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Raber M.,Istituto Scientifico | Scattoni V.,Istituto Scientifico | Gallina A.,Istituto Scientifico | Freschi M.,Istituto Scientifico Ospedale San Raffaele | And 4 more authors.
BJU International | Year: 2012

Objective To compare the prostate cancer detection rate and tolerance profile between a transrectal biopsy made with a 'side fire' (SF) and an 'end fire' (EF) ultrasound probe. Patients and Methods We selected patients undergoing first biopsy and re-biopsy of the prostate with a 14- and 18-core template using EF and SF transrectal probes, respectively. We compared the cancer detection rate between the two probes on first biopsy and re-biopsy and gauged patient tolerance using a visual analogue scale (VAS). Results A total of 1705 patients were included in the first biopsy group, while 487 were in the re-biopsy group. The overall detection rate of first biopsy was 37.2%; the overall detection rate of re-biopsy was 10.1%. No significant difference was found between the two probes in the first biopsy and re-biopsy sets (38% vs 36.5%, P= 0.55; 10.8% vs 9.3%, P= 0.7). The lack of any significant association between the type of probe used and prostate cancer detection was confirmed by univariable and multivariable analyses in both the first biopsy and re-biopsy sets after accounting for prostate-specific antigen values, per cent free prostate-specific antigen, digital rectal examination, and prostate and transition zone volumes. The patient tolerance profile of the SF group was significantly better than that of the EF group (mean VAS 1.78 ± 2.01 vs 1.45 ± 2.21; P= 0.02). Conclusion The prostate cancer detection rate does not depend on the type of probe used. However, the SF transrectal probe is associated with a better patient tolerance profile. © 2011 BJU International. Source


Mekinian A.,Paris-Sorbonne University | Lazzaroni M.G.,University of Brescia | Kuzenko A.,Clinical Immunology AO Ordine Mauriziano | Alijotas-Reig J.,Autonomous University of Barcelona | And 17 more authors.
Autoimmunity Reviews | Year: 2015

In European multicenter study, we aimed to describe the real-life hydroxychloroquine use in APS patients during pregnancy and determine its benefit in refractory obstetrical APS.We analyzed the outcome of pregnancies treated by hydroxychloroquine in patients with APS or asymptomatic antiphospholipid (aPL) antibodies carriers.Thirty patients with APS with 35 pregnancies treated by hydroxychloroquine were analyzed. Comparing the outcome of pregnancies treated by the addition of hydroxychloroquine to previous pregnancies under the conventional treatment, pregnancy losses decreased from 81% to 19% (p. <. 0.05), without differences in the associated treatments. The univariate analysis showed that the previous intrauterine deaths and higher hydroxychloroquine amount (400. mg per day) were the factors associated with pregnancy outcome. Considering 14 patients with previous refractory obstetrical APS (n. =. 5 with obstetrical and thrombotic primary APS and n. =. 9 with purely obstetrical APS), all with previous pregnancy losses under treatment (aspirin with LMWH in 11 cases and LMWH in 3 cases), the addition of hydroxychloroquine resulted in live born babies in 11/14 (78%) cases (p. <. 0.05).Our study shows the benefit of hydroxychloroquine addition in patients with refractory obstetrical APS and raises the need of prospective studies to confirm our preliminary study. © 2015 Elsevier B.V. Source


Canti V.,Istituto Scientifico Ospedale San Raffaele | Maggio L.,Istituto Scientifico Ospedale San Raffaele | Ramirez G.A.,Istituto Scientifico Ospedale San Raffaele | Locatelli A.,University of Milan Bicocca | And 13 more authors.
Lupus | Year: 2012

The impact of hypertension in the pregnancies from autoimmune patients is not unequivocally defined. We have prospectively followed 168 pregnancies from 135 patients from four Italian centres to verify the potential impact of hypertension in the antiphospholipid syndrome (APS). The rate of preeclampsia, mean neonatal weight and gestational age at delivery were significantly lower in patients with both APS and hypertension than in patients with hypertension or APS alone. This information may be relevant for counselling and care of these patients. © The Author(s), 2012. Reprints and permissions: http://www.sagepub.co.uk/journalsPermissions.nav. Source


Marinova M.,University of Padua | Altinier S.,University of Padua | Caldini A.,University of Florence | Passerini G.,Istituto Scientifico Ospedale San Raffaele | And 5 more authors.
Clinica Chimica Acta | Year: 2013

Background: Hemoglobin A1c (HbA1c) measurement is currently used for the routine monitoring of long-term glycemic status, thus playing a fundamental role in the management of this disease. Since this marker has recently been recommended as an additional tool for diagnosing diabetes, it's of the utmost importance to ensure that the precision and accuracy of HbA1c methods are satisfactory. Methods: We assessed the analytical performances of the Capillarys 2 Flex Piercing® analyzer and compared the results obtained with those from two other widely used HPLC instruments. Furthermore, we evaluated the convenience and ergonomics of the system in authentic routine work conditions in three centers. Results: Within-laboratory (n=40) and between-laboratory (n=120) imprecision CV% using four blood samples with different concentrations of HbA1c were <3.4% and <3.1% using IFCC units and <2.1% and <2.0% using NGSP units, respectively. The obtained trueness (<3mmol/mol, <0.3%) was highly satisfactory, nor was HbA1c measurement compromised by the presence of the commonly present hemoglobinopathies. The comparison made with established methods revealed excellent agreement (r>0.985). Conclusions: The evaluated method is precise, accurate and robust, with a high throughput. It also allows the identification of the most frequent Hb variants and therefore may be a valid alternative to other methods currently proposed for routine use in clinical laboratories. © 2013 Elsevier B.V. Source


Dallaspezia S.,Istituto Scientifico Ospedale San Raffaele | Poletti S.,Istituto Scientifico Ospedale San Raffaele | Lorenzi C.,Istituto Scientifico Ospedale San Raffaele | Pirovano A.,Istituto Scientifico Ospedale San Raffaele | And 2 more authors.
Molecular Diagnosis and Therapy | Year: 2012

Background: Bipolar disorder (BD) is a recurrent and disabling illness, characterized by periods of depression and mania. The history of the illness differs widely between patients, with episode frequency emerging as a strong predictor of poor illness outcome. Lithium salts are the first-choice long-term mood-stabilizing therapy, but not all patients respond equally to the treatment. Evidence suggests that alterations in glutamatergic systems may contribute to the pathophysiology of depression. Moreover, glutamate signaling is involved in brain development and synaptic plasticity, both of which are modified in individuals affected by BD, and has been implicated in the etiology of the disorder. The inactivation of glutamate is handled by a series of molecular glutamate transporters (excitatory amino acid transporters [EAATs]), among which EAAT2/SLC1A2 is responsible for up to 95% of extracellular glutamate clearance. A functional single-nucleotide polymorphism at -181 bp from the transcription start site of the SLC1A2 gene has been described. This T-to-G (DNA forward strand) polymorphism, commonly known as SLC1A2 -181A>C, affects transporter expression, with the variant G allele inducing a 30% reduction in promoter activity compared with the T allele. Objective: The aims of the study were to investigate if factors affecting glutamate function, such as SLC1A2 -181A>C (rs4354668), could affect recurrence of illness in BD, and if they interact with lithium salt treatment. Methods: We performed an observational study in our university hospital in Milan. We enrolled 110 subjects (76 females, 34 males) affected by BD type I. The exclusion criteria were other diagnoses on Axis I, mental retardation on Axis II, a history of epilepsy, and major medical and neurologic disorders. Fifty-four patients had been treated with lithium salts for more than 6 months. Patients were genotyped for SLC1A2 -181A>C by polymerase chain reaction-restriction fragment length polymorphism, and the influence of genotype on BD episode recurrence rates, and the interaction between the single nucleotide polymorphism and lithium treatment, were analyzed. Results: The SLC1A2 -181A>C genotype significantly influenced the total recurrence of episodes, with T/T homozygotes showing a significantly lower frequency of episodes (F = 3.26; p = 0.042), and an interaction between lithium treatment and genotype (F = 3.77; p = 0.026) was found to influence the history of the illness. Conclusion: According to our results, the glutamatergic system could be hypothesized to exert some influence on the history of illness in BD. The SLC1A2 functional polymorphism was shown to significantly influence the total episode recurrence rate, with wild-type T homozygotes presenting the lowest number of episodes, G homozygotes reporting the highest number, and heterozygotes showing an intermediate phenotype. We confirmed the efficacy of lithium treatment in reducing the recurrence of illness in BD, and we found an interaction between lithium treatment and the SLC1A2 -181A>C genotype, confirming previous studies reporting an interaction between lithium salts and the glutamatergic system. © 2012 Springer International Publishing Switzerland. Source

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