162 results on '"Argento, C."'
Search Results
52. Laser in situ keratomileusis for hyperopia
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Argento, C.
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- 2000
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53. Normal serum anti-Müllerian hormone levels in the general female population and the relationship with reproductive history.
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La Marca A, Spada E, Grisendi V, Argento C, Papaleo E, Milani S, and Volpe A
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- 2012
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54. Double stimulation in the same ovarian cycle (DuoStim) is an intriguing strategy to improve oocyte yield and the number of competent embryos in a short timeframe
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Roberta Venturella, Carlo Alviggi, Panagiotis Drakopoulos, Elisabetta Trabucco, Filippo Maria Ubaldi, Alberto Vaiarelli, Nicolò Ubaldi, Cindy Argento, Alessandro Conforti, Laura Rienzi, Danilo Cimadomo, Vaiarelli, A., Cimadomo, D., Argento, C., Ubaldi, N., Trabucco, E., Drakopoulos, P., Venturella, R., Conforti, A., Ggi, C. A., Rienzi, L., Ubaldi, F. M., Surgical clinical sciences, Centre for Reproductive Medicine - Gynaecology, and Faculty of Medicine and Pharmacy
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Oocyte ,Genetic testing ,Stimulation ,Fertilization in Vitro ,Luteal phase ,Embryo Culture Techniques ,Andrology ,03 medical and health sciences ,0302 clinical medicine ,Ovulation Induction ,Pregnancy ,Obstetrics and Gynaecology ,Follicular phase ,medicine ,Humans ,Advanced maternal age ,Blastocyst ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics and Gynecology ,Embryo ,medicine.disease ,Aneuploidy ,Embryo Culture Technique ,Time-to-Pregnancy ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Oocytes ,Female ,business ,Menstrual cycle ,Human - Abstract
Proper ovarian stimulation regimens are crucial for any patient undergoing in-vitro fertilization (IVF). However, maximizing the oocyte yield in advanced maternal age patients with poor or suboptimal response is still a challenge. In fact, no standard treatment has been outlined yet to manage these women. Across the last years, an improved efficiency of the IVF units via blastocyst culture, vitrification and reliable embryo selection approaches paved the way to the investigation of novel unconventional stimulation protocols, like double stimulation in a single ovarian cycle (DuoStim). DuoStim, by conjugating follicular phase stimulation (FPS) and luteal phase stimulation (LPS) in the same ovarian cycle, allows to maximize the number of oocytes obtained in a short timeframe, a precious outcome when we aim at shortening time to pregnancy. In this regard, LPS seems to contribute to conventional stimulation with more oocytes with a comparable competence as FPS, retrieved per ovarian cycle. Although any stimulation protocol which exploits anovulatory waves of follicular growth needs a thorough investigation, no evidence has been produced to question the safety of DuoStim, which to date represents the most intriguing strategy to treat poor prognosis in IVF.
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- 2019
55. Concordance between RTOG and EORTC prognostic criteria in low-grade gliomas
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Giuseppe Lamberti, Alicia Tosoni, Dario de Biase, Alba A. Brandes, Alexandro Paccapelo, Antonella Mura, Chiara Maria Argento, Stefania Bartolini, Enrico Franceschi, Monica Di Battista, Michela Visani, Franceschi E., Mura A., Lamberti G., De Biase D., Tosoni A., Di Battista M., Argento C., Visani M., Paccapelo A., Bartolini S., and Brandes A.A.
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0301 basic medicine ,Oncology ,Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Concordance ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Glioma ,Internal medicine ,Medicine ,Humans ,RTOG ,DNA Modification Methylases ,neoplasms ,Risk criteria ,Aged ,low-grade glioma ,business.industry ,Tumor Suppressor Proteins ,Cancer ,General Medicine ,Middle Aged ,medicine.disease ,Prognosis ,Isocitrate Dehydrogenase ,humanities ,Idh mutation ,Clinical trial ,Radiation therapy ,EORTC ,030104 developmental biology ,DNA Repair Enzymes ,030220 oncology & carcinogenesis ,Mutation ,Female ,Mgmt methylation ,Neoplasm Grading ,business - Abstract
Aim: European Organization for Research and Treatment of Cancer (EORTC) and the Radiation Therapy Oncology Group (RTOG) criteria are used to choose treatment in low-grade gliomas. However, no data exist on their concordance. Methods: Low-grade glioma patients treated at our institution from 1998 to 2015 and assessable for both RTOG and EORTC criteria were included to analyze their concordance. Surgery extension, postsurgical treatments, molecular characteristics ( IDH mutation, MGMT methylation and 1p/19q codeletion) were recorded. Results: We included 99 patients. The concordance was low (50.5%; K = 0.127; p = 0.021) but for two subgroups: EORTC high-risk patients were also RTOG high-risk patients (concordance: 97.5%) and RTOG low-risk patients were also EORTC low-risk patients (concordance: 90.9%). Conclusion: The concordance between RTOG and EORTC criteria is low. Thus, clinical trials adopting different risk criteria are not comparable.
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- 2019
56. Age-specific reference values for serum FSH and estradiol levels throughout the reproductive period
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Antonio La Marca, Maddalena Plebani, Silvano Milani, Annibale Volpe, Cindy Argento, Valentina Grisendi, Renato Seracchioli, Elena Spada, Grisendi V, Spada E, Argento C, Plebani M, Milani S, Seracchioli R, Volpe A, and La Marca A.
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Adult ,medicine.medical_specialty ,endocrine system ,Aging ,Serum fsh ,Adolescent ,Cross-sectional study ,Endocrinology, Diabetes and Metabolism ,Estradiol ,FSH ,nomogram ,reference values ,Biological Markers ,Cross-Sectional Studies ,Female ,Follicle Stimulating Hormone, Human ,Follicular Phase ,Humans ,Italy ,Linear Models ,Luminescent Measurements ,Ovary ,Pituitary Gland, Anterior ,Premenopause ,Reference Values ,Tertiary Care Centers ,Young Adult ,Up-Regulation ,Endocrinology ,Internal medicine ,Follicular phase ,medicine ,Young adult ,business.industry ,Obstetrics and Gynecology ,Nomogram ,medicine.disease ,medicine.anatomical_structure ,Reference values ,business ,Poor ovarian reserve ,hormones, hormone substitutes, and hormone antagonists ,Biomarkers - Abstract
High serum day 3 FSH levels are associated with poor ovarian reserve and reduced fertility, but the interpretation of FSH values according to age is still not univocal. The purpose of this study was to determine age-dependent reference values in women with regular menstrual cycles and FSH as a guide for specialists. The study was performed at the Department of Mother-Infant of a University-based tertiary care centre. One-hundred ninety-two healthy normal menstruating women were recruited for the study. All patients attended the department on menstrual cycle day 3 for a blood sample for FSH and estradiol determination. A linear relationship between FSH or estradiol serum levels and age was observed. The FSH level increased by 0.11 IU for every year of age (1 IU for every 9 years of age). The values of FSH and estradiol corresponding to the 5th, 25th, 50th, 75th, 95th centiles for any specific age have been calculated. Serum FSH levels need to be interpreted according to age-dependent reference values. Serum FSH levels on 95th centile for any age may represent a warning sign for reduced ovarian reserve.
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- 2014
57. Sequential alternating deferiprone and deferoxamine treatment compared to deferiprone monotherapy: main findings and clinical follow-up of a large multicenter randomized clinical trial in -thalassemia major patients
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Pietro Violi, R. Malizia, Domenico Giuseppe D'Ascola, Alessia Pepe, Alberto Morabito, Saveria Campisi, Gaetano Restivo Pantalone, Maria Antonietta Romeo, Calogera Gerardi, Michele Rizzo, Alessandra Quota, Christian Gluud, Aurelio Maggio, Paolo Cianciulli, Gennaro D'Amico, Francesco Gagliardotto, Aldo Filosa, Carmelo Magnano, Crocetta Argento, Paolo Rigano, Luciano Prossomariti, Vincenzo Caruso, Carmelo Fidone, Angela Vitrano, Liana Cuccia, Marcello Capra, Pantalone, GR, Maggio, A, Vitrano, A, Capra, M, Cuccia, L, Gagliardotto, F, Filosa, A, Romeo, MA, Magnano, C, Caruso, V, Argento, C, Gerardi, C, Campisi, S, Violi, P, Malizia, R, Cianciulli, P, Rizzo, M, D'Ascola, DG, Quota, A, Prossomariti, L, Fidone, C, Rigano, P, Pepe, A, D'Amico, G, Morabito, A, and Gluud, C
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Pyridones ,Thalassemia ,Clinical Biochemistry ,Deferoxamine ,Iron Chelating Agents ,Gastroenterology ,Drug Administration Schedule ,law.invention ,chemistry.chemical_compound ,Young Adult ,Randomized controlled trial ,law ,Internal medicine ,Medicine ,Humans ,Deferiprone ,Adverse effect ,Genetics (clinical) ,Survival analysis ,business.industry ,Biochemistry (medical) ,Serum ferritin level ,beta-Thalassemia ,Hematology ,Iron chelation therapy ,medicine.disease ,Chelation Therapy ,Treatment Outcome ,chemistry ,Drug Therapy, Combination ,Female ,business ,Thalassemia, Iron overload, Iron chelation therapy, Deferiprone (L1), Deferroxamine (DFO) ,medicine.drug ,Follow-Up Studies - Abstract
In β-thalassemia major (β-TM) patients, iron chelation therapy is mandatory to reduce iron overload secondary to transfusions. Recommended first line treatment is deferoxamine (DFO) from the age of 2 and second line treatment after the age of 6 is deferiprone (L1). A multicenter randomized open-label trial was designed to assess the effectiveness of long-term alternating sequential L1-DFO versus L1 alone iron chelation therapy in β-TM patients. Deferiprone 75 mg/kg 4 days/week and DFO 50 mg/kg/day for 3 days/week was compared with L1 alone 75 mg/kg 7 days/week during 5-year follow-up. A total of 213 thalassemia patients were randomized and underwent intention-to-treat analysis. Statistically, a decrease of serum ferritin levels was significantly higher in alternating sequential L1-DFO patients compared with L1 alone patients (p = 0.005). Kaplan-Meier survival analysis for the two chelation treatments did not show statistically significant differences (log-rank test, p = 0.3145). Adverse events and costs were comparable between the groups. Alternating sequential L1-DFO treatment decreased serum ferritin concentration during a 5-year treatment by comparison to L1 alone, without significant differences of survival, adverse events or costs. These findings were confirmed in a further 21-month follow-up. These data suggest that alternating sequential L1-DFO treatment may be useful for some β-TM patients who may not be able to receive other forms of chelation treatment.
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- 2011
58. Long-term sequential deferiprone-deferoxamine versus deferiprone alone for thalassemia major patients: a randomised clinical trial
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Paolo Rigano, Luciano Prossomariti, Domenico Giuseppe D'Ascola, Michele Rizzo, Christian Gluud, Aldo Filosa, Vincenzo Caruso, Calogera Gerardi, Carmelo Magnano, Pietro Violi, Saveria Campisi, Alessia Pepe, Gennaro D'Amico, Paolo Cianciulli, Carmelo Fidone, Alberto Morabito, Marcello Capra, Aurelio Maggio, Angela Vitrano, Francesco Gagliardotto, Alessandra Quota, Liana Cuccia, R. Malizia, Maria Antonietta Romeo, Crocetta Argento, Maggio, A, Vitrano, A, Capra, M, Cuccia, L, Gagliardotto, F, Filosa, A, Romeo, MA, Magnano, C, Caruso, V, Argento, C, Gerardi, C, Campisi, S, Violi, P, Malizia, R, Cianciulli, P, Rizzo, M, D’Ascola, DG, Quota, A, Prossomariti, L, Fidone, C, Rigano, P, Pepe, A, D’Amico, G, Morabito, A, and Gluud, C
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Adult ,Male ,medicine.medical_specialty ,Randomization ,Adolescent ,Pyridones ,Administration, Oral ,Kaplan-Meier Estimate ,Deferoxamine ,Infusions, Subcutaneous ,Iron Chelating Agents ,Gastroenterology ,law.invention ,Young Adult ,chemistry.chemical_compound ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Humans ,Deferiprone ,Adverse effect ,Decreased serum ferritin ,Survival analysis ,business.industry ,Hematology ,Surgery ,Clinical trial ,Chelation, thalassaemia, clinical trials, red blood cell disorders, iron overload ,Treatment Outcome ,chemistry ,Ferritins ,Thalassemia ,Drug Therapy, Combination ,Female ,business ,Follow-Up Studies ,medicine.drug - Abstract
A multicentre randomized open-label trial was designed to assess the effectiveness of long-term sequential deferiprone–deferoxamine (DFO–DFP) versus DFP alone to treat thalassaemia major (TM). DFP at 75 mg/kg, divided into three oral daily doses, for 4 d/week and DFO by subcutaneous infusion (8–12 h) at 50 mg/kg per day for the remaining 3 d/week was compared with DFP alone at 75 mg/kg, administered 7 d/week during a 5-year follow-up. The main outcome measures were differences between multiple observations of serum ferritin concentrations. Secondary outcomes were survival analysis, adverse events, and costs. Consecutive thalassaemia patients (275) were assessed for eligibility; 213 of these were randomized and underwent intention-to-treat analysis. The decrease of serum ferritin levels during the treatment period was statistically significant higher in sequential DFP–DFO patients compared with DFP-alone patients (P = 0.005). Kaplan– Meier survival analysis for the two chelation treatments did not show any statistically significant differences (log-rank test, P = 0.3145). Adverse events and costs were comparable between the groups. The trial results show that sequential DFP–DFO treatment compared with DFP alone significantly decreased serum ferritin concentration during treatment for 5 years without significant differences regarding survival, adverse events, or costs.
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- 2009
59. Improving survival with deferiprone treatment in patients with thalassemia major: A prospective multicenter randomised clinical trial under the auspices of the Italian Society for Thalassemia and Hemoglobinopathies
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Michele Rizzo, Crocetta Argento, Angela Vitrano, Pietro Violi, R. Malizia, Domenico Giuseppe D'Ascola, Carmelo Magnano, Aurelio Maggio, Marcello Capra, Saveria Campisi, Francesco Cantella, Francesca Valeria Commendatore, Francesco Gagliardotto, Liana Cuccia, Giovanni Giugno, Rocca Cingari, Carmelo Fidone, Maria Antonietta Romeo, Paolo Rigano, Luciano Prossomariti, Anna Meo, Paolo Cianciulli, Gaetano Roccamo, Aldo Filosa, Maria Concetta Galati, Gaetano Giuffrida, Vincenzo Caruso, Turi Lombardo, Angela Ciancio, Calogera Gerardi, Maggio, A, Vitrano, A, Capra, M, Cuccia, L, Gagliardotto, F, Filosa, A, Magnano, C, Rizzo, M, Caruso, V, Gerardi, C, Argento, C, Campisi, S, Cantella, F, Commendadore, F, D’Ascola, DG, Fidone, C, Ciancio, A, Galati, MC, Giuffrida, G, Cingari, R, Giugno, G, Lombardo, T, Prossomariti, L, Malizia, R, Meo, A, Roccamo, G, Romeo, MA, Violi, P, Cianciulli, P, and Rigano, P
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Male ,Thalassemia ,Kaplan-Meier Estimate ,law.invention ,chemistry.chemical_compound ,Randomized controlled trial ,law ,Cause of Death ,Neoplasms ,Deferiprone ,Prospective Studies ,Child ,Cause of death ,Hazard ratio ,Hematology ,Middle Aged ,Combined Modality Therapy ,Survival Rate ,Thalassemia, survival, chelation, treatment, trial, thalassemia major ,Combination ,Splenectomy ,Molecular Medicine ,Drug Therapy, Combination ,Female ,Adult ,medicine.medical_specialty ,Adolescent ,Pyridones ,Deferoxamine ,Iron Chelating Agents ,Young Adult ,Drug Therapy ,Internal medicine ,medicine ,Humans ,Blood Transfusion ,Chelation Therapy ,Heart Failure ,Kaplan-Meiers Estimate ,Proportional Hazards Models ,beta-Thalassemia ,Molecular Biology ,Survival rate ,Survival analysis ,business.industry ,Proportional hazards model ,Cell Biology ,medicine.disease ,Surgery ,chemistry ,business - Abstract
The prognosis for thalassemia major has dramatically improved in the last two decades. However, many transfusion-dependent patients continue to develop progressive accumulation of iron. This can lead to tissue damage and eventually death, particularly from cardiac disease. Previous studies that investigated iron chelation treatments, including retrospective and prospective non-randomised clinical trials, suggested that mortality, due mainly to cardiac damage, was reduced or completely absent in patients treated with deferiprone (DFP) alone or a combined deferiprone-deferoxamine (DFP-DFO) chelation treatment. However, no survival analysis has been reported for a long-term randomised control trial. Here, we performed a multicenter, long-term, randomised control trial that compared deferoxamine (DFO) versus DFP alone, sequential DFP-DFO, or combined DFP-DFO iron chelation treatments. The trial included 265 patients with thalassemia major, with 128 (48.3%) females and 137 (51.7%) males. No deaths occurred with the DFP-alone or the combined DFP-DFO treatments. One death occurred due to graft versus host disease (GVHD) in a patient that had undergone bone marrow transplantation; this patient was censored at the time of transplant. Only one death occurred with the DFP-DFO sequential treatment in a patient that had experienced an episode of heart failure one year earlier. Ten deaths occurred with the deferoxamine treatment. The main factors that correlated with an increase in the hazard ratio for death were: cirrhosis, arrhythmia, previous episode of heart failure, diabetes, hypogonadism, and hypothyroidism. In a Cox regression model, the interaction effect of sex and age was statistically significant (p-value
- Published
- 2009
60. Left atrial strain in patients with β-thalassemia major: a cross-sectional CMR study.
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Meloni A, Saba L, Positano V, Pistoia L, Porcu M, Massei F, Sanna PMG, Longo F, Giovangrossi P, Argento C, Gerardi C, Cademartiri F, and Cau R
- Abstract
Objectives: The aim of this cross-sectional study was to investigate the association of left atrial (LA) strain parameters with demographics, clinical data, cardiovascular magnetic resonance (CMR) findings, and cardiac complications (heart failure and arrhythmias) in a cohort of patients with β-thalassemia major (β-TM)., Materials and Methods: We considered 264 β-TM patients (133 females, 36.79 ± 11.95 years) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia (E-MIOT) project. Moreover, we included 35 sex- and age-matched healthy controls (14 females, mean age 37.36 ± 17.52 years). Reservoir, conduit, and booster LA functions were analysed by CMR feature tracking using dedicated software., Results: Compared to the healthy control group, β-TM patients demonstrated lower LA reservoir strain and booster strains, as well as LA reservoir and booster strain rates. However, no differences were found in LA conduit deformation parameters. In β-TM patients, ageing, sex, and left ventricle (LV) volume indexes were independent determinants of LA strain parameters. The number of segments with late gadolinium enhancement (LGE) significantly correlated with all LA strain parameters, with the exception of the LA conduit rate. Patients with cardiac complications exhibited significantly impaired strain parameters compared to patients without cardiac complications., Conclusion: In patients with β-TM, LA strain parameters were impaired compared to control subjects, and they exhibited a significant correlation with the number of LV segments with LGE. Furthermore, patients with cardiac complications had impaired left atrial strain parameters. Clinical relevance statement In patients with β-thalassemia major, left atrial strain parameters were impaired compared to control subjects and emerged as a sensitive marker of cardiac complications, stronger than cardiac iron levels., Key Points: • Compared to healthy subjects, β-thalassemia major patients demonstrated significantly lower left atrial reservoir strain and booster strains, as well as left atrial reservoir and booster strain rates. • In β-thalassemia major, ageing, sex, and left ventricular volume indexes were independent determinants of left atrial strain parameters, while left atrial strain parameters were not correlated with myocardial iron overload. • An independent association between reduced left atrial strain parameters and a history of cardiac complications was found in β-thalassemia major patients., (© 2024. The Author(s), under exclusive licence to European Society of Radiology.)
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- 2024
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61. Pattern and clinical correlates of renal iron deposition in adult beta-thalassemia major patients.
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Meloni A, Barbuto L, Positano V, Pistoia L, Spasiano A, Casini T, Massei F, Argento C, Giovangrossi P, Barone A, Romano L, and Cademartiri F
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- Female, Humans, Adult, Iron metabolism, Ferritins, Liver diagnostic imaging, Liver pathology, Myocardium pathology, Magnetic Resonance Imaging methods, Kidney diagnostic imaging, Kidney pathology, beta-Thalassemia complications, beta-Thalassemia pathology, Iron Overload pathology
- Abstract
We evaluated pattern and clinical correlates of renal T2* measurements in adult β-thalassemia major (β-TM) patients. Ninety β-TM patients (48 females, 38.15 ± 7.94 years), consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia network, underwent T2* magnetic resonance imaging (MRI) for quantification of iron overload (IO) in kidneys, liver, pancreas, and heart. Ten (11.1%) patients showed renal IO (T2* < 31 ms). Global kidney T2* values did not show a correlation with gender, age, splenectomy, regular transfusions or chelation starting age, pre-transfusion hemoglobin, and serum ferritin levels. Global kidney T2* values showed an inverse correlation with MRI liver iron concentration (LIC) values (R = - 0.349; p = 0.001) and a positive correlation with global pancreas T2* values (R = 0.212; p = 0.045). Frequency of renal IO was significantly higher in patients with cardiac IO than in patients without cardiac IO (50.0% vs. 6.3%; p = 0.001). A significant inverse association was detected between global kidneys T2* values and lactate dehydrogenase (LDH) (R = - 0.529; p < 0.0001). In multivariate regression analysis, MRI LIC and LDH were the strongest predictors of global kidney T2* values. A MRI LIC > 4.83 mg/g dw predicted the presence of renal IO (sensitivity = 90.0%; specificity = 61.2%). Global kidney T2* values were inversely correlated with uric acid (R = - 0.269; p = 0.025). In conclusion, in adult β-TM patients, renal iron deposition is not common and is linked to both hemolysis and total body iron overload., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
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- 2023
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62. Bone status and HCV infection in thalassemia major patients.
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Meloni A, Pistoia L, Maffei S, Ricchi P, Casini T, Corigliano E, Putti MC, Cuccia L, Argento C, Positano V, Pepe A, Cademartiri F, and Vassalle C
- Subjects
- Female, Humans, Bone Density, Hepacivirus, Lumbar Vertebrae, Osteocalcin, Vitamin D, Male, beta-Thalassemia, Hepatitis C, Hypogonadism, Iron Overload
- Abstract
Purpose: Hepatitis C virus (HCV) infection increases the risk for osteoporosis but this relationship has not been investigated among multi-transfused patients with thalassemia major (TM). We cross-sectionally explored the association of HCV infection with bone mineral density (BMD), vitamin D, and bone turnover biomarkers in TM., Methods: We considered 130 TM patients (41.89 ± 5.49 years, 67 females) enrolled in the E-MIOT (Extension-Myocardial Iron Overload in Thalassemia) Network. BMD measurements taken at the lumbar spine, femoral neck and total hip were expressed as Z-scores, with a BMD Z-score ≤ -2.0 indicating low bone mass., Results: Z-scores were not associated with gender, iron overload indices, vitamin D levels, and biochemical bone turnover markers, but decreased with aging and in presence of hypogonadism and were directly correlated with body mass index (BMI). The prevalence of low bone mass was 70.7 %. Three groups of patients were identified: 78 who never contracted the infection (group 0), 72 who cleared HCV (group 1), and 29 with chronic HCV infection (CHC) (group 2). All Z-scores progressively decreased according to HCV status from group 0 to group 2. Osteocalcin levels were significantly lower in groups 2 and 1 than in group 0. CHC patients were more likely to have low bone mass compared to HCV naive patients, after adjusting for age, BMI, hypogonadism, and pancreatic iron., Conclusion: In TM, CHC appears as one additive risk factor for low bone mass and osteocalcin may play a role in this association., Competing Interests: Declaration of competing interest The authors state no conflict of interest regarding this manuscript., (Copyright © 2023. Published by Elsevier Inc.)
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- 2023
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63. Bleeding Risk With Combination Intrapleural Fibrinolytic and Enzyme Therapy in Pleural Infection: An International, Multicenter, Retrospective Cohort Study.
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Akulian J, Bedawi EO, Abbas H, Argento C, Arnold DT, Balwan A, Batra H, Uribe Becerra JP, Belanger A, Berger K, Burks AC, Chang J, Chrissian AA, DiBardino DM, Fuentes XF, Gesthalter YB, Gilbert CR, Glisinski K, Godfrey M, Gorden JA, Grosu H, Gupta M, Kheir F, Ma KC, Majid A, Maldonado F, Maskell NA, Mehta H, Mercer J, Mullon J, Nelson D, Nguyen E, Pickering EM, Puchalski J, Reddy C, Revelo AE, Roller L, Sachdeva A, Sanchez T, Sathyanarayan P, Semaan R, Senitko M, Shojaee S, Story R, Thiboutot J, Wahidi M, Wilshire CL, Yu D, Zouk A, Rahman NM, and Yarmus L
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- Humans, Tissue Plasminogen Activator adverse effects, Fibrinolytic Agents adverse effects, Retrospective Studies, Hemorrhage chemically induced, Hemorrhage epidemiology, Enzyme Therapy, Pleural Effusion complications, Pleural Diseases complications, Communicable Diseases, Empyema, Pleural drug therapy, Empyema, Pleural epidemiology, Empyema, Pleural complications
- Abstract
Background: Combination intrapleural fibrinolytic and enzyme therapy (IET) has been established as a therapeutic option in pleural infection. Despite demonstrated efficacy, studies specifically designed and adequately powered to address complications are sparse. The safety profile, the effects of concurrent therapeutic anticoagulation, and the nature and extent of nonbleeding complications remain poorly defined., Research Question: What is the bleeding complication risk associated with IET use in pleural infection?, Study Design and Methods: This was a multicenter, retrospective observational study conducted in 24 centers across the United States and the United Kingdom. Protocolized data collection for 1,851 patients treated with at least one dose of combination IET for pleural infection between January 2012 and May 2019 was undertaken. The primary outcome was the overall incidence of pleural bleeding defined using pre hoc criteria., Results: Overall, pleural bleeding occurred in 76 of 1,833 patients (4.1%; 95% CI, 3.0%-5.0%). Using a half-dose regimen (tissue plasminogen activator, 5 mg) did not change this risk significantly (6/172 [3.5%]; P = .68). Therapeutic anticoagulation alongside IET was associated with increased bleeding rates (19/197 [9.6%]) compared with temporarily withholding anticoagulation before administration of IET (3/118 [2.6%]; P = .017). As well as systemic anticoagulation, increasing RAPID score, elevated serum urea, and platelets of < 100 × 10
9 /L were associated with a significant increase in bleeding risk. However, only RAPID score and use of systemic anticoagulation were independently predictive. Apart from pain, non-bleeding complications were rare., Interpretation: IET use in pleural infection confers a low overall bleeding risk. Increased rates of pleural bleeding are associated with concurrent use of anticoagulation but can be mitigated by withholding anticoagulation before IET. Concomitant administration of IET and therapeutic anticoagulation should be avoided. Parameters related to higher IET-related bleeding have been identified that may lead to altered risk thresholds for treatment., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)- Published
- 2022
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64. Second stimulation in the same ovarian cycle: an option to fully-personalize the treatment in poor prognosis patients undergoing PGT-A.
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Vaiarelli A, Cimadomo D, Gennarelli G, Guido M, Alviggi C, Conforti A, Livi C, Revelli A, Colamaria S, Argento C, Giuliani M, De Angelis C, Matteo M, Canosa S, D'Alfonso A, Cimadomo V, Rienzi L, and Ubaldi FM
- Subjects
- Aneuploidy, Female, Fertilization in Vitro, Genetic Testing, Humans, Menstrual Cycle physiology, Pregnancy, Prognosis, Blastocyst physiology, Embryo Transfer methods
- Abstract
Purpose: Our primary objective was to assess whether immediately undergoing a second stimulation in the same ovarian cycle (DuoStim) for advanced-maternal-age and/or poor-ovarian-reserve (AMA/POR) patients obtaining ≤ 3 blastocysts for preimplantation-genetic-testing-for-aneuploidies (PGT-A) is more efficient than the conventional-approach., Methods: All AMA/POR patients obtaining ≤ 3 blastocysts after conventional-stimulation between 2017 and 2019 were proposed DuoStim, and 143 couples accepted (DuoStim-group) and were matched for the main confounders to 143 couples who did not accept (conventional-group). GnRH-antagonist protocol with recombinant-gonadotrophins and agonist trigger, intra-cytoplasmatic-sperm-injection (ICSI) with ejaculated sperm, PGT-A and vitrified-warmed euploid single-blastocyst-transfer(s) were performed. The primary outcome was the cumulative-live-birth-delivery-rate per intention-to-treat (CLBdR per ITT) within 1 year. If not delivering, the conventional-group had 1 year to undergo another conventional-stimulation. A cost-effectiveness analysis was also conducted., Results: The CLBdR was 10.5% in the conventional-group after the first attempt. Only 12 of the 128 non-pregnant patients returned (165 ± 95 days later; drop-out = 116/128,90.6%), and 3 delivered. Thus, the 1-year CLBdR was 12.6% (N = 18/143). In the DuoStim-group, the CLBdR was 24.5% (N = 35/143; p = 0.01), 2 women delivered twice and 13 patients have other euploid blastocysts after a LB (0 and 2 in the conventional-group). DuoStim resulted in an incremental-cost-effectiveness-ratio of 23,303€. DuoStim was costlier and more effective in 98.7% of the 1000 pseudo-replicates generated through bootstrapping, and the cost-effectiveness acceptability curves unveiled that DuoStim would be more cost-effective than the conventional-approach at a willingness-to-pay threshold of 23,100€., Conclusions: During PGT-A treatments in AMA/POR women, DuoStim can be suggested in progress to rescue poor blastocyst yields after conventional-stimulation. It might indeed prevent drop-out or further aging between attempts., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2022
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65. Maternal body mass index associates with blastocyst euploidy and live birth rates: the tip of an iceberg?
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Fabozzi G, Cimadomo D, Allori M, Vaiarelli A, Colamaria S, Argento C, Amendola MG, Innocenti F, Soscia D, Maggiulli R, Mazzilli R, Ubaldi N, Iussig B, Marchetti M, Rienzi L, and Ubaldi FM
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- Adult, Female, Humans, Middle Aged, Pregnancy, Retrospective Studies, Young Adult, Abortion, Spontaneous etiology, Birth Rate, Body Mass Index, Embryo, Mammalian abnormalities, Overweight complications
- Abstract
Research Question: Does maternal preconceptional body mass index (BMI) associate with mean blastocyst euploidy rate (m-ER) per patient and live birth rate (LBR) after vitrified-warmed euploid single embryo transfer (SET)?, Design: Observational study conducted between April 2013 and March 2020 at a private IVF clinic, involving 1811 Caucasian women undergoing trophectoderm biopsy and comprehensive chromosome testing. The outcomes of 1125 first vitrified-warmed euploid SET were also analysed. Patients were clustered as normal weight (BMI 18.5-25; n = 1392 performing 859 SET), underweight (BMI <18.5; n = 160 performing 112 SET) and overweight (BMI >25; n = 259 performing 154 SET). m-ER per patient was the primary outcome. The secondary outcomes were all clinical outcomes per euploid SET. All data were adjusted for confounders through regression analyses., Results: The m-ER per patient decreases as maternal BMI increases from 17 up to 22-23 before reaching a plateau. A linear regression adjusted for maternal age confirmed this moderate association (unstandardized coefficient B: -0.6%, 95% confidence interval [CI]: -1.1 to -0.1%, P = 0.02). All clinical outcomes were similar between normal weight and underweight women. Overweight women, instead, showed higher miscarriage rate per clinical pregnancy (n = 20/75, 26.7% versus n = 67/461, 14.5%; odds ratio [OR] adjusted for blastocyst quality and day of full blastulation: 2.0, 95% CI: 1.1-3.6, P = 0.01) and lower LBR per SET (n = 55/154, 35.7% versus n = 388/859, 45.2%; OR adjusted for blastocyst quality and day of full blastulation: 0.67, 95% CI: 0.46-0.96, P = 0.03)., Conclusion: These data indicate a need for future research on more sensitive metrics to assess body fat mass and distribution, as well as on the mechanisms leading to lipotoxicity, thereby impairing embryo competence and/or endometrial receptivity. Overweight women should be informed of their higher risk for miscarriage and, whenever possible, encouraged to lose weight, especially before transfer., (Copyright © 2021 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)
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- 2021
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66. Oocyte competence is independent of the ovulation trigger adopted: a large observational study in a setting that entails vitrified-warmed single euploid blastocyst transfer.
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Cimadomo D, Vaiarelli A, Petriglia C, Fabozzi G, Ferrero S, Schimberni M, Argento C, Colamaria S, Giuliani M, Ubaldi N, Rienzi L, and Ubaldi FM
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- Adult, Birth Rate, Blastocyst metabolism, Chorionic Gonadotropin metabolism, Embryo Culture Techniques trends, Embryo Transfer trends, Female, Gonadotropin-Releasing Hormone agonists, Humans, Live Birth epidemiology, Oocyte Retrieval, Oocytes transplantation, Ovulation genetics, Ovulation Induction methods, Pregnancy, Pregnancy Rate, Sperm Injections, Intracytoplasmic, Vitrification, Chorionic Gonadotropin genetics, Fertilization in Vitro, Gonadotropin-Releasing Hormone genetics, Oocytes growth & development
- Abstract
Purpose: To assess whether the GnRH-agonist or urinary-hCG ovulation triggers affect oocyte competence in a setting entailing vitrified-warmed euploid blastocyst transfer., Methods: Observational study (April 2013-July 2018) including 2104 patients (1015 and 1089 in the GnRH-a and u-hCG group, respectively) collecting ≥1 cumulus-oocyte-complex (COC) and undergoing ICSI with ejaculated sperm, blastocyst culture, trophectoderm biopsy, comprehensive-chromosome-testing, and vitrified-warmed transfers at a private clinic. The primary outcome measure was the euploid-blastocyst-rate per inseminated oocytes. The secondary outcome measure was the maturation-rate per COCs. Also, the live-birth-rate (LBR) per transfer and the cumulative-live-birth-delivery-rate (CLBdR) among completed cycles were investigated. All data were adjusted for confounders., Results: The generalized-linear-model adjusted for maternal age highlighted no difference in the mean euploid-blastocyst-rate per inseminated oocytes in either group. The LBR per transfer was similar: 44% (n=403/915) and 46% (n=280/608) in GnRH-a and hCG, respectively. On the other hand, a difference was reported regarding the CLBdR per oocyte retrieval among completed cycles, with 42% (n=374/898) and 25% (n=258/1034) in the GnRh-a and u-hCG groups, respectively. Nevertheless, this variance was due to a lower maternal age and higher number of inseminated oocytes in the GnRH-a group, and not imputable to the ovulation trigger itself (multivariate-OR=1.3, 95%CI: 0.9-1.6, adjusted p-value=0.1)., Conclusion: GnRH-a trigger is a valid alternative to u-hCG in freeze-all cycles, not only for patients at high risk for OHSS. Such strategy might increase the safety and flexibility of controlled-ovarian-stimulation with no impact on oocyte competence and IVF efficacy.
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- 2021
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67. Separating Empty and Full Recombinant Adeno-Associated Virus Particles Using Isocratic Anion Exchange Chromatography.
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Dickerson R, Argento C, Pieracci J, and Bakhshayeshi M
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- Anions, Chromatography, Ion Exchange, Recombination, Genetic, Dependovirus genetics, Dependovirus isolation & purification, Genetic Vectors genetics, Genetic Vectors isolation & purification, Virion genetics, Virion isolation & purification
- Abstract
The development of recombinant adeno-associated virus (rAAV) gene therapies is becoming an increasing priority in the biotherapeutic landscape. One of the challenges associated with the production of rAAV is the formation of empty AAV particles that do not contain a therapeutic gene. The concerns about the impact of empty particles on clinical safety and rAAV-mediated gene expression have necessitated the development of purification processes to remove these species. The development of a robust and scalable purification process to separate empty and full AAV particles at large scale remains a challenge. In this study, a novel anion exchange chromatography process based on isocratic wash and elution steps to enrich full rAAV2 particles is presented. An operating design space is identified to ensure the robustness of the process. The isocratic chromatography provides several advantages over the traditional shallow linear gradient elution, including lower buffer consumption, smaller intermediate pool volumes, and more robust manufacturing., (© 2020 Wiley-VCH GmbH.)
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- 2021
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68. The euploid blastocysts obtained after luteal phase stimulation show the same clinical, obstetric and perinatal outcomes as follicular phase stimulation-derived ones: a multicenter study.
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Vaiarelli A, Cimadomo D, Alviggi E, Sansone A, Trabucco E, Dusi L, Buffo L, Barnocchi N, Fiorini F, Colamaria S, Giuliani M, Argento C, Rienzi L, and Ubaldi FM
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- Adult, Blastocyst, Cryopreservation, Female, Humans, Infant, Newborn, Male, Pregnancy, Prospective Studies, Retrospective Studies, Follicular Phase, Luteal Phase
- Abstract
Study Question: Are the reproductive outcomes (clinical, obstetric and perinatal) different between follicular phase stimulation (FPS)- and luteal phase stimulation (LPS)-derived euploid blastocysts?, Summary Answer: No difference was observed between FPS- and LPS-derived euploid blastocysts after vitrified-warmed single embryo transfer (SET)., What Is Known Already: Technical improvements in IVF allow the implementation non-conventional controlled ovarian stimulation (COS) protocols for oncologic and poor prognosis patients. One of these protocols begins LPS 5 days after FPS is ended (DuoStim). Although, several studies have reported similar embryological outcomes (e.g. fertilization, blastulation, euploidy) between FPS- and LPS-derived cohort of oocytes, information on the reproductive (clinical, obstetric and perinatal) outcomes of LPS-derived blastocysts is limited to small and retrospective studies., Study Design, Size, Duration: Multicenter study conducted between October 2015 and March 2019 including all vitrified-warmed euploid single blastocyst transfers after DuoStim. Only first transfers of good quality blastocysts (≥BB according to Gardner and Schoolcraft's classification) were included. If euploid blastocysts obtained after both FPS and LPS were available the embryo to transfer was chosen blindly. The primary outcome was the live birth rate (LBR) per vitrified-warmed single euploid blastocyst transfer in the two groups. To achieve 80% power (α = 0.05) to rule-out a 15% difference in the LBR, a total of 366 first transfers were required. Every other clinical, as well as obstetric and perinatal outcomes, were recorded., Participants/materials, Setting, Methods: Throughout the study period, 827 patients concluded a DuoStim cycle and among them, 339 did not identify any transferable blastocyst, 145 had an euploid blastocyst after FPS, 186 after LPS and 157 after both FPS and LPS. Fifty transfers of poor quality euploid blastocysts were excluded and 49 patients did not undergo an embryo transfer during the study period. Thus, 389 patients had a vitrified-warmed SET of a good quality euploid blastocyst (182 after FPS and 207 after LPS). For 126 cases (32%) where both FPS- and LPS-derived good quality blastocysts were available, the embryo transferred was chosen blindly with a 'True Random Number Generator' function where '0' stood for FPS-derived euploid blastocysts and '1' for LPS-derived ones (n = 70 and 56, respectively) on the website random.org. All embryos were obtained with the same ovarian stimulation protocol in FPS and LPS (GnRH antagonist protocol with fixed dose of rec-FSH plus rec-LH and GnRH-agonist trigger), culture conditions (continuous culture in a humidified atmosphere with 37°C, 6% CO2 and 5% O2) and laboratory protocols (ICSI, trophectoderm biopsy in Day 5-7 without assisted hatching in Day 3, vitrification and comprehensive chromosome testing). The women whose embryos were included had similar age (FPS: 38.5 ± 3.1 and LPS: 38.5 ± 3.2 years), prevalence of male factor, antral follicle count, basal hormonal characteristics, main cause of infertility and previous reproductive history (i.e. previous live births, miscarriages and implantation failures) whether the embryo came from FPS or LPS. All transfers were conducted after warming in an artificial cycle. The blastocysts transferred after FPS and LPS were similar in terms of day of full-development and morphological quality., Main Results and the Role of Chance: The positive pregnancy test rates for FPS- and LPS-derived euploid blastocysts were 57% and 62%, biochemical pregnancy loss rates were 10% and 8%, miscarriage rates were 15% and 14% and LBRs were 44% (n = 80/182, 95% CI 37-51%) and 49% (n = 102/207, 95% CI 42-56%; P = 0.3), respectively. The overall odds ratio for live birth (LPS vs FPS (reference)) adjusted for day of blastocyst development and quality, was 1.3, 95% CI 0.8-2.0, P = 0.2. Among patients with euploid blastocysts obtained following both FPS and LPS, the LBRs were also similar (53% (n = 37/70, 95% CI 41-65%) and 48% (n = 27/56, 95% CI 35-62%) respectively; P = 0.7). Gestational issues were experienced by 7.5% of pregnant women after FPS- and 10% of women following LPS-derived euploid single blastocyst transfer. Perinatal issues were reported in 5% and 0% of the FPS- and LPS-derived newborns, respectively. The gestational weeks and birthweight were similar in the two groups. A 5% pre-term delivery rate was reported in both groups. A low birthweight was registered in 2.5% and 5% of the newborns, while 4% and 7% showed high birthweight, in FPS- and LPS-derived euploid blastocyst, respectively. Encompassing the 81 FPS-derived newborns, a total of 9% were small and 11% large for gestational age. Among the 102 LPS-derived newborns, 8% were small and 6% large for gestational age. No significant difference was reported for all these comparisons., Limitations, Reasons for Caution: The LPS-derived blastocysts were all obtained after FPS in a DuoStim protocol. Therefore, studies are required with LPS-only, late-FPS and random start approaches. The study is powered to assess differences in the LBR per embryo transfer, therefore obstetric and perinatal outcomes should be considered observational. Although prospective, the study was not registered., Wider Implications of the Findings: This study represents a further backing of the safety of non-conventional COS protocols. Therefore, LPS after FPS (DuoStim protocol) is confirmed a feasible and efficient approach also from clinical, obstetric and perinatal perspectives, targeted at patients who need to reach the transfer of an euploid blastocyst in the shortest timeframe possible due to reasons such as cancer, advanced maternal age and/or reduced ovarian reserve and poor ovarian response., Study Funding/competing Interest(s): None., Trial Registration Number: N/A., (© The Author(s) 2020. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
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- 2020
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69. Double stimulation in the same ovarian cycle (DuoStim) is an intriguing strategy to improve oocyte yield and the number of competent embryos in a short timeframe.
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Vaiarelli A, Cimadomo D, Argento C, Ubaldi N, Trabucco E, Drakopoulos P, Venturella R, Conforti A, Alviggi C, Rienzi L, and Ubaldi FM
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- Embryo Culture Techniques, Female, Humans, Menstrual Cycle physiology, Pregnancy, Time-to-Pregnancy, Fertilization in Vitro methods, Oocytes metabolism, Ovulation Induction methods
- Abstract
Proper ovarian stimulation regimens are crucial for any patient undergoing in-vitro fertilization (IVF). However, maximizing the oocyte yield in advanced maternal age patients with poor or suboptimal response is still a challenge. In fact, no standard treatment has been outlined yet to manage these women. Across the last years, an improved efficiency of the IVF units via blastocyst culture, vitrification and reliable embryo selection approaches paved the way to the investigation of novel unconventional stimulation protocols, like double stimulation in a single ovarian cycle (DuoStim). DuoStim, by conjugating follicular phase stimulation (FPS) and luteal phase stimulation (LPS) in the same ovarian cycle, allows to maximize the number of oocytes obtained in a short timeframe, a precious outcome when we aim at shortening time to pregnancy. In this regard, LPS seems to contribute to conventional stimulation with more oocytes with a comparable competence as FPS, retrieved per ovarian cycle. Although any stimulation protocol which exploits anovulatory waves of follicular growth needs a thorough investigation, no evidence has been produced to question the safety of DuoStim, which to date represents the most intriguing strategy to treat poor prognosis in IVF.
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- 2019
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70. Comparison of Auto- and Fixed-Continuous Positive Airway Pressure on Air Leak in Patients with Obstructive Sleep Apnea: Data from a Randomized Controlled Trial.
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Lebret M, Rotty MC, Argento C, Pepin JL, Tamisier R, Arbib F, Jaffuel D, Molinari N, and Borel JC
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- Aged, Continuous Positive Airway Pressure adverse effects, Female, Humans, Male, Middle Aged, Continuous Positive Airway Pressure instrumentation, Sleep Apnea, Obstructive therapy
- Abstract
Auto-CPAP may cause sleep fragmentation due to variations in pressure and unintentional leaks. The aim of this study was to compare air leak between fixed-CPAP and auto-CPAP after 4 months of CPAP treatment. This study is an ancillary analysis of a randomized, double-blind, parallel, controlled trial over 4 months, comparing fixed- and auto-CPAP in newly diagnosed patients with OSA. The following data were extracted from the CPAP devices: mean and 90th percentile pressure, residual apnea-hypopnea index, mean CPAP use, and amount of leak. Within each arm, patients were also randomly allocated to use of one of the three different brands of devices. Since the leak was reported differently for each device, median leak value was determined for each brand and leaks were classified as "above the median" or "below the median". Data from 269 patients were analyzed. The univariate analysis showed that tobacco consumption, CPAP level, and oronasal masks were associated with leaks above the median value but not the type of CPAP. The multivariate analysis showed that only CPAP level and oronasal masks were associated with leaks below the median. There were no differences in the types of mask used between fixed- and auto-CPAP. There was no impact of the type of CPAP on leaks or the type of interface used. We used a method based on the median leak value to standardize comparisons across devices which report leaks with different definitions., Competing Interests: M Lebret and J-C Borel are employees of AGIR à dom, a nonprofit home care provider. J-C Borel has received grants, personal fees, and nonfinancial support from Philips Healthcare and ResMed unrelated to the submitted work. M Lebret has received personal fees and nonfinancial support from Air liquid Medical System and Sefam unrelated to the submitted work. The other authors declared no conflicts of interest.
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- 2019
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71. Concordance between RTOG and EORTC prognostic criteria in low-grade gliomas.
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Franceschi E, Mura A, Lamberti G, De Biase D, Tosoni A, Di Battista M, Argento C, Visani M, Paccapelo A, Bartolini S, and Brandes AA
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- Adult, Aged, DNA Modification Methylases genetics, DNA Repair Enzymes genetics, Disease-Free Survival, Female, Glioma genetics, Glioma pathology, Humans, Isocitrate Dehydrogenase genetics, Kaplan-Meier Estimate, Male, Middle Aged, Mutation, Neoplasm Grading, Tumor Suppressor Proteins genetics, Glioma epidemiology, Glioma therapy, Prognosis
- Abstract
Aim: European Organization for Research and Treatment of Cancer (EORTC) and the Radiation Therapy Oncology Group (RTOG) criteria are used to choose treatment in low-grade gliomas. However, no data exist on their concordance. Methods: Low-grade glioma patients treated at our institution from 1998 to 2015 and assessable for both RTOG and EORTC criteria were included to analyze their concordance. Surgery extension, postsurgical treatments, molecular characteristics ( IDH mutation, MGMT methylation and 1p/19q codeletion) were recorded. Results: We included 99 patients. The concordance was low (50.5%; K = 0.127; p = 0.021) but for two subgroups: EORTC high-risk patients were also RTOG high-risk patients (concordance: 97.5%) and RTOG low-risk patients were also EORTC low-risk patients (concordance: 90.9%). Conclusion: The concordance between RTOG and EORTC criteria is low. Thus, clinical trials adopting different risk criteria are not comparable.
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- 2019
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72. Analytical Strategies for Quantification of Adeno-Associated Virus Empty Capsids to Support Process Development.
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Fu X, Chen WC, Argento C, Clarner P, Bhatt V, Dickerson R, Bou-Assaf G, Bakhshayeshi M, Lu X, Bergelson S, and Pieracci J
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- Chromatography, High Pressure Liquid, Genetic Therapy, Microscopy, Electron, Transmission, Capsid ultrastructure, Dependovirus ultrastructure
- Abstract
Recombinant adeno-associated virus (rAAV)-mediated gene therapy is a fast-evolving field in the biotechnology industry. One of the major challenges in developing a purification process for AAV gene therapy is establishing an effective yet scalable method to remove empty capsids, or viral vectors lacking the therapeutic gene, from full capsids-viral product containing the therapeutic sequence. Several analytical methods that can quantify the empty-to-full capsid ratio have been reported in the literature. However, as samples can vary widely in viral titer, buffer matrix, and the relative level of empty capsids, understanding the specifications and limitations of different analytical methods is critical to providing appropriate support to facilitate process development. In this study, we developed a novel anion-exchange high-performance liquid chromatography assay to determine the empty-to-full capsid ratio of rAAV samples. The newly developed method demonstrated good comparability with both the transmission electron microscopy and analytical ultracentrifugation methods used in empty-to-full capsid ratio quantification, while providing much higher assay throughput and reducing the minimum sample concentration requirement to 2.7E11 viral genomes/mL.
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- 2019
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73. Female age, serum antimüllerian hormone level, and number of oocytes affect the rate and number of euploid blastocysts in in vitro fertilization/intracytoplasmic sperm injection cycles.
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La Marca A, Minasi MG, Sighinolfi G, Greco P, Argento C, Grisendi V, Fiorentino F, and Greco E
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- Adult, Biomarkers blood, Biopsy, Comparative Genomic Hybridization, Embryo Culture Techniques, Female, Fertility, Humans, Infertility blood, Infertility diagnosis, Infertility physiopathology, Male, Maternal Age, Ovary metabolism, Preimplantation Diagnosis methods, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Anti-Mullerian Hormone blood, Blastocyst pathology, Fertilization in Vitro adverse effects, Infertility therapy, Oocytes, Ovarian Reserve, Ovary physiopathology, Ploidies, Sperm Injections, Intracytoplasmic adverse effects
- Abstract
Objective: To study the relative role of female age and ovarian reserve, measured through serum antimüllerian hormone (AMH) in determining the rate and number of euploid blastocysts in in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles., Design: Retrospective analysis of cycles performed in 2014-2015., Setting: Tertiary referral IVF center., Patient(s): A total of 578 infertile couples undergoing IVF/ICSI and preimplantation genetic screening (PGS) analysis., Interventions(s): All embryos were cultured and biopsied at the blastocyst stage. The method involved whole-genome amplification followed by array comparative genome hybridization. Serum AMH was measured by means of the modified Beckman Coulter AMH Gen II assay., Main Outcome Measures: The rate and number of euploid blastocysts and their correlation with ovarian reserve and response to stimulation., Result(s): The mean (±SD) age of patients was 37.6 ± 4.1 years, and the mean number of blastocysts per patient was 3.1 ± 2. The total number of blastocysts available to the analysis was 1,814, and 36% of them were euploid after PGS. Age and serum AMH were significantly and independently related to the rate of euploid blastocysts available for patients. As an effect of the cohort size, the number of mature oocytes positively affected the total number of euploid blastocysts per patient., Conclusion(s): A strong positive age-independent relationship between AMH level and the rate of euploid blastocysts was found. This confirms that the measurement of ovarian reserve by means of AMH has high relevance when counseling infertile patients., (Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
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- 2017
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74. The era of comparable life expectancy between thalassaemia major and intermedia: Is it time to revisit the major-intermedia dichotomy?
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Vitrano A, Calvaruso G, Lai E, Colletta G, Quota A, Gerardi C, Concetta Rigoli L, Pitrolo L, Cuccia L, Gagliardotto F, Filosa A, Caruso V, Argento C, Campisi S, Rizzo M, Prossomariti L, Fidone C, Fustaneo M, Di Maggio R, and Maggio A
- Subjects
- Adult, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Survival Rate, Young Adult, beta-Thalassemia epidemiology, beta-Thalassemia therapy, Life Expectancy, beta-Thalassemia classification, beta-Thalassemia mortality
- Abstract
In the last few decades, the life expectancy of regularly transfused β-thalassaemia major (TM) patients has dramatically improved following the introduction of safe transfusion practices, iron chelation therapy, aggressive treatment of infections and improved management of cardiac complications. How such changes, especially those attributed to the introduction of iron chelation therapy, improved the survival of TM patients to approach those with β-thalassaemia intermedia (TI) remains unknown. Three hundred and seventy-nine patients with TM (n = 284, dead 40) and TI (n = 95, dead 13) were followed retrospectively since birth until 30 June 2015 or death. Kaplan-Meir curves showed statistically significant differences in TM and TI survival (P < 0·0001) before the introduction of iron chelation in 1965, which were no longer apparent after that date (P = 0·086), reducing the Hazard Ratio of death in TM compared to TI from 6·8 [95% confidence interval (CI) 2·6-17·5] before 1965 to 2·8 (95% CI 0·8-9·2). These findings suggest that, in the era of iron chelation therapy and improved survival for TM, the major-intermedia dichotomy needs to be revisited alongside future directions in general management and prevention for both conditions., (© 2016 John Wiley & Sons Ltd.)
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- 2017
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75. Real-life experience with liver iron concentration R2 MRI measurement in patients with hemoglobinopathies: baseline data from LICNET.
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Vitrano A, Calvaruso G, Tesé L, Gioia F, Cassarà F, Campisi S, Butera F, Commendatore V, Rizzo M, Santoro V, Cigna V, Quota A, Bagnato S, Argento C, Fidone C, Schembari D, Gerardi C, Barbiera F, Bellisssima G, Giugno G, Polizzi G, Rosso R, Abbate G, Caruso V, Chiodi E, Gamberini MR, Giorgi B, Putti MC, Filosa A, De Ritis MR, Oliva E, Arcadi N, Fustaneo M, Mistretta L, Di Maggio R, Sacco M, Veronica DS, Giangreco A, and Maggio A
- Subjects
- Adolescent, Adult, Aged, Alanine Transaminase blood, Biomarkers, Child, Comorbidity, Cross-Sectional Studies, Female, Ferritins blood, Hemoglobinopathies diagnosis, Humans, Iron Chelating Agents therapeutic use, Iron Overload drug therapy, Male, Middle Aged, Young Adult, Hemoglobinopathies complications, Iron metabolism, Iron Overload diagnosis, Iron Overload etiology, Liver metabolism, Liver pathology, Magnetic Resonance Imaging methods
- Abstract
Background: Real-life data on the use of R2 MRI for the assessment of liver iron concentration (LIC) remain limited., Methods: We conducted a cross-sectional analysis on 363 patients (mean age 35.6 yr, 44.1% men) with hemoglobinopathies (204 β-thalassemia major [TM], 102 β-thalassemia intermedia [TI], and 57 sickle cell disease [SCD]) that were evaluated with R2 MRI as part of LICNET, an MRI network of 13 Italian treatment centers., Results: The mean LIC was 7.8 mg/g (median: 4.0), with high LIC (>7 mg/g) noted in both transfused (TM, TI 37%; SCD 38%) and non-transfused (TI 20%) patients. Ferritin levels correlated with LIC in both transfused (TM, TI, SCD) and non-transfused (TI) patients (P < 0.001), although lower values predicted high LIC in non-transfused patients (1900 vs. 650 ng/mL in TM vs. non-transfused TI). A correlation between LIC and ALT levels was only noted in HCV-negative patients (rs = 0.316, P < 0.001). The proportion of patients with high LIC was significantly different between iron chelators used (P = 0.023), with the lowest proportion in deferasirox (30%) and highest in deferiprone (53%)-treated patients., Conclusions: High LIC values persist in subgroups of patients with hemoglobinopathy, warranting closer monitoring and management optimization, even for non-transfused patients with relatively low ferritin levels., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
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- 2016
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76. Modulation of gonadotrophin induced steroidogenic enzymes in granulosa cells by d-chiroinositol.
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Sacchi S, Marinaro F, Tondelli D, Lui J, Xella S, Marsella T, Tagliasacchi D, Argento C, Tirelli A, Giulini S, and La Marca A
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- Adult, Cells, Cultured, Dose-Response Relationship, Drug, Enzyme Induction drug effects, Enzyme Induction physiology, Female, Fertilization in Vitro methods, Humans, Aromatase biosynthesis, Gonadotropins pharmacology, Granulosa Cells drug effects, Granulosa Cells enzymology, Inositol pharmacology, Receptor, IGF Type 1 biosynthesis
- Abstract
Background: d-chiroinositol (DCI) is a inositolphosphoglycan (IPG) involved in several cellular functions that control the glucose metabolism. DCI functions as second messenger in the insulin signaling pathway and it is considered an insulin sensitizer since deficiency in tissue availability of DCI were shown to cause insulin resistance (IR). Polycystic ovary syndrome (PCOS) is a pathological condition that is often accompanied with insulin resistance. DCI can positively affects several aspect of PCOS etiology decreasing the total and free testosterone, lowering blood pressure, improving the glucose metabolism and increasing the ovulation frequency. The purpose of this study was to evaluate the effects of DCI and insulin combined with gonadotrophins namely follicle-stimulating hormone (FSH) and luteinizing hormone (LH) on key steroidogenic enzymes genes regulation, cytochrome P450 family 19 subfamily A member 1 (CYP19A1) and cytochrome P450 side-chain cleavage (P450scc) in primary cultures of human granulosa cells (hGCs). We also investigated whether DCI, being an insulin-sensitizer would be able to counteract the expected stimulator activity of insulin on human granulosa cells (hGCs)., Methods: The study was conducted on primary cultures of hGCs. Gene expression was evaluated by RT-qPCR method. Statistical analysis was performed applying student t-test, as appropriate (P < 0.05) set for statistical significance., Results: DCI is able to reduce the gene expression of CYP19A1, P450scc and insulin-like growth factor 1 receptor (IGF-1R) in dose-response manner. The presence of DCI impaired the increased expression of steroidogenic enzyme genes generated by the insulin treatment in gonadotrophin-stimulated hGCs., Conclusions: Insulin acts as co-gonadotrophin increasing the expression of steroidogenic enzymes genes in gonadotrophin-stimulated granulosa cells. DCI is an insulin-sensitizer that counteracts this action by reducing the expression of the genes CYP19A1, P450scc and IGF-1R. The ability of DCI to modulate in vitro ovarian activity of insulin could in part explain its beneficial effect when used as treatment for conditions associated to insulin resistance.
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- 2016
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77. The anti-Müllerian hormone (AMH) acts as a gatekeeper of ovarian steroidogenesis inhibiting the granulosa cell response to both FSH and LH.
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Sacchi S, D'Ippolito G, Sena P, Marsella T, Tagliasacchi D, Maggi E, Argento C, Tirelli A, Giulini S, and La Marca A
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- Anti-Mullerian Hormone administration & dosage, Culture Media chemistry, Estradiol biosynthesis, Female, Follicle Stimulating Hormone administration & dosage, Follicle Stimulating Hormone metabolism, Gene Expression Regulation, Developmental drug effects, Gonadotropins administration & dosage, Granulosa Cells drug effects, Humans, Luteinizing Hormone administration & dosage, Luteinizing Hormone metabolism, Primary Cell Culture, RNA, Messenger biosynthesis, Anti-Mullerian Hormone metabolism, Aromatase biosynthesis, Cholesterol Side-Chain Cleavage Enzyme biosynthesis, Granulosa Cells metabolism
- Abstract
Purpose: Anti Müllerian Hormone (AMH) has a negative and inhibitory role in many functions of human granulosa-lutein cells (hGCs) including notoriously the reduction of the aromatase CYP19A1 expression induced by follicle-stimulating hormone (FSH). No data have been provided on the possible role of AMH in modulating the response to luteinizing hormone (LH) (alone or combined with FSH) as well as its effect on other enzymes involved in steroidogenesis including aromatase P450scc. The aim of this study was to investigate the role of AMH as regulator of the basal and stimulated steroids production by hGCs., Methods: Primary culture of hGCs were incubated with hormones AMH, LH, and FSH, alone or in combination. The CYP19A1 and P450scc messenger RNA (mRNA) expression, normalized by housekeeping ribosomal protein S7 (RpS7) gene, was evaluated by reverse transcriptase quantitative PCR (RT-qPCR). Each reaction was repeated in triplicate. Negative controls using corresponding amount of vehicle control for each hormone treatment were performed., Result: AMH did not modulate the basal mRNA expression of both aromatase genes at any of the concentrations tested. Meanwhile, the strong mRNA induction of CYP19A1 and P450scc generated by a 24-h gonadotropin treatment (alone and combined) was suppressed by 20 ng/ml AMH added to culture medium., Conclusions: These findings contribute in clarifying the relationship between hormones regulating the early phase of steroidogenesis confirming that AMH is playing a suppressive role on CYP19A1 expression stimulated by gonadotropin in hGCs. Furthermore, a similar inhibitory effect for AMH was observed on P450scc gene expression when activated by gonadotropin treatment.
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- 2016
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78. Micropatterned charge heterogeneities via vapor deposition of aminosilanes.
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Pick C, Argento C, Drazer G, and Frechette J
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- Membranes, Artificial, Microscopy, Atomic Force, Gases chemistry, Silanes chemistry
- Abstract
Aminosilanes are routinely employed for charge reversal or to create coupling layers on oxide surfaces. We present a chemical vapor deposition method to pattern mica surfaces with regions of high-quality aminosilane (3-aminopropyltriethoxysilane, APTES) monolayers. The approach relies on the vapor deposition of an aminosilane through a patterned array of through-holes in a PDMS (poly(dimethylsiloxane)) membrane that acts as a mask. In aqueous solutions the surfaces have regular patterns of charge heterogeneities with minimal topographical variations over large areas. This versatile dry lift-off deposition method alleviates issues with multilayer formation and can be used to create charge patterns on curved surfaces. We identify the necessary steps to achieve high quality monolayers and charge reversal of the underlying mica surface: (1) hexane extraction to remove unreacted PDMS oligomers from the membrane that would otherwise deposit on and contaminate the substrate, (2) oxygen plasma treatment of the top of the membrane surfaces to generate a barrier layer that blocks APTES transport through the PDMS, and (3) low of the vapor pressure of APTES during deposition to minimize APTES condensation at the mica-membrane-vapor contact lines and to prevent multilayer formation. Under these conditions, AFM imaging shows that the monolayers have a height of 0.9 ± 0.2 nm with an increase in height up to 3 nm at the mica-membrane-vapor contact lines. Fluorescence imaging demonstrates pattern fidelity on both flat and curved surfaces, for feature sizes that vary between 6.5 and 40 μm. We verify charge reversal by measuring the double layer forces between a homogeneous (unpatterned) APTES monolayers and a mica surface in aqueous solution, and we characterize the surface potential of APTES monolayers by measuring the double-layer forces between identical APTES surfaces. We obtain a surface potential of +110 ± 6 mV at pH 4.0.
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- 2015
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79. Live birth rates in the different combinations of the Bologna criteria poor ovarian responders: a validation study.
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La Marca A, Grisendi V, Giulini S, Sighinolfi G, Tirelli A, Argento C, Re C, Tagliasacchi D, Marsella T, and Sunkara SK
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- Adult, Age Factors, Databases, Factual, Female, Fertilization in Vitro, Humans, Oocyte Retrieval, Ovarian Reserve, Treatment Outcome, Birth Rate, Live Birth, Ovary drug effects, Ovulation Induction methods
- Abstract
Purpose: to compare the baseline characteristics and chance of live birth in the different categories of poor responders identified by the combinations of the Bologna criteria and establish whether these groups comprise a homogenous population., Methods: database containing clinical and laboratory information on IVF treatment cycles carried out at the Mother-Infant Department of the University Hospital of Modena between year 2007 and 2011 was analysed. This data was collected prospectively and recorded in the registered database of the fertility centre. Eight hundred and thirty women fulfilled the inclusion/ exclusion criteria of the study and 210 women fulfilled the Bologna criteria definition for poor ovarian response (POR). Five categories of poor responders were identified by different combinations of the Bologna criteria., Results: There were no significant differences in female age, AFC, AMH, cycle cancellation rate and number of retrieved oocytes between the five groups. The live birth rate ranged between 5.5 and 7.4 % and was not statistically different in the five different categories of women defined as poor responders according to the Bologna criteria., Conclusion: The study demonstrates that the different groups of poor responders based on the Bologna criteria have similar IVF outcomes. This information validates the Bologna criteria definition as women having a uniform poor prognosis and also demonstrates that the Bologna criteria poor responders in the various subgroups represent a homogenous population with similar pre-clinical and clinical outcomes.
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- 2015
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80. Age-specific reference values for serum FSH and estradiol levels throughout the reproductive period.
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Grisendi V, Spada E, Argento C, Plebani M, Milani S, Seracchioli R, Volpe A, and La Marca A
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- Adolescent, Adult, Biomarkers blood, Cross-Sectional Studies, Estradiol metabolism, Female, Follicle Stimulating Hormone, Human metabolism, Humans, Italy, Linear Models, Luminescent Measurements, Ovary metabolism, Pituitary Gland, Anterior metabolism, Premenopause, Reference Values, Tertiary Care Centers, Young Adult, Aging, Estradiol blood, Follicle Stimulating Hormone, Human blood, Follicular Phase blood, Ovary growth & development, Pituitary Gland, Anterior growth & development, Up-Regulation
- Abstract
High serum day 3 FSH levels are associated with poor ovarian reserve and reduced fertility, but the interpretation of FSH values according to age is still not univocal. The purpose of this study was to determine age-dependent reference values in women with regular menstrual cycles and FSH as a guide for specialists. The study was performed at the Department of Mother-Infant of a University-based tertiary care centre. One-hundred ninety-two healthy normal menstruating women were recruited for the study. All patients attended the department on menstrual cycle day 3 for a blood sample for FSH and estradiol determination. A linear relationship between FSH or estradiol serum levels and age was observed. The FSH level increased by 0.11 IU for every year of age (1 IU for every 9 years of age). The values of FSH and estradiol corresponding to the 5th, 25th, 50th, 75th, 95th centiles for any specific age have been calculated. Serum FSH levels need to be interpreted according to age-dependent reference values. Serum FSH levels on 95th centile for any age may represent a warning sign for reduced ovarian reserve.
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- 2014
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81. Reference values in ovarian response to controlled ovarian stimulation throughout the reproductive period.
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La Marca A, Grisendi V, Spada E, Argento C, Milani S, Plebani M, Seracchioli R, and Volpe A
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- Adult, Chorionic Gonadotropin pharmacology, Female, Fertility Agents, Female pharmacology, Fertilization in Vitro methods, Fertilization in Vitro standards, Follicle Stimulating Hormone pharmacology, Humans, Maternal Age, Nomograms, Oocyte Retrieval standards, Ovary drug effects, Ovulation Induction methods, Pregnancy, Reference Values, Ovary physiology, Ovulation Induction standards, Reproduction physiology
- Abstract
Abstract The age-related decline in ovarian response to gonadotropins has been well known since the beginning of ovarian stimulation in IVF cycles and has been considered secondary to the age-related decline in ovarian reserve. The objective of this study was to establish reference values and to construct nomograms of ovarian response for any specific age to gonadotropins in IVF/ICSI cycles. We analyzed our database containing information on IVF cycles. According to inclusion and exclusion criteria, a total of 703 patients were selected. Among inclusion criteria, there were regular menstrual cycle, treatment with a long GnRH agonist protocol and starting follicle-stimulating hormone (FSH) dose of at least 200 IU per day. To estimate the reference values of ovarian response, the CG-LMS method was used. A linear decline in the parameters of ovarian response with age was observed: the median number of oocytes decreases approximately by one every three years, and the median number of follicles >16 mm by one every eight years. The number of oocytes and growing follicles corresponding to the 5th, 25th, 50th, 75th and 95th centiles has been calculated. This study confirmed the well known negative relationship between ovarian response to FSH and female ageing and permitted the construction of nomograms of ovarian response.
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- 2014
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82. Polymorphisms in gonadotropin and gonadotropin receptor genes as markers of ovarian reserve and response in in vitro fertilization.
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La Marca A, Sighinolfi G, Argento C, Grisendi V, Casarini L, Volpe A, and Simoni M
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- Anti-Mullerian Hormone metabolism, Biomarkers metabolism, Female, Follicle Stimulating Hormone, Human genetics, Follicle Stimulating Hormone, Human metabolism, Follicle Stimulating Hormone, beta Subunit metabolism, Glycoprotein Hormones, alpha Subunit metabolism, Humans, Infertility, Female metabolism, Infertility, Female therapy, Ovarian Follicle cytology, Ovarian Follicle physiology, Polymorphism, Single Nucleotide genetics, Receptors, FSH metabolism, Fertilization in Vitro methods, Follicle Stimulating Hormone, beta Subunit genetics, Genetic Markers, Glycoprotein Hormones, alpha Subunit genetics, Infertility, Female genetics, Receptors, FSH genetics
- Abstract
Since gonadotropins are the fundamental hormones that control ovarian activity, genetic polymorphisms may alter gonadal responsiveness to glycoproteins; hence they are important regulators of hormone activity at the target level. The establishment of the pool of primordial follicles takes place during fetal life and is mainly under genetic control. Consequently, single nucleotide polymorphisms (SNPs) in gonadotropins and their receptors do not seem to be associated with any significant modification in the endowment of nongrowing follicles in the ovary. Indeed, the age at menopause, a biological characteristic strongly related to ovarian reserve, as well as markers of functional ovarian reserve such as anti-Müllerian hormone and antral follicle count, are not different in women with different genetic variants. Conversely, some polymorphisms in FSH receptor (FSHR) seem to be associated with modifications in ovarian activity. In particular, studies suggest that the Ser680 genotype for FSHR is a factor of relative resistance to FSH stimulation resulting in slightly higher FSH serum levels, thus leading to a prolonged duration of the menstrual cycle. Moreover, some FSHR gene polymorphisms show a positive association with ovarian response to exogenous gonadotropin administration, hence exhibiting some potential for a pharmacogenetic estimation of the FSH dosage in controlled ovarian stimulation. The study of SNPs of the FSHR gene is an interesting field of research that could provide us with new information about the way each woman responds to exogenous gonadotropin administration during ovulation induction., (Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
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- 2013
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83. Individualization of the FSH starting dose in IVF/ICSI cycles using the antral follicle count.
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La Marca A, Grisendi V, Giulini S, Argento C, Tirelli A, Dondi G, Papaleo E, and Volpe A
- Abstract
Background: The FSH starting dose is usually chosen according to women's age, anamnesis, clinical criteria and markers of ovarian reserve. Currently used markers include antral follicle count (AFC), which is considered to have a very high performance in predicting ovarian response to FSH. The objective of the present study to elaborate a nomogram based on AFC for the calculation of the appropriate FSH starting dose in IVF cycles., Methods: This is a retrospective study performed at the Mother-Infant Department of Modena University Hospital. IVF patients (n=505) were subjected to blood sampling and transvaginal ultrasound for measurement of serum day3 FSH, estradiol and AFC. The variables predictive of the number of retrieved oocytes were assessed by backwards stepwise multiple regression. The variables reaching the statistical significance were then used in the calculation for the final predictive model., Results: A model based on age, AFC and FSH was able to accurately predict the ovarian sensitivity and accounted for 30% of the variability of ovarian response to FSH. An FSH dosage nomogram was constructed and overall it predicts a starting dose lower than 225 IU in 50.2% and 18.1% of patients younger and older than 35 years, respectively., Conclusions: The daily FSH dose may be calculated on the basis of age and two markers of ovarian reserve, namely AFC and FSH, with the last two variables being the most significant predictors. The nomogram seems easily applicable during the daily clinical practice.
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- 2013
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84. Development of a nomogram based on markers of ovarian reserve for the individualisation of the follicle-stimulating hormone starting dose in in vitro fertilisation cycles.
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La Marca A, Papaleo E, Grisendi V, Argento C, Giulini S, and Volpe A
- Subjects
- Adolescent, Adult, Biomarkers blood, Female, Follicle Stimulating Hormone blood, Humans, Infertility, Female blood, Ovulation Induction methods, Prospective Studies, Young Adult, Anti-Mullerian Hormone blood, Fertilization in Vitro methods, Follicle Stimulating Hormone administration & dosage, Infertility, Female drug therapy, Nomograms
- Abstract
Objective: To elaborate a nomogram based on markers of ovarian reserve for the calculation of the appropriate starting dose of follicle-stimulating hormone (FSH)., Design: Cohort study of infertile women., Setting: In vitro fertilisation (IVF) unit, University Hospital of Modena, Italy., Population: Women aged 18-40 years (n = 346) and undergoing their first IVF cycle., Methods: Serum FSH and anti-Müllerian hormone (AMH) measurement., Main Outcome Measures: Development of a model for the prediction of ovarian response to FSH., Results: A model based on age, AMH and FSH was able to accurately predict the ovarian sensitivity and accounted for 30% of the variability of ovarian response to FSH. An FSH dosage nomogram was constructed and overall it predicts a starting FSH dose <225 IU in 55.1 and 25.9% of women younger and older than 35 years, respectively., Conclusions: In the present study we clearly demonstrated that the daily FSH dose may be calculated on the basis of a woman's age and two markers of ovarian reserve, namely AMH and FSH, with the first two vari;s (age and AMH) being the most significant predictors. The nomogram we developed seems easily applicable for clinicians during their daily clinical practice., (© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.)
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- 2012
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85. Possibilities and limits of ovarian reserve testing in ART.
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La Marca A, Argento C, Sighinolfi G, Grisendi V, Carbone M, D'Ippolito G, Artenisio AC, Stabile G, and Volpe A
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- Adult, Anti-Mullerian Hormone blood, Cost-Benefit Analysis, Female, Fertilization in Vitro methods, Follicle Stimulating Hormone blood, Humans, Inhibins blood, Middle Aged, Oocytes physiology, Ovarian Follicle diagnostic imaging, Ovarian Follicle physiology, Ultrasonography, Infertility, Female therapy, Ovarian Function Tests methods, Ovary physiology, Ovulation Induction methods
- Abstract
Markers of ovarian reserve are associated with ovarian aging as they decline with chronologic age, and hence may predict stages of reproductive aging including the menopause transition. Assessment of ovarian reserve include measurement of serum follicle stimulating hormone (FSH), anti-M�llerian hormone (AMH), and inhibin-B. Ultrasound determination of antral follicle count (AFC), ovarian vascularity and ovarian volume also can have a role. The clomiphene citrate challenge test (CCCT), exogenous FSH ovarian reserve test (EFORT), and GnRH-agonist stimulation test (GAST) are dynamic methods that have been used in the past to assess ovarian reserve. In infertile women, ovarian reserve markers can be used to predict low and high oocyte yield and treatment failure in women undergoing in vitro fertilization. However the markers may have limitations when an in depth analysis of their accuracy, cost, convenience, and utility is performed. As ovarian reserve markers may permit the identification of both the extremes of ovarian stimulation, a possible role for their measurement may be in the individualization of treatment strategies in order to reduce the clinical risk of ART along with optimized treatment burden. It is fundamental to clarify the cost/benefit of its use in the ovarian reserve testing before initiation of an IVF cycle and whether the ovarian reserve markers-determined strategy of ovarian stimulation for assisted conception may be associated to improved live birth rate.
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- 2012
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86. Age-specific nomogram for the decline in antral follicle count throughout the reproductive period.
- Author
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La Marca A, Spada E, Sighinolfi G, Argento C, Tirelli A, Giulini S, Milani S, and Volpe A
- Subjects
- Adult, Age Factors, Cell Count standards, Cross-Sectional Studies, Diagnostic Techniques, Obstetrical and Gynecological standards, Down-Regulation, Female, Health, Humans, Middle Aged, Ovarian Follicle diagnostic imaging, Reference Values, Ultrasonography, Young Adult, Aging physiology, Nomograms, Ovarian Follicle cytology, Reproduction physiology
- Abstract
Objective: To investigate the relationship between antral follicle count (AFC) and chronological age and to establish normal values for AFC in women with regular menstrual cycles., Design: Cross-sectional study., Setting: University hospital., Patient(s): Four hundred fifteen premenopausal women were recruited for the study. Data from 362 patients were available for the statistical analysis., Intervention(s): AFC was measured by transvaginal ultrasound examination., Main Outcome Measure(s): Estimating the relationship between AFC and age and developing the AFC nomogram., Result(s): The analysis showed a linear decline in AFC with age; for every year increase in age, the median AFC decreases by 0.4. The AFC corresponding to the 5th, 25th, 50th, 75th, and 95th centiles for each age have been calculated., Conclusion(s): A linear relationship of AFC to age was found. For the first time, a nomogram reporting normal and interquartile values for AFC, age by age, throughout the reproductive period has been provided. Until now, the interpretation of the measurement was mainly based on the individual experience of the operator, because no normative data were present. Therefore, the establishment of a nomogram of AFC values is the first step to counsel patients on a scientific basis., (Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
- Published
- 2011
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87. Sequential alternating deferiprone and deferoxamine treatment compared to deferiprone monotherapy: main findings and clinical follow-up of a large multicenter randomized clinical trial in -thalassemia major patients.
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Pantalone GR, Maggio A, Vitrano A, Capra M, Cuccia L, Gagliardotto F, Filosa A, Romeo MA, Magnano C, Caruso V, Argento C, Gerardi C, Campisi S, Violi P, Malizia R, Cianciulli P, Rizzo M, D'Ascola DG, Quota A, Prossomariti L, Fidone C, Rigano P, Pepe A, D'Amico G, Morabito A, and Gluud C
- Subjects
- Adolescent, Adult, Chelation Therapy methods, Deferiprone, Deferoxamine therapeutic use, Drug Administration Schedule, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Iron Chelating Agents therapeutic use, Male, Pyridones therapeutic use, Treatment Outcome, Young Adult, Deferoxamine administration & dosage, Pyridones administration & dosage, beta-Thalassemia drug therapy
- Abstract
In β-thalassemia major (β-TM) patients, iron chelation therapy is mandatory to reduce iron overload secondary to transfusions. Recommended first line treatment is deferoxamine (DFO) from the age of 2 and second line treatment after the age of 6 is deferiprone (L1). A multicenter randomized open-label trial was designed to assess the effectiveness of long-term alternating sequential L1-DFO vs. L1 alone iron chelation therapy in β-TM patients. Deferiprone 75 mg/kg 4 days/week and DFO 50 mg/kg/day for 3 days/week was compared with L1 alone 75 mg/kg 7 days/week during a 5-year follow-up. A total of 213 thalassemia patients were randomized and underwent intention-to-treat analysis. Statistically, a decrease of serum ferritin level was significantly higher in alternating sequential L1-DFO patients compared with L1 alone patients (p = 0.005). Kaplan-Meier survival analysis for the two chelation treatments did not show statistically significant differences (log-rank test, p = 0.3145). Adverse events and costs were comparable between the groups. Alternating sequential L1-DFO treatment decreased serum ferritin concentration during a 5-year treatment by comparison to L1 alone, without significant differences of survival, adverse events or costs. These findings were confirmed in a further 21-month follow-up. These data suggest that alternating sequential L1-DFO treatment may be useful for some β-TM patients who may not be able to receive other forms of chelation treatment.
- Published
- 2011
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88. 4D vs 2D ultrasound-guided amniocentesis.
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Tonni G, Centini G, Rosignoli L, Argento C, and Centini G
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- Adult, Female, Fetal Diseases diagnosis, Gestational Age, Humans, Pregnancy, Reproducibility of Results, Amniocentesis methods, Image Processing, Computer-Assisted methods, Ultrasonography, Prenatal methods
- Abstract
Purpose: The aim of this study was to assess the effectiveness of 4D sonography (US) to guide amniocentesis when compared with standard 2D US, and to evaluate the impact this new method may have on needle placement, the number of needle insertions performed, and duration of the procedure., Methods: One hundred routine consecutive unselected amniocenteses were performed with 4D US-guided technique and compared with 100 standard 2D US-guided amniocenteses. All procedures were performed by trainees in maternal-fetal medicine under the supervision of expert sonographers., Results: There were no significant statistical differences between 4D and 2D US-guided amniocenteses. The procedure time was longer with the 4D US guidance than with the 2D US guidance, but this difference was not statistically significant. A 2nd needle insertion was necessary in two cases with 4D US guidance and in three cases with 2D US guidance. A better visualization of the needle tip was observed in both techniques when a 20-gauge needle was used., Conclusion: The 4D US, which allows the needle tip to be displayed in real time in three orthogonal planes simultaneously, thus providing reassurance that no fetal parts are in the needle path, did not offer any advantage over 2D US in guiding routine midtrimester amniocentesis and this new modality has not yet proved effective in reducing the number of needle insertions.
- Published
- 2009
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89. Prenatal diagnosis of a cavum veli interpositi.
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Blasi I, Henrich W, Argento C, and Chaoui R
- Subjects
- Adult, Female, Humans, Pregnancy, Brain Diseases diagnostic imaging, Septum Pellucidum abnormalities, Septum Pellucidum diagnostic imaging, Ultrasonography, Prenatal methods
- Published
- 2009
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90. Improving survival with deferiprone treatment in patients with thalassemia major: a prospective multicenter randomised clinical trial under the auspices of the Italian Society for Thalassemia and Hemoglobinopathies.
- Author
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Maggio A, Vitrano A, Capra M, Cuccia L, Gagliardotto F, Filosa A, Magnano C, Rizzo M, Caruso V, Gerardi C, Argento C, Campisi S, Cantella F, Commendatore F, D'Ascola DG, Fidone C, Ciancio A, Galati MC, Giuffrida G, Cingari R, Giugno G, Lombardo T, Prossomariti L, Malizia R, Meo A, Roccamo G, Romeo MA, Violi P, Cianciulli P, and Rigano P
- Subjects
- Adolescent, Adult, Blood Transfusion, Cause of Death, Child, Combined Modality Therapy, Deferiprone, Deferoxamine administration & dosage, Deferoxamine therapeutic use, Drug Therapy, Combination, Female, Heart Failure etiology, Heart Failure mortality, Humans, Iron Chelating Agents administration & dosage, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasms complications, Neoplasms mortality, Proportional Hazards Models, Prospective Studies, Pyridones administration & dosage, Splenectomy, Survival Rate, Young Adult, beta-Thalassemia complications, beta-Thalassemia mortality, beta-Thalassemia therapy, Chelation Therapy, Iron Chelating Agents therapeutic use, Pyridones therapeutic use, beta-Thalassemia drug therapy
- Abstract
The prognosis for thalassemia major has dramatically improved in the last two decades. However, many transfusion-dependent patients continue to develop progressive accumulation of iron. This can lead to tissue damage and eventually death, particularly from cardiac disease. Previous studies that investigated iron chelation treatments, including retrospective and prospective non-randomised clinical trials, suggested that mortality, due mainly to cardiac damage, was reduced or completely absent in patients treated with deferiprone (DFP) alone or a combined deferiprone-deferoxamine (DFP-DFO) chelation treatment. However, no survival analysis has been reported for a long-term randomised control trial. Here, we performed a multicenter, long-term, randomised control trial that compared deferoxamine (DFO) versus DFP alone, sequential DFP-DFO, or combined DFP-DFO iron chelation treatments. The trial included 265 patients with thalassemia major, with 128 (48.3%) females and 137 (51.7%) males. No deaths occurred with the DFP-alone or the combined DFP-DFO treatments. One death occurred due to graft versus host disease (GVHD) in a patient that had undergone bone marrow transplantation; this patient was censored at the time of transplant. Only one death occurred with the DFP-DFO sequential treatment in a patient that had experienced an episode of heart failure one year earlier. Ten deaths occurred with the deferoxamine treatment. The main factors that correlated with an increase in the hazard ratio for death were: cirrhosis, arrhythmia, previous episode of heart failure, diabetes, hypogonadism, and hypothyroidism. In a Cox regression model, the interaction effect of sex and age was statistically significant (p-value<0.013). For each increasing year of age, the hazard ratio for males was 1.03 higher than that for females (p-value<0.013). In conclusion, the results of this study show that the risk factors for predicting mortality in patients with thalassemia major are deferoxamine-treatment, complications, and the interaction effect of sex and age.
- Published
- 2009
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91. Long-term sequential deferiprone-deferoxamine versus deferiprone alone for thalassaemia major patients: a randomized clinical trial.
- Author
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Maggio A, Vitrano A, Capra M, Cuccia L, Gagliardotto F, Filosa A, Romeo MA, Magnano C, Caruso V, Argento C, Gerardi C, Campisi S, Violi P, Malizia R, Cianciulli P, Rizzo M, D'Ascola DG, Quota A, Prossomariti L, Fidone C, Rigano P, Pepe A, D'Amico G, Morabito A, and Gluud C
- Subjects
- Administration, Oral, Adolescent, Adult, Deferiprone, Deferoxamine therapeutic use, Drug Therapy, Combination, Female, Ferritins blood, Follow-Up Studies, Humans, Infusions, Subcutaneous, Iron Chelating Agents therapeutic use, Kaplan-Meier Estimate, Male, Pyridones therapeutic use, Thalassemia blood, Thalassemia mortality, Treatment Outcome, Young Adult, Deferoxamine administration & dosage, Iron Chelating Agents administration & dosage, Pyridones administration & dosage, Thalassemia drug therapy
- Abstract
A multicentre randomized open-label trial was designed to assess the effectiveness of long-term sequential deferiprone-deferoxamine (DFO-DFP) versus DFP alone to treat thalassaemia major (TM). DFP at 75 mg/kg, divided into three oral daily doses, for 4 d/week and DFO by subcutaneous infusion (8-12 h) at 50 mg/kg per day for the remaining 3 d/week was compared with DFP alone at 75 mg/kg, administered 7 d/week during a 5-year follow-up. The main outcome measures were differences between multiple observations of serum ferritin concentrations. Secondary outcomes were survival analysis, adverse events, and costs. Consecutive thalassaemia patients (275) were assessed for eligibility; 213 of these were randomized and underwent intention-to-treat analysis. The decrease of serum ferritin levels during the treatment period was statistically significant higher in sequential DFP-DFO patients compared with DFP-alone patients (P = 0.005). Kaplan-Meier survival analysis for the two chelation treatments did not show any statistically significant differences (long-rank test, P = 0.3145). Adverse events and costs were comparable between the groups. The trial results show that sequential DFP-DFO treatment compared with DFP alone significantly decreased serum ferritin concentration during treatment for 5 years without significant differences regarding survival, adverse events, or costs.
- Published
- 2009
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92. Bone demineralization in adult thalassaemic patients: contribution of GH and IGF-I at different skeletal sites.
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Scacchi M, Danesi L, Cattaneo A, Valassi E, Pecori Giraldi F, Argento C, D'Angelo E, Mirra N, Carnelli V, Zanaboni L, Tampieri B, Cappellini MD, and Cavagnini F
- Subjects
- Absorptiometry, Photon, Adolescent, Adult, Bone Demineralization, Pathologic blood, Bone Demineralization, Pathologic diagnostic imaging, Bone Demineralization, Pathologic epidemiology, Female, Femur diagnostic imaging, Femur pathology, Hand Bones diagnostic imaging, Hand Bones pathology, Human Growth Hormone blood, Human Growth Hormone deficiency, Humans, Insulin-Like Growth Factor I analysis, Lumbosacral Region diagnostic imaging, Lumbosacral Region pathology, Male, Middle Aged, Prevalence, Young Adult, beta-Thalassemia blood, beta-Thalassemia diagnostic imaging, beta-Thalassemia epidemiology, Bone Demineralization, Pathologic etiology, Human Growth Hormone physiology, Insulin-Like Growth Factor I physiology, beta-Thalassemia complications
- Abstract
Background and Objective: GH and IGF-I exert an important role in the control of bone formation, as shown by decreased bone mineral density and increased fracture risk in adult hypopituitary patients untreated for GH deficiency (GHD). Different degrees of bone demineralization are frequently reported in patients affected by beta-thalassaemia. Considering the high prevalence of GHD recently observed by our group among adult thalassaemic patients, we elected to study the possible role of GH-IGF-I abnormalities in the pathogenesis of the osteopenia/osteoporosis of this disease., Design: Sixty-four adult thalassaemic patients (49 with thalassaemia major and 15 with thalassaemia intermedia, 23 men and 41 women, aged 31.4 +/- 6.8 years) were studied., Methods: Bone mineral density was assessed by dual energy X-ray absorptiometry at lumbar spine in 62 patients and at proximal femur in 58. All patients underwent GHRH (1 microg/kg as an i.v. bolus) plus arginine (0.5 g/kg as a 30-min i.v. infusion) testing. Severe GHD was defined by GH peaks < 9 microg/l, whereas partial GHD was defined by GH peaks ranging from 9 to 16.5 microg/l. Blood samples for IGF-I measurement were collected., Results: Lumbar osteoporosis and osteopenia were demonstrated in 46/62 (74.1%) and 14/62 (22.5%) patients, respectively. Femoral osteoporosis and osteopenia were documented in 22/58 (37.9%) and 32/58 (55.1%) patients, respectively. Severe GHD was demonstrated in 16/64 patients (25%), while 11 additional patients (17.1%) displayed partial GHD. IGF-I standard deviation score (SDS) was low, that is, below -1.88, in the majority (54.6%) of patients. Lumbar T-score values were not correlated with either GH peaks or IGF-I SDS values. Femoral T-score values were positively correlated with GH peaks (r = 0.38, P < 0.005) and IGF-I SDS values (r = 0.39, P < 0.005). Multiple regression analysis pointed to both GH peak and IGF-I SDS as predictors of femoral T-score. Furthermore, mean femoral T-score was significantly lower in patients with severe GHD than in those with normal GH secretion (-2.94 +/- 0.25 vs.-2.15 +/- 0.12, P < 0.01)., Conclusion: This study, while confirming the high prevalence of both osteopenia/osteoporosis and somatotropin-somatomedin deficiency in adult thalassaemic patients, indicates that defective GH secretion and diminished serum IGF-I levels may contribute to femoral demineralization in these patients. Further studies are worth carrying out to evaluate the efficacy of biosynthetic GH administration on bone abnormalities of GH-deficient thalassaemic adults.
- Published
- 2008
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93. Growth hormone deficiency (GHD) in adult thalassaemic patients.
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Scacchi M, Danesi L, Cattaneo A, Valassi E, Pecori Giraldi F, Argento C, D'Angelo E, Mirra N, Carnelli V, Zanaboni L, Cappellini MD, and Cavagnini F
- Subjects
- Adult, Arginine, Butyrylcholinesterase blood, Cross-Sectional Studies, Female, Ferritins blood, Growth Hormone blood, Growth Hormone urine, Growth Hormone-Releasing Hormone, Humans, Hydrocortisone urine, Insulin-Like Growth Factor I analysis, Linear Models, Male, Prevalence, beta-Thalassemia complications, Growth Hormone deficiency, beta-Thalassemia metabolism
- Abstract
Background and Objective: Short stature and growth hormone deficiency (GHD) are frequent occurrences in thalassaemic children, while data on the prevalence of GHD in adult patients are lacking. Therefore, we elected to study the growth hormone and insulin-like growth factor-I (GH-IGF-I) axis in a large group of adult thalassaemic subjects., Design: Cross-sectional study on the prevalence of GHD in 94 adult thalassaemic patients (69 with thalassaemia major and 25 with thalassaemia intermedia, 39 men and 55 women, aged 31.5 +/- 6.8 years, on sex steroid replacement when necessary)., Methods: All patients underwent GHRH (1 microg/kg as an i.v. bolus) plus arginine (0.5 g/kg as a 30 min i.v. infusion) testing. Severe GHD was defined by GH peaks lower than 9 microg/l, whereas partial GHD was defined by GH peaks ranging from 9-16.5 microg/l. Blood samples for IGF-I, ferritin and pseudocholinesterase measurements were collected. Urinary free cortisol (UFC) levels were also assayed., Results: Severe GHD was demonstrated in 21 of the 94 patients (22.3%), while 18 additional patients (19.1%) displayed partial GHD. GH peaks were positively correlated with IGF-I standard deviation score (SDS) (r = 0.22, P < 0.05), although 1 of the 21 patients with severe GHD showed normal IGF-I SDS values, and 44 of the 55 patients with normal GH reserve displayed low IGF-I SDS. A strong positive correlation (r = 0.48, P < 0.0001) between IGF-I SDS and pseudocholinesterase was identified. No correlations were found between ferritin and UFC levels on the one hand and GH peaks and IGF-I SDS on the other., Conclusion: Findings from this study demonstrate that GHD, either partial or severe, is not a rare occurrence in adult thalassaemic patients. GHD is associated with a higher prevalence of low serum IGF-I levels, recorded also in patients with normal GH secretion. The lack of correlation between ferritin and both GH peaks and IGF-I SDS suggests that mechanisms additional to iron overload, whose relevance cannot however be definitely ruled out, play a role in the pathophysiology of somatotrophin-somatomedin deficiency in this clinical condition. The positive correlation between IGF-I SDS on the one hand and GH peaks and pseudocholinesterase values on the other hand indicates that reduced liver protidosynthetic activity, in addition to somatotrophin secretory status, is a major determinant of the impaired IGF-I production in thalassaemia. Therefore biosynthetic GH replacement therapy in GH-deficient thalassaemic adults is worth considering.
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- 2007
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94. Comparison of laser epithelial keratomileusis with and without the use of mitomycin C.
- Author
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Argento C, Cosentino MJ, and Ganly M
- Subjects
- Adult, Antibiotics, Antineoplastic administration & dosage, Female, Follow-Up Studies, Humans, Incidence, Intraoperative Period, Male, Mitomycin administration & dosage, Ophthalmic Solutions, Postoperative Complications epidemiology, Postoperative Complications prevention & control, Refraction, Ocular, Retrospective Studies, Treatment Outcome, Antibiotics, Antineoplastic therapeutic use, Epithelium, Corneal surgery, Keratectomy, Subepithelial, Laser-Assisted methods, Mitomycin therapeutic use, Myopia surgery
- Abstract
Purpose: To analyze the results of prophylactic intraoperative use of mitomycin C (MMC) in laser epithelial keratomileusis (LASEK)., Methods: A retrospective analysis of 30 LASEK cases that received MMC 0.02% intraoperatively (MMC group) was performed and compared to the results obtained in 28 LASEK cases not receiving MMC (no MMC group). Mitomycin C was placed in contact with the ablation zone for 75 seconds with an imbibed microsponge. Both groups received postoperative fluorometholone for 3 months. Preoperative spherical equivalent refraction was -5.72 +/- 2.82 diopters (D) in the MMC group and -5.81 +/- 2.74 D in the no MMC group. Best spectacle-corrected visual acuity was 0.88 +/- 0.12 in the MMC group and 0.88 +/- 0.13 in the no MMC group., Results: Spherical equivalent refraction at 6 months postoperatively was +0.11 +/- 0.13 D in the MMC group and +0.09 +/- 0.37 D in the no MMC group. Best spectacle-corrected visual acuity was 0.90 +/- 0.13 in the MMC group and 0.88 +/- 0.13 in the no MMC group. Uncorrected visual acuity (UCVA) > or = 20/40 was obtained in 93.3% of cases in the MMC group and in 89.3% of cases in the no MMC group; UCVA > or = 20/25 was achieved in 76.6% of cases in the MMC group and in 71.4% of cases in the no MMC group. Haze incidence for the MMC group was: trace: 0%, Grades I: 0%, II: 0%, III 0%, IV: 0%, and for the no MMC group: trace: 17.9%, Grades I: 3.6%, II: 0%, III: 0%, IV: 0%. A statistically significant difference (P<.001) was noted in haze intensity between the MMC group and no MMC group., Conclusions: Prophylactic use of intraoperative MMC in LASEK significantly decreases haze incidence.
- Published
- 2006
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95. Laser in situ keratomileusis: ablation on the flap and stromal bed in a primary treatment.
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Argento C and Cosentino MJ
- Subjects
- Adult, Corneal Stroma diagnostic imaging, Corneal Topography, Dilatation, Pathologic prevention & control, Female, Follow-Up Studies, Humans, Male, Nomograms, Postoperative Complications prevention & control, Retrospective Studies, Treatment Outcome, Ultrasonography, Visual Acuity physiology, Corneal Stroma surgery, Keratomileusis, Laser In Situ methods, Myopia surgery, Surgical Flaps
- Abstract
Purpose: To analyze outcomes of laser in situ keratomileusis (LASIK) performed on the flap and on the stromal bed at the same time in a primary treatment., Setting: Instituto de la Visión, Buenos Aires, Argentina., Methods: Twenty-two cases (13 female, 9 male) were studied retrospectively; the mean age of the patients was 33.15 years +/- 10.44 (SD). Inclusion criteria were low pachymetry or topographic asymmetry. Twenty cases (90.9%) presented with low pachymetry (512.2 +/- 21.40 mum), and 2 cases (9.1%) presented with topographic asymmetry (inferior-superior difference more than 1.5 diopters [D]). Ablation was performed on the flap from the back and on the bed. The flap was made using the Technolas Hansatome microkeratome and the ablation by the Technolas 217z excimer laser (both by Bausch & Lomb). Preoperatively, the spherical equivalent (SE) was -5.61 +/- 1.72 D, the cylinder was -1.78 +/- 1.24 D, and the best spectacle-corrected visual acuity (BSCVA) was 0.77 +/- 0.19. Difficulties and complications of the technique, efficacy and safety index, and aberrations were analyzed., Results: According to the surgical plan and our nomogram, diopters corrected on the flap were -1.73 +/- 1.08 and on the bed were -4.77 +/- 1.89. The mean follow-up was 8.28 +/- 2.19 months. At 6 months, the SE was -0.21 +/- 0.39, vectorial change was 1.69 +/- 0.74, and the BSCVA was 0.77 +/- 0.20. Postoperatively, no eye had an increase in refractive astigmatism. Uncorrected visual acuity was 20/40 or better in all cases (100%) and 20/25 or better in 13 cases (59.1%). Regarding gained and lost lines of BSCVA, 54.5% conserved the lines, 18.2% lost 1 line, 9.1% gained 1 line, and 18.2% gained 2 lines., Conclusions: Simultaneous ablation on the flap and on the bed in cases of low pachymetry or topographical asymmetry was predictable, effective, and safe.
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- 2006
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96. Intraocular lens power calculation after refractive surgery.
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Argento C, Cosentino MJ, and Badoza D
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- Female, Humans, Keratomileusis, Laser In Situ, Keratotomy, Radial, Male, Middle Aged, Reoperation, Cataract Extraction, Lenses, Intraocular, Models, Theoretical, Optics and Photonics, Phacoemulsification, Refractive Surgical Procedures
- Abstract
Purpose: To analyze the results of phacoemulsification cataract surgery in eyes that had had refractive surgery and to compare the predictability of various methods of intraocular lens (IOL) power calculation., Setting: Instituto de la Visión, Buenos Aires, Argentina., Methods: The study involved 7 cases that had phacoemulsification after radial keratotomy or laser in situ keratomileusis. The spherical equivalent (SE) and visual acuity were evaluated preoperatively and postoperatively to assess the changes before cataract development. The IOL power calculated with conventional keratometry (CK), adjusted keratometry, the clinical history method (CHM), corneal topography (CT), and the contact lens method (CLM) was compared with the final refractive and keratometric results measured with the BackCalcs (Holladay(R) IOL Consultant Program, Holladay Consulting, Inc.) to assess the accuracy and predictability of each method., Results: The mean SE was -4.82 diopters (D) +/- 5.13 (SD) before phacoemulsification and +0.19 +/- 1.01 D after phacoemulsification, and the mean best corrected visual acuity was 0.39 +/- 0.07 (20/50) and 0.80 +/- 0.06 (20/25), respectively., Conclusions: Post-phacoemulsification refraction in cases with previous refractive surgery appeared to be predictable when the appropriate calculation method was applied. When all the data were available, the CHM provided the best results. Adjusted keratometry and CT seemed to be more accurate than CK and the CLM.
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- 2003
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97. [Masquerade syndrome in a patient with a primary central nervous syndrome lymphoma].
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Mazzei JA, Campos AL, Melero MJ, Schlaen A, Argento C, and Zárate JO
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- Adult, Brain Neoplasms complications, Fatal Outcome, Humans, Infratentorial Neoplasms complications, Infratentorial Neoplasms diagnosis, Lymphoma, B-Cell complications, Male, Supratentorial Neoplasms complications, Supratentorial Neoplasms diagnosis, Uveitis etiology, Vitrectomy, Brain Neoplasms diagnosis, Lymphoma, B-Cell diagnosis, Uveitis diagnosis
- Abstract
We report the case of a 37-year-old, white male with a primary central nervous system lymphoma with multiple supra and infratentorial locations. The patient developed manifestations of intraocular inflammation secondary to the intracranial neoplasm (masquerade syndrome) and lymphocytopenia--with a low CD4 cell count--representing an immunodeficiency state which etiology was undiagnosed. The diagnosis of lymphoma was established by vitreous cytology. The patient died 10 months after the beginning of the symptoms.
- Published
- 2003
98. Arterial narrowing as a predictive factor in glaucoma.
- Author
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Angelica MM, Sanseau A, and Argento C
- Subjects
- Humans, Intraocular Pressure, Ocular Hypertension diagnosis, Optic Disk blood supply, Retrospective Studies, Glaucoma, Open-Angle diagnosis, Retinal Artery pathology, Retinal Artery Occlusion diagnosis
- Abstract
Purpose: To evaluate whether retinal arteriolar widths change in normal patients and in different glaucoma types. We measured the arteriolar width at the merge in the optic nerve (MD), at the edge of the optic nerve (ED) and at the peripapillary area (1 disc diameter distance) (disc distance D). HRT software 1.11, Interactive Means program was used. One hundred forty three eyes of seventy-two patients divided in four subgroups normal, low-tension glaucoma (LTG), primary open angle glaucoma (POAG) and ocular hypertensive (OH). No statistically significant was found in each studied group. The normal patients showed no changes in the retinal arteriolar width compared with all the glaucoma groups.
- Published
- 2001
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99. Oral fluorescein angiography with scanning laser ophthalmoscope.
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Argento CJ, Lopez Mato OR, and Martinez-Cartier MD
- Subjects
- Administration, Oral, Adolescent, Adult, Aged, Child, Female, Humans, Injections, Intravenous, Lasers, Male, Middle Aged, Fluorescein administration & dosage, Fluorescein Angiography methods, Ophthalmoscopes, Retinal Diseases diagnosis, Retinal Vessels pathology
- Abstract
Objective: To study the efficacy of oral fluorescein angiography compared to intravenous (IV) fluorescein angiography in several retinal diseases., Patients and Methods: We performed oral fluorescein angiography with a confocal SLO (Heidelberg Retina Angiograph-HRA) in fourteen psychologically challenged individuals and children, all of whom explicitly refused venipuncture. Patient's diagnosis included diabetes, central serous choroidopathy, toxoplasmosis and choroidal neovascularization. A dose of 30 mg/kg body weight of fluorescein was given., Results: We obtained images of adequate quality to allow interpretation in all cases., Conclusions: Even though the images were not nearly as good as when obtained after IV injection, we conclude that oral fluorescein angiography with SLO is an appropriate alternative in those cases where a venipuncture is contraindicated by medical or psychological reasons.
- Published
- 2001
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100. Smoothness of ablation on acrylic by four different excimer lasers.
- Author
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Argento C, Valenzuela G, Huck H, Cremona G, Cosentino MJ, and Gale MF
- Subjects
- Lasers, Excimer, Models, Anatomic, Surface Properties, Photorefractive Keratectomy methods, Polymethyl Methacrylate
- Abstract
Purpose: There are many different excimer laser devices available for photoablative refractive surgery. Smoothness of ablation may vary with different excimer lasers systems., Methods: Ablations were performed on polymethylmethacrylate (PMMA) plates of 8 x 4 x 0.5 cm, with four different excimer lasers: VISX-Star, Coherent Schwind Keratom I/II, Chiron Technolas Keracor 117C (Plano Scan), and the Nidek EC-5000, to determine and compare the homogeneity and smoothness of the surface. Ten -3.00 D samples, ten -6.00 D samples, and ten -9.00 D samples were ablated with each laser. The PMMA discs were examined with optical microscopy, documented by photographs, and each sample was measured quantitatively using a Hommel-Werkel rugosimeter. We used the same PMMA material throughout., Results: Statistically significant differences in smoothness were found between the Chiron Technolas 117C and the VISX-Star, Nidek and VISX-Star, and Coherent Schwind and VISX-Star in the homogeneities achieved by ablating -3.00 D. Ablations of -6.00 D resulted in homogeneities that were statistically significantly different: Chiron Technolas 117C with the other three devices, the Nidek EC-5000 with the VISX-Star, and the Coherent-Schwind with the VISX-Star. In the ablations for -9.00 D, statistically significant differences in homogeneity were found between the Chiron Technolas 117C and Nidek, between the Chiron and VISX-Star, between the Coherent Schwind and VISX-Star, and between the Nidek and VISX-Star. The laser with the scanning spot system was smoother., Conclusion: Scanning spot technology produced smooth ablations even up to -9.00 D.
- Published
- 2001
- Full Text
- View/download PDF
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