Azienda Ospedaliero Universitaria di Parma

Parma, Italy

Azienda Ospedaliero Universitaria di Parma

Parma, Italy
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Ormitti F.,Azienda Ospedaliero Universitaria di Parma | Ventura E.,Azienda Ospedaliero Universitaria di Parma | Summa A.,Azienda Ospedaliero Universitaria di Parma | Crisi G.,Azienda Ospedaliero Universitaria di Parma
American Journal of Neuroradiology | Year: 2010

The recently emerged novel influenza A(H1N1) virus continues to spread globally. The clinical disease generally appears mild, but unfavorable outcomes have been reported. We describe a case of a 3-year-old Italian girl infected with influenza A(H1N1) virus presenting with neurologic deterioration. CT findings were negative, but MR imaging findings were consistent with ANE. To our knowledge, this is the first case reported in Europe and the second in worldwide pediatric radiology literature.

Agency: European Commission | Branch: H2020 | Program: RIA | Phase: PHC-30-2015 | Award Amount: 4.84M | Year: 2016

Cancers of the Head and Neck Region (HNC) are the 6th more deadly cancers worldwide: in Europe ~150.000 new cases are detected and ~70.000 patients die every year. The main reasons for high mortality are the fact that the majority of cases are diagnosed in advanced Stage and the intrinsic heterogeneity of such tumors. At present the only adopted treatment decision method is based on TNM (Tumor-lymph-Nodes-Metastasis) prognostic system, that considers only a few risk factors such as smoking, alcohol abuse and more recently HPV. The TNM system is therefore inadequate to capture the patient-specific biomolecular characteristics of the tumor. HNC treatments can have hard impact on patients aesthetics and functionalities and, due to their toxicity, can cause severe morbidity and greatly deteriorate patients quality of life. A more precise prognostic prediction than the current TNM system is needed that allows implementing the first-line treatment that maximizes the therapeutic result and minimizes the impacts of therapy. BD2Decide DSS provides clinicians with the means and all the necessary information to tailor treatment and care delivery pathway to each and any HNC patient during their usual practice, in contrast to current one-size-fits-all approach. BD2Decide realizes and validates an Integrated Decision Support System that links population-specific epidemiology and behavioral data, patient-specific genomic, pathology, clinical and imaging data with big data techniques, multiscale prognostic models. Advanced graphical visualization tools are developed for prognostic data disclosure and patient co-participation to the selected treatment. BD2Decide will improve the clinical decision process, uncover new patient-specific patterns that can improve care, and create a virtuous circle of learning. A multicentric clinical study with more than 1.000 patients will be used to validate the system.

The forecasted increase in the number of older people for this century will be accompanied by an increase of those with disabilities. Disability is usually preceded by a condition named frailty that encompasses changes associated with ageing, life styles and chronic diseases. To detect and intervene on it is of outstanding importance to prevent disability, as recovery from disability is unlikely. Recent documents stress the necessity of testing the clinical utility (in terms of risk prediction, diagnosis validity and prognostic significance) of the existing definition of frailty by using combinations of clinical criteria (current definition) and lab Biomarkers (BMs). We will measure the levels of blood and urine omic-based BMs in old people selected from eight cohorts, which include up to 75,000 participants, using standardized and innovative technology (WP1). This figure will allow us to test the research questions with a high power and validity. Combining these lab BMs with clinical BMs, we will develop predictive, diagnostic and prognostic models (WP2), with its modulation by nutrition and physical activity, in general old population and in old people showing some characteristics that confer a high risk for developing frailty (selected cardiovascular risk factors and diseases) (WP4). After that, a selected set of BMs will be validated prospectively (WP3) and assessed to find the best-fitted models (WP4). These models will guide the development of the ready-to-use kits to be implemented in the clinical settings. These kits will be at the center of dissemination and exploitation activities (WP5, WP6). A well-balanced consortium distributed over the individual tasks in the respective work packages will carry it out, with a strong participation of SMEs. In summary, FRAILOMIC is original, relevant, pertinent, feasible, overcome the usual research bottlenecks on Biomarkers, and fits perfectly with the topics addressed by the HEALTH.2012.2.1.1-2 call in human subjects

Agency: European Commission | Branch: H2020 | Program: RIA | Phase: PHC-17-2014 | Award Amount: 6.43M | Year: 2015

Cardiovascular diseases (CVD) cause over 4 million deaths in Europe each year and mass disability: within the coming decades the disability-adjusted life years (DALYs) estimate is expected to rise from a loss of 85 million DALYs in 1990 to a loss of 150 million DALYs globally in 2020. Moreover, patient numbers are expected to rise rapidly in the next decades, due to an ageing society such that the burden of CVD for both patients and the healthcare sector will further rise. Cardiac rehabilitation (CR) is recognised as an effective approach for risk reduction and long term care of patients facing cardiovascular diseases (CVD). However, knowledge on CR in the elderly is limited, while tailoring of CR programmes to the elderly is needed. The reasons for this relates to the following aspects: 1) the elderly account for the majority of cardiac admissions and procedures, yet studies on cardiac rehabilitation have traditionally focused on younger patients, 2) many older patients who would derive benefit from CR interventions, do not participate, 3) there is a lack of commitment and adherence to CR within in the older population with only a minority completing the full programme and 4) a cardiovascular event in elderly patients could be a trigger for disability and dependence. Knowledge is lacking on effective approaches for this specific target group and moreover the specific challenges related to the target group must be addressed. With the ambition to achieve a breakthrough in cardiac care, the main objective of EU-CaRE is thus to obtain the evidence base to improve, tailor and optimise CR programmes regarding sustainable effectiveness, cost-effectiveness and participation level in the elderly. This is achieved through an comparative effectiveness analysis of current conventional cardiac rehabilitation programmes (CR), as well as new innovative mobile telemonitoring guided cardiac rehabilitation (mCR). As such, the project addresses the objectives of call PHC 17.

Agency: European Commission | Branch: FP7 | Program: CP | Phase: ICT-2007.5.3 | Award Amount: 3.98M | Year: 2008

NeoMark will perform research in the integration of heterogeneous clinical, laboratory, molecular and imaging data to develop a data integration environment facilitating multiscale and multilevel modeling, aimed at advancing models and methods currently in use to predict neoplastic reoccurrences, and to apply it to the study of oral cancer.\nSpecifically the scientific target will be to apply this multi-level data integration environment to the monitoring of the disease after remission, in order to early identify local or metastatic reoccurrence of the disease.\nThe technical target will be the development of two functional envirnments: one for the definition of biomarker profiles and one for the follow-up of the evolution of the disease. They will be based on the fusion of information from clinical data from health records and standard laboratory markers; from histological data from tumor mass specimens; from high-throughput genomic data from tumor tissue specimens, profiling gene expression at whole-genome level by oligo-RNA microarrays; from high-throughput genomic data from circulating cells specimens (whole blood sample), profiling gene expression at whole-genome level by oligo-RNA microarrays; from imaging data of the prime tumor mass (and secondary localizations if present) through imaging techniques, including image fusion, where relevant.\nThe outcomes of the project will be validated in two primary Clinical Centres in Spain and in Italy.\nIn this phase the early exploitation of NeoMark will also be assessed through the use of a RT-PCR platform to develop highly individual diagnostic tests to be used both at the time of first diagnosis, as well as for reoccurrence identification.

Agency: European Commission | Branch: FP7 | Program: CP-FP-SICA | Phase: HEALTH.2010.1.2-4 | Award Amount: 3.85M | Year: 2010

Chronic hepatitis C is one of the most common chronic viral infections of humans and a major cause of chronic liver disease, cirrhosis and liver cancer. Still about 4 million new infections occur world-wide each year with 50-85% of patients progressing to chronic hepatitis C. Currently there is no marker to predict spontaneous viral clearance and to guide treatment decisions. The major objectives of the HepaCute proposal are to develop biomarkers predicting the outcome of acute hepatitis C, improving the management of the related patients and thus decreasing the health burden of hepatitis C in Europe and Mediterranean partner countries (MPC). The HepaCute consortium has evolved from a series of EC-funded projects on hepatitis C (HCVacc/HepCvax/Virgil/HEPACIVAC) and consists of world leading experts in HCV epidemiology, immunology, and virology, including partners from Egypt and Morocco, who have strongly influenced the current management of patients with acute hepatitis C in their respective regions, and contributed considerably to our understanding of mechanisms of spontaneous viral clearance. The HepaCute proposal is closely connected to ongoing national, European, and Egyptian networks on HCV research (HepNet, EASL, STDF), which will support HepaCute to make it a success.Together with another pertinent EU-funded research project, SPHINX, it actively contributes to coordinating EU-funded hepatitis C research with pertinent research projects funded in the MCP countries, in particular with hepatitis research projects funded under the Egyptian Science and Technology Development Fund (STDF). Within HepaCute the most innovative technologies will be employed such as genome-wide association studies, transcriptomics, proteomics, and ultra-deep sequencing to better understand the early events in acute hepatitis C and to translate these results into readily practicable diagnostic tools to predict spontaneous viral clearance. HepaCute has firmly integrated partners from Egypt and Morocco with preexisting research collaborations with European partners into the scientific research programm and we expect this continuing partnership between European and Mediterranean countries to have a strong impact on the care of patients with acute hepatitis C both in Europe and MPC.

Colombo A.,San Raffaele Scientific Institute | Chieffo A.,San Raffaele Scientific Institute | Frasheri A.,ASL Trapani P.O | Garbo R.,San Giovanni Bosco Hospital | And 11 more authors.
Journal of the American College of Cardiology | Year: 2014

BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) following second-generation drug-eluting stent (DES) implantation is still debated. OBJECTIVES The aim of this study was to test the noninferiority of 6 versus 12 months of DAPT in patients undergoing percutaneous coronary intervention with second-generation DES. METHODS: The SECURITY (Second Generation Drug-Eluting Stent Implantation Followed by Six- Versus Twelve-Month Dual Antiplatelet Therapy) trial was a 1:1 randomized, multicenter, international, investigator-driven, noninferiority study conducted from July 2009 to June 2014. Patients with a stable or unstable angina diagnosis or documented silent ischemia undergoing revascularization with at least 1 second-generation DES were eligible. The primary endpoint was a composite of cardiac death, myocardial infarction (MI), stroke, definite or probable stent thrombosis, or Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding at 12 months. The main secondary endpoint was a composite of cardiac death, MI, stroke, definite or probable stent thrombosis, or BARC type 2, 3, or 5 bleeding at 12 and 24 months. RESULTS: Overall, 1,399 patients were enrolled in the study and randomized to receive 6 months (n = 682) versus 12 months (n = 717) DAPT. The primary composite endpoint occurred, respectively, in 4.5% versus 3.7% (risk difference 0.8%; 95% confidence interval [CI]: -2.4% to 1.7%; p = 0.469) at 12 months. The upper 95% CI limit was lower than the pre-set margin of 2%, confirming the noninferiority hypothesis (p < 0.05). Moreover, no differences were observed in the occurrence of the secondary endpoint at 12 months (5.3% vs. 4.0%, difference: 1.2%; 95% CI: -1.0 to 3.4; p = 0.273) and between 12 and 24 months (1.5% vs. 2.2%, difference: -0.7%; 95% CI: -2.1 to 0.6; p = 0.289). Finally, no differences were observed in de finite or probable stent thrombosis at 12 months (0.3% vs. 0.4%; difference: -0.1%; 95% CI: -0.7 to 0.4; p = 0.694) and between 12 and 24 months of follow-up (0.1% vs. 0%; difference: 0.1%; 95% CI: -0.1 to 0.4; p = 0.305). CONCLUSIONS: In a low-risk population, the noninferiority hypothesis of 6 vs. 12 months DAPT following secondgeneration DES implantation appears accepted for the incidence of cardiac death, MI, stroke, de finite/probable stent thrombosis, and BARC type 3 or 5 bleeding at 12 months. (Second Generation Drug-Eluting Stent Implantation Followed by Six- Versus Twelve-Month Dual Antiplatelet Therapy; NCT00944333). © 2014 by the American College of Cardiology Foundation.

Campobasso D.,Azienda Ospedaliero Universitaria di Parma
International journal of surgical pathology | Year: 2012

With no more than 60 reported cases, tumors of the seminal vesicles are rare. Because of poor and nonspecific symptoms diagnosis is often very difficult. This report presents a case of a 56-year-old man with right renal agenesis and intermittent hematospermia and bilateral cystic masses of the seminal vesicles. Transrectal biopsies of the cystic lesion revealed a papillary clear cell adenocarcinoma. The patient underwent radical prostatectomy and pelvic lymphoadenectomy. Lymph node metastases were found on histological examination. The patient received 4 cycles of chemotherapy and pelvic radiotherapy. He remains disease free 21 months after surgery. Radiological imaging in patients with hematospermia and hematuria will allow disease detection at earlier stages. Immunohistochemistry and histomorphology can be used for differential diagnosis. Surgery with clear margins offers the best chance to cure. Hormonal and radio-chemotherapy have a role as adjuvant and palliative treatment.

Ghetti C.,Azienda Ospedaliero Universitaria di Parma | Ortenzia O.,Azienda Ospedaliero Universitaria di Parma | Serreli G.,Azienda Ospedaliero Universitaria di Parma
Physica Medica | Year: 2012

Although iterative reconstruction is widely applied in SPECT/PET, its introduction in clinical CT is quite recent, in the past the demand for extensive computer power and long image reconstruction times have stopped the diffusion of this technique. Recently Iterative Reconstruction in Image Space (IRIS) has been introduced on Siemens top CT scanners. This recon method works on image data area, reducing the time-consuming loops on raw data and noise removal is obtained in subsequent iterative steps with a smoothing process. We evaluated image noise, low contrast resolution, CT number linearity and accuracy, transverse and z-axis spatial resolution using some dedicated phantoms in single, dual source and cardiac mode. We reconstructed images with a traditional filtered back-projection algorithm and with IRIS. The iterative procedure preserves spatial resolution, CT number accuracy and linearity moreover decreases image noise. These preliminary results support the idea that dose reduction with preserved image quality is possible with IRIS, even if studies on patients are necessary to confirm these data. © 2011 Associazione Italiana di Fisica Medica.

Ardissino D.,Azienda Ospedaliero Universitaria di Parma | Italian Atherosclerosis,Thrombosis and Vascular Biology Investigators
Journal of the American College of Cardiology | Year: 2011

The purpose of this study was to test whether the 9p21.3 variant rs1333040 influences the occurrence of new cardiovascular events and coronary atherosclerosis progression after early-onset myocardial infarction. 9p21.3 genetic variants are associated with ischemic heart disease, but it is not known whether they influence prognosis after an acute coronary event. Within the Italian Genetic Study of Early-onset Myocardial Infarction, we genotyped rs1333040 in 1,508 patients hospitalized for a first myocardial infarction before the age of 45 years who underwent coronary angiography without index event coronary revascularization. They were followed up for major cardiovascular events and angiographic coronary atherosclerosis progression. Over 16,599 person-years, there were 683 cardiovascular events and 492 primary endpoints: 77 cardiovascular deaths, 223 reoccurrences of myocardial infarction, and 383 coronary artery revascularizations. The rs1333040 genotype had a significant influence (p = 0.01) on the primary endpoint, with an adjusted hazard ratio of 1.19 (95% confidence interval [CI]: 1.08 to 1.37) for heterozygous carriers and 1.41 (95% CI: 1.06 to 1.87) for homozygous carriers. Analysis of the individual components of the primary endpoints provided no significant evidence that the rs1333040 genotype influenced the hazard of cardiovascular death (p = 0.24) or the reoccurrence of myocardial infarction (p = 0.57), but did provide significant evidence that it influenced on the hazard of coronary revascularization, with adjusted heterozygous and homozygous ratios of 1.38 (95% CI: 1.17 to 1.63) and 1.90 (95% CI: 1.36 to 2.65) (p = 0.00015), respectively. It also significantly influenced the angiographic endpoint of coronary atherosclerosis progression (p = 0.002). In early-onset myocardial infarction, the 9p21.3 variant rs1333040 affects the progression of coronary atherosclerosis and the probability of coronary artery revascularization during long-term follow-up. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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