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Visani L, Meattini I, Becherini C, Marrazzo L, Salvestrini V, Scoccimarro E, Desideri I, Francolini G, Bellini C, Valzano M, Simontacchi G, Scotti V, Arilli C, Casati M, Nori J, Bernini M, Orzalesi L, Pallotta S, Barletta G, Livi L. Radiotherapy in patients receiving anthracyclines: phase 3 SAFE trial (NCT2236806) interim analysis. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01480-0] [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: 11/19/2022]
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Visani L, Meattini I, Francolini G, Di Cataldo V, Becherini C, Nori J, Bernini M, Orzalesi L, Sanchez L, Scoccimarro E, Lucidi S, Bellini C, Desideri I, Scotti V, Doro R, Masi L, Loi M, Bianchi S, Mangoni M, Livi L. OC-0932 Preoperative radiation therapy in early breast cancer: phase II ROCK trial (NCT03520894). Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02712-8] [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: 11/24/2022]
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Visani L, Ratosa I, Scoccimarro E, Becherini C, Saieva C, Desideri I, Scotti V, Ozarem M, Ribnikar D, Aquilano M, Cerbai C, Orzalesi L, Bernini M, Sanchez L, Nori J, Bianchi S, Meattini I, Livi L. OC-0071 Safety and efficacy of concomitant radiation and CDK4/6 inhibitors in breast cancer patients. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06765-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Di Cataldo V, Francolini G, Visani L, Becherini C, Scoccimarro E, Masi L, Doro R, Salvatore G, Bianchi S, Vezzosi V, Lemmi E, Nori J, Sanchez L, Orzalesi L, Bernini M, Loi M, Desideri I, Mangoni M, Meattini I, Livi L. PO-1138 Preoperative radiation therapy in breast cancer: preliminary results from ROCK trial (NCT03520894). Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07589-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Meattini I, Rocco N, Bernini M, Bonzano E, De Rose F, De Santis M, Franco P, Meduri B, Parisi S, Pasinetti N, Prisco A, Fontana A, Becherini C, Livi L. Breast reconstruction and radiation therapy: consensus statements of the Italian association of radiotherapy and clinical oncology (AIRO) breast cancer group. Breast 2021. [DOI: 10.1016/s0960-9776(21)00160-0] [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: 10/21/2022] Open
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Visani L, Saieva C, Desideri I, Scotti V, Dominici L, Scoccimarro E, Aquilano M, Cerbai C, Palmieri V, Maragna V, Becherini C, Bernini M, Sanchez L, Orzalesi L, Nori J, Antonuzzo L, Bianchi S, Meattini I, Livi L. PO-0928: Safety and efficacy of concomitant RT and CDK4/6 inhibitors in metastatic breast cancer patients. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00945-2] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bernini M, Meattini I, Sordi S, Orzalesi L, Cucchiari J, Scotti V, Desideri I, Bianchi S, Livi L. Quality of life improvement and pain reduction in implant-based breast reconstruction by means of selective pectoralis major muscle denervation. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30587-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Marcasciano M, Kaciulyte J, Mori FLR, Lo Torto F, Barellini L, Loreti A, Fanelli B, De Vita R, Redi U, Marcasciano F, Di Cesare F, Dal Prà G, Conversi A, Elia L, Montemari G, Vaia N, Bernini M, Sordi S, Luridiana G, D'Ermo G, Monti M, De Luca A, Ricci F, Mazzocchi M, Gentilucci M, Greco M, Losco L, Valdatta LA, Raposio E, Giudice G, Maruccia M, Di Benedetto G, Cigna E, Casella D, Ribuffo D. Breast surgeons updating on the thresholds of COVID-19 era: results of a multicenter collaborative study evaluating the role of online videos and multimedia sources on breast surgeons education and training. Eur Rev Med Pharmacol Sci 2020; 24:7845-7854. [PMID: 32744712 DOI: 10.26355/eurrev_202007_22289] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Current trends show a rise of attention given to breast cancer patients' quality of life and the surgical reconstructive result. Along with this trend, surgical training quality and efficacy are gaining importance and innovative training methods such as online videos shared on social media portals, are becoming main updating tools. In hazardous times like COVID-19 pandemic nowadays, online communication becomes of vital importance and adaptation and innovation are fundamental to keep research and education alive. The authors aimed to investigate the role of video and multimedia sources on the daily activity and surgical training of a representative group of surgeons specifically dedicated to oncologic, oncoplastic and reconstructive breast surgeries. MATERIALS AND METHODS A survey was produced and administered to 20 major Italian Breast Centers. Collected data were analyzed with Fisher's Exact Test. RESULTS From October 2019 to March 2020, a total of 320 surveys were collected. Among the responders, there were 188 trainees (intern medical doctors and residents) and 110 faculty, 72% of them belonged to a plastic surgery environment, while 28% to general surgery environment. Almost all respondents have ever watched videos concerning breast surgery. CONCLUSIONS The results of the study show how breast surgeons rely on videos and web platforms, mostly YouTube, when searching for training info about surgical procedures. Social media offer great opportunities for sharing knowledge and diffusion of new ideas but greater attention to their reliability is mandatory.
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Affiliation(s)
- M Marcasciano
- Unità di Oncologia Chirurgica Ricostruttiva della Mammella, "Spedali Riuniti" di Livorno, "Breast Unit" Integrata di Livorno Cecina, Piombino Elba, Azienda USL Toscana Nord Ovest, Livorno, Italy.
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Livi L, Barletta G, Martella F, Desideri I, Scotti V, Becherini C, Saieva C, Terziani F, Bacci C, Airoldi M, Allegrini G, Amoroso D, Venditti F, Tarquini R, Orzalesi L, Sanchez L, Bernini M, Nori J, Fioretto L, Meattini I. Pre-specified interim analysis of the SAFE trial (NCT2236806): A 4-arm randomized, double-blind, controlled study evaluating the efficacy and safety of cardiotoxicity prevention in non-metastatic breast cancer patients treated with anthracyclines with or without trastuzumab. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.039] [Citation(s) in RCA: 2] [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: 11/15/2022] Open
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Meattini I, Bernini M, Saieva C, Desideri I, Scotti V, Salvestrini V, Visani L, Mariotti M, Delli Paoli C, Olmetto E, Maragna V, Orzalesi L, Sanchez L, Nori J, Bianchi S, Livi L. Abstract P3-12-07: Conservative breast reconstruction: Outcomes of 146 consecutive cases of prepectoral, subcutaneous implant-based breast reconstruction in a single-Institution series. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-12-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Aims. To evaluate acute and late toxicity-related factors among breast cancer (BC) patients who underwent prepectoral breast reconstruction (BR).
Methods. We performed a retrospective analysis of BC patients who underwent therapeutic or prophylactic mastectomy from October 2012 to May 2016 at our Center. We recorded individual patient-related features (i.e. age, body mass index [BMI], smoke-history, comorbidity, BRCA-carrier), BC-related treatments characteristics (i.e. axillary surgery, adjuvant radiotherapy [RT], adjuvant chemotherapy, primary systemic therapy [PST], endocrine therapy, and use of trastuzumab). Toxicity profile was evaluated in terms of complications related to BR; we recorded acute and late toxicity data and prosthesis/implant explant rate.
Results. We analyzed 146 consecutive BC patients treated with subcutaneous BR, 117 therapeutic and 29 prophylactic mastectomies. Thirty-seven patients received postmastectomy RT. Significant factors related to acute toxicity were: previous RT (34.5% [RT] vs 8.5% [no RT]; p=0.001), BMI (31.3% [BMI ≥25] vs 8.8% [<25]; p=0.003), previous breast surgery (22.2% [surgery] vs 8.7% [no surgery]; p=0.027), and diabetes (100% [diabetes] vs 11.9% [no diabetes]; p=0.002). Factors significantly correlated to implant/prosthesis explant were: current or previous smoking exposition (13.8% [smokers] vs 2.6% [non-smokers]; p=0.029) and PST (18.8% [PST] vs 3.5% [no PST]; p=0.022); axillary lymph node dissection (ALND) was significantly related to late toxicity (5.7% [ALND] vs 0%; p=0.04). At a 3-year median follow up, three deaths, five locoregional recurrences (LRR), and fourteen distant metastasis (DM) occurred among 117 patients treated by therapeutic mastectomy. Overall survival was 78.1%, LRR free-survival was 95%, and DM free-survival was 71.6%. Postmastectomy RT was not significantly related to acute, late toxicity, and explant occurrence.
Conclusions. In our experience prepectoral subcutaneous implant-based BR is a safe and effective approach, with low rates of acute toxicity. Major risk factors were evidenced for patients previously treated with RT or surgery, and in case of diabetes or BMI ≥25; postmastectomy RT seems not to be related to higher rate of toxicity. ALND seems to be the only factor significantly related to late toxicity. PST, and smoking exposition were significantly associated with higher rate of implant/prosthesis explant. However, further investigations and mature follow-up are warranted to confirm these encouraging results.
Citation Format: Meattini I, Bernini M, Saieva C, Desideri I, Scotti V, Salvestrini V, Visani L, Mariotti M, Delli Paoli C, Olmetto E, Maragna V, Orzalesi L, Sanchez L, Nori J, Bianchi S, Livi L. Conservative breast reconstruction: Outcomes of 146 consecutive cases of prepectoral, subcutaneous implant-based breast reconstruction in a single-Institution series [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-12-07.
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Affiliation(s)
- I Meattini
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - M Bernini
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - C Saieva
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - I Desideri
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - V Scotti
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - V Salvestrini
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - L Visani
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - M Mariotti
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - C Delli Paoli
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - E Olmetto
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - V Maragna
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - L Orzalesi
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - L Sanchez
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - J Nori
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - S Bianchi
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - L Livi
- Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
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Meattini I, Scotti V, Desideri I, Saieva C, Visani L, Salvestrini V, Cecchini S, De Feo ML, Mariotti M, Olmetto E, Delli Paoli C, Francolini G, Bernini M, Orzalesi L, Sanchez L, Nori J, Bianchi S, Livi L. Abstract P4-16-04: Oral ibandronate for osteopenic breast cancer patients receiving adjuvant aromatase inhibitors: secondary 5-year survival outcomes analysis of the single-center phase 2 BONADIUV trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-16-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. Several randomized trials demonstrated aromatase inhibitors (AI) superiority in terms of disease-free survival (DFS) compared to tamoxifen treatment for postmenopausal hormone receptor-positive breast cancer (BC) patients. Anyway, AI toxicity profile is a concern due to estrogen suppression. Pivotal trials demonstrated a significant bone mineral density (BMD) loss due to AI, with a consistent 5-year risk of bone fractures, thus impacting on patients' quality of life. Bisphosphonates represent an effective treatment in postmenopausal osteoporosis fractures prevention. However, an adequate patient's selection for adjuvant bisphosphonates treatment during AI endocrine therapy is still a challenge. Final results of BONADIUV trial presented at San Antonio Breast cancer Symposium in 2016 showed that treatment with ibandronate, as compared to placebo, significantly improved BMD change in osteopenic women treated with adjuvant AI, and consistently protected patients' bone loss. We present the secondary 5-year analysis on survival outcomes of the trial.
Patients and methods. The BONADIUV trial is a single-blind, randomized, placebo-controlled phase 2 study designed to evaluate the impact of ibandronate treatment on BMD in osteopenic women taking AI. Between January 2011 and May 2014, 171 osteopenic patients (lumbar spine [LS] and/or trochanter -1< T-score <-2.5), were randomized in a 1:1 ratio to receive either placebo or oral monthly ibandronate (150 mg). Treatment duration was 2 years, with 6-months evaluation. Primary endpoint was the mean BMD difference between the two arms at a 2-year follow up. Secondary analysis on survival outcomes (overall survival [OS] and invasive DFS [iDFS]) have been performed at 5-year median follow-up time. ClinicalTrials.gov identifier: NCT02616744.
Results. At the database cutoff time for the present analysis on May 4, 2018, median follow up was 63.3 months (mean 61.2; range 2.7-87.3) for whole series, 64.9 months (range 33.8-84.0) for the placebo arm, and 62.2 months (range 24.2-87.3) for the ibandronate arm. Ten patients in the placebo group and 17 patients in the ibandronate group withdrew the allocated arm before any follow up data collection, and so were excluded from the analysis, performed on 144 patients (72 patients per arm). At the database cutoff time, the OS rate was 97.2% in the placebo group and 100% in the ibandronate arm. We observed four loco-regional relapse (three in the placebo arm, one in the ibandronate arm; p=0.33), three distant metastases (none in the placebo arm, three in the ibandronate arm; p=0.075), and three contralateral BC (one in the placebo arm, two in the ibandronate arm; p=0.65). The number of iDFS events did not differ between groups: four in the placebo group and six in the ibandronate group (p=0.56). Up to data cutoff, two deaths have occurred; none in the placebo arm and two in the ibandronate arm (p=0.15). The OS rate did not differ between arms.
Conclusions. The secondary analysis of survival outcomes showed no difference between arms in terms of OS and iDFS rates. Further large investigations and mature follow-up from the published ones are awaited.
Citation Format: Meattini I, Scotti V, Desideri I, Saieva C, Visani L, Salvestrini V, Cecchini S, De Feo ML, Mariotti M, Olmetto E, Delli Paoli C, Francolini G, Bernini M, Orzalesi L, Sanchez L, Nori J, Bianchi S, Livi L. Oral ibandronate for osteopenic breast cancer patients receiving adjuvant aromatase inhibitors: secondary 5-year survival outcomes analysis of the single-center phase 2 BONADIUV trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-16-04.
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Affiliation(s)
- I Meattini
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - V Scotti
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - I Desideri
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - C Saieva
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - L Visani
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - V Salvestrini
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - S Cecchini
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - ML De Feo
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - M Mariotti
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - E Olmetto
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - C Delli Paoli
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - G Francolini
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - M Bernini
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - L Orzalesi
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - L Sanchez
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - J Nori
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - S Bianchi
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
| | - L Livi
- AOU Careggi Hospital - University of Florence, Florence, Italy; Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia, Ospedale S. Giuseppe, Empoli, Florence, Italy
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Affiliation(s)
- N. Di Paolo
- Dipartimenti di Nefrologia e Dialisi USL 30 Siena e Perugia
| | - G. Pula
- Istituto di Chirurgia Toracica e Cardiovascolare Università di Siena, Italy
| | | | - P.P. Giomarelli
- Istituto di Chirurgia Toracica e Cardiovascolare Università di Siena, Italy
| | - M. Demia
- Dipartimenti di Nefrologia e Dialisi USL 30 Siena e Perugia
| | - B. Biagioli
- Istituto di Chirurgia Toracica e Cardiovascolare Università di Siena, Italy
| | - E. Zei
- Dipartimenti di Nefrologia e Dialisi USL 30 Siena e Perugia
| | - M. Bernini
- Dipartimenti di Nefrologia e Dialisi USL 30 Siena e Perugia
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Meattini I, Bernini M, Casella D, Maragna V, Sordi S, Desideri I, Gaggelli I, Dominici L, Fausto A, Delli Paoli C, Olmetto E, Francolini G, Loi M, Scotti V, Greto D, Bonomo P, Simontacchi G, Nori J, Bianchi S, Livi L. EP-1299: Postmastectomy radiation therapy after subcutaneous direct-to-implant breast reconstruction. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31609-8] [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: 10/14/2022]
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Lastraioli E, Iorio J, Meattini I, Bernini M, Dominici L, Maragna V, Vezzosi V, Casella D, Nori J, Orzalesi L, Bianchi S, Livi L, Arcangeli A. hERG1 channel expression in breast cancer: Association with molecular parameters, pathological features and survival. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30645-2] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Meattini I, Pezzulla D, Carta GA, Becherini C, Perna M, Grassi R, Garlatti P, Desideri I, Scotti V, Bernini M, Sanchez LJ, Orzalesi L, Nori J, Bianchi S, Livi L. Abstract P6-09-07: Triple negative apocrine carcinomas as a distinct subtype of triple negative breast cancer: A case-control study. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-09-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction. Invasive apocrine carcinoma of the breast is a rare type of breast cancer (BC), pure apocrine carcinoma constitutes <1% of all BC. Mammary apocrine epithelium has a characteristic steroid receptor profile that is negative for full length estrogen receptor-alpha and progesterone receptor and is androgen receptor positive. Conflicting data are available on the outcome of this type of disease: few studies reported significantly different prognosis of triple negative (TN) apocrine carcinomas when compared to most non-apocrine triple negative (NA-TN) tumors. The aim of this study is to report our long-term experience in a single-center series of TN apocrine tumors.
Methods. We analyzed clinical and pathological features of a series of TN apocrine carcinomas treated at our Centre in a 15-year period. Clinical and pathological characteristics and outcomes have been compared with a control series of NA-TN tumors treated during the same follow up period. Local relapse-free survival (LRFS), distant metastases-free survival (DMFS), and overall survival (OS) have been evaluated and compared between groups of patients.
Results. Forty-five TN apocrine carcinomas were analyzed. The mean age at diagnosis was 60 years (range 34-83 years). The proportions of apocrine tumor grades varied, with G1 being seen in 6.8% of patients, G2 in 51.1%, and G3 in 40.1%. The majority of apocrine carcinomas had small tumor size (T1: 72.7%; T2: 27.3%), and negative axillary nodal status (66.7%). The series was compared to a homogenous control group of 45 NA-TN patients. The mean age was 54 years (range 32-79 years), affected by high grade (G3: 53.7%), small tumor size (T1: 87.5%; T2: 12.5%), and mostly negative axillary nodal status (82.9%). LRFS in the apocrine group was 85% and 78% at 5- and 10-year, respectively. LRFS in the NA-TN group was 90% and 79% at 5- and 10-year, respectively. No difference was evidenced between groups (HR 1.44 95%CI 0.62-3.79; p=0.39). DMFS in the apocrine group was 85% and 85% at 5- and 10-years, respectively. DMFS in the NA-TN group was 85% and 75% at 5- and 10-year, respectively. DMFS was significantly better in the apocrine group (HR 0.69 95%CI 0.28-1.62). OS in the apocrine group was 86% and 83% at 5- and 10-year, respectively. OS in the NA-TN group was 86% and 63% at 5- and 10-years, respectively. OS was significantly better in the apocrine group (HR 0.57 95%CI 0.26-1.18).
Conclusions. Apocrine carcinomas represent a clinic-pathological distinct group of triple-negative BC, characterized by significantly more favorable clinical prognosis in terms of long-term disease-related morbidity or mortality when compared to NA-TN tumors.
Citation Format: Meattini I, Pezzulla D, Carta GA, Becherini C, Perna M, Grassi R, Garlatti P, Desideri I, Scotti V, Bernini M, Sanchez LJ, Orzalesi L, Nori J, Bianchi S, Livi L. Triple negative apocrine carcinomas as a distinct subtype of triple negative breast cancer: A case-control study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-09-07.
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Affiliation(s)
- I Meattini
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - D Pezzulla
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - GA Carta
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - C Becherini
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - M Perna
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - R Grassi
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - P Garlatti
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - I Desideri
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - V Scotti
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - M Bernini
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - LJ Sanchez
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - L Orzalesi
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - J Nori
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - S Bianchi
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - L Livi
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
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Meattini I, Saieva C, Desideri I, Miccinesi G, Francolini G, Meacci F, Muntoni C, Scotti V, De Luca Cardillo C, Marrazzo L, Simontacchi G, Pallotta S, Sanchez L, Casella D, Bernini M, Orzalesi L, Nori J, Bianchi S, Livi L. Abstract P1-10-04: Accelerated partial breast irradiation versus whole breast irradiation: Health-related quality of life analysis from a phase 3 trial. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-10-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. Accelerated partial breast irradiation (APBI) represents a valid option for selected early breast cancer (BC); potential advantages of APBI include shorter treatment time, improved safety profile, and a cost reduction compared with standard fractionation.
We reported the final analysis of quality of life (QOL) results from a phase 3 randomized trial comparing standard adjuvant radiotherapy (50 Gy in 25 fractions, plus 10 Gy boost) to APBI using IMRT technique (30 Gy in 5 daily fractions). The 5-year results have been recently published showing equivalence in terms of local control (ClinicalTrials.gov, NCT02104895).
Methods. Overall 205 patients (105 APBI and 100 WBI) fully completed the given questionnaires at time 0 (RT start), time 1 (RT end), and time 2 (2-year follow up). Patients were asked to compile two specific questionnaires on QOL, the EORTC QLQ-C30 as a reliable and valid measure of the QOL of cancer patients in multicultural clinical research settings, and the BR23 module as a supplementary questionnaire for assessing QOL issues relevant to patients with BC. The statistical software SPSS (SPSS Inc, Chicago, IL, USA) for Windows (version 22), and STATA (StataCorp LP, College Station TX77845, USA) for Windows (version 12) were used. Chi-squared test or Mann Whitney U test were used to compare the individual characteristics of the patients between two arms. Mean and standard deviations (SD) were calculated for all QOL domains, and all scores were compared between APBI and WBI arms using the Mann Whitney test due to non-parametric distribution of data. The Kruskal-Wallis test was used to compare the scores between age groups.
Results. Mean values (and SD) of QLQ-C30 scores according to arm in the series of 205 BC patients at time 2 (time 0 vs time 2), showed significant improvement in favor of APBI in terms of global health status (mean 75.5 vs 59.5, SD range 13.3-22.0; p<0.0001), main functional (p<0.01), and symptom scales (p<0.01). Concerning the BR23 module, APBI showed significantly better outcome in terms of body image perception (mean 89 vs 72.1, SD 13.2-26.6; p<0.0001) and future perspective (84.8 vs 57, SD 23.1-28.5; p<0.0001) among functional scales; breast (6.1 vs 18.9, SD 6.6-18.2; p<0.0001) and arm symptoms (11.7 vs 19.6, SD 13.4-19; p=0.002) among symptom scales.
Conclusions. Women treated with APBI reported a significantly better QOL outcome as compared with women treated using WBI. QOL improvement was evidenced in terms of functional, symptoms, and global health status/QOL scales, both at the end of radiation and at a 2-year follow-up time.
Citation Format: Meattini I, Saieva C, Desideri I, Miccinesi G, Francolini G, Meacci F, Muntoni C, Scotti V, De Luca Cardillo C, Marrazzo L, Simontacchi G, Pallotta S, Sanchez L, Casella D, Bernini M, Orzalesi L, Nori J, Bianchi S, Livi L. Accelerated partial breast irradiation versus whole breast irradiation: Health-related quality of life analysis from a phase 3 trial [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-10-04.
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Affiliation(s)
- I Meattini
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - C Saieva
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - I Desideri
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - G Miccinesi
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - G Francolini
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - F Meacci
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - C Muntoni
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - V Scotti
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - C De Luca Cardillo
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - L Marrazzo
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - G Simontacchi
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - S Pallotta
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - L Sanchez
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - D Casella
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - M Bernini
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - L Orzalesi
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - J Nori
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - S Bianchi
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - L Livi
- University of Florence - Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy
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Livi L, Saieva C, Desideri I, Scotti V, De Luca Cardillo C, Carta G, Cecchini S, Orzalesi L, Sanchez LJ, Casella D, Bernini M, Nori J, Bianchi S, De Feo ML, Meattini I. Abstract P2-09-12: A single-blind, randomized, placebo-controlled phase II study to evaluate the impact of oral ibandronate on bone mineral density in osteopenic breast cancer patients receiving adjuvant aromatase inhibitors: Final results of the single-center BONADIUV trial. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-09-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. Several randomized trials demonstrated aromatase inhibitors (AI) superiority in terms of disease-free survival compared to tamoxifen treatment for postmenopausal hormone receptor-positive breast cancer (BC) patients. Anyway AI toxicity profile due to estrogen suppression is a concern. Pivotal trials demonstrated a significant bone mineral density (BMD) loss due to AI, with a consistent risk of fractures, thus impacting on patients' quality of life.
Bisphosphonates represent an effective treatment in postmenopausal osteoporosis fractures prevention. Several studies demonstrated that upfront bisphosphonates therapy prevents bone loss in postmenopausal women receiving adjuvant AI for early-stage BC. However an adequate patients selection for adjuvant bisphosphonates treatment during AI endocrine therapy is still a challenge.
We present the final results of the BONADIUV trial, a single-blind, randomized, placebo-controlled phase 2 study designed to evaluate the impact of ibandronate treatment on BMD in osteopenic women taking AI.
Methods. Between January 2011 and May 2014, 561 patients underwent a baseline BMD assessment before starting AI as planned adjuvant treatment. Overall 171 osteopenic patients (lumbar spine [LS] and/or trochanter -1< T-score <-2.5), were randomized in a 1:1 ratio to receive either placebo or oral monthly ibandronate (150 mg). All patients receive oral supplementation of calcium and vitamin D3. Study duration was 2 years. Exclusion criteria were: premenopausal status at time of randomization; comorbidities with increased risk of osteoporosis; body mass index <18; chronic use of steroids; previous use of bisphosphonates; psychiatric disorders. Primary endpoint was the mean BMD difference between the two arms at a 2-year follow up. ClinicalTrials.gov identifier: NCT02616744. A total of 72 patients per arm of treatment were needed to obtain an 85% statistical power in order to detect a 2% BMD mean difference between the two arms. Considering a 10% dropout, at least 158 patients were required.
Results. A total of 171 patients were randomized in the study. Overall 27 patients (15.8%) withdrew the protocol (17 ibandronate vs 10 placebo arm): the final analysis was performed on 144 patients (72 patients per arm). P-value from Wilcoxon test showed no significant difference between arms at baseline both for LS (p=0.94) and trochanter (p=0.83).
At 2-year, osteopenic patients treated with ibandronate gained +18.7% and +15.5% at the LS and trochanter BMD, respectively. Patients treated with placebo lost -13.3% at the LS, and gained +2.9% at the trochanter.
Trochanter p-value from covariance analysis showed a mean BMD change significantly in favor of ibandronate arm at 1-year (p=0.012), and borderline at 2-year (p=0.087). Concerning LS, the mean BMD change was significantly in favor of ibandronate arm both at 1-year (p=0.002) and 2-year (p<0.0001).
Conclusions. Final results of our study showed that treatment with ibandronate, as compared to placebo, improved BMD change in osteopenic women treated with adjuvant AI, and consistently protected patients' bone loss.
Citation Format: Livi L, Saieva C, Desideri I, Scotti V, De Luca Cardillo C, Carta G, Cecchini S, Orzalesi L, Sanchez LJ, Casella D, Bernini M, Nori J, Bianchi S, De Feo ML, Meattini I. A single-blind, randomized, placebo-controlled phase II study to evaluate the impact of oral ibandronate on bone mineral density in osteopenic breast cancer patients receiving adjuvant aromatase inhibitors: Final results of the single-center BONADIUV trial [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-09-12.
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Affiliation(s)
- L Livi
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia - Ospedale S. Giuseppe, Empoli, Italy
| | - C Saieva
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia - Ospedale S. Giuseppe, Empoli, Italy
| | - I Desideri
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia - Ospedale S. Giuseppe, Empoli, Italy
| | - V Scotti
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia - Ospedale S. Giuseppe, Empoli, Italy
| | - C De Luca Cardillo
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia - Ospedale S. Giuseppe, Empoli, Italy
| | - G Carta
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia - Ospedale S. Giuseppe, Empoli, Italy
| | - S Cecchini
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia - Ospedale S. Giuseppe, Empoli, Italy
| | - L Orzalesi
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia - Ospedale S. Giuseppe, Empoli, Italy
| | - LJ Sanchez
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia - Ospedale S. Giuseppe, Empoli, Italy
| | - D Casella
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia - Ospedale S. Giuseppe, Empoli, Italy
| | - M Bernini
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia - Ospedale S. Giuseppe, Empoli, Italy
| | - J Nori
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia - Ospedale S. Giuseppe, Empoli, Italy
| | - S Bianchi
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia - Ospedale S. Giuseppe, Empoli, Italy
| | - ML De Feo
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia - Ospedale S. Giuseppe, Empoli, Italy
| | - I Meattini
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy; Cancer Risk Factor Branch, Cancer Research and Prevention Institute (ISPO), Florence, Italy; Onco-Hematology Unit - Policlinico San Marco-IOB, Zingonia, Bergamo, Italy; UOSD Diabetologia Endocrinologia - Ospedale S. Giuseppe, Empoli, Italy
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Meattini I, Saieva C, Miccinesi G, Desideri I, Marrazzo L, Loi M, Meacci F, Muntoni C, Greto D, Topulli J, Nori J, Bernini M, Sanchez L, Orzalesi L, Mangoni M, Pallotta S, Bianchi S, Livi L. Health-related quality of life analysis from the accelerated partial breast irradiation IMRT-Florence phase 3 trial: Impact of age and scores trend over time. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30106-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Meattini I, Bicchierai G, Saieva C, De Benedetto D, Desideri I, Becherini C, Abdulcadir D, Vanzi E, Boeri C, Gabbrielli S, Lucci F, Sanchez L, Casella D, Bernini M, Orzalesi L, Vezzosi V, Greto D, Mangoni M, Bianchi S, Livi L, Nori J. Impact of molecular subtypes classification concordance between preoperative core needle biopsy and surgical specimen on early breast cancer management: Single-institution experience and review of published literature. Eur J Surg Oncol 2016; 43:642-648. [PMID: 27889196 DOI: 10.1016/j.ejso.2016.10.025] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [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: 04/24/2016] [Revised: 10/01/2016] [Accepted: 10/31/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Core needle biopsy (CNB) plays a crucial role as diagnostic tool for breast cancer (BC). The characterization of biomarkers status before surgical treatment is crucial when primary systemic therapy is a therapeutic option. The aim of this analysis was to report concordance between preoperative CNB and surgical specimen (SS) in evaluating biomarkers and molecular subtypes. METHODS Data have been collected from a cohort of 101 patients affected by early BC treated at Careggi Florence University Hospital, between January 2014 and March 2015. The conformity between molecular subtype classification was tested using kappa (κ) test. RESULTS Mean age was 57.5 years (range 29-86). There was concordance between the estrogen receptor (ER) assessment on CNB and SS in 95 cases (94.1%). Concordance of the progesterone receptor (PgR) assessment was observed in 89 cases (88.1%). Concordance for detecting immunohistochemistry-assessed BC molecular subtypes was 87.1% (κ = 0.78). Concerning Ki-67 evaluation, we report a concordance rate of 88.1% (κ = 0.68). The evaluation of luminal A plus luminal B/HER negative subgroup showed a κ-value of 0.65. CONCLUSIONS CNB showed good accuracy in evaluating hormonal receptors status, HER2, and BC molecular subtypes. Evaluation of Ki67 status was less accurate than other biomarkers; therefore, we recommend that it should be detected both on CNB and SS samples, especially in hormonal positive HER2 negative tumors, in order to avoid a misclassification of tumor subtypes that could lead to an omission of potential effective systemic therapy.
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Affiliation(s)
- I Meattini
- Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi Firenze, University of Florence, Florence, Italy.
| | - G Bicchierai
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - C Saieva
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - D De Benedetto
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - I Desideri
- Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi Firenze, University of Florence, Florence, Italy
| | - C Becherini
- Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi Firenze, University of Florence, Florence, Italy
| | - D Abdulcadir
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - E Vanzi
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - C Boeri
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - S Gabbrielli
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - F Lucci
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - L Sanchez
- Breast Surgery Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy
| | - D Casella
- Breast Surgery Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy
| | - M Bernini
- Breast Surgery Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy
| | - L Orzalesi
- Breast Surgery Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy
| | - V Vezzosi
- Division of Pathological Anatomy, University of Florence, Florence, Italy
| | - D Greto
- Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi Firenze, University of Florence, Florence, Italy
| | - M Mangoni
- Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi Firenze, University of Florence, Florence, Italy
| | - S Bianchi
- Division of Pathological Anatomy, University of Florence, Florence, Italy
| | - L Livi
- Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi Firenze, University of Florence, Florence, Italy
| | - J Nori
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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Meattini I, Saieva C, Desideri I, Simontacchi G, Marrazzo L, Scoccianti S, De Luca Cardillo C, Scotti V, Bonomo P, Mangoni M, Rossi F, Nori J, Casella D, Bernini M, Sanchez L, Orzalesi L, Pallotta S, Bianchi S, Livi L. PV-0512: Accelerated partial breast irradiation for Luminal-A breast cancer: analysis from a phase 3 trial. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31762-5] [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: 10/21/2022]
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21
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Di Paolo N, Pula G, Capotondo L, Bernini M, Gaggiotti E, Rossi P. Nutritional requirements and energy expenditure by indirect calorimetry in uremic patients during conservative management. Contrib Nephrol 2015; 65:60-71. [PMID: 3168463 DOI: 10.1159/000415749] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- N Di Paolo
- Nephrology and Dialysis Department, Regional Hospital of Siena, Italy
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Lastraioli E, Boni L, Romoli MR, Crescioli S, Taddei A, Beghelli S, Tomezzoli A, Vindigni C, Saragoni L, Messerini L, Bernini M, Bencini L, Giommoni E, Freschi G, Di Costanzo F, Scarpa A, Morgagni P, Farsi M, Roviello F, De Manzoni G, Bechi P, Arcangeli A. VEGF-A clinical significance in gastric cancers: immunohistochemical analysis of a wide Italian cohort. Eur J Surg Oncol 2014; 40:1291-8. [PMID: 24784776 DOI: 10.1016/j.ejso.2014.03.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 03/29/2014] [Accepted: 03/31/2014] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The clinical significance of VEGF-A expression in gastric cancer (GC) has been reported with contradicting results. We analyzed the expression and clinical significance of VEGF-A in a wide Italian cohort of GC specimens. METHODS VEGF-A expression was tested by immunohistochemistry in 507 patients with GC of all clinical stages. The impact of VEGF-A on overall survival (OS) was evaluated in conjunction with clinical and pathological parameters. RESULTS In the Italian cohort we studied VEGF-A was not an independent prognostic factor neither at the univariate nor at multivariate analysis. CONCLUSIONS Although frequently expressed, in our study VEGF-A was not able to discriminate between groups of patients with different risk.
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Affiliation(s)
- E Lastraioli
- Department of Clinical and Experimental Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy
| | - L Boni
- Clinical Trials Coordinating Center, Azienda Ospedaliero-Universitaria Careggi/Istituto Toscano Tumori, Largo GA Brambilla 3, 50134 Florence, Italy
| | - M R Romoli
- Department of Clinical and Experimental Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy
| | - S Crescioli
- Department of Clinical and Experimental Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy
| | - A Taddei
- Surgery and Translational Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy
| | - S Beghelli
- Department of Pathology and Diagnostics, University of Verona, Piazzale LA Scuro 10, 37134 Verona, Italy
| | - A Tomezzoli
- Pathology Division, Borgo Trento Hospital, Piazzale A Stefani 1, 37134 Verona, Italy
| | - C Vindigni
- Pathology Division, Azienda Ospedaliero-Universitaria Senese, Viale M Bracci 16, 53100 Siena, Italy
| | - L Saragoni
- Pathology Division, Morgagni-Pierantoni Hospital, Via C Forlanini 34, 47121 Forlì, Italy
| | - L Messerini
- Department of Clinical and Experimental Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy
| | - M Bernini
- General Surgery and Surgical Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo GA Brambilla 3, 50134 Florence, Florence, Italy
| | - L Bencini
- General Surgery and Surgical Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo GA Brambilla 3, 50134 Florence, Florence, Italy
| | - E Giommoni
- Medical Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo GA Brambilla 3, 50134 Florence, Florence, Italy
| | - G Freschi
- Surgery and Translational Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy
| | - F Di Costanzo
- Medical Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo GA Brambilla 3, 50134 Florence, Florence, Italy
| | - A Scarpa
- Department of Pathology and Diagnostics, University of Verona, Piazzale LA Scuro 10, 37134 Verona, Italy
| | - P Morgagni
- General Surgery, Morgagni-Pierantoni Hospital, Via C Forlanini 34, 47121 Forlì, Italy
| | - M Farsi
- General Surgery and Surgical Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo GA Brambilla 3, 50134 Florence, Florence, Italy
| | - F Roviello
- Department of General Surgery and Oncology, University of Siena, Viale M Bracci 16, 53100 Siena, Italy
| | - G De Manzoni
- Division of Surgery, University of Verona, Piazzale LA Scuro 10, 37134 Verona, Italy
| | - P Bechi
- Surgery and Translational Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy
| | - A Arcangeli
- Department of Clinical and Experimental Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy.
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Bernini G, Carrara D, Bacca A, Carli V, Virdis A, Rugani I, Duranti E, Ghiadoni L, Bernini M, Taddei S. Effect of acute and chronic vitamin D administration on systemic renin angiotensin system in essential hypertensives and controls. J Endocrinol Invest 2013; 36:216-20. [PMID: 23645099 DOI: 10.1007/bf03347275] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIM To investigate the systemic renin-angiotensin system (RAS) in essential hypertensives (EH) and controls (C) after short- and long-term vitamin D receptor activation. DESIGN Ten consecutive EH (under controlled low-salt diet) and 10 C underwent calcitriol administration (0.25 μg bid) for 1 week (Group A). Eighteen consecutive EH under angiotensin II receptor antagonist therapy received a single oral dose of 300,000 IU of cholecalciferol and were followed up for 8 weeks (Group B). METHODS In basal conditions and at the end of the study (1 week in Group A and 8 weeks in Group B), plasma renin activity (PRA), plasma active renin, aldosterone, and angiotensin II were evaluated, as well as blood pressure, plasma 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)2D], and PTH. RESULTS In Group A, plasma 25(OH)D levels in EH and C were below the normal range, although lower levels were found in the former. No association between basal plasma 25(OH)D or 1,25(OH)2D levels and blood pressure values or RAS components was observed either in the whole group or in the two subgroups. Calcitriol administration did not affect any RAS parameter either in EH or in C. In Group B, cholecalciferol significantly increased 25(OH)D and 1,25(OH)2D levels without interfering with the angiotensin II receptor antagonist-induced increase in RAS components. No correlation was found between plasma 25(OH)D or 1,25(OH)2D levels and blood pressure values or RAS parameters before and after cholecalciferol administration. CONCLUSIONS The present data suggest that, in our experimental conditions, vitamin D receptor activation is unable to influence systemic RAS activity.
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Affiliation(s)
- G Bernini
- Department of Internal Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy.
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Bernini G, Bacca A, Carli V, Carrara D, Materazzi G, Berti P, Miccoli P, Pisano R, Tantardini V, Bernini M, Taddei S. Cardiovascular changes in patients with primary aldosteronism after surgical or medical treatment. J Endocrinol Invest 2012; 35:274-80. [PMID: 21422805 DOI: 10.3275/7611] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 01/13/2023]
Abstract
BACKGROUND Data on the cardiovascular middle-term follow-up of patients with primary aldosteronism (PA) are scanty. AIM To detect the cardiovascular effects of surgery in patients with aldosterone (ALD)-producing adenoma (APA) and of pharmacotherapy in those with bilateral adrenal hyperplasia (BAH), a prospective study involving 60 consecutive patients with PA was performed. MATERIAL/ METHODS: Clinical, biochemical, and cardiovascular assessment was obtained before and after (31.5±4.4 months) surgery or proper medical treatment (32.1±5.0 months) in 19 and 41 patients, respectively. RESULTS As expected, plasma ALD normalized in all operated patients, while in the other group it did not change. Systolic and diastolic blood pressure decreased (p<0.001) after both treatments. However, absolute and percentage reduction was significantly more pronounced (p<0.01) in operated than in non-operated patients. Left ventricular (LV) mass showed significant reduction after surgery (LV mass g/m(2), p<0.0007; LV mass g/m(2.7), p<0.01), but no change after medical treatment, so that the differences between absolute and percentage values at follow- up were statistically significant (p<0.01) between groups. Basal LV mass/m(2.7) was positively associated with age (p<0.009), body mass index (p<0.0008), drug number (p<0.03), and ALD/plasma renin activity ratio (p<0.01). Allocating the patients according to plasma ALD and cardiac parameters, patients who presented ALD reduction during the study also had a decrement in cardiac mass (p<0.04). CONCLUSIONS Our data indicate that in patients with PA the removal of ALD excess by surgery in APA is effective in reducing blood pressure and in improving cardiac parameters, while anti-hypertensive therapy in BAH shows less positive impact on cardiovascular system.
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Affiliation(s)
- G Bernini
- Department of Internal Medicine, University of Pisa, Pisa, Italy.
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25
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Bernini M, Bacca A, Casto G, Carli V, Cupisti A, Carrara D, Farnesi I, Barsotti G, Naccarato AG, Bernini G. A case of pheochromocytoma presenting as secondary hyperaldosteronism, hyperparathyroidism, diabetes and proteinuric renal disease. Nephrol Dial Transplant 2011; 26:1104-7. [DOI: 10.1093/ndt/gfq747] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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26
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Carmellini M, Collini A, Ruggieri G, Bernini M. Conversion of Stable Kidney Transplant Recipients From a Twice-Daily to Once-Daily Everolimus Regimen. Transplant Proc 2010; 42:1312-3. [DOI: 10.1016/j.transproceed.2010.03.098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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27
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Galetta F, Bernini G, Franzoni F, Bacca A, Fivizzani I, Tocchini L, Bernini M, Fallahi P, Antonelli A, Santoro G. Cardiac remodeling in patients with primary aldosteronism. J Endocrinol Invest 2009; 32:739-45. [PMID: 19564719 DOI: 10.1007/bf03346529] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To evaluate the morpho-functional changes of the myocardium in patients with primary aldosteronism (PA). DESIGN An observational study in a university referral center for blood pressure diseases. PATIENTS Twenty- three patients with PA, 24 patients with essential hypertension (EH), and 15 normotensive controls (C) underwent conventional echocardiography with integrated backscatter (IBS) and tissue Doppler imaging (TDI) analysis. The corrected IBS (C-IBS) values and the systo-diastolic variation of IBS (CV-IBS) were performed at both interventricular septum and the posterior wall levels. TDI myocardial systolic (Sm), early diastolic (Em), and late diastolic (Am) velocities of both left ventricular walls were also determined. RESULTS In PA patients, septal and posterior wall CV-IBS were significantly lower than C (p<0.0001) and EH patients (p<0.001). In EH, CV-IBS was significantly lower than C (p<0.001). Patients with PA exhibited lower Sm, lower Em, and higher Am, and a subsequently reduced Em/Am ratio than C (p<0.001 for all) and EH (p<0.01 for all) at interventricular septum and lateral wall levels. In the latter, Sm, Em, and Em/Am ratio were lower and Am was higher than C (p<0.001 for all). In PA and EH patients, CV-IBS at both septum (r=-0.66, p<0.001) and posterior wall levels (r=-0.67, p<0.001) and Sm peak of both septum (r=-0.52, p<0.001) and lateral wall (r=-0.55, p<0.001) were inversely related to plasma aldosterone. CONCLUSIONS Patients with PA showed myocardial wall remodeling characterized by increased myocardial fibrosis and early left ventricular systodiastolic function abnormalities.
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Affiliation(s)
- F Galetta
- Department of Internal Medicine, University of Pisa, 56100 Pisa, Italy.
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Veraldi GF, Minicozzi AM, Bernini M, Genco B, Tedeschi U. Treatment of abdominal aortic aneurysms associated with pancreatic tumors: personal experience and review of the literature (1967-2006). INT ANGIOL 2008; 27:539-542. [PMID: 19078919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The aim of the present study was to discuss the approach to a rare, but challenging, clinical situation: the coexistence of an abdominal aortic aneurysm (AAA) and a pancreatic tumor. The authors present their experience and a review of the literature of the last 40 years. From January 1988 to December 2006 the authors faced 3 cases of associated AAA and pancreatic neoplasia. Through a Medline search the authors found 15 cases of this comorbidity reported in the literature from 1967 to 2006, obtaining a total number of 18 cases. The treatment of the two diseases was in a single stage in 4 cases (22%) and in two stages in 5 cases (28%), while only one pathology was treated in 7 cases (39%) and no treatment at all was attempted in 2 cases (11%). Mortality was 0%, while morbidity was 22%, i.e. in 4 cases out of 18, although no aortic prosthesis infection was recorded. From literature analysis and their experience the authors concluded that the surgical strategy in cases of AAA and a pancreatic tumor is to be chosen depending on the pancreatic tumor prognosis, the AAA dimensions and the schedule of chemotherapy. According to the authors, AAA surgical repair is recommended in case of pancreatic cystic adenoma and neuroendocrine neoplasia, in view of their good prognosis, while endovascular repair (EVAR), when feasible, is better in patients with pancreatic adenocarcinoma.
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Affiliation(s)
- G F Veraldi
- 1st Clinical Division of General Surgery, University of Verona, Verona, Italy.
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29
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Carmellini M, Collini A, Ruggieri G, Garosi G, Bernini M. Excellent Long-Term Results in De Novo Renal Transplant Recipients Treated With Proliferation Signal Inhibitors and Reduced Calcineurin Inhibitors Exposure. Transplant Proc 2008; 40:1858-61. [DOI: 10.1016/j.transproceed.2008.05.047] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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30
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Marcucci F, Passalacqua G, Canonica GW, Frati F, Salvatori S, Di cara G, Petrini I, Bernini M, Novembre E, Bernardini R, Incorvaia C, Sensi LG. Lower airway inflammation before and after house dust mite nasal challenge: an age and allergen exposure-related phenomenon. Respir Med 2007; 101:1600-8. [PMID: 17482451 DOI: 10.1016/j.rmed.2006.06.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2005] [Revised: 06/05/2006] [Accepted: 06/09/2006] [Indexed: 11/20/2022]
Abstract
BACKGROUND Upper and lower airways allergic disease is currently considered unitarily. Allergic inflammation in one site can extend to other sites of the respiratory tract. OBJECTIVE To evaluate bronchial inflammation before and after allergen-specific nasal challenge (ASNC) in rhinitic and asthmatic children, considering the different levels of allergen exposure, i.e. summer (low) and winter (high). METHODS Fourteen children with rhinitis and 15 with rhinitis and asthma, all monosensitized to mites and 10 healthy controls were studied. Nasal IgE were measured before ASNC in summer and in winter season. Nasal clinical score, eosinophil cationic protein (ECP), nasal tryptase, bronchial clinical score, FEV(1), PEF, sputum ECP, sputum tryptase and exhaled nitric oxide (eNO) were evaluated before and after ASNC in summer and winter season. RESULTS Nasal scores significantly increased after ASNC in rhinitic and asthmatic children in both seasons. Nasal IgE were significantly higher in summer compared to winter. Bronchial symptoms, FEV(1) and PEF showed no mean differences in rhinitic and asthmatic children after ASNC, with an increase of bronchial symptoms and a decrease of FEV(1) and PEF occurring in 3/15 asthmatic children. In both groups nasal tryptase and ECP after ASNC significantly increased in summer and winter, while sputum tryptase was undetectable before or after ASNC in both groups. Sputum ECP and eNO at baseline were significantly higher in patients than in controls (summer P=0.002, winter P=0.001). Sputum ECP significantly increased after ASNC in 3/15 asthmatics in summer and in 11/15 in winter, as well as in 3/14 rhinitics in summer and in 4/14 in winter. eNO significantly increased after ASNC in 3/15 asthmatics in summer and in 10/15 in winter, and in 1/14 rhinitics in summer and in 4/14 in winter. A significant median increase of sputum ECP (P=0.0007) and eNO (P=0.0012) after ASNC in asthmatic and of eNO (P=0.013) in rhinitic children was also found in winter. CONCLUSIONS Basal sputum ECP and eNO values, significantly higher before ASNC in rhinitic patients compared to control subjects, confirm the inflammatory link of upper and lower airways. The more frequent detection of inflammatory changes induced by ASNC in winter suggests that allergen exposure favours the transfer of nasal inflammation to lower airways.
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Affiliation(s)
- F Marcucci
- Department of Obstetric, Gynaecologic, Pediatric Sciences, University of Perugia, Policlinico Monteluce, Via Brunamonti, 06122 Perugia, Italy.
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31
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Collini A, De Bartolomeis C, Ruggieri G, Barni R, Bernini M, Carmellini M. Long-term outcome of renal transplantation from marginal donors. Transplant Proc 2007; 38:3398-9. [PMID: 17175283 DOI: 10.1016/j.transproceed.2006.10.055] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [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: 07/26/2006] [Indexed: 10/23/2022]
Abstract
Long-term survival of kidneys from suboptimal donors is known to be not as good as that from optimal ones. However, the shortage of donors has led many transplant centers to consider accepting older donors with comorbidities. We analyzed 238 patients who received deceased donor renal transplants in the period 2000-2005. The recipients were matched to be no more than 15 years older or younger than the corresponding donors. Among them 125 received a single and 18 a double transplantation from donors considered marginal, according to UNOS criteria for expanded criteria donor (ECD). Most kidneys were evaluated with a pretransplant biopsy, using the scoring system introduced by Karpinski in 1999. The analysis indicated clearly better results in the non-ECD group: both patients and graft survival rates were 10% higher at 1, 2, and 3 years. However, the ECD group showed satisfactory outcomes, confirming the utility of this procedure. The long-term survival rates of single or double grafts from marginal donors are satisfactory, confirming the practice of allocating kidneys after a preimplantation histological evaluation, allowing expansion of the donor pool and providing older patients access to the waiting lists.
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Affiliation(s)
- A Collini
- UOC Chirurgia dei Trapianti-Azienda Ospedaliera Universitaria Senese, Siena, Italy.
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Bernini G, Galetta F, Franzoni F, Bardini M, Bernardini M, Taurino C, Bernini M, Salvetti A. Vascular Remodelling in Carotid Arteries of Patients with Primary Aldosteronism by Backscatter Signal and Peripheral Vascular Stiffness Analysis. High Blood Press Cardiovasc Prev 2007. [DOI: 10.2165/00151642-200714030-00091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Collini A, De Bartolomeis C, Barni R, Ruggieri G, Bernini M, Carmellini M. Calcineurin-inhibitor induced pain syndrome after organ transplantation. Kidney Int 2006; 70:1367-70. [PMID: 16955101 DOI: 10.1038/sj.ki.5001833] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- A Collini
- UOC Chirurgia dei Trapianti, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
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De Bartolomeis C, Collini A, Barni R, Ruggieri G, Bernini M, Carmellini M. Cytomegalovirus infection with multiple colonic perforations in a renal transplant recipient. Transplant Proc 2006; 37:2504-6. [PMID: 16182726 DOI: 10.1016/j.transproceed.2005.06.082] [Citation(s) in RCA: 11] [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: 11/20/2022]
Abstract
Cytomegalovirus (CMV) continues to be potentially the most important pathogen affecting organ transplant recipients. Severe gastrointestinal complications have been reported to occur in about 10% of renal transplant recipients, sometimes with dramatic presentations. We report the case of a 57-year-old CMV-seropositive woman with end-stage renal failure who developed CMV-related colonic multiple perforation 30 days after cadaveric CMV-positive renal transplantation. CMV pp65 antigenemia test and CMV-PCR had always been negative on all the weekly controls routinely performed in the postoperative period. Only after the sudden onset of this complication did the antigenemia and PCR become positive. The relationship between infection and perforation has been established beyond any doubt, as the histology of the resected colonic segment revealed florid CMV infection with evidence of typical inclusions in both macrophages and endothelial cells. Colonic perforations are often fatal in transplant recipients because of inability to contain the perforation, and only a rapid diagnosis and an aggressive surgical treatment can improve the prognosis.
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Affiliation(s)
- C De Bartolomeis
- U.O.C. Chirurgia dei Trapianti, Azienda Ospedaliera Universitaria Senese, Siena, Italy
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35
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Marcucci F, Sensi L, Di Cara G, Salvatori S, Bernini M, Pecora S, Burastero SE. Three-year follow-up of clinical and inflammation parameters in children monosensitized to mites undergoing sub-lingual immunotherapy. Pediatr Allergy Immunol 2005; 16:519-26. [PMID: 16176400 DOI: 10.1111/j.1399-3038.2005.00301.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Parallel follow-up of clinical and inflammatory markers during sub-lingual immunotherapy (SLIT) is highly beneficial. Twenty-four children (age 4-16) monosensitized to house dust mite were randomized to receive either active or placebo SLIT for 1 yr in a double-blind placebo controlled design (Marcucci et al., Allergy 2003: 58: 657-62). Thereafter, for 2 yr they all received active treatment. Symptom scores for rhinitis, asthma, and drug usage were daily recorded. Eosinophil cationic protein (ECP) and tryptase in sputum and nasal secretions, serum and nasal mite-specific immunoglobulin E (IgE) were recorded before treatment and at 10-12 months intervals. Nasal ECP and nasal tryptase after specific nasal provocation tests were significantly reduced as compared to baseline values (p = 0.0043 and 0.0195, respectively) in the third year of active treatment. None of the other inflammatory parameters was increased. In placebo treated patients all these parameters tended to decrease only after switching to active treatment. Clinical scores did not improve in treated vs. placebo patients in the double-blind placebo-controlled phase of the study. In both cohorts a clinical benefit was observed as intra-group score reduction as compared to baseline. A significant difference was reached in patients treated for 2 yr for rhinitis and asthma (p = 0.0009 and 0.0019, respectively) but not for drug usage and in patients treated for 3 yr for rhinitis, asthma, and drug usage (p = 0.0105, 0.0048, and 0.02, respectively). SLIT in children monosensitized to mites reverted the spontaneous increase in nasal IgE and in local parameters of allergic inflammation. These outcomes were followed by a consolidated clinical improvement in the second and third year of treatment.
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Affiliation(s)
- F Marcucci
- Clinica Pediatrica, University of Perugia, Italy
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36
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Boggi U, Barsotti M, Collini A, Bernini M, Vistoli F, Paleologo G, Bianchi AM, Tregnaghi C, Nerucci B, Ruggieri G, Carmellini M, Rizzo G, Mosca F. Kidney Transplantation From Donors Aged 65 Years or More as Single or Dual Grafts. Transplant Proc 2005; 37:577-80. [PMID: 15848462 DOI: 10.1016/j.transproceed.2005.01.085] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [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: 01/20/2023]
Abstract
AIM The organ shortage and aging donor population force transplant centers to accept donors previously considered unusable for kidney transplantation. We report the experience of two Italian transplant centers with single (SKTx) and dual (DKTx) kidney transplantation from donors aged 65 years or more. METHODS The study population comprised 75 SKTx (mean donor age 70.5 years) and 28 DKTx (mean donor age 75.0 years). Kidneys from donors with a calculated admission creatinine clearance <50 mL/min, a Karpinski's score on kidney biopsy between 5 and 7, or both were allocated to DKTx. Grafts with better function or lower biopsy scores were employed for SKTx. RESULTS Delayed graft function occurred in 45.3% of SKTx and in 39.3% of DKTx. After a mean follow-up period of 30.0 +/- 19.5 months, the acute rejection rate was 24.0% in SKTx and 7.1% in DKTx. Mean serum creatinine was 1.8 +/- 0.9 and 1.8 +/- 1.3 mg/dL in SKTx, and 1.8 +/- 1.6 mg/dL and 1.3 +/- 0.2 mg/dL in DKTx at 1 and 5 years, respectively. Patient survival was 93.3% and 91.2% in SKTx, and 92.9% and 92.9% in DKTx at 1 and 5 years, respectively. Graft survival was 92.0% and 88.3% in SKTx, and 89.3% and 89.3% in DKTx at the same time intervals. Keeping preservation time below 16 hours and avoiding calcineurin inhibitors were both associated with improved graft survival and function. CONCLUSION Careful donor selection, short preservation time, and tailored immunosuppression allow safe and efficient use of elderly donor kidneys.
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Affiliation(s)
- U Boggi
- Department of Surgery and Transplantation, University of Pisa, Pisa, Italy
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Pedrazzani C, Laterza E, Pasini F, Grandinetti A, Bernini M, Giacopuzzi S, Zerman G, Tasselli S, Ruzzenente A, De Manzoni G. [Long-term results of neoadjuvant radiochemotherapy in squamous carcinoma of the thoracic esophagus]. MINERVA CHIR 2005; 60:11-16. [PMID: 15902048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
AIM Surgery is considered the mainstay of therapy for clinically resectable esophageal cancer, even though neoadjuvant treatments are frequently added. The aim of this study was to analyse our experience on neoadjuvant treatment of squamous cell carcinoma of the thoracic esophagus with special reference to long-term METHODS The results of 66 patients who underwent neoadjuvant chemo-radiotherapy for squamous cell carcinoma of the thoracic esophagus at the 1(st) Division of General Surgery, University of Verona, from February 1995 to December 2002 were analysed statistically. The median follow-up period for the surviving patients was 65.3 months. RESULTS The induction treatment was completed in 93.9% of cases, with a null treatment related mortality and a complication rate of 34.8%. Sixty-one out of the 66 patients (92.4%) underwent resection with a R0-resection rate of 83.9%. A major pathological response (responders) was gained in 42.6% of the cases, with a complete response (pTONO) observed in 29.5% of the cases. Overall 5-year survival for the 66 patients was 30%, while the 5-year survival rate raised to 43% in R0-patients. A better long-term survival was observed for responders with respect to ''non-responders'' with a 5-year survival rate of 70% and 13%, respectively (P<0.001). CONCLUSIONS This neoadjuvant protocol regimen represents a feasible treatment with an acceptable morbidity. The tumor efficacy in term of pathological responses was similar to literature RESULTS An high rate of R0-resections was achieved with a possibility of cure limited to this group of patients. A better long-term survival was observed in patients with major pathological responses.
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Affiliation(s)
- C Pedrazzani
- Prima Divisione Clinicizzata di Chirurgia Generale, Università di Verona, Piazzale Stefani 1, 37126 Verona, Italy
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Pedrazzani C, Pasini F, Giacopuzzi S, Bernini M, Ruzzenente A, Festini M, Tomasi I, Cristadoro L, de Manzoni G. [Surgical treatment of gasto-esophageal junction adenocarcinoma: long-term results of a single Italian centre]. G Chir 2004; 25:325-33. [PMID: 15756954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE The present study analysed the experience of a single Italian institution in the treatment of gastro-esophageal junction (GEJ) adenocarcinoma with the aim of assessing the long-term outcome after surgical resection. METHODS The results of 132 patients who underwent resection with curative intent for GEJ adenocarcinoma at the First Division of General Surgery, University of Verona, from January 1988 to February 2004, were analysed statistically with special reference to Siewert type. The median follow-up period for the surviving patients was 37 months. RESULTS Long-term survival was limited to patients who underwent RO resections (88.6%) with a 5-year survival rate of 28%. Univariate analysis showed Rp, T and pN categories to be significant prognostic factors (P<0.001), with chance of cure limited to patients with less than 6 involved lymph nodes. At multivariate analysis, R category and lymph node involvement were the most important prognostic factors while pT category lost the significance shown at univariate analysis (P=0.082). Siewert classification did not show any prognostic significance (P=0.969), but the mode of recurrence differed for the three Siewert types: in type I tumors, the majority of relapses were haematogenous (67%), while they were prevalently intra-abdominal in type III (65%) with a high rate of peritoneal carcinosis (26%). CONCLUSIONS The long-term prognosis for GEJ cancer remains poor, independently from Siewert type, with cure limited to patients with less than 6 involved lymph nodes.
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Affiliation(s)
- C Pedrazzani
- Prima Università degli Studi di Verona, Prima Divisione Clinicizzata di Chirurgia Generale
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Marcucci F, Passalacqua G, Canonica GW, Frati F, Salvatori S, Di Cara G, Bernini M, Barbato A, Mastrandrea F, Sensi LG. Measurement of nasal IgE in an epidemiological study: assessment of its diagnostic value in respiratory allergy. Eur Ann Allergy Clin Immunol 2004; 36:225-31. [PMID: 15329005] [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: 04/30/2023]
Abstract
BACKGROUND Specific questionnaire and skin prick test (SPT) are the most used methods in epidemiological studies on respiratory allergy. SPT, however, can be positive in many subjects without evidence of any allergic disease. Nasal IgE determination has been suggested by some authors as a valuable diagnostic method, which may overcome this lack of specificity. OBJECTIVE The aim of this study was to evaluate sensitivity and specificity of nasal specific IgE for the seven most common inhalant allergens in order to verify its reliability as a screening test. METHODS 126 children, involved in an epidemiological study on prevalence of respiratory allergic disease, were evaluated. All children were assessed with a specific questionnaire, SPT and nasal specific IgE. Nasal specific IgE were determined with a previously described method modified for screening purposes, in order to test seven allergens at the same time. When discordant results were obtained between questionnaire, SPT and nasal IgE, an allergen specific nasal challenge (ASNC) was performed and nasal tryptase was also determined before and after challenge. RESULTS The questionnaire was positive for respiratory allergy in 28/126 children. SPT was positive in 21 of the 28 children, but also in 5/10 children with atopic dermatitis (AD), and in 12/88 children without allergic symptoms. Nasal IgE were positive in 22/28 and also in 2/10 with AD. Nasal challenge and tryptase confirmed the negativity of nasal IgE in 12/17 children with positive SPT but totally negative for allergic respiratory disease. Moreover nasal IgE was found to be positive to dermatophagoides in one of seven children with negative SPT despite a clinical history suggestive for mite respiratory allergy. In this patient and in 2 of the 5 children with AD the positive nasal IgE to mites was confirmed by a positive ASNC and tryptase. CONCLUSIONS Nasal IgE have shown a specificity significantly higher than SPT (98% vs. 83%) and a good sensibility. This screening test may also be useful to detect the beginning of upper airways sensitization in patients with AD.
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Affiliation(s)
- F Marcucci
- Department of Obstetric, Gynaecologic and Pediatric Sciences, University of Perugia
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Biondi ML, Marasini B, Leviti S, Turri O, Bernini M, Seminati R, Porreca W, Guagnellini E. Genotyping Method for Point Mutation Detection in the Endothelial Nitric Oxide Synthase Exon 7 Using Fluorescent Probes. Clinical Validation in Systemic Sclerosis Patients. Clin Chem Lab Med 2001; 39:281-2. [PMID: 11350027 DOI: 10.1515/cclm.2001.043] [Citation(s) in RCA: 10] [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: 11/15/2022]
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Sacchetti G, Bernini M, Gobbi M, Parini S, Pirona L, Mennini T, Samanin R. Chronic treatment with desipramine facilitates its effect on extracellular noradrenaline in the rat hippocampus: studies on the role of presynaptic alpha2-adrenoceptors. Naunyn Schmiedebergs Arch Pharmacol 2001; 363:66-72. [PMID: 11191838 DOI: 10.1007/s002100000334] [Citation(s) in RCA: 49] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Adaptive phenomena such as desensitization of autoreceptors are considered an important factor in the achievement of therapeutic efficacy of antidepressant drugs after chronic treatment. We have studied whether a chronic treatment with desipramine had a greater effect than a single dose on the extracellular concentrations of noradrenaline in the dorsal hippocampus. Administration of 10 mg/kg i.p. desipramine once daily for 14 days significantly raised the basal extracellular noradrenaline in the dorsal hippocampus 24 h but not 48 h after the last drug injection. A challenge dose of desipramine increased extracellular noradrenaline in rats treated chronically with vehicle and desipramine. The effect was significantly higher in rats treated chronically with desipramine 48 h but not 24 h after the last injection. An intraperitoneal administration of the alpha2-adrenoceptor agonist clonidine at the dose of 10 microg/kg significantly reduced extracellular noradrenaline in the control group but not in animals chronically treated with desipramine whereas 30 microg/kg clonidine produced a similar decrease in both groups. Three concentrations of clonidine (0.05, 0.5 and 1 microM) infused into the hippocampus significantly reduced extracellular noradrenaline to a similar extent in rats chronically treated with saline or desipramine. Fourty-eight hours after the last injection of the chronic treatment, [3H]RX-821002 binding to alpha2-adrenoceptors in the rat locus coeruleus measured by autoradiography was not significantly modified. A slight (17%) but significant decrease of neuronal uptake of [3H]noradrenaline was found in synaptosome preparations from dorsal hippocampus of rats chronically treated with desipramine, but this was likely due to a decrease in affinity. The results suggest that a repeated treatment with desipramine (10 mg/kg i.p. once daily for 14 days) facilitates its effect on extracellular noradrenaline in the dorsal hippocampus and induces adaptive changes probably involving desensitization of alpha2-adrenoceptors, with no changes in their density, on noradrenergic neurons in the locus coeruleus.
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Affiliation(s)
- G Sacchetti
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
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Biondi ML, Turri O, Leviti S, Seminati R, Cecchini F, Bernini M, Ghilardi G, Guagnellini E. MMP1 and MMP3 polymorphisms in promoter regions and cancer. Clin Chem 2000; 46:2023-4. [PMID: 11106348] [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: 02/18/2023]
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Abstract
We describe an eight year old girl with acute relapsing disseminated encephalomyelitis (ADEM) who began to improve concomitantly with plasmapheresis therapy. The patient had previously undergone high-dose intravenous methylprednisolone, intravenous immunoglobulins and Interferon beta-1b treatment which did not control the clinical course of the disease. The long term follow-up suggests that plasmapheresis is effective in this disorder and may give better results than steroids or IVIG.
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Affiliation(s)
- P Balestri
- Institute of Clinical Pediatrics, University of Siena, Via M. Bracci, Le Scotte, 53100, Siena, Italy.
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Abstract
Diagnosis of drug exposure is strongly supported by analysis of hair samples. In the province of Brescia, Italy, for regranting driving license to drug addicts or occasional abusers, a control programme was adopted including analysis of illicit drugs in two hair segments (0-3 and 3-6 cm) and in urine. From January 1998 to April 1999, upon request of the Local Medical Commission, 697 hair samples were tested in our laboratory. One hundred and eighty subjects resulted positive in hair for one or two of the controlled drug classes (73.3% for cocaine, 10% for opiates, 16.7% for both). Positive subjects were classified by residence, age, sex and license category. Seventy-two subjects were called back after 6-12 months and submitted to a second hair and urine analysis: in 34 cases the result of the first analysis was confirmed (19 negatives, 15 positives for one or both drug classes). Another 37 cases tested positive at the first control and negative at the second, suggesting the hypothesis that a strict control may have a significant deterrent function. The high percentage of negative results at the second control may be explained by the prevalence of cocaine users in the examined population. Our results allow us to conclude that the strict application of control rules lead to a decrease of social risk behaviours.
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Affiliation(s)
- M C Ricossa
- Institute of Forensic Medicine, University of Brescia-Az., Italy
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Sacchetti G, Bernini M, Bianchetti A, Parini S, Invernizzi RW, Samanin R. Studies on the acute and chronic effects of reboxetine on extracellular noradrenaline and other monoamines in the rat brain. Br J Pharmacol 1999; 128:1332-8. [PMID: 10578149 PMCID: PMC1571760 DOI: 10.1038/sj.bjp.0702926] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/1999] [Revised: 09/07/1999] [Accepted: 09/09/1999] [Indexed: 11/09/2022] Open
Abstract
1 The effect of reboxetine, a novel antidepressant drug that potently and selectively inhibits neuronal noradrenaline (NA) uptake, on brain extracellular monoamines was studied by microdialysis. 2 Fifteen mg kg-1 i.p. reboxetine raised extracellular NA in the frontal cortex (by 242%) and dorsal hippocampus (by 240%). 3 Idazoxan (1 mg kg-1 s.c.), given 60 min after 15 mg kg-1 reboxetine, markedly potentiated the effect on extracellular NA in the frontal cortex (by 1580%) and dorsal hippocampus (by 1360%), but had no effect by itself. 4 Twenty-four hours after the last injection of a chronic schedule (15 mg kg-1 i.p. once daily for 14 days) reboxetine had no effect on basal extracellular concentrations of NA in the dorsal hippocampus and a challenge dose of reboxetine (15 mg kg-1) raised extracellular NA similarly in rats treated chronically with reboxetine (by 353%) and saline (by 425%). 5 Ten and 20 microg kg-1 i.p. clonidine dose-dependently reduced hippocampal extracellular NA similarly in rats given chronic reboxetine (by 32% and 57%) and saline (by 42% and 56%). 6 Extracellular concentrations of dopamine and 5-HT in the striatum were similar in rats treated chronically with reboxetine and saline. A challenge dose of reboxetine (15 mg kg-1) had no effect on striatal extracellular dopamine and slightly increased striatal extracellular 5-HT to a similar extent in rats treated chronically with reboxetine (by 137%) and saline (by 142%). 7 The results suggest that combining reboxetine with an alpha2-adrenoceptor antagonist may facilitate its antidepressant activity. Repeated treatment confirmed that reboxetine is fairly selective for the noradrenergic system but provided no evidence of adaptive changes in that system that could facilitate its effect on extracellular NA.
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Affiliation(s)
- G Sacchetti
- Istituto di Ricerche Farmacologiche 'Mario Negri', Laboratory of Neuropharmacology, Via Eritrea, 62 - 20157, Milano, Italy
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Daniele C, Romano A, Russo GR, Carluccio G, Bernini M, Reggiani A, Altavilla G. Role of Computed Tomography in Hyperparathiroidism of Urological Interest. Urologia 1986. [DOI: 10.1177/039156038605300401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | | | | | - A. Reggiani
- (Arcispedale S. Anna of Ferrara, Department of Urology - University of ferrara, Department of Pathology)
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Gherlinzoni F, Bacci G, Picci P, Capanna R, Calderoni P, Lorenzi EG, Bernini M, Emiliani E, Barbieri E, Normand A. A randomized trial for the treatment of high-grade soft-tissue sarcomas of the extremities: preliminary observations. J Clin Oncol 1986; 4:552-8. [PMID: 3514804 DOI: 10.1200/jco.1986.4.4.552] [Citation(s) in RCA: 101] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
A new trial for evaluating the effectiveness of adjuvant chemotherapy in high-grade soft-tissue sarcomas of the extremities in adult patients is presented. All patients after local treatment were randomized into two arms, one without further therapy and the other to receive adjuvant chemotherapy (Adriamycin [Farmitalia-Carlo Erba, Milan, Italy], 450 mg/m2). The preliminary results of the study are reported at a median observation period of 27.6 months. Of the 59 patients who entered the study, 79.1% in the chemotherapy group are without sign of disease, whereas the corresponding figure in the nonadjuvant chemotherapy group is 54.3%. The difference between the two groups is statistically significant (P less than .005, log rank test). These preliminary observations encourage continuation of the study.
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Di Paolo N, Sacchi G, De Mia M, Gaggiotti E, Capotondo L, Rossi P, Bernini M, Pucci AM, Ibba L, Sabatelli P. Morphology of the peritoneal membrane during continuous ambulatory peritoneal dialysis. Nephron Clin Pract 1986; 44:204-11. [PMID: 3785484 DOI: 10.1159/000183987] [Citation(s) in RCA: 147] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
In the last 3 years we performed 52 peritoneal biopsies (PB) in 31 patients on continuous ambulatory peritoneal dialysis (CAPD). Samples of the parietal peritoneum were obtained either during insertion of the catheter or while it was being repositioned or removed. PB was performed in 13 patients before initiating CAPD and in 27 after 7-49 months of CAPD while 7 had PB during peritonitis, and, again, in 5 of these cases, PB was repeated after 1-4 months for light, electron transmission, and scanning electron microscopy. BP after CAPD showed that mesothelial cells were irregularly spaced, and at times we observed alterations in the cellular structure. Rarely were these cells degenerating, while rarefaction and in many cases complete absence of microvilli were observed. In some cases the submesothelial layers showed rarefaction of the connective tissue and sclerosis. During peritonitis, PB showed more alterations with marked degeneration and in some cases necrosis of the mesothelium and alterations of connective tissue. PB performed some months after peritonitis showed only a partial regression of these alterations and sclerotic patches, and no microvilli were noted in the mesothelium.
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Di Paolo N, Buoncristiani U, Capotondo L, Gaggiotti E, De Mia M, Rossi P, Sansoni E, Bernini M. Phosphatidylcholine and peritoneal transport during peritoneal dialysis. Nephron Clin Pract 1986; 44:365-70. [PMID: 3796777 DOI: 10.1159/000184022] [Citation(s) in RCA: 84] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Peritoneal effluent of patients on chronic ambulatory peritoneal dialysis (CAPD) contains a surface-active material (SAM) made up of phospholipids and showing phosphatidylcholine on thin-layer chromatography. This substance drastically lowers surface tension, helps to repel water and has a lubricating effect. The presence of stratified phosphatidylcholine on the peritoneum might narrow the stagnant dialysate fluid layer and situations which can alter the quantity or composition of SAM may affect peritoneal transport and also, perhaps, the formation of adherences. This led us to verify, experimentally, the presence of phospholipids in basal conditions, after CAPD and during peritonitis and to check if addition of phosphatidylcholine to dialysis liquid is able to modify water transport in patients with low ultrafiltration and peritonitis. Phospholipids in the dialysis effluent of patients who have been on CAPD for a long time are lower than observed in the first days of peritoneal dialysis. A more drastic, significant decrease in phospholipids was observed in patients with low ultrafiltration and in patients with peritonitis. Mean ultrafiltration significantly increases in patients with low ultrafiltration and in those with peritonitis during dialysis exchanges containing phosphatidylcholine (50 mg/l) indicating that the latter is able to restore normal physiological conditions.
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Gennari C, Imbimbo B, Montagnani M, Bernini M, Nardi P, Avioli LV. Effects of prednisone and deflazacort on mineral metabolism and parathyroid hormone activity in humans. Calcif Tissue Int 1984; 36:245-52. [PMID: 6432287 DOI: 10.1007/bf02405325] [Citation(s) in RCA: 102] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The effects of two different glucocorticoids, prednisone and deflazacort, (an oxazoline derivative of prednisolone) on bone metabolism were analyzed in 10 patients with disorders that required glucocorticoid therapy. Significant elevations in blood immunoreactive parathyroid hormone, alkaline phosphatase and urinary calcium, phosphate, hydroxyproline and nephrogenous cyclic AMP were observed during prednisone therapy in addition to an increase in the exchangeable calcium pool as estimated by 47Ca-kinetic analyses. In contrast to these changes, deflazacort therapy induced minimal, and in some instances, no changes in these indices. In fact, in studies wherein prednisone therapy was followed by deflazacort alterations in bone metabolism, iPTH, and nephrogenous cAMP observed during prednisone were reversed. The data are consistent with the fact that the skeletal effects of prednisone therapy are mediated, at least in part, by increased parathyroid hormone activity, and that deflazacort is less potent in this regard.
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