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Avellaneda N, Maroli A, Tottrup A, Buskens C, Kotze PG, Pellino G, Dige A, Haase AM, Haanappel A, Giorgi L, Carvello M, Maruyama BY, Christensen P, Spinelli A. Short and long-term outcomes of surgery for inflammatory (uncomplicated) ileocecal Crohn's disease: Multicentric retrospective analysis of 211 patients. Dig Liver Dis 2024; 56:730-736. [PMID: 38044224 DOI: 10.1016/j.dld.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/11/2023] [Accepted: 10/19/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Surgical management for patients with inflammatory ileocecal Crohn's disease (CD) could be a reasonable alternative to second-line medical treatment. AIM To assess short and long-term outcomes of patients operated on for inflammatory, ileocecal Crohn's disease. METHODS A retrospective analysis of patients intervened at four referral hospitals during 2012-2021 was performed. RESULTS 211 patients were included. 43% of patients underwent surgery more than 5 years after diagnosis, and 49% had been exposed to at least one biologic agent preoperatively. 89% were operated by laparoscopy, with 1.6% conversion rate. The median length of the resected bowel was 25 cm (7-92) and three patients (1.43%) received a stoma. Median follow-up was 36 (17-70) months. The endoscopic recurrence-free survival proportion at 24, 48, 72, 96, and 120 months was 56%, 52%, 45%, 38%, and 33%, respectively. The clinical recurrence-free survival proportion at 24, 48, 72, 96, and 120 months was 83%, 79%, 76%, 74%, and 74%, respectively. In multivariate analysis, previous biological treatment (HR=2.01; p = 0.001) was associated with a higher risk of overall recurrence. CONCLUSION Surgery in patients with primary inflammatory ileocecal CD is associated with good postoperative outcomes, low postoperative morbidity with reasonable recurrence rates.
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Affiliation(s)
- Nicolas Avellaneda
- Department of Surgery, Aarhus University Hospital, Denmark; General Surgery Department, CEMIC, Buenos Aires, Argentina.
| | - Annalisa Maroli
- Division of Colon and Rectal Surgery, IRCCS - Humanitas Research Hospital, Milano, Italy; Department of Biomedical science, Humanitas University, Milan, Italy
| | - Anders Tottrup
- Department of Surgery, Aarhus University Hospital, Denmark
| | - Christianne Buskens
- Colorectal Surgery Department, Amsterdam Medical Hospitals, Amsterdam, the Netherlands
| | - Paulo Gustavo Kotze
- Colorectal Surgery Unit, Pontifícia Universidade Católica do Paraná (PUCPR), Brazil
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy; Colorectal Surgery, Vall d'Hebron University Hospital, Universitat Autonoma de Barcelona UAB, Barcelona, Spain
| | - Anders Dige
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Anne-Mette Haase
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Anouck Haanappel
- Colorectal Surgery Department, Amsterdam Medical Hospitals, Amsterdam, the Netherlands
| | - Lorenzo Giorgi
- Division of Colon and Rectal Surgery, IRCCS - Humanitas Research Hospital, Milano, Italy
| | - Michelle Carvello
- Division of Colon and Rectal Surgery, IRCCS - Humanitas Research Hospital, Milano, Italy; Department of Biomedical science, Humanitas University, Milan, Italy
| | | | | | - Antonino Spinelli
- Division of Colon and Rectal Surgery, IRCCS - Humanitas Research Hospital, Milano, Italy; Department of Biomedical science, Humanitas University, Milan, Italy
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Lombardi PM, Pansa A, Basato S, Giorgi L, Perano V, Marano S, Castoro C. Facing adenocarcinoma of distal esophagus and esophagogastric junction: a CROSS versus FLOT propensity score-matched analysis of oncological outcomes in a high-volume institution. Updates Surg 2023:10.1007/s13304-023-01497-5. [PMID: 36991302 DOI: 10.1007/s13304-023-01497-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/20/2023] [Indexed: 03/31/2023]
Abstract
Multimodality treatments are the gold standard for advanced resectable gastroesophageal cancer. Neoadjuvant CROSS and perioperative FLOT regimens are adopted for distal esophageal and esophagogastric junction adenocarcinoma (DE/EGJ AC). At present, none of the approaches is clearly superior in the context of a curative-intent multimodal treatment. We analyzed consecutive patients treated with CROSS or FLOT and surgery for DE/EGJ AC between August 2017 and October 2021. Propensity score matching was performed to balance baseline characteristics of patients. The primary endpoint was disease-free survival. Secondary endpoints included overall survival, 90-day morbidity/mortality rates, pathological complete response, margin-negative resection, and pattern of recurrence. Of the 111 patients included, 84 were correctly matched after PSM, 42 in each group. The 2-year DFS rate was 54.2% versus 64.1% in the CROSS and FLOT group, respectively (p = 0.182). Patients in the CROSS group showed a lower number of harvested LN when compared to the FLOT group (29.5 versus 39.0 respectively, p = 0.005). A higher rate of distal nodal recurrence was found in the CROSS group (23.8% versus 4.8%, p = 0.026). Although not significant, the CROSS group showed a trend toward higher rate of isolated distant recurrence (33.3% versus 21.4% respectively, p = 0.328), together with a higher rate of early recurrence (23.8% versus 9.5% respectively, p = 0.062). FLOT and CROSS regimens for DE/EGJ AC offer similar DFS and OS, together with comparable morbidity/mortality rates. CROSS regimen was associated with a higher distant nodal recurrence rate. Results of ongoing randomized clinical trials are awaited.
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Affiliation(s)
- Pietro Maria Lombardi
- Upper Gastrointestinal Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Andrea Pansa
- Upper Gastrointestinal Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy.
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.
| | - Silvia Basato
- Upper Gastrointestinal Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Lorenzo Giorgi
- Upper Gastrointestinal Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy
| | - Vittoria Perano
- Upper Gastrointestinal Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy
| | - Salvatore Marano
- Upper Gastrointestinal Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Carlo Castoro
- Upper Gastrointestinal Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy
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3
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Negro F, Napoletano G, Votino R, Banchelli I, Giorgi L. The issue of infertility in times of COVID-19: what do we know about it? Clin Ter 2021; 172:517-519. [PMID: 34821342 DOI: 10.7417/ct.2021.2368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Couple infertility constitutes a major source of concern and even distress for those involved, affecting roughly 50-80 million people in the world, according to World Health Organization data. There is no denying that medical and technological advancements in the field of as-sisted reproductive technology (ART) are among the greatest and most beneficial achievements of modern medicine. Countless couples have been able to achieve parenthood who in the past could not have, thanks to ART. Infertility itself used to be deemed insurmountable, especially when arising from uterine conditions (referred to as absolute uterine factor infertility, AUFI), neoplastic conditions or major complications affecting reproductive organs during previous pregnancies. The inability to have children is often considered by couples as a failure severely impacting their relationships, due to the unfulfilled biological potential in regard to parenting. However, in addition to its significance as a social problem, infertility is a medical issue which requires a strict and clearly defined path of diagnosis and treatment, particularly in times of COVID-19, when access to essential care has often been delayed with potentially harmful repercussions for patients seeking to achieve parenthood or to keep their fertility.
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Affiliation(s)
- F Negro
- Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - G Napoletano
- Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - R Votino
- Department of Obstetrics and Gynecology, S. Eugenio Hospital, Rome, Italy
| | - I Banchelli
- Department of Obstetrics and Gynecology, Santo Stefano Hospital of Prato, USL Toscana Centro, Italy
| | - L Giorgi
- Department of Obstetrics and Gynecology, Santo Stefano Hospital of Prato, USL Toscana Centro, Italy
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Moffa A, Giorgi L, Cassano M, Rinaldi V, Natalizia A, Bressi F, Guglielmelli E, Casale M. Non-implantable bone conduction device for hearing loss: a systematic review. J BIOL REG HOMEOS AG 2020; 34:97-110. Technology in Medicine. [PMID: 33386039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
There are different treatment options that employ a bone conduction transmission of the sound, for different types of hearing loss, as well as hearing aids, medical intervention via prostheses and surgically implanted medical devices. A middle ear disease causes a decline in the conductive mechanism of hearing. The current possibilities of compensating Conductive Hearing Loss (CHL) solutions include both surgical and no surgical Bone Conduction Devices (BCDs). Due to the invasiveness of the implantable devices and their specific requirements in terms of the temporal bone anatomy, non-implantable BCDs are in some cases preferred in the clinical routine. The goal of this review is to investigate the beneficial effects and safety of non-implantable BC devices, analysing the different type of solutions found so far. A systematic review was performed to identify all the clinical studies evaluating the use of non-invasive BCDs. A qualitative analysis based on data extracted was conducted. From 37 articles, 11 prospective studies and 1 retrospective study were selected for a full analysis, for a total of 173 patients from 4- to 77-years-old. Eight of these studies included adult patients, while the other four are paediatric studies. All the studies analyse non-implantable BCDs commonly used in case of CHL, sensorineural HL and single side deafness. Three of them analyse an adhesive device, six compare the adhesive device with a sound processor mounted on a support fitted on the head, one compare it also with an implant, one analyse the sound processor mounted on different type of support, and one compare different type of sound processor. All the studies showed advantages from the use of non-invasive BCDs, both on adults and children. The non-invasive BCDs analysed in this review show good results both from the audiological and subjective point of view and could be considered a safe and effective solution for patients suffering from conductive hearing loss, sensorineural hearing loss or single-side deafness. More studies are required to confirm these promising results.
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Affiliation(s)
- A Moffa
- Unit of Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
- Unit of Otolaryngology, University of Foggia, Foggia, Italy
| | - L Giorgi
- Research Unit of Advanced Robotics and Human-Centered Technologies, Campus Bio-Medico University of Rome, Italy
| | - M Cassano
- Unit of Otolaryngology, University of Foggia, Foggia, Italy
| | - V Rinaldi
- Unit of Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
| | - A Natalizia
- Unit of Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
| | - F Bressi
- Unit of Physical Medicine and Rehabilitation, Campus Bio-Medico University of Rome, Italy
| | - E Guglielmelli
- Research Unit of Advanced Robotics and Human-Centered Technologies, Campus Bio-Medico University of Rome, Italy
| | - M Casale
- Unit of Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
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5
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Patrini D, Lawrence D, Lampridis S, Minervini F, Giorgi L, Palermo R, Hayward M, Scarci M, Schmidt J, Bedetti B. The role of a multidisciplinary team in chest wall trauma management. J Vis Surg 2020. [DOI: 10.21037/jovs.2019.12.01] [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: 11/06/2022]
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6
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Giorgi L, Nevin A, Comelli D, Frizzi T, Alberti R, Zendri E, Piccolo M, Izzo FC. In-situ technical study of modern paintings - Part 2: Imaging and spectroscopic analysis of zinc white in paintings from 1889 to 1940 by Alessandro Milesi (1856-1945). Spectrochim Acta A Mol Biomol Spectrosc 2019; 219:504-508. [PMID: 31078817 DOI: 10.1016/j.saa.2019.04.084] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 04/12/2019] [Accepted: 04/29/2019] [Indexed: 06/09/2023]
Abstract
We present a multi-analytical in situ non-invasive study of a series of emblematic paintings by Alessandro Milesi (1856-1945) from the collection of the International Gallery of Modern Art Ca' Pesaro in Venice. Eight paintings dated from 1897 to 1910 were studied with imaging and spectroscopic techniques. White pigments were characterized by a combination of X-ray fluorescence spectroscopy which traced the presence of zinc-based pigments in Milesi's paintings, Raman Spectroscopy, Laser Induced Fluorescence (LIF) Spectroscopy and Time-resolved Luminescence Imaging. Time-resolved analysis of luminescence emissions revealed the nanosecond emission from organic compounds and the slower emission from the luminescent inorganic pigment Zinc Oxide that varied between 1.1 and 1.6 microseconds. In this work, data regarding the distribution of luminescent pigments was acquired with a time-gated imaging detector. Furthermore, differences in emission decay kinetics recorded from different paintings can be ascribed to different paint formulations or origins of the Zinc white in paint.
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Affiliation(s)
- L Giorgi
- Ca' Foscari University of Venice, Department of Environmental Science, Informatics and Statistics, Via Torino 155 b, Venice, Italy
| | - A Nevin
- Istituto di Fotonica e Nanotecnologie - Consiglio Nazionale delle Ricerche (IFN-CNR), Piazza L. da Vinci 32, Milano 20133, Italy; Department of Conservation, University of Gothenburg, Box 130, 40530 Göteborg, Sweden
| | - D Comelli
- Dipartimento di Fisica, Politecnico di Milano, Piazza L. da Vinci 32, Milano 20133, Italy
| | - T Frizzi
- XGLab S.R.L., Via Conte Rosso 23, I-20134 Milano, Italy
| | - R Alberti
- XGLab S.R.L., Via Conte Rosso 23, I-20134 Milano, Italy
| | - E Zendri
- Ca' Foscari University of Venice, Department of Environmental Science, Informatics and Statistics, Via Torino 155 b, Venice, Italy
| | - M Piccolo
- MUVE-Fondazione Musei Civici Venezia, Italy
| | - F C Izzo
- Ca' Foscari University of Venice, Department of Environmental Science, Informatics and Statistics, Via Torino 155 b, Venice, Italy.
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7
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Giorgi L, Nevin A, Nodari L, Comelli D, Alberti R, Gironda M, Mosca S, Zendri E, Piccolo M, Izzo FC. In-situ technical study of modern paintings part 1: The evolution of artistic materials and painting techniques in ten paintings from 1889 to 1940 by Alessandro Milesi (1856-1945). Spectrochim Acta A Mol Biomol Spectrosc 2019; 219:530-538. [PMID: 31078820 DOI: 10.1016/j.saa.2019.04.083] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/12/2019] [Accepted: 04/29/2019] [Indexed: 06/09/2023]
Abstract
A complementary multi-analytical in-situ approach has been adopted for the investigation of a corpus of ten paintings dating from 1889 and 1940 by the Venetian painter Alessandro Milesi (1856-1945), from the collection of the International Gallery of Modern Art Ca' Pesaro in Venice. Analyses were performed in situ with digital imaging, elemental and spectroscopic analysis. The analysis of pigments and binding media and their possible deterioration patterns were studied with a combination of X-Ray Fluorescence (XRF) Spectroscopy, External Reflection- Fourier Transform Infrared Spectroscopy (ER-FTIR) and Raman Spectroscopy. These analytical methods provide information regarding the evolution of the artist's palette and the painting techniques adopted in painting. Data suggest the widespread detection of zinc carboxylates, with implications for conservation and display.
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Affiliation(s)
- L Giorgi
- Ca' Foscari University of Venice, Department of Environmental Science, Informatics and Statistics, Via Torino 155 b, Venice 30173, Italy
| | - A Nevin
- Istituto di Fotonica e Nanotecnologie - Consiglio Nazionale delle Ricerche (IFN-CNR), Piazza Leonardo da Vinci 32, Milano 20133, Italy; Department of Conservation, University of Gothenburg, Box 130, 40530 Göteborg, Sweden
| | - L Nodari
- ICMATE-CNR, Institute for Condensed Matter Chemistry and Technology for Energy, National Research Council (ICMATE-CNR), and INSTM Research Unit, Padua Research Area, C.so Stati Uniti 4, 35127 Padua, Italy
| | - D Comelli
- Dipartimento di Fisica, Politecnico di Milano, Piazza L. da Vinci 32, Milano 20133, Italy
| | - R Alberti
- XGLab S.R.L., Via Conte Rosso 23, Milano 20134, Italy
| | - M Gironda
- XGLab S.R.L., Via Conte Rosso 23, Milano 20134, Italy
| | - S Mosca
- Dipartimento di Fisica, Politecnico di Milano, Piazza L. da Vinci 32, Milano 20133, Italy
| | - E Zendri
- Ca' Foscari University of Venice, Department of Environmental Science, Informatics and Statistics, Via Torino 155 b, Venice 30173, Italy
| | - M Piccolo
- MUVE- Fondazione Musei Civici, Venezia 30120, Italy
| | - F C Izzo
- Ca' Foscari University of Venice, Department of Environmental Science, Informatics and Statistics, Via Torino 155 b, Venice 30173, Italy.
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Rossi P, Ciattini S, Formica M, Fusi V, Giorgi L, Macedi E, Micheloni M, Paoli P. 3d-4f-3d trinuclear complexes with di-maltol-polyamine ligands. Solid state structure and solution behaviour. Inorganica Chim Acta 2018. [DOI: 10.1016/j.ica.2017.06.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Sabatini L, Battistelli M, Giorgi L, Iacobucci M, Gobbi L, Andreozzi E, Pianetti A, Franchi R, Bruscolini F. Tolerance to silver of an Aspergillus fumigatus strain able to grow on cyanide containing wastes. J Hazard Mater 2016; 306:115-123. [PMID: 26705888 DOI: 10.1016/j.jhazmat.2015.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 12/01/2015] [Accepted: 12/09/2015] [Indexed: 06/05/2023]
Abstract
We studied the strategy of an Aspergillus fumigatus strain able to grow on metal cyanide wastes to cope with silver. The tolerance test revealed that the Minimum Inhibitory Concentration of Ag(I) was 6mM. In 1mM AgNO3 aqueous solution the fungus was able to reduce and sequestrate silver into the cell in the form of nanoparticles as evidenced by the change in color of the biomass and Electron Microscopy observations. Extracellular silver nanoparticle production also occurred in the filtrate solution after previous incubation of the fungus in sterile, double-distilled water for 72h, therefore evidencing that culture conditions may influence nanoparticle formation. The nanoparticles were characterized by UV-vis spectrometry, X-ray diffraction and Energy Dispersion X-ray analysis. Atomic absorption spectrometry revealed that the optimum culture conditions for silver absorption were at pH 8.5.The research is part of a polyphasic study concerning the behavior of the fungal strain in presence of metal cyanides; the results provide better understanding for further research targeted at a rationale use of the microorganism in bioremediation plans, also in view of possible metal recovery. Studies will be performed to verify if the fungus maintains its ability to produce nanoparticles using KAg(CN)2.
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Affiliation(s)
- L Sabatini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Italy
| | - M Battistelli
- Department of Earth, Life Sciences & Environment, University of Urbino Carlo Bo, Italy
| | - L Giorgi
- Department of Base Sciences and Foundations, Chemistry Section, University of Urbino Carlo Bo, Italy
| | - M Iacobucci
- Department of Earth, Life Sciences & Environment, University of Urbino Carlo Bo, Italy
| | - L Gobbi
- Department of Science and Engineering of Matter, of Environment and Urban Planning, Polytechnic University of Marche, Ancona, Italy
| | - E Andreozzi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Italy
| | - A Pianetti
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Italy
| | - R Franchi
- Department of Base Sciences and Foundations, Chemistry Section, University of Urbino Carlo Bo, Italy
| | - F Bruscolini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Italy.
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10
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Potì L, Meloni G, Berrettini G, Fresi F, Foggi T, Secondini M, Giorgi L, Cavaliere F, Hackett S, Petronio A, Nibbs P, Forgan R, Leong A, Masciulli R, Pfander C. Sub-Nyquist field trial using time frequency packed DP-QPSK super-channel within fixed ITU-T grid. Opt Express 2015; 23:16196-16208. [PMID: 26193592 DOI: 10.1364/oe.23.016196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Sub-Nyquist time frequency packing technique was demonstrated for the first time in a super-channel field trial transmission over long-haul distances. The technique allows a limited spectral occupancy even with low order modulation formats. The transmission was successfully performed on a deployed Australian link between Sydney and Melbourne which included 995 km of uncompensated SMF with coexistent traffic. 40 and 100 Gb/s co-propagating channels were transmitted together with the super-channel in a 50 GHz ITU-T grid without additional penalty. The super-channel consisted of eight sub-channels with low-level modulation format, i.e. DP-QPSK, guaranteeing better OSNR robustness and reduced complexity with respect to higher order formats. At the receiver side, coherent detection was used together with iterative maximum-a-posteriori (MAP) detection and decoding. A 975 Gb/s DP-QPSK super-channel was successfully transmitted between Sydney and Melbourne within four 50GHz WSS channels (200 GHz). A maximum potential SE of 5.58 bit/s/Hz was achieved with an OSNR = 15.8 dB, comparable to the OSNR of the installed 100 Gb/s channels. The system reliability was proven through long term measurements. In addition, by closing the link in a loop back configuration, a potential SE∙d product of 9254 bit/s/Hz·km was achieved.
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Lagae L, Meshram C, Giorgi L, Patten A. Effects of adjunctive zonisamide treatment on weight and body mass index in children with partial epilepsy. Acta Neurol Scand 2015; 131:341-6. [PMID: 25659828 DOI: 10.1111/ane.12373] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Zonisamide has been associated with weight loss in children and adults. AIMS OF THE STUDY To assess the effects of adjunctive zonisamide on weight and body mass index (BMI) in children with partial epilepsy. METHODS A subanalysis was conducted of a Phase III trial and extension study, in which children with partial epilepsy received adjunctive zonisamide (target dose 8 mg/kg/day; maximum 500 mg/day). Changes in weight were correlated with skeletal development and sexual maturation. RESULTS Overall, 179 children (93 male, 86 female; age 6-18 years) received zonisamide (mean duration 370.6 days). Weight loss ≥ 5% was reported for 64 of 179 (35.8%) zonisamide-treated children. Of these, 46.9% were overweight/obese at study entry, compared with 23.4% at study end (P = 0.0007); 48.4% had normal weight at study entry, compared with 65.6% at study end (P = 0.03). Three patients were underweight at study entry, and four more became underweight by study end. No consistent correlations between weight loss and skeletal development or sexual maturation were observed. CONCLUSIONS Approximately one-third of children treated with zonisamide experienced ≥ 5% weight loss. Weight loss was most apparent in children with high baseline BMI values and did not appear to be associated with any consistent effects on growth and development.
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Affiliation(s)
- L. Lagae
- University of Leuven; Leuven Belgium
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12
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De Giorgi V, Papi F, Giorgi L, Savarese I, Verdelli A, Scarfì F, Gandini S. Skin self-examination and the ABCDE rule in the early diagnosis of melanoma: is the game over? Br J Dermatol 2014; 168:1370-1. [PMID: 23738643 DOI: 10.1111/bjd.12250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Trinka E, Giorgi L, Patten A, Segieth J. Safety and tolerability of zonisamide in elderly patients with epilepsy. Acta Neurol Scand 2013; 128:422-8. [PMID: 23773051 DOI: 10.1111/ane.12162] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess the safety/tolerability of zonisamide in elderly patients. MATERIALS & METHODS A pooled analysis of clinical study data from elderly (≥65 years) patients receiving add-on/monotherapy zonisamide for partial seizures was compared with pooled adult (18-65 years) study data. Assessments included treatment-emergent adverse events (TEAEs), clinical laboratory parameters and weight change. RESULTS Data were analyzed from 95 elderly and 1389 adult patients. Incidence of total TEAEs was similar (elderly, 78/95 [82%] vs adult, 1165/1389 [84%]); but lower in elderly versus adult patients for treatment-related TEAEs (53/95 [56%] vs 1010/1389 [73%]), severe TEAEs (11/95 [12%] vs 289/1389 [21%]), serious TEAEs (12/95 [13%] vs 230/1389 [17%]) and TEAEs leading to withdrawal (17/95 [18%] vs 312/1389 [23%]). Most TEAEs were of mild-to-moderate intensity. TEAEs reported more frequently by elderly versus adult patients included fatigue (11/95 [12%] vs 135/1389 [10%]), nasopharyngitis (8/95 [8%] vs 100/1389 [7%]), constipation (7/95 [7%] vs 67/1389 [5%]) and pruritus (6/95 [6%] vs 29/1389 [2%]). The only serious TEAEs reported by ≥2% of elderly patients were 'convulsions' (4/95 [4%] vs 49/1389 [4%]). Three elderly patients died; one death was considered treatment-related. TEAEs leading to discontinuation of ≥2% of elderly patients were dizziness (4/95 [4%]), headache (2/95 [2%]), somnolence (2/95 [2%]) and confusional state (2/95 [2%]). For elderly patients, there were minimal changes in clinical laboratory parameters, no reports of respiratory alkalosis or metabolic acidosis and no significant weight changes. CONCLUSIONS Zonisamide demonstrated a favourable safety/tolerability profile in elderly patients. No new or unexpected safety findings were identified.
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Affiliation(s)
- E. Trinka
- Department of Neurology; Christian Doppler Klinik; Paracelsus Medical University; Salzburg Austria
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Trinka E, Segieth J, Giorgi L. TOLERABILITY AND SAFETY OF ZONISAMIDE IN ELDERLY PATIENTS WITH PARTIAL EPILEPSY: RESULTS OF A POOLED ANALYSIS. J Neurol Neurosurg Psychiatry 2013. [DOI: 10.1136/jnnp-2013-306573.94] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Presi M, Chiuchiarelli A, Corsini R, Choudury P, Bottoni F, Giorgi L, Ciaramella E. Enhanced 10 Gb/s operations of directly modulated reflective semiconductor optical amplifiers without electronic equalization. Opt Express 2012; 20:B507-B512. [PMID: 23262895 DOI: 10.1364/oe.20.00b507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We report enhanced 10 Gb/s operation of directly modulated bandwidth-limited reflective semiconductor optical amplifiers. By using a single suitable arrayed waveguide grating we achieve simultaneously WDM demultiplexing and optical equalization. Compared to previous approaches, the proposed system results significantly more tolerant to seeding wavelength drifts. This removes the need for wavelength lockers, additional electronic equalization or complex digital signal processing. Uniform C-band operations are obtained experimentally with < 2 dB power penalty within a wavelength drift of 10 GHz (which doubles the ITU-T standard recommendations).
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Affiliation(s)
- M Presi
- Institute of Communications, Information And Perception Technologies, Scuola Superiore Sant’Anna di Pisa, Via G. Moruzzi 1, 56124 Pisa, Italy
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Abstract
Zonisamide is a benzisoxazole derivative, chemically unrelated to other antiepileptic drugs, that appears to have multiple mechanisms of action, including inhibition of Na(+) channels and reduction of T-type Ca(2+) currents. It is currently licensed in Europe and the USA for adjunctive treatment of partial seizures in adults, and in Europe as monotherapy for treatment of partial seizures in adults with newly diagnosed epilepsy. Zonisamide displays predictable, dose-dependent pharmacokinetics and has a half-life of ~60 h, allowing once- or twice-daily administration. It has a low potential for interactions with other medications, including oral contraceptives. The clinical efficacy of adjunctive zonisamide therapy has been established in four pivotal, phase III, randomized, double-blind, placebo-controlled trials, which together included approximately 850 patients, aged 12-77 years, with refractory partial epilepsy. In all four trials, zonisamide 300-600 mg/day resulted in significant reductions in median total seizure rates vs placebo, and zonisamide was generally well tolerated; the most frequently reported adverse events being somnolence, dizziness and anorexia/weight loss. Subanalysis of the primary European trial indicated that zonisamide was effective when administered as first-line adjunctive treatment, and a long-term extension to the same trial demonstrated that the efficacy and safety/tolerability of adjunctive zonisamide was sustained for up to 36 months. Once-daily monotherapy with zonisamide (200-500 mg/day) has been shown to be non-inferior to, and as well tolerated as, twice-daily monotherapy with controlled-release carbamazepine (400-1200 mg/day) in adults with newly diagnosed partial epilepsy. Zonisamide has also been shown to have favourable long-term retention rates, an important indication of its overall effectiveness.
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Affiliation(s)
- M. J. Brodie
- Epilepsy Unit; Western Infirmary; Glasgow; Scotland
| | - E. Ben-Menachem
- Institute for Clinical Neuroscience and Physiology; Sahlgrenska Academy, University of Gothenburg; Gothenburg; Sweden
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Rosati A, Segieth J, Giorgi L, Guerrini R. Results from the CATZ Study: A Phase III, Double-Blind, Randomized, Placebo-Controlled Trial To Assess the Efficacy and Safety of Adjunctive Zonisamide in Pediatric Patients with Partial-Onset Seizures (P06.100). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p06.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Baulac M, Brodie M, Segieth J, Giorgi L. Comparison of Zonisamide and Carbamazepine Monotherapy in Adults with Newly Diagnosed Partial Epilepsy: Results of a Phase III, Randomized, Double-Blind, Non-Inferiority Trial (PD3.009). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.pd3.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Baulac M, Brodie M, Segieth J, Giorgi L. Comparison of Zonisamide and Carbamazepine Monotherapy in Adults with Newly Diagnosed Partial Epilepsy: Results of a Phase III, Randomized, Double-Blind, Non-Inferiority Trial (IN5-1.005). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.in5-1.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Giorgi L, Salernitano E, Gagliardi S, Dikonimos T, Giorgi R, Lisi N, De Riccardis F, Martina V. Electrocatalysts for methanol oxidation based on platinum/carbon nanofibers nanocomposite. J Nanosci Nanotechnol 2011; 11:8812-8817. [PMID: 22400264 DOI: 10.1166/jnn.2011.3464] [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] [Indexed: 05/31/2023]
Abstract
New carbon nanomaterials, i.e., carbon nanotubes and nanofibers, with special physico-chemical properties, are recently studied as support for methanol oxidation reaction electrocatalysts replacing the most widely used carbon black. Particularly, carbon fibrous structures with high surface area and available open edges are thought to be promising. Platelet type carbon nanofibers, which have the graphene layers oriented perpendicularly to the fiber axis, exhibit a high ratio of edge to basal atoms. Different types of carbon nanofibers (tubular and platelet) were grown by plasma enhanced chemical vapour deposition on carbon paper substrates. The process was controlled and optimised in term of growth pressure and temperature. Carbon nanofibers were characterised by high resolution scanning electron microscopy and X-ray photoelectron spectroscopy to assess the morphological properties. Then carbon nanofibers of both morphologies were used as substrates for Pt electrodeposition. High resolution scanning electron microscopy images showed that the Pt nanoparticles distribution was well controlled and the particles size went down to few nanometers. Pt/carbon nanofibers nanocomposites were tested as electrocatalysts for methanol oxidation reaction. Cyclic voltammetry in H2SO4 revealed a catalyst with a high surface area. Cyclic voltammetry in presence of methanol indicated a high electrochemical activity for methanol oxidation reaction and a good long time stability compared to a carbon black supported Pt catalyst.
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Affiliation(s)
- L Giorgi
- ENEA Casaccia Research Center, Materials Technology Section, Via Anguillarese 301, 00123 Rome, Italy
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Giorgi L, Giorgi R, Gagliardi S, Serra E, Alvisi M, Signore MA, Piscopiello E. Platinum-gold nanoclusters as catalyst for direct methanol fuel cells. J Nanosci Nanotechnol 2011; 11:8804-8811. [PMID: 22400263 DOI: 10.1166/jnn.2011.3463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Nanosized platinum-gold alloys clusters have been deposited on gas diffusion electrode by sputter deposition. The deposits were characterized by FE-SEM, TEM and XPS in order to verify the formation of alloy nanoparticles and to study the influence of deposition technique on the nanomorphology. The deposition by sputtering process allowed a uniform distribution of metal particles on porous surface of carbon supports. Typical island growth mode was observed with the formation of a dispersed metal nanoclusters (mean size about 5 nm). Cyclic voltammetry was used to determine the electrochemical active surface and the electrocatalytic performance of the PtAu electrocatalysts for methanol oxidation reaction. The data were re-calculated in the form of mass specific activity (MSA). The sputter-catalyzed electrodes showed higher performance and stability compared to commercial catalysts.
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Affiliation(s)
- L Giorgi
- ENEA Casaccia Research Center, Physical Technologies and New Materials, via Anguillarese 301, 00060 Rome, Italy
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Ray Chaudhuri K, Martinez-Martin P, Rolfe KA, Cooper J, Rockett CB, Giorgi L, Ondo WG. Improvements in nocturnal symptoms with ropinirole prolonged release in patients with advanced Parkinson's disease. Eur J Neurol 2011; 19:105-13. [PMID: 21699627 DOI: 10.1111/j.1468-1331.2011.03442.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The 24-week, double-blind Efficacy and Safety Evaluation in PD-Adjunct (EASE-PD Adjunct) study randomized patients with advanced Parkinson's disease (PD) suboptimally controlled with levodopa to once-daily placebo or adjunctive ropinirole prolonged release (2-24 mg/day). We investigated the effect of ropinirole prolonged release on nocturnal symptoms in these patients. METHODS Total and grouped item PD Sleep Scale (PDSS) scores were analyzed post hoc in patients with baseline PDSS total scores ≤ 100 (troublesome nocturnal symptoms) and >100. RESULTS Baseline PDSS total score was ≤ 100 in 93 of 198 (47%) and 89 of 189 (47%) patients receiving ropinirole prolonged release and placebo, respectively; this subgroup displayed evidence at baseline of greater daily awake 'off' time, reduced night-time sleep and worse quality of life, than the PDSS >100 subgroup. Significant improvements with ropinirole prolonged release versus placebo in PDSS score from baseline to Week 24 last observation carried forward were observed for those with baseline PDSS ≤ 100 [adjusted mean treatment difference 9.0 (95% CI: 2.76, 15.33; P = 0.0051)], but not >100. The PDSS ≤ 100 subgroup demonstrated treatment benefits for PDSS groupings of motor symptoms on waking and global quality of sleep. Changes in daytime sleepiness were similar between treatment groups. The PDSS >100 subgroup demonstrated significant treatment benefit for global quality of sleep. The unadjusted odds ratio for a positive response with ropinirole prolonged release relative to placebo, for the PDSS ≤ 100 subgroup, was 2.90 (95% CI: 1.42, 5.95, P = 0.004). CONCLUSIONS Once-daily ropinirole prolonged release improves nocturnal symptoms in patients with advanced PD not optimally controlled with levodopa who suffer troublesome nocturnal disturbance.
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Affiliation(s)
- K Ray Chaudhuri
- National Parkinson Foundation Centre of Excellence, Kings College Hospital, Kings College and Institute of Psychiatry, London, UK.
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Antonelli A, Serafini S, Menotta M, Sfara C, Pierigé F, Giorgi L, Ambrosi G, Rossi L, Magnani M. Improved cellular uptake of functionalized single-walled carbon nanotubes. Nanotechnology 2010; 21:425101. [PMID: 20858931 DOI: 10.1088/0957-4484/21/42/425101] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Single-walled carbon nanotubes (SWNTs) due to their unique structural and physicochemical properties, have been proposed as delivery systems for a variety of diagnostic and therapeutic agents. However, SWNTs have proven difficult to solubilize in aqueous solution, limiting their use in biological applications. In an attempt to improve SWNTs' solubility, biocompatibility, and to increase cell penetration we have thoroughly investigated the construction of carbon scaffolds coated with aliphatic carbon chains and phospholipids to obtain micelle-like structures. At first, oxidized SWNTs (2370 ± 30 nmol mg(-1) of SWNTs) were covalently coupled with an alcoholic chain (stearyl alcohol, C(18)H(37)OH; 816 nmol mg(-1) of SWNTs). Subsequently, SWNTs-COOC(18)H(37) derivatives were coated with phosphatidylethanolamine (PE) or -serine (PS) phospholipids obtaining micelle-like structures. We found that cellular uptake of these constructs by phagocytic cells occurs via an endocytotic mechanism for constructs larger than 400 nm while occurs via diffusion through the cell membrane for constructs up to 400 nm. The material that enters the cell by phagocytosis is actively internalized by macrophages and localizes inside endocytotic vesicles. In contrast the material that enters the cells by diffusion is found in the cell cytosol. In conclusion, we have realized new biomimetic constructs based on alkylated SWNTs coated with phospholipids that are efficiently internalized by different cell types only if their size is lower than 400 nm. These constructs are not toxic to the cells and could now be explored as delivery systems for non-permeant cargoes.
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Affiliation(s)
- A Antonelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino (PU), Italy.
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Amatori S, Bagaloni I, Macedi E, Formica M, Giorgi L, Fusi V, Fanelli M. Malten, a new synthetic molecule showing in vitro antiproliferative activity against tumour cells and induction of complex DNA structural alterations. Br J Cancer 2010; 103:239-48. [PMID: 20571494 PMCID: PMC2906739 DOI: 10.1038/sj.bjc.6605745] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hydroxypyrones represent several classes of molecules known for their high synthetic versatility. This family of molecules shows several interesting pharmaceutical activities and is considered as a promising source of new antineoplastic compounds. METHODS In the quest to identify new potential anticancer agents, a new maltol (3-hydroxy-2-methyl-4-pyrone)-derived molecule, named malten (N,N'-bis((3-hydroxy-4-pyron-2-yl)methyl)-N,N'-dimethylethylendiamine), has been synthesised and analysed at both biological and molecular levels for its antiproliferative activity in eight tumour cell lines. RESULTS Malten exposure led to a dose-dependent reduction in cell survival in all the neoplastic models studied. Sublethal concentrations of malten induce profound cell cycle changes, particularly affecting the S and/or G2-M phases, whereas exposure to lethal doses causes the induction of programmed cell death. The molecular response to malten was also investigated in JURKAT and U937 cells. It showed the modulation of genes having key roles in cell cycle progression and apoptosis. Finally, as part of the effort to clarify the action mechanism, we showed that malten is able to impair DNA electrophoretic mobility and drastically reduce both PCR amplificability and fragmentation susceptibility of DNA. CONCLUSION Taken together, these results show that malten may exert its antiproliferative activity through the induction of complex DNA structural modifications. This evidence, together with the high synthetic versatility of maltol-derived compounds, makes malten an interesting molecular scaffold for the future design of new potential anticancer agents.
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Affiliation(s)
- S Amatori
- Molecular Pathology and Oncology Lab. 'PaoLa', Department of Biomolecular Sciences, University of Urbino 'Carlo Bo', via Arco d'Augusto, 2, 61032 Fano (PU), Italy
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Berrettini G, Giorgi L, Ponzini F, Cavaliere F, Ghiggino P, Poti L, Bogoni A. Testbed for experimental analysis on seamless evolution architectures from GPON to high capacity WDM-PON. IJCNDS 2010. [DOI: 10.1504/ijcnds.2010.033974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Stocchi F, Giorgi L, Rolfe K, Rockett C. P2.166 Once-daily ropinirole prolonged release improves activities of daily living and motor symptoms in patients with advanced Parkinson's disease. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70517-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hauser R, Hunter B, Rolfe K, Giorgi L. P2.132 Long-term safety and patient preference for dose frequency in patients receiving ropinirole prolonged release in early or advanced Parkinson's disease. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70483-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Martinez-Martin P, Giorgi L, Rolfe K, Chaudhuri K. P2.124 Changes in quality of life and nocturnal symptoms in sleep-impaired patients with advanced Parkinson's disease treated with ropinirole prolonged release. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70475-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Watts R, Giorgi L, Rolfe K, Lyons K. P2.173 Adjunctive ropinirole prolonged-release has similar effects on motor and non-motor symptoms in PD compared with carbidopa–levodopa, but delays dyskinesia onset. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70524-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ondo W, Giorgi L, Rolfe K, Chaudhuri K. P2.150 Ropinirole prolonged release improves nocturnal symptoms in patients with advanced Parkinson's disease: an analysis of individual items on the PDSS. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70501-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stocchi F, Hunter B, Giorgi L, Hauser R. P2.165 Dose-related decrease in “off” time with ropinirole prolonged release in patients with advanced Parkinson's disease. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70516-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Stocchi F, Hunter B, Giorgi L, Hersh B. P2.164 Ropinirole prolonged release maintains an increase in daily awake time spent “on” in patients with advanced Parkinson's disease. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70515-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mecacci F, Bianchi B, Pieralli A, Mangani B, Moretti A, Cioni R, Giorgi L, Mello G, Matucci-Cerinic M. Pregnancy outcome in systemic lupus erythematosus complicated by anti-phospholipid antibodies. Rheumatology (Oxford) 2008; 48:246-9. [PMID: 19109318 DOI: 10.1093/rheumatology/ken458] [Citation(s) in RCA: 27] [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] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Pregnant women affected by SLE are at high risk of gestational hypertension and pre-eclampsia (32-50%). This risk is particularly elevated if aPLs are dosable. The present study was planned to evaluate maternal-fetal outcomes of different groups of SLE pregnant patients characterized by diverse risk factors: patients affected by APS treated with a combination of low-dose aspirin (LDA) and low-molecular weight heparin (LMWH), nulliparous patients with dosable aPL treated by LMWH and SLE patients with no aPL administered no treatment during pregnancy. METHODS A retrospective description of maternal and fetal outcomes was made in a total of 62 pregnancies presenting APS in 8 cases (12.9%), aPL in 20 (32.2%) and no aPL in 34 (54.8%). RESULTS No statistically significant difference was found comparing fetal and maternal outcomes of the three groups despite differences in SLE activity: SLE aPL-positive pregnancies were associated with a higher incidence of nephritis and chronic hypertension than pregnancies treated for APS or not presenting with the added risk factor. The incidence of pre-eclampsia is 15% in aPL positive, 12.5% in APS and 14.7% in no aPL pregnancies, respectively. CONCLUSIONS LMWH is rather a possible option of prophylaxis for SLE aPL-positive pregnancies with potential maternal-fetal outcomes similar to aPL-negative patients or to standard treated APS.
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Affiliation(s)
- F Mecacci
- Department of Gynaecology, Perinatology and Human Reproduction, University of Florence, Florence, Italy
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Pozio A, Silva R, De Francesco M, Cardellini F, Giorgi L. Erratum to “A novel route to prepare stable Pt–Ru/C electrocatalysts for polymer electrolyte fuel cell”. Electrochim Acta 2003. [DOI: 10.1016/s0013-4686(02)00778-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Pozio A, Silva R, De Francesco M, Cardellini F, Giorgi L. A novel route to prepare stable Pt–Ru/C electrocatalysts for polymer electrolyte fuel cells. Electrochim Acta 2003. [DOI: 10.1016/s0013-4686(02)00779-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pozio A, Silva R, De Francesco M, Cardellini F, Giorgi L. A novel route to prepare stable Pt–Ru/C electrocatalysts for polymer electrolyte fuel cell. Electrochim Acta 2002. [DOI: 10.1016/s0013-4686(02)00622-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bedini A, Balsamini C, Di Giacomo B, Tontini A, Citterio B, Giorgi L, Di Modugno E, Tarzia G. Synthesis and biological evaluation of 6-bromo-6-substituted penicillanic acid derivatives as beta-lactamase inhibitors. Farmaco 2002; 57:663-9. [PMID: 12361234 DOI: 10.1016/s0014-827x(02)01261-2] [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: 01/18/2023]
Abstract
The synthesis of a selected set of 6-bromopenicillanic acid derivatives with an additional C6 substituent is reported. All these substances were tested as inhibitors of class A and C beta-lactamase enzymes derived from Escherichia coli (TEM-1) and E. cloacae (P99). As 6-(1-hydroxyethyl) derivatives 4c and 6c were found to be weak beta-lactamase inhibitors, they were further investigated in combination with amoxicillin against a series of beta-lactamase-producing bacterial strains. Some structure-activity relationships are discussed.
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Affiliation(s)
- A Bedini
- Istituto di Chimica Farmaceutica, Università di Urbino, Italy.
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Abstract
OBJECTIVE To determine the tolerability of lamotrigine in elderly patients with epilepsy. DESIGN Pooled data from 13 lamotrigine clinical trials. SETTING Multicentre clinical trials conducted in primary care and neurology practices. PARTICIPANTS 208 elderly patients (aged > or = 65 years) were identified: 146 lamotrigine-treated patients, 53 carbamazepine-treated patients and 9 phenytoin-treated patients. INTERVENTIONS Extent of exposure, incidence of drug-related adverse events, serious adverse events and study withdrawals were examined. RESULTS The median duration of exposure for lamotrigine monotherapy and add-on therapy was 24.1 and 47.4 weeks, respectively. The median daily dosage of lamotrigine was 100 mg for monotherapy (range 75 to 500 mg) and 300 mg for add-on therapy (range 25 to 700 mg). Overall, the incidence of drug-related adverse events was lower for lamotrigine than comparator drugs: 49% (72/146) for lamotrigine compared with 72% (38/53) for carbamazepine (p = 0.006), and 89% (8/9) for phenytoin (p = 0.035) although patient numbers in each treatment group were not comparable. Patients receiving lamotrigine reported incidences of somnolence (p = 0.012), rash (p = 0.034), and headache (nonsignificant) that were one-half the incidence reported with carbamazepine monotherapy. Rash was the most common reason for study withdrawal: 4% (6/146) lamotrigine, 17% (9/53) carbamazepine and 0% phenytoin. Seven (5%, 7/146) lamotrigine-treated patients, 4 (8%, 4/53) carbamazepine-treated patients and 1 (11%, 1/9) phenytoin-treated patient experienced drug-related serious adverse events. CONCLUSION Lamotrigine, used in the currently prescribed adult dosage regimen, was well tolerated in elderly patients with epilepsy.
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Affiliation(s)
- L Giorgi
- Glaxo Wellcome plc, Greenford, Middlesex, United Kingdom
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Dapporto P, Formica M, Fusi V, Giorgi L, Micheloni M, Paoli P, Pontellini R, Rossi P. Addition of small molecules by Zn(II) and Cu(II) dinuclear complexes obtained by an amino-phenolic ligand. Crystal structures of the dinuclear zinc complex assembling butanolate and azide anions. Inorg Chem 2001; 40:6186-92. [PMID: 11703118 DOI: 10.1021/ic0105415] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The coordination properties of the ligand 2,6-bis-[[bis-(2-aminoethyl)-amino]methyl]-phenol (L) toward the zinc ion were determined by means of potentiometric measurements in aqueous solution (298.1 +/- 0.1 K, I = 0.15 mol dm(-3)). L forms mono- and dinuclear complexes with zinc; the stable dinuclear complexes are practically the only existing species using L/Zn(II), molar ratio of 1:2. In these species, each dien subunit binds one zinc ion, while the phenolate moiety bound to both ions allows the two metal centers to be in close proximity with an incomplete coordination environment. The role of this metal-metal distance in binding secondary ligands was investigated for the dinuclear systems 2Zn/L and 2Cu/L by potentiometric (298.1 +/- 0.1 K, I = 0.15 mol dm(-3)) and NMR experiments in aqueous and methanol solution with a series of small guests having nitrogen donor atoms. The coordination sphere of the two metals was completed by adding 1 equiv of only those guests, which showed at least two contiguous donor atoms or two lone pairs on the same atom, to exactly fit the metal-metal distance without modifying the metal cluster. To do this, the imidazole molecule which shows the highest addition constants to the [M(2)H(-1)L](3+) species probably forms a mu-1,1-amino. These results are in agreement with the two crystal structures reported herein [Zn(2)(H(-1)L)(CH(3)CH(2)CH(2)CH(2)O)](ClO(4))(2) (space group P2(1)nb, a = 11.483(5), b = 14.166(5), c = 18.279(5) A, V = 2973(19) A(3), Z = 4, R = = 0.0701, wR2 = 0.1611) and [Zn(2)(H(-1)L)N(3)](ClO(4))(2) (space group C 2/c, a = 14.460(3), b = 12.814(3), c = 14.875(3) A, beta = 105.35(2) degrees, V = 2658(10) A(3), Z = 4, R = 0.0783, wR2 = 0.1806). In fact, these structures display a butanolate or azide guest linked to both Zn(II) ions of the dinuclear complex, resulting in a mu-1,1-oxo and mu-1,1-azido bridge, respectively.
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Affiliation(s)
- P Dapporto
- S. Stecco Department of Energetics, University of Florence, via S. Marta 3, I-50139 Florence, Italy
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Passalacqua E, Lufrano F, Squadrito G, Patti A, Giorgi L. Nafion content in the catalyst layer of polymer electrolyte fuel cells: effects on structure and performance. Electrochim Acta 2001. [DOI: 10.1016/s0013-4686(00)00679-4] [Citation(s) in RCA: 343] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pozio A, Giorgi L, Antolini E, Passalacqua E. Electroxidation of H2 on Pt/C Pt–Ru/C and Pt–Mo/C anodes for polymer electrolyte fuel cell. Electrochim Acta 2000. [DOI: 10.1016/s0013-4686(00)00625-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Lamotrigine is a novel anticonvulsant, which has proven to be effective both as add-on and monotherapy. 13 studies have demonstrated efficacy in 1096 children with a variety of seizure types. Tolerability information in these studies was collected in a standard fashion, where investigators reported all adverse events regardless of the perceived relationship to the test therapies. Generally, lamotrigine treatment in these clinical trials was generally given at higher initial doses and faster dose escalations than are currently recommended. Most adverse events associated with lamotrigine were mild to moderate in severity and did not result in discontinuation of treatment. Results from placebo-controlled, add-on trials showed that 85% of lamotrigine recipients experienced an adverse event compared with 83% of placebo recipients. Lamotrigine was associated with an increased risk of adverse events in the nervous system (dizziness, tremor, ataxia, and diplopia), gastrointestinal tract (nausea), and urinary tract (infection). The incidence of most adverse events was lower among lamotrigine recipients in monotherapy trials than in add-on trials, suggesting that concurrent anticonvulsant treatment or drug interactions can be confounding risk factors above that of lamotrigine treatment alone. Skin rash associated with hospitalisation and the discontinuation of study drug was reported more frequently by lamotrigine recipients than by placebo recipients and more frequently by children than by adults. The simultaneous use of valproic acid (sodium valproate) was associated with an increased incidence of rash. Lamotrigine, an effective broad spectrum anticonvulsant, is well tolerated in children. The qualitative features of adverse events that occur with lamotrigine treatment are similar for children and adults. The incidence of rash may be reduced with proper initial dosing and dose escalation.
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Affiliation(s)
- J A Messenheimer
- Neurology and Psychiatry Clinical Research, GlaxoWellcome Research Institute, Research Triangle Park, North Carolina 27709, USA.
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Brodie MJ, Overstall PW, Giorgi L. Multicentre, double-blind, randomised comparison between lamotrigine and carbamazepine in elderly patients with newly diagnosed epilepsy. The UK Lamotrigine Elderly Study Group. Epilepsy Res 1999; 37:81-7. [PMID: 10515178 DOI: 10.1016/s0920-1211(99)00039-x] [Citation(s) in RCA: 344] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In a multicentre, double-blind trial 150 elderly patients (mean age 77 years) with newly diagnosed epilepsy were randomised in a 2:1 ratio to treatment with lamotrigine (LTG) or carbamazepine (CBZ). Following a short titration period, the dosage was individualised for each patient while maintaining the blind over the next 24 weeks. The main difference between the groups was the rate of drop-out due to adverse events (LTG 18% versus CBZ 42%). This was in part a consequence of the lower rash rate with LTG (LTG 3%, CBZ 19%; 95% CI 7-25%). LTG-treated patients also complained less frequently of somnolence (LTG 12%, CBZ 29%; 95% CI 4-30%). Although there was no difference between the drugs in time to first seizure, a greater percentage of LTG-treated patients remained seizure-free during the last 16 weeks of treatment (LTG 39%, CBZ 21%; P = 0.027). Overall, more patients continued on treatment with LTG than CBZ (LTG 71%, CBZ 42%; P < 0.001) for the duration of the study. The hazard ratio for withdrawal was 2.4 (95% CI 1.4-4.0) indicating that a patient treated with CBZ was more than twice as likely to come off medication than one taking LTG. In conclusion, LTG can be regarded as an acceptable choice as initial treatment for elderly patients with newly diagnosed epilepsy.
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Affiliation(s)
- M J Brodie
- Department of Medicine and Therapeutics, Western Infirmary, Glasgow, UK.
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Lupo R, Giorgi L, Rapisarda S, Viola E, Pavesi FC. Neer capsular shift surgery in the treatment of recurrent antero-inferior shoulder dislocations. Chir Organi Mov 1999; 84:153-60. [PMID: 11569074] [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
A total of 47 patients affected with recurrent multidirectional shoulder dislocation with a prevalent anteroinferior component were submitted to Neer inferior capsular shift surgery. Bankart lesion, present in 24 patients, was repaired prior to performing capsuloligamentous surgery. The patients included in the study presented with generalized ligamentous hyperlaxity in 20 cases, while hyperlaxity was localized in the pathological shoulder in the remaining cases, presumably related to the high number of dislocations. The choice of performing Neer inferior capsular shift surgery was initially based on the data and the modern conceptions that emerged in the literature. Successively, the good results obtained encouraged us to follow the path taken, and we are currently encouraged to advise this surgical procedure for the category of patients mentioned above.
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Affiliation(s)
- R Lupo
- Istituto di Clinica Ortopedica e Traumatologica dell'Università di Pavia I.R.C.C.S. Policlinico San Matteo, Pavia
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Giorgi L, Antolini E, Pozio A, Passalacqua E. Influence of the PTFE content in the diffusion layer of low-Pt loading electrodes for polymer electrolyte fuel cells. Electrochim Acta 1998. [DOI: 10.1016/s0013-4686(98)00125-x] [Citation(s) in RCA: 200] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Passalacqua E, Lufrano F, Squadrito G, Patti A, Giorgi L. Influence of the structure in low-Pt loading electrodes for polymer electrolyte fuel cells. Electrochim Acta 1998. [DOI: 10.1016/s0013-4686(98)00124-8] [Citation(s) in RCA: 106] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
To date approximately 4000 adults > 12 years of age have been treated with lamotrigine in Glaxo Wellcome sponsored clinical trials. Review of the data from these trials shows lamotrigine to be effective and well tolerated in both add-on and monotherapy treatment. Safety of lamotrigine was comparable to that of other anticonvulsants in add-on controlled clinical trials. In addition, fewer than half the number of patients in monotherapy studies who were taking lamotrigine discontinued treatment because of adverse events compared to those taking carbamazepine and phenytoin. Most of the reported adverse events seen in lamotrigine treated patients in all studies were judged by the investigator to be mild or moderate in severity; few of the adverse events resulted in the withdrawal of patients from studies. Analysis of vital signs and clinical laboratory data have revealed no undesirable effect of lamotrigine on major systems of the body. The most concerning adverse event has been rash. In clinical trials, this has most often been limited to a simple morbilliform rash which is not associated with evidence of systemic involvement. The incidence of Stevens-Johnson syndrome (SJS) in clinical trials is approximately 1 in 1000. Rash associated with lamotrigine has typically occurred within the first 8 weeks of treatment. Data from clinical trials clearly point to exceeding currently recommended dosage guidelines of lamotrigine and co-administration of valproic acid (valproate sodium) as risk factors for rash. Early in 1997, Glaxo Wellcome strengthened existing warnings in the product label regarding the risk of rash and reinforced the importance of adherence to administration guidelines in an effort to reduce the incidence of rash.
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Affiliation(s)
- J Messenheimer
- Glaxo Wellcome Research Institute, Research Triangle Park, North Carolina, USA
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Giorgi L, Fanfani E, Paternostro E, Trovati F, Falchetti A, Novelli GP. Immediate-early genes expression in spinal cord as related to acute noxious stimulus. Int J Clin Pharmacol Res 1997; 17:59-61. [PMID: 9403355] [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: 02/05/2023]
Abstract
During the "central sensitization" phenomenon, noxious stimuli lead to expression of IEGs (c-fos, c-jun, krox-24); their proteic products have been postulated to convert short-term stimulations into long-lasting responses in dorsal-horn neurons. The aim of this study was to verify if analgesic drugs, such as morphine and ketorolac, may affect the c-fos protooncogene expression by using a method highly sensitive and specific, based on transformation of activated c-fos specific mRNA in cDNA (reverse transcription), its amplification (PCR) and final visualization by electrophoresis on agarose gel. Male Wistar rats were submitted to various stimuli in order to assess which procedure resulted in genic derepression; monolateral sciatic nerve ligature appeared to be the most effective. When the animals were pretreated with morphine or ketorolac and subsequently exposed to the monolateral sciatic nerve ligature, or treated with ketorolac immediately after the same painful stimulus, we found that only pretreatment with morphine completely blocked c-fos depression. Our results confirm that pretreatment with opioids is able to prevent IEGs derepression and the central sensitization phenomenon.
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Affiliation(s)
- L Giorgi
- Institute of Anaesthesiology and Intensive Care, University of Florence, Italy
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