61 research outputs found
Long-Term Risk of Arterial Thrombosis after Intracerebral Hemorrhage: MUCH-Italy
BACKGROUND: The identification of patients surviving an acute intracerebral hemorrhage who are at a long-term risk of arterial thrombosis is a poorly defined, crucial issue for clinicians. METHODS: In the setting of the MUCH-Italy (Multicenter Study on Cerebral Haemorrhage in Italy) prospective observational cohort, we enrolled and followed up consecutive 30-day intracerebral hemorrhage survivors to assess the long-term incidence of arterial thrombotic events, to assess the impact of clinical and radiological variables on the risk of these events, and to develop a tool for estimating such a risk at the individual level. Primary end point was a composite of ischemic stroke, myocardial infarction, or other arterial thrombotic events. A point-scoring system was generated by the β-coefficients of the variables independently associated with the long-term risk of arterial thrombosis, and the predictive MUCH score was calculated as the sum of the weighted scores. RESULTS: Overall, 1729 patients (median follow-up time, 43 months [25th to 75th percentile, 69.0]) qualified for inclusion. Arterial thrombotic events occurred in 169 (9.7%) patients. Male sex, diabetes, hypercholesterolemia, atrial fibrillation, and personal history of coronary artery disease were associated with increased long-term risk of arterial thrombosis, whereas the use of statins and antithrombotic medications after the acute intracerebral hemorrhage was associated with a reduced risk. The area under the receiver operating characteristic curve of the MUCH score predictive validity was 0.716 (95% CI, 0.56-0.81) for the 0- to 1-year score, 0.672 (95% CI, 0.58-0.73) for the 0- to 5-year score, and 0.744 (95% CI, 0.65-0.81) for the 0- to 10-year score. C statistic for the prediction of events that occur from 0 to 10 years was 0.69 (95% CI, 0.64-0.74). CONCLUSIONS: Intracerebral hemorrhage survivors are at high long-term risk of arterial thrombosis. The MUCH score may serve as a simple tool for risk estimation
Prevalence of Fabry disease and GLA variants in young patients with acute stroke: the challenge to widen the screening. The Fabry-Stroke Italian Registry
Background: Fabry disease (FD) is a treatable X-linked lysosomal storage disorder caused by GLA gene variants leading to alpha-galactosidase A deficiency. FD is a rare cause of stroke, and it is still controversial whether in stroke patients FD should be searched from the beginning or at the end of the diagnostic workup (in cryptogenic strokes). Methods: Fabry-Stroke Italian Registry is a prospective, multicentric screening involving 33 stroke units. FD was sought by measuring α-galactosidase A activity (males) and by genetic tests (males with reduced enzyme activity and females) in patients aged 18–60 years hospitalized for TIA, ischemic stroke, or intracerebral hemorrhage. We diagnosed FD in patients with 1) already known pathogenic GLA variants; 2) novel GLA variants if additional clinical, laboratory, or family-derived criteria were present. Results: Out of 1906 patients, we found a GLA variant in 15 (0.79%; 95%CI 0.44–1.29) with a certain FD diagnosis in 3 (0.16%; 95%CI 0.03–0.46) patients, none of whom had hemorrhage. We identified 1 novel pathogenic GLA variant. Ischemic stroke etiologies in carriers of GLA variants were: cardioaortic embolism (33%), small artery occlusion (27%), other causes (20%), and undetermined (20%). Mild severity, recurrence, previous TIA, acroparesthesias, hearing loss, and small artery occlusion were predictors of GLA variant. Conclusion: In this large multicenter cohort the frequency of FD and GLA variants was consistent with previous reports. Limiting the screening for GLA variants to patients with cryptogenic stroke may miss up to 80% of diagnoses. Some easily recognizable clinical features could help select patients for FD screening
A severe outbreak of bacterial lettuce soft rot caused by pectobacterium carotovorum subsp. carotovorum in Apulia (Italy)
A severe bacterial disease was observed in lettuce plants during surveys carried out in the province of Bari (Apulia, Italy). Symptoms were chlorosis and wilting of older leaves, water-soaked and dark green soft rot of the pith. Several bacterial isolates were obtained from the affected plants by isolations on semi-selective crystal violet pectate agar medium. Biochemical, nutritional, and athogenicity tests identified them as Pectobacterium carotovorum subsp. carotovorum. The nutritional profile obtained using the Biolog system and the 434 bp product amplifìed by PCR using primers designed on P. carotovorum pectate lyase-encoding gene sequence further confirmed the identity of the isolates. Some epidemiological aspects of the pathogen and the main measures to prevent and control the disease are reported
Helminthosporium gramineum e Ustilago nuda due parassiti dell'Orzo (Hordeum vulgare) oggi facilmente controllabili.
Prove di lotta contro "Oidio" e "Ruggine Bruna" del frumento duro eseguito in Puglia nel 1976 e nel 1977
Control of bacterial yellowing of cardoncello mushroom Pleurotus eryngii using acetic or hydrochloric acid solutions
Yellowing or bacteriosis is the most severe disease of Pleurotus eryngii, the mushroom commonly called “cardoncello” or “Ferula mushroom” in Italy. Two cropping cycles were performed with five commercial strains, to find out how acetic acid or hydrochloric acid solutions can be used to prevent or stop the disease. Pseudomonas “reactans” and other fluorescent Pseudomonads were consistently isolated from symptomatic basidiomata. The Colony-Forming-Units of total bacteria, fluorescent Pseudomonads and fungi, found in casing soil at the end of both experiments, were significantly lower in substrate bags treated with either of the two acidic solutions. This research showed that treatments with acetic acid and - to a lesser extent hydrochloric acid solutions - can reduce the spread and severity of P. eryngii yellowing
POS0253 RITUXIMAB-BIOSIMILAR FOR ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODIES-ASSOCIATED VASCULITIS: EXPERIENCE OF A SINGLE ITALIAN CENTER
Background:Rituximab (RTX), an anti-CD20 monoclonal antibody, represents a valuable treatment for anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV). RTX biosimilar CT-P10 (RTX-B) has been approved in Europe in all indications held by RTX originator (RTX-O). As stated by recent international consensus-based recommendations, 1 there is evidence regarding safety and efficacy of biosimilars in the context of rheumatic diseases, but it is encouraged to gather additional data. 2,3Objectives:To report the experience of a single Italian center with RTX-B in AAV in terms of safety and efficacy.Methods:We retrospectively reviewed the charts of all AAV patients followed up in our Small Vessel Vasculitis Clinic and we selected those who received RTX-B between October 2017 and May 2020, both naïve to RTX (RTX-Bn) or already treated with ≥1 course of RTX-O and switched to RTX-B (RTX-Bs). Baseline features, disease outcome, concomitant therapy and adverse events 6 (T6), 12 (T12) and 24 (T24) months after RTX-B introduction, when available, were collected. Non-parametric statistic tests were used.Results:Fifty-six AAV patients (44 [78.6%] granulomatosis with polyangiitis (GPA), 12 [21.4%)] microscopic polyangiitis (MPA)) received RTX-B with a median follow up of 20 (IQR 10-24) months. ANCA were positive in 49 (87.5%) patients. Ten (17.9%) patients were newly diagnosed with AAV, while 23 (41.1%) had refractory disease and another 23 had relapsing disease.Thirty-three (58.9%) patients were RTX-Bs, whereas 23 (41.1%) RTX-Bn. In 29 (51.8%) patients RTX was decided because of remission induction, while in 27 (48.2%) as maintenance regimen. Median cumulative RTX-B dose was 2.5 (2-3.875) grams with 3 (IQR 2-4) median courses. AAV activity, adverse events and concomitant therapy at T6, T12 and T24 are shown in Table 1. One GPA patient died of severe infection 3 months after a single infusion of RTX-B 500 mg as maintenance therapy.Table 1.AAV activity, concomitant therapy and adverse events at T0, T6, T12 and T24.T0T6T12T24n (%)56 (100)52 (92.6)40 (71.4)18 (32.1)Dose RTX-B, median (IQR) grams1.75 (0.5-2)0.5 (0.5-1)0.5 (0.5-1)0.5 (0.5-1)Concomitant prednisone therapy, n (%)42 (75)27 (48.2)13 (32.5)4 (22.2)Dose prednisone, median (IQR) milligrams/day5 (5-15.625)2.5 (2.5-5)3.75 (2.75-7.5)2.75 (1.56-4.5)Concomitant bDMARDs, n (%)10 (17.9)5 (9.6)3 (7.5)1 (5.6)RefractorinessNA4 (7.7)2 (5)1 (5.6)RelapseNA0 (0)3 (7.5)2 (11.1)RemissionNA48 (92.3)35 (87.5)15 (83.3)SuspensionNA10 (19.2)9 (22.5)4 (22.2)Infusion reaction, n (%)1 (1.8)1 (1.9)0 (0)0 (0)Infectious adverse events, n (%)NA10 (19.2)6 (15)3 (16.7)Severe infectious adverse events, n (%)NA2 (3.8)1 (2.5)0 (0)Considering the 52 (92.6%) patients who reached a 6 months-follow up, we marked a significant decrease of number of patients on steroid therapy (39 [75%] vs 27 [51.9%]; p=0.003), of median prednisone daily dose (5 [IQR 5-25] vs 2.5 [IQR 1.25-5 mg; p=0.001) and of number of patient on concomitant bDMARDs (10 [19.2%] vs 5 [9.6%]; p=0.003).Analysing the 40 (71.4%) patients who reached a 12 months-follow up, we confirmed the tendency with a decrease of number of patients on steroid therapy (29 [72.5%] vs 13 [32.5%]; p=0.007), of median prednisone daily dose (5 [IQR 5-12.5] vs 3.75 [IQR 2.75-7.5]; p=0.008) and of number of patient on concomitant bDMARDs (9 [22.5%] vs 3 [7.5%]; p=0.009).No statistically significant difference was found for the same variables comparing T0 versus T24.Conclusion:Our experience with RTX-B is limited; however, it represents an extensive report about the use of RTX-B in AAV patients and confirmed that it may be a well-tolerated and effective therapy in AAV setting, in agreement with previous evidence on RTX-O. Prospective and larger studies are needed to confirm this preliminary evidence.References:[1]Kay J, et al. Ann Rheum Dis 2018;77:165–74.[2]Kwon HC, et al. Yonsei Med J 2020;61:712-9.[3]Mittal S, et al. Clin Rheumatol 2021;40:645-51.Disclosure of Interests:Silvia Sartorelli: None declared, adriana cariddi: None declared, Luca Moroni: None declared, Elena Baldissera Speakers bureau: Pfizer, Roche, Sanofi-Genzyme, Consultant of: Novartis, Enrica Bozzolo: None declared, Lorenzo Dagna Consultant of: Abbvie, Amgen, Biogen, BristolMyers Squibb, Celltrion, Galapagos, GlaxoSmithKline, Novartis, Pfizer, Roche, Sanofi-Genzyme, and SOBI., Grant/research support from: The Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR) received unrestricted research/educational grants from Abbvie, Bristol-Myers Squibb, Celgene, GlaxoSmithKline, Janssen, Merk Sharp & Dohme, Mundipharma Pharmaceuticals, Novartis, Pfizer, Roche, Sanofi-Genzyme, and SOBI.</jats:sec
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