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Migliore A.,U.O.S. of Rheumatology | Massafra U.,U.O.S. of Rheumatology | Bizzi E.,U.O.S. of Rheumatology | Cassol M.,Ospedale San Pietro Fatebenefratelli | Granata M.,San Filippo Neri Hospital
International Journal of Immunopathology and Pharmacology | Year: 2014

The intra-articular administration of hyaluronic acid (HA) in hip osteoarthritis (OA) has been recently increased following the use of ultrasound guidance to perform an accurate delivery of the injected product. Viscosupplementation in hip OA seems to show similar results to those obtained by viscosupplementation in knee OA. However, an unmet need is the duration of symptomatic relief, therefore several new products are proposed to prolong and increase symptomatic effects. Among these, an innovative viscosupplement has been produced from high a concentration of HA combined with a high concentration of sorbitol as a free radical scavenger. The aim of this study is to evaluate the mid-term pain-relief effect of an ultrasound-guided injection of SynolisV-A (ANTI-OX-VS) in patients suffering from symptomatic hip osteoarthritis. Lequesne index, Health Assessment Questionnaire (HAQ), pain reduction, Global Patient Assessment (GPA), Global Medical Assessment (GMA) and reduction in monthly analgesic consumption were assessed during the 12-month follow-up after the injection. A total of 20 patients were enrolled in the study and received one IA US-guided injection of two syringes of ANTI-OX-VS into the target hip. Eleven drop-out patients were registered, of whom 2 were for loss of efficacy at 6 months, 1 for loss of efficacy at 9 months and 8 patients for severe comorbilities. Mean scores of all clinical parameters evaluated at each control visit were significantly different when compared with baseline mean value. No systemic adverse events were observed. Even though the sample size of this study is limited, the results suggest a durable good efficacy of a 4-ml single injection of ANTI-OX-VS in hip OA, at least for the patients who completed the study. A larger number of patients and an RCT are needed to confirm these data, investigating also the predictive factors of clinical response to ANTI-OX-VS. Copyright © by BIOLIFE, s.a.s.


PubMed | Ospedale San Pietro Fatebenefratelli
Type: | Journal: Case reports in cardiology | Year: 2014

A 51-year-old male patient presented to the emergency room with an anterior ST-elevation myocardial infarction. After a loading dose of both ticagrelor and aspirin, the patient underwent primary-PCI on the left anterior descending coronary artery with stent implantation. After successful revascularization, medical therapy included beta-blockers, statins, and angiotensin II receptor antagonists. Two days later, ivabradine was also administered in order to reduce heart rate at target, but the patient developed a severe symptomatic bradycardia and sinus arrest, even requiring administration of both atropine and adrenaline. Ivabradine and ticagrelor have been then suspended and this latter changed with prasugrel. Any other similar event was not reported during the following days. This clinical case raised concerns about the safety of the combination of beta-blockers and ivabradine in patients treated with ticagrelor, particularly during the acute phase of an acute coronary syndrome. These two latter drugs, in particular, might interact with the same receptor. In fact, ivabradine directly modulates the If-channel which is also modulated by the cyclic adenosine monophosphate levels. These latter have been shown to increase after ticagrelor assumption via inhibition of adenosine uptake by erythrocytes. Further studies are warrant to better clarify the safety of this association.


Piscitelli P.,University of Florence | Brandi M.L.,University of Florence | Tarantino U.,University of Rome Tor Vergata | Baggiani A.,University of Pisa | And 8 more authors.
Reumatismo | Year: 2010

Objectives: we aimed to analyze incidence and costs of hip fractures in Italy. Methods: we analyzed the Italian Ministry of Health national hospitalization and DRGs databases concerning fractures occurred in people ≥65 between 2003 and 2005. We have estimated incidence and direct costs sustained by the National Health Service for hospitalization and treatment of hip fractures on the basis of the value of the Diagnosis Related Groups (DRGs) referring to hip fractures. The expenses of rehabilitation and indirect costs were based on re-gional estimations. Results: between 2003 and 2005 we registered almost 90,000 hospital admissions per year (corresponding to 75,000 patients) because of hip fractures in people aged ≥65. Women accounted for the majority of hospital admissions due to hip fractures (78.0%; n=214,519). Among women, 84.3% of fractures (n=180,861) occurred in patients ≥75, which is known to be the age group with the highest prevalence of osteoporosis. Hospitalizations of both men and women showed an increasing trend across all the examined period. Hospital costs increased up to 467 million euros in 2005, while rehabilitation costs rose up to 531 million in the same year. Conclusions: hip fractures in the Italian population are increasing and represent a major public health challenge.


Bozzetti F.,University of Milan | Mariani L.,Fondazione IRCCS Instituto Nazionale Tumori | Lo Vullo S.,Fondazione IRCCS Instituto Nazionale Tumori | Amerio M.L.,Ospedale Cardinal Massaia | And 18 more authors.
Supportive Care in Cancer | Year: 2012

Purpose There is little information about the nutritional status of cancer outpatients because the practice of nutritional screening is rarely performed. This study aims to define the pattern of scores of nutritional risk in 1, 453 outpatients and factors associated with a high nutrition risk score, to facilitate the identification of such patients by the oncologists. Methods We prospectively screened the nutritional status of cancer outpatients according to the NRS-2002 score which combines indicators of malnutrition and of severity of the disease (1-3 points, respectively). A score ≥3 indicates "nutritional risk". The association of the nutritional scores with some patient/tumour/therapy-related variables was investigated through univariable and multivariable linear regression models. Results Thirty-two percent of outpatients were at nutritional risk. Primary tumour site, Eastern Cooperative Oncology Group score and presence of anorexia or fatigue were significantly associated with the nutrition risk score. Depending on the combination of these variables, it was possible to estimate different probabilities of nutritional risk. Conclusions The frequency of a relevant nutritional risk was higher than expected considering the favourably selected population. The nutritional risk was associated with common clinical variables which are usually recorded in the charts and could easily alert the oncologist on the need of a further nutritional assessment or a nutritional support. © 2011 Springer-Verlag.


Bardocci A.,Ospedale San Pietro Fatebenefratelli | Ciucci F.,Ospedale San Pietro Fatebenefratelli | Lofoco G.,Ospedale San Pietro Fatebenefratelli | Perdicaro S.,Reparto di Anestesia e Rianimazione | Lischetti A.,G B Bietti Eye Foundation Irccs
Graefe's Archive for Clinical and Experimental Ophthalmology | Year: 2011

Backgroud: Aim of the study was to investigate: 1) if second eye cataract surgery under topical anesthesia is more painful than surgery on the first eye, 2) if pain experienced during the procedure on the first eye may predict the pain of the second procedure, and 3) if patients' cooperation is different between the first and the second eye procedure. Methods: Seventy-three consecutive patients undergoing bilateral non-simultaneous cataract surgery were prospectively included in the study. Surgical technique was sutureless clear corneal phacoemulsification under topical anesthesia. Immediately after surgery every patient graded the pain experienced using a visual analogue scale (VAS) from 0 (no pain) to 10 (unbearable pain). At the end of each procedure the surgeon graded patients' cooperation using a 4-point scale. Results: Mean VAS score was 2.35 (SD 2.63) for the first eye and 2.89 (SD 2.93) for the second eye. Such a difference was not statistically significant (p=0.1777, Wilcoxon test). The correlation between the VAS score of the first and that of the second procedure was statistically significant (r=0.5514, p<0.0001, Spearman rank correlation). Patients' cooperation was 2.64 (SD 0.63) during the first procedure and 2.52 (SD 0.79) during the second procedure; this difference was not statistically significant (p=0.1769, Wilcoxon matched-pairs signed-ranks test). Conclusions: After uneventful cataract surgery under topical anesthesia, pain experienced and cooperation did not differ between first and second eye procedures. A correlation was found between pain scores of the first and the second eye procedures. © 2011 Springer-Verlag.


Rosato E.,University of Rome La Sapienza | Carello R.,Ospedale San Pietro Fatebenefratelli | Gabriele I.,Ospedale San Pietro Fatebenefratelli | Molinaro I.,University of Rome La Sapienza | And 2 more authors.
Journal of Biological Regulators and Homeostatic Agents | Year: 2011

Some patients with nickel (Ni) allergic contact dermatitis (ACD) suffer from systemic symptoms after ingestion of Ni-rich foods, a condition termed Systemic Nickel Allergy Syndrome (SNAS). The aim of this study is to investigate in children the relationship between Ni ACD and lymphocyte subsets or susceptibility to infections. Nineteen children with Ni ACD and 18 controls matched for sex and age were enrolled. All participants underwent patch test, skin prick test and clinical assessment. Serum immunoglobulins and flow cytometry for lymphocyte subset study were also evaluated. In children with Ni ACD a higher incidence of recurrent upper respiratory tract infections and recurrent otitis media were detected. Serum levels of immunoglobulins and lymphocyte subsets did not show significant changes (p>0.05) between the two groups studied. We can hypothesize that in children with Ni ACD the risk of recurrent infections is increased. Although the clinical manifestations of SNAS are still controversial, we can suppose that recurrent infections may be considered a clinical symptom of this syndrome. Copyright © by BIOLIFE, s.a.s.


Ciucci F.,Ospedale San Pietro Fatebenefratelli | Sacchetti M.,Ospedale San Pietro Fatebenefratelli | De Gaetano C.,Ospedale San Pietro Fatebenefratelli | Bardocci A.,Ospedale San Pietro Fatebenefratelli | Lofoco G.,Ospedale San Pietro Fatebenefratelli
European Journal of Ophthalmology | Year: 2015

Purpose: To report the onset of choroidal neovascularization (CNV) following hormonal stimulation for in vitro fertilization (IVF) in a healthy young woman. Methods: A 31-year-old woman presented with visual impairment following hormonal stimulation for IVF. Clinical history was collected and best-corrected visual acuity (BCVA), complete eye examination, optical coherence tomography (OCT), fluorescein angiography (FA), and indocyanine green angiography were performed. Results: Clinical history was negative with the exception of the use of medications for IVF in the previous weeks. Ocular examination revealed the presence of a CNV in the right eye, confirmed by OCT and FA, with a BCVA of 0.7 decimal units. Possible ocular and systemic diseases associated with CNV development were investigated and excluded. Treatment with 3 monthly intravitreal injections of anti–vascular endothelial growth factor (VEGF) was effective in reducing CNV size and restoring visual acuity. Conclusions: This is the first report describing the development of CNV following hormonal stimulation for IVF. The development of CNV may be associated with changes of sex hormones, cytokines, and angiogenic factor levels, including VEGF, induced by hormonal stimulation. © 2015 Wichtig Publishing.


PubMed | University of Rome Tor Vergata, IRCCS CSS San Giovanni Rotondo and CSS Mendel, University of Southern California, Technogenetics srl and Ospedale San Pietro Fatebenefratelli
Type: | Journal: Genomics insights | Year: 2015

We designed a targeted-array called GOLD (Gain or Loss Detection) Chip consisting of 900 FISH-mapped non-overlapping BAC clones spanning the whole genome to enhance the coverage of 66 unique human genomic regions involved in well known microdeletion/microduplication syndromes. The array has a 10 Mb backbone to guarantee the detection of the aneuploidies, and has an implemented resolution for telomeres, and for regions involved in common genomic diseases. In order to evaluate clinical diagnostic applicability of GOLDChip, analytical validity was carried-out via retrospective analysis of DNA isolated from a series of cytogenetically normal amniocytes and cytogenetically abnormal DNA obtained from cultured amniocytes, peripheral blood and/or cell lines. We recruited 47 DNA samples corresponding to pathologies with significant frequencies (Cri du Chat syndrome, Williams syndrome, Prader Willi/Angelman syndromes, Smith-Magenis syndrome, DiGeorge syndrome, Miller-Dieker syndrome, chromosomes 13, 18 and 21 trisomies). We set up an experimental protocol that allowed to identify chromosomal rearrangements in all the DNA samples analyzed. Our results provide evidence that our targeted BAC array can be used for the identification of the most common microdeletion syndromes and common aneuploidies.


PubMed | Ospedale San Pietro Fatebenefratelli
Type: Comparative Study | Journal: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie | Year: 2011

Aim of the study was to investigate: 1) if second eye cataract surgery under topical anesthesia is more painful than surgery on the first eye, 2) if pain experienced during the procedure on the first eye may predict the pain of the second procedure, and 3) if patients cooperation is different between the first and the second eye procedure.Seventy-three consecutive patients undergoing bilateral non-simultaneous cataract surgery were prospectively included in the study. Surgical technique was sutureless clear corneal phacoemulsification under topical anesthesia. Immediately after surgery every patient graded the pain experienced using a visual analogue scale (VAS) from 0 (no pain) to 10 (unbearable pain). At the end of each procedure the surgeon graded patients cooperation using a 4-point scale.Mean VAS score was 2.35 (SD 2.63) for the first eye and 2.89 (SD 2.93) for the second eye. Such a difference was not statistically significant (p=0.1777, Wilcoxon test). The correlation between the VAS score of the first and that of the second procedure was statistically significant (r=0.5514, p<0.0001, Spearman rank correlation). Patients cooperation was 2.64 (SD 0.63) during the first procedure and 2.52 (SD 0.79) during the second procedure; this difference was not statistically significant (p=0.1769, Wilcoxon matched-pairs signed-ranks test).After uneventful cataract surgery under topical anesthesia, pain experienced and cooperation did not differ between first and second eye procedures. A correlation was found between pain scores of the first and the second eye procedures.


Bardocci A.,Ospedale San Pietro Fatebenefratelli | Abad J.C.,Clinica Clofan | Tamburrelli C.,University Cattolica ore | Lofoco G.,Ospedale San Pietro Fatebenefratelli | And 2 more authors.
Seminars in Ophthalmology | Year: 2012

Purpose: We describe a case of early onset keratectasia after photorefractive keratectomy (PRK) in a patient with Vertical D topographic pattern in one eye and suspected keratoconus in the other eye. Methods: A 31-year-old woman underwent bilateral PRK: attempted correction was 8.002.00 × 30°in her right eye (RE) and 4.501.50 × 150°tabo in her left eye (LE). Preoperative corneal thickness was 512 m in the RE and 520 m in the LE. Preoperative topography showed an asymmetric bow-tie pattern and skewed axis in RE and a Vertical D pattern in LE. Intended maximum ablation was 91 m in RE and 66 m in LE. Results: Three months postoperatively the patient showed early topographic signs of bilateral keratectasia, evolved to manifest keratectasia after six years. Conclusions: Although rare after PRK, keratectasia may occur even following moderate (66 m) surface ablation in eyes with Vertical D topographic pattern in one eye and controlateral suspected keratoconus. © 2012 Informa Healthcare USA, Inc.

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