1.Alopecia areata after COVID-19 vaccination
Giuseppe GALLO ; Luca MASTORINO ; Luca TONELLA ; Simone RIBERO ; Pietro QUAGLINO
Clinical and Experimental Vaccine Research 2022;11(1):129-132
The coronavirus disease 2019 (COVID-19) vaccines are authorized for use in numerous countries worldwide. Several cutaneous findings are reported after severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) vaccination. Here, we report the case of a patient with a rapid onset of alopecia areata immediately after receiving the second dose of the COVID-19 vaccine. Alopecia areata is a common autoimmune disease leading to non-scarring hair loss. Among the many cutaneous adverse effects reported after the anti-SARS-COV2 vaccination, no episodes of alopecia areata have been described to date. In this paper, we report the first case of alopecia areata after COVID-19 vaccination described in the literature with a revision of cases of alopecia areata reported after other types of vaccination. Although the significance of these skin reactions is not yet known, further studies will certainly clarify whether the development of alopecia areata or other forms of immune-mediated reactions could represent a positive prognostic factor regarding immune protection from SARS-CoV-2.
2.Prognostic value of thymidylate synthase, topoisomerase-1 and Ki-67 in advanced colorectal cancer patients on irinotecan and fluorouracil treatment.
Jian-ming XU ; Bu-dong ZHU ; Anita MANGIA ; Gianni SIMONE ; Severino MONTEMURRO ; Francesco GIULIANI ; Evaristo MAIELLO ; Giuseppe COLUCCI ; Angelo PARADISO
Chinese Journal of Oncology 2005;27(5):312-315
OBJECTIVETo investigate the prognostic value of thymidylate synthase (TS), topoisomerase-1 (Topo-1), and proliferating index Ki-67 in advanced colorectal cancer patients on irinotecan (CPT-11) in combination with fluorouracil treatment (5-Fu).
METHODSThe biomarker expression of TS, Topo-1 and Ki-67 in 78 patients detected immunohistochemically were correlated with the clinical outcome.
RESULTSThe expressions of those biomarkers were not correlated with clinical therapeutic response, but with time to progression (TTP) and/or overall survival (OS). Patients with low expression of TS had significantly longer TTP (P < 0.05) and in OS (P < 0.05). The low expression of Ki-67 was also significantly predictive of longer survival (P < 0.05). As compared with any biomarker, the combination of any two biomarkers still possessed no predictive value to therapeutic response, but an enhanced predictive value to prognosis. The median time to progression in patients with low expression of TS, or Ki-67, or both were 9, 8 and 17 months, respectively; in patients with low expression of TS, or Topo-1, or both were 9, 9 and 13 months; in patients with low expression of Topo-1, or Ki-67, or both were 8, 9 and 11 months. TTP was significantly longer in patients with low expression of two biomarkers as compared with those with high expression (P = 0.031).
CONCLUSIONTS, Topo-1, and Ki-67 are not predictive for chemotherapy response to CPT-11 combined with 5-Fu, but valuable in predicting prognosis. The combination of any two biomarkers can provide more powerful prognostic information for advanced colorectal cancer patients.
Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Biomarkers, Tumor ; metabolism ; Camptothecin ; administration & dosage ; analogs & derivatives ; Colorectal Neoplasms ; drug therapy ; enzymology ; DNA Topoisomerases, Type I ; metabolism ; Female ; Fluorouracil ; administration & dosage ; Humans ; Ki-67 Antigen ; metabolism ; Male ; Middle Aged ; Prognosis ; Thymidylate Synthase ; metabolism ; Treatment Outcome
3.Impaired Colonic Contractility and Intestinal Permeability in Symptomatic Uncomplicated Diverticular Disease
Annamaria ALTOMARE ; Manuele GORI ; Silvia COCCA ; Simone CAROTTI ; Maria FRANCESCONI ; Mentore RIBOLSI ; Sara EMERENZIANI ; Giuseppe PERRONE ; Sergio MORINI ; Michele CICALA ; Michele P L GUARINO
Journal of Neurogastroenterology and Motility 2021;27(2):292-301
Background/Aims:
Impaired intestinal motility seems to play a crucial role in symptomatic uncomplicated diverticular disease (SUDD), although the mechanism is not clear. The aim of the present study is to explore the contractility patterns of colonic smooth muscle strips (MS) and smooth muscle cells (SMCs) and to assess mucosal integrity in SUDD patients.
Methods:
MS or SMCs were isolated from specimens of human distal colon of 18 patients undergoing surgery for non-obstructive colonic cancer, among them 9 with SUDD. Spontaneous phasic contractions on strips and morpho-functional parameters on cells were evaluated in basal conditions and in response to acetylcholine (ACh). Mucosal integrity of SUDD colonic biopsies was evaluated by the Ussing Chamber system. Immunohistochemical staining for tight junction protein complex and for Toll-like receptor 4 (TLR4) was performed.
Results:
Colonic MS of SUDD group showed a significant reduced basal tone and ACh-elicited contraction, compared to the control group (9.5 g and 47.0% in the SUDD group; 14.16 g and 69.0% in the control group; P < 0.05). SMCs of SUDD group showed a maximal contractile response to ACh significantly reduced compared to control group (8.8% vs 16.5%, P < 0.05). SUDD patients displayed lower transepithelial electrical resistance and increased paracellular permeability compared to control group. Immunohistochemical expression of TLR4 was not different in both groups, while tight junction protein complex expression was lower in SUDD patients compared to control group patients.
Conclusion
It could be hypothesized that in SUDD, in absence of severe inflammation, an increased intestinal mucosal permeability is related to altered colonic motility probably responsible for symptoms genesis.
4.Omic Approach in Non-smoker Female with Lung Squamous Cell Carcinoma Pinpoints to Germline Susceptibility and Personalized Medicine.
Margherita BALDASSARRI ; Chiara FALLERINI ; Francesco CETTA ; Marco GHISALBERTI ; Cristiana BELLAN ; Simone FURINI ; Ottavia SPIGA ; Sergio CRISPINO ; Giuseppe GOTTI ; Francesca ARIANI ; Piero PALADINI ; Alessandra RENIERI ; Elisa FRULLANTI
Cancer Research and Treatment 2018;50(2):356-365
PURPOSE: Lung cancer is strongly associated to tobacco smoking. However, global statistics estimate that in females the proportion of lung cancer cases that is unrelated to tobacco smoking reaches fifty percent, making questionable the etiology of the disease. MATERIALS AND METHODS: A never-smoker female with primary EGFR/KRAS/ALK-negative squamous cell carcinoma of the lung and their normal sibswere subjected to a novel integrative “omic” approach using a pedigree-based model for discovering genetic factors leading to cancer in the absence of well-known environmental trigger. A first-stepwhole-exome sequencing on tumor and normal tissue did not identify mutations in known driver genes. Building on the idea of a germline oligogenic origin of lung cancer, we performed whole-exome sequencing of DNA from patients' peripheral blood and their unaffected sibs. Finally, RNA-sequencing analysis in tumoral and matched non-tumoral tissues was carried out in order to investigate the clonal profile and the pathogenic role of the identified variants. RESULTS: Filtering for rare variants with Combined Annotation Dependent Depletion (CADD) > 25 and potentially damaging effect, we identified rare/private germline deleterious variants in 11 cancer-associated genes, none ofwhich, except one, sharedwith the healthy sib, pinpointing to a “private” oligogenic germline signature. Noteworthy, among these, two mutated genes, namely ACACA and DEPTOR, turned to be potential targets for therapy because related to known drivers, such as BRCA1 and EGFR. CONCLUSION: In the era of precision medicine, this report emphasizes the importance of an “omic” approach to uncover oligogenic germline signature underlying cancer development and to identify suitable therapeutic targets as well.
Carcinoma, Squamous Cell*
;
Disease Susceptibility
;
DNA
;
Epithelial Cells*
;
Exome
;
Female*
;
High-Throughput Nucleotide Sequencing
;
Humans
;
Lung Neoplasms
;
Lung*
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Multifactorial Inheritance
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Precision Medicine*
;
Smoking
5.Impaired Colonic Contractility and Intestinal Permeability in Symptomatic Uncomplicated Diverticular Disease
Annamaria ALTOMARE ; Manuele GORI ; Silvia COCCA ; Simone CAROTTI ; Maria FRANCESCONI ; Mentore RIBOLSI ; Sara EMERENZIANI ; Giuseppe PERRONE ; Sergio MORINI ; Michele CICALA ; Michele P L GUARINO
Journal of Neurogastroenterology and Motility 2021;27(2):292-301
Background/Aims:
Impaired intestinal motility seems to play a crucial role in symptomatic uncomplicated diverticular disease (SUDD), although the mechanism is not clear. The aim of the present study is to explore the contractility patterns of colonic smooth muscle strips (MS) and smooth muscle cells (SMCs) and to assess mucosal integrity in SUDD patients.
Methods:
MS or SMCs were isolated from specimens of human distal colon of 18 patients undergoing surgery for non-obstructive colonic cancer, among them 9 with SUDD. Spontaneous phasic contractions on strips and morpho-functional parameters on cells were evaluated in basal conditions and in response to acetylcholine (ACh). Mucosal integrity of SUDD colonic biopsies was evaluated by the Ussing Chamber system. Immunohistochemical staining for tight junction protein complex and for Toll-like receptor 4 (TLR4) was performed.
Results:
Colonic MS of SUDD group showed a significant reduced basal tone and ACh-elicited contraction, compared to the control group (9.5 g and 47.0% in the SUDD group; 14.16 g and 69.0% in the control group; P < 0.05). SMCs of SUDD group showed a maximal contractile response to ACh significantly reduced compared to control group (8.8% vs 16.5%, P < 0.05). SUDD patients displayed lower transepithelial electrical resistance and increased paracellular permeability compared to control group. Immunohistochemical expression of TLR4 was not different in both groups, while tight junction protein complex expression was lower in SUDD patients compared to control group patients.
Conclusion
It could be hypothesized that in SUDD, in absence of severe inflammation, an increased intestinal mucosal permeability is related to altered colonic motility probably responsible for symptoms genesis.
6.Is a Preoperative Assessment of the Early Recurrence of Pancreatic Cancer Possible after Complete Surgical Resection?.
Marco LA TORRE ; Giuseppe NIGRI ; Annalisa LO CONTE ; Federica MAZZUCA ; Simone Maria TIERNO ; Adelona SALAJ ; Paolo MARCHETTI ; Vincenzo ZIPARO ; Giovanni RAMACCIATO
Gut and Liver 2014;8(1):102-108
BACKGROUND/AIMS: The prognosis of pancreatic adenocarcinoma (PAC) is poor. The serum carbohydrate antigen 19-9 (CA 19-9) level has been identified as a prognostic indicator of recurrence and reduced overall survival. The aim of this study was to identify preoperative prognostic factors and to create a prognostic model able to assess the early recurrence risk for patients with resectable PAC. METHODS: A series of 177 patients with PAC treated surgically at the St. Andrea Hospital of Rome between January 2003 and December 2011 were reviewed retrospectively. Univariate and multivariate analyses were utilized to identify preoperative prognostic indicators. RESULTS: A preoperative CA 19-9 level >228 U/mL, tumor size >3.1 cm, and the presence of pathological preoperative lymph nodes statistically correlated with early recurrence. Together, these three factors predicted the possibility of an early recurrence with 90.4% accuracy. The combination of these three preoperative conditions was identified as an independent parameter for early recurrence based on multivariate analysis (p=0.0314; hazard ratio, 3.9811; 95% confidence interval, 1.1745 to 15.3245). CONCLUSIONS: PAC patient candidates for surgical resection should undergo an assessment of early recurrence risk to avoid unnecessary and ineffective resection and to identify patients for whom palliative or alternative treatment may be the treatment of choice.
Adenocarcinoma/*diagnosis/surgery
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Aged
;
CA-19-9 Antigen/blood
;
Feasibility Studies
;
Female
;
Humans
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Male
;
*Models, Biological
;
Neoplasm Recurrence, Local/*diagnosis
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Pancreatic Neoplasms/*diagnosis/surgery
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Prognosis
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Retrospective Studies
;
Tumor Markers, Biological/*blood
7.International multi-center study on clinical efficiency of robot-assisted laparoscopic partial nephrectomy in the treatment of clinical T2 renal tumors
Fei GUO ; Chao ZHANG ; Fubo WANG ; Linhui WANG ; Qing YANG ; Huamao YE ; Chen LYU ; Chengwu XIAO ; Yang WANG ; Simone GIUSEPPE ; Derweesh ITHAAR ; Minervini ANDREA ; Eun DANIEL ; Porpiglia FRANCESCO ; Perdona SISTO ; Porter JAMES ; Ferro MATTEO ; Mottrie ALEXANDRE ; Uzzo ROBERT ; Schips LUIGI ; White WESLEY ; Jacobsohn KEN ; Dasgupta PROKAR ; Autorino RICCARDO ; Lau CLAYTON ; Sundaram CHANDRU ; Capitanio UMBERTO ; Yinghao SUN ; Bo YANG
Chinese Journal of Urology 2018;39(6):407-412
Objective To analyze the safety and effectiveness of robot-assisted laparoscopic partial nephrectomy(RLPN) for cT2 renal tumors in international multi-centers.Methods This study was conducted to collect information on surgical procedures performed by RLPN and robot assisted laparoscopic radical nephrectomy (RRN) in nineteen international urological centers from January 2012 to December 2017.RLPN were performed in 159 patients (118 males and 41 females),with the average age of (59.3 ± 13.2) years,body mass index(BMI) of (28.7 ± 5.4)kg/m2,preoperative GFR of (77.3 ± 22.1) ml/min.RRN were performed in 219 patients,with the average age of (62.0 ± 12.9) years,BMI of (28.7 ±6.1) kg/m2,preoperative GFR of (71.4 ± 20.3) ml/min.There was no statistical difference between the two groups in gender and BMI.The age of the patients in RLPN group was younger than that in RRN group,and the preoperative GFR was better.The patient's baseline demographics,perioperative data,tumor pathology,oncologic outcomes,and renal function (GFR) were recorded.Results All 378 cases underwent successful surgery.The operation time of RLPN was 150 min(65-353 min),which was shorter than that of RRN [180 min(85-361 min),P < 0.001].The intra-operative blood loss of RLPN was more than that of RRN [150 ml (40-3 000 ml) vs.100 ml (10-1 100 ml),P < 0.001].The incidence of intra-operative complications were not statistically different between the two groups [5.7% (9/159) vs.3.2% (7/219),P =0.240].The incidence of postoperative complications was higher in the RLPN group than that in RRN group [19.5% (31/159) vs.10.5% (23/219),P =0.014],but there was no significant difference in the incidence of complications of grade 3 or above [4.4% (7/159) vs.2.3% (5/219),P =0.246].The recurrence-free survival rate of RLPN group was higher than that of RRN group [91.4% (117/128) vs.81.9% (167/204),P =0.013],and RLPN group was more conducive to renal function protection (P < 0.001).Conclusions RLPN for cT2 tumors can obtain effective tumor control rate and better renal function preservation.It could be an acceptable alternative for surgical management of cT2 tumors.
8.History of Migraine and Volume of Brain Infarcts: The Italian Project on Stroke at Young Age (IPSYS)
Valeria De GIULI ; Michele BESANA ; Mario GRASSI ; Marialuisa ZEDDE ; Andrea ZINI ; Corrado LODIGIANI ; Simona MARCHESELLI ; Anna CAVALLINI ; Giuseppe MICIELI ; Maurizia RASURA ; Maria Luisa DELODOVICI ; Giampaolo TOMELLERI ; Nicoletta CHECCARELLI ; Alberto CHITI ; Elisa GIORLI ; Massimo Del SETTE ; Lucia TANCREDI ; Antonella TORIELLO ; Massimiliano BRAGA ; Andrea MOROTTI ; Loris POLI ; Filomena CARIA ; Massimo GAMBA ; Rosalba PATELLA ; Alessandra SPALLONI ; Anna Maria SIMONE ; Rosario PASCARELLA ; Sandro BERETTA ; Enrico FAINARDI ; Alessandro PADOVANI ; Roberto GASPAROTTI ; Alessandro PEZZINI ;
Journal of Stroke 2019;21(3):324-331
BACKGROUND AND PURPOSE: Migraine has been shown to increase cerebral excitability, promote rapid infarct expansion into tissue with perfusion deficits, and result in larger infarcts in animal models of focal cerebral ischemia. Whether these effects occur in humans has never been properly investigated. METHODS: In a series of consecutive patients with acute ischemic stroke, enrolled in the setting of the Italian Project on Stroke at Young Age, we assessed acute as well as chronic infarct volumes by volumetric magnetic resonance imaging, and compared these among different subgroups identified by migraine status. RESULTS: A cohort of 591 patients (male, 53.8%; mean age, 37.5±6.4 years) qualified for the analysis. Migraineurs had larger acute infarcts than non-migraineurs (median, 5.9 cm³ [interquartile range (IQR), 1.4 to 15.5] vs. 2.6 cm³ [IQR, 0.8 to 10.1], P<0.001), and the largest volumes were observed in patients with migraine with aura (median, 9.0 cm³ [IQR, 3.4 to 16.6]). In a linear regression model, migraine was an independent predictor of increased log (acute infarct volumes) (median ratio [MR], 1.64; 95% confidence interval [CI], 1.22 to 2.20), an effect that was more prominent for migraine with aura (MR, 2.92; 95% CI, 1.88 to 4.54). CONCLUSIONS: These findings reinforce the experimental observation of larger acute cerebral infarcts in migraineurs, extend animal data to human disease, and support the hypothesis of increased vulnerability to ischemic brain injury in people suffering migraine.
Animals
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Brain Injuries
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Brain Ischemia
;
Brain
;
Cohort Studies
;
Cortical Spreading Depression
;
Humans
;
Linear Models
;
Magnetic Resonance Imaging
;
Migraine Disorders
;
Migraine with Aura
;
Models, Animal
;
Perfusion
;
Risk Factors
;
Stroke
9.Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic
Giorgio BOGANI ; Giovanni SCAMBIA ; Chiara CIMMINO ; Francesco FANFANI ; Barbara COSTANTINI ; Matteo LOVERRO ; Gabriella FERRANDINA ; Fabio LANDONI ; Luca BAZZURINI ; Tommaso GRASSI ; Domenico VITOBELLO ; Gabriele SIESTO ; Anna Myriam PERRONE ; Vanna ZANAGNOLO ; Pierandrea DE IACO ; Francesco MULTINU ; Fabio GHEZZI ; Jvan CASARIN ; Roberto BERRETTA ; Vito A CAPOZZI ; Errico ZUPI ; Gabriele CENTINI ; Antonio PELLEGRINO ; Silvia CORSO ; Guido STEVENAZZI ; Serena MONTOLI ; Anna Chiara BOSCHI ; Giuseppe COMERCI ; Pantaleo GRECO ; Ruby MARTINELLO ; Francesco SOPRACORDEVOLE ; Giorgio GIORDA ; Tommaso SIMONCINI ; Marta CARETTO ; Enrico SARTORI ; Federico FERRARI ; Antonio CIANCI ; Giuseppe SARPIETRO ; Maria Grazia MATARAZZO ; Fulvio ZULLO ; Giuseppe BIFULCO ; Michele MORELLI ; Annamaria FERRERO ; Nicoletta BIGLIA ; Fabio BARRA ; Simone FERRERO ; Umberto Leone Roberti MAGGIORE ; Stefano CIANCI ; Vito CHIANTERA ; Alfredo ERCOLI ; Giulio SOZZI ; Angela MARTOCCIA ; Sergio SCHETTINI ; Teresa ORLANDO ; Francesco G CANNONE ; Giuseppe ETTORE ; Andrea PUPPO ; Martina BORGHESE ; Canio MARTINELLI ; Ludovico MUZII ; Violante Di DONATO ; Lorenza DRIUL ; Stefano RESTAINO ; Alice BERGAMINI ; Giorgio CANDOTTI ; Luca BOCCIOLONE ; Francesco PLOTTI ; Roberto ANGIOLI ; Giulia MANTOVANI ; Marcello CECCARONI ; Chiara CASSANI ; Mattia DOMINONI ; Laura GIAMBANCO ; Silvia AMODEO ; Livio LEO ; Raphael THOMASSET ; Diego RAIMONDO ; Renato SERACCHIOLI ; Mario MALZONI ; Franco GORLERO ; Martina Di LUCA ; Enrico BUSATO ; Sami KILZIE ; Andrea DELL'ACQUA ; Giovanna SCARFONE ; Paolo VERCELLINI ; Marco PETRILLO ; Salvatore DESSOLE ; Giampiero CAPOBIANCO ; Andrea CIAVATTINI ; Giovanni Delli CARPINI
Journal of Gynecologic Oncology 2022;33(1):e10-
Objective:
Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients.
Methods:
This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak.
Results:
Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001).
Conclusion
Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic.