La nostra esperienza nel trattamento della pubertà precoce

Gli Autori riferiscono i risultati ottenuti in 54 bambine affette da pubertà precoce idiopatica ed in 10 bambine con pubertà anticipata utilizzando gli analoghi del GnRh. I loro risultati sono simili a quanto riportato in letteratura e dimostrano che la terapia è più efficace sulla pubertà precoce rispetto a quella anticipata ed è in genere ben tollerata. Gli Autori insistono sulla necessità di selezionare accuratamente le piccole pazienti prima di cominciare qualsiasi trattamento e ritengono che l'efficacia della terapia possa essere valutata sfruttando parametri clinici

Abitudini di vita e precursori dell'arteriosclerosi in un campione di soggetti in eta' evolutiva

AbstractConsiglio Nazionale delle Ricerche (CNR). Biblioteca Centrale / CNR - Consiglio Nazionale delle RichercheSIGLEITItal

Role of the adducin family genes in human essential hypertension

OBJECTIVE: In both humans and rats, polymorphisms of the alpha adducin (ADD1) gene are involved in renal sodium handling, essential hypertension and some of its organ complications. Adducin functions within cells as a heterodimer composed of various combinations of three subunits that are coded by three genes (ADD1, 2, 3) each located on a different chromosome. DESIGN: These characteristics provide the biochemical basis for investigating epistatic interactions among these loci. METHODS: We examined the three adducin gene polymorphisms and their association with ambulatory blood pressure (ABPM) and with plasma levels of renin activity (PRA), endogenous ouabain (EO), in 512 newly discovered and never-treated hypertensive patients. RESULTS: Relative to carriers of the wild type (Gly/Gly) ADD1 gene, patients carrying the mutated Trp ADD1 allele had higher blood pressure (systolic blood pressure (SBP) 143.2 +/- 1.0 versus 140.6 +/- 0.6 mmHg P = 0.027 and diastolic blood pressure (DBP) 94.2 +/- 0.77 versus 92.3 +/- 0.5 mmHg, P = 0.03), lower PRA and EO, consistent with the hypothesis of the renal sodium retaining effect of the Trp allele. Polymorphisms in the ADD2 and ADD3 genes taken alone were not associated with these variables. However, the differences in SBP and DBP between the two ADD1 genotypes were greatest in carriers of the ADD3 G allele (around + 8 mmHg). The significance of the interaction between ADD1 and ADD3 ranged between P = 0.020 to P = 0.006 according to the genetic model applied. CONCLUSIONS: The interaction of ADD1 and ADD3 gene variants in humans is statistically associated with variation in blood pressure, suggesting the presence of epistatic effects among these loci

Synod and Synodality. Theology, History, Canon Law and Ecumenism in new contact. International Colloquium Bruges 2003

In Bruges, theologians, historians, canonists and members of several Christian denominations discussed the problems of synodality within various traditions and tried to assess the significance of the synodal experience in various denominations. The interdisciplinary and interconfessional approach helped draw a rich and diversified picture, which makes it possible to look concurrently at the churches' past and present. By paying attention to the central and peripheral aspects, the dimension of theological reflection invariably intersected the dimension of normative production and the historical reconstruction of a few meaningful test cases

Bortezomib, thalidomide, and dexamethasone followed by double autologous haematopoietic stem-cell transplantation for newly diagnosed multiple myeloma (GIMEMA-MMY-3006): long-term follow-up analysis of a randomised phase 3, open-label study

Background: The phase 3 GIMEMA-MMY-3006 trial, which compared bortezomib, thalidomide, and dexamethasone (VTD) combination therapy with thalidomide and dexamethasone (TD) as induction therapy before and consolidation therapy after double autologous haematopoietic stem-cell transplantation (HSCT) for newly diagnosed multiple myeloma, showed the superiority of the triplet regimen over the doublet in terms of increased complete response rate and improved progression-free survival. We report the results from the final analysis of the study. Methods: In this randomised, open-label, phase 3 study, patients aged 18\u201365 years with previously untreated symptomatic multiple myeloma and a Karnofsky Performance Status of 60% or higher were enrolled at 73 centres in Italy. Patients were randomised (1:1) by a web-based system to receive three 21-day cycles of thalidomide (100 mg daily orally for the first 14 days and 200 mg daily thereafter) plus dexamethasone (total 320 mg per cycle; 40 mg on days 1\u20132, 4\u20135, 8\u20139, and 11\u201312 in the VTD regimen, and 40 mg on days 1\u20134 and 9\u201312 in the TD regimen), either alone (TD group) or with bortezomib (1\ub73 mg/m2 intravenously on days 1, 4, 8, and 11; VTD group). After double autologous HSCT, patients received two 35-day cycles of either the VTD or TD regimen, according to random assignment, as consolidation therapy. The primary outcome was the rate of complete response and near complete response after induction (already reported). In this updated analysis we assessed long-term progression-free survival and overall survival (secondary endpoints of the study) with an extended 10-year median follow-up, and analysed the variables influencing survival. Analysis was by intention to treat. The study is registered with ClinicalTrials.gov, NCT01134484. Findings: Between May 10, 2006, and April 30, 2008, 480 patients were enrolled and randomly assigned to receive VTD (241 patients) or TD (239 patients). Six patients withdrew consent before start of treatment. 236 (99 [42%] women) in the VTD group and 238 (102 [43%] women) in the TD group were included in the intention-to-treat analysis. The data cutoff date for this analysis was May 31, 2018. Median follow-up for surviving patients was 124\ub71 months (IQR 117\ub72\u2013131\ub77). The 10-year progression-free survival estimate for patients in the VTD group was 34% (95% CI 28\u201341) compared with 17% (13\u201323) for the TD group (hazard ratio [HR] 0\ub762 [95% CI 0\ub750\u20130\ub777]; p<0\ub70001). 60% (95% CI 54\u201367) of patients in the VTD group were alive at 10 years versus 46% (40\u201354) of patients in the TD group (HR 0\ub768 [95% CI 0\ub751\u20130\ub790]; p=0\ub70068). VTD was an independent predictor of improved progression-free survival (HR 0\ub760 [95% CI 0\ub748\u20130\ub776]; p<0\ub70001) and overall survival (HR 0\ub768 [0\ub750\u20130\ub791]; p=0\ub7010). The incidence of second primary malignancies per 100 person-years was 0\ub787 (95% CI 0\ub749\u20131\ub744) in the VTD group compared with 1\ub741 (0\ub788\u20132\ub713) in the TD group. Interpretation: Incorporation of VTD into double autologous HSCT resulted in clinically meaningful improvements in long-term progression-free survival and overall survival, confirming that a regimen including bortezomib and an immunomodulatory drug is the gold standard treatment for patients with newly diagnosed myeloma who are fit for high-dose chemotherapy. Funding: Ser\ue0gnoli Institute of Haematology, University of Bologna, and BolognAIL