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Ossoli A.,University of Milan | Lucca F.,University of Milan | Boscutti G.,Azienda Ospedaliero Universitaria Ospedali Riuniti di Trieste | Remaley A.T.,U.S. National Institutes of Health | Calabresi L.,University of Milan
Clinical Lipidology | Year: 2015

Lecithin:cholesterol acyltransferase (LCAT) synthesizes most of the plasma cholesteryl esters, and plays a major role in HDL metabolism. Mutations in the LCAT gene cause two syndromes, familial LCAT deficiency and fish-eye disease, both characterized by severe alterations in plasma lipoprotein profile. Renal disease is the major cause of morbidity and mortality in familial LCAT deficiency cases, but an established therapy is not currently available. The present therapy of LCAT deficiency is mainly aimed at correcting the dyslipidemia associated with the disease and at delaying evolution of chronic nephropathy. LCAT deficiency represents a candidate disease for enzyme replacement therapy. In vitro and in vivo studies proved the efficacy of recombinant human LCAT in correcting dyslipidemia, and recombinant human LCAT is presently under development. © 2015 Future Medicine Ltd.

Ruiz-Gonzalez Y.,University "Marta Abreu" of Las Villas | Perez-Diaz M.,University "Marta Abreu" of Las Villas | Martinez-Aguila D.,University "Marta Abreu" of Las Villas | Diaz-Barreto M.,Centro Para El Control Estatal Of Medicamentos | And 5 more authors.
IFMBE Proceedings | Year: 2015

Phase-contrast mammography with synchro-tron radiation is an innovative x-ray imaging technique that improves the identification of breast lesions. Previous studies have proven the superiority of the mammography images taken in the phase contrast modality using synchrotron radia-tion beams as compared with images taken in conventional mammography by subjective analyses. However, to our knowledge, no previous study has compared different acquisi-tion systems in order to quantify this improvement by means of objective robust indicators. In this research, we intend to quantify the superiority of phase contrast imaging by means of objective metrics of image quality. The initial analyses were made using phantom images from two digital equipment for mammography and phase contrast images using synchrotron radiation. The acquisition conditions were varied and three indexes of image quality estimated in order to compare the image quality. The results showed an improvement of the contrast in phase contrast images. This contrast improvements is important in the detection of small lesions and details. © Springer International Publishing Switzerland 2015

Perkan A.,Struttura Complessa di Cardiologia | Vitrella G.,Struttura Complessa di Cardiologia | Barbati G.,University of Turin | De Monte A.,Azienda Ospedaliero Universitaria Ospedali Riuniti di Trieste | And 10 more authors.
Journal of Cardiovascular Medicine | Year: 2013

BACKGROUND: The impact of diabetes in patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI) is unclear. The benefit of abciximab in this subset of patients remains controversial. METHODS AND RESULTS: Three hundred and twenty-seven consecutive and unselected patients with acute AMI treated with primary PCI were included in our single-center retrospective registry, 103 diabetic (31%) and 224 nondiabetic (69%). Abciximab was given at the physicianÊfrac14;s discretion. Diabetic patients were older (mean age 68. 5 ±â€Š11 vs. 65†Š±â€Š12 years; P =  0.009), had an increased prevalence of hypertension (73 vs. 54%; P = 0.001), a decreased prevalence of smoking (31 vs. 45%; P = 0.02), a longer duration of symptoms before hospital admission (190 vs. 143 min; P = 0.031), and a higher number of stents implanted (1.4 vs. 1.2; P =  0.04). Other clinical and angiographic characteristics were comparable in the two groups. Diabetic patients had a higher incidence of the combined end-point of death and reinfarction rate at 30 days (18 vs. 10%; P = 0.04) compared to nondiabetic patients. Abciximab treatment was associated with a lower in-hospital (23.8 vs. 5%; P = 0.005) and 30-day (23.8 vs. 6.6%; P = 0.012) mortality, and a lower incidence of death and reinfarction at 30 days (33.3 vs. 9.8%; P = 0.003) in diabetic patients. In nondiabetic patients, abciximab was not associated with improved outcome measures. Advanced Killip class (III and IV) and abciximab were found to be independently associated with 30-day death or myocardial infarction [respectively, odds ratio (OR) 6.075, 95% confidence interval (CI) 1.59-23.218, P = 0.008 and OR 0.177, 95% CI 0.034-0.938, P = 0.042] in the propensity score-matched populations of diabetic patients. Advanced Killip class and thrombolysis in myocardial infarction score index were found to be independently associated with 30-day death or myocardial infarction (respectively, OR 6.607, 95% CI 1.5-29.106, P =  0.013 and OR 1.094 95% CI 1.042-1.148, P†Š< 0.001) in the propensity score-matched populations of nondiabetic patients. CONCLUSIONS: In our registry diabetic patients treated with primary PCI for AMI had a worse in-hospital and 30-day outcome than nondiabetic patients. Adjunct pharmacologic treatment with abciximab was associated to a better prognosis only in diabetic patients. © 2013 Italian Federation of Cardiology.

Padovan M.,University of Ferrara | Filippini M.,Spedali Civili di Brescia | Tincani A.,Spedali Civili di Brescia | Lanciano E.,Policlinico Universitario | And 15 more authors.
Arthritis Care and Research | Year: 2016

Objective Rheumatoid arthritis (RA) with concomitant hepatitis B virus (HBV) infection represents a therapeutic challenge due to the risk of HBV reactivation under immunosuppressive treatment. To date there are few data coming from anecdotal case reports that concern HBV reactivation following treatment with abatacept. This observational retrospective study was aimed to assess the safety profile of abatacept in this particular clinical setting. Methods Eleven Italian rheumatologic centers provided data from patients with RA and positive HBV serology treated with intravenous abatacept. HBV markers and clinical and laboratory data were checked at followup visits every 3 months. Results In total, 72 patients were included in the study: 47 inactive carriers, 21 occult carriers, and 4 chronic active carriers for HBV. At baseline all of the patients had normal liver function tests and low or undetectable HBV DNA levels, except for those with chronic active hepatitis. Thirteen patients received prophylaxis with lamivudine, and 4 received treatment with adefovir or tenofovir. At the end of the 24-month followup period, 49 patients were being treated. Data from 316 followup visits showed that abatacept was safe. No patients experienced reactivation of hepatitis B. Treatment withdrawals (23 patients) were due to lack of efficacy, subject decision/lost at followup, or adverse events not related to HBV infection. Conclusion Our study provides reassuring data about the safety profile of abatacept in RA with concomitant HBV infection without universal antiviral prophylaxis. Further prospective studies are needed to confirm these preliminary results. © 2016, American College of Rheumatology.

Castelli E.,University of Trieste | Castelli E.,National Institute of Nuclear Physics, Italy | Tonutti M.,University of Trieste | Arfelli F.,University of Trieste | And 22 more authors.
Radiology | Year: 2011

Purpose: To prospectively evaluate the diagnostic contribution of mammography with synchrotron radiation in patients with questionable or suspicious breast abnormalities identified at combined digital mammography (DM) and ultrasonography (US). Materials and Methods: The ethics committee approved this prospective study, and written informed consent was obtained from all patients. Mammography with synchrotron radiation was performed with a phase-detection technique at a synchrotron radiation laboratory. Forty-nine women who met at least one of the inclusion criteria (palpable mass, focal asymmetry, architectural distortion, or equivocal or suspicious mass at DM; none clarified at US) were enrolled. Forty-seven women (mean age, 57.8 years ± 8.8 [standard deviation]; age range, 43-78 years) completed the study protocol, which involved biopsy or follow-up for 1 year as the reference standard. Breast Imaging Reporting and Data System (BI-RADS) scores of 1-3 were considered to indicate a negative result, while scores 4-5 were considered to indicate a positive result. The visibility of breast abnormalities and the glandular parenchymal structure at DM and at mammography with synchrotron radiation was compared by using the Wilcoxon signed rank test. Results: In 29 of the 31 patients with a final diagnosis of benign entity, mammography with synchrotron radiation yielded BI-RADS scores of 1-3. In 13 of the remaining 16 patients with a final diagnosis of malignancy, mammography with synchrotron radiation yielded BI-RADS scores of 4-5. Therefore, a sensitivity of 81% (13 of 16 patients) and a specificity of 94% (29 of 31 patients) were achieved with use of the described BI-RADS dichotomization system. Conclusion: These study results suggest that mammography with synchrotron radiation can be used to clarify cases of questionable or suspicious breast abnormalities identified at DM. © RSNA, 2011.

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