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Tosca M.A.,Pediatric Pulmonology and Allergy Unit | Silvestri M.,Pediatric Pulmonology and Allergy Unit | Olcese R.,Pediatric Pulmonology and Allergy Unit | Pistorio A.,Clinical Epidemiology and Biostatistic Unit | And 2 more authors.
Pediatric Allergy and Immunology | Year: 2012

Background: In children with asthma, discrepancies between objective indicators of airway obstruction and symptom perception are often observed. Although visual analogue scale (VAS) has been proposed as a useful tool for assessing accurate symptom perception, previous studies conducted in children with asthma included only small cohorts. A study was therefore designed to investigate the usefulness of VAS in establishing a reliable relationship between breathlessness perception and lung function in a large cohort of children with clinical diagnosis of asthma. Methods: A total of 703 children [470 boys and 233 girls, median age 10.29 (8.33-12.58)yr] with asthma were included in this cross-sectional, real-life study. Perception of breathlessness was assessed by using VAS, and lung volumes and expiratory flows were measured by spirometry. Results: Most children had intermittent or mild persistent asthma (93.3%), and only 46 children had a significant bronchial obstruction defined by FEV1 values <80% of predicted. Globally, VAS was significantly, even though weakly, related to lung function. Analyzing children with bronchial obstruction, a moderate relationship between both FEV1 (r=0.47) and FEF25-75 (r=0.42) and VAS was detected. A VAS value of 6 was found to be a reliable cutoff for discriminating children with bronchial obstruction (AUC 0.83 at ROC curve; OR 9.4). Conclusion: The present study demonstrates that VAS might be considered a useful tool to assess symptom perception, mainly in children with airflow limitation. © 2012 John Wiley & Sons A/S. Source


Rouzier R.,University Pierre and Marie Curie | Rouzier R.,Institute Paoli Calmette | Pronzato P.,IRCCS Azienda Ospedaliera | Chereau E.,Institute Paoli Calmette | And 3 more authors.
Breast Cancer Research and Treatment | Year: 2013

Breast cancer is the most common female cancer and is associated with a significant clinical and economic burden. Multigene assays and molecular markers represent an opportunity to direct chemotherapy only to patients likely to have significant benefit. This systematic review examines published health economic analyses to assess the support for adjuvant therapy decision making. Literature searches of PubMed, the Cochrane Library, and congress databases were carried out to identify economic evaluations of multigene assays and molecular markers published between 2002 and 2012. After screening and data extraction, study quality was assessed using the Quality of Health Economic Studies instrument. The review identified 29 publications that reported evaluations of two assays: Oncotype DX® and MammaPrint. Studies of both tests provided evidence that their routine use was cost saving or cost-effective versus conventional approaches. Benefits were driven by optimal allocation of adjuvant chemotherapy and reduction in chemotherapy utilization. Findings were sensitive to variation in the frequency of chemotherapy prescription, chemotherapy costs, and patients' risk profiles. Evidence suggests that multigene assays are likely cost saving or cost-effective relative to current approaches to adjuvant therapy. They should benefit decision making in early-stage breast cancer in a variety of settings worldwide. © 2013 The Author(s). Source


Tagliafico A.,University of Genoa | Cadoni A.,University of Genoa | Fisci E.,University of Genoa | Gennaro S.,IRCCS Azienda Ospedaliera | And 4 more authors.
Seminars in Musculoskeletal Radiology | Year: 2012

Imaging studies including ultrasound (US) and magnetic resonance imaging may be required to evaluate the median nerve in patients with suspected carpal tunnel syndrome. However, the radial and ulnar nerves contribute to sensory and motor innervations to the hand as well. Compressive, traumatic, and iatrogenic events may damage the small terminal branches of these nerves. In the hand, US is able to identify injuries of the median, ulnar, radial nerve, and terminal branches. This article presents the role of imaging to evaluate the nerves of the hand with an emphasis on US. Due to its high-resolution capabilities, US is useful to determine the location, extent, and type of nerve lesion. Moreover, US is useful for a postsurgical assessment. The anterior interosseous nerve, Guyon's tunnel syndrome, and Wartenberg's syndrome are also described. Copyright © 2012 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Source


Cirillo I.,Navy Medical Service | Ricciardolo F.L.M.,University of Turin | Medusei G.,Navy Medical Service | Signori A.,University of Genoa | Ciprandi G.,IRCCS Azienda Ospedaliera
International Archives of Allergy and Immunology | Year: 2013

Background: Nowadays it is possible to assess airway inflammation by measuring the fractional concentration of exhaled nitric oxide (FeNO) during an office visit and there is international consensus on the testing methodology. The aim of this study was to evaluate whether FeNO measurement may be a predictor of bronchial hyperreactivity (BHR) in patients with allergic rhinitis (AR). Methods: Two hundred eleven patients (196 males, median age 28.5 years) suffering from persistent AR were evaluated. Values for bronchial function (FVC, FEV1, and FEF25-75), bronchial provocation tests (methacholine), exhaled nitric oxide (FeNO), a visual analogue scale for nasal and bronchial symptoms, and sensitization were assessed. Results: A strong and inverse correlation between FeNO levels and BHR severity was found (r = -0.58). FeNO was a predictive factor for BHR, and 37 ppb was found to be the best cutoff (area under the curve 0.90) to define the presence of BHR in patients with AR. Conclusions: This study highlights the relevance of FeNO as a possible predictive marker for BHR in AR patients and underlines the close link between upper and lower airways. Thus, FeNO measurement could be a useful screening tool in identifying subjects with rhinitis at risk of developing asthma. © 2012 S. Karger AG, Basel. Source


Maric I.,University of Cagliari | Viaggi S.,University of Cagliari | Caria P.,University of Cagliari | Frau D.V.,University of Cagliari | And 2 more authors.
Molecular Cytogenetics | Year: 2011

Background: Differentiated thyroid carcinoma offers a good model to investigate the possible correlation between specific gene mutations and chromosome instability. Papillary thyroid neoplasms are characterized by different mutually exclusive genetic alterations, some of which are associated with aneuploidy and aggressive phenotype. Results: We investigated the centrosome status and mitotic abnormalities in three thyroid carcinoma-derived cell lines, each maintaining the specific, biologically relevant gene alteration harbored by the parental tumors: RET/PTC1 rearrangement in TPC1; heterozygous and homozygous BRAF V600E mutation in K1 and in B-CPAP, respectively. B-CPAP cells showed a statistically significant (P < 0.01) higher frequency of abnormal mitotic figures compared to TPC1 and K1 cells. Conclusions: Our data indicate that RET/PTC1 oncogenic activity is not related to mitotic chromosome impairment and missegregation whereas, based on the consistent difference in types/frequencies of centrosome and spindle abnormalities observed between K1 and B-CPAP cells, the hetero/homozygous allelic status of BRAF V600E mutation seems to be not irrelevant in respect to chromosomal instability development. © 2011 Maric et al; licensee BioMed Central Ltd. Source

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