Castel San Vincenzo, Italy
Castel San Vincenzo, Italy

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PubMed | Papa Giovanni XXIII Hospital, University of Verona, General Hospital, San Vincenzo Hospital and 21 more.
Type: Journal Article | Journal: Future oncology (London, England) | Year: 2016

To assess clinical outcomes in octogenarians treated with docetaxel (DOC) for metastatic castration-resistant prostate cancer.The multicenter retrospective study was based on a review of the pre- and post-DOC clinical history, DOC treatment and outcomes.We reviewed the records of 123 patients (median age: 82 years) who received DOC every 3 weeks or weekly, without significant grade 3-4 toxicities. Median progression-free survival was 7 months; median overall survival from the start of DOC was 20 months, but post-progression treatments significantly prolonged overall survival.The findings of this study suggest that toxicity is acceptable, survival is independent of patients age and survival can be significantly prolonged by the use of new agents.


Gebbia V.,University of Palermo | Bellavia M.,University of Palermo | Banna G.L.,Cannizzaro Hospital | Russo P.,University of Palermo | And 3 more authors.
Clinical Lung Cancer | Year: 2013

Background: Adherence to erlotinib could be a determinant for clinical outcome and treatment toxicity in patients with advanced non-small-cell lung cancer (A-NSCLC). Patients and Methods: In an observational study, the Basel Assessment of Adherence Scale (BAAS), a visual analogue scale (VAS), pill counting, and missed appointment rate were used to evaluate adherence in a first cohort of patients who was prescribed erlotinib without a specifically designed management strategy and in a second cohort of patients followed by an oral treatment monitoring program. Results: Adherence > 95% by BAAS at 2 months of treatment in the first and second cohorts was 72% and 84%, respectively (P =.042). Adherence by pill counting was 78% and 87% in the first and second cohorts, respectively (P =.0021). Disease control rate (DCR) (complete response [CR] + partial response [PR] + stable disease [SD]) was significantly higher in all patients whose adherence by BAAS at 2 months was ≥ 95% (P =.0266). DCR was higher in the second cohort compared with the first, being 63% (95% confidence interval [CI], 53%-72%) and 44% (95% CI, 30%-58%) in the second and the first cohort, respectively (P =.0368). A significant correlation between the number of adverse events and patient-reported adherence was observed (r = 0.105; P =.0001). Conclusion: Nonadherence may be related to poorer rates of response to erlotinib. Effective interventions to reduce nonadherence need to be implemented. © 2013 Elsevier Inc.


PubMed | Cannizzaro Hospital, Italian National Cancer Institute, St Michaels Hospital, University of Verona and 5 more.
Type: Journal Article | Journal: BMC cancer | Year: 2017

Mechanisms influencing breast cancer (BC) development and recurrence include hyperglycemia, hyperinsulinemia, high insulin-like growth factor-1, high circulating estrogen, inflammation and impaired cellular differentiation/apoptosis. A lifestyle program that targets all the above mechanisms may be warranted. Low glycemic index (GI) foods produce lower post-prandial glucose and insulin responses and have been associated with lower BC risk. Moderate physical activity post-diagnosis reduces BC recurrence and mortality, partly explained by reduced insulin and estrogen levels. Vitamin D increases cell differentiation/apoptosis and high serum vitamin D levels improve BC survival. Yet no trial has evaluated the combined effect of a low GI diet, moderate physical activity and vitamin D supplementation on BC recurrence in the context of a Mediterranean lifestyle setting.Women (30-74yr) who had undergone surgery for primary histologically confirmed BC (stages I-III) within the previous 12months, in cancer centres in Italy, will be randomized to follow, for a maximum of 33months, either a high intensity treatment (HIT) composed of low GI diet+exercise+vitamin D (60ng/mL serum concentration) or a lower intensity treatment (LITE) with general advice to follow a healthy diet and exercise pattern+vitamin D to avoid insufficiency. Both interventions are on a background of a Mediterranean diet. Considering a 20% recurrence rate within 3years for BC cases and a predicted rate of 10% in the HIT group, with power of 80% and two-sided alpha of 0.05, the subject number required will be 506 (n=253 in each arm). Clinic visits will be scheduled every 3months. Dietary and exercise counselling and vitamin D supplements will be given at each clinic visit when blood samples, anthropometric measures and 7-day food records will be collected.DEDiCa study aims to reduce BC recurrence in women with BC using a lifestyle approach with additional vitamin D and to investigate possible cardio-metabolic benefits as well as epigenetic modifications according to lifestyle changes. Given the supporting evidence and safety of the components of our intervention we believe it is feasible and urgent to test it in cancer patients.May 11, 2016; NCT02786875 .2015-005147-14.


Calvagna G.M.,San Vincenzo Hospital | Evola R.,San Vincenzo Hospital | Scardace G.,Medtronic | Valsecchi S.,Medtronic
PACE - Pacing and Clinical Electrophysiology | Year: 2012

We describe the case of a man with an implantable defibrillator and a dual-coil lead introduced via the right internal jugular vein. Due to pocket infection and lead erosion at the jugular vein, transvenous lead extraction was attempted with a mechanical single-sheath technique. The lead was completely removed without complications with culture and sensitivity results guiding an effective antibiotic therapy. (PACE 2012; 35:e258-e260) ©2011, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.


Ceresa F.,Ospedali Riuniti Papardo Piemonte Hospital | Calarco G.,Ospedali Riuniti Papardo Piemonte Hospital | Franzi E.,San Vincenzo Hospital | Patane F.,Ospedali Riuniti Papardo Piemonte Hospital
Interactive Cardiovascular and Thoracic Surgery | Year: 2010

Primary cardiac tumors are rarest form of cancer and the lipoma represent about 8% of these tumors. Cowden disease is a rare autosomal dominant disorder, associated to a germline mutation of the PTEN gene, characterized by multiple hamartomas and an increased risk of breast, thyroid and endometrial carcinomas. For the first time, we describe a right atrial lipoma in a patient affected by Cowden syndrome. The patient suffered of some episodes of atrial flutter. The echocardiogram showed a cardiac mass, suggestive of lipoma with cardiac magnetic resonance images. Right atrial mass was completely resected and the histological examination confirmed the diagnosis of lipoma. The patient was discharged from hospital without any complications. © 2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.


Calvagna G.M.,San Vincenzo Hospital | Romeo P.,San Vincenzo Hospital | Ceresa F.,Ospedale Papardo | Valsecchi S.,Boston Scientific Italy
PACE - Pacing and Clinical Electrophysiology | Year: 2013

Background Many techniques for the endovascular retrieval of lost or misplaced foreign objects have been developed, and the removal of almost every foreign object has become possible. In this paper, we report our experience in retrieving foreign objects lost during cardiac device implantations or previous extraction procedures. Methods This study was a retrospective analysis of the case records of all patients referred to our institution for transvenous retrieval of intravascular foreign objects. Results Over 10 years, 45 consecutive patients underwent procedures for the retrieval of intravascular foreign objects. These objects were: 25 distal portions of introducer sheaths, 18 pacing lead fragments, one guidewire, and one anchoring sleeve. The majority of fragments were located in the right ventricle and subclavian and caval veins. Some had migrated to the pulmonary artery or more distally. The median dwell time of the fragments was 3 months. Retrieval was most frequently achieved through the femoral veins, and was successful in 42 (93%) procedures. No procedure-related complications occurred in this series. Conclusions In the present single-center experience, the endovascular approach to retrieving intravascular objects lost during cardiac device implantation or previous extraction procedures seemed effective with currently available tools and was associated with no complications. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.


La Greca M.,San Vincenzo Hospital | Grasso G.,San Vincenzo Hospital | Antonelli G.,San Vincenzo Hospital | Russo A.E.,San Vincenzo Hospital | And 4 more authors.
OncoTargets and Therapy | Year: 2014

Neoadjuvant chemotherapy has been successfully tested in several bulky solid tumors, but it has not been utilized in advanced cutaneous melanoma, primarily because effective medical treatments for this disease have been lacking. However, with the development of new immunotherapies (monoclonal antibodies specific for cytotoxic T lymphocyte-associated antigen 4 [anti-CTLA-4] and programmed death protein-1 [anti-PD1]) and small molecules interfering with intracellular pathways (anti-BRAF and mitogen-activated protein kinase kinase [anti-MEK]) the use of this approach is becoming a viable treatment strategy for locally advanced melanoma. The neoadjuvant setting provides a double opportunity for a better knowledge of these drugs: a short-term evaluation of their intrinsic activity, and a deeper analysis of their action and resistance-induction mechanisms. BRAF inhibitors seem to be ideal candidates for the neoadjuvant setting, because of their prompt, repeatedly confirmed response in V600E BRAF-mutant metastatic melanoma. In this report we summarize studies focused on the neo- adjuvant use of traditional medical treatments in advanced melanoma and anecdotal cases of this approach with the use of biologic therapies. Moreover, we discuss our experience with neoadjuvant targeted therapy as a priming for radical surgery in a patient with BRAF V600E mutation-positive advanced melanoma. © 2014 La Greca et al.


Banna G.L.,University of Catania | Collova E.,Hospital of Legnano | Gebbia V.,University of Palermo | Lipari H.,University of Catania | And 6 more authors.
Cancer Treatment Reviews | Year: 2010

The use of oral anticancer drugs has shown a steady increase. Most patients prefer anticancer oral therapy to intravenous treatment primarily for the convenience of a home-based therapy, although they require that the efficacy of oral therapy must be equivalent and toxicity not superior than those expected with the intravenous treatment. A better patient compliance, drug tolerability, convenience and possible better efficacy for oral therapy as compared to intravenous emerge as the major reasons to use oral anticancer agents among oncologists. Inter- and intra-individual pharmacokinetic variations in the bioavailability of oral anticancer drugs may be more relevant than for intravenous agents. Compliance is particularly important for oral therapy because it determines the dose-intensity of the treatment and ultimately treatment efficacy and toxicity. Patient stands as the most important determinant of compliance. Possible measures for an active and safe administration of oral therapy include a careful preliminary medical evaluation and selection of patients based on possible barriers to an adequate compliance, pharmacologic issues, patient-focused education, an improvement of the accessibility to healthcare service, as well as the development of home-care nursing symptom-focused interventions. Current evidences show similar quality of life profile between oral and intravenous treatments, although anticancer oral therapy seems to be more convenient in terms of administration and reduced time lost for work or other activities. Regarding cost-effectiveness, current evidences are in favor of oral therapy, mainly due to reduced need of visits and/or day in hospital for the administration of the drug and/or the management of adverse events. © 2010 Elsevier Ltd.


Marcantoni C.,Cannizzaro Hospital | Castellino S.,San Vincenzo Hospital | Cicchetti T.,Azienda sanitaria provinciale | Mallamaci F.,Ospedali Riuniti
Journal of Nephrology | Year: 2011

The education level of women has increased significantly in recent decades. However, although there is a continued positive trend overall, women remain underrepresented (or misrepresented?) in the main fields of science. In Europe the proportion of women in scientific research is growing faster than that of men, but women are more likely than men to choose education, arts and humanities, health and welfare. Moreover, of the total number of women graduating in all faculties (55%), the percentage of women graduating in medicine is 65%-68%, in Europe as in the United States. As far as nephrology is concerned, unpublished data from the Italian Society of Nephrology indicate that female nephrologists make up almost 30% of the total number in the age group between 40 and 55, and this proportion is even higher in the age group younger than 40 years. In comparison with the past, there are some hints that things are going to change, but the path is still a difficult one, much effort is needed and there is a long way ahead. © 2011 Società Italiana di Nefrologia.


De Pasquale A.,San Vincenzo Hospital | Russa G.,Civico Gdi Cristina Benfratelli Hospital | Pulvirenti M.,Private Practice | Di Rosa L.,University of Palermo
Aesthetic Plastic Surgery | Year: 2013

This study aimed to describe the technique used by the authors in treating tear-trough deformity and to illustrate the effectiveness of high-frequency diagnostic ultrasound in the assessment of dermal filler longevity. In this consecutive interventional nonrandomized case series, 22 patients (18 women and 4 men) were evaluated. They ranged in age from 29 to 65 years (mean, 46.59 years ± 10.0 years). The patients were given multiple hyaluronic acid injections in the tear-trough area between 2009 and 2011. The injected areas then were evaluated with sonographic scans during the follow-up period. All the patients were examined preoperatively, 7 days after injection, then after 1, 6, and 12 months, and finally once a year. Pre- and postoperative photographs using standard positioning and lighting were taken as well as high-frequency ultrasound scans using a 15-MHz scanner with an axial resolution of 15 mm. The injection technique consisted of three to five injections perpendicular to the skin. These were administered just under the orbital rim, creating three column-shaped hyaluronic acid deposits deep in the orbicularis oculi muscle, from 0.2 mm to 0.5 mm below the orbital rim. Approximately 0.1 ml-0.3 ml was injected at a time. This technique creates a deep scaffolding that can fill the orbital hollow. The amount of filler used in each area ranged from 0.1 ml to 0.3 ml (mean, 0.267 ml ± 0.128 ml), whereas the mean filler quantity in each eyelid was 0.45 ml ± 0.14 ml. During the follow-up visit 1 week after the treatment, 21 patients (90 %) required a second series of injections either in the exact same areas or right next to the injected area to obtain a smoother appearance of the skin surface. During the sonographer examination, it was always possible to identify and measure the filler at the site of the injection. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. © 2013 Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery.

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