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GST Primary GST Primary Best Strategies for Health Care Quality Im... Best Strategies for Health Care Quality Improvement - Diabetes Quality Improvement Strategies for Antibio... Kathryn McDonald, Stanford-UCSF Evidence-b... Systematic review assessing the effect of ... Quality Improvement Strategies for Antibiotics Management Kathryn McDonald, Stanford-UCSF Evidence-based Practice Center, 117 Encina Commons, Stanford, CA 94305-6019, Kathy.mcdonald@stanford.edu Systematic review assessing the effect of quality improvement strategies on appropriate prescribing of antibiotics and appropriate choice of antibiotics. Adherence Adherence Assistive Devices Assistive Devices Childhood Burn Hanson MacMillan Childhood Burn Hanson MacMillan CLSA_9 CLSA_9 Cyberabuse Cyberabuse Cognitive Behavioural Therapy for Violent ... This review included randomized trials abo... Cognitive Behavioural Therapy for Violent Men who Batter Their Partners This review included randomized trials about the effects of cognitive behavioral therapy on domestic violence. The intervention included programs based on the Duluth Model. The violence had to be committed by a male toward his female partner. The violence also had to be physical. The primary outcomes were new arrests and convictions, and new reports of violence. CABG vs PCI CABG vs PCI Quality Improvement Strategies for Prevent... Quality Improvement Strategies for Preventing Nosocomial Infections (Created 17-Feb-06) Quality Improvement Strategies for Asthma ... Quality Improvement Strategies for Asthma Control Erectile Dysfunction (Created 30-Jan-06) Erectile Dysfunction (Created 30-Jan-06) Inequality - Smoking Cessation to Reduce S... This review was the first part of a projec... Inequality - Smoking Cessation to Reduce Socio-Economic Differences This review was the first part of a project about inequality. It included randomized trials about the effect of smoking cessation interventions on reducing socio-economic differences. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Diet and Physical Activity to Reduce Socio... This review was the second part in a proje... Diet and Physical Activity to Reduce Socio-Economic Differences This review was the second part in a project about inequality. It included randomized trials about the effect of interventions on reducing socio-economic differences in diet and physical activity. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Workfare The data in SRS are not identical to the d... Workfare The data in SRS are not identical to the data in the published report. We used SRS only for an updated search. The review included randomized trials about the effect of welfare-to-work programs. Participants were welfare recipients. There were basically two types of programs. The educational type tried to build knowledge and skills in order to help the welfare recipients acquire jobs that could support them economically. The "work first" approach was more aimed at getting the participants quickly into a job. Exercise interventions for the management ... The objective of this systematic review wa... Exercise interventions for the management of frailty The objective of this systematic review was to examine the effectiveness of current exercise interventions on the management of frailty. A comprehensive search of Medline, Embase, Psycinfo, Cinahl, Scopus, Ageline, Eric, and SportDiscus databases was conducted and produced 1808 citations. So far we have completed 2 levels of “title and abstract” screening and we ended up with 262 articles. We have just started the full text screening. Eligibility criteria included original studies whose participants were identified as frail or prefrail with specific criteria and in which structured physical activity was included as at least one component of the intervention. Create a free account, build a dictionary with saved terms to re-use later! Public Domestic Violence - Using Cognitive Behavior Therapy Smoking Cessation to Reduce Socio-Economic Differences Diet and Physical Activity to Reduce Socio-Economic Differences Workfare Exercise Interventions for the Management of Frailty Search     Simple Advanced Refine (4 coded questions)  Any of these:   Exact Phrase: All of these: None of these: Author: Periodical: Projects: No restrictions   Libraries: Public   Select SRS Projects Show Saved Terms Select Library Show articles that do not have abstracts  Humans or Animals Humans Animals Ages All Infant: birth-23 months All Child: 0-18 years All Adult: 19+ years Newborn: birth-1 month Infant: 1-23 months Preschool Child: 2-5 years Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Middle Aged + Aged: 45+ years Aged: 65+ years 80 and over: 80+ years Undetermined Type of Article Clinical Trial Editorial Letter Meta-Analysis Practice Guideline Randomized Controlled Trial Review Addresses Bibliography Biography Case Reports Classical Article Clinical Conference Clinical Trial, Phase I Clinical Trial, Phase II Clinical Trial, Phase III Clinical Trial, Phase IV Comment Comparative Study Consensus Development Conference Consensus Development Conference, NIH Controlled Clinical Trial Corrected and Republished Article Dictionary Directory Duplicate Publication English Abstract Evaluation Studies Festschrift Government Publications Guideline Historical Article Interview In Vitro Journal Article Lectures Legal Cases Legislation Multicenter Study News Newspaper Article Overall Patient Education Handout Periodical Index Published Erratum Retracted Publication Research Support, N.I.H., Extramural Research Support, N.I.H., Intramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. 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Retraction of Publication Scientific Integrity Review Support of Research Technical Report Twin Study Validation Studies Not a Primary Study or Review Unknown Primary Study Case Series Case Control Cohort Study Observational Study Qualitative Research CBA or ITS Registry Double Blind Controlled before after study Quasi-randomized trial Simple before after study Cluster-RCT Non-Randomized Study Report Book Book chapter Dissertation Conference procedings Secondary Research Not RCT Language English French German Italian Japanese Russian Spanish Afrikaans Albanian Unknown Arabic Armenian Azerbaijani Bosnian Bulgarian Catalan Chinese Croatian Czech Danish Dutch Esperanto Estonian Finnish Georgian Greek, Modern Hebrew Hindi Hungarian Icelandic Indonesian Kinyarwanda Korean Latin Latvian Lithuanian Macedonian Malay Malayalam Maori Multiple Languages Norwegian Persian Polish Portuguese Pushto Romanian Sanskrit Scottish gaelic Serbian Slovak Slovenian Swedish Thai Turkish Ukrainian Vietnamese Not English Not French Results(1-25 of 5,799) Sort By: Publication Date Relevance Took: 2.884 seconds to search 17,750,454  Action: Copy Results to new Clipboard Build Search Link Page 1 of 232 1 2 3 4 > Last >> (5799 articles found) Continuous quality improvement in intensive care medicine. The GiViTI Margherita Project - Report 2005. Jun 2006 S Boffelli,C Rossi,A Anghileri,M Giardino,L Carnevale,M Messina,M Neri,M Langer,G Bertolini,Italian Group for the Evaluation of Interventions in Intensive Care Medicine ,Abastanotti Marco,Alberti Arnaldo,Alborghetti Armando,Angiolini Patrizia,Anticoli Borza Stefani,Archi Davide,Arditi Enrico,Badii Flavio,Andrea Balata,Barattini Massimo,Barbagli Remo,Bartoccini Arcangelo,Bartoli Teresa,Bassi Francesco,Beck Eduardo,Belloni Umberto Giuseppe,Berardino Maurizio,Berasconi Mara Olga,Bianchin Andre,Blasetti Angelo,Boccalatte-Rosa Daniela,Bonaccorso Giuseppina,Bonfà Andrea,Monica Bonfiglio,Bonizzoli Manuela,Bottari Valter,Breschi Cesare,Bressan Silvia,Brunori Emaunuela,Burgio Gaetano,Buzzetti Virginio,Cabano Gian Virgilio,Calicchio Giuseppe,Caracciolo Massimo,Casagli Sergio,Casagrande Lucia,Casciani Massimo,Caracciolo Giacomo,Renata Cavallo,Chiarello Marco,Chieregato Arturo,Chinelli Elena,Chini Giuseppe,Clementi Stefano,Coaloa Maddalena,Colombo Riccardo,Colonna Salvatore silvio,Cominotti Silvano,Corsini Walter,Costanzo Eleonora,Crema Luciano,Crestan Ezio,Dal Cero Paolo,Dal Ferro Marino,Dal Poggetto Luigi,Dal Pos Lucia,David Antonio,De Blasio Roberto Alberto,De Luca Alessandra,De Negri Pasquale,Dei Poli Marco,Del Sarto Paolo,Di Masi Pierfrancesco,Di Pasquale Dino,Elvio De Blasio,Fabbri Emilio,Fabbri Lea,Fabbri Pier Giorgio,Fabi Maria Critina,Faccio Luciana,Falconio Anotnio,Fasiolo Simonetta,Febbrari Paolo,Ferrante Marco,Ferraro Fausto,Fiore Gilberto,Fontaneto Carlotta,Gabini Rita,Galeotti Elsa,Gamberini Emiliano,Garelli Alberto,Garofalo Giuseppe,Giacopuzzi Luigi,Gianni Massimo,Giannoni Stefano,Girardis Massimo,Giudici Daniela,Giugiaro Pier Mario,Gorietti Adonella,Grassi Paolo,Greco Maurizio,Guadagnucci Alberto,Guagliardi Clementina,Isetta Michele,Lampati Laura,Lapolla Antonio,Lazzaro Francesco,Livigni Sergio,Madona Roberto,Magatti Maria Federica,Maitan Stefano,Malacarne Paolo,Mangani Valerio,Mantovani Giorgio,Marchesi Gianmariano,Mastroianni Alessandro,Mastropierro Rosa,Mediani Teresa Sabina,Meloni Alessandra,Miglioranzi Renzo,Montani Cinza,Morigi Aristide,Mosca Carlo,Murru Salvatore,Nardi Giuseppe,Nascimben Ennio,Natalina Giuseppe,Negri Giovanni,Negro Giancarlo,Nicolini Andrea,Nuovo Domineco,Odetto Lorenzo,Olivieri Carlo,Ortoleva Antonino,Paganini Giorgio,Paganoni Guido,Palmer Maurizio,Panella Luigi,Papiri Silvano,Parlanti Garbe Massimiliano,Parma Alberto,Pastorelli Mauro,Pegoraro Maurizio,Pelosi Giuseppe,Pezza Brunello,Pezzi Angelo,Piccinini Paolo,Pinciroli Donatella,Piredda Giuseppe,Pisu Marina,Pizzaballa Marialuisa,Poole Daniele,Possamai Clemente,Postiglione Maurizio,Pulici Marco,Quattrocchi Pasqualino,Raffaeli Massimo,Righini Erminio,Riva Alberto,Rizzi Maurizio,Romitti Mario,Rossi Giancarlo,Rossi Maurizio,Rossi Nicola,Rossi Simona,Roticiani Valeria,Rottoli Federica,Salcuni Rosa,Schellino Maria Maddalena,Segala Vicenzo,Sicignano Alberto,Spadini Elisabetta,Staccioli Paola,Stefano Maurizio,Tavola Mario,Tetamo Romano,Tinacci Silvia,Todesco Livio,Tomasoni Gabriele,Tosi Luigi,Vaj Monica,Vespignani Maria Giovanna,Visconti Maria Grazia,Vivaldi Nicoletta,Vulcano Giuseppe Angelo,Zamperetti Nereo,Zampieri Giovanni,Zappa Sergio,Zava Raffaele,Zocaro Rosamaria AIM: The assessment of the quality of intensive care medicine is mandatory in the modern healthcare system. In Italy, the GiViTI (Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva) network is working in this field since 1991 and it now involves 295 out of the about 450 Italia... ( view more )n intensive care units (ICU). In 2002 GiViTI launched a project for the continuous quality assessment and improvement that is now joined by 180 ICUs. Data collected in 2005 are analyzed and presented. METHODS: All admitted patients were entered in a validated software, which performs a multitude of validity checks during the data entry. Data were further reviewed by the co-ordinating center; patients admitted in months with more than 10% of incomplete or inconsistent records in each ICU were excluded from the analysis. Each year, a multivariate logistic regression model is fitted to identify predictors of hospital mortality. Starting from the SAPS 2 and the 2004 GiViTI model predictions of hospital mortality, two calibration tables and curves are presented. RESULTS: In 2005, 180 Italian ICUs collected data on 55 246 patients. After excluding those admitted in months with an unjustified lower recruitment rate or with less than 90% of complete and consistent data, we had 52 816 (95.6%) valid cases. Although the rough hospital mortality in 2005 was 1% higher than in 2004 (22.6% vs 21.5%), the adjusted mortality shows a statistically significant 4% reduction (obser-ved-to-expected ratio: 0.96; 95% CI: 0.94-0.97). CONCLUSIONS: Italian ICUs in 2005 performed better than in 2004, at a parity of patient severity. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Adjuvant chemotherapy in completely resected gastric cancer: a randomized phase III trial conducted by GOIRC. Mar 19, 2008 Francesco Di Costanzo,Silvia Gasperoni,Luigi Manzione,Giancarlo Bisagni,Roberto Labianca,Stefano Bravi,Enrico Cortesi,Paolo Carlini,Raffaella Bracci,Silverio Tomao,Luca Messerini,Annarosa Arcangeli,Valter Torri,Domenico Bilancia,Irene Floriani,Maurizio Tonato,Italian Oncology Group for Cancer Research ,Angelo Dinota,Gennaro Strafiuso,Enrichetta Corgna,Stella Porrozzi,Corrado Boni,Ermanno Rondini,Alessandro Giunta,Barbara Monzio Compagnoni,Franco Biagioni,Maurizio Cesari,Giuseppe Fornarini,Fabrizio Nelli,Manlio Carboni,Francesco Cognetti,Maria Ruggeri Enzo,Andrea Piga,Adriana Romiti,Alessandra Olivetti,Luigi Masoni,Marinella De Stefanis,Angelo Dalla Mola,Salvatore Camera,Francesco Recchia,Sandro De Filippis,Loreto Scipioni,Sandra Zironi,Gabriele Luppi,Maurizio Italia,Stefano Banducci,Andrea Pisani Leretti,Bruno Massidda,Maria Teresa Ionta,Angelo Nicolosi,Rodolfo Canaletti,Bruno Biscottini,Fausto Grigniani,Federica Di Costanzo,Rossella Rovei,Enrico Croce,Rosalia Carroccio,Germana Gilli,Carla Cavalli,Angelo Olgiati,Umberto Pandolfi,Riccardo Rossetti,Giovanni Natalini,Paolo Foa,Sabina Oldani,Lorenzo Bruno,Stefano Cascinu,Giuseppina Catalano,Vincenzo Catalano,Ferdinando Lungarotti,Antonio Farris,Maria Giuseppina Sarobba,Mario Trignano,Antonio Muscogiuri,Fontana Francavilla,Franco Figoli,Maurizio Leoni,Giorgio Papiani,Gianfranco Orselli,Mauro Antimi,Vincenzo Bellini,Alessandro Cabassi,Antonio Contu,Antonio Pazzola,Mario Frignano,Elena Lastraioli,Matilde Saggese,Diletta Bianchini,Lorenzo Antonuzzo,Micol Mela,Roberta Camisa BACKGROUND: Complete surgical resection of gastric cancer is potentially curative, but long-term survival is poor. METHODS: Patients with histologically proven adenocarcinoma of the stomach of stages IB, II, IIIA and B, or IV (T4N2M0) and treated with potentially curative surgery were randomly assi... ( view more )gned to follow-up alone or to intravenous treatment with four cycles (repeated every 21 days) of PELF (cisplatin [40 mg/m(2), on days 1 and 5], epirubicin [30 mg/m(2), days 1 and 5], L-leucovorin [100 mg/m(2), days 1-4], and 5-fluorouracil [300 mg/m(2), days 1-4] in a hospital setting. Frequencies and severity of adverse events were determined. Overall survival (OS) and disease-free survival (DFS) were compared between the treatment arms using Kaplan-Meier analysis and a Cox proportional hazards regression model. All statistical tests were two-sided. RESULTS: From January 1995 through September 2000, 258 patients were randomly assigned to chemotherapy (n = 130) or surgery alone (n = 128). Patient characteristics were well balanced between the two arms. Among those who received chemotherapy, grade 3 or 4 toxic effects including vomiting, mucositis, and diarrhea were experienced by 21.1%, 8.4%, and 11.8% of patients, respectively. Leucopenia, anemia, and thrombocytopenia of grade 3 or 4 were experienced by 20.3%, 3.3%, and 4.2% of patients, respectively. After a median follow-up of 72.8 months, 128 patients (49.6%) experienced recurrence and 139 (53.9%) deaths were observed, one toxicity-related. Relative to treatment with surgery alone, adjuvant chemotherapy did not increase disease-free survival (hazard ratio [HR] of recurrence = 0.92; 95% confidence interval [CI] = 0.66 to 1.27) or overall survival (HR of death = 0.90; 95% CI = 0.64 to 1.26). CONCLUSIONS: Our results failed to provide proof of an effect of adjuvant chemotherapy with PELF on overall survival or disease-free survival. The estimated effect of chemotherapy (10% reduction in the hazard of death or relapse) is modest and consistent with the results of meta-analyses of adjuvant chemotherapy without platinum agents. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Follow-up of CRT-ICD: implications for the use of remote follow-up systems. Data from the InSync ICD Italian Registry. Jan 2008 Maurizio Lunati,Maurizio Gasparini,Massimo Santini,Maurizio Landolina,Giovanni B Perego,Carlo Pappone,Maurizio Marzegalli,Carlo Argiolas,Anant Murthy,Sergio Valsecchi,InSync ICD Italian Registry Investigators BACKGROUND: Launch of remote follow-up systems in Europe is currently underway. However, there is insufficient understanding of postimplant practices with respect to device follow-up, reprogramming of device features, and postshock clinic visits. METHODS: We analyzed device-stored data from patient... ( view more )s implanted with biventricular defibrillators (CRT-ICD) to characterize the management of patients in current clinical practice and the potential impact of remote follow-up systems. RESULTS: Two hundred and seventeen patients were identified, all with complete device-data for at least one year. Over a follow-up period of 570 +/- 158 days, 1,959 device interrogations were performed. Of these, the majority (1,280, 65%) involved the reprogramming of device parameters. The mean time interval between interrogations was 70 +/- 25 days. Overall, a marked reduction of interrogations requiring reprogramming was observed between the first six months of follow-up and subsequent periods (from 3.6 +/- 1.8 to 1.1 +/- 1.0 interrogations/six months). A mean of 6.0 +/- 5.9 device parameters was reprogrammed during the first six months of follow-up, versus 4.4 +/- 5.6 (P = 0.000) during the subsequent period. From multivariate analysis, a higher-than-median number of interrogations was found to be significantly associated with defibrillator shocks (OR:2.51; 95%CI:1.42-4.42). Following a shock, a total of 133 interrogations in 60 patients were performed with 80% of these occurring within five days of the shock, and 49% did not require device reprogramming. CONCLUSION: Six months after implant, reprogramming of device parameters is significantly less frequent, making the use of remote follow-up systems a practical alternative for patients and physicians. Moreover, a considerable portion of post-shock interrogations does not involve reprogramming and may therefore be performed remotely. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Developing clinical recommendations for breast, colorectal, and lung cancer adjuvant treatments using the GRADE system: a study from the Programma Ricerca e Innovazione Emilia Romagna Oncology Research Group. Mar 1, 2008 Rossana De Palma,Alessandro Liberati,Giovannino Ciccone,Elena Bandieri,Maurizio Belfiglio,Manuela Ceccarelli,Maurizio Leoni,Giuseppe Longo,Nicola Magrini,Maurizio Marangolo,Fausto Roila,Programma Ricerca e Innovazione Emilia Romagna Oncology Research Group PURPOSE: In the area of anticancer drugs, the legitimate search for effective interventions can be jeopardized by the strong pressure for accelerated approval, which may hinder the full assessment of their benefit-risk profile. We aimed to produce drug-specific recommendations using an explicit app... ( view more )roach that separates the judgments on quality of evidence from the judgment about strength of recommendations. MATERIALS AND METHODS: We used the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) system to develop recommendations for the use of specific anticancer drugs/regimens; 12 clinical questions relevant to adjuvant treatment of breast (three), colorectal (four) and lung (five) cancer have been assessed by multidisciplinary panels supported by a group of methodologists. RESULTS: For nine of 12 questions, recommendations were produced (one strong and six weak in favor and one weak and one strong against the index treatment); for the remaining three questions no specific course of action could be recommended. The perceived benefits to risk balance of the treatment was the most important and statistically significant (P < .01) predictor of panels' recommendations and of their strength, whereas panelists' personal (age, sex) and professional (specialty) characteristics were not statistically associated. CONCLUSION: Because the GRADE system sets out an explicit process going from evaluation of the quality of evidence and benefit-risk profile to the judgment of the strength of recommendations, in this experience, it proved very useful to combine methodologic rigor with the interdisciplinary participation that is important in the definition of evidence based clinical policies. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Comparison of the effects of cardiac resynchronization therapy in patients with class II versus class III and IV heart failure (from the InSync/InSync ICD Italian Registry). Sep 15, 2007 Maurizio Landolina,Maurizio Lunati,Maurizio Gasparini,Massimo Santini,Luigi Padeletti,Augusto Achilli,Stefano Bianchi,Francesco Laurenzi,Antonio Curnis,Antonio Vincenti,Sergio Valsecchi,Alessandra Denaro,InSync/InSync ICD Italian Registry Investigators Cardiac resynchronization therapy (CRT) is recommended for patients with New York Heart Association (NYHA) class III or IV heart failure and wide QRS complexes. The aim of this study was to compare the effects of CRT in patients in NYHA class II with those in NYHA class III or IV. Nine hundred fift... ( view more )y-two patients (188 in NYHA class II) consecutively implanted with biventricular devices and enrolled in a national observational registry were studied. Clinical outcomes were estimated after 12 months of CRT, and long-term survival was assessed. At a median follow-up of 16 months, significantly fewer major cardiovascular events were reported in patients in NYHA class II compared with NYHA class III or IV (rate 13 vs 23 per 100 patient-years of follow-up, p<0.001). The percentage of patients who improved in NYHA class status after 12 months of CRT was lower in those in class II than in those in class III or IV (34% vs 69%, p<0.001), whereas the absolute increase in the ejection fraction was similar (8+/-9% vs 9+/-11%, p=NS), as well as the reductions in end-diastolic diameter (-3+/-8 vs -3+/-8 mm, p=NS) and end-systolic diameter (-4+/-10 vs -6+/-10 mm, p=NS). The NYHA class II group experienced lower all-cause mortality (log-rank test p=0.018). In the 2 groups, patients with major cardiovascular events during follow-up exhibited less or no reverse remodeling compared with those with better long-term clinical outcomes. In conclusion, the results of this study indicate that CRT induced similar improvements in ventricular function in the 2 groups, whereas the improvement in functional status was significantly lower for patients in NYHA class II than for those in class III or IV. A positive effect of CRT on cardiac dimensions was associated with a long-term beneficial effect on disease progression in patients in NYHA class II. ( view less ) View Full Abstract View Article Details   Related Articles Efficacy of cardiac resynchronization therapy in very old patients: the Insync/Insync ICD Italian Registry. Sep 2007 Augusto Achilli,Federico Turreni,Maurizio Gasparini,Maurizio Lunati,Massimo Sassara,Massimo Santini,Maurizio Landolina,Luigi Padeletti,Andrea Puglisi,Mario Bocchiardo,Serafino Orazi,Giovanni Battista Perego,Sergio Valsecchi,Alessandra Denaro AIMS: To assess the effects of cardiac resynchronization therapy (CRT) in > or =80-year-old patients vs. patients <80 years, in terms of clinical, functional, and echocardiographic parameters after 12 month of CRT, survival, and incidence of arrhythmic events. METHODS AND RESULTS: The study populat... ( view more )ion consisted of 1181 CRT patients (85 were > or =80 years old). They were enrolled in a national observational registry and underwent baseline evaluation and periodical follow-up visits. In the overall population, New York Heart Association class and ejection fraction (EF) improved and ventricular diameters decreased. Similar changes were observed in the two groups. In the study population, 157 patients died, 144 (13%) in the <80 years group and 13 (15%) in the > or =80 years group. There was a higher all-cause mortality (log-rank test, P = 0.015) among > or =80 years patients, with a trend towards higher sudden cardiac death (SCD) (P = 0.057), but similar non-SCD (P = 0.293). Using the combined endpoint of SCD or appropriate shock from a defibrillator for ventricular fibrillation, no significant differences resulted between groups (P = 0.455). In both groups, lower EF was associated with higher mortality. CONCLUSION: Cardiac resynchronization therapy demonstrated similar efficacy in patients aged > or =80 years and in those under 80, in terms of clinical and functional parameters and reverse remodelling. Similarly, CRT resulted in comparable effects on death for heart failure and on SCD. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Clustering of ventricular tachyarrhythmias in heart failure patients implanted with a biventricular cardioverter defibrillator. Dec 2006 Maurizio Lunati,Maurizio Gasparini,Mario Bocchiardo,Antonio Curnis,Maurizio Landolina,Angelo Carboni,Gianni Luzzi,Gabriele Zanotto,Pierantonio Ravazzi,Giovanni Magenta,Alessandra Denaro,Paola Distefano,Andrea Grammatico,InSync ICD Italian Registry Investigators BACKGROUND: Temporal patterns of ventricular tachyarrhythmia (VT/VF) have been studied only in patients who have received implantable cardioverter defibrillators (ICD) for secondary prevention of sudden death, and mainly in ischemic patients. The aim of this study was to evaluate VT/VF recurrence p... ( view more )atterns in heart failure (HF) patients with biventricular ICD and to stratify results according to HF etiology and ICD indication. METHODS AND RESULTS: We studied 421 patients (91% male, 66 +/- 9 years). HF etiology was ischemic in 292 patients and nonischemic in 129. ICD indication was for primary prevention in 227 patients and secondary prevention in 194. Baseline left ventricular ejection fraction (LVEF) was 26 +/- 7%, QRS duration 168 +/- 32 msec, and NYHA class 2.9 +/- 0.6. In a follow-up of 19 +/- 11 months, 1,838 VT/VF in 110 patients were appropriately detected. In 59 patients who had > or = 4 episodes, we tried to determine whether VT/VF occurred randomly or rather tended to cluster by fitting the frequency distribution of tachycardia interdetection intervals with exponential functions: VT/VF clusters were observed in 46 patients (78% of the subgroup of patients with > or = 4 episodes and 11% of the overall population). On multivariate logistic analysis, VT/VF clusters were significantly (P < 0.01) associated with ICD indication for secondary prevention (odds ratio [OR] = 3.12; confidence interval [CI] = 1.56-6.92), nonischemic HF etiology (OR = 4.34; CI = 2.02-9.32), monomorphic VT (OR = 4.96; CI = 2.28-10.8), and LVEF < 25% (OR = 3.34; CI = 1.54-7.23). Cardiovascular hospitalizations and deaths occurred more frequently in cluster (21/46 [46%]) than in noncluster patients (63/375 (17%), P < 0.0001). CONCLUSIONS: In HF patients with biventricular ICDs, VT/VF clusters may be regarded as the epiphenomenon of HF deterioration or as a marker of suboptimal response to cardiac resynchronization therapy. ( view less ) View Full Abstract View Article Details   Related Articles Characteristics of ventricular tachyarrhythmias occurring in ischemic versus nonischemic patients implanted with a biventricular cardioverter-defibrillator for primary or secondary prevention of sudden death. Sep 2006 Giuseppe Boriani,Maurizio Gasparini,Maurizio Lunati,Massimo Santini,Maurizio Landolina,Antonio Vincenti,Antonio Curnis,Mario Bocchiardo,Luigi Padeletti,Mauro Biffi,Luca Allaria,Alessandra Denaro,InSync ICD Italian Registry Investigators OBJECTIVES: The InSync ICD Registry evaluated patients indicated for cardiac resynchronization therapy with defibrillation. BACKGROUND: Cardiac resynchronization therapy with defibrillation systems are prescribed for both primary and secondary prevention of sudden cardiac death in patients with hea... ( view more )rt failure with both ischemic and nonischemic etiology. The characterization of ventricular tachyarrhythmias detected by the ICD is not well known in these subpopulations. METHODS: We enrolled 421 patients with symptomatic heart failure despite optimized medical treatment, ventricular dyssynchrony, and primary or secondary ICD indications. An electrophysiologist reviewed all spontaneous episodes. Patients were grouped by etiology and ICD indications. RESULTS: The 421 patients included 292 ischemic (159 primary prevention) and 129 nonischemic (68 primary prevention) patients. In 19 +/- 11 months of follow-up, 110 patients (63 ischemic, 30 primary prevention and 47 nonischemic, 21 primary prevention) presented ventricular tachyarrhythmias, occurring in a ventricular tachycardia (VT) or a ventricular fibrillation zone (1382 and 456 events, respectively). The incidence of overall ventricular tachyarrhythmias in nonischemic patients in secondary prevention (35.7% at 1 year) was higher than in ischemic patients implanted for either indication (16.5% and 22.9% at 1 year, respectively). The incidence of self-terminating ventricular tachyarrhythmias was greater in patients with nonischemic heart disease, regardless of indication. Patients with ischemic heart disease in primary prevention had a lower occurrence of VTs, whereas nonischemic patients in primary prevention had faster VTs. CONCLUSIONS: Both rate of occurrence and characteristics of detected ventricular tachyarrhythmias vary according to underlying etiology and indication. Therefore, different device programming according to patient's profile is advisable to improve ventricular tachyarrhythmias management. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Treatment effects of partially hydrolyzed guar gum on symptoms and quality of life of patients with irritable bowel syndrome. A multicenter randomized open trial. Jun 2005 Giancarlo Parisi,Enrico Bottona,Maurizio Carrara,Fabrizio Cardin,Alessandra Faedo,Dario Goldin,Marco Marino,Maurizio Pantalena,Gianni Tafner,Giorgio Verdianelli,Maurizio Zilli,Gioacchino Leandro The effects of partially hydrolyzed guar gum (PHGG) were compared in patients with irritable bowel syndrome, at 10 g/day (N = 40) and 5 g/day (N = 46) for 12 weeks. Gastrointestinal symptoms (GSRS), quality of life (SF-36), and psychological symptoms (HADS) were evaluated at baseline, during treatm... ( view more )ent (months 1 and 3), and at follow-up (month 6). In both groups symptoms and quality of life improved significantly after the first month of administration until follow-up compared to those at baseline. However, the improvement was significantly reduced at follow-up compared to the end of treatment. PHGG was effective for improving somatic (gastrointestinal symptoms) and psychological (quality of life and psychological distress) symptoms over the short term. Since the improvement tended to decrease after the end of the treatment period, further studies should evaluate the benefits of PHGG at a maintenance dosage. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Effect of low dose methotrexate on bone density in women with rheumatoid arthritis: results from a multicenter cross-sectional study. Jul 2004 Ombretta di Munno,Maurizio Mazzantini,Luigi Sinigaglia,Gerolamo Bianchi,Giovanni Minisola,Maurizio Muratore,Renato la Corte,Luigi di Matteo,Bianca Canesi,Maurizio Caminiti,Marco Broggini,Silvano Adami OBJECTIVE: To analyze the influence of low dose methotrexate (MTX) on bone using data from a large multicenter, cross-sectional study on bone mineral density (BMD) in women with rheumatoid arthritis (RA). METHODS: We selected 731 female patients with RA divided into 2 groups on the basis of MTX use... ( view more ): never MTX users (n = 485) and MTX users for at least 6 months (n = 246). Demographic, disease, and treatment related variables were collected for each patient. BMD was measured at lumbar spine and proximal femur by dual energy x-ray absorptiometry. Osteoporosis was defined as BMD < -2.5 T-score. RESULTS: The frequency of osteoporosis among never MTX users and MTX users was 29.1% and 28.3% (p = NS) for lumbar spine, and 34.8% and 37.8% (p = NS) for femoral neck, respectively. Mean T-score values at lumbar spine and femoral neck were comparable in the 2 groups, even after adjusting for age, menopausal status, body mass index (BMI), Health Assessment Questionnaire (HAQ) score, and steroid use. The generalized linear model showed that age, menopause, BMI, HAQ score, and steroid use were significant independent predictors of BMD at lumbar or at femoral level, whereas MTX use was not. Logistic procedure showed that only age, HAQ score, and BMI were significantly associated with the risk of osteoporosis. CONCLUSION: We found no negative effect of low dose MTX on BMD in women with RA. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Hyperfractionated radiotherapy and chemotherapy for childhood ependymoma: final results of the first prospective AIEOP (Associazione Italiana di Ematologia-Oncologia Pediatrica) study. Apr 1, 2004 Maura Massimino,Lorenza Gandola,Felice Giangaspero,Alessandro Sandri,Pinuccia Valagussa,Giorgio Perilongo,Maria Luisa Garrè,Umberto Ricardi,Marco Forni,Lorenzo Genitori,Giovanni Scarzello,Filippo Spreafico,Salvina Barra,Maurizio Mascarin,Bianca Pollo,Martina Gardiman,Armando Cama,Pierina Navarria,Maurizio Brisigotti,Paola Collini,Rita Balter,Paola Fidani,Maurizio Stefanelli,Roberta Burnelli,Paolo Potepan,Marta Podda,Guido Sotti,Enrico Madon,AIEOP Pediatric Neuro-Oncology Group PURPOSE: A postsurgical "stage-based" protocol for ependymoma was designed. METHODS AND MATERIALS: Children were given: (1) focal hyperfractionated radiotherapy (HFRT) if with no evidence of disease (NED), or (2) 4 courses with VEC followed by HFRT for residual disease (ED). HFRT dose was 70.4 Gy (... ( view more )1.1 Gy/fraction b.i.d.); VEC consisted of VCR 1.5 mg/m2 1/w, VP16 100 mg/m2/day x 3, CTX 3 g/m2 d 1. When feasible, second-look surgery was recommended. RESULTS: Sixty-three consecutive children were enrolled: 46 NED, 17 ED; the tumor was infratentorial in 47 and supratentorial in 16, with spinal metastasis in 1. Of NED patients, 35 of 46 have been treated with HFRT; 8 received conventionally fractionated radiotherapy, and 3 received no treatment. Of the 17 ED patients, 9 received VEC + HFRT; violations due to postsurgical morbidity were as follows: HFRT only (2), conventionally fractionated radiotherapy (3) + VEC (2), and no therapy (1). Objective responses to VEC were seen in 54%; objective responses to RT were seen in 75%. Overall survival and progression-free survival at 5 years for all 63 children were 75% and 56%, respectively; for the NED subgroup, 82% and 65%; and for the ED subgroup, 61% and 35%, respectively. All histologies were centrally reviewed. At multivariate analysis, grading, age, and site proved significant for prognosis. CONCLUSIONS: HFRT, despite the high total dose adopted, did not change the prognosis of childhood ependymoma as compared to historical series: New radiotherapeutic approaches are needed to improve local control. Future ependymoma strategies should consider grading when stratifying treatment indications. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Apoptotic DNA binds to HLA class II molecules inhibiting antigen presentation and participating in the development of anti-inflammatory functional behavior of phagocytic macrophages. Jan 2003 Gilberto Filaci,Paola Contini,Marco Fravega,Daniela Fenoglio,Bruno Azzarone,Michel Julien-Giron,Roberto Fiocca,Maurizio Boggio,Vittorio Necchi,Andrea De Lerma Barbaro,Andrea Merlo,Marta Rizzi,Massimo Ghio,Maurizio Setti,Francesco Puppo,Maurizio Zanetti,Francesco Indiveri Resident macrophages are mainly responsible for the clearance of apoptotic cells from tissue by phagocytosis. Phagocytosis of apoptotic cells is not accompanied by activation of inflammatory mechanisms, unlike what happens when necrotic phenomena occur. We analyzed the effect of phagocytosis of apo... ( view more )ptotic bodies on macrophage cell functions. After phagocytosis of apoptotic cells macrophages were unable to present an exogenous antigen to autologous antigen-specific T-cell lines. The inhibition was mediated by different mechanisms including binding of apoptotic DNA to human leukocyte antigen (HLA) class II molecules of macrophages, decreased expression of co-stimulatory molecules and increased secretion of tumor growth factor beta (TGFbeta). When dendritic cells were cultured with macrophages phagocytosing apoptotic cells, or with their supernatant, impaired dendritic cell antigen presenting activity and reduced tumor necrosis factor alpha (TNFalpha) secretion were found. Our results suggest that: (1) the phagocytosis of apoptotic bodies inhibits macrophage antigen presentation; (2) such inhibition is mediated by the binding of apoptotic DNA to macrophage HLA class II molecules as well as by the activation of biological mechanisms that induce an anti-inflammatory functional behavior in macrophages; and (3) macrophages phagocytosing apoptotic cells inhibit antigen presentation of neighboring dendritic cells via TGFbeta secretion. These events are likely related to the preservation of healthy tissues from the onset of inflammation. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Genetic analysis of Paraoxonase (PON1) locus reveals an increased frequency of Arg192 allele in centenarians. May 2002 Massimiliano Bonafè,Francesca Marchegiani,Maurizio Cardelli,Fabiola Olivieri,Luca Cavallone,Simona Giovagnetti,Carlo Pieri,Maurizio Marra,Roberto Antonicelli,Leonarda Troiano,Paola Gueresi,Giovanni Passeri,Maurizio Berardelli,Giuseppe Paolisso,Michelangela Barbieri,Silvia Tesei,Rosmarie Lisa,Giovanna De Benedictis,Claudio Franceschi Human Paraoxonase (PON1) is a High-Density Lipoprotein (HDL)-associated esterase that hydrolyses lipo-peroxides. PON1 has recently attracted attention as a protective factor against oxidative modification of LDL and may therefore play an important role in the prevention of the atherosclerotic proce... ( view more )ss. Two polymorphisms have been extensively studied: a Leucine (L allele) to Methionine (M allele) substitution at codon 55, and a Glutamine (A allele) to Arginine (B allele) substitution at codon 192. We have examined these two aminoacidic changes in 579 people aged 20 to 65 years old, and 308 centenarians. We found that the percentage of carriers of the B allele at codon 192 (B+ individuals) is higher in centenarians than in controls (0.539 vs 0.447), moreover we found that among the B+ individuals, the phenomenon was due to an increase of people carrying M alleles at codon 55 locus. In conclusion, we propose that genetic variability at PON1 locus affects survival at extreme advanced age. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Pregnancy outcome after cabergoline treatment in early weeks of gestation. 2002 Nov-Dec Elena Ricci,Fabio Parazzini,Tiziano Motta,Carlo I Ferrari,Annamaria Colao,Antonio Clavenna,Francesca Rocchi,Emanuela Gangi,Sandra Paracchi,Maurizio Gasperi,Maurizio Lavezzari,Anna Elisa Nicolosi,Simona Ferrero,Maria Luisa Landi,Paolo Beck-Peccoz,Maurizio Bonati We collected information on 61 pregnancies in 50 women treated with cabergoline. These pregnancies resulted in 12 (19.7%) early terminations (five induced abortions, six spontaneous abortions, one hydatidiform mole) and 49 (80.3%) live births. In one case, malformations were suspected by a gynecolo... ( view more )gist based on ultrasound at 12 gestational weeks and the pregnancy was terminated; additional information was not available. There was one case of trisomy 18. The frequency of spontaneous and induced abortions and major congenital malformations was comparable with rates in the general population. The data did not indicate any potential adverse effect of the drug on pregnancy. The data from this study in combination with previous reports can exclude a congenital malformation risk greater than 10% associated with pregnancy exposure to cabergoline. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Antiproliferative and proapoptotic activities of new pyrazolo[3,4-d]pyrimidine derivative Src kinase inhibitors in human osteosarcoma cells. May 2008 Adriano Spreafico,Silvia Schenone,Tommaso Serchi,Maurizio Orlandini,Adriano Angelucci,David Magrini,Giulia Bernardini,Giulia Collodel,Anna Di Stefano,Cristina Tintori,Mauro Bologna,Fabrizio Manetti,Maurizio Botta,Annalisa Santucci Osteosarcoma is the most frequent primitive malignant tumor of the skeletal system, characterized by an extremely aggressive clinical course that still lacks an effective treatment. Src kinase seems to be involved in the osteosarcoma malignant phenotype. We show that the treatment of human osteosar... ( view more )coma cell lines with a new pyrazolo[3,4-d]pyrimidine derivative Src inhibitor, namely SI-83, impaired cell viability, with a half-maximal inhibitory concentration of 12 microM in nonstarved cells and a kinetic different from that known for the Src inhibitor PP2. Analysis by terminal deoxynucleotidyl transferase-mediated nick end labeling, Hoechst, and flow cytometric assay showed that SI-83 induced apoptosis in SaOS-2 cells. Moreover, SI-83, by inhibiting Src phosphorylation, decreased in vivo osteosarcoma tumor mass in a mouse model. Finally, SI-83 showed selectivity for osteosarcoma, since it had a far lower effect in primary human osteoblasts. These results show that human osteosarcoma had Src-dependent proliferation and that modulation of Src activity may be a therapeutic target of this new compound with low toxicity for nonneoplastic cells. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Peptide-nucleic acid-mediated enriched polymerase chain reaction as a key point for non-invasive prenatal diagnosis of beta-thalassemia. Apr 2008 Silvia Galbiati,Barbara Foglieni,Maurizio Travi,Cristina Curcio,Gabriella Restagno,Luca Sbaiz,Maddalena Smid,Federica Pasi,Augusto Ferrari,Maurizio Ferrari,Laura Cremonesi The presence of fetal DNA in maternal plasma can be exploited to develop new procedures for non-invasive prenatal diagnosis. Tests to detect 7 frequent beta-globin gene mutations in people of Mediterranean origin were applied to the analysis of maternal plasma in couples where parents carried diffe... ( view more )rent mutations. A mutant enrichment amplification protocol was optimized by using peptide nucleic acids (PNAs) to clamp maternal wild-type alleles. By this approach, 41 prenatal diagnoses were performed by microelectronic microchip analysis, with total concordance of results obtained on fetal DNA extracted from chorionic villi. Among these, 27/28 were also confirmed by direct sequencing and 4 by pyrosequencing. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Functional properties of cells obtained from human cord blood CD34+ stem cells and mouse cardiac myocytes in coculture. Apr 2008 Alessia Orlandi,Francesca Pagani,Daniele Avitabile,Giuseppina Bonanno,Giovanni Scambia,Elisa Vigna,Francesca Grassi,Fabrizio Eusebi,Sergio Fucile,Maurizio Pesce,Maurizio C Capogrossi Prior in vitro studies suggested that different types of hematopoietic stem cells may differentiate into cardiomyocytes. The present work examined whether human CD34(+) cells from the human umbilical cord blood (hUCB), cocultured with neonatal mouse cardiomyocytes, acquire the functional properties... ( view more ) of myocardial cells and express human cardiac genes. hUCB CD34(+) cells were cocultured onto cardiomyocytes following an infection with a lentivirus-encoding enhanced green fluorescent protein (EGFP). After 7 days, mononucleated EGFP(+) cells were tested for their electrophysiological features by patch clamp and for cytosolic [Ca(2+)] ([Ca(2+)](i)) homeostasis by [Ca(2+)](i) imaging of X-rhod1-loaded cells. Human Nkx2.5 and GATA-4 expression was examined in cocultured cell populations by real-time RT-PCR. EGFP(+) cells were connected to surrounding cells by gap junctions, acquired electrophysiological properties similar to those of cardiomyocytes, and showed action potential-associated [Ca(2+)](i) transients. These cells also exhibited spontaneous sarcoplasmic reticulum [Ca(2+)](i) oscillations and the associated membrane potential depolarization. However, RT-PCR of both cell populations showed no upregulation of human-specific cardiac genes. In conclusion, under our experimental conditions, hUCB CD34(+) cells cocultured with murine cardiomyocytes formed cells that exhibited excitation-contraction coupling features similar to those of cardiomyocytes. However, the expression of human-specific cardiac genes was undetectable by RT-PCR. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Remission of left ventricular systolic dysfunction and of heart failure symptoms after cardiac resynchronization therapy: temporal pattern and clinical predictors. Mar 2008 Maurizio Gasparini,François Regoli,Carlo Ceriotti,Paola Galimberti,Renato Bragato,Stefano De Vita,Daniela Pini,Bruno Andreuzzi,Maurizio Mangiavacchi,Catherine Klersy BACKGROUND: The aim of the study was to determine whether cardiac resynchronization therapy (CRT) may induce a heart failure (HF) remission phase (recovery to New York Heart Association functional class I-II and regression of left ventricular [LV] dysfunction: LV ejection fraction [EF] > or = 50%) ... ( view more )and to define the incidence and predictors of such a process. METHODS: Cardiac resynchronization therapy devices were successfully implanted in 520 consecutive HF patients from 1999 to 2006 (mean age 66 years, 82% male sex, New York Heart Association class > or = II, LVEF 28%, QRS 164 milliseconds, 6-minute hall walk distance 302 m) at our institution. Follow-up data were prospectively collected every 3 to 6 months. Continuous variables were stratified in tertiles. RESULTS: Over a median follow-up of 28 months, 26% of patients achieved LV remission (rate: 16 per 100 person-years). At univariate analysis, female sex (P = .032), non-coronary artery disease (CAD) etiology (P < .001), mitral regurgitation < 2/4 (P = .022), higher EF tertile (P < .001), lower diameter and volume tertiles (both P < .001), previous conventional right ventricle pacing (P = .029), and post-CRT-paced QRS (P = .008) predicted remission. At multivariate analysis, non-CAD etiology, LVEF 30% to 35%, and LV end-diastolic volume < 180 mL were strongly associated with HF remission phase (all P < .001). Concomitance of these 3 factors yielded a significantly higher remission rate compared with either no or only 1 factor (respectively, 60 vs 7 and 11 per 100 person-years, P < .001). CONCLUSIONS: Cardiac resynchronization therapy induces HF remission phase in 26% of patients, even after 3 years. Non-CAD etiology and moderately compromised LV function at baseline may easily predict this process. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Lung cancer screening with spiral CT: baseline results of the randomized DANTE trial. Mar 2008 Maurizio Infante,Fabio Romano Lutman,Silvio Cavuto,Giorgio Brambilla,Giuseppe Chiesa,Eliseo Passera,Enzo Angeli,Maurizio Chiarenza,Giuseppe Aranzulla,Umberto Cariboni,Marco Alloisio,Matteo Incarbone,Alberto Testori,Anna Destro,Federico Cappuzzo,Massimo Roncalli,Armando Santoro,Gianluigi Ravasi,DANTE Study Group BACKGROUND: Despite the high survival rates reported for screening-detected cases, the potential of screening of high-risk subjects for reducing lung cancer mortality is still unproven. We herewith present the baseline results of a randomized trial comparing screening for lung cancer with annual sp... ( view more )iral computed tomography (CT) versus a yearly clinical review. METHODS: Male subjects, 60-74 years old, and smokers of 20+ pack-years were enrolled. All participants received a baseline medical examination, chest X-rays (CXR) and sputum cytology upon accrual. Subjects randomized in the spiral CT group received a spiral CT scan at baseline, then yearly for the following 4 years. For controls, a yearly clinical examination was scheduled for the following 4 years. RESULTS: 2472 subjects were randomized (1276 spiral CT arm, 1196 controls). Age, smoking exposure and co-morbid conditions were similar in the two groups. In the spiral CT group, 28 lung cancers were detected, 13 of which were visible in the baseline chest X-rays (overall prevalence 2.2%). Sixteen out of 28 tumours (57%) were stage I, and 19 (68%) were resectable. In the control group, eight cases were detected by the baseline chest X-rays (prevalence rate 0.67%), four (50%) were stage I, and six (75%) were resectable. CONCLUSIONS: Baseline lung cancer detection rate in the spiral CT arm was higher than in most published studies. The stage I detection rate was increased four-fold by spiral CT versus chest X-rays. However, more tumours in an advanced stage were also detected by CT. The high resection rate of screening-detected patients suggests a possible increase in cure rate. However, longer follow-up is required for definitive conclusions. This trial has been registered at www.Clinicaltrials.gov, registration No. NCT00420862. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Paraoxonase 1: genetics and activities during aging. Feb 2008 Francesca Marchegiani,Maurizio Marra,Fabiola Olivieri,Maurizio Cardelli,Richard W James,Massimo Boemi,Claudio Franceschi The increasing longevity of the population, one of the most important issues throughout the planet, is a very complex phenomenon (trait), likely resulting from a variety of environmental determinants interacting with and modulated by genetic mechanisms, mostly devoted to maintenance and repair. In ... ( view more )fact, the genes involved in longevity impact upon basic processes such as inflammation, glucose and energy utilization, and oxidative stress. Based on the free radical theory of aging, in the past few years we have focused our attention on an enzyme that protects lipids from peroxidative damage-paraoxonase 1 (PON1). PON1 has been widely investigated, especially for its involvement in atherosclerosis and age-related diseases. In this review, we summarize data on the role played by PON1 on aging and its possible involvement in human longevity, focusing on the relationship between genetic polymorphisms and enzyme activity and its capability to counteract oxidative stress. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Randomized, multicenter, phase IIb study of preoperative chemoradiotherapy in T3 mid-distal rectal cancer: raltitrexed + oxaliplatin + radiotherapy versus cisplatin + 5-fluorouracil + radiotherapy. Feb 1, 2008 Vincenzo Valentini,Claudio Coco,Bruce D Minsky,Maria Antonietta Gambacorta,Maurizio Cosimelli,Rita Bellavita,Alessio G Morganti,Giuseppe La Torre,Lucio Trodella,Domenico Genovesi,Maurizio Portaluri,Riccardo Maurizi-Enrici,Fernando Barbera,Ernesto Maranzano,Marco Lupattelli PURPOSE: To prospectively compare the rates of pathologic response, acute toxicity, and sphincter preservation with two different schedules of preoperative chemoradiotherapy in patients with cT3 mid-distal rectal cancer. METHODS AND MATERIALS: Patients with cT3 and/or N+ resectable rectal carcinoma... ( view more ) were randomized to receive one of the two following chemoradiotherapy regimens: cisplatin, 5-fluorouracil, and radiotherapy (PLAFUR) or raltitrexed, oxaliplatin, and radiotherapy (TOMOX-RT). For PLAFUR, cisplatin (60 mg/m(2)) was given on Days 1 and 29, with a prolonged infusion of 5-fluorouracil (1,000 mg/m(2)) on Days 1-4 and 29-32, plus concurrent radiotherapy (50.4 Gy in 1.8-Gy fractions daily). For TOMOX-RT, raltitrexed (3 mg/m(2)) and oxaliplatin (130 mg/m(2)) was given on Days 1, 19, and 38 with the same radiotherapy regimen as used for PLAFUR. Surgery was performed 6-8 weeks after completion of chemoradiotherapy. All pathologic specimens were reviewed by a designated expert pathologist. The primary endpoint of this study was pathologic tumor downstaging (defined as tumor regression grade 1-2). Secondary endpoints included the incidence of ypT0, clinical tumor downstaging, sphincter-saving surgery, and acute treatment-related toxicity. RESULTS: Between 2002 and 2005, 164 patients were accrued in 10 Italian centers, 83 patients in the PLAFUR arm and 81 in the TOMOX-RT arm. Overall, tumor regression grade 1-2 was observed in 76 patients (46.4%) and ypT0 in 49 (29.9%). The tumor regression grade 1-2 rate was 41.0% vs. 51.9% (p = 0.162) and the ypT0 rate was 24.1% vs. 35.8% (p = 0.102) for the PLAFUR vs. TOMOX-RT arm, respectively. The overall rate of tumor regression grade 1 and ypN+ was 4.6%. The occurrence of ypT downstaging was significantly greater in the TOMOX-RT arm (p = 0.035). Grade 3-4 acute toxicity occurred in 19 patients (11.6%): 7.1% in the PLAFUR arm vs. 16.4% in the TOMOX-RT arm. Sphincter-saving surgery was performed in 143 patients (87.2%) overall: 87.9% in the PLAFUR arm and 86.4% in the TOMOX-RT arm. CONCLUSIONS: Compared with the PLAFUR regimen, TOMOX-RT achieved a greater incidence of downstaging but was associated with a correspondingly greater rate of acute Grade 3+ toxicity. With longer follow-up, the local control and survival rates might offer additional guidance as to the choice of regimen. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Modelling amphetamine/receptor interactions: a gas-phase study of complexes formed between amphetamine and Some chiral amido[4]resorcinarenes. 2008 Bruno Botta,Andrea Tafi,Fabiana Caporuscio,Maurizio Botta,Laura Nevola,Ilaria D'Acquarica,Caterina Fraschetti,Maurizio Speranza Diastereomeric proton-bound complexes formed between (R)- and (S)-amphetamine and some chiral amido[4]resorcinarene receptors display significant enantioselectivities when reacting with the enantiomers of 2-aminobutane in the gas phase. The origins of the measured enantioselectivities are discussed... ( view more ) in the light of molecular mechanics calculations and molecular dynamics simulations and are ascribed to a combination of structural and dynamic factors, including the lengths and the isomeric structures of the host asymmetric pendants and the frequencies and amplitudes of their motion, as well as those of the proton-bonded amphetamine guests. The emerging picture may represent a starting point for deeper comprehension of the factors determining the different affinities of (R)- and (S)-amphetamine towards various chiral receptors, their selective binding to the monoamine transporters, and their sensitivity to specific inorganic ions. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Isolation of the left atrial surface from cardiac multi-detector CT images based on marker controlled watershed segmentation. Jan 2008 Alessandro Cristoforetti,Luca Faes,Flavia Ravelli,Maurizio Centonze,Maurizio Del Greco,Renzo Antolini,Giandomenico Nollo The delineation of left atrium (LA) and pulmonary veins (PVs) anatomy from high resolution images holds importance for atrial fibrillation (AF) investigation and treatment. In this study, a semiautomatic segmentation procedure for LA and PVs inner surface from contrast enhanced CT data was develope... ( view more )d. The procedure consists of a three dimensional marker controlled watershed segmentation applied to the external morphological gradient, followed by variable threshold surface extraction from the original intensity image. A preliminary anisotropic non-linear filtering was implemented to improve the S/N ratio of CT images. The performance of segmentation was evaluated on cardiac CT scans of 12 AF patients both qualitatively and quantitatively. The qualitative evaluation by expert radiologist assessed the segmentation as overall successful in all patients and capable of extracting both the LA body and the connected vascular trees. The quantitative validation, by computing discrepancy measures with respect to a manually segmented gold standard, indicated an average of about 90% of voxels correctly classified and an average border mismatch lower than 1.5 voxels (1.2 mm). The accurate extraction of the inner LA-PVs walls provided by this method, along with the minimal required human intervention, should facilitate the use of anatomical atrial models for the non-pharmacological treatment of AF. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Identification and classification of hereditary nonpolyposis colorectal cancer (Lynch syndrome): adapting old concepts to recent advancements. Report from the Italian Association for the study of Hereditary Colorectal Tumors Consensus Group. Dec 2007 Maurizio Ponz de Leon,Lucio Bertario,Maurizio Genuardi,Giovanni Lanza,Cristina Oliani,Guglielmina Nadia Ranzani,Giovanni Battista Rossi,Liliana Varesco,Tiziana Venesio,Alessandra Viel Knowledge about hereditary nonpolyposis colorectal cancer (HNPCC)/Lynch syndrome clearly evolved during the last 10 to 15 years much more rapidly than in the past century. Consequently, long-established concepts and attitudes that held for many years should now be changed or updated. With regard to... ( view more ) classification, we suggest maintaining the eponym "Lynch syndrome" for families that have a well-documented deficiency of the DNA mismatch repair system, whereas "clinical hereditary nonpolyposis colorectal cancer" should be reserved for those families that meet the Amsterdam criteria but without evidence of mismatch repair impairment. Any family (or individual) meeting one or more of the Bethesda criteria can be considered as suspected HNPCC. For the identification of hereditary colorectal cancer molecular screening or the pedigree analysis show advantages and disadvantages; the ideal would be to combine the two approaches. Diffusion of the microsatellite instability test and of immunohistochemistry in the pathology laboratories might render in the immediate future molecular screening more realistic. Strict endoscopic surveillance of family members at risk (with first colonoscopy at age 20-25 years and then every 2-3 years) is needed only in families with documented alterations of the DNA mismatch repair. To a certain extent, our conclusions were similar to the recently proposed "European guidelines for the clinical management of HNPCC," although we prefer the term "clinical hereditary nonpolyposis colorectal cancer," instead of familial colorectal cancer, for families meeting the Amsterdam criteria but not having evidence of mismatch repair impairment. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Cardiac magnetic resonance imaging detects subclinical right ventricular impairment in systemic sclerosis. Dec 2007 Gian Paolo Bezante,Daniela Rollando,Marta Sessarego,Nicoletta Panico,Maurizio Setti,Gilberto Filaci,Giuseppe Molinari,Manrico Balbi,Maurizio Cutolo,Antonio Barsotti,Francesco Indiveri,Massimo Ghio OBJECTIVE: To assess myocardial involvement in patients with systemic sclerosis (SSc) with no signs or symptoms of cardiac impairment (New York Heart Association functional class I). METHODS: Fifty patients (45 women, 5 men, age 53.3 +/- 12.9 yrs) who did not complain of serious diseases other than... ( view more ) SSc were recruited out of 119 consecutive patients with SSc. Thirty-three were found to have limited cutaneous SSc (lSSc) and 17 diffuse SSc (dSSc). All underwent cardiovascular magnetic resonance imaging (MRI) to determine right and left systolic and diastolic volumes and ventricular ejection fractions (RVEF and LVEF). Thirty-one healthy subjects matched for sex, age, and body surface area (BSA) were studied as controls. Diffusion lung capacity test (DLCO) and high resolution computed tomography were performed to evaluate lung involvement. RESULTS: Disease duration between patients with lSSc (14.1 +/- 11.4 yrs) and those with dSSc (6.9 +/-4.4yrs) was found to be significantly different (p < 0.003). lSSc patients were older than those with dSSc (54.8 +/- 13.7 yrs vs 50.4 +/- 9.9 yrs, respectively; p < 0.04). Anticentromere antibodies and Scl-70 were positive in 23 (46%) and 17 patients (34%). Except for the left and right systolic volumes, all unadjusted cardiac MRI measures were significantly reduced in SSc compared to the controls (p < 0.001 and p < 0.009). These differences persisted after adjustment for subjects' height and BSA. Raw RVEF data and RVEF data matched for height and BSA were significantly reduced in dSSc patients in comparison to lSSc (p < 0.03). CONCLUSION: Compromised RVF was found in patients with asymptomatic SSc. Unlike standard diagnostic techniques, cardiac MRI appears to be a rapid and noninvasive means of determining subclinical right myocardial involvement that is otherwise undetected in patients with SSc. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Page 1 of 232 1 2 3 4 > Last >> (5799 articles found)

      
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