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Rizzetto R, Porcaro A, Amigoni N, Tafuri A, Cerrato C, Bianchi A, Gallina S, Orlando R, Gozzo A, Migliorini F, Antoniolli SZ, Monaco C, De Marco V, Brunelli M, Cerruto M, Polati E, Antonelli A. The American Society of Anesthesiologists’ (ASA) physical status system classification predicted the risk of postoperative complications at hospital discharge in 1329 consecutive patients treated with radical prostatectomy for clinical prostate cancer. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)01016-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Di Menna L, Busceti CL, Ginerete RP, D'Errico G, Orlando R, Alborghetti M, Bruno V, Battaglia G, Fornai F, Leoni L, Rampioni G, Visca P, Monn JA, Nicoletti F. The bacterial quorum sensing molecule, 2-heptyl-3-hydroxy-4-quinolone (PQS), inhibits signal transduction mechanisms in brain tissue and is behaviorally active in mice. Pharmacol Res 2021; 170:105691. [PMID: 34044128 DOI: 10.1016/j.phrs.2021.105691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/25/2021] [Accepted: 05/20/2021] [Indexed: 12/29/2022]
Abstract
Interkingdom communication between bacteria and host organisms is one of the most interesting research topics in biology. Quorum sensing molecules produced by Gram-negative bacteria, such as acylated homoserine lactones and quinolones, have been shown to interact with host cell receptors, stimulating innate immunity and bacterial clearance. To our knowledge, there is no evidence that these molecules influence CNS function. Here, we have found that low micromolar concentrations of the Pseudomonas aeruginosa quorum sensing autoinducer, 2-heptyl-3-hydroxy-4-quinolone (PQS), inhibited polyphosphoinositide hydrolysis in mouse brain slices, whereas four selected acylated homoserine lactones were inactive. PQS also inhibited forskolin-stimulated cAMP formation in brain slices. We therefore focused on PQS in our study. Biochemical effects of PQS were not mediated by the bitter taste receptors, T2R4 and T2R16. Interestingly, submicromolar concentrations of PQS could be detected in the serum and brain tissue of adult mice under normal conditions. Levels increased in five selected brain regions after single i.p. injection of PQS (10 mg/kg), peaked after 15 min, and returned back to normal between 1 and 4 h. Systemically administered PQS reduced spontaneous locomotor activity, increased the immobility time in the forced swim test, and largely attenuated motor response to the psychostimulant, methamphetamine. These findings offer the first demonstration that a quorum sensing molecule specifically produced by Pseudomonas aeruginosa is centrally active and influences cell signaling and behavior. Quorum sensing autoinducers might represent new interkingdom signaling molecules between ecological communities of commensal, symbiotic, and pathogenic microorganisms and the host CNS.
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Affiliation(s)
| | | | | | | | - R Orlando
- IRCCS Neuromed, Pozzilli, Italy; Department of Physiology and Phamacology, Sapienza University, Roma, Italy
| | - M Alborghetti
- Department of Neuroscience, Mental Health, and Sensory Organs, Sapienza University, Italy
| | - V Bruno
- IRCCS Neuromed, Pozzilli, Italy; Department of Physiology and Phamacology, Sapienza University, Roma, Italy
| | - G Battaglia
- IRCCS Neuromed, Pozzilli, Italy; Department of Physiology and Phamacology, Sapienza University, Roma, Italy
| | - F Fornai
- IRCCS Neuromed, Pozzilli, Italy; Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - L Leoni
- Department of Science, Roma Tre University, Roma, Italy
| | - G Rampioni
- Department of Science, Roma Tre University, Roma, Italy; Fondazione Santa Lucia IRCCS, Roma, Italy
| | - P Visca
- Department of Science, Roma Tre University, Roma, Italy; Fondazione Santa Lucia IRCCS, Roma, Italy
| | | | - F Nicoletti
- IRCCS Neuromed, Pozzilli, Italy; Department of Physiology and Phamacology, Sapienza University, Roma, Italy.
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Shahid A, Huang M, Yeung S, Parsa C, Orlando R, Andresen B, Travers J, Huang Y. 061 Absence of Adrb2 minimally affects UV-induced immunosuppression and skin cancer development. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Papasavas P, Olugbile S, Wu U, Robinson K, Roberts AL, O'Sullivan DM, McLaughlin T, Mather JF, Steinberg AC, Orlando R, Kumar A. Seroprevalence of SARS-CoV-2 antibodies, associated epidemiological factors and antibody kinetics among healthcare workers in Connecticut. J Hosp Infect 2021; 114:117-125. [PMID: 33930487 PMCID: PMC8076763 DOI: 10.1016/j.jhin.2021.04.021] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) are at the front line of the ongoing coronavirus 2019 (COVID-19) pandemic. Comprehensive evaluation of the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) among HCWs in a large healthcare system could help to identify the impact of epidemiological factors and the presence of symptoms on the immune response to the infection over time. AIM To determine the seroprevalence of SARS-CoV-2-specific antibodies among HCWs, identify associated epidemiological factors and study antibody kinetics. METHODS A longitudinal evaluation of the seroprevalence and epidemiology of SARS-CoV-2-specific antibodies was undertaken in approximately 30,000 HCWs in the largest healthcare system in Connecticut, USA. FINDINGS At baseline, the prevalence of SARS-CoV-2 antibody among 6863 HCWs was 6.3% [95% confidence interval (CI) 5.7-6.9%], and was highest among patient care support (16.7%), medical assistants (9.1%) and nurses (8.2%), and lower for physicians (3.8%) and advanced practice providers (4.5%). Seroprevalence was significantly higher among African Americans [odds ratio (OR) 3.26 compared with Caucasians, 95% CI 1.77-5.99], in participants with at least one symptom of COVID-19 (OR 3.00, 95% CI 1.92-4.68), and in those reporting prior quarantine (OR 3.83, 95% CI 2.57-5.70). No symptoms were reported in 24% of seropositive participants. Among the 47% of participants who returned for a follow-up serological test, the seroreversion rate was 39.5% and the seroconversion rate was 2.2%. The incidence of re-infection in the seropositive group was zero. CONCLUSION Although there is a decline in the immunoglobulin G antibody signal over time, 60.5% of seropositive HCWs had maintained their seroconversion status after a median of 5.5 months.
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Affiliation(s)
- P Papasavas
- Department of Surgery, Hartford Hospital, Hartford, CT, USA.
| | - S Olugbile
- Cancer Institute, Hartford HealthCare, Hartford, CT, USA
| | - U Wu
- Administration, Hartford HealthCare, Hartford, CT, USA
| | - K Robinson
- Department of Emergency Medicine, Hartford Hospital, Hartford, CT, USA
| | - A L Roberts
- Department of Clinical Laboratory Services: Microbiology, Hartford HealthCare, Hartford, CT, USA
| | | | - T McLaughlin
- Department of Surgery, Hartford Hospital, Hartford, CT, USA
| | - J F Mather
- Hartford Healthcare Research Program, Hartford, CT, USA
| | - A C Steinberg
- Department of Medical Affairs, Hartford HealthCare, Hartford, CT, USA
| | - R Orlando
- Department of Academic Affairs, Hartford HealthCare, Hartford, CT, USA
| | - A Kumar
- Clinical Affairs, Hartford HealthCare, Hartford, CT, USA
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Macaluso FS, Fries W, Viola A, Centritto A, Cappello M, Giuffrida E, Privitera AC, Piccillo G, Magnano A, Vinci E, Vassallo R, Trovatello A, Belluardo N, Giangreco E, Camilleri S, Garufi S, Bertolami C, Ventimiglia M, Renna S, Orlando R, Rizzuto G, Orlando A. The SPOSIB SB2 Sicilian Cohort: Safety and Effectiveness of Infliximab Biosimilar SB2 in Inflammatory Bowel Diseases, Including Multiple Switches. Inflamm Bowel Dis 2021; 27:182-189. [PMID: 32083291 DOI: 10.1093/ibd/izaa036] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND No data on the recently introduced infliximab (IFX) biosimilar SB2 in inflammatory bowel disease (IBD) are available. METHODS The Sicilian Prospective Observational Study of Patients With IBD Treated With Infliximab Biosimilar SB2 is a multicenter, observational, prospective study performed among the cohort of the Sicilian Network for Inflammatory Bowel Disease. All consecutive IBD patients starting the IFX biosimilar SB2 from its introduction in Sicily (March 2018) to September 2019 (18 months) were enrolled. RESULTS Two hundred seventy-six patients (Crohn disease: 49.3%, ulcerative colitis: 50.7%) were included: 127 (46.0%) were naïve to IFX and naïve to anti-tumor necrosis factor medications (anti-TNFs), 65 (23.5%) were naïve to IFX and previously exposed to anti-TNFs, 17 (6.2%) were switched from an IFX originator to SB2, 43 (15.6%) were switched from the biosimilar CT-P13 to SB2, and 24 (8.7%) were multiply switched (from IFX originator to CT-P13 to SB2). The cumulative number of infusions of SB2 was 1798, and the total follow-up time was 182.7 patient-years. Sixty-seven serious adverse events occurred in 57 patients (20.7%; incidence rate: 36.7 per 100 patient-year), and 31 of these events caused the withdrawal of the drug. The effectiveness after 8 weeks of treatment was evaluated in patients naïve to IFX (n = 192): 110 patients (57.3%) had steroid-free remission, while 56 patients had no response (29.2%). At the end of follow-up, 72 patients (26.1%) interrupted the treatment, without significant differences in treatment persistency estimations between the five groups (log-rank P = 0.15). CONCLUSIONS The safety and effectiveness of SB2 seem to be overall similar to those reported for the IFX originator and CT-P13.
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Affiliation(s)
| | - Walter Fries
- Inflammatory Bowel Disease Unit, A.O.U. Policlinico G. Martino, Messina, Italy
| | - Anna Viola
- Inflammatory Bowel Disease Unit, A.O.U. Policlinico G. Martino, Messina, Italy
| | - Andrea Centritto
- Inflammatory Bowel Disease Unit, A.O.U. Policlinico G. Martino, Messina, Italy
| | - Maria Cappello
- Gastroenterology and Hepatology Unit, A.O.U. Policlinico G. Giaccone, Palermo, Italy
| | - Enrica Giuffrida
- Gastroenterology and Hepatology Unit, A.O.U. Policlinico G. Giaccone, Palermo, Italy
| | | | - Giovita Piccillo
- Inflammatory Bowel Disease Unit, A.O. Cannizzaro, Catania, Italy
| | - Antonio Magnano
- Gastroenterology Unit, A.O.U. Policlinico Vittorio Emanuele, Catania, Italy
| | - Elisa Vinci
- Gastroenterology Unit, A.O.U. Policlinico Vittorio Emanuele, Catania, Italy
| | - Roberto Vassallo
- Gastroenterology and Endoscopy Unit, A.O. Buccheri La Ferla Fatebenefratelli, Palermo, Italy
| | | | | | | | | | - Serena Garufi
- Gastroenterology Unit, A.O.O.R. S. Elia- M. Raimondi, Caltanissetta, Italy
| | | | - Marco Ventimiglia
- Inflammatory Bowel Disease Unit, A.O.O.R. Villa Sofia-Cervello, Palermo, Italy
| | - Sara Renna
- Inflammatory Bowel Disease Unit, A.O.O.R. Villa Sofia-Cervello, Palermo, Italy
| | - Rosalba Orlando
- Inflammatory Bowel Disease Unit, A.O.O.R. Villa Sofia-Cervello, Palermo, Italy
| | - Giulia Rizzuto
- Inflammatory Bowel Disease Unit, A.O.O.R. Villa Sofia-Cervello, Palermo, Italy
| | - Ambrogio Orlando
- Inflammatory Bowel Disease Unit, A.O.O.R. Villa Sofia-Cervello, Palermo, Italy
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Macaluso FS, Ventimiglia M, Fries W, Viola A, Sitibondo A, Cappello M, Scrivo B, Busacca A, Privitera AC, Camilleri S, Garufi S, Di Mitri R, Mocciaro F, Belluardo N, Giangreco E, Bertolami C, Renna S, Orlando R, Rizzuto G, Cottone M, Orlando A. A propensity score weighted comparison of vedolizumab and adalimumab in Crohn's disease. J Gastroenterol Hepatol 2021; 36:105-111. [PMID: 32428981 DOI: 10.1111/jgh.15107] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/23/2020] [Accepted: 05/12/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM There are no head-to-head randomized controlled trials between biologics in Crohn's disease (CD). We aimed to perform a multicenter, real-life comparison of the effectiveness of vedolizumab (VDZ) and adalimumab (ADA) in CD. METHODS Data of consecutive patients with CD treated with VDZ and ADA from January 2016 to April 2019 were extracted from the cohort of the Sicilian Network for Inflammatory Bowel Disease. The effectiveness was evaluated at 12, 52 weeks, and as failure-free survival at the end of follow up. Propensity score analysis was performed using the inverse probability of treatment weighting method. RESULTS Five hundred eighty-five treatments (VDZ: n = 277; ADA: n = 308) were included (median follow-up: 56.0 weeks). After 12 weeks, a clinical response was achieved in 64.3% patients treated with VDZ and in 83.1% patients treated with ADA (odds ratio [OR] 0.65, 95% confidence interval [CI] 0.38-1.10, P = 0.107), while at 52 weeks, a clinical response was observed in 54.0% patients treated with VDZ and in 69.1% patients treated with ADA (OR 0.77, 95% CI 0.45-1.31, P = 0.336). Cox survival analysis weighted for propensity score showed no significant difference in the probability of failure-free survival between the two drugs (hazard ratio = 1.20, 95% CI 0.83-1.74, P = 0.340). Post-treatment endoscopic response and mucosal healing rates were similar between the two groups (endoscopic response: 35.3% for VDZ and 25.5% for ADA, P = 0.15; mucosal healing: 31.8% for VDZ and 33.8% for ADA, P = 0.85). CONCLUSIONS In the first study comparing VDZ and ADA in CD via propensity score analysis, the drugs showed comparable effectiveness and a similar safety profile.
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Affiliation(s)
| | - Marco Ventimiglia
- Inflammatory Bowel Disease Unit, A.O.O.R. "Villa Sofia-Cervello", Palermo, Italy
| | - Walter Fries
- Inflammatory Bowel Disease Unit, A.O.U. Policlinico "G. Martino", Messina, Italy
| | - Anna Viola
- Inflammatory Bowel Disease Unit, A.O.U. Policlinico "G. Martino", Messina, Italy
| | - Aldo Sitibondo
- Inflammatory Bowel Disease Unit, A.O.U. Policlinico "G. Martino", Messina, Italy
| | - Maria Cappello
- Gastroenterology and Hepatology Unit, A.O.U. Policlinico "G. Giaccone", Palermo, Italy
| | - Barbara Scrivo
- Gastroenterology and Hepatology Unit, A.O.U. Policlinico "G. Giaccone", Palermo, Italy
| | - Anita Busacca
- Gastroenterology and Hepatology Unit, A.O.U. Policlinico "G. Giaccone", Palermo, Italy
| | | | - Salvatore Camilleri
- Gastroenterology Unit, A.O.O.R. "S. Elia- M. Raimondi", Caltanissetta, Italy
| | - Serena Garufi
- Gastroenterology Unit, A.O.O.R. "S. Elia- M. Raimondi", Caltanissetta, Italy
| | - Roberto Di Mitri
- Gastroenterology and Endoscopy Unit, A.R.N.A.S. "Civico Di Cristina Benfratelli", Palermo, Italy
| | - Filippo Mocciaro
- Gastroenterology and Endoscopy Unit, A.R.N.A.S. "Civico Di Cristina Benfratelli", Palermo, Italy
| | | | | | | | - Sara Renna
- Inflammatory Bowel Disease Unit, A.O.O.R. "Villa Sofia-Cervello", Palermo, Italy
| | - Rosalba Orlando
- Inflammatory Bowel Disease Unit, A.O.O.R. "Villa Sofia-Cervello", Palermo, Italy
| | - Giulia Rizzuto
- Inflammatory Bowel Disease Unit, A.O.O.R. "Villa Sofia-Cervello", Palermo, Italy
| | - Mario Cottone
- Inflammatory Bowel Disease Unit, A.O.O.R. "Villa Sofia-Cervello", Palermo, Italy
| | - Ambrogio Orlando
- Inflammatory Bowel Disease Unit, A.O.O.R. "Villa Sofia-Cervello", Palermo, Italy
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Macaluso FS, Ventimiglia M, Fries W, Viola A, Cappello M, Scrivo B, Magnano A, Pluchino D, Camilleri S, Garufi S, Mitri RD, Mocciaro F, Magrì G, Ferracane C, Citrano M, Graziano F, Bertolami C, Renna S, Orlando R, Rizzuto G, Cottone M, Orlando A. A propensity score weighted comparison of Vedolizumab, Adalimumab, and Golimumab in patients with ulcerative colitis. Dig Liver Dis 2020; 52:1461-1466. [PMID: 32601033 DOI: 10.1016/j.dld.2020.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND No real-life study on the comparative effectiveness of Vedolizumab (VDZ), Adalimumab (ADA), and Golimumab (GOL) in ulcerative colitis (UC) is currently available. AIMS To compare the effectiveness of the three biologics in consecutive patients with UC. METHODS A three-arms propensity score-adjusted analysis was performed using the Inverse Probability of Treatment Weighting method. RESULTS 463 treatments (VDZ: n = 187; ADA: n = 168; GOL: n = 108) were included (median follow-up: 47.6 weeks). At 12 weeks (n = 463), a steroid-free remission was reported in 24.1% patients in the VDZ group, in 33.3% patients in the ADA group, and in 30.6% patients in the GOL group (p = n.s. for all comparisons). At 52 weeks (n = 377), a steroid-free remission was reported in 51.5% patients in the VDZ group, in 31.2% patients in the ADA group, and in 29.4% patients in the GOL group (p = 0.002 for VDZ vs. ADA, p = 0.001 for VDZ vs. GOL, p = n.s. for ADA vs. GOL). Cox survival analysis demonstrated that patients treated with VDZ had reduced probability of treatment discontinuation compared to those treated with ADA (HR: 0.42, 95% CI 0.28-0.64, p < 0.001) and GOL (HR: 0.30, 95% CI 0.19-0.46, p < 0.001), while patients treated with ADA had reduced risk of treatment discontinuation compared to those treated with GOL (HR: 0.71, 95% CI 0.50-1.00, p = 0.048). CONCLUSIONS VDZ was superior to ADA and GOL at 52 weeks and as treatment persistence, while ADA showed a superior treatment persistence compared to GOL.
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Affiliation(s)
- Fabio Salvatore Macaluso
- Inflammatory bowel disease Unit, A.O.O.R. "Villa Sofia-Cervello", Viale Strasburgo 233, 90146 Palermo, Italy.
| | - Marco Ventimiglia
- Inflammatory bowel disease Unit, A.O.O.R. "Villa Sofia-Cervello", Viale Strasburgo 233, 90146 Palermo, Italy
| | - Walter Fries
- Inflammatory bowel disease Unit, A.O.U. Policlinico "G. Martino", Messina, Italy
| | - Anna Viola
- Inflammatory bowel disease Unit, A.O.U. Policlinico "G. Martino", Messina, Italy
| | - Maria Cappello
- Gastroenterology and Hepatology Unit, A.O.U. Policlinico "G. Giaccone", Palermo, Italy
| | - Barbara Scrivo
- Gastroenterology and Hepatology Unit, A.O.U. Policlinico "G. Giaccone", Palermo, Italy
| | - Antonio Magnano
- Gastroenterology Unit, A.O.U. Policlinico "Vittorio Emanuele", Catania, Italy
| | - Dario Pluchino
- Gastroenterology Unit, A.O.U. Policlinico "Vittorio Emanuele", Catania, Italy
| | - Salvatore Camilleri
- Gastroenterology Unit, A.O.O.R. "S. Elia- M. Raimondi", Caltanissetta, Italy
| | - Serena Garufi
- Gastroenterology Unit, A.O.O.R. "S. Elia- M. Raimondi", Caltanissetta, Italy
| | - Roberto Di Mitri
- Gastroenterology and endoscopy Unit, A.R.N.A.S. "Civico Di Cristina Benfratelli", Palermo, Italy
| | - Filippo Mocciaro
- Gastroenterology and endoscopy Unit, A.R.N.A.S. "Civico Di Cristina Benfratelli", Palermo, Italy
| | - Giovanni Magrì
- Gastroenterology Unit, A.O. "Santa Marta e S. Venera", Acireale, Italy
| | | | - Michele Citrano
- Pediatrics Unit, A.O.O.R. "Villa Sofia-Cervello", Palermo, Italy
| | | | | | - Sara Renna
- Inflammatory bowel disease Unit, A.O.O.R. "Villa Sofia-Cervello", Viale Strasburgo 233, 90146 Palermo, Italy
| | - Rosalba Orlando
- Inflammatory bowel disease Unit, A.O.O.R. "Villa Sofia-Cervello", Viale Strasburgo 233, 90146 Palermo, Italy
| | - Giulia Rizzuto
- Inflammatory bowel disease Unit, A.O.O.R. "Villa Sofia-Cervello", Viale Strasburgo 233, 90146 Palermo, Italy
| | - Mario Cottone
- Inflammatory bowel disease Unit, A.O.O.R. "Villa Sofia-Cervello", Viale Strasburgo 233, 90146 Palermo, Italy
| | - Ambrogio Orlando
- Inflammatory bowel disease Unit, A.O.O.R. "Villa Sofia-Cervello", Viale Strasburgo 233, 90146 Palermo, Italy
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Macaluso FS, Fries W, Renna S, Viola A, Muscianisi M, Cappello M, Guida L, Siringo S, Camilleri S, Garufi S, Privitera AC, Belluardo N, Giangreco E, Bertolami C, Vassallo R, Rizzuto G, Orlando R, Ventimiglia M, Orlando A. Effectiveness and safety of vedolizumab in biologically naïve patients: A real-world multi-centre study. United European Gastroenterol J 2020; 8:1045-1055. [PMID: 32772830 DOI: 10.1177/2050640620948802] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Biologically naïve patients with inflammatory bowel disease treated with vedolizumab (VDZ) are largely underrepresented in real-world cohorts. A multi-centre, observational cohort study was performed on the effectiveness and safety of VDZ in biologically naïve subjects with Crohn's disease (CD) and ulcerative colitis (UC). METHODS Data of consecutive biologically naïve patients with CD and UC treated with VDZ from July 2016 to December 2019 were extracted from the cohort of the Sicilian Network for Inflammatory Bowel Disease. RESULTS A total of 172 consecutive patients (CD: N = 88; UC: N = 84; median age 66.0 years) were included, with a median follow-up of 58.8 weeks. After 14 weeks, a clinical response was reported in 68.2% of patients with CD and 67.9% of patients with UC treated with VDZ, including 45.5% patients in the CD group and 46.4% patients in the UC group who achieved steroid-free remission. After 52 weeks, a clinical response was reported in 77.4% of CD and in 73.8% of UC patients treated with VDZ, including 59.7% patients in the CD group and 60.7% patients in the UC group who achieved steroid-free remission. CONCLUSIONS This study demonstrates the effectiveness and safety of VDZ as a first-line biological, particularly among elderly patients.
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Affiliation(s)
| | - Walter Fries
- Inflammatory Bowel Disease Unit, AOU Policlinico 'G. Martino', Messina, Italy
| | - Sara Renna
- Inflammatory Bowel Disease Unit, AOOR 'Villa Sofia-Cervello', Palermo, Italy
| | - Anna Viola
- Inflammatory Bowel Disease Unit, AOU Policlinico 'G. Martino', Messina, Italy
| | - Marco Muscianisi
- Inflammatory Bowel Disease Unit, AOU Policlinico 'G. Martino', Messina, Italy
| | - Maria Cappello
- Gastroenterology and Hepatology Unit, AOU Policlinico 'G. Giaccone', Palermo, Italy
| | - Laura Guida
- Gastroenterology and Hepatology Unit, AOU Policlinico 'G. Giaccone', Palermo, Italy
| | | | | | - Serena Garufi
- Gastroenterology Unit, AOOR 'S. Elia-M. Raimondi', Caltanissetta, Italy
| | | | | | | | | | - Roberto Vassallo
- Gastroenterology and Endoscopy Unit, AO 'Buccheri La Ferla Fatebenefratelli', Palermo, Italy
| | - Giulia Rizzuto
- Inflammatory Bowel Disease Unit, AOOR 'Villa Sofia-Cervello', Palermo, Italy
| | - Rosalba Orlando
- Inflammatory Bowel Disease Unit, AOOR 'Villa Sofia-Cervello', Palermo, Italy
| | - Marco Ventimiglia
- Inflammatory Bowel Disease Unit, AOOR 'Villa Sofia-Cervello', Palermo, Italy
| | - Ambrogio Orlando
- Inflammatory Bowel Disease Unit, AOOR 'Villa Sofia-Cervello', Palermo, Italy
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Garbo GM, Renna S, Caputo V, Orlando E, Macaluso FS, Orlando R, Bongiorno MR, Orlando A. Letter: psoriasiform eruption during vedolizumab therapy. Aliment Pharmacol Ther 2019; 50:342-343. [PMID: 31313356 DOI: 10.1111/apt.15389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
| | - Sara Renna
- IBD Unit, Villa Sofia Cervello Hospital, Palermo, Italy
| | - Valentina Caputo
- Department of Pro.M.I.S.E. "Giuseppe D'Alessandro," Section of Dermatology, University of Palermo, AOUP Paolo Giaccone, Palermo, PA, Italy
| | - Elisabetta Orlando
- Department of Pro.M.I.S.E. "Giuseppe D'Alessandro," Section of Pathology, University of Palermo, AOUP Paolo Giaccone, Palermo, PA, Italy
| | | | | | - Maria Rita Bongiorno
- Department of Pro.M.I.S.E. "Giuseppe D'Alessandro," Section of Dermatology, University of Palermo, AOUP Paolo Giaccone, Palermo, PA, Italy
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Macaluso FS, Fries W, Privitera AC, Cappello M, Siringo S, Inserra G, Magnano A, Di Mitri R, Mocciaro F, Belluardo N, Scarpulla G, Magrì G, Trovatello A, Carroccio A, Genova S, Bertolami C, Vassallo R, Romano C, Citrano M, Accomando S, Ventimiglia M, Renna S, Orlando R, Rizzuto G, Porcari S, Ferracane C, Cottone M, Orlando A. A Propensity Score-matched Comparison of Infliximab and Adalimumab in Tumour Necrosis Factor-α Inhibitor-naïve and Non-naïve Patients With Crohn's Disease: Real-Life Data From the Sicilian Network for Inflammatory Bowel Disease. J Crohns Colitis 2019; 13:209-217. [PMID: 30295785 DOI: 10.1093/ecco-jcc/jjy156] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS There is an unmet need to better understand the effectiveness of different biologics in inflammatory bowel diseases. We aimed at performing a multicentre, real-life comparison of the effectiveness of infliximab [IFX] and adalimumab [ADA] in Crohn's disease [CD]. METHODS Data of consecutive patients with CD treated with IFX and ADA from January 2013 to May 2017 were extracted from the cohort of the Sicilian Network for Inflammatory Bowel Disease. We used propensity score-matching accounting for the main baseline characteristics in TNF-α inhibitor-naïve and non-naïve patients. RESULTS A total of 632 patients [735 total treatments] were included. Among naïve patients, a clinical benefit [the sum of steroid-free remission plus clinical response] was achieved in 81.8% patients treated with ADA and in 77.6% patients treated with IFX (adjusted odds ratio [OR]: 1.23, 95% CI 0.63-2-44, p = 0.547] at 12 weeks; after 1 year, a clinical benefit was achieved in 69.2% of patients treated with ADA and in 64.5% patients treated with IFX [adjusted OR: 1.10, 95% CI 0.61-1.96, p = 0.766]. Among non-naïve patients, a clinical benefit was achieved in 61.7% of patients treated with ADA and in 68.1% of patients treated with IFX [adjusted OR: 0.72, 95% CI 0.21-2.44, p = 0.600] at 12 weeks; after 1 year, a clinical benefit was achieved in 48.9% of patients treated with ADA and in 40.4% patients treated with IFX [adjusted OR: 1.23, 95% CI 0.54-2.86, p = 0.620]. CONCLUSIONS In this propensity score-matched comparison of ADA and IFX in CD, both drugs showed high rates of clinical benefit, without significant differences between them.
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Affiliation(s)
| | - Walter Fries
- Inflammatory Bowel Disease Unit, A.O.U. Policlinico 'G. Martino', Messina, Italy
| | | | - Maria Cappello
- Gastroenterology and Hepatology Unit, A.O.U. Policlinico 'G. Giaccone', Palermo, Italy
| | | | - Gaetano Inserra
- Internal Medicine Unit, A.O.U. Policlinico 'Vittorio Emanuele', Catania, Italy
| | - Antonio Magnano
- Gastroenterology Unit, A.O.U. Policlinico 'Vittorio Emanuele', Catania, Italy
| | - Roberto Di Mitri
- Gastroenterology and Endoscopy Unit, A.R.N.A.S. 'Civico Di Cristina Benfratelli', Palermo, Italy
| | - Filippo Mocciaro
- Gastroenterology and Endoscopy Unit, A.R.N.A.S. 'Civico Di Cristina Benfratelli', Palermo, Italy
| | | | - Giuseppe Scarpulla
- Gastroenterology Unit, A.O.O.R. 'S. Elia- M. Raimondi', Caltanissetta, Italy
| | - Giovanni Magrì
- Gastroenterology Unit, A.O. 'Santa Marta e S. Venera', Acireale, Italy
| | | | | | - Salvatore Genova
- Gastroenterology and Endoscopy Unit, A.O. 'S. Antonio Abate', Trapani, Italy
| | | | - Roberto Vassallo
- Gastroenterology and Endoscopy Unit, A.O. 'Buccheri La Ferla Fatebenefratelli', Palermo, Italy
| | - Claudio Romano
- Pediatric Gastroenterology Unit, A.O.U. Policlinico 'G. Martino', Messina, Italy
| | - Michele Citrano
- Pediatric Unit, A.O.O.R. 'Villa Sofia-Cervello', Palermo, Italy
| | | | - Marco Ventimiglia
- Inflammatory Bowel Disease Unit, A.O.O.R. 'Villa Sofia-Cervello', Palermo, Italy
| | - Sara Renna
- Inflammatory Bowel Disease Unit, A.O.O.R. 'Villa Sofia-Cervello', Palermo, Italy
| | - Rosalba Orlando
- Inflammatory Bowel Disease Unit, A.O.O.R. 'Villa Sofia-Cervello', Palermo, Italy
| | - Giulia Rizzuto
- Inflammatory Bowel Disease Unit, A.O.O.R. 'Villa Sofia-Cervello', Palermo, Italy
| | - Serena Porcari
- Inflammatory Bowel Disease Unit, A.O.U. Policlinico 'G. Martino', Messina, Italy
| | | | - Mario Cottone
- Inflammatory Bowel Disease Unit, A.O.O.R. 'Villa Sofia-Cervello', Palermo, Italy
| | - Ambrogio Orlando
- Inflammatory Bowel Disease Unit, A.O.O.R. 'Villa Sofia-Cervello', Palermo, Italy
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Macaluso FS, Cappello M, Giuffrida E, Fries W, Centritto A, Privitera AC, Inserra G, Vassallo R, Magnano A, Vinci E, Garufi S, Ventimiglia M, Renna S, Orlando R, Rizzuto G, Cottone M, Orlando A. Letter: SPOSIB SB2-a Sicilian prospective observational study of IBD patients treated with infliximab biosimilar SB2. Aliment Pharmacol Ther 2019; 49:234-236. [PMID: 30589969 DOI: 10.1111/apt.15071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
| | - Maria Cappello
- Gastroenterology and Hepatology Unit, A.O.U. Policlinico "G. Giaccone", Palermo, Italy
| | - Enrica Giuffrida
- Gastroenterology and Hepatology Unit, A.O.U. Policlinico "G. Giaccone", Palermo, Italy
| | - Walter Fries
- Inflammatory Bowel Disease Unit, A.O.U. Policlinico "G. Martino", Messina, Italy
| | - Andrea Centritto
- Inflammatory Bowel Disease Unit, A.O.U. Policlinico "G. Martino", Messina, Italy
| | | | - Gaetano Inserra
- Internal Medicine Unit, A.O.U. Policlinico "Vittorio Emanuele", Catania, Italy
| | - Roberto Vassallo
- Gastroenterology and Endoscopy Unit, A.O. "Buccheri La Ferla Fatebenefratelli", Palermo, Italy
| | - Antonio Magnano
- Gastroenterology Unit, A.O.U. Policlinico "Vittorio Emanuele", Catania, Italy
| | - Elisa Vinci
- Gastroenterology Unit, A.O.U. Policlinico "Vittorio Emanuele", Catania, Italy
| | - Serena Garufi
- Gastroenterology Unit, A.O.O.R. "S. Elia- M. Raimondi", Caltanissetta, Italy
| | - Marco Ventimiglia
- Inflammatory Bowel Disease Unit, A.O.O.R. "Villa Sofia-Cervello", Palermo, Italy
| | - Sara Renna
- Inflammatory Bowel Disease Unit, A.O.O.R. "Villa Sofia-Cervello", Palermo, Italy
| | - Rosalba Orlando
- Inflammatory Bowel Disease Unit, A.O.O.R. "Villa Sofia-Cervello", Palermo, Italy
| | - Giulia Rizzuto
- Inflammatory Bowel Disease Unit, A.O.O.R. "Villa Sofia-Cervello", Palermo, Italy
| | - Mario Cottone
- Inflammatory Bowel Disease Unit, A.O.O.R. "Villa Sofia-Cervello", Palermo, Italy
| | - Ambrogio Orlando
- Inflammatory Bowel Disease Unit, A.O.O.R. "Villa Sofia-Cervello", Palermo, Italy
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Macaluso FS, Orlando R, Fries W, Scolaro M, Magnano A, Pluchino D, Cappello M, Morreale GC, Siringo S, Privitera AC, Ferracane C, Belluardo N, Alberghina N, Ventimiglia M, Rizzuto G, Renna S, Cottone M, Orlando A. The real-world effectiveness of vedolizumab on intestinal and articular outcomes in inflammatory bowel diseases. Dig Liver Dis 2018; 50:675-681. [PMID: 29576495 DOI: 10.1016/j.dld.2018.02.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 02/19/2018] [Accepted: 02/21/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND The effectiveness of vedolizumab in real-world practice is under evaluation, while its role in inflammatory bowel disease-associated spondyloarthritis is still unclear. AIMS To report real-world data about the effectiveness of vedolizumab on intestinal and articular symptoms after 10 and 22 weeks of treatment. METHODS Web-based data from the cohort of the Sicilian Network for Inflammatory Bowel Disease (SN-IBD) were extracted to perform a prospective multicentre observational study. RESULTS 163 patients (84 with Crohn's disease and 79 with ulcerative colitis) were included. At week 10, a steroid-free remission was achieved in 71 patients (43.6%), while at week 22 a steroid-free remission was obtained in 40.8% of patients. A response on articular symptoms was reported after 10 weeks of treatment in 17 out of 43 (39.5%) patients with active spondyloarthritis at baseline, and in 10 out of 22 (45.4%) patients at week 22. The only factor associated with articular response was the coexistence of clinical benefit on intestinal symptoms (at week 10: OR 8.471, p = 0.05; at week 22: OR 5.600, p = 0.08). CONCLUSIONS Vedolizumab showed good effectiveness after 10 and 22 weeks of treatment. A subset of patients reported improvement also on articular symptoms, probably as a consequence of the concomitant control of gut inflammation.
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Affiliation(s)
| | - Rosalba Orlando
- Inflammatory Bowel Disease Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Walter Fries
- Inflammatory Bowel Disease Unit, A.O.U. Policlinico "G. Martino", Messina, Italy
| | - Mariangela Scolaro
- Inflammatory Bowel Disease Unit, A.O.U. Policlinico "G. Martino", Messina, Italy
| | - Antonio Magnano
- Gastroenterology Unit, A.O.U. Policlinico "Vittorio Emanuele", Catania, Italy
| | - Dario Pluchino
- Gastroenterology Unit, A.O.U. Policlinico "Vittorio Emanuele", Catania, Italy
| | - Maria Cappello
- Gastroenterology and Hepatology Unit, A.O.U. Policlinico "P. Giaccone", Palermo, Italy
| | | | | | | | | | | | | | - Marco Ventimiglia
- Inflammatory Bowel Disease Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Giulia Rizzuto
- Inflammatory Bowel Disease Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Sara Renna
- Inflammatory Bowel Disease Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Mario Cottone
- Inflammatory Bowel Disease Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Ambrogio Orlando
- Inflammatory Bowel Disease Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
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Macaluso FS, Orlando R, Renna S, Sapienza C, Ventimiglia M, Rizzuto G, Cottone M, Orlando A. Letter: the addition of an immunosuppressant in patients with unsatisfactory response to vedolizumab. Aliment Pharmacol Ther 2018. [PMID: 29512915 DOI: 10.1111/apt.14541] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- F S Macaluso
- IBD Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - R Orlando
- IBD Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - S Renna
- IBD Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - C Sapienza
- IBD Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - M Ventimiglia
- IBD Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - G Rizzuto
- IBD Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - M Cottone
- IBD Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - A Orlando
- IBD Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
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Macaluso FS, Sapienza C, Ventimiglia M, Renna S, Rizzuto G, Orlando R, Di Pisa M, Affronti M, Orlando E, Cottone M, Orlando A. The Addition of an Immunosuppressant After Loss of Response to Anti-TNFα Monotherapy in Inflammatory Bowel Disease: A 2-Year Study. Inflamm Bowel Dis 2018; 24:394-401. [PMID: 29361087 DOI: 10.1093/ibd/izx010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND The addition of an immunosuppressant (IM) after loss of response to anti-TNFα monotherapy is an emerging strategy of therapeutic optimization in patients with inflammatory bowel disease (IBD). However, few clinical data have been reported to date. We aimed to evaluate the efficacy and safety of this selective combination therapy in patients with IBD. METHODS All consecutive patients with loss of response to anti-TNFα monotherapy despite an intensive dose optimization who added an IM from October 2014 to October 2016 were entered into a prospective database. RESULTS Among 630 patients treated with anti-TNFα agents during the study period, 46 (7.3%) added an IM. A total of 31 patients (67.4%) were treated with an intravenous anti-TNFα (infliximab, as originator or biosimilar), while 15 (32.6%) were treated with a subcutaneous anti-TNFα agent (10 adalimumab and 5 golimumab). The mean duration of follow-up was 12.8 ± 7.3 months. Twenty-one patients (45.7%) remained on combination therapy at the end of follow-up: 15 (32.6%) maintained a steroid-free remission, and 6 (13.0%) achieved a clinical response. In patients who experienced treatment success, the median value of C-reactive protein decreased from baseline to the end of follow-up (13.2 vs 3.0, P = 0.01; normal values <5 mg/L). Adverse events leading to treatment discontinuation were reported in 8 out of 46 patients (17.4%). CONCLUSIONS In the largest cohort on this argument reported to date, the addition of an IM was an effective and safe optimization strategy after loss of response to anti-TNFα monotherapy. Low doses of IM were sufficient to achieve a clinical response.
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Affiliation(s)
| | | | | | - Sara Renna
- Division of Internal Medicine, University of Palermo, Italy
| | - Giulia Rizzuto
- Division of Internal Medicine, University of Palermo, Italy
| | | | - Marta Di Pisa
- Gastroenterology and Endoscopy Unit, ''Villa Sofia-Cervello'' Hospital, Palermo, Italy
| | - Marco Affronti
- Division of Internal Medicine, University of Palermo, Italy
| | | | - Mario Cottone
- Division of Internal Medicine, University of Palermo, Italy
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Erba A, Baima J, Bush I, Orlando R, Dovesi R. Large-Scale Condensed Matter DFT Simulations: Performance and Capabilities of the CRYSTAL Code. J Chem Theory Comput 2017; 13:5019-5027. [PMID: 28873313 DOI: 10.1021/acs.jctc.7b00687] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Nowadays, the efficient exploitation of high-performance computing resources is crucial to extend the applicability of first-principles theoretical methods to the description of large, progressively more realistic molecular and condensed matter systems. This can be achieved only by devising effective parallelization strategies for the most time-consuming steps of a calculation, which requires some effort given the usual complexity of quantum-mechanical algorithms, particularly so if parallelization is to be extended to all properties and not just to the basic functionalities of the code. In this Article, the performance and capabilities of the massively parallel version of the Crystal17 package for first-principles calculations on solids are discussed. In particular, we present: (i) recent developments allowing for a further improvement of the code scalability (up to 32 768 cores); (ii) a quantitative analysis of the scaling and memory requirements of the code when running calculations with several thousands (up to about 14 000) of atoms per cell; (iii) a documentation of the high numerical size consistency of the code; and (iv) an overview of recent ab initio studies of several physical properties (structural, energetic, electronic, vibrational, spectroscopic, thermodynamic, elastic, piezoelectric, topological) of large systems investigated with the code.
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Affiliation(s)
- A Erba
- Dipartimento di Chimica, Università di Torino , Via Giuria 5, 10125 Torino, Italy
| | - J Baima
- Dipartimento di Chimica, Università di Torino , Via Giuria 5, 10125 Torino, Italy
| | - I Bush
- Oxford e-Research Centre, University of Oxford , 7 Keble Road, OX1 3QG, Oxford, U.K
| | - R Orlando
- Dipartimento di Chimica, Università di Torino , Via Giuria 5, 10125 Torino, Italy
| | - R Dovesi
- Dipartimento di Chimica, Università di Torino , Via Giuria 5, 10125 Torino, Italy
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Macaluso FS, Renna S, Maida M, Dimarco M, Sapienza C, Affronti M, Orlando E, Rizzuto G, Orlando R, Ventimiglia M, Cottone M, Orlando A. Tolerability profile of thiopurines in inflammatory bowel disease: a prospective experience. Scand J Gastroenterol 2017; 52:981-987. [PMID: 28554266 DOI: 10.1080/00365521.2017.1333626] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The occurrence of thiopurine-related adverse events (AEs) may complicate the management of patients with inflammatory bowel disease (IBD). We aimed to evaluate the tolerability of thiopurines in a current IBD setting. MATERIALS AND METHODS All consecutive patients who started a treatment with azathioprine (AZA) from January 2010 to March 2016 were entered in a prospectively maintained database, and the AEs which led to the permanent discontinuation of the drug were reported. RESULTS Two hundred and fifty three patients were included. Median total follow-up was 32 months (range: 0.2-75 months). At the end of the study, AZA was discontinued in 160 patients (63.2%). The main reason leading to drug withdrawal was the occurrence of AEs (109/160 patients [68.1%]; cumulative incidence among the entire cohort: 43.1%). Overall, the most frequent AEs leading to treatment withdrawal were nausea (31/253 patients, 12.3%) and subjective symptoms, i.e., poorly defined side effects such as fatigue, headache and muscle pain (20/253 patients, 7.9%). Among the 109 AZA-intolerant patients, a switch to 6-mercaptopurine (6-MP) was performed in 44 cases (40.4%). At the end of follow-up, 6-MP was discontinued in 35/44 patients (79.5%), mostly due to AEs (29/35 patients, 82.8%). Azathioprine-induced hepatic and pancreatic toxicity was associated with male gender (p = .01 and p = .03, respectively), and occurrence of nausea with Crohn's disease (p = .04). CONCLUSIONS Our real-life prospective cohort showed the higher cumulative incidence of thiopurine withdrawal due to AEs reported to date. Switching from AZA to 6-MP was often ineffective.
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Affiliation(s)
- Fabio Salvatore Macaluso
- a Di.Bi.M.I.S., Division of Internal Medicine , "Villa Sofia-Cervello" Hospital, University of Palermo , Palermo , Italy
| | - Sara Renna
- a Di.Bi.M.I.S., Division of Internal Medicine , "Villa Sofia-Cervello" Hospital, University of Palermo , Palermo , Italy
| | - Marcello Maida
- b Gastroenterology and Endoscopy Unit , "Villa Sofia-Cervello" Hospital , Palermo , Italy
| | - Mariangela Dimarco
- a Di.Bi.M.I.S., Division of Internal Medicine , "Villa Sofia-Cervello" Hospital, University of Palermo , Palermo , Italy
| | - Chiara Sapienza
- a Di.Bi.M.I.S., Division of Internal Medicine , "Villa Sofia-Cervello" Hospital, University of Palermo , Palermo , Italy
| | - Marco Affronti
- a Di.Bi.M.I.S., Division of Internal Medicine , "Villa Sofia-Cervello" Hospital, University of Palermo , Palermo , Italy
| | - Emanuele Orlando
- a Di.Bi.M.I.S., Division of Internal Medicine , "Villa Sofia-Cervello" Hospital, University of Palermo , Palermo , Italy
| | - Giulia Rizzuto
- a Di.Bi.M.I.S., Division of Internal Medicine , "Villa Sofia-Cervello" Hospital, University of Palermo , Palermo , Italy
| | - Rosalba Orlando
- a Di.Bi.M.I.S., Division of Internal Medicine , "Villa Sofia-Cervello" Hospital, University of Palermo , Palermo , Italy
| | - Marco Ventimiglia
- a Di.Bi.M.I.S., Division of Internal Medicine , "Villa Sofia-Cervello" Hospital, University of Palermo , Palermo , Italy
| | - Mario Cottone
- a Di.Bi.M.I.S., Division of Internal Medicine , "Villa Sofia-Cervello" Hospital, University of Palermo , Palermo , Italy
| | - Ambrogio Orlando
- a Di.Bi.M.I.S., Division of Internal Medicine , "Villa Sofia-Cervello" Hospital, University of Palermo , Palermo , Italy
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Macaluso FS, Maida M, Renna S, Orlando E, Affronti M, Sapienza C, Dimarco M, Orlando R, Rizzuto G, Cottone M, Orlando A. Mycophenolate mofetil is a valid option in patients with inflammatory bowel disease resistant to TNF-α inhibitors and conventional immunosuppressants. Dig Liver Dis 2017; 49:157-162. [PMID: 27876682 DOI: 10.1016/j.dld.2016.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/02/2016] [Accepted: 10/03/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Few studies investigated the role of mycophenolate mofetil in inflammatory bowel disease, and none of them had specifically focused on patients with previous multiple intolerances and/or nonresponses to conventional immunosuppressants and biologics. AIMS To evaluate clinical benefit and tolerability profile of mycophenolate mofetil in patients with inflammatory bowel disease and limited treatment options. METHODS All consecutive patients with previous multiple intolerances and/or nonresponses to immunosuppressants and biologics who started an off-label treatment with mycophenolate mofetil from January 2014 to February 2016 were entered in a prospectively maintained database. RESULTS Twenty-four patients were included. Four weeks after initiation of mycophenolate mofetil therapy, a steroid-free remission was achieved in 4 patients (16.7%), while a clinical response in 13 (54.1%). At the end of follow-up, 12 patients (50.0%) remained on mycophenolate mofetil. Six achieved and maintained steroid-free remission throughout the study period (25.0%), and a further 6 patients (25.0%) achieved a clinical response with complete discontinuation of steroids. Twelve patients (50.0%) were considered as treatment failure, and five of them underwent surgery. CONCLUSIONS This is the first experience reporting a clinical benefit and tolerability of mycophenolate mofetil in patients with inflammatory bowel disease and multiple previous failures to other immunosuppressants and/or biologics.
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Affiliation(s)
- Fabio Salvatore Macaluso
- Di.Bi.M.I.S., Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, University of Palermo, Italy.
| | - Marcello Maida
- Gastroenterology and Endoscopy Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Sara Renna
- Di.Bi.M.I.S., Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, University of Palermo, Italy
| | - Emanuele Orlando
- Di.Bi.M.I.S., Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, University of Palermo, Italy
| | - Marco Affronti
- Di.Bi.M.I.S., Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, University of Palermo, Italy
| | - Chiara Sapienza
- Di.Bi.M.I.S., Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, University of Palermo, Italy
| | - Mariangela Dimarco
- Di.Bi.M.I.S., Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, University of Palermo, Italy
| | - Rosalba Orlando
- Di.Bi.M.I.S., Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, University of Palermo, Italy
| | - Giulia Rizzuto
- Di.Bi.M.I.S., Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, University of Palermo, Italy
| | - Mario Cottone
- Di.Bi.M.I.S., Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, University of Palermo, Italy
| | - Ambrogio Orlando
- Di.Bi.M.I.S., Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, University of Palermo, Italy
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Orlando A, Orlando R, Ciccia F, Renna S, Rizzo A, Cottone M, Macaluso FS. Clinical benefit of vedolizumab on articular manifestations in patients with active spondyloarthritis associated with inflammatory bowel disease. Ann Rheum Dis 2017; 76:e31. [PMID: 28096071 DOI: 10.1136/annrheumdis-2016-211011] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 12/27/2016] [Accepted: 12/28/2016] [Indexed: 12/21/2022]
Affiliation(s)
- Ambrogio Orlando
- Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Rosalba Orlando
- Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Francesco Ciccia
- Di.Bi.M.I.S., Section of Rheumatology, University of Palermo, Palermo, Italy
| | - Sara Renna
- Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Aroldo Rizzo
- Department of Pathology, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Mario Cottone
- Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, Palermo, Italy
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Gillett K, Lippiett K, Astles C, Longstaff J, Orlando R, Lin SX, Powell A, Roberts C, Chauhan AJ, Thomas M, Wilkinson TM. Managing complex respiratory patients in the community: an evaluation of a pilot integrated respiratory care service. BMJ Open Respir Res 2016; 3:e000145. [PMID: 28074134 PMCID: PMC5174798 DOI: 10.1136/bmjresp-2016-000145] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/14/2016] [Accepted: 09/23/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction In the UK, there is significant variation in respiratory care and outcomes. An integrated approach to the management of high-risk respiratory patients, incorporating specialist and primary care teams' expertise, is the basis for new integrated respiratory services designed to reduce this variation; however, this model needs evaluating. Methods To evaluate an integrated service managing high-risk respiratory patients, electronic searches for patients with asthma and chronic obstructive pulmonary disease at risk of poor outcomes were performed in two general practitioner (GP) practices in a local service-development initiative. Patients were reviewed at joint clinics by primary and secondary care professionals. GPs also nominated patients for inclusion. Reviews were delivered to best standards of care including assessments of diagnosis, control, spirometry, self-management, education, medication, inhaler technique and smoking cessation support. Follow-up of routine clinical data collected at 9-months postclinic were compared with seasonally matched 9-months prior to integrated review. Results 82 patients were identified, 55 attended. 13 (23.6%) had their primary diagnosis changed. In comparison with the seasonally adjusted baseline period, in the 9-month follow-up there was an increase in inhaled corticosteroid prescriptions of 23.3%, a reduction in short-acting β2-agonist prescription of 33.3%, a reduction in acute respiratory exacerbations of 67.6%, in unscheduled GP surgery visits of 53.3% and acute respiratory hospital admissions reduced from 3 to 0. Only 4 patients (7.3%) required referral to secondary care. Health economic evaluation showed respiratory-related costs per patient reduced by £231.86. Conclusions Patients with respiratory disease in this region at risk of suboptimal outcomes identified proactively and managed by an integrated team improved outcomes without the need for hospital referral.
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Affiliation(s)
- K Gillett
- National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Wessex, Respiratory Theme , Southampton , UK
| | - K Lippiett
- National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Wessex, Respiratory Theme , Southampton , UK
| | - C Astles
- National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Wessex, Respiratory Theme , Southampton , UK
| | - J Longstaff
- Wessex Academic Health Sciences Network (AHSN) , Portsmouth , UK
| | - R Orlando
- National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Wessex, Methodological Hub , Southampton , UK
| | - S X Lin
- National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Wessex, Methodological Hub , Southampton , UK
| | - A Powell
- West Hampshire Clinical Commissioning Group (CCG) , Eastleigh , UK
| | - C Roberts
- Wessex Academic Health Sciences Network (AHSN) , Portsmouth , UK
| | - A J Chauhan
- Wessex Academic Health Sciences Network (AHSN) , Portsmouth , UK
| | - M Thomas
- National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Wessex, Respiratory Theme, Southampton, UK; Department of Primary Care and Populations Sciences, University of Southampton, Southampton, UK
| | - T M Wilkinson
- National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Wessex, Respiratory Theme, Southampton, UK; Department of Clinical and Experimental Sciences, University of Southampton, Southampton, UK
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Renna S, Orlando E, Macaluso FS, Maida M, Affronti M, Giunta M, Sapienza C, Rizzuto G, Orlando R, Dimarco M, Cottone M, Orlando A. Letter: a prospective real life comparison of the efficacy of adalimumab vs. golimumab in moderate to severe ulcerative colitis. Aliment Pharmacol Ther 2016; 44:310-1. [PMID: 27375103 DOI: 10.1111/apt.13692] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- S Renna
- DiBiMis, Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, Palermo University, Palermo, Italy
| | - E Orlando
- DiBiMis, Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, Palermo University, Palermo, Italy
| | - F S Macaluso
- DiBiMis, Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, Palermo University, Palermo, Italy
| | - M Maida
- Gastroenterology and Endoscopy Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - M Affronti
- DiBiMis, Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, Palermo University, Palermo, Italy
| | - M Giunta
- Gastroenterology and Endoscopy Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - C Sapienza
- DiBiMis, Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, Palermo University, Palermo, Italy
| | - G Rizzuto
- DiBiMis, Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, Palermo University, Palermo, Italy
| | - R Orlando
- DiBiMis, Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, Palermo University, Palermo, Italy
| | - M Dimarco
- DiBiMis, Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, Palermo University, Palermo, Italy
| | - M Cottone
- DiBiMis, Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, Palermo University, Palermo, Italy
| | - A Orlando
- DiBiMis, Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, Palermo University, Palermo, Italy.
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Granata A, Ligresti D, Curcio G, Barresi L, Tarantino I, Orlando R, Traina M. Hemospray rescue treatment of gastroenteric anastomotic bleeding. Endoscopy 2016; 47 Suppl 1 UCTN:E327-8. [PMID: 26115399 DOI: 10.1055/s-0034-1392322] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Antonino Granata
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Dario Ligresti
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Gabriele Curcio
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Luca Barresi
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Ilaria Tarantino
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Rosalba Orlando
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Mario Traina
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
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Granata A, Curcio G, Barresi L, Ligresti D, Tarantino I, Orlando R, Traina M. Hemospray rescue treatment of severe refractory bleeding associated with ischemic colitis: a case series. Int J Colorectal Dis 2016; 31:719-20. [PMID: 25943279 DOI: 10.1007/s00384-015-2212-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2015] [Indexed: 02/04/2023]
Affiliation(s)
- Antonino Granata
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127, Palermo, Italy.
| | - Gabriele Curcio
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127, Palermo, Italy
| | - Luca Barresi
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127, Palermo, Italy
| | - Dario Ligresti
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127, Palermo, Italy
| | - Ilaria Tarantino
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127, Palermo, Italy
| | - Rosalba Orlando
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127, Palermo, Italy
| | - Mario Traina
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127, Palermo, Italy
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Rugini E, Orlando R. High efficiency shoot regeneration from calluses of strawberry(FragariaXananassaDuch.) stipules ofin vitroshoot cultures. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/00221589.1992.11516286] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Curcio G, Granata A, Ligresti D, Orlando R, Tarantino I, Barresi L, Traina M. Video of the month: crowbar endoscopic enucleation of a giant appendicolith. Am J Gastroenterol 2015; 110:1142. [PMID: 26263356 DOI: 10.1038/ajg.2015.109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Gabriele Curcio
- IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione), Palermo, Italy
| | - Antonino Granata
- IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione), Palermo, Italy
| | - Dario Ligresti
- IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione), Palermo, Italy
| | - Rosalba Orlando
- IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione), Palermo, Italy
| | - Ilaria Tarantino
- IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione), Palermo, Italy
| | - Luca Barresi
- IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione), Palermo, Italy
| | - Mario Traina
- IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione), Palermo, Italy
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Orlando R, Foggia M, Maraolo AE, Mascolo S, Palmiero G, Tambaro O, Tosone G. Prevention of hepatitis B virus infection: from the past to the future. Eur J Clin Microbiol Infect Dis 2015; 34:1059-70. [PMID: 25678010 DOI: 10.1007/s10096-015-2341-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 01/27/2015] [Indexed: 12/17/2022]
Abstract
About 3-5 % of the world's population is chronically infected by hepatitis B virus (HBV) and is at risk of developing liver cirrhosis or hepatocellular carcinoma. The risk of dying prematurely because of chronic HBV infection is higher in younger people. The current strategies to prevent HBV infection involve immunization (active and/or passive) and antiviral chemoprophylaxis. The vaccines available for active immunization, containing hepatitis B surface antigen, are safe and confer long-term immunity in most healthy subjects. Since the vaccination is unsatisfactory in some patients, e.g., those with chronic kidney disease, human immunodeficiency virus infection, type I diabetes mellitus, and celiac disease, new strategies of vaccination are required. The neonatal, infant, and adolescent routine program vaccination in about 180 countries has greatly decreased the disease burden. Passive immunization with specific HBV immunoglobulins is recommended after single acute exposure, in infants born to infected mothers, and in HBV-infected patients undergoing liver transplantation combined with nucleoside/nucleotide analogues (chemoprophylaxis). Chemoprophylaxis is also indicated in HBV carrier candidates for immunosuppressive treatment and in patients with occult B infection undergoing immunosuppressive therapy or hematopoietic stem cell transplantation. Since HBV is not eradicable by an immune response or by antiviral drugs developed so far, the only preventive strategy remains global neonatal vaccination in all countries, firstly in HBV-endemic countries.
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Affiliation(s)
- R Orlando
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Via Sergio Pansini 5, 80131, Napoli, Italy
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Di Mitri R, Mocciaro F, Sferrazza S, Orlando R, Costanza V. Colonic perforation caused by the inadvertent trapping of mucosa in a retrieval net. Endoscopy 2014; 46 Suppl 1 UCTN:E169-70. [PMID: 24756278 DOI: 10.1055/s-0034-1365097] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Roberto Di Mitri
- Gastroenterology and Endoscopy Unit, A.R.N.A.S. Civico-Di Cristina-Benfratelli Hospital, Palermo, Italy
| | - Filippo Mocciaro
- Gastroenterology and Endoscopy Unit, A.R.N.A.S. Civico-Di Cristina-Benfratelli Hospital, Palermo, Italy
| | - Sandro Sferrazza
- Gastroenterology and Endoscopy Unit, A.R.N.A.S. Civico-Di Cristina-Benfratelli Hospital, Palermo, Italy
| | - Rosalba Orlando
- Gastroenterology and Endoscopy Unit, A.R.N.A.S. Civico-Di Cristina-Benfratelli Hospital, Palermo, Italy
| | - Vincenzo Costanza
- Gastroenterology and Endoscopy Unit, A.R.N.A.S. Civico-Di Cristina-Benfratelli Hospital, Palermo, Italy
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Orlando R, Pennant M, Rooney S, Khogali S, Bayliss S, Hassan A, Moore D, Barton P. Cost-effectiveness of transcatheter aortic valve implantation (TAVI) for aortic stenosis in patients who are high risk or contraindicated for surgery: a model-based economic evaluation. Health Technol Assess 2014; 17:1-86. [PMID: 23948359 DOI: 10.3310/hta17330] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Calcific aortic stenosis (AS) is a common valvular heart disease. Patients with severe symptomatic AS typically survive less than 3 years. In such patients, intervention with surgical aortic valve replacement (SAVR) may increase survival. However, in some patients SAVR is associated with a high operative risk and medical management is considered appropriate. Transcatheter aortic valve implantation (TAVI) is a relatively recent technique to avoid the invasiveness of open surgery. This procedure has been used for the treatment of patients with severe AS who are unsuitable for SAVR (because it is too high risk and/or for other reasons such as suffering from porcelain aorta) and is increasingly being considered for other patients. OBJECTIVES To determine the cost-effectiveness of TAVI being made available for patients who are high risk or contraindicated for SAVR through a review of existing economic evaluations and development of a model. DATA SOURCES AND REVIEW METHODS Bibliographic databases [MEDLINE, EMBASE, The Cochrane Library, Health Technology Assessment (HTA), Database of Abstracts of Reviews of Effects (DARE) and NHS Economic Evaluation Database (EED), Centre for Reviews and Dissemination HTA, DARE and NHS EED], guideline resources, current trials registers, websites/grey literature and manufacturers' websites, and consultation with clinical experts were used to identify studies for the review and information for the model. Databases were searched from 2007 to November 2010. A model was built to assess the cost-effectiveness of TAVI separately in patients suitable and unsuitable for SAVR, together with overall results for the effect of making TAVI available. Substantial deterministic sensitivity analysis was carried out together with probabilistic sensitivity analysis. RESULTS No fully published cost-effectiveness studies were found. Modelling patients not suitable for SAVR, the base-case results show TAVI as more costly but more effective than medical management, with an incremental cost-effectiveness ratio (ICER) of £12,900 per quality-adjusted life-year (QALY). The ICER was below £20,000 per QALY for over 99% of model runs in the probabilistic sensitivity analysis. For patients suitable for SAVR, the comparator with TAVI is a mixture of SAVR and medical management. TAVI is both more costly and less effective than this comparator assuming that most patients would receive SAVR in the absence of TAVI. This is robust to a number of assumption changes about the effects of treatment, but sensitive to assumptions about the proportion of patients receiving SAVR in the comparator. If the use of TAVI is extended to include more patients suitable for SAVR, the overall results from the model become less favourable for TAVI. LIMITATIONS The modelling involves extrapolation of short-term data and the comparison between TAVI and SAVR is not based on randomised data. More trial data on the latter have been published since the modelling was undertaken. CONCLUSIONS The results for TAVI compared with medical management in patients unsuitable for surgery are reasonably robust and suggest that TAVI is likely to be cost-effective. For patients suitable for SAVR, TAVI could be both more costly and less effective than SAVR. The overall results suggest that, if a very substantial majority of TAVI patients are those unsuitable for SAVR, the cost-effectiveness of a broad policy of introducing TAVI may fall below £20,000 per QALY. Future work required includes the incorporation of new data made available after completion of this work. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- R Orlando
- Unit of Health Economics, University of Birmingham, Birmingham, UK
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Bailey CJ, Orlando R, Kinghorn P, Armour K, Perry R, Coast J. MEASURING THE QUALITY OF END OF LIFE USING ICECAP SCM: FEASIBILITY AND ACCEPTABILITY. BMJ Support Palliat Care 2014. [DOI: 10.1136/bmjspcare-2014-000653.22] [Citation(s) in RCA: 7] [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: 11/04/2022]
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Lacivita V, Erba A, Noël Y, Orlando R, D’Arco P, Dovesi R. Zinc oxide nanotubes: An ab initio investigation of their structural, vibrational, elastic, and dielectric properties. J Chem Phys 2013; 138:214706. [DOI: 10.1063/1.4808156] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Erba A, Ferrabone M, Baima J, Orlando R, Rérat M, Dovesi R. The vibration properties of the (n,0) boron nitride nanotubes from ab initio quantum chemical simulations. J Chem Phys 2013; 138:054906. [DOI: 10.1063/1.4788831] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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Pennant M, Orlando R, Barton P, Bayliss S, Routh K, Meads C. Prucalopride for the treatment of women with chronic constipation in whom standard laxative regimens have failed to provide adequate relief. Health Technol Assess 2012; 15 Suppl 1:43-50. [PMID: 21609652 DOI: 10.3310/hta15suppl1/05] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of prucalopride for the treatment of women with chronic constipation in whom standard laxative regimens have failed to provide adequate relief. The ERG report is based on the manufacturer's submission (MS) to the National Institute for Health and Clinical Excellence as part of the single technology appraisal process. In the submission, quality-of-life data [Patient Assessment of Constipation Quality of Life (PAC-QOL) and Patient Assessment of Constipation Symptoms (PAC-SYM) questionnaires] from trials of prucalopride were extrapolated to EQ-5D (European Quality of Life-5 Dimensions) data and used to inform effectiveness in an economic model. Response rates to prucalopride were derived from observed response rates in trials, defined as the proportion of patients achieving an average of three or more spontaneous complete bowel movements over the 4- or 12-week trial periods. Adult (18-64 years) and elderly (≥ 65 years) patients were considered separately in the model. Cost-effectiveness was determined from estimated improvements in EQ-5D and anticipated response rates, adjusted for baseline severity of chronic constipation. The ERG considered that the patients participating in these trials were not representative of those in the licensed indication. They were not all refractory to laxatives, and baseline EQ-5D scores showed a large spread in quality of life, with many patients experiencing little baseline dissatisfaction. The mapping of quality-of-life data from trials (PAC-QOL and PAC-SYM data) to EQ-5D was unclear and invalidated. The assumption of the long-term effectiveness and safety of prucalopride to 1 year was considered unjustified. There was no justification or sources given for coefficients used to predict effectiveness in the economic model, and no costs other than the cost of prucalopride were incorporated into the model. Owing to the many areas of uncertainty, particularly the effectiveness of prucalopride in the licensed patient group and its long-term effectiveness and safety, it was considered that the MS provided no evidence for whether prucalopride is effective or not in women with laxative-refractory chronic constipation. Further subgroup analysis of the actual patient group of interest may have better guided decision-making. However, long-term efficacy data, with validated estimates of quality of life incorporated in a well-founded model, would be important for an evidence-based judgement to be made.
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Affiliation(s)
- M Pennant
- West Midlands Health Technology Assessment Collaboration, Department of Public Health, Epidemiology & Biostatistics, University of Birmingham, Birmingham, UK.
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Coast J, Sutton E, Orlando R, Armour K. Measuring benefits at end of life for economic evaluation: measure development and a ‘thinkaloud’ study. BMJ Support Palliat Care 2012. [DOI: 10.1136/bmjspcare-2012-000264.1] [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: 11/03/2022]
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Lumachi F, Basso S, Marino F, Orlando R, Basso U, Chiara G. 3516 POSTER Risk Factors Incidence in Postmenopausal Women With Hormone Receptor Negative/HER2 Positive and Triple Negative Breast Cancer – Preliminary Results. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71172-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lumachi F, Basso S, Marino F, Orlando R, Basso U, Chiara G. 5100 POSTER Relationship Between Survival, Hormone Receptor Rate, and Ca 15-3 Serum Levels in Patients With Isolated Liver Metastases From Breast Cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71542-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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35
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Pennant M, Orlando R, Barton P, Bayliss S, Routh K, Meads C. Prucalopride for the treatment of women with chronic constipation in whom standard laxative regimens have failed to provide adequate relief. Health Technol Assess 2011. [DOI: 10.3310/hta15suppl1-05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of prucalopride for the treatment of women with chronic constipation in whom standard laxative regimens have failed to provide adequate relief. The ERG report is based on the manufacturer’s submission (MS) to the National Institute for Health and Clinical Excellence as part of the single technology appraisal process. In the submission, quality-of-life data [Patient Assessment of Constipation Quality of Life (PAC-QOL) and Patient Assessment of Constipation Symptoms (PAC-SYM) questionnaires] from trials of prucalopride were extrapolated to EQ-5D (European Quality of Life-5 Dimensions) data and used to inform effectiveness in an economic model. Response rates to prucalopride were derived from observed response rates in trials, defined as the proportion of patients achieving an average of three or more spontaneous complete bowel movements over the 4- or 12-week trial periods. Adult (18–64 years) and elderly (≥ 65 years) patients were considered separately in the model. Cost-effectiveness was determined from estimated improvements in EQ-5D and anticipated response rates, adjusted for baseline severity of chronic constipation. The ERG considered that the patients participating in these trials were not representative of those in the licensed indication. They were not all refractory to laxatives, and baseline EQ-5D scores showed a large spread in quality of life, with many patients experiencing little baseline dissatisfaction. The mapping of quality-of-life data from trials (PAC-QOL and PAC-SYM data) to EQ-5D was unclear and invalidated. The assumption of the long-term effectiveness and safety of prucalopride to 1 year was considered unjustified. There was no justification or sources given for coefficients used to predict effectiveness in the economic model, and no costs other than the cost of prucalopride were incorporated into the model. Owing to the many areas of uncertainty, particularly the effectiveness of prucalopride in the licensed patient group and its long-term effectiveness and safety, it was considered that the MS provided no evidence for whether prucalopride is effective or not in women with laxative-refractory chronic constipation. Further subgroup analysis of the actual patient group of interest may have better guided decision-making. However, long-term efficacy data, with validated estimates of quality of life incorporated in a well-founded model, would be important for an evidence-based judgement to be made.
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Affiliation(s)
- M Pennant
- West Midlands Health Technology Assessment Collaboration, Department of Public Health, Epidemiology & Biostatistics, University of Birmingham, Birmingham, UK
| | - R Orlando
- West Midlands Health Technology Assessment Collaboration, Department of Public Health, Epidemiology & Biostatistics, University of Birmingham, Birmingham, UK
| | - P Barton
- West Midlands Health Technology Assessment Collaboration, Department of Public Health, Epidemiology & Biostatistics, University of Birmingham, Birmingham, UK
| | - S Bayliss
- West Midlands Health Technology Assessment Collaboration, Department of Public Health, Epidemiology & Biostatistics, University of Birmingham, Birmingham, UK
| | - K Routh
- West Midlands Health Technology Assessment Collaboration, Department of Public Health, Epidemiology & Biostatistics, University of Birmingham, Birmingham, UK
| | - C Meads
- West Midlands Health Technology Assessment Collaboration, Department of Public Health, Epidemiology & Biostatistics, University of Birmingham, Birmingham, UK
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De La Pierre M, Orlando R, Maschio L, Doll K, Ugliengo P, Dovesi R. Performance of six functionals (LDA, PBE, PBESOL, B3LYP, PBE0, and WC1LYP) in the simulation of vibrational and dielectric properties of crystalline compounds. The case of forsterite Mg2SiO4. J Comput Chem 2011; 32:1775-84. [DOI: 10.1002/jcc.21750] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Revised: 12/13/2010] [Accepted: 12/17/2010] [Indexed: 11/06/2022]
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Scimeca D, Mocciaro F, Cottone M, Montalbano LM, D'Amico G, Olivo M, Orlando R, Orlando A. Efficacy and safety of endoscopic balloon dilation of symptomatic intestinal Crohn's disease strictures. Dig Liver Dis 2011; 43:121-5. [PMID: 20561831 DOI: 10.1016/j.dld.2010.05.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [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] [Received: 11/15/2009] [Revised: 04/12/2010] [Accepted: 05/04/2010] [Indexed: 12/11/2022]
Abstract
AIM To evaluate prospectively the clinical efficacy and safety of endoscopic hydrostatic balloon dilation in a consecutive cohort of symptomatic intestinal Crohn's disease strictures. METHODS Between September 2003 and December 2008 we performed endoscopic balloon dilations in 37 Crohn's disease patients with 39 intestinal symptomatic strictures (4 naïve and 35 postoperative). Dilations were performed using a Rigiflex through-the-scope balloon. Clinical success rate was claimed if a patient remained asymptomatic and did not require surgery or further endoscopic dilation, following technical success. Actuarial curves of clinical, endoscopic (redilation) and surgical recurrence were obtained by Kaplan-Meier method. Demographic and disease variables were related to the main outcomes. RESULTS After a mean follow-up of 26.3 months (range, 2-61 months), the long-term global benefit rate was 89% (33/37). The 1-2-3 years cumulative symptom-free rates were respectively: 76%, 55% and 46%. Four patients were operated upon. Technical success predicts a lower rate of surgery. There were no complications related to the endoscopic procedures. CONCLUSIONS Endoscopic balloon dilation of symptomatic Crohn's disease strictures may achieve clinical benefit in many patients and is a valid alternative to surgery in the management of the disease. Dilation may be repeated in recurrent intestinal obstructions and appears safe without morbidity.
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Affiliation(s)
- Daniela Scimeca
- Department of Medicine, Pneumology and Nutrition Clinic, V Cervello Hospital, Palermo University, Palermo, Italy.
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Diamanti O, Orlando R, Schiavon V. P112 What is the nurse's role in the malnutrition of the chemotherapy patient? Eur J Oncol Nurs 2010. [DOI: 10.1016/s1462-3889(10)70174-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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39
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Veropalumbo E, Marrone A, Vallefuoco L, Perruolo G, Orlando R, Scordino F, Tosone G, Zampino R, Trani B, Genovese A, Spadaro G, D’Orio C, Portella G. Immunocompromised Patients with HBsAgaDeterminant Mutants: Comparison of HBsAg Diagnostic Assays. Intervirology 2010; 53:183-7. [DOI: 10.1159/000289342] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Accepted: 12/22/2009] [Indexed: 11/19/2022] Open
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40
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Renna S, Orlando A, Orlando R, Cottone M. [Problems related to postoperative clinical relapse and endoscopic recurrence in Crohn's disease]. Recenti Prog Med 2009; 100:469-478. [PMID: 20030170] [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
Crohn's disease is a chronic inflammatory condition that may involve any segment of the gastrointestinal tract. Up to 70% of patients with Crohn's disease will undergo intestinal resection during the course of their disease for complications, but also for the control of symptoms when medical therapy is not useful. At 1 year after a first resection, up to 70% of patients show an endoscopic recurrence and 20-30% have clinical relapse. Ileocolonoscopy is considered the gold standard for postoperative recurrence assessment. Several other risk factors for postoperative recurrence have been identified such as smoking, the disease activity before surgery, the ileocolonic disease, the younger age, the fistulising disease. Several different therapeutic approaches have been evaluated in the prevention of postoperative recurrence. In clinical practice, mesalazine is the first-line treatment used in the postoperative setting, despite considerable controversy as to its efficacy. Immunosuppressive treatment is based on scant evidence but is currently used as a second-line treatment in post-surgical patients at high risk for recurrence, with severe symptoms or with early endoscopic lesions in the neoterminal ileum. Biologic therapy (infliximab) is a candidate new therapy but further controlled trials are needed.
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Affiliation(s)
- Sara Renna
- Dipartimento di Medicina, Pneumologia e Fisiologia della Nutrizione Umana, Azienda Ospedaliera Cervello, Università di Palermo.
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Ferrari AM, Valenzano L, Meyer A, Orlando R, Dovesi R. Quantum-Mechanical ab Initio Simulation of the Raman and IR Spectra of Fe3Al2Si3O12 Almandine. J Phys Chem A 2009; 113:11289-94. [DOI: 10.1021/jp901993e] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A. M. Ferrari
- Dipartimento di Chimica IFM and NIS (Nanostructured Interfaces and Surfaces) Centre of Excellence, Università di Torino, Via P. Giuria 7, 10125 Torino, Italy, and Dipartimento di Scienze e Tecnologie Avanzate, Università del Piemonte Orientale, Viale T. Michel 11, 15121 Alessandria, Italy
| | - L. Valenzano
- Dipartimento di Chimica IFM and NIS (Nanostructured Interfaces and Surfaces) Centre of Excellence, Università di Torino, Via P. Giuria 7, 10125 Torino, Italy, and Dipartimento di Scienze e Tecnologie Avanzate, Università del Piemonte Orientale, Viale T. Michel 11, 15121 Alessandria, Italy
| | - A. Meyer
- Dipartimento di Chimica IFM and NIS (Nanostructured Interfaces and Surfaces) Centre of Excellence, Università di Torino, Via P. Giuria 7, 10125 Torino, Italy, and Dipartimento di Scienze e Tecnologie Avanzate, Università del Piemonte Orientale, Viale T. Michel 11, 15121 Alessandria, Italy
| | - R. Orlando
- Dipartimento di Chimica IFM and NIS (Nanostructured Interfaces and Surfaces) Centre of Excellence, Università di Torino, Via P. Giuria 7, 10125 Torino, Italy, and Dipartimento di Scienze e Tecnologie Avanzate, Università del Piemonte Orientale, Viale T. Michel 11, 15121 Alessandria, Italy
| | - R. Dovesi
- Dipartimento di Chimica IFM and NIS (Nanostructured Interfaces and Surfaces) Centre of Excellence, Università di Torino, Via P. Giuria 7, 10125 Torino, Italy, and Dipartimento di Scienze e Tecnologie Avanzate, Università del Piemonte Orientale, Viale T. Michel 11, 15121 Alessandria, Italy
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Tiseo D, Tosone G, Conte MCD, Scordino F, Mansueto G, Mesolella M, Parrella G, Pennone R, Orlando R. Isolated laryngeal leishmaniasis in an immunocompetent patient: a case report. Infez Med 2008; 16:233-235. [PMID: 19155691] [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: 05/27/2023]
Abstract
Visceral leishmaniasis, a protozoan disease caused by Leishmania infantum, is endemic in the Mediterranean basin, especially southern and Tyrrhenian Italy. Its aetiological agent can also sporadically cause isolated laryngeal localization in at-risk patients (i.e., heavy smokers, immunocompromised patients). This rare localization is often pauci-symptomatic and thus can easily escape diagnosis. A case of isolated leishmaniasis limited to the left vocal cord in an immunocompetent Italian male without significant risk factors, randomly discovered upon histological examination, is described herein. We inquire how many patients affected by non-specific symptoms such as dysphonia and live in countries where Leishmania infantum infection is reported, could be truly affected by Leishmania spp infection.
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Affiliation(s)
- D Tiseo
- Dipartimento di Medicina Pubblica e Sicurezza Sociale, Sezione di Malattie Infettive, University of Naples Federico II, Naples, Italy
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Zicovich-Wilson CM, Torres FJ, Pascale F, Valenzano L, Orlando R, Dovesi R. Ab initiosimulation of the IR spectra of pyrope, grossular, and andradite. J Comput Chem 2008; 29:2268-78. [DOI: 10.1002/jcc.20993] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Orlando R, Civalleri B, Dovesi R, Roetti C. Advances in quantum ab initiocalculations with the CRYSTALcode. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308097742] [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: 11/10/2022] Open
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Tosone G, Tiseo D, Parrella G, Piazza M, Orlando R. Mediastinal teratocarcinoma as initial manifestation of asymptomatic HIV infection: a case report. Minerva Med 2008; 99:417-419. [PMID: 18663349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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46
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Ferrero M, Rérat M, Orlando R, Dovesi R, Bush IJ. Coupled perturbed Kohn-Sham calculation of static polarizabilities of periodic compounds. ACTA ACUST UNITED AC 2008. [DOI: 10.1088/1742-6596/117/1/012016] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Matrisciano F, Caruso A, Orlando R, Marchiafava M, Bruno V, Battaglia G, Gruber SHM, Melchiorri D, Tatarelli R, Girardi P, Mathè AA, Nicoletti F. Defective group-II metaboropic glutamate receptors in the hippocampus of spontaneously depressed rats. Neuropharmacology 2008; 55:525-31. [PMID: 18590921 DOI: 10.1016/j.neuropharm.2008.05.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2008] [Revised: 05/06/2008] [Accepted: 05/18/2008] [Indexed: 12/21/2022]
Abstract
Spontaneously depressed flinders sensitive line (FSL) rats showed a reduced expression of mGlu2/3 metabotropic glutamate receptors in the hippocampus, as compared to "non-depressed" flinders resistant line (FRL) rats. No changes in mGlu2/3 receptor protein levels were found in other brain regions, including the amygdala, hypothalamus, and cerebral cortex. Biochemical analysis of receptor signalling supported the reduction of mGlu2/3 receptors in the hippocampus of FSL rats. Accordingly, the selective mGlu2/3 receptor agonist, LY379268 (1microM) reduced forskolin-stimulated cAMP formation by 56% and 32% in hippocampal slices from FRL and FSL rats, respectively. In addition, LY379268 enhanced 3,5-dihydroxyphenylglycine-stimulated inositol phospholipid hydrolysis from 65% to 215% in hippocampal slices from FRL rats, whereas it was inactive in slices from FRL rats. We also examined the behavioural response of FSL rats to systemic injection of LY379268 (0.5mg/kg, i.p., once a day for 1-21 days) by measuring the immobility time in the forced swim test, which is known to be increased in these rats. LY379268 was administered alone or combined with the classical antidepressant, chlorimipramine (10mg/kg, i.p.). LY379268 alone had no effect at any of the selected time-points, whereas chlorimipramine alone reduced the immobility time only after 21 days of treatment. In contrast, when combined with LY379268, chlorimipramine reduced the immobility time during the first 14 days of treatment. These data support the view that mGlu2/3 receptors might be involved in the pathophysiology of depressive disorders, and that pharmacological activation of these receptors may shorten the latency of antidepressant medication.
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Affiliation(s)
- F Matrisciano
- Department of Physiology and Pharmacology, University of Rome "Sapienza", Piazzale Aldo Moro, 5, 00185 Rome, Italy.
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Civalleri B, Middlemiss D, Orlando R, Wilson C, Ugliengo P. Testing the combination of Hartree–Fock exchange and Wilson–Levy correlation for weakly bonded extended systems. Chem Phys Lett 2008. [DOI: 10.1016/j.cplett.2007.11.095] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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49
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Orlando R, Tosone G, Portella G, Veropalumbo E, D'Onofrio M, Piazza M. Prolonged persistence of lamivudine-resistant mutant and emergence of new lamivudine-resistant mutants two years after lamivudine withdrawal in HBsAg-positive chronic hepatitis patient: a case report. Infection 2007; 36:472-4. [PMID: 17962902 DOI: 10.1007/s15010-007-7073-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2007] [Accepted: 04/25/2007] [Indexed: 11/24/2022]
Abstract
Lamivudine can select resistant hepatitis B virus (HBV) tyrosine-methionine-aspartate-aspartate aminoacid motif (YMDD) mutants, which usually disappear in few months after lamivudine withdrawal. We report an unusual case of a male adult patient who showed a prolonged persistence of the M204I mutation up to 24 months after lamivudine withdrawal followed by the emergence of new distinct YMDD mutants (namely M204V, V207L). Only 42 months after lamivudine withdrawal wild-type YMDD motif became dominant over the YMDD mutants. To our knowledge, a so prolonged persistence of a YMDD mutant and also the emergence of new YMDD mutants many months after drug withdrawal are unusual.
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Affiliation(s)
- R Orlando
- Department of Public Medicine and Social Security, Section of Infectious Diseases, University of Naples Federico II, Via Sergio Pansini 5, Naples, Italy.
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Orlando R, Lirussi F. Hepatitis C Virus Infection: Sexual or Non-Sexual Transmission Between Spouses? A Case Report and Review of the Literature. Infection 2007; 35:465-8. [PMID: 17906840 DOI: 10.1007/s15010-007-6188-7] [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] [Subscribe] [Scholar Register] [Received: 07/12/2006] [Accepted: 01/08/2007] [Indexed: 01/16/2023]
Abstract
The most efficient route of transmission of hepatitis C virus (HCV) infection is through contaminated blood. Sexual transmission or other close human contact could play a role in sporadic infections. We describe a case of acute hepatitis C progressing to chronic hepatitis over a follow-up of 4 years in a 44-year-old woman having a long-standing monogamous relationship with an HCV infected partner. The infection followed the accidental exposure to her husband's contaminated blood containing a high viral load. The case reported here is the first characterized by a documented direct percutaneous HCV transmission outside the healthcare setting, and suggests that sexual exposure to HCV should be considered only after an accurate exclusion of other routes of intrafamilial spread of the infection. Such conclusion is based on a thorough and updated review of the literature concerning both sexual and household transmission of HCV.
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Affiliation(s)
- R Orlando
- Department of Medical and Surgical Sciences, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
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