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Rotondano G.,Ospedale Maresca | Cipolletta L.,Ospedale Maresca | Grossi E.,Bracco S.p.A. | Intraligi M.,Semeion Research Center for science of Communication | And 2 more authors.
Gastrointestinal Endoscopy | Year: 2011

Background: Risk stratification systems that accurately identify patients with a high risk for bleeding through the use of clinical predictors of mortality before endoscopic examination are needed. Computerized (artificial) neural networks (ANNs) are adaptive tools that may improve prognostication. Objective: To assess the capability of an ANN to predict mortality in patients with nonvariceal upper GI bleeding and compare the predictive performance of the ANN with that of the Rockall score. Design: Prospective, multicenter study. Setting: Academic and community hospitals. Patients: This study involved 2380 patients with nonvariceal upper GI bleeding. Intervention Upper GI endoscopy. Main Outcome Measurements: The primary outcome variable was 30-day mortality, defined as any death occurring within 30 days of the index bleeding episode. Other outcome variables were recurrent bleeding and need for surgery. Results: We performed analysis of certified outcomes of 2380 patients with nonvariceal upper GI bleeding. The Rockall score was compared with a supervised ANN (TWIST system, Semeion), adopting the same result validation protocol with random allocation of the sample in training and testing subsets and subsequent crossover. Overall, death occurred in 112 cases (4.70%). Of 68 pre-endoscopic input variables, 17 were selected and used by the ANN versus 16 included in the Rockall score. The sensitivity of the ANN-based model was 83.8% (76.7-90.8) versus 71.4% (62.8-80.0) for the Rockall score. Specificity was 97.5 (96.8-98.2) and 52.0 (49.8 4.2), respectively. Accuracy was 96.8% (96.0-97.5) versus 52.9% (50.8-55.0) (P < .001). The predictive performance of the ANN-based model for prediction of mortality was significantly superior to that of the complete Rockall score (area under the curve 0.95 [0.92-0.98] vs 0.67 [0.65-0.69]; P < .001). Limitations: External validation on a subsequent independent population is needed, patients with variceal bleeding and obscure GI hemorrhage are excluded. Conclusion In patients with nonvariceal upper GI bleeding, ANNs are significantly superior to the Rockall score in predicting the risk of death. © 2011 American Society for Gastrointestinal Endoscopy.

Forti P.,Cardiology and Hepatology | Ravaglia G.,Cardiology and Hepatology | Grossi E.,Bracco SpA
Neurobiology of Aging | Year: 2010

Data mining of a large data base from the population longitudinal study named "The Conselice Study" has been the focus of the present investigation. Initially, 65 years old or older participants were interviewed, underwent medical and cognitive examination, and were followed up for 5 years: 937 subjects completed the follow-up. Relationships of 35 genetic and/or phenotypic factors with incident cognitive decline and dementia were investigated. The new mathematical approach, called the Auto Contractive Map (AutoCM), was able to show the differential importance of each variables. This new variable processing created a semantic connectivity map that: (a) preserved non-linear associations; (b) showed connection schemes; (c) captured the complex dynamics of adaptive interactions. This method, based on an artificial adaptive system, was able to define the association strength of each variable with all the others. Few variables resulted to be aggregation points and were considered as major biological hubs. Three hubs were identified in the hydroxyl-methyl-gutaryl-CoA reductase (HMGCR) enzyme, plasma cholesterol levels and age. Gene variants and cognate phenotypic variables showed differential degrees of relevance to brain aging and dementia. This data analysis method was compared with another mathematical model called mutual information relevance network and results are presented and discussed. © 2008 Elsevier Inc. All rights reserved.

Buscema M.,Semeion Research Center | Penco S.,Niguarda Ca Granda Hospital | Grossi E.,Bracco SpA
Neurology Research International | Year: 2012

Background. Complex diseases like amyotrophic lateral sclerosis (ALS) implicate phenotypic and genetic heterogeneity. Therefore, multiple genetic traits may show differential association with the disease. The Auto Contractive Map (AutoCM), belonging to the Artificial Neural Network (ANN) architecture, spatializes the correlation among variables by constructing a suitable embedding space where a visually transparent and cognitively natural notion such as closeness among variables reflects accurately their associations. Results. In this pilot case-control study single nucleotide polymorphism (SNP) in several genes has been evaluated with a novel data mining approach based on an AutoCM. We have divided the ALS dataset into two dataset: Cases and Control dataset; we have applied to each one, independently, the AutoCM algorithm. Six genetic variants were identified which differently contributed to the complexity of the system: three of the above genes/SNPs represent protective factors, APOA4, NOS3, and LPL, since their contribution to the whole complexity resulted to be as high as 0.17. On the other hand ADRB3, LIPC, and MMP3, whose hub relevancies contribution resulted to be as high as 0.13, seem to represent susceptibility factors. Conclusion. The biological information available on these six polymorphisms is consistent with possible pathogenetic pathways related to ALS. © 2012 Massimo Buscema et al.

Damiani V.,San Giovanni Addolorata Hospital | Dominici P.,Bracco S.p.A.
Minerva Pediatrica | Year: 2011

Aim. Nasal congestion is the main symptom in common upper respiratory diseases in childhood. Intranasal administration of sympatheticomimetics decongestants is commonly adopted for this symptom. The Italian Drug Agency stated a warning against the use of these drugs in children under 12 years of age. The aim of this study is to evaluate the efficacy on nasal symptoms and the safety of a new medical device based on colloidal silver and carbossimetyl beta glucan compared with saline solution treatment in a group of children (0-12 years) affected by viral rhinitis. Methods. Hundred consecutive outpatient children (0-12 year old), affected by common cold syndrome with evident nasal obstruction were randomly assigned to two type of intervention: group 1. receiving colloidal silver and carbossimetyl beta glucan; group 2. receiving saline solution. Each subject underwent clinical history and objective examination of rhinosinusal district at enrolment. Upper respiratory pathologie-related symptoms were specifically evaluated by using the Canadian Acute Respiratory Illness and Flu Scale (CARIFS). Results. A significant improvement of CARIFS score was observed into the two groups. The score improvement of these two treatment was confirmed in all the age sub-group. We observed a statistically significant difference in mean post-treatment CARIFS score and CARIFS globas VAS (Visual Analogic Scale) in children of group 1 compared with children in goup 2 (2.28±1.58 vs. 5.08±3.39; P<0.001 and VAS: 1.87±1.38 vs. VAS: 3.34±2.19; P=0.012, respectively). At the end of treatment, 90% of subjects in group 1 resulted completely recovered, whereas 10% experienced some degree of complications (otitis, tracheitis, bronchitis). In group 2 a complete recovering was achieved in 66% of subjects, the remaining 34% developed complications. Tolerability profiles were similar in the two groups with no statistical differences in side effects in all age subgroups. Conclusion. Despite both treatments reached significative improvements in CARIFS global score and VAS and in physical examination of nasal mucosa and secretion at the end of the therapy, colloidal silver and carbossimetyl beta glucan showed a better performance with a significant difference in mean post-treatment CARIFS global score and CARIFS VAS compared to treatment with saline solution.

Compare A.,University of Bergamo | Callus E.,IRCCS | Grossi E.,Bracco SpA
Eating and Weight Disorders | Year: 2012

BACKGROUND: Binge eating disorder (BED) is a complex and multifaceted eating disorder, and the literature indicates that BED patients show greater difficulty in identifying and making sense of emotional states, and that they have limited access to emotion regulation strategies. Findings show many links between mindfulness and emotional regulation, however there has been no previous research on mindfulness traits in BED patients. METHOD: One hundred fifty BED patients (N=150: women=98, men=52; age 49.3±4.1) were matched for gender, age, marital status and educational level with 150 non-bingeing obese and 150 normal-weight subjects. All were assessed with the Five Facet Mindfulness Questionnaire (FFMQ), Binge Eating Scale (BES), Objective bulimic episodes (EDE-OBEs) and Body Uneasiness Test (BUT). For all the participants past or current meditation experience was an exclusion criteria. RESULTS: Findings showed that Mindfulness-global, Non reactivity to experience, Acting with awareness, Describing with words and Observation of experience scores were significantly lower in BED than control groups (p<0.05). However, on the mindfulness measures, the obese control group did not differ from the normal weight control group. Moreover, correlations showed that mindfulness was more widely negatively correlated with the BED's OBEs, BES and BUT-GSI scores. Meanwhile, binge eating behaviours, frequency and severity (OBEs and BES) were more negatively correlated with action (Nonreactivity-to-experience and Acting-with-awareness scores). Body Uneasiness was more negatively correlated with mental processes (Describing-with-words and Observation-ofexperience) and mindfulness features. CONCLUSION: Implications on understanding of the mechanisms underlying the development and maintenance of problematic eating in BED were considered. Moreover, clinical considerations on treatment targets of mindfulnessbased eating awareness training were discussed. © 2012, Editrice Kurtis.

Marmo R.,Hospital Curto | Koch M.,Hospital Maresca | Cipolletta L.,ACO San Filippo Neri | Bianco M.A.,ACO San Filippo Neri | And 2 more authors.
Gastrointestinal Endoscopy | Year: 2014

Background Nonvariceal upper GI bleeding (NVUGIB) that occurs in patients already hospitalized for another condition is associated with increased mortality, but outcome predictors have not been consistently identified. Objective To assess clinical outcomes of NVUGIB and identify predictors of mortality from NVUGIB in patients with in-hospital bleeding compared with outpatients. Design Secondary analysis of prospectively collected data from 2 nationwide multicenter databases. Descriptive, inferential, and multivariate logistic regression models were carried out in 338 inpatients (68.6 ± 16.4 years of age, 68% male patients) and 1979 outpatients (67.8 ± 17 years of age, 66% male patients). A predictive model was constructed using the risk factors identified at multivariate analysis, weighted according to the contribution of each factor. Settings A total of 23 Italian community and tertiary care centers. Patients Consecutive patients admitted for acute NVUGIB. Interventions Early endoscopy, medical and endoscopic treatment as appropriate. Main Outcome Measurements Recurrent bleeding, surgery, and 30-day mortality. Results The mortality rate in patients with in-hospital bleeding was significantly higher than that in outpatients (8.9% vs 3.8%; odds ratio [OR] 2.44; 95% confidence interval [CI], 1.57-3.79; P <.0001). Hemodynamic instability on presentation (OR 7.31; 95% CI, 2.71-19.65) and the presence of severe comorbidity (OR 6.72; 95% CI, 1.87-24.0) were the strongest predictors of death for in-hospital bleeders. Other independent predictors of mortality were a history of peptic ulcer disease and failed endoscopic treatment. Rebleeding was a strong predictor of death only for outpatients (OR 5.22; 95% CI, 2.45-11.10). Risk factors had a different prognostic impact on the 2 populations, resulting in a significantly different prognostic accuracy of the model (area under the receiver-operating characteristic curve = 0.83; 95% CI, 0.77-0-93 vs 0.74; 95% CI, 0.68-0.80; P <.02). Limitations Study design not experimental, no data on ward specialty, potential referral bias. Conclusions In-hospital bleeders have a significantly higher risk of death because they are sicker and more often hemodynamically unstable than outpatients. Predictors of death have a different impact in the 2 populations. © 2014 by the American Society for Gastrointestinal Endoscopy.

The invention regards the use of triiodothyronine sulfate, commonly named T_(3)S, as a medicament having thyromimetic activity for the treatment of pathologies due to organic deficiency of triiodothyronine (T_(3)), as such or in association with thyroxine (T_(4)), and pharmaceutical formulations for oral administration thereof.

The invention regards the use of triiodothyronine sulfate, commonly named T_(3)S, as a medicament having thyromimetic activity for the treatment of pathologies due to organic deficiency of triiodothyronine (T_(3)), as such or in association with thyroxine (T_(4)), and pharmaceutical formulations for oral administration thereof.

The invention regards the use of triiodothyronine sulfate, commonly named T_(3)S, as a medicament having thyromimetic activity for the treatment of pathologies due to organic deficiency of triiodothyronine (T_(3)), as such or in association with thyroxine (T_(4)), and pharmaceutical formulations for oral administration thereof.

Bracco S.P.A. | Date: 2010-07-20

The involvement of intestinal microbiota in the initiation and perpetuation of inflammatory bowel disease is widely accepted. To reestablish the homeostasis of the gut the use of probiotics has been proposed, with however, limited clinical benefit. This invention relates to an assay based on the modulation of the immunological activity in DCs (dendritic cells) by probiotic strains, in particular L. paracasei and their use in protecting against inflammatory bowel and liver diseases.

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