1
|
Brancato V, Esposito G, Coppola L, Cavaliere C, Mirabelli P, Scapicchio C, Borgheresi R, Neri E, Salvatore M, Aiello M. Standardizing digital biobanks: integrating imaging, genomic, and clinical data for precision medicine. J Transl Med 2024; 22:136. [PMID: 38317237 PMCID: PMC10845786 DOI: 10.1186/s12967-024-04891-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/14/2024] [Indexed: 02/07/2024] Open
Abstract
Advancements in data acquisition and computational methods are generating a large amount of heterogeneous biomedical data from diagnostic domains such as clinical imaging, pathology, and next-generation sequencing (NGS), which help characterize individual differences in patients. However, this information needs to be available and suitable to promote and support scientific research and technological development, supporting the effective adoption of the precision medicine approach in clinical practice. Digital biobanks can catalyze this process, facilitating the sharing of curated and standardized imaging data, clinical, pathological and molecular data, crucial to enable the development of a comprehensive and personalized data-driven diagnostic approach in disease management and fostering the development of computational predictive models. This work aims to frame this perspective, first by evaluating the state of standardization of individual diagnostic domains and then by identifying challenges and proposing a possible solution towards an integrative approach that can guarantee the suitability of information that can be shared through a digital biobank. Our analysis of the state of the art shows the presence and use of reference standards in biobanks and, generally, digital repositories for each specific domain. Despite this, standardization to guarantee the integration and reproducibility of the numerical descriptors generated by each domain, e.g. radiomic, pathomic and -omic features, is still an open challenge. Based on specific use cases and scenarios, an integration model, based on the JSON format, is proposed that can help address this problem. Ultimately, this work shows how, with specific standardization and promotion efforts, the digital biobank model can become an enabling technology for the comprehensive study of diseases and the effective development of data-driven technologies at the service of precision medicine.
Collapse
Affiliation(s)
| | - Giuseppina Esposito
- Bio Check Up S.R.L, 80121, Naples, Italy
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131, Naples, Italy
| | | | | | - Peppino Mirabelli
- UOS Laboratori di Ricerca e Biobanca, AORN Santobono-Pausilipon, Via Teresa Ravaschieri, 8, 80122, Naples, Italy
| | - Camilla Scapicchio
- Academic Radiology, Department of Translational Research, University of Pisa, via Roma, 67, 56126, Pisa, Italy
| | - Rita Borgheresi
- Academic Radiology, Department of Translational Research, University of Pisa, via Roma, 67, 56126, Pisa, Italy
| | - Emanuele Neri
- Academic Radiology, Department of Translational Research, University of Pisa, via Roma, 67, 56126, Pisa, Italy
| | | | | |
Collapse
|
2
|
Brancato V, Cerrone M, Garbino N, Salvatore M, Cavaliere C. Current status of magnetic resonance imaging radiomics in hepatocellular carcinoma: A quantitative review with Radiomics Quality Score. World J Gastroenterol 2024; 30:381-417. [PMID: 38313230 PMCID: PMC10835534 DOI: 10.3748/wjg.v30.i4.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/05/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Radiomics is a promising tool that may increase the value of magnetic resonance imaging (MRI) for different tasks related to the management of patients with hepatocellular carcinoma (HCC). However, its implementation in clinical practice is still far, with many issues related to the methodological quality of radiomic studies. AIM To systematically review the current status of MRI radiomic studies concerning HCC using the Radiomics Quality Score (RQS). METHODS A systematic literature search of PubMed, Google Scholar, and Web of Science databases was performed to identify original articles focusing on the use of MRI radiomics for HCC management published between 2017 and 2023. The methodological quality of radiomic studies was assessed using the RQS tool. Spearman's correlation (ρ) analysis was performed to explore if RQS was correlated with journal metrics and characteristics of the studies. The level of statistical signi-ficance was set at P < 0.05. RESULTS One hundred and twenty-seven articles were included, of which 43 focused on HCC prognosis, 39 on prediction of pathological findings, 16 on prediction of the expression of molecular markers outcomes, 18 had a diagnostic purpose, and 11 had multiple purposes. The mean RQS was 8 ± 6.22, and the corresponding percentage was 24.15% ± 15.25% (ranging from 0.0% to 58.33%). RQS was positively correlated with journal impact factor (IF; ρ = 0.36, P = 2.98 × 10-5), 5-years IF (ρ = 0.33, P = 1.56 × 10-4), number of patients included in the study (ρ = 0.51, P < 9.37 × 10-10) and number of radiomics features extracted in the study (ρ = 0.59, P < 4.59 × 10-13), and time of publication (ρ = -0.23, P < 0.0072). CONCLUSION Although MRI radiomics in HCC represents a promising tool to develop adequate personalized treatment as a noninvasive approach in HCC patients, our study revealed that studies in this field still lack the quality required to allow its introduction into clinical practice.
Collapse
Affiliation(s)
- Valentina Brancato
- Department of Information Technology, IRCCS SYNLAB SDN, Naples 80143, Italy
| | - Marco Cerrone
- Department of Radiology, IRCCS SYNLAB SDN, Naples 80143, Italy
| | - Nunzia Garbino
- Department of Radiology, IRCCS SYNLAB SDN, Naples 80143, Italy
| | - Marco Salvatore
- Department of Radiology, IRCCS SYNLAB SDN, Naples 80143, Italy
| | - Carlo Cavaliere
- Department of Radiology, IRCCS SYNLAB SDN, Naples 80143, Italy
| |
Collapse
|
3
|
Cavaliere C, Baldi D, Brancato V, Aiello M, Salvatore M. A customized anthropomorphic 3D-printed phantom to reproducibility assessment in computed tomography: an oncological case study. Front Oncol 2023; 13:1123796. [PMID: 37700836 PMCID: PMC10493384 DOI: 10.3389/fonc.2023.1123796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 08/07/2023] [Indexed: 09/14/2023] Open
Abstract
Introduction Studies on computed tomography (CT) reproducibility at different acquisition parameters have to take into account radiation dose administered and related ethical issues. 3D-printed phantoms provide the possibility to investigate these features deeply and to foster CT research, also taking advantage by outperforming new generation scanners. The aim of this study is to propose a new anthropomorphic 3D-printed phantom for chest lesions, tailored on a real patient CT scan, to investigate the variability of volume and Hounsfield Unit (HU) measurements at different CT acquisition parameters. Methods The chest CT of a 75-year-old patient with a paramediastinal lung lesion was segmented based on an eight-compartment approach related to HU ranges (air lung, lung interstitium, fat, muscle, vascular, skin, bone, and lesion). From each mask produced, the 3D.stl model was exported and linked to a different printing infill value, based on a preliminary test and HU ratios derived from the patient scan. Fused deposition modeling (FDM) technology printing was chosen with filament materials in polylactic acid (PLA). Phantom was acquired at 50 mAs and three different tube voltages of 80, 100, and 120 kVp on two different scanners, namely, Siemens Somatom Force (Siemens Healthineers, Erlangen, Germany; same setting of real patient for 80 kVp acquisition) and GE 750 HD CT (GE Healthcare, Chicago, IL). The same segmentation workflow was then applied on each phantom acquisition after coregistration pipeline, and Dice Similarity Coefficient (DSC) and HU averages were extracted and compared for each compartment. Results DSC comparison among real patient versus phantom scans at different kVp, and on both CT scanners, demonstrated a good overlap of different compartments and lesion vascularization with a higher similarity for lung and lesion masks for each setting (about 0.9 and 0.8, respectively). Although mean HU was not comparable with real data, due to the PLA material, the proportion of intensity values for each compartment remains respected. Discussion The proposed approach demonstrated the reliability of 3D-printed technology for personalized approaches in CT research, opening to the application of the same workflow to other oncological fields.
Collapse
|
4
|
Verdicchio M, Brancato V, Cavaliere C, Isgrò F, Salvatore M, Aiello M. A pathomic approach for tumor-infiltrating lymphocytes classification on breast cancer digital pathology images. Heliyon 2023; 9:e14371. [PMID: 36950640 PMCID: PMC10025040 DOI: 10.1016/j.heliyon.2023.e14371] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/03/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
Background and objectives The detection of tumor-infiltrating lymphocytes (TILs) could aid in the development of objective measures of the infiltration grade and can support decision-making in breast cancer (BC). However, manual quantification of TILs in BC histopathological whole slide images (WSI) is currently based on a visual assessment, thus resulting not standardized, not reproducible, and time-consuming for pathologists. In this work, a novel pathomic approach, aimed to apply high-throughput image feature extraction techniques to analyze the microscopic patterns in WSI, is proposed. In fact, pathomic features provide additional information concerning the underlying biological processes compared to the WSI visual interpretation, thus providing more easily interpretable and explainable results than the most frequently investigated Deep Learning based methods in the literature. Methods A dataset containing 1037 regions of interest with tissue compartments and TILs annotated on 195 TNBC and HER2+ BC hematoxylin and eosin (H&E)-stained WSI was used. After segmenting nuclei within tumor-associated stroma using a watershed-based approach, 71 pathomic features were extracted from each nucleus and reduced using a Spearman's correlation filter followed by a nonparametric Wilcoxon rank-sum test and least absolute shrinkage and selection operator. The relevant features were used to classify each candidate nucleus as either TILs or non-TILs using 5 multivariable machine learning classification models trained using 5-fold cross-validation (1) without resampling, (2) with the synthetic minority over-sampling technique and (3) with downsampling. The prediction performance of the models was assessed using ROC curves. Results 21 features were selected, with most of them related to the well-known TILs properties of having regular shape, clearer margins, high peak intensity, more homogeneous enhancement and different textural pattern than other cells. The best performance was obtained by Random-Forest with ROC AUC of 0.86, regardless of resampling technique. Conclusions The presented approach holds promise for the classification of TILs in BC H&E-stained WSI and could provide support to pathologists for a reliable, rapid and interpretable clinical assessment of TILs in BC.
Collapse
Affiliation(s)
| | - Valentina Brancato
- IRCCS SYNLAB SDN, Via E. Gianturco 113, Naples, 80143, Italy
- Corresponding author.
| | - Carlo Cavaliere
- IRCCS SYNLAB SDN, Via E. Gianturco 113, Naples, 80143, Italy
| | - Francesco Isgrò
- Department of Electrical Engineering and Information Technologies, University of Naples Federico II, Claudio 21, Naples, 80125, Italy
| | - Marco Salvatore
- IRCCS SYNLAB SDN, Via E. Gianturco 113, Naples, 80143, Italy
| | - Marco Aiello
- IRCCS SYNLAB SDN, Via E. Gianturco 113, Naples, 80143, Italy
| |
Collapse
|
5
|
Valentino M, Bianco V, Miccio L, Memmolo P, Brancato V, Libretti P, Gambacorta M, Salvatore M, Ferraro P. Beyond conventional microscopy: Observing kidney tissues by means of fourier ptychography. Front Physiol 2023; 14:1120099. [PMID: 36860516 PMCID: PMC9968938 DOI: 10.3389/fphys.2023.1120099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/01/2023] [Indexed: 02/17/2023] Open
Abstract
Kidney microscopy is a mainstay in studying the morphological structure, physiology and pathology of kidney tissues, as histology provides important results for a reliable diagnosis. A microscopy modality providing at same time high-resolution images and a wide field of view could be very useful for analyzing the whole architecture and the functioning of the renal tissue. Recently, Fourier Ptychography (FP) has been proofed to yield images of biology samples such as tissues and in vitro cells while providing high resolution and large field of view, thus making it a unique and attractive opportunity for histopathology. Moreover, FP offers tissue imaging with high contrast assuring visualization of small desirable features, although with a stain-free mode that avoids any chemical process in histopathology. Here we report an experimental measuring campaign for creating the first comprehensive and extensive collection of images of kidney tissues captured by this FP microscope. We show that FP microscopy unlocks a new opportunity for the physicians to observe and judge renal tissue slides through the novel FP quantitative phase-contrast microscopy. Phase-contrast images of kidney tissue are analyzed by comparing them with the corresponding renal images taken under a conventional bright-field microscope both for stained and unstained tissue samples of different thicknesses. In depth discussion on the advantages and limitations of this new stain-free microscopy modality is reported, showing its usefulness over the classical light microscopy and opening a potential route for using FP in clinical practice for histopathology of kidney.
Collapse
Affiliation(s)
- Marika Valentino
- National Research Council (CNR) of Italy, Institute of Applied Sciences and Intelligent Systems (ISASI), Pozzuoli, Italy,Department of Electric and Information Technologies Engineering, University of Naples “Federico II”, Naples, Italy
| | - Vittorio Bianco
- National Research Council (CNR) of Italy, Institute of Applied Sciences and Intelligent Systems (ISASI), Pozzuoli, Italy,*Correspondence: Vittorio Bianco, ; Marcello Gambacorta,
| | - Lisa Miccio
- National Research Council (CNR) of Italy, Institute of Applied Sciences and Intelligent Systems (ISASI), Pozzuoli, Italy
| | - Pasquale Memmolo
- National Research Council (CNR) of Italy, Institute of Applied Sciences and Intelligent Systems (ISASI), Pozzuoli, Italy
| | | | | | - Marcello Gambacorta
- IRCCS SYNLAB SDN, Naples, Italy,*Correspondence: Vittorio Bianco, ; Marcello Gambacorta,
| | | | - Pietro Ferraro
- National Research Council (CNR) of Italy, Institute of Applied Sciences and Intelligent Systems (ISASI), Pozzuoli, Italy
| |
Collapse
|
6
|
Brancato V, Brancati N, Esposito G, La Rosa M, Cavaliere C, Allarà C, Romeo V, De Pietro G, Salvatore M, Aiello M, Sangiovanni M. A Two-Step Feature Selection Radiomic Approach to Predict Molecular Outcomes in Breast Cancer. Sensors (Basel) 2023; 23:1552. [PMID: 36772592 PMCID: PMC9921618 DOI: 10.3390/s23031552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/13/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Breast Cancer (BC) is the most common cancer among women worldwide and is characterized by intra- and inter-tumor heterogeneity that strongly contributes towards its poor prognosis. The Estrogen Receptor (ER), Progesterone Receptor (PR), Human Epidermal Growth Factor Receptor 2 (HER2), and Ki67 antigen are the most examined markers depicting BC heterogeneity and have been shown to have a strong impact on BC prognosis. Radiomics can noninvasively predict BC heterogeneity through the quantitative evaluation of medical images, such as Magnetic Resonance Imaging (MRI), which has become increasingly important in the detection and characterization of BC. However, the lack of comprehensive BC datasets in terms of molecular outcomes and MRI modalities, and the absence of a general methodology to build and compare feature selection approaches and predictive models, limit the routine use of radiomics in the BC clinical practice. In this work, a new radiomic approach based on a two-step feature selection process was proposed to build predictors for ER, PR, HER2, and Ki67 markers. An in-house dataset was used, containing 92 multiparametric MRIs of patients with histologically proven BC and all four relevant biomarkers available. Thousands of radiomic features were extracted from post-contrast and subtracted Dynamic Contrast-Enanched (DCE) MRI images, Apparent Diffusion Coefficient (ADC) maps, and T2-weighted (T2) images. The two-step feature selection approach was used to identify significant radiomic features properly and then to build the final prediction models. They showed remarkable results in terms of F1-score for all the biomarkers: 84%, 63%, 90%, and 72% for ER, HER2, Ki67, and PR, respectively. When possible, the models were validated on the TCGA/TCIA Breast Cancer dataset, returning promising results (F1-score = 88% for the ER+/ER- classification task). The developed approach efficiently characterized BC heterogeneity according to the examined molecular biomarkers.
Collapse
Affiliation(s)
- Valentina Brancato
- IRCCS SYNLAB SDN, Istituto di Ricerca Diagnostica e Nucleare, Via E. Gianturco 113, 80143 Naples, Italy
| | - Nadia Brancati
- Institute for High Performance Computing and Networking, National Research Council of Italy (ICAR-CNR), Via P. Castellino 111, 80131 Naples, Italy
| | - Giusy Esposito
- Bio Check Up S.r.l., Via Riviera di Chiaia 9a, 80122 Naples, Italy
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Massimo La Rosa
- Institute for High Performance Computing and Networking, National Research Council of Italy (ICAR-CNR), Via P. Castellino 111, 80131 Naples, Italy
| | - Carlo Cavaliere
- IRCCS SYNLAB SDN, Istituto di Ricerca Diagnostica e Nucleare, Via E. Gianturco 113, 80143 Naples, Italy
| | - Ciro Allarà
- Bio Check Up S.r.l., Via Riviera di Chiaia 9a, 80122 Naples, Italy
| | - Valeria Romeo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Giuseppe De Pietro
- Institute for High Performance Computing and Networking, National Research Council of Italy (ICAR-CNR), Via P. Castellino 111, 80131 Naples, Italy
| | - Marco Salvatore
- IRCCS SYNLAB SDN, Istituto di Ricerca Diagnostica e Nucleare, Via E. Gianturco 113, 80143 Naples, Italy
| | - Marco Aiello
- IRCCS SYNLAB SDN, Istituto di Ricerca Diagnostica e Nucleare, Via E. Gianturco 113, 80143 Naples, Italy
| | - Mara Sangiovanni
- Institute for High Performance Computing and Networking, National Research Council of Italy (ICAR-CNR), Via P. Castellino 111, 80131 Naples, Italy
| |
Collapse
|
7
|
Brancato V, Cavaliere C, Garbino N, Isgrò F, Salvatore M, Aiello M. The relationship between radiomics and pathomics in Glioblastoma patients: Preliminary results from a cross-scale association study. Front Oncol 2022; 12:1005805. [PMID: 36276163 PMCID: PMC9582951 DOI: 10.3389/fonc.2022.1005805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/21/2022] [Indexed: 12/01/2022] Open
Abstract
Glioblastoma multiforme (GBM) typically exhibits substantial intratumoral heterogeneity at both microscopic and radiological resolution scales. Diffusion Weighted Imaging (DWI) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) are two functional MRI techniques that are commonly employed in clinic for the assessment of GBM tumor characteristics. This work presents initial results aiming at determining if radiomics features extracted from preoperative ADC maps and post-contrast T1 (T1C) images are associated with pathomic features arising from H&E digitized pathology images. 48 patients from the public available CPTAC-GBM database, for which both radiology and pathology images were available, were involved in the study. 91 radiomics features were extracted from ADC maps and post-contrast T1 images using PyRadiomics. 65 pathomic features were extracted from cell detection measurements from H&E images. Moreover, 91 features were extracted from cell density maps of H&E images at four different resolutions. Radiopathomic associations were evaluated by means of Spearman's correlation (ρ) and factor analysis. p values were adjusted for multiple correlations by using a false discovery rate adjustment. Significant cross-scale associations were identified between pathomics and ADC, both considering features (n = 186, 0.45 < ρ < 0.74 in absolute value) and factors (n = 5, 0.48 < ρ < 0.54 in absolute value). Significant but fewer ρ values were found concerning the association between pathomics and radiomics features (n = 53, 0.5 < ρ < 0.65 in absolute value) and factors (n = 2, ρ = 0.63 and ρ = 0.53 in absolute value). The results of this study suggest that cross-scale associations may exist between digital pathology and ADC and T1C imaging. This can be useful not only to improve the knowledge concerning GBM intratumoral heterogeneity, but also to strengthen the role of radiomics approach and its validation in clinical practice as "virtual biopsy", introducing new insights for omics integration toward a personalized medicine approach.
Collapse
Affiliation(s)
| | | | | | - Francesco Isgrò
- Department of Electrical Engineering and Information Technologies, University of Napoli Federico II, Napoli, Italy
| | | | | |
Collapse
|
8
|
Della Pepa G, Brancato V, Costabile G, Salamone D, Corrado A, Vitale M, Cavaliere C, Mancini M, Salvatore M, Luongo D, Riccardi G, Rivellese AA, Annuzzi G, Bozzetto L. An Isoenergetic Multifactorial Diet Reduces Pancreatic Fat and Increases Postprandial Insulin Response in Patients With Type 2 Diabetes: A Randomized Controlled Trial. Diabetes Care 2022; 45:1935-1942. [PMID: 35862001 DOI: 10.2337/dc22-0605] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 06/12/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To compare the effect of an isocaloric multifactorial diet with a diet rich in monounsaturated fatty acids (MUFA) and similar macronutrient composition on pancreatic fat (PF) and postprandial insulin response in type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS According to a randomized controlled parallel-group design, 39 individuals with T2D, 35-75 years old, in satisfactory blood glucose control, were assigned to an 8 week isocaloric intervention with a multifactorial diet rich in MUFA, polyunsaturated fatty acids, fiber, polyphenols, and vitamins (n = 18) or a MUFA-rich diet (n = 21). Before/after the intervention, PF content was measured by the proton-density fat fraction using a three-dimensional mDIXON MRI sequence, and plasma insulin and glucose concentrations were measured over a 4 h test meal with a similar composition as the assigned diet. RESULTS After 8 weeks, PF significantly decreased after the multifactorial diet (from 15.7 ± 6.5% to 14.1 ± 6.3%; P = 0.024), while it did not change after the MUFA diet (from 17.1 ± 10.1% to 18.6 ± 10.6%; P = 0.139) with a significant difference between diets (P = 0.014). Postprandial glucose response was similar in the two groups. Early postprandial insulin response (incremental postprandial areas under the curve [iAUC0-120]) significantly increased with the multifactorial diet (from 36,340 ± 34,954 to 44,138 ± 31,878 pmol/L/min; P = 0.037), while it did not change significantly in the MUFA diet (from 31,754 ± 18,446 to 26,976 ± 12,265 pmol/L/min; P = 0.178), with a significant difference between diets (P = 0.023). Changes in PF inversely correlated with changes in early postprandial insulin response (r = -0.383; P = 0.023). CONCLUSIONS In patients with T2D, an isocaloric multifactorial diet, including several beneficial dietary components, markedly reduced PF. This reduction was associated with an improved postprandial insulin response.
Collapse
Affiliation(s)
- Giuseppe Della Pepa
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | | | - Giuseppina Costabile
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.,Task Force on Microbiome Studies, Federico II University, Naples, Italy
| | - Dominic Salamone
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Alessandra Corrado
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Marilena Vitale
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | | | - Marcello Mancini
- Institute of Biostructure and Bioimaging of the National Research Council, Naples, Italy
| | | | - Delia Luongo
- Institute of Biostructure and Bioimaging of the National Research Council, Naples, Italy
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Angela A Rivellese
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.,Task Force on Microbiome Studies, Federico II University, Naples, Italy
| | - Giovanni Annuzzi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.,Task Force on Microbiome Studies, Federico II University, Naples, Italy
| | - Lutgarda Bozzetto
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.,Task Force on Microbiome Studies, Federico II University, Naples, Italy
| |
Collapse
|
9
|
Brancato V, Garbino N, Salvatore M, Cavaliere C. MRI-Based Radiomic Features Help Identify Lesions and Predict Histopathological Grade of Hepatocellular Carcinoma. Diagnostics (Basel) 2022; 12:diagnostics12051085. [PMID: 35626241 PMCID: PMC9139902 DOI: 10.3390/diagnostics12051085] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/06/2022] [Accepted: 04/23/2022] [Indexed: 02/04/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common form of liver cancer. Radiomics is a promising tool that may increase the value of magnetic resonance imaging (MRI) in the management of HCC. The purpose of our study is to develop an MRI-based radiomics approach to preoperatively detect HCC and predict its histological grade. Thirty-eight HCC patients at staging who underwent axial T2-weighted and dynamic contrast-enhanced MRI (DCE-MRI) were considered. Three-dimensional volumes of interest (VOIs) were manually placed on HCC lesions and normal hepatic tissue (HT) on arterial phase post-contrast images. Radiomic features from T2 images and arterial, portal and tardive post-contrast images from DCE-MRI were extracted by using Pyradiomics. Feature selection was performed using correlation filter, Wilcoxon-rank sum test and mutual information. Predictive models were constructed for HCC differentiation with respect to HT and HCC histopathologic grading used at each step an imbalance-adjusted bootstrap resampling (IABR) on 1000 samples. Promising results were obtained from radiomic prediction models, with best AUCs ranging from 71% to 96%. Radiomics MRI based on T2 and DCE-MRI revealed promising results concerning both HCC detection and grading. It may be a suitable tool for personalized treatment of HCC patients and could also be used to develop new prognostic biomarkers useful for HCC assessment without the need for invasive procedures.
Collapse
|
10
|
Brancato V, Della Pepa G, Bozzetto L, Vitale M, Annuzzi G, Basso L, Cavaliere C, Salvatore M, Rivellese AA, Monti S. Evaluation of a Whole-Liver Dixon-Based MRI Approach for Quantification of Liver Fat in Patients with Type 2 Diabetes Treated with Two Isocaloric Different Diets. Diagnostics (Basel) 2022; 12:diagnostics12020514. [PMID: 35204604 PMCID: PMC8871286 DOI: 10.3390/diagnostics12020514] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/04/2022] [Accepted: 02/15/2022] [Indexed: 02/04/2023] Open
Abstract
Dixon-based methods for the detection of fatty liver have the advantage of being non-invasive, easy to perform and analyze, and to provide a whole-liver coverage during the acquisition. The aim of the study was to assess the feasibility of a whole-liver Dixon-based approach for liver fat quantification in type 2 diabetes (T2D) patients who underwent two different isocaloric dietary treatments: a diet rich in monosaturated fatty acids (MUFA) and a multifactorial diet. Thirty-nine T2D patients were randomly assigned to MUFA diet (n = 21) and multifactorial diet (n = 18). The mean values of the proton density fat fraction (PDFF) over the whole liver and over the ROI corresponding to that chosen for MRS were compared to MRS-PDFF using Spearman’s correlation (ρ). Before–after changes in percentage of liver volume corresponding to MRI-PDFF above thresholds associated with hepatic steatosis (LV%TH, with TH = 5.56%, 7.97% and 8.8%) were considered to assess the proposed approach and compared between diets using Wilcoxon rank-sum test. Statistical significance set at p < 0.05. A strong linear relationship was found between MRS-PDFF and MRI-PDFFs (ρ = 0.85, p < 0.0001). Changes in LV%TH% were significantly higher (p < 0.05) in the multifactorial diet than in MUFA diet (25% vs. 9%, 35% vs. 12%, and 38% vs. 13% decrease, respectively, for TH = 5.56%, 7.97%, and 8.8%) and this was reproducible compared to results obtained using the standard liver fat analysis. A volumetric approach based on Dixon method could be an effective, non-invasive technique that could be used for the quantitative analysis of hepatic steatosis in T2D patients.
Collapse
Affiliation(s)
- Valentina Brancato
- IRCCS Synlab SDN, 80143 Naples, Italy; (L.B.); (C.C.); (M.S.)
- Correspondence:
| | - Giuseppe Della Pepa
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (G.D.P.); (L.B.); (M.V.); (G.A.); (A.A.R.)
| | - Lutgarda Bozzetto
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (G.D.P.); (L.B.); (M.V.); (G.A.); (A.A.R.)
| | - Marilena Vitale
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (G.D.P.); (L.B.); (M.V.); (G.A.); (A.A.R.)
| | - Giovanni Annuzzi
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (G.D.P.); (L.B.); (M.V.); (G.A.); (A.A.R.)
| | - Luca Basso
- IRCCS Synlab SDN, 80143 Naples, Italy; (L.B.); (C.C.); (M.S.)
| | - Carlo Cavaliere
- IRCCS Synlab SDN, 80143 Naples, Italy; (L.B.); (C.C.); (M.S.)
| | - Marco Salvatore
- IRCCS Synlab SDN, 80143 Naples, Italy; (L.B.); (C.C.); (M.S.)
| | - Angela Albarosa Rivellese
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (G.D.P.); (L.B.); (M.V.); (G.A.); (A.A.R.)
| | - Serena Monti
- Institute of Biostructures and Bioimaging, National Research Council, 80145 Naples, Italy;
| |
Collapse
|
11
|
Garbino N, Brancato V, Salvatore M, Cavaliere C. A Systematic Review on the Role of the Perfusion Computed Tomography in Abdominal Cancer. Dose Response 2021; 19:15593258211056199. [PMID: 34880716 PMCID: PMC8647276 DOI: 10.1177/15593258211056199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background and purpose Perfusion Computed Tomography (CTp) is an imaging technique which allows
quantitative and qualitative evaluation of tissue perfusion through dynamic
CT acquisitions. Since CTp is still considered a research tool in the field
of abdominal imaging, the aim of this work is to provide a systematic
summary of the current literature on CTp in the abdominal region to clarify
the role of this technique for abdominal cancer applications. Materials and Methods A systematic literature search of PubMed, Web of Science, and Scopus was
performed to identify original articles involving the use of CTp for
clinical applications in abdominal cancer since 2011. Studies were included
if they reported original data on CTp and investigated the clinical
applications of CTp in abdominal cancer. Results Fifty-seven studies were finally included in the study. Most of the included
articles (33/57) dealt with CTp at the level of the liver, while a low
number of studies investigated CTp for oncologic diseases involving UGI
tract (8/57), pancreas (8/57), kidneys (3/57), and colon–rectum (5/57). Conclusions Our study revealed that CTp could be a valuable functional imaging tool in
the field of abdominal oncology, particularly as a biomarker for monitoring
the response to anti-tumoral treatment.
Collapse
|
12
|
Aiello M, Esposito G, Pagliari G, Borrelli P, Brancato V, Salvatore M. How does DICOM support big data management? Investigating its use in medical imaging community. Insights Imaging 2021; 12:164. [PMID: 34748101 PMCID: PMC8574146 DOI: 10.1186/s13244-021-01081-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/25/2021] [Indexed: 12/15/2022] Open
Abstract
The diagnostic imaging field is experiencing considerable growth, followed by increasing production of massive amounts of data. The lack of standardization and privacy concerns are considered the main barriers to big data capitalization. This work aims to verify whether the advanced features of the DICOM standard, beyond imaging data storage, are effectively used in research practice. This issue will be analyzed by investigating the publicly shared medical imaging databases and assessing how much the most common medical imaging software tools support DICOM in all its potential. Therefore, 100 public databases and ten medical imaging software tools were selected and examined using a systematic approach. In particular, the DICOM fields related to privacy, segmentation and reporting have been assessed in the selected database; software tools have been evaluated for reading and writing the same DICOM fields. From our analysis, less than a third of the databases examined use the DICOM format to record meaningful information to manage the images. Regarding software, the vast majority does not allow the management, reading and writing of some or all the DICOM fields. Surprisingly, if we observe chest computed tomography data sharing to address the COVID-19 emergency, there are only two datasets out of 12 released in DICOM format. Our work shows how the DICOM can potentially fully support big data management; however, further efforts are still needed from the scientific and technological community to promote the use of the existing standard, encouraging data sharing and interoperability for a concrete development of big data analytics.
Collapse
Affiliation(s)
- Marco Aiello
- IRCCS SDN, Via Emanuele Gianturco 113, 80143, Naples, Italy.
| | | | | | | | | | | |
Collapse
|
13
|
Brancato V, Garbino N, Mannelli L, Aiello M, Salvatore M, Franzese M, Cavaliere C. Impact of radiogenomics in esophageal cancer on clinical outcomes: A pilot study. World J Gastroenterol 2021; 27:6110-6127. [PMID: 34629823 PMCID: PMC8476334 DOI: 10.3748/wjg.v27.i36.6110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/16/2021] [Accepted: 07/30/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Esophageal cancer (ESCA) is the sixth most common malignancy in the world, and its incidence is rapidly increasing. Recently, several microRNAs (miRNAs) and messenger RNA (mRNA) targets were evaluated as potential biomarkers and regulators of epigenetic mechanisms involved in early diagnosis. In addition, computed tomography (CT) radiomic studies on ESCA improved the early stage identification and the prediction of response to treatment. Radiogenomics provides clinically useful prognostic predictions by linking molecular characteristics such as gene mutations and gene expression patterns of malignant tumors with medical images and could provide more opportunities in the management of patients with ESCA.
AIM To explore the combination of CT radiomic features and molecular targets associated with clinical outcomes for characterization of ESCA patients.
METHODS Of 15 patients with diagnosed ESCA were included in this study and their CT imaging and transcriptomic data were extracted from The Cancer Imaging Archive and gene expression data from The Cancer Genome Atlas, respectively. Cancer stage, history of significant alcohol consumption and body mass index (BMI) were considered as clinical outcomes. Radiomic analysis was performed on CT images acquired after injection of contrast medium. In total, 1302 radiomics features were extracted from three-dimensional regions of interest by using PyRadiomics. Feature selection was performed using a correlation filter based on Spearman’s correlation (ρ) and Wilcoxon-rank sum test respect to clinical outcomes. Radiogenomic analysis involved ρ analysis between radiomic features associated with clinical outcomes and transcriptomic signatures consisting of eight N6-methyladenosine RNA methylation regulators and five up-regulated miRNA. The significance level was set at P < 0.05.
RESULTS Of 25, five and 29 radiomic features survived after feature selection, considering stage, alcohol history and BMI as clinical outcomes, respectively. Radiogenomic analysis with stage as clinical outcome revealed that six of the eight mRNA regulators and two of the five up-regulated miRNA were significantly correlated with ten and three of the 25 selected radiomic features, respectively (-0.61 < ρ < -0.60 and 0.53 < ρ < 0.69, P < 0.05). Assuming alcohol history as clinical outcome, no correlation was found between the five selected radiomic features and mRNA regulators, while a significant correlation was found between one radiomic feature and three up-regulated miRNAs (ρ = -0.56, ρ = -0.64 and ρ = 0.61, P < 0.05). Radiogenomic analysis with BMI as clinical outcome revealed that four mRNA regulators and one up-regulated miRNA were significantly correlated with 10 and two radiomic features, respectively (-0.67 < ρ < -0.54 and 0.53 < ρ < 0.71, P < 0.05).
CONCLUSION Our study revealed interesting relationships between the expression of eight N6-methyladenosine RNA regulators, as well as five up-regulated miRNAs, and CT radiomic features associated with clinical outcomes of ESCA patients.
Collapse
|
14
|
Brancato V, Borrelli P, Alfano V, Picardi M, Mascalchi M, Nicolai E, Salvatore M, Aiello M. The impact of MR-based attenuation correction in spinal cord FDG-PET/MR imaging for neurological studies. Med Phys 2021; 48:5924-5934. [PMID: 34369590 PMCID: PMC9293017 DOI: 10.1002/mp.15149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 05/30/2021] [Accepted: 07/24/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose Positron emission tomography (PET) attenuation correction (AC) in positron emission tomography‐magnetic resonance (PET/MR) scanners constitutes a critical and barely explored issue in spinal cord investigation, mainly due to the limitations in accounting for highly attenuating bone structures which surround the spinal canal. Our study aims at evaluating the clinical suitability of MR‐driven AC (MRAC) for 18‐fluorodeoxy‐glucose positron emission tomography (18F‐FDG‐PET) in spinal cord. Methods Thirty‐six patients, undergoing positron emission tomography‐computed tomography (PET/CT) and PET/MR in the same session for oncological examination, were retrospectively analyzed. For each patient, raw PET data from PET/MR scanner were reconstructed with 4‐ and 5‐class MRAC maps, generated by hybrid PET/MR system (PET_MRAC4 and PET_MRAC5, respectively, where PET_MRAC is PET images reconstructed using MR‐based attenuation correction map), and an AC map derived from CT data after a custom co‐registration pipeline (PET_rCTAC, where PET_rCTAC is PET images reconstructed using CT‐based attenuation correction map), which served as reference. Mean PET standardized uptake values (SUVm) were extracted from the three reconstructed PET images by regions of interest (ROIs) identified on T2‐weighted MRI, in the spinal cord, lumbar cerebrospinal fluid (CSF), and vertebral marrow at five levels (C2, C5, T6, T12, and L3). SUVm values from PET_MRAC4 and PET_MRAC5 were compared with each other and with the reference by means of paired t‐test, and correlated using Pearson's correlation (r) to assess their consistency. Cohen's d was calculated to assess the magnitude of differences between PET images. Results SUVmvalues from PET_MRAC4 were lower than those from PET_MRAC5 in almost all analyzed ROIs, with a mean difference ranging from 0.03 to 0.26 (statistically significant in the vertebral marrow at C2 and C5, spinal cord at T6 and T2, and CSF at L3). This was also confirmed by the effect size, with highest values at low spinal levels (d = 0.45 at T12 in spinal cord, d = 0.95 at L3 in CSF). SUVm values from PET_MRAC4 and PET_MRAC5 showed a very good correlation (0.81 < r < 0.97, p < 0.05) in all spinal ROIs. Underestimation of SUVm between PET_MRAC4 and PET_rCTAC was observed at each level, with a mean difference ranging from 0.02 to 0.32 (statistically significant in the vertebral marrow at C2 and T6, and CSF at L3). Although PET_MRAC5 underestimates PET_rCTAC (mean difference ranging from 0.02 to 0.3), an overall decrease in effect size could be observed for PET_MRAC5, mainly at lower spinal levels (T12, L3). SUVm from both PET_MRAC4 and PET_MRAC5 methods showed r value from good to very good with respect to PET_rCTAC (0.67 < r < 0.9 and 0.73 < r < 0.94, p < 0.05, respectively). Conclusions Our results showed that neglecting bones in AC can underestimate the FDG uptake measurement of the spinal cord. The inclusion of bones in MRAC is far from negligible and improves the AC in spinal cord, mainly at low spinal levels. Therefore, care must be taken in the spinal canal region, and the use of AC map reconstruction methods accounting for bone structures could be beneficial.
Collapse
Affiliation(s)
| | | | | | - Marco Picardi
- Department of Clinical Medicine and Surgery, Federico II University Medical School, Naples, Italy
| | - Mario Mascalchi
- «Mario Serio» Department of Experimental and Clinical Biomedical Sciences, University of Florence, Italy
| | | | | | | |
Collapse
|
15
|
Basso L, Baldi D, Mannelli L, Cavaliere C, Salvatore M, Brancato V. Investigating Dual-Energy CT Post-Contrast Phases for Liver Iron Quantification: A Preliminary Study. Dose Response 2021; 19:15593258211011359. [PMID: 34121963 PMCID: PMC8173994 DOI: 10.1177/15593258211011359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/17/2021] [Accepted: 03/29/2021] [Indexed: 12/03/2022] Open
Abstract
Background and Purpose: Quantification of hepatic virtual iron content (VIC) by using Multidetector Dual Energy Computed Tomography (DECT) has been recently investigated since this technique could offer a good compromise between accuracy and non-invasiveness for liver iron content quantification. The aim of our study is to investigate differences in VIC at different DECT time points (namely baseline and arterial, venous and tardive phases), identifying the most reliable and also exploring the underlying temporal trend of these values. Materials and Methods: Eleven patients who underwent DECT examination and were characterized by low liver fat content were included in this retrospective study. By using the Syngo.via Frontier–DE IronVNC tool, regions of interest (ROI) were placed on the VIC images at 3 hepatic levels, both in left and right liver lobes, at each DECT time point. Friedman’s test followed by Bonferroni-adjusted Wilcoxon signed-rank test for post-hoc analysis was performed to assess differences between DECT timepoints. Page’s L test was performed to test the temporal trend of VIC across the 4 examined timepoints. Results: For both liver lobes, Friedman’s test followed by Bonferroni-adjusted Wilcoxon signed-rank test revealed that VIC values differed significantly when extracted from ROIs placed at the 4 different timepoints. The Page’s L test for multiple comparison revealed a significant growing trend for VIC, from baseline acquisition to the fourth and last time point post-contrast agent injection. Conclusions: The extraction of hepatic VIC in healthy subjects was found to be significantly influenced by the DECT time point chosen for the extrapolation of the VIC values.
Collapse
|
16
|
Brancato V, Aiello M, Basso L, Monti S, Palumbo L, Di Costanzo G, Salvatore M, Ragozzino A, Cavaliere C. Evaluation of a multiparametric MRI radiomic-based approach for stratification of equivocal PI-RADS 3 and upgraded PI-RADS 4 prostatic lesions. Sci Rep 2021; 11:643. [PMID: 33436929 PMCID: PMC7804929 DOI: 10.1038/s41598-020-80749-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 12/24/2020] [Indexed: 12/11/2022] Open
Abstract
Despite the key-role of the Prostate Imaging and Reporting and Data System (PI-RADS) in the diagnosis and characterization of prostate cancer (PCa), this system remains to be affected by several limitations, primarily associated with the interpretation of equivocal PI-RADS 3 lesions and with the debated role of Dynamic Contrast Enhanced-Magnetic Resonance Imaging (DCE-MRI), which is only used to upgrade peripheral PI-RADS category 3 lesions to PI-RADS category 4 if enhancement is focal. We aimed at investigating the usefulness of radiomics for detection of PCa lesions (Gleason Score ≥ 6) in PI-RADS 3 lesions and in peripheral PI-RADS 3 upgraded to PI-RADS 4 lesions (upPI-RADS 4). Multiparametric MRI (mpMRI) data of patients who underwent prostatic mpMRI between April 2013 and September 2018 were retrospectively evaluated. Biopsy results were used as gold standard. PI-RADS 3 and PI-RADS 4 lesions were re-scored according to the PI-RADS v2.1 before and after DCE-MRI evaluation. Radiomic features were extracted from T2-weighted MRI (T2), Apparent diffusion Coefficient (ADC) map and DCE-MRI subtracted images using PyRadiomics. Feature selection was performed using Wilcoxon-ranksum test and Minimum Redundancy Maximum Relevance (mRMR). Predictive models were constructed for PCa detection in PI-RADS 3 and upPI-RADS 4 lesions using at each step an imbalance-adjusted bootstrap resampling (IABR) on 1000 samples. 41 PI-RADS 3 and 32 upPI-RADS 4 lesions were analyzed. Among 293 radiomic features, the top selected features derived from T2 and ADC. For PI-RADS 3 stratification, second order model showed higher performances (Area Under the Receiver Operating Characteristic Curve—AUC— = 80%), while for upPI-RADS 4 stratification, first order model showed higher performances respect to superior order models (AUC = 89%). Our results support the significant role of T2 and ADC radiomic features for PCa detection in lesions scored as PI-RADS 3 and upPI-RADS 4. Radiomics models showed high diagnostic efficacy in classify PI-RADS 3 and upPI-RADS 4 lesions, outperforming PI-RADS v2.1 performance.
Collapse
Affiliation(s)
| | | | | | - Serena Monti
- Institute of Biostructures and Bioimaging, National Research Council, Naples, Italy
| | - Luigi Palumbo
- Department of Radiology, S. Maria Delle Grazie Hospital, Pozzuoli, Italy
| | | | | | - Alfonso Ragozzino
- Department of Radiology, S. Maria Delle Grazie Hospital, Pozzuoli, Italy
| | | |
Collapse
|
17
|
Brancato V, Aiello M, Della Pepa R, Basso L, Garbino N, Nicolai E, Picardi M, Salvatore M, Cavaliere C. Automatic Prediction and Assessment of Treatment Response in Patients with Hodgkin's Lymphoma Using a Whole-Body DW-MRI Based Approach. Diagnostics (Basel) 2020; 10:diagnostics10090702. [PMID: 32948043 PMCID: PMC7555579 DOI: 10.3390/diagnostics10090702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 12/25/2022] Open
Abstract
The lack of validation and standardization represents the main drawback for a clear role of whole-body diffusion weighted imaging (WB-DWI) for prediction and assessment of treatment response in Hodgkin’s lymphoma (HL). We explored the reliability of an automatic approach based on the WB-DWI technique for prediction and assessment of response to treatment in patients with HL. The study included 20 HL patients, who had whole-body positron emission tomography (PET)/ magnetic resonance Imaging (MRI) performed before, during and after chemotherapy. Using the syngo.via MR Total Tumor Load tool, we automatically extracted values of diffusion volume (DV) and its associated histogram features by WB-DWI images, and evaluated their utility in predicting and assessing interim and end-of-treatment (EOT) response. The Mann–Whitney test followed by receiver operator characteristic (ROC) analysis was performed between features and their inter-time point percentage differences for patients having a complete or partial treatment response, revealing that several WB-DWI associated features allowed for prediction of interim response and both prediction and assessment of EOT response. Our proposed method offers huge advantages in terms of saving time and work, enabling clinicians to draw conclusions relating to HL treatment response in a fully automatic way, and encloses, also, all DWI advantages compared to PET/ computed tomography (CT).
Collapse
Affiliation(s)
- Valentina Brancato
- IRCCS SDN (Istituto di Ricovero e Cura a Carattere Scientifico, SYNLAB istituto di Diagnostica Nucleare), 80143 Napoli, Italy; (V.B.); (L.B.); (N.G.); (E.N.); (M.S.); (C.C.)
| | - Marco Aiello
- IRCCS SDN (Istituto di Ricovero e Cura a Carattere Scientifico, SYNLAB istituto di Diagnostica Nucleare), 80143 Napoli, Italy; (V.B.); (L.B.); (N.G.); (E.N.); (M.S.); (C.C.)
- Correspondence:
| | - Roberta Della Pepa
- Department of Clinical Medicine and Surgery, Hematology Section, Federico II University of Naples, 80131 Naples, Italy; (R.D.P.); (M.P.)
| | - Luca Basso
- IRCCS SDN (Istituto di Ricovero e Cura a Carattere Scientifico, SYNLAB istituto di Diagnostica Nucleare), 80143 Napoli, Italy; (V.B.); (L.B.); (N.G.); (E.N.); (M.S.); (C.C.)
| | - Nunzia Garbino
- IRCCS SDN (Istituto di Ricovero e Cura a Carattere Scientifico, SYNLAB istituto di Diagnostica Nucleare), 80143 Napoli, Italy; (V.B.); (L.B.); (N.G.); (E.N.); (M.S.); (C.C.)
| | - Emanuele Nicolai
- IRCCS SDN (Istituto di Ricovero e Cura a Carattere Scientifico, SYNLAB istituto di Diagnostica Nucleare), 80143 Napoli, Italy; (V.B.); (L.B.); (N.G.); (E.N.); (M.S.); (C.C.)
| | - Marco Picardi
- Department of Clinical Medicine and Surgery, Hematology Section, Federico II University of Naples, 80131 Naples, Italy; (R.D.P.); (M.P.)
| | - Marco Salvatore
- IRCCS SDN (Istituto di Ricovero e Cura a Carattere Scientifico, SYNLAB istituto di Diagnostica Nucleare), 80143 Napoli, Italy; (V.B.); (L.B.); (N.G.); (E.N.); (M.S.); (C.C.)
| | - Carlo Cavaliere
- IRCCS SDN (Istituto di Ricovero e Cura a Carattere Scientifico, SYNLAB istituto di Diagnostica Nucleare), 80143 Napoli, Italy; (V.B.); (L.B.); (N.G.); (E.N.); (M.S.); (C.C.)
| |
Collapse
|
18
|
Della Pepa G, Vetrani C, Brancato V, Vitale M, Monti S, Annuzzi G, Lombardi G, Izzo A, Tommasone M, Cipriano P, Clemente G, Mirabelli P, Mancini M, Salvatore M, Riccardi G, Rivellese AA, Bozzetto L. Effects of a multifactorial ecosustainable isocaloric diet on liver fat in patients with type 2 diabetes: randomized clinical trial. BMJ Open Diabetes Res Care 2020; 8:8/1/e001342. [PMID: 32448788 PMCID: PMC7252961 DOI: 10.1136/bmjdrc-2020-001342] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/11/2020] [Accepted: 04/23/2020] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Treatment options for non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes (T2D) are still a matter of debate. We compared the effects of a diet including different components versus a proven beneficial diet rich in monounsaturated fatty acids (MUFAs) on liver fat in T2D. RESEARCH DESIGN AND METHODS According to a parallel design, 49 individuals with T2D, overweight/obese, with high waist circumference, 35-75 years-old, in satisfactory blood glucose control with diet or drugs not affecting liver fat content, were randomly assigned to an 8-week isocaloric intervention with a MUFA diet (n=26) or a multifactorial diet rich in fiber, MUFA, n-6 and n-3 polyunsaturated fatty acids, polyphenols, and vitamins D, E, and C (n=23). Before and after the intervention, liver fat content was evaluated by proton magnetic resonance spectroscopy (1H-MRS). 1H-MRS complete data were available for n=21 (MUFA diet) and n=18 (multifactorial diet) participants. RESULTS Adherence to dietary interventions was optimal. No significant differences between groups in body weight reduction, plasma glycated hemoglobin, insulin, glucose, lipids and liver enzymes were observed. Liver fat significantly decreased after both the multifactorial diet (9.18%±7.78% vs 5.22%±4.80%, p=0.003) and the MUFA diet (9.47%±8.89% vs 8.07%±8.52%, p=0.027) with a statistically significant difference between changes either in absolute terms (-4.0%±4.5% vs -1.4%±2.7%, p=0.035) or percent (-40%±33% vs -19%±25%, p=0.030). CONCLUSIONS An isocaloric multifactorial diet including several beneficial dietary components induced a clinically relevant reduction of liver fat in patients with T2D, more pronounced than that induced by simply replacing saturated fat with MUFA. This suggests that the 'optimal diet' for NAFLD treatment in T2D should be based on synergic actions of different dietary components on multiple pathophysiological pathways. TRIAL REGISTRATION NUMBER NCT03380416.
Collapse
Affiliation(s)
- Giuseppe Della Pepa
- Department of Clinical Medicine and Surgery, University of Naples Federico II School of Medicine and Surgery, Napoli, Campania, Italy
| | - Claudia Vetrani
- Department of Clinical Medicine and Surgery, University of Naples Federico II School of Medicine and Surgery, Napoli, Campania, Italy
| | | | - Marilena Vitale
- Department of Clinical Medicine and Surgery, University of Naples Federico II School of Medicine and Surgery, Napoli, Campania, Italy
| | - Serena Monti
- Institute of Biostructure and Bioimaging, National Research Council, Napoli, Campania, Italy
| | - Giovanni Annuzzi
- Department of Clinical Medicine and Surgery, University of Naples Federico II School of Medicine and Surgery, Napoli, Campania, Italy
| | - Gianluca Lombardi
- Department of Clinical Medicine and Surgery, University of Naples Federico II School of Medicine and Surgery, Napoli, Campania, Italy
| | - Anna Izzo
- Department of Clinical Medicine and Surgery, University of Naples Federico II School of Medicine and Surgery, Napoli, Campania, Italy
| | - Marianna Tommasone
- Department of Clinical Medicine and Surgery, University of Naples Federico II School of Medicine and Surgery, Napoli, Campania, Italy
| | - Paola Cipriano
- Department of Clinical Medicine and Surgery, University of Naples Federico II School of Medicine and Surgery, Napoli, Campania, Italy
| | - Gennaro Clemente
- Institute for Research on Population and Social Policies, National Research Council, Fisciano, Italy
| | | | - Marcello Mancini
- Institute of Biostructure and Bioimaging, National Research Council, Napoli, Campania, Italy
| | | | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, University of Naples Federico II School of Medicine and Surgery, Napoli, Campania, Italy
| | - Angela Albarosa Rivellese
- Department of Clinical Medicine and Surgery, University of Naples Federico II School of Medicine and Surgery, Napoli, Campania, Italy
| | - Lutgarda Bozzetto
- Department of Clinical Medicine and Surgery, University of Naples Federico II School of Medicine and Surgery, Napoli, Campania, Italy
| |
Collapse
|
19
|
Monti S, Brancato V, Di Costanzo G, Basso L, Puglia M, Ragozzino A, Salvatore M, Cavaliere C. Multiparametric MRI for Prostate Cancer Detection: New Insights into the Combined Use of a Radiomic Approach with Advanced Acquisition Protocol. Cancers (Basel) 2020; 12:cancers12020390. [PMID: 32046196 PMCID: PMC7072162 DOI: 10.3390/cancers12020390] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/27/2020] [Accepted: 02/05/2020] [Indexed: 12/20/2022] Open
Abstract
Prostate cancer (PCa) is a disease affecting an increasing number of men worldwide. Several efforts have been made to identify imaging biomarkers to non-invasively detect and characterize PCa, with substantial improvements thanks to multiparametric Magnetic Resonance Imaging (mpMRI). In recent years, diffusion kurtosis imaging (DKI) was proposed to be directly related to tissue physiological and pathological characteristic, while the radiomic approach was proven to be a key method to study cancer imaging phenotypes. Our aim was to compare a standard radiomic model for PCa detection, built using T2-weighted (T2W) and Apparent Diffusion Coefficient (ADC), with an advanced one, including DKI and quantitative Dynamic Contrast Enhanced (DCE), while also evaluating differences in prediction performance when using 2D or 3D lesion segmentation. The obtained results in terms of diagnostic accuracy were high for all of the performed comparisons, reaching values up to 0.99 for the area under a receiver operating characteristic curve (AUC), and 0.98 for both sensitivity and specificity. In comparison, the radiomic model based on standard features led to prediction performances higher than those of the advanced model, while greater accuracy was achieved by the model extracted from 3D segmentation. These results provide new insights into active topics of discussion, such as choosing the most convenient acquisition protocol and the most appropriate postprocessing pipeline to accurately detect and characterize PCa.
Collapse
Affiliation(s)
- Serena Monti
- IRCCS SDN, 80143 Naples, Italy; (S.M.); (L.B.); (M.S.); (C.C.)
| | - Valentina Brancato
- IRCCS SDN, 80143 Naples, Italy; (S.M.); (L.B.); (M.S.); (C.C.)
- Correspondence: ; Tel.: +39-081-2408-299
| | | | - Luca Basso
- IRCCS SDN, 80143 Naples, Italy; (S.M.); (L.B.); (M.S.); (C.C.)
| | - Marta Puglia
- Ospedale S. Maria delle Grazie, 80078 Pozzuoli, Italy; (G.D.C.); (M.P.); (A.R.)
| | - Alfonso Ragozzino
- Ospedale S. Maria delle Grazie, 80078 Pozzuoli, Italy; (G.D.C.); (M.P.); (A.R.)
| | - Marco Salvatore
- IRCCS SDN, 80143 Naples, Italy; (S.M.); (L.B.); (M.S.); (C.C.)
| | - Carlo Cavaliere
- IRCCS SDN, 80143 Naples, Italy; (S.M.); (L.B.); (M.S.); (C.C.)
| |
Collapse
|
20
|
Brancato V, Cavaliere C, Salvatore M, Monti S. Non-Gaussian models of diffusion weighted imaging for detection and characterization of prostate cancer: a systematic review and meta-analysis. Sci Rep 2019; 9:16837. [PMID: 31728007 PMCID: PMC6856159 DOI: 10.1038/s41598-019-53350-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 10/28/2019] [Indexed: 12/24/2022] Open
Abstract
The importance of Diffusion Weighted Imaging (DWI) in prostate cancer (PCa) diagnosis have been widely handled in literature. In the last decade, due to the mono-exponential model limitations, several studies investigated non-Gaussian DWI models and their utility in PCa diagnosis. Since their results were often inconsistent and conflicting, we performed a systematic review of studies from 2012 examining the most commonly used Non-Gaussian DWI models for PCa detection and characterization. A meta-analysis was conducted to assess the ability of each Non-Gaussian model to detect PCa lesions and distinguish between low and intermediate/high grade lesions. Weighted mean differences and 95% confidence intervals were calculated and the heterogeneity was estimated using the I2 statistic. 29 studies were selected for the systematic review, whose results showed inconsistence and an unclear idea about the actual usefulness and the added value of the Non-Gaussian model parameters. 12 studies were considered in the meta-analyses, which showed statistical significance for several non-Gaussian parameters for PCa detection, and to a lesser extent for PCa characterization. Our findings showed that Non-Gaussian model parameters may potentially play a role in the detection and characterization of PCa but further studies are required to identify a standardized DWI acquisition protocol for PCa diagnosis.
Collapse
|
21
|
Kundu B, Bastos ARF, Brancato V, Cerqueira MT, Oliveira JM, Correlo VM, Reis RL, Kundu SC. Mechanical Property of Hydrogels and the Presence of Adipose Stem Cells in Tumor Stroma Affect Spheroid Formation in the 3D Osteosarcoma Model. ACS Appl Mater Interfaces 2019; 11:14548-14559. [PMID: 30943004 DOI: 10.1021/acsami.8b22724] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Osteosarcoma is one of the most common metastatic bone cancers, which results in significant morbidity and mortality. Unfolding of effectual therapeutic strategies against osteosarcoma is impeded because of the absence of adequate animal models, which can truly recapitulate disease biology of humans. Tissue engineering provides an opportunity to develop physiologically relevant, reproducible, and tunable in vitro platforms to investigate the interactions of osteosarcoma cells with its microenvironment. Adipose-derived stem cells (ASCs) are detected adjacent to osteosarcoma masses and are considered to have protumor effects. Hence, the present study focuses on investigating the role of reactive ASCs in formation of spheroids of osteosarcoma cells (Saos 2) within a three-dimensional (3D) niche, which is created using gellan gum (GG)-silk fibroin. By modifying the blending ratio of GG-silk, the optimum stiffness of the resultant hydrogels such as GG and GG75: S25 is obtained for cancer spheroid formation. This work indicates that the co-existence of cancer and stem cells can form a spheroid, the hallmark of cancer, only in particular microenvironment stiffness. The incorporation of fibrillar silk fibroin within the hydrophilic network of GG in GG75: S25 spongy-like hydrogels closely mimics the stiffness of commercially established cancer biomaterials (e.g., Matrigel, HyStem). The GG75: S25 hydrogel maintains the metabolically active construct for a longer time with elevated expression of osteopontin, osteocalcin, RUNX 2, and bone sialoprotein genes, the biomarkers of osteosarcoma, compared to GG. The GG75: S25 construct also exhibits intense alkaline phosphatase expression in immunohistochemistry compared to GG, indicating itspotentiality to serve as biomimetic niche to model osteosarcoma. Taken together, the GG-silk fibroin-blended spongy-like hydrogel is envisioned as an alternative low-cost platform for 3D cancer modeling.
Collapse
Affiliation(s)
- B Kundu
- I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics , University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine , AvePark, Zona Industrial da Gandra , Barco, Guimarães 4805-017 , Portugal
- ICVS/3B's-PT Government Associate Laboratory , Braga, Guimarães 4805-017 , Portugal
| | - A R F Bastos
- I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics , University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine , AvePark, Zona Industrial da Gandra , Barco, Guimarães 4805-017 , Portugal
- ICVS/3B's-PT Government Associate Laboratory , Braga, Guimarães 4805-017 , Portugal
| | - V Brancato
- I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics , University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine , AvePark, Zona Industrial da Gandra , Barco, Guimarães 4805-017 , Portugal
- ICVS/3B's-PT Government Associate Laboratory , Braga, Guimarães 4805-017 , Portugal
| | - M T Cerqueira
- I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics , University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine , AvePark, Zona Industrial da Gandra , Barco, Guimarães 4805-017 , Portugal
- ICVS/3B's-PT Government Associate Laboratory , Braga, Guimarães 4805-017 , Portugal
| | - J M Oliveira
- I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics , University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine , AvePark, Zona Industrial da Gandra , Barco, Guimarães 4805-017 , Portugal
- ICVS/3B's-PT Government Associate Laboratory , Braga, Guimarães 4805-017 , Portugal
- The Discoveries Centre for Regenerative and Precision Medicine , Headquarters at University of Minho , Avepark , Barco, Guimarães 4805-017 , Portugal
| | - V M Correlo
- I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics , University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine , AvePark, Zona Industrial da Gandra , Barco, Guimarães 4805-017 , Portugal
- ICVS/3B's-PT Government Associate Laboratory , Braga, Guimarães 4805-017 , Portugal
- The Discoveries Centre for Regenerative and Precision Medicine , Headquarters at University of Minho , Avepark , Barco, Guimarães 4805-017 , Portugal
| | - R L Reis
- I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics , University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine , AvePark, Zona Industrial da Gandra , Barco, Guimarães 4805-017 , Portugal
- ICVS/3B's-PT Government Associate Laboratory , Braga, Guimarães 4805-017 , Portugal
- The Discoveries Centre for Regenerative and Precision Medicine , Headquarters at University of Minho , Avepark , Barco, Guimarães 4805-017 , Portugal
| | - S C Kundu
- I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics , University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine , AvePark, Zona Industrial da Gandra , Barco, Guimarães 4805-017 , Portugal
- ICVS/3B's-PT Government Associate Laboratory , Braga, Guimarães 4805-017 , Portugal
| |
Collapse
|
22
|
Visco AM, Brancato V, Torrisi L, Cutroneo M. Employment of Carbon Nanomaterials for Welding Polyethylene Joints with a Nd:YAG Laser. International Journal of Polymer Analysis and Characterization 2014. [DOI: 10.1080/1023666x.2014.921108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
23
|
Visco AM, Campo N, Brancato V, Trimarchi M. Influence of α-Tocopherol Load and Annealing Treatment on the Wear Resistance of Biomedical UHMWPE Irradiated with Electron Beam. International Journal of Polymer Analysis and Characterization 2013. [DOI: 10.1080/1023666x.2013.819545] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
24
|
Tarantino G, Valentino R, Di Somma C, D'Esposito V, Passaretti F, Pizza G, Brancato V, Orio F, Formisano P, Colao A, Savastano S. Bisphenol A in polycystic ovary syndrome and its association with liver-spleen axis. Clin Endocrinol (Oxf) 2013; 78:447-53. [PMID: 22805002 DOI: 10.1111/j.1365-2265.2012.04500.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [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: 05/03/2012] [Revised: 07/04/2012] [Accepted: 07/10/2012] [Indexed: 12/16/2022]
Abstract
CONTEXT Bisphenol A, one of the highest-volume chemicals currently available, is known to act as endocrine disruptor and alters several metabolic functions, including inflammatory pathways. Elevated serum levels of bisphenol A have been found in women with polycystic ovary syndrome (PCOS) and a role of low-grade chronic inflammation has been recently reported in the pathogenesis of this syndrome. Increased spleen volume, a reliable and stable index of chronic inflammation, was strictly associated with the severity of hepatic steatosis (HS) in obese subjects, determining the so-called liver-spleen axis. OBJECTIVE To evaluate the contribution of increased serum bisphenol A levels to low-grade chronic inflammation, HS and hyperandrogenism in women with PCOS. DESIGN, SETTING AND PARTICIPANTS Forty lean and overweight/obese premenopausal women with PCOS and 20 healthy age-matched women were consecutively enrolled in a cross-sectional study from 2009 to 2011 at the Federico II University Hospital in Naples. MEASUREMENTS Bisphenol A, homoeostasis model assessment of insulin resistance (HoMA-IR), laboratory liver tests, testosterone, sex hormone-binding globulin, free androgen index (FAI), C-reactive protein, interleukin-6, and the ultrasound quantification of HS and spleen longitudinal diameter. RESULTS Independently of body weight, higher bisphenol A levels in PCOS women were associated with higher grades of insulin resistance, HS, FAI and inflammation, spleen size showing the best correlation. At multivariate analysis, spleen size and FAI were the best predictors of bisphenol A (β coefficients 0.379, P = 0.007 and 0.343, P = 0.014, respectively). CONCLUSIONS In premenopausal women with PCOS, we evidenced an association of serum bisphenol A levels with HS and markers of low-grade inflammation, in particular with spleen size, unravelling the presence of the liver-spleen axis in this syndrome.
Collapse
Affiliation(s)
- Giovanni Tarantino
- Department of Clinical and Experimental Medicine, University Federico II of Naples, Naples, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Cutolo PP, Nosso G, Vitolo G, Brancato V, Capaldo B, Angrisani L. Clinical efficacy of laparoscopic sleeve gastrectomy vs laparoscopic gastric bypass in obese type 2 diabetic patients: a retrospective comparison. Obes Surg 2013; 22:1535-9. [PMID: 22960950 DOI: 10.1007/s11695-012-0657-5] [Citation(s) in RCA: 36] [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] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are performed in patients with obesity and type 2 diabetes mellitus (T2DM). The aim of this study is to evaluate retrospectively the clinical efficacy of RYGB and SG in two groups of obese T2DM patients. METHODS From the hospital database, we extracted the clinical records of 31 obese T2DM patients, of whom 15 (7 F/8 M) had undergone laparoscopic SG (LSG) and 16 (7 F/9 M) laparoscopic RYGB (LRYGB) in the period 2005-2008. The groups were comparable for age (range 33-59 years) and BMI (range 38-57 kg/m(2)). LRYGB alimentary limb was 150 cm, and biliopancreatic limb was 150 cm from the Treitz ligament. LSG vertical transection was calibrated on a 40-Fr orogastric bougie. Data were analysed at 6, 12 and 18-24 months with reference to weight loss and remission of comorbidities. RESULTS The reduction in body weight was comparable in the two groups. At 18-24 months the percent BMI reduction was 29 ± 8 and 33 ± 11 % in LSG and LRYGB, respectively. Percent excess weight loss was 53 ± 16 and 52 ± 19 % in LSG and LRYGB, respectively. Thirteen patients in LSG and 14 patients in LRYGB discontinued their hypoglycaemic medications. Five (55 %) patients in LSG and eight (89 %) in LRYGB discontinued antihypertensive drugs. Three out of five patients in LSG and one out of two patients in LRYGB withdrew lipid-lowering agents. CONCLUSIONS LSG and LRYGB are equally effective in terms of weight loss and remission of obesity-related comorbidities. Controlled long-term comparisons are needed to establish the optimal procedure in relation to patients' characteristics.
Collapse
Affiliation(s)
- P P Cutolo
- General and Laparoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy.
| | | | | | | | | | | |
Collapse
|
26
|
Tarantino G, Di Somma C, Pizza G, Brancato V, Nedi V, Valentino R, Orio F, Pivonello C, Colao A, Savastano S. Polycystic Ovary Syndrome and Hepatic Steatosis: Could Low-Grade Chronic Inflammation Be Mediated by the Spleen? EUR J INFLAMM 2013. [DOI: 10.1177/1721727x1301100117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Polycystic Ovary Syndrome (PCOS) is characterized by an extreme variety of phenotypes and controversial metabolic implications. Hepatic Steatosis (HS) and low-grade chronic inflammation (LGCI) might be common findings in PCOS. We conducted a cross-sectional study to evaluate the LGCI and HS in young women with PCOS according to their Body Mass index (BMI), Insulin Resistance (IR), and PCOS phenotypes. Sixty young premenopausal PCOS women and 20 age-matched controls participated. Primary outcome measures were the presence/severity of HS; LGCI index evaluated as spleen longitudinal diameter (SLD) by UltraSound, C-Reactive Protein (CRP) and Interleukin (IL)-6 levels; BMI and the Homeostasis Model Assessment (HoMA) of IR. The second outcome measures were testosterone, Sex Hormone-Binding Globulin (SHBG) levels, and Free Androgen Index (FAI). The presence of HS and LGCI was not significantly different between NW and O/O patients, while there were significant differences particularly when the PCOS-women were grouped according to IR or to PCOS phenotypes. At multiple regression adjusted for BMI, HoMA-IR and the spleen size were the major determinants of the severity of HS (β= 0.36, p=0.007, and β= 0.28, p=0.034, respectively). At multiple regression SLD represented the unique predictor of FAI (β=0.32; p=0.018). In young women with PCOS, HS was detected independently from obesity and was well predicted not only by IR but also by spleen size, with variable expression of the liver-spleen axis across the different PCOS subtypes. A possible role of the spleen in determining LGCI also in women with PCOS is emphasized.
Collapse
Affiliation(s)
- G. Tarantino
- Department of Clinical and Experimental Medicine, University Federico II of Naples, Italy
| | | | - G. Pizza
- Department of Molecular and Clinical Endocrinology and Oncology, Division of Endocrinology, University Federico II of Naples, Italy
| | - V. Brancato
- Department of Molecular and Clinical Endocrinology and Oncology, Division of Endocrinology, University Federico II of Naples, Italy
| | - V. Nedi
- Department of Molecular and Clinical Endocrinology and Oncology, Division of Endocrinology, University Federico II of Naples, Italy
| | - R. Valentino
- C.N.R. Institute of Experimental Endocrinology and Oncology ‘G. Salvatore’, Naples, Italy
| | - F. Orio
- Department of Endocrinology, Parthenope University, Naples, Italy
| | - C. Pivonello
- Department of Molecular and Clinical Endocrinology and Oncology, Division of Endocrinology, University Federico II of Naples, Italy
| | - A. Colao
- Department of Molecular and Clinical Endocrinology and Oncology, Division of Endocrinology, University Federico II of Naples, Italy
| | - S. Savastano
- Department of Molecular and Clinical Endocrinology and Oncology, Division of Endocrinology, University Federico II of Naples, Italy
| |
Collapse
|
27
|
Berger M, Graf S, Brancato V, Heidegger C, Coronado M, Pichard C. O14 La nutrition parentérale complémentaire ne compromet pas le contrôle glycémique aux soins intensifs. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70018-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
28
|
Savastano S, Valentino R, Di Somma C, Orio F, Pivonello C, Passaretti F, Brancato V, Formisano P, Colao A, Beguinot F, Tarantino G. Serum 25-Hydroxyvitamin D Levels, phosphoprotein enriched in diabetes gene product (PED/PEA-15) and leptin-to-adiponectin ratio in women with PCOS. Nutr Metab (Lond) 2011; 8:84. [PMID: 22112520 PMCID: PMC3293764 DOI: 10.1186/1743-7075-8-84] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 11/23/2011] [Indexed: 02/06/2023] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is frequently associated with hypovitaminosis D. Vitamin D is endowed with pleiotropic effects, including insulin resistance (IR) and apoptotic pathway. Disruption of the complex mechanism that regulated ovarian apoptosis has been reported in PCOS. Phosphoprotein enriched in diabetes gene product (PED/PEA-15), an anti-apoptotic protein involved in type 2 diabetes mellitus (T2DM), is overexpressed in PCOS women, independently of obesity. Leptin-to-adiponectin ratio (L/A) is a biomarker of IR and low-grade inflammation in PCOS. The aim of the study was to investigate the levels of 25-hydroxy vitamin D (25(OH)D), and L/A, in association with PED/PEA-15 protein abundance, in both lean and overweight/obese (o/o) women with PCOS. Patients and Methods PED/PEA-15 protein abundance and circulating levels of 25(OH)D, L/A, sex hormone-binding globulin, and testosterone were evaluated in 90 untreated PCOS patients (25 ± 4 yrs; range 18-34) and 40 healthy controls age and BMI comparable, from the same geographical area. FAI (free androgen index) and the homeostasis model assessment of insulin resistance (HoMA-IR) index were calculated. Results In o/o PCOS, 25(OH)D levels were significantly lower, and L/A values were significantly higher than in lean PCOS (p < 0.001), while there were no differences in PED/PEA-15 protein abundance. An inverse correlation was observed between 25(OH)D and BMI, PED/PEA-15 protein abundance, insulin, HoMA-IR, FAI (p < 0.001), and L/A (p < 0.05). At the multivariate analysis, in o/o PCOS L/A, insulin and 25(OH)D were the major determinant of PED/PEA-15 protein abundance (β = 0.45, β = 0.41, and β = -0.25, respectively). Conclusions Lower 25(OH)D and higher L/A were associated to PED/PEA-15 protein abundance in PCOS, suggesting their involvement in the ovarian imbalance between pro-and anti-apoptotic mechanisms, with high L/A and insulin and low 25(OH)D levels as the main determinants of PED/PEA-15 protein variability. Further studies, involving also different apoptotic pathways or inflammatory cytokines and granulosa cells are mandatory to better define the possible bidirectional relationships between 25(OH)D, PED/PEA-15 protein abundance, leptin and adiponectin in PCOS pathogenesis.
Collapse
Affiliation(s)
- Silvia Savastano
- Department of Molecular and Clinical Endocrinology and Oncology, Division of Endocrinology, University Federico II of Naples, Via S, Pansini 5, Naples, 80131, Italy.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Savastano S, Balato N, Gaudiello F, Di Somma C, Brancato V, Colao A, Ayala F, Tarantino G. Insulin-like Growth Factor-1, Psoriasis, and Inflammation: A Ménage à Trois? EUR J INFLAMM 2011. [DOI: 10.1177/1721727x1100900308] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Psoriatic patients have an accumulation of metabolic syndrome (MS) and cardiovascular diseases (CVD), likely mediated by systemic inflammation, and exhibiting low circulating levels of insulin-like growth factor (IGF)-I, a marker of MS and CVD in the general population. The aim of this study is to determine the association of IGF-I and inflammation, and to assess the cardio-metabolic risk calculating the visceral adiposity index (VAI), in a group of psoriatic patients without MS. IGF-I, fibrinogen, C-reactive protein (CRP), and interleukin (IL)-6 levels were determined in 20 patients with moderate to severe psoriasis (age range 23–77 yrs) without MS, according to criteria of the National Cholesterol Education Program's Adult Panel III (ATP III), and 20 age- and BMI-matched controls. The standard deviation score (SDS) of IGF-I levels according to age (zSDS), the homeostasis model assessment of insulin resistance (HOMA-IR), the whole-body insulin sensitivity index (ISI), and VAI were also calculated. Psoriasis Area and Severity Index (PASI) mean value was 17.8±11. HDL cholesterol and IGF-I zSDS values were lower (p<0.001) and waist circumference (p<0.001), VAI, fibrinogen, and IL-6 (p<0.005) were higher compared with controls, while HOMA-IR and ISI were not statistically different. Lower IGF-I zSDS values were associated to higher values of BMI (p=0.04), waist circumference, VAI (p<0.001), PASI (p=0.011), or IL-6 (p<0.001). At the multivariate analysis PASI was the major determinant of IGF-I zSDS (p=0.016), accounting for 37% of its variability. In a subset of psoriatic patients without MS, chronic inflammation might be an important modulator of low IGF-I status, as a further possible mechanistic link between psoriasis and associated metabolic co-morbidities. The negative correlation between age-related IGF-I values and VAI suggest the involvement of adipocyte dysfunction in low IGF-I status more than MS per se. Further studies are needed to address whether these results are valid also for other psoriatic patients.
Collapse
Affiliation(s)
- S. Savastano
- Department of Molecular and Clinical
Endocrinology and Oncology, Division of Endocrinology, Federico II University
Medical School of Naples
| | - N. Balato
- Department of Systematic Pathology,
Division of Clinical Dermatology, Federico II University Medical School of
Naples
| | - F. Gaudiello
- Department of Systematic Pathology,
Division of Clinical Dermatology, Federico II University Medical School of
Naples
| | | | - V. Brancato
- Department of Molecular and Clinical
Endocrinology and Oncology, Division of Endocrinology, Federico II University
Medical School of Naples
| | - A. Colao
- Department of Molecular and Clinical
Endocrinology and Oncology, Division of Endocrinology, Federico II University
Medical School of Naples
| | - F. Ayala
- Department of Systematic Pathology,
Division of Clinical Dermatology, Federico II University Medical School of
Naples
| | - G. Tarantino
- Department of Clinical and
Experimental Medicine, Federico II University Medical School of Naples, Italy
| |
Collapse
|
30
|
Berger M, Brancato V, Graf S, Heidegger C, Darmon P, Pichard C. OP027 SPN STUDY: SUPPLEMENTAL PARENTERAL NUTRITION (PN) TO REACH ENERGY TARGET DOES NOT COMPROMISE GLUCOSE CONTROL. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s1744-1161(11)70027-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
31
|
Abstract
BACKGROUND With a reported incidence of 1 to 2 cases per million, adrenocortical cancer (ACC) is a rare disease with poor prognosis. Age distribution shows two peaks: early childhood and between age 40 and 50 years, with females more frequently affected. Sequelae can include Cushing syndrome, virilization and hypertension or local symptoms consistent with abdominal obstruction. Although most cases of ACC are of sporadic origin, they may also occur as part of a congenital or familial disease in which the genetic abnormalities are well established. ACC can also be discovered incidentally in asymptomatic individuals. In sporadic ACC, some molecular modifications are commonly observed (i.e., overexpression of insulin-like growth factor II or vascular endothelial growth factor and somatic mutations of tumor protein 53). When surgical resection of the tumor is impossible or ineffective, chemotherapy with etoposide, doxorubicin and cisplatin plus mitotane or with streptozotocin plus mitotane is frequently used; however, the overall survival rates are disappointing. CONCLUSIONS Hormonal evaluation is essential to diagnose ACC and the prognosis depends on many factors. New treatments, such as insulin-like growth factor I receptor antibodies, tyrosine kinase inhibitors and other antiangiogenic compounds, are now being intensively investigated to identify better therapies for this extremely severe malignant neoplasia.
Collapse
Affiliation(s)
- A Patalano
- Unit of Endocrinology, Department of Medical and Surgical Sciences, University of Padua, Padua, Italy
| | | | | |
Collapse
|
32
|
Piazze JJ, Anceschi MM, Maranghi L, Brancato V, Marchiani E, Cosmi EV. Fetal lung maturity in pregnancies complicated by insulin-dependent and gestational diabetes: a matched cohort study. Eur J Obstet Gynecol Reprod Biol 1999; 83:145-50. [PMID: 10391524 DOI: 10.1016/s0301-2115(98)90333-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To study fetal lung maturity (FLM) as determined by amniotic fluid (AF) tests in diabetic pregnancies (DP) under euglycemic metabolic control, in comparison with matched controls (C). PATIENTS AND METHODS From 514 consecutive pregnancies where amniocentesis was performed for FLM assessment, we selected 45 glycemic controlled DP. Nineteen DP were Type I (IDDM) and 26 pregnancies were diagnosed Type III (GDM). Cases were matched to C by therapy with corticosteroids, gestational age at amniocentesis, pregnancy complications other than diabetes and gender. FLM was determined by the shake test and lamellar bodies (LB) count, lecithin/sphingomyelin (L/S) ratio (planimetric and stechiometric) and phosphatidylglycerol presence (PG). DP were further sub-divided according to gestational age period at amniocentesis, type of diabetes, associated therapy and fetal malformations. RESULTS RDS (n=2) and neonatal wet lung (n=5) were diagnosed in neonates from diabetic mothers. We found no statistical difference when comparing FLM indices between DP and C groups: shake test 3.1:1+/-1.2 vs. 2.7:1+/-1.2, P<0.40; planimetric L/S 3.4+/-1.4 vs. 3.1+/-2.0, P<0.27; stechiometric L/S 8.2+/-7.4 vs. 7.1+/-6.1, P<0.54; percentage of PG positivity 57% vs. 46%, P<0.13; lamellar bodies count (X10(3)/microl) 42.8+/-36.9 vs. 41.5+/-30.4, P<0.72. No differences were found between DP and controls for subgroups according to gestational age, type of Diabetes (IDDM or GDM), congenital lesions and associated therapy. CONCLUSIONS In euglycemic, metabolically controlled diabetic patients FLM is not delayed, however an increased risk for neonatal wet lung should be considered.
Collapse
Affiliation(s)
- J J Piazze
- Second Institute of Gynecology and Obstetrics, La Sapienza University, Rome, Italy
| | | | | | | | | | | |
Collapse
|
33
|
Abstract
The aim of this study was to evaluate the impact of primary cytomegalovirus (CMV) infection on fetal pulmonary surfactant production as assessed by different tests for the diagnosis of fetal lung maturity (FLM) on amniotic fluid (AF). A cross-sectional cohort study. AF samples from 11 pregnant women with primary CMV infection were examined for FLM between the 26th and 37th week of gestation. Normal pregnancies (n = 11) were matched for gestational age at amniocentesis and at delivery, birth weight, Apgar score and gender sex. FLM was assessed by planimetric and stoichiometric lecithin to sphingomyelin ratio (L/S), phosphatidylglycerol (PG) presence and lamellar bodies count (LB). Maternal immunological parameters (T-cells, natural killer [NK] activity) were also considered. Mean planimetric L/S ratio (4.2+/-2.1 vs 2.3+/-0.7, P < 0.01) and LB count (42.6 x 10(3)+/-19.0 x 10(3) vs 16.8 x 10(3)+/-11.5 x 10(3), P < 0.004) were higher in controls when compared to CMV infected patients. Moreover, planimetric L/S ratio was higher in five CMV non-infected babies compared to six CMV-infected babies (3.1+/-1.3 vs 1.9+/-0.8, P < 0.05). When FLM was related to maternal immunological results, planimetric and stoichiometric L/S and LBs count were negatively correlated with CD8+ T-cells (r = -0.8, P < 0.05; r = -0.9, P < 0.05; r = -0.9, P < 0.01, respectively); LBs was also negatively correlated with CD14+ T-cells (r = -0.8, P < 0.03). In contrast, a positive correlation was found between stoichiometric L/S and NK activity (r = 0.9, P > 0.01). Maternal primary CMV infection impairs FLM indices as a possible result of reduced surfactant release and/or production. Significant correlations were found between immunity status of CMV-infected mothers and FLM tests.
Collapse
Affiliation(s)
- J Piazze
- II Istituto di Clinica Ginecologica ed Ostetrica, Università La Sapienza di Roma, Policlinico Umberto I, Rome, Italy
| | | | | | | | | | | | | |
Collapse
|
34
|
Affiliation(s)
- J J Piazze
- 2nd Institute of Obstetrics and Gynecology, Policlinico Umberto I, La Sapienza University, Rome, Italy.
| | | | | | | |
Collapse
|
35
|
Brancato V, Delvecchio G, Simone P. [Survival and mortality in a cohort of heroin addicts in 1985-1994]. Minerva Med 1995; 86:97-9. [PMID: 7603612] [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: 01/26/2023]
Abstract
Between 1985 and 1994, 138 intravenons drug addicts were observed, 62 were HIV ab positive. 26 patients died (10 overdose and 9 AIDS). AIDS is, at present, the most frequent cause of death.
Collapse
Affiliation(s)
- V Brancato
- USSL 25-Clusone, Bergamo, Servizio di Medicina di Base
| | | | | |
Collapse
|
36
|
Abstract
DSM-III and DSM-III-R defined the diagnostic criteria of brief reactive psychosis (BRP) identifying some personality disorders (PDs) as predisposing factors: up to now no experimental data support this hypothesis. In this research, the authors studied the link between BRP and PDs, assessing axis II diagnosis (SIDP-R), after recovery of BRP in a group of 23 patients. Eighty-seven percent of the patients (n = 19) received at least one diagnosis of PDs. The widespread presence of PDs and, particularly, the high prevalence of cluster C (n = 11, 47.8%), are only partially in accordance with the hypothesis of DSM-III. A possible alternative model of interaction is suggested.
Collapse
Affiliation(s)
- C Maffei
- Unit of Medical Psychology and Psychotherapy, Scientific Institute S. Raffaele, Milano, Italy
| | | | | | | | | | | |
Collapse
|
37
|
Cavallaro R, Regazzetti MG, Mundo E, Brancato V, Smeraldi E. Tardive dyskinesia outcomes: clinical and pharmacologic correlates of remission and persistence. Neuropsychopharmacology 1993; 8:233-9. [PMID: 8099483 DOI: 10.1038/npp.1993.26] [Citation(s) in RCA: 30] [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: 01/28/2023]
Abstract
Reversible tardive dyskinesia (TD) outcomes have been reported in long-term neuroleptic (NL)-treated patients. In this study the course of TD outcomes was followed-up for 3 years in a population of 125 institutionalized schizophrenic patients (mean age 57.8 years) receiving continuous NL treatment. Tardive dyskinesia occurrence and severity were assessed by means of the Rockland Simpson Scale (RSS). The prevalence of TD rose from 39.2% at the first examination to 52.8% at last follow-up examination; however, 28.6% of TD-affected patients recovered and 30% improved. Significant risk factors for a persistent TD outcome result included age over 56 years, duration of illness over 30 years, and a total RSS score over 22. Cumulative NL exposure, over 3550 g of chlorpromazine equivalents, was also a significant risk factor for TD. Results from this study confirm that there is the possibility of improvement and remission in an aged, long-term institutionalized population of TD patients. In this report we point out prognostic factors for positive outcome.
Collapse
Affiliation(s)
- R Cavallaro
- Department of Neuropsychiatric Sciences, S. Raffaele Hospital, University of Milan, Italy
| | | | | | | | | |
Collapse
|
38
|
Abstract
The symptomatology of 15 borderline (BDL) depressed and 45 non-BDL depressed consecutive inpatients was assessed using the Hamilton depression scale (HAM-D) and the 90-item Symptoms Checklist (SCL-90) self-rating questionnaire. No significant differences were found in the total scorings of the two instruments in the two groups of patients. However, while non-BDL depressive rated significantly higher in items related to melancholic forms of depression, BDL depressives showed less specific symptoms, and the persistence, or possibly the magnification, of their maladaptive personologic structure. Two discriminant analyses, performed on the ratings at the HAM-D and SCL-90 of the two groups of patients, suggested that although the total degree of severity may be the same, the depressive episodes of BDL patients are qualitatively different from those of patients with less maladaptive personologic traits.
Collapse
Affiliation(s)
- L Bellodi
- Department of Neuropsychiatric Sciences, University of Milan School of Medicine, S. Raffaele Hospital, Italy
| | | | | | | | | |
Collapse
|
39
|
Delvecchio G, Brancato V. [Mortality and HIV infection in a group of intravenous heroin addicts from 1985 to 1989]. Minerva Med 1991; 82:675-8. [PMID: 1745378] [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: 12/28/2022]
Abstract
One hundred and eighty-seven heroin addicts resident in Valle Seriana Superiore were monitored from July 1985 to July 1989. This sample was representative of a total population of drug addicts estimated at some 350 subjects, 90 of whom (48.1%) were HIV-positive in Elisa assays and Western blot control tests. Six patients (3.2%) died; 3 of whom (3%) were HIV-positive and 3 (3.3%) were HIVab-negative. The most frequent cause of death (59%) was heroin overdose, which occurred in both HIV-positive and negative subjects, showing that the fear of contracting the disease or its possible evolution is not a deterrent in modifying risk behaviour. During the four years of the study, 5 (5.5%) of the HIV-positive patients developed confirmed AIDS. Only one patient died from AIDS, thus confirming the current risk of death as being 1.1% in seropositive patients. An increase in mortality due to AIDS is expected in the future, in line with the current prevalent mortality rate due to heroin overdose.
Collapse
Affiliation(s)
- G Delvecchio
- Divisione di Malattie Infettive OO.RR., USSL n. 25, Clusone, Bergamo
| | | |
Collapse
|
40
|
Abstract
In the light of the existence of controversial reports on the stability of Li ratio, we investigated a group of affective patients wishing to verify intraindividual stability of this parameter in the different phases of the disease, that is normothymia and manic and depressive episodes. We found lower Li ratios for the periods preceding any relapse. Further, we analyzed whether or not some epidemiological factors, such as polarity, sex, actual age, age of onset, might affect interindividual variability of the Li ratio. We found that they did not as single factors. Interaction between polarity and the presence of relapses appeared to significantly affect the Li ratio.
Collapse
Affiliation(s)
- M Catalano
- Institute of Clinical Psychiatry, Milan, Italy
| | | | | | | | | |
Collapse
|
41
|
Brambilla F, Facchinetti F, Petraglia F, Smeraldi E, Bellodi L, Brancato V, Genazzani AR. Effects of neuroleptic treatments on peripheral opioid secretion. Neuropsychobiology 1987; 18:68-73. [PMID: 2897644 DOI: 10.1159/000118395] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The effects of short- and long-term neuroleptic therapy on peripheral secretion of beta-endorphin (beta-EP) and beta-lipotropin (beta-LPH) were examined in 25 chronic schizophrenic patients. Haloperidol was given to 8 patients for 10 days (group A: 0.1 mg/kg b.w./day) and to another group of 8 patients for 30 days (group B: 10-18 mg/day). The other 9 patients were given a combination of haloperidol (6-30 mg/day) with either chlorpromazine (25-75 mg/day), clotiapine (40-60 mg/day), or fluphenazine decanoate (25-75 mg/month) for 14-18 months (group C). beta-EP and beta-LPH levels were assayed before and after each treatment. Haloperidol plasma levels were assayed in group B patients at the end of treatment. beta-EP mean basal levels were higher in patients than in controls; however, beta-LPH mean basal levels were higher only for group A patients. After treatment, the mean levels did not differ from those prior to therapy in groups A and B, while beta-LPH levels were significantly higher in group C. Level increases or decreases in single patients did not correlate with drug dose or duration of treatment, with baseline peptide levels or with the clinical effects of the various treatments.
Collapse
|
42
|
Borgia M, Brancato V, Borgia R. [Controlled study on the effects of 2 different therapeutic approaches in the treatment of chronic constipation]. Clin Ter 1986; 118:165-70. [PMID: 3530618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
43
|
Perna A, Patanè E, Brancato V. [Ubidecarenone in cardiologic therapy in a bronchopneumology ward]. Boll Chim Farm 1986; 125:46S-52S. [PMID: 3741654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
44
|
Borgia M, Sepe N, Brancato V, Costa G, Simone P, Borgia R, Lugli R. Treatment of chronic constipation by a bulk-forming laxative (Fibrolax). J Int Med Res 1983; 11:124-7. [PMID: 6852360 DOI: 10.1177/030006058301100212] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Seventy-five patients affected by chronic constipation were treated for 4 weeks with an Ispaghula Husk preparation (Fibrolax), a bulk-forming laxative. Frequency, stool consistency, abdominal pain and signs of venous stasis improved after treatment. No important side-effect was recorded. Cholesterol, HDL-cholesterol and triglycerides did not show significant changes.
Collapse
|