S Croce Carle Hospital

Cuneo, Italy

S Croce Carle Hospital

Cuneo, Italy

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PubMed | S Croce & Carle Hospital, Biostatistic Unit, University of Milan, Instituto Superiore Of Sanita and 2 more.
Type: Clinical Trial, Phase II | Journal: Clinical cancer research : an official journal of the American Association for Cancer Research | Year: 2014

To evaluate safety and activity of perifosine and sorafenib combination therapy in patients with lymphoproliferative diseases.Patients with relapsed and refractory lymphoproliferative diseases received perifosine (50 mg twice daily) for 1 month. Patients achieving less than partial response (PR) after perifosine alone were administered the combination therapy [perifosine plus sorafenib (400 mg twice daily)] until progressive disease (PD) or unacceptable toxicity occurred. The pERK and pAKT in peripheral blood lymphocytes as well as serum cytokine levels were investigated as predictive biomarkers of response.Forty patients enrolled in this study. After 1 month of perifosine alone, 36 who achieved less than PR went on to combination therapy, whereas four patients with chronic lymphocytic leukemia (CLL) who achieved PR continued with perifosine alone for a median of 10 months (range, 4-21). The most common drug-related toxicities were grade 1-2 anemia (17%), thrombocytopenia (9%), diarrhea (25%), joint pain (22%), and hand-foot skin reaction (25%). Three patients experienced grade 3 pneumonitis. Eight patients (22%) achieved PR, 15 (42%) achieved stable disease, and 13 (36%) experienced PD. A 28% PR rate was recorded for 25 patients with Hodgkin lymphoma. Among all patients, median overall survival and progression-free survival were 16 and 5 months, respectively. Early reductions in pERK and pAKT significantly correlated with the probability of clinical response.Perifosine and sorafenib combination therapy is feasible with manageable toxicity and demonstrates promising activity in patients with Hodgkin lymphoma. The predictive value of pERK and pAKT should be confirmed in a larger patient cohort.


Feola M.,Cardiovascular Rehabilitation Heart Failure Unit | Valeri L.,Ss Annunziata Hospital | Menditto E.,Cardiovascular Rehabilitation Heart Failure Unit | Nervo E.,Cardiovascular Rehabilitation Heart Failure Unit | And 4 more authors.
Journal of Endocrinological Investigation | Year: 2010

This study compared two different methods, namely the immunoradiometric (IRMA) and fluorimetric (FIA), in order to determine plasma brain natriuretic peptide (BNP) in congestive heart failure (CHF) patients. Methods: CHF in-patients underwent echocardiography and plasma BNP determination using both two methods. The echocardiograms analysed left ventricular end-systolic (LVESV) and end-diastolic (LVEDV) volumes and systolic dysfunction [left ventricular ejection fraction (LVEF) <50%]. Results: Seventy-three (71% males, age 67±9.6 yr) patients were enrolled, 31.5% affected by valvular heart disease. The mean LVEF was 39.8±14.1%; in 26 (35%) a hypertensive etiology emerged. The immunoradiometric assay (IRMA) BNP was found to be significantly lower than the FIA determination 116.5±149 pg/ml vs 267.3±285.6 pg/ml; p=0.0001) and the two methods were closely correlated (r=0.89; p=0.00001). Logistic regression demonstrated a significant correlation between BNP, LVEF, and LVESV/LVEDV (r=-0.45, p=0.0003; r=-0.48, p=0.00001; r=0.22 p=0.003; r=0.34 p=0.0001; r=0.13 p=0.02; r=0.28 p=0.001 IRMA and FIA, respectively). IRMA BNP and FIA BNP significantly increased according to the worsening functional class [from 34.3±60.2 pg/ml in NYHA (New York Heart Association) I to 555.5±273.1 pg/ml in NYHA IV; from 86.1±162.1 pg/ml in NYHA I to 1070±42.2 pg/ml in NYHA IV, respectively]. In severe systolic dysfunction (LVEF<30%), receiver operating characteristic analysis revealed a satisfactorily sensitivity and specificity using a cut-off point of 50.6 pg/ml with IRMA and 243 pg/ml with FIA. In mild systolic dysfunction (LVEF<50%), a good sensitivity and specificity using a cut-off point of 42 pg/ml with IRMA and 182 pg/ml with FIA emerged. Conclusions: In CHF patients both BNP methods correlated with NYHA class, LVEF, and ventricular volumes. ©2010, Editrice Kurtis.


Viti A.,S Croce Carle Hospital | Terzi A.,Sacro Cuore Research Hospital | Bertolaccini L.,Sacro Cuore Research Hospital
Journal of Thoracic Disease | Year: 2015

Aim of this paper is a general definition of probability, of its main mathematical features and the features it presents under particular circumstances. The behavior of probability is linked to the features of the phenomenon we would predict. This link can be defined probability distribution. Given the characteristics of phenomena (that we can also define variables), there are defined probability distribution. For categorical (or discrete) variables, the probability can be described by a binomial or Poisson distribution in the majority of cases. For continuous variables, the probability can be described by the most important distribution in statistics, the normal distribution. Distributions of probability are briefly described together with some examples for their possible application.


PubMed | S Croce Carle Hospital
Type: Journal Article | Journal: Journal of thoracic disease | Year: 2015

Aim of this paper is a general definition of probability, of its main mathematical features and the features it presents under particular circumstances. The behavior of probability is linked to the features of the phenomenon we would predict. This link can be defined probability distribution. Given the characteristics of phenomena (that we can also define variables), there are defined probability distribution. For categorical (or discrete) variables, the probability can be described by a binomial or Poisson distribution in the majority of cases. For continuous variables, the probability can be described by the most important distribution in statistics, the normal distribution. Distributions of probability are briefly described together with some examples for their possible application.


PubMed | S Croce & Carle Hospital
Type: Journal Article | Journal: Calcified tissue international | Year: 2011

Osteocalcin (OC) has been proposed as a regulator of insulin sensitivity in both humans and other animals. Primary hyperparathyroidism (PHPT) is characterized by high OC levels and insulin resistance. The aim of this study was to evaluate whether in PHPT the link between OC levels and blood markers of insulin resistance was maintained. In a consecutive series of 219 adult PHPT patients, serum OC as well as fasting insulin and glucose levels were measured. Insulin sensitivity was estimated by homeostatic model assessment (HOMA2-S%). The same parameters were evaluated in a subgroup of 45 patients after parathyroidectomy (PTX). PHPT patients were characterized by markedly high OC levels. After subdividing them according to glucose tolerance, it was found that OC was similar in subjects with normal glucose tolerance (NGT) and impaired glucose tolerance (IGT), while diabetic subjects had lower serum OC than those with NGT (P < 0.02) or IGT (P < 0.04). OC was negatively associated with fasting glucose and positively associated with HOMA2-S%. OC independently predicted HOMA2-S% in a multivariate analysis. In the subgroup of surgically cured PHPT patients, OC levels significantly decreased after PTX, while HOMA2-S% did not change. Our findings indicate that in PHPT there is a positive relationship between OC and glucose metabolism, OC being one of the predictors of insulin sensitivity. However, data in surgically cured patients, showing OC normalization in spite of unchanged HOMA2-S%, suggest that OC does not likely play a major role in affecting insulin sensitivity in PHPT.

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