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Choi AR, D'Agostino R, Farris M, Abdulhaleem M, Wang Y, Smith M, Ruiz J, Lycan T, Petty W, Cramer CK, Tatter SB, Laxton A, White J, Su J, Whitlow CT, Xing F, Chan MD. Genomic Signature for Oligometastatic Disease in Non-Small Cell Lung Cancer Patients with Brain Metastases. Int J Radiat Oncol Biol Phys 2023; 117:S129. [PMID: 37784331 DOI: 10.1016/j.ijrobp.2023.06.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Biomarkers for oligometastatic disease remain elusive and few studies have attempted to correlate genomic data to the presence of true oligometastatic disease. MATERIALS/METHODS Patients with non-small cell lung cancer (NSCLC) and brain metastases were identified in our departmental database. Electronic medical records were used to identify patients for whom liquid biopsy-based comprehensive genomic profiling (Guardant Health) was available. Oligometastatic disease was defined as patients having ≤5 non-brain metastases without diffuse involvement of a single organ. Widespread disease was any spread beyond oligometastatic. Fisher's exact tests were used to identify mutations statistically associated (p<0.1) with either oligometastatic or widespread extracranial disease. A score of +1 was assigned for every mutation present associated with oligometastatic disease, and -1 was assigned for mutations associated with widespread disease. Scores were summed for each patient to create a risk score for the likelihood of oligometastatic disease, with scores subsequently correlated to the likelihood of having oligometastatic disease vs widespread disease. For oligometastatic patients, a competing risk analysis was done to assess for cumulative incidence of oligometastatic progression accounting for the potential competing risks of widespread progression of extracranial disease or death. Cox regression was used to determine the association between oligometastatic risk score and oligometastatic progression. RESULTS One hundred thirty patients met study criteria and were included in the analysis. 51 patients (39%) had oligometastatic disease. Genetic mutations included in the Guardant panel associated (p<0.1) with the presence of oligometastatic extracranial disease included ATM, JAK2, MAP2K2, and NTRK1; ARID1A and CCNE1 were associated with widespread disease. Patients with a positive, neutral and negative risk score for oligometastatic disease had a 78%, 41% and 11.5% likelihood of having oligometastatic disease, respectively (p<0.0001). Overall survival for patients with positive, neutral and negative risk scores for oligometastatic disease was 86% vs 82% vs 64% at 6 months (p = 0.2). The competing risk analysis found that the oligometastatic risk score was significantly associated with the likelihood of oligometastatic progression based on the Wald Chi-square test. Patients with positive, neutral and negative risk scores for oligometastatic disease had a cumulative incidence of oligometastatic progression of 77% vs 35% vs 33% at 6 months (p = 0.03 from competing risk model). CONCLUSION Elucidation of a genomic signature for oligometastatic disease derived from non-invasive liquid biopsy appears feasible for NSCLC patients. Patients with the oligometastatic signature exhibited higher rates of early oligometastatic progression. Validation of this signature could lead to a biomarker that has the potential to direct local therapies in oligometastatic patients.
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Affiliation(s)
- A R Choi
- Department of Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, NC
| | - R D'Agostino
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC
| | - M Farris
- Department of Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, NC
| | - M Abdulhaleem
- Department of HospitalMedicine, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Y Wang
- Department of Molecular and Cellular Bioscience, Wake Forest University School of Medicine, Winston-Salem, NC
| | - M Smith
- Department of Molecular and Cellular Bioscience, Wake Forest University School of Medicine, Winston-Salem, NC
| | - J Ruiz
- Department of Internal Medicine, Section of Hematology and Oncology, Wake Forest University School of Medicine, Winston-Salem, NC
| | - T Lycan
- Department of Internal Medicine, Section of Hematology and Oncology, Wake Forest University School of Medicine, Winston-Salem, NC
| | - W Petty
- Department of Internal Medicine, Section of Hematology and Oncology, Wake Forest University School of Medicine, Winston-Salem, NC
| | - C K Cramer
- Department of Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, NC
| | - S B Tatter
- Department of Neurosurgery, Wake Forest University School of Medicine, Winston-Salem, NC
| | - A Laxton
- Department of Neurosurgery, Wake Forest University School of Medicine, Winston-Salem, NC
| | - J White
- Department of Neurosurgery, Wake Forest University School of Medicine, Winston-Salem, NC
| | - J Su
- Department of Diagnostic Radiology, Wake Forest University School of Medicine, Winston-Salem, NC
| | - C T Whitlow
- Department of Diagnostic Radiology, Wake Forest University School of Medicine, Winston-Salem, NC
| | - F Xing
- Department of Cancer Biology, Wake Forest University School of Medicine, Winston-Salem, NC
| | - M D Chan
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC
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Razavian N, Shenker RF, D'Agostino R, Hughes RT. A Systematic Review and Meta-Analysis of Toxicity in Oropharyngeal Cancer Patients Treated with Proton Therapy. Int J Radiat Oncol Biol Phys 2023; 117:e618. [PMID: 37785854 DOI: 10.1016/j.ijrobp.2023.06.1999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Proton radiotherapy (PRT) is an emerging treatment modality for patients with oropharyngeal cancer (OPC). Due to its dosimetric properties, PRT is hypothesized to be associated with lower rates of acute and late toxicity than photon intensity modulated radiotherapy (IMRT). Current evidence supporting PRT in this setting is limited to small, single institution reports. We sought to examine pooled rates of PRT toxicity from the current literature. MATERIALS/METHODS A systematic review of PubMed, Embase, and Web of Science was performed. Articles published from 1980-2022 that contained >10 patients treated with definitive or adjuvant PRT for OPC were included. From these studies acute and late clinician rated adverse events (CRAEs) were extracted. The primary outcomes were the pooled rates of grade 3 or higher (G3+) acute CRAEs. The secondary outcomes were the pooled rates of late CRAEs. Pooled rates were estimated using random effects models for CRAEs that were reported in ≥3 studies and graded using Common Terminology Criteria for Adverse Events (CTCAE). In studies that reported both PRT and IMRT, a mixed effects log odds ratios (ORs) was used to compare risk of CRAE between modalities. RESULTS A total of 8 studies (5 retrospective, 3 prospective) with 291 patients treated with PRT for OPC were identified. The majority of patients were men (90%) with HPV-associated disease (93%) treated with definitive intent (56%). Primary tumor was most frequently tonsil (55%); 58% had T1-2, and 60% had N2-3 disease (AJCC7). Estimated pooled rates of G3+ acute CRAEs were as follows: dermatitis: 22%, mucositis: 38%, xerostomia: 1.6%, dysphagia: 15%, and weight loss: 1.9%. Estimated pooled rates of G2+ acute CRAEs were as follows: dermatitis: 73%, xerostomia: 12%, weight loss: 14%, and dysgeusia: 29%. Rate of acute hospitalization was 10%. In terms of late toxicities of PRT, the pooled rate of G2+and G3+ xerostomia were 22.5% and 1.2%, respectfully, while the rates G2+ and G3+ dysphagia were 15.6% and 2.6%, respectfully. Among the included studies, 4 studies reported CRAEs from patients treated with IMRT. Due to inconsistent reporting of CRAEs, only use of feeding tube (FT) could be compared between treatment modalities. PRT was associated with significantly lower FT use in the acute setting compared to IMRT - 18% versus 28%, respectively (log OR -0.88, P<0.001). Long term FT use was not significantly different between PRT and IMRT - 1.4% versus 2.7%, respectively (log OR -0.95, P = 0.24). CONCLUSION In the largest pooled analysis of PRT for OPC to date, PRT was associated with a 3-fold reduction of acute, but not late, FT use compared to IMRT. The pooled rates of other PBT CRAEs appear to be at least similar to, if not less than, those reported on IMRT trials treating similarly selected patients. Ultimately, heterogeneity in reporting PRT toxicity outcomes greatly reduces the interpretability of these data and limits proton-photon comparisons. Maximizing consistency of CRAE reporting in future studies is critical.
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Affiliation(s)
- N Razavian
- Department of Radiation Oncology, Wake Forest University School of Medicine, Winston Salem, NC
| | - R F Shenker
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC
| | - R D'Agostino
- Wake Forest School of Medicine, Winston-Salem, NC
| | - R T Hughes
- Department of Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, NC
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Kishor Ganti A, Prince P, Wang X, Estrin A, Boccuti A, Rengarajan B, Naveh N, D'Agostino R, Alvord T, Ben-Joseph R. PP01.76 Lurbinectedin vs an External Control arm in Patients with Small Cell Lung Cancer. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.102] [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: 01/29/2023]
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Razavian N, D'Agostino R, Steber C, Helis C, Hughes R. Risk of Contralateral Failure Following Ipsilateral Neck Irradiation for Tonsil Cancer – A Systematic Review and Meta-Analysis of 1,487 Patients. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1390] [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: 11/28/2022]
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Estrin A, Wang X, Boccuti A, Prince P, Gautam N, Rengarajan B, Li W, Lu T, Cao Y, Naveh N, D'Agostino R, Ben-Joseph R, Ganti A. 1539P Real-world (RW) outcomes of second-line (2L) small cell lung cancer (SCLC) patients treated with lurbinectedin. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1633] [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: 11/28/2022] Open
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Hughes R, Lycan T, Bunch P, Greven K, Frizzell B, Furdui C, D'Agostino R, Triozzi P, Zhang W, Porosnicu M. Quad-Shot Radiotherapy in Combination with Immune Checkpoint Inhibition for Advanced/Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma: A Single-Arm Pilot Study. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.097] [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: 11/27/2022]
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Dabaja MF, Greco G, Blanda V, Tempesta M, Bayan A, Torina A, Vesco G, D'Agostino R, Lelli R, Ezzedine M, Mortada H, Raoult D, Fournier PE, Mortada M. Multispacer sequence typing of Coxiella burnetii from milk and hard tick samples from ruminant farms in Lebanon. Vet Ital 2020; 56:289-296. [PMID: 33635617 DOI: 10.12834/vetit.1799.13290.1] [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] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 07/06/2020] [Indexed: 11/03/2022]
Abstract
his study was carried out to detect and characterize Coxiella burnetii in ruminant milk samples and in different tick species from seropositive farms in four Lebanese regions. Milk and tick samples were screened for C. burnetii presence by quantitative real-time PCR (qPCR) targeting IS1111 region followed by multispacer sequence typing (MST). The overall positive percentages of 9.6% (27/282) and 95.45% (84/88) for C. burnetii were recorded in ruminant milk and tick samples, respectively. In detail, the C. burnetii DNA was recorded in 52/54 (96.3%) of Rhipicephalus annulatus, 20/21 (95.24%) of Rhipicephalus turanicus, 6/6 (100%) of Hyalomma anatolicum, 5/6 (83.3%) of Rhipicephalus sanguineus and 1/1 of Rhipicephalus bursa. After genotyping of some IS1111-positive samples (17/111), different MST genotypes were identified. Out of 15 positive ticks, 10 were infected with MST2 genotype, 4 were infected with MST7 genotype and 1 was infected with MST57. Moreover, genotypes MST20 and MST58 were found in one cow and one goat milk samples, respectively. The present study confirmed the high genetic diversity of C. burnetii in Lebanon.
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Affiliation(s)
| | - Grazia Greco
- Faculty of Veterinary Medicine, University of Bari, Bari, Italy.
| | - Valeria Blanda
- Istituto Zooprofilattico Sperimentale della Sicilia "A. Mirri", Italy.
| | - Maria Tempesta
- Faculty of Veterinary Medicine, University of Bari, Bari, Italy.
| | - Ali Bayan
- Lebanese University, Faculty of Sciences, Section I, Hadath, Lebanon.
| | - Alessandra Torina
- Istituto Zooprofilattico Sperimentale della Sicilia "A. Mirri", Italy.
| | - Gesualdo Vesco
- Istituto Zooprofilattico Sperimentale della Sicilia "A. Mirri", Italy.
| | | | - Rossella Lelli
- Istituto Zooprofilattico Sperimentale dell' Abruzzo e del Molise, Teramo, Italy.
| | - Mohamad Ezzedine
- 2Lebanese University, Doctoral School of sciences and Technology, Beirut, Lebanon.
| | - Hussein Mortada
- Lebanese University, Faculty of Agriculture, Beirut, Lebanon.
| | - Didier Raoult
- URMITE, UM 63, CNRS 7278, IRD 198, Inserm 1095, Aix-Marseille University, Marseille, France.
| | - Pierre Edouard Fournier
- URMITE, UM 63, CNRS 7278, IRD 198, Inserm 1095, Aix-Marseille University, Marseille, France.
| | - Mohamad Mortada
- Lebanese University, Doctoral School of sciences and Technology, Beirut, Lebanon.
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Bindi E, Torino G, Noviello C, Simonini A, Torre M, D'Agostino R, Cobellis G. Recurrent tracheoesophageal fistula secondary to clips migration after thoracoscopic esophageal atresia repair. Journal of Pediatric Surgery Case Reports 2020. [DOI: 10.1016/j.epsc.2020.101651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Tarantino V, Savaia V, D'Agostino R, Silvestri M, Passali FM, Di Girolamo S, Ciprandi G. Bacteriotherapy in children with recurrent upper respiratory tract infections. Eur Rev Med Pharmacol Sci 2020; 23:39-43. [PMID: 30920639 DOI: 10.26355/eurrev_201903_17347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Children with recurrent upper-airway infections (UI) represent a social issue for their economic burden and negative impact on families. Bacteriotherapy is a new therapeutic strategy that could potentially prevent infections. The current study tested the hypothesis that recurrent UI may be prevented by bacteriotherapy. PATIENTS AND METHODS This open study was conducted in an outpatient clinic, enrolling 80 children (40 males, mean age 5.26±2.52 years) suffering from recurrent UI. Children were treated with a nasal spray containing Streptococcus salivarius 24SMB and Streptococcus oralis 89a, 2 puffs per nostril twice a day for a week; this course was repeated for 3 months. The evaluated parameters were: number of UI and number of school and work absences; these outcomes were compared with those recorded in the past year. RESULTS The mean number of UI significantly diminished: from 5.98 (2.30) in the past year to 2.75 (2.43) after treatment (p<0.0001). The number of school and work absences significantly diminished (from 4.50±2.81 to 2.80±3.42 and from 2.33±2.36 to 1.48±2.16 respectively; p<0.0001 for both). CONCLUSIONS This preliminary experiment suggests that bacteriotherapy using Streptococcus salivarius 24SMB and Streptococcus oralis89a nasal spray could prevent recurrent UI in children.
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Affiliation(s)
- V Tarantino
- Dipartimento Testa-Collo e Neuroscienze - IRCCS Istituto Giannina Gaslini, Genoa, Italy
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Wilson H, D'Agostino R, Lycan T, Commander S, Topaloglu U, Porosnicu M. Exploration of Next-Generation Sequencing of Tumor Tissue and Blood in Head and Neck Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.391] [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: 10/24/2022]
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Ibrahim N, McCarthy C, Shrestha S, Lyass A, Li Y, Gaggin H, Simon M, Massaro J, D'Agostino R, Garasic J, Van Kimmenade RRJ, Januzzi J. P2712Blood kidney injury molecule-1 predicts short and longer-term kidney outcomes in patients undergoing diagnostic coronary and/or peripheral angiography - results from the CASABLANCA study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2712] [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: 11/12/2022] Open
Affiliation(s)
- N Ibrahim
- Massachusetts General Hospital, Cardiology, Boston, United States of America
| | - C McCarthy
- Massachusetts General Hospital, Cardiology, Boston, United States of America
| | - S Shrestha
- Massachusetts General Hospital, Cardiology, Boston, United States of America
| | - A Lyass
- Baim Institute for Clinical Research, Boston, United States of America
| | - Y Li
- Baim Institute for Clinical Research, Boston, United States of America
| | - H Gaggin
- Massachusetts General Hospital, Cardiology, Boston, United States of America
| | - M Simon
- Massachusetts General Hospital, Cardiology, Boston, United States of America
| | - J Massaro
- Boston University, Department of Biostatistics, Boston, United States of America
| | - R D'Agostino
- Baim Institute for Clinical Research, Boston, United States of America
| | - J Garasic
- Massachusetts General Hospital, Cardiology, Boston, United States of America
| | | | - J Januzzi
- Massachusetts General Hospital, Cardiology, Boston, United States of America
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Gnatiuc L, Herrington WG, Halsey J, Tuomilehto J, Fang X, Kim HC, De Bacquer D, Dobson AJ, Criqui MH, Jacobs DR, Leon DA, Peters SAE, Ueshima H, Sherliker P, Peto R, Collins R, Huxley RR, Emberson JR, Woodward M, Lewington S, Aoki N, Arima H, Arnesen E, Aromaa A, Assmann G, Bachman DL, Baigent C, Bartholomew H, Benetos A, Bengtsson C, Bennett D, Björkelund C, Blackburn H, Bonaa K, Boyle E, Broadhurst R, Carstensen J, Chambless L, Chen Z, Chew SK, Clarke R, Cox C, Curb JD, D'Agostino R, Date C, Davey Smith G, De Backer G, Dhaliwal SS, Duan XF, Ducimetiere P, Duffy S, Eliassen H, Elwood P, Empana J, Garcia-Palmieri MH, Gazes P, Giles GG, Gillis C, Goldbourt U, Gu DF, Guasch-Ferre M, Guize L, Haheim L, Hart C, Hashimoto S, Hashimoto T, Heng D, Hjermann I, Ho SC, Hobbs M, Hole D, Holme I, Horibe H, Hozawa A, Hu F, Hughes K, Iida M, Imai K, Imai Y, Iso H, Jackson R, Jamrozik K, Jee SH, Jensen G, Jiang CQ, Johansen NB, Jorgensen T, Jousilahti P, Kagaya M, Keil J, Keller J, Kim IS, Kita Y, Kitamura A, Kiyohara Y, Knekt P, Knuiman M, Kornitzer M, Kromhout D, Kronmal R, Lam TH, Law M, Lee J, Leren P, Levy D, Li YH, Lissner L, Luepker R, Luszcz M, MacMahon S, Maegawa H, Marmot M, Matsutani Y, Meade T, Morris J, Morris R, Murayama T, Naito Y, Nakachi K, Nakamura M, Nakayama T, Neaton J, Nietert PJ, Nishimoto Y, Norton R, Nozaki A, Ohkubo T, Okayama A, Pan WH, Puska P, Qizilbash N, Reunanen A, Rimm E, Rodgers A, Saitoh S, Sakata K, Sato S, Schnohr P, Schulte H, Selmer R, Sharp D, Shifu X, Shimamoto K, Shipley M, Silbershatz H, Sorlie P, Sritara P, Suh I, Sutherland SE, Sweetnam P, Tamakoshi A, Tanaka H, Thomsen T, Tominaga S, Tomita M, Törnberg S, Tunstall-Pedoe H, Tverdal A, Ueshima H, Vartiainen E, Wald N, Wannamethee SG, Welborn TA, Whincup P, Whitlock G, Willett W, Woo J, Wu ZL, Yao SX, Yarnell J, Yokoyama T, Yoshiike N, Zhang XH. Sex-specific relevance of diabetes to occlusive vascular and other mortality: a collaborative meta-analysis of individual data from 980 793 adults from 68 prospective studies. Lancet Diabetes Endocrinol 2018; 6:538-546. [PMID: 29752194 PMCID: PMC6008496 DOI: 10.1016/s2213-8587(18)30079-2] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/20/2018] [Accepted: 02/26/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Several studies have shown that diabetes confers a higher relative risk of vascular mortality among women than among men, but whether this increased relative risk in women exists across age groups and within defined levels of other risk factors is uncertain. We aimed to determine whether differences in established risk factors, such as blood pressure, BMI, smoking, and cholesterol, explain the higher relative risks of vascular mortality among women than among men. METHODS In our meta-analysis, we obtained individual participant-level data from studies included in the Prospective Studies Collaboration and the Asia Pacific Cohort Studies Collaboration that had obtained baseline information on age, sex, diabetes, total cholesterol, blood pressure, tobacco use, height, and weight. Data on causes of death were obtained from medical death certificates. We used Cox regression models to assess the relevance of diabetes (any type) to occlusive vascular mortality (ischaemic heart disease, ischaemic stroke, or other atherosclerotic deaths) by age, sex, and other major vascular risk factors, and to assess whether the associations of blood pressure, total cholesterol, and body-mass index (BMI) to occlusive vascular mortality are modified by diabetes. RESULTS Individual participant-level data were analysed from 980 793 adults. During 9·8 million person-years of follow-up, among participants aged between 35 and 89 years, 19 686 (25·6%) of 76 965 deaths were attributed to occlusive vascular disease. After controlling for major vascular risk factors, diabetes roughly doubled occlusive vascular mortality risk among men (death rate ratio [RR] 2·10, 95% CI 1·97-2·24) and tripled risk among women (3·00, 2·71-3·33; χ2 test for heterogeneity p<0·0001). For both sexes combined, the occlusive vascular death RRs were higher in younger individuals (aged 35-59 years: 2·60, 2·30-2·94) than in older individuals (aged 70-89 years: 2·01, 1·85-2·19; p=0·0001 for trend across age groups), and, across age groups, the death RRs were higher among women than among men. Therefore, women aged 35-59 years had the highest death RR across all age and sex groups (5·55, 4·15-7·44). However, since underlying confounder-adjusted occlusive vascular mortality rates at any age were higher in men than in women, the adjusted absolute excess occlusive vascular mortality associated with diabetes was similar for men and women. At ages 35-59 years, the excess absolute risk was 0·05% (95% CI 0·03-0·07) per year in women compared with 0·08% (0·05-0·10) per year in men; the corresponding excess at ages 70-89 years was 1·08% (0·84-1·32) per year in women and 0·91% (0·77-1·05) per year in men. Total cholesterol, blood pressure, and BMI each showed continuous log-linear associations with occlusive vascular mortality that were similar among individuals with and without diabetes across both sexes. INTERPRETATION Independent of other major vascular risk factors, diabetes substantially increased vascular risk in both men and women. Lifestyle changes to reduce smoking and obesity and use of cost-effective drugs that target major vascular risks (eg, statins and antihypertensive drugs) are important in both men and women with diabetes, but might not reduce the relative excess risk of occlusive vascular disease in women with diabetes, which remains unexplained. FUNDING UK Medical Research Council, British Heart Foundation, Cancer Research UK, European Union BIOMED programme, and National Institute on Aging (US National Institutes of Health).
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Torina A, Blanda V, Blanda M, Auteri M, La Russa F, Scimeca S, D'Agostino R, Disclafani R, Villari S, Currò V, Caracappa S. A Geographical Information System Based Approach for Integrated Strategies of Tick Surveillance and Control in the Peri-Urban Natural Reserve of Monte Pellegrino (Palermo, Southern Italy). Int J Environ Res Public Health 2018; 15:ijerph15030404. [PMID: 29495440 PMCID: PMC5876949 DOI: 10.3390/ijerph15030404] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 02/21/2018] [Accepted: 02/21/2018] [Indexed: 01/17/2023]
Abstract
Ticks (Acari: Ixodidae) are bloodsucking arthropods involved in pathogen transmission in animals and humans. Tick activity depends on various ecological factors such as vegetation, hosts, and temperature. The aim of this study was to analyse the spatial/temporal distribution of ticks in six sites within a peri-urban area of Palermo (Natural Reserve of Monte Pellegrino) and correlate it with field data using Geographical Information System (GIS) data. A total of 3092 ticks were gathered via dragging method from June 2012 to May 2014. The species collected were: Ixodes ventalloi (46.09%), Hyalomma lusitanicum (19.99%), Rhipicephalus sanguineus (17.34%), Rhipicephalus pusillus (16.11%), Haemaphisalis sulcata (0.36%), Dermacentor marginatus (0.10%), and Rhipicephalus turanicus (0.03%). GIS analysis revealed environmental characteristics of each site, and abundance of each tick species was analysed in relation to time (monthly trend) and space (site-specific abundance). A relevant presence of I. ventalloi in site 2 and H. lusitanicum in site 5 was observed, suggesting the possible exposure of animals and humans to tick-borne pathogens. Our study shows the importance of surveillance of ticks in peri-urban areas and the useful implementation of GIS analysis in vector ecology; studies on temporal and spatial distribution of ticks correlated to GIS-based ecological analysis represent an integrated strategy for decision support in public health.
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Affiliation(s)
- Alessandra Torina
- Istituto Zooprofilattico Sperimentale della Sicilia "A.Mirri", Via G. Marinuzzi 3, 90100 Palermo, Italy.
| | - Valeria Blanda
- Istituto Zooprofilattico Sperimentale della Sicilia "A.Mirri", Via G. Marinuzzi 3, 90100 Palermo, Italy.
| | - Marcellocalogero Blanda
- Istituto Zooprofilattico Sperimentale della Sicilia "A.Mirri", Via G. Marinuzzi 3, 90100 Palermo, Italy.
| | - Michelangelo Auteri
- Istituto Zooprofilattico Sperimentale della Sicilia "A.Mirri", Via G. Marinuzzi 3, 90100 Palermo, Italy.
| | - Francesco La Russa
- Istituto Zooprofilattico Sperimentale della Sicilia "A.Mirri", Via G. Marinuzzi 3, 90100 Palermo, Italy.
| | - Salvatore Scimeca
- Istituto Zooprofilattico Sperimentale della Sicilia "A.Mirri", Via G. Marinuzzi 3, 90100 Palermo, Italy.
| | - Rosalia D'Agostino
- Istituto Zooprofilattico Sperimentale della Sicilia "A.Mirri", Via G. Marinuzzi 3, 90100 Palermo, Italy.
| | - Rosaria Disclafani
- Istituto Zooprofilattico Sperimentale della Sicilia "A.Mirri", Via G. Marinuzzi 3, 90100 Palermo, Italy.
| | - Sara Villari
- Istituto Zooprofilattico Sperimentale della Sicilia "A.Mirri", Via G. Marinuzzi 3, 90100 Palermo, Italy.
| | - Vittoria Currò
- Istituto Zooprofilattico Sperimentale della Sicilia "A.Mirri", Via G. Marinuzzi 3, 90100 Palermo, Italy.
| | - Santo Caracappa
- Istituto Zooprofilattico Sperimentale della Sicilia "A.Mirri", Via G. Marinuzzi 3, 90100 Palermo, Italy.
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Henson A, Ayala-Peacock D, Chung C, Hepel J, Chao S, Contessa J, Fiveash J, Attia A, McTyre E, Braunstein S, Page B, Shen C, Kleinberg L, Watabe K, Pasche B, D'Agostino R, Chan M. DBF 2.0: A Web-Based Predictive Model for Distant Brain Failure, Brain Metastasis Velocity, and Early Death After Radiosurgery for Brain Metastases. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.778] [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: 11/26/2022]
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Hughes R, Ahmed T, Urbanic J, D'Agostino R, Dothard A, Lally B, Ruiz J, Hinson W, Bonomi M, Rusthoven K, Petty W, Blackstock A. Results of a Phase 2 Study of Consolidative Thoracic Radiotherapy and/or Stereotactic Body Radiotherapy for Oligometastatic NSCLC. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.525] [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: 11/16/2022]
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16
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Blanda V, Torina A, La Russa F, D'Agostino R, Randazzo K, Scimeca S, Giudice E, Caracappa S, Cascio A, de la Fuente J. A retrospective study of the characterization of Rickettsia species in ticks collected from humans. Ticks Tick Borne Dis 2017; 8:610-614. [PMID: 28457821 DOI: 10.1016/j.ttbdis.2017.04.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 04/10/2017] [Accepted: 04/10/2017] [Indexed: 11/19/2022]
Abstract
Rickettsiae (family Rickettsiaceae, order Rickettsiales) are obligate intracellular bacteria transmitted by arthropod vectors. Several Rickettsia species causing vector-borne rickettsioses belong to the spotted fever group (SFG). Traditionally, Rickettsia conorii has been considered as the main etiologic agent of Mediterranean spotted fever. However, the molecular characterization of rickettsiae allowed identifying other species involved in spotted fever in the Mediterranean region. In this study, 42 ticks collected from humans were subjected to morphological identification and molecular characterization of Rickettsia species potentially involved in human rickettsiosis in Sicily. Fourteen ticks positive to at least two Rickettsia spp. molecular markers were used in the study. Identified Rickettsia spp. included R. conorii, found in Rhipicephalus sanguineus sensu lato and Rhipicephalus turanicus, Rickettsia aeschlimannii found in Hyalomma marginatum, Hyalomma lusitanicum, Dermacentor marginatus and Ixodes ricinus, Rickettsia massiliae found in R. turanicus and R. sanguineus s.l., and Rickettsia slovaca found in D. marginatus and R. sanguineus s.l. Our results showed a great variety of zoonotic Rickettsia spp. in ticks collected from humans in Sicily. The Rickettsia spp. reported in this study were identified in previously recognized or new potential tick vectors in Europe, highlighting the risk of infection by different Rickettsia spp. for humans bitten by ticks in Sicily.
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Affiliation(s)
- Valeria Blanda
- Istituto Zooprofilattico Sperimentale della Sicilia, Via Gino Marinuzzi 3, 90129 Palermo, Italy.
| | - Alessandra Torina
- Istituto Zooprofilattico Sperimentale della Sicilia, Via Gino Marinuzzi 3, 90129 Palermo, Italy.
| | - Francesco La Russa
- Istituto Zooprofilattico Sperimentale della Sicilia, Via Gino Marinuzzi 3, 90129 Palermo, Italy.
| | - Rosalia D'Agostino
- Istituto Zooprofilattico Sperimentale della Sicilia, Via Gino Marinuzzi 3, 90129 Palermo, Italy.
| | - Kety Randazzo
- Istituto Zooprofilattico Sperimentale della Sicilia, Via Gino Marinuzzi 3, 90129 Palermo, Italy.
| | - Salvatore Scimeca
- Istituto Zooprofilattico Sperimentale della Sicilia, Via Gino Marinuzzi 3, 90129 Palermo, Italy.
| | - Elisabetta Giudice
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale Ferdinando Stagno d'Alcontres 31, 98166 S. Agata-Messina, Italy.
| | - Santo Caracappa
- Istituto Zooprofilattico Sperimentale della Sicilia, Via Gino Marinuzzi 3, 90129 Palermo, Italy.
| | - Antonio Cascio
- Department of Health Promotion Sciences and Mother and Child Care "G. D'Alessandro", University of Palermo, Via del Vespro, 129 - 90127 Palermo, Italy.
| | - José de la Fuente
- SaBio. Instituto de Investigación en Recursos Cinegéticos, IREC (CSIC, UCLM, JCCM), Ronda de Toledo s/n, 13005 Ciudad Real, Spain; Department of Veterinary Pathobiology, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK 74078, USA.
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Torina A, Cordaro A, Blanda V, D'Agostino R, Scimeca S, Scariano ME, Sireci G, Lelli R. A promising new ELISA diagnostic test for cattle babesiosis based on Babesia bigemina Apical Membrane Antigen-1. Vet Ital 2017; 52:63-9. [PMID: 27033532 DOI: 10.12834/vetit.74.237.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Babesiosis due to Babesia bigemina is a relevant tick-borne disease, affecting cattle worldwide. Many surface proteins of the pathogen including the Apical Membrane Antigen 1 (AMA-1) - have been analysed for vaccine and diagnostic purposes. This study focused on B. bigemina AMA-1 and on its use for the assessment of diagnostic tests. After bioinformatic analyses, AMA-1 codifying region was amplified and cloned into an expression vector used to induce protein synthesis in Escherichia coli cells. AMA-1 was purified by affinity chromatography and used to set up the best condition for an ELISA protocol. Bovine field sera positive to B. bigemina were used to evaluate the presence of anti-AMA-1 antibodies. In order to verify the assay specificity, sera positive to Babesia bovis or to the piroplasm Theileria annulata were also included. Significant differences were obtained between sera negative to both B. bigemina and B. bovis and samples positive to B. bigemina, to B. bovis or to both pathogens. No significant reaction was observed with T. annulata positive sera. The results showed that AMA-1 protein is suitable to be used as antigen in diagnostic assays for babesiosis diagnosis in cattle, as it does not show any cross reaction with anti-T. annulata antibodies.
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Affiliation(s)
- Alessandra Torina
- Istituto Zoopro lattico Sperimentale della Sicilia, Via G. Marinuzzi 3, 90129 Palermo, Italy
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Borg H, Lang W, D'Agostino R, Young S, Lawrence J, Pihoker C, Kim G, Wadwa P, Tamborlane W, Mayer-Davis E. Association of insulin sensitivity (IS) with age at menarche (AAM) in girls with type 1 diabetes (T1D): search for diabetes in youth study. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Torina A, Blanda V, Antoci F, Scimeca S, D'Agostino R, Scariano E, Piazza A, Galluzzo P, Giudice E, Caracappa S. A Molecular survey of Anaplasma spp., Rickettsia spp., Ehrlichia canis and Babesia microti in foxes and fleas from Sicily. Transbound Emerg Dis 2014; 60 Suppl 2:125-30. [PMID: 24589112 DOI: 10.1111/tbed.12137] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Fleas (Insecta: Siphonaptera) are obligate bloodsucking insects, which parasitize birds and mammals, and are distributed throughout the world. Several species have been implicated in pathogen transmission. This study aimed to monitor red foxes and the fleas isolated from them in the Palermo and Ragusa provinces of Sicily, Italy, as these organisms are potential reservoirs and vectors of pathogens. Thirteen foxes (Vulpes vulpes) and 110 fleas were analysed by polymerase chain reaction (PCR) to detect DNA of the pathogens Ehrlichia canis, Babesia microti, Rickettsia spp., Anaplasma phagocytophilum, Anaplasma platys, Anaplasma marginale and Anaplasma ovis. In the foxes, A. ovis was detected in only one animal, whereas the prevalence of the E. canis pathogen was 31%. B. microti and Rickettsia spp. were not detected. Of all of the collected fleas, 75 belonged to the species Xenopsylla cheopis, 32 belonged to Ctenocephalides canis, two belonged to Ctenocephalides felis and one belonged to Cediopsylla inaequalis. In the fleas, the following pathogens were found: A. ovis (prevalence 25%), A. marginale (1%), A. phagocytophilum (1%), Rickettsia felis (2%) and E. canis (3%). X. cheopis was the flea species most frequently infected with Anaplasma, in particular A. ovis (33%), A. marginale (1%) and A. phagocytophilum (1%). Both C. felis exemplars were positive for R. felis. E. canis was found in the lone C. inaequalis and also in 3% of the X. cheopis specimens. No fleas were positive for B. microti or A. platys. As foxes often live in proximity to domestic areas, they may constitute potential reservoirs for human and animal parasites. Further studies should be performed on fleas to determine their vectorial capacity.
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Affiliation(s)
- A Torina
- Istituto Zooprofilattico Sperimentale della Sicilia "A. Mirri", Palermo, Italy; Facoltà di Medicina Veterinaria, Università degli Studi di Messina, polo universitario dell'Annunziata, Messina, Italy
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Margheri G, D'Agostino R, Trigari S, Sottini S, Del Rosso M. The β-subunit of cholera toxin has a high affinity for ganglioside GM1 embedded into solid supported lipid membranes with a lipid raft-like composition. Lipids 2014; 49:203-6. [PMID: 24122042 DOI: 10.1007/s11745-013-3845-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 09/13/2013] [Indexed: 10/26/2022]
Abstract
In this communication, we report on the fabrication of GM1-rich solid-supported bilayer lipid membranes (ssBLM) made of sphingomyelin and cholesterol, the main components of lipid rafts,which are the physiological hosting microenvironment of GM1 on the cell membrane. The functionality of the ganglioside has been checked by measuring the apparent dissociation constant K(D) of the complex formed by the β-subunit of the cholera toxin and GM1. The value found deviates less than one order of magnitude from that measured for in vivo cells, indicating the potential of these ssBLM as optimized in vitro biomimetic platforms.
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Chiesa S, Caorsi R, Penco F, Bertoni A, Borghini S, Sementa A, Omenetti A, Bellora F, D'Agostino R, Martini A, Gattorno M. OR5-001 – Characterization of tonsil infiltration in PFAPA. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952809 DOI: 10.1186/1546-0096-11-s1-a94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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22
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Dabelea D, Mayer-Davis EJ, Andrews JS, Dolan LM, Pihoker C, Hamman RF, Greenbaum C, Marcovina S, Fujimoto W, Linder B, Imperatore G, D'Agostino R. Clinical evolution of beta cell function in youth with diabetes: the SEARCH for Diabetes in Youth study. Diabetologia 2012; 55:3359-68. [PMID: 22990715 PMCID: PMC4492685 DOI: 10.1007/s00125-012-2719-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 08/17/2012] [Indexed: 01/12/2023]
Abstract
AIMS/HYPOTHESIS Few studies have explored the epidemiology of beta cell loss in youth with diabetes. This report describes the evolution and major determinants of beta cell function, assessed by fasting C-peptide (FCP), in the SEARCH for Diabetes in Youth study. METHODS Participants were 1,277 youth with diabetes (948 positive for diabetes autoantibodies [DAs] and 329 negative for DAs), diagnosed when aged <20 years, who were followed from a median of 8 months post diagnosis, for approximately 30 months. We modelled the relationship between rate of change in log FCP and determinants of interest using repeated measures general linear models. RESULTS Among DA-positive youth, there was a progressive decline in beta cell function of 4% per month, independent of demographics (age, sex, race/ethnicity), genetic susceptibility to autoimmunity (HLA risk), HbA(1c) and BMI z score, or presence of insulin resistance. Among DA-negative youth, there was marked heterogeneity in beta cell loss, reflecting an aetiologically mixed group. This group likely includes youths with undetected autoimmunity (whose decline is similar to that of DA-positive youth) and youth with non-autoimmune, insulin-resistant diabetes, with limited decline (~0.7% per month). CONCLUSIONS/INTERPRETATION SEARCH provides unique estimates of beta cell function decline in a large sample of youth with diabetes, indicating that autoimmunity is the major contributor. These data contribute to a better understanding of clinical evolution of beta cell function in youth with diabetes, provide strong support for the aetiological classification of diabetes type and may inform tertiary prevention efforts targeted at high-risk groups.
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Affiliation(s)
- D Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, 13001 East 17th Ave, Aurora, CO 80045, USA.
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Torina A, Agnone A, Blanda V, Alongi A, D'Agostino R, Caracappa S, Marino AMF, Di Marco V, de la Fuente J. Development and validation of two PCR tests for the detection of and differentiation between Anaplasma ovis and Anaplasma marginale. Ticks Tick Borne Dis 2012. [PMID: 23182548 DOI: 10.1016/j.ttbdis.2012.10.033] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Anaplasma ovis and Anaplasma marginale are tick-transmitted bacteria that cause anaplasmosis in domestic and wild animals. Recent results show that some domestic and wild animals and ticks are susceptible to both A. ovis and A. marginale, thus supporting the need to differentiate between these species in hosts and ticks diagnosed with Anaplasma infection. However, although anaplasmosis is one of the most common diseases of grazing animals worldwide, rapid and effective tests are not available for the detection of and discrimination between these 2 Anaplasma species. The objective of this research was to develop an easy and reliable method to identify and discriminate between the closely related pathogens A. ovis and A. marginale. A. ovis and A. marginale major surface protein 4 (msp4) gene sequences were retrieved from different geographic strains and aligned to design 2 sets of primers in a region with significant differences between the 2 species, but completely conserved among strains. PCR reactions using these primers were 100% species-specific and detected all strains from each pathogen previously identified with other methods. The 2 sets of primers designed for the specific PCR amplification of A. ovis and A. marginale allow easy-to-detect and discriminate between the 2 pathogens, thus avoiding the time-consuming sequencing or multi-gene amplification procedures. This PCR provides a tool for the detection of A. ovis and A. marginale in ticks and in wildlife and domestic hosts.
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Affiliation(s)
- Alessandra Torina
- Istituto Zooprofilattico Sperimentale della Sicilia, Via Gino Marinuzzi, n. 3, 90123 Palermo, Italy.
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Naik S, D'Agostino R, Lamar Z, Graham R, Vatca M, Agnew E, Higgins A, Levitan D, Hurd D. Outcomes of Second Transplants for Disease Recurrence or for Myelodysplasia (MDS) Developing After an Initial Transplant (Tx). Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gristina R, Nardulli M, Sardella E, Intranuovo F, Salama R, Pignatelli D, Pistillo B, Dilecce G, D'Agostino R, Favia P. Remote and Direct Plasma Processing of Cells: How to Induce a Desired Behavior. Plasma Med 2012. [DOI: 10.1615/plasmamed.2013006350] [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: 11/13/2022]
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Ciccone MM, Cortese F, Fiorella A, Scicchitano P, Cito F, Quistelli G, Pertosa G, D'Agostino R, Guida P, Favale S. The clinical role of contrast-enhanced ultrasound in the evaluation of renal artery stenosis and diagnostic superiority as compared to traditional echo-color-Doppler flow imaging. INT ANGIOL 2011; 30:135-139. [PMID: 21427650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM The purpose of this study was to investigate the feasibility of contrast-enhanced ultrasound (CEUS) in the evaluation of renal artery stenosis as compared with traditional techniques: echo color Doppler (ECD) investigation and selective angiography .CEUS is a technique based on the injection of an intravascular biocompatible tracer, namely an intravenous contrast galactose microparticle suspension containing microbubbles (Levovist), that has a similar rheology to that of red blood cells, allowing quantification of renal tissue perfusion. METHODS A population of 120 hypertensive patients (82 men, mean age 55) with a systolic abdominal murmur and/or a diagnosis of poly-districtual atherosclerosis was studied by ECD and CEUS (Levovist). Selective angiography was performed in patients with renal artery stenosis demonstrated by one of the two ultrasonographic techniques. RESULTS Forty of the 120 patients in the study population showed renal artery stenosis at one of the two ultrasound techniques: ECD identified renal artery stenosis in 33 cases and CEUS in 38. Instead, selective angiography had detected renal artery stenosis in 38 patients, the same with renal artery stenosis diagnosed by CEUS. Thus, CEUS sensitivity, specificity and accuracy were similar to those of angiography while six false negatives and two false positives were obtained with ECD. CONCLUSION Our results suggest that this renal CEUS is a promising, new, non-invasive method for screening patients with suspected renal artery stenosis. This technique appears to be superior to traditional ECD flow imaging for diagnosing renal artery stenosis and so may be an important aid in cardiovascular diagnostics.
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Affiliation(s)
- M M Ciccone
- Section of Cardiovascular Disease, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Italy.
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Dabelea D, Dolan LM, D'Agostino R, Hernandez AM, McAteer JB, Hamman RF, Mayer-Davis EJ, Marcovina S, Lawrence JM, Pihoker C, Florez JC. Association testing of TCF7L2 polymorphisms with type 2 diabetes in multi-ethnic youth. Diabetologia 2011; 54:535-9. [PMID: 21109996 PMCID: PMC3766323 DOI: 10.1007/s00125-010-1982-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Accepted: 10/25/2010] [Indexed: 10/18/2022]
Abstract
AIM/HYPOTHESIS Common variants in the transcription factor 7-like 2 (TCF7L2) gene have been associated with type 2 diabetes in adults. However, it is not known whether TCF7L2 variation increases the risk of early onset type 2 diabetes. Using a case-control design, we examined whether the reported variants [rs12255372 (T/G) and rs7903146 (T/C)] are associated with type 2 diabetes in SEARCH for Diabetes in Youth study participants. METHODS Variants were genotyped in 694 non-Hispanic white (NHW) youth (86 cases, mean age 15.5 years, mean BMI 34.8; and 608 controls, mean age 14.4 years, mean BMI 22.3) and 545 African-American (AA) youth (154 cases, mean age 15.9, mean BMI 37; and 391 controls, mean age 14.8, mean BMI 23.8). Logistic regression adjusted for age, sex, BMI and West African ancestry. RESULTS The association of the risk T allele with case/control status was different in AA and NHW youth (p = 0.025). Among AA youth, each copy of the T allele (rs7903146) was associated with a 1.97-fold (1.37, 2.82) increased odds for type 2 diabetes (p < 0.0001), after adjustment for age, sex, BMI and African ancestry. No significant association was detected in NHW youth (adjusted OR, 1.14; 0.73, 1.79). CONCLUSION/INTERPRETATION TCF7L2 variation is associated with an increased risk of early-onset type 2 diabetes among AA youth, and the association appears to be stronger in AA than NHW youth. This suggests potential different contributions of genetic and environmental factors to early-onset type 2 diabetes by race.
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Affiliation(s)
- D Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, 13001 17th Place, Aurora, CO 80045, USA.
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Naik S, Shope D, Albright C, Graham R, Levitan D, Zamkoff K, D'Agostino R, Hurd D. Transplant Outcomes in Multiple Myeloma Patients Younger Versus Older Than 60 Years of Age in the Era of Newer Targeted Agents. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.302] [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: 10/18/2022]
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Pinnix ZK, Miller LD, Wang W, D'Agostino R, Kute T, Willingham MC, Hatcher H, Tesfay L, Sui G, Di X, Torti SV, Torti FM. Ferroportin and Iron Regulation in Breast Cancer Progression and Prognosis. Sci Transl Med 2010; 2:43ra56. [DOI: 10.1126/scitranslmed.3001127] [Citation(s) in RCA: 285] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Attia A, Case LD, D'Agostino R, Lesser GJ, McMullen K, Naughton MJ, Rapp SR, Rosdhal R, Shaw EG. Phase II study of ginkgo biloba in irradiated brain tumor survivors: Effects on quality of life (QOL), mood, and cognitive function. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e12523] [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: 11/20/2022] Open
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D'Agostino R. Abstract: 108 CVD GLOBAL RISK MODELS: THE FRAMINGHAM EXPERIENCE. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70054-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jackson D, White I, Kostis JB, Wilson AC, Folsom AR, Wu K, Chambless L, Benderly M, Goldbourt U, Willeit J, Kiechl S, Yarnell JWG, Sweetnam PM, Elwood PC, Cushman M, Psaty BM, Tracy RP, Tybjaerg-Hansen A, Haverkate F, de Maat MPM, Thompson SG, Fowkes FGR, Lee AJ, Smith FB, Salomaa V, Harald K, Rasi V, Vahtera E, Jousilahti P, D'Agostino R, Kannel WB, Wilson PWF, Tofler G, Levy D, Marchioli R, Valagussa F, Rosengren A, Wilhelmsen L, Lappas G, Eriksson H, Cremer P, Nagel D, Curb JD, Rodriguez B, Yano K, Salonen JT, Nyyssönen K, Tuomainen TP, Hedblad B, Engström G, Berglund G, Loewel H, Koenig W, Hense HW, Meade TW, Cooper JA, De Stavola B, Knottenbelt C, Miller GJ, Cooper JA, Bauer KA, Rosenberg RD, Sato S, Kitamura A, Naito Y, Iso H, Salomaa V, Harald K, Rasi V, Vahtera E, Jousilahti P, Palosuo T, Ducimetiere P, Amouyel P, Arveiler D, Evans AE, Ferrieres J, Juhan-Vague I, Bingham A, Schulte H, Assmann G, Cantin B, Lamarche B, Despres JP, Dagenais GR, Tunstall-Pedoe H, Lowe GDO, Woodward M, Ben-Shlomo Y, Davey Smith G, Palmieri V, Yeh JL, Meade TW, Rudnicka A, Brennan P, Knottenbelt C, Cooper JA, Ridker P, Rodeghiero F, Tosetto A, Shepherd J, Lowe GDO, Ford I, Robertson M, Brunner E, Shipley M, Feskens EJM, Di Angelantonio E, Kaptoge S, Lewington S, Lowe GDO, Sarwar N, Thompson SG, Walker M, Watson S, White IR, Wood AM, Danesh J. Systematically missing confounders in individual participant data meta-analysis of observational cohort studies. Stat Med 2009; 28:1218-37. [PMID: 19222087 PMCID: PMC2922684 DOI: 10.1002/sim.3540] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
One difficulty in performing meta-analyses of observational cohort studies is that the availability of confounders may vary between cohorts, so that some cohorts provide fully adjusted analyses while others only provide partially adjusted analyses. Commonly, analyses of the association between an exposure and disease either are restricted to cohorts with full confounder information, or use all cohorts but do not fully adjust for confounding. We propose using a bivariate random-effects meta-analysis model to use information from all available cohorts while still adjusting for all the potential confounders. Our method uses both the fully adjusted and the partially adjusted estimated effects in the cohorts with full confounder information, together with an estimate of their within-cohort correlation. The method is applied to estimate the association between fibrinogen level and coronary heart disease incidence using data from 154 012 participants in 31 cohorts.† Copyright © 2009 John Wiley & Sons, Ltd.
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Brindle P, May M, Gill P, Cappuccio F, D'Agostino R, Fischbacher C, Ebrahim S. Primary prevention of cardiovascular disease: a web-based risk score for seven British black and minority ethnic groups. Heart 2006; 92:1595-602. [PMID: 16762981 PMCID: PMC1861244 DOI: 10.1136/hrt.2006.092346] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To recalibrate an existing Framingham risk score to produce a web-based tool for estimating the 10-year risk of coronary heart disease (CHD) and cardiovascular disease (CVD) in seven British black and minority ethnic groups. DESIGN Risk prediction models were recalibrated against survey data on ethnic group risk factors and disease prevalence compared with the general population. Ethnic- and sex-specific 10-year risks of CHD and CVD, at the means of the risk factors for each ethnic group, were calculated from the product of the incidence rate in the general population and the prevalence ratios for each ethnic group. SETTING Two community-based surveys. PARTICIPANTS 3778 men and 4544 women, aged 35-54, from the Health Surveys for England 1998 and 1999 and the Wandsworth Heart and Stroke Study. MAIN OUTCOME MEASURES 10-year risk of CHD and CVD. RESULTS 10-year risk of CHD and CVD for non-smoking people aged 50 years with a systolic blood pressure of 130 mm Hg and a total cholesterol to high density lipoprotein cholesterol ratio of 4.2 was highest in men for those of Pakistani and Bangladeshi origin (CVD risk 12.6% and 12.8%, respectively). CHD risk in men with the same risk factor values was lowest in Caribbeans (2.8%) and CVD risk was lowest in Chinese (5.4%). Women of Pakistani origin were at highest risk and Chinese women at lowest risk for both outcomes with CVD risks of 6.6% and 1.2%, respectively. A web-based risk calculator (ETHRISK) allows 10-year risks to be estimated in routine primary care settings for relevant risk factor and ethnic group combinations. CONCLUSIONS In the absence of cohort studies in the UK that include significant numbers of black and minority ethnic groups, this risk score provides a pragmatic solution to including people from diverse ethnic backgrounds in the primary prevention of CVD.
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Affiliation(s)
- P Brindle
- Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK.
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Nobile M, Cannarsi M, Altieri C, Sinigaglia M, Favia P, Iacoviello G, D'Agostino R. Effect of Ag-containing Nano-composite Active Packaging System on Survival of Alicyclobacillus acidoterrestris. J Food Sci 2006. [DOI: 10.1111/j.1365-2621.2004.tb09899.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sarkozy A, Conti E, Neri C, D'Agostino R, Digilio MC, Esposito G, Toscano A, Marino B, Pizzuti A, Dallapiccola B. Spectrum of atrial septal defects associated with mutations of NKX2.5 and GATA4 transcription factors. J Med Genet 2006; 42:e16. [PMID: 15689439 PMCID: PMC1735979 DOI: 10.1136/jmg.2004.026740] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- A Sarkozy
- CSS Hospital, IRCCS, San Giovanni Rotondo, Italy, and CSS- Mendel Institute, Rome, Italy
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Danesh J, Lewington S, Thompson SG, Lowe GDO, Collins R, Kostis JB, Wilson AC, Folsom AR, Wu K, Benderly M, Goldbourt U, Willeit J, Kiechl S, Yarnell JWG, Sweetnam PM, Elwood PC, Cushman M, Psaty BM, Tracy RP, Tybjaerg-Hansen A, Haverkate F, de Maat MPM, Fowkes FGR, Lee AJ, Smith FB, Salomaa V, Harald K, Rasi R, Vahtera E, Jousilahti P, Pekkanen J, D'Agostino R, Kannel WB, Wilson PWF, Tofler G, Arocha-Piñango CL, Rodriguez-Larralde A, Nagy E, Mijares M, Espinosa R, Rodriquez-Roa E, Ryder E, Diez-Ewald MP, Campos G, Fernandez V, Torres E, Marchioli R, Valagussa F, Rosengren A, Wilhelmsen L, Lappas G, Eriksson H, Cremer P, Nagel D, Curb JD, Rodriguez B, Yano K, Salonen JT, Nyyssönen K, Tuomainen TP, Hedblad B, Lind P, Loewel H, Koenig W, Meade TW, Cooper JA, De Stavola B, Knottenbelt C, Miller GJ, Cooper JA, Bauer KA, Rosenberg RD, Sato S, Kitamura A, Naito Y, Palosuo T, Ducimetiere P, Amouyel P, Arveiler D, Evans AE, Ferrieres J, Juhan-Vague I, Bingham A, Schulte H, Assmann G, Cantin B, Lamarche B, Després JP, Dagenais GR, Tunstall-Pedoe H, Woodward M, Ben-Shlomo Y, Davey Smith G, Palmieri V, Yeh JL, Rudnicka A, Ridker P, Rodeghiero F, Tosetto A, Shepherd J, Ford I, Robertson M, Brunner E, Shipley M, Feskens EJM, Kromhout D, Dickinson A, Ireland B, Juzwishin K, Kaptoge S, Lewington S, Memon A, Sarwar N, Walker M, Wheeler J, White I, Wood A. Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis. JAMA 2005; 294:1799-809. [PMID: 16219884 DOI: 10.1001/jama.294.14.1799] [Citation(s) in RCA: 460] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Plasma fibrinogen levels may be associated with the risk of coronary heart disease (CHD) and stroke. OBJECTIVE To assess the relationships of fibrinogen levels with risk of major vascular and with risk of nonvascular outcomes based on individual participant data. DATA SOURCES Relevant studies were identified by computer-assisted searches, hand searches of reference lists, and personal communication with relevant investigators. STUDY SELECTION All identified prospective studies were included with information available on baseline fibrinogen levels and details of subsequent major vascular morbidity and/or cause-specific mortality during at least 1 year of follow-up. Studies were excluded if they recruited participants on the basis of having had a previous history of cardiovascular disease; participants with known preexisting CHD or stroke were excluded. DATA EXTRACTION Individual records were provided on each of 154,211 participants in 31 prospective studies. During 1.38 million person-years of follow-up, there were 6944 first nonfatal myocardial infarctions or stroke events and 13,210 deaths. Cause-specific mortality was generally available. Analyses involved proportional hazards modeling with adjustment for confounding by known cardiovascular risk factors and for regression dilution bias. DATA SYNTHESIS Within each age group considered (40-59, 60-69, and > or =70 years), there was an approximately log-linear association with usual fibrinogen level for the risk of any CHD, any stroke, other vascular (eg, non-CHD, nonstroke) mortality, and nonvascular mortality. There was no evidence of a threshold within the range of usual fibrinogen level studied at any age. The age- and sex- adjusted hazard ratio per 1-g/L increase in usual fibrinogen level for CHD was 2.42 (95% confidence interval [CI], 2.24-2.60); stroke, 2.06 (95% CI, 1.83-2.33); other vascular mortality, 2.76 (95% CI, 2.28-3.35); and nonvascular mortality, 2.03 (95% CI, 1.90-2.18). The hazard ratios for CHD and stroke were reduced to about 1.8 after further adjustment for measured values of several established vascular risk factors. In a subset of 7011 participants with available C-reactive protein values, the findings for CHD were essentially unchanged following additional adjustment for C-reactive protein. The associations of fibrinogen level with CHD or stroke did not differ substantially according to sex, smoking, blood pressure, blood lipid levels, or several features of study design. CONCLUSIONS In this large individual participant meta-analysis, moderately strong associations were found between usual plasma fibrinogen level and the risks of CHD, stroke, other vascular mortality, and nonvascular mortality in a wide range of circumstances in healthy middle-aged adults. Assessment of any causal relevance of elevated fibrinogen levels to disease requires additional research.
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Tarantino V, D'Agostino R, Melagrana A, Porcu A, Stura M, Vallarino R, Calevo MG. Safety of electronic molecular resonance adenoidectomy. Int J Pediatr Otorhinolaryngol 2004; 68:1519-23. [PMID: 15533564 DOI: 10.1016/j.ijporl.2004.07.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2004] [Revised: 07/09/2004] [Accepted: 07/14/2004] [Indexed: 10/26/2022]
Abstract
Adenoidectomy is one of the most frequent operations in children. In order to reduce hospital stay costs, today, this procedure is performed as day surgery. Even though adenoidectomy is not considered risky, some minor complications may occur, the most important being bleeding (0.5-8% incidence). The surgical technique used can influence considerably postoperative pain and time to recovery. This aspect is essential in the management of day surgery patients, for whom the need of safe and rapid maneuvers associated with early recovery determines the choice of the surgical procedure. Recently, we developed a surgical technique based on the use of an electronic molecular resonance tool associated with bendable suction electrocautery. This study was carried out on 600 patients, divided into two groups, the first undergoing ablation using the molecular resonance tool and the second undergoing curette adenoidectomy. The two groups were homogeneous for age, sex, surgical indications, and grade of adenoid hypertrophy. The following parameters were considered: duration of surgery, importance of intraoperative bleeding, time to cicatrization, incidence of bleeding complications. Duration of surgery and intra- and postoperative bleeding were much lower in the first group than in the group undergoing traditional adenoidectomy. In addition, rhinopharyngeal complete cicatrization, defined as absolute absence of pseudomembrane, was much quicker in the first group, as assessed by postoperative endoscopy. Another major advantage offered by the molecular resonance tool is the accuracy of surgery performed under visual control in a practically bloodless field. To sum up, this method, thanks to its technical features and safety, is particularly indicated in children and in patients with coagulation disorders.
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Affiliation(s)
- V Tarantino
- Department of Otolaryngology, Scientific Direction, Istituto G. Gaslini, Largo Gerolamo Gaslini, 5, 16148 Genova, Italy.
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Marrugat J, D'Agostino R, Sullivan L, Elosua R, Wilson P, Ordovas J, Solanas P, Cordón F, Ramos R, Sala J, Masiá R, Kannel WB. An adaptation of the Framingham coronary heart disease risk function to European Mediterranean areas. J Epidemiol Community Health 2003; 57:634-8. [PMID: 12883073 PMCID: PMC1732543 DOI: 10.1136/jech.57.8.634] [Citation(s) in RCA: 246] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To determine whether the Framingham function accurately predicts the 10 year risk of coronary disease and to adapt this predictive method to the characteristics of a Spanish population. METHOD AND RESULTS A Framingham function for predicting 10 year coronary deaths and non-fatal myocardial infarction was applied to the population of the province of Gerona, Spain, where the cumulated incidence rate of myocardial infarction has been determined since 1988 by a specific registry. The prevalence of cardiovascular risk factors in this region of Spain was established in 1995 by a cross sectional study on a representative sample of 1748 people. The number of cases estimated by the Framingham function for 10 year coronary deaths and non-fatal myocardial infarction was compared with that observed. The Framingham function estimated 2425 coronary heart disease cases in women and 1181 were observed. In men, 9919 were estimated and 3706 were observed. Recalibrating the Framingham equations to the event rate and the prevalence of the risk factors in Gerona led to estimates very close to the number of cases observed in Gerona men and women. CONCLUSIONS The Framingham function estimates more than doubled the actual risk of coronary disease observed in north east Spain. After calibration, the Framingham function became an effective method of estimating the risk in this region with low coronary heart disease incidence.
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Affiliation(s)
- J Marrugat
- Unitat de Lipids i Epidemiologia Cardiovascular, Institut Municipal d'Investigació Médica (IMIM), Spain.
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Abstract
This retrospective study reviews our experience in the management of acute otomastoiditis over 10 years. During the study period we identified 40 cases in children aged 3 months-15 years with a peak incidence in the second year of life. Sixty per cent of them had a history of acute otitis media (AOM). All the children were already receiving oral antibiotic therapy. Otalgia, fever, poor feeding and vomiting were the most common symptoms, all the children had evidence of retroauricolar inflammation. Computerized tomography (CT) and magnetic resonance imaging (MRI) were used to support the diagnosis and to evaluate possible complications. Streptococcus pneumoniae was the most common isolated bacterium. All the patients received intravenous antibiotics, 65% of children received only medical treatment, 35% also underwent surgical intervention. Mean length of hospital stay was 12.3 days. Cholesteathoma was diagnosed in one child. We conclude from our study that acute otomastoiditis is a disease mainly affecting young children, that develops from AOM resistant to oral antibiotics. Adequate initial management always requires intravenous antibiotics, conservative surgical treatment with miryngotomy is appropriate in children not responding within 48 h from beginning of therapy. Mastoidectomy should be performed in all the patients with acute coalescent mastoiditis or in case of evidence of intracranial complications.
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Affiliation(s)
- V Tarantino
- ENT Department, Divisione di Otorinolaringoiatria, Istituto G Gaslini, Largo G Gaslini 5, Genova 16148, Italy.
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Festa A, D'Agostino R, Tracy RP, Haffner SM. C-reactive protein is more strongly related to post-glucose load glucose than to fasting glucose in non-diabetic subjects; the Insulin Resistance Atherosclerosis Study. Diabet Med 2002; 19:939-43. [PMID: 12421431 DOI: 10.1046/j.1464-5491.2002.00824.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS It has been suggested that cardiovascular disease may be more strongly related to post-challenge glycaemia than to fasting glucose concentrations. We hypothesized that subclinical inflammation, as indicated by elevated serum levels of C-reactive protein (CRP), may partially explain the association of cardiovascular disease with post-challenge glycaemia. METHODS We studied the relationship of CRP (measured with a highly sensitive immunoassay) with fasting glucose and 2-h glucose concentrations during an oral glucose tolerance test in non-diabetic subjects from the Insulin Resistance Atherosclerosis Study. RESULTS Spearman correlation analyses and multiple linear regression analyses showed a significant association of both fasting glucose and 2-h glucose concentrations with CRP levels, after adjusting for demographic covariates (age, sex, ethnicity, clinical centre; Spearman correlation coefficients: r = 0.18 for fasting glucose, r = 0.27 for 2-h glucose, both P < 0.0001). However, after additional adjustment for body mass index and waist-hip ratio only 2-h glucose (and not fasting glucose) was significantly related to CRP (r = 0.03 for fasting glucose, P = NS; r = 0.14 for 2-h glucose, P < 0.0001). Adding insulin sensitivity to the multivariate models further weakened the relationship of CRP to 2-h glucose (r = 0.07, P < 0.05). CRP mean values increased by 2-h glucose category (normal vs. impaired glucose tolerance vs. isolated post-challenge hyperglycaemia). CONCLUSIONS Chronic, subclinical inflammation, as indicated by elevated circulating CRP levels, is more strongly associated with post-challenge glycaemia than with fasting glucose levels in non-diabetic subjects. This association is partially independent of body fat and insulin resistance.
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Affiliation(s)
- A Festa
- Department of Medicine, University of Texas Health Science Center at San Antonio, TX 78228-3900, USA
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Abstract
We compared the efficacy of bithermal (BAT) and monothermal cold (MCAT) and warm (MWAT) air caloric tests in identifying labyrinthine function anomalies in the child. At first, we established confidence intervals of normality for both monothermal tests in 40 children (22 males, 18 females) aged 6-14 years, clinically healthy and normal as previously shown by BAT. Subsequently, we compared the results of BAT with those of MCAT and MWAT performed in 46 children (22 males, 24 females) aged 6-14 years, affected by multiple labyrinthine diseases. These results confirmed that, as in the adult, MCAT alone should not be used in the evaluation of labyrinthine function in vertiginous patients. As to MWAT, we obtained good sensitivity and specificity with respect to BAT (83% and 90% for 90% probability; 78% and 92.5% for 95% probability). Sensitivity values increased or decreased depending on the disease causing vertiginous symptoms, with decreased or increased number of false negatives. In our opinion, MWAT cannot replace BAT for the study of labyrinthine function in children. MWAT alone can be used when vertigo is ascribable to vestibular neuritis or to endogenous disease (dysmetabolic, dyscrasic, dysendocrine).
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Affiliation(s)
- A Melagrana
- Department of Otolaryngology, G. Gaslini Institute, Largo Gerolamo Gaslini 5, 6184, Genoa, Italy
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Mickels N, McManus C, Massaro J, Friden P, Braman V, D'Agostino R, Oppenheim F, Warbington M, Dibart S, Van Dyke T. Clinical and microbial evaluation of a histatin-containing mouthrinse in humans with experimental gingivitis. J Clin Periodontol 2001; 28:404-10. [PMID: 11350502 DOI: 10.1034/j.1600-051x.2001.028005404.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE P-113, a 12 amino acid histatin-based peptide, was evaluated in a mouthrinse formulation for safety, prevention of the development of experimental gingivitis, and for its effects on periodontal flora. METHOD 159 periodontally healthy subjects abstained from oral hygiene procedures and self-administered either 0.005%, 0.01%, 0.05% P-113 or placebo mouthrinse formulations twice daily over a four week treatment period. During this time, the safety, anti-plaque, and anti-gingivitis effects of P-113 were evaluated. RESULTS There was a significant reduction in plaque (p=0.046) and a reduction in gingivitis (p=0.086) for subjects using 0.01% P-113 mouthrinse. Significantly more subjects in the 0.01% and 0.05% treatment groups showed a small increase in plaque index of <0.25 as compared to the placebo group (p<0.05). Similar trends were noted for changes in the % of sites with bleeding on probing in the 0.01% P-113 group. There were no treatment-related adverse events, and there were no adverse shifts in supragingival microflora during the study. CONCLUSION These data suggest that P-113 mouthrinse is safe and reduces plaque, gingivitis and gingival bleeding in the human experimental gingivitis model.
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Affiliation(s)
- N Mickels
- Boston University Goldman School of Dental Medicine, MA, USA
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Islam A, Mitchel JT, Hays J, Rosen R, D'Agostino R. Challenges in conducting multicenter clinical trials in female sexual dysfunction: baseline differences between study populations. J Sex Marital Ther 2001; 27:525-530. [PMID: 11554215 DOI: 10.1080/713846823] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Female sexual dysfunction (FSD) presents several unique challenges in the design and interpretation of multicenter clinical trials. This paper discusses the issue of baseline differences between study populations, using the demographic data of a recent publication describing the validation of a new questionnaire for the evaluation of FSD.
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Affiliation(s)
- A Islam
- Target Health Inc., 305 Madison Avenue, 25th Floor, New York, NY 10165, USA.
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Festa A, D'Agostino R, Williams K, Karter AJ, Mayer-Davis EJ, Tracy RP, Haffner SM. The relation of body fat mass and distribution to markers of chronic inflammation. Int J Obes (Lond) 2001; 25:1407-15. [PMID: 11673759 DOI: 10.1038/sj.ijo.0801792] [Citation(s) in RCA: 485] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2000] [Revised: 12/06/2000] [Accepted: 01/15/2001] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To study the relation of fibrinogen and C-reactive protein (CRP) to various measures of body fat and body fat distribution and to investigate whether these relations were explained by differences in insulin sensitivity. DESIGN AND SUBJECTS Cross-sectional analysis of the IRAS (Insulin Resistance Atherosclerosis Study), a large (n=1559) tri-ethnic population (non-Hispanic whites, African-Americans and Mexican-Americans) across different states of glucose tolerance. MEASUREMENTS Glucose tolerance (oral glucose tolerance test), insulin sensitivity (frequently sampled intravenous glucose tolerance test and minimal model analysis), assessment of body fat mass and distribution (weight, girths, bioelectrical impedance), subclinical atherosclerosis (B-mode ultrasonography of carotid artery intima-media thickness, IMT), CRP (highly sensitive immunoassay), fibrinogen (standard assay). RESULTS Both CRP and fibrinogen were related to all measures of body fat. Strong correlations (correlation coefficient r > or = 0.35) were found between CRP and body mass index (BMI), waist circumference and adipose body mass, respectively. The associations were consistent in non-diabetic and type-2 diabetic subjects, were generally stronger in women, and were only moderately attenuated by the prevailing insulin sensitivity (S(I)). In a multivariate linear regression model waist circumference explained 14.5% of the variability of circulating CRP levels (P=0.0001), BMI 0.4% (P=0.0067), and S(I) 1.7% (P=0.0001). Common carotid artery IMT was related to CRP and fibrinogen in men, but not in women, and was attenuated after adjusting for BMI or waist. CONCLUSION Our findings show that measures of body fat are strongly associated with circulating levels of CRP and fibrinogen. These associations were not explained by lower S(I) in obese subjects. Chronic, subclinical inflammation may be one pathophysiological mechanism explaining the increased risk of atherosclerotic disease associated with adiposity.
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Affiliation(s)
- A Festa
- Department of Medicine, Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio, Texas, USA
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Wetzl RG, Taglione G, Ceresa F, D'Agostino R, Foresta S, Guarnerio C, Ladiana N, Megaro F, Zanesi R, De Vietro A, Pavani M. [Severe and prolonged post-dural puncture headache: from pathological basis to therapeutic role and correct timing for epidural blood patch]. Minerva Anestesiol 2001; 67:233-7. [PMID: 11778123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Believed to be due to unbalance between cerebrospinal fluid (CSF) production rate and its loss through the spinal dural puncture hole, post-dural puncture headache (PDPH) is often considered as a physiological syndrome, usually reversible without pathological sequelae after dural hole's closure. The clinical case here presented (incapacitating headache associated with diagnostic dural puncture in a leukaemic young female patient who underwent bone marrow transplantation) shows potentially fatal pathological sequelae following prolonged headache (untreated, due to the severe postransplant immunodeficiency and coagulopathy). The observed RMI lesions suggest interesting conclusions about the clinical indications and correct timing of autologous epidural blood patch (EBP). We also suggest the ways to preventing rebound intracranial hypertension following autologous epidural blood patch in patients suffering from incapacitating and prolonged headache.
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Affiliation(s)
- R G Wetzl
- Servizio Anestesia e Rianimazione, Azienda Ospedaliera Ospedale Niguarda, Ca' Granda, Milan, Italy
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Carr JJ, Danitschek JA, Goff DC, Crouse JR, D'Agostino R, Chen MY, Burke GL. Coronary artery calcium quantification with retrospectively gated helical CT: protocols and techniques. Int J Cardiovasc Imaging 2001; 17:213-20. [PMID: 11587455 DOI: 10.1023/a:1010604724001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Current generation Helical Computed Tomography, when coupled with cardiac gating can be used to measure coronary vascular calcium. In this article we review the development of retrospectively gated helical computed tomography on a single slice HCT system and its relation to electron beam CT. The impact of heart rate on selection of helical pitch for the creation of a diastolic image set is detailed, as well as, scanning and post-processing techniques are discussed. The development and initial experience of cardiac gating with multidetector CT systems is presented.
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Affiliation(s)
- J J Carr
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1088, USA.
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Bluemke DA, Stillman AE, Bis KG, Grist TM, Baum RA, D'Agostino R, Malden ES, Pierro JA, Yucel EK. Carotid MR angiography: phase II study of safety and efficacy for MS-325. Radiology 2001; 219:114-22. [PMID: 11274545 DOI: 10.1148/radiology.219.1.r01ap42114] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the safety and efficacy of MS-325 in patients suspected of having carotid arterial disease. MATERIALS AND METHODS Fifty carotid arteries in 26 patients were imaged with three-dimensional spoiled gradient-recalled-echo magnetic resonance (MR) angiography at 5 and 50 minutes after injection of MS-325. MS-325 was administered intravenously as a single dose of 0.01, 0.03, or 0.05 mmol per kilogram of body weight as determined with a dose randomization scheme for four, nine, and 13 patients, respectively. Safety, including clinical laboratory changes and electrocardiographic monitoring, was assessed until approximately 3 days after injection. Conventional contrast agent-enhanced angiography was used as the standard of reference. Independent readers blinded to the dose interpreted the MR angiographic and conventional images. Images were assessed for location and extent of carotid arterial stenosis. RESULTS There were no severe or serious adverse events. For the determination of clinically significant stenosis (>70%) on the 5-minute images, sensitivity, specificity, and accuracy (P =.07, three-way comparison) were 100%, 100%, and 100%; 63%, 100%, and 88%; and 40%, 75%, and 55% at 0.01, 0.03, and 0.05 mmol/kg, respectively. Sensitivity and specificity for images at 50 minutes after MS-325 administration showed the same trends as the 5-minute images. CONCLUSION Overall accuracy for MS-325-enhanced carotid MR angiography performed during steady-state conditions of circulating contrast agent approximately 5 minutes after injection was high (88%-100%) at 0.03 and 0.01 mmol/kg. MS-325 was well tolerated at all evaluated doses.
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Affiliation(s)
- D A Bluemke
- Department of Radiology, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287, USA.
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Abstract
Aortoesophageal fistula due to an aortic arch aneurysm is a rare entity with an extremely high mortality. There are few reports of successfully managed cases and even fewer of long term survival. We report a case of an aortoesophageal fistula resulting from a mycotic pseudoaneurysm of the distal aortic arch in a patient with melioidosis, its surgical management, and outcome.
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Affiliation(s)
- M A Patel
- Division of Cardiothoracic Surgery, Fletcher Allen Health Center Care and the University of Vermont, Burlington, USA
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Paskett ED, Rushing J, D'Agostino R, Tatum C, Velez R. Cancer screening behaviors of low-income women: the impact of race. Womens Health 2001; 3:203-26. [PMID: 9426494] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Cancer mortality rates are greater for African Americans than for whites. Reasons for this are due in part to the disproportionate number of the poor who are African American. Of particular concern are breast, cervical, and colorectal cancer, as screening exams, when used regularly, can reduce mortality. As part of an National Cancer Institute-funded study to improve breast and cervical cancer screening among low-income, predominately African American women, a survey was done to collect data on knowledge, attitudes, and practices related to breast, cervical, and colorectal cancer. A total of 300 women, African American and white residents of low-income housing communities, completed the survey. More African American women than white women had a mammogram within guidelines (52% vs. 40%), a clinical breast exam within the last year (60% vs. 56%), a Pap smear within the last 3 years (80% vs. 59%), and a Fecal Occult Blood Test within the last year (21% vs. 17%). Slightly more white women had a flexible sigmoidoscopy (FS) exam within the last 5 years (31% vs. 24%). When adjusted for age differences in the two populations, the differences in receiving regular screening exams were not statistically significant. Variables related to receiving these tests for all women included receiving regular check-ups (breast cancer); beliefs (breast and colorectal cancer screening), and knowledge (cervical cancer). Among African American women, barriers to screening were important for breast screening and regular checkups were related to Pap smear screening (odds ratio [OR] = 13.9, p < .01). High perceived risk of colorectal cancer was related to recent FS only for white women (OR = 47.9, p = .012). Women in this homogenous income group had similar rates of screening and had similar barriers to receiving recommended screening tests; thus, interventions should address beliefs and knowledge of risk targeted to all low-income women.
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Affiliation(s)
- E D Paskett
- Department of Public Health Services, Bowman Gray School of Medicine, Winston-Salem, NC 27157-1063, USA.
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