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Napoli, Italy

Clavarezza M.,Ospedale Sacro Cuore Don Calabria | Mustacchi G.,Centro Oncologico | Gardini A.C.,IRST | Del Mastro L.,IRRCS A.O.U. San Martino IST | And 11 more authors.
BMC Cancer | Year: 2012

Background: International treatment guidelines recommend administration of adjuvant chemotherapy in early breast cancer based on clinical, prognostic and predictive parameters.Methods: An observational study (NEMESI) was conducted in 63 Italian oncology centres in patients with early breast cancer. Age, performance status, concomitant disease, menopausal status, histology, tumor dimension (pT), axillary lymph node status (pN), grading (G), estrogen and progesterone receptor (ER and PgR), proliferative index (ki67 or MIB-1), human epidermal growth factor receptor 2 (HER2) and type of adjuvant treatment were recorded. The primary objective of the study was to define parameters influencing the decision to prescribe adjuvant chemotherapy and the type of chemotherapy.Results: Data for 1894 patients were available. 69.0% postmenopausal, 67.0% pT1, 22.3% pTmic/pT1a/pT1b, 61.0% pN0, 48.7% luminal A, 18.1% luminal B, 16.1% HER2 positive, 8.7% triple negative, 8.4% unknown. 57.8% received adjuvant chemotherapy: 38.1% of luminal A, 67.3% luminal B, 88.2% HER2-positive, 97.6% triple negative. Regimens administered: 9.1% CMF-like, 48.8% anthracyclines, 38.4% anthracyclines plus taxanes, 3.7% taxanes alone. Increasing pT/pN and, marginally, HER2-positive were associated with the prescription of anthracyclines plus taxanes. Suboptimal schedules (CMF-like or AC/EC or FEC-75) were prescribed in 37.3% receiving chemotherapy, even in HER2-positive and triple negative disease (36.5% and 34.0%, respectively).Conclusions: This study showed an overprescription of adjuvant chemotherapy for early breast cancer, particularly referred to luminal A. pT, pN and, marginally, HER2 were the principal determinants for the choice of chemotherapy type. Suboptimal chemotherapy regimens were adopted in at least one third of HER2-positve and triple negative. © 2012 clavarezza et al.; licensee BioMed Central Ltd. Source

Liguori C.,AORN Cardarelli | Pitocco F.,Biomedical University of Rome | Di Giampietro I.,Biomedical University of Rome | De Vivo A.E.,Biomedical University of Rome | And 4 more authors.
BioMed Research International | Year: 2015

Objectives. To evaluate a population of asymptomatic thalassemia major (TM) and thalassemia intermedia (TI) patients using cardiovascular magnetic resonance (CMR). We supposed that TI group could be differentiated from the TM group based on T 2∗ and that the TI group could demonstrate higher cardiac output. Methods. A retrospective analysis of 242 patients with TM and TI was performed (132 males, 110 females; mean age 39.6 ± 8 years; 186 TM, 56 TI). Iron load was assessed by T 2∗ measurements; volumetric functions were analyzed using steady-state-free precession sequences. Results. Significant difference in left-right heart performance was observed between TM with iron overload and TI patients and between TM with iron overload and TM without iron overload (P < 0.05); no significant differences were observed between TM without iron overload and TI patients. A significant correlation was observed between T 2∗ and ejection fraction of right ventricle- (RV-) ejection fraction of left ventricle (LV); an inverse correlation was present among T 2∗ values and end-diastolic volume of LV, end-systolic volume of LV, stroke volume of LV, end-diastolic volume of RV, end-systolic volume of RV, and stroke volume of RV. Conclusions. CMR is a leading approach for cardiac risk evaluation of TM and TI patients. © 2015 Carlo Liguori et al. Source

Anselmetti G.C.,IRCC Candiolo | Bonaldi G.,Ospedali Riuniti | Carpeggiani P.,NOCSE | Manfre L.,AO Cannizzaro | And 2 more authors.
Acta Neurochirurgica, Supplementum | Year: 2011

Percutaneous vertebroplasty and kyphoplasty are procedures used to treat pain associated with vertebral compression fractures. Controversies are still open regarding indications, efficacy and safety of the procedures, and regarding the potential benefits, advantages and shortcomings of PV versus KP. Aim of this article is to report 7 years' experience in vertebral augmentation of the E.VE.RES.T. (European VErtebroplasty RESearch Team) group. The main topics are the treatments of hemangioma and malignant lesions, technically challenging cases such as vertebra plana, multifragmented fractures, multilevel treatments, refracture of augmented vertebra, and treatment of cervical junction and sacrum. © 2011 Springer-Verlag/Wien. Source

Di Bonito P.,S. Maria delle Grazie | Licenziati M.R.,AORN Santobono Pausilipon | Baroni M.G.,University of Cagliari | Baroni M.G.,University of Rome La Sapienza | And 7 more authors.
Obesity | Year: 2014

Objective To evaluate normoglycemic overweight/obese (Ow/Ob) children whose post-load plasma glucose (2hPG) cut-point may be significantly associated with cardiometabolic risk factors (CMRFs) and whether this cut-point predicts preclinical signs of organ damage. Methods One thousand seven hundred and thrity four normoglycemic Ow/Ob children were stratified into quintiles of 2hPG, the sixth group was constituted by 101 children with impaired glucose tolerance (IGT). Results Moving from the lower quintiles of 2hPG to IGT, the groups differed for Prepubertal stage, BMI, fasting PG, insulin levels, blood pressure, and lipids. To evaluate the best cut-off of 2hPG related to CMRFs, the area under the receiver operating characteristic curve and the Youden's index was calculated. Insulin resistance, high blood pressure, and high triglyceride/HDL-C ratio were associated with a 2hPG cut-off of 110 mg/dl. Children with 2hPG ≥110 mg/dl showed 1.3-3.2 fold higher risk to have high levels of ALT (as surrogate of nonalcoholic fatty liver disease) or increased carotid intima-media thickness. Conclusions This study, performed in a large cohort of Ow/Ob children, shows that an atherogenic risk profile and preclinical signs of organ damage are associated with post-challenge elevations in plasma glucose still considered in the high normal range. Copyright © 2014 The Obesity Society. Source

Berisso M.Z.,Padre Antero Micone Hospital | Fabbri G.,Coordinating Center | Gonzini L.,Coordinating Center | Caruso D.,Padre Antero Micone Hospital | And 6 more authors.
Journal of Cardiovascular Medicine | Year: 2014

AIMS: To provide insights on the antiarrhythmic management of atrial fibrillation among patients enrolled in the Antithrombotic Agents in Atrial Fibrillation (ATA-AF) study, and to assess the adherence of the Italian cardiologists and internists to guidelines recommendations. METHODS AND RESULTS: The ATA-AF study is a multicenter, observational study with prospective data collection on the management and treatment of patients with atrial fibrillation. From March to July 2010, 6910 patients with atrial fibrillation were recruited in 164 Italian Cardiology (Card) and 196 Internal Medicine (IMed) centers. Permanent atrial fibrillation was diagnosed in 50.8%, persistent atrial fibrillation in 24.4%, paroxysmal in 15.5%, and first-detected atrial fibrillation in 9.3% of the patients. Rhythm control (rhyC) strategy was pursued in 27.5% (39.6% Card vs. 12.9% IMed; P<0.0001) and rate control (raC) in 51.4% (43.7% Card vs. 60.7% IMed; P<0.0001); in 21.1% the antiarrhythmic strategy was not defined. Patients assigned to rhyC were younger and with less comorbidities than those assigned to raC. Adjusted multivariable analysis showed that atrial fibrillation type, setting of management, age and site of patient discharge were the most important independent predictors of rhyC assignment. The severity of atrial fibrillation-related symptoms was not associated with rhyC assignment. At discharge, beta-blockers, amiodarone and class 1c antiarrhythmic drugs were the drugs mainly used in the Card centers; and beta-blockers, digitalis, amiodarone and diltiazem/verapamil were used in the IMed centers. Amiodarone was overused in both Card and IMed centers. CONCLUSION: In the present study, rhyC was the strategy mainly pursued by cardiologists and raC by internists; treatment strategy assignment and antiarrhythmic therapy often do not agree with the guideline recommendations. © 2014 Italian Federation of Cardiology. Source

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