1
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Wolf J, Heist R, Kim T, Nishio M, Dooms C, Kanthala R, Leo E, Giorgetti E, Wang Y, Mardjuadi F, Cortot A. 994P Efficacy and safety of capmatinib plus spartalizumab in treatment-naïve patients with advanced NSCLC harboring MET exon 14 skipping mutation. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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2
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Zipfel S, Biancari F, Mariscalco G, Dalén M, Settembre N, Welp H, Perrotti A, Wiebe K, Leo E, Loforte A, Chocron S, Pacini D, Juvonen T, Broman LM, Di Perna D, Yusuff H, Harvey C, Mongardon N, Maureira JP, Levy B, Falk L, Ruggieri VG, Kluge S, Reichenspurner H, Folliguet T, Fiore A. Extracorporeal Membrane Oxygenation for Patients with Severe COVID-19-Related ARDS: A European Multicenter Analysis. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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3
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Chaparro M, Garre A, Guerra Veloz MF, Vázquez Morón JM, De Castro ML, Leo E, Rodriguez E, Carbajo AY, Riestra S, Jiménez I, Calvet X, Bujanda L, Rivero M, Gomollón F, Benítez JM, Bermejo F, Alcaide N, Gutiérrez A, Mañosa M, Iborra M, Lorente R, Rojas-Feria M, Barreiro-de Acosta M, Kolle L, Van Domselaar M, Amo V, Argüelles F, Ramírez E, Morell A, Bernardo D, Gisbert JP. Effectiveness and Safety of the Switch from Remicade® to CT-P13 in Patients with Inflammatory Bowel Disease. J Crohns Colitis 2019; 13:1380-1386. [PMID: 30976785 DOI: 10.1093/ecco-jcc/jjz070] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS To evaluate the clinical outcomes in patients with IBD after switching from Remicade® to CT-P13 in comparison with patients who maintain Remicade®. METHODS Patients under Remicade® who were in clinical remission with standard dosage at study entry were included. The 'switch cohort' [SC] comprised patients who made the switch from Remicade® to CT-P13, and the 'non-switch' cohort [NC] patients remained under Remicade®. RESULTS A total of 476 patients were included: 199 [42%] in the SC and 277 [58%] in the NC. The median follow-up was 18 months in the SC and 23 months in the NC [p < 0.01]. Twenty-four out of 277 patients relapsed in the NC; the incidence of relapse was 5% per patient-year. The cumulative incidence of relapse was 2% at 6 months and 10% at 24 months in this group. Thirty-eight out of 199 patients relapsed in the SC; the incidence rate of relapse was 14% per patient-year. The cumulative incidence of relapse was 5% at 6 months and 28% at 24 months. In the multivariate analysis, the switch to CT-P13 was associated with a higher risk of relapse (HR = 3.5, 95% confidence interval [CI] = 2-6). Thirteen percent of patients had adverse events in the NC, compared with 6% in the SC [p < 0.05]. CONCLUSIONS Switching from Remicade® to CT-P13 might be associated with a higher risk of clinical relapse, although this fact was not supported in our study by an increase in objective markers of inflammation. The nocebo effect might have influenced this result. Switching from Remicade® to CT-P13 was safe.
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Affiliation(s)
- M Chaparro
- Gastroenterology Units from Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP] and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid, Spain
| | - A Garre
- Gastroenterology Units from Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP] and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid, Spain
| | - M F Guerra Veloz
- Gastroenterology Units from Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - J M Vázquez Morón
- Gastroenterology Units from Hospital Juan Ramón Jiménez, Huelva, Spain
| | - M L De Castro
- Gastroenterology Units from Complejo Hospitalario Universitario de Vigo, Vigo, Spain
| | - E Leo
- Gastroenterology Units from Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - E Rodriguez
- Gastroenterology Units from Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - A Y Carbajo
- Gastroenterology Units from Hospital Universitario Río Hortega, Valladolid, Spain
| | - S Riestra
- Gastroenterology Units from Hospital Universitario Central de Asturias and ISPA, Asturias, Spain
| | - I Jiménez
- Gastroenterology Units from Hospital de Galdakao-Usansolo, Vizcaya, Spain
| | - X Calvet
- Gastroenterology Units from Consorcí Corporació Sanitària Parc Tauli de Sabadell and CIBERehd, Barcelona, Spain
| | - L Bujanda
- Gastroenterology Units from Instituto Biodonostia, Universidad del País Vasco [UPV/EHU] and CIBERehd, San Sebastián, Spain
| | - M Rivero
- Gastroenterology Units from Hospital Universitario Marqués de Valdecilla and IDIVAL, Santander, Spain
| | - F Gomollón
- Gastroenterology Units from Hospital Clínico Universitario Lozano Blesa, IIS Aragón and CIBERehd, Zaragoza, Spain
| | - J M Benítez
- Gastroenterology Units from Hospital Universitario Reina Sofía, Córdoba, Spain
| | - F Bermejo
- Gastroenterology Units from Hospital Universitario de Fuenlabrada and Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - N Alcaide
- Gastroenterology Units from Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - A Gutiérrez
- Gastroenterology Units from Hospital General Universitario de Alicante and CIBERehd, Alicante, Spain
| | - M Mañosa
- Gastroenterology Units from Hospital Germans Trials i Pujol and CIBERehd, Barcelona, Spain
| | - M Iborra
- Gastroenterology Units from Hospital Universitario y Politécnico de La Fe and CIBERehd, Valencia, Spain
| | - R Lorente
- Gastroenterology Units from Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - M Rojas-Feria
- Gastroenterology Units from Hospital Universitario Nuestra Señora de Valme, Sevilla, Spain
| | - M Barreiro-de Acosta
- Gastroenterology Units from Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | - L Kolle
- Gastroenterology Units from Hospital General de La Palma, La Palma, Spain
| | - M Van Domselaar
- Gastroenterology Units from Hospital Universitario de Torrejón, Madrid, Spain
| | - V Amo
- Gastroenterology Units from Hospital Regional Universitario de Málaga, Málaga, Spain
| | - F Argüelles
- Gastroenterology Units from Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - E Ramírez
- Gastroenterology Units from Pharmacy Unit, Hospital Universitario de La Princesa, IIS-IP, Madrid, Spain
| | - A Morell
- Gastroenterology Units from Pharmacy Unit, Hospital Universitario de La Princesa, IIS-IP, Madrid, Spain
| | - D Bernardo
- Gastroenterology Units from Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP] and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid, Spain
| | - J P Gisbert
- Gastroenterology Units from Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP] and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid, Spain
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Molinari A, Leo E, Ferraresi M, Ferrari S, Terzi A, Sommaruga S. Distal Extended Endovascular Aortic Repair PETTICOAT: A Modified Technique to Improve False Lumen Remodeling in Acute Type B Aortic Dissection. J Vasc Surg 2019. [DOI: 10.1016/j.jvs.2019.06.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cascinelli N, Greco M, Leo E, Agresti R, Andreola S. Monoclonal Antibodies MBr1 and MBr8 as Predictors of Response to Oophorectomy in Advanced Breast Cancer. Tumori 2018; 74:309-12. [PMID: 3400120 DOI: 10.1177/030089168807400311] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The response to oophorectomy in 40 patients with advanced breast cancer was evaluated as a function of the presence or absence of the antigens recognized by the monoclonal antibodies MBrl, MBr8, and MOv2 on the cell surface of the primary tumor. Two groups (20 patients alive 5 years after oophorectomy and 20 patients who died within 5 years) were evaluated. These groups had a) the same distribution of lymph node status, diameter of the primary, and the presence of estrogen receptors at the time of first treatment and b) a comparable extent of the disease at the time of oophorectomy. The frequency of complete response after oophorectomy was significantly higher in patients whose tumors did not express the antigens recognized by antibodies MBrl and MBr8. Fourteen of the 22 patients with tumors not reacting with MBrl and 11 of the 18 negative to MBr8 had a complete response. There was no correlation with response and the monoclonal antibody MOv2. Both MBrl and MBr8 were present in 11 patients and both were absent in another 11. The simultaneous absence of the two antigens was related to the highest complete response rate (9 out of 11 patients).
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Affiliation(s)
- N Cascinelli
- Division of Surgical Oncology B, Istituto Nazionale Tumori, Milano, Italy
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6
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Abstract
The concentrations of serum albumin and the cumulative loss of albumin through the drainage tubes were followed in 14 patients who underwent radical mastectomy for cancer. The concentration of serum albumin declined during the postoperative period, and the nadir was on the 5th day. On the first 5 days a good correlation was observed between hypoalbuminemia and loss of albumin from the wound. After this period, hypoalbuminemia persisted unchanged although small quantities of albumin continued to be lost through the drains. It is concluded that in surgery complicated by abundant serum discharge, the albumin loss may be the main cause of postoperative hypoalbuminemia.
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7
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Gallino G, Belli F, Bonfanti G, Ditto A, Andreola S, Tragni G, Massone PP, Civelli E, Vitellaro M, Leo E, Cascinelli N. Surgical Treatment of Gastric Metastases from Cutaneous Melanoma: Experience of the National Cancer Institute of Milan. Tumori 2018; 87:229-31. [PMID: 11693800 DOI: 10.1177/030089160108700404] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim To evaluate the role of a surgical approach in patients affected with gastric metastases from cutaneous melanoma. Methods A retrospective review of our local melanoma database of 2100 patients identified 31 cases with gastric metastatic deposits. Nine of them were considered candidates for surgical resection. Results Median overall survival of the 9 patients who underwent surgery was 14.2 months. Six (67%) underwent a local radical resection of disease, and 3 (33%) had a simple exploratory laparotomy. The median survival was 21.6 months (range, 4-32 months) for the subset receiving radical surgery and 3.6 months (range, 2-6 months) for the patients who had no resection. Median follow-up was 14.2 months. No specific correlation of serologic LDH levels and final outcome, as documented elsewhere, was observed. A marked decreased or substantial remission of symptoms with an improvement in quality of life was observed in all radically resected patients. Conclusions Patients with gastric metastases from melanoma may benefit from surgery if all macroscopic disease can be removed. In addition, gastric resection in patients with symptomatic melanoma spread to the stomach provides important symptomatic palliation.
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Affiliation(s)
- G Gallino
- Department of Surgery, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
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Civelli EM, Gallino G, Mariani L, Cozzi G, Biganzoli E, Salvetti M, Gallo R, Belli F, Bonfanti G, Bertario L, Andreola S, Leo E. Double-Contrast Barium Enema and Computerised Tomography in the Pre-Operative Evaluation of Rectal Carcinoma: Are they Still Useful Diagnostic Procedures? Tumori 2018; 86:389-92. [PMID: 11130567 DOI: 10.1177/030089160008600504] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose In modern management of rectal carcinoma, the preoperative evaluation of disease parameters is important for selection of therapeutic options. Such parameters are currently defined through endorectal ultrasonography or endoscopic ultrasonography. A retrospective analysis of the parameters obtained with double-contrast barium enema (DCBE) and endorectal balloon computed tomography (CT) was conducted to verify the diagnostic reliability of the radiological techniques and to establish whether there is still an indication for their use. Methods 53 consecutive patients with adenocarcinoma of the distal half of the rectal ampulla underwent double contrast barium enema examination and CT of the pelvis with endorectal balloon. On the basis of the DCBE and CT assessment we evaluated: 1) the distance between the cranial extremity of the anal canal and the distal margin of the neoplasm; 2) the radial diffusion of the tumor; 3) the metastatic involvement of the perirectal and inferior mesenteric lymph nodes. Results 1) CT and DBCE measurements of the distal margin tended to coincide, but both tended to overestimate the measurement when compared to the pathologic examination; 2) in the identification of neoplastic infiltration of perirectal fat (T3) CT had 100% sensitivity, 78.7% specificity and 86.8% accuracy; 3) the CT sensitivity for detecting lymph node metastasis was 52.6%, specificity 85.3% and accuracy 73.6%. Conclusions The diagnostic information provided by the radiological examinations is comparable to that of clinical and instrumental methods currently employed for staging of rectal carcinoma, although the latter are preferred because they are more readily accessible and less costly. DCBE and CT can therefore be usefully employed for staging of cancer of the rectum in those cases in which there are limitations of the current standard methods.
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Affiliation(s)
- E M Civelli
- Department of Radiology, Istituto Nazionale perlo Studio e la Cura dei Tumori, Milan, Italy
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9
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Gallino G, Belli F, Tragni G, Ferro F, Massone PP, Ditto A, Leo E, Cascinelli N. Association between Cutaneous Melanoma and Neurofibromatosis Type 1: Analysis of Three Clinical Cases and Review of the Literature. Tumori 2018; 86:70-4. [PMID: 10778770 DOI: 10.1177/030089160008600113] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The authors report a rare association between cutaneous melanoma and Von Recklinghausen's disease (NF-1) and analyze the possible meaning of this occurrence. Various types of tumors have been associated with NF-1, in particular those of neuroectodermal origin, such as malignant peripheral nerve sheath tumors (MPNST) and phaeochromocytoma. The development of malignant melanoma in NF-1 patients is rare. Data from the literature is enable to demonstrate an increased incidence of cutaneous melanoma in patients with neurofibromatosis but the association of these two disorders seems reasonable in theory, as both are abnormalities of a neural crest origin. The cases described may represent not only a clinical report of two rarely associated disorders, but may also confirm the biological mechanisms responsible for these infrequent diseases.
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Affiliation(s)
- G Gallino
- Division of General Surgery B, National Cancer Institute, Milan, Italy
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O'Connor M, Cadogan E, Leo E, Hughes A, Learoyd M, Xu H, Li J, Yates J. Generation of a novel preclinical PK/PD model provides insights into PARP inhibitor clinical monotherapy activity. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx367.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Niger M, Maggi C, Di Bartolomeo M, Perrone F, Tamborini E, Milione M, Deraco M, Kusamura S, Baratti D, Berenato R, Caporale M, Consonni P, Bossi I, Leo E, Pelosi G, de Braud F, Pietrantonio F. Metronomic capecitabine and bevacizumab is an active combination in patients with relapsed peritoneal pseudomyxoma. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv344.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Baratti D, Kusamura S, Pietrantonio F, Guaglio M, Berenato R, Niger M, Caporale M, Leo E, Deraco M, De Braud F. Adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with colorectal cancer at high risk for the development of peritoneal metastases. A matched case-control study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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13
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Maggi C, De Braud F, Di Bartolomeo M, Perrone F, Tamborini E, Milione M, Deraco M, Kusamura S, Baratti D, Berenato R, Caporale M, Consonni P, Niger M, Bossi I, Leo E, Pelosi G, Pietrantonio F. 2366 Metronomic capecitabine and bevacizumab is an active combination in patients with relapsed peritoneal pseudomyxoma. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31282-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Baratti D, Kusamura S, Iusco D, Bonomi S, Grassi A, Virzì S, Leo E, Deraco M. Postoperative complications after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy affect long-term outcome of patients with peritoneal metastases from colorectal cancer: a two-center study of 101 patients. Dis Colon Rectum 2014; 57:858-68. [PMID: 24901687 DOI: 10.1097/dcr.0000000000000149] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy is an effective but potentially morbid treatment for colorectal cancer peritoneal metastases. The impact of treatment-related morbidity on long-term survival has been reported in various malignancies, but it has never been assessed in this clinical setting. OBJECTIVE The aim of this study was to assess the impact of major postoperative complications on oncological outcomes after cytoreduction and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases. DESIGN Two prospective databases were reviewed. Major complications were defined as grade 3 to 5 according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. The extent of peritoneal involvement was scored by the use of the Peritoneal Cancer Index. SETTINGS This study was conducted in 2 high-volume peritoneal malignancy management centers. PATIENTS One hundred one consecutive patients with peritoneal metastases potentially amenable to macroscopically complete cytoreduction were selected. INTERVENTIONS Peritonectomy procedures and multivisceral resections were used to remove all macroscopic tumor, and mitomycin-C plus cisplatin-based hyperthermic intraperitoneal chemotherapy was used to control microscopic residual disease. MAIN OUTCOME MEASURES The primary outcomes measured were overall and disease-specific survival. RESULTS Mortality and major morbidity were 3.0%, and 23.8%. Median follow-up was 44.9 months (95% CI, 24.1-65.7). Five-year disease-specific survival was 14.3% for patients who experienced major complications and 52.3% for those who did not (p = 0.001). Five-year overall survival was 11.7% for patients who experienced major complications, and 58.8% for those who did not (p = 0.003). At multivariate analysis, major morbidity correlated to both worse overall and disease-specific survival, along with a Peritoneal Cancer Index >19, and suboptimal cytoreduction. Poor performance status correlated only to worse disease-specific survival, and liver metastases correlated to worse overall survival. Longer operative time (OR, 4.1; 95% CI, 1.3-12.6; p = 0.01) and Peritoneal Cancer Index >19 (OR, 2.6; 95% CI, 1.1-6.0; p = 0.02) were independent risk factors for major morbidity. LIMITATIONS This study is limited by its observational design. CONCLUSIONS The prevention of major complications, by refining surgical technique and patient selection, is crucial because it affects oncologic outcome.
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Affiliation(s)
- D Baratti
- 1Peritoneal Surface Malignancy Program,Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy 2General Surgery Unit, Bentivoglio Hospital, Bentivoglio (BO), Italy 3Colorectal Unit, Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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Coronel J, Roper MH, Herrera C, Bonilla C, Jave O, Gianella C, Sabogal I, Huancaré V, Leo E, Tyas A, Mendoza-Ticona A, Caviedes L, Moore DAJ. Validation of microscopic observation drug susceptibility testing for rapid, direct rifampicin and isoniazid drug susceptibility testing in patients receiving tuberculosis treatment. Clin Microbiol Infect 2013; 20:536-41. [PMID: 24107197 PMCID: PMC4302318 DOI: 10.1111/1469-0691.12401] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 11/19/2012] [Revised: 07/22/2013] [Accepted: 09/16/2013] [Indexed: 12/01/2022]
Abstract
Drug susceptibility testing (DST) is often needed in patients clinically failing tuberculosis (TB) therapy. Most studies of phenotypic direct drug susceptibility tests, such as microscopic observation drug susceptibility (MODS) tests, have been performed in patients not receiving TB treatment. The effect of ongoing TB treatment on the performance of MODS direct DST has not been previously explored, but patients failing such therapy constitute an important target group. The aim of this study was to determine the performance of MODS direct rifampicin and isoniazid DST in patients clinically failing first-line TB treatment, and to compare MODS direct DST with indirect proportion method DST. Sputa from 264 TB patients were cultured in parallel in Lowenstein–Jensen (LJ) and MODS assays; strains were tested for rifampicin and isoniazid susceptibility by the proportion method at the national reference laboratory. Ninety-three samples were culture-positive by LJ and MODS (concordance of 96%; kappa 0.92). With conventional MODS plate DST reading (performed on the same day as the sample is classified as culture-positive), the isoniazid DST concordance was 96.8% (kappa 0.89), and the concordance for rifampicin susceptibility testing was 92.6% (kappa 0.80). Reading of MODS DST plates 1 week after cultures had been determined to be culture-positive improved overall performance marginally—the isoniazid DST concordance was 95.7% (kappa 0.85); and the rifampicin DST concordance was 96.8% (kappa 0.91). Sensitivity for detection of multidrug-resistant TB was 95.8%. MODS testing provided reliable rifampicin and isoniazid DST results for samples obtained from patients receiving TB therapy. A modified DST reading schedule for such samples, with a final reading 1 week after a MODS culture turns positive, marginally improves the concordance with reference DST.
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Affiliation(s)
- J Coronel
- Laboratorio de Investigación de Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Peru
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McClanahan F, Hielscher T, Rieger M, Hensel M, Bentz M, Schmidt-Wolf I, Käbisch A, Salwender H, Dürk H, Staiger H, Mandel T, Neben K, Hillengass J, Leo E, Krämer A, Ho AD, Witzens-Harig M. Final results of a randomized trial comparing 1, 3, or 6 infusions of Rituximab plus 6 cycles CHOP provide valuable preliminary data towards a more cost-effective and safer treatment of advanced follicular lymphoma. Am J Hematol 2012; 87:E68-71. [PMID: 22847344 DOI: 10.1002/ajh.23286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
MESH Headings
- Adult
- Aged
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antibodies, Monoclonal, Murine-Derived/adverse effects
- Antibodies, Monoclonal, Murine-Derived/economics
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/economics
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor
- Cost-Benefit Analysis
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/adverse effects
- Cyclophosphamide/economics
- Doxorubicin/administration & dosage
- Doxorubicin/adverse effects
- Doxorubicin/economics
- Humans
- Kaplan-Meier Estimate
- Lymphoma, Follicular/drug therapy
- Lymphoma, Follicular/economics
- Lymphoma, Follicular/genetics
- Middle Aged
- Polymerase Chain Reaction
- Prednisone/administration & dosage
- Prednisone/adverse effects
- Prednisone/economics
- Proportional Hazards Models
- Remission Induction
- Rituximab
- Treatment Outcome
- Vincristine/administration & dosage
- Vincristine/adverse effects
- Vincristine/economics
- Young Adult
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Affiliation(s)
- F McClanahan
- Internal Medicine V, University of Heidelberg, Heidelberg, Germany
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Poiasina E, Battaglia L, Leo E, Muscarà C, Rampa M, Vannelli A. Delayed and occult splenic rupture: a diagnostic puzzle. G Chir 2012; 33:119-122. [PMID: 22668529] [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: 06/01/2023]
Abstract
Splenic rupture is a common complaint encountered in emergency surgery. Trauma is the most common cause of splenic rupture, while non-traumatic or occult splenic rupture (OSR) is a rare condition. The differential diagnosis weighs on treatment that ranges between close monitoring, splenorrhaphy, splenic conservation and splenectomy. We report a case of an 63-year-old man presenting with acute atraumatic left upper quadrant pain. Preliminary diagnosis was subsequently determined to be a hematoma secondary to OSR. More accurate detailed history revealed a previous trauma, which occurred more than one year before and mimicked an OSR. Delayed and occult splenic rupture are as different diagnosis as different treatment. Even in emergency surgery, the key for a target therapeutic strategy should consider an accurate diagnostic time.
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Affiliation(s)
- E Poiasina
- Division of General Surgery B, Fondazione IRCCS "Istituto Nazionale Tumori", Milan, Italy
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Vannelli A, Lualdi M, Sottotetti E, Morelli D, Colombo A, Battaglia L, Leo E. 1431 POSTER Application of Native Fluorescence of Blood Plasma in Colorectal Cancer Detection: Results of a Prospective Study. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70924-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abad C, González-Escribano MF, Diaz-Gallo LM, Lucena-Soto JM, Márquez JL, Leo E, Crivell C, Gómez-García M, Martín J, Núñez-Roldán A, García-Lozano JR. Association of Toll-like receptor 10 and susceptibility to Crohn's disease independent of NOD2. Genes Immun 2011; 12:635-42. [PMID: 21716313 DOI: 10.1038/gene.2011.41] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Impaired innate inflammatory response has a key role in the Crohn's disease (CD) pathogenesis. The aim of this study was to investigate the possible role of the TLR10-TLR1-TLR6 gene cluster in CD susceptibility. A total of 508 CD patients (284, cohort 1 and 224, cohort 2) and 576 controls were included. TLR10-TLR1-TLR6 cluster single-nucleotide polymorphisms genotyping, NOD2 mutations and TLR10 mRNA quantification were performed using TaqMan assays. Nucleotide-binding oligomerization domain containing 2 (NOD2) and Toll-like receptor (TLR) loci interaction was analyzed by logistic regression and multifactor-dimensionality reduction (MDR). Entropy-based analysis was used to interpret combination effects. One TLR10 haplotype (TLR10(GGGG)) was found associated with CD susceptibility in both cohorts, individuals with two copies had approximately twofold more risk of CD susceptibility than individuals having no copies (odds ratio=1.89, P-value=0.0002). No differences in the mRNA levels were observed among the genotypes. The strongest model for predicting CD risk according to the MDR analysis was a two-locus model including NOD2 mutations and TLR10(GGGG) haplotype (P(c)<0.0001). The interaction gain attributed to the combination of both genes was negative (IG=-2.36%), indicating redundancy or independent effects. Our results support association of the TLR10 gene with CD susceptibility. The effect of TLR10 would be independent of NOD2, suggesting different signaling pathways for both genes.
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Affiliation(s)
- C Abad
- Servicio de Inmunología, Instituto de Biomedicina, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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20
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Costa S, Venturoli S, Mennini FS, Marcellusi A, Pesaresi M, Leo E, Falasca A, Marra E, Cricca M, Santini D, Zerbini M, Pelusi G. Population-based frequency assessment of HPV-induced lesions in patients with borderline Pap tests in the Emilia-Romagna Region: the PATER study. Curr Med Res Opin 2011; 27:569-78. [PMID: 21222568 DOI: 10.1185/03007995.2010.546730] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The PATER study assessed the frequency of high-risk (HR) and low-risk (LR) human papillomavirus (HPV) in HPV-induced lesions in patients with borderline cytology. METHODS This retrospective observational cohort study was designed to evaluate ASCUS patients detected through a local cervical cancer screening programme and referred to the Department of Gynaecology and Obstetrics at the S. Orsola-Malpighi University Hospital in Bologna, in the period between January 2000 and December 2007. RESULTS In 1047 patients aged 38.4 ± 9.6 years (range 23-65 years), 34.8% (n = 364) was positive for HR- or LR-HPV DNA. The mean age of women with HPV infection was significantly lower compared with the negative group (36.8 ± 9.4 versus 39.3 ± 9.6 years; p < 0.001). Overall, 357 (34.1%) women had cervical lesions: 279 (26.6%) had CIN1, 18 (1.7%) CIN2, and 60 (5.7%) CIN3+. HR-HPV genotype was detected in 83.3%, and 91.5% of patients with CIN2 and CIN3+ respectively. Among the 124 CIN1 HPV-positive women, 8.9% harboured LR-HPV genotypes, 80.6% HR-HPV and 10.5% a combination of HR- and LR-HPV. HPV-6 and 11 accounted for 19.4% of all HPV-positive CIN1 lesions. CONCLUSION Our study suggest that: in ASCUS patients over 40 years there is a low risk of positivity for HPV infection; the HPV DNA testing in patients with CIN3+ and a mean age close to 40 years is highly sensitive (98.3%) and acceptably specific (75.5%); the frequency of LR-HPV (alone or in combination with HR) in ASCUS cytology is not negligible. A tetravalent-based HPV vaccination alongside the screening programme would provide considerable clinical, organizational, and economic benefits.
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Affiliation(s)
- S Costa
- Department of Gynaecology and Obstetrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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21
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Rampa M, Boati P, Battaglia L, Leo E, Vannelli A. [Elective laparoscopic cholecystectomy: the limit of a dream become true]. G Chir 2011; 32:77-82. [PMID: 21352716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Laparoscopic technique in elective cholecystectomy is the last step in an evolutive time to minimize the abdominal access. From 1st January 2004 to 31th December 2006 we analyzed 5515 cholecystectomy procedures: 4877 laparoscopic cholecystectomy, 635 open cholecystectomy. Complications and supplementary diagnosis have been identified in SDO Lombardia's country database. Morbidity occurred in 82 patients (12.9%) with open technique and 109 patients (2.23%) with laparoscopic technique; mortality occurred in 11 patients (1.73%) with open technique and 1 patient (0.02%) with laparoscopic technique. Mean hospital stay are 14.40 days with open technique and 4.75 with laparoscopic technique. Morbidity in open technique is 6 fold more than laparoscopia technique. The difference between the two technique is present in literature and it's the result of non invasive technique compared with the incision of the laparoscopia technique. This is the critical point in the difference of hospital stay between the two technique all to the good of laparoscopy. The high mortality ratio is due to the selective criteria in laparoscopic technique. First remark is the high quality of our hospital care, compared with hospital teaching in the word. In this hospital the laparoscopic cholecystectomy is the gold standard in cholelitiasis treatment. The second remark is the limit of the open technique in severe cholelitiasis with evidence in high ratio of hospital stay, morbidity and mortality.
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Affiliation(s)
- M Rampa
- Foundation IRCSS Istituto Nazionale dei Tumori, Milano, Italy
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22
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Venturoli S, Leo E, Cricca M, Nocera M, Plazzi M, Musiani M, Zerbini M. PX-8 Comparison of abbott realtime HPV assay and digene HC2 HPV DNA test for the detection of high-risk HPV DNA in a referral population setting. J Clin Virol 2009. [DOI: 10.1016/s1386-6532(09)70230-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Burch JB, Tom J, Zhai Y, Criswell L, Leo E, Ogoussan K. Shiftwork impacts and adaptation among health care workers. Occup Med (Lond) 2009; 59:159-66. [DOI: 10.1093/occmed/kqp015] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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24
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Garrido A, Giráldez A, Trigo C, Leo E, Guil A, Márquez JL. [Intravenous proton-pump inhibitor for acute peptic ulcer bleeding--is profound acid suppression beneficial to reduce the risk of rebleeding?]. Rev Esp Enferm Dig 2009; 100:466-9. [PMID: 18942898 DOI: 10.4321/s1130-01082008000800004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To compare two regimens of pantoprazole administered intravenously in patients with ulcerative gastrointestinal bleeding (UGB), and a high risk of presenting with persitent or recurrent hemorrhage. MATERIAL AND METHOD Patients were randomized into two groups: group 0--treatment with a 80 mg bolus of pantoprazole administered intravenously, followed by continuous infusion of 8 mg/h for 72 hours; group 1--treatment with 40 mg of pantoprazole administered intravenously on a daily basis. The percentage of hemorrhagic persistence/recurrence in both groups was analyzed, as were transfusion requirements, need for surgery, and mortality resulting from the hemorrhagic episode. RESULTS There were 20 patients in group 0 and 21 in group 1. No differences were found between groups in terms of gender, age, smoking habits, use of NSAIDs, presence of hemodynamic instability or stigmata in ulcer crater (Forrest Ia: 5 vs. 14.3%, p = 0.322; Forrest Ib: 30 vs. 33.3%, p = 0.819; Forrest IIa: 60 vs. 50.1%, p = 0.753). In group 0, 90% of patients received endoscopic treatment, versus 100% in group 1, p = 0.232. In group 0, 50% of patients had a transfusion, as compared to 52.4% in group 1, p = 0.879. In group 0, 2 patients (10.5%) presented with recurrent hemorrhage, versus 3 patients (14.3%) in group 1. Surgery was required by 1 person from each group, and 1 patient in group 0 died. CONCLUSIONS Maximum acid inhibition with a bolus and then a continuous infusion of pantoprazole does not yield better results than treatment with conventional doses in acute hemorrhagic episodes.
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Affiliation(s)
- A Garrido
- Servicio de Aparato Digestivo, Hospital Virgen del Rocío, Seville.
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25
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Perrone F, Lampis A, Orsenigo M, Di Bartolomeo M, Gevorgyan A, Losa M, Frattini M, Riva C, Andreola S, Bajetta E, Bertario L, Leo E, Pierotti MA, Pilotti S. PI3KCA/PTEN deregulation contributes to impaired responses to cetuximab in metastatic colorectal cancer patients. Ann Oncol 2008; 20:84-90. [PMID: 18669866 DOI: 10.1093/annonc/mdn541] [Citation(s) in RCA: 334] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND It has been reported that KRAS mutations (and to a lesser extent KRAS mutations with the BRAF V600E mutation) negatively affect response to anti-epidermal growth factor receptor (EGFR) mAbs in metastatic colorectal cancer (mCRC) patients, while the biological impact of the EGFR pathway represented by PI3K/PTEN/AKT on anti-EGFR treatment is still not clear. PATIENTS AND METHODS We analysed formalin-fixed samples from a cohort of 32 mCRC patients treated with cetuximab by means of EGFR immunohistochemistry, EGFR and PTEN FISH analysis, and KRAS, BRAF, PI3KCA, and PTEN genomic sequencing. RESULTS Ten (31%) of 32 patients showed a partial response to cetuximab and 22 (69%) did not [nonresponder (NR)]. EGFR immunophenotype and FISH-based gene status did not predict an anti-EGFR mAb response, whereas KRAS mutations (24%) and PI3K pathway activation, by means of PI3KCA mutations (13%) or PTEN mutation (10%)/loss (13%), were significantly restricted to, respectively, 41% and 37% of NRs. CONCLUSION These findings suggested that KRAS mutations and PI3KCA/PTEN deregulation significantly correlate with resistance to cetuximab. In line with this, patients carrying KRAS mutations or with activated PI3K profiles can benefit from targeted treatments only by switching off molecules belonging to the downstream signalling of activated EGFR, such as mammalian target of rapamycin.
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Affiliation(s)
- F Perrone
- Experimental Molecular Pathology, Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Kornacker M, Kornacker B, Schmitt C, Leo E, Ho AD, Hensel M. Commercial LightCycler-based quantitative real-time PCR compared to nested PCR for monitoring of Bcl-2/IgH rearrangement in patients with follicular lymphoma. Ann Hematol 2008; 88:43-50. [PMID: 18636259 DOI: 10.1007/s00277-008-0550-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Accepted: 06/24/2008] [Indexed: 10/21/2022]
Abstract
Translocation of chromosomes 14 and 18 [t(14;18)] for detection of minimal residual disease in follicular lymphoma patients can be analyzed by nested polymerase chain reaction (PCR) or by quantitative PCR like LightCycler-based assays. We have compared both methods in blood and bone marrow samples of 28 patients enrolled in a clinical study on immunochemotherapy. In 42% of samples, the bcl2-IgH rearrangement was detectable by nested PCR, but not by LightCycler PCR. Nested PCR was able to reveal a significant drop in positive bone marrow or peripheral blood samples after therapy. In contrast, with LightCycler PCR, the detected drop in t(14;18)-positive cells did not reach statistical significance. The majority of patients showed positive results with nested PCR of peripheral blood or bone marrow without any associations to presence or absence of histological bone marrow (BM) infiltration by lymphoma cells. With LightCycler PCR, the numbers of positive cells were higher in samples from patients with BM infiltration of lymphoma cells (1.9 x 10(-2)) compared to samples from patients without involvement (4.08 x 10(-5)). A similar trend was seen in samples derived from the peripheral blood. Positivity for t(14;18) after therapy in two patients correlated with clinical relapse 6 months later. The data shown here demonstrate a lower sensitivity of LightCycler vs. nested PCR for detection of t(14;18). The usefulness of nested PCR for t(14;18) for risk stratification after primary therapy has to be validated in larger trials.
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Affiliation(s)
- M Kornacker
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
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Belli F, Gallino GF, Lo Vullo S, Mariani L, Poiasina E, Leo E. Melanoma of the anorectal region: the experience of the National Cancer Institute of Milano. Eur J Surg Oncol 2008; 35:757-62. [PMID: 18602790 DOI: 10.1016/j.ejso.2008.05.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Accepted: 05/03/2008] [Indexed: 12/14/2022] Open
Abstract
AIMS This study describes the experience of the National Cancer Institute of Milano in the treatment of anorectal melanoma over the last 32 years. METHODS The influence of different surgical approaches on local care and final outcome was investigated on 40 completely evaluable patients, followed for a median follow-up time of 75 months. The analysis was carried out by calculating and comparing overall survival, disease-free survival and cumulative incidence curves of disease recurrence. RESULTS Thirty-one patients underwent radical surgery: nine abdominoperineal resections, four total rectal resections and coloendoanal anastomosis, and 18 local excisions. The remaining nine patients received palliative treatments. Median overall survival time for patients receiving non-radical treatments was poor: only 6 months. However, even when a radical surgery was undergone, the prognosis of patients with anal melanoma remains dismal. Local relapse incidence was 45.8% for the limited surgery group, but non-existent for the extended-surgery group (p = 0.007). However, the median disease-free survival time was 7 and 9 months for patients receiving limited or major surgery (p = 0.97). Overall survival was 17 months, irrespective of the adopted surgery. CONCLUSION Prognosis of anal melanoma remains poor. Final outcome is not influenced by modality of surgery. A limited but radical excision can be considered whenever possible while a major demolitive surgery should be applied only for therapy of advanced or bulky lesions.
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Affiliation(s)
- F Belli
- Division of Colo-Rectal Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy.
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Frattini M, Gallino G, Signoroni S, Balestra D, Lusa L, Battaglia L, Sozzi G, Bertario L, Leo E, Pilotti S, Pierotti MA. Quantitative and qualitative characterization of plasma DNA identifies primary and recurrent colorectal cancer. Cancer Lett 2008; 263:170-81. [PMID: 18395974 DOI: 10.1016/j.canlet.2008.03.021] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2008] [Revised: 03/17/2008] [Accepted: 03/19/2008] [Indexed: 02/06/2023]
Abstract
Because plasma DNA may be a useful tool for cancer detection, we screened primary tumors and related multiple plasma samples at the time of surgery and during the follow-up period for plasma DNA level as well as for K-Ras mutations and p16INK4a promoter hypermethylation in colorectal cancer patients. At the time of surgery, DNA levels were higher in tumor patients than in healthy donors, and K-Ras and p16INK4a alterations were detected in 7 and 11 cancers respectively, and in all related plasma samples. During the follow-up, plasma DNA levels decrease progressively but rapidly increased when a relapse occurred, whereas K-Ras and p16INK4a alterations were detected only in relapsed patients. Therefore, combined quantitative and qualitative analyses of plasma DNA confirm the presence of colorectal cancer, define disease-free status and indicate the presence of relapse.
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Affiliation(s)
- M Frattini
- Experimental Molecular Pathology, Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Stühmer T, Arts J, King P, Page M, Bommert K, Leo E, Bargou RC. A first-in-class HDM2-inhibitor (JNJ-26854165) in phase I development shows potent activity against multiple myeloma (MM) cells in vitro and ex vivo. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.14694] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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30
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Cricca M, Venturoli S, Leo E, Musiani M, Zerbini M. ANALISI DI TRASCRITTI VIRALI DI HPV16 COME INDICATORI DI CARCINOMA CERVICALE IN SITU. Microbiol Med 2007. [DOI: 10.4081/mm.2007.2797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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31
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Zugmaier G, Viardot A, Hess G, Noppeney R, Kufer P, Leo E, Reitsma D, Goebeler M, Knop S, Einsele H, Bargou R. P047 The bi-specific T-cell enhancer (BiTE) MT103 (MEDI-538) shows clinical activity in pre-treated NHL: update from the ongoing Phase I study MT103-104. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70395-8] [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: 10/22/2022]
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Tosi G, Costantino L, Rivasi F, Ruozi B, Leo E, Vergoni AV, Tacchi R, Bertolini A, Vandelli MA, Forni F. Targeting the central nervous system: In vivo experiments with peptide-derivatized nanoparticles loaded with Loperamide and Rhodamine-123. J Control Release 2007; 122:1-9. [PMID: 17651855 DOI: 10.1016/j.jconrel.2007.05.022] [Citation(s) in RCA: 166] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2007] [Revised: 05/16/2007] [Accepted: 05/21/2007] [Indexed: 10/23/2022]
Abstract
Polymeric nanoparticles (Np) represent one of the most innovative non-invasive approaches for the drug delivery to the central nervous system (CNS). It is known that the ability of the Np to cross the Blood Brain Barrier (BBB), thus allowing the drugs to exert their pharmacological activity in the central nervous district, is linked to their surface characteristics. Recently it was shown that the biocompatible polyester poly(d,l-lactide-co-glycolide) (PLGA) derivatized with the peptide H(2)N-Gly-l-Phe-d-Thr-Gly-l-Phe-l-Leu-l-Ser(O-beta-d-Glucose)-CONH(2) [g7] was a useful starting material for the preparation of Np (g7-Np); moreover, fluorescent studies showed that these Np were able to cross the BBB. In this research, g-7 Np were loaded with Loperamide in order to assess their ability as drug carriers for CNS, and with Rhodamine-123, in order to qualitatively determine their biodistribution in different brain macro-areas. A pharmacological evidence is given that g7-Np are able to cross the BBB, ensuring, for the first time, a sustained release of the embedded drug, and that these Np are able to reach all the brain areas here examined. The ability to enter the CNS appears to be linked to the sequence of the peptidic moiety present on their surface.
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Affiliation(s)
- G Tosi
- Department of Pharmaceutical Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Vannelli A, Leo E, Scaramellini G, Cantù G, Rampa A, Battaglia L, Poiasina E, Aceto R, Aiello A, Manenti G. [Fees as the expression of system inadequacy: the paradox of oncologic DRG at excellent centers]. G Chir 2007; 28:301-5. [PMID: 17785040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
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Garrido A, Márquez JL, Guerrero FJ, Leo E, Pizarro MA, Trigo C. [Changes in the etiology, outcome, and characteristics of patients with acute gastrointestinal bleeding between 1999 and 2005]. Rev Esp Enferm Dig 2007; 99:275-9. [PMID: 17650937 DOI: 10.4321/s1130-01082007000500006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVES To analyze the evolution of the following variables in patients admitted to a Blood Unit for gastrointestinal bleeding throughout 1999-2005: etiology, comorbid diseases, use of NSAIDs/anticoagulants, and mortality. MATERIAL AND METHODS We analyzed the evolution of the following causes of GIB that required admission to the Blood Unit from 1999 to 2005: duodenal ulcer (DU), gastric ulcer (GU), portal hypertension (PHT), and others. We also analyzed changes in the percentage of patients admitted with comorbid disease, use of NSAIDs/anticoagulants, and mortality. RESULTS 1,611 Patients with a mean age of 60.45 years (59.7-61.2) were included in this study; 76.41% were males (74.3-78.5). DU was the cause of bleeding in 22.20% of cases (20.2-24.3), GU in 18.40% of cases (16.6-20.4), and PHT in 33.60% of cases (31.3-36.0). In all, 34.5% (32.6-37.3) of patients were taking NSAIDs, 7.1% (6.0-8.6) were receiving anticoagulant therapy, 72.6% (70.4-74.8) presented with comorbid disease, and overall mortality was 6.27% (5.16-7.59). Throughout the 1999-2005 period there was an increase in the number of patients with comorbid diseases (p < 0.02), and a decrease in cases of DU (p < 0.04), without significant differences in the remaining variables. CONCLUSIONS DU, GU and PHT account for three quarters of admissions to our Blood Unit. Over the last seven years, there has been a decrease in cases due to DU, and an increase in patients with comorbid disease; overall mortality rates have remained stable.
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Affiliation(s)
- A Garrido
- Unidad de Sangrantes, Hospital Virgen del Rocío, Sevilla.
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Vannelli A, Poiasina E, Battaglia L, Belli F, Bonfanti G, Gallino G, Vitellaro M, De Dosso S, Leo E. Healthcare economics and evidence based medicine: all that glitters is not gold. Minerva Med 2007; 98:159-61. [PMID: 17519858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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Garrido A, Márquez JL, Guerrero FJ, Pizarro MA, Leo E, Giráldez A. Transfusion requirements in patients with gastrointestinal bleeding: a study in a Blood Unit at a referral hospital. Rev Esp Enferm Dig 2007; 98:760-9. [PMID: 17094725 DOI: 10.4321/s1130-01082006001000006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES 1. To study transfusion requirements in the Department of Gastroenterology of a Tertiary Referral Hospital, and their evolution over the last seven years. 2. To analyze risk factors associated with greater erythrocyte transfusion requirements. PATIENTS AND METHODS erythrocyte transfusion requirements were compared for patients admitted to the Department of Gastroenterology at Hospital Virgen del Rocío, Seville, from 1999 to 2005. Clinical data of interest have been analyzed in order to determine factors associated with greater transfusion requirements. RESULTS 1,611 patients with a mean age of 60.45 years (59.7-61.2) were included in this study; 76.41% were males. Gastric ulcers were the cause of bleeding in 18.4% of cases (with 69% requiring transfusions); duodenal ulcers caused 22.2% of cases (with 52.9% requiring transfusions), and portal hypertension caused 33.6% of cases (with 90.2% requiring transfusions). Upper and lower gastrointestinal bleeding of unknown origin requires transfusions in 88.9 and 96.2% of cases, respectively.A multivariate logistic regression analysis showed that clinical presentations such as hematemesis (odds ratio = 3.12), hematochezia (odds ratio = 33.17), gastrointestinal hemorrhage of unknown origin (odds ratio = 6.57), and hemorrhage as a result of portal hypertension (odds ratio = 3.43) were associated with greater transfusion requirements for erythrocyte concentrates. No significant differences were observed between the percentages of patients who received transfusions from 1999 to 2005. CONCLUSIONS 1. No differences have been observed between the percentages of patients who received transfusions over the last seven years at our Department of Gastroenterology. 2. Patients presenting with hematemesis or hematochezia, in addition to those with bleeding of unknown origin or from portal hypertension, are prone to have greater transfusion requirements.
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Affiliation(s)
- A Garrido
- Gastrointestinal Bleeding Unit, Hospital Virgen del Rocío, Seville, Spain.
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Leo E, Contado C, Bortolotti F, Pavan B, Scatturin A, Tosi G, Manfredini S, Angusti A, Dalpiaz A. Nanoparticle formulation may affect the stabilization of an antiischemic prodrug. Int J Pharm 2006; 307:103-13. [PMID: 16289882 DOI: 10.1016/j.ijpharm.2005.09.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2005] [Revised: 09/22/2005] [Accepted: 09/29/2005] [Indexed: 11/16/2022]
Abstract
The prodrug 5'-octanoyl-CPA (Oct-CPA) of the antiischemic N6-cyclopentyladenosine (CPA) has been encapsulated by nanoprecipitation in poly(lactic acid) nanoparticles, which have been recovered by gel-filtration, ultra-centrifugation or dialysis. We have analysed how different surfactants and purification methods can influence the nanoparticle characteristics. The particle sizes have been obtained by scanning electron microscope, whereas a SdFFF system was employed to detect their distributions. The Oct-CPA release from nanoparticles and stabilities in human blood of free and encapsulated prodrug have been analysed by HPLC techniques. The effects of nanoparticles on CPA interaction toward adenosine A1 receptor (its action site) have been analysed using radiolabelled drugs. The smallest nanoparticles and the best degree of homogeneity have been obtained using sodium cholate; the best recovery has been achieved by dialysis, whereas gel-filtration and ultra-centrifugation have induced the greatest removal of surfactants. The release of Oct-CPA was better controlled from the nanoparticles obtained using Pluronic F68 and purified by gel-filtration or ultra-centrifugation. Similarly, these nanoparticles better increased the stability of the prodrug in human blood. In particular, the nanoparticles purified by ultra-centrifugation induced a strong stability to a fraction of the encapsulated Oct-CPA. Any interference by unloaded nanoparticles has been registered for CPA-adenosine A1 receptor interaction.
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Affiliation(s)
- E Leo
- Dipartimento di Scienze Farmaceutiche, Modena and Reggio Emilia University, via G. Campi 183, I-41100 Modena, Italy
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Leo E, Biancari F, Hanhela R, Karlqvist K, Romsi P, Ylönen K, Rainio P, Satta J, Juvonen T. Baseline oxygen delivery is associated with an increased risk of severe postoperative complications after elective open repair of abdominal aortic aneurysm. J Cardiovasc Surg (Torino) 2005; 46:279-84. [PMID: 15956926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
AIM Oxyhemodynamic parameters have been shown to have a relevant impact on the immediate postoperative outcome after major surgery, but it is not known their specific impact on the outcome after elective repair of abdominal aortic aneurysm (AAA). METHODS One-hundred and forty-one patients underwent elective open repair of infrarenal AAA and hemodynamic parameters were monitored perioperatively. RESULTS One patient (0.7%) died postoperatively, 23 (16.3%) experienced a myocardial ischemic event and 9 of them (6.4%) had a myocardial infarction. Baseline oxygen delivery was not predictive of such myocardial ischemic events. Thirty-three patients (23.4%) suffered severe postoperative complications. The median baseline oxygen delivery was 429.5 mL/min/m2 among patients who had severe postoperative complications, whereas it was 505.5 mL/min/m2 among those who did not have severe complications (p=0.03). However, this parameter did not retain its significance at multivariate analysis. When only the preoperative variables were included in the logistic regression model, the Glasgow Aneurysm Score (P=0.004, Oddsratio 1.94, 95% C.I. 1.24-3.05) was the only predictor of severe postoperative complications. The Glasgow Aneurysm Score was significantly correlated with baseline oxygen delivery (P=-0.256, P=0.003). CONCLUSIONS Baseline oxygen delivery is associated with an increased risk of severe postoperative complications after elective open repair of AAA. The value of preoperative optimization of oxygen delivery should be evaluated in this patient population.
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Affiliation(s)
- E Leo
- Division of Cardiothoracic and Vascular Surgery Department of Surgery, University of Oulu, Oulu, Finland
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Nesi F, Leo E, Biancari F, Bartolucci R, Rainio P, Satta J, Rabitti G, Juvonen T. Preoperative Risk Stratification in Patients Undergoing Elective Infrarenal Aortic Aneurysm Surgery: Evaluation of Five Risk Scoring Methods. Eur J Vasc Endovasc Surg 2004; 28:52-8. [PMID: 15177232 DOI: 10.1016/j.ejvs.2004.02.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2004] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate five risk scoring methods in predicting the immediate postoperative outcome after elective open repair of abdominal aortic aneurysm (AAA). DESIGN Retrospective evaluation of the Eagle score, Glasgow aneurysm score, Leiden score, modified Leiden score and Vanzetto score in a consecutive series of patients. PATIENTS Two hundred and eighty-six consecutive patients undergoing elective infrarenal aortic aneurysm repair. RESULTS Nine patients (3.1%) died in hospital and another 35 (12%) experienced severe postoperative complications. For the Glasgow aneurysm score, Leiden score, modified Leiden score and Vanzetto score receiver operating characteristics (ROC) curve analysis for prediction of in-hospital mortality showed area under the curve (AUC) of 0.749 (p=0.01), 0.777 (p=0.008), 0.788 (p=0.006) and 0.794 (p=0.005), respectively. The Eagle risk score was less accurate for predicting in-hospital mortality. The risk-scoring systems did not perform well in predicting post-operative complications, but multivariate analysis showed that the modified Leiden score was an independent predictor of postoperative complications. CONCLUSION All scoring systems predict, with reasonable accuracy, the risk of in-hospital death in patients undergoing elective open repair of AAA, whereas the accuracy in predicting severe postoperative complications is less.
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Affiliation(s)
- F Nesi
- Division of Vascular Surgery, Department of Cardiovascular Sciences, San Camillo-Forlanini Hospital, 00152 Rome, Italy
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Nesi F, Pogany G, Bartolucci R, Leo E, Rabitti G. Emergency repair of type IV thoracoabdominal aneurysm with the use of a singular shunt to maintain visceral perfusion. Eur J Vasc Endovasc Surg 2004; 27:445-6. [PMID: 15015198 DOI: 10.1016/j.ejvs.2003.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2003] [Indexed: 11/18/2022]
Affiliation(s)
- F Nesi
- Department of Cardiovascular Sciences, Division of Vascular Surgery, S Camillo-Forlanini Hospital, Rome, Italy
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Biancari F, Leo E, Ylönen K, Vaarala MH, Rainio P, Juvonen T. Value of the Glasgow Aneurysm Score in predicting the immediate and long-term outcome after elective open repair of infrarenal abdominal aortic aneurysm. Br J Surg 2003; 90:838-44. [PMID: 12854110 DOI: 10.1002/bjs.4130] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND This study aimed to explore the value of the Glasgow Aneurysm Score in predicting the immediate and long-term outcome after elective open repair of abdominal aortic aneurysm (AAA). METHODS Some 403 patients underwent elective open repair of an infrarenal AAA and were classified retrospectively according to the criteria of the Glasgow Aneurysm Score (risk score = (age in years) + (7 for myocardial disease) + (10 for cerebrovascular disease) + (14 for renal disease)). RESULTS Fourteen patients (3.5 per cent) died after operation, 23 (5.7 per cent) had a myocardial infarction and six (1.5 per cent) had a stroke. One hundred and nine patients (27.0 per cent) experienced severe postoperative complications. The Glasgow Aneurysm Score was predictive of postoperative death (area under the receiver-operator characteristic curve (AUC) 0.80, 95 per cent confidence interval (c.i.) 0.71 to 0.90), severe postoperative complications (AUC 0.67, 95 per cent c.i. 0.61 to 0.73), myocardial infarction (AUC 0.72, 95 per cent c.i. 0.62 to 0.82), myocardial infarction-related postoperative death (AUC 0.78, 95 per cent c.i. 0.63 to 0.94) and stroke (AUC 0.84, 95 per cent c.i. 0.74 to 0.95). Univariate analysis showed that this risk index was also predictive of long-term survival. CONCLUSION The Glasgow Aneurysm Score is a good predictor of outcome after elective open repair of AAA. Its simplicity and accuracy make it useful for preoperative risk stratification.
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Affiliation(s)
- F Biancari
- Division of Cardiothoracic and Vascular Surgery, University of Oulu, Oulu, Finland.
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Leo E. [Conservative surgery for distal rectal tumors: illusion or reality?]. G Chir 2003; 24:215-9. [PMID: 14569916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
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Abstract
Topoisomerase II is the target of several anticancer agents. The discovery of a second enzyme, called topoisomerase II beta, genetically distinct from alpha, prompted the investigation on the different functional roles of the two isoforms. Whereas the first recognized isozyme is essential for life due to its role in chromosome condensation and segregation, beta functions remained elusive, although its importance in neural development is appearing clearer. Topoisomerase II beta is regulated differently than alpha, and its level of expression does not change significantly during cell cycle. The presence of this isoform in non-proliferating cells suggests that drug preferentially aimed at beta may be active in slow growing tumors. Topoisomerase II poisons were hence evaluated in light of their selectivity toward one or the other isozyme, indicating how the beta isoform may represent an important target for selected classes of drugs. Newer compounds were also synthesized and tested for their potential antitumor activity and their topoisomerase II beta poisoning. The literature dealing with "old" and "new" drugs targeted at topoisomerase II is reviewed trying to link, whenever possible, selective poisoning and cytotoxic effects to chemical structures, in the hope to indicate new lead compounds that will contribute to unveil molecular determinants of selectivity.
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Affiliation(s)
- B Gatto
- Dept. of Pharmaceutical Sciences, University of Padova, via Marzolo 5, 35131 Padova, Italy.
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Leo E, Krämer A, Hochhaus A, Krasniqi F, Hehlmann R, Ho AD. Gangrene of the toes in a patient with chronic myelogenous leukemia after long-term hydroxyurea therapy. Ann Hematol 2002; 81:467-9. [PMID: 12224005 DOI: 10.1007/s00277-002-0505-0] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 09/24/2001] [Accepted: 06/26/2002] [Indexed: 11/30/2022]
Abstract
Gangrene of the toes and digits appears to be a rare but very severe complication of long-term hydroxyurea therapy. Nothing is known regarding the pathophysiology and the type of vascular damage leading to this syndrome. Here we report a case of a 49-year-old male presenting with gangrene of the toes of both feet 4.5 years after initiation of hydroxyurea therapy for chronic myelogenous leukemia. Blisters on the toes occurred for the first time 9 months prior to hospitalization. Successively, all ten toes showed signs of beginning gangrene with one toe removed surgically 8 months before admission. Presence of diabetes mellitus or peripheral angiopathy was ruled out and platelet counts were within the physiologic range during the last years, excluding thrombocythemia as another rare cause for gangrene in patients with myeloproliferative diseases. Whereas perimalleolar ulcerations of the legs are a more common complication of hydroxyurea, gangrene of the toes as a consequence of hydroxyurea treatment has been described previously only once in the literature. At this point in time cessation of hydroxyurea treatment appears to be the only therapeutic option, thereby avoiding further progress of gangrene in patients with chronic myelogenous leukemia treated with hydroxyurea.
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Affiliation(s)
- E Leo
- Universitätsklinikum Heidelberg, Abteilung für Hämatologie, Onkologie und Rheumatologie, Hospitalstr. 3, 69115 Heidelberg, Germany.
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Kornacker M, Kraemer A, Leo E, Ho AD. Occurrence of sarcoidosis subsequent to chemotherapy for non-Hodgkin's lymphoma: report of two cases. Ann Hematol 2002; 81:103-5. [PMID: 11907791 DOI: 10.1007/s00277-001-0415-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2001] [Accepted: 11/19/2001] [Indexed: 10/27/2022]
Abstract
Sarcoidosis-lymphoma syndrome is a well-established syndrome where sarcoidosis is followed by the development of a lymphoproliferative disease such as non-Hodgkin's lymphoma (NHL). Here we report two patients with NHL who developed sarcoidosis subsequent to the diagnosis of lymphoproliferative disease. In both cases, chemotherapeutic treatment had already been initiated or was completed when sarcoidosis occurred. In these patients, sarcoidosis may have been triggered by immunologic aberrations induced by antineoplastic therapy or as a consequence of an underlying immunologic disturbance associated with the lymphoma. When a suspected relapse of lymphoma presents with signs and symptoms compatible with sarcoidosis, this rare immunologic disorder has to be ruled out by careful clinical and histopathologic analysis to prevent mistreatment.
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Affiliation(s)
- M Kornacker
- Department of Medicine V, University of Heidelberg, Hospitalstr. 3, 69115 Heidelberg, Germany.
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Abstract
Oral administration of peptide and protein drugs requires their protection from the acidic and enzymatic degradation in the gastro-intestinal environment and their targeting to the absorption zone. For this purpose, an alginate microsystem, as a carrier of bovine serum albumin (BSA), as a model protein, was developed using a spray-drying technique. A hardening process with Ca2+ and chitosan (CS) provided a system with resistance to the gastro-intestinal barriers and of appropriate size for targeting to the Peyer's patches. The present work aims to evaluate the effects of the ratio of sodium alginate (Na-A) and BSA as well as the pH of the crosslinking medium on the microsystem properties. Microparticle morphological and dimensional characteristics did not change significantly with the formulation variables. BSA loading at a pH value less than the protein isoelectric point (pI) was higher than that at a pH similar to the pI owing to an electrostatic interaction between the charged protein and the polyanionic alginate. The maximum encapsulation efficiency was obtained at the highest Na-A/BSA ratio. Protein release in a simulated gastro-intestinal fluid was not affected by the preparative variables, but was controlled by the pH-dependent nature of the polymer material. Polyacrylamide gel electrophoresis (PAGE) demonstrated the stability of the protein to both the preparative conditions and the gastro-intestinal pH values.
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Affiliation(s)
- G Coppi
- Department of Pharmaceutical Sciences, University of Modena and Reggio Emilia, Modena, Italy.
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Damascelli B, Cantù G, Mattavelli F, Tamplenizza P, Bidoli P, Leo E, Dosio F, Cerrotta AM, Di Tolla G, Frigerio LF, Garbagnati F, Lanocita R, Marchianò A, Patelli G, Spreafico C, Tichà V, Vespro V, Zunino F. Intraarterial chemotherapy with polyoxyethylated castor oil free paclitaxel, incorporated in albumin nanoparticles (ABI-007): Phase I study of patients with squamous cell carcinoma of the head and neck and anal canal: preliminary evidence of clinical activity. Cancer 2001; 92:2592-602. [PMID: 11745194 DOI: 10.1002/1097-0142(20011115)92:10<2592::aid-cncr1612>3.0.co;2-4] [Citation(s) in RCA: 118] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND This study was designed to determine the feasibility, maximum tolerated dose, and toxicities of intraarterial administration of paclitaxel-albumin nanoparticles in patients with advanced head and neck and recurrent anal canal squamous cell carcinoma. Antitumor activity also was assessed. METHODS Forty-three patients (31 with advanced head and neck and 12 with recurrent anal canal squamous cell carcinoma) were treated intraarterially with ABI-007 every 4 weeks for 3 cycles. In total, 120 treatment cycles were completed, 86 in patients with head and neck carcinoma (median, 3 cycles; range, 1-4) and 34 in patients with anal canal carcinoma (median, 3 cycles; range, 1-4). ABI-007 was compared preliminarily with Taxol for in vitro cytostatic activity. Increasing dose levels from 120 to 300 mg/m2 were studied in 18 patients. Pharmacokinetic profiles after intraarterial administration were obtained in a restricted number of patients. RESULTS The dose-limiting toxicity of ABI-007 was myelosuppression consisting of Grade 4 neutropenia in 3 patients. Nonhematologic toxicities included total alopecia (30 patients), gastrointestinal toxicity (3 patients, Grade 2), skin toxicity (5 patients, Grade 2), neurologic toxicity (4 patients, Grade 2) ocular toxicity (1 patient, Grade 2), flu-like syndrome (7 patients, Grade 2; 1 patient, Grade 3). In total, 120 transfemoral, percutaneous catheterization procedure-related complications occurred only during catheterization of the neck vessels in 3 patients (2 TIA, 1 hemiparesis) and resolved spontaneously. CONCLUSIONS Intraarterial administration of ABI-007 by percutaneous catheterization does not require premedication, is easy and reproducible, and has acceptable toxicity. The maximum tolerated dose in a single administration was 270 mg/m2. Most dose levels showed considerable antitumor activity (42 assessable patients with 80.9% complete response and partial response). The recommended Phase II dose is 230 mg/m2 every 3 weeks.
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Affiliation(s)
- B Damascelli
- Department of Radiology, Istituto Nazionale Tumori, Milano, Italy.
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Panzironi G, De Cristofaro F, Angelini P, Ricci F, Campagnano S, De Vargas Macciucca M, Leo E, D'Andrea V. Heterotaxia: radiological and surgical observations in a case of polysplenic syndrome. Chir Ital 2001; 53:723-7. [PMID: 11723906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
We describe a case of asymptomatic polysplenic syndrome as suggested by ultrasonography, gastrointestinal series, computed tomography, magnetic resonance imaging scans and arteriography, and confirmed at surgery. Spleen malformation is frequently associated with heterotaxia and other malformations of the thoracic and abdominal organs, but no pathognomonic features can be detected in relation to this condition. In our patient, imaging studies revealed the presence of a polylobulated spleen in an atypical position below the liver, associated with malpositioning of the gastric fundus and gastro-oesophageal junction with interruption of the inferior vena cava, but no congenital heart disease. In conclusion, polysplenic syndrome is a rare clinical condition, occasionally found in asymptomatic adults. Radiological detection could be mistaken for mediastinal or abdominal pathological masses, and only a thorough study performed with several different radiological methods can determine the precise anatomy of the structures involved so as to be able to plan surgery where necessary.
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Affiliation(s)
- G Panzironi
- Department of Radiology, University of Rome La Sapienza, Rome
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Cordero C, Leo E, Cayuela A, Bozada JM, García E, Pizarro MA. Validity of early colonoscopy for the treatment of adenomas missed by initial endoscopic examination. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS : ORGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE PATOLOGIA DIGESTIVA 2001; 93:519-28. [PMID: 11692781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
OBJECTIVE To determine whether the features of adenomas identified in a first endoscopic examination may predict the presence of polyps with advanced pathological features that may have gone unnoticed and whether early colonoscopy may benefit these patients. MATERIAL AND METHODS We examined 133 patients with diagnosis of colonic adenomas who had undergone complete colonoscopy and endoscopic polypectomy. All of them underwent colonoscopic follow-up at 3 years. Seventy nine patients underwent colonoscopic follow-up both at 6 months and at 3 years, while 54 patients underwent just colonoscopic follow-up at 3 years and 47 just at 6 months. RESULTS Fifteen per cent of the patients analyzed developed polyps with pathological features after 6 months. The size and histological analysis of the polyps detected in the initial colonoscopic examination did not affect these results (p < 0.05). The number of polyps was statistically significant: patients with 3 or more polyps in the initial colonoscopic examination presented more polyps with pathological features after six months (25.8 versus 5.8%, p = 0002). This follow-up examination at 3 years did not reveal a higher occurrence of polyps with pathological features in any of the two groups of patients, namely, those who had undergone early colonoscopy and those who had not. CONCLUSIONS Patients with multiple polyps have greater probability of developing synchronous polyps with some pathological features which may have gone unnoticed. Since early examination has not shown to provide a benefit for these patients, the first follow-up colonoscopy should be performed at 3 years, particularly if the initial colonoscopy is negative.
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Affiliation(s)
- C Cordero
- Digestive Service, University Hospital Virgen del Rocío, Sevilla, Spain.
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Andreola S, Leo E, Belli F, Bonfanti G, Sirizzotti G, Greco P, Valvo F, Tomasic G, Gallino GF. Adenocarcinoma of the lower third of the rectum surgically treated with a <10-MM distal clearance: preliminary results in 35 N0 patients. Ann Surg Oncol 2001; 8:611-5. [PMID: 11508624 DOI: 10.1007/s10434-001-0611-6] [Citation(s) in RCA: 16] [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: 10/25/2022]
Abstract
BACKGROUND Recent reports suggest that a distal clearance (DC) of 10 mm at the lower surgical margin may be considered adequate in the surgical treatment of rectal cancer, but there are no data on the possible adequacy of a < 10-mm DC in N0 patients in whom a good prognosis can otherwise be expected, that is, those with negative surgical margins and negative lymph nodes. METHODS Between November 1991 and December 1998, 154 consecutive patients with adenocarcinoma of the lower third of the rectum had a total rectal resection with total mesorectal excision and coloendoanal anastomosis. Among 76 N0 patients, there were 35 with <10-mm DC and 41 with > or =10-mm DC. Each group was divided into two subgroups depending on whether the surgical margins were involved or not, and the rate of local recurrence in the various categories was compared. All B2 Astler-Coller stage patients in the series received postsurgical chemoradiotherapy. RESULTS The local recurrence rate in the 35 patients with DC < 10 mm was 11.4% and that of the 41 patients with DC > or =10 mm was 7.3%. When only patients with negative surgical margins were considered, the local recurrence rate was 3.4% for those with < 10-mm DC and 5.1% for those with > or =10-mm DC. CONCLUSIONS Our results suggest that a radical surgery with <10-mm DC followed by chemoradiotherapy may be adequate in N0 patients, provided that a careful pathologic examination of the surgical specimen excludes the presence of lymph node metastases and that the distal rectal and mesorectal resection margins fall in healthy tissue.
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Affiliation(s)
- S Andreola
- Department of Pathology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
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