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Fiorino E, Giudici F, Aguggini S, Strina C, Milani M, Ziglioli N, Dester M, Barbieri G, Alberio M, Azzini C, Ferrero G, Ungari M, Dreezen C, Pronin D, Generali D. P157 MammaPrint 8-year follow up results in patients with early breast cancer from a single-center Italian cohort study. Breast 2023. [DOI: 10.1016/s0960-9776(23)00274-6] [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: 03/15/2023] Open
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Fortuna L, Bottari A, Bisogni D, Coratti F, Giudici F, Orlandini B, Dragoni G, Cianchi F, Staderini F. Gastric Antral Vascular Ectasia (GAVE) a case report, review of the literature and update of techniques. Int J Surg Case Rep 2022; 98:107474. [PMID: 35963152 PMCID: PMC9386635 DOI: 10.1016/j.ijscr.2022.107474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/30/2022] [Accepted: 07/30/2022] [Indexed: 01/10/2023] Open
Abstract
Introduction and importance Gastric Antral Vascular Ectasia is a rare disorder that causes up to 4 % of severe acute gastrointestinal bleeding. It affects elderly females with iron deficiency anemia due to chronic blood loss as a common presenting sign. Case presentation We report the case of a 70-year-old man admitted to the Urgency Department for severe asthenia associated with abdominal pain and severe anemia. An urgent upper endoscopic examination showed antral hyperemic streaks and vascular ectasias extending from the pyloric ring to the gastric body as well as signs of recent bleeding. Histological results demonstrated the pathognomonic features of GAVE. Clinical discussion The first line treatment is considered argon plasma coagulation (APC), given its wider availability, safety, efficacy and cost-effectiveness. In current literature, other therapies and different types of endoscopic treatments have been proposed, such as EBL, RFA and Yag: laser. To date, there is no specific recommendation that privileges one method over another in the treatment of GAVE, although APC has proven effective and even better in terms of complications and costs than the other techniques. Conclusion In our experience, endoscopic coagulation with APC probes is a relatively easy-to-use technique with low cost, minimal invasiveness and provides immediate results. On the other hand, a standardized algorithm is also required concerning to the different subtypes to give the best treatment in every case.
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de la Fouchardiere C, Jannin A, Giudici F, Wassermann J, Chougnet C, Drui D, Godbert Y, Illouz F, Bardet S, Roudaut N, Batisse Lignier M, Groussin L, Klein M, Zerdoud S, Lamartina L, Baudin E, Borson-Chazot F, Do Cao C, Borget I, Hadoux J. 1647MO BRAF mutated anaplastic thyroid carcinoma: Clinical characteristics and outcome under BRAF inhibitors and chemotherapy in real-life practice, a multicentric retrospective study of the French ENDOCAN TUTHYREF network. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Rassy E, Garberis I, Tran Dien A, Scott V, Bouakka I, Bassil J, Lacroix-Triki M, Zanconati F, Giudici F, Generali D, Rouleau E, Lacroix L, André F, Pistilli B. 18P Comparative genomic profiling of primary and locally recurrent luminal breast cancers (BC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Giudici F, Pistilli B, Vaz-Duarte-Luis I, Michiels S, Bardet A. Survie à long terme du traitement adjuvant par tamoxifène dans le cancer du sein précoce: nouvelles perspectives en fonction de l'adhérence. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.03.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Fiorindi C, Campani F, Rasero L, Campani C, Livi L, Giovannoni L, Amato C, Giudici F, Bartoloni A, Fattirolli F, Lavorini F, Olivotto I, Nannoni A. Prevalence of nutritional risk and malnutrition during and after hospitalization for COVID-19 infection: Preliminary results of a single-centre experience. Clin Nutr ESPEN 2021; 45:351-355. [PMID: 34620339 PMCID: PMC8327581 DOI: 10.1016/j.clnesp.2021.07.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 03/22/2021] [Revised: 06/21/2021] [Accepted: 07/23/2021] [Indexed: 01/04/2023]
Abstract
Background & aims The effect of the COVID-19 infection on nutritional status is not well established. Worldwide epidemiological studies have begun to investigate the incidence of malnutrition during hospitalization for COVID-19. The prevalence of malnutrition during follow-up after COVID-19 infection has not been investigated yet. The primary objective of the present study was to estimate the prevalence of the risk of malnutrition in hospitalized adult patients with COVID-19, re-evaluating their nutritional status during follow-up after discharge. The secondary objective was to identify factors that may contribute to the onset of malnutrition during hospitalization and after discharge. Methods We enrolled 142 COVID-19 patients admitted to Careggi University Hospital. Nutritional parameters were measured at three different timepoints for each patient: upon admission to hospital, at discharge from hospital and 3 months after discharge during follow-up. The prevalence of both the nutritional risk and malnutrition was assessed. During the follow-up, the presence of nutritional impact symptoms (NIS) was also investigated. An analysis of the association between demographic and clinical features and nutritional status was conducted. Results The mean unintended weight loss during hospitalization was 7.6% (p < 0.001). A positive correlation between age and weight loss during hospitalization was observed (r = 0.146, p = 0.08). Moreover, for elderly patients (>61 years old), a statistically significant correlation between age and weight loss was found (r = 0.288 p = 0.05). Patients admitted to an Intensive Care Unit (ICU) or Intermediate Care Unit (IMCU) had a greater unintended weight loss than patients who stayed in a standard care ward (5.46% vs 1.19%; p < 0.001). At discharge 12 patients were malnourished (8.4%) according to the ESPEN definition. On average, patients gained 4.36 kg (p < 0.001) three months after discharge. Overall, we observed a weight reduction of 2.2% (p < 0.001) from the habitual weight measured upon admission. Patients admitted to an ICU/IMCU showed a higher MUST score three months after discharge (Cramer's V 0.218, p = 0.035). With regard to the NIS score, only 7 patients (4.9%) reported one or more nutritional problems during follow-up. Conclusions The identification of groups of patients at a higher nutritional risk could be useful with a view to adopting measures to prevent worsening of nutritional status during hospitalization. Admission to an ICU/IMCU, age and length of the hospital stay seem to have a major impact on nutritional status. Nutritional follow-up should be guaranteed for patients who lose more than 10% of their habitual weight during their stay in hospital, especially after admission to an ICU/IMCU.
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Affiliation(s)
- C Fiorindi
- Department of Health Science, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
| | - F Campani
- Department of Health Science, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
| | - L Rasero
- Department of Health Science, University of Florence, Florence, Italy.
| | - C Campani
- Department of Experimental & Clinical Medicine, University of Florence, Florence, Italy.
| | - L Livi
- Department of Health Science, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
| | - L Giovannoni
- Department of Health Science, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
| | - C Amato
- Department of Health Science, University of Florence, Florence, Italy.
| | - F Giudici
- Department of Experimental & Clinical Medicine, University of Florence, Florence, Italy.
| | - A Bartoloni
- Infectious and Tropical Diseases Unit, Careggi University and Hospital, Florence, Italy.
| | - F Fattirolli
- Cardiac Rehabilitation Unit, Careggi University Hospital, Florence, Italy.
| | - F Lavorini
- Department of Cardiothoracovascular Medicine, Careggi Hospital, Florence, Italy.
| | - I Olivotto
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy.
| | - A Nannoni
- Department of Health Science, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
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Piasentin A, Rizzo M, Ciabattoni R, Visalli G, Marrocchio C, Rebez G, Claps F, Ongaro L, Giudici F, Cernic S, Bertolotto M, Cova M, Trombetta C, Liguori G. Retrospective analysis of three nephrometry systems in predicting outcomes of renal percutaneous cryoablation. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00736-9] [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: 10/20/2022] Open
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Dobrinja C, Samardzic N, Giudici F, Raffaelli M, De Crea C, Sessa L, Docimo G, Ansaldo GL, Minuto M, Varaldo E, Dionigi G, Spiezia S, Boniardi M, Pauna I, De Pasquale L, Testini M, Gurrado A, Pasculli A, Pezzolla A, Lattarulo S, Calò PG, Graceffa G, Massara A, Docimo L, Ruggiero R, Parmeggiani D, Iacobone M, Innaro N, Lombardi CP, de Manzini N. Hemithyroidectomy versus total thyroidectomy in the intermediate-risk differentiated thyroid cancer: the Italian Societies of Endocrine Surgeons and Surgical Oncology Multicentric Study. Updates Surg 2021; 73:1909-1921. [PMID: 34435312 DOI: 10.1007/s13304-021-01140-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/26/2021] [Indexed: 11/27/2022]
Abstract
The surgical treatment of the intermediate-risk DTC (1-4 cm) remains still controversial. We analyzed the current practice in Italy regarding the surgical management of intermediate-risk unilateral DTC to evaluate risk factors for recurrence and to identify a group of patients to whom propose a total thyroidectomy (TT) vs. hemithyroidectomy (HT). Among 1896 patients operated for thyroid cancer between January 2017 and December 2019, we evaluated 564 (29.7%) patients with unilateral intermediate-risk DTC (1-4 cm) without contralateral nodular lesions on the preoperative exams, chronic autoimmune thyroiditis, familiarity or radiance exposure. Data were collected retrospectively from the clinical register from 16 referral centers. The patients were followed for at least 14 months (median time 29.21 months). In our cohort 499 patients (88.4%) underwent total thyroidectomy whereas 65 patients (11.6%) underwent hemithyroidectomy. 151 (26.8%) patients had a multifocal DTC of whom 57 (10.1%) were bilateral. 21/66 (32.3%) patients were reoperated within 2 months from the first intervention (completion thyroidectomy). Three patients (3/564) developed regional lymph node recurrence 2 years after surgery and required a lymph nodal neck dissection. The single factor related to the risk of reoperation was the histological diameter (HR = 1.05 (1.00-1-09), p = 0.026). Risk stratification is the key to differentiating treatment options and achieving better outcomes. According to the present study, tumor diameter is a strong predictive risk factor to proper choose initial surgical management for intermediate-risk DTC.
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Affiliation(s)
- C Dobrinja
- UOC Clinica Chirurgica di Trieste, Dipartimento Universitario Clinico di Scienze Mediche Chirurgiche e della Salute, Trieste, Italy
| | - N Samardzic
- UOC Clinica Chirurgica di Trieste, Dipartimento Universitario Clinico di Scienze Mediche Chirurgiche e della Salute, Trieste, Italy. .,Division of General Surgery, Department of Medical and Surgical Sciences, Cattinara Hospital, Università degli Studi di Trieste, Strada di Fiume 447, 34149, Trieste, Italy.
| | - F Giudici
- UOC Clinica Chirurgica di Trieste, Dipartimento Universitario Clinico di Scienze Mediche Chirurgiche e della Salute, Trieste, Italy
| | - M Raffaelli
- UNITÀ OPERATIVA COMPLESSA Chirurgia Endocrina e Metabolica, Dipartimento Scienze mediche e chirurgiche, Policlinico Gemelli, Roma, Italy
| | - C De Crea
- UNITÀ OPERATIVA COMPLESSA Chirurgia Endocrina e Metabolica, Dipartimento Scienze mediche e chirurgiche, Policlinico Gemelli, Roma, Italy
| | - L Sessa
- UNITÀ OPERATIVA COMPLESSA Chirurgia Endocrina e Metabolica, Dipartimento Scienze mediche e chirurgiche, Policlinico Gemelli, Roma, Italy
| | - G Docimo
- UOSD Chirurgia Tiroidea Università della Campania "Luigi Vanvitelli", Caserta, Italy
| | - G L Ansaldo
- U.O.S. di Chirurgia Endocrina, IRCCS Ospedale Policlinico San Martino di Genova, Genoa, Italy
| | - M Minuto
- U.O.S. di Chirurgia Endocrina, IRCCS Ospedale Policlinico San Martino di Genova, Genoa, Italy
| | - E Varaldo
- U.O.S. di Chirurgia Endocrina, IRCCS Ospedale Policlinico San Martino di Genova, Genoa, Italy
| | - G Dionigi
- UOSD di Chirurgia Endocrina e Mininvasiva, Policlinico Gaetano Martino MESSINA Azienda Ospedaliera Universitaria, Messina, Italy
| | | | - M Boniardi
- Chirurgia Endocrina-Chirurgia Oncologica e Mininvasiva, Ospedale Niguarda di Milano, Milan, Italy
| | - I Pauna
- Chirurgia Endocrina-Chirurgia Oncologica e Mininvasiva, Ospedale Niguarda di Milano, Milan, Italy
| | - L De Pasquale
- Servizio di Chirurgia di Tiroide e Paratiroidi, U.O. ORL Asst Santi Paolo e Carlo, Ospedale Polo Universitario San Paolo, Via A. di Rudinì, 8, 20142, Milano, Italy
| | - M Testini
- U.O.C. di Chirurgia Generale Universitaria "V. Bonomo", Azienda Ospedaliero Universitaria Policlinico di Bari. Dipartimento di Scienze Biomediche ed Oncologia Umana, Università degli Studi "A. Moro" di Bari, Bari, Italy
| | - A Gurrado
- U.O.C. di Chirurgia Generale Universitaria "V. Bonomo", Azienda Ospedaliero Universitaria Policlinico di Bari. Dipartimento di Scienze Biomediche ed Oncologia Umana, Università degli Studi "A. Moro" di Bari, Bari, Italy
| | - A Pasculli
- U.O.C. di Chirurgia Generale Universitaria "V. Bonomo", Azienda Ospedaliero Universitaria Policlinico di Bari. Dipartimento di Scienze Biomediche ed Oncologia Umana, Università degli Studi "A. Moro" di Bari, Bari, Italy
| | - A Pezzolla
- Policlinico di Bari, UOS Videolaparoscopica, Bari, Italy
| | - S Lattarulo
- Policlinico di Bari, UOS Videolaparoscopica, Bari, Italy
| | - P G Calò
- Chirurgia Generale Polispecialistica, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy
| | - G Graceffa
- UO CH ONCOLOGICA, Policlinico P. Giaccone di Palermo, Università degli Studi di Palermo, Palermo, Italy
| | - A Massara
- UO CH ONCOLOGICA, Policlinico P. Giaccone di Palermo, Università degli Studi di Palermo, Palermo, Italy
| | - L Docimo
- XI Chirurgia Generale, Universita' della Campania Luigi Vanvitelli, Via Pansini 5, Naples, Italy
| | - R Ruggiero
- XI Chirurgia Generale, Universita' della Campania Luigi Vanvitelli, Via Pansini 5, Naples, Italy
| | - D Parmeggiani
- XI Chirurgia Generale, Universita' della Campania Luigi Vanvitelli, Via Pansini 5, Naples, Italy
| | - M Iacobone
- Endocrinochirurgia- Azienda Ospedaliera di Padova, Padua, Italy
| | - N Innaro
- Unità Operativa di Endocrinochirurgia, Azienda Ospedaliero-Universitaria Mater Domini, Catanzaro, Italy
| | - C P Lombardi
- Unità Operativa Complessa Chirurgia Endocrina, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - N de Manzini
- UOC Clinica Chirurgica di Trieste, Dipartimento Universitario Clinico di Scienze Mediche Chirurgiche e della Salute, Trieste, Italy
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Bozzao F, Tomietto P, Baratella E, Giudici F, Kodric M, Della Porta R, Prearo I, Pirronello SMG, Fischetti F, Confalonieri M, Fabris B. POS1435 CLINICAL CHARACTERIZATION AND PREDICTIVE FACTORS FOR PROGRESSION IN A COHORT OF ILD PATIENTS WITH FEATURES OF AUTOIMMUNITY: ARE IPAF CRITERIA SUFFICIENT? Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:It is unknown whether patients with interstitial lung disease (ILD) and only some features of autoimmunity have a different natural history from those with a defined connective tissue disease (CTD-ILD). The classification criteria for “ILD with autoimmune features” (IPAF) may not be able to characterize all these patients, especially those with a usual interstitial pneumonia (UIP) pattern [1].Objectives:To determine clinical characteristics and predictive factors for progression in a cohort of ILD patients with features of autoimmunity, through the application of classification criteria for IPAF and specific CTD, whenever possible.Methods:We retrospectively selected a cohort of consecutive patients with ILD as onset manifestation and features of autoimmunity (at least 1 autoantibody and/or 1 clinical sign/symptom), evaluated by our multidisciplinary unit from March 2009 to March 2020. All the final diagnoses were revised according to the latest CTD and IPAF criteria. Patients were followed up for 33 (16.5-69.5) months.Results:Of the 101 patients enrolled (67.4±10.9 yrs, F/M ratio 65/36), 53 (52.5%) and 37 (36.6%) respectively satisfied the CTD and IPAF criteria. Eleven patients (10.9%) did not satisfy IPAF criteria because of only 1 item (clinical or serologic) within the IPAF domains and a UIP pattern; we defined this group as “autoimmune” UIP (AI-UIP). All the 8 patients initially classified as undifferentiated CTD had sufficient IPAF criteria. Among the IPAF patients (68.2±10.1 years, F/M ratio 20/17), the most common findings were: Nonspecific interstitial pneumonia pattern (56.8%), antinuclear antibodies positivity (43.2%) and arthritis (24.3%). The combination of a positive morphologic and serologic domain was the most common to reach the diagnosis (48.6%). Some IPAF patients had features not included in IPAF criteria, such as non-anti-synthetase myositis-specific antibodies (21.6%), objective sicca syndrome (13.5%) and anti-myeloperoxidase antibodies (2.7%). Over a median of 17 months, 2 IPAF patients (5.4%) developed a definite UIP pattern, while 4 (10.8%) a specific CTD. Comparing the IPAF, CTD-ILD and AI-UIP groups, no statistically significant differences were found in the mean age, sex distribution, smoking habits and mean duration of the disease. However, IPAF patients had a significantly higher prevalence of arterial hypertension and left-sided heart failure and a lower predominance of UIP pattern as expected (10.8% vs. 32.1% vs. 100%, p<0.01). Although no differences were found at the diagnosis, at 1 year the proportion of IPAF patients with radiological progression of the fibrosis and/or functional deterioration (defined by a decline in FVC of ≥ 10% and/or DLCO of ≥ 15% predicted) was lower to that of CTD-ILD and AI-UIP (17.1% vs. 31.4% vs. 63.6%, p 0.01). Fewer IPAF patients needed oxygen support (8.6% vs. 31.4% vs. 36.4, p 0.02). Considering the overall 101 patients, having an IPAF and a UIP pattern respectively predicted a slower (OR: 0.37, p 0.04) and a faster (OR: 3.56, p 0.01) ILD progression at the multivariate analysis.Conclusion:In our cohort, IPAF criteria were useful to identify a subset of patients with a slower ILD progression and a possible evolution to CTD (10-15% of cases) [2]. These criteria do not characterize all the patients with a UIP pattern and limited features of autoimmunity, which seem to have a worse prognosis, independently from the final diagnosis. Further studies are needed to clarify if the prognosis of AI-UIP is different from that of idiopathic pulmonary fibrosis.References:[1]Graney, et al. Ann Am Thorac Soc 2019;16(5):525-33.[2]Sebastiani, et al. Biomedicines 2021,9,17.Disclosure of Interests:None declared
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Ianza A, Di Chicco A, Biagi C, Giudici F, Dicorato A, Guglielmi A, Variola F, Tomasi S, Roviello G, Generali D, Zanconati F. EGFR mutation analysis on circulating free DNA in NSCLC: a single-center experience. J Cancer Res Clin Oncol 2021; 147:2301-2307. [PMID: 34003366 PMCID: PMC8236477 DOI: 10.1007/s00432-021-03658-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/03/2021] [Indexed: 11/30/2022]
Abstract
Purpose Monitoring mutation status in circulating free DNA (cfDNA) during target therapy could hold significant clinical importance in non-small cell lung cancer (NSCLC). Our aim is to establish if EGFR mutational status change on cfDNA has predictive value that can impact clinical management of NSCLC patients care. Methods This study included 30 patients with EGFR-mutated NSCLC. Blood samples were collected at diagnosis (T0) and in 19 patients during therapy (T1). Results Concordance between T0 and T1 EGFR mutation status for patients evaluable for both samples (n = 19) was 79%, with a sensitivity of 100% (95% CI: 55.5–100.0) and specificity of 60.0% (95% CI: 26.2–86.8). For the patients in oncological therapy with targeted drug and with T1 sample available (n = 18), survival outcomes were evaluated. For both mutation-negative T0 and T1 patients, 12-month progression-free survival (PFS) was 66.7% (95% CI: 27.2–100.0) and 12-month overall survival (OS) was 100% (95% CI: 1.00–1.00); for patients mutated both at T0 and T1, PFS was 22.2% (95% CI: 6.5–75.4%) and OS was 55.6% (95% CI: 20.4–96.1%). Conclusion EGFR mutation status can be assessed using cfDNA for routine purposes and longitudinal assessment of plasma mutation is an easy approach to monitor the therapeutic response or resistance onset.
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Affiliation(s)
- Anna Ianza
- Department of Medical, Surgery and Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy.
| | - A Di Chicco
- Department of Medical, Surgery and Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy
| | - C Biagi
- Azienda Sanitaria Universitaria Goriziano Isontina, Cattinara Academic Hospital, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
| | - F Giudici
- Department of Medical, Surgery and Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy
| | - A Dicorato
- Azienda Sanitaria Universitaria Goriziano Isontina, Cattinara Academic Hospital, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
| | - A Guglielmi
- Azienda Sanitaria Universitaria Goriziano Isontina, Cattinara Academic Hospital, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
| | - F Variola
- Azienda Sanitaria Universitaria Goriziano Isontina, Cattinara Academic Hospital, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
| | - S Tomasi
- Azienda Sanitaria Universitaria Goriziano Isontina, Cattinara Academic Hospital, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
| | - G Roviello
- Department of Medical, Surgery and Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy
| | - D Generali
- Department of Medical, Surgery and Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy.,Breast Cancer Unit and Translational Research Unit, ASST Cremona, Cremona, Italy
| | - F Zanconati
- Department of Medical, Surgery and Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy.,Azienda Sanitaria Universitaria Goriziano Isontina, Cattinara Academic Hospital, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
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Giudici F, Scomersi S, Coren T, Tonutti M, Rizzardi C, Dell’Antonio A, Fezzi M, Dore F, Ceccherini R, Schiattarella A, Milan V, Zanconati F, Bortul M. Breast cancer in elderly patients: are we choosing wisely? A critical review of the breast unit of Trieste. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30607-9] [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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Ianza A, Giudici F, Pinello C, Corona SP, Strina C, Bernocchi O, Bortul M, Milani M, Sirico M, Allevi G, Aguggini S, Cocconi A, Azzini C, Dester M, Cervoni V, Bottini A, Cappelletti M, Generali D. ΔKi67 proliferation index as independent predictive and prognostic factor of outcome in luminal breast cancer: data from neoadjuvant letrozole-based treatment. Tumour Biol 2020; 42:1010428320925301. [PMID: 32489146 DOI: 10.1177/1010428320925301] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
A key tool for monitoring breast cancer patients under neoadjuvant treatment is the identification of reliable predictive markers. Ki67 has been identified as a prognostic and predictive marker in ER-positive breast cancer. Ninety ER-positive, HER2 negative locally advanced breast cancer patients received letrozole (2.5 mg daily) and cyclophosphamide (50 mg daily) with/without Sorafenib (400 mg/bid daily) for 6 months before undergoing surgery. Ki67 expression and tumor size measured with caliber were determined at baseline, after 30 days of treatment and at the end of treatment. Patients were assigned to a clinical response category according to Response Evaluation Criteria in Solid Tumors, both at 30 days and before surgery and further classified as high-responder and low-responder according to the median variation of Ki67 values between biopsy and 30 days and between biopsy and surgery time. The predictive role of Ki67 and its changes with regard to clinical response and survival was analyzed. No differences in terms of survival outcomes emerged between the arms of treatment, while we observed a higher percentage of women with progression or stable disease in arm with the combination containing Sorafenib (20.5% vs 7.1%, p = 0.06). Clinical complete responders experienced a greater overall variation in Ki67 when compared with partial responders and patients with progressive/stable disease (66.7% vs 30.7%, p = 0.009). High responders showed a better outcome than low responders in terms of both disease-free survival (p = 0.009) and overall survival (p = 0.002). ΔKi67 score evaluated between basal and residual tumor at definitive surgery showed to be highly predictive of clinical complete response, and a potential parameter to be used for predicting disease-free survival and overall survival in luminal breast cancer treated with neoadjuvant endocrine-based therapy.
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Affiliation(s)
- A Ianza
- Department of Medical, Surgery & Health Sciences, University of Trieste, Trieste, Italy
| | - F Giudici
- Department of Medical, Surgical & Health Sciences, Cattinara Teaching Hospital, University of Trieste, Trieste, Italy
| | - C Pinello
- Department of Medical, Surgical & Health Sciences, Cattinara Teaching Hospital, University of Trieste, Trieste, Italy
| | - S P Corona
- Department of Medical, Surgical & Health Sciences, Cattinara Teaching Hospital, University of Trieste, Trieste, Italy
| | - C Strina
- Breast Cancer Unit and Translational Research Unit, ASST Cremona, Cremona, Italy
| | - O Bernocchi
- Department of Medical, Surgical & Health Sciences, Cattinara Teaching Hospital, University of Trieste, Trieste, Italy
| | - M Bortul
- Department of Medical, Surgical & Health Sciences, Cattinara Teaching Hospital, University of Trieste, Trieste, Italy
| | - M Milani
- Breast Cancer Unit and Translational Research Unit, ASST Cremona, Cremona, Italy
| | - M Sirico
- Breast Cancer Unit and Translational Research Unit, ASST Cremona, Cremona, Italy
| | - G Allevi
- Breast Cancer Unit and Translational Research Unit, ASST Cremona, Cremona, Italy
| | - S Aguggini
- Breast Cancer Unit and Translational Research Unit, ASST Cremona, Cremona, Italy
| | - A Cocconi
- Breast Cancer Unit and Translational Research Unit, ASST Cremona, Cremona, Italy
| | - C Azzini
- Breast Cancer Unit and Translational Research Unit, ASST Cremona, Cremona, Italy
| | - M Dester
- Breast Cancer Unit and Translational Research Unit, ASST Cremona, Cremona, Italy
| | - V Cervoni
- Breast Cancer Unit and Translational Research Unit, ASST Cremona, Cremona, Italy
| | - A Bottini
- Breast Cancer Unit and Translational Research Unit, ASST Cremona, Cremona, Italy
| | - M Cappelletti
- Breast Cancer Unit and Translational Research Unit, ASST Cremona, Cremona, Italy
| | - D Generali
- Department of Medical, Surgical & Health Sciences, Cattinara Teaching Hospital, University of Trieste, Trieste, Italy.,Breast Cancer Unit and Translational Research Unit, ASST Cremona, Cremona, Italy
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13
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Corona SP, Bortul M, Scomersi S, Bigal C, Bottin C, Zanconati F, Fox SB, Giudici F, Generali D. Management of the axilla in breast cancer: outcome analysis in a series of ductal versus lobular invasive cancers. Breast Cancer Res Treat 2020; 180:735-745. [PMID: 32060782 DOI: 10.1007/s10549-020-05565-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 02/03/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Axillary lymph node dissection (ALND) has been considered essential for the staging of breast cancer (BC). As the impact of tumor biology on clinical outcomes is recognized, a surgical de-escalation approach is being implemented. We performed a retrospective study focused on surgical management of the axilla in invasive lobular carcinoma (ILC) versus invasive ductal carcinoma (IDC). MATERIALS AND METHODS 1151 newly diagnosed BCs, IDCs (79.6%) or ILCs (20.4%), were selected among patients treated at our Breast Cancer Unit from 2012 to 2018. Tumor characteristics and clinical information were collected and predictors of further metastasis after positive sentinel lymph node biopsy (SLNB) analyzed in relation to disease-free survival (DFS) and overall survival (OS). RESULTS 27.5% of patients with ILC had ≥ 3 metastatic lymph nodes at ALND after positive SLNB versus 11.48% of IDCs (p = 0.04). Risk predictors of further metastasis at ALND were the presence of > 2 positive lymph nodes at SLNB (OR = 4.72, 95% CI 1.15-19.5 p = 0.03), T3-T4 tumors (OR = 4.93, 95% CI 1.10-22.2, p = 0.03) and Non-Luminal BC (OR = 2.74, 95% CI 1.16-6.50, p = 0.02). The lobular histotype was not associated with the risk of further metastasis at ALND (OR = 1.62, 95% CI 0.77-3.41, p = 0.20). CONCLUSIONS ILC histology is not associated with higher risk of further metastasis at ALND in our analysis. However, surgical management decisions should be taken considering tumor histotype, biology and expected sensitivity to adjuvant therapies.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Axilla
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Lobular/mortality
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/surgery
- Disease Management
- Female
- Follow-Up Studies
- Humans
- Lymph Node Excision/mortality
- Mastectomy/mortality
- Middle Aged
- Neoplasm Invasiveness
- Prognosis
- Retrospective Studies
- Sentinel Lymph Node Biopsy/mortality
- Survival Rate
- Young Adult
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Affiliation(s)
- S P Corona
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Cattinara Hospital 447, 34129, Trieste, Italy.
| | - M Bortul
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Cattinara Hospital 447, 34129, Trieste, Italy
| | - S Scomersi
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Cattinara Hospital 447, 34129, Trieste, Italy
| | - C Bigal
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Cattinara Hospital 447, 34129, Trieste, Italy
| | - C Bottin
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Cattinara Hospital 447, 34129, Trieste, Italy
| | - F Zanconati
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Cattinara Hospital 447, 34129, Trieste, Italy
| | - S B Fox
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
- Department of Clinical Pathology, University of Melbourne, Melbourne, VIC, Australia
| | - F Giudici
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Cattinara Hospital 447, 34129, Trieste, Italy
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Via Loredan, 18, Padua, 35131, Italy
| | - D Generali
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Cattinara Hospital 447, 34129, Trieste, Italy
- U.O. Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, viale Concordia 1, Cremona, 26100, Italy
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14
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Muca M, Pagnan L, Belgrano MG, Giudici F, Vitrella G, Sinagra G, Cova MA. P448Correlation between native T1 and T2 mapping and MRI strain parameters in patients with myocarditis: a pilot study. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez118.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Muca
- Integrated University Hospital of Trieste (ASUITS), Radiology department, Trieste, Italy
| | - L Pagnan
- Integrated University Hospital of Trieste (ASUITS), Radiology department, Trieste, Italy
| | - M G Belgrano
- Integrated University Hospital of Trieste (ASUITS), Radiology department, Trieste, Italy
| | - F Giudici
- Section of Biomedical Statistics, Department of Mathematics and Informatics, University of Trieste, Trieste, Italy
| | - G Vitrella
- Integrated University Hospital of Trieste (ASUITS), Integrated cardiovascular activity department, Trieste, Italy
| | - G Sinagra
- Integrated University Hospital of Trieste (ASUITS), Integrated cardiovascular activity department, Trieste, Italy
| | - M A Cova
- Integrated University Hospital of Trieste (ASUITS), Radiology department, Trieste, Italy
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15
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Corona SP, Roviello G, Strina C, Milani M, Madaro S, Zanoni D, Allevi G, Aguggini S, Cappelletti MR, Francaviglia M, Azzini C, Cocconi A, Sirico M, Bortul M, Zanconati F, Giudici F, Rosellini P, Meani F, Pagani O, Generali D. Efficacy of extended aromatase inhibitors for hormone-receptor-positive breast cancer: A literature-based meta-analysis of randomized trials. Breast 2019; 46:19-24. [PMID: 31051411 DOI: 10.1016/j.breast.2019.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 03/28/2019] [Accepted: 04/22/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Endocrine treatment with Tamoxifen and aromatase inhibitors (AIs) is a staple in the management of hormone receptor positive breast cancer (HR + BC). It has become clear that HR + BC carries a consistent risk of relapse up to 15 years post-diagnosis. While increasing evidence supports the use of extended adjuvant Tamoxifen over 5 years, controversial data are available on the optimal duration of extended AIs adjuvant treatment. We performed a meta-analysis to assess the real impact of extended adjuvant therapy with AIs on disease-free survival (DFS). METHODS A literature-based meta-analysis of randomized controlled trials (RCTs) was undertaken. Relevant publications from PubMed, the Cochrane Library, and abstracts from American Society of Clinical Oncology (ASCO) and San Antonio Breast Cancer (SABCS) symposia were searched. Primary and secondary endpoints were Disease Free Survival (DFS) and overall survival (OS) respectively. A subgroup analysis was also performed to elucidate the impact of nodal involvement. RESULTS The pooled analysis revealed a significant increase in DFS in the extended AIs group (hazard ratio (HR): 0.78, 95% CI: 0.68-0.90; P = 0.0006). The subgroup analysis according to nodal status showed a greater DFS benefit with extended AIs in patients with positive nodes (HR = 0.67 versus 0.80). Our analysis also demonstrated no improvement in OS with extended AIs (HR = 0.99, 95%CI: 0.87-1.12; P = 0.84). CONCLUSION This work confirmed the efficacy of extended adjuvant treatment with AIs for HR + early breast cancer, with a 22% increase in DFS, but no impact on OS. Greater efficacy was observed in women with positive nodal status.
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Affiliation(s)
- S P Corona
- Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy.
| | - G Roviello
- Department of Health Sciences, University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - C Strina
- U.O. Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, Viale Concordia 1, 26100, Cremona, Italy
| | - M Milani
- U.O. Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, Viale Concordia 1, 26100, Cremona, Italy
| | - S Madaro
- U.O. Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, Viale Concordia 1, 26100, Cremona, Italy
| | - D Zanoni
- U.O. Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, Viale Concordia 1, 26100, Cremona, Italy
| | - G Allevi
- U.O. Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, Viale Concordia 1, 26100, Cremona, Italy
| | - S Aguggini
- U.O. Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, Viale Concordia 1, 26100, Cremona, Italy
| | - M R Cappelletti
- U.O. Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, Viale Concordia 1, 26100, Cremona, Italy
| | - M Francaviglia
- U.O. Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, Viale Concordia 1, 26100, Cremona, Italy
| | - C Azzini
- U.O. Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, Viale Concordia 1, 26100, Cremona, Italy
| | - A Cocconi
- U.O. Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, Viale Concordia 1, 26100, Cremona, Italy
| | - M Sirico
- U.O. Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, Viale Concordia 1, 26100, Cremona, Italy
| | - M Bortul
- Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy
| | - F Zanconati
- Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy
| | - F Giudici
- Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy
| | - P Rosellini
- Unit of Medical Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci - Policlinico "Le Scotte" 53100, Siena, Italy
| | - F Meani
- Centro di Senologia della Svizzera Italiana (CSSI), Ospedale Regionale di Lugano, CH-6962, Viganello, Switzerland
| | - O Pagani
- Centro di Senologia della Svizzera Italiana (CSSI), Ospedale Regionale di Lugano, CH-6962, Viganello, Switzerland
| | - D Generali
- Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy; U.O. Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, Viale Concordia 1, 26100, Cremona, Italy
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16
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Sobhani N, Roviello G, Pivetta T, Ianza A, Bonazza D, Zanconati F, Giudici F, Bottin C, Corona SP, Guglielmi A, Rizzardi C, Milione M, Cortale M, Confalonieri M, Generali D. Tumour infiltrating lymphocytes and PD-L1 expression as potential predictors of outcome in patients with malignant pleural mesothelioma. Mol Biol Rep 2019; 46:2713-2720. [PMID: 30840203 DOI: 10.1007/s11033-019-04715-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 02/23/2019] [Indexed: 12/29/2022]
Abstract
Malignant pleural mesothelioma (MPM) is a rare and aggressive form of tumour. Some mesotheliomas have been proven to be highly immunogenic. Here, we investigated the correlation between tumour infiltrating lymphocytes (TILs) or programmed cell death ligand 1 (PD-L1) expression with overall survival (OS) in patients with MPM. 62 Paraffin-embedded formalin fixed (PEFF) samples were analysed for TILs and PD-L1 expression. Patients were divided in 4 groups according to a cut-off of the percentage of TILs found per sample as measured by immunohistichemistry: "0" or absent (between 0 and 5%), "1" or low (between 6 and 25%), "2" or moderate (between 26 and 50%) and "3" or high (between 51 and 75%). OS was then correlated with different TILs' expression patterns. Moreover, PD-L1 expression was assessed within the tumour as well as in the adjacent stroma on the same samples. Higher expression of peritumoral TILs (Group 2 + 3) versus Group 0 and 1 correlated with improved OS (p-value = 0.02). On the contrary PD-L1 expression seemed to be inversely correlated with clinical outcomes, even in the absence of statistical significance (HR 1.76; p = 0.083 95% IC 0.92-3.36 in areas within the tumour; HR 1.60; p = 0.176 95%; IC 0.80-3.19 in areas within the stroma). No relationship between TILs and PD-L1 expression was identified. Our research supports the use of TILs and PD-L1 expression as potential outcome predictors in patients with MPM. The use of TILs and PD-L1 as biomarkers for checkpoint inhibitors' efficacy warrants future investigation.
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Affiliation(s)
- N Sobhani
- Department of Medicine, Surgery & Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149, Trieste, Italy. .,Department of Medicine, Surgery & Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy.
| | - G Roviello
- Department of Medicine, Surgery & Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy.,Division of Medical Oncology, Department of Onco-Hematology, IRCCS-CROB, Referral Cancer Center of Basilicata, via Padre Pio 1, 85028, Rionero in Vulture, PZ, Italy
| | - T Pivetta
- Department of Medicine, Surgery & Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149, Trieste, Italy
| | - A Ianza
- Department of Medicine, Surgery & Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy
| | - D Bonazza
- Department of Medicine, Surgery & Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149, Trieste, Italy
| | - F Zanconati
- Department of Medicine, Surgery & Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149, Trieste, Italy
| | - F Giudici
- Department of Medicine, Surgery & Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149, Trieste, Italy
| | - C Bottin
- Department of Medicine, Surgery & Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149, Trieste, Italy
| | - S P Corona
- Department of Medicine, Surgery & Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149, Trieste, Italy
| | - A Guglielmi
- Department of Medicine, Surgery & Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy
| | - C Rizzardi
- Department of Medicine, Surgery & Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149, Trieste, Italy
| | - M Milione
- Pathology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Cortale
- Department of Medicine, Surgery & Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149, Trieste, Italy
| | - M Confalonieri
- Department of Medicine, Surgery & Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149, Trieste, Italy
| | - D Generali
- Department of Medicine, Surgery & Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy.,Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.,Breast Cancer Unit and Translational Research Unit, ASST Cremona, Cremona, Italy
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17
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Schnapper G, Casella D, Giudici F, Miano E, Riboni G, Serra M, Valdora F, Rossi F. Data Manager in Senology: It is time to recognize this figure officially. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30681-6] [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: 10/17/2022]
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18
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Keiser O, Giudici F, Müllhaupt B, Junker C, Dufour JF, Moradpour D, Bruggmann P, Terziroli B, Semela D, Brezzi M, Bertisch B, Estill J, Negro F, Spoerri A. Trends in hepatitis C-related mortality in Switzerland. J Viral Hepat 2018; 25:152-160. [PMID: 29159841 DOI: 10.1111/jvh.12803] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 08/07/2017] [Indexed: 12/24/2022]
Abstract
In order to accurately assess the burden of hepatitis C (HCV) and develop effective interventions, we must understand the magnitude and trends of mortality related to the disease. In the United States, HCV-related mortality is continuously increasing. We have no comparable data for Switzerland and other European countries, although a modelling study predicted a similar increase. We analysed time trends (1 January 1995-31 December 2014) in HCV-specific mortality rates in the Swiss general population using the death registry of the Swiss Federal Statistical Office (SFSO). We compared HCV-related mortality to HIV-related and hepatitis B (HBV)-related mortality. To determine potential under-reporting in HCV-related mortality, we probabilistically linked the SFSO data to persons who died in the Swiss Hepatitis C Cohort Study (SCCS). SFSO data showed that HCV-related mortality more than doubled between 1995 and 2003, but has since stabilized at ~2.5/100 000 person-years. Since 2000, HCV-related mortality has been higher than HIV-related mortality and was about fivefold higher in 2014. HBV-related mortality remained low at ~0.5/100 000 person-years. Of 4556 persons in the SCCS, 421 have died and 86.2% could be linked to the death registry. According to the SCCS, 133 deaths were HCV-related. HCV was not mentioned on the SFSO death certificate of 45% of these (n = 60/133). In conclusion, HCV-related mortality remained constant, possibly because quality of care was high, or because of under-reporting or because mortality has not yet increased. However, HCV-related mortality is now much higher than HIV- and HBV-related mortality, and under-reporting was common.
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Affiliation(s)
- O Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - F Giudici
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - B Müllhaupt
- Gastroenterology and Hepatology University Hospital Zurich, Zurich, Switzerland
| | - C Junker
- Federal Statistical Office, Neuchâtel, Switzerland
| | - J-F Dufour
- Hepatology, Department of Clinical Research, University of Bern, Bern, Switzerland.,University Clinic of Visceral Surgery and Medicine, Inselspital Bern, Bern, Switzerland
| | - D Moradpour
- Division of Gastroenterology and Hepatology, University Hospital Lausanne (CHUV), Lausanne, Switzerland
| | - P Bruggmann
- Arud Centres for Addiction Medicine, Zurich, Switzerland
| | | | - D Semela
- Division of Gastroenterology and Hepatology, St Gallen, Switzerland
| | - M Brezzi
- Institute of Global Health, University of Geneva, Geneva, Switzerland.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - B Bertisch
- Institute of Global Health, University of Geneva, Geneva, Switzerland.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Checkpoint Zurich, Zurich, Switzerland
| | - J Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - F Negro
- Divisions of Gastroenterology and Hepatology and of Clinical Pathology, University Hospitals Geneva, Geneva, Switzerland
| | - A Spoerri
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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19
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Gurrieri L, Giudici F, Fedele D, Dicorato A, Malagoli M, Moroso S, Del Conte G, Zanconati F, Guglielmi A. Does second-line therapy affect the outcome of the patients with cholangiocarcinoma? A single institution experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx425.028] [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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20
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Abstract
AIM The onset of symptoms after removal of the ileocaecal valve (ICV) may be perceived as an unwanted effect of surgery and induce patients to bring unnecessary litigation against surgeons. The aim of our study is to assess the real impact on the quality of life of patients whose ICV has been surgically removed, using three validated questionnaires. METHOD In patients who had their ICV removed surgically, the Gastrointestinal Quality of life (GIQLI) questionnaire and those used by the European Organization for research and Treatment of Cancer (EORTC) were administered before and after surgery. The empirical rule effect size method was used to evaluate the clinical significance of the statistical data. RESULTS We interviewed 225 patients. Data collected through the three questionnaires highlighted a trend towards postoperative improvement of the selected gastrointestinal symptoms compared with the baseline. The GIQLI questionnaire showed a statistically significant improvement in 'pain', 'nausea' and 'constipation' during the follow-up. Constipation appeared more frequently in patients older than 70 years compared with younger ones. The EORTC-QLQ-C30 questionnaire showed a significant correlation between diarrhoea and extended right colectomy at 3 months after surgery, which was not confirmed at 6 months. The EORTC QLQ-CR29 questionnaire showed a slight deterioration of 'leakage of stools from the anal opening' at 6 months after surgery, but this symptom was not deemed clinically significant. CONCLUSION We found that bowel functions in most patients after surgical removal of the ICV were satisfactory. Providing patients with a comprehensive and exhaustive informed consent during preoperative consultations could promote patient trust and avoid misunderstandings.
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Affiliation(s)
- S Palmisano
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Trieste, Italy
| | - M Silvestri
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Trieste, Italy
| | - M Troian
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Trieste, Italy
| | - P Germani
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Trieste, Italy
| | - F Giudici
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Trieste, Italy
| | - N de Manzini
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Trieste, Italy
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Giudici F, Bertisch B, Negro F, Stirnimann G, Müllhaupt B, Moradpour D, Cerny A, Keiser O. Access to therapy and therapy outcomes in the Swiss Hepatitis C Cohort Study: a person-centred approach. J Viral Hepat 2016; 23:697-707. [PMID: 27006320 DOI: 10.1111/jvh.12535] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 02/10/2016] [Indexed: 12/25/2022]
Abstract
Socio-demographic and behavioural characteristics are associated with delayed diagnosis and disease progression in HCV-infected persons. However, many analyses focused on single variables rather than groups defined by several variables. We used latent class analysis to study all 4488 persons enrolled in the Swiss Hepatitis C Cohort Study. Groups were identified using predefined variables at enrolment. The number of groups was selected using the Bayesian information criterion. Mortality, loss to follow-up, cirrhosis, treatment status and response to antivirals were analysed using Laplace and logistic regressions. We identified five groups and named them according to their characteristics: persons who inject drugs, male drinkers, Swiss employees, foreign employees and retirees. Two groups did not conform to common assumptions about persons with chronic hepatitis C and were already in an advanced stage of the disease at enrolment: 'male drinkers' and 'retirees' had a high proportion of cirrhosis at enrolment (15% and 16% vs <10.3%), and the shortest time to death (adjusted median time 8.7 years and 8.8 years vs >9.0). 'Male drinkers' also had high substance use, but they were well educated and were likely to be employed. This analysis may help identifying high-risk groups which may benefit from targeted interventions.
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Affiliation(s)
- F Giudici
- Institute of Social and Preventive Medicine, Bern, Switzerland
| | - B Bertisch
- Institute of Social and Preventive Medicine, Bern, Switzerland.,Checkpoint Zürich, Zürich, Switzerland
| | - F Negro
- Divisions of Gastroenterology and Hepatology and of Clinical Pathology, University Hospitals, Geneva, Switzerland
| | - G Stirnimann
- University Clinic of Visceral Surgery and Medicine, Inselspital, Bern, Switzerland
| | - B Müllhaupt
- Swiss Hepato-Pancreato-Biliary Center and Department of Gastroenterology and Hepatology, University Hospital, Zürich, Switzerland
| | - D Moradpour
- Division of Gastroenterology and Hepatology, University Hospital, Lausanne, Switzerland
| | - A Cerny
- Epatocentro Ticino Foundation, Lugano, Switzerland
| | - O Keiser
- Institute of Social and Preventive Medicine, Bern, Switzerland
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Vidali C, Breast Cancer Study Group A, Giudici F. EP-1238: Hypofractionated whole-breast radiotherapy in Italy: A survey by the Breast Cancer Study Group of AIRO. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31356-6] [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: 11/17/2022]
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Zagra A, Minoia L, Archetti M, Corriero AS, Ricci K, Teli M, Giudici F. Prospective study of a new dynamic stabilisation system in the treatment of degenerative discopathy and instability of the lumbar spine. Eur Spine J 2012; 21 Suppl 1:S83-9. [PMID: 22415759 PMCID: PMC3325398 DOI: 10.1007/s00586-012-2223-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 02/19/2012] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Posterior dynamic stabilisation (PDS) aims at relieving lumbar discogenic pain and preserving adjacent levels from accelerated degeneration. PURPOSE To evaluate the results of a novel PDS system in 32 adult patients affected by chronic low back pain (CLBP) due to degenerative lumbar spine instability (DLSI). METHOD A progressive follow-up for 12 months of 32 patients, with collection of complete clinical (ODI and VAS back + leg) and radiological data (resting + functional radiographs and MRI). RESULTS Mean ODI scores improved from 49 to 6%, VAS back from 5 to 1 and VAS leg from 7 to 2. Twenty-two patients underwent fusion of a lower lumbar segment and stabilisation of an upper segment (hybrid fusion) whereas ten underwent dynamic stabilisation. In 16/32 patients, decompression was added to treat radicular pain. Motion in non-fused instrumented levels was unrestricted on functional X-rays and MRIs did not show significant morphologic changes. Four patients (12.5%) had unchanged functional and pain scores while two (6.3%) suffered worsening low back pain necessitating implant removal and spinal fusion. No infection, no new neurologic deficit or implant failure was recorded. CONCLUSIONS The 1 year follow-up shows that the tested PDS system is able to provide a significant improvement in pain and disability scores when applied to patients affected by DLSI. The system does not provide better clinical results when compared to similar trials on posterior fusion. Further follow-up is ongoing to investigate the potential preservation of adjacent levels from accelerated degeneration.
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Affiliation(s)
- A Zagra
- 1st Department of Spinal Surgery, Galeazzi Orthopaedic Institute, Via Galeazzi 4, 20161 Milan, Italy.
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Valanzano R, Giudici F, Messerini L, Nesi G, Tonelli F. Recurrence rates and long-term follow-up of gastrointestinal stromal tumors. Suppl Tumori 2005; 4:S105. [PMID: 16437935] [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] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
- R Valanzano
- Department of Clinical Pathophysiology, Surgery Unit, University of Florence
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25
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Bedeschi A, Visentin G, Perrone E, Giudici F, Zarini F, Franceschi G, Meinardi G, Castellani P, Jabes D, Rossi R. Synthesis and structure-activity relations in the class of 2-(pyridyl)penems. J Antibiot (Tokyo) 1990; 43:306-13. [PMID: 2182592 DOI: 10.7164/antibiotics.43.306] [Citation(s) in RCA: 5] [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] [Indexed: 12/30/2022]
Abstract
The isosteric CH----N substitution in the class of 2-arylpenems results in improved antibacterial activity, with retention of the favorable characteristic of stability towards renal dehydropeptidase. High therapeutic efficacy was demonstrated in experimental mice septicemias with the 2-(3-pyridyl) derivative 2b and its orally absorbed acetoxymethyl ester prodrug 4n.
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Affiliation(s)
- A Bedeschi
- Farmitalia Carlo Erba SpA, R. & D., Infectious Diseases Dept., Milan, Italy
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Perrone E, Alpegiani M, Bedeschi A, Giudici F, Zarini F, Franceschi G, Della Bruna C, Jabes D, Meinardi G. Novel quaternary ammonium penems: the [(pyridinio)methyl]-phenyl derivatives. J Antibiot (Tokyo) 1987; 40:1636-9. [PMID: 3693132 DOI: 10.7164/antibiotics.40.1636] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- E Perrone
- Farmitalia Carlo Erba SpA, R. & D. Infectious Diseases Dept., Milan, Italy
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Perrone E, Alpegiani M, Bedeschi A, Giudici F, Zarini F, Franceschi G, Della Bruna C, Jabes D, Meinardi G. 2-(quaternary ammonio)-methyl penems. J Antibiot (Tokyo) 1986; 39:1351-5. [PMID: 3781933 DOI: 10.7164/antibiotics.39.1351] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Perrone E, Alpegiani M, Giudici F, Buzzetti F, Nannini G, Meinardi G, Grasso S, Bianchi A, de Carneri I. Cephalosporins. VII. Synthesis and antibacterial activity of new cephalosporins bearing a 2-imino-3-hydroxythiazoline (2-aminothiazole N-oxide) in the C-7 acylamino side chain. J Antibiot (Tokyo) 1984; 37:1423-40. [PMID: 6334680 DOI: 10.7164/antibiotics.37.1423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Introduction of a hydroxyl group into the thiazole ring nitrogen of cephalosporins belonging to the cefotiam and cefotaxime families gave rise to products, better described by the tautomeric N-oxide form, which proved particularly active against Gram-negative bacteria. Cephems bearing a (Z)-alkoxyimino functionality are of special interest for broadness of spectrum; among them, 7 beta-[(Z)-2-(2-amino-4-thiazolyl-N-oxide)-2 -methoxyiminoacetamido]-3-(tetrazolo-[1,5-b] pyridazin-6-yl)thiomethyl-3-cephem-4-carboxylic acid (5c-7, FCE 20635), in other ways similar to cefotaxime, showed useful levels of activity against cephalosporinase-producing strains resistant to the reference drug. Preliminary in vivo studies demonstrated the therapeutic efficacy of the new compound in the treatment of experimental systemic, subcutaneous and urinary tract infections in mice.
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Bedeschi A, Crugnola A, Giudici F, Perrone E, Nannini G, Meinardi G. Cephalosporins. V. Synthesis and in vitro activity of some 7-[2-methoxyimino-(substituted thio)alkanoyl]amino cephalosporanic acid derivatives. J Antibiot (Tokyo) 1982; 35:712-20. [PMID: 7118727 DOI: 10.7164/antibiotics.35.712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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30
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Perrone E, Nannini G, Giudici F, Severino D, Giraldi PN, Meinardi G, Ceriani A. Cephalosporins IV. Synthesis and structure-activity relationships of new 7 alpha-methoxy-7 beta-vinylenethioacetamido cephalosporins. J Antibiot (Tokyo) 1982; 35:321-8. [PMID: 7076579 DOI: 10.7164/antibiotics.35.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The synthesis and in vitro activity of 7 alpha-methoxy-7 beta-vinylenethioacetamido cephalosporins with various substituents at the 3-position are described. These cephalosporins showed good activity against beta-lactamase producing Gram-negative bacteria. 7 alpha-Methoxy-7-[(Z)-beta-cyano-vinylenethioacetamido]-3-[(1-methyl-1H-tetrazol -5-yl)thiomethyl]-3-cephem-4-carboxylic acid (3) was several times more active in vitro than cefoxitin and comparable to cefmetazole.
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