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1. The natural history and surgical outcome of patients with scimitar syndrome: a multi-centre European study

Author

Vida, Vladimiro L, Guariento, Alvise, Milanesi, Ornella, Gregori, Dario, Stellin, Giovanni, Zucchetta F, Zanotto L, Padalino MA, Castaldi B, Bosiznik S, Crepaz R, Stuefer J, de Maria Garcia Gonzales F, Castaneda AR, Crupi G, Agnoletti G, Bondanza S, Marasini M, Zannini L, Butera G, Frigiola A, Varrica A, Chiappa E, Pilati M, Carotti A, Matteo T, Prandstraller D, Gargiulo G, Giovanna Russo M, Santoro G, Caianiello G, Spadoni I, Murzi B, Arcieri L, Pozzi M, Porcedda G, Berggren H, Carrel T, Kadner A, Çiçek S, Zorman Y, Fragata J, Gordo A, Hazekamp M, Sojak V, Hraska V, Asfour B, Maruszewski B, Kozlowski M, Metras D, Pretre R, Rubay J, Sairanen H, Sarris G, Schreiber C, Ono M, Meyns B, Van den Bossche K, Tlaskal T, Lo Rito M, Joon Yoo S, Van Arsdell GS, Calderone C, Iwamoto Y, Leon-Wyss J, Di Filippo S, Leconte C, Mulder BJ, Ebels T, Arrigoni S, Valsangiacomo E, Hitendu D, Konstantinov IE, Gamillscheg A, Gabriela D, Herberg U, Dulac Y, Edmerger J, Zarate Fuentes A, Miguel Gil Jaurena J, Bo I, Ghez O, Rigby ML, Bacha EA, Kalfa D, Speggiorin S, Bu'Lock F, Al-Ahmadi M, Di Salvo G, Surmacz R, Yemets IM, Mykychak YB, Lugones I, Cameron DE, Vricella LA, Troconis CJ, Thiene G, Angelini A, Zanotto L., Vida, Vladimiro L, Guariento, Alvise, Milanesi, Ornella, Gregori, Dario, Stellin, Giovanni, Zucchetta F, Zanotto L, Padalino MA, Castaldi B, Bosiznik S, Crepaz R, Stuefer J, de Maria Garcia Gonzales F, Castaneda AR, Crupi G, Agnoletti G, Bondanza S, Marasini M, Zannini L, Butera G, Frigiola A, Varrica A, Chiappa E, Pilati M, Carotti A, Matteo T, Prandstraller D, Gargiulo G, Giovanna Russo M, Santoro G, Caianiello G, Spadoni I, Murzi B, Arcieri L, Pozzi M, Porcedda G, Berggren H, Carrel T, Kadner A, Çiçek S, Zorman Y, Fragata J, Gordo A, Hazekamp M, Sojak V, Hraska V, Asfour B, Maruszewski B, Kozlowski M, Metras D, Pretre R, Rubay J, Sairanen H, Sarris G, Schreiber C, Ono M, Meyns B, Van den Bossche K, Tlaskal T, Lo Rito M, Joon Yoo S, Van Arsdell GS, Calderone C, Iwamoto Y, Leon-Wyss J, Di Filippo S, Leconte C, Mulder BJ, Ebels T, Arrigoni S, Valsangiacomo E, Hitendu D, Konstantinov IE, Gamillscheg A, Gabriela D, Herberg U, Dulac Y, Edmerger J, Zarate Fuentes A, Miguel Gil Jaurena J, Bo I, Ghez O, Rigby ML, Bacha EA, Kalfa D, Speggiorin S, Bu'Lock F, Al-Ahmadi M, Di Salvo G, Surmacz R, Yemets IM, Mykychak YB, Lugones I, Cameron DE, Vricella LA, Troconis CJ, Thiene G, Angelini A, Zanotto L., Cardiology, APH - Personalized Medicine, APH - Aging & Later Life, ACS - Heart failure & arrhythmias, Cardiothoracic Surgery, Zucchetta, F, Zanotto, L, Padalino, Ma, Castaldi, B, Bosiznik, S, Crepaz, R, Stuefer, J, De Maria Garcia Gonzales, F, Castaneda, Ar, Crupi, G, Agnoletti, G, Bondanza, S, Marasini, M, Zannini, LUIGI PIERO, Butera, G, Frigiola, A, Varrica, A, Chiappa, E, Pilati, M, Carotti, A, Matteo, T, Prandstraller, D, Gargiulo, G, Giovanna Russo, M, Santoro, G, Caianiello, G, Spadoni, I, Murzi, B, Arcieri, L, Pozzi, M, Porcedda, G, Berggren, H, Carrel, T, Kadner, A, Çiçek, S, Zorman, Y, Fragata, J, Gordo, A, Hazekamp, M, Sojak, V, Hraska, V, Asfour, B, Maruszewski, B, Kozlowski, M, Metras, D, Pretre, R, Rubay, J, Sairanen, H, Sarris, G, Schreiber, C, Ono, M, Meyns, B, Van Den Bossche, K, Tlaskal, T, Lo Rito, M, Joon Yoo, S, Van Arsdell, G, Calderone, C, Iwamoto, Y, Leon-wyss, J, Di Filippo, S, Leconte, C, Mulder, Bj, Ebels, T, Arrigoni, S, Valsangiacomo, E, Hitendu, D, Konstantinov, Ie, Gamillscheg, A, Gabriela, D, Herberg, U, Dulac, Y, Edmerger, J, Zarate Fuentes, A, Miguel Gil Jaurena, J, Bo, I, Ghez, O, Rigby, Ml, Bacha, Ea, Kalfa, D, Speggiorin, S, Bu'Lock, F, Al-ahmadi, M, Di Salvo, G, Surmacz, R, Yemets, Im, Mykychak, Yb, Lugones, I, Cameron, De, Vricella, La, Troconis, Cj, Thiene, G, Angelini, A, Zanotto, L., and University of Zurich

Subjects
Male, Pediatrics, medicine.medical_specialty, Time Factors, Natural history, 610 Medicine & health, Congenital heart defect, Multi-centre study, Surgery, 030204 cardiovascular system & hematology, Asymptomatic, 2705 Cardiology and Cardiovascular Medicine, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Scimitar syndrome, medicine, Humans, Registries, Cardiac Surgical Procedures, Retrospective Studies, business.industry, Incidence (epidemiology), Incidence, Scimitar Syndrome, Infant, Newborn, Infant, Retrospective cohort study, Odds ratio, medicine.disease, Pulmonary hypertension, Echocardiography, Doppler, Europe, Survival Rate, Stenosis, Treatment Outcome, 030228 respiratory system, 10036 Medical Clinic, Pulmonary Veins, Child, Preschool, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

Aims Treatment decisions in patients with scimitar syndrome (SS) are often challenging, especially in patients with isolated SS who are often asymptomatic and who might be diagnosed accidentally. We queried a large multi-institutional registry of SS patients to evaluate the natural history of this condition and to determine the efficacy of surgical treatment in terms of survival and clinical status. Methods and results We collected data on 485 SS patients from 51 institutions; 279 (57%) patients were treated surgically (STPs) and 206 (43%) were clinically monitored (CMPs). Median age at last follow-up was 11.6 years (interquartile range 4-22 years). Overall survival probability at 30 years of age was 88% [85-92% confidence intervals (CI)] and was lower in patients with associated congenital heart disease (CHD) (P

Published
2018
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2. Geographical variability of patient characteristics and treatment patterns affect outcomes for incident hemodialysis patients

Author

Martin-Malo, A., Papadimitriou, M., Cruz, J., Bustamante, J., Verbeelen, D., Nony, A., Vanholder, R., Jacobson, S. H., Montenegro, J., Hannedouche, T., Wizemann, V., Locatelli, F., La Milia, V., Pozzi, M., Di Filippo, S., La Greca, G., Ronco, C., Brendolan, A., Crepaldi, C., Stefoni, S., Ciancialo, G., Baraldi, O., Maschio, G., Loschiavo, C., Barbieri, C., Milanesi, F., Redaelli, B., Stella, A., Vigano, M. R., Stellato, T., Villa, G., Segagli, S., Montagna, G., Quarello, F., Vallero, A., Forneris, G., Borghi, M., Tagliaferri, M., Palmerio, G., Imbasciati, E., Farina, M., Bucci, R., Stallone, C., Aucella, F., Bellazzi, C., De Vincenti, A., Giannattasio, M., Detomaso, F., Malberti, F., Pecchini, P., Fabris, A., Zanella, M., Feriani, M., Genchi, R., Fraticelli, M., D'Amico, M., Bernardi, L. E., Palumbo, R., De Cicco, C., Czekalski, S., Pietrzak, I., Drobnik, M., Weyde, W., Krajewska, M., Penar, J., Aljama, P., Martin Malo, A., Berdud, I., Alvarez De Lara, M. A., Navas, A., Martin Garcia, J., Chacon, J. C., Junco, E., Lopez Gomez, J. M., Villaverde, M., Martin Garcia, D., Sanchez, L., Ocharan, J., Barril, G., Besada, E., Pastor, J. M., Gallar, P., Almaraz, M., Alcala, M., Silgado, G., Gruss, E., Portoles, J. M., Delgado, R., Bittar, H., Chanard, J., Randoux, C., Maheut, H., Dimitrov, Y., Bouiller, M., Simon, P., Ang, K. S., Cremault, A., Ryckelynck, J. -P., Levaltier, B., Jonon, B., Saidani, F., Maurice, F., Kessler, M., Hachicha, M., Reach, I., Bataille, P., Nour, D., Loureiro, A., Paiva, A., Carvalho, D., Buinho, F., Santos, J. P., Sotto, K., Sousa, S., Da Cruz, L., Henriques, C., Santos, J., Vinhas, J., Assuncao, J., Memmos, D., Belechri, A. M., Giamalis, P., Dhondt, A., Veys, N., Van Biesen, W., Krzesinski, J. -M., Tielemans, C., Lins, R., Larsson, K., Kurkus, J., Weiss, L., Welander, G., Seidel, S., Lotz, C., Gruber, H., Weinreich, T., Rawer, P., Martin-Malo, Alejandro, Papadimitriou, Menelao, Cruz, Joao, Bustamante, Jesu, Verbeelen, Dierik, Nony, Alain, Vanholder, Raymond, Jacobson, Stefan H., Montenegro, Jesu, Hannedouche, Thierry, Wizemann, Volker, Locatelli, Francesco, Membrane Permeability Outcome (MPO) Study Group [.., Baraldi, Olga, and ].

Subjects
Male, Pediatrics, Epidemiology, Prevalence, Comorbidity, Kaplan-Meier Estimate, Comorbidities, Renal Dialysi, Cardiovascular Disease, Medicine, education.field_of_study, Europe, Hemodialysis, Mortality, Practice patterns, Hazard ratio, Diabetes Mellitu, Vascular Access Device, Middle Aged, Treatment Outcome, Cardiovascular Diseases, Nephrology, Female, Comorbiditie, Hemodialysi, Vascular Access Devices, Human, medicine.medical_specialty, Membrane permeability, Population, Permeability, Practice pattern, Renal Dialysis, Confidence Intervals, Diabetes Mellitus, Humans, Renal Insufficiency, Chronic, education, Survival analysis, Serum Albumin, Proportional Hazards Models, Aged, Analysis of Variance, business.industry, Proportional hazards model, Membranes, Artificial, Cholesterol, LDL, medicine.disease, Proportional Hazards Model, Calcium, business, Confidence Interval, Demography, Kidney disease
Abstract

Background: Geographical differences in disease prevalence and mortality have been described in the general population and in chronic kidney disease patients in Europe. In this secondary analysis of the Membrane Permeability Outcome (MPO) study, we addressed differences in patient and treatment patterns, and whether these affect patient outcomes. Methods: Participating countries were grouped according to geographical location; thus study centers in France, Greece, Italy, Portugal and Spain were allocated to southern Europe (n=499), and those in all other countries (Belgium, Germany, Poland and Sweden) to northern Europe (n=148). Descriptive analysis of patient and treatment patterns at study start, as well as survival analysis, was performed. Results: In patients from the northern European countries, a higher prevalence of diabetes mellitus and of cardiovascular disease was observed than in those from southern Europe (diabetes 35.1% vs. 21.0%, p=0.0007; cardiovascular disease 40.5% vs. 22.8%, p

Published
2013

3. Caractéristiques et suivi prospectif sur deux ans des enfants atteints d'hypertension artérielle pulmonaire

Author

Fraisse, Alain, Jais, Xavier, Schleich, Jean-Marc, di Filippo, S., Maragnes, P., Beghetti, Maurice, Gressin, V., Voisin, M., Dauphin, C., Clerson, P., Godart, F., and Bonnet, D.

Subjects
Male, Questionnaires, Time Factors, Adolescent, Kaplan-Meier Estimate, France/epidemiology, Disease-Free Survival, Heart Defects, Congenital/complications/epidemiology, Risk Factors, Prevalence, Humans, Genetic Predisposition to Disease, Prospective Studies, Child, ddc:618, Antihypertensive Agents/therapeutic use, Hemodynamics, Infant, Treatment Outcome, Child, Preschool, Exercise Test, Quality of Life, Educational Status, Hypertension, Pulmonary/diagnosis/drug therapy/*epidemiology/etiology/mortality, Female, Follow-Up Studies
Abstract

BACKGROUND: Limited data are available describing paediatric pulmonary arterial hypertension. AIMS: To characterize the epidemiology, management and impact on quality of life and outcome of paediatric pulmonary arterial hypertension, excluding persistent pulmonary hypertension of the newborn and pulmonary arterial hypertension caused by congenital heart disease. METHODS: In this multicentre study, children with pulmonary arterial hypertension were included and followed prospectively for two years at 21 referral centres in France. WHO functional class, 6-minute walk distance and quality of life (CHQ-PF50 questionnaire) were evaluated. RESULTS: Fifty children were included with a mean age of 8.9 +/- 5.4 years from May 2005 until June 2006. The estimated prevalence for pulmonary arterial hypertension was 3.7 cases/million. Patients had idiopathic pulmonary arterial hypertension (60%), familial pulmonary arterial hypertension (10%), pulmonary arterial hypertension associated with, but not caused by, congenital heart disease (24%), pulmonary arterial hypertension associated with connective tissue disease (4%) or portal hypertension (2%). During follow-up, the combination of pulmonary arterial hypertension-specific therapies was increasingly prescribed (44% patients versus 22% at inclusion). Patients remained stable regarding clinical status, 6-minute walk distance and quality of life. Survival estimates after one and two years were 86% (95% CI 76, 96) and 82% (95% CI 71, 93), respectively. CONCLUSIONS: In children, idiopathic/familial pulmonary arterial hypertension accounts for the majority of cases. A specific pulmonary arterial hypertension group in conjunction with congenital heart disease can be identified that resembles patients with idiopathic pulmonary arterial hypertension. Combined pulmonary arterial hypertension-specific therapies may have contributed to disease stability and favourable survival.

Published
2010

4. Prognostic Factors Influencing Tumor Response, Locoregional Control and Survival, in Melanoma Patients with Multiple Limb In-transit Metastases Treated with TNF alpha-based Isolated Limb Perfusion

Author

Di Filippo, F., Giacomini, P., Rossi, C. R., Mario Santinami, Anza, M., Garinei, R., Perri, P., Botti, C., Di Angelo, P., Sofra, C., Pasqualoni, R., Sperduti, I., Cavaliere, F., Di Filippo, S., Corrias, F., Armenti, A., Ferraresi, V., and Ginebri, A.

Subjects
Adult, Aged, 80 and over, Male, Maximum Tolerated Dose, Tumor Necrosis Factor-alpha, Regional perfusion, TNF, melanoma, prognostic factors, in-transit metastases, Extremities, Middle Aged, Prognosis, Perfusion, Treatment Outcome, Humans, Female, Neoplasm Metastasis, Melphalan, Aged
Abstract

In isolated limb perfusion (ILP) with tumor necrosis factor-alpha (TNFalpha) and interferon (IFN)-gamma, pioneered by Lienard and Lejenne in 1988, TNFalpha was empirically employed at a dosage (3-4 mg) ten times higher than the systemic maximum tolerable dose (MTD). We previously conducted a phase I/II study in 20 patients with in-transit melanoma metastases, using a combination of melphalan and TNFalpha at dosages ranging from 0.5 to 3.3 mg. The dose of 1 mg of TNFalpha was identified as optimal in terms of both efficacy and toxicity. The aim of the present study was to describe our experience with 113 stage IIIA/IIIAB melanoma patients treated with a TNFalpha-based ILP and identify prognostic factors for response, locoregional control and survival.Patients at stage IIIA-IIIAB (presence of in-transit metastases and/or regional node involvement) were considered eligible. The disease was bulky (or=10 nodulesor=3 cm or fewer nodules with a diameter3 cm) in 42.5% of the patients and unresectable in 33% . Forty patients were treated with a TNFalpha dosage of1 mg and 73 with 1 mg. Patients with tumors in the upper and lower limbs were submitted to ILP via axillary and iliac vessels, respectively. TNFalpha was injected in the arterial line of an extracorporeal circuit at the pre-established dose, followed by melphalan (13 and 10 mg/l of limb volume for the upper and lower limbs, respectively) 30 minutes later.Complete responses (CR) and partial responses (PR) were 63% and 24.5%, respectively, with an objective response (OR) of 87.5%. No change (NC) was observed in only 12.5% of the patients. Upon multivariate analysis, only bulky disease maintained its independent value for tumor response with an odds ratio of 4.07 and a p-value of 0.02. The 5-year locoregional disease-free survival was 42.7%. Upon multivariate analysis, the only prognostic factors were stage, age and bulky disease. The 5-year overall survival was 49%. Multivariate analysis showed that only sex, stage and CR maintained their independent values.TNFalpha-based ILP was proven to be an effective treatment for melanoma patients with in-transit metastases. The TNFalpha dosage of 1 mg was as effective as 3-4 mg, with lower toxicity and cost. We propose that TNFalpha and melphalan-based ILP should be employed for bulky tumors or after failure of melphalan-based ILP.

Published
2009

5. Hyperthermic antiblastic perfusion with TNFalpha and melphalan in stage III limb melanoma patients: A phase I - II SITILO study

Author

Di Filippo F, Cr, Rossi, Garinei R, Anzà M, Francesco Cavaliere, Botti C, Perri P, Di Filippo S, Di Angelo P, Principi F, and Laurenzi L

Subjects
Adult, Male, Dose-Response Relationship, Drug, Maximum Tolerated Dose, Tumor Necrosis Factor-alpha, Extremities, Hyperthermia, Induced, Middle Aged, Combined Modality Therapy, Survival Analysis, Chemotherapy, Cancer, Regional Perfusion, Antineoplastic Combined Chemotherapy Protocols, Humans, Female, Melanoma, Melphalan, Aged
Abstract

Hyperthermic antiblastic perfusion (HAP) has been proven to be an effective treatment of loco-regional spreading limb melanoma. The mean complete response (CR) rate obtained is 54%, with an objective responses (OR) rate ranging between 70% and 100%. Recently, Tumor Necrosis Factor (TNFalpha) has been employed at high dosages (3-4 mg) in association to Melphalan and hyperthermia. This trimodality combination increased the percentage of CR (70%-90%), but systemic toxicity was also reported due to high TNF doses. A phase I - II study was undertaken in order to assess the MTD of TNFalpha in association to true hyperthermia (41.5 degrees C) and Melphalan. Twenty patients affected with stages IIIA (9 patients), IIIAB (10 patients), and IV (1 patient) were enrolled in this study. The trimodality treatment did not increase the local and systemic toxicity. CR was observed in 70% of the patients, PR in 20% with on OR rate of 90%. These figures are overlapping those obtained with high TNF dosages. No correlation was observed between tumor responses and TNF doses. Taking into account that 70% of our patients have been treated with TNF dosages between 0.5 mg on 1.6 mg, we conclude that 1 mg is the best dosage to be applied during HAP. Patients with bulky tumor are the best candidate to TNF perfusion, because no differences have been observed in terms of CR in patients with low tumor burden treated with TNF-Melphalan-hyperthermia or Melphalan-hyperthermia.

Published
2006

6. [Doxorubicin in antiblastic hyperthermic perfusion in the treatment of advanced soft-tissue sarcoma of the limbs]

Author

Di Filippo F, Patrizi V, Francesco Cavaliere, Garinei R, Anzà M, Perri P, Botti C, Di Filippo S, and Vespa A

Subjects
Male, Antibiotics, Antineoplastic, Doxorubicin, Chemotherapy, Cancer, Regional Perfusion, Humans, Extremities, Female, Sarcoma, Soft Tissue Neoplasms, Hyperthermia, Induced, Middle Aged, Combined Modality Therapy, Neoplasm Staging
Abstract

Different antineoplastic drugs have been associated to hyperthermia in the treatment of advanced soft tissue limb sarcoma with a good results in terms of conservative surgery (77%-97%), locoregional control (77%-87%) and overall survival (72%). Two different studies were performed: the first was carried out to analyze the doxorubicin-TNFalpha-hyperthermia association (three different trials) in terms of toxicity and efficacy of the treatment (tumor response, locoregional control, disease free and overall survival). The results showed that the trimodality association (doxorubicin TNFalpha and hyperthermia) is the best regimen able to obtain a 77% of objective response and 77% of limb sparing in patients candidate to amputation but may result in high local toxicity if high temperatures (41.5 degrees C) were maintained during perfusion. The second study describes the employment of liposomal doxorubicin in hyperthermic antiblastic perfusion (HAP) in terms of tumor response, conservative surgery and toxicity; the maximum tolerable dose (MTD) of doxorubicin was 16 mg/l of perfused limb volume at the temperature of 41.5 degrees C; the conservative surgery was possible in 91% of the cases and mild (grade I and II) toxicity was observed in the perfused limb with high temperature (41.5 degrees C).

Published
2006

7. 'Pulse oral' versus intravenous calcitriol therapy in chronic hemodialysis patients. A prospective and randomized study

Author

Bacchini G, Fabrizi F, Pontoriero G, Daniele Marcelli, Di Filippo S, and Locatelli F

Subjects
Male, Administration, Oral, Middle Aged, Alkaline Phosphatase, Phosphates, Calcitriol, Parathyroid Hormone, Renal Dialysis, Injections, Intravenous, Hypercalcemia, Humans, Calcium, Female, Hyperparathyroidism, Secondary, Prospective Studies
Abstract

The aim of this prospective and randomized study was to compare the efficacy, side effects, and costs of 'pulse oral' versus intravenous calcitriol in the treatment of secondary hyperparathyroidism in hemodialysis (HD) patients. A total of 20 patients were randomized to receive over a 4-month period pulse orally administered calcitriol (pulse oral group; n = 10) or intravenous calcitriol (intravenous group; n = 10). All patients used standard dialysate calcium (1.75 mmol/l) throughout the study period. In accordance with the study design calcium dialysate concentrations were reduced when this was necessary to avoid hypercalcemic crises. The patients were stratified into two subgroups according to their initial serum PTH levels: patients with mild or moderate degree of hyperparathyroidism (17 patients) and patients with severe hyperparathyroidism (3 patients). Intravenous and pulse oral cacitriol did not significantly reduce serum PTH concentrations in patients with severe hyperparathyroidism (1,157 +/- 156 vs. 807 +/- 228 pg/ml [corrected], p = 0.09). Intermittent calcitriol, administered by intravenous or oral route, significantly reduced serum PTH levels (326 +/- 119 vs. 109 +/- 79 pg/ml [corrected], p = 0.0001) in patients with mild or moderate hyperparathyroidism. In patients with mild or moderate hyperparathyroidism, intravenous calcitriol significantly reduced PTH concentrations at the end of the 1st month, before the increase of serum ionized calcium levels, whereas 'pulse oral' calcitriol significantly suppressed parathyroid activity at the end of the 2nd month. Calcium dialysate concentration was reduced in 9 out of 10 (90%) patients of the pulse oral group and in all patients (10/10) of intravenous group. The incidence of hypercalcemic crises was 24% (39/160) in the pulse oral group and 14% (27/160) in the intravenous group. Analysis of costs showed that intravenous calcitriol was more expensive compared to pulse oral calcitriol. These data indicate that intermittent intensive calcitriol therapy, regardless of the route of administration, is effective in suppressing parathyroid activity in HD patients with mild or moderate hyperparathyroidism. In contrast, intermittent calcitriol therapy has a limited ability to achieve sustained serum PTH reductions in HD patients with severe hyperparathyroidism. Intravenous calcitriol was more expensive than pulse oral calcitriol, and we recommend the use of pulse oral calcitriol in HD patients with mild or moderate secondary hyperparathyroidism.

Published
1997

8. Non-specific rhinoreactivity: non-specific nasal provocation tests with methacholine and cold water solution

Author

Filiaci, F, Zambetti, Giampietro, DI FILIPPO, S, and Mancini, Cm

Subjects
Adult, Male, Nasal Provocation Tests, Rhinitis, Allergic, Perennial, Adolescent, Rhinitis, Allergic, Seasonal, Water, Middle Aged, Cold Temperature, Nasal Mucosa, Humans, Methacholine Compounds, Female, Methacholine Chloride, Aged
Abstract

The Department of Allergo-Immunology of the II ENT Division of Rome University has studied the behaviour, relative to non-specific nasal provocation with methacholine and with cold water solution, in normal subjects, in subjects with seasonal allergic rhinitis in and out of crisis, and in subjects with perennial rhinitis of allergic and non-allergic origin. All subjects underwent an ENT visit, rhinoreomanometry (RRM), mucociliary Clearance (MCT) and quantitative evaluation of nasal secretion, both before and after the single non-specific provocations. We saw that even though provocation with methacholine didn't cause a significant reduction of nasal conductance, it was the cause of noticeable modifications of the amount of nasal secretion, according to the groups taken into consideration. Furthermore, provocation with the cold water solution, which didn't provoke noticeable changes in the mucociliary clearance and in the quantity of nasal secretion, did, however cause noticeable modification of the nasal conductance in all groups examined.

Published
1985

9. Hyperthermic isolated perfusion with tumor necrosis factor-alpha and doxorubicin for the treatment of limb-threatening soft tissue sarcoma: The experience of the Italian Society of Integrated Locoregional Treatment in Oncology (SITILO)

Author

Di Filippo, F., Giacomini, P., Ross, C. R., Mario Santinami, Garinei, R., Anza, M., Deraco, M., Botti, C., Perri, P., Cavaliere, F., Di Angelo, P., Sofra, C., Sperduti, I., Pasqualoni, R., Di Filippo, S., Corrias, F., Armenti, A., and Ferraresi, V.

Subjects
Adult, Aged, 80 and over, Male, Adolescent, Tumor Necrosis Factor-alpha, Extremities, Sarcoma, Soft Tissue Neoplasms, Hyperthermia, Induced, Middle Aged, Disease-Free Survival, Perfusion, Treatment Outcome, Doxorubicin, Recurrence, Chemotherapy, Cancer, Regional Perfusion, Antineoplastic Combined Chemotherapy Protocols, Humans, Female, Aged
Abstract

Tumor necrosis factor-alpha (TNFalpha)-based hyperthermic isolated limb perfusion (HILP) is routinely carried out at most oncological institutions in the treatment of locally advanced soft tissue limb sarcoma (STS), employing high TNFalpha dosages. After a phase I-II study, the SITILO (Italian Society of Integrated Locoregional Therapies in Oncology) centers began to employ the lower dose of 1 mg of TNFalpha. The aim of this paper is to report on the results obtained in 75 patients with limb-threatening STS treated with a low TNFalpha dose and doxorubicin (Dx).HILP with TNFalpha (at a dosage of eitheror=1 mg or1 mg) and Dx was administered to 75 patients with limb-threatening STS: 37 males and 38 females; median age 50 years; tumor in the lower and upper limbs in 58 and 17 patients, respectively; primary and recurrent tumors in 45 and 30 patients, respectively. Most tumors (77%) were high grade. Tumor resection was carried out 6 to 8 weeks after HILP.The grade of limb toxicity was mild to moderate in the vast majority of patients (76%). Grades IV and V were observed, but only when high muscle temperatures were recorded and high TNFalpha dosages were employed. Systemic toxicity was also mild to moderate and there were no postoperative deaths. Complete and partial tumor responses were 34% and 48%, respectively, with an overall response of 82% . Limb sparing surgery was carried out in 85.3% of patients. At a median follow-up of 28 months, 16 recurrences (21.3%) were recorded, with a 5-year locoregional disease-free survival of 63% . The 5-year disease-free survival and overall survival were 36.7% and 61.6%, respectively.HILP with 1 mg of TNFalpha is an effective neoadjuvant therapy resulting in a high rate of limb sparing in limb-threatening STS, with acceptable local reactions and negligible systemic toxicity.

10. Doxorubicin in isolation limb perfusion in the treatment of advanced limb soft tissue sarcoma

Author

Di Filippo, F., Garinei, R., Anza, M., Cavaliere, F., Giannarelli, D., Cagol, Pp, Carlo Riccardo Rossi, Santinami, M., Deraco, M., Botti, C., Perri, P., Di Filippo, S., Piarulli, Li, and Bruno, P.

Subjects
Adult, Male, Antibiotics, Antineoplastic, Adolescent, Dose-Response Relationship, Drug, Maximum Tolerated Dose, Tumor Necrosis Factor-alpha, Extremities, Sarcoma, Soft Tissue Neoplasms, Hyperthermia, Induced, Middle Aged, doxorubicin, Disease-Free Survival, Neoadjuvant Therapy, hyperthermic perfusion, Sex Factors, limb soft tissue sarcoma, TNF alpha, Chemotherapy, Cancer, Regional Perfusion, Antineoplastic Combined Chemotherapy Protocols, Humans, Female, Aged
Abstract

Hyperthermic antiblastic perfusion/HAP) has been proven to be an effective neoadjuvant treatment in the treatment of advanced soft tissue limb sarcoma. As a matter of fact high percentage of limb sparing surgery, local control and functional results have been obtained wide this technique. Many antineoplastic drugs have been associated to hyperthermia by isolation limb perfusion, the aim of this paper was to describe the results obtained with doxorubicin in association to hyperthermia with or without Tumor Necrosis Factor (TNF) alpha in order to identify the most effective regimen in the multidisciplinary treatment of soft tissue limb sarcoma. A total of 106 patients have been evaluated. Three different study were performed: the first was a phase I study carried out in order to assess the maximum tolerable dose (MTD) of doxorubicin during HAP; the second was a phase II study with doxorubicin, and the third was a phase I - II study aimed at evaluating the MTD and tumor response of TNF alpha in association to doxorubicin and hyperthermia. Grade IV limb toxicity was recorded in 11 patients ( 4 in trial A, 3 in trial B, and 4 in trial C). The grade of limb reaction was strictly related to TNF dosage (1 mg) and temperature level (41.5 degrees C), therefore the best regimen is represented by temperature level not exceeding 41.5 degrees C and 1 mg of TNFalpha. The trimodality association (TNF, doxorubicin and hyperthermia) was proven to be the best regimen able to obtain a 77% of objective response (complete response, 22%) and a 77% of limb sparing in patients candidate to amputation. The results above mentioned showed the HAP with doxorubicin and TNFalpha (1 mg) is a very effective neoadjuvant treatment in the multidisciplinary treatment of advanced soft tissue limb sarcoma.

11. Sentinel node biopsy in cutaneous melanoma: Correlations between melanoma prognostic factors and sentinel node status

Author

Minutilli, E., Giannarelli, D., Anzà, M., Garinei, R., Perri, P., Botti, C., Piarulli, L., Bruno, P., Sandra Rea, Visca, P., Mottolese, M., Di Filippo, S., and Di Filippo, F.

Subjects
Adult, Male, Skin Neoplasms, Staining and Labeling, Sentinel Lymph Node Biopsy, Middle Aged, Prognosis, Immunohistochemistry, Radiography, Lymphatic Metastasis, Mitotic Index, Humans, Female, Lymph Nodes, Radionuclide Imaging, Melanoma, Ulcer, Aged
Abstract

This study aims to correlate the most important prognostic factors of primary melanoma with sentinel node (SN) positive for metastases. We have enrolled 84 patients subjected to sentinel node biopsies for cutaneous melanomas of Breslow's thicknessor = 0.75 mm by using an intra-operative gamma probe after lymphoscintigraphy, without blue dye support. SN metastases were reported in 27% of cases (14% by histology and 13% by immunohistochemistry). By chi-square test Breslow's thickness2mm (p= 0.004), IV and V Clark's level (p= 0.02), ulceration (p= 0.05) and high mitotic rate (p= 0.05) were statistically significant (p0.05) with reference to SN positive for metastases, unlike the site of cutaneous melanoma, vertical growth phase, tumour infiltrating lymphocytes, regression and vascular invasion. Breslow's thickness remains the first prognostic factor to be considered for sentinel node biopsy in cutaneous melanoma, but other markers must be carefully estimated.

12. Recombinant hepatitis B vaccine use in chronic hemodialysis patients. Long-term evaluation and cost-effectiveness analysis

Author

Fabrizi F, Di Filippo S, Daniele Marcelli, Guarnori I, Raffaele L, Crepaldi M, Erba G, and Locatelli F

Subjects
Adult, Aged, 80 and over, Male, Vaccines, Synthetic, Adolescent, Cost-Benefit Analysis, Middle Aged, Hepatitis B, Hepatitis B Core Antigens, Immunoenzyme Techniques, Evaluation Studies as Topic, Renal Dialysis, Chronic Disease, Humans, Blood Transfusion, Female, Hepatitis B Vaccines, Hepatitis Antibodies, Immunization Schedule, Aged
Abstract

The prevalence of hepatitis B virus (HBV) infection in our unit was 45% (86/190); there were 77 (40.5%) and 9 (4.7%) patients with previous and persistent HBV infection, respectively. Recombinant hepatitis B vaccine was given to 118 chronic HD patients with a regimen of 3 double doses administered intramuscularly at 0, 1 and 2 months, obtaining a seroprotection rate of 67% (79/118), 57% (45/79) being high responders. At month 24, 78% (40/51) maintained protective levels of anti-HBs, 45% (18/40) of them being high responders. There was a statistically significant difference between responder and non-responder patients with regard to nutritional parameters such as serum total proteins and mean levels of transferrinemia. The number of diabetic patients was significantly increased in the nonresponder group. Patients with persistent antibodies ('persistent responders') were younger and had a shorter duration of HD treatment compared to those responders who rapidly lost anti-HBs ('transient responders'). Serological positivity for antibodies against hepatitis B core antigen significantly facilitates the decrease of anti-HBs antibodies over time. We detected seven episodes of HBV infection among HD patients at our unit before the beginning of the vaccination program. On the contrary, there were no episodes of HBV infection among responder vaccinees during the 24-month follow-up period. After the initial cost of vaccination, a savings of US$ 3,272 per year was realized by the elimination of frequent serologic screening of vaccine responders.

13. SARS-CoV-2 Serum Neutralization Assay: A Traditional Tool for a Brand-New Virus

Author

Matusali G., Colavita F., Lapa D., Meschi S., Bordi L., Piselli P., Gagliardini R., Corpolongo A., Nicastri E., Antinori A., Ippolito G., Capobianchi M. R., Castilletti C., Abbate I., Agrati C., Aleo L., Alonzi T., Amendola A., Apollonio C., Arduini N., Bartolini B., Berno G., Biancone S., Bibbo A., Brega C., Canali M., Cannas A., Carletti F., Carrara S., Casetti R., Castillettiy C., Chiappini R., Ciafrone L., Cimini E., Coen S., Condello R., Coppola A., D'arezzo S., Di Caro A., Di Filippo S., De Giuli C., Fabeni L., Felici L., Ferraioli V., Forbici F., Garbuglia A. R., Giombini E., Gruber C. E. M., Khouri D., Lalle E., Leone B., Mazzarelli A., Messina F., Minosse C., Montaldo C., Neri S., Nisii C., Petrivelli E., Petroni F., Petruccioli E., Pisciotta M., Pizzi D., Prota G., Rozera G., Rueca M., Sabatini R., Sarti S., Sberna G., Sciamanna R., Selleri M., Selvaggi C., Stellitano C., Toffoletti A., Truffa S., Turchi F., Valli M. B., Venditti C., Vincenti D., Vulcano A., Zambelli E., Bevilacqua N., Bordoni V., D'abramo A., Lepore L., Mariano A., Palazzolo C., Lorenzini P., Notari S., Sacchi A., Scorzolini L., Bettini A., Francalancia M., Specchiarello E., Federica M., Gaetano D., Luigi F., Barbara G., Roberto I., Giovanni M., Mirco M., Rachele S., Matusali, G., Colavita, F., Lapa, D., Meschi, S., Bordi, L., Piselli, P., Gagliardini, R., Corpolongo, A., Nicastri, E., Antinori, A., Ippolito, G., Capobianchi, M. R., Castilletti, C., Abbate, I., Agrati, C., Aleo, L., Alonzi, T., Amendola, A., Apollonio, C., Arduini, N., Bartolini, B., Berno, G., Biancone, S., Bibbo, A., Brega, C., Canali, M., Cannas, A., Carletti, F., Carrara, S., Casetti, R., Castillettiy, C., Chiappini, R., Ciafrone, L., Cimini, E., Coen, S., Condello, R., Coppola, A., D'Arezzo, S., Di Caro, A., Di Filippo, S., De Giuli, C., Fabeni, L., Felici, L., Ferraioli, V., Forbici, F., Garbuglia, A. R., Giombini, E., Gruber, C. E. M., Khouri, D., Lalle, E., Leone, B., Mazzarelli, A., Messina, F., Minosse, C., Montaldo, C., Neri, S., Nisii, C., Petrivelli, E., Petroni, F., Petruccioli, E., Pisciotta, M., Pizzi, D., Prota, G., Rozera, G., Rueca, M., Sabatini, R., Sarti, S., Sberna, G., Sciamanna, R., Selleri, M., Selvaggi, C., Stellitano, C., Toffoletti, A., Truffa, S., Turchi, F., Valli, M. B., Venditti, C., Vincenti, D., Vulcano, A., Zambelli, E., Bevilacqua, N., Bordoni, V., D'Abramo, A., Lepore, L., Mariano, A., Palazzolo, C., Lorenzini, P., Notari, S., Sacchi, A., Scorzolini, L., Bettini, A., Francalancia, M., Specchiarello, E., Federica, M., Gaetano, D., Luigi, F., Barbara, G., Roberto, I., Giovanni, M., Mirco, M., and Rachele, S.

Subjects
0301 basic medicine, Male, lcsh:QR1-502, serology, Antibodies, Viral, lcsh:Microbiology, Serology, protective immunity, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Neutralizing antibody, biology, Middle Aged, 3. Good health, Algorithm, Titer, Infectious Diseases, Female, Neutralization Test, Algorithms, Human, Adult, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Protective immunity, Article, Virus, COVID-19 Serological Testing, 03 medical and health sciences, Neutralization Tests, Immunity, Virology, Neutralizing antibodie, Humans, neutralizing antibodies, Kinetic, Receiver operating characteristic, business.industry, SARS-CoV-2, COVID-19, Gold standard (test), Antibodies, Neutralizing, Kinetics, 030104 developmental biology, ROC Curve, Immunoglobulin G, Immunology, biology.protein, business
Abstract

SARS-CoV-2 serum neutralization assay represents the gold standard for assessing antibody-mediated protection in naturally infected and vaccinated individuals. In the present study, 662 serum samples collected from February 2020 to January 2021 from acute and convalescent COVID-19 patients were tested to determine neutralizing antibody (NAb) titers using a microneutralization test (MNT) for live SARS-CoV-2. Moreover, anti-SARS-CoV-2 IgG, IgA, and IgM directed against different viral antigens were measured by high-throughput automated platforms. We observed higher levels of NAbs in elderly (&gt, 60 years old) individuals and in patients presenting acute respiratory distress syndrome. SARS-CoV-2 NAbs develop as soon as five days from symptom onset and, despite a decline after the second month, persist for over 11 months, showing variable dynamics. Through correlation and receiver operating characteristic (ROC) curve analysis, we set up a testing algorithm, suitable for the laboratory workload, by establishing an optimal cutoff value of anti-SARS-CoV-2 IgG for convalescent plasma donors to exclude from MNT samples foreseen to have low/negative NAb titers and ineligible for plasma donation. Overall, MNT, although cumbersome and not suitable for routine testing of large sample sizes, remains the reference tool for the assessment of antibody-mediated immunity after SARS-CoV-2 infection. Smart testing algorithms may optimize the laboratory workflow to monitor antibody-mediated protection in COVID-19 patients, plasma donors, and vaccinated individuals.

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14. Effect of a plasma sodium biofeedback system applied to HFR on the intradialytic cardiovascular stability. Results from a randomized controlled study

Author

Francesco Locatelli, Luigi Coli, Filippo Aucella, Peter Ahrenholz, Francesco Quarello, Paola Mesiano, Sibilla Sagripanti, Joan Fort, Thierry Petitclerc, Carmine Stallone, Roland E. Winkler, Antonio Gesuete, Lise Mandart, Sergio Stefoni, Andrea Serra, Carlo Navino, Simeone Andrulli, Antonio Scarlatella, Giovanni M. Frascà, Christian Tielemans, Christine Fumeron, Silvana Savoldi, Salvatore Di Filippo, Locatelli F, Stefoni S, Petitclerc T, Colì L, Di Filippo S, Andrulli S, Fumeron C, Frascà GM, Sagripanti S, Savoldi S, Serra A, Stallone C, Aucella F, Gesuete A, Scarlatella A, Quarello F, Mesiano P, Ahrenholz P, Winkler R, Mandart L, Fort J, Tielemans C, Navino C., and Internal Medicine Specializations

Subjects
Male, biofeedback, sodium online measure, medicine.medical_specialty, Time Factors, SODIUM ONLINE, medicine.medical_treatment, Blood Pressure, Hemodiafiltration, law.invention, Randomized controlled trial, INTRADIALYTIC HYPOTENSION, law, Hfr cell, Hemofiltration, medicine, Clinical endpoint, Humans, Prospective Studies, Plasma Volume, Prospective cohort study, Dialysis, Aged, Aged, 80 and over, Transplantation, Cross-Over Studies, Néphrologie - urologie, business.industry, Sodium, Hemodynamics, intradialytic hypotension, Biofeedback, Psychology, Middle Aged, biochemical phenomena, metabolism, and nutrition, equipment and supplies, Transplantation d'organes, Crossover study, Surgery, carbohydrates (lipids), Blood pressure, BIOFEEDBACK, Nephrology, Anesthesia, Kidney Failure, Chronic, bacteria, Female, Hypotension, business
Abstract

BackgroundIntradialytic hypotension (IDH) is still a major clinical problem for haemodialysis (HD) patients. Haemodiafiltration (HDF) has been shown to be able to reduce the incidence of IDH.MethodsFifty patients were enrolled in a prospective, randomized, crossover international study focussed on a variant of traditional HDF, haemofiltration with endogenous reinfusion (HFR). After a 1-month run-in period on HFR, the patients were randomized to two treatments of 2 months duration: HFR (Period A) or HFR-Aequilibrium (Period B), followed by a 1-month HFR wash-out period and then switched to the other treatment. HFR-Aequilibrium (HFR-Aeq) is an evolution of the haemofiltration with endogenous reinfusion (HFR) dialysis therapy, with dialysate sodium concentration and ultrafiltration rate profiles elaborated by an automated procedure. The primary end point was the frequency of IDH.ResultsSymptomatic hypotension episodes were significantly lower on HFR-Aeq versus HFR (23 ± 3 versus 31 ± 4 of sessions, respectively, P l l0.03), as was the per cent of clinical interventions (17 ± 3 of sessions with almost one intervention on HFR-Aeq versus 22 ± 2 on HFR, P, SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2012
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15. Human OX40 tunes the function of regulatory T cells in tumor and nontumor areas of hepatitis C virus-infected liver tissue

Author

Gianluca Mennini, Silvia Piconese, Massimo Sanchez, G. Grazi, Guido Antonelli, Vincenzo Barnaba, Massimo Rossi, Ilenia Pacella, Claudio Tripodo, Eleonora Timperi, Stefania Brozzetti, Simona Di Filippo, Katia Fazzi, Maria A ntonietta Lozzi, V. Schinzari, Nicola Guglielmo, Department of Internal Medicine and Medical Specialities, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Università degli studi di Palermo - University of Palermo, Dip di Chirurgia Generale e Trapianti d’Organo - Sapienza Università, Dipartimento di Chirurgia - Sapienza Università, Department of Molecular Medicine, Institut Pasteur, Fondation Cenci Bolognetti - Istituto Pasteur Italia, Fondazione Cenci Bolognetti, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], CISDEM-CSIC, Institute of Construction Science 'Eduardo Torreja', Réseau International des Instituts Pasteur (RIIP), This work was supported by the following grants obtained by V.B.: Associazione Italiana per la Ricerca sul Cancro (AIRC, progetto 'Investigator Grant' [IG]-2010/13 no. 10756), European Union grants (IMECS no. 201169, FP7-Health-2007-A, and SPHYNX no. 261365, FP7-Health-2010), Ministero della Sanità (Ricerca finalizzata [RFPS-2006-3-337923 and RFPS-2007-1-636647] and Istituto Superiore di Sanità [Progetto AIDS-2008]), Ministero dell’Istruzione,dell’Università e della Ricerca (MIUR, Programmi di ricerca di interesse nazionale [PRIN]-2008/10 no. 7245/1, [PRIN]-2011/13 no. 2010LC747T-004, AteneoSapienza [2009-C26A09PELN, 2010-C26A1029ZS, 2011-C26A11BYWP, and 2012-C26A12JL55], and Fondo per gli investimenti di ricerca di base [FIRB]-2011/13 no. RBAP10TPXK), Fondazione Cariplo (progetti no. 13535 and 3603 2010/12), FISM (Fondazione Italiana Sclerosi Multipla onlus) grant no. 2011/R/4, Fondazione Italiana per la Ricerca sull’Artrite (FIRA 2010), and Istituto Italiano di Tecnologia (IIT, A2 project 2013). This work was also supported bygrants obtained by S.P. from Associazione Italiana Ricerca sul Cancro (MFAG 8726) and from Ministero dell’Istruzione, dell’Università e della Ricerca (FIRB-Futuro in ricerca RBFR12I3UB_002)., The authors thank Marco Cassatella and Federica Calzetti (Università di Verona) for providing anti‐M‐DC8 antibody, Maria Cristina Gagliardi (Istituto Superiore di Sanità, Rome) for providing anti‐CD206 antibody, Carla Guarnotta (Università di Palermo) for technical assistance in immunohistochemical stainings, and Stefania Morrone ('Sapienza' Università di Roma, Rome) for help with cell sorting. The authors also acknowledge Massimo Locati and Alberto Mantovani for their helpful discussion., Piconese, Silvia, Timperi, Eleonora, Pacella, Ilenia, Schinzari, Valeria, Tripodo, Claudio, Rossi, Massimo, Guglielmo, Nicola, Mennini, Gianluca, Grazi, Gian Luca, Di Filippo, Simona, Brozzetti, Stefania, Fazzi, Katia, Antonelli, Guido, Lozzi, Maria Antonietta, Sanchez, Massimo, Barnaba, Vincenzo, Piconese, S, Timperi, E, Pacella, I, Schinzari, V, Tripodo, C, Rossi, M, Guglielmo, N, Mennini, G, Grazi, GL, Di Filippo, S, Brozzetti, S, Fazzi, K, Antonelli, G, Lozzi, MA, Sanchez, M, and Barnaba, V.

Subjects
MESH: Receptors, OX40/metabolism, MESH: Interleukin-12/metabolism, Liver Cirrhosis, Male, Macrophage, medicine.disease_cause, MESH: Carcinoma, Hepatocellular/immunology, T-Lymphocytes, Regulatory, MESH: OX40 Ligand/metabolism, 0302 clinical medicine, MESH: Aged, 80 and over, MESH: T-Lymphocytes, Regulatory/physiology, MESH: Up-Regulation, OX40, MESH: Aged, Aged, 80 and over, 0303 health sciences, education.field_of_study, T REG, MESH: Middle Aged, Medicine (all), MESH: Liver Cirrhosis/immunology, Liver Neoplasms, hemic and immune systems, Middle Aged, MESH: Liver Neoplasms/immunology, Phenotype, Hepatitis C, Interleukin-12, 3. Good health, Up-Regulation, Liver Neoplasm, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Interleukin 12, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, medicine.symptom, MESH: Hepatitis C/immunology, HEPATITIS C VIRUS, Human, medicine.medical_specialty, Carcinoma, Hepatocellular, Hepatitis C virus, Liver Cirrhosi, Population, Inflammation, chemical and pharmacologic phenomena, [SDV.CAN]Life Sciences [q-bio]/Cancer, OX40 Ligand, Biology, MESH: Phenotype, MESH: Liver Neoplasms/virology, 03 medical and health sciences, Ikaros Transcription Factor, Downregulation and upregulation, Internal medicine, medicine, Humans, MESH: Macrophages/metabolism, education, 030304 developmental biology, Aged, MESH: Humans, Hepatology, Macrophages, MESH: Carcinoma, Hepatocellular/virology, Receptors, OX40, MESH: Ikaros Transcription Factor/metabolism, MESH: Hepatitis C/complications, MESH: Male, OX40 ligand, Immunology, MESH: Liver Cirrhosis/virology, MESH: Female, 030215 immunology
Abstract

International audience; Regulatory T cells (Tregs) can be considered as a mixed population of distinct subsets, endowed with a diverse extent and quality of adaptation to microenvironmental signals. Here, we uncovered an opposite distribution of Treg expansion, phenotype, and plasticity in different microenvironments in the same organ (liver) derived from patients with chronic hepatitis C: On the one side, cirrhotic and tumor fragments were moderately and highly infiltrated by Tregs, respectively, expressing OX40 and a T-bet high IFN-c – " T-helper (Th)1-suppressing " phenotype; on the other side, noncirrhotic liver specimens contained low frequencies of Tregs that expressed low levels of OX40 and highly produced interferon-gamma (IFN-c; T-bet 1 IFN-c 1), thus becoming " Th1-like " cells. OX40-expressing and Th1-suppressing Tregs were enriched in the Helios-positive subset, carrying highly demethylated Treg cell-specific demethylated region that configures committed Tregs stably expressing forkhead box protein 3. OX40 ligand, mostly expressed by M2-like monocytes and macrophages, boosted OX40 1 Treg proliferation and antagonized the differentiation of Th1-like Tregs. However, this signal is counteracted in non-cirrhotic liver tissue (showing various levels of inflammation) by high availability of interleukin-12 and IFN-c, ultimately leading to complete, full Th1-like Treg differentiation. Conclusion: Our data demonstrate that Tregs can finely adapt, or even subvert, their classical inhibitory machinery in distinct microenvironments within the same organ. (HEPATOLOGY 2014;60:1494-1507)

Published
2014
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16. Automatic Adaptive System Dialysis for Hemodialysis-Associated Hypotension and Intolerance: A Noncontrolled Multicenter Trial

Author

Carlo Mura, Davide Ricci, Francesco Paolo Ferrandello, Maurizio Tancredi, Giancarlo Marinangeli, Giorgia Comai, Gaetano La Manna, Sergio Stefoni, Salvatore Di Filippo, Filippo Aucella, Ermanno Di Loreto, Alessandro Balducci, Roberto Bellazzi, Mauro Martello, Renzo Tarchini, Matteo Piccari, D Lambertini, Francesco Locatelli, Massimo Bacchi, Luigi Coli, Giuseppe Emiliani, G. Palombo, Luciano Cristinelli, Mauro Ursino, Marina Di Luca, Giacomo Forneris, Vincenzo Panichi, Francesco Quarello, Massimo Morosetti, Colì L, La Manna G, Comai G, Ursino M, Ricci D, Piccari M, Locatelli F, Di Filippo S, Cristinelli L, Bacchi M, Balducci A, Aucella F, Panichi V, Ferrandello FP, Tarchini R, Lambertini D, Mura C, Marinangeli G, Loreto ED, Quarello F, Forneris G, Tancredi M, Morosetti M, Palombo G, Luca MD, Martello M, Emiliani G, Bellazzi R, and Stefoni S.

Subjects
Male, medicine.medical_specialty, hypotension, profiler, Vomiting, Nausea, medicine.medical_treatment, Hypovolemia, Blood Pressure, Heart Rate, Renal Dialysis, Multicenter trial, Heart rate, medicine, Humans, Prospective Studies, sodium, Dialysis, Aged, Muscle Cramp, business.industry, Standard treatment, Body Weight, Headache, Syndrome, Middle Aged, Models, Theoretical, Surgery, Treatment Outcome, Blood pressure, Nephrology, Anesthesia, Female, Hemodialysis, Hemodialysi, medicine.symptom, business
Abstract

BACKGROUND: Hemodialysis is complicated by a high incidence of intradialytic hypotension and disequilibrium symptoms caused by hypovolemia and a decrease in extracellular osmolarity. Automatic adaptive system dialysis (AASD) is a proprietary dialysis system that provides automated elaboration of dialysate and ultrafiltration profiles based on the prescribed decrease in body weight and sodium content. STUDY DESIGN: A noncontrolled (single arm), multicenter, prospective, clinical trial. SETTING & PARTICIPANTS: 55 patients with intradialytic hypotension or disequilibrium syndrome in 15 dialysis units were studied over a 1-month interval using standard treatment (642 sessions) followed by 6 months using AASD (2,376 sessions). INTERVENTION: AASD (bicarbonate dialysis with dialysate sodium concentration and ultrafiltration rate profiles determined by the automated procedure). OUTCOMES: Primary and major secondary outcomes were the frequency of intradialytic hypotension and symptoms (hypotensive events, headache, nausea, vomiting, and cramps), respectively. RESULTS: More stable intradialytic systolic and diastolic blood pressures with lower heart rate were found using AASD compared with standard treatment. Sessions complicated by hypotension decreased from 58.7% ± 7.3% to 0.9% ± 0.6% (P < 0.001). The incidence of other disequilibrium syndrome symptoms was lower in patients receiving AASD. There were no differences in end-session body weight, interdialytic weight gain, or presession natremia between the standard and AASD treatment periods. LIMITATIONS: A noncontrolled (single arm) study, no crossover from AASD to standard treatment. CONCLUSIONS: This study shows the long-term clinical efficacy of AASD for intradialytic hypotension and disequilibrium symptoms in a large number of patients and dialysis sessions.

Published
2011

17. [Pneumothorax in pregnancy. A review of 16 cases including one of the authors']

Author

F, Giampaglia, G, De Placido, O, Santopaolo, M, Alifano, G, Guggino, S, Mastroianni, S, Di Filippo, Giampaglia, F, DE PLACIDO, Giuseppe, Santopaolo, O, Alifano, M, Guggino, G, Mastroianni, S, and Di Filippo, S.

Subjects
Adult, Pregnancy Complications, Thoracotomy, Cesarean Section, Pregnancy, Drainage, Humans, Pneumothorax, Female, Puerperal Disorders
Abstract

Pneumothorax in pregnancy raises several problems especially of therapy. In the present study we report a case observed in our Institution and literature data on 15 further cases. Pneumothorax occurred in 9 cases in the course of pregnancy, in 6 cases during delivery and in 1 case in the post-partum period. Immediate treatment was insertion of pleural drain in 13 patients and bed rest in 3 patients. Surgery was required in 8 cases and was performed after delivery in 5 cases and during pregnancy in 3 cases, 6 thoracotomies, 1 bilateral thoracotomy and 1 sternotomy for bilateral pneumothorax were carried out. Actually a videothoracoscopic treatment, requiring general anaesthesia, is also possible. In all observed cases pneumothorax didn't represent a serious risk for both mother and foetus, for the timely therapeutic measures. Pneumothorax represents an uncommon pathology, usually underestimated in literature, that must be taken into account whenever during pregnancy or the post-partum period a progressive respiratory failure arises.

Published
1994

18. The superparamagnetic iron oxide tracer: a valid alternative in sentinel node biopsy for breast cancer treatment

Author

I. Galanou, Paola Rucci, Matteo Ghilli, L. Fustaino, C. Battaglia, Manuela Roncella, S. Di Filippo, Maria Pia Fantini, F. Di Filippo, Elisa Carretta, Ghilli, M., Carretta, E., Di Filippo, F., Battaglia, C., Fustaino, L., Galanou, I., Di Filippo, S., Rucci, P., Fantini, M.P., and Roncella, M.

Subjects
0301 basic medicine, Adult, medicine.medical_specialty, Concordance, Contrast Media, Breast Neoplasms, Ferric Compounds, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, breast cancer, superparamagnetic iron oxide particles, Biopsy, Clinical endpoint, medicine, media_common.cataloged_instance, Humans, Prospective Studies, European union, radioisotope, Prospective cohort study, Magnetite Nanoparticles, sentinel lymph node biopsy, Early Detection of Cancer, media_common, Aged, Aged, 80 and over, medicine.diagnostic_test, business.industry, Carcinoma, Ductal, Breast, Sentinel node, Middle Aged, medicine.disease, Surgery, breast unit, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Female, Radiology, Breast Carcinoma In Situ, Breast carcinoma, business
Abstract

The European Union has determined that from 2016 breast cancer patients should be treated in Specialist Breast Units that achieve the minimum standards for the mandatory quality indicators as defined by Eusoma. The existing standard for axillary lymph node staging in breast cancer is sentinel node biopsy (SNB), performed using Technetium-sulphur colloid ((99m) Tc) alone or with blue dye. The major limits of radioisotope consist in the problems linked to radioactivity, in the shortage of tracer and nuclear medicine units. Among existing alternative tracers, SentiMag(®) , which uses superparamagnetic iron oxide particles, can represent a valid option for SNB. We conducted a paired, prospective, multicentre study to evaluate the non-inferiority of SentiMag(®) vs. (99m) Tc. The primary end point was the detection rate (DR) per patient. The study sample consists of 193 women affected by breast carcinoma with negative axillary assessment. The concordance rate per patients between (99m) Tc and SentiMag(®) was 97.9%. The DR per patient was 99.0% for (99m) Tc and 97.9% for SentiMag(®) . SentiMag(®) appears to be non-inferior to the radiotracer and safe. While (99m) Tc remains the standard, SentiMag(®) DR appears adequate after a minimum learning curve. In health care settings where nuclear medicine units are not available, SentiMag/Sienna+(®) allows effective treatment of breast cancer patients.

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