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Gianfrilli D, Ferlin A, Isidori AM, Garolla A, Maggi M, Pivonello R, Santi D, Sansone A, Balercia G, Granata ARM, Sinisi A, Lanfranco F, Pasqualetti P, Foresta C, Lenzi A. Risk behaviours and alcohol in adolescence are negatively associated with testicular volume: results from the Amico‐Andrologo survey. Andrology 2019; 7:769-777. [DOI: 10.1111/andr.12659] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 01/06/2023]
Affiliation(s)
- D. Gianfrilli
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology Sapienza University of Rome Rome Italy
| | - A. Ferlin
- Department of Clinical and Experimental Sciences Unit of Endocrinology and Metabolism University of Brescia Brescia Italy
| | - A. M. Isidori
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology Sapienza University of Rome Rome Italy
| | - A. Garolla
- Unit of Andrology and Reproductive Medicine Department of Medicine University of Padova Padova Italy
| | - M. Maggi
- Sexual Medicine and Andrology Dipartimento Scienze Biomediche Sperimentali e Cliniche ‘Mario Serio’ University of Florence Firenze Italy
| | - R. Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia Università Federico II di Napoli Naples Italy
| | - D. Santi
- Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena Italy
| | - A. Sansone
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology Sapienza University of Rome Rome Italy
| | - G. Balercia
- Endocrinology, Department of Clinical and Molecular Sciences Polytechnic University of Marche Ancona Italy
| | - A. R. M. Granata
- Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena Italy
| | - A. Sinisi
- Andrology Unit Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences University HospitalL. Vanvitelli University of Campania Naples Italy
| | - F. Lanfranco
- Andrology Unit Division of Endocrinology, Diabetology and Metabolism Department of Medical Sciences University of Turin Torino Italy
| | - P. Pasqualetti
- Service of Medical Statistics and Information Technology Fatebenefratelli Foundation for Health Research and Education Rome Italy
| | - C. Foresta
- Unit of Andrology and Reproductive Medicine Department of Medicine University of Padova Padova Italy
| | - A. Lenzi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology Sapienza University of Rome Rome Italy
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Di Girolamo A, Albanesi M, Sinisi A, Nettis E, Di Bona D, Caiaffa MF, Macchia L. Rapid desensitization for brentuximab vedotin (Adceteris ®) allergy: a case report. Clin Mol Allergy 2018; 16:22. [PMID: 30386181 PMCID: PMC6205792 DOI: 10.1186/s12948-018-0100-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 10/19/2018] [Indexed: 11/10/2022] Open
Abstract
Background Brentuximab vedotin (BV) is an antibody-drug conjugate formed by an anti-CD30 chimeric IgG1 conjugated with monomethyl-auristatin-E. BV targets the CD30+ cells, which characterize Hodgkin lymphoma as well as anaplastic large cell lymphoma. Once bound to the CD30+ cells BV exerts its cytotoxic effect via the monomethyl-auristatin-E moiety. So far, accounts on immediate adverse reactions to BV remain anecdotal. Moreover, few reports exist on desensitization for BV. Case presentation A 20-year old male patient was diagnosed with Hodgkin lymphoma in July 2014. The first line treatment with adriblastine, bleomicine, vinblastine and dacarbazine lead to a partial remission. Thus, a treatment with BV was started. However, during the second BV infusion, he developed generalized urticaria and dyspnea. In order not to discontinue the treatment with BV, we performed a thorough allergological workup and designed a 12-step rapid desensitization protocol. Overall the desensitization procedure was well tolerated and no major adverse reactions occurred. Conclusion Rapid desensitization is a suitable and safe option in the case of BV allergy and prevents the BV treatment withdrawal.
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Affiliation(s)
- Attilio Di Girolamo
- 1Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari-Aldo Moro, Piazza Giulio Cesare, Policlinico, 70124 Bari, Italy
| | - Marcello Albanesi
- 1Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari-Aldo Moro, Piazza Giulio Cesare, Policlinico, 70124 Bari, Italy
| | - Alessandro Sinisi
- 1Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari-Aldo Moro, Piazza Giulio Cesare, Policlinico, 70124 Bari, Italy
| | - Eustachio Nettis
- 1Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari-Aldo Moro, Piazza Giulio Cesare, Policlinico, 70124 Bari, Italy
| | - Danilo Di Bona
- 1Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari-Aldo Moro, Piazza Giulio Cesare, Policlinico, 70124 Bari, Italy
| | - Maria Filomena Caiaffa
- 2Department of Medical and Surgical Sciences, School and Chair of Allergology and Clinical Immunology, University of Foggia, Via Luigi Pinto 1, 70100 Foggia, Italy
| | - Luigi Macchia
- 1Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari-Aldo Moro, Piazza Giulio Cesare, Policlinico, 70124 Bari, Italy
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Albanesi M, Nico A, Sinisi A, Giliberti L, Rossi MP, Rossini M, Kourtis G, Rucco AS, Loconte F, Muolo L, Zurlo M, Di Bona D, Caiaffa MF, Macchia L. A 13-year real-life study on efficacy, safety and biological effects of Vespula venom immunotherapy. Clin Mol Allergy 2018; 16:2. [PMID: 29375272 PMCID: PMC5774115 DOI: 10.1186/s12948-017-0079-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 09/20/2017] [Accepted: 12/18/2017] [Indexed: 11/10/2022] Open
Abstract
Background Hymenoptera venom immunotherapy (VIT) is a clinically effective treatment. However, little is known about its long-term clinical efficacy and biological effects. Several mechanisms have been proposed to account for VIT efficacy, including reduction of specific IgE and induction of allergen-specific IgG4, but the overall picture remains elusive. We investigated Vespula VIT clinical efficacy up to 8 years after discontinuation and the kinetics of Vespula-specific IgE and IgG4. Out of 686 consecutive patients we retrospectively selected and analysed a series of 23 patients with Vespula allergy that underwent a 5-year IT course, followed by a prolonged follow-up. Methods Clinical efficacy of VIT was assessed as number and severity of reactions to Vespula re-stinging events. The presence of Vespula-specific IgE and IgG4 was also monitored over time. Results During the VIT treatment, patients were protected, reporting no reactions or mild reactions in occasion of re-stinging events. This protection was entirely maintained during the follow-up, up to 8 years. Skin reactivity (reflecting mast cell-bound Vespula-specific IgE) and circulating Vespula-specific IgE levels declined substantially during VIT. Notably, this reduction was maintained over time during the follow-up. Moreover, all the patients were analysed for IgG4. A robust induction of Vespula-specific IgG4 was observed during the VIT course, with a substantial decline during the follow-up. Conclusions We conclude that Vespula VIT is a clinically effective treatment, which induces long-term protection after discontinuation. The reduction of specific IgE, assessed by skin tests and RAST, closely matches the VIT- induced protection, while the IgG4 induction seems not to be associated with VIT clinical efficacy in the long term. Electronic supplementary material The online version of this article (10.1186/s12948-017-0079-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marcello Albanesi
- 1School and Chair of Allergology and Clinical Immunology, Department of Emergency and Organ Transplantation, University of Bari-Aldo Moro, Piazza Giulio Cesare 13, Policlinico, 70124 Bari, Italy
| | - Andrea Nico
- 1School and Chair of Allergology and Clinical Immunology, Department of Emergency and Organ Transplantation, University of Bari-Aldo Moro, Piazza Giulio Cesare 13, Policlinico, 70124 Bari, Italy
| | - Alessandro Sinisi
- 1School and Chair of Allergology and Clinical Immunology, Department of Emergency and Organ Transplantation, University of Bari-Aldo Moro, Piazza Giulio Cesare 13, Policlinico, 70124 Bari, Italy
| | - Lucia Giliberti
- 1School and Chair of Allergology and Clinical Immunology, Department of Emergency and Organ Transplantation, University of Bari-Aldo Moro, Piazza Giulio Cesare 13, Policlinico, 70124 Bari, Italy
| | - Maria Pia Rossi
- 1School and Chair of Allergology and Clinical Immunology, Department of Emergency and Organ Transplantation, University of Bari-Aldo Moro, Piazza Giulio Cesare 13, Policlinico, 70124 Bari, Italy
| | - Margherita Rossini
- Unit of Clinical Pathology, Policlinico di Bari, Piazza Giulio Cesare 13, Policlinico, 70124 Bari, Italy
| | - Georgios Kourtis
- 1School and Chair of Allergology and Clinical Immunology, Department of Emergency and Organ Transplantation, University of Bari-Aldo Moro, Piazza Giulio Cesare 13, Policlinico, 70124 Bari, Italy
| | - Anna Simona Rucco
- 1School and Chair of Allergology and Clinical Immunology, Department of Emergency and Organ Transplantation, University of Bari-Aldo Moro, Piazza Giulio Cesare 13, Policlinico, 70124 Bari, Italy
| | - Filomena Loconte
- 1School and Chair of Allergology and Clinical Immunology, Department of Emergency and Organ Transplantation, University of Bari-Aldo Moro, Piazza Giulio Cesare 13, Policlinico, 70124 Bari, Italy
| | - Loredana Muolo
- 1School and Chair of Allergology and Clinical Immunology, Department of Emergency and Organ Transplantation, University of Bari-Aldo Moro, Piazza Giulio Cesare 13, Policlinico, 70124 Bari, Italy
| | - Marco Zurlo
- 1School and Chair of Allergology and Clinical Immunology, Department of Emergency and Organ Transplantation, University of Bari-Aldo Moro, Piazza Giulio Cesare 13, Policlinico, 70124 Bari, Italy
| | - Danilo Di Bona
- 1School and Chair of Allergology and Clinical Immunology, Department of Emergency and Organ Transplantation, University of Bari-Aldo Moro, Piazza Giulio Cesare 13, Policlinico, 70124 Bari, Italy
| | - Maria Filomena Caiaffa
- 3School and Chair of Allergology and Clinical Immunology, Department of Medical and Surgical Sciences, University of Foggia, Via Luigi Pinto 1, 70100 Foggia, Italy
| | - Luigi Macchia
- 1School and Chair of Allergology and Clinical Immunology, Department of Emergency and Organ Transplantation, University of Bari-Aldo Moro, Piazza Giulio Cesare 13, Policlinico, 70124 Bari, Italy
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Albanesi M, Sinisi A, Frisenda F, Di Bona D, Caiaffa M, Macchia L. Importance of Specific IgE/Total IgE Ratio in Disambiguating Amoxicillin Allergy Diagnosis in a Real-Life Setting. Int Arch Allergy Immunol 2018; 177:167-169. [DOI: 10.1159/000489705] [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] [Received: 01/31/2018] [Accepted: 04/30/2018] [Indexed: 11/19/2022] Open
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Bertuzzi G, Sinisi A, Pecorari D, Caruana L, Mazzanti A, Bernardi L, Fochi M. Nucleophilic Dearomatization of Pyridines under Enamine Catalysis: Regio-, Diastereo-, and Enantioselective Addition of Aldehydes to Activated N-Alkylpyridinium Salts. Org Lett 2017; 19:834-837. [PMID: 28128963 DOI: 10.1021/acs.orglett.6b03824] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Catalytic addition of chiral enamines to azinium salts is a powerful tool for the synthesis of enantioenriched heterocycles. An unprecedented asymmetric dearomative addition of aldehydes to activated N-alkylpyridinium salts is presented. The process exhibits complete C-4 regioselectivity along with high levels of diastereo- and enantiocontrol, achieving a high-yielding synthesis of a broad range of optically active 1,4-dihydropyridines. Moreover, the presented methodology enables the synthesis of functionalized octahydropyrrolo[2,3-c]pyridines, the core structure of anticancer peptidomimetics.
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Affiliation(s)
- Giulio Bertuzzi
- Department of Industrial Chemistry "Toso Montanari" and INSTM RU Bologna, Alma Mater Studiorum-University of Bologna , Via Risorgimento 4, 40136 Bologna, Italy
| | - Alessandro Sinisi
- Department of Industrial Chemistry "Toso Montanari" and INSTM RU Bologna, Alma Mater Studiorum-University of Bologna , Via Risorgimento 4, 40136 Bologna, Italy
| | - Daniel Pecorari
- Department of Industrial Chemistry "Toso Montanari" and INSTM RU Bologna, Alma Mater Studiorum-University of Bologna , Via Risorgimento 4, 40136 Bologna, Italy
| | - Lorenzo Caruana
- Department of Industrial Chemistry "Toso Montanari" and INSTM RU Bologna, Alma Mater Studiorum-University of Bologna , Via Risorgimento 4, 40136 Bologna, Italy
| | - Andrea Mazzanti
- Department of Industrial Chemistry "Toso Montanari" and INSTM RU Bologna, Alma Mater Studiorum-University of Bologna , Via Risorgimento 4, 40136 Bologna, Italy
| | - Luca Bernardi
- Department of Industrial Chemistry "Toso Montanari" and INSTM RU Bologna, Alma Mater Studiorum-University of Bologna , Via Risorgimento 4, 40136 Bologna, Italy
| | - Mariafrancesca Fochi
- Department of Industrial Chemistry "Toso Montanari" and INSTM RU Bologna, Alma Mater Studiorum-University of Bologna , Via Risorgimento 4, 40136 Bologna, Italy
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Bertuzzi G, Sinisi A, Caruana L, Mazzanti A, Fochi M, Bernardi L. Catalytic Enantioselective Addition of Indoles to Activated N-Benzylpyridinium Salts: Nucleophilic Dearomatization of Pyridines with Unusual C-4 Regioselectivity. ACS Catal 2016. [DOI: 10.1021/acscatal.6b01962] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Giulio Bertuzzi
- Department of Industrial
Chemistry “Toso Montanari” and INSTM RU Bologna, Alma Mater Studiorum—University of Bologna, V. Risorgimento 4, 40136 Bologna, Italy
| | - Alessandro Sinisi
- Department of Industrial
Chemistry “Toso Montanari” and INSTM RU Bologna, Alma Mater Studiorum—University of Bologna, V. Risorgimento 4, 40136 Bologna, Italy
| | - Lorenzo Caruana
- Department of Industrial
Chemistry “Toso Montanari” and INSTM RU Bologna, Alma Mater Studiorum—University of Bologna, V. Risorgimento 4, 40136 Bologna, Italy
| | - Andrea Mazzanti
- Department of Industrial
Chemistry “Toso Montanari” and INSTM RU Bologna, Alma Mater Studiorum—University of Bologna, V. Risorgimento 4, 40136 Bologna, Italy
| | - Mariafrancesca Fochi
- Department of Industrial
Chemistry “Toso Montanari” and INSTM RU Bologna, Alma Mater Studiorum—University of Bologna, V. Risorgimento 4, 40136 Bologna, Italy
| | - Luca Bernardi
- Department of Industrial
Chemistry “Toso Montanari” and INSTM RU Bologna, Alma Mater Studiorum—University of Bologna, V. Risorgimento 4, 40136 Bologna, Italy
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Staibano S, Franco R, Mezza E, Chieffi P, Sinisi A, Pasquali D, Errico ME, Nappi C, Tremolaterra F, Somma P, Mansueto G, De Rosa G. Loss of oestrogen receptor beta, high PCNA and p53 expression and aneuploidy as markers of worse prognosis in ovarian granulosa cell tumours. Histopathology 2003; 43:254-62. [PMID: 12940778 DOI: 10.1046/j.1365-2559.2003.01706.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [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: 01/10/2023]
Abstract
AIMS Ovarian granulosa cell tumour (OGCT) is a sex-cord stromal tumour with a general trend toward late relapse and/or metastasis. However, mortality rate corrected for long-term follow-up shows that about 50% of patients die within 20 years of diagnosis. Classical clinicopathological parameters are unable to predict the biological behaviour of OGCT. The involvement of a recently characterized subtype of oestrogen receptor, ERbeta, in ovarian carcinogenesis has been hypothesized. METHODS AND RESULTS We examined by immunohistochemistry the expression of ERbeta, proliferating cell nuclear antigen (PCNA) and p53 in a selected series of 30 OGCT, to evaluate their role in the prognostic evaluation of this tumour. Immunohistochemistry was performed on formalin-fixed paraffin-embedded sections. Results were compared with the DNA-ploidy of the tumours (evaluated by image analysis) and with the follow-up data of the patients. CONCLUSIONS Loss of ERbeta expression, high PCNA expression and aneuploidy, characterized a subgroup of OGCT with a worse outcome. The identification of a high-risk subclass of OGCT may be of primary importance in addressing appropriate therapeutic strategies, offering the chance to prevent relapses and metastases by using adjunctive, specifically targetted, more aggressive therapies.
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Affiliation(s)
- S Staibano
- Department of Biomorphological and Functional Sciences, University 'Federico II' of Naples, Naples, Italy.
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Sinisi A. [Internal migration and rural society in southern Italy (sixteenth to nineteenth centuries)]. Boll Demogr Stor 2002:41-70. [PMID: 12319597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Gunji K, De Bellis A, Li AW, Yamada M, Kubota S, Ackrell B, Wengrowicz S, Bellastella A, Bizzarro A, Sinisi A, Wall JR. Cloning and characterization of the novel thyroid and eye muscle shared protein G2s: autoantibodies against G2s are closely associated with ophthalmopathy in patients with Graves' hyperthyroidism. J Clin Endocrinol Metab 2000; 85:1641-7. [PMID: 10770210 DOI: 10.1210/jcem.85.4.6553] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Serum autoantibodies against eye muscle antigens are closely linked with thyroid-associated ophthalmopathy (TAO), although their significance is unclear. The two antigens that are most often recognized are eye muscle membrane proteins with molecular masses of 55 and 64 kDa, as determined from immunoblotting with crude human or porcine eye muscle membranes. We cloned a fragment of the 55-kDa protein by screening an eye muscle expression library with affinity-purified anti-55 kDa protein antibody prepared from a TAO patient's serum. A complementary DNA (cDNA) encoding a novel protein, which we have called G2s, was sequenced on both strands, and its size was 411 bp. The open reading frame of G2s corresponded to a 121-amino acid peptide with a size of 1.4 kb. Using the rapid amplification of 5'-cDNA ends technique we were able to clone an additional 0.3 kb of the protein. G2s did not share significant homologies with any other entered protein in computer databases and had one putative transmembrane domain. Using the 1.4 kb cDNA as probe in Northern blotting of a panel of messenger ribonucleic acids prepared from human tissues, the parent protein was shown to correspond to a large molecule of about 5.8 kb with a calculated molecular mass of approximately 220 kDa, consistent with earlier immunoblot studies performed in the absence of reducing agents. G2s was strongly expressed in eye muscle, thyroid, and other skeletal muscle and to a lesser extent in pancreas, liver, lung, and heart muscle, but not in kidney or orbital fibroblasts. We tested sera from patients with Graves' hyperthyroidism with and without ophthalmopathy and from control patients and subjects for antibodies against a G2s fusion protein by immunoblotting and enzyme-linked immunosorbent assay. In immunoblotting, antibodies reactive with G2s were identified in 70% of patients with TAO of less than 3 yr duration, 53% with TAO of more than 3 yr duration, 36% with Graves' hyperthyroidism without evident ophthalmopathy, 17% with Hashimoto's thyroiditis, 3% with type 1 diabetes, 23% with nonimmunological thyroid disorders, and 16% of normal subjects. The prevalences, compared to normal values, were significant for the two groups of patients with TAO, but not for the other groups. Tests were positive in 54% of patients with active TAO, 33% with chronic ophthalmopathy, 36% with Graves' hyperthyroidism, 54% with Hashimoto's thyroiditis, 23% with type 1 diabetes, and in 11% of normal subjects using enzyme-linked immunosorbent assay. The antibodies predicted the development of the ocular myopathy subtype of TAO in six of seven patients and the congestive ophthalmopathy subtype in seven of eight patients, respectively, with Graves' hyperthyroidism studied prospectively during and after antithyroid drug therapy. Antibodies reactive with G2s may be early markers of ophthalmopathy in patients with Graves' hyperthyroidism. Because G2s is expressed in both thyroid and eye muscle, immunoreactivity against a shared epitope in the two tissues may explain the well known link between thyroid autoimmunity and ophthalmopathy.
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Affiliation(s)
- K Gunji
- Department of Medicine, Allegheny University of the Health Sciences, Pittsburgh, Pennsylvania 16212, USA
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Elizari MV, Martínez JM, Belziti C, Ciruzzi M, Pérez de la Hoz R, Sinisi A, Carbajales J, Scapín O, Garguichevich J, Girotti L, Cagide A. Morbidity and mortality following early administration of amiodarone in acute myocardial infarction. GEMICA study investigators, GEMA Group, Buenos Aires, Argentina. Grupo de Estudios Multicéntricos en Argentina. Eur Heart J 2000; 21:198-205. [PMID: 10639301 DOI: 10.1053/euhj.1999.1687] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS The objective of this study was to ascertain the effect of intravenous and oral amiodarone on morbidity and mortality in patients during the first hours after the onset of an acute myocardial infarction. METHODS AND RESULTS A cohort of 1073 patients admitted to the CCU within 24 h of the onset of symptoms of an acute myocardial infarction and heart failure (Killip and Kimball A-B) were randomized to receive amiodarone (n=542) or placebo (n=531) for 6 months. Because of the higher mortality, on an interim analysis, from a 'high dose' of amiodarone or placebo (516 patients) the protocol was changed to a 'low dose' or placebo (557 patients). Mortality with high doses of amiodarone was 16.30% vs 10.16% in the placebo group (P=0.04), whereas mortality with low doses was 6.61% vs 9.47% in the control group (P=0.20). Several non-fatal adverse effects were observed in 108 and 73 patients treated with amiodarone and placebo, respectively. CONCLUSION This study demonstrated that early administration of amiodarone in low doses to patients with an acute myocardial infarction may be used only if life-threatening arrhythmia justify its prescription. Conversely, when given in high doses, it might increase mortality.
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Affiliation(s)
- M V Elizari
- Hospital Ramos Mejía, Buenos Aires, Argentina
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Bobba A, Iolascon A, Giannattasio S, Albrizio M, Sinisi A, Prisco F, Schettini F, Marra E. Characterisation of CAH alleles with non-radioactive DNA single strand conformation polymorphism analysis of the CYP21 gene. J Med Genet 1997; 34:223-8. [PMID: 9132494 PMCID: PMC1050897 DOI: 10.1136/jmg.34.3.223] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The major cause of congenital adrenal hyperplasia (CAH), a common recessive genetic disease, is the deficiency of steroid 21-hydroxylase (21OH), a microsomal enzyme encoded by the CYP21 gene. Although several CAH causing mutations have been identified in the CYP21 gene of patients with 21OH deficiency, genotyping of the 21OH locus is quite complex because of the high frequency of gene conversion and the presence of multiple mutations on single CAH alleles. In order to perform the complete characterisation of the CYP21 gene coding region more simply, we developed a highly sensitive, non-radioactive method allowing DNA single strand conformation polymorphism (DNA-SSCP) analysis. This method was applied to the characterisation of all the exons and intron-exon junctions of the CYP21 gene in five patients affected by the simple virilising form and one affected by the salt wasting form. In all samples showing SSCP signals, direct sequence analysis showed the presence of more than one single sequence variant. In particular, four mutations which are already known to cause the disease, 16 polymorphisms, and one newly identified C to T transition at position 849 were detected. A random sequence analysis, performed on 31 out of 81 exons showing a normal SSCP pattern, shows the method to be highly sensitive: no sequence variant was detected, thus confirming the validity of this non-radioactive DNA-SSCP analysis in characterising the CYP21 gene in patients with steroid 21OH deficiency. Notwithstanding the complete characterisation of all exons and exon/intron junctions of the CYP21 gene, no complete genotype/phenotype correlation was found in the panel of patients analysed, thus suggesting that characterisation of CAH alleles must be extended to outside the coding region of the CYP21 gene, most probably into the promoter region.
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Affiliation(s)
- A Bobba
- CNR Centro di Studio sui Mitocondri e Metabolismo Energetico, Bari, Italy
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