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Motta M, Zanocco M, Rondinella A, Iodice V, Sin A, Fedrizzi L, Andreatta F. Inhibitive effect of 8-hydroxyquinoline on corrosion of gray cast iron in automotive braking systems. Electrochim Acta 2023. [DOI: 10.1016/j.electacta.2023.142221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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McColl E, Davies-House A, Witton R, Wilcock M, Motta M. Phenoxymethylpenicillin. Br Dent J 2023; 234:11-12. [PMID: 36639456 DOI: 10.1038/s41415-023-5442-4] [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: 01/14/2023]
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Wilcock M, Motta M, Trevan L. A short survey on GP practices’ approach (structure and process) for managing sepsis. International Journal of Pharmacy Practice 2022. [DOI: 10.1093/ijpp/riac089.069] [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: 12/05/2022]
Abstract
Abstract
Introduction
Sepsis poses a challenge for general practice, and sepsis awareness raising amongst healthcare professionals is a priority, with general practices expected to have an identified sepsis lead who has updated staff.1 The Royal College of General Practitioners (RCGP) made sepsis a clinical priority to raise awareness of how appropriate GP action could have an impact.2 In September 2020, locality-based prescribing meetings were held focusing on sepsis. For the 2021/22 General Practice Prescribing Quality Scheme it was decided to ascertain what practices had in place to manage suspected sepsis.
Aim
To assess whether GP practices in Cornwall have the structure and processes in place to manage sepsis.
Methods
A pre-piloted paper survey, based on a literature review, was delivered to all practices. There were seven questions (mixture of closed questions and questions allowing expanded answers, and a free text comment option). The sepsis lead GP responded on behalf of the practice. Survey completion, along with completion of other elements of the Prescribing Quality Scheme, generated an incentive payment to practices. This service evaluation did not require ethical approval.
Results
Fifty-one of 57 (89%) surgeries responded. When asked if all practice staff were familiar with the terminology “Red Flag Sepsis’, 36 replied yes, 4 replied only clinical staff, and 11 no. Receptionist training on this topic had occurred in 33 practices, but not in 18. All 51 replied they had the necessary equipment readily available to assess patients with possible sepsis. As regards intravenous antibiotics routinely stocked in the practice, five had none, and for those that kept antibiotics it was a mixture of benzylpenicillin, ceftriaxone, cefotaxime or Tazocin. Thirty-seven were unable to take a blood culture prior to first dose of antibiotics for a patient with Red Flag Sepsis, including one highlighting such a patient would have immediate hospital referral. Fourteen answered yes to this question, including one also highlighting immediate hospital referral. Thirty-five practices had a safety-net resource aligning with NICE guidance3 for giving to adults, parents and carers being managed in the community, whilst ten said no and 5 clarified that they give verbal advice but no written information. Fifteen had implemented change in their practice that they would share with other practices though only 12 provided brief details. Free text comments generated themes around staff training, including administration of IV antibiotics by GPs, and whether practices should be taking blood cultures and associated practical issues.
Discussion/Conclusion
The RCGP states that ideally all staff in a sepsis aware practice will have had education about sepsis.2 We found this had not occurred in 18/51 (35%) practices, and in 11/51 (22%) practices staff appeared unfamiliar with the terminology “Red Flag Sepsis’. The issue of taking blood cultures (73% said they were unable to do this) generated concerns and further discussion with Microbiology colleagues is needed. Practices have identified actions to be taken subsequent to this survey. We recognise limitations of a small survey from late 2021 conducted in a single centre in England, possibly subject to social-desirability bias.
References
1. NHS England. CCG Improvement and Assessment Framework 2017/18: Technical Annex NHS England: Central Analytical team. Available from: https://www.england.nhs.uk/wp-content/uploads/2017/11/ccg-technical-annex-2017-18-v1-1.pdf
2. Royal College of General Practitioners. Sepsis toolkit [Internet]. Available from: https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/sepsis-toolkit.aspx
3. National Institute for Health and Care Excellence. Sepsis: recognition, diagnosis and early management. (NICE guideline 51). 2016. Available from: https://www.nice.org.uk/guidance/ng51
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Affiliation(s)
| | - M Motta
- Cornwall and Isles of Scilly ICB
| | - L Trevan
- Cornwall and Isles of Scilly ICB
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4
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Mazzoni G, Alberti D, Torri F, Motta M, Platto C, Franceschetti L, Sartori E E, Signorelli M. Prediction of complex gastroschisis: The evolution of therapeutic techniques and their relation with fetal sonographic features. J Neonatal Perinatal Med 2021; 15:137-145. [PMID: 34334428 DOI: 10.3233/npm-210746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND To analyze prenatal ultrasound (US) markers to predict treatment and adverse neonatal outcome in fetal gastroschisis. METHODS It was conducted a retrospective single-center study considering all pregnancies with isolated gastroschisis that were treated in our department between 2008 and 2020. 17 US markers were analyzed. Moreover, the association between prenatal ultrasound signs and neonatal outcomes was analyzed: need of bowel resection, techniques of reduction, type of closure, adverse neonatal outcomes, time to full enteral feeding, length of total parenteral nutrition and length of hospitalization. RESULTS The analysis included 21 cases. We found significant associations between intestinal dilation (≥10 mm) appeared before 30 weeks of gestation and the need of bowel resection (p = 0.001), the length of total parenteral nutrition (p = 0,0013) and the length of hospitalization (p = 0,0017). Intrauterine growth restriction (IUGR) is a risk factor for serial reduction (p = 0,035). There were no signs significantly associated with the type of closure. Hyperbilirubinemia is related with gestational age (GA) at the diagnosis of intra-abdominal bowel dilation (IABD) (p = 0.0376) and maximum IABD (p = 0.05). All newborns with sepsis had echogenic loops in uterus (p = 0.026). The relation between the GA at delivery and the GA at the extra-abdominal bowel dilation (EABD)≥10 mm was r = 0.70. CONCLUSION We showed the significant role of the early presence of bowel dilation in predicting intestinal resection and adverse outcomes. All IUGR fetuses needed staged reduction through the silo-bag technique. The echogenic bowel was related to neonatal sepsis, while IABD was associated with hyperbilirubinemia.
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Affiliation(s)
- G Mazzoni
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - D Alberti
- Department of Pediatric Surgery, Spedali Civili Children's Hospital of Brescia, Brescia BS, Italy
| | - F Torri
- Department of Pediatric Surgery, Spedali Civili Children's Hospital of Brescia, Brescia BS, Italy
| | - M Motta
- Department of Neonatology, University of Brescia, Brescia BS, Italy
| | - C Platto
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - L Franceschetti
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - E Sartori E
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - M Signorelli
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
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Merli M, Rattotti S, Spina M, Re F, Motta M, Piazza F, Orsucci L, Ferreri AJ, Perbellini O, Dodero A, Vallisa D, Pulsoni A, Santoro A, Zuccaro V, Chimienti E, Russo F, Visco C, Zignego AL, Marcheselli L, Luminari S, Paulli M, Bruno R, Arcaini L. DIRECT‐ACTING ANTIVIRALS AS PRIMARY TREATMENT FOR HCV‐ASSOCIATED INDOLENT NON‐HODGKIN LYMPHOMAS: THE PROSPECTIVE BART STUDY OF THE
FONDAZIONE ITALIANA LINFOMI. Hematol Oncol 2021. [DOI: 10.1002/hon.77_2879] [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: 11/10/2022]
Affiliation(s)
- M. Merli
- University Hospital "Ospedale di Circolo e Fondazione Macchi" ‐ ASST Sette Laghi University of Insubria Hematology Varese Italy
| | - S. Rattotti
- Fondazione IRCCS Policlinico San Matteo Hematology Pavia Italy
| | - M. Spina
- Centro di Riferimento Oncologico IRCCS Medical Oncology and Immune‐related Tumors Aviano (PN) Italy
| | - F. Re
- Azienda Ospedaliera Universitaria Hematology and BMT Center Parma Italy
| | - M. Motta
- ASST Spedali Civili Brescia Hematology Brescia Italy
| | - F. Piazza
- Azienda Ospedaliera‐Universitaria University of Padova Medicine, Hematology Padova Italy
| | - L. Orsucci
- Città della Salute e della Scienza di Torino Hematology Torino Italy
| | | | | | - A. Dodero
- Fondazione IRCCS Istituto Nazionale dei Tumori Hematology Milano Italy
| | - D. Vallisa
- Ospedale Guglielmo da Saliceto Hematology Piacenza Italy
| | - A. Pulsoni
- Sapienza University of Rome Translational and Precision Medicine Roma Italy
| | - A. Santoro
- Humanitas Research Hospital Medical Oncology and Hematology Unit Rozzano Milan Italy
| | - V. Zuccaro
- Fondazione IRCCS Policlinico San Matteo University of Pavia Infectious and Tropical Diseases Pavia Italy
| | - E. Chimienti
- Centro di Riferimento Oncologico IRCCS Medical Oncology and Immune‐related Tumors Aviano (PN) Italy
| | - F. Russo
- Azienda Ospedaliera Universitaria Hematology and BMT Center Parma Italy
| | - C. Visco
- University of Verona Medicine, Section of Hematology Verona Italy
| | - A. L. Zignego
- University of Florence Clinical and Experimental Medicine Interdepartmental Hepatology Center MASVE Florence Italy
| | | | - S. Luminari
- AUSL ‐ IRCCS Reggio Emilia University of Modena and Reggio Emilia Hematology Reggo Emilia Italy
| | - M. Paulli
- Fondazione IRCCS Policlinico San Matteo University of Pavia Anatomic Pathology Unit Pavia Italy
| | - R. Bruno
- Fondazione IRCCS Policlinico San Matteo University of Pavia Infectious and Tropical Diseases Pavia Italy
| | - L. Arcaini
- University of Pavia Molecular Medicine Pavia Italy
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6
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Zanni G, D'Abrusco F, Nicita F, Cascioli S, Tosi M, Corrente F, Serpieri V, Ciccone R, Motta M, Vasco G, Carsetti R, Valente EM, Bertini E. PIGQ-Related Glycophosphatidylinositol Deficiency Associated with Nonprogressive Congenital Ataxia. Cerebellum 2021; 21:525-530. [PMID: 34089469 DOI: 10.1007/s12311-021-01288-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 10/21/2022]
Abstract
The glycophosphatidylinositol (GPI) anchor pathway plays an essential role in posttranslational modification of proteins to facilitate proper membrane anchoring and trafficking to lipid rafts, which is critical for many cell functions, including embryogenesis and neurogenesis. GPI biosynthesis is a multi-step process requiring the activity of over 25 distinct genes, most of them belonging to the phosphatidylinositol glycan (PIG) family and associated with rare neurodevelopmental disorders. PIGQ encodes the phosphatidylinositol glycan class Q protein and is part of the GPI-N-acetylglucosaminyltransferase complex that initiates GPI biosynthesis from phosphatidylinositol (PI) and N-acetylglucosamine (GlcNAc) on the cytoplasmic side of the endoplasmic reticulum (ER). Pathogenic variants in the PIGQ gene have been previously reported in 10 patients with congenital hypotonia, early-infantile epileptic encephalopathy, and premature death occurring in more than half cases. We detected a novel homozygous variant in PIGQ (NM_004204.5: c.1631dupA; p.Tyr544fs*79) by WES trio-analysis of a male patient with a neurodevelopmental disorder characterized by nonprogressive congenital ataxia, intellectual disability, generalized epilepsy, and cerebellar atrophy. Flow cytometry confirmed deficiency of several GPI-anchored proteins on leukocytes (CD14, FLAER). Clinical features of this case broaden the phenotypic spectrum of PIGQ-related GPI deficiency, outlining the importance of glycophosphatidylinositol (GPI) anchor pathway in the pathogenesis of cerebellar ataxia.
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Affiliation(s)
- G Zanni
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - F D'Abrusco
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - F Nicita
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - S Cascioli
- Unit of Diagnostic Immunology, Department of Laboratories, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Tosi
- Child Neurology and Psychiatry Unit, University Hospital of Rome Tor Vergata, Rome, Italy
| | - F Corrente
- Unit of Diagnostic Immunology, Department of Laboratories, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - V Serpieri
- Department of Molecular Medicine, University of Pavia, Pavia, Italy.,Neurogenetics Research Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - R Ciccone
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - M Motta
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - G Vasco
- Unit of Neurorehabilitation, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - R Carsetti
- Unit of Diagnostic Immunology, Department of Laboratories, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - E M Valente
- Department of Molecular Medicine, University of Pavia, Pavia, Italy.,Neurogenetics Research Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - E Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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7
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Frustaci AM, Tedeschi A, Zinzani PL, Pietrasanta D, Coscia M, Zenz T, Motta M, Gaidano G, Scarfò L, Deodato M, Zamprogna G, Vitale C, Cairoli R, Rossi D, Montillo M. MOLTO, A MULTICENTER, OPEN LABEL, UNCONTROLLED, PHASE II CLINICAL TRIAL ON VENETOCLAX, ATEZOLIZUMAB, OBINUTUZUMAB IN RICHTER TRANSFORMATION: SAFETY INTERIM ANALYSIS. Hematol Oncol 2021. [DOI: 10.1002/hon.40_2880] [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: 11/11/2022]
Affiliation(s)
- A. M. Frustaci
- ASST Grande Ospedale Metropolitano Niguarda Hematology Milan Italy
| | - A. Tedeschi
- ASST Grande Ospedale Metropolitano Niguarda Hematology Milan Italy
| | - P. L. Zinzani
- "L. e A. Seràgnoli," University of Bologna Hematology Bologna Italy
| | - D. Pietrasanta
- Azienda Ospedaliera SS Arrigo e Biagio e Cesare Arrigo Hematology Alessandria Italy
| | - M. Coscia
- A.O.U. Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences University of Torino Hematology Torino Italy
| | - T. Zenz
- University Hospital Zürich and University of Zürich Hematology Zurich Switzerland
| | - M. Motta
- ASST Spedali Civili Hematology Brescia Italy
| | - G. Gaidano
- University of Eastern Piedmont Translational Medicine, Division of Hematology Novara Italy
| | - L. Scarfò
- Università Vita‐Salute San Raffaele and IRCC Ospedale San Raffaele Hematology Milano Italy
| | - M. Deodato
- ASST Grande Ospedale Metropolitano Niguarda Hematology Milan Italy
| | - G. Zamprogna
- ASST Grande Ospedale Metropolitano Niguarda Hematology Milan Italy
| | - C. Vitale
- A.O.U. Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences University of Torino Hematology Torino Italy
| | - R. Cairoli
- ASST Grande Ospedale Metropolitano Niguarda Hematology Milan Italy
| | - D. Rossi
- Oncology Institute of Southern Switzerland; Institute of Oncology Research Hematology Bellinzona Switzerland
| | - M. Montillo
- ASST Grande Ospedale Metropolitano Niguarda Hematology Milan Italy
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8
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D'Alessio A, Del Poggio P, Bracchi F, Cesana G, Sertori N, Di Mauro D, Fargnoli A, Motta M, Giussani C, Moro P, Vitale G, Giacomini M, Borra G. Low-dose ruxolitinib plus steroid in severe SARS-CoV-2 pneumonia. Leukemia 2021; 35:635-638. [PMID: 33173161 PMCID: PMC7654848 DOI: 10.1038/s41375-020-01087-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/31/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023]
Affiliation(s)
- A D'Alessio
- COVID Medical Department, Policlinico S.Marco Gruppo San Donato University and Research Hospital, Zingonia, Bergamo, Italy
| | - P Del Poggio
- COVID Medical Department, Policlinico S.Marco Gruppo San Donato University and Research Hospital, Zingonia, Bergamo, Italy.
| | - F Bracchi
- COVID Medical Department, Policlinico S.Marco Gruppo San Donato University and Research Hospital, Zingonia, Bergamo, Italy
| | - G Cesana
- COVID Medical Department, Policlinico S.Marco Gruppo San Donato University and Research Hospital, Zingonia, Bergamo, Italy
| | - N Sertori
- COVID Medical Department, Policlinico S.Marco Gruppo San Donato University and Research Hospital, Zingonia, Bergamo, Italy
| | - D Di Mauro
- COVID Medical Department, Policlinico S.Marco Gruppo San Donato University and Research Hospital, Zingonia, Bergamo, Italy
| | - A Fargnoli
- COVID Medical Department, Policlinico S.Marco Gruppo San Donato University and Research Hospital, Zingonia, Bergamo, Italy
| | - M Motta
- COVID Medical Department, Policlinico S.Marco Gruppo San Donato University and Research Hospital, Zingonia, Bergamo, Italy
| | - C Giussani
- COVID Medical Department, Policlinico S.Marco Gruppo San Donato University and Research Hospital, Zingonia, Bergamo, Italy
| | - P Moro
- COVID Medical Department, Policlinico S.Marco Gruppo San Donato University and Research Hospital, Zingonia, Bergamo, Italy
| | - G Vitale
- Intensive Care Unit, Policlinico S.Marco Gruppo San Donato University and Research Hospital, Zingonia, Bergamo, Italy
| | - M Giacomini
- Intensive Care Unit, Policlinico S.Marco Gruppo San Donato University and Research Hospital, Zingonia, Bergamo, Italy
| | - G Borra
- Policlinico S.Marco Gruppo San Donato University and Research Hospital, Zingonia, Bergamo, Italy
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9
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Brambilla C, Escobedo A, Artioli R, Lechuga MJ, Motta M, Bonadonna G. Medical Castration with Zoladex: A Conservative Approach to Premenopausal Breast Cancer. Tumori 2018; 77:145-50. [PMID: 1828640 DOI: 10.1177/030089169107700211] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
For almost a century surgical castration represented the initial standard therapy for metastatic breast cancer in premenopausal women with hormone dependent tumors. Today the suppression of ovarian function can also be obtained by the administration of supraphysiologic doses of luteinizing hormone releasing hormone (LHRH) agonists. From April 1987 to February 1989, 23 premenopausal patients with advanced breast cancer (median age 39 years, range 28-52, ER positive 20, unknown 3; prior chemotherapy 17) were treated with the LHRH agonist goserelin depot (Zoladex) at the dose of 3.6 mg. every 4 weeks. Twenty-two patients were evaluable. Serum levels of 17 β estradiol, progesterone, FSH and LH were suppressed by goserelin and fell to postmenopausal values within 8 weeks of therapy in 77 % of cases. Complete response (CR) plus partial response (PR) was documented in 7 of 22 (32 %) and occurred in all major sites of disease. Five patients achieved CR (soft tissue 3, viscera 2). Response rate was higher in patients not previously treated with chemotherapy (4/6). In the present series, all responses were seen in women > 35 years old, regularly menstruating at the start of treatment. Time to progression for the entire case series was 22 weeks and for responders 64 weeks. Oophorectomy was performed after disease progression in four patients without success. Goserelin was well tolerated. Local cutaneous dyschromia occurred in 45 % and hot flushes in 82 %. Treatment efficacy of goserelin is comparable to that of oophorectomy, without the psychological trauma and the morbidity related to surgical castration.
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Affiliation(s)
- C Brambilla
- Division of Medical Oncology, Istituto Nazionale Tumori, Milan, Italy
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10
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Villa E, Michelotti F, Motta M, Ravasio A, Gherardi D, Manazzale V, Locatelli F, Trombetta L, Salmoiraghi P, Mascioli G, Vavassori V. PO-1087: Radiotherapy (RT) and cardiac implantable electronic devices (CIEDs): a prospective study. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31397-5] [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: 10/14/2022]
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11
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Shaw G, Brisbois J, Pinheiro LBGL, Müller J, Blanco Alvarez S, Devillers T, Dempsey NM, Scheerder JE, Van de Vondel J, Melinte S, Vanderbemden P, Motta M, Ortiz WA, Hasselbach K, Kramer RBG, Silhanek AV. Quantitative magneto-optical investigation of superconductor/ferromagnet hybrid structures. Rev Sci Instrum 2018; 89:023705. [PMID: 29495853 DOI: 10.1063/1.5016293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We present a detailed quantitative magneto-optical imaging study of several superconductor/ferromagnet hybrid structures, including Nb deposited on top of thermomagnetically patterned NdFeB and permalloy/niobium with erasable and tailored magnetic landscapes imprinted in the permalloy layer. The magneto-optical imaging data are complemented with and compared to scanning Hall probe microscopy measurements. Comprehensive protocols have been developed for calibrating, testing, and converting Faraday rotation data to magnetic field maps. Applied to the acquired data, they reveal the comparatively weaker magnetic response of the superconductor from the background of larger fields and field gradients generated by the magnetic layer.
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Affiliation(s)
- G Shaw
- Experimental Physics of Nanostructured Materials, Q-MAT, CESAM, Université de Liège, B-4000 Sart Tilman, Belgium
| | - J Brisbois
- Experimental Physics of Nanostructured Materials, Q-MAT, CESAM, Université de Liège, B-4000 Sart Tilman, Belgium
| | - L B G L Pinheiro
- Departamento de Física, Universidade Federal de São Carlos, 13565-905 São Carlos, SP, Brazil
| | - J Müller
- Experimental Physics of Nanostructured Materials, Q-MAT, CESAM, Université de Liège, B-4000 Sart Tilman, Belgium
| | - S Blanco Alvarez
- Experimental Physics of Nanostructured Materials, Q-MAT, CESAM, Université de Liège, B-4000 Sart Tilman, Belgium
| | - T Devillers
- Univ. Grenoble Alpes, CNRS, Institut Néel, 38000, Grenoble, France
| | - N M Dempsey
- Univ. Grenoble Alpes, CNRS, Institut Néel, 38000, Grenoble, France
| | - J E Scheerder
- Laboratory of Solid-State Physics and Magnetism, KU Leuven, Celestijnenlaan 200 D, Box 2414, B-3001 Leuven, Belgium
| | - J Van de Vondel
- Laboratory of Solid-State Physics and Magnetism, KU Leuven, Celestijnenlaan 200 D, Box 2414, B-3001 Leuven, Belgium
| | - S Melinte
- Université catholique de Louvain, Institute of Information and Communication Technologies, Electronics and Applied Mathematics (ICTM), Institut de la Matière Condensée et des Nanosciences (IMCN), 1348 Louvain-la-Neuve, Belgium
| | - P Vanderbemden
- Université de Liège, SUPRATECS and Department of Electrical Engineering and Computer Science, Sart Tilman B-4000, Belgium
| | - M Motta
- Departamento de Física, Universidade Federal de São Carlos, 13565-905 São Carlos, SP, Brazil
| | - W A Ortiz
- Departamento de Física, Universidade Federal de São Carlos, 13565-905 São Carlos, SP, Brazil
| | - K Hasselbach
- Univ. Grenoble Alpes, CNRS, Institut Néel, 38000, Grenoble, France
| | - R B G Kramer
- Univ. Grenoble Alpes, CNRS, Institut Néel, 38000, Grenoble, France
| | - A V Silhanek
- Experimental Physics of Nanostructured Materials, Q-MAT, CESAM, Université de Liège, B-4000 Sart Tilman, Belgium
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12
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Fusco F, Lembo A, Ludovico G, Farina FP, Montorsi F, Fabris GM, Soli M, Scarpa RM, Gentile V, Motta M, Spera E, Casarico A, Sicuteri R, Rossi A, Mirone V. Tadalafil versus sildenafil citrate in the treatment of ED: Italian patients’ preferences and explanatory notes. Urologia 2018. [DOI: 10.1177/039156030807500105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
This is an open, multicentre, randomized, crossover study having the aim to evaluate the preference for sildenafil citrate or tadalafil in a population of Italian patients affected by ED, and to compare the efficacy and safety of these two drugs. Material and Methods. From October 2003 to November 2004, thirteen Italian centers enrolled ED patients (age >18) being in steady and naïve relation to ED treatment, both through PDE5 inhibitors and any other treatment option. These patients were randomized to sildenafil or tadalafil for 12 weeks, after which they were switched to the alternative treatment for a further 12 weeks. The preference was evaluated through the Treatment Preference Question (TPQ): “During this clinical trial you have taken tadalafil and sildenafil for the treatment of erectile dysfunction. Which medication do you prefer to take for the next 8 weeks of treatment?”. Moreover, patients were asked to express their preference as “strong” or “moderate” and to answer some questions to clarify the reasons behind their preference. SEP and IIEF-EF questionnaires were used for a comparison of efficacy. Results. 167 patients were enrolled, 144 of whom completed both treatment periods. On being asked the TPQ, 75% of patients (n=108) decided to continue treatment with tadalafil, in particular because it made it possible to have an erection many hours after taking the medication (first or second preference reason for 64.8% of patients), while 25% (n=36) preferred sildenafil (p=0.001). Both drugs improved the IIEF-EF and SEP scores compared to baseline, with a slightly but significantly greater improvement with tadalafil for both parameters. Conclusions. Tadalafil and sildenafil are both effective and well tolerated. Most of the patients prefer tadalafil thanks to the possibility of having sexual intercourse many hours after taking the medication.
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Affiliation(s)
- F. Fusco
- Clinica Urologica, Università Federico II, Napoli
| | - A. Lembo
- USC Urologia, Ospedali Riuniti di Bergamo
| | - G.M. Ludovico
- Unità di Urologia Operativa, Ospedale Civile, Monopoli (BA)
| | | | - F. Montorsi
- Reparto di Urologia, Ospedale S. Raffaele Milano
| | | | - M. Soli
- Dipartimento di Andrologia, AO e Policlinico S. Orsola Malpighi, Bologna
| | | | - V. Gentile
- Dipartimento di Urologia U. Bracci, Università La Sapienza, Roma
| | - M. Motta
- Urologia Clinica II, Ospedale V. Emanuele, Catania
| | - E. Spera
- Urologia, Università Tor Vergata, Roma
| | | | | | | | - V. Mirone
- Clinica Urologica, Università Federico II, Napoli
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Ghia P, Scarfò L, Coscia M, Sancetta R, Ferrario A, Tedeschi A, Farina L, Laurenti L, Orlandi E, Reda G, Motta M, Carlo Stella C, Massaia M, Quaresmini G, Rossini F, Ladetto M, Gaidano G, Rossi V, Montillo M. A MRD-GUIDED APPROACH FOR THE COMBINATION OF IBRUTINIB TO VENETOCLAX IN RELAPSED/REFRACTORY PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA (IMPROVE STUDY). Hematol Oncol 2017. [DOI: 10.1002/hon.2440_11] [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: 11/11/2022]
Affiliation(s)
- P. Ghia
- Strategic Program on CLL; IRCCS Ospedale San Raffaele; Milan Italy
| | - L. Scarfò
- Strategic Program on CLL; IRCCS Ospedale San Raffaele; Milan Italy
| | - M. Coscia
- Division of Hematology, University of Torino; AOU Città della Salute e della Scienza di Torino; Torino Italy
| | - R. Sancetta
- U.O.C. Ematologia; Azienda ULSS 3 Serenissima; Mestre Italy
| | - A. Ferrario
- UOC Ematologia; Azienda Socio Sanitaria Territoriale dei Sette Laghi Ospedale di Circolo e Fondazione Macchi; Varese Italy
| | - A. Tedeschi
- Department of Haematology & Oncology Service of Haematology; Niguarda Cancer Center Niguarda Hospital; Milan Italy
| | - L. Farina
- Istituto Nazionale dei Tumori; Unità Trapianto di Midollo; Milan Italy
| | - L. Laurenti
- Policlinico A. Gemelli; Università Cattolica del Sacro Cuore; Rome Italy
| | - E. Orlandi
- S.C Ematologia; Fondazione IRCCS Policlinico San Matteo; Pavia Italy
| | - G. Reda
- UOC Oncoematologia; Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico; Milan Italy
| | - M. Motta
- U.O. Ematologia; Spedali Civili di Brescia-Azienda Ospedaliera; Brescia Italy
| | - C. Carlo Stella
- Sezione di Ematologia; Cancer Center Humanitas; Rozzano Italy
| | - M. Massaia
- Struttura Complessa di Ematologia; Azienda Ospedaliera S. Croce e Carle di Cuneo; Cuneo
| | - G. Quaresmini
- Ematologia; Azienda Ospedaliera Papa Giovanni XXIII; Bergamo Italy
| | - F. Rossini
- Divisione di Ematologia e Trapianto di Midollo, Ospedale S. Gerardo; Universita' di Milano Bicocca; Monza Italy
| | - M. Ladetto
- Ematologia; Presidio Ospedaliero SS Antonio e Biagio; Alessandria Italy
| | - G. Gaidano
- Divisione di Ematologia; Università del Piemonte Orientale "Amedeo Avogadro"; Novara Italy
| | - V. Rossi
- Hematology & Transfusion Medicine; L. Sacco University Hospital & School of Medicine; Milan Italy
| | - M. Montillo
- Department of Haematology & Oncology Service of Haematology; Niguarda Cancer Center Niguarda Hospital; Milan Italy
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14
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Nalli C, Iodice A, Andreoli L, Galli J, Lojacono A, Motta M, Fazzi E, Tincani A. Long-term neurodevelopmental outcome of children born to prospectively followed pregnancies of women with systemic lupus erythematosus and/or antiphospholipid syndrome. Lupus 2017; 26:552-558. [DOI: 10.1177/0961203317694960] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Systemic lupus erythematosus (SLE) and antiphospholipid antibody syndrome (APS) are autoimmune diseases that affect women of childbearing age. Maternal IgG antiphospholipid antibodies (aPL) can cross the placenta during pregnancy and theoretically reach the fetal brain. Some studies showed an increased number of learning disabilities in these children. Objectives To evaluate the long-term neurodevelopmental outcome of 40 children (median age 7.4 years) born to mothers with SLE and/or APS carrying positive IgG aPL during the third trimester of pregnancy. Methods Children were checked for neurological physical exam and intellectual/cognitive functioning by the Wechsler scale for corrected age. We submitted to the mothers the Child Behavior CheckList (CBCL) and a homemade set of questions created by pediatric neurologists. Results In all children neurological physical exam and intelligence levels were found to be normal. A cognitive impairment or a discrepant cognitive profile was found in 3 (7%) and 11 (28%) children, respectively. Learning disabilities were diagnosed in 3 children (19% of school-age children), all born to mothers with triple aPL positivity. A history of epilepsy was shown in four children (10%). Conclusions: Children born to women with SLE and/or APS may need a long-term follow-up focusing on milestones of neurodevelopment in order to detect and correct any alteration as early as possible.
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Affiliation(s)
- C Nalli
- Rheumatology and Immunology Unit, Department of Clinical and Experimental Sciences, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | - A Iodice
- Child Neuropsychiatry Unit, Santa Maria Nuova Hospital IRCCS, Reggio Emilia, Italy
| | - L Andreoli
- Rheumatology and Immunology Unit, Department of Clinical and Experimental Sciences, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | - J Galli
- Unit of Child and Adolescent Neuropsychiatry, Department of Clinical and Experimental Sciences, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | - A Lojacono
- Obstetrics and Gynecology, Department of Clinical and Experimental Sciences, ASST Spedali Civili and University of Brescia, Italy
| | - M Motta
- Neonatology and NICU, ASST Spedali Civili, Brescia, Italy
| | - E Fazzi
- Unit of Child and Adolescent Neuropsychiatry, Department of Clinical and Experimental Sciences, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | - A Tincani
- Rheumatology and Immunology Unit, Department of Clinical and Experimental Sciences, ASST Spedali Civili and University of Brescia, Brescia, Italy
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15
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Tolaney SM, Forero-Torres A, Boni V, Bachelot T, Lu YS, Maur M, Fasolo A, Motta M, Pan C, Dobson J, Hewes B, Chin Lee S. Abstract P4-22-12: Ribociclib + fulvestrant in postmenopausal women with HR+, HER2– advanced breast cancer (ABC). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-22-12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Endocrine therapy (ET) is the treatment backbone for hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) ABC, but efficacy is limited by ET resistance. The cyclin-dependent kinase (CDK) 4/6–cyclin D (CCND1)–retinoblastoma (Rb) and phosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) pathways have been implicated in ET resistance. CDK4/6 and PI3K/mTOR inhibitors act synergistically with ET in preclinical and clinical studies of HR+ breast cancer. Ribociclib (LEE011; CDK4/6 inhibitor) + fulvestrant ± alpelisib (BYL719) or buparlisib (BKM120) in HR+, HER2– ABC is being investigated in a Phase Ib/II study (NCT02088684). Here, we present results from the ribociclib + fulvestrant combination, with intermittent and continuous ribociclib dosing.
Methods: Postmenopausal patients (pts) with HR+, HER2– ABC refractory to aromatase inhibitors received ribociclib intermittently (600 mg/day, 3-weeks-on/1-week-off; Arm A) or continuously (400 mg/day; Arm B; following Arm A safety evaluation) + fulvestrant (500 mg; Cycle 1 Day 1 and 15; subsequent cycles Day 1). Primary objective: dose-limiting toxicities (DLTs) to confirm the recommended Phase II dose of ribociclib + fulvestrant. Secondary objectives: safety, pharmacokinetics, and preliminary antitumor activity (RECIST v1.1); biomarkers that may correlate with response were also assessed.
Results: As of March 10, 2016, 24 pts received ribociclib + fulvestrant (Arm A, n=13; Arm B, n=11); 4 pts in Arm B were ongoing; median duration of exposure was 7.4 (Arm A) and 4.5 (Arm B) months. Median number of prior regimens: 4 (Arm A) and 3 (Arm B). Treatment discontinuation (n; Arm A, Arm B) was due to disease progression (11, 4), physician decision (1, 2), and adverse events (AEs; 1, 1). DLTs in Cycle 1 (n; Arm A, Arm B) were Grade [G] 3 pulmonary embolism (1, 0) and G3 aspartate aminotransferase elevation (0, 1). The most common G3/4 drug-related AE (Arm A, Arm B) was neutropenia (62%, 36%); 5 pts had QTcF prolongation >60 ms (n; 4, 1).
Common all-Grade drug-related AEs (>35% pts) n (%)Arm A (n=13)Arm B (n=11)Neutropenia10 (77)7 (64)Fatigue9 (69)3 (27)Nausea6 (46)5 (46)Anemia6 (46)0 (0)Reduced appetite5 (39)1 (9)
Best overall responses (BORs; n; Arm A, Arm B): partial response (PR; 3, 1), stable disease (SD; 9, 6), and neither complete response nor progressive disease (NCRNPD; non-measurable disease; 1, 4). Overall response rate: 23% (Arm A) and 9% (Arm B); disease control rate (BOR of complete response, PR, SD, or NCRNPD): 100% in both arms. Next-generation sequencing data (n; Arm A, Arm B) were available for 16 pts (7, 9): 5 pts had CCND1 alterations (PR [1, 0], SD [2, 1], and NCRNPD [0, 1]); 11 pts had PIK3CA alterations (PR [1, 0], SD [3, 4], and NCRNPD [1, 2]); 2 of these pts had both CCND1 and PIK3CA alterations (SD [1, 0] and NCRNPD [0, 1]).
Conclusions: Ribociclib + fulvestrant has a manageable safety profile and shows preliminary clinical activity in pretreated pts with HR+, HER2– ABC. Both ribociclib intermittent and continuous dosing schedules were well tolerated. Clinical responses were observed in tumors with and without CDK4/6–cyclin D–Rb and PI3K/mTOR pathway alterations.
Citation Format: Tolaney SM, Forero-Torres A, Boni V, Bachelot T, Lu Y-S, Maur M, Fasolo A, Motta M, Pan C, Dobson J, Hewes B, Chin Lee S. Ribociclib + fulvestrant in postmenopausal women with HR+, HER2– advanced breast cancer (ABC) [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 P4-22-12.
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Affiliation(s)
- SM Tolaney
- Dana-Faber Cancer Institute, Boston, MA; University of Alabama at Birmingham Hospital, Birmingham, AL; START Madrid-Centro Integral Oncológico Clara Campal Hospital, Madrid, Spain; Centre Léon Bérard, Lyon, France; National Taiwan University College of Medicine, Taipei, Taiwan; University Hospital of Modena and Reggio Emilia, Modena, Italy; San Raffaele Hospital, Milan, Italy; Novartis Institutes for BioMedical Research, Cambridge, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; National University Cancer Institute, National University Health System, Singapore
| | - A Forero-Torres
- Dana-Faber Cancer Institute, Boston, MA; University of Alabama at Birmingham Hospital, Birmingham, AL; START Madrid-Centro Integral Oncológico Clara Campal Hospital, Madrid, Spain; Centre Léon Bérard, Lyon, France; National Taiwan University College of Medicine, Taipei, Taiwan; University Hospital of Modena and Reggio Emilia, Modena, Italy; San Raffaele Hospital, Milan, Italy; Novartis Institutes for BioMedical Research, Cambridge, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; National University Cancer Institute, National University Health System, Singapore
| | - V Boni
- Dana-Faber Cancer Institute, Boston, MA; University of Alabama at Birmingham Hospital, Birmingham, AL; START Madrid-Centro Integral Oncológico Clara Campal Hospital, Madrid, Spain; Centre Léon Bérard, Lyon, France; National Taiwan University College of Medicine, Taipei, Taiwan; University Hospital of Modena and Reggio Emilia, Modena, Italy; San Raffaele Hospital, Milan, Italy; Novartis Institutes for BioMedical Research, Cambridge, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; National University Cancer Institute, National University Health System, Singapore
| | - T Bachelot
- Dana-Faber Cancer Institute, Boston, MA; University of Alabama at Birmingham Hospital, Birmingham, AL; START Madrid-Centro Integral Oncológico Clara Campal Hospital, Madrid, Spain; Centre Léon Bérard, Lyon, France; National Taiwan University College of Medicine, Taipei, Taiwan; University Hospital of Modena and Reggio Emilia, Modena, Italy; San Raffaele Hospital, Milan, Italy; Novartis Institutes for BioMedical Research, Cambridge, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; National University Cancer Institute, National University Health System, Singapore
| | - Y-S Lu
- Dana-Faber Cancer Institute, Boston, MA; University of Alabama at Birmingham Hospital, Birmingham, AL; START Madrid-Centro Integral Oncológico Clara Campal Hospital, Madrid, Spain; Centre Léon Bérard, Lyon, France; National Taiwan University College of Medicine, Taipei, Taiwan; University Hospital of Modena and Reggio Emilia, Modena, Italy; San Raffaele Hospital, Milan, Italy; Novartis Institutes for BioMedical Research, Cambridge, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; National University Cancer Institute, National University Health System, Singapore
| | - M Maur
- Dana-Faber Cancer Institute, Boston, MA; University of Alabama at Birmingham Hospital, Birmingham, AL; START Madrid-Centro Integral Oncológico Clara Campal Hospital, Madrid, Spain; Centre Léon Bérard, Lyon, France; National Taiwan University College of Medicine, Taipei, Taiwan; University Hospital of Modena and Reggio Emilia, Modena, Italy; San Raffaele Hospital, Milan, Italy; Novartis Institutes for BioMedical Research, Cambridge, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; National University Cancer Institute, National University Health System, Singapore
| | - A Fasolo
- Dana-Faber Cancer Institute, Boston, MA; University of Alabama at Birmingham Hospital, Birmingham, AL; START Madrid-Centro Integral Oncológico Clara Campal Hospital, Madrid, Spain; Centre Léon Bérard, Lyon, France; National Taiwan University College of Medicine, Taipei, Taiwan; University Hospital of Modena and Reggio Emilia, Modena, Italy; San Raffaele Hospital, Milan, Italy; Novartis Institutes for BioMedical Research, Cambridge, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; National University Cancer Institute, National University Health System, Singapore
| | - M Motta
- Dana-Faber Cancer Institute, Boston, MA; University of Alabama at Birmingham Hospital, Birmingham, AL; START Madrid-Centro Integral Oncológico Clara Campal Hospital, Madrid, Spain; Centre Léon Bérard, Lyon, France; National Taiwan University College of Medicine, Taipei, Taiwan; University Hospital of Modena and Reggio Emilia, Modena, Italy; San Raffaele Hospital, Milan, Italy; Novartis Institutes for BioMedical Research, Cambridge, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; National University Cancer Institute, National University Health System, Singapore
| | - C Pan
- Dana-Faber Cancer Institute, Boston, MA; University of Alabama at Birmingham Hospital, Birmingham, AL; START Madrid-Centro Integral Oncológico Clara Campal Hospital, Madrid, Spain; Centre Léon Bérard, Lyon, France; National Taiwan University College of Medicine, Taipei, Taiwan; University Hospital of Modena and Reggio Emilia, Modena, Italy; San Raffaele Hospital, Milan, Italy; Novartis Institutes for BioMedical Research, Cambridge, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; National University Cancer Institute, National University Health System, Singapore
| | - J Dobson
- Dana-Faber Cancer Institute, Boston, MA; University of Alabama at Birmingham Hospital, Birmingham, AL; START Madrid-Centro Integral Oncológico Clara Campal Hospital, Madrid, Spain; Centre Léon Bérard, Lyon, France; National Taiwan University College of Medicine, Taipei, Taiwan; University Hospital of Modena and Reggio Emilia, Modena, Italy; San Raffaele Hospital, Milan, Italy; Novartis Institutes for BioMedical Research, Cambridge, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; National University Cancer Institute, National University Health System, Singapore
| | - B Hewes
- Dana-Faber Cancer Institute, Boston, MA; University of Alabama at Birmingham Hospital, Birmingham, AL; START Madrid-Centro Integral Oncológico Clara Campal Hospital, Madrid, Spain; Centre Léon Bérard, Lyon, France; National Taiwan University College of Medicine, Taipei, Taiwan; University Hospital of Modena and Reggio Emilia, Modena, Italy; San Raffaele Hospital, Milan, Italy; Novartis Institutes for BioMedical Research, Cambridge, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; National University Cancer Institute, National University Health System, Singapore
| | - S Chin Lee
- Dana-Faber Cancer Institute, Boston, MA; University of Alabama at Birmingham Hospital, Birmingham, AL; START Madrid-Centro Integral Oncológico Clara Campal Hospital, Madrid, Spain; Centre Léon Bérard, Lyon, France; National Taiwan University College of Medicine, Taipei, Taiwan; University Hospital of Modena and Reggio Emilia, Modena, Italy; San Raffaele Hospital, Milan, Italy; Novartis Institutes for BioMedical Research, Cambridge, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; National University Cancer Institute, National University Health System, Singapore
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Andreoli L, Bertsias GK, Agmon-Levin N, Brown S, Cervera R, Costedoat-Chalumeau N, Doria A, Fischer-Betz R, Forger F, Moraes-Fontes MF, Khamashta M, King J, Lojacono A, Marchiori F, Meroni PL, Mosca M, Motta M, Ostensen M, Pamfil C, Raio L, Schneider M, Svenungsson E, Tektonidou M, Yavuz S, Boumpas D, Tincani A. EULAR recommendations for women's health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis 2016; 76:476-485. [PMID: 27457513 PMCID: PMC5446003 DOI: 10.1136/annrheumdis-2016-209770] [Citation(s) in RCA: 434] [Impact Index Per Article: 54.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/13/2016] [Accepted: 06/25/2016] [Indexed: 12/26/2022]
Abstract
Objectives Develop recommendations for women's health issues and family planning in systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS). Methods Systematic review of evidence followed by modified Delphi method to compile questions, elicit expert opinions and reach consensus. Results Family planning should be discussed as early as possible after diagnosis. Most women can have successful pregnancies and measures can be taken to reduce the risks of adverse maternal or fetal outcomes. Risk stratification includes disease activity, autoantibody profile, previous vascular and pregnancy morbidity, hypertension and the use of drugs (emphasis on benefits from hydroxychloroquine and antiplatelets/anticoagulants). Hormonal contraception and menopause replacement therapy can be used in patients with stable/inactive disease and low risk of thrombosis. Fertility preservation with gonadotropin-releasing hormone analogues should be considered prior to the use of alkylating agents. Assisted reproduction techniques can be safely used in patients with stable/inactive disease; patients with positive antiphospholipid antibodies/APS should receive anticoagulation and/or low-dose aspirin. Assessment of disease activity, renal function and serological markers is important for diagnosing disease flares and monitoring for obstetrical adverse outcomes. Fetal monitoring includes Doppler ultrasonography and fetal biometry, particularly in the third trimester, to screen for placental insufficiency and small for gestational age fetuses. Screening for gynaecological malignancies is similar to the general population, with increased vigilance for cervical premalignant lesions if exposed to immunosuppressive drugs. Human papillomavirus immunisation can be used in women with stable/inactive disease. Conclusions Recommendations for women's health issues in SLE and/or APS were developed using an evidence-based approach followed by expert consensus.
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Affiliation(s)
- L Andreoli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Rheumatology and Clinical Immunology, Spedali Civili, Brescia, Italy
| | - G K Bertsias
- Department of Rheumatology, Clinical Immunology and Allergy, University of Crete Medical School, Heraklion, Greece
| | - N Agmon-Levin
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel.,The Faculty of Medicine, Tel Aviv University, Israel
| | - S Brown
- Royal National Hospital For Rheumatic Diseases, Bath, UK
| | - R Cervera
- Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Catalonia, Spain
| | - N Costedoat-Chalumeau
- AP-HP, Hôpital Cochin, Centre de référence maladies auto-immunes et systémiques rares, Paris, France.,Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - A Doria
- Rheumatology Unit, Department of Medicine, University of Padua, Italy
| | - R Fischer-Betz
- Policlinic of Rheumatology, Hiller Research Unit, University Clinic Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - F Forger
- Department of Rheumatology, Immunology and Allergology, University Hospital of Bern, Bern, Switzerland
| | - M F Moraes-Fontes
- Unidade de Doenças Auto-imunes-Serviço Medicina Interna 7.2, Hospital Curry Cabral/Centro Hospitalar Lisboa Central, NEDAI/SPMI, Lisboa, Portugal
| | - M Khamashta
- Lupus Research Unit, The Rayne Institute, St. Thomas Hospital, London, UK.,Department of Rheumatology, Dubai Hospital, Dubai, United Arab Emirates
| | - J King
- EULAR PARE Patient Research Partner, London, UK
| | - A Lojacono
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Obstetrics and Gynaecology, Spedali Civili, Brescia, Italy
| | - F Marchiori
- EULAR PARE Patient Research Partner, Rome, Italy
| | - P L Meroni
- Department of Clinical Sciences and Community Health, University of Milan, Istituto Auxologico Italiano, Milan, Italy
| | - M Mosca
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Motta
- Neonatology and Neonatal Intensive Care Unit, Spedali Civili, Brescia, Italy
| | - M Ostensen
- Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - C Pamfil
- Department of Rheumatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - L Raio
- Department of Obstetrics and Gynaecology, University Hospital of Bern, Inselspital, Switzerland
| | - M Schneider
- Policlinic of Rheumatology, Hiller Research Unit, University Clinic Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - E Svenungsson
- Rheumatology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - M Tektonidou
- Rheumatology Unit, Joint Academic Rheumatology Programme, 1st Department of Propaedeutic Internal Medicine Athens, National and Kapodistrian University of Athens, Athens, Greece
| | - S Yavuz
- Department of Rheumatology, Istanbul Bilim University, Istanbul Florence Nightingale Hospital, Esentepe-Istanbul, Turkey
| | - D Boumpas
- 4th Department of Internal Medicine, 'Attikon' University Hospital, Medical School, University of Athens, Athens, Greece.,Joint Academic Rheumatology Program, National and Kapodestrian University of Athens, Athens, Greece
| | - A Tincani
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Rheumatology and Clinical Immunology, Spedali Civili, Brescia, Italy
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17
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Neri F, Chimini L, Filippini E, Motta M, Faden D, Tincani A. Pregnancy in patients with rheumatic diseases: psychological implication of a chronic disease and neuropsychological evaluation of the children. Lupus 2016; 13:666-8. [PMID: 15485099 DOI: 10.1191/0961203303lu2003oa] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
As a consequence of the general improvement in the diagnosis and management of rheumatic diseases, patients achieve a better quality of life, with the possibility of a normal family life including one or more pregnancies. It is important, therefore, to consider the psychological aspects of these mothers’ life and the influence of their chronic disease on their children is development. Several papers have reported the impact of systemic lupus erythematosus (SLE) on the quality of life. They found higher incidence of anxiety (from 15 to 45%) and depression (from 25 to 47%) compared to the general population. We have investigated the psychological influence of SLE on family planning, and we observed that it can interfere with physiological phenomena such as parenthood and the upbringing of children. The children of lupus mothers have a normal intelligence level for their age. What is emerging, however, is an increased incidence of learning disabilities compared to the general population. This observation suggests the importance of an early neuropsychological examination, in order to identify the children needing particular care. Therefore, psychological support seems to be an important help in the counseling of patients with rheumatic disease and in the future life of their children.
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Affiliation(s)
- F Neri
- Pediatric Neuropsychiatry Institute, University of Brescia, Italy.
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Cimaz R, Meregalli E, Biggioggero M, Airò P, Danieli E, Antonioli CM, Motta M, Chirico G, Columbrita D, Frassi M, Meroni PL, Tincani A. Response to tetanus vaccination in infants exposed in utero to immunosuppressants for maternal autoimmune disorders. Lupus 2016; 16:129-32. [PMID: 17402369 DOI: 10.1177/0961203306075738] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Immunosuppressive drugs given during pregnancy to mothers suffering from a systemic autoimmune disease (AID) can cross the placenta, thus being potentially able to affect the offspring immune system. Aim of our study was to evaluate the in vivo immune function of a series of these newborns. Twenty-two babies born from mothers suffering from autoimmune diseases (AID) who had been taking immunosuppressive drugs during pregnancy were evaluated for their response to vaccination with C. Tetani toxoid. Six babies born from mothers receiving low-dose aspirin only were used as controls. The immune response to C. Tetani vaccination was evaluated with an ELISA to detect circulating antibodies. Five children out of 28 (17%) did not achieve a protective titer of anti C. Tetanitoxoid IgG. No clear relationship was found between specific drug exposure and antibody response. Our findings suggest that maternal immunosuppressive treatment given for a systemic AID can affect the response to an active immunization, without specificities for drug types used.
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Affiliation(s)
- R Cimaz
- Hospices Civils de Lyon- Universitè Lyon 1, Lyon, France.
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Tincani A, Danieli E, Nuzzo M, Scarsil M, Motta M, Cimaz R, Lojacono A, Nacinovich R, Taddei F, Doria A, Brucato A, Meroni P. Impact of in utero environment on the offspring of lupus patients. Lupus 2016; 15:801-7. [PMID: 17153854 DOI: 10.1177/0961203306071005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [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: 11/15/2022]
Abstract
The number of patients affected by systemic lupus erythematosus (SLE) that decide to have children has greatly increased probably because of recent improvements in the diagnosis and management of the disease. This has stimulated our interest in defining the outcome of children, focusing both on neonatal problems and long term development. SLE patients still carry a risk of pregnancy loss. However, due to careful monitoring and treatment by a multidisciplinary team, the number of losses has dramatically decreased, but an increased number of preterm deliveries is still a problem. Neonatal lupus is linked to the presence of anti-Ro/SS-A and anti-La/SS-B antibodies in the mother, although other factors probably of fetal origin are important. Neonatal lupus is a complex condition whose most serious manifestation is the congenital heart block (CHB). Usually, children with complete CHB need permanent pacing, but apparently do not have neuropsychological problems. Studies focusing on the neuropsychological development of SLE offspring show an increased number of learning disabilities in children with normal intelligence levels. Fetal consequence of maternal treatment need to be considered choosing non teratogenic drugs, but the withdrawal of medications just because the patient is pregnant should be avoided to avoid SLE flares.
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Affiliation(s)
- A Tincani
- Spedali Civili and University of Brescia, Brescia, Italy.
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Motta M, Tincani A, Lojacono A, Faden D, Gorla R, Airò P, Neri F, Gasparoni A, Ciardelli L, de Silvestri A, Marconi M, Chirico G. Neonatal outcome in patients with rheumatic disease. Lupus 2016; 13:718-23. [PMID: 15485111 DOI: 10.1191/0961203403lu2002oa] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Rheumatic autoimmune diseases have a higher prevalence in women, particularly during their childbearing age. Due to improved management, an increasing number of patients plan and carry out one or more pregnancies. Therefore, a growing interest is being paid to the possible consequences of maternal disease and associated treatment on the fetus and newborn infant. If maternal disease is characterized by the presence of IgG isotype autoantibodies, these can cross the placenta with possible antibody-mediated damage to the fetus. This is typically the case of the so called neonatal lupus erythematosus (NLE); a similar mechanism has been shown in infants of patients with immune thrombocytopenic purpura (ITP) and, less frequently, in those from mothers with antiphospholipid syndrome (APS). Indeed, this last condition is often responsible for placental, rather than neonatal, pathology. In addition, immunosuppressive and other drugs administered to the mothers during pregnancy and lactation might affect the fetal and neonatal immune system development. Finally, mothers disease and/or treatment could be related to neuropsychological alteration reported in some of their children.
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Affiliation(s)
- M Motta
- Neonatology and Neonatal Intensive Care, Spedali Civili, Brescia, Italy.
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Neri F, Chimini L, Bonomi F, Filippini E, Motta M, Faden D, Lojacono A, Rebaioli CB, Frassi M, Danieli E, Tincani A. Neuropsychological development of children born to patients with systemic lupus erythematosus. Lupus 2016; 13:805-11. [PMID: 15540514 DOI: 10.1191/0961203304lu2018oa] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To verify the neuropsychological development in the offspring of patients with systemic lupus erythematosus (SLE), 47 children (23 male and 24 female) from affected women were studied. The tests applied were related to the children’s ages: Griffiths scale up to four years, WPPSI and metaphonological tests (MP, evaluating the phonological consciousness) from four to six years of age, WISC-R test and Rey test (evaluating the visual-space abilities) from six years onwards; finally, specific tests for the diagnosis of learning disabilities (LD) between the ages of seven and 13. Intelligence levels were always normal (mean IQ score 106.32; median 104; SD 9.05). Three out of eight examined children failed MP, therefore may develop LD and will need further evaluation later. Fourteen children were specifically studied for LD and three reported scores lower than normal, but only two (who were brothers) were defined dyslexic. Antiphospholipid antibodies (aPL) were positive in the mothers of the three children with impaired LD tests. Other maternal autoantibodies or drugs administered during pregnancy did not seem to be related to LD. In conclusion, maternal SLE does not impair intelligence levels, but may increase the occurrence of LD particularly in male children (2/8 males examined, 25%). Both maternal aPL and genetic background may have pathogenetic implications.
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Affiliation(s)
- F Neri
- Pediatric Neuropsychiatry Institute, University of Brescia, Brescia, Italy
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Abstract
Neurotrophins, such as brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF), have been implicated in the generation and modulation of pain. To investigate whether alterations in neurotrophin levels can be detected in subjects suffering from nociceptive disorders, such as primary headaches, we determined the peripheral (platelet and plasma) levels of BDNF and NGF in patients suffering from migraine, with or without aura, or cluster headache (CH), in the interictal phase, and in healthy volunteers. All primary headaches patients studied showed significantly decreased platelet levels of BDNF (migraine vs. controls P < 0.001; CH vs. controls P < 0.01), while a selective reduction of platelet NGF was observed in migraine sufferers and not in CH patients compared with control subjects (migraine vs. controls P < 0.001). These changes were not accompanied by significant modifications of neurotrophin plasma levels. Our findings show for the first time that changes in peripheral levels of neurotrophines (BDNF and NGF) occur in patients suffering from different types of primary headaches, suggesting a potential involvement of BDNF and NGF in the pathophysiology of these disorders, and raising the possibility that differences in peripheral neurotrophins may help to distinguish migraine biologically from CH.
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Affiliation(s)
- F Blandini
- Laboratory of Functional Neurochemistry, Neurological Institute C. Mondino, Pavia, Italy
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Dall'ara F, Reggia R, Bazzani C, Andreoli L, Agosti M, Mazza G, Lazzaroni M, Lojacono A, Motta M, Tincani A. FRI0176 Safety of anti-TNF Alfa Agents during Pregancy and Breastfeeding: Longterm Follow up of Exposed Children in A Case-Series of Mothers with Chronic Arthritides. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4123] [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: 11/03/2022]
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Bertaina G, Motta M, Rossi M, Vitali E, Galli DE. One-Dimensional Liquid ^{4}He: Dynamical Properties beyond Luttinger-Liquid Theory. Phys Rev Lett 2016; 116:135302. [PMID: 27081985 DOI: 10.1103/physrevlett.116.135302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Indexed: 06/05/2023]
Abstract
We compute the zero-temperature dynamical structure factor of one-dimensional liquid ^{4}He by means of state-of-the-art quantum Monte Carlo and analytic continuation techniques. By increasing the density, the dynamical structure factor reveals a transition from a highly compressible critical liquid to a quasisolid regime. In the low-energy limit, the dynamical structure factor can be described by the quantum hydrodynamic Luttinger-liquid theory, with a Luttinger parameter spanning all possible values by increasing the density. At higher energies, our approach provides quantitative results beyond the Luttinger-liquid theory. In particular, as the density increases, the interplay between dimensionality and interaction makes the dynamical structure factor manifest a pseudo-particle-hole continuum typical of fermionic systems. At the low-energy boundary of such a region and moderate densities, we find consistency, within statistical uncertainties, with predictions of a power-law structure by the recently developed nonlinear Luttinger-liquid theory. In the quasisolid regime, we observe a novel behavior at intermediate momenta, which can be described by new analytical relations that we derive for the hard-rods model.
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Affiliation(s)
- G Bertaina
- Dipartimento di Fisica, Università degli Studi di Milano, via Celoria 16, I-20133 Milano, Italy
| | - M Motta
- Department of Physics, The College of William and Mary, Williamsburg, Virginia 23187, USA
| | - M Rossi
- Scuola Normale Superiore, Piazza dei Cavalieri 7, I-56126 Pisa, Italy
- International Center for Theoretical Physics (ICTP), Strada Costiera 11, I-34154 Trieste, Italy
- Dipartimento di Fisica e Astronomia, Università degli Studi di Padova, via Marzolo 8, I-35131 Padova, Italy
| | - E Vitali
- Department of Physics, The College of William and Mary, Williamsburg, Virginia 23187, USA
| | - D E Galli
- Dipartimento di Fisica, Università degli Studi di Milano, via Celoria 16, I-20133 Milano, Italy
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Motta M, Tatti M, Furlan F, Celato A, Di Fruscio G, Polo G, Manara R, Nigro V, Tartaglia M, Burlina A, Salvioli R. Clinical, biochemical and molecular characterization of prosaposin deficiency. Clin Genet 2016; 90:220-9. [DOI: 10.1111/cge.12753] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 01/28/2016] [Accepted: 01/29/2016] [Indexed: 12/22/2022]
Affiliation(s)
- M. Motta
- Genetics and Rare Diseases Research Division; Ospedale Pediatrico Bambino Gesù; Rome Italy
| | - M. Tatti
- Department of Haematology, Oncology and Molecular Medicine; Istituto Superiore di Sanità; Rome Italy
| | - F. Furlan
- Division of Inherited Metabolic Diseases; University Hospital; Padua Italy
| | - A. Celato
- Division of Inherited Metabolic Diseases; University Hospital; Padua Italy
| | - G. Di Fruscio
- Department of Biochemistry, Biophysics and General Pathology; Second University of Naples; Naples Italy
- Telethon Institute of Genetics and Medicine (TIGEM); Naples Italy
| | - G. Polo
- Division of Inherited Metabolic Diseases; University Hospital; Padua Italy
| | - R. Manara
- Division of Inherited Metabolic Diseases; University Hospital; Padua Italy
| | - V. Nigro
- Department of Biochemistry, Biophysics and General Pathology; Second University of Naples; Naples Italy
- Telethon Institute of Genetics and Medicine (TIGEM); Naples Italy
| | - M. Tartaglia
- Genetics and Rare Diseases Research Division; Ospedale Pediatrico Bambino Gesù; Rome Italy
| | - A. Burlina
- Division of Inherited Metabolic Diseases; University Hospital; Padua Italy
| | - R. Salvioli
- Department of Haematology, Oncology and Molecular Medicine; Istituto Superiore di Sanità; Rome Italy
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Motta M, Galli DE, Moroni S, Vitali E. Imaginary time density-density correlations for two-dimensional electron gases at high density. J Chem Phys 2015; 143:164108. [DOI: 10.1063/1.4934666] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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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Mussa A, De Andrea M, Motta M, Mormile A, Palestini N, Corrias A. Predictors of Malignancy in Children with Thyroid Nodules. J Pediatr 2015; 167:886-892.e1. [PMID: 26164379 DOI: 10.1016/j.jpeds.2015.06.026] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 05/06/2015] [Accepted: 06/08/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To evaluate the diagnostic accuracy of clinical, laboratory, and ultrasound (US) imaging characteristics of thyroid nodules in assessing the likelihood of malignancy. STUDY DESIGN Data from 184 children and adolescents with thyroid nodules were evaluated and compared with respective cytologic/histologic outcomes. A regression model was designed to assess the predictors associated with malignancy and to calculate ORs. RESULTS Twenty-nine malignant neoplasms (25 papillary, 1 medullary, 3 Hurtle-cell carcinomas), 8 follicular adenomas, and 147 goitrous nodules (92 based on cytology, 55 on follow-up) were diagnosed. Fine-needle aspiration biopsy diagnostic accuracy, sensitivity, and specificity were 91%, 100%, and 88%, respectively. Male sex, compression symptoms, palpable lymphopathy, thyroid stimulating hormone concentration, microcalcifications, indistinct margins, hypoechoic US pattern, pathologic lymph node alterations, and increased intranodular vascularization were associated with malignancy. Regular margins, mixed echoic pattern, and peripheral-only vascularization were associated with benignity. During follow-up, nodule growth was associated with malignant disease, especially with levothyroxine therapy. A multivariate analysis confirmed that microcalcifications, hypoechoic pattern, intranodular vascularization, lymph node alterations, and thyroid stimulating hormone concentration were independent predictors of malignant outcome. For each predictor, we provide sensitivity, specificity, and positive/negative predictive values. CONCLUSIONS Clinical, laboratory, and US features of nodules can be used as predictors of malignancy in children. Although none has diagnostic accuracy as high as that of fine-needle aspiration biopsy, these predictors should be considered in deciding the diagnostic approach of children with thyroid nodules.
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Affiliation(s)
- Alessandro Mussa
- Department of Public Health and Pediatric Sciences, University of Torino, Torino, Italy.
| | - Maurilio De Andrea
- Endocrinology, Diabetes and Metabolic Disease Unit, Azienda Ospedaliera Ordine Mauriziano, Torino, Italy
| | - Manuela Motta
- Anatomical Pathology Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, Torino, Italy
| | - Alberto Mormile
- Endocrinology, Diabetes and Metabolic Disease Unit, Azienda Ospedaliera Ordine Mauriziano, Torino, Italy
| | - Nicola Palestini
- General Surgery, Department of Medical and Surgical Sciences, University of Torino, Ospedale Molinette, Città della Salute e della Scienza di Torino, Torino, Italy
| | - Andrea Corrias
- Department of Public Health and Pediatric Sciences, University of Torino, Torino, Italy
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Andreoli L, Bertsias G, Agmon-Levin N, Brown S, Cervera R, Costedoat-Chalumeau N, Doria A, Fischer-Betz R, Forger F, Moraes-Fontes M, Khamashta M, King J, Lojacono A, Marchiori F, Meroni P, Mosca M, Motta M, Ostensen M, Pamfil C, Raio L, Schneider M, Svenungsson E, Tektonidou M, Yavuz S, Boumpas D, Tincani A. OP0086 Eular Recommendations for Women's Health and the Management of Family Planning, Assisted Reproduction, Pregnancy, and Menopause in Patients With Systemic Lupus Erythematosus and/or the Antiphospholipid Syndrome. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Nalli C, Iodice A, Andreoli L, Lojacono A, Motta M, Fazzi E, Tincani A. AB0557 Long Term Neurodevelopmental Outcome in Children Born to Mothers with Antiphospholipid Antibodies During Pregnancy. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1333] [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: 11/03/2022]
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Agosti M, Andreoli L, Bazzani C, Nalli C, Reggia R, Gorla R, Taglietti M, Lojacono A, Motta M, Tincani A. SAT0159 Long-Term Follow-Up of Children Born to Mothers with Chronic Arthritides and Exposed in Utero to Anti-TNF-Alpha Agents: A Case-Control Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1971] [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: 11/04/2022]
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Russolillo N, Vigano' L, Razzore P, Langella S, Motta M, Bertuzzo F, Papotti M, Ferrero A. Survival prognostic factors of gastro-enteric-pancreatic neuroendocrine tumors after primary tumor resection in a single tertiary center: Comparison of gastro-enteric and pancreatic locations. Eur J Surg Oncol 2015; 41:751-7. [DOI: 10.1016/j.ejso.2015.02.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 01/16/2015] [Accepted: 02/13/2015] [Indexed: 11/25/2022] Open
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Garino F, Deandrea M, Motta M, Mormile A, Ragazzoni F, Palestini N, Freddi M, Gasparri G, Sgotto E, Pacchioni D, Limone PP. Diagnostic performance of elastography in cytologically indeterminate thyroid nodules. Endocrine 2015; 49:175-83. [PMID: 25273318 DOI: 10.1007/s12020-014-0438-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 09/23/2014] [Indexed: 12/11/2022]
Abstract
Cytological examination of material from fine-needle aspiration biopsy is the mainstay of diagnosis of thyroid nodules, thanks to its remarkable accuracy and scarcity of complications. However, follicular lesions (also called indeterminate lesions or Thy3 in the current classification), a heterogeneous group of lesions in which cytology is unable to give a definitive diagnosis to, represent its main limit. Elastography has been proposed as a potential diagnostic tool to define the risk of malignancy in the aforementioned nodules, but at present there is no conclusive data due to the small number of specifically addressed studies and the lack of concordance among them. The objective of our study was to evaluate the role of real-time elastography (RTE) for refining diagnosis of Thy3 nodules, by integrating diagnostic information provided by traditional ultrasound (US). The study included 108 patients with Thy3 nodules awaiting for surgery, which were evaluated by US (considering hypoecogenicity, irregular margins, microcalcifications, halo sign, and intranodular vascularization) and RTE. Nodules were classified at RTE using a four-class color scale. At histologic examination, 75 nodules were benign and 33 malignant. As expected, none of the ultrasound parameters alone was adequate in predicting malignancy or benignity of the nodules; in the presence of at least two US risk factors, we obtained 61 % sensitivity, 83 % specificity, and 77 % accuracy with 6.8 OR (95 % CI 2.4-20.4). RTE scores 3 and 4 showed 76 % sensitivity, 88 % specificity, 74 % PPV, and 89 % NPV with diagnostic accuracy of 84 %; the data are statistically significant (p < 0.0001) with a OR of 21.9 (95 % CI 7.1-76). By combining RTE with US parameters, the presence of at least 2 characters of suspicion had 88 % sensitivity and 94 % NPV with 23.8 OR (95 % CI 7-106.3). The use of combined RTE and US leads to the identification of two patients subpopulations which have a significantly different malignancy risk (6 vs. 63 %); further studies are needed to verify if it is possible to send only the first group to thyroidectomy and the other to follow-up.
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Affiliation(s)
- Francesca Garino
- Division of Endocrinology Diabetes and Metabolism, Department of Medicine, A.O. Ordine Mauriziano, Largo Turati 62, 10128, Turin, Italy,
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Nalli C, Iodice A, Andreoli L, Lojacono A, Motta M, Fazzi E, Tincani A. The effects of lupus and antiphospholipid antibody syndrome on foetal outcomes. Lupus 2014; 23:507-17. [PMID: 24763535 DOI: 10.1177/0961203313501402] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disease that primarily affects women of childbearing-age. Antiphospholipid syndrome (APS) is a systemic autoimmune disorder defined by the occurrence of venous and arterial thrombosis, often multiple, and pregnancy morbidity in the presence of antiphospholipid antibodies (aPL). Recently, the long-term outcome of children born to patients with lupus and APS has become a major topic of interest both to patients and physicians. One of the major problems related to maternal disease is preterm delivery with all the consequences that this condition may bring. Prematurity may also be due to the presence of aPL; however, aPL do not generally display any thrombotic potential on neonates. Another complication may be neonatal lupus (NL), mediated by the presence of maternal antibodies (anti-Ro/SSA and anti-La/SSB). In addition, behaviour and neuropsychological outcomes have also been a matter of interest, but there are currently few data available. Beyond the biological influence of both maternal disease and autoimmune background, it is important to focus on the possible influence of maternal chronic illness on the neuropsychological development of her children. Whether aPL exposure could have a direct effect on brain development is still being debated. In children of mothers with APS, language delays have been noted and learning disabilities were described with a higher rate than the general age-school population. Several studies were performed on children born to lupus mothers: even if maternal lupus does not seem to impair intelligence levels, it may increase the occurrence of learning disabilities and particularly dyslexia in male children. To the best of our knowledge, no studies are available on the long-term outcome of children born to mothers with lupus or APS and particularly regarding the development of autoimmune diseases. Nevertheless, common experience of experts in the field is that these children do not show a significantly increased risk of displaying the same autoimmune disease as their mothers. The purpose of this paper is to answer the frequently asked questions of patients with lupus and APS who desire to become mothers, based on the little information available.
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Affiliation(s)
- C Nalli
- 1Rheumatology and Clinical Immunology, Department of Clinical and Experimental Sciences, Spedali Civili and University of Brescia, Italy
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Bardia A, Chavez-MacGregor C, Modi S, Campone M, Ma B, Kittaneh M, Dirix L, Motta M, Zhang V, Bhansali S, Fjaellskog M, Oliveira M. 500 Triple blockade with LEE011, everolimus, and exemestane in women with ER+/HER2− advanced/metastatic breast cancer: results from a Phase Ib clinical trial. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70626-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Background Systemic lupus erythematosus (SLE) and antiphospholipid antibody syndrome (APS) are autoimmune diseases that affect women of childbearing age. Pregnancies in these patients carry several complications such as prematurity. Maternal IgG antiphospholipid antibodies (aPL) can cross the placenta but they don’t generally cause any neonatal thrombotic event. Because of the incompleteness of the fetal blood-brain barrier, aPL could theoretically reach the fetal brain. Whether this can have an effect on brain development is still under investigation. Some studies performed in children of patients with SLE and/or APS showed an increased number of learning disabilities without impairment in intelligence level. Objectives The objectives of this article are to evaluate the neurodevelopment outcome in 30 children (median age 9 years) born to mothers with SLE and/or APS with IgG anti-beta2-glycoprotein I during the third trimester of pregnancy and found positive for the same antibodies at birth. Methods A neurological physical exam was performed in all children. We submitted some questionnaires to the mothers: the Child Behavior CheckList (CBCL) and a homemade set of questions obtained by a team composed of rheumatologists and pediatric neurologists. Intellectual functioning was determined by the Wechsler scale for corrected age. Results In all children neurological physical exam and intelligence levels were found to be normal but mild behavior disorders and history of neurological manifestations were shown in three children. Conclusions Offspring of patients with SLE and/or APS are generally healthy. We and others observed the occurrence of minor neurological disorders that might be related to maternal disease or to prematurity. The limited number of the available data on this sensitive issue supports the need for further studies.
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Affiliation(s)
- C Nalli
- Rheumatology and Clinical Immunology
| | - A Iodice
- Unit of Child and Adolescent Neuropsychiatry
| | | | - A Lojacono
- Obstetrics and Gynecology, Department of Clinical and Experimental Sciences, Spedali Civili and University of Brescia, Italy
| | - M Motta
- Neonatology and NICU, Spedali Civili, Brescia, Italy
| | - E Fazzi
- Unit of Child and Adolescent Neuropsychiatry
| | - A Tincani
- Rheumatology and Clinical Immunology
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Nalli C, Iodice A, Andreoli L, Lojacono A, Motta M, Fazzi E, Tincani A. SAT0018 Neurodevelopmental Long Term Outcome in Children Born to Mothers with Systemic Lupus Erythematosus and Antiphospholipid Syndrome. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5324] [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: 11/04/2022]
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Lazzaroni M, Fredi M, Andreoli L, Brucato A, Caporali R, Caramaschi P, Doria A, Gerosa M, Guillevin L, Inverardi F, Lojacono A, Meroni P, Montecucco C, Mosca M, Motta M, Ramoni V, Sfriso P, Sinico R, Strigini F, Tani C, Tincani A. OP0230 Systemic Vasculitis and Pregnancy: A Multicenter Study on Maternal and Neonatal Outcome of 66 Prospectively Followed Pregnancies. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2312] [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: 11/04/2022]
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Mekinian A, Carbillon L, Nicaise-Roland P, Rousseau H, Lachassinne E, Motta M, Vicaut E, Boinot C, Avcin T, De Carolis S, Rovere-Querini P, Lambert M, Derenne S, Pourrat O, Chollet-Martin S, Biasini-Rebaioli R, Rovelli R, Lojacono A, Ambrozic A, Benbara A, Pierre F, Allegri F, Nuzzo M, Hatron PY, Tincani A, Aurousseau MH, Boffa MC, Fain O. Mothers' antiphospholipid antibodies during pregnancy and the relation to offspring outcome. Clin Exp Rheumatol 2014; 32:446. [PMID: 24847815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Accepted: 01/09/2014] [Indexed: 06/03/2023]
Affiliation(s)
- A Mekinian
- Service de Médecine Interne, Hopital Jean Verdier, Bondy, France.
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Motta M, Galli DE, Moroni S, Vitali E. Imaginary time correlations and the phaseless auxiliary field quantum Monte Carlo. J Chem Phys 2014; 140:024107. [DOI: 10.1063/1.4861227] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Vai A, Pierelli A, Locatelli F, Vavassori V, Della Bosca E, Ravasio A, Motta M, Manazzale V, Salmoiraghi P. EP-1648: Prostate intrafraction motion assessment using a temporaryimplanted wired electromagnetic tracking system. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31766-7] [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: 10/23/2022]
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41
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Bocca C, Ievolella M, Autelli R, Motta M, Mosso L, Torchio B, Bozzo F, Cannito S, Paternostro C, Colombatto S, Parola M, Miglietta A. Expression of Cox-2 in human breast cancer cells as a critical determinant of epithelial-to-mesenchymal transition and invasiveness. Expert Opin Ther Targets 2013; 18:121-35. [PMID: 24325753 DOI: 10.1517/14728222.2014.860447] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Cyclooxygenase-2 (COX-2) is overexpressed in several malignancies and is implicated in breast cancer progression. OBJECTIVES We investigated whether changes in COX-2 expression may affect epithelial-to-mesenchymal transition (EMT) and then invasive potential of human breast cancer cells, in relationship with hypoxia. COX-2-null MCF-7 human breast cancer cells, MCF-7 cells transiently expressing COX-2 and COX-2-expressing MDA-MB-231 cells were employed. RESULTS COX-2 overexpression resulted in downregulation of E-cadherin and β-catenin, upregulation of vimentin, N-cadherin and SNAI1, suggesting EMT occurrence. COX-2-overexpressing MCF-7 cells were also characterized by increased invasiveness and release of matrix-metalloproteinase-9. The above-mentioned characteristics, homologous to those detected in highly invasive MDA-MB-231 cells, were reverted by treatment of COX-2-overexpressing MCF-7 cells with celecoxib, a COX-2-specific inhibitor, partly through the inhibition of COX-2-related intracellular generation of reactive oxygen species. Hypoxia further exacerbated COX-2 expression, EMT changes and invasive ability in both COX-2-overexpressing MCF-7 cells and MDA-MB-231 cells. Finally, immunohistochemistry performed on samples from normal and neoplastic human breast tissues revealed that COX-2-positive malignant cells were also positive for EMT-related antigens, hypoxia-inducible factor (HIF)-2α and the oxidative stress marker heme oxygenase. CONCLUSIONS These findings support the existence of a direct link between COX-2 overexpression, EMT and invasiveness in human breast cancer cells, emphasizing the role of hypoxic microenvironment.
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Affiliation(s)
- Claudia Bocca
- University of Torino, Department of Clinical and Biological Sciences , C.so Raffaello, 30 - 10125 Torino , Italy +39 0116707756 ; +39 0116707753 ;
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Guerra A, Marotta V, Deandrea M, Motta M, Limone PP, Caleo A, Zeppa P, Esposito S, Fulciniti F, Vitale M. BRAF (V600E) associates with cytoplasmatic localization of p27kip1 and higher cytokeratin 19 expression in papillary thyroid carcinoma. Endocrine 2013. [PMID: 23203004 DOI: 10.1007/s12020-012-9843-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The genetic alterations are responsible for the altered protein expression in tumors. The knowledge of the link between the altered protein expression and genetic alterations may provide potentially important biological and clinical information. In this study, the expression of some protein markers (Gal-3, p21Kip1, CK19) known to be associated to the papillary thyroid carcinoma (PTC) was assessed in a series of surgical samples by immunohistochemistry, and the association between expression of these markers and the BRAF (V600E) mutation was investigated. Gal-3 positive staining was evident in 26 % of benign nodules. The BRAF (V600E) mutation and Gal-3 expression, were found in 55.5 and 87 % of PTC respectively, and were unlinked. The expression of CK19 in benign nodules was weak and limited to scattered follicular cells. Diffuse cytoplasmatic expression of CK19 was present in malignant tumors in a variable percentage of cells. A higher percentage of CK19 expressing cells was associated with BRAF (V600E) (P ≤ 0.001). All benign nodules displayed nuclear p27kip1 in more than 15 % of the cells. Twenty-nine PTC showed a cytoplasmatic staining with negative nuclei. PTC with cytoplasmatic or 0-5 % of cells with nuclear staining, 6-15 % or >15 % of cells with nuclear staining were 72 (66.7 %), 24 (22.2 %), and 12 (11.1 %) respectively. In BRAF (V600E) positive tumors, the cytoplasmatic localization of p27kip1 was significantly more frequent (P = 0.024). In conclusion, we provide evidences that BRAF (V600E) is non-associated with Gal-3 expression, whereas it is associated with cytoplasmatic localization of p27kip1 and higher CK19 expression in PTC.
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Affiliation(s)
- Anna Guerra
- Department of Medicine and Surgery, University of Salerno, Via Allende, 84081, Baronissi, Salerno, Italy
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Abstract
AIM To review the working principles of thromboelastography and evaluate the current knowledge about the possibility of its implementation in the neonatal intensive care unit setting. METHOD Thorough search of the literature in the PubMed database (until May 31, 2012) concerning Thromboelastography (TEG) and/or Thromboelastometry (ROTEM) use in the newborn infant. RESULTS Neonatal data are limited to a small number of healthy subjects and virtually absent in the extreme premature infant. Healthy newborns exhibit age dependent accelerated initiation and propagation of coagulation despite prolonged standard plasma coagulation test results, whereas clot firmness and fibrinolysis are similar to adult values. Several neonatal pathological conditions (e.g. sepsis; hypothermia) are linked with substantial changes in the thromboelastographic parameters. CONCLUSIONS The current knowledge is too limited to express a definitive indication on the reliability of the use of viscoelastic point of care analyzer in the neonatal intensive care unit setting. However, their potential use not only as a diagnostic tool, but also to guide the transfusion therapy requires careful consideration.
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Affiliation(s)
- M Radicioni
- Neonatal Intensive Care - Paediatric Clinic, S. Maria della Misericordia Hospital of Perugia, Perugia, Italy.
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Viganò L, Ravarino N, Ferrero A, Motta M, Torchio B, Capussotti L. Prospective Evaluation of Accuracy of Liver Biopsy Findings in the Identification of Chemotherapy-Associated Liver Injuries. ACTA ACUST UNITED AC 2012; 147:1085-91. [DOI: 10.1001/archsurg.2012.1867] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Uccello M, Vacante M, Giordano M, Malaguarnera M, Biondi A, Basile F, Malaguarnera G, Pennisi M, Motta M. Osteoblastoma of cervical spine causing an unusual neck pain. Eur Rev Med Pharmacol Sci 2012; 16 Suppl 4:17-20. [PMID: 23090798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Osteoblastoma is a rare benign tumor of bone that accounts for approximately 1% of primary skeletal neoplasms, with around 90% of cases diagnosed in the second and third decades of life. Cervical spine is an usual localization of osteoblastoma. The main clinical manifestation in case of cervical spine location is a progressive and resistant pain, possibly accompanied by stiffness, scoliosis or other ailments, including severe neurological deficits. Owing to a non-specific clinical presentation of osteoblastoma, the delay in diagnosis is common. Osteoblastomas may have an aggressive behavior, tend to enlarge and damage the bone and adjacent structures. The treatment of choice is, therefore, a wide and complete surgical excision of the lesion in order to achieve full recovery and prevent recurrence or, in some cases, malignant transformation. In the case of persistent neck pain, not readily relieved by aspirin and possibly accompanied by stiffness, scoliosis or neurological deficits, especially in young subjects, osteoblastoma of cervical spine may be one of the diagnostic options to be considered, in order to avoid delay in diagnosis. We report the case of a 41-year-old male affected by cervical spine osteoblastoma causing a lasting neck pain.<br />
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Affiliation(s)
- M Uccello
- School of Medicine, University of Catania, Catania, Italy
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Ragazzoni F, Deandrea M, Mormile A, Ramunni MJ, Garino F, Magliona G, Motta M, Torchio B, Garberoglio R, Limone P. High diagnostic accuracy and interobserver reliability of real-time elastography in the evaluation of thyroid nodules. Ultrasound Med Biol 2012; 38:1154-1162. [PMID: 22542262 DOI: 10.1016/j.ultrasmedbio.2012.02.025] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 02/17/2012] [Accepted: 02/24/2012] [Indexed: 05/31/2023]
Abstract
Elastography is a new diagnostic tool in the evaluation of thyroid nodules. Aim of the study was to evaluate the accuracy and reliability of elastography in discriminating thyroid lesions and the interobserver variability. One hundred thirty-two nodules in 115 patients selected for thyroid surgery underwent conventional ultrasound and elastographic evaluation. Elastography score was divided in four categories (totally elastic nodule, mainly elastic, mainly rigid and totally rigid) according to signal distribution. Three independent operators conducted the study. Final histology showed 92 benign nodules and 40 malignant. On elastography, 77/92 benign nodules were classified as score 1 or 2 and 34/40 malignant nodules as score 3 or 4 (sensitivity 85%, specificity 83.7%, positive predictive value [PPV] 69.3%, negative predictive value [NPV] 92.7%). Rate of concordance between operators was good (K test: 0.64, p < 0.0001). Simple to use, with good interobserver agreement, elastography has all the requisites to become an important complement of conventional US examination in the near future.
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Affiliation(s)
- Federico Ragazzoni
- Endocrinology, Diabetes and Metabolic Disease Unit, A.O. Ordine Mauriziano di Torino, Torino, Italy.
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Motta M, Boffa MC, Tincani A, Avcin T, De Carolis S, Lachassinne E. Follow-up of babies born to mothers with antiphospholipid syndrome: Preliminary data from the European neonatal registry. Lupus 2012; 21:761-3. [DOI: 10.1177/0961203312446387] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this review preliminary data on the follow-up of 141 babies born to mothers with antiphospholipid syndrome are reported. In spite of maternal treatment, the rate of both preterm delivery and low birth weight were 16 and 17%, respectively. At birth, no clinical evidence of perinatal thrombosis was observed. Placental transfer of antiphospholipid antibodies occurred in 20, 25 and 43% of cases for lupus anticoagulant, anticardiolipin and anti-β2-glycoprotein I antibodies, respectively. At 24 months of follow-up, four children showed behaviour abnormalities suggesting the possible need for long-term neurological evaluation in this clinical setting.
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Affiliation(s)
- M Motta
- Neonatology and Neonatal Intensive Care Unit, Children’s Hospital of Brescia, Italy
| | - MC Boffa
- Laboratoire d’Hematologie, Hôpital Jean-Verdier, Bondy, France
| | - A Tincani
- Rheumatology and Clinical Immunology, Spedali Civili and University of Brescia, Brescia, Italy
| | - T Avcin
- Allergology, Rheumatology and Clinical Immunology, University Children’s Hospital Ljubljana, University Medical Center, Ljubljana, Slovenia
| | - S De Carolis
- Obstetrics and Gynecology, Catholic University, Roma, Italy
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Malaguarnera G, Leggio F, Vacante M, Motta M, Giordano M, Bondi A, Basile F, Mastrojeni S, Mistretta A, Malaguarnera M, Toscano MA, Salmeri M. Probiotics in the gastrointestinal diseases of the elderly. J Nutr Health Aging 2012; 16:402-10. [PMID: 22499466 DOI: 10.1007/s12603-011-0357-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Changes of the gut microflora in elderly appear to involve a reduction in numbers of healthy bacteria (lactobacilli and bifidobacteria) and an increase in numbers of potentially pathogenic species. These changes are generally described as gastrointestinal disorders and infections. This review analyses benefits of probiotics in old people, with particular interesting for the latest researches relevant to elderly people, e.g. trials examining enteric infections, antibiotic-associated diarrhea and Clostridium difficile associated diarrhea, functional bowel problems (constipation and irritable bowel syndrome), inflammatory bowel diseases, stimulation of the immune system and prevention of cancer. A growing number of researches indicates that some probiotic strains may help to maintain the health in old people, suggesting both health and cost-saving benefits in offering fermented dairy products. These benefits include: establishment of balanced intestinal microflora; improving colonization resistance and or prevention of diarrhea; reduction of fecal enzymes; reduction of serum cholesterol; reduction of potential mutagenes; reduction of lactose intolerance; synthesis of vitamins; predigestion of proteins.
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Affiliation(s)
- G Malaguarnera
- Department of Microbiology, University of Catania, Catania, Italy
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Scarfò L, Zibellini S, Tedeschi A, Maura F, Neri A, Bertazzoni P, Sarina B, Nalli G, Motta M, Rossini F, Cortelezzi A, Montillo M, Orlandi E, Ghia P. Impact of B-cell count and imaging screening in cMBL: any need to revise the current guidelines? Leukemia 2012; 26:1703-7. [PMID: 22285997 DOI: 10.1038/leu.2012.20] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Nalli C, Andreoli L, Motta M, Norman GL, Shums Z, Binder WL, Nuzzo M, Frassi M, Lojacono A, Meini A, Medeghini V, Avcin T, Meroni PL, Tincani A. [Fine specificity of anti-β2glycoprotein I antibodies in systemic autoimmune diseases is mostly directed against domain 1]. Reumatismo 2011; 63:91-6. [PMID: 21776445 DOI: 10.4081/reumatismo.2011.91] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Anti-β2 GPI are a formal laboratory criterion for the antiphospholipid syndrome (APS). They were demonstrated to be a risk factor for thrombosis and fetal losses but can also be detected in patients with systemic autoimmune disease (SAD), in healthy adults individuals and pre-school children. It has been suggested that different subpopulations of anti-β2GPI may carry different pathogenetic potential: autoantibodies against Domain1 seem to be associated with thrombosis; autoantibodies against Domain4/5 have been identified in patients with non-thrombotic conditions. METHODS We studied 48 patients with SAD (32 systemic lupus erythematosus, 16 undifferentiated connettive tissue disease), 64 patients with APS, 57 one-year-old healthy children born to mother with SAD, 33 children with atopic dermatitis. All subjects were IgG anti-β2 GPI positive. The specificity of anti-β2 GPI was investigated using ELISA research products containing recombinant β2 GPI D1 and D4/5 antigens. Cut-off values are calculated as 95th percentile on 100 NHD. IgG anti-β2 GPI were tested at a validated home-made ELISA routinely performed in our laboratory. No thrombotic events were recordered in patients with SAD and in both groups of children. RESULTS Patients with SAD and APS showed prevalent reactivity for D1 while children in both groups preferentially recognize D4/5. CONCLUSIONS IgG anti-β2 GPI against D1 seem to cluster in patients with systemic autoimmune conditions. Their pathogenic potential in determine APS manifestations may be mitigated by adequate prophylaxis.
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Affiliation(s)
- C Nalli
- U.O. Reumatologia e Immunologia Clinica, A.O. Spedali Civili, Piazzale Spedali Civili 1, Brescia, Italia
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