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Zito P, Manganelli M, Lampasi A, Pipolo S, Lopes R. Final design of the DTT Toroidal power supply circuit. Fusion Engineering and Design 2023. [DOI: 10.1016/j.fusengdes.2023.113595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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Lampasi A, Pipolo S, Albanese R, Ambrosino R, Bifaretti S, Bojoi R, Bonaiuto V, Castaldo A, Caldora M, Cocchi A, Di Pietrantonio M, Griva G, Lopes C, Manganelli M, Minucci S, Musumeci S, Romano R, Terlizzi C, Trotta A, Zito P. Overview of the Divertor Tokamak Test (DTT) coil power supplies. Fusion Engineering and Design 2023. [DOI: 10.1016/j.fusengdes.2023.113442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Zampella E, Piscopo L, Manganelli M, Volpe F, Nappi C, Gaudieri V, Pace L, Schlumberger M, Cuocolo A, Klain M. Prognostic value of 12-month response to therapy in pediatric patients with differentiated thyroid cancer. Endocrine 2023; 80:612-618. [PMID: 36692657 PMCID: PMC10199830 DOI: 10.1007/s12020-023-03309-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/10/2023] [Indexed: 01/25/2023]
Abstract
PURPOSE In pediatric patients with differentiated thyroid cancer (DTC) we assessed the prognostic value of the 12-month response to therapy after initial treatment with surgery and radioactive iodine (RAI). METHODS We retrospectively evaluated 94 pediatric patients with DTC, treated with surgery and RAI who were initially classified as low, intermediate or high risk of relapse of disease according to the American Thyroid Association (ATA) guidelines. Twelve months after RAI administration the response to therapy was assessed by serum thyroglobulin (Tg) measurement and neck ultrasound and patients were classified as having excellent response (ER) or no-ER. RESULTS At the 12 months evaluation, 62 (66%) patients had ER and 32 (34%) no-ER. During a mean follow-up time of 86 months (range 9-517), 19 events occurred (20% cumulative event rate). Events occurred more frequently in younger patients (p < 0.05), in those at ATA intermediate/high risk (p < 0.01) and with a pre-RAI therapy Tg level > 10 ng/mL (p < 0.001), and in those with no-ER (p < 0.001). At multivariate analysis, the evidence of no-ER was the only independent predictor of events. CONCLUSION In pediatric patients with DTC, the response to therapy evaluated 12 months after initial treatment has an independent prognostic impact and is able to predict mid-term outcome. Patients with no-ER at 12 months after RAI therapy should be closely followed-up.
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Affiliation(s)
- Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Leonardo Pace
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Martin Schlumberger
- Consultant, Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
| | - Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
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Piscopo L, Volpe F, Nappi C, Zampella E, Manganelli M, Matrisciano F, Totaro P, Pace L, Maurea S, Cuocolo A, Klain M. Second Primary Malignancies in Patients with Differentiated Thyroid Cancer after Radionuclide Therapy: A Retrospective Single-Centre Study. Curr Oncol 2022; 30:37-44. [PMID: 36661652 PMCID: PMC9857292 DOI: 10.3390/curroncol30010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/14/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022] Open
Abstract
Second primary malignancies (SPM) are described as any primary, not synchronous, malignancy arising in a different anatomical district, with confirmed histological diagnosis. Age at diagnosis, previous non-thyroidal primary malignancy, and radioactive iodine (RAI) therapy have been proposed as independent risk factors for SPM. RAI therapy is a standard treatment for moderate-high risk differentiated thyroid cancer (DTC), and its effect on the development of SPM has become a critical topic in DTC treatment. The purpose of this retrospective single-center study was to investigate the occurrence and the possible association of non-thyroidal SPM diagnosed after DTC and RAI therapy in a cohort of 1326 consecutive DTC patients referred at our Institution for RAI treatment from 1993 to 2009. Eighty-nine patients with ages ≤ 18 years at the time of DTC diagnosis or with a follow-up of ≤12 months were excluded from the final analysis. All patients underwent a complete clinical and hematological follow-up every 6 months for a minimum of 12 months. During follow-up (mean 89 ± 73 months), 25 patients (2%) had an SPM diagnosis (mean 133 ± 73 months). The most common site of the second malignancy was the breast, accounting for 32% of all SPM, followed by colon-rectal cancer (16%), leukemia, and gynecological and kidney cancer (4%). At Cox univariable regression analysis, age at DTC diagnosis (p < 0.001), age ≥55 years (p < 0.001) and follow-up duration (p < 0.004) were associated with SPM onset, while no significant association was observed with the administered activity of radioiodine. In conclusion, our data suggest that the older a person gets, the more sharply the likelihood of developing additional diseases, such as PMS, increases. Similarly, for follow-up, the more a patient is followed up clinically over time, the higher the risk of new diagnoses increases.
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Affiliation(s)
- Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | | | - Francesca Matrisciano
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | - Pasquale Totaro
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | - Leonardo Pace
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | - Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
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Volpe F, Piscopo L, Manganelli M, Falzarano M, Volpicelli F, Nappi C, Imbriaco M, Cuocolo A, Klain M. Intramedullary Spinal Cord Metastases from Differentiated Thyroid Cancer, a Case Report. Life (Basel) 2022; 12:863. [PMID: 35743894 PMCID: PMC9225536 DOI: 10.3390/life12060863] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/25/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023] Open
Abstract
Intramedullary spinal cord metastases (ISCM) are uncommon metastases of the spinal cord. Magnetic resonance (MR) plays an important role in surgical planning when ISCM is suspected in the differential diagnosis. The incidence of ISCM is expected to increase due to the longer survival of cancer patients as well as the widespread use of MR in the diagnosis of neurological syndromes. The management of these patients is controversial because of the multiple clinical presentations and lack of controlled studies on the efficacy of different therapeutic approaches. Increased awareness of this rare entity may lead to an earlier diagnosis with novel imaging approaches at a stage when neurological deficits are reversible. A case of ISCM in a 49-year-old patient with differentiated thyroid cancer is reported.
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Gaio E, Ferro A, Lampasi A, Maistrello A, Dan M, Falvo M, Gasparini F, Lunardon F, Magnanimo A, Manganelli M, Minucci S, Panella S, Proietti Cosimi M, Ratti D, Barucca L, Ciattaglia S, Franke T, Federici G, Piovan R. Status and challenges for the concept design development of the EU DEMO Plant Electrical System. Fusion Engineering and Design 2022. [DOI: 10.1016/j.fusengdes.2022.113052] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Klain M, Nappi C, De Risi M, Piscopo L, Volpe F, Manganelli M, Caiazzo E, Bianco D, Schlumberger M, Cuocolo A. Whole-Body Radioiodine Effective Half-Life in Patients with Differentiated Thyroid Cancer. Diagnostics (Basel) 2021; 11:diagnostics11101740. [PMID: 34679438 PMCID: PMC8535104 DOI: 10.3390/diagnostics11101740] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/17/2021] [Accepted: 09/19/2021] [Indexed: 11/19/2022] Open
Abstract
Background: Radioactive 131I (RAI) therapy is used in patients with differentiated thyroid cancer (DTC) after total thyroidectomy for remnant ablation, adjuvant treatment or treatment of persistent disease. 131I retention data, which are used to indicate the time at which a 131I treated DTC patient can be released from the hospital, may bring some insights regarding clinical factors that prolong the length of hospitalization. The aim of this study was to investigate the 131I whole-body retention in DTC patients during 131I therapy. Methods: We monitored 166 DTC patients to follow the 131I whole-body retention during 131I therapy with a radioactivity detector fixed on the ceiling of each protected room. A linear regression fit permitted us to estimate the whole-body 131I effective half-life in each patient, and a relationship was sought between patients’ clinical characteristics and whole-body effective 131I half-life. Results: The effective 131I half-life ranged from 4.08 to 56.4 h. At multivariable analysis, longer effective 131I half-life was related to older age and extensive extra-thyroid disease. Conclusions: 131I effective half-life during 131I treatment in DTC patients is highly variable among patients and is significantly longer in older and in patients with RAI uptake in large thyroid remnants or in extrathyroidal disease that significantly prolongs the whole-body retention of 131I.
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Affiliation(s)
- Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Marina De Risi
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Mariarosaria Manganelli
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Elisa Caiazzo
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Davide Bianco
- Italian Aerospace Research Centre (CIRA), 81043 Capua, Italy;
| | - Martin Schlumberger
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
- Correspondence:
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Klain M, Maurea S, Gaudieri V, Zampella E, Volpe F, Manganelli M, Piscopo L, De Risi M, Cuocolo A. The diagnostic role of total-body 18F-FDG PET/CT in patients with multiple tumors: a report of the association of thyroid cancer with lung or renal tumors. Quant Imaging Med Surg 2021; 11:4211-4215. [PMID: 34476200 DOI: 10.21037/qims-21-36] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/14/2021] [Indexed: 01/17/2023]
Affiliation(s)
- Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Marina De Risi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
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Nappi C, Petretta M, Cantoni V, Green R, Assante R, Zampella E, Gaudieri V, Mannarino T, D"antonio A, Manganelli M, Piscopo L, Ponsiglione A, Acampa W, Cuocolo A. Prognostic value of heart rate reserve in patients with suspected coronary artery disease undergoing stress myocardial perfusion imaging. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111.037] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background. The prognostic value of stress myocardial perfusion single-photon emission computed tomography (MPS) has been widely demonstrated. Also, chronotropic incompetence, evaluated by heart rate reserve (HRR) is associated with increased risk of adverse events. Yet, the incremental prognostic value of HRR over stress MPS data has not been fully investigated.
Purpose. To assess the incremental prognostic value of HRR over stress MPS finding in patients with suspected coronary artery disease (CAD) undergoing exercise stress MPS.
Methods. The study population consisted of 866 consecutive patients with suspected CAD undergoing exercise stress-MPS at University of Naples Federico II, between May 2002 and January 2014 as part of their diagnostic program. The primary study endpoint was all-cause mortality. All patients were followed for at least 60 months. HRR was calculated as the difference between peak exercise and resting HR, divided by the difference of age-predicted maximal and resting HR and expressed as percent. The summed difference score (SDS) was considered an index of ischemic burden. Patients were considered to have mild ischemia with a SDS of 2 to 6, and moderate-severe ischemia with a SDS ≥6. During follow-up, the occurrence of all-cause of deaths was noted and considered as event. Follow-up was censored at 84 months.
Results. During follow-up, 61 deaths occurred, with a 7% cumulative event rate. Patients experiencing death were older (56.2 ± 10.7 years vs. 66.4 ± 8.6 years), with a higher prevalence of male gender (56% vs. 87 %, P < 0.05) and diabetes mellitus (23% vs. 36%, P < 0.05). At stress-MPS, patients with event had lower mean values of HRR (53.2 ± 21.3% vs. 61.5 ± 16.4%, P < 0.0001) and higher prevalence of moderate-severe ischemia (24% vs. 8%, P < 0.0001). The best trade-off between sensitivity and specificity for identifying chronotropic incompetence was a HRR <67% with an area under the receiver operating characteristic curve of 0.62. The event free survival was lower in patients with HRR <67% compared to those with HRR ≥67% (log-rank 9.75, P < 0.005). Accordingly, the annualized event rate was 0.006 in patients with HRR <67% and 0.014 in those with HRR ≥67% (P < 0.001). At Cox regression analysis, univariable predictors of all-cause mortality were age, male gender, diabetes mellitus, HRR and moderate-severe ischemia (all P < 0.05). At multivariable analysis age, male gender, HRR and moderate-severe ischemia were independent predictors of all-cause mortality (all P < 0.05). HRR improved the prognostic power of a model including clinical data and MPS findings for the prediction of all-cause mortality, increasing the global chi-square from 76.16 to 82.68 (P < 0.005).
Conclusion. Chronotropic incompetence assessed by HRR evaluation, has independent and incremental prognostic value in predicting all cause of death in patients with suspected CAD undergoing exercise stress-MPS.
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Affiliation(s)
- C Nappi
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | | | - V Cantoni
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - R Green
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - R Assante
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - E Zampella
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - V Gaudieri
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - T Mannarino
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - A D"antonio
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - M Manganelli
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - L Piscopo
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - A Ponsiglione
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - W Acampa
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - A Cuocolo
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
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Klain M, Nappi C, Zampella E, Cantoni V, Green R, Piscopo L, Volpe F, Manganelli M, Caiazzo E, Petretta M, Schlumberger M, Cuocolo A. Ablation rate after radioactive iodine therapy in patients with differentiated thyroid cancer at intermediate or high risk of recurrence: a systematic review and a meta-analysis. Eur J Nucl Med Mol Imaging 2021; 48:4437-4444. [PMID: 34142215 PMCID: PMC8566414 DOI: 10.1007/s00259-021-05440-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/31/2021] [Indexed: 12/01/2022]
Abstract
Purpose We performed a systematic review and a meta-analysis to investigate the successful ablation rate after radioiodine (RAI) administration in patients with differentiated thyroid cancer (DTC) at intermediate-high risk of recurrence. Methods A comprehensive literature search of the PubMed, Scopus, and Web of Science databases was conducted according to the PRISMA statement. Results The final analysis included 9 studies accounting for 3103 patients at intermediate-high risk of recurrence. In these patients, the successful ablation rates ranged from 51 to 94% with a 71% pooled successful ablation and were higher in intermediate (72%) than in high (52%)-risk patients. Despite the rigorous inclusion standards, a significant heterogeneity among the evaluated studies was observed. Higher administered RAI activities are associated with a lower successful ablation rate in the whole population and in the subgroup of high-risk patients. Furthermore, pooled recurrence rate in intermediate-risk patients achieving successful ablation was only 2% during the subsequent 6.4-year follow-up while the pooled recurrence rate was 14% in patients who did not achieve a successful ablation. Conclusion In a large sample of 3103 patients at intermediate-high risk of persistent/recurrent disease, 71% of patients achieved a successful ablation. In these intermediate-risk patients, the probability of subsequent recurrence is low and most recurrence occurred in those with already abnormal findings at the first control. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-021-05440-x.
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Affiliation(s)
- Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Valeria Cantoni
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Roberta Green
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Elisa Caiazzo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Martin Schlumberger
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
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Klain M, Zampella E, Manganelli M, Gaudieri V, Nappi C, D'Antonio A, Piscopo L, Volpe F, Pace L, Schlumberger M, Cuocolo A. Risk of structural persistent disease in pediatric patients with low or intermediate risk differentiated thyroid cancer. Endocrine 2021; 71:378-384. [PMID: 32529282 DOI: 10.1007/s12020-020-02379-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/01/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE In pediatric patients with differentiated thyroid cancer (DTC), the risk of recurrence is high and the indication for postoperative 131I administration is still debated. The aim of this study was to assess the outcome in low and intermediate risk pediatric DTC patients. METHODS We retrospectively evaluated 45 pediatric patients with low or intermediate risk DTC, treated with surgery and 131I between 1992 and 2002 and with no detectable antithyroglobulin (Tg) antibodies. Follow-up was performed every 6-12 months with Tg blood level determination and imaging procedures. RESULTS During follow-up (64 ± 53 months), 15 events occurred (33% cumulative event rate, with an annual event rate of 5% person years). Five of these patients were submitted to additional surgery and all these 15 patients underwent a second 131I treatment course. All patients were alive at the end of the follow-up. Structural persistent disease occurred more frequently in patients at intermediate risk (p < 0.01) and in those with Tg values after thyroid hormone withdrawal >10 ng/ml before 131I therapy (p < 0.01). At multivariate analysis, only a postoperative thyroid stimulating hormone-stimulated Tg level >10 ng/ml was an independent predictor of persistent disease. CONCLUSIONS In pediatric patients with DTC, postoperative high stimulated Tg values (>10 ng/ml) should be taken into account for deciding the extent of both initial treatment and follow-up.
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Affiliation(s)
- Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Adriana D'Antonio
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Leonardo Pace
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Martin Schlumberger
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
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Zuccarello P, Manganelli M, Oliveri Conti G, Copat C, Grasso A, Cristaldi A, De Angelis G, Testai E, Stefanelli M, Vichi S, Fiore M, Ferrante M. Water quality and human health: A simple monitoring model of toxic cyanobacteria growth in highly variable Mediterranean hot dry environments. Environ Res 2021; 192:110291. [PMID: 33027628 DOI: 10.1016/j.envres.2020.110291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 06/11/2023]
Abstract
Due to population growth, urbanization and economic development, demand for freshwater in urban areas is increasing throughout Europe. At the same time, climate change, eutrophication and pollution are affecting the availability of water supplies. Sicily, a big island in southern Italy, suffers from an increasing drought and consequently water shortage. In the last decades, in Sicilian freshwater reservoirs several Microcystis aeruginosa and more recently Planktothrix rubescens blooms were reported. The aims of the study were: (1) identify and quantify the occurring species of cyanobacteria (CB), (2) identify which parameters, among those investigated in the waters, could favor their growth, (3) set up a model to identify reservoirs that need continuous monitoring due to the presences, current or prospected, of cyanobacterial blooms and of microcystins, relevant for environmental and, consequentially, for human health. Fifteen artificial reservoirs among the large set of Sicilian artificial water bodies were selected and examined for physicochemical and microbiological characterization. Additional parameters were assessed, including the presence, identification and count of the cyanobacterial occurring species, the measurement of microcystins (MCs) levels and the search for the genes responsible for the toxins production. Principal Component Analysis (PCA) was used to relate environmental condition to cyanobacterial growth. Water quality was poor for very few parameters, suggesting common anthropic pressures, and PCA highlighted clusters of reservoirs vulnerable to hydrological conditions, related to semi-arid Mediterranean climate and to the use of the reservoir. In summer, bloom was detected in only one reservoir and different species was highlighted among the Cyanobacteria community. The only toxins detected were microcystins, although always well below the WHO reference value for drinking waters (1.0 μg/L). However, molecular analysis could not show the presence of potential cyanotoxins producers since a few numbers of cells among total could be sufficient to produce these low MCs levels but not enough high to be proved by the traditional molecular method applied. A simple environmental risk-based model, which accounts for the high variability of both cyanobacteria growth and cyanotoxins producing, is proposed as a cost-effective tool to evaluate the need for monitoring activities in reservoirs aimed to guarantee supplying waters safety.
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Affiliation(s)
- P Zuccarello
- Environmental and Food Hygiene Laboratories, Department "G.F. Ingrassia", University of Catania, Italy
| | - M Manganelli
- Environment and Health Department, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - G Oliveri Conti
- Environmental and Food Hygiene Laboratories, Department "G.F. Ingrassia", University of Catania, Italy.
| | - C Copat
- Environmental and Food Hygiene Laboratories, Department "G.F. Ingrassia", University of Catania, Italy
| | - A Grasso
- Environmental and Food Hygiene Laboratories, Department "G.F. Ingrassia", University of Catania, Italy
| | - A Cristaldi
- Environmental and Food Hygiene Laboratories, Department "G.F. Ingrassia", University of Catania, Italy
| | - G De Angelis
- Environment and Health Department, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - E Testai
- Environment and Health Department, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - M Stefanelli
- Research Certification and Control Division, INAIL, Via Fontana Candida 1, Monteporzio Catone, Rome, Italy
| | - S Vichi
- Environment and Health Department, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - M Fiore
- Environmental and Food Hygiene Laboratories, Department "G.F. Ingrassia", University of Catania, Italy
| | - M Ferrante
- Environmental and Food Hygiene Laboratories, Department "G.F. Ingrassia", University of Catania, Italy
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13
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Klain M, Nappi C, Maurea S, De Risi M, Volpe F, Caiazzo E, Piscopo L, Manganelli M, Schlumberger M, Cuocolo A. Management of differentiated thyroid cancer through nuclear medicine facilities during Covid-19 emergency: the telemedicine challenge. Eur J Nucl Med Mol Imaging 2020; 48:831-836. [PMID: 32965559 PMCID: PMC7509822 DOI: 10.1007/s00259-020-05041-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/13/2020] [Indexed: 02/07/2023]
Abstract
Purpose To investigate whether a telemedicine service (TMS) carried out during the Covid-19 pandemic impacted on management of patients with differentiated thyroid cancer (DTC). Methods We retrospectively reviewed the number and the findings of outpatient visits in DTC subjects referred between March 11, 2020, and May 31, 2020, during the Covid-19 pandemic at the Radiometabolic Unit of the University of Naples Federico II. Office visits scheduled in March and May 2020 were converted in teleconsultation reaching all patients planned for an in-ward access to advise them to use the TMS for all clinical necessity. The number and the findings of DTC patients evaluated by in-ward access in the corresponding period of 2019 were also assessed for direct comparison. Results The number of outpatient visits performed by TMS during the pandemic (n = 445) and by in-ward access in the corresponding period of 2019 (n = 525) was comparable with only 15% of outpatient evaluations missed. Conclusions Our findings demonstrate the utility of telemedicine tools to avoid the potential negative impact of interruption or postponement of diagnostic and/or therapeutic procedures. Therefore, investments in medical network system development, including the implementation of telehealth approaches, should be encouraged at national and international levels.
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Affiliation(s)
- Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Marina De Risi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Elisa Caiazzo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Martin Schlumberger
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
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14
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15
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Guida S, Foti C, Manganelli M, Bartolomeo N, Pellacani G, Bonamonte D, Filotico R, Guida G. MC1R genotype and psoriasis: is there a link revealing a phenotypic difference? J Eur Acad Dermatol Venereol 2018; 32:e119-e120. [DOI: 10.1111/jdv.14607] [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: 11/29/2022]
Affiliation(s)
- S. Guida
- Dermatology Unit; University of Modena and Reggio Emilia; Modena Italy
| | - C. Foti
- Dermatological Clinic; Department of Biomedical Science and Human Oncology; University of Bari; Bari Italy
| | - M. Manganelli
- Molecular Biology Section; Department of Basic Medical Sciences; Neurosciences and Sense Organs; University of Bari; Bari Italy
| | - N. Bartolomeo
- Hygiene Section; Department of Biomedical Sciences and Human Oncology; University of Bari; Bari Italy
| | - G. Pellacani
- Dermatology Unit; University of Modena and Reggio Emilia; Modena Italy
| | - D. Bonamonte
- Dermatological Clinic; Department of Biomedical Science and Human Oncology; University of Bari; Bari Italy
| | - R. Filotico
- Dermatology Unit; Hospital “A. Perrino”; Brindisi Italy
| | - G. Guida
- Molecular Biology Section; Department of Basic Medical Sciences; Neurosciences and Sense Organs; University of Bari; Bari Italy
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16
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Caprio MG, Manganelli M, Limone S, Sorbillo M, Quarantelli M, Cuocolo A, Mainolfi CG. Extra-osseous 99mTc methylene diphosphonate uptake detected enlargement of the knee joint in patient with polyarthritis. SAGE Open Med Case Rep 2017; 5:2050313X17741824. [PMID: 29163955 PMCID: PMC5692125 DOI: 10.1177/2050313x17741824] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 10/16/2017] [Indexed: 01/15/2023] Open
Abstract
Bone scintigraphy is a nuclear scanning test used to find abnormalities in the skeleton. Certain abnormal processes involving soft tissues can also cause skeletal accumulation of radiotracer during bone scintigraphy. We present a case of periarticular knee soft tissue 99mTc methylene diphosphonate uptake in a patient with asymmetric polyarthritis. A 33-year-old patient with asymmetric polyarthritis, skin lesions and joint pain underwent bone scintigraphy. Total body examination showed an extra-osseous uptake in periarticular soft tissue of knees joints. A detailed history checkup, physical examination and laboratory tests were carried out to understand the link between the extra-osseous uptake and the phosphonate binding in periarticular soft tissue. To improve the anatomical description of the soft tissue of the knees and to clarify the nature of the extra-skeletal 99mTc methylene diphosphonate uptake, magnetic resonance imaging scan was performed. 99mTc-labeled phosphonate binding has been reported in a number of extra-osseous conditions, but to our knowledge, there are a few cases showing bone tracer uptake in polyarthritis. In polyarthritic patients, whole-body bone scintigraphy were useful in examining the whole joints and detecting possible dubious extra-osseous uptake; in fact, it is able to select subjects who require further in-depth analysis, for example, magnetic resonance imaging.
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Affiliation(s)
- Maria Grazia Caprio
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
| | | | - Simona Limone
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Mario Quarantelli
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Ciro Gabriele Mainolfi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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17
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Manganelli M, Mansi L. Michael Buchfelder and Federica Guaraldi (Eds): Imaging in Endocrine Disorders. Eur J Nucl Med Mol Imaging 2017. [DOI: 10.1007/s00259-017-3629-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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18
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Malfatti F, Turk V, Tinta T, Mozetič P, Manganelli M, Samo TJ, Ugalde JA, Kovač N, Stefanelli M, Antonioli M, Fonda-Umani S, Del Negro P, Cataletto B, Hozić A, Ivošević Denardis N, Zutić V, Svetličić V, Mišić Radić T, Radić T, Fuks D, Azam F. Microbial mechanisms coupling carbon and phosphorus cycles in phosphorus-limited northern Adriatic Sea. Sci Total Environ 2014; 470-471:1173-1183. [PMID: 24246940 DOI: 10.1016/j.scitotenv.2013.10.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Revised: 10/11/2013] [Accepted: 10/13/2013] [Indexed: 06/02/2023]
Abstract
The coastal northern Adriatic Sea receives pulsed inputs of riverine nutrients, causing phytoplankton blooms and seasonally sustained dissolved organic carbon (DOC) accumulation-hypothesized to cause episodes of massive mucilage. The underlying mechanisms regulating P and C cycles and their coupling are unclear. Extensive biogeochemical parameters, processes and community composition were measured in a 64-day mesocosms deployed off Piran, Slovenia. We followed the temporal trends of C and P fluxes in P-enriched (P+) and unenriched (P-) mesocosms. An intense diatom bloom developed then crashed; however, substantial primary production was maintained throughout, supported by tightly coupled P regeneration by bacteria and phytoplankton. Results provide novel insights on post-bloom C and P dynamics and mechanisms. 1) Post-bloom DOC accumulation to 186 μM remained elevated despite high bacterial carbon demand. Presumably, a large part of DOC accumulated due to the bacterial ectohydrolytic processing of primary productivity that adventitiously generated slow-to-degrade DOC; 2) bacteria heavily colonized post-bloom diatom aggregates, rendering them microscale hotspots of P regeneration due to locally intense bacterial ectohydrolase activities; 3) Pi turnover was rapid thus suggesting high P flux through the DOP pool (dissolved organic phosphorus) turnover; 4) Alpha- and Gamma-proteobacteria dominated the bacterial communities despite great differences of C and P pools and fluxes in both mesocosms. However, minor taxa showed dramatic changes in community compositions. Major OTUs were presumably generalists adapted to diverse productivity regimes.We suggest that variation in bacterial ectohydrolase activities on aggregates, regulating the rates of POM→DOM transition as well as dissolved polymer hydrolysis, could become a bottleneck in P regeneration. This could be another regulatory step, in addition to APase, in the microbial regulation of P cycle and the coupling between C and P cycles.
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Affiliation(s)
- F Malfatti
- Scripps Institution of Oceanography, University California San Diego, 92037 La Jolla, USA
| | - V Turk
- National Institute of Biology, Marine Station Piran, 66330 Piran, Slovenia
| | - T Tinta
- National Institute of Biology, Marine Station Piran, 66330 Piran, Slovenia
| | - P Mozetič
- National Institute of Biology, Marine Station Piran, 66330 Piran, Slovenia
| | - M Manganelli
- Istituto Superiore per la Prevenzione e la Sicurezza del Lavoro (ISPESL), DIPIA, 00040 Monteporzio Catone, Roma, Italy; Istituto Superiore di Sanità, Dept. of Environment and Primary Prevention, Roma, Italy
| | - T J Samo
- Scripps Institution of Oceanography, University California San Diego, 92037 La Jolla, USA
| | - J A Ugalde
- Scripps Institution of Oceanography, University California San Diego, 92037 La Jolla, USA
| | - N Kovač
- National Institute of Biology, Marine Station Piran, 66330 Piran, Slovenia
| | - M Stefanelli
- Istituto Superiore per la Prevenzione e la Sicurezza del Lavoro (ISPESL), DIPIA, 00040 Monteporzio Catone, Roma, Italy; Istituto Superiore di Sanità, Dept. of Environment and Primary Prevention, Roma, Italy
| | - M Antonioli
- Universita' degli Studi di Trieste, Dipartimento di Biologia, 34127 Trieste, Italy
| | - S Fonda-Umani
- Universita' degli Studi di Trieste, Dipartimento di Biologia, 34127 Trieste, Italy
| | - P Del Negro
- Istituto Nazionale di Oceanografia e Geofisica Sperimentale, Sezione Bio, 34151 Santa Croce, Trieste, Italy
| | - B Cataletto
- Istituto Nazionale di Oceanografia e Geofisica Sperimentale, Sezione Bio, 34151 Santa Croce, Trieste, Italy
| | - A Hozić
- Ruđer Bošković Institute, Division for Marine and Environmental Research, 10000 Zagreb, Croatia
| | - N Ivošević Denardis
- Ruđer Bošković Institute, Division for Marine and Environmental Research, 10000 Zagreb, Croatia
| | - V Zutić
- Ruđer Bošković Institute, Division for Marine and Environmental Research, 10000 Zagreb, Croatia
| | - V Svetličić
- Ruđer Bošković Institute, Division for Marine and Environmental Research, 10000 Zagreb, Croatia
| | - T Mišić Radić
- Ruđer Bošković Institute, Division for Marine and Environmental Research, 10000 Zagreb, Croatia
| | - T Radić
- Institute for Adriatic Crops and Karst Reclamation, Split, Croatia
| | - D Fuks
- Ruđer Bošković Institute, Center for Marine Research, Rovinj, Croatia
| | - F Azam
- Scripps Institution of Oceanography, University California San Diego, 92037 La Jolla, USA
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