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Pistoia, Italy

Pegurri L.,University of Brescia | Buglione M.,University of Brescia | Girelli G.,Ivrea Hospital | Guarnieri A.,University of Turin | And 18 more authors.
Tumori | Year: 2014

Aims and background. In 2002, a survey including 1759 patients treated from 1980 to 1998 established a "benchmark" Italian data source for prostate cancer radiotherapy. This report updates the previous one. Methods. Data on clinical management and outcomes of 3001 patients treated in 15 centers from 1999 through 2003 were analyzed and compared with those of the previous survey. Results. Significant differences in clinical management (-10% had abdominal ma gnetic resonance imaging; +26% received ≥70 Gy, +48% conformal radiotherapy, -20% pelvic radiotherapy) and in G3-4 toxicity rates (-3.8%) were recorded. Actuarial 5- year overall, disease-specific, clinical relapse-free, and biochemical relapse-free survival rates were 88%, 96%, 96% and 88%, respectively. At multivariate analysis, D'Amico risk categories significantly impacted on all the outcomes; higher radiotherapy doses were significantly related with better overall survival rates, and a similar trend was evident for disease-specific and biochemical relapse-free survival; cumulative probability of 5-year late G1-4 toxicity was 24.8% and was significantly related to higher radiotherapy doses (P <0.001). Conclusions. The changing patterns of practice described seem related to an improvement in efficacy and safety of radiotherapy for prostate cancer. However, the impact of the new radiotherapy techniques should be prospectively evaluated. Source

Moretti S.,University of Florence | Massi D.,University of Florence | Farini V.,University of Florence | Baroni G.,University of Florence | And 4 more authors.
Laboratory Investigation | Year: 2013

Recent studies sight β-adrenergic receptor (AR) antagonists as novel therapeutic agents for melanoma, as they may reduce disease progression. Here within, we evaluated the expression of β-ARs in a series of human cutaneous melanocytic lesions, and studied the effect of their endogenous agonists, norepinephrine (NE) and epinephrine (E), on primary and metastatic human melanoma cell lines. Using immunohistochemistry, we found that both β1- and β2-ARs are expressed in tissues from benign melanocytic naevi, atypical naevi and malignant melanomas and that expression was significantly higher in malignant tumours. Melanoma cell lines (human A375 primary melanoma cell line and human Hs29-4T metastatic melanoma cell lines) also expressed β1- and β2-ARs by measuring transcripts and proteins. NE or E increased metalloprotease-dependent motility, released interleukin-6 and 8 (IL-6, IL-8) and vascular endothelial growth factor (VEGF). These effects of catecholamines were inhibited by the unselective β-AR antagonist propranolol. The role of soluble factors elicited by catecholamines seemed pleiotropic as VEGF synergized with NE increased melanoma invasiveness through 3D barriers, while IL-6 participated in stromal fibroblast activation towards a myofibroblastic phenotype. Our results indicate that NE and E produce in vitro via β-ARs activation a number of biological responses that may exert a pro-tumorigenic effect in melanoma cell lines. The observation that β-ARs are upregulated in malignant melanoma tissues support the hypothesis that circulating catecholamines NE and E, by activating their receptors, favour melanoma progression in vivo. © 2013 USCAP, Inc All rights reserved. Source

Dionisio D.,A+ Network | Racalbuto V.,Italian Cooperation Headquarters at the Italian Ministry of Foreign Affairs | Messeri D.,Pistoia Hospital
Open AIDS Journal | Year: 2010

Patent pools for second and third-line Fixed Dose Combination (FDC) antiretroviral drugs (ARVs) should not be delayed as they are instrumental to urgent public health needs in the under-served markets. Nonetheless, multinational originator companies still seem to perceive patent pooling for ARVs as a minefield that would offer the generic competitors lots of deeply exploitable opportunities, to the detriment of patent owner's rights. This paper analyses the brand industry concerns, while looking for a strategy up to a really equitable and free world market, without any discrimination between end-users in wealthy and resource-limited countries. This strategy would urge partnerships between originator companies first to make newer FDC ARVs quickly available and allow patent pool agreements with generic counterparts to be negotiated straight afterwards. The patent pool strategy highlighted in this paper would assert the primacy of health over for-profit policies, while aligning with the 61st WHO's Assembly recommendations and G7, G8 and World Trade Organisation's warnings and pledges against trade protectionism. © Dionisio et al.;. Source

Dionisio D.,Pistoia Hospital
Translational Biomedicine | Year: 2010

Background: Communicable diseases (including HIV/AIDS, malaria, tuberculosis, schistosomiasis, river blindness, Cha- gas, sleeping sickness, and leishmaniasis) disproportionately affect the people living in resource-limited countries. While current patent system does not work for poor end users in these countries, it adds to the stranglehold on access to lifesaving medicines by the protectionist policies of wealthy countries. Nonetheless, increasing pressure is registe- red nowadays for strategies up to promoting pharmaceutical innovation, research and development (R&D) and equita- ble access to medicines in the sake of the worst-off. Method: Analysis here will compare some strategy models in their potential to fairly attune patents to innovation, R&D and access, in the light of new perspectives by governments and institutions aligning with the spirit and resolutions of just closed sixty-third WHO World Health Assembly. Conclusion: No single model is likely to be enough solution, and a combination of two or more may be needed to ensure that outputs of R&D, innovation and access are available without restrictions. To this aim, all models should complement current intellectual property regimens and channel open source schemes, sustainable financing mechanisms, and needs-driven rather than merely market-driven rules. © Under License of Creative Commons Attribution 3.0 License. Source

Fanos V.,University of Cagliari | Tagliabue P.,UO Neonatologia e Terapia Intensiva Neonatale | Agostiniani R.,Pistoia Hospital | Carbone M.T.,Ospedale SS. Annunziata | And 2 more authors.
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2012

Medical errors are topics of increasing importance in neonatology. Very few data are available on neonatal malpractice claims. We report the first data obtained in Italy on neonatology regarding a wide population study during a 6-year survey. Data concerning 191 claims regarding delivery room (n = 77; 38.74%), nursery (n = 72; 37,69%), NICU (n = 42; 21,98%) and the transport system (n = 3; 1.57%) are presented and discussed. On data allow an analysis of main causes and suggest how to face the problem. © 2012 Informa UK, Ltd. Source

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