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2. Pharmacological treatment of asthma in a cohort of adults during a 20-year period: results from the European Community Respiratory Health Survey I, II and III

Author

Christer Janson, Simone Accordini, Lucia Cazzoletti, Isa Cerveri, Sebastien Chanoine, Angelo Corsico, Diogenes Seraphim Ferreira, Judith Garcia-Aymerich, David Gislason, Rune Nielsen, Ane Johannessen, Rain Jogi, Andrei Malinovschi, Jesús Martinez-Moratalla Rovira, Alessandro Marcon, Isabelle Pin, Jennifer Quint, Valerie Siroux, Enrique Almar, Valeria Bellisario, Karl A. Franklin, José A. Gullón, Mathias Holm, Joachim Heinrich, Dennis Nowak, José Luis Sánchez-Ramos, Joost J. Weyler, Deborah Jarvis, The members of the ECRHS I scientific team., P. Burney, S. Chinn, C. Luczynska, D. Jarvis, E. Lai, P. Vermeire, H. Kesteloot, J. Bousquet, D. Nowak, J. Prichard, R. de Marco, B. Rijcken, J.M. Anto, J. Sunyer, J. Alves, G. Boman, N. Nielsen, P. Paoletti, M. Abramson, J. Kutin, F. van Bastelaer, R. Jõgi, A. Taytard, I. Pin, C. Pison, F. Neukirch, R. Liard, J. Knani, H-E. Wichmann, J. Heinrich, H. Magnussen, T. Gislason, D. Gislason, A. Marinoni, I. Cerveri, M. Bugiani, C. Bucca, C. Romano, L. Cascio, C. Campello, J. Droste, M. Kerkhof, A. Gulsvik, E. Omenaas, J. Martinez-Moratalla, E. Almar, A. Mateos, M. Arévalo, A. Sánchez, M. Vizcaya, X. Aguilar, A. Teixidó, J.M. Antó, M. Kogevinas, F. Burgos, J. Castellsagué, J. Roca, JB. Soriano, A. Tobías, N. Muiñozguren, J. Ramos González, A. Capelastegui, J. Maldonado Pérez, A. Pereira, J. Sánchez, J. Quiros, I. Huerta, F. Payo, N. Lindholm, P. Plaschke, C. Janson, E. Björnsson, L. Rosenhall, E. Norrman, B. Lundbäck, U. Ackermann-Liebrich, N. Küenzli, A. Perruchoud, M. Burr, J. Layzell, R. Hall, B. Harrison, The members of the ECRHS II scientific team., J. Knox, M. Wjst, N. Kuenzli, E.H. Walters, J. Raven, J. Weyler, M. van Sprundel, V. Nelen, A. Soon, C. Raherison, J. Ferran-Quentin, B. Leynaert, M. Zureik, P.J. Bousquet, C. Frye, I. Meyer, E. Bjornsson, K.B. Jörundsdóttir, S. Villani, M. Ponzio, F. Frigerio, M. Comelli, M. Grassi, A. Corsico, R. Bono, P. Piccioni, E. Caria, A. Carosso, E. Migliore, G. Castiglioni, G. Verlato, E. Zanolin, S. Accordini, A. Poli, V. Lo Cascio, M. Ferrari, I. Cazzoletti, C. Svanes, B. Laerum, J. Martinez-Moratalla Rovira, C. Boix, G. González, J.M. Ignacio García, J. Solera, J. Damián, J.P. Zock, X. Basagaña, A. Jaen, C. Acosta, N. Muñozguren, J. Ramos, I. Urrutia, U. Aguirre, J. Maldonado, J.L. Sanchez, A. de la Vega, L. Palenciano, J. Azofra, A. Cañada, K. Toren, L. Lillienberg, A.C. Olin, B. Balder, A. Pfeifer-Nilsson, R. Sundberg, D. Norback, G. Wieslander, M. Gunnbjornsdottir, M. Soderberg, K.A. Franklin, B. Lundback, B. Forsberg, L. Nystrom, B. Dibbert, M. Hazenkamp, M. Brutsche, D. Seaton, The members of the ECRHS III scientific team., M. Tumilty, J. Potts, T. Gislasson, T. Rochat, B. Leyneart, G. Benke, S. Dharmage, B. Thompson, S. Kaushik, M. Matheson, H. Bentouhami, H. Orru, P.O. Girodet, V. Siroux, J. Ferran, J.L. Cracowski, P. Demoly, A. Bourdin, I. Vachier, D. Soussan, D. Courbon, C. Neukirch, L. Alavoine, X. Duval, I. Poirier, E. Becker, G. Woelke, O. Manuwald, A-M. Kirsten, B. Benediktsdottir, E.S. Arnardottir, M. Clausen, G. Gudmundsson, L. Gudmundsdottir, H. Palsdottir, K. Olafsdottir, S. Sigmundsdottir, K. Bara-Jörundsdottir, A. Grosso, F. Albicini, E. Gini, E.M. Di Vincenzo, V. Ronzoni, F. Campanella, M. Gnesi, F. Manzoni, L. Rossi, O. Ferraro, R. Tassinari, V. Bellisario, G. Trucco, L. Calciano, L. Cazzoletti, A.M. Fratta Pasini, F. Locatelli, P. Marchetti, A. Marcon, E. Montoli, G. Nguyen, M. Olivieri, C. Papadopoulou, C. Posenato, G. Pesce, P. Vallerio, H.M. Boezen, A. Johannessen, T. Skorge, F. Gomez Real, S. García, A. Núñez, P. López, R. Sánchez, E. Mancebo, J-M. Antó, J. Garcia-Aymerich, A.E. Carsin, C. Sanjuas, S. Guerra, B. Jacquemin, P. Davdand Galdakao, S. Pascual, J. Antonio Maldonado, J.L. Sánchez, L. Palacios, N. Sánchez, M. Fernández, B. Robles, K. Torén, M. Holm, J-L. Kim, A-C. Olin, A. Dahlman-Höglund, L. Braback, L. Modig, B. Järvholm, K.A. Bertilsson, H. Franklin, C. Wahlgreen, B. Andersson, U. Spetz Nystrom, G.M. Bodinaa Lund, K. Nisser, N.M. Probst-Hensch, N. Künzli, D. Stolz, C. Schindler, J.M. Gaspoz, E. Zemp Stutz, M. Adam, C. Autenrieth, I. Curjuric, J. Dratva, A. Di Pasquale, R. Ducret-Stich, E. Fischer, L. Grize, A. Hensel, D. Keidel, A. Kumar, M. Imboden, N. Maire, A. Mehta, H. Phuleria, M. Ragettli, M. Ritter, E. Schaffner, G.A. Thun, A. Ineichen, T. Schikowski, M. Tarantino, M. Tsai, S. Kapur, R. Newson, N. Innes, and A. Wilson

Subjects
Medicine
Abstract

Asthma often remains uncontrolled, despite the fact that the pharmacological treatment has undergone large changes. We studied changes in the treatment of asthma over a 20-year period and identified factors associated with the regular use of inhaled corticosteroid (ICS) treatment. Changes in the use of medication were determined in 4617 randomly selected subjects, while changes in adults with persistent asthma were analysed in 369 participants. The study compares data from three surveys in 24 centres in 11 countries. The use of ICSs increased from 1.7% to 5.9% in the general population and the regular use of ICSs increased from 19% to 34% among persistent asthmatic subjects. The proportion of asthmatic subjects reporting asthma attacks in the last 12 months decreased, while the proportion that had seen a doctor in the last 12 months remained unchanged (42%). Subjects with asthma who had experienced attacks or had seen a doctor were more likely to use ICSs on a regular basis. Although ICS use has increased, only one-third of subjects with persistent asthma take ICSs on a regular basis. Less than half had seen a doctor during the last year. This indicates that underuse of ICSs and lack of regular healthcare contacts remains a problem in the management of asthma.

Published
2019
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6. Historical trends of the ecotoxicological pesticide risk from the main grain crops in Rolling Pampa (Argentina).

Author

Diego O Ferraro, Felipe Ghersa, Rodrigo de Paula, Alejandra C Duarte Vera, and Sebastián Pessah

Subjects
Medicine, Science
Abstract

We showed the results of the first long-term analysis (1987-2019) of pesticide (herbicides, fungicides and insecticides) impact in the Rolling Pampa, one of the main agricultural areas of Argentina. Using a clear and meaningful tool, based not only on acute toxicity but also on scaling up the results to total sown area, we identified time trends for both pesticide impact and the ecoefficiency of modal pesticide profiles. By the end of the time series, soybean showed a pesticide impact four times greater than maize crop in the studied area. However, the time trend in the subperiod (2012-2019) showed a sustainable pattern of pesticide use in soybean crop, with an improvement in its ecoefficiency. Oppositely, maize showed a relatively constant ecoefficiency value during most of the time series, suggesting a possible path towards an unsustainable cropping system. Findings from this study suggest that some efforts have to be made to improve the pest management decisions towards a more efficient pesticide profiles in maize crop and to keep improving the ecotoxicity pesticide profile in soybean crops because of its large sown area in the studied area.

Published
2020
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9. Una nueva aproximación metodológica basada en redes conceptuales y redes probabilísticas para evaluar la provisión de servicios de los ecosistemas

Author

Florencia Rositano and Diego O. Ferraro

Subjects
Environmental sciences, GE1-350, Ecology, QH540-549.5
Abstract

En los últimos años han surgido varias herramientas para evaluar la provisión de servicios de los ecosistemas (SE) desde un punto de vista ecológico. No obstante, la complejidad de los SE desalienta los intentos de adoptar una única aproximación metodológica. El objetivo de este trabajo consistió en evaluar un nuevo marco de análisis de la provisión de SE, sobre la base de redes conceptuales y redes probabilísticas. Para cumplir con el objetivo se describió el desarrollo de una red conceptual y se representó el conjunto de variables que determinan la provisión de ocho SE de la Región Pampeana. Luego, se parametrizó esa red mediante una metodología probabilística conocida como Redes Bayesianas, para ser, después, aplicada a tres zonas agrícolas pampeanas. Por último, se plantearon ventajas y desventajas de este nuevo marco de análisis mediante una comparación con otras aproximaciones para el estudio de la provisión de SE, desarrolladas en Argentina y en otras partes del mundo, tales como InVEST, RIOS, ARIES y ECOSER. El enfoque aquí presentado puede ser útil para: a) evaluar la sustentabilidad de los agroecosistemas pampeanos desde una dimensión ecológica, o b) asistir a los tomadores de decisión (i.e., productores y asesores agropecuarios) para implementar estrategias sustentables de uso de la tierra.

Published
2017
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11. A fuzzy knowledge-based model for assessing risk of pesticides into the air in cropping systems

Author

Diego O, Ferraro and Rodrigo, de Paula

Subjects
Environmental Engineering, Fuzzy Logic, Environmental Chemistry, Agriculture, Pesticides, Volatilization, Ecotoxicology, Pollution, Waste Management and Disposal
Abstract

Pesticide use in current cropping systems has become a key input to improve productivity. However, their potential risk to nature demands tools for designing a sustainable use. In this work, a fuzzy knowledge-based model was developed for assessing risk of pesticides into the air. The model was based on fuzzy logic theory which provides a means for representing uncertainty by including knowledge about different processes related to pesticide dynamics using functions, control rules and logical inference systems. All these elements were built through a literature review. Results from the sensitivity analysis on the final model structure showed that the Henry's law constant was the most influential input variable related to the active ingredient identity, while the most influential management and environmental input variables on the pesticide air risk values were the droplet size together with the application method and the current wet bulb temperature depression value, respectively. Results from an independent model validation showed a significant goodness-of-fit between the simulated risk of drift and volatilization and the observed values under experimental conditions. Long-term simulations in a real soybean production system in Argentina showed results of drift reduction in post-emergence conditions of the crop under aerial application condition, and a significant effect of the identity of the active ingredient in the risk values. Simulated risk values from the developed model allow to identify ex ante the combination of agronomic decisions, together with environmental conditions that can reduce the risk of pesticides in the air in real production systems. Further combination with ecotoxicological classification tools should improve pesticide use assessment in agricultural systems.

Published
2022
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12. Evaluación exergética de la producción de etanol en base a grano de maíz: un estudio de caso en la Región Pampeana (Argentina)

Author

Diego O. Ferraro

Subjects
sustentabilidad, agricultura, deterioro, exergía, Environmental sciences, GE1-350, Ecology, QH540-549.5
Abstract

La transformación de los sistemas naturales en sistemas productivos altera no sólo su estructura sino también su funcionalidad. La necesidad de evaluar y monitorear esos cambios funcionales ha llevado al desarrollo y la aplicación de un gran número de indicadores del impacto de las actividades humanas sobre los ecosistemas. En este trabajo se presenta un marco teórico para el estudio del deterioro de los ecosistemas agrícolas a través del análisis de los flujos de energía. Se presentan los fundamentos de la evaluación del funcionamiento de los agroecosistemas a través del uso de la energía útil o exergía, y se ilustra la metodología de cálculo en un sistema agrícola de la Región Pampeana destinado a la producción de etanol sobre la base de grano de maíz. Los resultados indican que si bien el impacto potencial en términos de extracción de recursos (bajo la forma de exergía consumida) es mayor en la fase industrial, las ineficiencias en la fase agrícola son mucho más marcadas. En cuanto al ciclado interno de exergía, los resultados de este trabajo indican que 41% de la exergía utilizada para obtener 1 MJ de exergía proviene de fuentes no renovables, y se eleva a 71% si se toma en cuenta el aporte neto de exergía del combustible, después de descontarle los costos exergéticos acumulados durante los procesos de elaboración. Estos resultados indican que el sistema analizado de producción de etanol sobre la base de maíz cumple de manera parcial las condiciones deseables de baja extracción de recursos del ambiente y alta renovabilidad de la producción.

Published
2008

13. Erratum to: Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition) (Autophagy, 12, 1, 1-222, 10.1080/15548627.2015.1100356

Author

Klionsky, D.J. Abdelmohsen, K. Abe, A. Abedin, M.J. Abeliovich, H. Arozena, A.A. Adachi, H. Adams, C.M. Adams, P.D. Adeli, K. Adhihetty, P.J. Adler, S.G. Agam, G. Agarwal, R. Aghi, M.K. Agnello, M. Agostinis, P. Aguilar, P.V. Aguirre-Ghiso, J. Airoldi, E.M. Ait-Si-Ali, S. Akematsu, T. Akporiaye, E.T. Al-Rubeai, M. Albaiceta, G.M. Albanese, C. Albani, D. Albert, M.L. Aldudo, J. Algül, H. Alirezaei, M. Alloza, I. Almasan, A. Almonte-Beceril, M. Alnemri, E.S. Alonso, C. Altan-Bonnet, N. Altieri, D.C. Alvarez, S. Alvarez-Erviti, L. Alves, S. Amadoro, G. Amano, A. Amantini, C. Ambrosio, S. Amelio, I. Amer, A.O. Amessou, M. Amon, A. An, Z. Anania, F.A. Andersen, S.U. Andley, U.P. Andreadi, C.K. Andrieu-Abadie, N. Anel, A. Ann, D.K. Anoopkumar-Dukie, S. Antonioli, M. Aoki, H. Apostolova, N. Aquila, S. Aquilano, K. Araki, K. Arama, E. Aranda, A. Araya, J. Arcaro, A. Arias, E. Arimoto, H. Ariosa, A.R. Armstrong, J.L. Arnould, T. Arsov, I. Asanuma, K. Askanas, V. Asselin, E. Atarashi, R. Atherton, S.S. Atkin, J.D. Attardi, L.D. Auberger, P. Auburger, G. Aurelian, L. Autelli, R. Avagliano, L. Avantaggiati, M.L. Avrahami, L. Azad, N. Awale, S. Bachetti, T. Backer, J.M. Bae, D.-H. Bae, J.-S. Bae, O.-N. Bae, S.H. Baehrecke, E.H. Baek, S.-H. Baghdiguian, S. Bagniewska-Zadworna, A. Bai, H. Bai, J. Bai, X.-Y. Bailly, Y. Balaji, K.N. Balduini, W. Ballabio, A. Balzan, R. Banerjee, R. Bánhegyi, G. Bao, H. Barbeau, B. Barrachina, M.D. Barreiro, E. Bartel, B. Bartolomé, A. Bassham, D.C. Bassi, M.T. Bast, R.C., Jr. Basu, A. Batista, M.T. Batoko, H. Battino, M. Bauckman, K. Baumgarner, B.L. Bayer, K.U. Beale, R. Beaulieu, J.-F. Beck, G.R., Jr. Becker, C. Beckham, J.D. Bédard, P.-A. Bednarski, P.J. Begley, T.J. Behl, C. Behrends, C. Behrens, G.M.N. Behrns, K.E. Bejarano, E. Belaid, A. Belleudi, F. Bénard, G. Berchem, G. Bergamaschi, D. Bergami, M. Berkhout, B. Berliocchi, L. Bernard, A. Bernard, M. Bernassola, F. Bertolotti, A. Bess, A.S. Besteiro, S. Bettuzzi, S. Bhalla, S. Bhattacharyya, S. Bhutia, S.K. Biagosch, C. Bianchi, M.W. Biard-Piechaczyk, M. Billes, V. Bincoletto, C. Bingol, B. Bird, S.W. Bitoun, M. Bjedov, I. Blackstone, C. Blanc, L. Blanco, G.A. Blomhoff, H.K. Boada-Romero, E. Böckler, S. Boes, M. Boesze-Battaglia, K. Boise, L.H. Bolino, A. Boman, A. Bonaldo, P. Bordi, M. Bosch, J. Botana, L.M. Botti, J. Bou, G. Bouché, M. Bouchecareilh, M. Boucher, M.-J. Boulton, M.E. Bouret, S.G. Boya, P. Boyer-Guittaut, M. Bozhkov, P.V. Brady, N. Braga, V.M.M. Brancolini, C. Braus, G.H. Bravo-San-Pedro, J.M. Brennan, L.A. Bresnick, E.H. Brest, P. Bridges, D. Bringer, M.-A. Brini, M. Brito, G.C. Brodin, B. Brookes, P.S. Brown, E.J. Brown, K. Broxmeyer, H.E. Bruhat, A. Brum, P.C. Brumell, J.H. Brunetti-Pierri, N. Bryson-Richardson, R.J. Buch, S. Buchan, A.M. Budak, H. Bulavin, D.V. Bultman, S.J. Bultynck, G. Bumbasirevic, V. Burelle, Y. Burke, R.E. Burmeister, M. Bütikofer, P. Caberlotto, L. Cadwell, K. Cahova, M. Cai, D. Cai, J. Cai, Q. Calatayud, S. Camougrand, N. Campanella, M. Campbell, G.R. Campbell, M. Campello, S. Candau, R. Caniggia, I. Cantoni, L. Cao, L. Caplan, A.B. Caraglia, M. Cardinali, C. Cardoso, S.M. Carew, J.S. Carleton, L.A. Carlin, C.R. Carloni, S. Carlsson, S.R. Carmona-Gutierrez, D. Carneiro, L.A.M. Carnevali, O. Carra, S. Carrier, A. Carroll, B. Casas, C. Casas, J. Cassinelli, G. Castets, P. Castro-Obregon, S. Cavallini, G. Ceccherini, I. Cecconi, F. Cederbaum, A.I. Ceña, V. Cenci, S. Cerella, C. Cervia, D. Cetrullo, S. Chaachouay, H. Chae, H.-J. Chagin, A.S. Chai, C.-Y. Chakrabarti, G. Chamilos, G. Chan, E.Y.W. Chan, M.T.V. Chandra, D. Chandra, P. Chang, C.-P. Chang, R.C.-C. Chang, T.Y. Chatham, J.C. Chatterjee, S. Chauhan, S. Che, Y. Cheetham, M.E. Cheluvappa, R. Chen, C.-J. Chen, G. Chen, G.-C. Chen, G. Chen, H. Chen, J.W. Chen, J.-K. Chen, M. Chen, M. Chen, P. Chen, Q. Chen, Q. Chen, S.-D. Chen, S. Chen, S.S.-L. Chen, W. Chen, W.-J. Chen, W.Q. Chen, W. Chen, X. Chen, Y.-H. Chen, Y.-G. Chen, Y. Chen, Y. Chen, Y. Chen, Y.-J. Chen, Y.-Q. Chen, Y. Chen, Z. Chen, Z. Cheng, A. Cheng, C.H.K. Cheng, H. Cheong, H. Cherry, S. Chesney, J. Cheung, C.H.A. Chevet, E. Chi, H.C. Chi, S.-G. Chiacchiera, F. Chiang, H.-L. Chiarelli, R. Chiariello, M. Chieppa, M. Chin, L.-S. Chiong, M. Chiu, G.N.C. Cho, D.-H. Cho, S.-G. Cho, W.C. Cho, Y.-Y. Cho, Y.-S. Choi, A.M.K. Choi, E.-J. Choi, E.-K. Choi, J. Choi, M.E. Choi, S.-I. Chou, T.-F. Chouaib, S. Choubey, D. Choubey, V. Chow, K.-C. Chowdhury, K. Chu, C.T. Chuang, T.-H. Chun, T. Chung, H. Chung, T. Chung, Y.-L. Chwae, Y.-J. Cianfanelli, V. Ciarcia, R. Ciechomska, I.A. Ciriolo, M.R. Cirone, M. Claerhout, S. Clague, M.J. Cl� ria, J. Clarke, P.G.H. Clarke, R. Clementi, E. Cleyrat, C. Cnop, M. Coccia, E.M. Cocco, T. Codogno, P. Coers, J. Cohen, E.E.W. Colecchia, D. Coletto, L. Coll, N.S. Colucci-Guyon, E. Comincini, S. Condello, M. Cook, K.L. Coombs, G.H. Cooper, C.D. Cooper, J.M. Coppens, I. Corasaniti, M.T. Corazzari, M. Corbalan, R. Corcelle-Termeau, E. Cordero, M.D. Corral-Ramos, C. Corti, O. Cossarizza, A. Costelli, P. Costes, S. Cotman, S.L. Coto-Montes, A. Cottet, S. Couve, E. Covey, L.R. Cowart, L.A. Cox, J.S. Coxon, F.P. Coyne, C.B. Cragg, M.S. Craven, R.J. Crepaldi, T. Crespo, J.L. Criollo, A. Crippa, V. Cruz, M.T. Cuervo, A.M. Cuezva, J.M. Cui, T. Cutillas, P.R. Czaja, M.J. Czyzyk-Krzeska, M.F. Dagda, R.K. Dahmen, U. Dai, C. Dai, W. Dai, Y. Dalby, K.N. Valle, L.D. Dalmasso, G. D'amelio, M. Damme, M. Darfeuille-Michaud, A. Dargemont, C. Darley-Usmar, V.M. Dasarathy, S. Dasgupta, B. Dash, S. Dass, C.R. Davey, H.M. Davids, L.M. Dávila, D. Davis, R.J. Dawson, T.M. Dawson, V.L. Daza, P. de Belleroche, J. de Figueiredo, P. de Figueiredo, R.C.B.Q. de la Fuente, J. De Martino, L. De Matteis, A. De Meyer, G.R.Y. De Milito, A. De Santi, M. de Souza, W. De Tata, V. De Zio, D. Debnath, J. Dechant, R. Decuypere, J.-P. Deegan, S. Dehay, B. Del Bello, B. Del Re, D.P. Delage-Mourroux, R. Delbridge, L.M.D. Deldicque, L. Delorme-Axford, E. Deng, Y. Dengjel, J. Denizot, M. Dent, P. Der, C.J. Deretic, V. Derrien, B. Deutsch, E. Devarenne, T.P. Devenish, R.J. Di Bartolomeo, S. Di Daniele, N. Di Domenico, F. Di Nardo, A. Di Paola, S. Di Pietro, A. Di Renzo, L. Di Antonio, A. Díaz-Araya, G. Díaz-Laviada, I. Diaz-Meco, M.T. Diaz-Nido, J. Dickey, C.A. Dickson, R.C. Diederich, M. Digard, P. Dikic, I. Dinesh-Kumar, S.P. Ding, C. Ding, W.-X. Ding, Z. Dini, L. Distler, J.H.W. Diwan, A. Djavaheri-Mergny, M. Dmytruk, K. Dobson, R.C.J. Doetsch, V. Dokladny, K. Dokudovskaya, S. Donadelli, M. Dong, X.C. Dong, X. Dong, Z. Donohue, T.M., Jr. Donohue-Jr, T.M. Doran, K.S. D'orazi, G. Dorn, G.W., II Dosenko, V. Dridi, S. Drucker, L. Du, J. Du, L.-L. Du, L. du Toit, A. Dua, P. Duan, L. Duann, P. Dubey, V.K. Duchen, M.R. Duchosal, M.A. Duez, H. Dugail, I. Dumit, V.I. Duncan, M.C. Dunlop, E.A. Dunn, W.A., Jr. Dupont, N. Dupuis, L. Durán, R.V. Durcan, T.M. Duvezin-Caubet, S. Duvvuri, U. Eapen, V. Ebrahimi-Fakhari, D. Echard, A. Eckhart, L. Edelstein, C.L. Edinger, A.L. Eichinger, L. Eisenberg, T. Eisenberg-Lerner, A. Eissa, N.T. El-Deiry, W.S. El-Khoury, V. Elazar, Z. Eldar-Finkelman, H. Elliott, C.J.H. Emanuele, E. Emmenegger, U. Engedal, N. Engelbrecht, A.-M. Engelender, S. Enserink, J.M. Erdmann, R. Erenpreisa, J. Eri, R. Eriksen, J.L. Erman, A. Escalante, R. Eskelinen, E.-L. Espert, L. Esteban-Martínez, L. Evans, T.J. Fabri, M. Fabrias, G. Fabrizi, C. Facchiano, A. Færgeman, N.J. Faggioni, A. Fairlie, W.D. Fan, C. Fan, D. Fan, J. Fang, S. Fanto, M. Fanzani, A. Farkas, T. Faure, M. Favier, F.B. Fearnhead, H. Federici, M. Fei, E. Felizardo, T.C. Feng, H. Feng, Y. Feng, Y. Ferguson, T.A. Fernández, Á.F. Fernandez-Barrena, M.G. Fernandez-Checa, J.C. Fernández-López, A. Fernandez-Zapico, M.E. Feron, O. Ferraro, E. Ferreira-Halder, C.V. Fesus, L. Feuer, R. Fiesel, F.C. Filippi-Chiela, E.C. Filomeni, G. Fimia, G.M. Fingert, J.H. Finkbeiner, S. Finkel, T. Fiorito, F. Fisher, P.B. Flajolet, M. Flamigni, F. Florey, O. 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Zhang, J. Zhang, J.-P. Zhang, L. Zhang, L. Zhang, L. Zhang, M.-Y. Zhang, X. Zhang, X.D. Zhang, Y. Zhang, Y. Zhang, Y. Zhang, Y. Zhang, Y. Zhao, M. Zhao, W.-L. Zhao, X. Zhao, Y.G. Zhao, Y. Zhao, Y. Zhao, Y.-X. Zhao, Z. Zhao, Z.J. Zheng, D. Zheng, X.-L. Zheng, X. Zhivotovsky, B. Zhong, Q. Zhou, G.-Z. Zhou, G. Zhou, H. Zhou, S.-F. Zhou, X.-J. Zhu, H. Zhu, H. Zhu, W.-G. Zhu, W. Zhu, X.-F. Zhu, Y. Zhuang, S.-M. Zhuang, X. Ziparo, E. Zois, C.E. Zoladek, T. Zong, W.-X. Zorzano, A. Zughaier, S.M.

Published
2016

14. Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition)

Author

Klionsky, D.J. Abdelmohsen, K. Abe, A. Abedin, M.J. Abeliovich, H. Arozena, A.A. Adachi, H. Adams, C.M. Adams, P.D. Adeli, K. Adhihetty, P.J. Adler, S.G. Agam, G. Agarwal, R. Aghi, M.K. Agnello, M. Agostinis, P. Aguilar, P.V. Aguirre-Ghiso, J. Airoldi, E.M. Ait-Si-Ali, S. Akematsu, T. Akporiaye, E.T. Al-Rubeai, M. Albaiceta, G.M. Albanese, C. Albani, D. Albert, M.L. Aldudo, J. Algül, H. Alirezaei, M. Alloza, I. Almasan, A. Almonte-Beceril, M. Alnemri, E.S. Alonso, C. Altan-Bonnet, N. Altieri, D.C. Alvarez, S. Alvarez-Erviti, L. Alves, S. Amadoro, G. Amano, A. Amantini, C. Ambrosio, S. Amelio, I. Amer, A.O. Amessou, M. Amon, A. An, Z. Anania, F.A. Andersen, S.U. Andley, U.P. Andreadi, C.K. Andrieu-Abadie, N. Anel, A. Ann, D.K. Anoopkumar-Dukie, S. Antonioli, M. Aoki, H. Apostolova, N. Aquila, S. Aquilano, K. Araki, K. Arama, E. Aranda, A. Araya, J. Arcaro, A. Arias, E. Arimoto, H. Ariosa, A.R. Armstrong, J.L. Arnould, T. Arsov, I. Asanuma, K. Askanas, V. Asselin, E. Atarashi, R. Atherton, S.S. Atkin, J.D. Attardi, L.D. Auberger, P. Auburger, G. Aurelian, L. Autelli, R. Avagliano, L. Avantaggiati, M.L. Avrahami, L. Azad, N. Awale, S. Bachetti, T. Backer, J.M. Bae, D.-H. Bae, J.-S. Bae, O.-N. Bae, S.H. Baehrecke, E.H. Baek, S.-H. Baghdiguian, S. Bagniewska-Zadworna, A. Bai, H. Bai, J. Bai, X.-Y. Bailly, Y. Balaji, K.N. Balduini, W. Ballabio, A. Balzan, R. Banerjee, R. Bánhegyi, G. Bao, H. Barbeau, B. Barrachina, M.D. Barreiro, E. Bartel, B. Bartolomé, A. Bassham, D.C. Bassi, M.T. Bast, R.C., Jr. Basu, A. Batista, M.T. Batoko, H. Battino, M. Bauckman, K. Baumgarner, B.L. Bayer, K.U. Beale, R. Beaulieu, J.-F. Beck, G.R., Jr. Becker, C. Beckham, J.D. Bédard, P.-A. Bednarski, P.J. Begley, T.J. Behl, C. Behrends, C. Behrens, G.M.N. Behrns, K.E. Bejarano, E. Belaid, A. Belleudi, F. Bénard, G. Berchem, G. Bergamaschi, D. Bergami, M. Berkhout, B. Berliocchi, L. Bernard, A. Bernard, M. Bernassola, F. Bertolotti, A. Bess, A.S. Besteiro, S. Bettuzzi, S. Bhalla, S. Bhattacharyya, S. Bhutia, S.K. Biagosch, C. Bianchi, M.W. Biard-Piechaczyk, M. Billes, V. Bincoletto, C. Bingol, B. Bird, S.W. Bitoun, M. Bjedov, I. Blackstone, C. Blanc, L. Blanco, G.A. Blomhoff, H.K. Boada-Romero, E. Böckler, S. Boes, M. Boesze-Battaglia, K. Boise, L.H. Bolino, A. Boman, A. Bonaldo, P. Bordi, M. Bosch, J. Botana, L.M. Botti, J. Bou, G. Bouché, M. Bouchecareilh, M. Boucher, M.-J. Boulton, M.E. Bouret, S.G. Boya, P. Boyer-Guittaut, M. Bozhkov, P.V. Brady, N. Braga, V.M.M. Brancolini, C. Braus, G.H. Bravo-San-Pedro, J.M. Brennan, L.A. Bresnick, E.H. Brest, P. Bridges, D. Bringer, M.-A. Brini, M. Brito, G.C. Brodin, B. Brookes, P.S. Brown, E.J. Brown, K. Broxmeyer, H.E. Bruhat, A. Brum, P.C. Brumell, J.H. Brunetti-Pierri, N. Bryson-Richardson, R.J. Buch, S. Buchan, A.M. Budak, H. Bulavin, D.V. Bultman, S.J. Bultynck, G. Bumbasirevic, V. Burelle, Y. Burke, R.E. Burmeister, M. Bütikofer, P. Caberlotto, L. Cadwell, K. Cahova, M. Cai, D. Cai, J. Cai, Q. Calatayud, S. 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Published
2016

15. Quality of Life after Cistectomy

Author

A. Giollo, O. Ferraro, S. Ferretti, A. Barbieri, N. Azzolini, P. Cortellini, U. Maestroni, and M. Panteri

Subjects
Gerontology, Quality of life (healthcare), business.industry, Medicine, General Medicine, business
Abstract

We have considered the aspects and the differences of quality of life and erectile function of 32 consecutive patients underwent to surgical operation of radical cistectomy and urinary diversion (11 patients with ileoureteralcutanous sec. Bricker and 21 patients with orthotopic neobladder). Medical Outcomes Study - Short Form - SF36 TEST and International Index of Erectile Function - IIEF-5, TEST have been administered to the patients, to know the Quality of Life assessment and the erectile dysfunction. The evaluation and analysis of the answers show no statistical significant differences between the two groups of patients about quality of life and sexual aspects.

Published
2004
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16. Disparities in access to anti-HER2 therapies in neoadjuvant chemotherapy: A prognostic analysis based on real-world data comparing Brazil's public and private healthcare systems.

Author

Antonini M, Mattar A, Pereira da Costa Pinheiro DJ, Maia IB, Teixeira MD, Amorim AG, Ferraro O, Chrispim de Oliveira L, Ramos MDNM, Cavalcante FP, Zerwes F, Madeira M, Barroso-Sousa R, de Camargo Millen E, Frasson AL, Brenelli FP, Facina G, Fenile R, Gebrim LH, and Real JM

Abstract

Background: Trastuzumab has significantly improved the treatment of HER2-positive breast cancer, particularly in the neoadjuvant setting, where its combination with chemotherapy increases the pathologic complete response (pCR) rate. This retrospective cohort study assesses the implications of disparities in access to trastuzumab within the Brazilian public healthcare system, focusing on pCR, overall survival (OS) and disease-free survival (DFS) in non-metastatic, HER2-positive breast cancer patients undergoing neoadjuvant chemotherapy (NAC)., Methods: The study was conducted in the Hospital Pérola Byington (PEROLA), a public institution, and in the Hospital do Servidor Público Estadual (HSPE), a private institution. pCR was defined as the absence of residual invasive or in situ tumors in the breast and axillary nodes. OS and DFS were calculated by Kaplan-Meier survival analysis for a 5-year period., Results: From 2011 to 2020, 381 patients at PEROLA and 78 at HSPE underwent NAC. Trastuzumab availability was higher at HSPE (83.4 % vs. 60.0 %, p < 0.0001). Use of trastuzumab correlated with significantly higher pCR rates at both the PEROLA (54.3 % vs. 26.4 %, p < 0.0001) and the HSPE (52.7 % vs. 26.4 %, p < 0.0001). HER2-positive patients with pCR at HSPE also had better OS (80 % vs. 61 %, p < 0.0001) and DFS (89 % vs. 67 %, p < 0.0001) compared to those at PEROLA., Conclusion: There were significant differences in the provision of trastuzumab between the public and private healthcare systems, adversely affecting clinical outcomes and patient survival. The current data highlight the pressing need to address equity in cancer treatment to improve prognosis for every patient., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2025
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17. Enhancement of human native skin fibroblast proliferation in natural salso-bromo-iodic mineral water added to in vitro culture.

Author

Saler M, Ferraro O, Faga A, Sansotta D, Villani S, and Nicoletti G

Abstract

Background: The favorable regenerative effects of some mineral waters on wound healing have long been empirically demonstrated., Objectives: The aim of this experimental study is to investigate the effects of an Italian salso-bromo-iodic mineral water (Rivanazzano, Italy) on an in vitro human native fibroblast culture model to identify any potential regenerative actions., Material and Methods: Human native fibroblasts were cultured under different experimental conditions: - Dulbecco's modified Eagle's medium (DMEM) reconstituted with distilled water (control); - DMEM reconstituted with filtered mineral water collected from the spring; - DMEM reconstituted with filtered mineral water collected at the balneotherapy facility; - DMEM reconstituted with filtered, heated mineral water collected at the balneotherapy facility; - DMEM partially replaced with filtered mineral water collected from the spring at different concentrations (10%, 20%, 30%, 40%, 50%); - DMEM partially replaced with filtered, heated mineral water collected at the balneotherapy facility at different concentrations (10%, 20%, 30%, 40%, 50%); - DMEM partially replaced with filtered mineral water collected at the balneotherapy facility at different concentrations (10%, 20%, 30%, 40%, 50%). Cell proliferation and viability were evaluated using spectrophotometric analysis following staining with the XTT Microculture Tetrazolium Assay. Statistical analyses were performed for each experimental condition at 24, 48 and 72 h., Results: The best outcomes were observed in fibroblasts cultured with DMEM partially replaced with filtered mineral water collected from the spring, within the range of 20-50%., Conclusions: Our research results showed that Rivanazzano salso-bromo-iodic mineral water has a stimulating effect on in vitro human native fibroblast cultures. This activity was most pronounced with water collected from the spring, and it decreased with water collected at the balneotherapy facilities. These findings could form the basis for clinical applications in wound healing and balneotherapy.

Published
2024
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18. Knowledge related to breast cancer screening programs by physicians in Brazil.

Author

Antonini M, Pannain GD, Souza GSS, Ferraro O, Mattar A, Lopes RGC, and Real JM

Subjects
Humans, Female, Brazil, Cross-Sectional Studies, Middle Aged, Adult, Health Knowledge, Attitudes, Practice, Gynecology education, Guideline Adherence statistics & numerical data, Obstetrics education, Aged, Clinical Competence statistics & numerical data, Male, Mass Screening statistics & numerical data, Surveys and Questionnaires, Physicians, Family statistics & numerical data, Ultrasonography, Mammary statistics & numerical data, Breast Neoplasms diagnostic imaging, Breast Neoplasms diagnosis, Early Detection of Cancer statistics & numerical data, Practice Patterns, Physicians' statistics & numerical data, Mammography statistics & numerical data
Abstract

Background: Antonini et al. evaluated gynecologists', obstetricians', and family and community physicians knowledge of breast cancer screening and their adherence to recommendations defined by the BI-RADS™ system. The study demonstrated that inadequate training resulted in insufficient screening and failure to follow the protocols recommended by the BIRADS™ system., Background: ■ Variability in screening protocols: only 42.8% of gynecologists and obstetricians follow the 40-74 years protocol, while 76.6% of family physicians follow the 50-69 years protocol., Background: ■ High rate of incorrect BIRADS. interpretation: there were 46.3% incorrect responses among gynecologists and obstetricians and 77.9% among family physicians, highlighting significant knowledge gaps., Background: ■ Misconception about breast ultrasound: 39.1% of gynecologists and obstetricians and 20.3% of family physicians incorrectly consider ultrasound as a screening method., Background: ■ Impact of inadequate training: inadequate training leads to improper screening practices that do not align with the BIRADS. recommended guidelines., Objective: To evaluate the knowledge and practices of gynecologists, obstetricians, and family and community physicians in Brazil regarding breast cancer screening, mammographic findings defined by the BIRADS™ system, and their approach to suspected clinical lesions., Methods: This was an observational, cross-sectional, descriptive study conducted using an online research questionnaire distributed via email to 9,000 gynecologists and obstetricians and 5,600 family and community and preventive medicine doctors actively practicing in Brazil., Results: Among gynecologists and obstetricians, 42.8% follow the 40-74 years screening, 33.5% follow the 50-69 years screening, and 23.6% do not follow any specific protocol. Among the family and community physicians, 76.6% follow the 50-69 years screening protocol, and 23.4% do not follow any specific protocol. When we evaluated the responses regarding the behaviors of each BIRADS™ classification, 46.3% of responses were wrong among gynecologists and obstetricians, and 77.9% were wrong among community and preventive medicine doctors, exhibiting a significant difference. The role of breast ultrasound in screening was evaluated; 39.1% of gynecologists and obstetricians and 20.3% of community and preventive medicine doctors consider it as a screening method. Among gynecologists and obstetricians who do not follow any screening protocol, 94.7% consider ultrasound as a screening method. Among community and preventive medicine doctors, only 26.5% of physicians who follow the 50-69 years screening method consider it as a screening method., Conclusion: Inadequate training results in gynecologists and obstetricians, and family and community physicians performing inadequate screening and not following the recommended practices outlined in the BIRADS™ system.

Published
2024
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19. Real-world evidence of survival outcomes in breast cancer subtypes after neoadjuvant chemotherapy in a Brazilian reference center.

Author

Antonini M, Mattar A, Bauk Richter FG, Pannain GD, Teixeira MD, Amorim AG, da Costa Pinheiro DJP, Soares LR, Cavalcante FP, Moreira Ramos MDN, Madeira M, Zerwes F, Ferraro O, Lopes RGC, and Gebrim LH

Subjects
Humans, Female, Middle Aged, Retrospective Studies, Brazil, Adult, Aged, Cohort Studies, Treatment Outcome, Breast Neoplasms drug therapy, Breast Neoplasms pathology, Breast Neoplasms mortality, Neoadjuvant Therapy methods
Abstract

Background: Neoadjuvant chemotherapy (NAC), traditionally used for locally advanced disease, is now applied for operable disease, particularly to treat aggressive breast cancer (BC). This study aimed to characterize the pathological complete response (pCR) and its relationship with overall survival (OS) and disease-free survival (DFS) among BC patients receiving NAC in a Brazilian public reference center, as well as the association between pCR and BC subtypes., Methods: A retrospective cohort study used a comprehensive BC database from a Brazilian women's health reference center, including patients diagnosed between 2011 and 2020 who underwent NAC. We collected demographic, cancer-specific, and treatment-related data, analyzing OS and DFS based on pCR status using the semiparametric Kaplan-Meier method, with the date of BC diagnosis as the starting point., Results: The study included 1,601 patients, with an average age of 49 years and a majority presenting stage IIIa disease (35%). Most had invasive nonspecial type (NST) BC (94%), and a significant portion (86.7%) exhibited a Ki-67 index <14. The overall pCR rate was 22.7%, with higher frequencies observed in the triple negative and luminal B subtypes. Patients who achieved pCR had significantly higher survival rates (89% alive vs. 61%, P<0.001) and better DFS (90% vs. 66%, P<0.001), except in the luminal A subtype, where pCR did not correlate with improved OS or DFS., Conclusions: These updated real-world data (RWD) from BC patients who underwent NAC in Brazil revealed a pCR rate of 22.7% in all cancer subtypes and stages. pCR was not associated with better outcomes in patients with luminal A, contrasting with other subtypes.

Published
2024
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20. Male and female disparities in breast cancer epidemiology: A comparative cross-sectional analysis of a Brazilian cohort (2017-2021).

Author

Antonini M, Mattar A, Pannain GD, Buttenbender SF, Pinheiro DJPDC, Teixeira MD, Amorim AG, Ferraro O, Lopes RGC, and Gebrim LH

Abstract

Male breast cancer (MBC) is a rare condition, accounting for approximately 1 % of all breast cancer cases. Nevertheless, the paucity of MBC-specific research has impeded a thorough understanding of MBC. In this study, we aimed to delineate the epidemiological implications of MBC in Brazil and benchmarked it against female breast cancer (FBC). This retrospective study analyzed data from the DATASUS database (2017-2021), which assessed the incidence of breast cancer in both sexes. All statistical analyses were performed using descriptive statistics and inferential methods, with significance set at a 95 % confidence interval. We identified 4,326 (1.7 %) and 233,793 (94.2 %) patients with MBC and FBC, respectively, in Brazil. Despite the general population concentration in the Southeast, MBC cases were more prevalent in the Northeast (p < 0.0004). At breast cancer diagnosis, males were typically older (mean age 59.5 [±10.2] years) than females (mean age 55.7 7 [±9.8] years). MBC was more commonly diagnosed clinically compared with FBC, which was most commonly diagnosed via screening. Surgical diagnostics were twice as likely in males, who also more frequently presented with advanced disease stages (stages III and IV; 72.8 % vs. 59.3 %), leading to a higher rate of mastectomy. Treatment was initiated earlier in males than in females. Although MBC comprises a minority of breast cancer cases, it is more frequently diagnosed at an advanced stage compared with FBC and necessitates aggressive treatment. Our study also underscores the potential benefit of prompt initiation of therapy and need for tailored clinical approaches in patients with MBC., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Published
2024
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21. Two Years Post-COVID-19: An Ecologic Study Evaluating the Impact on Brazil's Mammographic Screening Program.

Author

Antonini M, Mattar A, Pinheiro DJPDC, Teixeira MD, Amorim AG, Ferraro O, Cavalcante FP, Zerwes F, Madeira M, Millen EC, Frasson AL, Lopes RGC, Brenelli FP, Leite RM, Gebrim LH, and Freitas-Junior R

Subjects
Humans, Female, Brazil epidemiology, Middle Aged, Aged, Retrospective Studies, SARS-CoV-2, Mass Screening methods, Mass Screening statistics & numerical data, Neoplasm Staging, Mammography statistics & numerical data, Mammography methods, COVID-19 epidemiology, COVID-19 diagnostic imaging, Breast Neoplasms diagnostic imaging, Breast Neoplasms epidemiology, Breast Neoplasms diagnosis, Early Detection of Cancer methods, Early Detection of Cancer statistics & numerical data
Abstract

Objectives: The objective of this study was to assess the impact of the COVID-19 pandemic, after 2 years, on mammographic screening in Brazil evaluating BIRADS® results, breast cancer diagnosis rates, and breast cancer stage., Study Design: This was an ecological observational study based on retrospective data from Brazil's mammographic screening program from 2015 to 2023., Methods: Data were obtained from the national screening database DATASUS - SISCAN (Cancer System Information) and retrieved in March 2024. Inclusion criteria comprised completeness of mammogram data (incomplete records were excluded), female participants aged 50 to 69 years, and mammograms exclusively performed for screening purposes. The study analyzed the number of mammograms conducted during the specified period, focusing on BIRADS® test results., Results: Out of 23,851,371 mammograms performed between 2015 and 2023, 15,000,628 were included for analysis. A significant reduction of 39.6% in mammograms was observed in 2020 compared to 2019, followed by a 12.6% decrease in 2021. Notably, a substantial rise in BIRADS categories 4 and 5 examinations was seen post-pandemic. Breast cancer staging analysis revealed a shift towards more advanced stages (III and IV) diagnosed post-pandemic, suggesting potential delays in detection and diagnosis., Conclusions: In conclusion, the study highlighted significant discrepancies in mammographic screenings and breast cancer diagnosis rates over 9 years. The pandemic reflected significant influence on the timing and stage at diagnosis, suggesting potential delays in detection and diagnosis that resulted in later identification of more advanced disease stages., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2024
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22. Real-world evidence of neoadjuvant chemotherapy for breast cancer treatment in a Brazilian multicenter cohort: Correlation of pathological complete response with overall survival.

Author

Antonini M, Mattar A, Bauk Richter FG, Pannain GD, Teixeira MD, Amorim AG, Ferraro O, Guedes Lopes RC, Gebrim LH, and Real JM

Subjects
Humans, Female, Adolescent, Adult, Brazil, Neoadjuvant Therapy, Retrospective Studies, Cohort Studies, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Prognosis, Trastuzumab therapeutic use, Disease-Free Survival, Breast Neoplasms pathology
Abstract

Objectives: We aimed to evaluate the pCR rate in patients receiving NAC for the treatment of breast cancer (BC) in a multicenter cohort in Brazil. Additionally, we aimed to use RWD to assess the impact of pCR on OS and DFS., Methods: This was a retrospective, multicenter cohort study that included female patients over 18 years of age who were diagnosed with nonmetastatic breast cancer and received NAC. OS and DFS at five years were estimated by the Kaplan‒Meier method. Additionally, we conducted a multivariate analysis to identify factors that were significantly associated with pCR and OS., Results: From 2011 to 2020, 1891 patients were included in the study, and 421 (22,3%) achieved pCR (ypT0 ypN0). Considering the presence of residual DCIS, pCR was achieved in 467 patients (23,5%). The pCR rate varied between the subtypes: HER-2+ (p = 0,016) and clinical stage IIIA and IIIB (p < 0,001). Among HER-2+ patients, those who received trastuzumab had a significantly higher pCR rate than those who did not receive trastuzumab (p < 0.0001). Similarly, patients with TNBC who received treatment with platinum-based regimens also showed higher pCR rates (p < 0.0001). OS was grouped according to pCR status, and the OS rate was 88,3% in the pCR group and 58.1% in the non-pCR group (p < 0.0001). The five-year DFS was 92.2% in the pCR group and 64.3% in the non-pCR group (p < 0.0001)., Conclusion: The pCR rate and its prognostic value varied across BC subtypes. In our study, pCR could be used as a surrogate of favorable clinical outcome, as it was associated with higher OS and DFS rates., Competing Interests: Declaration of competing interest None., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2023
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23. Systematic Review of Nomograms Used for Predicting Pathological Complete Response in Early Breast Cancer.

Author

Antonini M, Pannain GD, Mattar A, Ferraro O, Lopes RGC, Real JM, and Okumura LM

Subjects
Female, Humans, Retrospective Studies, Breast Neoplasms drug therapy, Breast Neoplasms pathology, Nomograms
Abstract

Pathological complete response (pCR) is an important surrogate outcome to assess the effects of neoadjuvant chemotherapy (NAC). Nomograms to predict pCR have been developed with local data to better select patients who are likely to benefit from NAC; however, they were never critically reviewed regarding their internal and external validity. The purpose of this systematic review was to critically appraise nomograms published in the last 20 years (2010-2022). Articles about nomograms were searched in databases, such as PubMed/MEDLINE, Embase and Cochrane. A total of 1120 hits were found, and seven studies were included for analyses. No meta-analysis could be performed due to heterogeneous reports on outcomes, including the definition of pCR and subtypes. Most nomograms were developed in Asian centers, and nonrandomized retrospective cohorts were the most common sources of data. The most common subtype included in the studies was triple negative (50%). There were articles that included HER2+ (>80%). In one study, scholars performed additional validation of the nomogram using DFS and OS as outcomes; however, there was a lack of clarity on how such endpoints were measured. Nomograms to predict pCR cannot be extrapolated to other settings due to local preferences/availability of NAC. The main gaps identified in this review are also opportunities for future nomogram research and development.

Published
2023
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24. Impact of the COVID-19 pandemic on the breast cancer early diagnosis program in Brazil.

Author

Antonini M, Pinheiro DJPDC, Matos ABTMB, Ferraro O, Mattar A, Okumura LM, Lopes RGC, and Real JM

Abstract

During the COVID-19 pandemic, several screening exams were postponed, including mammograms. The aim of this study was to evaluate the impact of COVID-19 in mammographic screening in Brazil, considering 2015 to 2021. This was descriptive ecologic study based on the retrospective data of Brazil's mammographic screening program. A Brazilian national screening database (DATASUS - SISCAN (Cancer System Information)) was used as the data source, and the data in this database are publicly available for download and analysis. We report the number of screening rate from January 2015 to December 2021, using 2020 as reference year for COVID-19. From 2015 to 2021, 10,763,894 mammograms were performed and included in the analysis. Reductions of 39.6% and 13.3% were found in 2020 in 2021, respectively. During the pandemic's peak, the reduction was more pronounced, with maximum reductions of 82.4% in May 2020 and 34.8% in April 2021. There was an increase in the number of mammograms performed on high-risk patients from 11.2% in 2020 to 13.9% in 2021. This research demonstrated a decline in the breast cancer screening rate during the two years of the COVID-19 pandemic; this reduction will increase the burden of advanced breast cancer, potentially impacting morbidity and mortality related to this neoplasm., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Published
2023
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25. Does Pink October really impact breast cancer screening?

Author

Antonini M, Pinheiro DJPDC, Salerno GRF, Matos ABTMB, Ferraro O, Mattar A, Lopes RGC, and Real JM

Abstract

Objective: This study aims to evaluate the impact of the Pink October Campaign on the increase in mammographic screening in Brazil., Study Design: Ecological observational study, based on retrospective data., Methods: Brazilian national screening database (DATASUS/SISMAMA/Information System on Breast Cancer) was used as a data source and is publicly available for download and analysis. We report screening numbers and outcome rates from January 2017 to December 2021 comparing statistically (ANOVA test, post-Tukey test), age groups, regions of Brazil, and the four quarters of the year., Results: During the study period, the average number of exams performed monthly over the five years was 137,400.117. An increase in the number of mammograms performed in October was identified, as well as in the two following months, respectively 33%, 39%, and 22%, with statistical significance (p = 0.000) in relation to the three quarters of the year. In addition, in the other months, we found values below the monthly average. Statistical difference was not found in the increase in mammograms considering age groups (p = 0.5) and different regions of the country (p = 0.6)., Conclusions: This study showed an increase in mammographic screening in the three months following the Pink October Campaign, so we should intensify similar actions throughout the year and not just in October., Competing Interests: I, Marcelo Antonini, author responsible for the manuscript “PINK OCTOBER REALLY IMPACT BREAST CANCER SCREENING IN BRAZIL?”, declare that none of the authors of this study has any type of interest described below, or others that configure the so-called Conflict of Interest. I declare that the submitted manuscript did not receive any financial support, neither I nor the other authors., (© 2022 The Authors.)

Published
2022
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26. Impact of natural menopause on multiple sclerosis: a multicentre study.

Author

Baroncini D, Annovazzi PO, De Rossi N, Mallucci G, Torri Clerici V, Tonietti S, Mantero V, Ferrò MT, Messina MJ, Barcella V, La Mantia L, Ronzoni M, Barrilà C, Clerici R, Susani EL, Fusco ML, Chiveri L, Abate L, Ferraro O, Capra R, Colombo E, Confalonieri P, and Zaffaroni M

Subjects
Adolescent, Adult, Disease Progression, Female, Humans, Italy epidemiology, Middle Aged, Recurrence, Retrospective Studies, Risk Factors, Time Factors, Young Adult, Menopause, Multiple Sclerosis epidemiology
Abstract

Objective: To study the effect of natural menopause on multiple sclerosis clinical course., Methods: This was an observational, retrospective, multicentre, cohort study. Menopause onset was defined by the final menstrual period (FMP) beyond which no menses occurred for 12 months. We included multiple sclerosis (MS) patients with FMP occurred after 2005 and a recorded follow-up of at least 2 years pre-FMP and post-FMP. We excluded patients with primary progressive course, iatrogenic menopause and with other confounders that could mask menopause onset. We compared relapse-rate and expanded disability status scale (EDSS) scores pre-FMP and post-FMP, searching for possible interactions with age, disease duration, cigarette smoking and nulliparity status., Results: 148 patients were included (mean observation: 3.5 years pre-FMP and post-FMP). Most patients (92%) received disease-modifying therapies, mainly first-lines. After menopause the annualised relapse rate (ARR) significantly decreased (from 0.21±0.31 to 0.13± 0.24; p=0.005), while disability worsened (increase of mean 0.4 vs 0.2 points after menopause; p<0.001). Older age and long-lasting disease were associated with ARR reduction (p=0.013), but not with disability worsening. Cigarette smokers showed a trend to a higher disability accumulation after menopause (p=0.059)., Conclusion: Natural menopause seems to be a turning point to a more progressive phase of MS. Relapse rate is also reduced after menopause, but this effect could be driven most by ageing and shifting to progressive phase in patients with long-lasting disease. Cigarette smoking could speed up disability progression after menopause., Competing Interests: Competing interests: DB received travel grants from Genzyme, Merck and Biogen for participation at national and international congresses; he received speaking honoraria from Sanofi and Novartis, and personal compensation from Almirall for scientific publication. POA received honoraria for lecturing and participation in advisory boards, and/or travel expenses for attending congresses and meetings from Merck, Biogen, Teva, Sanofi- Genzyme, Mylan, Almirall, Roche and Novartis. NDR received speaker honoraria from Biogen Idec, Genzyme, Novartis, Sanofi-Aventis; received funding for participation in advisory board to Novartis and Genzyme-Sanofi and for traveling to scientific meetings from Biogen Idec, teva, Sanofi-Genzyme, Roche, Almirall and NovartisGiulia Mallucci received support to travel to scientific meetings from Bayer Schering, Biogen Idec, Genzyme, Merck Serono, Novartis, Roche, Sanofi-Aventis, Teva; received speaker honoraria from Biogen Idec and served on the scientific advisory board for Biogen, Genzyme and Merck SeronoValentina Torri Clerici acted as an Advisory Board member of Novartis and Merck-Serono, received funding for travelling and honoraria for speaking or writing from Teva, Biogen, Genzyme, Merk-Serono and Almirall. She received support for research project by Almirall. Simone Tonietti received honoraria for lecturing from Teva and Sanofi-Genzime, for writing from Teva, for participation in advisory boards from Merck and Biogen and for travel expenses for attending congresses and meetings from Merck, Biogen, Teva, Sanofi-Genzyme and Novartis. MJM received funding for travelling and honoraria for speaking or writing from Genzyme. MR received travel grants for congresses participation from Biogen, Genzyme, Novartis e Merck. He received honoraria for conferences organisation from Biogen. He received honoraria from Merck, Novartis, Biogen for advisory boards participation. VB received speaking honoraria and/or consultant fees from Biogen Idec, Merck Serono, Bayer, Sanofi-Genzyme, Novartis. Vittorio Mantero received honoraria for participation to advisory boards and/or travel expenses for attending congresses and meetings from Merck, Biogen, Teva, Sanofi-Genzyme, Roche and Novartis. PC was a board member of Biogen Idec, received travel grants from Sanofi, Biogen and Merck Serono. RC was consulting fees from Biogen, Teva, Genzyme, Merck Serono, and Novartis. Mauro Zaffaroni received honoraria for lecturing or participation in advisory boards, and financial support for attending congresses from Almirall, Biogen Idec, Genzyme, Merck Serono, Novartis, and Teva. Emanuela Susani, Maria Letizia Fusco, Caterina Barrilà, Luca Chiveri, Loredana La Mantia, Maria Teresa Ferrò, Raffaella Clerici, Ottavia Ferraro, Elena Colombo and Lucia Abate have nothing to disclose., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2019
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27. Familial heterozygous hypobetalipoproteinemia and breast cancer risk: A systematic review and suggestions for further research.

Author

Lima Pessoa E, Costa Vilella Dos Reis M, Sayuri Yamamoto T, Ribeiro Neto M, Ferraro O, Alves MJ, and Guedes Coelho Lopes R

Subjects
Apolipoprotein B-100 blood, Breast Neoplasms genetics, Case-Control Studies, Cohort Studies, Female, Heterozygote, Humans, Hypobetalipoproteinemia, Familial, Apolipoprotein B complications, Hypobetalipoproteinemia, Familial, Apolipoprotein B genetics, Hypobetalipoproteinemias genetics, Lipoproteins, LDL blood, Risk Factors, Breast Neoplasms etiology, Hypobetalipoproteinemias complications
Published
2019
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28. Genetic polymorphism of GSTM1 in women with breast cancer and interact with reproductive history and several clinical pathologies.

Author

Linhares JJ, Da Silva ID, De Souza NC, Noronha EC, Ferraro O, De Carvalho CV, Baracat EC, and Baracat FF

Subjects
Adult, Case-Control Studies, Female, Gene Deletion, Genotype, Humans, Middle Aged, Risk Factors, Smoking adverse effects, Breast Neoplasms genetics, Glutathione Transferase genetics, Polymorphism, Genetic, Reproductive History
Abstract

Due to the conflicting results regarding the association between breast cancer and the GSTM1 null mutation, our aim was to research this association in a Brazilian population and correlations with smoking, reproductive history and several clinical pathologies. A case-control study was performed on 105 women with breast cancer and 278 controls. Extraction of DNA was accomplished according to the protocol of the GFX kit and polymorphism analysis by the PCR technique. The control and experimental groups were compared and statistical analysis assessed by X2 or Fisher's exact test. The deletion in the GSTM1 gene in the breast cancer group had a prevalence of 32 (30.4%) individuals with the presence of null mutation. In the control group, the null mutation was present in 104 (37.4%) women. Upon comparison of the two groups, no statistically significant difference of the GSTM1 gene was observed, with an odds ratio (OR) of 0.74, 95%, confidence interval (CI) 0.45 - 1.20, p = 0.277. The results conclusively show that single gene GSTM1 polymorphisms do not confer a substantial risk of breast cancer to its carriers. Furthermore, in this study no correlation was found between GSTs and smoking, reproductive history and several clinical pathologies with respect to cancer risk.

Published
2005
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