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Crystal JS, Thompson JF, Hyngstrom J, Caracò C, Zager JS, Jahkola T, Bowles TL, Pennacchioli E, Beitsch PD, Hoekstra HJ, Moncrieff M, Ingvar C, van Akkooi A, Sabel MS, Levine EA, Agnese D, Henderson M, Dummer R, Neves RI, Rossi CR, Kane JM, Trocha S, Wright F, Byrd DR, Matter M, Hsueh EC, MacKenzie-Ross A, Kelley M, Terheyden P, Huston TL, Wayne JD, Neuman H, Smithers BM, Ariyan CE, Desai D, Gershenwald JE, Schneebaum S, Gesierich A, Jacobs LK, Lewis JM, McMasters KM, O'Donoghue C, van der Westhuizen A, Sardi A, Barth R, Barone R, McKinnon JG, Slingluff CL, Farma JM, Schultz E, Scheri RP, Vidal-Sicart S, Molina M, Testori AAE, Foshag LJ, Van Kreuningen L, Wang HJ, Sim MS, Scolyer RA, Elashoff DE, Cochran AJ, Faries MB. Therapeutic Value of Sentinel Lymph Node Biopsy in Patients With Melanoma: A Randomized Clinical Trial. JAMA Surg 2022; 157:835-842. [PMID: 35921122 PMCID: PMC9475390 DOI: 10.1001/jamasurg.2022.2055] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/19/2022] [Indexed: 12/12/2022]
Abstract
Importance Sentinel lymph node (SLN) biopsy is a standard staging procedure for cutaneous melanoma. Regional disease control is a clinically important therapeutic goal of surgical intervention, including nodal surgery. Objective To determine how frequently SLN biopsy without completion lymph node dissection (CLND) results in long-term regional nodal disease control in patients with SLN metastases. Design, Setting, and Participants The second Multicenter Selective Lymphadenectomy Trial (MSLT-II), a prospective multicenter randomized clinical trial, randomized participants with SLN metastases to either CLND or nodal observation. The current analysis examines observation patients with regard to regional nodal recurrence. Trial patients were aged 18 to 75 years with melanoma metastatic to SLN(s). Data were collected from December 2004 to April 2019, and data were analyzed from July 2020 to January 2022. Interventions Nodal observation with ultrasonography rather than CLND. Main Outcomes and Measures In-basin nodal recurrence. Results Of 823 included patients, 479 (58.2%) were male, and the mean (SD) age was 52.8 (13.8) years. Among 855 observed basins, at 10 years, 80.2% (actuarial; 95% CI, 77-83) of basins were free of nodal recurrence. By univariable analysis, freedom from regional nodal recurrence was associated with age younger than 50 years (hazard ratio [HR], 0.49; 95% CI, 0.34-0.70; P < .001), nonulcerated melanoma (HR, 0.36; 95% CI, 0.36-0.49; P < .001), thinner primary melanoma (less than 1.5 mm; HR, 0.46; 95% CI, 0.27-0.78; P = .004), axillary basin (HR, 0.61; 95% CI, 0.44-0.86; P = .005), fewer positive SLNs (1 vs 3 or more; HR, 0.32; 95% CI, 0.14-0.75; P = .008), and SLN tumor burden (measured by diameter less than 1 mm [HR, 0.39; 95% CI, 0.26-0.60; P = .001] or less than 5% area [HR, 0.36; 95% CI, 0.24-0.54; P < .001]). By multivariable analysis, younger age (HR, 0.57; 95% CI, 0.39-0.84; P = .004), thinner primary melanoma (HR, 0.40; 95% CI, 0.22-0.70; P = .002), axillary basin (HR, 0.55; 95% CI, 0.31-0.96; P = .03), SLN metastasis diameter less than 1 mm (HR, 0.52; 95% CI, 0.33-0.81; P = .007), and area less than 5% (HR, 0.58; 95% CI, 0.38-0.88; P = .01) were associated with basin control. When looking at the identified risk factors of age (50 years or older), ulceration, Breslow thickness greater than 3.5 mm, nonaxillary basin, and tumor burden of maximum diameter of 1 mm or greater and/or metastasis area of 5% or greater and excluding missing value cases, basin disease-free rates at 5 years were 96% (95% CI, 88-100) for patients with 0 risk factors, 89% (95% CI, 82-96) for 1 risk factor, 86% (95% CI, 80-93) for 2 risk factors, 80% (95% CI, 71-89) for 3 risk factors, 61% (95% CI, 48-74) for 4 risk factors, and 54% (95% CI, 36-72) for 5 or 6 risk factors. Conclusions and Relevance This randomized clinical trial was the largest prospective evaluation of long-term regional basin control in patients with melanoma who had nodal observation after removal of a positive SLN. SLN biopsy without CLND cleared disease in the affected nodal basin in most patients, even those with multiple risk factors for in-basin recurrence. In addition to its well-validated value in staging, SLN biopsy may also be regarded as therapeutic in some patients. Trial Registration ClinicalTrials.gov Identifier: NCT00297895.
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Affiliation(s)
| | - John F Thompson
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | - John Hyngstrom
- Department of Surgery, University of Utah, Salt Lake City
| | - Corrado Caracò
- Istituto Nazionale Tumori IRCCS Fondazione "G. Pascale," Napoli, Italy
| | - Jonathan S Zager
- Departments of Cutaneous Oncology and Sarcoma, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Tiina Jahkola
- Department of Plastic and Reconstructive Surgery, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Tawnya L Bowles
- Department of Surgical Oncology, Intermountain Medical Center, Salt Lake City, Utah
| | - Elisabetta Pennacchioli
- Division of Melanoma, Soft Tissue Sarcomas and Rare Tumors, European Institute of Oncology, Milano, Italy
| | | | - Harald J Hoekstra
- Department of Surgery, University Hospital Groningen, Groningen, the Netherlands
| | - Marc Moncrieff
- Department of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | | | - Alexander van Akkooi
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | - Edward A Levine
- Department of Surgical Oncology, Wake Forest University, Winston-Salem, North Carolina
| | - Doreen Agnese
- Department of Surgery, Ohio State University, Columbus
| | - Michael Henderson
- Department of Surgery, University of Melbourne, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Rogerio I Neves
- Department of Surgery, Pennsylvania State University Milton S. Hershey Medical Center, Hershey
- Now at Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | | | - John M Kane
- Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, New York
| | - Steven Trocha
- Department of Surgical Oncology, Prisma Health, Columbia, South Carolina
| | - Frances Wright
- Department of Surgical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - David R Byrd
- Department of Surgery, University of Washington, Seattle
| | - Maurice Matter
- Department of Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Eddy C Hsueh
- Department of Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri
| | - Alastair MacKenzie-Ross
- Department of Plastic Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Mark Kelley
- Department of Surgery, Vanderbilt University, Nashville, Tennessee
| | | | - Tara L Huston
- Department of Surgery, Stony Brook University, Stony Brook, New York
| | - Jeffrey D Wayne
- Department of Surgery, Northwestern University, Chicago, Illinois
| | - Heather Neuman
- Department of Surgery, University of Wisconsin at Madison
| | - B Mark Smithers
- Department of Surgery, University of Queensland, Brisbane, Australia
| | - Charlotte E Ariyan
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Darius Desai
- Department of Surgery, Saint Luke's University Hospital, Bethlehem, Pennsylvania
| | | | - Shlomo Schneebaum
- Department of Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Anja Gesierich
- Department of Dermatology, University Hospital Wurzburg, Wurzburg, Germany
| | - Lisa K Jacobs
- Department of Surgery, Johns Hopkins University, Baltimore, Maryland
| | - James M Lewis
- Department of Surgery, University of Tennessee Medical Center, Knoxville
| | - Kelly M McMasters
- Department of Surgery, University of Louisville, Louisville, Tennessee
| | | | | | - Armando Sardi
- Department of Surgical Oncology, Mercy Medical Center, Baltimore, Maryland
| | - Richard Barth
- Department of Surgery, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire
| | - Robert Barone
- Surgical Oncology, Sharp Hospital, San Diego, California
| | - J Greg McKinnon
- Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | | | - Jeffrey M Farma
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Erwin Schultz
- Department of Dermatology, Nuremberg General Hospital, Paracelsus Medical Center, Nuremberg, Germany
| | | | - Sergi Vidal-Sicart
- Nuclear Medicine Department, Hospital Clinic Barcelona, Barcelona, Spain
| | - Manuel Molina
- Department of Surgery, Lakeland Regional Health, Lakeland, Florida
| | | | - Leland J Foshag
- Department of Surgical Oncology, John Wayne Cancer Institute, Santa Monica, California
| | - Lisa Van Kreuningen
- Manager of Research Operations, Saint John's Cancer Institute, Santa Monica, California
| | - He-Jing Wang
- Department of Medicine Statistics Core, David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Myung-Shin Sim
- Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Richard A Scolyer
- Melanoma Institute Australia, Department of Medicine, University of Sydney, Sydney, Australia
| | - David E Elashoff
- Department of Medicine Statistics Core, David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Alistair J Cochran
- Department of Anatomic Pathology, David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Mark B Faries
- The Angeles Clinic and Research Institute, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
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Di Terlizzi V, Barone R, Manuppelli V, Correale M, Casavecchia G, Goffredo G, Pellegrino P, Puteo A, Ieva R, Di Biase M, Brunetti N, Iacoviello M. P237 INFLUENCE OF HEART RATE ON LEFT AND RIGHT VENTRICULAR LONGITUDINAL STRAIN IN PATIENTS WITH CHRONIC HEART FAILURE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Myocardial deformation evaluated by two–dimensional speckle tracking echocardiography (STE) is a useful tool to evaluate both left and right ventricular function. However, there are no conclusive data about the relationship between strain measures and heart rate (HR).
Aim of the Study
To analyse changes in left (LV) and right ventricular (RV) longitudinal strain associated with variations of HR in patients with and without chronic heart failure (CHF). Methods. We enrolled 45 patients. Of the 38 patients diagnosed with CHF, 21 were carrying an ICD (Group 1), and 17 an ICD with CRT (Group 2). Group 3 included 7 participants without CHF with sinus node dysfunction that were carrying a pacemaker. The frequency of atrial stimulation was increased to 90 beats/min and an echocardiogram was performed at each increase of 10 beats/min. Global LV and RV longitudinal strain (LVGLS and RVGLS, respectively) and RV free wall longitudinal strain (RVfwLS) were calculated at each HR, together with other echocardiographic parameters. Worsening or improvement of strain measures was defined as a relative change from baseline of 10%.
Results
The reproducibility of strain measurements was assessed in all the images obtained at the different HRs for 19 of the study participants. A high degree of reproducibility was observed for LVGLS (ICC = 0.96; 95% CI, 0.93 – 0.97) as well as for RVGLS (ICC = 0.91; 95%CI, 0.86 – 0.94) and RVfwLS (ICC = 0.91; 95%CI, 0.85 – 0.94). When analysed as continuous variables, significant reductions in LVGLS were detected at higher HRs, whereas improvements in both RVGLS and RVfwLS were observed (left panels of the figure). Patients with worsening of LVGLS (76% overall) were more likely to present lower baseline LV function and maximum relative changes of LVGLS correlated significantly with the E/e’ ratios (r = –0.56; p < 0.001). Only few patients (18% for RVGLS and 16% for RVfwLS) exhibited HR–related worsening of RV strain measures, which was associated with lower levels of baseline RV function and higher pulmonary systolic pressures. Finally, 21 (47%) and 25 (56%) of the participants responded with improvements in RVGLS and RVfwLS, respectively. Right panels of the figure show the trend of left and right measures in the different groups.
Conclusions
Our findings revealed heterogeneous RV and LV responses to increases in HR. These findings might ultimately be used to optimize cardiac functionality at rest in patients diagnosed with CHF.
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Affiliation(s)
| | | | | | | | | | | | | | | | - R Ieva
- POLICLINICO RIUNITI, FOGGIA
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Barone R, Goffredo G, Di Terlizzi V, Correale M, Casavecchia G, Ieva R, Cuculo A, Brunetti N, Iacoviello M. P243 RELEVANCE OF RENAL RESISTANCE INDEX INCREASE AFTER CORONARY ANGIOGRAPHY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Renal resistance index is a Doppler derived measure which is able to reflect the pathophysiological background of Cardiorenal Syndrome (CS). There are no data about the influence of the intravascular administration of contrast media on RRI and its relationship with worsening of renal function (WRF).
Aim of the Study
To evaluate changes in renal resistance index (RRI) after coronary angiography in patients with and without WRF. METHODS We enrolled 115 patients (mean age 64 years, 73% males, 84% hypertensive, 43% diabetic, 30% with acute coronary syndrome, 21% affected by chronic heart failure, CHF, with a mean left ventricular ejection fraction, LVEF, of 51±11) with suspected coronary artery disease, stable angina, or acute coronary syndromes who have been referred for coronary angiography (with or without pre–existing renal impairment). Renal arterial echo–color Doppler was used to calculate RRI before and 48 hours after coronary angiography. WRF was defined as an increase of creatinine >0.3 mg/dl and of at least 25% from baseline 24–48 hours after coronary angiography.
Results
Fourteen (12%) among the enrolled patients showed WRF. As expected, a significant increase of creatinine serum levels was observed in patients with WRF (from 1.14±0.40 to 1.71±0.49, p < 0.001) but not those without (from 0.89±0.27 to 0.92±0.28, p n.s.) WRF. On the other hand, RRI significantly increased both in patients with (from 72.8±4.3 to 76.4±5.2, p < 0.05) and without (from 63.1±7.2 to 65.4±7.1, p < 0.05). However, both at baseline and after angiography, patients with WRF showed RRI values significantly greater when compared with those without. At ROC curve analyses for WRF, the baseline and after angiography RRI sowed similar AUC (0.88 and 0.90, respectively) and for both RRI values the best cut–off was 70% (sensitivity of 79% and 93% and Specificity of 93% and 82%, respectively). As shown in the figure, the high predictive accuracy of RRI values was due to the fact that, although increased after angiography, the proportion of patients without WRF and with RRI>70% remained very low.
Conclusion
After coronary angiography RRI significantly increase both in patients with and without WRF. However, a larger proportion of patients with WRF present a critically increased RRI, i.e. equal or above 70%, before and after angiography probably because reflecting the pathophysiological background underlying the progression of cardiorenal syndrome.
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Affiliation(s)
| | | | | | | | | | - R Ieva
- POLICLINICO RIUNITI, FOGGIA
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Diomede N, Terazzi E, Correale M, Di Terlizzi V, Barone R, Manuppelli V, Brunetti N, Iacoviello M. P235 CLINICAL AND INSTRUMENTAL CORRELATES OF LEFT AND RIGHT ATRIAL TWO–DIMENSIONAL STRAIN MEASUREMENTS IN PATIENTS WITH HEART FAILURE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
The two–dimensional strain obtained through Speckle Tracking Imaging (STI) represents an innovative, rapid and semi–automatic echocardiographic method to study systolic and diastolic function. By analyzing the deformation of cardiac segments, it provides an indirect index of myocardial contractility and relaxation of left and right ventricles, but also of both left and right atria.
Purpose of the Study
The aim of this study was to evaluate the clinical and instrumental correlates of the different measures of right and left atrial strain in a group of patients with chronic heart failure (CHF). Method. We enrolled 165 out patients with CHF (63 ± 14 years, 76% male, 39 ± 11% ejection fraction). All patients underwent a cardiological examination, ECG and echocardiogram. The echocardiographic images were analyzed using an innovative software (TomTec, Philips) able to semi–automatically analyze both the ventricular and atrial strain. For each patient, both for the left atrium (LA) and the right atrium (RA), the measures related to all atrial functional phases were calculated: reservoir (r), conduit (cd) and contraction (ct).
Results
At univariate and multivariate logistic regression models, the main determinants of atrial strain measurements were evaluated. As shown in the Table, both for the RA and LA the reservoir and conduit were more closely associated with ventricular systolic function and age. LA contraction was associated only with E/e‘ and heart rate, whereas for the RA one there was no independent statistical association with the parameters studied.
Conclusions
The Strain parameters that evaluate right and left atrial function have an independent association with different clinical and instrumental variables. These results support the hypothesis that the reservoir and conduit measurements express a different physiological and pathophysiological substrate than the contraction measures.
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Affiliation(s)
- N Diomede
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - E Terazzi
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - M Correale
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - V Di Terlizzi
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - R Barone
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - V Manuppelli
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - N Brunetti
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - M Iacoviello
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
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Terazzi E, Diomede N, Correale M, Di Terlizzi V, Barone R, Manuppelli V, Brunetti N, Iacoviello M. P233 ASSOCIATIONS BETWEEN LEFT AND RIGHT ATRIAL BIDIMENSIONAL STRAIN AND HEART FAILURE PROGRESSION. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Two dimensional speckle tracking is an innovative echocardiographic method which analyses myocardial deformation thus allowing the evaluation of both atrial and ventricular function. Recently, new software are available to measure it by semiautomatic analyses.
Aim of the Study
To evaluate the association between left and right atrial Strain and the occurrence of clinical events related to the heart failure (HF) progression. Method. We enrolled 165 outpatients with chronic HF (76% males, NYHA 2.2 ± 0.69, ejection fraction 39±11%). All underwent a clinical and echocardiographic evaluation. An innovative software (TomTec, Philips) was used to analyse the images in order to semi–automatically calculate of atrial Strain. For each patient all the measures relative to the different phases of atrial deformation were considered both for the left atrium (LA) and the right one (RA), i.e. reservoir (r), conduit (cd) and contraction (ct). During the follow–up, we defined the HF progression as hospitalization due to HF worsening and/or heart transplantation and/or cardiovascular death.
Results
During a median follow–up of 5 months, at least one event related to HF progression occurred in 22 patients: all underwent at least one hospitalization, 7 patients died because of cardiovascular reasons and 2 underwent heart transplantation. At Cox univariate analysis, LASr (HR: 0,93; 95%CI: 0,88–0,97, p: 0.004; C–index 0,7), LAScd (HR: 1,09; 95%CI: 1,01–1,19; p: 0,023; C–index: 0,64), RASr (HR: 0,95; 95%CI: 0,90–0,99; p: 0,031; C–index: 0,68), RAScd (HR: 1,08; 95%CI: 1,01–1,15; p: 0,021; C–index: 0,67), but not LASct (HR: 1,04; 95%CI: 0,99–1,09; p 0,094; C–index 0,62) and RASct (HR: 1,02; 95%CI: 0,96–1,09; p: 0,61; C–index: 0,55), were significantly associated to HF progression. LASr and RASr showed the higher accuracy in predicting the events by the estimation of C index. At ROC curve analysis, for LASr the best cut–off was 16.1% (Sensitivity 83%, Specificity 56%) and for RASr 17.3% (Sensitivity 79%, Specificity 60%). Figure shows Kaplan–Meier curves for the considered end–point according with these cut–offs.
Conclusions
The preliminary results of this study have showed the association between LA and RA Strain variables and the HF progression. The prosecution of this study will be finalised to demonstrate the prognostic independent and incremental significance.
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Affiliation(s)
- E Terazzi
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - N Diomede
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - M Correale
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - V Di Terlizzi
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - R Barone
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - V Manuppelli
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - N Brunetti
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - M Iacoviello
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
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Goffredo G, Barone R, Di Terlizzi V, Correale M, Casavecchia G, Ieva R, Cuculo A, Brunetti N, Iacoviello M. P216 RENAL RESISTANCE INDEX IS INDEPENDENTLY ASSOCIATED WITH THE WORSENING OF RENAL FUNCTION AFTER CORONARY ANGIOGRAPHY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
The term Cardiorenal Syndrome (CS) has been recently introduced to indicate the close relationship between cardiovascular and renal diseases, which are able to reciprocally influence the each other progression. In this setting the renal resistance index (RRI) has been demonstrated to be a useful parameter able to detect patients at higher risk of CS. However, there are no data about its role in predicting worsening of renal function (WRF) mediated by the intravascular administration of contrast.
Aim of the Study
To evaluate the role of RRI in predicting WRF after coronary angiography. METHODS We enrolled 115 patients (mean age 64 years, 73% males, 84% hypertensive, 43% diabetic, 30% with acute coronary syndrome, 21% affected by chronic heart failure, CHF, with a mean left ventricular ejection fraction, LVEF, of 51±11) with suspected coronary artery disease, stable angina, or acute coronary syndromes who have been referred for coronary angiography (with or without pre–existing renal impairment). All patients underwent medical examination, electrocardiogram, echocardiographic and chemical evaluation, and renal arterial echo–color Doppler used to calculate RRI. WRF was defined as an increase of creatinine >0.3 mg/dl and of at least 25% from baseline 24–48 hours after coronary angiography.
Results
After coronary angiography, 14 (12%) of the enrolled patients showed WRF. As shown in the Table, at univariate regression analysis baseline RRI was associated with WRF as well as age, peripheral artery disease, CHF, atrial fibrillation, NYHA class, LVEF, mitral regurgitation (MR), central venous pressure (CVP), tricuspid regurgitation (TR), estimated glomerular filtration rate (GFR). In a multivariate forward stepwise regression model, including all univariate predictors, history of CHF, high CVP and RRI were the only parameters significantly associated with WRF.
Conclusion
Our findings demonstrate that in patients undergoing coronary angiography, history of CHF, high CVP and RRI are independent predictors of WRF. RRI, but not GFR, is independently associated with WRF probably because providing additional relevant information about cardiorenal pathophysiological factors reflecting the hemodynamic status and kidney flow reserve.
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Affiliation(s)
| | | | | | | | | | - R Ieva
- POLICLINICO RIUNITI, FOGGIA
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Rella R, Bufi E, Belli P, Petta F, Serra T, Masiello V, Scrofani AR, Barone R, Orlandi A, Valentini V, Manfredi R. Association between background parenchymal enhancement and tumor response in patients with breast cancer receiving neoadjuvant chemotherapy. Diagn Interv Imaging 2020; 101:649-655. [PMID: 32654985 DOI: 10.1016/j.diii.2020.05.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/21/2020] [Accepted: 05/27/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE To analyze the relationships between background parenchymal enhancement (BPE) of the contralateral healthy breast and tumor response after neoadjuvant chemotherapy (NAC) in women with breast cancer. MATERIALS AND METHODS A total of 228 women (mean age, 47.6 years±10 [SD]; range: 24-74 years) with invasive breast cancer who underwent NAC were included. All patients underwent breast magnetic resonance imaging (MRI) before and after NAC and 127 patients underwent MRI before, during (after the 4th cycle of NAC) and after NAC. Quantitative semi-automated analysis of BPE of the contralateral healthy breast was performed. Enhancement level on baseline MRI (baseline BPE) and MRI after chemotherapy (final BPE), change in enhancement rate between baseline MRI and final MRI (total BPE change) and between baseline MRI and midline MRI (early BPE change) were recorded. Associations between BPE and tumor response, menopausal status, tumor phenotype, NAC type and tumor stage at diagnosis were searched for. Pathologic complete response (pCR) was defined as the absence of residual invasive cancer cells in the breast and ipsilateral lymph nodes. RESULTS No differences were found in baseline BPE, final BPE, early and total BPE changes between pCR and non-pCR groups. Early BPE change was higher in non-pCR group in patients with stages 3 and 4 breast cancers (P=0.019) and in human epidermal growth factor receptor 2 (HER2)-negative patients (P=0.020). CONCLUSION Early reduction of BPE in the contralateral breast during NAC may be an early predictor of loss of tumor response, showing potential as an imaging biomarker of treatment response, especially in women with stages 3 or 4 breast cancers and in HER2 - negative breast cancers.
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Affiliation(s)
- R Rella
- UOC di Diagnostica per Immagini ed Interventistica Generale, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - E Bufi
- UOC di Diagnostica per Immagini ed Interventistica Generale, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
| | - P Belli
- UOC di Diagnostica per Immagini ed Interventistica Generale, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - F Petta
- UOC di Diagnostica per Immagini ed Interventistica Generale, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - T Serra
- UOC di Diagnostica per Immagini ed Interventistica Generale, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - V Masiello
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - A R Scrofani
- UOC di Diagnostica per Immagini ed Interventistica Generale, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - R Barone
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - A Orlandi
- U.O.C Oncologia Medica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - V Valentini
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - R Manfredi
- UOC di Diagnostica per Immagini ed Interventistica Generale, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Università Cattolica Sacro Cuore, 00168 Rome, Italy
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8
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Miccò M, Campitelli M, Sbarra M, Carra N, Barone R, Gui B, Gambacorta MA, Valentini V, Manfredi R. DW-MRI predictive factors for radiation-induced vaginal stenosis in patients with cervical cancer. Clin Radiol 2019; 75:216-223. [PMID: 31806362 DOI: 10.1016/j.crad.2019.10.021] [Citation(s) in RCA: 2] [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] [Received: 03/15/2019] [Accepted: 10/30/2019] [Indexed: 11/30/2022]
Abstract
AIM To find diffusion-weighted (DW) magnetic resonance imaging (MRI) parameters predictive for radiation-induced vaginal stenosis (VS) in locally advanced cervical cancer (LACC) treated with neoadjuvant chemoradiation therapy (CRT). MATERIALS AND METHODS Retrospective analysis of 43 patients with LACC who underwent 1.5 T DW-MRI before (baseline), after 2 weeks (early), and at the end of CRT (final). At MRI, vaginal length, thickness, width, and cervical tumour volume (TV) were measured. Vaginal signal intensity at DW-MRI was analysed at final MRI. CRT-induced VS was graded using Common Terminology Criteria for Adverse Events (CTCAE) v4.03. Correlations between DW-MRI and clinical data were made using Wilcoxon's test, Mann-Whitney test, Fisher's exact test, or chi-squared test as appropriate. Receiver operating characteristic (ROC) curves were generated for variables to evaluate diagnostic ability to predict CRT-induced VS using a logistic regression model. RESULTS Asymptomatic vaginal toxicity (CTCAE Grade 1) was observed in 14 patients and symptomatic CRT-induced VS (CTCAE Grade ≥2) was detected in 29 patients. Baseline TV was higher in Grade 1 than in Grade ≥2 (p=0.013). Median vaginal length, thickness, and width decreased between baseline and final MRI in all patients (p<0.0001) without significant variances between CTCAE grades. Significant differences were observed in DW-MRI patterns (p<0.0001). In Grade ≥2, DWI showed signal loss of vaginal mucosa in 17 patients (63%) and diffuse restricted diffusion of vaginal wall in eight patients (30%). AUC was 0.938 (coefficient=4.72; p<0.001) for DWI and 0.712 (coefficient=-2.623×10 -5; p=0.004) for TV. CONCLUSIONS This is the first study using DW-MRI for predicting CRT-induced VS. DWI is useful tool in patients with LACC after CRT for early prevention and management strategies for VS.
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Affiliation(s)
- M Miccò
- Radiologia Diagnostica e Interventistica Generale, Area Diagnostica per Immagini, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, Rome, 00168, Italy
| | - M Campitelli
- Radioterapia Oncologica, Area Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, Rome, 00168, Italy
| | - M Sbarra
- Radiologia Diagnostica e Interventistica Generale, Area Diagnostica per Immagini, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, Rome, 00168, Italy; Istituto di Radiologia, Università Cattolica del Sacro Cuore, Largo F. Vito, 1, Rome, 00168, Italy.
| | - N Carra
- Radioterapia Oncologica, Area Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, Rome, 00168, Italy; Istituto di Radiologia, Università Cattolica del Sacro Cuore, Largo F. Vito, 1, Rome, 00168, Italy
| | - R Barone
- RADIUS S.r.l., Budrio (BO), Italy
| | - B Gui
- Radiologia Diagnostica e Interventistica Generale, Area Diagnostica per Immagini, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, Rome, 00168, Italy
| | - M A Gambacorta
- Radioterapia Oncologica, Area Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, Rome, 00168, Italy; Istituto di Radiologia, Università Cattolica del Sacro Cuore, Largo F. Vito, 1, Rome, 00168, Italy
| | - V Valentini
- Radioterapia Oncologica, Area Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, Rome, 00168, Italy; Istituto di Radiologia, Università Cattolica del Sacro Cuore, Largo F. Vito, 1, Rome, 00168, Italy
| | - R Manfredi
- Radiologia Diagnostica e Interventistica Generale, Area Diagnostica per Immagini, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, Rome, 00168, Italy; Istituto di Radiologia, Università Cattolica del Sacro Cuore, Largo F. Vito, 1, Rome, 00168, Italy
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9
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Marazzi F, Masiello V, Barone R, Magri V, Mulé A, Santoro A, Cacciatori F, Boldrini L, Franceschini G, Moschella F, Naso G, Tomao S, Mantini G, Masetti R, Smaniotto D, Valentini V. OncotypeDX® predictive nomogram for recurrence score output: A machine learning system based on quantitative immunochemistry analysis - ADAPTED01. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.085] [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: 11/14/2022] Open
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10
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Mostile G, Barone R, Nicoletti A, Rizzo R, Martinelli D, Sturiale L, Fiumara A, Jankovic J, Zappia M. Hyperkinetic movement disorders in congenital disorders of glycosylation. Eur J Neurol 2019; 26:1226-1234. [PMID: 31132195 DOI: 10.1111/ene.14007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 05/14/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Congenital disorders of glycosylation (CDG) represent an increasing number of rare inherited metabolic diseases associated with abnormal glycan metabolism and disease onset in infancy or early childhood. Most CDG are multisystemic diseases mainly affecting the central nervous system. The aim of the current study was to investigate hyperkinetic movement disorders in patients affected by CDG and to characterize phenomenology based on CDG subtypes. METHODS Subjects were identified from a cohort of patients with CDG who were referred to the University Hospital of Catania, Italy. Patients were evaluated by neurologists with expertise in movement disorders and videotaped using a standardized protocol. RESULTS A variety of hyperkinetic movement disorders was detected in eight unrelated CDG patients. Involuntary movements were generally observed early in childhood, maintaining a clinical stability over time. Distribution ranged from a generalized, especially in younger subjects, to a segmental/multifocal involvement. In patients with phosphomannomutase 2 CDG, the principal movement disorders included dystonia and choreo-athetosis. In patients affected by other CDG types, the movement disorders ranged from pure generalized chorea to mixed movement disorders including dystonia and complex stereotypies. CONCLUSIONS Hyperkinetic movement disorder is a key clinical feature in patients with CDG. CDG should be considered in the differential diagnosis of childhood-onset dyskinesia, especially when associated with ataxia, developmental delay, intellectual disability, autism or seizure disorder.
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Affiliation(s)
- G Mostile
- Neurology Clinic, Department 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
| | - R Barone
- Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.,Regional Referral Center for Inborn Errors Metabolism, Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.,Institute for Polymers Composites and Biomaterials, CNR, Catania, Italy
| | - A Nicoletti
- Neurology Clinic, Department 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
| | - R Rizzo
- Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - D Martinelli
- Division of Metabolism, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - L Sturiale
- Institute for Polymers Composites and Biomaterials, CNR, Catania, Italy
| | - A Fiumara
- Regional Referral Center for Inborn Errors Metabolism, Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - J Jankovic
- Parkinson's Disease Center and Movement Disorder Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - M Zappia
- Neurology Clinic, Department 'G.F. Ingrassia', Section of Neurosciences, University of Catania, Catania, Italy
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Marazzi F, Mulè A, Masiello V, Masetti R, Barone R, Franceschini G, Cacciatori F, Moschella F, Cannatà C, Boldrini L, Mantini G, Smaniotto D, Valentini V. EP-1325 Personalized Medicine in breast cancer: a nomogram from prognostic score to deescalate radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31745-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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12
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Kelly KJ, Alsayadnasser M, Vaida F, Veerapong J, Baumgartner JM, Patel S, Ahmad S, Barone R, Lowy AM. Does Primary Tumor Side Matter in Patients with Metastatic Colon Cancer Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy? Ann Surg Oncol 2019; 26:1421-1427. [PMID: 30815802 DOI: 10.1245/s10434-019-07255-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND Primary tumor location has been shown to be prognostic of overall survival (OS) in patients with both locally advanced and metastatic colorectal cancer. The impact of sidedness on prognosis has not been evaluated in the setting of peritoneal-only metastases treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS A retrospective review of prospectively maintained databases of patients with peritoneal surface malignancy undergoing CRS/HIPEC from three high-volume centers was performed. RESULTS A total of 115 patients with metastatic colon cancer to the peritoneum who underwent CRS/HIPEC with mitomycin C were identified. Fifty-one patients (45%) had left-sided primary tumors, and 64 (55%) had right-sided primary tumors. Patients with right-sided tumors were more likely to be older (median age 56 vs. 49 years, p = 0.007) and to have signet ring cell histology (17% vs. 4%, p = 0.026). Patients with right-sided tumors had median disease-free survival (DFS) and OS of 14 months (95% confidence interval [CI] 10.5-17.5) and 36 months (95% CI 27.4-44.6), respectively, versus 16 months (95% CI 11.0-21.0) and 69 months (95% CI 24.3-113.7) for those patients with left-sided tumors. On multivariate analysis, primary tumor side was an independent predictor of both DFS and OS. CONCLUSIONS In this study, there was a dramatic, clinically significant difference in OS between patients with right- and left-sided tumors, and primary tumor side was an independent predictor of DFS and OS. Primary tumor side should be considered in patient selection for CRS with or without HIPEC.
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Affiliation(s)
- Kaitlyn J Kelly
- Department of Surgery, Division of Surgical Oncology, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA.
| | - Masumah Alsayadnasser
- Department of Surgery, Division of Surgical Oncology, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
| | - Florin Vaida
- Department of Family Medicine and Public Health, Division of Biostatistics and Bioinformatics, University of California, San Diego, San Diego, CA, USA
| | - Jula Veerapong
- Department of Surgery, Division of Surgical Oncology, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
| | - Joel M Baumgartner
- Department of Surgery, Division of Surgical Oncology, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
| | - Sameer Patel
- Department of Surgery, Division of Surgical Oncology, University of Cincinnati, Cincinnati, OH, USA
| | - Syed Ahmad
- Department of Surgery, Division of Surgical Oncology, University of Cincinnati, Cincinnati, OH, USA
| | - Robert Barone
- Department of Surgery, Sharp Memorial Hospital, San Diego, CA, USA
| | - Andrew M Lowy
- Department of Surgery, Division of Surgical Oncology, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
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Fiumara A, Barone R, Buttitta P, Musso R, Pavone L, Nigro F, Jaeken J. Haemostatic Studies in Carbohydrate-deficient Glycoprotein Syndrome Type I. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1650611] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryCDG syndrome (CDGS) type I is the most frequent form of a group of metabolic disorders characterised by a defect of the carbohydrate moiety of glycoproteins. A large number of plasma glycoproteins, including clotting factors and inhibitors, are decreased and stroke-like episodes have been described in about half of the reported patients. We studied blood coagulation factors, inhibitors and D-dimer plasma levels in four subjects, aged 12-23 years, with CDGS type I. Factors VIII, XI, antithrombin III activity, antigen plasma levels of antithrombin III, free protein S and protein C were decreased whereas protein C as activity was normal. In addition two patients had reduction of factors II, V, VII, IX, X reflecting the phenotypic heterogeneity associated with CDGS type I. D-dimer plasma concentrations were elevated in all subjects. The hypercoagulable state as consequence of the combined deficiencies of coagulation inhibitors could contribute to the stroke-like phenomena in CDGS type I.
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Affiliation(s)
- A Fiumara
- Department of Paediatrics, University of Catania, Italy
| | - R Barone
- Department of Paediatrics, University of Catania, Italy
| | - P Buttitta
- The Department of Neonatology, G. Cristina Hospital, Palermo, Italy
| | - R Musso
- Department of Hematology, Hemophilia Section, University of Catania, Italy
| | - L Pavone
- Department of Paediatrics, University of Catania, Italy
| | - F Nigro
- Department of Paediatrics, University of Catania, Italy
| | - J Jaeken
- Department of Paediatrics, University of Leuven, Belgium
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14
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Tortelli R, Arcuti S, Copetti M, Barone R, Zecca C, Capozzo R, Barulli MR, Simone IL, Logroscino G. Pseudobulbar affect as a negative prognostic indicator in amyotrophic lateral sclerosis. Acta Neurol Scand 2018. [PMID: 29527672 DOI: 10.1111/ane.12918] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To evaluate whether the presence of pseudobulbar affect (PBA) in an early stage of the disease influences survival in a population-based incident cohort of amyotrophic lateral sclerosis (ALS). METHODS Incident ALS cases, diagnosed according to El Escorial criteria, were enrolled from a prospective population-based registry in Puglia, Southern Italy. The Center for Neurologic Study-Lability Scale (CNS-LS), a self-administered questionnaire, was used to evaluate PBA. Total scores range from 7 to 35. A score ≥13 was used to identify PBA. Cox proportional hazard models were used for survival analysis. The modified C-statistic for censored survival data was used for models' discrimination. RECursive Partitioning and AMalgamation (RECPAM) analysis was used to identify subgroups of patients with different patterns of risk, depending on baseline characteristics. RESULTS We enrolled 94 sporadic ALS, median age of 64 years (range: 26-80). At the censoring date, 65 of 94 (69.2%), 39 of 60 (65.0%), and 26 of 34 (76.5%) patients reached the outcome (tracheotomy/death), in the whole, non-PBA and in the PBA groups, respectively. Kaplan-Meier survival curves for the two subgroups were not significantly different (log-rank test: 1.3, P = .25). The discrimination ability of a multivariable model with demographic and clinical variables of interest was not improved by adding PBA. In the RECPAM analysis, ALSFRSr and the total score of CNS-LS scale (</≥10) were the most important variables for differentiating all risk categories. CONCLUSIONS These preliminary results underlie that the presence of PBA at entry negatively influences survival in a specific subgroup of patients with ALS characterized by less functional impairment.
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Affiliation(s)
- R. Tortelli
- Unit of Neurodegenerative Diseases; Department of Clinical Research in Neurology; University of Bari “A. Moro” at Pia Fondazione Card. G. Panico; Tricase Lecce Italy
| | - S. Arcuti
- Unit of Biostatistics; IRCCS “Casa Sollievo della Sofferenza”; San Giovanni Rotondo Foggia Italy
| | - M. Copetti
- Unit of Biostatistics; IRCCS “Casa Sollievo della Sofferenza”; San Giovanni Rotondo Foggia Italy
| | - R. Barone
- Unit of Neurodegenerative Diseases; Department of Clinical Research in Neurology; University of Bari “A. Moro” at Pia Fondazione Card. G. Panico; Tricase Lecce Italy
| | - C. Zecca
- Unit of Neurodegenerative Diseases; Department of Clinical Research in Neurology; University of Bari “A. Moro” at Pia Fondazione Card. G. Panico; Tricase Lecce Italy
| | - R. Capozzo
- Unit of Neurodegenerative Diseases; Department of Clinical Research in Neurology; University of Bari “A. Moro” at Pia Fondazione Card. G. Panico; Tricase Lecce Italy
| | - M. R. Barulli
- Unit of Neurodegenerative Diseases; Department of Clinical Research in Neurology; University of Bari “A. Moro” at Pia Fondazione Card. G. Panico; Tricase Lecce Italy
| | - I. L. Simone
- Department of Basic Medical Sciences, Neurosciences and Sense Organs; University of Bari “A. Moro”; Bari Italy
| | - G. Logroscino
- Unit of Neurodegenerative Diseases; Department of Clinical Research in Neurology; University of Bari “A. Moro” at Pia Fondazione Card. G. Panico; Tricase Lecce Italy
- Department of Basic Medical Sciences, Neurosciences and Sense Organs; University of Bari “A. Moro”; Bari Italy
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Agrigento V, Barone R, Sclafani S, Di Maggio R, Sacco M, Maggio A, D'Alcamo E. Response to Alpha-Interferon Treatment of the Congenital Dyserythropoietic Anemia type I in Two Sicilian Beta Thalassemia Carriers. Indian J Hematol Blood Transfus 2017; 33:621-623. [PMID: 29075082 DOI: 10.1007/s12288-016-0765-9] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 12/07/2016] [Indexed: 11/30/2022] Open
Abstract
Congenital dyserythropoietic anemia type I (CDAI) is an autosomal recessive inherited haematological disorder associated with moderate-to-severe anemia characterized by ineffective erythropoiesis with distinct morphological abnormalities in erythroid precursors. We present two case of congenital dyserythropoietic anemia type I in two Sicilian patients heterozygous for β0 39 globin gene cod 39 C > T with marked bone marrow abnormalities, responding to treatment with alpha interferon. The diagnosis was established using routine haematological and biochemical test, light and electron microscopy; molecular analysis of the CDAN1 gene associated to the CDAI disease was performed. The response to the treatment was monitored using the hemoglobin levels, the red cell count, the reticulocyte count and the transfusional requirement. This report points out the usefulness of the treatment with interferon alpha in two Sicilian beta thalassemia carriers, in which the therapy was well tolerated without producing any side effects; in these patients the transfusion requirements after the initiation of interferon therapy decreased.
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Affiliation(s)
- V Agrigento
- U.O.C. Ematologia per le Malattie Rare del Sangue e degli Organi Ematopoietici, Azienda Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco n. 180, 90146 Palermo, Italy
| | - R Barone
- U.O.C. Ematologia per le Malattie Rare del Sangue e degli Organi Ematopoietici, Azienda Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco n. 180, 90146 Palermo, Italy
| | - S Sclafani
- U.O.C. Ematologia per le Malattie Rare del Sangue e degli Organi Ematopoietici, Azienda Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco n. 180, 90146 Palermo, Italy
| | - R Di Maggio
- U.O.C. Ematologia per le Malattie Rare del Sangue e degli Organi Ematopoietici, Azienda Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco n. 180, 90146 Palermo, Italy
| | - M Sacco
- U.O.C. Ematologia per le Malattie Rare del Sangue e degli Organi Ematopoietici, Azienda Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco n. 180, 90146 Palermo, Italy
| | - A Maggio
- U.O.C. Ematologia per le Malattie Rare del Sangue e degli Organi Ematopoietici, Azienda Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco n. 180, 90146 Palermo, Italy
| | - E D'Alcamo
- U.O.C. Ematologia per le Malattie Rare del Sangue e degli Organi Ematopoietici, Azienda Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco n. 180, 90146 Palermo, Italy
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Palmigiano A, Bua RO, Barone R, Rymen D, Régal L, Deconinck N, Dionisi-Vici C, Fung CW, Garozzo D, Jaeken J, Sturiale L. MALDI-MS profiling of serum O-glycosylation and N-glycosylation in COG5-CDG. J Mass Spectrom 2017; 52:372-377. [PMID: 28444691 DOI: 10.1002/jms.3936] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 02/07/2017] [Accepted: 04/21/2017] [Indexed: 06/07/2023]
Abstract
Congenital disorders of glycosylation (CDG) are due to defective glycosylation of glycoconjugates. Conserved oligomeric Golgi (COG)-CDG are genetic diseases due to defects of the COG complex subunits 1-8 causing N-glycan and O-glycan processing abnormalities. In COG-CDG, isoelectric focusing separation of undersialylated glycoforms of serum transferrin and apolipoprotein C-III (apoC-III) allows to detect N-glycosylation and O-glycosylation defects, respectively. COG5-CDG (COG5 subunit deficiency) is a multisystem disease with dysmorphic features, intellectual disability of variable degree, seizures, acquired microcephaly, sensory defects and autistic behavior. We applied matrix-assisted laser desorption/ionization-MS for a high-throughput screening of differential serum O-glycoform and N-glycoform in five patients with COG5-CDG. When compared with age-matched controls, COG5-CDG showed a significant increase of apoC-III0a (aglycosylated glycoform), whereas apoC-III1 (mono-sialylated glycoform) decreased significantly. Serum N-glycome of COG5-CDG patients was characterized by the relative abundance of undersialylated and undergalactosylated biantennary and triantennary glycans as well as slight increase of high-mannose structures and hybrid glycans. Using advanced and well-established MS-based approaches, the present findings reveal novel aspects on O-glycan and N-glycan profiling in COG5-CDG patients, thus providing an increase of current knowledge on glycosylation defects caused by impairment of COG subunits, in support of clinical diagnosis. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- A Palmigiano
- CNR - Institute for Polymers, Composites and Biomaterials, via P. Gaifami, 18 - 95126, Catania, Italy
| | - R O Bua
- CNR - Institute for Polymers, Composites and Biomaterials, via P. Gaifami, 18 - 95126, Catania, Italy
| | - R Barone
- CNR - Institute for Polymers, Composites and Biomaterials, via P. Gaifami, 18 - 95126, Catania, Italy
- Child Neurology and Psychiatry, Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia, 78 - 95123, Catania, Italy
| | - D Rymen
- Center for Human Genetics, University of Leuven, Herestraat 49, B-3000, Leuven, Belgium
- Center for Metabolic Diseases, University Hospital Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium
| | - L Régal
- Department of Pediatric Neurology and Metabolic Disorders, UZ Brussel - University Hospital Brussels, Campus Jette Laarbeeklaan 101, 1000, Brussels, Belgium
| | - N Deconinck
- Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Avenue Jean Joseph Crocq 15, 1020, Brussels, Belgium
| | - C Dionisi-Vici
- Division of Metabolism, Bambino Gesù Children's Research Hospital, piazza S. Onofrio 4, 00165, Rome, Italy
| | - C-W Fung
- Department of Pediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong
| | - D Garozzo
- CNR - Institute for Polymers, Composites and Biomaterials, via P. Gaifami, 18 - 95126, Catania, Italy
| | - J Jaeken
- Center for Metabolic Diseases, University Hospital Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium
| | - L Sturiale
- CNR - Institute for Polymers, Composites and Biomaterials, via P. Gaifami, 18 - 95126, Catania, Italy
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D'Alcamo E, Agrigento V, Pitrolo L, Sclafani S, Barone R, Calvaruso G, Buffa V, Maggio A. New Codanin-1 Gene Mutations in a Italian Patient with Congenital Dyserythropoietic Anemia Type I and Heterozygous Beta-Thalassemia. Indian J Hematol Blood Transfus 2016; 32:278-81. [PMID: 27408412 DOI: 10.1007/s12288-015-0633-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 12/16/2015] [Indexed: 11/26/2022] Open
Abstract
Congenital dyserythropoietic anemia type I is an autosomal recessive disorder associated with macrocytic anemia, ineffective erythropoiesis, iron overloading and characterized by abnormal chromatin ultrastructure in erythroblasts such as internuclear chromatin bridges, spongy heterochromatin and invagination of the nuclear membrane. A 58-year-old Causasian man with chronic hemolytic anemia, heterozygous for β (+) -globin IVS1, nt110 G>A mutation (causing abnormal alpha:beta globin chain ratio) showed clinical, laboratory and hematological features suggesting diagnosis of CDA1. Sequence analysis of CDA-related genes revealed compound heterozygosity for two novel mutations in the CDAN1 gene: a frameshift mutation 3367 del 4 (TTAG) in exon 25 and a missense mutation c.1811 G>T in exon 11 causing an aminoacid change from glycine to valine at codon 565 (G565V). One of the propositus' brothers showed the same gene mutations. As the CDA1 can mimic thalassemia, a frequent misdiagnosis is possible especially in countries where the prevalence of thalassemia is high. A strong clinical suspicion in patients who do not reveal a clear genetic basis for presumed thalassemia may help clinch the correct diagnosis.
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Affiliation(s)
- Elena D'Alcamo
- Ospedale V. Cervello UOC Ematologia per le Malattie Rare del Sangue e degli Organi Ematopoietici, Azienda Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco n° 180, 90146 Palermo, Italy
| | - V Agrigento
- Ospedale V. Cervello UOC Ematologia per le Malattie Rare del Sangue e degli Organi Ematopoietici, Azienda Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco n° 180, 90146 Palermo, Italy
| | - L Pitrolo
- Ospedale V. Cervello UOC Ematologia per le Malattie Rare del Sangue e degli Organi Ematopoietici, Azienda Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco n° 180, 90146 Palermo, Italy
| | - S Sclafani
- Ospedale V. Cervello UOC Ematologia per le Malattie Rare del Sangue e degli Organi Ematopoietici, Azienda Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco n° 180, 90146 Palermo, Italy
| | - R Barone
- Ospedale V. Cervello UOC Ematologia per le Malattie Rare del Sangue e degli Organi Ematopoietici, Azienda Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco n° 180, 90146 Palermo, Italy
| | - G Calvaruso
- Ospedale V. Cervello UOC Ematologia per le Malattie Rare del Sangue e degli Organi Ematopoietici, Azienda Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco n° 180, 90146 Palermo, Italy
| | - V Buffa
- Ospedale V. Cervello UOC Ematologia per le Malattie Rare del Sangue e degli Organi Ematopoietici, Azienda Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco n° 180, 90146 Palermo, Italy
| | - A Maggio
- Ospedale V. Cervello UOC Ematologia per le Malattie Rare del Sangue e degli Organi Ematopoietici, Azienda Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco n° 180, 90146 Palermo, Italy
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Giliberto C, Reggio E, Sofia V, Giuliano L, Lo Fermo S, Barone R, Zappia M. Electroclinical features of a patient with GLUT1 deficiency syndrome and adult onset periodic weakness. Eur J Neurol 2016; 23:e1-3. [PMID: 26768679 DOI: 10.1111/ene.12831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 08/03/2015] [Indexed: 11/30/2022]
Affiliation(s)
- C Giliberto
- Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy
| | - E Reggio
- Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy
| | - V Sofia
- Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy
| | - L Giuliano
- Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy
| | - S Lo Fermo
- Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy
| | - R Barone
- Child Neurology and Psychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - M Zappia
- Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy
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Ciancio AL, Barone R, Zollo L, Carpino G, Davalli A, Sacchetti R, Guglielmelli E. A bio-inspired force control for cyclic manipulation of prosthetic hands. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:4824-7. [PMID: 26737373 DOI: 10.1109/embc.2015.7319473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The human hand is considered as the highest example of dexterous system capable of interacting with different objects and adapting its manipulation abilities to them. The control of poliarticulated prosthetic hands represents one important research challenge, typically aiming at replicating the manipulation capabilities of the natural hand. For this reason, this paper wants to propose a bio-inspired learning architecture based on parallel force/position control for prosthetic hands, capable of learning cyclic manipulation capabilities. To this purpose, it is focused on the control of a commercial biomechatronic hand (the IH2 hand) including the main features of recent poliarticulated prosthetic hands. The training phase of the hand was carried out in simulation, the parallel force/position control was tested in simulation whereas preliminary tests were performed on the real IH2 hand. The results obtained in simulation and on the real hand provide an important evidence of the applicability of the bio-inspired neural control to real biomechatronic hand with the typical features of a hand prosthesis.
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Ferrante M, Barone R, Fazio A, Zerbo S, Margherita V, Rizzo R, Fichera G, Fiore M. Prevalence and age at diagnosis of Autism Spectrum Disorder in south Italy, 2004–2014. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.099] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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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Lipari L, Gerbino A, Lipari A, Barone R, Farina E. Atrial natriuretic Peptide expression in human articular cartilage. J BIOL REG HOMEOS AG 2015; 29:235-238. [PMID: 25864764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This immunohistochemical study aims to investigate the Atrial natriuretic peptide (ANP)-presence and localization in human articular cartilage. Fragments of articular cartilage covering the femoral head were removed from patients submitted to surgical operation after femoral neck fracture without joint disease. The samples were immunostained with anti-ANP antibody. The results demonstrate that ANP is present in chondrocytes in all the three zones of the articular cartilage. Superficial chondrocytes show strong ANP-immunopositivty. The presence of ANP in the articular cartilage suggests that ANP may play a role in cartilage metabolism by regulating transport of molecules through the different zones of the articular cartilage and in maintenance of its homeostasis; probably ANP could be also involved in the regulation of the balance between synovial fluid and the other body fluids.
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Affiliation(s)
- L Lipari
- Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Italy
| | - A Gerbino
- Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Italy
| | - A Lipari
- Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Italy
| | - R Barone
- Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Italy
| | - E Farina
- Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Italy
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Giliberto C, Sofia V, Barone R, Guerrini R, Zappia M. P850: Electrophysiological pattern in GLUT1 deficiency syndrome (A275T mutation). Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50880-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Turaga K, Levine E, Barone R, Sticca R, Petrelli N, Lambert L, Nash G, Morse M, Adbel-Misih R, Alexander HR, Attiyeh F, Bartlett D, Bastidas A, Blazer T, Chu Q, Chung K, Dominguez-Parra L, Espat NJ, Foster J, Fournier K, Garcia R, Goodman M, Hanna N, Harrison L, Hoefer R, Holtzman M, Kane J, Labow D, Li B, Lowy A, Mansfield P, Ong E, Pameijer C, Pingpank J, Quinones M, Royal R, Salti G, Sardi A, Shen P, Skitzki J, Spellman J, Stewart J, Esquivel J. Consensus guidelines from The American Society of Peritoneal Surface Malignancies on standardizing the delivery of hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer patients in the United States. Ann Surg Oncol 2013; 21:1501-5. [PMID: 23793364 DOI: 10.1245/s10434-013-3061-z] [Citation(s) in RCA: 133] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND The American Society of Peritoneal Surface Malignancies (ASPSM) is a consortium of cancer centers performing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). This is a position paper from the ASPSM on the standardization of the delivery of HIPEC. METHODS A survey was conducted of all cancer centers performing HIPEC in the United States. We attempted to obtain consensus by the modified method of Delphi on seven key HIPEC parameters: (1) method, (2) inflow temperature, (3) perfusate volume, (4) drug, (5) dosage, (6) timing of drug delivery, and (7) total perfusion time. Statistical analysis was performed using nonparametric tests. RESULTS Response rates for ASPSM members (n = 45) and non-ASPSM members (n = 24) were 89 and 33 %, respectively. Of the responders from ASPSM members, 95 % agreed with implementing the proposal. Majority of the surgical oncologists favored the closed method of delivery with a standardized dual dose of mitomycin for a 90-min chemoperfusion for patients undergoing cytoreductive surgery for peritoneal carcinomatosis of colorectal origin. CONCLUSIONS This recommendation on a standardized delivery of HIPEC in patients with colorectal cancer represents an important first step in enhancing research in this field. Studies directed at maximizing the efficacy of each of the seven key elements will need to follow.
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Affiliation(s)
- K Turaga
- Medical College of Wisconsin, Milwaukee, WI, USA
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Gioviale MC, Damiano G, Puleio R, Bellavia M, Cassata G, Palumbo VD, Spinelli G, Altomare R, Barone R, Cacciabaudo F, Buscemi G, Lo Monte AI. Histologic effects of University of Wisconsin two-layer method preservation of rat pancreas. Transplant Proc 2013; 45:1723-8. [PMID: 23769032 DOI: 10.1016/j.transproceed.2013.02.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 01/28/2013] [Accepted: 02/06/2013] [Indexed: 11/25/2022]
Abstract
Marginal donors represent a poorly utilized source of organs for transplantation despite their availability. The key is to reduce the ischemic damage in the effort to improve organ quality. This study investigated the histologic effects after in situ perfusion of preservation with a two-layer method compared with the classic University of Wisconsin preservation in term of tissue integrity and number of viable exocrine cells in the rat pancreas both after exsanguination and at 8 weeks of cryopreservation. Pancreata harvested from 60 rats were collected using 3 methods: two-layer method following University of Wisconsin perfusion; exsanguination; and classic University of Wisconsin perfusion/storage. In addition to histologic analysis of collected pancreata, we analyzed the number of CK19(+) cells and their viability using chi-square tests with values P < .05 considered to be significant. Rat pancreas histology showed as University of Wisconsin in situ perfusion and preservation by the two-layer method to be more effective to maintain the morphologic integrity of both exocrine and endocrine tissues. There were a larger number of CK19(+) cells with good viability. Moreover, the effects of oxygenation were visible in pancreas biopsies preserved after exsanguination. In situ University of Wisconsin perfusion and preservation for 240 minutes with the two-layer method yielded greater numbers and viability of CK19(+) cells even after 8 weeks of cryopreservation.
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Affiliation(s)
- M C Gioviale
- Dipartimento di Discipline Chirurgiche ed Oncologiche, Università degli Studi di Palermo, Palermo, Italy
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Negri AL, Del Valle EE, Zanchetta MB, Nobaru M, Silveira F, Puddu M, Barone R, Bogado CE, Zanchetta JR. Evaluation of bone microarchitecture by high-resolution peripheral quantitative computed tomography (HR-pQCT) in hemodialysis patients. Osteoporos Int 2012; 23:2543-50. [PMID: 22234812 DOI: 10.1007/s00198-011-1890-9] [Citation(s) in RCA: 27] [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: 10/21/2011] [Accepted: 12/19/2011] [Indexed: 10/14/2022]
Abstract
UNLABELLED Hemodialyzed patients have decreased bone strength not completely characterized. We evaluated bone microarchitecture in hemodialysis patients and compared it to that of subjects without renal disease by high-resolution peripheral quantitative computed tomography (HR-pQCT). Hemodialysis patients have a marked decreased in cortical density, thickness, and area with significant reduction in trabecular parameters that correlated with the severity of secondary hyperparathyroidism only in women. INTRODUCTION Although fracture risk is greatly increased in dialysis patients, the corresponding decreased in bone strength has not been completely characterized. METHODS We evaluated volumetric bone mineral density (vBMD) and bone microstructure by HR-pQCT at the distal radius and tibia in 50 hemodialyzed (HD) patients (30 females, mean age 53.2 ± 6 years and 20 males, mean age 59.1 ± 11 years) and 50 sex- and age-matched controls. RESULTS At the distal radius HD, women showed a 29% reduction in total and trabecular density and trabecular bone volume fraction (p < 0.0001) compared to controls. Trabecular number was reduced by 25% (p < 0.0001), while trabecular separation was increased by 51%. Cortical thickness (-40%, p < 0.0001) and cortical area (-42%, p < 0.0001) were the parameters most reduced, while compact density was the parameter least reduced (-15%, p < 0.0001). Similar findings were found at the tibia. In HD men, HR-pQCT at the distal radius and tibia showed a reduction in volumetric density and microstructure parameters to a lesser extent than in women. In the hemodialyzed group, cortical thickness at the radius was negatively correlated with age both in women and men. At the distal radius and tibia, we found significant negative correlations between Log iPTH and total alkaline phosphatase with cortical vBMD(r = -0.48, p < 0.01; r = -0.69, p < 0.001), thickness (-0.37, p < 0.05; r = -0.60, p < 0.001), and area ((r = -0.43, p = 0.02; r = -0.65, p < 0.001) but only in women. CONCLUSION We conclude that hemodialysis patients have a marked decreased in cortical density, thickness, and area with significant reduction in trabecular parameters that correlated with the severity of secondary hyperparathyroidism only in women.
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Affiliation(s)
- A L Negri
- Instituto de Investigaciones Metabólicas, Universidad del Salvador, Libertad 836 1 piso, Buenos Aires 1012, Argentina.
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Patrier L, Dupuis AM, Granger Vallee A, Chenine L, Leray-Moragues H, Chalabi L, Morena M, Canaud B, Cristol JP, Akizawa T, Fukuhara S, Fukagawa M, Onishi Y, Yamaguchi T, Hasegawa T, Kido R, Kurokawa K, Vega O, Usvyat L, Rosales L, Thijssen S, Levin N, Kotanko P, An WS, Son YK, Kim SE, Kim KH, Han JY, Bae HR, Park Y, Passlick-Deetjen J, Kroczak M, Buschges-Seraphin B, Covic AC, Ponce P, Marzell B, Schulze F, de Francisco ALM, Esteve V, Junque A, Duarte V, Fulquet M, Saurina A, Pou M, Salas K, Macias J, Sanchez Ramos A, Lavado M, Ramirez de Arellano M, Del Valle E, Negri AL, Ryba J, Peri P, Puddu M, Bravo M, Rosa Diez G, Crucelegui S, Sintado L, Bevione PE, Canalis M, Fradinger E, Marini A, Marelli C, Schiller A, Covic A, Schiller O, Roman V, Andrei C, Berca S, Ivacson Z, Anton C, Raletchi C, Sezer S, Tutal E, Bal Z, Erkmen Uyar M, Ozdemir Acar FN, Lessard M, Ouimet D, Leblanc M, Nadeau-Fredette AC, Bell R, Lafrance JP, Pichette V, Vallee M, Solak Y, Atalay H, Torun B, Tonbul Z, Lacueva J, Santamaria C, Bordils A, Vicent C, Fernandez M, Casado M, Karakan S, Sezer S, Tutal E, Ozdemir Acar N, Ishimura E, Okuno S, Tsuboniwa N, Ichii M, Yamakawa T, Shoji S, Inaba M, Lomonte C, Derosa C, Libutti P, Teutonico A, Chimienti D, Antonelli M, Bruno A, Cocola S, Basile C, Petrucci I, Giovannini L, Samoni S, Colombini E, Cupisti A, Meola M, Stancu S, Zugravu A, Stanescu B, Barbulescu C, Anghel C, Cinca S, Petrescu L, Mircescu G, Hung PH, Chiang PC, Jong IC, Hsiao CY, Hung KY, Tentori F, Karaboyas A, Sen A, Hecking M, Bommer J, Depner T, Akiba T, Port FK, Robinson BM, Basile C, Libutti P, Di Turo AL, Vernaglione L, Casucci F, Losurdo N, Teutonico A, Lomonte C, Sanadgol H, Baiani M, Mohanna M, Basile C, Libutti P, Di Turo AL, Casucci F, Losurdo N, Teutonico A, Vernaglione L, Lomonte C, Negri AL, Del Valle EE, Zanchetta MB, Nobaru M, Silveira F, Puddu M, Barone R, Bogado CE, Zanchetta JR, Mlot-Michalska M, Grzegorzewska AE, Fedak D, Kuzniewski M, Janda K, Krzanowski M, Pawlica D, Kusnierz-Cabala B, Solnica B, Sulowicz W, Novotna H, vara F, Polakovic V, Sedlackova E, Marzell B, Kaufmann P, Merello JI, Mora J, Crespo A, Arens HJ, Passlick-Deetjen J, Takahashi T, Ogawa H, Kitajima Y, Sato Y, Cayabyab S, Mallari J, Kikuchi H, Nakayama H, Saito N, Shimada H, Miyazaki S, Sakai S, Suzuki M, Gonzalez E, Torregrosa V, Cannata J, Gonzalez MT, Arenas MD, Montenegro J, Rios F, Mora J, Moreno R, Muniz ML, Copley JB, Smyth M, Poole L, Wilson R. Bone disease in CKD 5D. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.40] [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: 11/14/2022] Open
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Ferri L, Guido C, la Marca G, Malvagia S, Cavicchi C, Fiumara A, Barone R, Parini R, Antuzzi D, Feliciani C, Zampetti A, Manna R, Giglio S, Della Valle CM, Wu X, Valenzano KJ, Benjamin R, Donati MA, Guerrini R, Genuardi M, Morrone A. Fabry disease: polymorphic haplotypes and a novel missense mutation in the GLA gene. Clin Genet 2011; 81:224-33. [PMID: 21517827 DOI: 10.1111/j.1399-0004.2011.01689.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Fabry disease: polymorphic haplotypes and a novel missense mutation in the GLA gene. Fabry disease (FD) is an X-linked lysosomal storage disorder with a heterogeneous spectrum of clinical manifestations that are caused by the deficiency of α-galactosidase A (α-Gal-A) activity. Although useful for diagnosis in males, enzyme activity is not a reliable biochemical marker in heterozygous females due to random X-chromosome inactivation, thus rendering DNA sequencing of the α-Gal-A gene, alpha-galactosidase gene (GLA), the most reliable test for the confirmation of diagnosis in females. The spectrum of GLA mutations is highly heterogeneous. Many polymorphic GLA variants have been described, but it is unclear if haplotypes formed by combinations of such variants correlate with FD, thus complicating molecular diagnosis in females with normal α-Gal-A activity. We tested 67 female probands with clinical manifestations that may be associated with FD and 110 control males with normal α-Gal-A activity. Five different combinations of GLA polymorphic variants were identified in 14 of the 67 females, whereas clearcut pathogenetic alterations, p.Met51Ile and p.Met290Leu, were identified in two cases. The latter has not been reported so far, and both mutant forms were found to be responsive to the pharmacological chaperone deoxygalactonojirimycin (DGJ; migalastat hydrochloride). Analysis of the male control population, as well as male relatives of a suspected FD female proband, permitted the identification of seven different GLA gene haplotypes in strong linkage disequilibrium. The identification of haplotypes in control males provides evidence against their involvement in the development of FD phenotypic manifestations.
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Affiliation(s)
- L Ferri
- Department of Sciences for Woman and Child's Health, University of Florence, Florence, Italy
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Fiumara A, Barone R, Arena A, Filocamo M, Lissens W, Pavone L, Sorge G. Krabbe leukodystrophy in a selected population with high rate of late onset forms: longer survival linked to c.121G>A (p.Gly41Ser) mutation. Clin Genet 2010; 80:452-8. [DOI: 10.1111/j.1399-0004.2010.01572.x] [Citation(s) in RCA: 24] [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: 11/28/2022]
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Nogueira JP, Maraninchi M, Lorec AM, Corroller ABL, Nicolay A, Gaudart J, Portugal H, Barone R, Vialettes B, Valéro R. Specific adipocytokines profiles in patients with hyperactive and/or binge/purge form of anorexia nervosa. Eur J Clin Nutr 2010; 64:840-4. [DOI: 10.1038/ejcn.2010.66] [Citation(s) in RCA: 24] [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: 11/09/2022]
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Quintana E, Sturiale L, Montero R, Andrade F, Fernandez C, Couce ML, Barone R, Aldamiz-Echevarria L, Ribes A, Artuch R, Briones P. Secondary disorders of glycosylation in inborn errors of fructose metabolism. J Inherit Metab Dis 2009; 32 Suppl 1:S273-8. [PMID: 19768653 DOI: 10.1007/s10545-009-1219-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [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: 04/15/2009] [Revised: 07/20/2009] [Accepted: 07/23/2009] [Indexed: 02/02/2023]
Abstract
Adamowicz and colleagues raised the alert in 2007 about patients with atypical hereditary fructose intolerance (HFI) primarily misdiagnosed as CDG Ix. We describe a girl with neonatal hypertonia, facial trismus, absent swallowing and coughing reflexes, gastro-oesophageal reflux and sporadically elevated Krebs cycle metabolites and lactate. At 14 months microcephaly and hepatomegaly were noted, with hypertransaminasaemia but normal blood coagulation, glucose, phosphate, and absent urinary reducing substances. Neurological impairment persisted. Because of hepatic and neurological abnormalities with developmental delay, Tf IEF was performed and showed a severe type 1 pattern, resulting in a wrong diagnosis of CDG. Subsequently, an aversion to fruits suggested HFI, confirmed by the finding of ALDOB mutations (p.A150P/p.N335K). The girl improved with fructose-free diet, but liver cirrhosis led to hepatic transplantation. She is now 7 years old with good evolution; facial trismus and hypertonia reversed, but microcephaly persists. Transferrin MALDI-TOF MS characterization revealed underoccupation of glycosylation sites and glycan abnormalities, which reversed with dietary treatment. High maternal fructose concentrations might have caused neonatal abnormalities. Although in our patient's mother there is no fructose accumulation at present, it is possible that increased ingestion of fruits and vegetables during pregnancy, together with her heterozygosity, caused an accumulation of fructose that finally affected the fetus. We also describe slightly abnormal transferrin isoelectric focusing and MALDI-TOF MS patterns of intact transferrin and N-glycans in a fructose-1,6-bisphosphatase (FBP1)-deficient patient. While HFI is a well-known cause of secondary CDG, we found no reports of abnormal transferrin isoelectric focusing patterns in FBP1 deficiency and we introduce this condition as a possible secondary cause for altered transferrin isoelectric focusing.
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Affiliation(s)
- E Quintana
- Institut de Bioquímica Clínica, Servei de Bioquímica i Genètica Molecular, Hospital Clínic, Edificio Helios III, c/ Mejia Lequerica s/n, 08028, Barcelona, Spain
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Barone R, Bellafiore M, Leonardi V, Zummo G. Structural analysis of rat patellar tendon in response to resistance and endurance training. Scand J Med Sci Sports 2009; 19:782-9. [DOI: 10.1111/j.1600-0838.2008.00863.x] [Citation(s) in RCA: 20] [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: 11/29/2022]
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Clauser B, Barone R, Briccoli L, Baleani A. Complications in surgical removal of mandibular third molars. Minerva Stomatol 2009; 58:359-366. [PMID: 19633636] [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: 05/28/2023]
Abstract
The most frequent complications after surgical removal of an impacted mandibular third molar are the following: alveolar osteitis, infections, neurological damage involving the inferior alveolar and lingual nerves. All of these postoperative complications are more frequent in older patients. Their increase starts at about 25 years of age. Alveolar osteitis is the most frequent postoperative complication, but it is easily handled; its pathogenesis remains unknown, even if cigarette smoking enhances its incidence; other putative risk factors have not been confirmed. An effective etiologic therapy is not yet available, but the symptoms can be managed by means of local medication. Postoperative infections can still cause very severe problems, especially in elderly patients, if the treatment is not correct and timely. Antibiotic prophylaxis is indicated in selected cases. The possibility of neurological complications is often associated with anxiety both in the patient and doctor: fortunately, their incidence has been lowered by improved surgical techniques; moreover, risk indicators have been identified on the panoramic radiographs; three-dimensional imaging is useful in planning the surgical intervention in risky cases.
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Barone R, Sturiale L, Fiumara A, Uziel G, Garozzo D, Jaeken J. Borderline mental development in a congenital disorder of glycosylation (CDG) type Ia patient with multisystemic involvement (intermediate phenotype). J Inherit Metab Dis 2007; 30:107. [PMID: 17186415 DOI: 10.1007/s10545-006-0486-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2006] [Revised: 10/06/2006] [Accepted: 12/05/2006] [Indexed: 11/29/2022]
Abstract
CDG Ia (phosphomannomutase deficiency) has a wide clinical spectrum with the most severe affected patients having multisystemic disease in addition to severe nervous system involvement. We report a patient with CDG Ia and an intermediate phenotype due to mild neurological impairment and borderline cognitive abilities despite the occurrence of typical extraneurological symptoms. These included liver involvement, coagulopathy and failure to thrive with enteropathy. Genotype analyses showed that he was compound heterozygous for T237R/C241S mutations. This observation underlines that the CDG Ia clinical spectrum may include intraindividual variability that might reflect different degrees of glycosylation abnormalities among distinct body compartments. CDG Ia should be considered in cases of unexplained liver involvement and/or enteropathy in patients with mild developmental delay and subtle neurological signs.
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Affiliation(s)
- R Barone
- Institute of Chemistry and Technology of Polymers, CNR, Catania, Italy
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Abstract
Activated macrophages are major effectors at all stages of lesion formation in multiple sclerosis (MS) brain. Here, we report that the macrophage enzyme chitotriosidase (Chit) is significantly elevated both in plasma and cerebrospinal fluid (CSF) of patients with MS as compared to healthy controls and other neurological patients (P<0.001). Furthermore, the Chit activity in blood significantly associates with the MS clinical course (higher in secondary progressive relative to relapsing-remitting, P=0.01) and the clinical severity as measured by Kurtkze's Expanded Disability Status Scale (P<0.001). Also, we found that Chit activity is compartmentalized in the central nervous system of early MS patients and that its CSF/plasma quotient, in the presence of a preserved albumin quotient, correlates with the extent of future clinical deterioration (r=0.91; P<0.001). These findings confirm that innate immunity, here represented by Chit, is clinically relevant in MS and allows, if confirmed, reconsidering novel MS therapeutic strategies specifically aimed at this branch of the immune response.
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Affiliation(s)
- S Sotgiu
- Institute of Clinical Neurology, University of Sassari, Sassari, Italy.
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Esquivel J, Sticca R, Sugarbaker P, Levine E, Yan TD, Alexander R, Baratti D, Bartlett D, Barone R, Barrios P, Bieligk S, Bretcha-Boix P, Chang CK, Chu F, Chu Q, Daniel S, de Bree E, Deraco M, Dominguez-Parra L, Elias D, Flynn R, Foster J, Garofalo A, Gilly FN, Glehen O, Gomez-Portilla A, Gonzalez-Bayon L, Gonzalez-Moreno S, Goodman M, Gushchin V, Hanna N, Hartmann J, Harrison L, Hoefer R, Kane J, Kecmanovic D, Kelley S, Kuhn J, Lamont J, Lange J, Li B, Loggie B, Mahteme H, Mann G, Martin R, Misih RA, Moran B, Morris D, Onate-Ocana L, Petrelli N, Philippe G, Pingpank J, Pitroff A, Piso P, Quinones M, Riley L, Rutstein L, Saha S, Alrawi S, Sardi A, Schneebaum S, Shen P, Shibata D, Spellman J, Stojadinovic A, Stewart J, Torres-Melero J, Tuttle T, Verwaal V, Villar J, Wilkinson N, Younan R, Zeh H, Zoetmulder F, Sebbag G. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of peritoneal surface malignancies of colonic origin: a consensus statement. Society of Surgical Oncology. Ann Surg Oncol 2006. [PMID: 17072675 DOI: 10.1245/s10434-007-9599-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Esquivel J, Sticca R, Sugarbaker P, Levine E, Yan TD, Alexander R, Baratti D, Bartlett D, Barone R, Barrios P, Bieligk S, Bretcha-Boix P, Chang CK, Chu F, Chu Q, Daniel S, de Bree E, Deraco M, Dominguez-Parra L, Elias D, Flynn R, Foster J, Garofalo A, Gilly FN, Glehen O, Gomez-Portilla A, Gonzalez-Bayon L, Gonzalez-Moreno S, Goodman M, Gushchin V, Hanna N, Hartmann J, Harrison L, Hoefer R, Kane J, Kecmanovic D, Kelley S, Kuhn J, Lamont J, Lange J, Li B, Loggie B, Mahteme H, Mann G, Martin R, Misih RA, Moran B, Morris D, Onate-Ocana L, Petrelli N, Philippe G, Pingpank J, Pitroff A, Piso P, Quinones M, Riley L, Rutstein L, Saha S, Alrawi S, Sardi A, Schneebaum S, Shen P, Shibata D, Spellman J, Stojadinovic A, Stewart J, Torres-Melero J, Tuttle T, Verwaal V, Villar J, Wilkinson N, Younan R, Zeh H, Zoetmulder F, Sebbag G. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of peritoneal surface malignancies of colonic origin: a consensus statement. Society of Surgical Oncology. Ann Surg Oncol 2006; 14:128-33. [PMID: 17072675 DOI: 10.1245/s10434-006-9185-7] [Citation(s) in RCA: 294] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2006] [Revised: 06/02/2006] [Accepted: 06/02/2006] [Indexed: 12/11/2022]
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Nguyen HV, Akbarnia BA, van Dam BE, Raiszadeh K, Bagheri R, Canale S, Sylvain GM, Barone R, Bench G. Anterior exposure of the spine for removal of lumbar interbody devices and implants. Spine (Phila Pa 1976) 2006; 31:2449-53. [PMID: 17023854 DOI: 10.1097/01.brs.0000240271.39583.b6] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [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: 02/01/2023]
Abstract
STUDY DESIGN A retrospective review of a consecutive series of 14 patients operated on between March 1998 and April 2005. OBJECTIVES To report on patients having undergone revision lumbar surgery anteriorly to remove interbody devices placed anteriorly or posteriorly and to determine the incidence of associated complications. SUMMARY OF BACKGROUND DATA The popularity of interbody lumbar surgery has grown in recent years. Consequently, the number of anterior revision procedures has increased. The risks associated with anterior approach for revision procedures and interbody device removal, in particular, have not been reported. METHODS The results of 13 consecutive patients who had removal of interbody devices through an anterior approach and 1 patient with removal of anterior fixation (7 males, 7 females; mean age 43 years) were reviewed. The procedure during which the original implant was placed was a posterior lumbar interbody fusion in 4, transforaminal lumbar interbody fusion in 5, and anterior lumbar interbody fusion in 5 patients. Four attending spine surgeons performed the procedures with the assistance of 4 experienced access surgeons. RESULTS Ten of 14 (71%) patients had complications associated with anterior exposure of revision surgery. Vascular injury is the most common complication (57%). Vascular complications occurred in 100% (4/4) of the revisions of previous posterior lumbar interbody fusions and 80% (4/5) of previous anterior lumbar interbody fusions. The complication rate at L4-5 and L5-S1 was 89% and 40%, respectively. There was 1 postoperative mortality. CONCLUSIONS Anterior removal of lumbar interbody devices placed anteriorly or posteriorly has a high incidence of complication. Average blood loss and hospital stay are increased with revision anterior surgery. The vascular complication rate is 2-fold higher at L4-L5 level compared to L5-S1.
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Affiliation(s)
- Hoan-Vu Nguyen
- University of California, San Diego and San Diego Center for Spinal Disorders, La Jolla, CA 92037, USA
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Bembi B, Marchetti F, Guerci VI, Ciana G, Addobbati R, Grasso D, Barone R, Cariati R, Fernandez-Guillen L, Butters T, Pittis MG. Substrate reduction therapy in the infantile form of Tay-Sachs disease. Neurology 2006; 66:278-80. [PMID: 16434676 DOI: 10.1212/01.wnl.0000194225.78917.de] [Citation(s) in RCA: 42] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Substrate reduction therapy (SRT) with miglustat has been proposed for treatment of some lysosomal storage disorders. Based on the positive experience in Gaucher disease and experimental data in Tay-Sachs (TSD) and Sandhoff animal models, the authors investigated the clinical efficacy of SRT in two patients with infantile TSD. SRT could not arrest the patients' neurologic deterioration. However, a significant drug concentration in CSF as well as macrocephaly prevention were observed.
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Affiliation(s)
- B Bembi
- Unità di Malattie Metaboliche, I.R.C.C.S. Burlo Garofolo, Trieste, Italy.
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Barone R, Lempereur L, Anastasi M, Parano E, Pavone P. Congenital insensitivity to pain with Anhidrosis (NTRK1 mutation) and early onset renal disease: clinical report on three sibs with a 25-year follow-up in one of them. Neuropediatrics 2005; 36:270-3. [PMID: 16138253 DOI: 10.1055/s-2005-872808] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Congenital insensitivity to pain with anhidrosis (CIPA) is an autosomal recessive disorder caused by mutations in the neurotrophic tyrosine receptor kinase 1 (NTRK1) gene which encodes the receptor for nerve growth factor (NGF). We report the clinical course in three sibs with CIPA and proven NTRK1 gene mutations with a follow-up over a 25-year period in one of them. They had the characteristic clinical features of an abnormally high pain threshold, and mental retardation; in addition their clinical course was marked by the occurrence of early onset renal disease with recurrent microhematuria and proteinuria and frequent observations of increased serum creatinine and blood urea levels. Light microscopy study of a renal biopsy performed in one of them at age of 20 months showed focal glomerulosclerosis, interstitial fibrosis and tubular atrophy. This patient and his younger brother died because of renal failure at the age of 25 years and 14 years, respectively. The sister still alive showed renal impairment and deep venous thrombosis associated with lupus anticoagulant activity, decrease of circulating autoreactive CD5 (+) B lymphocytes and increased urinary levels of IgG and kappa and lambda light chains, suggesting a possible defect in regulation of B-lymphocyte function. In the light of the NGF-related molecular defect, the extraneurological tissue involvement in CIPA might in part reflect dysregulation of immune mechanisms which possibly brings about a chronic inflammatory response. This, in turn, could result in renal disease which should be mentioned among the life-threatening complications associated with this disorder.
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Affiliation(s)
- R Barone
- Department of Pediatrics, University of Catania, Italy
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Negri AL, Barone R, Bogado CE, Zanchetta JR. [Relationship between weight, body composition and bone mass in peritoneal dialysis]. Nefrologia 2005; 25:269-74. [PMID: 16053008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
Patients in chronic dialysis show a decrease in total bone mass. The factors that determine this decrease are not well known. In normal populations weight and its compartments are important determinants of bone mass. We studied total bone mineral content (TBMC), a measure of bone mass, and body composition using DEXA densitometry in 65 patients (45 females and 20 males) who had been in peritoneal dialysis for a mean of 40.3 +/- 23.2 months. Forty-eight patients (73.8%) had been previously in hemodialysis. The mean total time in dialysis for these patients was 76.8 months. As a group patients showed a very significant positive correlation between TBMC and weight, height, and lean body mass. A negative correlation was found between TBMC with the time in dialysis and iPTH. In men we found significant simple positive correlations between TBMC and weight, height and lean body mass. In women we found simple positive correlations of TBMC with weight, height and lean body mass and a negative correlation with iPTH. In the multiple regression analysis, lean body mass was the only body composition parameter that had a significantly positive correlation with TBMC in men; in women only height correlated positively with TBMC and iPTH continued to correlate negatively with bone mass. When we considered pre and postmenopausal women separately, bone mass was correlated positively with height and lean body mass and negatively with iPTH in postmenopausal women and only with height in pre-menopausal females. We conclude that the lean body mass compartment. is the most important component of weight that determines TBMC in peritoneal dialysis patients particularly in males and postmenopausal women. In postmenopausal women, secondary hyperparathyroidism seems to be particularly detrimental on bone mass.
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MESH Headings
- Absorptiometry, Photon
- Adult
- Aged
- Body Composition
- Body Height
- Body Weight
- Bone Density
- Bone Diseases, Metabolic/blood
- Bone Diseases, Metabolic/etiology
- Bone Diseases, Metabolic/pathology
- Bone Diseases, Metabolic/physiopathology
- Bone and Bones/chemistry
- Female
- Humans
- Hyperparathyroidism, Secondary/blood
- Hyperparathyroidism, Secondary/complications
- Hyperparathyroidism, Secondary/pathology
- Kidney Failure, Chronic/complications
- Kidney Failure, Chronic/physiopathology
- Kidney Failure, Chronic/therapy
- Male
- Middle Aged
- Minerals/analysis
- Organ Size
- Osteoporosis, Postmenopausal/complications
- Parathyroid Hormone/blood
- Peritoneal Dialysis/adverse effects
- Postmenopause
- Premenopause
- Sex Factors
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Affiliation(s)
- A L Negri
- Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina
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Glehen O, Kwiatkowski F, Sugarbaker PH, Elias D, Levine EA, De Simone M, Barone R, Yonemura Y, Cavaliere F, Quenet F, Gutman M, Tentes AAK, Lorimier G, Bernard JL, Bereder JM, Porcheron J, Gomez-Portilla A, Shen P, Deraco M, Rat P. Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a multi-institutional study. J Clin Oncol 2004; 22:3284-92. [PMID: 15310771 DOI: 10.1200/jco.2004.10.012] [Citation(s) in RCA: 840] [Impact Index Per Article: 42.0] [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: 12/12/2022] Open
Abstract
PURPOSE The three principal studies dedicated to the natural history of peritoneal carcinomatosis (PC) from colorectal cancer consistently showed median survival ranging between 6 and 8 months. New approaches combining cytoreductive surgery and perioperative intraperitoneal chemotherapy suggest improved survival. PATIENTS AND METHODS A retrospective multicenter study was performed to evaluate the international experience with this combined treatment and to identify the principal prognostic indicators. All patients had cytoreductive surgery and perioperative intraperitoneal chemotherapy (intraperitoneal chemohyperthermia and/or immediate postoperative intraperitoneal chemotherapy). PC from appendiceal origin was excluded. RESULTS The study included 506 patients from 28 institutions operated between May 1987 and December 2002. Their median age was 51 years. The median follow-up was 53 months. The morbidity and mortality rates were 22.9% and 4%, respectively. The overall median survival was 19.2 months. Patients in whom cytoreductive surgery was complete had a median survival of 32.4 months, compared with 8.4 months for patients in whom complete cytoreductive surgery was not possible (P <.001). Positive independent prognostic indicators by multivariate analysis were complete cytoreduction, treatment by a second procedure, limited extent of PC, age less than 65 years, and use of adjuvant chemotherapy. The use of neoadjuvant chemotherapy, lymph node involvement, presence of liver metastasis, and poor histologic differentiation were negative independent prognostic indicators. CONCLUSION The therapeutic approach combining cytoreductive surgery with perioperative intraperitoneal chemotherapy achieved long-term survival in a selected group of patients with PC from colorectal origin with acceptable morbidity and mortality. The complete cytoreductive surgery was the most important prognostic indicator.
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Affiliation(s)
- O Glehen
- Centre Hospitalo-Universitaire Lyon Sud, Pierre Bénite, France
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Malaguarnera L, Simporè J, Prodi DA, Angius A, Sassu A, Persico I, Barone R, Musumeci S. A 24-bp duplication in exon 10 of human chitotriosidase gene from the sub-Saharan to the Mediterranean area: role of parasitic diseases and environmental conditions. Genes Immun 2004; 4:570-4. [PMID: 14647197 DOI: 10.1038/sj.gene.6364025] [Citation(s) in RCA: 76] [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: 02/06/2023]
Abstract
Human chitotriosidase (Chit) is a member of the chitinase family and it is synthesized by activated macrophages. Recently, a genetic polymorphism was found to be responsible for the common deficiency in Chit activity, frequently encountered in different populations. We analyzed the Chit gene in some ethnic groups from the Mediterranean and African areas, to evaluate whether the Chit gene polymorphism correlates with the changes in environmental features and the disappearance of parasitic diseases. We found a heterozygote frequency for the duplication of 24 bp in exon 10 of 44% in Sicily and 32.71% in Sardinia, whereas those homozygous Chit deficient were 5.45 and 3.73%, respectively. In contrast, in Benin and Burkina Faso, both mesoendemic regions for Plasmodium falciparum malaria and other infections due to intestinal parasites, a low incidence of Chit mutation was found (heterozygous 0 and 2%, respectively) and no subject was homozygous for Chit deficiency. Our results provide evidence of the fact that the low frequency or the absence of mutant Chit gene may represent a protective factor in the population still living in disadvantaged environmental conditions. The present study suggests that the disappearance of parasitic diseases and the improved environmental conditions may have ensued the occurrence of a high percentage of 24-bp mutation in Sicily, in Sardinia and in other Mediterranean countries, whereas in the sub-Saharan regions (Benin and Burkina Faso), the widespread parasitic diseases and the poor social status have contributed to maintenance of the wild-type Chit gene.
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Affiliation(s)
- L Malaguarnera
- Department of Biomedical Sciences, University of Catania, Italy
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45
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Valkema R, Kvols LK, Pauwels S, Jamar F, Barone R, Lasher J, Krenning EP. Peptide receptor radiotherapy (PRRT) with [Y-90-DOTA,Tyr3]octreotide: Toxicity and efficacy of 4-cycle and single-cycle regimens. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3046] [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: 11/20/2022] Open
Affiliation(s)
- R. Valkema
- Erasmus MC, Rotterdam, Netherlands; H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL; Cliniques Universitaires Saint-Luc, Brussels, Belgium; Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - L. K. Kvols
- Erasmus MC, Rotterdam, Netherlands; H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL; Cliniques Universitaires Saint-Luc, Brussels, Belgium; Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - S. Pauwels
- Erasmus MC, Rotterdam, Netherlands; H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL; Cliniques Universitaires Saint-Luc, Brussels, Belgium; Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - F. Jamar
- Erasmus MC, Rotterdam, Netherlands; H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL; Cliniques Universitaires Saint-Luc, Brussels, Belgium; Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - R. Barone
- Erasmus MC, Rotterdam, Netherlands; H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL; Cliniques Universitaires Saint-Luc, Brussels, Belgium; Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - J. Lasher
- Erasmus MC, Rotterdam, Netherlands; H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL; Cliniques Universitaires Saint-Luc, Brussels, Belgium; Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - E. P. Krenning
- Erasmus MC, Rotterdam, Netherlands; H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL; Cliniques Universitaires Saint-Luc, Brussels, Belgium; Novartis Pharmaceuticals Corporation, East Hanover, NJ
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46
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De Simone M, Scuderi S, Vaira M, Costamagna D, Barone R, Fiorentini G, Dentico P, Caponi A, Ciaccio B, Caponi C, Ferri L, Martini E, Cantini S. Treatment of pseudomyxoma peritonei with two times--cytoreduction and hypertermic antiblastic peritoneal perfusion (HAPP). J Exp Clin Cancer Res 2003; 22:25-8. [PMID: 16767902] [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: 05/10/2023]
Abstract
Pseudomyxoma peritonei is a rare neoplasia with a low grade of clinical malignity in which neoplastic masses product large amount of mucinous material. Its treatment advocates an aggressive cytoreduction of all visceral and peritoneal lesions and Hyperthermic Antiblastic Peritoneal Perfusion (HAPP). In three cases we programmed a two stage surgical approach for the massive amount of peritoneal implants. Two times we achieved our aim, while one time, the wide progression of the disease during the two surgical procedures made useless our efforts to have a complete cytoreduction and the following HAPP. This last patient refused systemic chemotherapy between the two surgeries and we think that this should be one of the reasons of the failure.
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Affiliation(s)
- M De Simone
- San Giuseppe Hospital, Oncological Surgery Department, Empoli.
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47
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Low RN, McCue M, Barone R, Saleh F, Song T. MR staging of primary colorectal carcinoma: comparison with surgical and histopathologic findings. ACTA ACUST UNITED AC 2003; 28:784-93. [PMID: 14753591 DOI: 10.1007/s00261-003-0032-z] [Citation(s) in RCA: 28] [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: 11/25/2022]
Abstract
BACKGROUND We retrospectively evaluated the accuracy of magnetic resonance (MR) imaging in staging colorectal cancer and assessing local tumor extent, nodal involvement, and distant abdominal and pelvic metastases. METHODS Forty-eight patients with primary colorectal carcinoma were referred for presurgical abdominal and pelvic MR imaging. MR imaging included T1-weighted, fat-suppressed T2-weighted, and fat-suppressed gadolinium-enhanced spin gradient-echo imaging. The prospective interpretations of the MR examinations were reviewed. MR depiction of local tumor extent, nodal involvement, and distant metastases at 18 anatomic locations was noted and compared with subsequent surgical and histopathologic findings. RESULTS Overall TNM MR staging agreed with surgical and pathologic staging in 41 (85%) of 48 patients, including 21 (78%) of 27 colon cancers and 20 (95%) of 21 rectal cancers. For depth of tumor penetration, which was evaluable in 44 patients, MR imaging agreed with pathologic results in 38 (86%) of 44 patients, including 22 (88%) of 25 colon cancers and 16 (84%) of 19 rectal cancers. In 42 (95%) of 44 patients, MR images correctly distinguished tumor confined to the bowel wall (T0, T1, and T2) from tumor with transmural tumor extension (T3 and T4). Regional nodal metastases were depicted in 15 of 22 patients (sensitivity, 68%; accuracy, 83%). Nodal metastases were better depicted for rectal cancer in eight of nine patients, compared with colon cancer in seven of 13 patients. Distant metastases were correctly depicted on MR imaging in 13 of 14 patients (sensitivity, 93%; accuracy, 98%). In the site-by-site analysis, MR imaging prospectively depicted 66 of 77 sites of surgically confirmed metastatic tumor in the abdomen and pelvis (sensitivity, 86%; specificity, 99%; accuracy, 98%). CONCLUSION MR imaging using currently available techniques can effectively image local tumor extent and distant metastases in patients with colorectal carcinoma. Especially for colon cancer, incomplete depiction of nodal metastases in normal-size lymph nodes remains a limitation of cross-sectional imaging studies.
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Affiliation(s)
- R N Low
- Department of Diagnostic Radiology, Sharp and Children's MRI Center, Sharp Memorial Hospital, 7901 Frost Street, San Diego, CA 92123, USA
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48
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Morrone A, Cavicchi C, Bardelli T, Antuzzi D, Parini R, Di Rocco M, Feriozzi S, Gabrielli O, Barone R, Pistone G, Spisni C, Ricci R, Zammarchi E. Fabry disease: molecular studies in Italian patients and X inactivation analysis in manifesting carriers. J Med Genet 2003; 40:e103. [PMID: 12920095 PMCID: PMC1735554 DOI: 10.1136/jmg.40.8.e103] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- A Morrone
- Department of Paediatrics, Florence, Italy
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49
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Costamagna D, Scuderi S, Vaira M, Barone R, De Simone M. [Treatment of peritoneal mesothelioma using cytoreduction and intraperitoneal hyperthermic chemotherapy]. Tumori 2003; 89:40-2. [PMID: 12903541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
UNLABELLED Malignant mesothelioma of the peritoneum is a rare tumor for which the therapeutic approach has not yet been standardized. Cytoreductive surgery and hyperthermic antiblastic peritoneal perfusion (HAPP) may be effective in the treatment of this neoplasm. From 1995 to March 2003, we operated 24 patients with malignant peritoneal mesothelioma. Nineteen times we were able to perform radical surgery and HAPP: 6 CC-0, 10 CC-1 and 3 CC-2 (nodules smaller than 1 cm). HAPP was performed by the original "semi-closed" technique, using MMC+ CDDP in 3 patients, CDDP + doxorubicin in 15 patients, only doxorubicin in 1 patient). RESULTS Operating mortality was 11% and postoperative morbidity was 26%. 4 patients are DOD (40, 20, and 2 at 2 months); 5 patients are AWD (72, 34, 25, and 2 at 15 months); 8 patients are NED (81, 47, 2 at 20 months, 16, 13, 12 months, 1 patient recently operated). The median survival is 40 months. The high rate of morbidity and mortality is due to the presence of postoperative paraneoplastic syndromes, with alterations of coagulation and onset of ARDS. Therefore the good survival results make the methodic one of the best options in the treatment of the disease.
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Vaira M, Scuderi S, Costamagna D, Barone R, De Simone M. [Use of pentaglobin in the treatment of sepsis in the patient undergoing intraperitoneal hyperthermic chemotherapy]. Tumori 2003; 89:296-7. [PMID: 12903625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
In patients subjected to cytoreduction and hyperthermic antiblastic peritoneal perfusion (HAPP), their immunocompromized conditions claim a very aggressive therapeutic approach in case of periotonitis and sepsis. Therefore, we use an adjuvant therapy of severe bacterial infections additional to antibiotic therapy by using Pentaglobin. It contains human plasma proteins, of which immunoglobulin at least 95%, with high rate of IgG, IgM and IgA, infused intravenously at 12 mL/h for 3 days continuously. From November 2000 to March 2003, we combined this approach for the treatment of peritonitis/sepsis in 11 patients. In 10 patients we obtained a complete control of the infective status in 8 days, while 1 patient died for MOFF. So, even with the exiguity of our casuistry, we obtained a better and more rapid clinical control of the patients respect to the previous period when the Pentaglobin was not used.
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Affiliation(s)
- M Vaira
- Centro di Chirurgia Oncologica Avanzata, Torino
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