacological Research, Via Gavazzeni 11, 24125, Bergamo, Italy.
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18
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Crippa L, Gasparri A, Sacchi A, Ferrero E, Curnis F, Corti A. Antitumor activity and mechanism of action of ultra-low dose endothelial-monocyte activating polypeptide-II combined with a tumor targeting derivative of TNF. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)71456-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
Febrile neutropenia (FN) is one of the most common and severe complications of chemotherapy, particularly when used for the treatment of hematological malignancies and bone marrow transplantation. Estimating its cost for the National Health service (NHS) is difficult, in that the cost of FN is included in the overall reimbursement, which is based on the main DRG declared at discharge. Aim of the present survey, conducted on the patient population treated in two oncology centers in Milan in the years 2001- 2002, was to evaluate the most frequent DRGs associated with neutropenia, with the objective to estimate the mean cost per patient hospitalized with FN. As expected, oncology patients with NF are spread through a wide range of DRGs, but the mean cost per patient resulted comparable in the two considered hospitals ( ~ 9500 euro), as well as the overall distribution among DRGs. The single most frequent DRG was 398 (diseases of reticuloendothelial and immune systems, with complications) which appears to be appropriate, being the closest to the clinical definition of FN available.
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20
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Cavaletti G, Cavalletti E, Crippa L, Di Luccio E, Oggioni N, Mazzanti B, Biagioli T, Sala F, Sala V, Frigo M, Rota S, Tagliabue E, Stanzani L, Galbiati S, Rigolio R, Zoia C, Tredici G, Perseghin P, Dassi M, Riccio P, Lolli F. Pixantrone (BBR2778) reduces the severity of experimental allergic encephalomyelitis. J Neuroimmunol 2004; 151:55-65. [PMID: 15145604 DOI: 10.1016/j.jneuroim.2004.02.008] [Citation(s) in RCA: 23] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2003] [Revised: 01/12/2004] [Accepted: 02/20/2004] [Indexed: 11/21/2022]
Abstract
Pixantrone is less cardiotoxic and is similarly effective to mitoxantrone (MTX) as an antineoplastic drug. In our study, pixantrone reduced the severity of acute and decreased the relapse rate of chronic relapsing experimental allergic encephalomyelitis (EAE) in rats. A marked and long-lasting decrease in CD3+, CD4+, CD8+ and CD45RA+ blood cells and reduced anti-MBP titers were observed with both pixantrone and MTX. In vitro mitogen- and antigen-induced T-cell proliferation tests of human and rodents cells evidenced that pixantrone was effective at concentrations which can be effectively obtained after i.v. administration in humans. Cardiotoxicity was present only in MTX-treated rats. The effectiveness and the favorable safety profile makes pixantrone a most promising immunosuppressant agent for clinical use in multiple sclerosis (MS).
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Affiliation(s)
- G Cavaletti
- Department of Neuroscience and Biomedical Technologies, University of Milan Bicocca, and Department of Neurology, S. Gerardo Hospital, Monza, Italy.
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Abstract
This retrospective study describes the clinicopathological findings in five cats with soft tissue mineralisation of interdigital spaces and footpads. Paw disease was the reason for veterinary consultation in three out of five cats. All cats had laboratory findings suggestive of renal failure and high solubility product [calciumxphosphorus]. In all cases, cytological examination of paw lesions was suggestive of calcinosis. The results of our study agree with two previous case reports of paw calcification in the cat, suggesting a metastatic pathogenesis and a correlation between paw mineralisation and renal failure.
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Affiliation(s)
- W Bertazzolo
- Clinica Veterinaria Alto Lambro, Via Molini taverna 1, 20050, Gerno di Lesmo, (MI), Italy.
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22
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Pravettoni D, Toccacieli S, Monestiroli S, Crippa L, Canali E, Salvi S, Scanziani E. Cilia-Associated Respiratory (CAR) bacillus infection in veal calves and adult cattle. Dtsch Tierarztl Wochenschr 2001; 108:386-9. [PMID: 11599441] [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: 02/21/2023]
Abstract
Cilia-Associated Respiratory (CAR) bacillus is a filamentous bacterium that colonizes the ciliated epithelium of the respiratory tract of many animal species and that has been associated with chronic inflammatory lesions in naturally and experimentally infected rats, mice and rabbits. In the present study, the prevalence of CAR bacillus infection and histological lesions of the trachea in veal calf and adult cattle were investigated. Forty five healthy veal calves and 45 adult cattle, raised in 18 different herds were selected at slaughter. From each animal, a tracheal sample was processed for histology, stain-ed with the Warthin-Starry method to evaluate the presence of CAR bacillus, and with haematoxylin and eosin to evaluate the presence of inflammatory lesions. CAR bacillus was identified in 17 veal calves (37.7%) and in 7 adult cattle (15.5%). Inflammatory lesions were found in 42 veal calves (93.3%) and in 41 adult cattle (91.1%). Statistical analysis pointed out a significant correlation between the presence and number of CAR bacilli and the presence and number of lymphoid follicles (P = 0.0071) and the presence and severity of neutrophilic infiltrates (P = 0.0428). These results indicate that CAR bacillus infection is common in cattle and is correlated with tracheal inflammatory lesions.
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Affiliation(s)
- D Pravettoni
- Istituto di Patologia Speciale e Clinica Medica Veterinaria, Università degli Studi di Milano, Facoltà di Medicina Veterinaria, Milano, Italy
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Micheli F, Crippa L, Donati D, Di Fabio R, Leslie C. A new alternative synthesis of 5-cyanophthalide, a versatile intermediate in the preparation of the antidepressant drug citalopram. Farmaco 2001; 56:715-8. [PMID: 11680817 DOI: 10.1016/s0014-827x(01)01108-9] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
An alternative versatile synthesis of 5-cyanophthalide, a key synthetic intermediate in the preparation of the antidepressant drug Citalopram, is presented. The synthesis reported here allows the preparation of this important intermediate in three steps, avoiding the manipulation of environmentally detrimental cyanides.
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Affiliation(s)
- F Micheli
- GlaxoSmithKline Group, GlaxoWellcome SpA, Medicines Research Centre, Verona, Italy.
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24
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Crippa L, Gobbi A, Ceruti RM, Clifford CB, Remuzzi A, Scanziani E. Ringtail in suckling Munich Wistar Fromter rats: a histopathologic study. Comp Med 2000; 50:536-9. [PMID: 11099138] [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]
Abstract
Ringtail is a pathologic condition of the tail of rats and other rodents that is traditionally attributed to low environmental humidity, although dietary deficiencies, genetic susceptibility, environmental temperature, and degree of hydration of the animal also have been suggested as possible causes. To the authors' knowledge, a detailed histopathologic study that may serve to shed light on the etiopathogenesis of this disease has not yet been published. We describe the histologic findings of ringtail observed in 12 suckling Munich Wistar Fromter (MWF) rats from two litters. Epidermal hyperplasia characterized by orthokeratotic and parakeratotic hyperkeratosis and acanthosis was observed in all affected rats. Numerous often dilated vessels were present in the dermis of tails that appeared of red/brown color at gross examination. In severe cases, the dilated vascular structures were thrombotic and accompanied by dermal hemorrhages and focal coagulative necrosis of the overlying epidermis. These findings suggest that epidermal acanthosis and hyperkeratosis are the main and primary events in the development of ringtail. To clarify the cause of this disease, future studies should be focused on the numerous factors that can induce such epidermal changes.
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25
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Della Valle P, Crippa L, Garlando AM, Pattarini E, Safa O, Viganò D'Angelo S, D'Angelo A. Interference of lupus anticoagulants in prothrombin time assays: implications for selection of adequate methods to optimize the management of thrombosis in the antiphospholipid-antibody syndrome. Haematologica 1999; 84:1065-74. [PMID: 10586206] [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: 02/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Prolonged anticoagulation aiming at International Normalized Ratio (INR) values > 3.0 has been recommended for patients with thrombosis and the antiphospholipid-antibody syndrome. We evaluated the influence of anticoagulant antibodies in two different prothrombin time (PT) assays carried out on plasma from lupus anticoagulant patients on oral anticoagulation. DESIGN AND METHODS INR values obtained with a combined (final test plasma dilution 1:20) and a recombinant (final test plasma dilution 1:3) thromboplastin were compared in 17 patients with persistent lupus anticoagulants (LA) receiving oral anticoagulant treatment and monitored for 69.8 patient-years. Doses of anticoagulant drugs were always assigned based on the results obtained with the combined thromboplastin, aiming at a target INR of 2.5 or 3.0 for patients with venous or arterial thromboembolic disease. Paired determinations with both reagents were also obtained throughout the study period in 150 patients on stable oral anticoagulation but free of antiphospholipid antibodies. Total IgG fractions were purified from selected patients to evaluate effect in the two PT assay systems. RESULTS No patient experienced recurrence of thrombosis or major bleeding complications (95% confidence interval: 0.1-6.5 per 100 patient-years). INR values with the recombinant reagent were significantly higher than with the combined reagent in 8 LA patients (mean DINR ranging from 0.17 to 0.54) of the degree of anticoagulation was overestimated in all but one LA patients with the recombinant reagent when compared to the DINR observed in non-LA patients (-0.64 +/- 0.42). The anti-cardiolipin IgG titer (r(2) = 0.43, p = 0.004) and the anti-b(2)GPI IgG titer (r(2) = 0.30, p = 0.023) were positively associated with the mean deltaINR observed in LA patients. When added to plasmas with different levels of vitamin K-dependent factors, total IgG fractions from 6 LA patients with significant overestimation of the INR with the recombinant reagent (mean DINR ranging from 0.17 to 0.54, group 1) and from 7 LA patients with mean deltaINR < or = 0.0 (ranging from -0.25 to 0.04, group 2) reproduced the effects observed ex vivo in the two assay systems. However, when total IgG fractions were tested at the same final concentration in the two PT assay systems, there was no difference in the clotting times determined with total IgG fractions from group 1 and group 2 LA patients. Addition of negatively charged liposomes (0.4 and 0.8 mg/mL final concentrations) to platelet free plasma from LA-free patients on stable oral anticoagulation caused a 20% to 48% prolongation of the prothrombin time determined with the recombinant reagent. In contrast, no significant prolongation of the prothrombin time determined with the recombinant reagent was observed upon addition of negatively charged liposomes to plasma from group 1 LA patients. INTERPRETATION AND CONCLUSIONS These results confirm previous suggestions of assay-dependency of INR values in LA patients on oral anticoagulation. For these patients, accurate INR values may be obtained using combined thromboplastin reagents that permit testing at high plasma dilution.
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Affiliation(s)
- P Della Valle
- Coagulation Service and Thrombosis Research Unit, Scientific Institute H S. Raffaele, Milan, Italy
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26
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Safa O, Crippa L, Della Valle P, Sabbadini MG, Viganò D'Angelo S, D'Angelo A. IgG reactivity to phospholipid-bound beta(2)-glycoprotein I is the main determinant of the fraction of lupus anticoagulant activity quenched by addition of hexagonal (II) phase phospholipid in patients with the clinical suspicion of antiphospholipid-antibody syndrome. Haematologica 1999; 84:829-38. [PMID: 10477458] [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: 02/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Autoantibodies to beta(2)-glycoprotein I (beta(2)-GPI) and/or prothrombin (FII) have been involved in the expression of lupus anticoagulant (LA) activity, an in vitro phenomenon associated with an increased risk of arterial and/or venous thromboembolic events. However, LA activity sustained by anti-FII antibodies has a much weaker association with thrombosis than LA activity sustained by anti-beta(2)-GPI antibodies. Because assays aimed at detecting LA activity are now commercially available, we evaluated the relative sensitivity to anti-FII and anti-beta(2)-GPI antibodies of a commercial LA assay in a consecutive series of patients with the clinical suspicion of anti-phospholipid antibody (APA) syndrome. DESIGN AND METHODS One hundred and ten consecutive patients with the clinical suspicion of APA syndrome (primary in 39) and 36 healthy controls were evaluated for the presence of LA activity (LA, Staclot, Stago), anticardiolipin antibodies (Quanta Lite aCL IgG, IgM, Inova Diagnostics), and IgG binding to solid-phase and/or phospholipid (PL)-bound beta(2)-GPI and FII by ELISA assays developed an optimized in our laboratory. Odds ratios for the association of IgG binding activity with LA and the aCL IgG status were calculated. In LA patients, dependency of LA potency (as assessed by clotting time prolongation in absence or presence of hexagonal phospholipid) on autoantibody titers was analyzed by the generalized linear model. Total IgG fractions were purified from selected patients to evaluate their ability to inhibit prothrombin activation at low FII concentration. RESULTS Anticardiolipin antibodies (aCL) of the IgG or IgM type were found in 64 and 23 patients and LA activity in 49 patients. Anti-beta(2)-GPI and anti-FII (solid-phase and PL-bound) IgG titers exceeding by more than 3 standard deviations the mean values observed in control subjects were found in 46 and 47 patients and in 56 and 30 patients respectively, with the highest titers detected in the subgroup of patients with both LA and aCL IgG. The relative risk of LA for patients free of anti-FII and/or anti-beta(2)-GPI IgG was 0.03 after stratification for the aCL IgG status. Anti-beta(2)-GPI (solid-phase and PL-bound) IgG (RR 34.4 and 12.6) and anti-FII (solid-phase) IgG (RR 6.33) were all associated with LA activity. However, when taking into account co-existence of anti-FII and anti-beta(2)-GPI IgG in the same patients, the relative risk of LA for patients with isolated anti-FII IgG (solid-phase and/or PL-bound) was 0.50, whereas it ranged from 4.24 to 8.70 for all the antibody combinations including anti-beta(2)-GPI IgG. Anti-beta(2)-GPI (PL-bound) and aCL IgG titers were the only significant predictors of LA potency determined in absence phospholipid (anti-beta(2)-GPI IgG) or in presence of hexagonal phospholipid (aCL IgG). Total IgG fractions purified from 12 patients (6 with anti-FII IgG) did not significantly inhibit factor II activity up to a 150-fold molar excess. INTERPRETATION AND CONCLUSIONS These results highlight the high prevalence of anti-FII and anti-beta(2)-GPI IgG in patients with the clinical suspicion of APA syndrome and particularly in the subgroup of patients with LA activity. The fraction of LA activity which can be quenched by addition of hexagonal phospholipid is, however, only dependent on IgG directed to PL-bound beta(2)-GPI. Other antibodies associated with anticardiolipin IgG may explain residual clotting time prolongation observed in the presence of hexagonal phospholipid.
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Affiliation(s)
- O Safa
- Coagulation Service and Throbosis Research Unit, IRCCS H S. Raffaele, Milan, Italy
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Gobbi A, Crippa L, Scanziani E. Corynebacterium bovis infection in waltzing mice. Lab Anim Sci 1999; 49:132-3. [PMID: 10331539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Gobbi A, Crippa L, Scanziani E. Corynebacterium bovis infection in immunocompetent hirsute mice. Lab Anim Sci 1999; 49:209-11. [PMID: 10331552] [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] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- A Gobbi
- Istituto di Anatomia Patologica Veterinaria e Patologia Aviare, Facoltà di Medicina Veterinaria, Milan, Italy
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29
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Gemma M, Beretta L, De Vitis A, Mattioli C, Calvi MR, Antonino A, Rizzi B, Crippa L, D'Angelo A. Complications of internal jugular vein retrograde catheterization. Acta Neurochir Suppl 1998; 71:320-3. [PMID: 9779219 DOI: 10.1007/978-3-7091-6475-4_93] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
We report on the incidence of complications of 172 internal jugular vein retrograde catheterizations (IJVRCs) performed on 126 patients. Standard cannulation and X-ray control of the catheter tip placement were performed. Difficulties encountered during the manouvre were registered. Patients with a jugular catheter in place for more than one day had neck echography on catheter removal and one week later. Carotid artery puncture occurred in 20 (12%) cases and lymphatic vessel puncture in one. In 13 (8%) cases IJVRC failed due to difficulties in advancing the guide. X-ray films documented catheter misplacement in 39 (23%) cases: loop into the internal jugular vein in 11 (6%); paravertebral venous plexus cannulated in one; other extracranial jugular afferent cannulated in 4 (2%); catheter tip into the jugular lumen in 10 (6%); catheter tip beyond the jugular bulb in 13 (8%). First neck echography documented: one perivascular hematoma (absent one week later); 3 (4%) jugular vein thrombosis (2 asymptomatic and absent one week later; one symptomatic and still evident one week later). Positive neck echography was not associated with difficulties, length of catheterization, diameter of the catheter. IJVRC is a simple and safe procedure with a low incidence of serious complications.
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Affiliation(s)
- M Gemma
- Neurosurgical Intensive Care Unit, Scientific Inst. Hosp. S. Raffaele, Milano, Italy
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30
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Duga S, Gobbi A, Asselta R, Crippa L, Tenchini ML, Simonic T, Scanziani E. Analysis of the 16S rRNA gene sequence of the coryneform bacterium associated with hyperkeratotic dermatitis of athymic nude mice and development of a PCR-based detection assay. Mol Cell Probes 1998; 12:191-9. [PMID: 9727194 DOI: 10.1006/mcpr.1998.0168] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
By 16S rDNA sequencing the authors have characterized the coryneform bacteria associated with hyperkeratotic dermatitis (HD) of athymic nude mice isolated from six different outbreaks of the disease in Northern Italy. This analysis has allowed the authors to confirm the classification of the bacteria as Corynebacterium bovis and to develop a 16S rDNA-based polymerase chain reaction (PCR) detection assay. The test was performed directly on the DNA extracted from epidermal swabs. The PCR primers were chosen to match the 16S rDNA sequence fragments which differ most from the other Corynebacterium spp. The test was shown to be both sensitive and specific for C. bovis. Detection of as few as three viable bacterial cells was possible with the use of an oligonucleotide probe in a liquid hybridization assay.
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MESH Headings
- Animals
- Base Sequence
- Corynebacterium/genetics
- Corynebacterium/isolation & purification
- Corynebacterium Infections/genetics
- Corynebacterium Infections/microbiology
- Corynebacterium Infections/veterinary
- Genes, Bacterial
- Mice
- Mice, Nude
- Molecular Sequence Data
- Polymerase Chain Reaction
- RNA, Ribosomal, 16S/analysis
- RNA, Ribosomal, 16S/genetics
- Rodent Diseases/genetics
- Rodent Diseases/microbiology
- Sensitivity and Specificity
- Sequence Analysis, DNA
- Skin/microbiology
- Skin Diseases, Bacterial/genetics
- Skin Diseases, Bacterial/microbiology
- Skin Diseases, Bacterial/veterinary
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Affiliation(s)
- S Duga
- Istituto di Fisiologia Veterinaria e Biochimica, Università di Milano, Italy
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31
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Caniatti M, Crippa L, Giusti M, Mattiello S, Grilli G, Orsenigo R, Scanziani E. Cilia-associated respiratory (CAR) bacillus infection in conventionally reared rabbits. Zentralbl Veterinarmed B 1998; 45:363-71. [PMID: 9719769 DOI: 10.1111/j.1439-0450.1998.tb00805.x] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study was designed to investigate the prevalence of Cilia-associated respiratory (CAR) bacillus infection in rabbits reared for meat production in Italy and to correlate the presence of CAR bacillus with inflammatory lesions of the respiratory tract. Seventy health, 3-month-old, New Zealand White rabbits, raised in 10 different rabbitries in Northern Italy were randomly selected at slaughter. No gross lesions were found at necropsy in any rabbit. In each animal, the trachea and lungs were sampled, fixed in 10% formalin, embedded in paraffin and stained with the Warthin-Starry method to evaluate the presence of CAR bacillus, and with haematoxylin and eosin to evaluate the presence of inflammatory lesions. CAR bacillus was present in 50 out of 70 rabbits (71.4%) with a prevalence of the infection that varied from 30% to 100% in the seven rabbitries. CAR bacillus was present both in the trachea and bronchi in 23 cases (32.8%), only in the trachea in 24 cases (34.3%) and only in the bronchi in three cases (4.3%). Inflammatory lesions were found in the trachea (22 cases, 31.4%) and the bronchi (58 cases, 82.8). There was a strong, statically significant correlation between the presence of CAR bacillus in the bronchi and bronchial inflammatory lesions (P < 0.0001). This study indicates that CAR bacillus infection is widespread in conventionally reared rabbits in Italy and that a possible correlation exists between the presence of CAR bacillus and bronchial inflammatory lesions.
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Affiliation(s)
- M Caniatti
- Istituto di Anatomia Patologica Veterinaria e Patologia Aviare, Universitá degli Studi di Milano, Milan, Italy
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32
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Scanziani E, Gobbi A, Crippa L, Giusti AM, Pesenti E, Cavalletti E, Luini M. Hyperkeratosis-associated coryneform infection in severe combined immunodeficient mice. Lab Anim 1998; 32:330-6. [PMID: 9718482 DOI: 10.1258/002367798780559239] [Citation(s) in RCA: 17] [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: 11/18/2022]
Abstract
Hyperkeratosis-associated coryneform (HAC) is a coryneform bacterium, with a biochemical profile similar to Corynebacterium bovis, that causes hyperkeratotic dermatitis in athymic nude mice. In the present study 28 severe combined immunodeficient (SCID) mice coming from six different animal facilities were submitted for bacteriological and pathological examination. HAC was isolated from 10 SCID mice belonging to two of these facilities. Two of the HAC-infected mice showed macroscopical lesions consisting in large alopecic areas, with small white flakes, involving the dorsum, flanks, neck and cheeks. Histologically, the skin of these animals was characterized by diffuse acanthosis and hyperkeratosis. In the other eight HAC-infected SCID mice no macroscopical lesions were observed but focal areas of minimal to mild acanthosis were histologically detected in five cases. These results suggest that HAC can infect SCID mice inducing skin lesions similar, although generally less severe, to those observed in nude mice with hyperkeratotic dermatitis. Our results pointed out that SCID mice may play an important role in the epidemiology of hyperkeratotic dermatitis of athymic nude mice.
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Affiliation(s)
- E Scanziani
- Istituto di Anatomia Patologica Veterinaria e Patologia Aviare, Facoltà di Medicina Veterinaria, Milan, Italy
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Baudo F, Caimi TM, de Cataldo F, Ravizza A, Arlati S, Casella G, Carugo D, Palareti G, Legnani C, Ridolfi L, Rossi R, D'Angelo A, Crippa L, Giudici D, Gallioli G, Wolfler A, Calori G. Antithrombin III (ATIII) replacement therapy in patients with sepsis and/or postsurgical complications: a controlled double-blind, randomized, multicenter study. Intensive Care Med 1998; 24:336-42. [PMID: 9609411 DOI: 10.1007/s001340050576] [Citation(s) in RCA: 165] [Impact Index Per Article: 6.3] [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: 02/07/2023]
Abstract
BACKGROUND ATIII is decreased in sepsis and/or shock and its baseline value correlates with mortality. The efficacy of ATIII therapy on mortality was assessed in a selected group of patients admitted to the intensive care unit (ICU) in a double-blind, randomized, multicenter study. METHODS 120 patients admitted to the ICU with an ATIII concentration < 70% were randomized to receive ATIII (total dose 24000 units) or placebo treatment for 5 days; 56 patients had septic shock. RESULTS ATIII concentrations in the treated group remained constant throughout the treatment period (range 97-102%). The Kaplan-Meier analysis showed no difference in overall survival between the two groups: 50 and 46% for ATIII and placebo, respectively. Septic shock and hemodynamic support were unbalanced in the two groups at admission. Therefore the Cox analysis was carried out after adjusting for these two variables. Treatment with ATIII decreases the risk of death with an odds ratio (OR) of 0.56. Of the covariates analyzed, septic shock and the baseline multiple organ failure score were negatively associated with survival and plasma activity level was positively associated with survival with an OR of 0.97 for each 1% increase in the ATIII plasma concentration at baseline. CONCLUSIONS The results of ATIII treatment in this population of patients suggests that replacement therapy reduces mortality in the subgroup of septic shock patients only.
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Affiliation(s)
- F Baudo
- Department of Hematology, Ospedale Niguarda, Milano, Italy.
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D'Angelo A, Della Valle P, Crippa L. Monitoring warfarin therapy in patients with lupus anticoagulants. Ann Intern Med 1998; 128:504-5. [PMID: 9499339 DOI: 10.7326/0003-4819-128-6-199803150-00017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Abstract
Forty-three wild rats (Rattus norvegicus) trapped in Milan (Italy) were examined for gastric spiral bacteria and to evaluate associated histological lesions. Spiral bacteria were histologically detected in the stomach of 10 rats (23%). The morphological features of these microorganisms, observed using both light and electron microscopy, correspond to those of Helicobacter heilmannii. Mild gastritis characterized by focal lymphoplasmacytic infiltration of the lamina propria was observed in six rats with gastric spiral bacteria. Our findings suggest a causal role of these bacteria in inducing a gastric inflammatory response.
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Affiliation(s)
- A M Giusti
- Istituto di Anatomia Patologica Veterinaria e Patologia Aviare, Università degli Studi di Milano, Italy
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36
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D'Angelo A, Safa O, Crippa L, Garlando A, Sabbadini MG, Vigano' D'Angelo S. Relationship of lupus anticoagulant, anticardiolipin, anti-beta2-GPI and anti-prothrombin autoantibodies with history of thrombosis in patients with the clinical suspicion of APA-syndrome. Thromb Haemost 1997; 78:967-8. [PMID: 9268210] [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: 02/05/2023]
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37
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Scanziani E, Gobbi A, Crippa L, Giusti AM, Giavazzi R, Cavalletti E, Luini M. Outbreaks of hyperkeratotic dermatitis of athymic nude mice in northern Italy. Lab Anim 1997; 31:206-11. [PMID: 9230500 DOI: 10.1258/002367797780596310] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Hyperkeratotic dermatitis of athymic nude mice is an infectious disease caused by a coryneform bacterium. During the spring of 1995, outbreaks of hyperkeratotic dermatitis were observed in several nude mice facilities in northern Italy. In this report we describe the clinical, histopathological and microbiological features of the disease in two different animal facilities. Affected animals showed a typical 'scaly' appearance with small white flakes of material adherent to the skin. In one of the outbreaks (facility 2) the lesions were less severe and involved only limited areas of the body. The infection spread very quickly and the morbidity reached more than 80% in a few days, while the mortality was about 1%. The lesions resolved spontaneously within 7-10 days. Histological examination of affected skin revealed orthokeratotic hyperkeratosis, acanthosis and dermal inflammatory infiltration which were more severe in mice from facility 1. In Gram-stained sections groups of rods consistent with coryneform bacteria were detectable in the keratin layers covering the epidermal surface. A coryneform bacterium, biochemically typed as Corynebacterium bovis, was isolated from 11 out of 11 mice from facility 1 and from 8 out of 11 mice from facility 2.
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Affiliation(s)
- E Scanziani
- Istituto di Anatomia Patologica Veterinaria e Patologia Aviare, Facoltà di Medicina Veterinaria, Milan, Italy
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38
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Crippa L, D'Angelo SV, Tomassini L, Rizzi B, D'Alessandro G, D'Angelo A. The utility and cost-effectiveness of D-dimer measurements in the diagnosis of deep vein thrombosis. Haematologica 1997; 82:446-51. [PMID: 9299859] [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: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The potential utility of D-dimer measurements for the diagnosis of deep vein thrombosis became evident soon after the development of reliable commercial assays. The purpose of this review is to outline some critical aspects affecting cost-effectiveness of D-dimer measurements in the diagnosis of deep vein thrombosis (DVT). METHODS The authors have been working in this field contributing original papers whose data have been used for this study. In addition, the material analyzed in this article includes papers published in the journals covered by the Science Citation Index and Medline. RESULTS D-dimer levels are very sensitive to the process of fibrin formation/dissolution occurring with ongoing thrombosis. However, they may not be highly specific for venous thromboembolism as they are influenced by the presence of comorbid conditions potentially elevating plasma D-dimer (cancer, surgery, infectious diseases). In addition, commercially available ELISA assays, although quantitative and reproducible, cannot be used under emergency conditions because they are time-consuming and suited for batch-processing of plasma samples. Recently, new assays have been introduced which permit fast and quantitative D-dimer estimations in individual patients. We have evaluated the utility of two new rapid assays (LPIA D-dimer. Mitsubishi, and VIDAS D-DIMER, bio-Merieux) in combination with compression real-time-B-mode ultrasonography for the detection of deep vein thrombosis in asymptomatic patients following elective hip replacement and in patients with clinically suspected deep vein thrombosis. In both settings, we identified cut-off values with optimal sensitivity which allow exclusion of deep vein thrombosis in a considerable percentage of patients, with substantial sparing of economic resources. In fact, based on a cost-effectiveness analysis, a diagnostic algorithm combining D-dimers measurement and compression ultrasonography would result in cost-savings ranging from 5% to 55% in patients with high or low clinical pretest probability respectively. However, the specificity of D-dimer measurements for deep vein thrombosis was much higher in symptomatic than in asymptomatic patients. Choice of the cut-off value proved to be dependent on the method as well as on the patient populations studied. CONCLUSIONS The cost-effectiveness of D-dimers measurement in the diagnosis of asymptomatic DVT remains questionable. Conversely, our data strongly support the utility of D-dimers determinations in the diagnosis of symptomatic DVT. In terms of sparing economic resources, the introduction in the clinical laboratory of the rapid quantitative assays would be highly convenient, because they avoid a source of bias in the interpretation of D-dimers results, are easy to perform and do not require dedicated personnel or instrumentation. Prospective management studies validating the utility of D-dimer measurement in the diagnosis of deep vein thrombosis are urgently needed.
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Affiliation(s)
- L Crippa
- Coagulation Service, Scientific Institute H San Raffaele, Milan, Italy
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Crippa L, Giusti AM, Sironi G, Cavalletti E, Scanziani E. Asymptomatic adenoviral respiratory tract infection in guinea pigs. Lab Anim Sci 1997; 47:197-9. [PMID: 9150502] [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] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- L Crippa
- Safety Department, Research Center, Boehringer Mannheim Italia, Monza, Italy
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40
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D'Angelo A, Mazzola G, Crippa L, Fermo I, Viganò D'Angelo S. Hyperhomocysteinemia and venous thromboembolic disease. Haematologica 1997; 82:211-9. [PMID: 9175329] [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: 02/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVE In spite of the large number of reports showing that hyperhomocysteinemia (HHcy) is an independent risk factor for atherosclerosis and arterial occlusive disease, this metabolite of the methionine pathway is measured in relatively few laboratories and its importance is not fully appreciated. Recent data strongly suggest that mild HHcy is also involved in the pathogenesis of venous thromboembolic disease. The aim of this paper is to analyze the most recent advances in this field. EVIDENCE AND INFORMATION SOURCES The material examined in the present review includes articles and abstracts published in journals covered by the Science Citation Index and Medline. In addition the authors of the present article have been working in the field of mild HHcy as cause of venous thromboembolic disease. STATE OF ART AND PERSPECTIVES The studies examined provide very strong evidence supporting the role of moderate HHcy in the development of premature and/or recurrent venous thromboembolic disease. High plasma homocysteine levels are also a risk factor for deep vein thrombosis in the general population. Folic acid fortification of food has been proposed as a major tool for reducing coronary artery disease mortality in the United States. Vitamin supplementation may also reduce recurrence of venous thromboembolic disease in patients with HHcy. At the present time, however, the clinical efficacy of this approach has not been tested. In addition, the bulk of evidence indicates that fasting total homocysteine determinations can identify up to 50% of the total population of hyperhomocysteinemic subjects. Patients with isolated methionine intolerance may benefit from vitamin B6 supplementation. Homocysteine-lowering vascular disease prevention trials are urgently needed. Such controlled studies, however, should not focus exclusively on fasting homocysteine determinations and folic acid monotherapy.
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Affiliation(s)
- A D'Angelo
- Coagulation Service, Scientific Institute H San Raffaele, Milan, Italy
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41
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Della Valle P, Crippa L, Safa O, Tomassini L, Pattarini E, Vigano-D'Angelo S, Grazia Sabbadini M, D'Angelo A. Potential failure of the International Normalized Ratio (INR) System in the monitoring of oral anticoagulation in patients with lupus anticoagulants. Ann Med Interne (Paris) 1996; 147 Suppl 1:10-4. [PMID: 8952752] [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: 02/03/2023]
Abstract
Patients with antiphospholipid antibody syndrome (APS) experience a higher rate of recurrence of thrombosis than the general population of patients with thrombotic disease. Based on a retrospective analysis, it has been suggested that patients with APS should be kept on prolonged anticoagulation aiming at international normalised ratio (INR) values > 3.0. To evaluate whether the requirement for more intense anticoagulation depends on the variable sensitivity of thromboplastin reagents to the influence of aPLA, we monitored oral anticoagulant treatment in 10 patients with persistent lupus anticoagulants (LA) and venous thromboembolic disease using two thromboplastin reagents: Pro-IL-Complex (Instrumentation Laboratory, combined) and Recombiplastin (Ortho, recombinant). Acenocoumarol dosage was always assigned based on INR values obtained with the combined thromboplastin using diluted (1:20) test plasma, aiming at an INR interval of 2.0 to 3.0. Single INR determinations with both reagents were obtained throughout the study period for 110 aPLA-free patients on stable oral anticoagulation. Using the manufacturer's instrument-certified international sensitivity index (ISI) values, INR obtained with the recombinant reagent were significantly higher than those obtained with the combined reagent in LA-positive patients, but they were lower in LA-negative patients. After correction for local ISI calibration in LA-negative patients, INR values of 3.1 and 4.6 with Recombiplastin corresponded, respectively, to INR values of 2.0 and 3.0 with Pro-IL-Complex. These results indicate the thromboplastin-dependency of INR values in patients with LA, thereby questioning the validity of the INR system for the monitoring of oral anticoagulant treatment in these patients.
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Affiliation(s)
- P Della Valle
- Coagulation Service, Scientific Institute H.S. Raffaele, Milan, Italy
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42
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D'Angelo A, D'Alessandro G, Tomassini L, Pittet JL, Dupuy G, Crippa L. Evaluation of a new rapid quantitative D-dimer assay in patients with clinically suspected deep vein thrombosis. Thromb Haemost 1996; 75:412-6. [PMID: 8701399] [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: 02/01/2023]
Abstract
The sensitivity and specificity for deep vein thrombosis (DVT) of a new rapid, quantitative and precise (total imprecision < 10%) D-dimer assay suitable for individual measurements (VIDAS D-DIMER, bio-Mérieux, France) were evaluated in a consecutive series of 103 in- and out-patients submitted to serial compression ultrasonography (C-US) for the clinical suspicion of DVT (n = 66) or of DVT recurrence (n = 37) and symptoms lasting from 1 to 15 days. DVT was found in 22 patients at baseline testing and no patient with an initially negative C-US developed vein incompressibility at follow up. The time elapsed from the onset of symptoms was negatively associated with D-dimer levels both in patients with and in those without DVT. In the entire series of patients, the sensitivity of a positive D-dimer test ( > or = 1.0 microgram/ml) for the presence of DVT was 96% (21/22 patients, 95% confidence interval 75-100%) with a specificity of 75% (64-84%), a negative predictive value of 98% (90-100%), a positive predictive value of 51% (35-67%), and an overall accuracy of 80% (70-87%). A normal D-dimer value (0.22 microgram/ml) was observed in one patient with DVT and symptoms lasting from 15 days. The approach of withholding C-US testing in patients with symptoms lasting from less than 11 days and D-dimer levels below the cut-off value was compared to serial C-US testing alone in a cost-effectiveness analysis subdividing the 66 patients with a first episode according to their clinical pretest probability of DVT. Thrombosis was detected in 6.7% of the patients in the low probability group (n = 15), 16.7% of the patients in the moderate probability group (n = 24), 51.9% of the patients in the high probability group (n = 27) and 8.1% of patients with suspected DVT recurrence. Calculated cost-savings for each DVT diagnosed ranged from 5% in the high pretest probability group to 55% in the low pretest probability group and to 77% in patients with suspected DVT recurrence. The safety of avoiding C-US testing in symptomatic patients with a negative D-dimer test should be evaluated in clinical management studies.
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Affiliation(s)
- A D'Angelo
- Servizio di Coagulazione, Istituto Scientfico H.S. Raffaele, Milano, Italy
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Crippa L, Ravasi F, D'Angelo SV, Varagona R, Milani E, Safa O, Tessari L, D'Angelo A. Diagnostic value of compression ultrasonography and fibrinogen-related parameters for the detection of postoperative deep vein thrombosis following elective hip replacement: a pilot study. Thromb Haemost 1995; 74:1235-9. [PMID: 8607101] [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: 01/31/2023]
Abstract
To determine their ability to diagnose postoperative deep vein thrombosis (DVT) D-dimer - by three methods -, fibrinogen degradation products (FgDP) and fibrinogen levels were measured in 68 consecutive patients before elective surgery for hip replacement and on postoperative day 1, 3, 6, and 10. All patients received prophylaxis and underwent compression real-time B-mode ultrasonography (C-US) on postoperative day 5 and 9, and bilateral ascending venography on day 10. Twenty-two out of 68 patients developed asymptomatic postoperative DVT, which was limited to the calf veins in 14 and involved the proximal veins in 8 patients. C-US was negative in all patients on day 5. On day 9, C-US sensitivity and specificity for proximal DVT were 63% (95% confidence interval: 26%-90% and 98% (89%-100%) respectively. Postoperative changes in the laboratory parameters evaluated were not different in patients with or without DVT until day 10. On day 10, mean D-dimer, FgDP and fibrinogen levels were significantly higher in patients with DVT than in those without DVT (p values between 0.006 and 0.032), but only D-dimer was higher with DVT involving two or more venous segments than with thrombosis involving one venous segment only (p < 0.05). Stepwise logistic regression analysis identified D-dimer and fibrinogen on day 10 as predictors of postoperative DVT. In a receiver operator curve and after weighing for the coefficients generated by logistic regression analysis, the combination of a latex photometric immuno-assay and of PT-derived fibrinogen yielded-at a cut-off value of 7.0 a sensitivity of 100% (73%-100%) and a specificity of 58% (39%-75%) for DVT, with a negative predictive value of 100% (78%-100%), a positive predictive value of 52% (32%-71%) and an overall accuracy of 71% (55%-83%). These results suggest that two simple, fast and reproducible tests may permit the identification of patients at low risk of having postoperative DVT and that a combination of sensitive laboratory assays and of the highly specific C-US may select patients requiring anticoagulant treatment. Efficacy and cost-effectiveness of this approach should be evaluated in large clinical management studies.
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Affiliation(s)
- L Crippa
- Coagulation Service, Istituto Scientifico H.S. Raffaele, Milano, Italy
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Scanziani E, Crippa L, Giusti AM, Luini M, Pacciarini ML, Tagliabue S, Cavalletti E. Leptospira interrogans serovar sejroe infection in a group of laboratory dogs. Lab Anim 1995; 29:300-6. [PMID: 7564215 DOI: 10.1258/002367795781088261] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Interstitial nephritis was seen histologically in 19 (59%) out of 32 pure-breed beagle dogs (16 males and 16 females) subjected to standard safety tests. In these animals no clinical abnormalities were observed and all the tested parameters (haematology, biochemistry and urine analysis) were within the normal ranges. Leptospiral antibody titres ranging from 1 : 100 to 1 : 6400, against a serovar (hardjo) belonging to the Sejroe serogroup, were detected by the microscopic agglutination test (MAT) in the serum of the 19 dogs with interstitial nephritis. All animals without renal lesions were seronegative. Leptospiral antigen was detected immunohistochemically in the kidneys of 4 dogs; leptospires were detected in Warthin-Starry stained sections of one dog. Leptospires were isolated from the kidneys of 3 of the 4 dogs examined by bacterial culture. The isolated strains were typed as serovar sejroe by restriction endonuclease digestion and Southern blot hybridization analysis of their DNA. It was concluded that Leptospira interrogans serovar sejroe, was responsible for an asymptomatic chronic renal infection which was widespread in this group of laboratory dogs.
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Affiliation(s)
- E Scanziani
- Istituto di Anatomia Patologica Veterinaria e Patologia Aviare, Facoltà di Medicina Veterinaria, Milan, Italy
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45
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Crippa L. Lungworm infection in laboratory dogs reared in Italy. Parassitologia 1995; 37:83-5. [PMID: 8532374] [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: 01/31/2023]
Abstract
Lungworms, Filaroides hirthi, were observed in histological lung sections in 4 out of 96 beagle dogs (4.2%) reared for experimental studies in Italy. Infected animals were 2 males and 2 females, 8 months old, with no clinical signs, while in another case a granulomatous lesion, possibly transmitted by this lungworm, was found. Histopathological changes of lung induced by F. hirthi can mimic some drug-induced and neoplastic lesions, and therefore to cause misunderstanding during interpretation of results of toxicological studies. This is the first report of F. hirthi infection of laboratory dogs reared in Italy.
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Affiliation(s)
- L Crippa
- Boehringer Mannheim Italia Research Centre, Monza (MI), Italy
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46
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D'Angelo A, Crippa L, Agazzi A, Della Valle P, Anzalone N, Garlando AM, D'Angelo SV. Oral anticoagulants: old drugs with a promising future. Haematologica 1995; 80:92-101. [PMID: 7628778] [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: 01/26/2023] Open
Affiliation(s)
- A D'Angelo
- Servizio di Coagulazione, Istituto Scientifico S. Raffaele, Milano, Italy
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Flores D'Arcais A, De Biase D, Riva P, Tito A, Crippa L, Mariani E. [Influence of maternal smoking on cord serum IgE levels in newborns]. Minerva Pediatr 1993; 45:443-7. [PMID: 8133835] [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: 01/29/2023]
Abstract
Allergic diseases are among the most common diseases in childhood and their prevalence is 14%. One of the most important pathogenetic factors is the ability to produce IgE and the measurement of cord serum IgE seems to be very important for early detection of newborns at risk. Besides, cigarette smoke, among the environmental factors, has been demonstrated to influence the immunologic system, inducing an increase in IgE production. The aim of this study is to evaluate fetal production of IgE in newborns with a family history of atopy and whose mother has been smoking during pregnancy. The measurement of cord serum IgE has been performed in 215 at term newborns (weight at birth > 2500 g, Apgar score at 5' > 7). A careful history has been obtained with particular regard at the presence of familiarity for allergies and a cigarette smoking during pregnancy. According to the history, children have been divided in 3 groups: Group 1: 126 newborns without familiar history of allergy and born from no smoking mothers (control group); Group 2: 46 newborns with familiar history for allergy and born from no smoking mothers; Group 3: 43 newborns without familiar history for allergy born from smoking mothers. The II and III groups of newborns present total IgE levels on cord serum significantly higher than the control group. Besides a positive correlation between the number of cigarettes smoked during pregnancy and the value of cord serum IgE has been detected. It is well known that both genetic and environmental factors play an important role in the pathogenesis of allergic diseases.(ABSTRACT TRUNCATED AT 250 WORDS)
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D'Angelo A, Della Valle P, Crippa L, Pattarini E, Grimaldi LM, Viganò D'Angelo S. Brief report: autoimmune protein S deficiency in a boy with severe thromboembolic disease. N Engl J Med 1993; 328:1753-7. [PMID: 8497285 DOI: 10.1056/nejm199306173282405] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- A D'Angelo
- Servizio di Coagulazione, Istituto Scientifico H.S. Raffaele, Milan, Italy
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Abstract
Fifty-two cases of gastrointestinal mucosal tumours of the dog were examined for argyrophil cells by means of the Grimelius stain. Argyrophil cells were found in each of five cases (100 per cent) of gastric adenoma, in five (71.4 per cent) of seven large-intestine adenomas, in 13 (59.1 per cent) of 22 gastric carcinomas, in five (62.5 per cent) of eight small-intestine carcinomas and in four (40 per cent) of ten large-intestine carcinomas. The argyrophil cells represented a minority of the tumour cell population in all cases. These results demonstrate that a significant proportion of gastrointestinal mucosal tumours of the dog contain a mixture of epithelial and endocrine cells. Similar findings have been reported in man.
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Affiliation(s)
- E Scanziani
- Istituto di Anatomia Patologica Veterinaria e Patologia Aviare, Università degli Studi di Milano, Italy
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50
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Flores D'Arcais A, Crippa L, De Biase D, Romagnoni G. [Pharmacokinetics of broxaterol in asthmatic children]. Minerva Pediatr 1992; 44:421-5. [PMID: 1361960] [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: 03/25/2023]
Abstract
Pharmacological profile of broxaterol, a new beta adrenergic compound, was investigated in 12 asthmatic children (6 male and 6 female with age 8-13 years). This study was performed from November to May, and venous blood was collected after 30, 45, 120, 180, 240 minutes from administration of 0.5 mg broxaterol; the urine was collected every 4 hours drug intake (0-4, 4-8, 8-12 hours). Drug absorption proved very fast: T max was 0.9 hours and Cmax was 2.05 micrograms/ml. T 1/2 was 2.3 hours. The urine concentration of broxaterol in the urine 0-4 and 4-8 hours after administration, was 6.11 and 2.3% (as drug percentage), after 8 hours no broxaterol was evaluated in the urine. Pharmacological profile of broxaterol in asthmatic children and adults is comparable.
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Affiliation(s)
- A Flores D'Arcais
- Istituto Scientifico H S. Raffaele, Università degli Studi di Milano
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