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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.

Dutto M.,Medical Entomology Consultant | 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.

Disoteo O.,Niguarda Hospital | Grimaldi F.,University of Santa Maria in Ecuador | Papini E.,Regina Apostolorum Hospital | Attanasio R.,Galeazzi Institute IRCCS | And 4 more authors.
Annals of Global Health | Year: 2015

Background Diabetes is a significant health problem in Italy as in other western countries. Objective To review available epidemiological data and the legislative framework for diabetes care in Italy. Methods Review of Italian Health Ministry's official documents and analysis of epidemiological data published by Italian Scientific Societies. Findings 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. Conclusions 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. © 2015 Icahn School of Medicine at Mount Sinai.

Levis A.,SS Antonio and Biagio Hospital | Stacchini A.,Flow Cytometry Unit | Ciriello M.M.,Laboratory of Clinical Pathology | Geuna M.,Flow Cytometry Unit | And 14 more authors.
European Journal of Haematology | Year: 2011

Objectives:Morphology and cytogenetics are currently used to define prognosis in myelodysplastic syndromes (MDS). However, these parameters have some limits. Flow cytometry has been recently included in the diagnostic panel for MDS, and its prognostic significance is under evaluation. Methods: Marrow aspirates from 424 MDS patients were analyzed by flow cytometry to evaluate the impact of bone marrow cell immunophenotype on overall survival (OS) and leukemia-free survival (LFS). The immature compartment of myeloblasts was analyzed by the quantitative expression of CD34 (<3% vs. ≥3%), CD117, and CD11b -/CD66b - (<5% vs. ≥5%); myeloid maturation was analyzed by the expression of CD11b +/CD66b ++ (<15% vs. ≥15%) and CD11b +/CD66b + (<25% vs. ≥25%). Results:  In univariate analysis, the expression of immaturity markers (CD34 +, CD117 +, and CD11b -/CD66b -) was associated with shorter LFS and OS (P<0.0001); higher expression of differentiation markers (CD11b +/CD66b ++ and CD11b +/CD66b +) was associated with longer LFS (P<0.0001 and P=0.0002, respectively) and OS (P<0.0001). In multivariate analysis, expression of CD34 + (P=0.007), CD117 + (P=0.013), and CD11b +/CD66b ++ (P=0.023) retained independent prognostic value for OS, while only the expression of CD34 + was a prognostic factor for LFS (P=0.0003). Two different risk groups were defined according to the presence of 0-1 or ≥2 of these factors with significant different LFS and OS (P<0.0001). This score showed prognostic value in predicting survival even in subanalysis according to IPSS and WHO subgroups. Conclusions: Flow cytometric analysis in MDS may provide meaningful prognostic information. Blast percentage expressed as CD117 + or CD34 + cells and the quantitative assessment of myeloid maturation showed prognostic value for survival. © 2011 John Wiley & Sons A/S.

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.

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