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San Giovanni Valdarno, Italy

Rago A.,University of Rome La Sapienza | Grammatico S.,University of Rome La Sapienza | Za T.,Catholic University of America | Levi A.,University of Rome La Sapienza | And 14 more authors.
Cancer | Year: 2012

Background: Smoldering multiple myeloma (SMM) presents a high risk of progression to symptomatic MM (sy-MM). Herein, we analyzed some predictors of development of sy-MM. In 144 patients with SMM, we also compared the risk of progression predicted by bone marrow plasma cell (BMPC) involvement on the bone marrow biopsy (BMB) versus bone marrow aspirates (BMA). Methods: From January 1980 to July 2010, 397 patients with SMM observed in 12 centers of the Multiple Myeloma GIMEMA (Gruppo Italiano Malattie EMatologiche dell'Adulto) Latium Working Group have been analyzed. At progression to sy-MM, the severity of clinical presentation was graded according to the need of intensive supportive care. Results: After a median follow-up of 135 months, the cumulative incidence of progression rates to sy-MM were 45%, 55%, and 75% at 10, 15, and 20 years, respectively. Hemoglobin ≤12.5 g/dL, monoclonal component ≥2.5 g/dL, and BMPC ≥60% were the only parameters negatively affecting the cumulative incidence of progression. In particular, 10 of 397 (2.5%) patients with BMPC ≥60% had a 5.6-fold increased risk of fast progression (within 2 years), which occurred with severe clinical manifestations in 62% of cases. BMB was more sensitive for the detection of BMPC involvement, even though BMA was a more reliable indicator of a rapid progression to sy-MM. Conclusions: The highest risk of rapid evolution to sy-MM and the severity of clinical manifestation at the progression suggest that SMM patients with a BMPC ≥60% should be treated soon after diagnosis. Moreover, BMPC is a more reliable index for progression to sy-MM if assessed by BMA. © 2012 American Cancer Society.

Lorenzon L.,University of Rome La Sapienza | Benevolo M.,Regina Elena Cancer Institute | Visca P.,Regina Elena Cancer Institute | Venturo I.,Regina Elena Cancer Institute | And 4 more authors.
International Journal of Surgical Pathology | Year: 2013

This report describe the case of a patient presenting with pulmonary metastases from a penile cancer, where the presence of the human papillomavirus (HPV) type 16 DNA both in the primary tumor and in the distant metastases confirmed the spreading of the disease, ruling out a possible primary lung squamous cell carcinoma. Indeed, according to the findings, the HPV genotyping test might help in the identification of metastatic disease from anogenital malignancies or other HPV-related cancers. © The Author(s) 2013.

Del Vecchio L.,A. Manzoni Hospital | Lusenti T.,Santa Maria Nuova Hospital | Del Rosso G.,Giuseppe Mazzini Hospital | Malandra R.,Giuseppe Mazzini Hospital | And 2 more authors.
Journal of Nephrology | Year: 2013

Background: Hypertension is very common among patients receiving hemodialysis; however, little is known about its prevalence and control following the publication of the Kidney Disease Outcomes Quality Initiative (KDOQI) recommendations. Methods: This was a multicenter, observational, prospective, cross-sectional study aimed at evaluating the prevalence of hypertension and its awareness in a large sample of hemodialysis patients in Italy, and assessing possible relationships between high blood pressure (BP) values and traditional and nontraditional cardiovascular risk factors. Predialysis hypertension was defined as systolic BP (SBP)/diastolic BP (DBP) ≥140/90 mm Hg, and postdialysis hypertension as SBP/ DBP ≥130/80 mm Hg or the use of antihypertensive medications. Results: We collected data for 4,022 patients (men/ women 2,478/1,544, mean age 67.14 ± 14.08 years) from 77 dialysis centers. Of these, 2,832 patients (70.3%) were defined as having predialysis hypertension. At logistic regression analysis, diabetes, months on dialysis, serum albumin levels and treatment with erythropoiesis-stimulating agent (ESA) were independent factors predicting predialysis hypertension. Antihypertensive agents were used in 57.7% of the patients, leading to adequate BP control in only 40% of them. Factors independently predicting inadequate BP control were diabetes, ESA therapy, high serum cholesterol and higher Kt/V values. Conclusions: Hypertension is highly prevalent in this Italian hemodialysis population; achievement of adequate BP control is inadequate. It is unclear whether this may reflect suboptimal diagnosis or treatment of hypertension or, more likely, the allowance of higher predialysis BP values to try to avoid abrupt BP falls during the dialytic session. © 2012 Società Italiana di Nefrologia.

Scacchi R.,CNR Institute of Molecular Biology and Pathology | Ruggeri M.,S. Giovanni Addolorata Hospital | Corbo R.M.,CNR Institute of Molecular Biology and Pathology | Corbo R.M.,University of Rome La Sapienza
Clinica Chimica Acta | Year: 2011

Butyrylcholinesterase (BChE) and acetylcholinesterase (AchE) are two enzymes of the cholinergic system putatively involved in coronary artery disease (CAD). We investigated two single nucleotide polymorphisms (SNPs) of the genes encoding these enzymes to determine whether some allele or genotype might represent a factor of risk or protection for CAD onset. AChE rs2571598 and BChE rs1803274 (the so-called K-variant) SNPs were investigated in a sample of 199 patients and 199 healthy subjects. No significant results were obtained for BChE, whereas for AChE the A allele was found significantly more frequent in patients than in controls (0.437 vs. 0.332; p= 0.002). The crude Odds Ratio (OR) for CAD conferred by carrying the A allele was 1.76 (95% confidence interval [CI] 1.17-2.65). Stratification of the sample by gender revealed that the statistical significance was limited to female, where the crude OR associated with the A allele was 3.26 (95% CI 1.58-6.73). The lipidic pattern was also tested and related to variation of the two SNPs. In this case, an at limits significant result (p= 0.03) was obtained for BChE, whose A allele (the K variant) in patients was found associated with higher plasma concentrations of high density lipoprotein-cholesterol. © 2011 Elsevier B.V.

Tangari M.,S. Giovanni Addolorata Hospital | Carbone S.,University of Rome La Sapienza | Gallo M.,S. Giovanni Addolorata Hospital | Campi A.,S. Giovanni Addolorata Hospital
Journal of Shoulder and Elbow Surgery | Year: 2011

Background: The aim of this study is to assess the validity of a mini-open tenodesis of the long head of the biceps tendon (LHBT) performed on 5 professional wrestlers injured while fighting. Methods: Five professional wrestlers with an acute rupture of the LHBT were treated with a mini-open tenodesis procedure without arthroscopic assistance. This technique is performed with 2 miniscule incisions of the skin. The tendon is prepared with biological fibrin glue and with a No. 2 Fiberwire; after that, the tendon is sutured to the bicipital groove with a suture anchor. At the follow-up exam (average 7.6 years; range, 2-13), clinical assessments were obtained with the Constant score (CS) and Mayo Elbow Performance Score (MEPS). Forearm flexion strength was measured with a dynamometer, and a magnetic resonance image was also obtained. Results: At the follow-up, the average age of the patients was 32.6 years (range, 28-40). The average CS of the involved shoulder was 95 points (range, 92-98), compared to 97 points (range, 94-98) of the contralateral side (P = .37). The MEPS was 99.76 for the elbow of the involved side and 99.84 for the contralateral one (P = .34). No significant difference was noted for the forearm flexion strength (P = .31). Discussion: In this study, patients were all high-demand wrestlers and biceps tenodesis was mandatory. Mini-opening without arthroscopic assistance tenodesis of the long head of the bicep tendon to the bicipital groove has been used for these professional wrestlers. Functional and cosmetic results of this technique have been excellent, and it allowed athletes to return shortly to their sport activity. © 2011 Journal of Shoulder and Elbow Surgery Board of Trustees.

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