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Montera MC, Giordano A, Asperti C, Aruanno A, Barzaghi CE, Bignardi D, Borrelli P, Bommarito L, Busa M, Calafiore P, Carusi V, Cinquini M, Cortellini G, Cocchi R, D'Auria F, De Caro F, Demonte A, Di Leo E, Di Lizia M, Di Rienzo A, Fumagalli F, Kihlgren P, Lodi Rizzini F, Macchia D, Manzotti G, Marra AM, Mileto P, Mietta S, Montagni M, Nettis E, Nucera E, Peveri S, Pivetta D, Pirisi M, Ramirez GA, Rivolta F, Rizzi A, Savoia A, Pedicini A, Scarpa A, Zambito M, Zisa G, Yacoub MR. The role of skin tests with polyethylene glycol and polysorbate 80 in the vaccination campaign for COVID-19: results from an Italian multicenter survey. Eur Ann Allergy Clin Immunol 2024; 56:17-25. [PMID: 36927838 DOI: 10.23822/eurannaci.1764-1489.291] [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] [Indexed: 03/18/2023]
Abstract
Summary Background. International guidelines suggested skin tests with Polyethylene-glycol (PEG) and polysorbate 80 (PS-80), to investigate a possible hypersensitivity to these excipients either to identify subjects at risk of developing allergic reactions to Covid-19 vaccines, or in patients with suspected IgE mediated hypersensitivity reactions (HR) to the Covid-19 vaccine. The main purpose of this study was to investigate the prevalence of PEG and PS sensitization in patients with a clinical history of HR to drugs containing PEG/PS and in patients with a suspected Covid-19 vaccine immediate HR. Methods. This was a multicenter retrospective study conducted by allergists belonging to 20 Italian medical centers. Skin testing was performed in 531 patients with either a clinical history of suspected hypersensitivity reaction (HR) to drugs containing PEG and/or PS-80 (group 1:362 patient) or a suspected HR to Covid-19 vaccines (group 2: 169 patient), as suggested by the AAIITO/SIAAIC guidelines for the "management of patients at risk of allergic reactions to Covid-19 vaccines" [1]. Results. 10/362 (0.02%) had positive skin test to one or both excipients in group 1, 12/169 (7.1%) in group 2 (p less than 0.01). In group 2 HRs to Covid-19 vaccines were immediate in 10/12 of cases and anaphylaxis occurred in 4/12 of patients. Conclusions. The positivity of skin test with PEG and or PS before vaccination is extremely rare and mostly replaceable by an accurate clinical history. Sensitization to PEG and PS has to be investigated in patients with a previous immediate HR to a Covid-19 vaccine, in particular in patients with anaphylaxis.
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Affiliation(s)
- M C Montera
- University Hospital "O.O.R.R. San Giovanni di Dio and Ruggi d'Aragona", Salerno, Italy
| | - A Giordano
- UO University Hospital "O.O.R.R. San Giovanni di Dio and Ruggi d'Aragona", Salerno, Italy
| | - C Asperti
- Unit of Immunology, Rheumatology, Allergology and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - A Aruanno
- Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - D Bignardi
- Allergology Unit, IRCCS San Martino Polyclinic Hospital, Genoa, Italy
| | - P Borrelli
- SSD Dermatology, Beauregard Hospital, Valle d'Aosta, Italy
| | - L Bommarito
- Turin Local Health Authority 4, Turin, Italy
| | - M Busa
- UOS Dermatology Hospital of Mirano, Venice, Italy
| | | | - V Carusi
- Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
| | - M Cinquini
- SSVD Allergology, Spedali Civili, Brescia, Italy
| | - G Cortellini
- SSI Allergology Romagna Health Authority, Rimini Hospital, Italy
| | - R Cocchi
- Pneumology Unit, Busto Arsizio Hospital, Varese, Italy
| | | | - F De Caro
- UO University Hospital "O.O.R.R. San Giovanni di Dio and Ruggi d'Aragona", Salerno, Italy
| | - A Demonte
- Simple Operating Unit of Allergology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - E Di Leo
- Section of Allergy and Clinical Immunology, Unit of Internal Medicine- "F. Miulli" Hospital, Acquaviva delle Fonti, Bari, Italy
| | - M Di Lizia
- UOSD. Allergology Giulianova, Teramo, Italy
| | - A Di Rienzo
- Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
| | | | | | - F Lodi Rizzini
- SSVD Allergology, Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences (DSCS), University of Brescia, Brescia, Italy
| | - D Macchia
- SOS Allergology Clinical Immunology, San Giovanni di Dio Hospital, Florence, Italy
| | - G Manzotti
- Allergology Clinic, Casa di Cura Palazzolo, Bergamo, Italy
| | - A M Marra
- ASST Rhodense, Rho Hospital, Milan, Italy
| | - P Mileto
- SSVD Allergology, Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences (DSCS), University of Brescia, Brescia, Italy
| | - S Mietta
- Turin Local Health Authority 4, Turin, Italy
| | | | - E Nettis
- Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy
| | - E Nucera
- Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - S Peveri
- ASST Bergamo Ovest, Bergamo, Italy
| | - D Pivetta
- SSVD Allergology, Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences (DSCS), University of Brescia, Brescia, Italy
| | - M Pirisi
- Division of Internal Medicine, Ospedale Maggiore della Carità, Novara, Italy
| | - G A Ramirez
- Unit of Immunology, Rheumatology, Allergology and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - F Rivolta
- UOC General Medicine, Immunology and Allergology, IRCCS Cà Granda Foundation, Maggiore Policlinico Hospital, Milan, Italy
| | - A Rizzi
- Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Savoia
- Ospedale del Sacro Cuore di Gesù - Fatebenefratelli, Benevento, Italy
| | - A Pedicini
- Ospedale del Sacro Cuore di Gesù - Fatebenefratelli, Benevento, Italy
| | - A Scarpa
- UOS Dermatology Hospital of Mirano, Venice, Italy
| | - M Zambito
- Specialist Outpatient Allergy Unit, ASP 6 Palermo, Palermo, Italy
| | - G Zisa
- SS Allergology and Clinical Immunology, Maggiore della Carità Hospital, Novara, Italy
| | - M-R Yacoub
- Unit of Immunology, Rheumatology, Allergology and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy
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2
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Parente R, Sartorio S, Brussino L, De Pasquale T, Zoli A, Agolini S, Di Agosta E, Quattrocchi P, Borrelli P, Bignardi D, Petraroli A, Senter R, Popescu Janu V, Cogliati C, Guarino MD, Rossi O, Firinu D, Pucci S, Spadaro G, Triggiani M, Cancian M, Zanichelli A. Multicentric Observational Study on Safety and Tolerability of COVID-19 Vaccines in Patients with Angioedema with C1 Inhibitor Deficiency: Data from Italian Network on Hereditary and Acquired Angioedema (ITACA). Vaccines (Basel) 2023; 11:vaccines11040852. [PMID: 37112764 PMCID: PMC10145557 DOI: 10.3390/vaccines11040852] [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: 03/03/2023] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Angioedema due to C1 inhibitor deficiency (AE-C1-INH) is a rare disease characterized by recurrent and unpredictable attacks of angioedema. Multiple trigger factors, including trauma, emotional stress, infectious diseases, and drugs, could elicit angioedema attacks. The aim of this study was to collect data on the safety and tolerability of COVID-19 vaccines in a population of patients affected by AE-C1-INH. Adult patients with AE-C1-INH, followed by Reference Centers belonging to the Italian Network for Hereditary and Acquired Angioedema (ITACA), were enrolled in this study. Patients received nucleoside-modified mRNA vaccines and vaccines with adenovirus vectors. Data on acute attacks developed in the 72 h following COVID-19 vaccinations were collected. The frequency of attacks in the 6 months after the COVID-19 vaccination was compared with the rate of attacks registered in the 6 months before the first vaccination. Between December 2020 and June 2022, 208 patients (118 females) with AE-C1-INH received COVID-19 vaccines. A total of 529 doses of the COVID-19 vaccine were administered, and the majority of patients received mRNA vaccines. Forty-eight attacks of angioedema (9%) occurred within 72 h following COVID-19 vaccinations. About half of the attacks were abdominal. Attacks were successfully treated with on-demand therapy. No hospitalizations were registered. There was no increase in the monthly attack rate following the vaccination. The most common adverse reactions were pain at the site of injection and fever. Our results show that adult patients with angioedema due to C1 inhibitor deficiency can be safely vaccinated against SARS-CoV-2 in a controlled medical setting and should always have available on-demand therapies.
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Affiliation(s)
- Roberta Parente
- Division of Allergy and Clinical Immunology, University of Salerno, 84131 Salerno, Italy
| | - Silvio Sartorio
- Referral Centre for Systemic Autoimmune Diseases, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico di Milano, 20122 Milan, Italy
| | - Luisa Brussino
- Allergy and Clinical Immunology Unit, Department of Medical Sciences, University of Torino & Mauriziano Hospital, 10128 Torino, Italy
| | | | - Alessandra Zoli
- SOD Immunologia Clinica, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - Stefano Agolini
- SOD Immunologia Clinica, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - Ester Di Agosta
- Immunoallergology Unit, University Hospital of Careggi, 50141 Florence, Italy
| | - Paolina Quattrocchi
- Department of Clinical and Experimental Medicine, School and Operative Unit of Allergy and Clinical Immunology, University of Messina, 98125 Messina, Italy
| | - Paolo Borrelli
- SSD Dermatologia e Allergologia-Ospedale Beauregard, 11100 Aosta, Italy
| | - Donatella Bignardi
- Department of Medicine Integrated with the Territory, Ospedale Policlinico San Martino, IRCCS Ospedale Policlinico, Genova UO Allergologia, 16142 Genova, Italy
| | - Angelica Petraroli
- Department of Internal Medicine, Clinical Immunology, Clinical Pathology and Infectious Disease, Azienda Ospedaliera Universitaria Federico II, 80131 Napoli, Italy
| | - Riccardo Senter
- Department of Systems Medicine, University Hospital of Padua, 35126 Padua, Italy
| | | | - Chiara Cogliati
- Internal Medicine, L Sacco Hospital, ASST Fatebenfratelli-Sacco, 20157 Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy
| | | | - Oliviero Rossi
- Immunoallergology Unit, University Hospital of Careggi, 50141 Florence, Italy
| | - Davide Firinu
- Division of Allergy and Clinical Immunology, University of Cagliari, 09124 Cagliari, Italy
| | | | - Giuseppe Spadaro
- Department of Internal Medicine, Clinical Immunology, Clinical Pathology and Infectious Disease, Azienda Ospedaliera Universitaria Federico II, 80131 Napoli, Italy
| | - Massimo Triggiani
- Division of Allergy and Clinical Immunology, University of Salerno, 84131 Salerno, Italy
| | - Mauro Cancian
- Department of Systems Medicine, University Hospital of Padua, 35126 Padua, Italy
| | - Andrea Zanichelli
- Operative Unit of Medicine, Angioedema Center, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20097 Milan, Italy
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3
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Costantini E, Carrarini C, Borrelli P, De Rosa M, Calisi D, Consoli S, D’Ardes D, Cipollone F, Di Nicola M, Onofrj M, Reale M, Bonanni L. Different peripheral expression patterns of the nicotinic acetylcholine receptor in dementia with Lewy bodies and Alzheimer's disease. Immun Ageing 2023; 20:3. [PMID: 36647139 PMCID: PMC9843938 DOI: 10.1186/s12979-023-00329-9] [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] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/26/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND The diffuse distribution of nicotinic cholinergic receptors (nAChRs) in both brain and peripheral immune cells points out their involvement in several pathological conditions. Indeed, the deregulated function of the nAChR was previously correlated with cognitive decline and neuropsychiatric symptoms in Alzheimer's disease (AD) and Dementia with Lewy bodies (DLB). The evaluation in peripheral immune cells of nAChR subtypes, which could reflect their expression in brain regions, is a prominent investigation area. OBJECTIVES This study aims to evaluate the expression levels of both the nAChR subunits and the main known inflammatory cytokines in peripheral blood mononuclear cells (PBMCs) of patients with DLB and AD to better characterize their involvement in these two diseases. RESULTS Higher gene expression levels of TNFα, IL6 and IL1β were observed in DLB and AD patients in comparison with healthy controls (HC). In our cohort, a reduction of nAChRα4, nAChRβ2 and nAChRβ4 was detected in both DLB and AD with respect to HC. Considering nAChR gene expressions in DLB and AD, significant differences were observed for nAChRα3, nAChRα4, nAChRβ2 and nAChRβ4 between the two groups. Moreover, the acetylcholine esterase (AChE) gene expression was significantly higher in DLB than in AD. Correlation analysis points out the relation between different nAChR subtype expressions in DLB (nAChRβ2 vs nAChRα3; nAChRα4 vs nAChRα3) and AD (nAChRα4 vs nAChRα3; nAChRα4 vs nAChRβ4; nAChRα7 vs nAChRα3; nAChRα7 vs nAChRα4). CONCLUSIONS Different gene expressions of both pro-inflammatory cytokines and nAChR subtypes may represent a peripheral link between inflammation and neurodegeneration. Inflammatory cytokines and different nAChRs should be valid and accurate peripheral markers for the clinical diagnosis of DLB and AD. However, although nAChRs show a great biological role in the regulation of inflammation, no significant correlation was detected between nAChR subtypes and the examined cytokines in our cohort of patients.
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Affiliation(s)
- E. Costantini
- grid.412451.70000 0001 2181 4941Department of Medicine and Aging Sciences, University “G. d’Annunzio”, Via dei Vestini, 66100 Chieti, Italy
| | - C. Carrarini
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging, and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - P. Borrelli
- grid.412451.70000 0001 2181 4941Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University “G. d’Annunzio”, Via dei Vestini, 66100 Chieti, Italy
| | - M. De Rosa
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging, and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - D. Calisi
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging, and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - S. Consoli
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging, and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - D. D’Ardes
- grid.412451.70000 0001 2181 4941Department of Medicine and Aging Sciences, University “G. d’Annunzio”, Via dei Vestini, 66100 Chieti, Italy
| | - F. Cipollone
- grid.412451.70000 0001 2181 4941Department of Medicine and Aging Sciences, University “G. d’Annunzio”, Via dei Vestini, 66100 Chieti, Italy
| | - M. Di Nicola
- grid.412451.70000 0001 2181 4941Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University “G. d’Annunzio”, Via dei Vestini, 66100 Chieti, Italy
| | - M. Onofrj
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging, and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - M. Reale
- grid.412451.70000 0001 2181 4941Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio”, Via dei Vestini, 66100 Chieti, Italy
| | - L. Bonanni
- grid.412451.70000 0001 2181 4941Department of Medicine and Aging Sciences, University “G. d’Annunzio”, Via dei Vestini, 66100 Chieti, Italy
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Vieira DCS, Borrelli P, Jahanianfard D, Benali A, Scarpa S, Panagos P. Wildfires in Europe: Burned soils require attention. Environ Res 2023; 217:114936. [PMID: 36442524 DOI: 10.1016/j.envres.2022.114936] [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] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 06/16/2023]
Abstract
Annually, millions of hectares of land are affected by wildfires worldwide, disrupting ecosystems functioning by affecting on-site vegetation, soil, and above- and belowground biodiversity, but also triggering erosive off-site impacts such as water-bodies contamination or mudflows. Here, we present a soil erosion assessment following the 2017's wildfires at the European scale, including an analysis of vegetation recovery and soil erosion mitigation potential. Results indicate a sharp increase in soil losses with 19.4 million Mg additional erosion in the first post-fire year when compared to unburned conditions. Over five years, 44 million Mg additional soil losses were estimated, and 46% of the burned area presented no signs of full recovery. Post-fire mitigation could attenuate these impacts by 63-77%, reducing soil erosion to background levels by the 4th post-fire year. Our insights may help identifying target policies to reduce land degradation, as identified in the European Union Soil, Forest, and Biodiversity strategies.
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Affiliation(s)
- D C S Vieira
- European Commission, Joint Research Centre (JRC), Ispra, Italy.
| | - P Borrelli
- Department of Science, Roma Tre University, Rome, Italy
| | - D Jahanianfard
- Centro de Estudos Florestais, Instituto Superior de Agronomia, Universidade de Lisboa, Lisbon, Portugal
| | - A Benali
- Centro de Estudos Florestais, Instituto Superior de Agronomia, Universidade de Lisboa, Lisbon, Portugal
| | - S Scarpa
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - P Panagos
- European Commission, Joint Research Centre (JRC), Ispra, Italy
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Lappi A, Cammarata E, Nicola S, Borrelli P. Palmoplantar pustular psoriasis induced by ocrelizumab in a patient affected by multiple sclerosis. Ital J Dermatol Venerol 2022; 157:459-460. [PMID: 36213976 DOI: 10.23736/s2784-8671.22.07245-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Astrid Lappi
- SSD Dermatology and Allergology, Beauregard Hospital, Aosta, Italy
| | - Edoardo Cammarata
- SSD Dermatology and Allergology, Beauregard Hospital, Aosta, Italy -
- Department of Health Science, University of Eastern Piedmont, Novara, Italy
| | - Stefania Nicola
- SSD Dermatology and Allergology, Beauregard Hospital, Aosta, Italy
| | - Paolo Borrelli
- SSD Dermatology and Allergology, Beauregard Hospital, Aosta, Italy
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Asero R, Nucera E, Rizzi A, Aruanno A, Uasuf CG, Manzotti G, Villalta D, Conte M, Pastorello EA, Losappio L, Schroeder JV, Pinter E, Miglionico M, Vantaggio L, Macchia D, Radice A, Marra AM, Barzaghi C, Santucci A, Cortellini G, Peveri S, Montagni M, Demonte A, Borrelli P, Errico MA, Rivolta F, Pravettoni V, Sangalli A, Magnani M, Celi G, Yang B, Costantino MT, Deleonardi G, Boni E, Gattoni M, Rizzini FL, Di Paolo C, Montera M, Giordano A, De Carli M, Murzilli F, Fumagalli F, Maffeis L, Ghiglioni DG, Centonze S, Di Lizia M, Calafiore P, Scala E. Peanut allergy in Italy: A unique Italian perspective. J Allergy Clin Immunol Glob 2022; 1:61-66. [PMID: 37780582 PMCID: PMC10509966 DOI: 10.1016/j.jacig.2022.02.001] [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] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/12/2022] [Accepted: 02/15/2022] [Indexed: 10/03/2023]
Abstract
Background Peanut allergy has not been well characterized in Italy. Objective Our aim was to better define the clinical features of peanut allergy in Italy and to detect the peanut proteins involved in allergic reactions. Methods A total of 22 centers participated in a prospective survey of peanut allergy over a 6-month period. Clinical histories were confirmed by in vivo and/or in vitro diagnostic means in all cases. Potential risk factors for peanut allergy occurrence were considered. Levels of IgE to Arachis hypogea (Ara h) 1, 2, 3, 6, 8, and 9 and profilin were measured. Results A total of 395 patients (aged 2-80 years) were enrolled. Of the participants, 35% reported local reactions, 38.2% reported systemic reactions, and 26.6% experienced anaphylaxis. The sensitization profile was dominated by Ara h 9 (77% of patients were sensitized to it), whereas 35% were sensitized to pathogenesis-related protein 10 (PR-10) and 26% were sensitized to seed storage proteins (SSPs). Sensitization to 2S albumins (Ara h 2 and Ara h 6) or lipid transfer protein (LTP) was associated with the occurrence of more severe symptoms, whereas profilin and PR-10 sensitization were associated with milder symptoms. Cosensitization to profilin reduced the risk of severe reactions in both Ara h 2- and LTP-sensitized patients. SSP sensitization prevailed in younger patients whereas LTP prevailed in older patients (P < .01). SSP sensitization occurred mainly in northern Italy, whereas LTP sensitization prevailed in Italy's center and south. Atopic dermatitis, frequency of peanut ingestion, peanut consumption by other family members, or use of peanut butter did not seem to be risk factors for peanut allergy onset. Conclusions In Italy, peanut allergy is rare and dominated by LTP in the country's center and south and by SSP in the north. These 2 sensitizations seem mutually exclusive. The picture differs from that in Anglo-Saxon countries.
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Affiliation(s)
- Riccardo Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Milan, Italy
| | - Eleonora Nucera
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore – Roma, Italy
| | - Angela Rizzi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore – Roma, Italy
| | - Arianna Aruanno
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore – Roma, Italy
| | - Carina G. Uasuf
- Allergy Center, Institute of Traslational Pharmacology, National Research Council (CNR), Palermo, Italy
| | | | - Danilo Villalta
- SSD di Immunologia e Allergologia, PO S. Maria degli Angeli, Pordenone, Italy
| | | | - Elide A. Pastorello
- Dipartimento di Allergologia, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Laura Losappio
- Dipartimento di Allergologia, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Jan V. Schroeder
- Dipartimento di Allergologia, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Elena Pinter
- UOC Medicina Interna e Immunologia Clinica, Dipartimento Medicina Traslazionale e di Precisione, Sapienza University of Rome, Rome, Italy
| | - Marzia Miglionico
- Allergy and Clinical Immunology Residency Program, Department of Molecular Medicine, Sapienza University of Rome, Italy
| | - Lorenzo Vantaggio
- Allergy and Clinical Immunology Residency Program, Department of Molecular Medicine, Sapienza University of Rome, Italy
| | - Donatella Macchia
- SOS Allergologia e Immunologia Clinica, Ospedale San Giovanni di Dio, Firenze, Italy
| | - Anna Radice
- SOS Allergologia e Immunologia Clinica, Ospedale San Giovanni di Dio, Firenze, Italy
| | - Alessandro M. Marra
- ASST Rhodense - UO Pneumologia - Ospedale di Garbagnate Milanese, Milan, Italy
| | - Claudio Barzaghi
- ASST Rhodense - Ambulatorio di Allergologia - Ospedale di Rho, Italy
| | - Annalisa Santucci
- Ausl Romagna, UOS interdipartimentale di Allergologia, Ospedale degli Infermi di Rimini, Italy
| | - Gabriele Cortellini
- Ausl Romagna, UOS interdipartimentale di Allergologia, Ospedale degli Infermi di Rimini, Italy
| | - Silvia Peveri
- UOsD Allergologia, Ospedale G. Da Saliceto, Piacenza, Italy
| | | | | | - Paolo Borrelli
- SSD Dermatologia - Ambulatorio Allergologia e Immunologia Clinica, Ospedale Beauregard, Aosta, Italy
| | - Micol A. Errico
- SSD Dermatologia - Ambulatorio Allergologia e Immunologia Clinica, Ospedale Beauregard, Aosta, Italy
| | - Federica Rivolta
- General Medicin, Immunology and Allergy Department - IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico - Milan, Italy
| | - Valerio Pravettoni
- General Medicin, Immunology and Allergy Department - IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico - Milan, Italy
| | - Andrea Sangalli
- Allergy and Clinical Immunology Residency, University of Milan, Italy
| | | | - Giorgio Celi
- Centro DH Allergologia e Immunologia Clinica, Ospedale Carlo Poma ASST-Mantova, Italy
| | - Baoran Yang
- Centro DH Allergologia e Immunologia Clinica, Ospedale Carlo Poma ASST-Mantova, Italy
| | - Maria T. Costantino
- Centro DH Allergologia e Immunologia Clinica, Ospedale Carlo Poma ASST-Mantova, Italy
| | | | - Elisa Boni
- Allergologia e autoimmunità LUM AUSL Bologna, Italy
| | - Marco Gattoni
- Scuola di Specializzazione in Allergologia e Immunologia Clinica Università degli Studi di Bologna, Italy
| | | | | | - Mariacarmela Montera
- Allergologia e Immunologia Clinica, Ospedale G. Fuscito, Mercato S. Severino; Ospedaliero-Universitaria Ruggi D'Aragona, Salerno, Italy
| | - Annaclaudia Giordano
- Allergologia e Immunologia Clinica, Ospedale G. Fuscito, Mercato S. Severino; Ospedaliero-Universitaria Ruggi D'Aragona, Salerno, Italy
| | - Marco De Carli
- S.O.C Medicina 2, Presidio Ospedaliero Santa Maria della Misericordia, Udine, Italy
| | - Francesco Murzilli
- U.O.S.D. di Allergologia, Ospedale S.S. Filippo e Nicola, Avezzano, Italy
| | | | - Laura Maffeis
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Pediatric Intermediate Care Unit, Milan, Italy
| | - Daniele Giovanni Ghiglioni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Pediatric Highly Intensive Care Unit, Milan, Italy
| | | | | | | | - Enrico Scala
- Istituto Dermopatico dell’Immacolata, Roma, Italy
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7
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Cammarata E, Lappi A, Nicola S, Borrelli P. Generalized granuloma annulare: Narrow-band UVB phototherapy combined with tacrolimus ointment. Dermatol Ther 2021; 35:e15250. [PMID: 34877764 DOI: 10.1111/dth.15250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 11/15/2021] [Accepted: 12/03/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Edoardo Cammarata
- Department of Health Science, University of Eastern Piedmont, Novara, Italy.,SSD Dermatologia e Allergologia, Ospedale Beauregard, Aosta, Italy
| | - Astrid Lappi
- SSD Dermatologia e Allergologia, Ospedale Beauregard, Aosta, Italy
| | - Stefania Nicola
- SSD Dermatologia e Allergologia, Ospedale Beauregard, Aosta, Italy
| | - Paolo Borrelli
- SSD Dermatologia e Allergologia, Ospedale Beauregard, Aosta, Italy
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8
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Asero R, Ariano R, Aruanno A, Barzaghi C, Borrelli P, Busa M, Celi G, Cinquini M, Cortellini G, D’Auria F, De Carli M, Di Paolo C, Garzi G, Lodi Rizzini F, Magnani M, Manzotti G, Marra A, Miceli Sopo S, Murzilli F, Nucera E, Pinter E, Pravettoni V, Rivolta F, Rizzi A, Saporiti N, Scala E, Villalta D, Yacoub M, Zisa G. Systemic allergic reactions induced by labile plant-food allergens: Seeking potential cofactors. A multicenter study. Allergy 2021; 76:1473-1479. [PMID: 33080053 DOI: 10.1111/all.14634] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 07/20/2020] [Revised: 09/13/2020] [Accepted: 10/05/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Heat-and-pepsin-sensitive plant food allergens (PR-10 and profilin) sometimes cause systemic reaction. OBJECTIVE To detect the risk factors for systemic reactions induced by labile food allergens. METHODS A retrospective multicenter study was performed on patients with a documented history of systemic allergic reaction to labile plant food allergens and on age-matched controls with a history of oral allergy syndrome (OAS) induced by the same foods. Offending foods, their amount, and state (solid or liquid), and potential cofactors (nonsteroidal anti-inflammatory drugs, protonic pump inhibitors, exercise, alcohol, and fasting) were considered. RESULTS We studied 89 patients and 81 controls. Sensitization to PR-10 or profilin, IgE to Bet v 1 and/or Bet v 2, and foods causing OAS were similar in the two groups. Twenty patients experienced >1 systemic allergic reaction. Tree nuts, Rosaceae, Apiaceae, and soymilk were the main offending foods. Seventeen (19%) patients were taking a PPI when the systemic reaction occurred (vs 5% in controls; P < .025). The ingestion of the offending food in liquid form (soymilk) was frequent among patients (15%) but unusual among controls (2%; P < .025). Soy milk-induced systemic reactions were independent of PPI treatment. Fasting and excess of allergen, but not NSAID and exercise, were other relevant cofactors for systemic reactions. Systemic reactions occurred without any identifiable cofactor in 39 (44%) cases. CONCLUSION PR-10- and profilin-induced systemic reactions are facilitated by PPI, ingestion of large amounts of unprocessed foods, and fasting. Soybean beverages represent a risk for PR-10 hypersensitive patients and should be avoided.
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Affiliation(s)
- Riccardo Asero
- Ambulatorio di Allergologia Clinica san Carlo Paderno Dugnano (MI) Italia
| | | | - Arianna Aruanno
- Fondazione Policlinico Universitario A. Gemelli‐ IRCCS Università Cattolica del Sacro Cuore Roma Italy
| | - Claudio Barzaghi
- Ambulatorio di Allergologia UOC Medicina ASST Rhodenese, P.O Rho Rho Italia
| | - Paolo Borrelli
- SSD Dermatologia e Allergologia ‐ Ospedale Beauregard Aosta Italia
| | - Moira Busa
- Ambulatorio di Allergologia U.O.S. Dermatologia Ospedale di Mirano (VE) Mirano Italia
- Ambulatorio di Allergologia Ospedale di Bassano del Grappa (VI) Bassano del Grappa Italia
| | | | | | | | | | - Marco De Carli
- S.O.C Medicina 2 Presidio Ospedaliero "Santa Maria della Misericordia" Udine Italy
| | | | - Giulia Garzi
- Ambulatorio di Allergologia UOC Medicina Interna ed Immunologia Clinica, Policlinico Umberto I Roma Italia
| | - Fabio Lodi Rizzini
- Dipartimento Scienze Cliniche e Sperimentali Università Studi Brescia / SSVD Allergologia Spedali Civili Brescia Italy
| | | | | | - Alessandro Marra
- Ambulatorio di Allergologia UOC Medicina ASST Rhodenese, P.O Rho Rho Italia
| | - Stefano Miceli Sopo
- Pediatric Allergy Unit Pediatrics Area Department of Life Sciences and Public Health Policlinico Gemelli Fondazione Universitaria IRCCS Università Cattolica del Sacro Cuore Roma Italia
| | - Francesco Murzilli
- U.O.S.D. di Allergologia Ospedale S.S. Filippo e Nicola Avezzano (AQ) Italy
| | - Eleonora Nucera
- Fondazione Policlinico Universitario A. Gemelli‐ IRCCS Università Cattolica del Sacro Cuore Roma Italy
| | - Elena Pinter
- Ambulatorio di Allergologia UOC Medicina Interna ed Immunologia Clinica, Policlinico Umberto I Roma Italia
| | - Valerio Pravettoni
- UOC General Medicine Immunology and Allergology – IRCCS Foudation Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
| | - Federica Rivolta
- UOC General Medicine Immunology and Allergology – IRCCS Foudation Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
| | - Angela Rizzi
- Fondazione Policlinico Universitario A. Gemelli‐ IRCCS Università Cattolica del Sacro Cuore Roma Italy
| | - Nicoletta Saporiti
- Unit of Immunology Rheumatology, Allergy and Rare Diseases IRCCS Ospedale San Raffaele Milano Italy
| | | | - Danilo Villalta
- Immunologia e Allergologia Ospedale S. Maria degli Angeli Pordenone Italia
| | - Mona‐Rita Yacoub
- Unit of Immunology Rheumatology, Allergy and Rare Diseases IRCCS Ospedale San Raffaele Milano Italy
| | - Giuliana Zisa
- S.S. Allergologia e Immunologia Clinica S.C.D.U. Medicina Interna I ‐ A.O.U. Maggiore della Carità di Novara Novara Italy
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Scala E, Abeni D, Tedeschi A, Manzotti G, Yang B, Borrelli P, Marra A, Giani M, Sgadari A, Saltalamacchia F, Asero R. Atopic status protects from severe complications of COVID-19. Allergy 2021; 76:899-902. [PMID: 32799364 PMCID: PMC7461535 DOI: 10.1111/all.14551] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/05/2020] [Accepted: 08/05/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Enrico Scala
- Istituto Dermopatico dell'Immacolata IRCCS FLMM Roma Italia
| | - Damiano Abeni
- Istituto Dermopatico dell'Immacolata IRCCS FLMM Roma Italia
| | - Alberto Tedeschi
- UO Medicina Generale Ospedale Bolognini ASST Bergamo Est Seriate Italia
| | | | | | - Paolo Borrelli
- SSD Dermatologia e Allergologia Ospedale Beauregard Aosta Italia
| | | | - Mauro Giani
- Istituto Dermopatico dell'Immacolata IRCCS FLMM Roma Italia
| | | | | | - Riccardo Asero
- Ambulatorio di Allergologia Clinica San Carlo Paderno Dugnano Italia
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10
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Platzgummer S, Bizzaro N, Bilò MB, Pravettoni V, Cecchi L, Sargentini V, Caponi L, Visentini D, Brusca I, Pesce G, Bagnasco M, Antico A, Montera MC, Quercia O, Musarra A, Bonazza L, Borrelli P, Cortellini G, Polillo BR, Valenti B, Zedda MT, Asero R, Villalta D. Recommendations for the Use of Tryptase in the Diagnosis of Anaphylaxis and Clonal Mastcell Disorders. Eur Ann Allergy Clin Immunol 2020; 52:51-61. [PMID: 31994369 DOI: 10.23822/eurannaci.1764-1489.133] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Tryptase is a serin-protease produced and released by mast cells after IgE-mediated or non-IgE mediated stimuli. We here review the various aspects related to the molecular characteristics of the enzyme and its biological effects, the genetic basis of its production and the release kinetics. Recommendations for the clinical use of tryptase measurement developed by a task force of Società Italiana di Patologia Clinica e Medicina di Laboratorio and Associazione Allergologi Immunologi Italiani Territoriali e Ospedalieri are given on the best procedure for a correct definition of the reference values in relation to the inter-individual variability and to the correct determination of tryptase in blood and other biological liquids, in the diagnosis of anaphylaxis (from drugs, food, insect sting, or idiophatic), death from anaphylaxis (post mortem assessment) and cutaneous or clonal mastcell disorders.
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Affiliation(s)
- S Platzgummer
- Laboratorio di Patologia Clinica, Ospedale Franz Tappeiner, Merano, Bolzano
| | - N Bizzaro
- Laboratorio di Patologia Clinica, Ospedale San Antonio, Tolmezzo, Azienda Sanitaria Universitaria Integrata, Udine
| | - M B Bilò
- Unità di Allergologia, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona
| | - V Pravettoni
- Dipartimento di Medicina Generale, Immunologia e Allergologia, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milano
| | - L Cecchi
- SOS Allergologia e Immunologia Prato, USL Toscana Centro, Prato
| | - V Sargentini
- UOC Patologia Clinica, Ospedale San Filippo Neri ASL Roma 1, Roma
| | - L Caponi
- Laboratorio di Patologia Clinica, Azienda Ospedaliero-Universitaria Pisana, Università di Pisa, Pisa
| | - D Visentini
- SOS Laboratorio di Immunopatologia e Allergologia, Azienda Sanitaria Universitaria Integrata, Udine
| | - I Brusca
- UOC Patologia Clinica, Ospedale Buccheri La Ferla Fatebenefratelli, Palermo
| | - G Pesce
- Laboratorio Diagnostico di Autoimmunologia IRCCS, Ospedale Policlinico S. Martino, Università di Genova, Dipartimento di Medicina Interna e Specialità mediche (DIMI), Genova
| | - M Bagnasco
- Dipartimento di Medicina Interna e Specialità Mediche (DIMI), Università degli studi di Genova
| | - A Antico
- UOC Servizio Medicina di Laboratorio, AULSS 7 Regione Veneto, Santorso, Vicenza
| | - M C Montera
- Allergologia e Immunologia Clinica, Ospedale G. Fuscito, Mercato S. Severino, Az. Ospedaliero-Universitaria Ruggi D'Aragona, Salerno
| | - O Quercia
- S.S. Interdipartimentale di Allergologia, Ospedale di Faenza, Ravenna
| | - A Musarra
- Servizio di Allergologia, Casa della Salute di Scilla, Scilla, Reggio Calabria
| | - L Bonazza
- Divisione di Pneumologia, Ospedale di Bolzano
| | - P Borrelli
- Ambulatorio di Allergologia e Immunologia Clinica, Ospedale Beauregard, Aosta
| | | | - B R Polillo
- UOS Allergologia, PTP Nuovo Regina Margherita, Roma
| | - B Valenti
- Allergologia e Pneumologia, PTA Biondo, ASP, Palermo
| | - M T Zedda
- Libero professionista in Allergologia, Cagliari
| | - R Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Milano
| | - D Villalta
- SSD Immunologia e Allergologia, Presidio Ospedaliero S. Maria degli Angeli, Pordenone
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11
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Gastaldi M, De Rosa A, Maestri M, Zardini E, Scaranzin S, Guida M, Borrelli P, Ferraro OE, Lampasona V, Furlan R, Irani SR, Waters P, Lang B, Vincent A, Marchioni E, Ricciardi R, Franciotta D. Acquired neuromyotonia in thymoma-associated myasthenia gravis: a clinical and serological study. Eur J Neurol 2019; 26:992-999. [PMID: 30714278 PMCID: PMC6593867 DOI: 10.1111/ene.13922] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 01/30/2019] [Indexed: 12/27/2022]
Abstract
Background and purpose Acquired neuromyotonia can occur in patients with thymoma, alone or in association with myasthenia gravis (MG), but the clinical prognostic significance of such comorbidity is largely unknown. The clinico‐pathological features were investigated along with the occurrence of neuromyotonia as predictors of tumour recurrence in patients with thymoma‐associated myasthenia. Methods A total number of 268 patients with thymomatous MG were studied retrospectively. Patients with symptoms of spontaneous muscle overactivity were selected for autoantibody testing using immunohistology for neuronal cell‐surface proteins and cell‐based assays for contactin‐associated protein 2 (CASPR2), leucine‐rich glioma inactivated 1 (LGI1), glycine receptor and Netrin‐1 receptor antibodies. Neuromyotonia was diagnosed according to the presence of typical electromyography abnormalities and/or autoantibodies against LGI1/CASPR2. Results Overall, 33/268 (12%) MG patients had a thymoma recurrence. Five/268 (2%) had neuromyotonia, four with typical autoantibodies, including LGI1 (n = 1), CASPR2 (n = 1) or both (n = 2). Three patients had Netrin‐1 receptor antibodies, two with neuromyotonia and concomitant CASPR2+LGI1 antibodies and one with spontaneous muscle overactivity without electromyography evidence of neuromyotonia. Thymoma recurrence was more frequent in those with (4/5, 80%) than in those without (28/263, 10%, P < 0.001) neuromyotonia. Neuromyotonia preceded the recurrence in 4/5 patients. In univariate analysis, predictors of thymoma recurrence were age at thymectomy [odds ratio (OR) 0.95, 95% confidence interval (CI) 0.93–0.97], Masaoka stage ≥IIb (OR 10.73, 95% CI 2.38–48.36) and neuromyotonia (OR 41.78, 95% CI 4.71–370.58). Conclusions De novo occurrence of neuromyotonia in MG patients with previous thymomas is a rare event and may herald tumour recurrence. Neuronal autoantibodies can be helpful to assess the diagnosis. These observations provide pragmatic risk stratification for tumour vigilance in patients with thymomatous MG.
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Affiliation(s)
- M Gastaldi
- Neuroimmunology Laboratory, IRCCS Mondino Foundation, Pavia, Italy
| | - A De Rosa
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Maestri
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - E Zardini
- Neuroimmunology Laboratory, IRCCS Mondino Foundation, Pavia, Italy
| | - S Scaranzin
- Neuroimmunology Laboratory, IRCCS Mondino Foundation, Pavia, Italy
| | - M Guida
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - P Borrelli
- Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, Italy
| | - O E Ferraro
- Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, Italy
| | - V Lampasona
- Division of Genetics and Cell Biology, Genomic Unit for the Diagnosis of Human Pathologies, San Raffaele Scientific Institute, Milan, Italy
| | - R Furlan
- Division of Neuroscience, INSPE, San Raffaele Scientific Institute, Milan, Italy
| | - S R Irani
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - P Waters
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - B Lang
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - A Vincent
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - E Marchioni
- Neuroncology and Neuroinflammation Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - R Ricciardi
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - D Franciotta
- Neuroimmunology Laboratory, IRCCS Mondino Foundation, Pavia, Italy
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12
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Pontillo G, Cocozza S, Lanzillo R, Russo C, Stasi MD, Paolella C, Vola EA, Criscuolo C, Borrelli P, Palma G, Tedeschi E, Morra VB, Elefante A, Brunetti A. Determinants of Deep Gray Matter Atrophy in Multiple Sclerosis: A Multimodal MRI Study. AJNR Am J Neuroradiol 2018; 40:99-106. [PMID: 30573464 DOI: 10.3174/ajnr.a5915] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 10/29/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND PURPOSE Deep gray matter involvement is a consistent feature in multiple sclerosis. The aim of this study was to evaluate the relationship between different deep gray matter alterations and the development of subcortical atrophy, as well as to investigate the possible different substrates of volume loss between phenotypes. MATERIALS AND METHODS Seventy-seven patients with MS (52 with relapsing-remitting and 25 with progressive MS) and 41 healthy controls were enrolled in this cross-sectional study. MR imaging investigation included volumetric, DTI, PWI and Quantitative Susceptibility Mapping analyses. Deep gray matter structures were automatically segmented to obtain volumes and mean values for each MR imaging metric in the thalamus, caudate, putamen, and globus pallidus. Between-group differences were probed by ANCOVA analyses, while the contribution of different MR imaging metrics to deep gray matter atrophy was investigated via hierarchic multiple linear regression models. RESULTS Patients with MS showed a multifaceted involvement of the thalamus and basal ganglia, with significant atrophy of all deep gray matter structures (P < .001). In the relapsing-remitting MS group, WM lesion burden proved to be the main contributor to volume loss for all deep gray matter structures (P ≤ .006), with a minor role of local microstructural damage, which, in turn, was the main determinant of deep gray matter atrophy in patients with progressive MS (P ≤ .01), coupled with thalamic susceptibility changes (P = .05). CONCLUSIONS Our study confirms the diffuse involvement of deep gray matter in MS, demonstrating a different behavior between MS phenotypes, with subcortical GM atrophy mainly determined by global WM lesion burden in patients with relapsing-remitting MS, while local microstructural damage and susceptibility changes mainly accounted for the development of deep gray matter volume loss in patients with progressive MS.
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Affiliation(s)
- G Pontillo
- From the Departments of Advanced Biomedical Sciences (G.P., S.C., C.R., M.D.S., C.P., E.A.V., E.T., A.E., A.B.).,Institute of Biostructure and Bioimaging (G.P.), National Research Council, Naples, Italy
| | - S Cocozza
- From the Departments of Advanced Biomedical Sciences (G.P., S.C., C.R., M.D.S., C.P., E.A.V., E.T., A.E., A.B.)
| | - R Lanzillo
- Neurosciences and Reproductive and Odontostomatological Sciences (R.L., C.C., V.B.M.), University of Naples "Federico II", Naples, Italy
| | - C Russo
- From the Departments of Advanced Biomedical Sciences (G.P., S.C., C.R., M.D.S., C.P., E.A.V., E.T., A.E., A.B.)
| | - M D Stasi
- From the Departments of Advanced Biomedical Sciences (G.P., S.C., C.R., M.D.S., C.P., E.A.V., E.T., A.E., A.B.)
| | - C Paolella
- From the Departments of Advanced Biomedical Sciences (G.P., S.C., C.R., M.D.S., C.P., E.A.V., E.T., A.E., A.B.)
| | - E A Vola
- From the Departments of Advanced Biomedical Sciences (G.P., S.C., C.R., M.D.S., C.P., E.A.V., E.T., A.E., A.B.)
| | - C Criscuolo
- Neurosciences and Reproductive and Odontostomatological Sciences (R.L., C.C., V.B.M.), University of Naples "Federico II", Naples, Italy
| | | | - G Palma
- From the Departments of Advanced Biomedical Sciences (G.P., S.C., C.R., M.D.S., C.P., E.A.V., E.T., A.E., A.B.)
| | - E Tedeschi
- From the Departments of Advanced Biomedical Sciences (G.P., S.C., C.R., M.D.S., C.P., E.A.V., E.T., A.E., A.B.)
| | - V B Morra
- Neurosciences and Reproductive and Odontostomatological Sciences (R.L., C.C., V.B.M.), University of Naples "Federico II", Naples, Italy
| | - A Elefante
- From the Departments of Advanced Biomedical Sciences (G.P., S.C., C.R., M.D.S., C.P., E.A.V., E.T., A.E., A.B.)
| | - A Brunetti
- From the Departments of Advanced Biomedical Sciences (G.P., S.C., C.R., M.D.S., C.P., E.A.V., E.T., A.E., A.B.)
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13
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Bilò MB, Martini M, Berra D, Scarpa A, Losappio L, Quercia O, Lodi Rizzini F, Bignardi D, Cortellini G, Zisa G, Del Giudice A, Manzotti G, Marcotulli C, Murzilli F, Cilia M, Pravettoni V, Borrelli P, Pastorello EA. Hymenoptera Venom Immunotherapy: How to Safely Switch to the Same Venom From a Different Manufacturer. J Investig Allergol Clin Immunol 2018; 28:205-208. [DOI: 10.18176/jiaci.0242] [Citation(s) in RCA: 6] [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: 11/20/2022] Open
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14
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Monti S, Palma G, Borrelli P, Tedeschi E, Cocozza S, Salvatore M, Mancini M. A multiparametric and multiscale approach to automated segmentation of brain veins. Annu Int Conf IEEE Eng Med Biol Soc 2018; 2015:3041-4. [PMID: 26736933 DOI: 10.1109/embc.2015.7319033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cerebral vein analysis provides a fundamental tool to study brain diseases such as neurodegenerative disorders or traumatic brain injuries. In order to assess the vascular anatomy, manual segmentation approaches can be used but are observer-dependent and time-consuming. In the present work, a fully automated cerebral vein segmentation method is proposed, based on a multiscale and multiparametric approach. The combined investigation of the R2(*)- and a Vesselness probability-map was used to obtain a fast and highly reliable classification of venous voxels. A semiquantitative analysis showed that our approach outperformed the previous state-of-the-art algorithm both in sensitivity and specificity. Inclusion of this tool within a parametric brain framework may therefore pave the way for a quantitative study of the intracranial venous system.
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Borrelli P, Van Oost K, Meusburger K, Alewell C, Lugato E, Panagos P. A step towards a holistic assessment of soil degradation in Europe: Coupling on-site erosion with sediment transfer and carbon fluxes. Environ Res 2018; 161:291-298. [PMID: 29175727 PMCID: PMC5773246 DOI: 10.1016/j.envres.2017.11.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 09/18/2017] [Accepted: 11/03/2017] [Indexed: 05/27/2023]
Abstract
Soil degradation due to erosion is connected to two serious environmental impacts: (i) on-site soil loss and (ii) off-site effects of sediment transfer through the landscape. The potential impact of soil erosion processes on biogeochemical cycles has received increasing attention in the last two decades. Properly designed modelling assumptions on effective soil loss are a key pre-requisite to improve our understanding of the magnitude of nutrients that are mobilized through soil erosion and the resultant effects. The aim of this study is to quantify the potential spatial displacement and transport of soil sediments due to water erosion at European scale. We computed long-term averages of annual soil loss and deposition rates by means of the extensively tested spatially distributed WaTEM/SEDEM model. Our findings indicate that soil loss from Europe in the riverine systems is about 15% of the estimated gross on-site erosion. The estimated sediment yield totals 0.164 ± 0.013Pgyr-1 (which corresponds to 4.62 ± 0.37Mgha-1yr-1 in the erosion area). The greatest amount of gross on-site erosion as well as soil loss to rivers occurs in the agricultural land (93.5%). By contrast, forestland and other semi-natural vegetation areas experience an overall surplus of sediments which is driven by a re-deposition of sediments eroded from agricultural land. Combining the predicted soil loss rates with the European soil organic carbon (SOC) stock, we estimate a SOC displacement by water erosion of 14.5Tg yr-1. The SOC potentially transferred to the riverine system equals to 2.2Tgyr-1 (~15%). Integrated sediment delivery-biogeochemical models need to answer the question on how carbon mineralization during detachment and transport might be balanced or even off-set by carbon sequestration due to dynamic replacement and sediment burial.
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Affiliation(s)
- P Borrelli
- European Commission, Joint Research Centre, Directorate for Sustainable Resources, Ispra, Italy; Environmental Geosciences, University of Basel, Switzerland.
| | - K Van Oost
- TECLIM - Georges Lemaître Centre for Earth and Climate Research, Université Catholique de Louvain, Louvain-la-Neuve BE 1348, Belgium
| | - K Meusburger
- Environmental Geosciences, University of Basel, Switzerland
| | - C Alewell
- Environmental Geosciences, University of Basel, Switzerland
| | - E Lugato
- European Commission, Joint Research Centre, Directorate for Sustainable Resources, Ispra, Italy
| | - P Panagos
- European Commission, Joint Research Centre, Directorate for Sustainable Resources, Ispra, Italy
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Arrigoni C, Puci M, Grugnetti AM, Collivasone L, Fenizia E, Borrelli P, Vellone E, Alvaro R, Piredda M, De Marinis MG. Italian version of Nursing Students' Perception of Instructor Caring (I-NSPIC): assessment of reliability and validity. BMC Med Educ 2017; 17:218. [PMID: 29149842 PMCID: PMC5693487 DOI: 10.1186/s12909-017-1032-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 10/31/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Clinical experience is an essential component of nursing education since it provides students with the opportunity to construct and develop clinical competencies. Instructor caring is a pivotal facilitator at the forefront of clinical education, playing a key and complex educating role in clinical sectors. For these reasons the aims of this study was to assess the validity and reliability of the Italian version of NSPIC (I-NSPIC). METHODS A validation multicentre study was conducted in three different Italian universities. A total of 333 nursing students were enrolled in the 2014/2015 academic year. Exploratory factor analysis (EFA) with oblique rotation was performed to test the construct validity of I-NSPIC. The Cronbach's alpha coefficient and test retest via Intraclass Correlation Coefficient (ICC) analyses were done to assess the internal consistency and stability of the scale. A Spearman's correlation with another scale (CLES-T) was used to examine the concurrent validities. RESULTS Four factors (control versus flexibility, supportive learning climate, confidence through caring, appreciation of life meaning and respectful sharing) were identified in EFA. The Cronbach's alpha value showed that I-NSPIC was a reliable instrument (α = 0.94) and the ICC coefficient was satisfactory. CONCLUSION The I-NSPIC is a valid instrument for assessing the perception of instructor caring in Italian nursing students. It may also prove helpful in promoting the caring ability of nursing students and in increasing the caring interactions in the relationship between instructor and nursing students. The knowledge emerged from this study provide important insight in developing effective training strategies in the clinical training of undergraduate nursing students.
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Affiliation(s)
- C. Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Unit of Hygiene, University of Pavia, Via Forlanini, 2-27100 Pavia, Italy
| | - M. Puci
- Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Via Forlanini, 2-27100 Pavia, Italy
| | - A. M. Grugnetti
- Department of Public Health, Experimental and Forensic Medicine, Unit of Hygiene, University of Pavia, Via Forlanini, 2-27100 Pavia, Italy
- IRCCS Policlinic San Matteo Foundation Pavia, Via Forlanini, 2-27100 Pavia, Italy
| | - L. Collivasone
- Azienda Ospedaliera di Pavia, Corso Milano, 19, Vigevano, Pavia, Italy
| | - E. Fenizia
- Tor Vergata University, Faculty of Medicine, Via Montpellier, 1, 00133 Rome, Italy
| | - P. Borrelli
- Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Via Forlanini, 2-27100 Pavia, Italy
| | - E. Vellone
- Tor Vergata University, Faculty of Medicine, Via Montpellier, 1, 00133 Rome, Italy
| | - R. Alvaro
- Tor Vergata University, Faculty of Medicine, Via Montpellier, 1, 00133 Rome, Italy
| | - M. Piredda
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo, 21-00128 Rome, Italy
| | - M. G. De Marinis
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo, 21-00128 Rome, Italy
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Cocozza S, Russo C, Pisani A, Olivo G, Riccio E, Cervo A, Pontillo G, Feriozzi S, Veroux M, Battaglia Y, Concolino D, Pieruzzi F, Mignani R, Borrelli P, Imbriaco M, Brunetti A, Tedeschi E, Palma G. Redefining the Pulvinar Sign in Fabry Disease. AJNR Am J Neuroradiol 2017; 38:2264-2269. [PMID: 29051208 DOI: 10.3174/ajnr.a5420] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 07/22/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE The pulvinar sign refers to exclusive T1WI hyperintensity of the lateral pulvinar. Long considered a common sign of Fabry disease, the pulvinar sign has been reported in many pathologic conditions. The exact incidence of the pulvinar sign has never been tested in representative cohorts of patients with Fabry disease. The aim of this study was to assess the prevalence of the pulvinar sign in Fabry disease by analyzing T1WI in a large Fabry disease cohort, determining whether relaxometry changes could be detected in this region independent of the pulvinar sign positivity. MATERIALS AND METHODS We retrospectively analyzed brain MR imaging of 133 patients with Fabry disease recruited through specialized care clinics. A subgroup of 26 patients underwent a scan including 2 FLASH sequences for relaxometry that were compared with MRI scans of 34 healthy controls. RESULTS The pulvinar sign was detected in 4 of 133 patients with Fabry disease (3.0%). These 4 subjects were all adult men (4 of 53, 7.5% of the entire male population) with renal failure and under enzyme replacement therapy. When we tested for discrepancies between Fabry disease and healthy controls in quantitative susceptibility mapping and relaxometry maps, no significant difference emerged for any of the tested variables. CONCLUSIONS The pulvinar sign has a significantly lower incidence in Fabry disease than previously described. This finding, coupled with a lack of significant differences in quantitative MR imaging, allows hypothesizing that selective involvement of the pulvinar is a rare neuroradiologic sign of Fabry disease.
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Affiliation(s)
- S Cocozza
- From the Departments of Advanced Biomedical Sciences (S.C., C.R., G.O., A.C., G.P., M.I., A.B., E.T.)
| | - C Russo
- From the Departments of Advanced Biomedical Sciences (S.C., C.R., G.O., A.C., G.P., M.I., A.B., E.T.)
| | - A Pisani
- Public Health (A.P., E.R.), Nephrology Unit, University "Federico II," Naples, Italy
| | - G Olivo
- Department of Neuroscience (G.O.), Uppsala University, Uppsala, Sweden
| | - E Riccio
- Public Health (A.P., E.R.), Nephrology Unit, University "Federico II," Naples, Italy
| | - A Cervo
- From the Departments of Advanced Biomedical Sciences (S.C., C.R., G.O., A.C., G.P., M.I., A.B., E.T.)
| | - G Pontillo
- From the Departments of Advanced Biomedical Sciences (S.C., C.R., G.O., A.C., G.P., M.I., A.B., E.T.).,Institute of Biostructure and Bioimaging (G.P.), National Research Council, Naples, Italy
| | - S Feriozzi
- Nephrology and Dialysis Department (S.F.), Belcolle Hospital, Viterbo, Italy
| | - M Veroux
- Department of Medical and Surgical Sciences and Advanced Technologies (M.V.), University Hospital of Catania, Catania, Sicily, Italy
| | - Y Battaglia
- Department of Specialized Medicine (Y.B.), Division of Nephrology and Dialysis, St. Anna Hospital-University, Ferrara, Italy
| | - D Concolino
- Department of Pediatrics (D.C.), University Magna Graecia, Catanzaro, Italy
| | - F Pieruzzi
- Nephrology Unit (F.P.), University of Milano-Bicocca, Milan, Italy
| | - R Mignani
- Nephrology and Dialysis Department (R.M.), Infermi Hospital, Rimini, Italy
| | | | - M Imbriaco
- From the Departments of Advanced Biomedical Sciences (S.C., C.R., G.O., A.C., G.P., M.I., A.B., E.T.)
| | - A Brunetti
- From the Departments of Advanced Biomedical Sciences (S.C., C.R., G.O., A.C., G.P., M.I., A.B., E.T.)
| | - E Tedeschi
- From the Departments of Advanced Biomedical Sciences (S.C., C.R., G.O., A.C., G.P., M.I., A.B., E.T.)
| | - G Palma
- From the Departments of Advanced Biomedical Sciences (S.C., C.R., G.O., A.C., G.P., M.I., A.B., E.T.)
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Arrigoni C, Grugnetti AM, Caruso R, Gallotti ML, Borrelli P, Puci M. Nursing students' clinical competencies: a survey on clinical education objectives. Ann Ig 2017; 29:179-188. [PMID: 28383609 DOI: 10.7416/ai.2017.2145] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Developing clearly defined competencies and identifying strategies for their measurement remain unfortunately a critical aspect of nursing training. In the current international context, which continues to be characterised by deep economic crisis, universities have a fundamental role to play in redefining the educational goals to respond to the expectations of certain geographical areas of interest, as underscored in the Bologna Process (Joint Declaration of the European Ministers of Education Convened in Bologna 19 June 1999). DESIGN AND AIM OF STUDY The aim of this observational study was to examine the clinical learning context of nursing students using a tool developed by a team of teachers for the analysis of clinical learning. METHODS Redefinition of the clinical learning objectives with reference to the competencies set out in the questionnaire validated by Venturini et al. (2012) and the subsequent use of the tool created by the team of teachers for students in the first, second and third-year courses of the 2013/14 academic year, covering all the internships called for in those years. RESULTS All nursing students enrolled in the first, second and third year of the nursing undergraduate degree program at the University of Pavia (no. 471) participated in this survey. A total of 1,758 clinical internships were carried out: 461 for the first year, 471 for the second year and 826 for the third year. Setting objectives, beginning with the educational offerings in the several clinical contexts, represents a strong point for this process. The results highlight a level of heterogeneity and complexity intrinsic to the University of Pavia educational system, characterized by clinical settings with different clinical levels (Research hospital and other traditional hospitals) that offering different levels of training. CONCLUSIONS The use of the self-evaluation form for clinical learning made it possible to perform real-time observations of the training activities of the entire student body. An educational model structured in this way allows the student to develop their capacity for critical thinking. For educational activities, such a self-evaluation form represents an ideal instrument for identifying areas in need of improvement. This explorative study, carried out by means of a self-evaluation form, is the first-step toward the development of an educational programme that is more uniform and easily traceable within the academic system.
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Affiliation(s)
- C Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Unit of Hygiene, University of Pavia, Italy
| | - A M Grugnetti
- IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - R Caruso
- Health Professions Research and Development Unit IRCCS Policlinico San Donato, Milano Italy
| | - M L Gallotti
- Department of Public Health, Experimental and Forensic Medicine, Unit of Hygiene, University of Pavia, Italy
| | - P Borrelli
- Department of Public Health, Experimental and Forensic Medicine, Biostatistics and Clinical Epidemiology Unit, University of Pavia, Italy
| | - M Puci
- Department of Public Health, Experimental and Forensic Medicine, Biostatistics and Clinical Epidemiology Unit, University of Pavia, Italy
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Bautista-Ballesteros J, Torres-Espallardo I, Borrelli P, Rivas-Sanchez A, Bello P, Martí-Bonmatí L. Individualized dosimetry in patients with differentiated thyroid cancer based on external dose rate. Optimization of the number of measurements. Rev Esp Med Nucl Imagen Mol 2016. [DOI: 10.1016/j.remnie.2016.01.001] [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: 11/28/2022]
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Bautista-Ballesteros JA, Torres-Espallardo I, Borrelli P, Rivas-Sanchez A, Bello P, Martí-Bonmatí L. Individualised dosimetry in patients with differentiated thyroid cancer based on external dose-rate. Optimisation of the number of measurements. Rev Esp Med Nucl Imagen Mol 2015; 35:107-14. [PMID: 26598429 DOI: 10.1016/j.remn.2015.09.009] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/18/2015] [Accepted: 09/21/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To compare the results of individual dosimetry in differentiated thyroid cancer patients treated with (131)I at our centre with the established limits and dosimetry results of published studies. Analysis of the optimal number of measurements necessary to reduce the impact of dosimetry for the comfort of the patient and, secondly, on the workload of health workers. MATERIAL AND METHODS Dosimetry was performed in the Nuclear Medicine Department of the University and Polytechnic Hospital La Fe, on 29 patients suffering from differentiated thyroid cancer and treated with activities between 1.02 and 5.51 GBq (mean 2.68 GBq) of (131)I. The Spanish Society of Medical Physics (SEFM) protocol was used, based on measurements of external dose rate adjusted to a bi-exponential curve according to a two compartment model. Different dosimetries were performed on each patient, taking different selections of the available measurements in order to find the optimal number. RESULTS Results are well below the dosimetry limits, and are consistent with those obtained in other centres. The number of measurements can be reduced from 5, as proposed in the SEFM protocol, to 4 without significant loss of accuracy. Further reducing measures may be justified in individual cases. CONCLUSIONS The values obtained for the dosimetry quantities are significantly below the established limits. A reduction in measurements can be assumed at the cost of a moderate increase in uncertainty, benefiting the patient.
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Affiliation(s)
| | - I Torres-Espallardo
- Servicio de Medicina Nuclear, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - P Borrelli
- Servicio de Medicina Nuclear, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - A Rivas-Sanchez
- Servicio de Medicina Nuclear, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - P Bello
- Servicio de Medicina Nuclear, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - L Martí-Bonmatí
- Servicio de Radiología, Hospital Universitario y Politécnico La Fe, Valencia, España; Grupo de Investigación Biomédica (GIBI2(30)), Hospital Universitario y Politécnico La Fe, Valencia, España
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Arrigoni C, Micheletti P, Grugnetti AM, Ferrari P, Borrelli P, Montomoli C, Pelissero G. The students' reasons to choose a nursing degree program: an Italian exploratory study. Ann Ig 2015; 26:570-7. [PMID: 25524082 DOI: 10.7416/ai.2014.2016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND From the international literature very interesting cues emerge about students' motivations to choose a Nursing Degree Program. Unfortunately, this phenomenon is largely unexplored in Italy. An observational study was conducted at the University of Pavia, with the aim to investigate the reasons underpinning the students' choice to enter a Nursing Degree Program. METHODS A semi-structured, self-administrated questionnaire was used for this single-center cross-sectional study. The questionnaire was aimed to investigate the reasons underpinning the students' choice to enter a Nursing Degree Program, using both open-ended and close-ended multiple choice questions. Descriptive statistics have been used to describe collected data. Open-ended response analysis was conducted through an exploratory and qualitative analysis of language. RESULTS Response rate was 71% (196/275). Our study results highlighted a variety of reasons that encourage students to begin a Nursing Degree Program: the feeling of usefulness (80%), the desire to help and to care people (78%), the interest in the sciences (71%), the compassion to the suffering people (66%). We also identified 4 categories that describe which characteristics a nurse should have according to the students' point of view: expertise; personal characteristics; to experience the professional life as a social function and to have interest in the health field. CONCLUSIONS Students' answers indicate that often the choice to enter a Nursing Degree Program is not supported by clear ideas and strong motivations. We consider it crucial to provide a realistic image of the nursing role and opportunities for career development, so that students can have the right elements to make a conscious choice. There is a need for more qualitative research to explore the reasons why students choose the Nursing Degree Program; moreover, to identify, from the beginning of the course, those students who are in crisis of motivation, in order to adopt support strategies that could enable them to successfully achieve academic career.
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Affiliation(s)
- C Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - P Micheletti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | | | - P Ferrari
- Polyclinic University Career Center, University of Pavia, Italy
| | - P Borrelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - C Montomoli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - G Pelissero
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
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Bova M, Guilarte M, Sala-Cunill A, Borrelli P, Rizzelli GML, Zanichelli A. Treatment of ACEI-related angioedema with icatibant: a case series. Intern Emerg Med 2015; 10:345-50. [PMID: 25666515 DOI: 10.1007/s11739-015-1205-9] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 01/28/2015] [Indexed: 11/29/2022]
Abstract
No specific drugs are licensed for the treatment of ACE inhibitor (ACEI)-acquired angioedema (ACEI-AAE). Icatibant, an antagonist of the B2 receptor of bradykinin, is a potential treatment for this condition; however, its use in this setting is poorly documented. We report here clinical outcomes of 13 patients with ACEI-AAE treated with icatibant, in a real-life setting. Thirteen patients on ACEI seen in an Emergency Department (ED) with angioedema involving face, lips or the upper airways were analyzed. Angioedema due to known causes other than ACEI treatment was excluded. Initially, all patients received standard therapy (antihistamine, corticosteroids and epinephrine). Due to the lack of response and a worsening severity of symptoms, all patients received one subcutaneous injection of icatibant (30 mg/mL). Following icatibant treatment, all patients experienced improvement in the symptoms. The median time from onset of clinical symptoms to injection of icatibant was 3 h (IQR 2.5-5.5 h). Symptom relief was reported at 30 min (IQR 27.5-70 min). A complete resolution of symptoms was observed at 5 h (IQR 4-7 h). Ten patients had previously experienced angioedema attacks. The Median time to complete resolution of the previous attacks was higher (54 h; IQR 33-63 h), than after icatibant (p = 0.002) therapy. No patients required tracheal intubation or tracheotomy, and all patients were discharged within 24 h. No adverse events were reported. Before discharge, all patients were instructed to discontinue ACEI, and to take a different antihypertensive agent. This case series supports the efficacy of icatibant in improving symptoms of ACEI-AAE.
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Affiliation(s)
- Maria Bova
- U.O.C. Medicina Interna, Ospedale Martiri di Villa Malta, Sarno (SA), Italy,
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Zanichelli A, Arcoleo F, Barca MP, Borrelli P, Bova M, Cancian M, Cicardi M, Cillari E, De Carolis C, De Pasquale T, Del Corso I, Massardo I, Minale P, Montinaro V, Neri S, Perricone R, Pucci S, Quattrocchi P, Rossi O, Triggiani M. A nationwide survey of hereditary angioedema due to C1 inhibitor deficiency in Italy. World Allergy Organ J 2015. [PMCID: PMC4406698 DOI: 10.1186/1939-4551-8-s1-a184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Fayeye F, Borrelli P, Esmyot M, Erinle B, Mahran MA, Neale E, Cameron S, Takher P. Rates of subsequent surgery following endometrial ablation among English women with menorrhagia: population-based cohort study. BJOG 2014; 121:1316. [PMID: 25155328 DOI: 10.1111/1471-0528.12863] [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] [Accepted: 03/03/2014] [Indexed: 11/28/2022]
Affiliation(s)
- F Fayeye
- Department of Obstetrics and Gynaecology, Bedford Hospital NHS Trust, Bedford, UK
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Neri G, Marini R, Cappa M, Borrelli P, Opitz JM. Simpson-Golabi-Behmel syndrome: an X-linked encephalo-tropho-schisis syndrome. 1988. Am J Med Genet A 2014; 161A:2697-703. [PMID: 24166811 DOI: 10.1002/ajmg.a.36317] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The following paper by Professor GiovanniNeri and colleagues was originally published in 1988, American Journal of Medical Genetics 30:287–299. This paper represented a seminal work at the time of publication as it not only reported a new family with a disorder that had been called the “gigantism-dysplasia syndrome”, but also suggested naming the condition the Simpson-Golabi-Behmel syndrome. This eponym has clearly stood “the test of time”, and that designation is now widely accepted. This paper is graciously republished by Wiley-Blackwell in the Special Festschrift issue honoring Professor Neri. We report on another family with the so-called "gigantism-dysplasia syndrome", an X-linked condition characterized by pre-and postnatal overgrowth, characteristic face with apparent coarseness, dysplastic changes in several tissues, and mild intellectual impairment. This condition has been called the Golabi-Rosen syndrome; however, we agree that is the same entity as that described, in a milder form, by Simpson et al. in 1975 and by Behmel et al. in 1984. Therefore, we suggest that this entity be designated the Simpson-Golabi-Behmel syndrome. The manifestations in affected individuals suggest that this condition represents an X-linked encephalo-tropho-schisis syndrome.
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Affiliation(s)
- G Neri
- Istituto di Biologia e Genetica, Università "G. D'Annunzio", Chieti
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Carrà G, Segagni Lusignani G, Sciarini P, Borrelli P, Popa I, Montomoli C, Clerici M. S14-01 Geographical variations for addiction risk among dually diagnosed people cared in parallel systems. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)70001-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Ciprandi G, Cadario G, Valle C, Ridolo E, Verini M, Di Gioacchino M, Minelli M, Gangemi S, Sillano V, Colangelo C, Pravettoni V, Pellegrino R, Borrelli P, Fiorina A, Carosso A, Gasparini A, Riario-Sforza GG, Incorvaia C, Puccinelli P, Scurati S, Frati F. Sublingual immunotherapy in polysensitized patients: effect on quality of life. J Investig Allergol Clin Immunol 2010; 20:274-279. [PMID: 20815304] [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: 05/29/2023] Open
Abstract
BACKGROUND Quality of life (QOL) is an important issue in allergic rhinitis and has been evaluated in a number of studies that have shown how it is impaired in untreated patients and improved by effective treatment. However, there are no data concerning QOL after sublingual immunotherapy (SLIT) in polysensitized patients. OBJECTIVE To evaluate the effect, in real-life clinical practice, of SLIT on QOL in a population of polysensitized patients with allergic rhinitis. METHODS We prospectively evaluated 167 consecutively enrolled polysensitized patients with allergic rhinitis. QOL was measured in all cases with the Rhinoconjunctivitis Quality of Life Questionnaire at baseline and after 1 year of SLIT (performed in approximately 70% of cases using single allergen extracts provided by the same manufacturer). RESULTS The most frequent causes of sensitization were grass pollen, Parietaria, and house dust mites. The mean number of sensitizations per patient was 3.65. SLIT was performed with 1 extract in 123 patients (73.6%), with 2 extracts in 31 patients (18.6%), and with more than 2 extracts in 13 patients (7.8%). The mean values of all the QOL items improved significantly (P < .01 in all cases), with the following reductions noted: activities, 3.96 to 2.89; sleep, 2.07 to 1.56; general problems, 2.16 to 1.5; practical problems, 3.69 to 2.58; nasal symptoms, 3.57 to 2.50; eye symptoms, 2.92 to 1.83; and emotional aspects, 2.2 to 1.44. CONCLUSIONS This study provides evidence that QOL can be improved in polysensitized patients treated with SLIT, and that the use of just 1 or 2 allergen extracts seems to be sufficient and effective in terms of improving QOL.
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MESH Headings
- Administration, Sublingual
- Adolescent
- Adult
- Animals
- Antigens, Dermatophagoides/therapeutic use
- Antigens, Plant/therapeutic use
- Desensitization, Immunologic
- Female
- Humans
- Immunization
- Male
- Parietaria/immunology
- Poaceae/immunology
- Pollen/adverse effects
- Pyroglyphidae/immunology
- Quality of Life
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/immunology
- Rhinitis, Allergic, Perennial/physiopathology
- Rhinitis, Allergic, Perennial/therapy
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/immunology
- Rhinitis, Allergic, Seasonal/physiopathology
- Rhinitis, Allergic, Seasonal/therapy
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Affiliation(s)
- G Ciprandi
- Department of Internal Medicine, University of Genoa, Genoa, Italy.
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Teutonico F, Mai R, Devinsky O, Lo Russo G, Weiner HL, Borrelli P, Balottin U, Veggiotti P. Epilepsy surgery in tuberous sclerosis complex: early predictive elements and outcome. Childs Nerv Syst 2008; 24:1437-45. [PMID: 18704447 DOI: 10.1007/s00381-008-0679-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2008] [Revised: 06/10/2008] [Indexed: 11/26/2022]
Abstract
AIM The aim of the study was to evaluate the surgical treatment of epilepsy and detection of possible early surgery predictive elements in patients with tuberous sclerosis complex (TSC). MATERIALS AND METHODS Forty-two TSC patients with epilepsy were selected and divided into two main groups: definite and fruste forms. Definite forms were divided into different groups: patients with pharmacologically controlled epilepsy, patients with pharmacoresistant epilepsy excluded from surgery after an extensive presurgical assessment, and patients with a pharmacoresistant epilepsy who underwent surgery. We compared the definite TSC groups to identify elements that predict surgical candidacy. Second, we compared all operated patients to assess surgical outcome. CONCLUSION We found several factors that could predict a surgical intervention even if identification of patients with refractory epilepsy who can benefit from surgery is an evolving process. Also, several positive factors for good surgical outcome were identified. Patients with the fruste form had excellent surgical outcome.
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Affiliation(s)
- F Teutonico
- Child Neuropsychiatry Unit, Department of Child Neurology and Psychiatry, IRCCS C. Mondino Foundation, University of Pavia, Via Mondino, 2, 27100, Pavia, Italy
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29
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Ciprandi G, Alesina R, Ariano R, Aurnia P, Borrelli P, Cadario G, Capristo A, Carosso A, Casino G, Castiglioni G, Cesinaro Di Rocco P, Colangelolo C, Di Gioacchino M, Di Paola MG, Errico G, Fiorina A, Gambuzza F, Gangemi S, Gasparini A, Giugno R, Iemoli E, Isola S, Maniero G, Marengo F, Mazzali P, Minelli M, Mosca M, Pellegrino R, Piconi S, Pravettoni V, Quaglio L, Ricciardi L, Ridolo E, Sillano V, Valle C, Varin E, Verini M, Zambito M, Riario-Sforza GG, Incorvaia C, Puccinelli P, Scurati S, Frati F. Characteristics of patients with allergic polysensitization: the POLISMAIL study. Eur Ann Allergy Clin Immunol 2008; 40:77-83. [PMID: 19334371] [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: 05/27/2023]
Abstract
BACKGROUND The natural history of respiratory allergy is commonly characterized by a worsening of symptom severity, frequent comorbidity of rhinitis and asthma, and polysensitization to aeroallergens. The polysensitization phenomenon starts since childhood and is rare to find monosensitized adult patients. However, there are few studies investigating the characteristics of polysensitized patients. METHODS This study was performed on a large cohort of patients with allergic rhinitis (assessed by ARIA criteria) and/or mild to moderate asthma (assessed by GINA). The kind and the number of sensitizations, their patterns, and the relation with quality of life (QoL) measured by the Juniper's RQLQ guestionnaire, were evaluated. RESULTS Globally 418 patients (50.2% males, 49.8% females, mean age 26.4 years, range 3.5-65 years, 64 smokers, 371 non-smokers) were enrolled: 220 had allergic rhinitis alone, and 198 allergic rhinitis and asthma. The mean number ofsensitizations was 2.6. Three hundred-five patients (73%) had persistent rhinitis (PER), 220 of them with moderate-severe form. There was no significant derence in rate of rhinitis and asthma in monosensitized or polysensitized patients. Most patients were sensitized to pollens, whereas only 24.2% of them were sensitized to perennial allergens. Polysensitization was significantly associated with some issues of QoL, confirming previous findings, but not with number ofsensitizations. CONCLUSIONS This study provides data confirming for poly-sensitized patients the relevance of ARIA classification of AR. PER is the most common form of AR in this cohort, symptoms are frequently moderate-severe, and asthma is present in about the half of patients with AR.
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MESH Headings
- Adolescent
- Adult
- Age Factors
- Aged
- Allergens/adverse effects
- Animals
- Anti-Allergic Agents/therapeutic use
- Antigens, Plant/adverse effects
- Asthma/drug therapy
- Asthma/epidemiology
- Asthma/etiology
- Cats
- Child
- Child, Preschool
- Cohort Studies
- Dogs
- Female
- Fungi
- Humans
- Immunization
- Italy/epidemiology
- Male
- Middle Aged
- Pollen/adverse effects
- Prospective Studies
- Pyroglyphidae
- Quality of Life
- Rhinitis, Allergic, Perennial/drug therapy
- Rhinitis, Allergic, Perennial/epidemiology
- Rhinitis, Allergic, Perennial/etiology
- Rhinitis, Allergic, Seasonal/drug therapy
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/etiology
- Skin Tests
- Smoking/epidemiology
- Young Adult
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Affiliation(s)
- G Ciprandi
- Dipartimento Medicina Interna, Az. Osp. Universitaria San Martino, Genoa, Italy
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30
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Ciprandi G, Cadario G, Di Gioacchino M, Tosca M, Bernardini R, Marseglia G, Gangemi S, Isola S, Marengo F, Minelli M, Ricciardi L, Ridolo E, Valle C, Verini M, Borrelli P, Varin E, Sambugaro R, Puccinelli P, Incorvaia C, Russello M, Milioni M, Boccardo R, Piergentili E, Di Rienzo A, Frati F. Intermittent and Persistent Allergic Rhinitis and Association with Asthma in Children. EUR J INFLAMM 2008; 6:123-128. [DOI: 10.1177/1721727x0800600304] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2023] Open
Abstract
The natural history of allergic rhinitis (AR) is commonly characterized by worsening of symptom severity, frequent comorbidity with asthma, and polysensitization to aeroallergens. The polysensitization phenomenon starts in early childhood. AR classification has been recently revised, and some studies investigated the new types: intermittent (IAR) and persistent (PER) AR. However, no study has been carried out on children regarding this issue. This preliminary study was performed on a large cohort of children with allergic rhinitis to evaluate the type and severity of rhinitis and its possible association with asthma, including severity grade. One hundred and thirty-nine children (86 males, 53 females, mean age 11.8 years, range 3.5–17.7 years) with allergic rhinitis were prospectively and consecutively evaluated. Seventy-one children had rhinitis alone and 68 had rhinitis associated with asthma. Forty children had IAR, 30 of whom with moderate-severe grade. Ninety-nine children had PER, 65 of whom had moderate-severe grade. The severity of AR was not associated with asthma presence (Fisher χ2 = 0.5765; Prob.=0.9018). Regarding asthma severity, 30 children had the intermittent form, whereas 38 had the persistent form: 15 mild, 22 moderate, and 1 severe. This study provides the first evidence concerning the ARIA classification in children, partially confirming findings obtained in adulthood.
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Affiliation(s)
| | - G. Cadario
- S.C. Allergologia e Immunologia Clinica, A.O. San Giovanni Battista (Molinette), Torino
| | - M. Di Gioacchino
- Dipartimento di Medicina e Scienze dell'Invecchiamento, Immunologia e Medicina del lavoro, Università G. d'Annunzio, Chieti
| | - M.A. Tosca
- U.O. Pneumologia, Istituto G. Gaslini, Genova
| | | | - G.L. Marseglia
- Clinica Pediatrica Fondazione IRCCS San Matteo, Università di Pavia, Pavia
| | - S. Gangemi
- S.U.O. Complessa Allergologia, Policlinico, Messina
| | - S. Isola
- Ambulatorio di Allergologia, U.O. Medicina Generale, Ospedale Campi Salentina, Lecce
| | - F. Marengo
- S.C. Allergologia e Immunologia Clinica, A.O. San Giovanni Battista (Molinette), Torino
| | - M. Minelli
- Ambulatorio di Allergologia, U.O. Medicina Generale, Ospedale Campi Salentina, Lecce
| | - L. Ricciardi
- S.U.O. Complessa Allergologia, Policlinico, Messina
| | - E. Ridolo
- Dipartimento di Scienze Cliniche, Università di Parma
| | - C. Valle
- Unità di Allergologia, Ospedale S. Paolo, Milano
| | - M. Verini
- U.O. Allergologia e Fisiopatologia Respiratoria, Clinica Pediatrica, Ospedale Clinicizzato, Chieti
| | | | - E. Varin
- Clinica Pediatrica Fondazione IRCCS, Ospedale Maggiore, Policlinico Mangiagalli Regina Elena Milano
| | | | | | | | | | - M. Milioni
- Clinica Pediatrica, Università di Perugia, Perugia, Italy
| | - R. Boccardo
- Clinica Pediatrica, Università di Perugia, Perugia, Italy
| | - E. Piergentili
- Clinica Pediatrica, Università di Perugia, Perugia, Italy
| | - A. Di Rienzo
- Clinica Pediatrica, Università di Perugia, Perugia, Italy
| | - F. Frati
- Scientific Department Stallergenes, Milano
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31
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Borrelli P, Pesenti Campagnoni M. Anaphylaxis management in ER. Emerg Care J 2006. [DOI: 10.4081/ecj.2006.3.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
PURPOSE Maintenance of spermatogenesis in hypogonadotropic hypogonadal patients is possible and is an objective to be actively pursued. Gonadotropin releasing hormone and gonadotropin/ testosterone therapy can develop and maintain sex characteristics and spermatogenesis such that even small gonads should be preserved. An empty scrotum, like any other congenital or acquired condition compromising the size of the genitalia, can produce serious psychosexual problems and have an extremely negative effect on normal social life. MATERIALS AND METHODS In 2 adolescents affected by Kallmann's syndrome with testes of infantile volume 1 gonad was transferred to the contralateral hemiscrotum and replaced by an adult testicular prosthesis. RESULTS There were no postoperative complications. The cosmetic results were considered satisfactory by the patients and their parents. CONCLUSIONS When possible and when there is no risk of physiological repercussions, every effort should be made to normalize the appearance of the genital area for strong psychological reasons.
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Affiliation(s)
- F Ferro
- Andrological Surgery Unit and Endocrinology, Bambino Gesù Children's Hospital, Rome, Italy.
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33
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Borrelli AL, Borrelli P, Felicetti M, Di Domenico A, Laboccetta A, Torella M. Nuchal translucency as an important ultrasound screening tool for the early diagnosis of first trimester chromosomal abnormalities. A preliminary experience. Minerva Ginecol 2004; 56:179-80. [PMID: 15258549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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34
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Borrelli AL, Borrelli P, Di Domenico A, Felicetti M, Corcione M, Torella M. The incidence of chromosomal anomalies in fetuses affected by mild renal pyelectasis. Minerva Ginecol 2004; 56:137-40. [PMID: 15258542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
AIM The aim of this study was to evaluate the clinical significance of borderline fetal pyelectasis, whether it is associated with chromosomal aberration or is the expression of a structural defect of the urinary tracts. METHODS We carried out echographies on 2900 pregnant women in the 2nd trimester of their pregnancies between January 1998 and March 2002 at the Department of Obstetrics, Gynaecology and Neonatology. Any patient with fetuses affected by borderline pyelectasis in association with other echographic markers of aneuploidy and in women 35 years of age and older with fetuses presenting isolated pyelectasis underwent amniocentesis for karyotyping. RESULTS We discovered 2.1% (62 cases) of borderline pyelectasis in the general population. The karyotype was normal in all cases of isolated pyelectasis; 3/5 of the fetuses with borderline renal pyelectasts associated with other risk factors showed a chromosomal aberration. CONCLUSION In accordance with existing documentation, the results of our research confirmed that isolated borderline pyelectasis does not increase the risk of chromosomopathies; this latter is significantly more frequent when pyelectasis is present in older pregnant women (>35 years of age) or is associated with other sonographic markers of chromosomal anomalies (choroids plexus cysts, cystic hygroma etc.). Prenatal cytogenetic tests of the fetal karyotype are to be recommended in older mothers and/or in presence of associated echographic anomalies. In this study we propose an early diagnosis of mild forms of pyelectasis which are misdiagnosed by superficial echographies, but which can be associated with chromosomopathy.
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Affiliation(s)
- A L Borrelli
- Department of Obstetric, Gynecology and Neonatology, Faculty of Medicine and Surgery, Second University of Naples, Naples, Italy.
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35
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Abstract
Deletions and mutations in the growth hormone receptor gene are the underlying etiology of Laron syndrome (LS). Most of the patients are distributed in and originating from the Mediterranean and Middle-Eastern countries. Thirty-nine mutations have been described so far. We hereby report 2 novel nonsense mutations, one in exon 2 found in three Jewish-Iraqi patients from Israel; and another in exon 6 found in an Italian girl. DNA sequencing of exon 2 revealed a G to A transition at nucleotide 83 in the fourth codon of the signal peptide (W-15X). In exon 6, a T to A transversion was found in amino acid 141 (L141X). Both mutations introduced a premature termination codon that led to a truncated non-functioning receptor. In addition we found in the Jewish-Iraqi patients, a mutation in exon 7 (R211H, previously described) and in the Italian family the polymorphism Gly168, in exon 6.
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Affiliation(s)
- O Shevah
- Endocrine and Diabetes Research Unit, Schneider Children's Medical Center, Tel-Aviv University, Israel
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36
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37
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Schiaffini R, Ciampalini P, Fierabracci A, Spera S, Borrelli P, Bottazzo GF, Crinò A. The Continuous Glucose Monitoring System (CGMS) in type 1 diabetic children is the way to reduce hypoglycemic risk. Diabetes Metab Res Rev 2002; 18:324-9. [PMID: 12203948 DOI: 10.1002/dmrr.309] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Diabetic children treated with intensive insulin therapy are showing a dangerous increase in severe hypoglycemic episodes. The Continuous Glucose Monitoring System (CGMS) allows glycemic profiles to be monitored over a 72-h period. The aim of the present study was to evaluate whether this system is sufficiently sensitive to detect asymptomatic hypoglycemia, and to determine if its periodic application would help to minimize the hypoglycemic risk in children with type 1 diabetes mellitus (T1DM). METHODS Twenty-seven T1DM children (age range 6-13.1 years) were enrolled in the study. The sensor was inserted subcutaneously in each patient and the standard four or five registrations of capillary glycemia per day were performed. Eighteen patients continued in the study and the glucose sensor was again inserted after a 6-week interval. At the beginning and end of the study, fructosamine, glycosylated hemoglobin (HbA(1c)), median glycemia, number and duration of hypoglycemic events and insulin requirement were evaluated. RESULTS A significantly higher number of asymptomatic hypoglycemic events was revealed by CGMS in comparison with the standard system (3.6 +/- 2.3 vs 0.7 +/- 0.9; p < 0.0001). In patients who continued in the study, insulin therapy adjustments reduced the incidence of hypoglycemic events (2.5 +/- 1.7 vs 3.9 +/- 2.2; p < 0.05). At the 6-week point, the fructosamine level was reduced (330 +/- 30 vs 349 +/- 24 micro mol/l; p < 0.05). CONCLUSIONS The CGMS is a useful device not only for detecting unrecognized hypoglycemia, but also for modifying insulin therapy in order to reduce hypoglycemic events. The system appears to be useful in avoiding long exposure to hypoglycemia.
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Affiliation(s)
- R Schiaffini
- Unit of Autoimmune Endocrine Diseases, Bambino Gesù Children's Hospital, National Medical Research Institute, Rome, Italy
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38
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Felicetti M, Domenico AD, Salzano P, Borrelli P, Laboccetta A, Borrelli AL. The importance of high resolution transvaginal sonography in early screening of fetal chromosomal pathology. CLIN EXP OBSTET GYN 2001; 28:53-4. [PMID: 11332591] [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: 02/19/2023]
Abstract
BACKGROUND Continuous technological improvement made in the field of ultrasound applied to obstetric diagnostics (see tridimensional sonography) has contributed to a better and non-invasive early diagnosis of fetal malformations. METHODS To evaluate the usefulness of ultrasound in detecting early chromosomal derangements, the authors carried out a high resolution transvaginal sonography (> 6.5 mHz), between the 10th and 14th week of gestational age, on 650 pregnant women at risk for congenital anomalies and afterwards they were subjected to early amniocentesis RESULTS Sonographic fetal anomalies were seen in 61 cases (9.3%). The incidence of fetal anomalies in these cases was 52.5%. Trisomies and number of sexual chromosome anomalies were seen, especially, in the cases of cystic septated hygroma and fetal nuchal translucency > or = 3 mm which are the most frequent sonographic markers of chromosomopathies. CONCLUSIONS Although further studies are necessary, these findings suggest the usefulness of high resolution transvaginal sonography for the early screening of chromosomopathies.
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Affiliation(s)
- M Felicetti
- Obstetrics, Gynacology & Neonatal Department, Faculty of Medicine and Surgery, II University of Naples, Italy
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39
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Salzano P, Felicetti M, Laboccetta A, Borrelli P, Di Domenico A, Borrelli AL. [Prevention of gestational hypertension with calcium, linoleic acid, mono and polyunsaturated fatty acid supplements]. Minerva Ginecol 2001; 53:235-8. [PMID: 11431639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the benefits of calcium, linoleic acid and mono- and polyunsaturated fatty acids in the prevention of gestational hypertension. METHODS Between January 1999 and June 2000, 65 primagravidas with a risk of gestational hypertension between the 20th and 24th week of pregnancy were recruited using Doppler velocimetry of the uterine arteries and Holter 24-h pressure monitoring. Patients with diabetes, hypertensive gestosis and previous renal pathologies were excluded. The patients were divided into 2 unequal groups: Group A (40 patients) was treated with calcium, linoleic acid, and mono and polyunsaturated fatty acid supplements; Group B (25 patients) received no treatment. The patients in both groups underwent Doppler velocimetry of the uterine arteries and Holter pressure monitoring at 28-30-32-35 weeks of gestation. RESULTS Calcium linoleic acid and mono and polyunsaturated fatty acid supplements were effective in significantly reducing the incidence of gestational hypertension (p>0.05); in fact 90% of patients in Group A underwent a physiological evolution of pregnancy compared to only 10% affected by gestational hypertension. In the control group the incidence of this pathology was much higher (32%). CONCLUSIONS The authors conclude that calcium linoleic acid and mono and polyunsaturated fatty acid supplements are useful and effective in the prevention of gestational hypertension in women at risk for this pathology.
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Affiliation(s)
- P Salzano
- Facoltà di Medicina e Chirurgia, Dipartimento di Ostetricia, Ginecologia e Neonatologia, II Università degli Studi, Naples, Italy
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Setti M, Bruzzone B, Ansaldi F, Borrelli P, Indiveri F, Icardi G. Identification of key mutations in HIV reverse transcriptase gene can influence the clinical outcome of HAART. J Med Virol 2001; 64:199-206. [PMID: 11424105 DOI: 10.1002/jmv.1037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Therapeutic failures due to in vivo loss of drug sensitivity are still a major problem in AIDS care. Currently, the role of and methods for detecting resistant mutant strains in patients before therapeutic choices are still under debate. To investigate the relevance of screening for key mutations alone the commercial INNO-LiPA HIV-1 RT method was applied retrospectively to analyzing several HIV codons correlated with resistance to RTI (reverse-transcriptase inhibitors) in sera from 62 patients before starting HAART protocols, selected on the basis of clinical parameters. INNO-LiPA detected several resistant mutant strains, which were strictly consistent with previous selective pressure in the patients. A significant correlation between genotype pattern and response to HAART was found. The presence of key mutations associated with resistance to one or two RTI included in the protocol correlated with a decrease in treatment benefits, whereas patients with wild-type or non-resistant viral strains exhibited better response to HAART. Even if this information had been available when treatment was started, 45 of the patients would not have received different treatment. When compared with the total number of patients, the subgroup receiving a treatment that was considered retrospectively as consistent with the key mutation pattern exhibited a significantly better outcome. Although the interpretation of resistance-related key mutations needs improvement, this surrogate LiPA method seems to maintain a predictive role in the management of HIV infection, and is less expensive.
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Affiliation(s)
- M Setti
- Department of Internal Medicine, University of Genoa, Italy.
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Felicetti M, Di Domenico A, Salzano P, Borrelli P, Borrelli M, Laboccetta A, Di Monaco A, Borrelli AL. [Usefulness of ultrasonography of the cervical canal in the screening of pregnant women at risk of premature labor]. Minerva Ginecol 2001; 53:82-5. [PMID: 11526729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
BACKGROUND Goal of the study is to evaluate the utility of cervical sonography in the second quarter as screening of pregnancies with risk of preterm labor. METHODS A.A. evaluate, by transvaginal sonography (TVS) of the uterine cervix, 75 pregnancies with history of preterm labor and 25 with risk of preterm labor between XXIV and XXXIII week of pregnancy. The uterine cervix length < 40 mm and width > 5 mm, funneling were pathological and predictive factors of preterm labor. RESULTS Eighty-five percent of pregnancies that have, at sonography TVG, abnormal values of length and width of uterine cervix, delivered before XXXVI week. CONCLUSIONS These results confirm the importance of the high frequency ultrasonography transvaginal, TVS, for its predictive value and for treatment in pregnancies with risk of preterm labor.
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Affiliation(s)
- M Felicetti
- Facoltà di Medicina e Chirurgia, Dipartimento di Ostetricia, Ginecologia e Neonatologia, II Università degli Studi, Napoli
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42
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Di Domenico A, Felicetti M, Salzano P, Borrelli P, Borrelli M, Laboccetta A, Di Monaco A, Borrelli AL. [Risk of chromosomal pathology in fetus with abnormal umbilical artery flowmetry]. Minerva Ginecol 2001; 53:78-81. [PMID: 11526728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
BACKGROUND Goal of this study is to consider the incidence of chromosomal abnormalities in fetuses by velocimetry abnormalities. METHODS The author select 64 pregnancies by velocimetry abnormalities of umbilical artery diastolic flow (ARED: Absent or Reverse end Diastolic Flow). RESULTS The fetal cariotype from amniociti or from umbilical blood at delivery moment is resulted abnormal in 5 cases. Fetal-maternal risk factors of chromosomopaties are: malformations; fetal growth retardation; maternal age > or = 35. CONCLUSIONS Other studies and other results are necessary for this discussion.
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Affiliation(s)
- A Di Domenico
- Facoltà di Medicina e Chirurgia, Dipartimento di Ostetricia, Ginecologia e Neonatologia, II Università degli Studi, Napoli
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Cisternino M, Arrigo T, Pasquino AM, Tinelli C, Antoniazzi F, Beduschi L, Bindi G, Borrelli P, De Sanctis V, Farello G, Galluzzi F, Gargantini L, Lo Presti D, Sposito M, Tatò L. Etiology and age incidence of precocious puberty in girls: a multicentric study. J Pediatr Endocrinol Metab 2000; 13 Suppl 1:695-701. [PMID: 10969911 DOI: 10.1515/jpem.2000.13.s1.695] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We review the etiology and age incidence of precocious puberty in 438 girls examined between 1988-1998; 428 (97.7%) had central precocious puberty (CPP), the remaining 10 (2.3%) gonadotropin-independent precocious puberty (GIPP) of ovarian origin. The majority of CPP girls (59.6%) were aged between 7-7.9 yr, 22.4% were 6 year olds, and only 18% were under 6 years old. Cranial CT and/or MRI performed in 304/428 girls, showed neurogenic abnormalities in 56/304 (18.4%) CPP girls; 30 (9.9%) were due to previously diagnosed intracranial abnormalities and the remaining 26 (8.5%) were detected at the diagnosis of CPP. The frequency of neurogenic CPP tended to be higher in girls under 4 years of age while the frequency of idiopathic CPP tended to be higher in girls aged between 7-7.9 years, but no statistically significant differences were found. Interestingly, some CNS anomalies either of tumoral or congenital origin were detected at presentation in 7% of the girls aged over 7 years. Other related or coincidental clinical anomalies, mainly due to genetic diseases, were observed in 22/304 (7.2%) patients. History of precocious maternal menarche was found in 12/304 (4%) girls. In conclusion, idiopathic CPP was observed in 74% of the girls in this study. Neurogenic anomalies or other coincidental or related clinical findings were observed in the remaining 26%. The increased frequency of idiopathic CPP in girls aged over 7 years may suggest an early, but otherwise normal onset of puberty in many of these girls as a consequence of the trend towards earlier maturation. Nonetheless, the finding of CNS anomalies also in the older patients, raises the question of whether these patients should undergo a complete diagnostic work-up.
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Affiliation(s)
- M Cisternino
- Department of Pediatrics, IRCCS Policlinico S. Matteo, University of Pavia, Italy.
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Antoniazzi F, Arrigo T, Cisternino M, Galluzzi F, Bertelloni S, Pasquino AM, Borrelli P, Osio D, Mengarda F, De Luca F, Tatò L. End results in central precocious puberty with GnRH analog treatment: the data of the Italian Study Group for Physiopathology of Puberty. J Pediatr Endocrinol Metab 2000; 13 Suppl 1:773-80. [PMID: 10969920 DOI: 10.1515/jpem.2000.13.s1.773] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report some end results with GnRH agonist (GnRHa) treatment in central precocious puberty (CPP), in terms of final height (FH), ovarian function, peak bone mass, body composition and psychological problems. The two studies reported (Study I and II) are part of the activity of the Italian Study Group for Physiopathology of Puberty. Study L Growth data were analyzed of three groups of patients: treated with i.n. spray buserelin, i.m. triptorelin and untreated. Both GnRHa administration modes were effective in arresting pubertal development and all girls had complete recovery of the reproductive axis after therapy. Treated patients showed an improvement in final height in comparison with untreated patients and compared to predicted height at the start of treatment with both agonist treatments. However, patients treated with the long-acting slow release preparation had a better improvement in adult height and reached or exceeded the genetic height potential. Study II. In a retrospective evaluation of the outcome in 71 girls with idiopathic CPP treated with triptorelin, we found that FH fell within the population norm and the target range in 87.3% and 90% of the patients respectively. The tallest FH was recorded in the patients who started therapy at less than 6 years of age and in those who discontinued treatment at a bone age of 12.0-12.5 yr. Finally, we and other groups have recently found normal values of bone mineral density in girls at the end of GnRHa treatment in the great majority of patients.
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Arrigo T, Cisternino M, Galluzzi F, Bertelloni S, Pasquino AM, Antoniazzi F, Borrelli P, Crisafulli G, Wasniewska M, De Luca F. When to stop GnRH analog therapy: the experience of the Italian Study Group for Physiopathology of Puberty. J Pediatr Endocrinol Metab 2000; 13 Suppl 1:759-64. [PMID: 10969918 DOI: 10.1515/jpem.2000.13.s1.759] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Data reported in this study have been recently published elsewhere. The authors retrospectively analyzed the auxological response to GnRH agonist treatment and the final height (FH) outcome in 71 girls with idiopathic and truly precocious (onset before 8 years) central puberty (CTPP), who had been treated with the same therapy protocol (Decapeptyl Depot at the dose of 60 microg/kg i.m. every 28 days) for at least 2 years (since 7.0 +/- 1.3 yr) and followed until puberty was completed and FH was reached. During the entire treatment period we observed: A) a decrease of height standard deviation scores (SDS) (from 1.5+/-1.7 to 0.9+/-1.3 SDS, p<0.01); B) a striking deceleration of BA, revealed by the subnormal deltaBA:deltaCA ratio (0.2 +/- 0.1); C) an increase of predicted adult height (from 155.6+/-7.0 to 160.7+/-6.7 cm, p<0.0005). Treatment interruption was followed by notable catchdown growth, with FH (158.4 +/- 5.8 cm) lower (p < 0.025) with respect to that predicted at the end of therapy. However FH fell within the population norm and the target range in 87.3% and 90% of patients, respectively. The tallest FH was recorded in the patients who discontinued treatment at a BA of 12.0-12.5 years. We conclude that: 1) Most girls with idiopathic CTPP treated by GnRH agonists may achieve an adult height within the population norm and/or their target range; 2) The height gain from therapy onset until FH attainment, however, is generally rather limited (on average 2.9 cm) and only few patients are able to reach their target percentile; 3) The most favorable height prognosis with respect to target height (TH) is generally observed in the patients with the tallest H2 and the lowest BA2:CA2 ratio, due to the notable deterioration of height prognosis which frequently follows therapy interruption; 4) In order to strengthen the weak therapeutic effect of GnRH agonists in CTPP, this treatment should be discontinued at a BA of 12-12.5 years.
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Affiliation(s)
- T Arrigo
- Institute of Pediatrics, University of Messina, Italy
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46
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Palka G, Stuppia L, Guanciali Franchi P, Chiarelli F, Fischetto R, Borrelli P, Giannotti A, Fioretti G, Rinaldi MM, Mingarelli R, Rappold GA, Calabrese G. Short arm rearrangements of sex chromosomes with haploinsufficiency of the SHOX gene are associated with Leri-Weill dyschondrosteosis. Clin Genet 2000; 57:449-53. [PMID: 10905666 DOI: 10.1034/j.1399-0004.2000.570609.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [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: 11/23/2022]
Abstract
Twelve patients with different features of Turner syndrome, and with Xp and Yp rearrangements involving the pseudoautosomal region (PAR1) are described. In all patients, FISH analysis showed loss of one copy of the Short Stature Homeobox (SHOX)-containing gene. Ten patients had short stature and one disproportionate (mesomelic) normal stature, while the last one had normal stature. Skeletal abnormalities, including shortened ulna, were detected in nine subjects, and in six of them Madelung deformity was observed. These clinical data indicated a genotype phenotype correlation between haploinsufficiency of SHOX, and short stature and skeletal abnormalities.
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Affiliation(s)
- G Palka
- Dipartimento di Scienze Biomediche, Università G D'Annunzio, Chieti, Italy.
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Borrelli P, Imperato A, Murdaca G, Scudeletti M. Liposomal amphotericin B as first line and secondary prophylactic treatment for visceral leishmaniasis in a patient infected with HIV. Ann Ital Med Int 2000; 15:169-71. [PMID: 10920508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Visceral leishmaniasis has emerged in both endemic and non-endemic areas as an opportunistic infection in HIV-positive subjects. At risk for infection are HIV-positive intravenous drug abusers with a low CD4 T cell count and a high HIV viral load. In these patients, who are not always symptomatic, leishmaniasis is probably due to endogenous reactivation and often presents in an atypical fashion. Death results from uncontrolled bleeding or bacterial infections. The clinical and biological spectrum of this disease suggests that it should be included among the diagnostic criteria for AIDS. Visceral leishmaniasis responds poorly to therapy and, when responsive, the relapse rate is high. Treatment protocols and criteria to document cure after treatment have not been definitely established. Lastly, there is no effective immuno- or chemo-prophylaxis against this protozoan. We report the case of an HIV-infected patient affected by visceral leishmaniasis who was successfully treated with liposomal amphotericin B given both as first line and as secondary prophylactic therapy. The patient has remained disease-free for 26 months after his first remission whereas, to our knowledge, almost all immunocompromised patients relapse within 12 months.
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Affiliation(s)
- P Borrelli
- Dipartimento di Medicina Interna, Università degli Studi di Genova
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Patrono C, Rizzo C, Tessa A, Giannotti A, Borrelli P, Carrozzo R, Piemonte F, Bertini E, Dionisi-Vici C, Santorelli FM. Novel 7-DHCR mutation in a child with Smith-Lemli-Opitz syndrome. Am J Med Genet 2000; 91:138-40. [PMID: 10748414 DOI: 10.1002/(sici)1096-8628(20000313)91:2<138::aid-ajmg12>3.0.co;2-q] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Smith-Lemli-Opitz syndrome (SLOS) is an autosomal recessive disorder characterized by minor facial anomalies, mental retardation, and multiple congenital abnormalities. Biochemically, the disorder is caused by deficient activity of 7-dehydrocholesterol reductase, which catalyzes the reduction of the Delta7 double bond of 7-dehydrocholesterol to produce cholesterol. Recently, mutations in the gene encoding 7-dehydrocholesterol reductase (7DHCR) were found to cause SLOS. We report the first molecular characterization of an Italian SLOS patient. Interestingly, his paternal 7DHCR allele, of Arab origin, harbored a novel P329L mutation which in combination with a maternal splice-site (IVS8-1 G>C) mutation resulted in a relatively milder phenotype.
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Affiliation(s)
- C Patrono
- Department of Molecular Medicine, IRCCS Children's Hospital Bambino Gesù, Rome, Italy
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49
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Stuppia L, Calabrese G, Borrelli P, Gatta V, Morizio E, Mingarelli R, Di Gilio MC, Crinò A, Giannotti A, Rappold GA, Palka G. Loss of the SHOX gene associated with Leri-Weill dyschondrosteosis in a 45,X male. J Med Genet 1999; 36:711-3. [PMID: 10507731 PMCID: PMC1734422] [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: 02/14/2023]
Abstract
A male patient is reported with a 45,X karyotype and Leri-Weill dyschondrosteosis (LWD). FISH analysis with SHOX and SRY gene probes was carried out. One copy of both SHOX and SRY was detected in interphase nuclei, clarifying the origin of LWD and the male phenotype. Molecular results suggested that the 45,X karyotype arose through two independent events. The first occurred at paternal meiosis leading to an unequal crossing over between the short arms of the X and Y chromosomes. As a consequence, the SRY gene was translocated onto Xp, thereby explaining the male phenotype of the patient. The second event probably occurred at maternal meiosis or at the early stages of the zygote resulting in the loss of the maternal X chromosome.
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Affiliation(s)
- L Stuppia
- Dipartimento di Scienze Biomediche, Università di Chieti, Italy
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50
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Arrigo T, Cisternino M, Galluzzi F, Bertelloni S, Pasquino AM, Antoniazzi F, Borrelli P, Crisafulli G, Wasniewska M, De Luca F. Analysis of the factors affecting auxological response to GnRH agonist treatment and final height outcome in girls with idiopathic central precocious puberty. Eur J Endocrinol 1999; 141:140-4. [PMID: 10427157 DOI: 10.1530/eje.0.1410140] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of this retrospective study was to analyze the factors which affected the auxological response to GnRH agonist treatment and the final height (FH) outcome in 71 girls with idiopathic and truly precocious (onset before 8 years) central puberty (CTPP) who had been treated with the same therapy protocol (Decapeptyl Depot, 60 microg/kg i.m. every 28 days) for at least 2 years (since 7.0+/-1. 3 (S.D.) years of age) and followed until puberty was completed and FH was reached. During the entire treatment period we observed: (a) a decrease of height standard deviation scores (SDS) (from 1.5+/-1.7 to 0.9+/-1.3 SDS, P<0.01); (b) a striking deceleration of bone age (BA), revealed by the subnormal DeltaBA:Deltachronological age (CA) ratio (0.2+/-0.1); (c) an increase of predicted adult height (from 155.6+/-7.0 to 160.7+/-6.7 cm, P<0.0005). Treatment interruption was followed by an important catch-down growth, with an FH (158.4+/-5.8 cm) lower (P<0.025) than that predicted at the end of therapy. However, FH fell within the population norm and the target range in respectively 87.3 and 90% of the patients. The tallest FH was recorded in the patients who started therapy at less than 6 years of age and in those who discontinued treatment at a BA of 12.0--12.5 years. At stepwise regression analysis, FH in the whole study population was positively affected by the following independent factors: (a) height at the end of therapy (F=45.45, P<0.0001); (b) pretreatment height (F=13.91, P<0.0005); (c) treatment duration (F=8. 51, P<0.005); (d) target height (TH) (F=7.70, P<0.01). We conclude that: (i) most girls with idiopathic CTPP treated by GnRH agonists may achieve an adult height within the population norm and/or their target range; (ii) the height gain from therapy onset until FH attainment, however, is generally rather limited (on average 2.9 cm) and only few patients are able to reach their target percentile; (iii) the most favorable height prognosis with respect to TH is generally observed in the subjects with the tallest height at the end of treatment and the lowest BA2:CA2 ratio, due to the important deterioration of height prognosis which frequently follows therapy interruption; (iv) FH is also significantly conditioned by both TH and treatment duration; (v) in order to strengthen the weak therapeutic effect of GnRH agonists in CTPP this treatment should be started as early as possible and discontinued at a BA of 12.0--12.5 years.
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Affiliation(s)
- T Arrigo
- Institute of Pediatrics, University of Messina, Messina, Italy
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