Santa Croce del Sannio, Italy
Santa Croce del Sannio, Italy

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Zinzani P.L.,University of Bologna | Corradini P.,University of Milan | Gallamini A.,Santa Croce and Carle Hospital | Grossi A.,Oncology Unit | And 5 more authors.
Leukemia and Lymphoma | Year: 2012

Alemtuzumab is a humanized monoclonal antibody that recognizes the CD52 antigen expressed on malignant and normal B lymphocytes. It has come to be used therapeutically in B-cell malignancies and, in addition, it shows interesting activity also in T-cell lymphomas. Published literature and abstract proceedings were scanned, and a systematic review of phase II studies administering alemtuzumab in patients with T-cell lymphomas was performed. Alemtuzumab is an effective alternative option for patients with peripheral T-cell lymphomas and cutaneous T-cell lymphomas. Alemtuzumab may belong to the current standard of care for nodal and cutaneous T-cell lymphomas. © 2012 Informa UK, Ltd.


Tassone F.,Santa Croce and Carle Hospital | Guarnieri A.,Santa Croce and Carle Hospital | Castellano E.,Santa Croce and Carle Hospital | Baffoni C.,Santa Croce and Carle Hospital | And 2 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2015

Objective: Decreased renal function has been consistently included among factors prompting recommendation for surgery in primary hyperparathyroidism (PHPT). However, most retrospective studies addressing this issue did not show an improvement in renal function after parathyroidectomy (PTX). The aim of this study was to investigate changes in renal function after PTX in PHPT patients subdivided according to renal function at diagnosis. Design: This was a retrospective cross-sectional study. Patients and Methods: We studied 109 consecutive PHPT patients before and after PTX. Biochemical evaluation included fasting total and ionized serum calcium, phosphate, creatinine, immunoreactive intact PTH, and 25-hydroxyvitamin D3 levels. Glomerular filtration rate (GFR) was assessed with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Results: Mean (± SD) CKD-EPI estimated GFR (eGFR) at diagnosis was 82.4 ± 19.3 mL/min/1.73 m2 (median, 84.8 mL/min/1.73 m2; interquartile range, 68.5-94.2 mL/min/1.73 m2). Patients with eGFR equal to or higher than 60 mL/min/1.73 m2 (group 1, n = 95) were significantly younger than patients with eGFR lower than 60 mL/min/1.73 m2 (group 2, n = 14; P < .0003). After PTX, eGFR did not change in patients of group 2 (P = .509), whereas it was significantly reduced in patients of group 1 (P < .0002). The difference in eGFR between baseline and post-PTX values was correlated negatively with baseline serum creatinine (R = -0.27; P = .0052) and positively with baseline CKD-EPI eGFR (R = 0.32; P = .00062). At multiple regression analysis, only systolic blood pressure and baseline CKD-EPI eGFR were independent predictors of GFR variation. Conclusion: Surgical cure of PHPT halts renal function deterioration in patients with coexisting renal disease. Our study thus supports the indication for surgery in patients with eGFR less than 60 mL/min/1.73 m2, as recommended by current guidelines. Moreover, our data show that presurgical renal function is a relevant predictor of renal function after PTX. Copyright © 2015 by the Endocrine Society.


PubMed | Galeazzi Institute, Papa Giovanni XXIII Hospital and Santa Croce and Carle Hospital
Type: | Journal: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists | Year: 2016

To characterize PHPT patients with renal stones and to compare silent with symptomatic stone formers.We reviewed clinical data of 234 patients with PHPT, comparing those with and without renal stones (n = 109 and 125, respectively), and among stone formers those symptomatic vs silent (n = 93 and 16, respectively).Stone formers were younger, had higher urinary calcium levels and higher eGFR vs patients without stones. Patients with silent stones had higher PTH and lower 25OH-vitamin D levels, and more frequently microlithiasis than patients with symptomatic renal stones.Nephrolithiasis is a common complication of PHPT. Most patients with silent renal stones have microlithiasis, associated to some features of more severe disease. Lower 25OHD levels in silent stone formers raise the hypothesis that vitamin D status can influence the clinical expression of nephrolithiasis in PHPT patients.


Campana F.,Santa Croce and Carle Hospital | Caramello G.,Santa Croce and Carle Hospital | Dallorto L.,University of Turin | Rolle T.,University of Turin
BMJ Case Reports | Year: 2015

The Posner-Schlossman syndrome (PSS) is an elusive disease that can lead to serious consequences such as glaucomatous damage. Deep sclerectomy has been proven thus far to be the most effective surgical intervention to keep intraocular pressure (IOP) elevation under control compared with other surgical techniques, because it presents the least amount of postoperative complications. The aim of this case report is to demonstrate the efficacy of deep sclerectomy with T-Flux and the long-lasting effects that persist after 7 years in an eye affected by PSS. This case report demonstrates that an intervention of deep sclerectomy can lead to excellent results in terms of visual acuity as well as IOP lowering early in the history of the patient affected by PSS so that it can preclude establishment of glaucomatous damage. Copyright 2015 BMJ Publishing Group. All rights reserved.


PubMed | Regina Apostolorum Hospital, Niguarda Hospital, Galeazzi Institute IRCCS, University of Santa María in Ecuador and Santa Croce and Carle Hospital
Type: Journal Article | Journal: Annals of global health | Year: 2016

Diabetes is a significant health problem in Italy as in other western countries.To review available epidemiological data and the legislative framework for diabetes care in Italy.Review of Italian Health Ministrys official documents and analysis of epidemiological data published by Italian Scientific Societies.Diabetes affects more than 5% of the Italian population. The expenditures for the care of people with diabetes are about 10 billion ($US 11 billion) a year and are increasing over time. Italian law regulates the clinical care of people with diabetes and creates a clinical framework involving medical organizations, prevention programs, personnel training, and legal protection. The National Health Program is structured in essential levels of assistance that can be defined differently in the various regions. In 2013, the National Diabetes Plan, defining priority areas for intervention, was approved and represents the main regulatory tool for the management of diabetes within the Italian National Health Service. In Italy, the status of diabetes care is being monitored using the data from 2 permanent observatories: the ARNO Observatory Diabetes and the Associazione Medici Diabetologi Annals.A comprehensive approach to diabetes is offered to all citizens, consonant with the constitutionally guaranteed right to health. However, this important effort translates into a relevant financial burden for the National Health Service.


Pinto C.,S Orsola Malpighi Hospital | Barone C.A.,Gemelli Hospital | Girolomoni G.,University of Verona | Ussi E.G.,Radiotherapy Unit | And 3 more authors.
Oncologist | Year: 2011

Background. Cetuximab was demonstrated by clinical trials to improve response rate and survival of patients with metastatic and nonresectable colorectal cancer or carcinoma of the head and neck. Appropriate management of skin toxicity associated with epidermal growth factor receptor inhibitor (EGFR-i) therapy is necessary to allow adequate drug administration and to improve quality of life and outcomes. Methods. A group of Italian Experts produced recommendations for skin toxicity management using the RAND/UCLA Appropriateness Method. Statements were generated on the basis of a systematic revision of the literature and voted twice by a panel of 40 expert physicians; the second vote was preceded by a meeting of the panelists. Results. Skin toxicity included skin rash, skin dryness, pruritus, paronychia, hair abnormality, and mucositis. Recommendations for prophylaxis and therapeutic interventions for each type of toxicity were proposed. Conclusions. Interventions that were considered appropriate to improve compliance and outcomes of cancer patients treated with EGFR-i were identified. © Alpha Med Press.


Dutto M.,Santa Croce and Carle Hospital | Bertero M.,Santa Croce and Carle Hospital
Journal of Preventive Medicine and Hygiene | Year: 2010

We present a case of cutaneous myiasis occurring in a hospital environment (nosocomial myiasis) in an patient with serious multiple traumas sustained in a motorcycle accident. The agent responsible for the myiasis was identified as Sarcophaga cruentata (Meigen 1826). The larvae found in the necrotic wound were removed and the necessary environmental measures were taken to avoid further infestation. Although nonocomial myiasis is a form of parasitosis already cited in the in literature, it is a rare event and worthy of attention to aid in identifying parasitosis in hospitalized subjects in order to expedite proper diagnosis and treatment.


Castellano E.,Santa Croce and Carle Hospital | Attanasio R.,Galeazzi Institute | Gianotti L.,Santa Croce and Carle Hospital | Cesario F.,Santa Croce and Carle Hospital | And 2 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2016

Introduction: A reduction in bone mineral density (BMD) is common in primary hyperparathyroidism (PHPT), above all at cortical sites. Guidelines for the management of asymptomatic PHPT (aPHPT) recommend a BMD evaluation at the lumbar spine, hip, and forearm. Surgery is recommended for patients with a T-score less than or equal to-2.5 at any of these sites. However, a BMD evaluation at the forearm is not routinely performed. Aim: To evaluate the impact of measuring forearm BMD in the clinical management of aPHPT. Subjects and Methods: We retrospectively reviewed a prospective database of 172 patients with aPHPT, selecting the 116 patients in whom a dual X-ray absorptiometry (DXA) scan had been performed at all 3 sites. Results: Seventy-four out of 116 patients had a densitometric diagnosis of osteoporosis (OP) at any site, and the forearm was the only site involved in 13/74 (group A, 17.6% of osteoporotic patients and 11.2% of the whole aPHPT cohort). Patients belonging to group A were significantly older than the other aPHPT patients, whereas no difference was found in biochemical measurements. Six out of 13 patients belonging to group A (5.2% of the whole aPHPT cohort) fulfilled surgical criteria based only on a forearm T-score. Conclusions: DXA at 3 sites revealed OP at the forearm, but not at the other sites, in 11.2% of aPHPT patients. Half of these cases met surgical criteria based on this one factor alone. These patients did not show any clinical (except age) or biochemical differences from the other patients. The implementation of forearm DXA increases the rate of patients with aPHPT meeting surgical criteria. © 2016 by the Endocrine Society.


PubMed | Galeazzi Institute and Santa Croce and Carle Hospital
Type: Journal Article | Journal: Journal of endocrinological investigation | Year: 2016

Mild primary hyperparathyroidism (PHPT) was recently clearly defined for the first time. Our study was thus aimed to pinpoint proportion and clinical characteristics of this kind of patients.We retrospectively evaluated our series of 360 consecutive patients with PHPT, selecting those with all features allowing a correct classification (serum total and ionized calcium, phosphate, creatinine, PTH, 25OHD, urinary calcium, renal and neck ultrasound, MIBI scintiscan, and DEXA at lumbar spine, femoral neck, and distal third of radius). Patients were defined asymptomatic (aPHPT) when bone or kidney was not involved and no hypercalcemic symptom occurred; mild PHPT was defined as aPHPT not meeting updated surgical criteria.Seventy-five patients among 172 classified as aPHPT had all available data required for surgical evaluation and could be evaluated. Sixty/75 met surgical criteria and the remaining 15 were classified as mild. Mild PHPT patients had lower total and ionized calcium, urinary calcium, and PTH levels than aPHPT meeting surgical criteria, while vitamin D levels and BMD were similar.Mild PHPT strictly defined according to the last consensus represents a small subgroup with a less active form of the disease.


PubMed | Santa Croce and Carle Hospital
Type: Journal Article | Journal: The Journal of clinical endocrinology and metabolism | Year: 2015

Decreased renal function has been consistently included among factors prompting recommendation for surgery in primary hyperparathyroidism (PHPT). However, most retrospective studies addressing this issue did not show an improvement in renal function after parathyroidectomy (PTX). The aim of this study was to investigate changes in renal function after PTX in PHPT patients subdivided according to renal function at diagnosis.This was a retrospective cross-sectional study.We studied 109 consecutive PHPT patients before and after PTX. Biochemical evaluation included fasting total and ionized serum calcium, phosphate, creatinine, immunoreactive intact PTH, and 25-hydroxyvitamin D3 levels. Glomerular filtration rate (GFR) was assessed with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.Mean ( SD) CKD-EPI estimated GFR (eGFR) at diagnosis was 82.4 19.3 mL/min/1.73 m(2) (median, 84.8 mL/min/1.73 m(2); interquartile range, 68.5-94.2 mL/min/1.73 m(2)). Patients with eGFR equal to or higher than 60 mL/min/1.73 m(2) (group 1, n = 95) were significantly younger than patients with eGFR lower than 60 mL/min/1.73 m(2) (group 2, n = 14; P < .0003). After PTX, eGFR did not change in patients of group 2 (P = .509), whereas it was significantly reduced in patients of group 1 (P < .0002). The difference in eGFR between baseline and post-PTX values was correlated negatively with baseline serum creatinine (R = -0.27; P = .0052) and positively with baseline CKD-EPI eGFR (R = 0.32; P = .00062). At multiple regression analysis, only systolic blood pressure and baseline CKD-EPI eGFR were independent predictors of GFR variation.Surgical cure of PHPT halts renal function deterioration in patients with coexisting renal disease. Our study thus supports the indication for surgery in patients with eGFR less than 60 mL/min/1.73 m(2), as recommended by current guidelines. Moreover, our data show that presurgical renal function is a relevant predictor of renal function after PTX.

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