383 research outputs found

    Monitoring Neoadjuvant Chemotherapy Through Time Domain Diffuse Optical Spectroscopy in Breast Cancer Patients: Preliminary Clinical Results

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    The purpose of this clinical study is to monitor NeoAdjuvant Chemotherapy through time domain Diffuse Optical Spectroscopy, correlate the optical results with conventional imaging techniques and pathological response and eventually predict the efficacy of NAC in breast cancer patients. Our seven wavelength (635 -1060 nm) optical mammograph is used to perform non-invasive measurements on patients undergoing NAC in this study. The broad spectral range helps us to fully analyze tissue composition, that includes hemoglobin, water lipids and collagen concentration, to track the tumor response during the course of the therapy. In this paper, we present the preliminary results of five patients

    Preliminary Evidence of the Efficacy of Time-Resolved Broad-Spectrum Optical Mammography in Monitoring Neoadjuvant Chemotherapy

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    We present initial results of a clinical trial involving breast cancer patients under neoadjuvant chemotherapy, monitored through our time-resolved optical mammograph. Besides hemoglobin, water and lipids, we assess collagen concentration systematically for the first time

    INCIDENCE OF PSYCHOTIC DISORDERS IN PALERMO: PRELIMINARY DATA

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    Background: The incidence of psychotic disorders varies in different geographical areas (McGrath 2004). Recent data suggest that the incidence is higher in males, migrant minorities and in urban areas. There aren\u2019t many available epidemiological data on the incidence of psychotic disorders in Italy. This is the first incidence study on psychotic disorders carried out in Palermo, the capital of Sicily. Methods: we screened all patients presenting with their first episode of psychosis to the mental health services of our catchment area (5 inpatient, 5 outpatient units and 3 private psychiatric hospitals) over a period of three years (2008-2011). The diagnosis of psychosis was defined using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN Wing, J. K., et al., 1990).The main socio-demographic data were collected using the MRC Social Data Schedule. When subjects were not available (did not consent) for interview, information was collected from clinical notes. The population at risk referred to the people aged from 18-65 who were resident in the same catchment area (Palermo Municipality) in the period considered, according to the data of the Statistic Office of Palermo Municipality). Results: we identified 216 patients affected by a first episode of psychosis (FEP): 135 M (62.5%) and 81 F (37.5%), mean age 31.42 years (SD: 11.44). 77.1% of FEP had a diagnosis of non affective psychosis, 12.8% of affective psychosis and 10.1% received a diagnosis of other psychosis. 204 subjects were Caucasian, 12 non Caucasian belonging to various ethnicities and they were all first generation migrants (4 Indian, 3 African, 2 Bangladeshi, and 3 Mixed). Population at risk is 425.194 people. The mean age of onset was lower in men than women M: 29.98 years (SD: 10.41) vs. F: 34.28 (SD:12.64) (p=0.013)The incidence of psychotic disorders in our catchment area is 16,9 per 100.000 person years. It was higher in men 21,9 per 100.000 than women 12,2 per 100.000. Discussion: Our study is the first epidemiological study in Sicily investigating the incidence of psychotic disorders. In our population men have a higher incidence of psychotic disorders than women and an earlier age of onset

    Enniatin and Beauvericin Biosynthesis in Fusarium Species: Production Profiles and Structural Determinant Prediction

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    Citation: Liuzzi, V. C., Mirabelli, V., Cimmarusti, M. T., Haidukowski, M., Leslie, J. F., Logrieco, A. F., . . . Mule, G. (2017). Enniatin and Beauvericin Biosynthesis in Fusarium Species: Production Profiles and Structural Determinant Prediction. Toxins, 9(2), 17. doi:10.3390/toxins9020045Members of the fungal genus Fusarium can produce numerous secondary metabolites, including the nonribosomal mycotoxins beauvericin (BEA) and enniatins (ENNs). Both mycotoxins are synthesized by the multifunctional enzyme enniatin synthetase (ESYN1) that contains both peptide synthetase and S-adenosyl-L-methionine-dependent N-methyltransferase activities. Several Fusarium species can produce ENNs, BEA or both, but the mechanism(s) enabling these differential metabolic profiles is unknown. In this study, we analyzed the primary structure of ESYN1 by sequencing esyn1 transcripts from different Fusarium species. We measured ENNs and BEA production by ultra-performance liquid chromatography coupled with photodiode array and Acquity QDa mass detector (UPLC-PDA-QDa) analyses. We predicted protein structures, compared the predictions by multivariate analysis methods and found a striking correlation between BEA/ENN-producing profiles and ESYN1 three-dimensional structures. Structural differences in the beta strand's Asn789-Ala793 and His797-Asp802 portions of the amino acid adenylation domain can be used to distinguish BEA/ENN-producing Fusarium isolates from those that produce only ENN

    A Quantitative Estimate of the Expected Shortening of the Median Isolation Period of Patients With COVID-19 After the Adoption of a Symptom-Based Strategy

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    A long period of isolation was observed in patients hospitalized for COVID-19 in Milan over March-September 2020 (45; IQR: 37–54 days). A significantly shorter period would have been observed by the application of May-WHO (22, IQR: 17–30 days, P < 0.001) and October-Italian (26, IQR: 21–34 days, P < 0.001) Guidelines. The adoption of the new symptom-based criteria is likely to lead to a significant reduction in the length of the isolation period with potential social, economic and psychological benefits, particularly in the younger population with mild/moderate disease and no comorbidities. In our opinion, the release from isolation after 21 days from symptoms onset, even without a PCR diagnostic test, in most cases seems the most adequate strategy that could balance precautions to prevent SARS CoV-2 transmission and unnecessary prolonged isolation or overuse of diagnostic testing

    Identification of a minimum number of genes to predict triple-negative breast cancer subgroups from gene expression profiles

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    Background: Triple-negative breast cancer (TNBC) is a very heterogeneous disease. Several gene expression and mutation profiling approaches were used to classify it, and all converged to the identification of distinct molecular subtypes, with some overlapping across different approaches. However, a standardised tool to routinely classify TNBC in the clinics and guide personalised treatment is lacking. We aimed at defining a specific gene signature for each of the six TNBC subtypes proposed by Lehman et al. in 2011 (basal-like 1 (BL1); basal-like 2 (BL2); mesenchymal (M); immunomodulatory (IM); mesenchymal stem-like (MSL); and luminal androgen receptor (LAR)), to be able to accurately predict them. Methods: Lehman’s TNBCtype subtyping tool was applied to RNA-sequencing data from 482 TNBC (GSE164458), and a minimal subtype-specific gene signature was defined by combining two class comparison techniques with seven attribute selection methods. Several machine learning algorithms for subtype prediction were used, and the best classifier was applied on microarray data from 72 Italian TNBC and on the TNBC subset of the BRCA-TCGA data set. Results: We identified two signatures with the 120 and 81 top up- and downregulated genes that define the six TNBC subtypes, with prediction accuracy ranging from 88.6 to 89.4%, and even improving after removal of the least important genes. Network analysis was used to identify highly interconnected genes within each subgroup. Two druggable matrix metalloproteinases were found in the BL1 and BL2 subsets, and several druggable targets were complementary to androgen receptor or aromatase in the LAR subset. Several secondary drug–target interactions were found among the upregulated genes in the M, IM and MSL subsets. Conclusions: Our study took full advantage of available TNBC data sets to stratify samples and genes into distinct subtypes, according to gene expression profiles. The development of a data mining approach to acquire a large amount of information from several data sets has allowed us to identify a well-determined minimal number of genes that may help in the recognition of TNBC subtypes. These genes, most of which have been previously found to be associated with breast cancer, have the potential to become novel diagnostic markers and/or therapeutic targets for specific TNBC subsets

    Brentuximab vedotin consolidation after autologous stem cell transplantation for Hodgkin lymphoma: A Fondazione Italiana Linfomi real-life experience

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    The standard management for relapsed or refractory classical Hodgkin lymphoma (cHL) is salvage therapy followed by autologous stem cell transplantation (ASCT). This strategy allows almost 50% of patients to be cured. Post-ASCT maintenance treatment with brentuximab vedotin (BV) confers improved progression-free survival (PFS) to cHL patients at high risk of relapse. We investigated the outcome of 105 cHL patients receiving post-ASCT BV maintenance in the real-life setting of 23 Italian hematology centers. This population included naïve patients and those previously exposed to BV. Median follow-up was 20 months. Patients presented a median of two lines of treatment pre-ASCT, with 51% receiving BV. Twenty-nine percent of patients had at least two high-risk factors (refractory disease, complete response [CR] less than 12 months, extranodal disease at relapse), while 16% presented none. At PET-CT, a Deauville score (DS) of 1–3 was reported in 75% and 78% of pre- and post-ASCT evaluations, respectively. Grade 3–4 adverse events (AEs), mainly peripheral neuropathy, were observed in 16% of patients. Three-year PFS and overall survival (OS) were 62% and 86%, respectively. According to BV exposure, 3-year PFS and OS were 54% and 71%, respectively, for naïve and 77% and 96%, respectively, for previously exposed patients. Refractory disease (hazard ratio [HR] 4.46; p&nbsp;=&nbsp;0.003) and post-ASCT DS 4–5 (HR 3.14; p&nbsp;=&nbsp;0.005) were the only two factors significantly associated with PFS reduction in multivariable analysis. Post-ASCT BV maintenance is an effective, safe treatment option for cHL naïve patients and those previously exposed to BV

    Effectiveness of Golimumab as Second Anti-TNFα Drug in Patients with Rheumatoid Arthritis, Psoriatic Arthritis and Axial Spondyloarthritis in Italy: GO-BEYOND, a Prospective Real-World Observational Study

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    In this prospective observational study, data were collected from 34 rheumatology clinics in Italy in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) who started golimumab (GLM) as a second anti-TNFα drug. The primary objective was to evaluate the effectiveness of GLM after 6 months. Changes in quality of life using the EQ-5D-5L were also assessed. A total of 194 patients aged 53.2 ± 12 years started GLM as a second anti-TNF drug: 39 (20.1%) with RA, 91 (46.9%) with PsA and 64 (32.9%) with axSpA. After 6 months of GLM treatment, 68% of RA patients achieved low disease activity (LDA; DAS28-CRP ≤ 3.2), 31.9% of PsA patients achieved minimal disease activity and 32.5% of axSpA patients achieved LDA (ASDAS-CRP &lt; 2.1). Good/moderate EULAR response was achieved in 61.9% and 73.8% of patients with RA and PsA, respectively, and 16% of axSpA patients achieved a 50% improvement in BASDAI. Across all indications, improvements in disease activity measures and EQ-5D-5L domains were observed over 6 months. The main reasons for GLM interruption were lack/loss of efficacy (7.2%) or adverse events (2%). This study confirms the effectiveness of GLM as a second-line anti-TNF for the treatment of RA, PsA and axSpA in a real-world setting in Italy
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