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Quarta A, Iannucci D, Guarino M, Blasetti A, Chiarelli F. Hypoglycemia in Children: Major Endocrine-Metabolic Causes and Novel Therapeutic Perspectives. Nutrients 2023; 15:3544. [PMID: 37630734 PMCID: PMC10459037 DOI: 10.3390/nu15163544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Hypoglycemia is due to defects in the metabolic systems involved in the transition from the fed to the fasting state or in the hormone control of these systems. In children, hypoglycemia is considered a metabolic-endocrine emergency, because it may lead to brain injury, permanent neurological sequelae and, in rare cases, death. Symptoms are nonspecific, particularly in infants and young children. Diagnosis is based on laboratory investigations during a hypoglycemic event, but it may also require biochemical tests between episodes, dynamic endocrine tests and molecular genetics. This narrative review presents the age-related definitions of hypoglycemia, its pathophysiology and main causes, and discusses the current diagnostic and modern therapeutic approaches.
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Affiliation(s)
| | | | | | | | - Francesco Chiarelli
- Department of Pediatrics, University of Chieti—Pescara, Gabriele D’Annunzio, 66100 Chieti, Italy; (A.Q.); (D.I.); (M.G.); (A.B.)
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Quarta A, Guarino M, Tripodi R, Giannini C, Chiarelli F, Blasetti A. Diet and Glycemic Index in Children with Type 1 Diabetes. Nutrients 2023; 15:3507. [PMID: 37630698 PMCID: PMC10459060 DOI: 10.3390/nu15163507] [Citation(s) in RCA: 1] [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: 07/19/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
In children with type 1 diabetes, a healthy lifestyle is important to control postprandial glycemia and to avoid hyperglycemic peaks that worsen the inflammatory state of vessels and tissues. Glycemic index and glycemic load are two important indexes which assess the quality and quantity of foods consumed during meals. The main macronutrients of the diet have a different effect on postprandial blood glucose levels, so it is important that diabetic children consume foods which determine a slower and steadier glycemic peak. In this review, we present the results of the most recent studies carried out in the pediatric population with T1D, whose aim was to analyze the effects of low-glycemic-index foods on glycemic control. The results are promising and demonstrate that diets promoting low-glycemic-index foods guarantee a greater glycemic stability with a reduction in postprandial hyperglycemic peaks. However, one of the main limitations is represented by the poor adherence of children to a healthy diet. In order to obtain satisfactory results, a possibility might be to ensure a balanced intake of low-, moderate- and high-glycemic-index foods, preferring those with a low glycemic index and limiting the consumption of the high- and moderate-glycemic-index types.
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Affiliation(s)
| | | | | | | | | | - Annalisa Blasetti
- Department of Pediatrics, University of Chieti—Pescara, G. D’Annunzio, 66100 Chieti, Italy; (A.Q.); (M.G.); (R.T.); (C.G.); (F.C.)
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Guarino M, La Bella S, Santoro M, Caposiena D, Di Lembo E, Chiarelli F, Iannetti G. The Leading Role of Brain and Abdominal Radiological Features in the Work-Up of Anti-NMDAR Encephalitis in Children: An Up-To-Date Review. Brain Sci 2023; 13:brainsci13040662. [PMID: 37190627 DOI: 10.3390/brainsci13040662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023] Open
Abstract
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis (NMDARe) is the most common cause of nonviral encephalitis, mostly affecting young women and adolescents with a strong female predominance (F/M ratio of around 4:1). NMDARe is characterized by the presence of cerebrospinal fluid (CSF) antibodies against NMDARs, even though its pathophysiological mechanisms have not totally been clarified. The clinical phenotype of NMDARe is composed of both severe neurological and neuropsychiatric symptoms, including generalized seizures with desaturations, behavioral abnormalities, and movement disorders. NMDARe is often a paraneoplastic illness, mainly due to the common presence of concomitant ovarian teratomas in young women. Abdominal ultrasonography (US) is a key imaging technique that should always be performed in suspected patients. The timely use of abdominal US and the peculiar radiological features observed in NMDARe may allow for a quick diagnosis and a good prognosis, with rapid improvement after the resection of the tumor and the correct drug therapy.
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Affiliation(s)
- Miriana Guarino
- Department of Pediatrics, University of Chieti-Pescara "G. D'Annunzio", Via Dei Vestini 5, Ospedale Clinicizzato Chieti (CH), 66100 Chieti, Italy
| | - Saverio La Bella
- Department of Pediatrics, University of Chieti-Pescara "G. D'Annunzio", Via Dei Vestini 5, Ospedale Clinicizzato Chieti (CH), 66100 Chieti, Italy
| | - Marco Santoro
- Department of Radiology, Pescara Public Hospital "Santo Spirito", 65124 Pescara, Italy
| | - Daniele Caposiena
- Department of Radiology, Pescara Public Hospital "Santo Spirito", 65124 Pescara, Italy
| | - Enza Di Lembo
- Department of Internist Ultrasound, Pescara Public Hospital "Santo Spirito", 65124 Pescara, Italy
| | - Francesco Chiarelli
- Department of Pediatrics, University of Chieti-Pescara "G. D'Annunzio", Via Dei Vestini 5, Ospedale Clinicizzato Chieti (CH), 66100 Chieti, Italy
| | - Giovanni Iannetti
- Department of Internist Ultrasound, Pescara Public Hospital "Santo Spirito", 65124 Pescara, Italy
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Guarino M, Matonti L, Chiarelli F, Blasetti A. Primary prevention programs for childhood obesity: are they cost-effective? Ital J Pediatr 2023; 49:28. [PMID: 36864472 PMCID: PMC9983264 DOI: 10.1186/s13052-023-01424-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 02/02/2023] [Indexed: 03/04/2023] Open
Abstract
Childhood obesity is increasing all over the world. It is associated with a reduction in quality of life and a relevant burden on society costs. This systematic review deals with the cost-effectiveness analysis (CEA) of primary prevention programs on childhood overweight/obesity, in order to benefit from cost-effective interventions.We screened and evaluated all the studies with a cost-effectiveness analysis on childhood obesity primary prevention program by PUBMED and Google Scholar, using inclusion and exclusion criteria. The quality of the studies was assessed by Drummond's checklist.Ten studies were included. Two of them examined the cost-effectiveness of community-based prevention programs, four focused only on school-based programs while four more studies examined both community-based and school-based programs. The studies were different in terms of study design, target population, health and economic outcomes. Seventy per cent of the works had positive economic results.The majority of the studies showed effective economic outcomes applying primary prevention programs on childhood obesity. It is important to increase homogeneity and consistency among different studies.
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Affiliation(s)
| | - Lorena Matonti
- grid.4708.b0000 0004 1757 2822University of Study G. d’Annunzio, Chieti-Pescara, Italy
| | - Francesco Chiarelli
- grid.4708.b0000 0004 1757 2822University of Study G. d’Annunzio, Chieti-Pescara, Italy
| | - Annalisa Blasetti
- grid.4708.b0000 0004 1757 2822University of Study G. d’Annunzio, Chieti-Pescara, Italy
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Blasetti A, Quarta A, Guarino M, Cicolini I, Iannucci D, Giannini C, Chiarelli F. Role of Prenatal Nutrition in the Development of Insulin Resistance in Children. Nutrients 2022; 15:nu15010087. [PMID: 36615744 PMCID: PMC9824240 DOI: 10.3390/nu15010087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022] Open
Abstract
Nutrition during the prenatal period is crucial for the development of insulin resistance (IR) and its consequences in children. The relationship between intrauterine environment, fetal nutrition and the onset of IR, type 2 diabetes (T2D), obesity and metabolic syndrome later in life has been confirmed in many studies. The intake of carbohydrates, protein, fat and micronutrients during pregnancy seems to damage fetal metabolism programming; indeed, epigenetic mechanisms change glucose-insulin metabolism. Intrauterine growth restriction (IUGR) induced by unbalanced nutrient intake during prenatal life cause fetal adipose tissue and pancreatic beta-cell dysfunction. In this review we have summarized and discussed the role of maternal nutrition in preventing insulin resistance in youth.
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Kozono D, Stinchcombe T, Salama J, Bogart J, Petty W, Guarino M, Bazhenova L, Larner J, Weiss J, Dipetrillo T, Feigenberg S, Chen X, Sun Z, Nuthalapati S, Rosenwinkel L, Johnson E, Bach B, Luo Y, Vokes E. P01.23 Veliparib (V) in Combination with Carboplatin/Paclitaxel (C/P)-Based Chemoradiotherapy (CRT) in Patients With Stage III NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.347] [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: 10/21/2022]
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Kizilbash S, El-Khoueiry A, Lerner R, Ma P, Almubarak M, Mody K, Burkard M, Guarino M, Jenab-Wolcott J, Sankar N, Choy G, Espiritu L, Zhang X, Luria A, Benedetti F, Dees E. Phase 1/2 study of the safety and efficacy of APL-101, a specific c-MET inhibitor. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31095-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Algazi A, Guarino M, Panella T, Celebi J, Csiki I, Drumheller A, Campbell J, Pierce R, Smith W. 924P SNS-301 added to pembrolizumab in patients (Pts) with ASPH+ advanced squamous cell carcinoma of the head & neck (SCCHN). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1039] [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: 10/23/2022] Open
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Fabbian F, Fedeli U, De Giorgi A, Cappadona R, Guarino M, Gallerani M, De Giorgio R, Manfredini R. Sex and acute oesophageal variceal bleeding-related in-hospital mortality: a 15-year retrospective study. Eur Rev Med Pharmacol Sci 2020; 23:811-817. [PMID: 30720189 DOI: 10.26355/eurrev_201901_16895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The relationship between in-hospital mortality (IHM) and acute oesophageal variceal bleeding (AOEVB) has not been fully assessed. The aim of this study was to establish the association between sex and mortality for patients hospitalized with AOEVB. PATIENTS AND METHODS We analyzed hospitalizations from the Italian Health Ministry database by identifying all patients discharged with AOEVB from January 2001 to December 2015. A total of 144,943 hospitalizations were for oesophageal varices, but only 24,570 emergency admissions with AOEVB coded as the primary or secondary diagnosis were included for analysis. Factors independently associated with IHM were evaluated by multilevel logistic regression. RESULTS Approximately half of the population was aged ≥ 65 years, and nearly 10% was diagnosed with hepatocellular carcinoma. Overall, the IHM was 11.8%, with 12.1% in males and 11.3% in females, increasing from 9.2% among subjects aged < 55 years to 18.9% among those aged ≥ 85 years. The crude risk of death was slightly higher among females; however, when age and clinical presentation were considered, female sex was associated with reduced mortality. For liver disease, the risk of death in women was lower only in those with non-alcoholic liver disease (odds ratio= 0.77, 0.66-0.89), but it was similar to that in men for unspecified, cancer and alcoholic liver disease. The risk declined over time and was increased in patients with multiple comorbidities. CONCLUSIONS AOEVB-related IHM decreased from 2001-2005 to 2011-2015. Factors affecting mortality included liver disease, age, sex, development of hepatocellular carcinoma and comorbidities.
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Affiliation(s)
- F Fabbian
- Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Ferrara, Italy.
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Guarino M, Bologna A, Ursini F, De Giorgi A, Alfano F, Gambuti E, Marchesini M, Strada A, Volpato S, De Giorgio R. Chronobiology of acute pancreatitis in a single Italian centre. Eur Rev Med Pharmacol Sci 2020; 24:1988-1994. [PMID: 32141567 DOI: 10.26355/eurrev_202002_20376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Seasonal variation may occur in many different diseases hence influencing awareness in clinical practice. This study aimed to establish seasonal variations of acute pancreatitis by using a validated chronobiological analysis. PATIENTS AND METHODS All cases of acute pancreatitis consecutively observed in fifteen years, i.e., from January 2003 to December 2017, at St. Anna University Hospital of Ferrara, Italy, were included in this study. Accurate statistical and logistic regression analyses were applied to our database. RESULTS A total number of 1883 consecutive cases of acute pancreatitis were observed. A significant peak was identified in the summer period (p=0.014). Patient stratification, according to age, showed that elderly people had an increased incidence of acute pancreatitis in autumn and summer (being the biliary stone disease the main cause, p=0.011) vs. other seasons (p=0.003). Mortality occurred more prominently in males vs. females, although the latter gender was more prone to acute pancreatitis (p=0.017). CONCLUSIONS In a single centre of Northern East of Italy, we demonstrated that acute pancreatitis had a clear seasonal variation with a prominent incidence during summer. Various associated factors could contribute to this chronobiological pattern, including gender, age, and biliary stone disease.
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Affiliation(s)
- M Guarino
- Departments of Medical Sciences and Internal Medicine Unit; St. Anna University Hospital in Cona, Ferrara, University of Ferrara, Ferrara, Italy.
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Lages M, Brito G, Lopes N, Fonseca-Pinto R, Guarino M. Predicting metabolic risk in healthy volunteers through assessment of physiological responses to ingestion of different meals. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.048] [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: 11/12/2022] Open
Affiliation(s)
- M Lages
- ciTechCare, Polytechnic Institute of Leiria, Portugal
| | - G Brito
- ciTechCare, Polytechnic Institute of Leiria, Portugal
- School of Technology and Management, Polytechnic Institute of Leiria, Portugal
| | - N Lopes
- ciTechCare, Polytechnic Institute of Leiria, Portugal
- School of Technology and Management, Polytechnic Institute of Leiria, Portugal
| | - R Fonseca-Pinto
- ciTechCare, Polytechnic Institute of Leiria, Portugal
- School of Technology and Management, Polytechnic Institute of Leiria, Portugal
| | - M Guarino
- ciTechCare, Polytechnic Institute of Leiria, Portugal
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Abstract
Aims To investigate the distribution of basement membrane components type IV collagen and laminin in synovial sarcomas. Methods Paraffin sections from four synovial sarcomas were studied by the peroxidase-antiperoxldase procedure using specific antibodies to type IV collagen and laminin. Results Type IV collagen and laminin immunoreactivity was confined around epithelial areas in biphasic tumors. Several interruptions and discontinuities of the linear basement membrane profile were seen in sites of transition between mesenchymal and epithelial tissue. Moreover, a spot-like immunoreactivity was often observed in the spindle cell component of biphasic tumors. Monophasic tumors were either negative or showed a pericellular staining for both type IV collagen and laminin. Conclusions The distribution of basement membrane components is clearly related to the formation of epithelial elements in biphasic synovial sarcoma. The spot-like immunoreactivity of the spindle cell component, and the basement membrane interruptions at the boundary between mesenchymal and epithelial tissue, are both consistent with early basement membrane formation by developing epithelium. These findings support the concept that synovial sarcomas are basically soft tissue carcinosarcomas and that the epithelial component of the tumors develops by conversion of mesenchyme to epithelium.
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Affiliation(s)
- M Guarino
- Department of Anatomical Pathology, Hospital of Treviglio, Bergamo, Italy
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Guarino M, Giordano F, Pallotti F, Polizzotti G, Tricomi P, Cristofori E. Malignant Mixed Müllerian Tumor of the Uterus. Features Favoring its Origin from a Common Cell Clone and an Epithelial-to-Mesenchymal Transformation Mechanism of Histogenesis. Tumori 2018; 84:391-7. [PMID: 9678624 DOI: 10.1177/030089169808400316] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and background Various histogenetic mechanisms have been postulated to explain the biphasic carcinomatous-sarcomatous appearance of malignant mixed müllerian tumors (MMMTs), but the nature of these uncommon neoplasms is still unclear. Some evidence would suggest that MMMT displays similarities with sarcomatoid carcinoma, a tumor arising in extragenital sites that also features a mixed appearance. To gain further insight into the histogenesis of this tumor, we have studied by immunohistochemistry a case of uterine MMMT showing an extensive rhabdomyosarcomatous component. Methods A panel of antibodies including reactivity for p53, cytokeratin, vimentin, desmin, muscle actin, epithelial membrane antigen (EMA), myoglobin, type IV collagen, laminin, and tenascin was applied to paraffin tumor sections by means of the avidin-biotin complex technique. Results p53 immunoreactivity was observed in approximately the same number of cells in carcinomatous and sarcomatous tissue. The former stained for vimentin, cytokeratin and EMA, while the latter, in addition to expressing vimentin, desmin, muscle actin and myoglobin, also exhibited immunoreactivity for epithelial markers such as cytokeratin and EMA. At the borders between carcinoma and sarcoma the basement membrane pattern, as seen by staining for type IV collagen and laminin, showed interruptions in correspondence with areas of transition between the two tissues. Antibody to tenascin strongly labeled the sarcomatous tissue immediately around carcinomatous elements. Conclusions A similar immunoreactivity for p53 in both carcinomatous and sarcomatous components, expression of epithelial markers in the sarcomatous cells, and disruption of the basement membrane profile in areas of transition between carcinomatous and sarcomatous tissue, would all suggest, as has been postulated for extragenital sarcomatoid carcinomas, an origin from a common epithelial clone and an epithelial-to-mesenchymal transformation-based mechanism of development for this MMMT. In addition, these findings provide further analogies between these categories of tumors, supporting a unifying nosological concept for MMMTs and sarcomatoid carcinomas of non-genital tract origin.
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Affiliation(s)
- M Guarino
- Department of Pathology, Hospital of Vimercate, Italy
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Abstract
Aims Eight sarcomatoid carcinomas from various anatomical locations were investigated by immunohistochemical staining to laminin, type IV collagen and heparan sulfate proteoglycan, to study the characteristics of basement membranes at the interface between carcinomatous and sarcomatous tissues. Methods Paraffin wax embedded tissue sections from representative tumor samples have been stained with specific antibodies, using the peroxidase-antiperoxidase technique. Results In all cases several interruptions or discontinuities of the basement membrane staining pattern were seen. In 4 cases, larger defects or complete loss of staining was also noted. At these places, the boundaries between carcinomatous and sarcomatous tissue were often blurred. Conclusions Disruption and loss of basement membranes at interface between carcinomatous and sarcomatous tissues is a frequent finding in sarcomatoid carcinomas. These changes could be consistent with an epithelial origin of the sarcomatous component in these tumors by means of an epithelial-mesenchymal conversion mechanism.
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Affiliation(s)
- M Guarino
- Department of Anatomical Pathology, Hospital of Treviglio, Italy
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Abstract
Liposarcoma is a soft tissue tumor usually observed in adults. Although occasional cases have been reported in childhood, it is virtually unknown in infants and small children. Our experience documents a case of liposarcoma in a 6-year-old girl, an extremely rare occurrence in this age-group. The patient underwent wide local excision followed by chemotherapy. Histologically, the tumor was a myxoid type. Differential diagnosis and problems concerning prognosis and therapy of this tumor in children are discussed.
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Affiliation(s)
- M Guarino
- Department of Anatomical Pathology, Hospital of Treviglio (Bergamo), Italy
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Tullo E, Fontana I, Peña Fernandez A, Vranken E, Norton T, Berckmans D, Guarino M. Association between environmental predisposing risk factors and leg disorders in broiler chickens. J Anim Sci 2017; 95:1512-1520. [PMID: 28464112 DOI: 10.2527/jas.2016.1257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Footpad dermatitis and lameness are a major welfare concern in broiler chicken farming. In general, footpad lesions are linked to poor environmental conditions. Ulcers that arise from advanced lesions can negatively affect the gait of the birds, with effects on the animal welfare, including, in the worst cases, inability to reach the feed or water. In this study, the degree of footpad dermatitis and lameness was manually scored on 4 broiler farms across Europe, as part of an EU-wide welfare assessment program. The welfare of the chickens was assessed 3 times per production cycle (at wk 3, 4, and 5), scoring footpad dermatitis, lameness, and litter quality. In the same broiler farms, variables such as air temperature and relative humidity were automatically measured over the same period. These variables were combined into a widely accepted thermal comfort index and associated to upper and lower thresholds, which made it possible to quantify the percentage of time the birds spent out of the thermal comfort zone (POOC). The data was analyzed by combining data from the welfare assessments with environmental data collected by the automated monitoring systems. Considering the comparison between POOC classes, the highest probabilities of footpad dermatitis and lameness were obtained when POOC values exceeded the 70% threshold. Therefore, the analysis showed that footpad dermatitis and lameness were more frequent when the flock was exposed to poor environmental conditions for prolonged periods ( < 0.001). Since environmental conditions can be continuously measured, and the risk factor for footpad dermatitis and lameness increases with poor environmental conditions, there is the possibility to develop a detection and control system of severe lesions.
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Tagawa S, Faltas B, Lam E, Saylor P, Bardia A, Hajdenberg J, Morgans A, Lim E, Kalinsky K, Petrylak D, Guarino M, Galsky M, Maliakal P, Mudenda B, Sharkey R, Wegener W, Goldenberg D. Sacituzumab govitecan (IMMU-132) for patients with pretreated metastatic urothelial uancer (UC): interim results. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx371.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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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Andriulli A, Guarino M, Morisco F. Letter: the efficacy of interferon-free regimens in HCV-related Child C cirrhosis needs careful interpretation-Authors' reply. Aliment Pharmacol Ther 2017; 46:77. [PMID: 28589587 DOI: 10.1111/apt.14099] [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: 12/08/2022]
Affiliation(s)
- A Andriulli
- Division of Gastroenterology, Casa Sollievo Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - M Guarino
- Division of Gastroenterology, Casa Sollievo Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - F Morisco
- Division of Gastroenterology, Casa Sollievo Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
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Guarino M, Morisco F, Valvano MR, Ippolito AM, Librandi M, Andriulli N, Greco M, Amoruso A, Iacobellis A, Niro G, Caporaso N, Andriulli A. Systematic review: interferon-free regimens for patients with HCV-related Child C cirrhosis. Aliment Pharmacol Ther 2017; 45:1193-1200. [PMID: 28261822 DOI: 10.1111/apt.14017] [Citation(s) in RCA: 12] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/21/2017] [Accepted: 02/07/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND It is unclear whether the efficacy and long-term outcome of treating patients with hepatitis C virus (HCV)-positive cirrhosis with the new protease inhibitors will extend to those with Child C cirrhosis. AIM To assess the effectiveness of the interferon-free regimens in Child C cirrhotic patients with HCV infection. METHODS A systematic Medline search was conducted to retrieve studies describing the treatment of Child C patients with direct-acting agents. Citations from identified studies were cross-referenced and abstracts from European Association for the Study of the Liver (EASL) and American Association for the Study of Liver Disease (AASLD) meetings were checked. Extracted data were evaluated using a meta-analysis to calculate a weighted response rate. RESULTS Seven full-text records and two conference abstracts were retained for analysis from the 649 records identified. Data from an Italian real-life trial were also interrogated. Information on treatment outcome was available for 228 of the 240 Child C patients evaluated in the 10 trials. Overall, the weighted mean sustained virological response (SVR12) was 74.9% (95% CI: 65.6-82.4%). Neither duration of treatment (24 or 12 weeks), nor addition of ribavirin influenced these rates. The weighted SVR12 was 65.4% (95% CI: 46.8-80.2) after sofosbuvir/simeprevir, 76.0% (95% CI: 54.4-89.3%) after sofosbuvir/daclatasvir and 83.0% (95% CI: 73.4-89.6) after sofosbuvir/ledipasvir. Some studies did not provide information on the rate of post-treatment relapse or functional improvement. However, in those studies that did provide such data, a relapse was documented in 12.1% of patients and an improvement of ≥2 points on the model for end-stage liver disease (MELD) score in 61.1% of patients. CONCLUSION The improvement in MELD scores strongly suggests HCV-positive patients with Child C cirrhosis should be treated with these agents.
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Affiliation(s)
- M Guarino
- Gastroenterology Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - F Morisco
- Gastroenterology Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - M R Valvano
- Division of Gastroenterology, Casa Sollievo Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - A M Ippolito
- Division of Gastroenterology, Casa Sollievo Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | | | | | - M Greco
- Division of Internal Medicine and Clinical Immunology, San Martino Hospital, IRCCS, Genova, Italy
| | - A Amoruso
- Division of Emergency Medicine, San Carlo Hospital, Potenza, Italy
| | - A Iacobellis
- Division of Gastroenterology, Casa Sollievo Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - G Niro
- Division of Gastroenterology, Casa Sollievo Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - N Caporaso
- Gastroenterology Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - A Andriulli
- Division of Gastroenterology, Casa Sollievo Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
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Bardia A, Diamond JR, Mayer IA, Isakoff SJ, Abramson V, Starodub AN, O'Shaughnessy J, Kalinsky K, Moroose R, Shah N, Juric D, Shapiro GI, Guarino M, Ocean AJ, Messersmith WA, Berlin JD, Wegener WA, Sharkey RM, Goldenberg DM, Vahdat LT. Abstract P4-22-15: Sacituzumab govitecan (IMMU-132), an anti-Trop-2-SN-38 antibody-drug conjugate (ADC) for the treatment of relapsed/refractory, metastatic triple-negative breast cancer (mTNBC): Updated results. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-22-15] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. mTNBC has an aggressive course with limited effective therapy options and a median progression-free survival (PFS) of 2-4 months (mos) with standard therapy. Sacituzumab govitecan (IMMU-132) is an ADC targeting Trop-2, an antigen present in many epithelial cancers, including TNBC, and delivering SN-38, a topoisomerase I inhibitor as its therapeutic moiety. IMMU-132 was awarded Breakthrough Therapy designation by FDA based on its previously reported activity in relapsed/refractory mTNBC patients. Here we present updated results from the mTNBC cohort of an ongoing phase I/II study (ClinicalTrials.gov, NCT01631552).
Methods. mTNBC patients (pts) received IMMU-132 10 mg/kg on days 1 and 8 every 21 days. Trop-2 expression was not required for enrollment, but available tumor specimens underwent immunohistological (IHC) testing. Efficacy was assessed locally by RECIST 1.1; ORR, PFS and overall survival (OS) were determined for all pts. Pharmacokinetic parameters were estimated in select pts with adequate blood sampling. Immunogenicity to IMMU-132 was examined in all pts.
Results. We previously reported preliminary efficacy results in 51 mTNBC patients. Here we present data on 69 patients with data cutoff June 5, 2016. Median age was 56 years (31-81) and a median of 5 prior therapies (range 1-12), with 66 evaluable for response; ORR was 29% (19/66) 2 confirmed complete (CR) and 17 confirmed partial responses (PR). The median intention-to-treat PFS is 5.6 mos (95% CI, 3.6-7.1 mos) and median OS is 14.3 mos (95% CI, 10.5-18.8 mos). PRs included 2 pts whose tumors did not respond to anti-PD-L1 therapy. The duration of response in the 19 confirmed responders (8 continuing therapy) is 11.5 mos (95% CI = 7.6 to 12.7). The clinical benefit rate (CR+PR+SD>6 mos) for the 66 assessable patients is currently 45.5%. The majority (88%) of archival tumor specimens were moderately (2+) to strongly (3+) positive by IHC for Trop-2, precluding using Trop-2 expression as a selection criterion. Among current adverse events, grade >3 drug-related toxicities included neutropenia (35%), leukopenia (16%), anemia (13%), vomiting (9%), diarrhea (10%), and febrile neutropenia (4%). Clearance kinetics in 8 pts showed IMMU-132 and IgG had a terminal half-life of 15.3 ± 2.7 h and 86.5 ± 40.5 h, respectively, with area under the curve for free SN-38 (unbound) only 3% of the total amount of SN-38 (e.g., IgG bound). Thus, most SN-38 remains bound to the conjugate, and is released at a rate predicted from in vitro serum stability studies. No pt developed anti-IMMU-132 antibodies.
Conclusion The Trop-2-targeting ADC, IMMU-132, delivering cytotoxic doses of SN-38, shows high objective and durable tumor responses with manageable toxicity in heavily-pretreated pts with mTNBC in this updated cohort, supporting further development in this population with an unmet medical need.
Citation Format: Bardia A, Diamond JR, Mayer IA, Isakoff SJ, Abramson V, Starodub AN, O'Shaughnessy J, Kalinsky K, Moroose R, Shah N, Juric D, Shapiro GI, Guarino M, Ocean AJ, Messersmith WA, Berlin JD, Wegener WA, Sharkey RM, Goldenberg DM, Vahdat LT. Sacituzumab govitecan (IMMU-132), an anti-Trop-2-SN-38 antibody-drug conjugate (ADC) for the treatment of relapsed/refractory, metastatic triple-negative breast cancer (mTNBC): Updated results [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-22-15.
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Affiliation(s)
- A Bardia
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - JR Diamond
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - IA Mayer
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - SJ Isakoff
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - V Abramson
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - AN Starodub
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - J O'Shaughnessy
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - K Kalinsky
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - R Moroose
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - N Shah
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - D Juric
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - GI Shapiro
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - M Guarino
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - AJ Ocean
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - WA Messersmith
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - JD Berlin
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - WA Wegener
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - RM Sharkey
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - DM Goldenberg
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - LT Vahdat
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
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Tullo E, Fontana I, Peña Fernandez A, Vranken E, Norton T, Berckmans D, Guarino M. Association between environmental predisposing risk factors and leg disorders in broiler chickens. J Anim Sci 2017. [DOI: 10.2527/jas2016.1257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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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Cocca S, Guarino M, Cicala M. Asymptomatic Parasitic Infection in a Crohn's Disease Patient on Anti-TNFα Therapy: An Alert for Our Patients? J Crohns Colitis 2016; 10:1455-1456. [PMID: 27208388 DOI: 10.1093/ecco-jcc/jjw109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 05/16/2016] [Indexed: 02/08/2023]
Affiliation(s)
- S Cocca
- Department of Gastrointestinal Diseases, Campus Bio-Medico University, Rome, Italy
| | - M Guarino
- Department of Gastrointestinal Diseases, Campus Bio-Medico University, Rome, Italy
| | - M Cicala
- Department of Gastrointestinal Diseases, Campus Bio-Medico University, Rome, Italy
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Tullo E, Fontana I, Gottardo D, Sloth K, Guarino M. Technical note: Validation of a commercial system for the continuous and automated monitoring of dairy cow activity. J Dairy Sci 2016; 99:7489-7494. [DOI: 10.3168/jds.2016-11014] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 05/20/2016] [Indexed: 11/19/2022]
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Guarino M, Loperto I, Camera S, Cossiga V, Di Somma C, Colao A, Caporaso N, Morisco F. Osteoporosis across chronic liver disease. Osteoporos Int 2016; 27:1967-77. [PMID: 26846777 DOI: 10.1007/s00198-016-3512-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 01/29/2016] [Indexed: 02/06/2023]
Abstract
Osteoporosis is a complication of chronic liver disease, with impact on morbidity, quality of life, and survival. The progress of medicine and the new therapies stretched the disease's natural history and improved the survival of patients with liver disease. So, it is fundamental to make better the quality of life and to prevent complications. Metabolic bone disorders are common complications of chronic liver disease (CLD). Patients with CLD have an increased risk of bone fractures, with significant impact on morbidity, quality of life, and even on survival. Bone diseases, including osteomalacia, osteoporosis, and osteopenia, are frequently observed in many types of liver disease. The pathogenesis of damage and the mechanisms of bone loss are different in relation to the specific liver disease. The relevance of these conditions induced many authors to create a new nosographic entity known as "hepatic osteodystrophy", although this term is rarely used anymore and it is now commonly referred to as osteopenia or osteoporosis associated with chronic liver disease. This review is based on the personal experiences of the authors and upon research done of the available literature on this subject matter. The authors searched the PubMed database for publications containing the term "liver disease" in combination with "bone disease", "hepatic osteodistrophy", "osteoporosis", "osteopenia", "osteomalacia", and "fractures". They selected publications from the past 10 years but did not exclude older seminal publications, especially for colestatic liver diseases. This review of literature shows that osteoporosis crosses all CLD. It is important to underline that the progress of medicine and the new therapies stretched the disease's natural history and improved the survival of patients with CLD. It is fundamental to make better the quality of life and it is mandatory to prevent complications and in particular the osteoporotic ones, especially fractures.
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Affiliation(s)
- M Guarino
- Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples "Federico II", via Sergio Pansini, 5, 80131, Napoli, Italy
| | - I Loperto
- Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples "Federico II", via Sergio Pansini, 5, 80131, Napoli, Italy
| | - S Camera
- Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples "Federico II", via Sergio Pansini, 5, 80131, Napoli, Italy
| | - V Cossiga
- Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples "Federico II", via Sergio Pansini, 5, 80131, Napoli, Italy
| | - C Di Somma
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University of Naples "Federico II", via Sergio Pansini, 5, 80131, Napoli, Italy
| | - A Colao
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University of Naples "Federico II", via Sergio Pansini, 5, 80131, Napoli, Italy
| | - N Caporaso
- Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples "Federico II", via Sergio Pansini, 5, 80131, Napoli, Italy
| | - F Morisco
- Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples "Federico II", via Sergio Pansini, 5, 80131, Napoli, Italy.
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Ocean A, Starodub A, Messersmith W, Picozzi V, Guarino M, Thomas S, Bardia A, Shah M, Govindan S, Maliakal P, Wegener W, Sharkey R, Wilhelm F, Goldenberg D. P-162 Interim Results of IMMU-132 (Sacituzumab Govitecan), an Anti-Trop-2 Antibody-Drug Conjugate (ADC), in Patients (pts) with Metastatic Gastrointestinal (GI) Cancers. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.162] [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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27
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Vandermeulen J, Bahr C, Tullo E, Fontana I, Ott S, Kashiha M, Guarino M, Moons CPH, Tuyttens FAM, Niewold TA, Berckmans D. Discerning pig screams in production environments. PLoS One 2015; 10:e0123111. [PMID: 25923725 PMCID: PMC4414550 DOI: 10.1371/journal.pone.0123111] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 02/27/2015] [Indexed: 11/19/2022] Open
Abstract
Pig vocalisations convey information about their current state of health and welfare. Continuously monitoring these vocalisations can provide useful information for the farmer. For instance, pig screams can indicate stressful situations. When monitoring screams, other sounds can interfere with scream detection. Therefore, identifying screams from other sounds is essential. The objective of this study was to understand which sound features define a scream. Therefore, a method to detect screams based on sound features with physical meaning and explicit rules was developed. To achieve this, 7 hours of labelled data from 24 pigs was used. The developed detection method attained 72% sensitivity, 91% specificity and 83% precision. As a result, the detection method showed that screams contain the following features discerning them from other sounds: a formant structure, adequate power, high frequency content, sufficient variability and duration.
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Affiliation(s)
- J. Vandermeulen
- M3-BIORES—Measure, Model & Manage Bioresponses, KU Leuven, Leuven, Belgium
| | - C. Bahr
- M3-BIORES—Measure, Model & Manage Bioresponses, KU Leuven, Leuven, Belgium
| | - E. Tullo
- Department of Health, Animal Science and Food Safety, Università degli Studi di Milano, Milan, Italy
| | - I. Fontana
- Department of Health, Animal Science and Food Safety, Università degli Studi di Milano, Milan, Italy
| | - S. Ott
- Livestock-Nutrition-Quality, KU Leuven, Leuven, Belgium
- Departement of Animal Nutrition, Genetics and Ethology, Laboratory for Ethology, Ghent university, Merelbeke, Belgium
| | - M. Kashiha
- M3-BIORES—Measure, Model & Manage Bioresponses, KU Leuven, Leuven, Belgium
| | - M. Guarino
- Department of Health, Animal Science and Food Safety, Università degli Studi di Milano, Milan, Italy
| | - C. P. H. Moons
- Departement of Animal Nutrition, Genetics and Ethology, Laboratory for Ethology, Ghent university, Merelbeke, Belgium
| | - F. A. M. Tuyttens
- Departement of Animal Nutrition, Genetics and Ethology, Laboratory for Ethology, Ghent university, Merelbeke, Belgium
- Institute for Agricultural and Fisheries Research (ILVO), Animal Sciences Unit, Melle, Belgium
| | - T. A. Niewold
- Livestock-Nutrition-Quality, KU Leuven, Leuven, Belgium
| | - D. Berckmans
- M3-BIORES—Measure, Model & Manage Bioresponses, KU Leuven, Leuven, Belgium
- * E-mail:
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Chini L, Orlacchio A, Silenzi R, Della Gatta F, Iannini R, Monteferrario E, Spano S, Guarino M, Moschese V, Simonetti G. Neuroimaging is useful for monitoring disease activity in linear scleroderma "en coup de sabre". Minerva Pediatr 2014; 66:89-93. [PMID: 24608585] [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: 06/03/2023]
Abstract
Scleroderma is a group of rare chronic connective tissue disorders characterized by collagen accumulation that causes tissue hardening with consequent fibrosis. Skin involvement is mostly frequent, although several internal organs can be impaired (heart, lungs, liver, etc.). In childhood, juvenile localized scleroderma (JLS) is more frequently observed; in this subtype cutaneous lesions predominate frequently on the limbs but also on the face and scalp; in this case, it is referred to as scleroderma "en coup de sabre" (ECDS). Neurological abnormalities have been described in association with ECDS as an effect of progressive scalp and underlying tissues involvement. Up to now, no validated biomarkers exist to evaluate disease evolution and, in this way, frequently diagnosis of central nervous system (CNS) involvement occurs when patients are already symptomatic. We describe the case of a 5-year old girl, with a diagnosis of ECDS characterized by the typical scalp lesion, with slight subsidence of the underlying diploe. In this case, radiological examination has been essential to evaluate the degree of progression of skin and soft tissues lesions and to clarify the right therapeutic approach. In selected JLS children, both MRI and CT with 3D reconstruction images provide a useful tool to monitor disease evolution and to address therapeutic choices.
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Affiliation(s)
- L Chini
- Pediatric Allergology and Immunology Department Tor Vergata Hospital Tor Vergata University, Rome, Italy -
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Ismayilova G, Sonoda L, Fels M, Rizzi R, Oczak M, Viazzi S, Vranken E, Hartung J, Berckmans D, Guarino M. Acoustic-reward learning as a method to reduce the incidence of aggressive and abnormal behaviours among newly mixed piglets. Anim Prod Sci 2014. [DOI: 10.1071/an13202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of the study was to test whether aggressive actions among piglets could be redirected by an automatically generated sound signal followed by a sweet food reward. Per round, four litters of 25-day-old piglets (BHZP breed) were trained 5 times per day over 8 days to expect a sweet feed reward from a dog feeder after hearing a specific sound. In total 144 piglets in 14 entire litters were trained in five trials. At the end of the training 71% of the piglets were around the feeder 5 s after the feeder sound. After the training period, the piglets were weaned and mixed in two pens, 12 piglets per pen. During 2 days (3 h/day) after mixing two observers (one per pen) hidden behind a wooden wall activated the feeder when aggressive or abnormal behaviour started. A total of 616 aggressive events and 31 incidences of abnormal behaviour (ear biting) were used for the analysis. The logistic regression showed that the type of behaviour had a significant effect on the piglets’ response to the feeder sound (P < 0.001). The results showed the possibility of interruption of the aggressive behaviours such as head thrust [odds ratio (OR) = 0.43], jump on other (OR = 0.56) or attack with bite (OR = 0.61). Ear biting was very unlikely to continue (OR = 0.55). The risk of continuing elevated aggression level behaviours was doubled in the event of chasing (OR = 2.16) and the risk that fight would continue after the feeder sound was released was 7 times higher (OR = 7.89). Categorical analysis showed a significant effect (<0.001) of the time intervals t ≤ 1 s and 1 s < t ≤ 3 s on interruption of aggression by the feeder sound release. The piglets’ response to the feeder sound differed significantly between the experimental days (P < 0.001). On the second day of mixing, the feeder sound interrupted 74.9% of aggressive events, compared with 33.7% on the first day. The results suggest that acoustic-reward treatment can distract pigs from performing certain aggressive behaviours and ear biting in piglets when properly applied in time.
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Costa A, Ismayilova G, Borgonovo F, Viazzi S, Berckmans D, Guarino M. Image-processing technique to measure pig activity in response to climatic variation in a pig barn. Anim Prod Sci 2014. [DOI: 10.1071/an13031] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In the past decades, the increasing scale of intensive pig farms led farmers to use automatic tools to monitor the welfare and health of their animals. Visual observation and manual monitoring, usually practiced in small-scale farms, is unreliable in large-scale husbandry, and is expensive and time consuming. Environmental parameters are crucial information for the efficient management of piggery buildings, as they have a significant effect on production efficiency, health and welfare of confined animals. The aim of the present study was to evaluate the relationship between pig activity and environmental parameters in a pig building by means of image analysis. The barn for 350 fattening pigs was open-space, mechanically ventilated and subdivided into 16 pens with fully slatted floor. The room was equipped to monitor the ventilation rate, internal and external temperature and relative humidity every minute. For the experiments, two adjacent pens were selected, each 5.9 by 2.6 m, with ~16 pigs in each. Pigs were continuously monitored during 30 days using an infrared-sensitive CCD camera that was mounted 5 m above the floor. Recorded data were processed in real time by Eyenamic, an innovative software that continuously and automatically registers the behaviour of a group of animals, intended as the activity and occupation indices of the pigs. A preliminary virtual subdivision of the two pens in four zones (two zones for each pen) was performed to evaluate differences in activity/occupation indices in ‘front’ and ‘back’ zones of the pen. Recorded images were visually observed in the laboratory to estimate pig activity type in relation to the indices calculated by Eyenamic software. The occupation index showed higher values (up to 0.75 units) in Zones 1 and 4 placed near the corridor. There was a significant relation between pig occupation index measured in the two pens and ventilation rate, temperature and humidity. The interaction between ventilation and humidity and temperature and humidity significantly affected pig movements during the day. Pigs tended to stay in the part of the pen far from the external wall, where air velocity was higher, probably because this is a ‘central zone’ in the barn, characterised by a reasonable air movement (~0.30 m/s). On the contrary, the part of the pen nearest to the external wall, characterised by a humid floor surface and by a limited air speed, was occupied by animals at the trough mainly during feeding times and for defecation and urination.
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Ammoscato F, Scirocco A, Altomare A, Matarrese P, Petitta C, Ascione B, Caronna R, Guarino M, Marignani M, Cicala M, Chirletti P, Malorni W, Severi C. Lactobacillus rhamnosus protects human colonic muscle from pathogen lipopolysaccharide-induced damage. Neurogastroenterol Motil 2013; 25:984-e777. [PMID: 24118564 DOI: 10.1111/nmo.12232] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [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] [Received: 05/31/2013] [Accepted: 08/15/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Lactobacillus species might positively affect gastrointestinal motility. These Gram-positive bacteria bind Toll-like receptor 2 (TLR2) that elicits anti-inflammatory activity and exerts protective effects on damage induced by lipopolysaccharide (LPS). Whether such effect occurs in gastrointestinal smooth muscle has not been established yet. Aim of this study was to characterize the effects of Lactobacillus rhamnosus GG (LGG) and of supernatants harvested from LGG cultures on human colonic smooth muscle and to explore their protective activity against LPS-induced myogenic morpho-functional alterations. METHODS The effects of LGG (ATCC 53103 strain) and of supernatants have been tested on both human colonic smooth muscle strips and isolated cells in the absence or presence of LPS obtained from a pathogenic strain of Escherichia coli. Their effects on myogenic morpho-functional properties, on LPS-induced NFκB activation, and on cytokine production have been evaluated. Toll-like receptor 2 expression has been analyzed by qPCR and flow cytometry. KEY RESULTS Lactobacillus rhamnosus GG exerted negligible transient effects per se whereas it was capable of activating an intrinsic myogenic response counteracting LPS-induced alterations. In particular, both LGG and supernatants significantly reduced the LPS-induced morpho-functional alterations of muscle cells, i.e. cell shortening and inhibition of contractile response. They also hindered LPS-induced pro-inflammatory effects by decreasing pro-inflammatory transcription factor NFκB activation and pro-inflammatory cytokine IL-6 secretion, and restored the secretion levels of anti-inflammatory cytokine IL10. CONCLUSIONS & INFERENCES Taken together these data demonstrate that LGG protects human colonic smooth muscle from LPS-induced myogenic damage and might be beneficial on intestinal motor disorders due to bacterial infection.
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Affiliation(s)
- F Ammoscato
- Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy
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Morisco F, Castiglione F, Rispo A, Stroffolini T, Sansone S, Vitale R, Guarino M, Biancone L, Caruso A, D'Inca R, Marmo R, Orlando A, Riegler G, Donnarumma L, Camera S, Zorzi F, Renna S, Bove V, Tontini G, Vecchi M, Caporaso N. Effect of immunosuppressive therapy on patients with inflammatory bowel diseases and hepatitis B or C virus infection. J Viral Hepat 2013; 20:200-8. [PMID: 23383659 DOI: 10.1111/j.1365-2893.2012.01643.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 05/29/2012] [Indexed: 12/16/2022]
Abstract
Viral hepatitis reactivation has been widely reported in patients undergoing immunosuppressive therapy; however, few data are available about the risk of HBV and HCV reactivation in patients with inflammatory bowel disease, receiving immunosuppressive drugs. The aim of our study was to assess the prevalence of HBV and HCV infection in a consecutive series of patients with inflammatory bowel disease and to value the effects of immunosuppressive therapy during the course of the infection. Retrospective observational multicenter study included all consecutive patients with inflammatory bowel disease who have attended seven Italian tertiary referral hospitals in the last decade. A total of 5096 patients were consecutively included: 2485 Crohn's disease and 2611 Ulcerative Colitis. 30.5% and 29.7% of the patients were investigated for HBV and HCV infection. A total of 30 HBsAg positive, 17 isolated anti-HBc and 60 anti-HCV-positive patients were identified. In all, 20 patients with HBV or HCV infection received immunosuppressive therapy (six HBsAg+; four isolated anti-HBc+ and 10 anti-HCV+). One of six patients showed HBsAg+ and one of four isolated anti-HBc+ experienced reactivation of hepatitis. Two of six HBsAg patients received prophylactic therapy with lamivudine. Only one of 10 anti-HCV+ patients showed mild increase in viral load and ALT elevation. Screening procedures for HBV and HCV infection at diagnosis have been underused in patients with inflammatory bowel disease. We confirm the role of immunosuppressive therapy in HBV reactivation, but the impact on clinical course seems to be less relevant than previous reported.
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Affiliation(s)
- F Morisco
- Clinical and Experimental Medicine, Gastroenterology Unit, University of Naples Federico II, Naples, Italy.
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Guarino M, Cheng L, Cicala M, Ripetti V, Biancani P, Behar J. Progesterone receptors and serotonin levels in colon epithelial cells from females with slow transit constipation. Neurogastroenterol Motil 2011; 23:575-e210. [PMID: 21481100 DOI: 10.1111/j.1365-2982.2011.01705.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [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: 12/16/2022]
Abstract
BACKGROUND Females with slow transit constipation (STC) exhibit progesterone receptor (P4R) overexpression in colon muscle that impair their contractility. These studies examined whether these patients have an overexpression of P4R in epithelial cells and whether P4 affects the SERT-5-HT pathway. METHODS Tissues were obtained from surgical specimens of seven females with STC and six controls. Feasibility studies were performed in biopsies from six patients with STC and three controls. P4R, SERT and TPH-1 mRNA and protein expression and 5-HT by ELISA were determined. Contraction was studied in normal muscle cells pretreated with P4 or buffer. Progesterone effects on SERT and 5-HT levels were studied in normal human mucosa in vitro and in wild and SERT knockout mice in vivo. KEY RESULTS P4R was overexpressed in epithelial cells in STC compared with controls. The levels of SERT were lower and 5-HT higher in STC. In epithelial cells P4 treatment decreased SERT and increased mucosal 5-HT without affecting TPH-1. Progesterone impaired the contraction of normal muscle cells induced by Ach and 5-HT. Progesterone decreased SERT and increased 5-HT levels in the colon of wild mice in vivo but had no effect on the high basal levels of 5-HT in SERT knockout mice. CONCLUSIONS & INFERENCES P4R are present in colon epithelial cells and are overexpressed in females with STC. These cells have reduced SERT and high 5-HT levels and normal TPH-1. These 5-HT signaling abnormalities are related to overexpression of P4R since they are reproduced in human epithelial cells in vitro and in mice in vivo.
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Affiliation(s)
- M Guarino
- Department of Medicine, Campus Bio-Medico University, Rome, Italy
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Trimboli P, Rossi F, Baldelli R, Laurenti O, Nigri G, Ventura C, Appetecchia M, Attanasio D, Romanelli F, Guidobaldi L, Guarino M, Crescenzi A, Valabrega S. Measuring calcitonin in washout of the needle in patients undergoing fine needle aspiration with suspicious medullary thyroid cancer. Diagn Cytopathol 2011; 40:394-8. [DOI: 10.1002/dc.21731] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Accepted: 04/06/2011] [Indexed: 11/07/2022]
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Ferrari S, Piccinini R, Silva M, Exadaktylos V, Berckmans D, Guarino M. Cough sound description in relation to respiratory diseases in dairy calves. Prev Vet Med 2010; 96:276-80. [PMID: 20633937 DOI: 10.1016/j.prevetmed.2010.06.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2009] [Revised: 06/14/2010] [Accepted: 06/15/2010] [Indexed: 10/19/2022]
Abstract
Cough can be a biomarker in case of respiratory diseases. By monitoring and analyzing cough sounds through automatic devices, the farmer can obtain an early warning about a developing outbreak of respiratory infections. Cough sounds can be characterized by particular acoustic features (amplitude, frequency and duration) that are obtained by sound recording, labeling and analytic procedures. Based on these features, it might be possible to develop an automated cough recognition system. The aim of the study described in this paper is to investigate whether it is possible to discriminate cough sounds from other frequently occurring sounds in youngstock stables. Nasal swabs and blood were taken to identify the microbiological agents responsible for the respiratory problems. The collected cough sounds were compared to metal rack sounds, which are very common sounds in cattle farming, to identify acoustic differences between them. Results show that the length of cough sounds was significantly different from metal rack sounds (0.34 versus 0.37 s, P<0.05). Also, the analysis of amplitude and fundamental frequency showed significant differences between both types of sounds (resp. 0.21 and 0.18; 1326 and 3868 HZ). This indicates that it is possible discriminate cough sounds from other sounds and that cough sound can be used as a non-invasively diagnostic tool for respiratory diseases in youngstock groups.
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Affiliation(s)
- S Ferrari
- Department of Veterinary Sciences and Technologies for Food Safety, Faculty of Veterinary Medicine, Università degli Studi di Milano, Via Celoria 10, 20133 Milano, Italy.
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Trimboli P, Rossi F, Condorelli E, Laurenti O, Ventura C, Nigri G, Romanelli F, Guarino M, Valabrega S. Does normal thyroid gland by ultrasonography match with normal serum thyroid hormones and negative thyroid antibodies? Exp Clin Endocrinol Diabetes 2009; 118:630-2. [PMID: 19998241 DOI: 10.1055/s-0029-1237700] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Few papers have shown that a hypoechoic appearance of the thyroid gland at ultrasonography (US) is related to a hypofunction and serum positivity of thyroid antibodies (T-Ab). However, it is not ascertained if normal thyroid appearance at US correspond to normal thyroid laboratory tests. The aim of this study was to assess the value of normal thyroid at US in predicting normal thyroid hormones and negative T-Ab in a cohort of 48 adult patients. All patients (37 females and 11 males) were referred to our hospital to undergo their first thyroid US examination, followed by a thyroid function evaluation. All subjects had normal thyroid gland at US. As a control group 65 patients with hypoechoic and inhomogeneous thyroid gland were enrolled. All 48 patients had normal free-T (3) and free-T (4) levels. While 41 patients (85.4%) showed normal TSH, in 7 subjects (14.6%) TSH was elevated and a significant (p < 0.001) difference was recorded between the two groups in mean TSH value. Positive T-Ab value was found in 5 patients (10.4%) and the remaining 43 patients (89.6%) had negative T-Ab. TSH was not significantly correlated with age, thyroid volume or BMI. The multivariate model showed that only BMI was significantly correlated to thyroid volume (p < 0.01, r(2)=0.31). These results showed that normal thyroid recorded by US matches with normal thyroid laboratory assessment to a large degree. These preliminary data need to be confirmed in a prospective study and in a larger series and should suggest the evaluation of thyrotropin and thyroid antibodies in subjects with normal thyroid gland as assessed by US.
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Affiliation(s)
- P Trimboli
- Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy.
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Nikolinakos P, Altorki N, Guarino M, Tran H, Rajagopalan D, Swann S, Bordogna W, Ottesen L, Yankelevitz D, Heymach JV. Analyses of plasma cytokine/angiogenic factors (C/AFs) profile during preoperative treatment with pazopanib (GW786034) in early-stage non-small cell lung cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.7568] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [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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Altorki N, Guarino M, Lee P, Pass HI, Filip E, Bauer T, Roychowdhury D, Zaks T, Ottesen L, Yankelevitz D. Preoperative treatment with pazopanib (GW786034), a multikinase angiogenesis inhibitor in early-stage non-small cell lung cancer (NSCLC): A proof-of-concept phase II study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.7557] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [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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Masters GA, Guarino M, Schneider C, Biggs D, Grubbs S. A phase I study of pegylated doxorubicin (DOX) and weekly topotecan (TOP) in patients (pts) with advanced solid tumors. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.12018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
12018 Background: The primary endpoint of this prospective phase I study of DOX-TOP in pts with advanced solid tumors was to identify the maximum tolerated dose and dose-limiting toxicities (DLT) of this combination. Other objectives included a description of additional toxicities and efficacy in this patient population with refractory cancers. Pharmacokinetic sampling of TOP plasma levels will be reported separately. Methods: Eligible pts had advanced solid tumors and had either failed standard chemotherapy (chemo) or were pts for whom no standard therapy existed. They had ECOG PS = 0–2, adequate organ function, and gave written, informed consent. Initial doses included DOX 40 mg/m2 day 1 and TOP 2 mg/m2 days 1, 8 and 15 q 28 days. TOP was to be escalated in cohorts of pts. DLT was defined as febrile neutropenia, grade 4 thrombocytopenia, any grade 3 non-hematologic toxicity, or the inability to receive subsequent treatment due to ongoing toxicity. Treatment was held for ANC < 1000 or platelets < 75,000. Results: Fourteen pts have been enrolled on this phase I study, all of whom were evaluable for toxicity. There were 12 males and 2 females, and the median age was 57 years (range 25–86). Four had ECOG PS = 0, 9 had PS = 1, and 1 had PS = 2. Cancer types included head and neck (3), renal (2), and breast, pancreas, liver, esophagus, germ cell tumor, sarcoma, and others (one each). In the 6 pts treated at dose level 1, toxicities included grade 3 anemia (1) and neutropenia (2), and grade 4 neutropenia (1). DLT consisted of grade 4 thrombocytopenia (1) and inability to deliver day 15 TOP in 3/6 pts at this dose. Thus, TOP was reduced to 1.5 mg/m2 weekly for dose level -1, and 8 pts have been treated. Toxicities included grade 3 anemia (1)and neutropenia (2), and grade 4 neutropenia (1) and thrombocytopenia (1). Enrollment continues at this dose level to confirm tolerability. No patient achieved an objective response to therapy, but 2 pts have stable disease for up to 4 cycles. Conclusions: DOX-TOP can be safely combined in pts with advanced solid tumors, with hematologic toxicity as the DLT. The preliminary recommended phase II dose is DOX 40 mg/m2 and TOP 1.5 mg/m2. We plan to explore an additional dose level of DOX 30 mg/m2 and TOP 2 mg/m2. Phase II evaluation is contemplated in selected tumor types. [Table: see text]
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Affiliation(s)
| | | | | | - D. Biggs
- Helen Graham Cancer Center, Newark, DE
| | - S. Grubbs
- Helen Graham Cancer Center, Newark, DE
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Guarino M, Benito-Leon J, Decruyenaere J, Schmutzhard E, Weissenborn K, Stracciari A. EFNS guidelines on management of neurological problems in liver transplantation. Eur J Neurol 2006; 13:2-9. [PMID: 16420387 DOI: 10.1111/j.1468-1331.2006.01353.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Neurological impairment after orthotopic liver transplantation (OLT) is common and represents a major source of morbidity and mortality. The diagnosis and management of neurological problems occurring after OLT are difficult and evidence-based guidelines for this task are currently lacking. A Task Force was set up under the auspices of the European Federation of Neurological Societies to devise guidelines to prevent and manage neurological problems in OLT. We selected six major neurological problems and approached them combining an evidence-based scientific literature analysis with a search of consensus by means of a Delphi process. Search results were translated into a series of recommendations constituting a basis for better care of patients with neurological complications after OLT.
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Affiliation(s)
- M Guarino
- Neurology Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy
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Traina ME, Guarino M, Urbani E, Vollono C. [Long-term effects on male gonadal function of antitumoral drugs used during childhood]. Minerva Pediatr 2006; 58:183-91. [PMID: 16835577] [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: 05/10/2023]
Abstract
The survival rate of children and adolescents with cancer has improved dramatically in the last decades so that the prospect of survival in adulthood is today a realistic expectation for about 70% of the treated patients. However, the deleterious impact that chemotherapy and radiotherapy have on the reproductive function and future fertility could compromise the quality of life of the survivors in adulthood. The interest of the scientific community on this topic is increasing and focused on a more accurate evaluation of the reproductive risk among cancer treated children and on the development of less aggressive therapies. In the present review, some information about the long-term effects on the male reproductive function, particularly vulnerable to the cancer therapies, are reported from clinical and experimental studies. Furthermore, the concern about the development of pharmacological treatments and assisted reproductive techniques that might preserve or restore the fertility potential in children being treated with gonadotoxic cancer therapy, is discussed. These new strategies are still under experimentation and deeper knowledges on the functional development of the gonads during infancy, both in human and animals models are required. On the other hand, the future clinical application of these strategies in children rise important ethical and legal problems.
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Affiliation(s)
- M E Traina
- Dipartimento del Farmaco, Istituto Superiore di Sanità, Roma, Italy.
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Lodi R, Tonon C, Stracciari A, Weiger M, Camaggi V, Iotti S, Donati G, Guarino M, Bolondi L, Barbiroli B. Diffusion MRI shows increased water apparent diffusion coefficient in the brains of cirrhotics. Neurology 2004; 62:762-6. [PMID: 15007127 DOI: 10.1212/01.wnl.0000113796.30989.74] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.8] [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: 01/09/2023] Open
Abstract
BACKGROUND Brain edema and increased intracranial pressure worsen prognosis in patients with end-stage chronic cirrhosis. OBJECTIVE To use diffusion-weighted imaging (DWI) to quantify water apparent diffusion coefficient (ADC) in different brain regions of patients with chronic liver failure with or without hepatic encephalopathy. METHODS The authors studied 14 patients with viral liver cirrhosis and 12 sex- and age-matched healthy volunteers. Seven patients had no clinical evidence of hepatic encephalopathy; six had grade I hepatic encephalopathy; and one had grade II hepatic encephalopathy. Brain DWI was obtained using a single-shot echo-planar imaging sequence, and four gradient strengths (b values = 0, 300, 600, and 900 s/mm(2)) were applied to calculate the average diffusivity maps. RESULTS Mean ADC values in the brains of patients with cirrhosis were significantly increased in all selected regions of interest (caudate, putamen, and pallidus nuclei; occipital, parietal, and frontal lobe white matter) except in the thalamus. Venous ammonia was linearly related to ADC values in deep gray and white matter regions of interest. CONCLUSIONS Brain water apparent diffusion coefficient is increased in patients with chronic liver disease and may be useful in monitoring patients with hepatic encephalopathy.
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Affiliation(s)
- R Lodi
- Department of Clinical Medicine, Internal Medicine and Gastroenterology, University of Bologna, Italy.
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La Morgia C, Mondini S, Guarino M, Bonifazi F, Cirignotta F. Busulfan neurotoxicity and EEG abnormalities: a case report. Neurol Sci 2004; 25:95-7. [PMID: 15221628 DOI: 10.1007/s10072-004-0237-0] [Citation(s) in RCA: 15] [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] [Received: 11/23/2003] [Accepted: 03/04/2004] [Indexed: 11/26/2022]
Abstract
A 21-year-old woman with acute lymphoblastic leukemia underwent bone marrow transplantation (BMT). The conditioning regimen consisted of an association of busulfan (BU) and cyclophosphamide (Cy). The day after starting BU, she suffered a generalized tonic-clonic seizure. Electroencephalography (EEG) performed the day after the seizure showed diffuse polyspikes and spike-and-wave discharges. EEG on the following days showed persistent abnormalities (slowing of background activity intermixed with diffuse slow waves and isolated delta and theta bursts). These abnormalities persisted for about 20 days with complete normalization one month after the seizure. We suggest that BU is implicated in these abnormalities and emphasize the importance of EEG recording before and after bone marrow transplantation to disclose BU neurotoxicity.
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Affiliation(s)
- C La Morgia
- Neurology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Via Albertoni 15, I-40138 Bologna, Italy.
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Affiliation(s)
| | | | | | - S. Ponzi
- Otorhinolaryngology, Hospital of Vimercate, Milan, Italy
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46
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Abstract
Liver transplantation (LT) is the best treatment for end-stage liver diseases but it entails a high incidence of neuropsychiatric complications. These may be related to the operation or occur postoperatively, usually within the first month. The occurrence of neurological problems after LT increases the risk of mortality. The etiology of such complications is various, often multifactorial, immunosuppression being one of the most important causes. Immunosuppressive drugs may cause a wide spectrum of neuropsychiatric complications--mainly affecting the CNS--ranging from mild to severe disorders. A survey of the most frequent disorders is presented. In the management of liver-transplanted patients, the awareness of potential neurological and psychiatric problems is crucial for patients' survival, since it assists clinicians in prevention, prompt diagnosis, and treatment.
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Affiliation(s)
- A Stracciari
- Unità Operativa di Neurologia, Policlinico S. Orsola-Malpighi, Albertoni, Bologna, Italy.
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47
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Abstract
Extracellular hyaline globules resulting from abnormal accumulation of matrix components have been described in several pathological conditions, including renal tumors. We studied 16 renal oncocytomas and observed these bodies in 11 of them. In these tumors, they showed a homogeneous texture as well as roundish, smooth contours, and were easily detected in hematoxylin-eosin sections in five cases. PAS staining greatly facilitated the identification of globules in the remaining six cases, where they were fewer in number. Immunohistochemically, they appeared to be composed primarily of basement membrane material, being strongly reactive to antibodies for type IV collagen, laminin, and heparan sulphate proteoglycan. In addition, a weak immunoreactivity for type I and type III collagen, and fibronectin was observed in some cases, whereas no globule stained for tenascin. We also analyzed 89 renal cell carcinomas, and found somewhat similar bodies in 10 of them. However, they were more scanty in the latter tumors, and displayed a more irregular configuration with granular or smudged contours. We conclude that, although the mere presence of extracellular hyaline globules does not justify a distinction between renal oncocytoma and renal cell carcinoma, the detection of a large number of well-demarcated, roundish extracellular bodies with smooth contours suggests renal oncocytoma.
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Affiliation(s)
- M Guarino
- Departments of Anatomical Pathology of D. Cotugno Hospital, Naples, Italy
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Stracciari A, Guarino M, Pazzaglia P, Marchesini G, Pisi P. Acquired hepatocerebral degeneration: full recovery after liver transplantation. J Neurol Neurosurg Psychiatry 2001; 70:136-7. [PMID: 11118272 PMCID: PMC1763458 DOI: 10.1136/jnnp.70.1.136] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Guarino M, Casmiro M, D'Alessandro R. Campylobacter jejuni infection and Guillain-Barré syndrome: a case-control study. Emilia-Romagna Study Group on Clinical and Epidemiological problems in neurology. Neuroepidemiology 2000; 17:296-302. [PMID: 9890808 DOI: 10.1159/000026183] [Citation(s) in RCA: 19] [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: 11/19/2022] Open
Abstract
We performed a case-control study to investigate the association between Campylobacter jejuni (CJ) infection and Guillain-Barr| syndrome (GBS) or Miller-Fisher syndrome. We compared 60 cases with 109 hospital controls matched for age, gender, hospital and geographical location. To diagnose the CJ infection, we considered the association between serologic positivity for CJ and a previous diarrheal illness within 3 months of inclusion in the study. Fifteen percent of cases versus 5% of hospital controls had CJ infection (p < 0.003, OR = 3.96, 95% CI: 1.0817.85). However, CJ infection was related to GBS only if it occurred during the previous month (p< 0.001, OR = 7.29, 95% CI: 1.4371.28). No statistical differences were found between the cases who were positive for CJ infection and those who were negative for CJ infection when studied by stepwise multivariate logistic regression for age, gender, clinical and electrophysiological features and outcome. Recent CJ infection may be a risk factor for GBS.
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Affiliation(s)
- M Guarino
- Institute of Neurology, Neuroepidemiology Unit, via Foscolo, 7 Bologna,Italy
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Abstract
BACKGROUND Liver transplantation (LT) is the sole resolutive therapy for Wilson disease (WD) and is the treatment of choice for patients with WD who have fulminant hepatic failure or end-stage cirrhosis. Although its role in managing the neurological manifestations of WD is not yet conclusive, LT has recently been advocated as a therapy for neurologically affected patients with WD with stable liver function. OBJECTIVE To evaluate the effect of LT on the neurological manifestations of WD. OBSERVATION A 44-year-old man with WD with cirrhosis and neurological symptoms (motor dysfunction and cognitive impairment) experienced a dramatic improvement in motor function early after LT, as well as normalization of copper balance and the disappearance of Kayser-Fleischer rings. Abnormalities seen on magnetic resonance imaging scans were reversed 18 months after LT. Cognitive testing 2 years after LT showed a moderate global improvement. CONCLUSIONS In this case, LT healed the neurological manifestations of WD. To date, this favorable result has been seen in almost 80% of cases. However, the decision to perform LT in patients with WD solely on the basis of neurological impairment must be considered experimental.
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Affiliation(s)
- A Stracciari
- Neurological Service, S. Orsola-Malpighi Hospital, Bologna, Italy.
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